Wildfire risk related to hazards on people and assets is expected to increase in the face of climate change,especially in fire-prone environments such as the Mediterranean Basin.Distinguishing rationalities,i.e.,the c...Wildfire risk related to hazards on people and assets is expected to increase in the face of climate change,especially in fire-prone environments such as the Mediterranean Basin.Distinguishing rationalities,i.e.,the complex profile of multi-thematic,wildfire-related perceptions that collectively characterize and quantify all of a society’s responses,its interrelations,and influence on its insights,are of primary importance to understand the degree of preparedness and the direction that wildfire management policies are moving.Greece is a country that suffered mega-wildfire events during the first years of the twenty-first century.This paper presents a scheme of advanced multivariate statistical procedures applied on standard social survey questionnaires to uncover different or similar rationalities between fire management services and the general public.Profession-centered versus message-oriented rationalities is defined.They differ mainly on the priorities attributed to strengthening personnel and equipment capacities versus the need for public education and awareness.Both are evaluated against the needs of long-term risk assessment and forest management policies in Greece.The main conclusion is that Greek society,although traumatized by recent fire disasters,is not yet prepared for long-term strategic forestry adaptation and planning.展开更多
Let X be a closed simply connected rationally elliptic 4-manifold.The rational homotopy type of homotopy fixed point sets X^(hS^(1))is determined,and based on some relations between X^(hS^(1))and X^(S^(1)),the rationa...Let X be a closed simply connected rationally elliptic 4-manifold.The rational homotopy type of homotopy fixed point sets X^(hS^(1))is determined,and based on some relations between X^(hS^(1))and X^(S^(1)),the rational homotopy type of the fixed point set X^(S^(1))is determined.展开更多
This research aims to understand the causes of fraud through the approach of the Fraud Triangle Theory,which includes three main factors:pressure,opportunity,rationalization.By using the Systematic Literature Review m...This research aims to understand the causes of fraud through the approach of the Fraud Triangle Theory,which includes three main factors:pressure,opportunity,rationalization.By using the Systematic Literature Review method from various relevant international journals,it analyzed systematically to identify patterns,trends,and theoretical contributions to efforts in detecting and preventing fraud.The results of this study show that the three factors in the Fraud Triangle Theory significantly contribute to the occurrence of fraud.Opportunity as the most dominant factor is caused by weak internal control systems and lack of oversight.In addition,economic pressure,and a permissive organizational environment,as well as the rationalization processes by individuals,also increase the tendency for a person to commit fraud.These findings emphasize the need for a comprehensive approach in fraud prevention strategies,through ethical values,the establishment of an organizational culture with integrity,and the implementation of more effective internal control and oversight.展开更多
In the successive rise of the metaverse and artificial intelligence(AI),rationalism and emotionalism have consistently manifested as symptoms of modernity throughout their developmental trajectories.This paper argues ...In the successive rise of the metaverse and artificial intelligence(AI),rationalism and emotionalism have consistently manifested as symptoms of modernity throughout their developmental trajectories.This paper argues that the achievements and crises of both fields signify the triumph of rationalism in the context of deepening modernity,while simultaneously harboring an intrinsic impetus and possibility for transitioning from rationalism to emotionalism.This dynamic serves as a quintessential representation of modernity’s crises and their transcendence.Centered on embodied cognitive science,AI and the metaverse—rooted in rationalism—now face challenges in shifting toward emotionalism,revealing their inadequacy in addressing this shift.Humanity must explore new modernity-deepening paradigms grounded in emotionalism to confront and transcend the potential crises posed by the metaverse and AI.展开更多
Background:Neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ration(PLR)have been shown to contribute to tumour progression and response to therapy.Methods:We retrospectively counted NLR and PLR in 719 patients ...Background:Neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ration(PLR)have been shown to contribute to tumour progression and response to therapy.Methods:We retrospectively counted NLR and PLR in 719 patients with advanced malignancies receiving chemo-and/or immuno-therapy.Results:Both the pretreatment NLR and PLR were significantly elevated in patients with progressive disease than in those without progressive disease.Compared to low groups,the high NLR and PLR groups showed significantly worse event free survival.Conclusion:We propose that NLR and PLR are not only effective blood markers for predicting therapeutic responses to chemo-and/or immuno-therapy,but also useful in detecting survival in diverse malignancies.展开更多
Heparin,a glycosaminoglycan,is a stable source of carbon that supports the growth of microorganisms in the human intestine.It is also a commonly used anticoagulant drug in clinical practice,with significant therapeuti...Heparin,a glycosaminoglycan,is a stable source of carbon that supports the growth of microorganisms in the human intestine.It is also a commonly used anticoagulant drug in clinical practice,with significant therapeutic effects.Low molecular weight heparin(LMWH)is a highly active low molecular weight fragment obtained via enzymatic reaction or the chemical degradation of heparin.LMWH has been applied globally in the prevention and treatment of venous thromboembolism in thrombosis patients.Simultaneously,as a potential prebiotic,because of its low molecular weight,LMWH can be well degraded by the gut microbiota to maintain intestinal balance.Enzymatic heparin degradation has recently emerged as a viable disposal method for LMWH preparation;however,only very few benchmark enzymes have been thoroughly described and subjected to protein engineering to improve their properties over the past few years.The commercialization of enzymes will require the development of robustly engineered enzymes that meet the demands of industrial processes.Herein,we report a rational protein engineering strategy that includes molecular dynamic simulations of flexible amino acid mutations and disulfide bond screening.Several Bacteroides thetaiotaomicron heparanase I(Bt-HepI)mutants were obtained and screened for high thermal stability.We obtained the Bt-HepI^(D204C/K208C/H189W/Q198R)variant,which features a stabilized protein surface structure,with a 1.3-fold increase in catalytic constant/michaelis-menten constant(k_(cat)/K_(m)),a 2.44-fold increase in thermal stability at 50℃,and a 1.8-fold decrease in the average molecular weight of LMWH produced at 40℃compared with that seen with Bt-HepI^(WT).Our study establishes a strategy to engineer thermostable HepI to underpin its industrial applications.展开更多
Chlorobenzene is a model molecule for researching harmful chlorinated volatile organic compounds.Designing the chemical adsorption site for complex molecules such as chlorobenzene is challenging without a large datase...Chlorobenzene is a model molecule for researching harmful chlorinated volatile organic compounds.Designing the chemical adsorption site for complex molecules such as chlorobenzene is challenging without a large dataset and reasonable descriptors.Here,the adsorption of chlorobenzene on a phosphorylated CeO_(2)catalyst was analyzed using density functional theory calculations.Three different surface phosphate(H_(x)PO_(4))models were constructed and used to adsorb chlorobenzene.An orbital interaction with fully occupied antibonding is found in one of three physical adsorptions.Based on this,the surface sites of a tri-cluster(M_(3))located at the CeO_(2)surface have been suggested to activate chlorobenzene.Three different clusters have been tested,namely Fe_(3),Ru_(3),and B_(3).All these clusters can activate and twist chlorobenzene by donating electrons.Fe_(3)and Ru_(3)form bonds with weak covalent and strong ionic characters,while B3forms strong covalent bonds between boron and carbon.This work not only predicts a class of sites for chlorobenzene activation that may prevent polychlorinated by-products but also gives a template for catalyst rational design according to fundamental catalytic theory.展开更多
Dual-atom catalysts(DACs),a natural extension of single-atom catalysts(SACs),have emerged as a prominent focal point in the field of heterogeneous catalysis,particularly in the context of chemical and energy conversio...Dual-atom catalysts(DACs),a natural extension of single-atom catalysts(SACs),have emerged as a prominent focal point in the field of heterogeneous catalysis,particularly in the context of chemical and energy conversion processes.Despite the fact that the catalytic activity of DACs is significantly modulated by the electronic structure of the catalyst,understanding how electron spin states are affected by variations in topology and geometric structure remains challenging and relatively unexplored.Herein,we propose the rational design of stable DACs composed of two iron atoms anchored on pristine graphdiyne(GDY),Fe_(2)-GDYn.A comprehensive and systematic investigation was carried out to elucidate the electronic configuration and spin states involved in the deliberate convergence towards the magnetic ground state,with the aim of uncovering the structure-spin relationship.Through an in-depth analysis of spin populations,electronic localization/delocalization,and the chemical bonding characteristics of the central metal atoms and the GDY skeleton,it was revealed that the spin coupling between the two iron atoms is preponderantly dictated by adjacent short-range Fe-Fe interactions.Conversely,spin decoupling can be attributed to the long-rangeπ-bond component within the linkage.Moreover,geometric and chemical bonding asymmetries were found to induce orbital and spin splitting in iron atoms possessing an electronic configuration of d8.These findings provide important insights into the relationship between topology and spin,thereby presenting novel strategies for the rational design of spin-manipulated DACs.展开更多
Objective:To analyze the positive impact of pharmaceutical care in the ophthalmology perioperative period on the rational use of antibiotics.Methods:A total of 115 patients who underwent ophthalmological surgery betwe...Objective:To analyze the positive impact of pharmaceutical care in the ophthalmology perioperative period on the rational use of antibiotics.Methods:A total of 115 patients who underwent ophthalmological surgery between March and June 2023 were selected as the control group,receiving routine medication management.Another 115 patients who underwent ophthalmological surgery between July and October 2023 were selected as the observation group,receiving pharmaceutical care.The rationality of medication use,mastery of medication knowledge,medication compliance,and adverse reaction rates were compared between the two groups.Results:The observation group had higher rationality of medication use,higher scores for mastery of medication knowledge,higher medication compliance,and a lower adverse reaction rate compared to the control group(P<0.05).Conclusion:The combination of antibiotic therapy and pharmaceutical care in the ophthalmology perioperative period can improve the rationality of medication use,enhance patients’mastery of medication knowledge,increase their medication compliance,and prevent adverse reactions to antibiotics.展开更多
Objective To establish a drug use evaluation(DUE)standard for meropenem in a tertiary medical institution in Beijing,and to analyze the use of meropenem for promoting the rational use of antibiotics.Methods A criteria...Objective To establish a drug use evaluation(DUE)standard for meropenem in a tertiary medical institution in Beijing,and to analyze the use of meropenem for promoting the rational use of antibiotics.Methods A criteria of DUE of meropenem was established based on drug instructions,related guidelines and experts’opinions.Then,120 cases of meropenem use from January to December 2021 were selected to carry out a retrospective study.Results and Conclusion 120 cases of meropenem use involved 8 clinical departments,including 38 cases in the Department of Respiratory Medicine,25 cases in the Department of Tuberculosis,and 20 cases in the Department of Gastroenterology.The detection rate of pathogenic microorganisms before first use was 79.17%,and the clinical treatment effectiveness rate was 81.67%.The irrational use of meropenem included poor grasp of usage indications,excessively high starting points,inappropriate usage and dosage,non-standard treatment courses,and excessive combination medication.Pharmacists should strengthen the monitoring and evaluation of carbapenem drugs such as meropenem,provide timely feedback on relevant situations,and promote rational clinical medication.展开更多
Objective:To analyze the effect of pharmacist-led rational drug use management of antibiotics during the perioperative period in gynecology.Methods:Two hundred patients who underwent gynecological surgery between Marc...Objective:To analyze the effect of pharmacist-led rational drug use management of antibiotics during the perioperative period in gynecology.Methods:Two hundred patients who underwent gynecological surgery between March 2023 and December 2023 were selected and randomly divided into two groups.In the experimental group,the pharmacist led the medication management during the perioperative use of antibiotics,while the control group received routine antibiotic management.The management effects were compared between the two groups.Results:The irrational drug use rate,the incidence of adverse drug reactions,the cost of antibiotics,and the incidence of postoperative infection were all lower in the experimental group compared to the control group(P<0.05).Conclusion:Implementing pharmacist-led medication management during the perioperative period of gynecological surgery can prevent irrational drug use,reduce adverse drug reactions,control drug costs,and lower the risk of postoperative infection.展开更多
Objective:To explore the intervention value of the medical institution prescription review mechanism on the rationality of Western medicine use.Methods:A total of 159 patients(with 159 western medicine prescriptions)a...Objective:To explore the intervention value of the medical institution prescription review mechanism on the rationality of Western medicine use.Methods:A total of 159 patients(with 159 western medicine prescriptions)admitted to the hospital from January 2023 to December 2024 were selected and divided into an observation group(n=80,adopting the medical institution prescription review mechanism)and a control group(n=79,without prescription review)based on the random number table method.A comparative analysis was conducted on the work quality of medical personnel,irrational prescription drug use,and prescription drug dispensing situations.Results:The work quality of medical personnel in the observation group was significantly better than that in the control group(P<0.05).The incidence of irrational prescription drug use in the observation group(22.50%)was significantly higher than that in the control group(7.59%)(P<0.05).The observation group had fewer types of prescribed drugs,lower usage rates of injections and antibiotics,and a significantly higher usage rate of national essential drugs compared to the control group(P<0.05).Conclusion:The prescription review mechanism can significantly improve the work quality of medical personnel,increase the detection rate of irrational drug use,reduce the types of prescription drugs and the use of injections and antibiotics,and promote the standardized application of national essential drugs,which has important intervention value.展开更多
This paper examines the classic Chinese novel Journey to the West through the lens of rational choice theory,with a particular focus on the logic of cultivation and behavioral decision-making.By incorporating the noti...This paper examines the classic Chinese novel Journey to the West through the lens of rational choice theory,with a particular focus on the logic of cultivation and behavioral decision-making.By incorporating the notion of“inner cultivation”(xin xing xiulian)into the analytical framework,we introduce the concept of the“cultivating economic agent,”aiming to explore how rationality is generated,evolved,and transcended throughout the spiritual journey.The study argues that,in the context of Eastern culture,rationality is not merely an innate or static faculty but one that can be cultivated and transformed.Through textual analysis of the behavioral trajectories of Sun Wukong,Zhu Bajie,and Tang Sanzang,we uncover a structured behavioral logic of“goal orientation–institutional discipline–purification of the mind.”The findings suggest that although cultivation behaviors are not utilitarian decisions per se,they exhibit rational characteristics such as goal stability,autonomous will,and embedded incentives.展开更多
Objective:Irrational medicine consumption practices increase the country's health expenditures and raise public health concerns,challenging sustainable development in multiple ways.The objective of this study is t...Objective:Irrational medicine consumption practices increase the country's health expenditures and raise public health concerns,challenging sustainable development in multiple ways.The objective of this study is to identify the key factors influencing irrational medicine consumption and devise a strategic framework to encourage responsible medicine use.Method:A cross-sectional qualitative descriptive design was used.Study data were collected using semi-structured interviews and analysed using thematic analysis to identify the key factors contributing to irrational medicine consumption.Results:Various factors like cyberchondria coupled with health misinformation,inaccessible healthcare,limited product choices,misleading online pharmacies,and infeasible pharmaceutical regulations act as key drivers of irresponsible medicine consumption.The participants recommended enhancing healthcare access,utilizing technology,promoting health literacy,and updating regulations as strategies to improve responsible medicine use.Against this backdrop,the study proposes a double helix model for responsible consumption of medicines through bilateral efforts from both consumers and the health system.Conclusion:Highlighting the importance of responsible consumption,this paper calls health system actors to action to accelerate the efforts to foster responsible consumption of medicines.展开更多
Objective:To explore the adverse reactions associated with antibiotics and analyze strategies for their rational use.Methods:A retrospective analysis was conducted on 60 patients who experienced adverse reactions to a...Objective:To explore the adverse reactions associated with antibiotics and analyze strategies for their rational use.Methods:A retrospective analysis was conducted on 60 patients who experienced adverse reactions to antibiotics between August 2021 and August 2023.The types of antibiotics that caused adverse reactions were analyzed,and the symptoms of adverse reactions and measures for rational use of antibiotics were summarized.Results:Among the analyzed cases of adverse reactions to antibiotics,the highest rate was observed in patients aged 61–75 years,accounting for 38.33%,followed by patients aged 51–60 years,accounting for 20.00%.In terms of the types of antibiotics that caused adverse reactions,cephalosporins were the most common,accounting for 40.00%,followed by penicillins,accounting for 18.33%.Analysis of the systems involved in adverse reactions showed that skin and appendage disorders were the most common,accounting for 36.67%,followed by the digestive system,accounting for 28.33%.Conclusion:Irrational use of antibiotics can lead to adverse drug reactions.Therefore,it is necessary to analyze strategies for the rational use of antibiotics to reduce adverse drug reactions and ensure the safety of antibiotic use.展开更多
The high-speed development of space defense technology demands a high state estimation capacity for spacecraft tracking methods.However,reentry flight is accompanied by complex flight environments,which brings to the ...The high-speed development of space defense technology demands a high state estimation capacity for spacecraft tracking methods.However,reentry flight is accompanied by complex flight environments,which brings to the uncertain,complex,and strongly coupled non-Gaussian detection noise.As a result,there are several intractable considerations on the problem of state estimation tasks corrupted by complex non-Gaussian outliers for non-linear dynamics systems in practical application.To address these issues,a new iterated rational quadratic(RQ)kernel high-order unscented Kalman filtering(IRQHUKF)algorithm via capturing the statistics to break through the limitations of the Gaussian assumption is proposed.Firstly,the characteristic analysis of the RQ kernel is investigated in detail,which is the first attempt to carry out an exploration of the heavy-tailed characteristic and the ability on capturing highorder moments of the RQ kernel.Subsequently,the RQ kernel method is first introduced into the UKF algorithm as an error optimization criterion,termed the iterated RQ kernel-UKF(RQ-UKF)algorithm by derived analytically,which not only retains the high-order moments propagation process but also enhances the approximation capacity in the non-Gaussian noise problem for its ability in capturing highorder moments and heavy-tailed characteristics.Meanwhile,to tackle the limitations of the Gaussian distribution assumption in the linearization process of the non-linear systems,the high-order Sigma Points(SP)as a subsidiary role in propagating the state high-order statistics is devised by the moments matching method to improve the RQ-UKF.Finally,to further improve the flexibility of the IRQ-HUKF algorithm in practical application,an adaptive kernel parameter is derived analytically grounded in the Kullback-Leibler divergence(KLD)method and parametric sensitivity analysis of the RQ kernel.The simulation results demonstrate that the novel IRQ-HUKF algorithm is more robust and outperforms the existing advanced UKF with respect to the kernel method in reentry vehicle tracking scenarios under various noise environments.展开更多
[Objectives]This study was conducted to promote the rational use of special use level of antibiotics in clinic and delay the emergence of drug resistance.[Methods]The application of antibiotics for special use among i...[Objectives]This study was conducted to promote the rational use of special use level of antibiotics in clinic and delay the emergence of drug resistance.[Methods]The application of antibiotics for special use among inpatients of a hospital in 2019 was analyzed.The data in the drug information management system of the hospital were queried,and the collected expert consultation records of special-use antibiotics were sorted out.Indicators including the use rate of special-use antibiotics,antibiotic use density(AUD),defined daily dose system(DDDs)and defined daily dose system cost(DDDc)of each drug,the annual pathogen detection rate,disease distribution and pathogenic microorganism detection were summarized and analyzed for inpatients in the hospital retrospectively.[Results]In 2019,the average annual use rate of special-use antibiotics in the hospital was 1.53%,and the average annual use density was 1.59 DDDs.The antibiotics with the top three DDDs were imipenem and cilastatin,meropenem and cefepime.The antibiotics with the top three DDDc were voriconazole dispersible tablets,voriconazole for injection,and meropenem for injection.The average annual detection rate of microorganisms was 85.77%.The diseases were mainly diagnosed as respiratory infections such as pneumonia and secondary infections after radiotherapy and chemotherapy before medication,and the detected pathogens were mainly Candida and its subspecies,Escherichia coli,and Klebsiella and its subspecies.[Conclusions]The clinical use of special-use antibiotics in the hospital was basically reasonable,but there were still some problems.It is necessary to increase management efforts,strengthen training for relevant medical personnel,and provide management ideas for further standardizing the use of antibiotics in the hospital.展开更多
With digital coding technology,reconfigurable intelligent surfaces(RISs)become powerful real-time sys-tems for manipulating electromagnetic(EM)waves.However,most automatic RIS designs involve exten-sive numerical simu...With digital coding technology,reconfigurable intelligent surfaces(RISs)become powerful real-time sys-tems for manipulating electromagnetic(EM)waves.However,most automatic RIS designs involve exten-sive numerical simulations of the unit,including the passive pattern and active devices,requiring high data acquisition and training costs.In addition,for passive patterns,the widely employed random pixe-lated method presents design efficiency and effectiveness challenges due to the massive pixel combina-tions and blocked excitation current flow in discrete patterns.To overcome these two critical problems,we propose a versatile RIS design paradigm with efficient topology representation and a separate design architecture.First,a non-uniform rational B-spline(NURBS)is introduced to represent continuous pat-terns and solve excitation current flow issues.This representation makes it possible to finely tune con-tinuous patterns with several control points,greatly reducing the pattern solution space by 20-fold and facilitating RIS optimization.Then,employing multiport network theory to separate the passive pat-tern and active device from the unit,the separate design architecture significantly reduces the dataset acquisition cost by 62.5%.Through multistep multiport calculation,the multistate EM responses of the RIS under different structural combinations can be quickly obtained with only one prediction of pattern response,thereby achieving dataset and model reuse for different RIS designs.With a hybrid continuous-discrete optimization algorithm,three examples—including two typical high-performance RISs and an ultra-wideband multilayer RIS—are provided to validate the superiority of our paradigm.Our work offers an efficient solution for RIS automatic design,and the resulting structure is expected to boost RIS appli-cations in the fields of wireless communication and sensing.展开更多
文摘Wildfire risk related to hazards on people and assets is expected to increase in the face of climate change,especially in fire-prone environments such as the Mediterranean Basin.Distinguishing rationalities,i.e.,the complex profile of multi-thematic,wildfire-related perceptions that collectively characterize and quantify all of a society’s responses,its interrelations,and influence on its insights,are of primary importance to understand the degree of preparedness and the direction that wildfire management policies are moving.Greece is a country that suffered mega-wildfire events during the first years of the twenty-first century.This paper presents a scheme of advanced multivariate statistical procedures applied on standard social survey questionnaires to uncover different or similar rationalities between fire management services and the general public.Profession-centered versus message-oriented rationalities is defined.They differ mainly on the priorities attributed to strengthening personnel and equipment capacities versus the need for public education and awareness.Both are evaluated against the needs of long-term risk assessment and forest management policies in Greece.The main conclusion is that Greek society,although traumatized by recent fire disasters,is not yet prepared for long-term strategic forestry adaptation and planning.
文摘Let X be a closed simply connected rationally elliptic 4-manifold.The rational homotopy type of homotopy fixed point sets X^(hS^(1))is determined,and based on some relations between X^(hS^(1))and X^(S^(1)),the rational homotopy type of the fixed point set X^(S^(1))is determined.
文摘This research aims to understand the causes of fraud through the approach of the Fraud Triangle Theory,which includes three main factors:pressure,opportunity,rationalization.By using the Systematic Literature Review method from various relevant international journals,it analyzed systematically to identify patterns,trends,and theoretical contributions to efforts in detecting and preventing fraud.The results of this study show that the three factors in the Fraud Triangle Theory significantly contribute to the occurrence of fraud.Opportunity as the most dominant factor is caused by weak internal control systems and lack of oversight.In addition,economic pressure,and a permissive organizational environment,as well as the rationalization processes by individuals,also increase the tendency for a person to commit fraud.These findings emphasize the need for a comprehensive approach in fraud prevention strategies,through ethical values,the establishment of an organizational culture with integrity,and the implementation of more effective internal control and oversight.
基金supported by the China Metaverse and Digital Talent Development Initiative and the general project of the National Social Science Foundation of China titled“Theoretical Interpretation of Advertising Messaging and the Development of a Typical Case Database”(19BXW085).
文摘In the successive rise of the metaverse and artificial intelligence(AI),rationalism and emotionalism have consistently manifested as symptoms of modernity throughout their developmental trajectories.This paper argues that the achievements and crises of both fields signify the triumph of rationalism in the context of deepening modernity,while simultaneously harboring an intrinsic impetus and possibility for transitioning from rationalism to emotionalism.This dynamic serves as a quintessential representation of modernity’s crises and their transcendence.Centered on embodied cognitive science,AI and the metaverse—rooted in rationalism—now face challenges in shifting toward emotionalism,revealing their inadequacy in addressing this shift.Humanity must explore new modernity-deepening paradigms grounded in emotionalism to confront and transcend the potential crises posed by the metaverse and AI.
基金supported by the project of Young Technical Talents of Tianjin Medical University General Hospital(GG-2021-08).
文摘Background:Neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ration(PLR)have been shown to contribute to tumour progression and response to therapy.Methods:We retrospectively counted NLR and PLR in 719 patients with advanced malignancies receiving chemo-and/or immuno-therapy.Results:Both the pretreatment NLR and PLR were significantly elevated in patients with progressive disease than in those without progressive disease.Compared to low groups,the high NLR and PLR groups showed significantly worse event free survival.Conclusion:We propose that NLR and PLR are not only effective blood markers for predicting therapeutic responses to chemo-and/or immuno-therapy,but also useful in detecting survival in diverse malignancies.
基金supported by the Natural Science Foundation of Jiangsu Province(BE2021623,BK20220155)Natural Science Foundation of Jiangsu Province(BE2021623)+4 种基金National Natural Science Foundation of China(32001665,U1903205,32021005)the National Key Research and Development Program of China(2017YF0400303)the Key Scientific and Technological Research Projects in the Key Areas of the Xinjiang Production and Construction Corps(2018AB010)the Key Research and Development 303 Program of Ningxia(2020BFG02012)Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province。
文摘Heparin,a glycosaminoglycan,is a stable source of carbon that supports the growth of microorganisms in the human intestine.It is also a commonly used anticoagulant drug in clinical practice,with significant therapeutic effects.Low molecular weight heparin(LMWH)is a highly active low molecular weight fragment obtained via enzymatic reaction or the chemical degradation of heparin.LMWH has been applied globally in the prevention and treatment of venous thromboembolism in thrombosis patients.Simultaneously,as a potential prebiotic,because of its low molecular weight,LMWH can be well degraded by the gut microbiota to maintain intestinal balance.Enzymatic heparin degradation has recently emerged as a viable disposal method for LMWH preparation;however,only very few benchmark enzymes have been thoroughly described and subjected to protein engineering to improve their properties over the past few years.The commercialization of enzymes will require the development of robustly engineered enzymes that meet the demands of industrial processes.Herein,we report a rational protein engineering strategy that includes molecular dynamic simulations of flexible amino acid mutations and disulfide bond screening.Several Bacteroides thetaiotaomicron heparanase I(Bt-HepI)mutants were obtained and screened for high thermal stability.We obtained the Bt-HepI^(D204C/K208C/H189W/Q198R)variant,which features a stabilized protein surface structure,with a 1.3-fold increase in catalytic constant/michaelis-menten constant(k_(cat)/K_(m)),a 2.44-fold increase in thermal stability at 50℃,and a 1.8-fold decrease in the average molecular weight of LMWH produced at 40℃compared with that seen with Bt-HepI^(WT).Our study establishes a strategy to engineer thermostable HepI to underpin its industrial applications.
基金the support from the National Key Research and Development Program of China(No.2023YFA1508500)the National Natural Science Foundation of China(No.22276120)。
文摘Chlorobenzene is a model molecule for researching harmful chlorinated volatile organic compounds.Designing the chemical adsorption site for complex molecules such as chlorobenzene is challenging without a large dataset and reasonable descriptors.Here,the adsorption of chlorobenzene on a phosphorylated CeO_(2)catalyst was analyzed using density functional theory calculations.Three different surface phosphate(H_(x)PO_(4))models were constructed and used to adsorb chlorobenzene.An orbital interaction with fully occupied antibonding is found in one of three physical adsorptions.Based on this,the surface sites of a tri-cluster(M_(3))located at the CeO_(2)surface have been suggested to activate chlorobenzene.Three different clusters have been tested,namely Fe_(3),Ru_(3),and B_(3).All these clusters can activate and twist chlorobenzene by donating electrons.Fe_(3)and Ru_(3)form bonds with weak covalent and strong ionic characters,while B3forms strong covalent bonds between boron and carbon.This work not only predicts a class of sites for chlorobenzene activation that may prevent polychlorinated by-products but also gives a template for catalyst rational design according to fundamental catalytic theory.
文摘Dual-atom catalysts(DACs),a natural extension of single-atom catalysts(SACs),have emerged as a prominent focal point in the field of heterogeneous catalysis,particularly in the context of chemical and energy conversion processes.Despite the fact that the catalytic activity of DACs is significantly modulated by the electronic structure of the catalyst,understanding how electron spin states are affected by variations in topology and geometric structure remains challenging and relatively unexplored.Herein,we propose the rational design of stable DACs composed of two iron atoms anchored on pristine graphdiyne(GDY),Fe_(2)-GDYn.A comprehensive and systematic investigation was carried out to elucidate the electronic configuration and spin states involved in the deliberate convergence towards the magnetic ground state,with the aim of uncovering the structure-spin relationship.Through an in-depth analysis of spin populations,electronic localization/delocalization,and the chemical bonding characteristics of the central metal atoms and the GDY skeleton,it was revealed that the spin coupling between the two iron atoms is preponderantly dictated by adjacent short-range Fe-Fe interactions.Conversely,spin decoupling can be attributed to the long-rangeπ-bond component within the linkage.Moreover,geometric and chemical bonding asymmetries were found to induce orbital and spin splitting in iron atoms possessing an electronic configuration of d8.These findings provide important insights into the relationship between topology and spin,thereby presenting novel strategies for the rational design of spin-manipulated DACs.
文摘Objective:To analyze the positive impact of pharmaceutical care in the ophthalmology perioperative period on the rational use of antibiotics.Methods:A total of 115 patients who underwent ophthalmological surgery between March and June 2023 were selected as the control group,receiving routine medication management.Another 115 patients who underwent ophthalmological surgery between July and October 2023 were selected as the observation group,receiving pharmaceutical care.The rationality of medication use,mastery of medication knowledge,medication compliance,and adverse reaction rates were compared between the two groups.Results:The observation group had higher rationality of medication use,higher scores for mastery of medication knowledge,higher medication compliance,and a lower adverse reaction rate compared to the control group(P<0.05).Conclusion:The combination of antibiotic therapy and pharmaceutical care in the ophthalmology perioperative period can improve the rationality of medication use,enhance patients’mastery of medication knowledge,increase their medication compliance,and prevent adverse reactions to antibiotics.
文摘Objective To establish a drug use evaluation(DUE)standard for meropenem in a tertiary medical institution in Beijing,and to analyze the use of meropenem for promoting the rational use of antibiotics.Methods A criteria of DUE of meropenem was established based on drug instructions,related guidelines and experts’opinions.Then,120 cases of meropenem use from January to December 2021 were selected to carry out a retrospective study.Results and Conclusion 120 cases of meropenem use involved 8 clinical departments,including 38 cases in the Department of Respiratory Medicine,25 cases in the Department of Tuberculosis,and 20 cases in the Department of Gastroenterology.The detection rate of pathogenic microorganisms before first use was 79.17%,and the clinical treatment effectiveness rate was 81.67%.The irrational use of meropenem included poor grasp of usage indications,excessively high starting points,inappropriate usage and dosage,non-standard treatment courses,and excessive combination medication.Pharmacists should strengthen the monitoring and evaluation of carbapenem drugs such as meropenem,provide timely feedback on relevant situations,and promote rational clinical medication.
文摘Objective:To analyze the effect of pharmacist-led rational drug use management of antibiotics during the perioperative period in gynecology.Methods:Two hundred patients who underwent gynecological surgery between March 2023 and December 2023 were selected and randomly divided into two groups.In the experimental group,the pharmacist led the medication management during the perioperative use of antibiotics,while the control group received routine antibiotic management.The management effects were compared between the two groups.Results:The irrational drug use rate,the incidence of adverse drug reactions,the cost of antibiotics,and the incidence of postoperative infection were all lower in the experimental group compared to the control group(P<0.05).Conclusion:Implementing pharmacist-led medication management during the perioperative period of gynecological surgery can prevent irrational drug use,reduce adverse drug reactions,control drug costs,and lower the risk of postoperative infection.
文摘Objective:To explore the intervention value of the medical institution prescription review mechanism on the rationality of Western medicine use.Methods:A total of 159 patients(with 159 western medicine prescriptions)admitted to the hospital from January 2023 to December 2024 were selected and divided into an observation group(n=80,adopting the medical institution prescription review mechanism)and a control group(n=79,without prescription review)based on the random number table method.A comparative analysis was conducted on the work quality of medical personnel,irrational prescription drug use,and prescription drug dispensing situations.Results:The work quality of medical personnel in the observation group was significantly better than that in the control group(P<0.05).The incidence of irrational prescription drug use in the observation group(22.50%)was significantly higher than that in the control group(7.59%)(P<0.05).The observation group had fewer types of prescribed drugs,lower usage rates of injections and antibiotics,and a significantly higher usage rate of national essential drugs compared to the control group(P<0.05).Conclusion:The prescription review mechanism can significantly improve the work quality of medical personnel,increase the detection rate of irrational drug use,reduce the types of prescription drugs and the use of injections and antibiotics,and promote the standardized application of national essential drugs,which has important intervention value.
文摘This paper examines the classic Chinese novel Journey to the West through the lens of rational choice theory,with a particular focus on the logic of cultivation and behavioral decision-making.By incorporating the notion of“inner cultivation”(xin xing xiulian)into the analytical framework,we introduce the concept of the“cultivating economic agent,”aiming to explore how rationality is generated,evolved,and transcended throughout the spiritual journey.The study argues that,in the context of Eastern culture,rationality is not merely an innate or static faculty but one that can be cultivated and transformed.Through textual analysis of the behavioral trajectories of Sun Wukong,Zhu Bajie,and Tang Sanzang,we uncover a structured behavioral logic of“goal orientation–institutional discipline–purification of the mind.”The findings suggest that although cultivation behaviors are not utilitarian decisions per se,they exhibit rational characteristics such as goal stability,autonomous will,and embedded incentives.
文摘Objective:Irrational medicine consumption practices increase the country's health expenditures and raise public health concerns,challenging sustainable development in multiple ways.The objective of this study is to identify the key factors influencing irrational medicine consumption and devise a strategic framework to encourage responsible medicine use.Method:A cross-sectional qualitative descriptive design was used.Study data were collected using semi-structured interviews and analysed using thematic analysis to identify the key factors contributing to irrational medicine consumption.Results:Various factors like cyberchondria coupled with health misinformation,inaccessible healthcare,limited product choices,misleading online pharmacies,and infeasible pharmaceutical regulations act as key drivers of irresponsible medicine consumption.The participants recommended enhancing healthcare access,utilizing technology,promoting health literacy,and updating regulations as strategies to improve responsible medicine use.Against this backdrop,the study proposes a double helix model for responsible consumption of medicines through bilateral efforts from both consumers and the health system.Conclusion:Highlighting the importance of responsible consumption,this paper calls health system actors to action to accelerate the efforts to foster responsible consumption of medicines.
文摘Objective:To explore the adverse reactions associated with antibiotics and analyze strategies for their rational use.Methods:A retrospective analysis was conducted on 60 patients who experienced adverse reactions to antibiotics between August 2021 and August 2023.The types of antibiotics that caused adverse reactions were analyzed,and the symptoms of adverse reactions and measures for rational use of antibiotics were summarized.Results:Among the analyzed cases of adverse reactions to antibiotics,the highest rate was observed in patients aged 61–75 years,accounting for 38.33%,followed by patients aged 51–60 years,accounting for 20.00%.In terms of the types of antibiotics that caused adverse reactions,cephalosporins were the most common,accounting for 40.00%,followed by penicillins,accounting for 18.33%.Analysis of the systems involved in adverse reactions showed that skin and appendage disorders were the most common,accounting for 36.67%,followed by the digestive system,accounting for 28.33%.Conclusion:Irrational use of antibiotics can lead to adverse drug reactions.Therefore,it is necessary to analyze strategies for the rational use of antibiotics to reduce adverse drug reactions and ensure the safety of antibiotic use.
基金supported by the National Natural Science Foundation of China under Grant No.12072090.
文摘The high-speed development of space defense technology demands a high state estimation capacity for spacecraft tracking methods.However,reentry flight is accompanied by complex flight environments,which brings to the uncertain,complex,and strongly coupled non-Gaussian detection noise.As a result,there are several intractable considerations on the problem of state estimation tasks corrupted by complex non-Gaussian outliers for non-linear dynamics systems in practical application.To address these issues,a new iterated rational quadratic(RQ)kernel high-order unscented Kalman filtering(IRQHUKF)algorithm via capturing the statistics to break through the limitations of the Gaussian assumption is proposed.Firstly,the characteristic analysis of the RQ kernel is investigated in detail,which is the first attempt to carry out an exploration of the heavy-tailed characteristic and the ability on capturing highorder moments of the RQ kernel.Subsequently,the RQ kernel method is first introduced into the UKF algorithm as an error optimization criterion,termed the iterated RQ kernel-UKF(RQ-UKF)algorithm by derived analytically,which not only retains the high-order moments propagation process but also enhances the approximation capacity in the non-Gaussian noise problem for its ability in capturing highorder moments and heavy-tailed characteristics.Meanwhile,to tackle the limitations of the Gaussian distribution assumption in the linearization process of the non-linear systems,the high-order Sigma Points(SP)as a subsidiary role in propagating the state high-order statistics is devised by the moments matching method to improve the RQ-UKF.Finally,to further improve the flexibility of the IRQ-HUKF algorithm in practical application,an adaptive kernel parameter is derived analytically grounded in the Kullback-Leibler divergence(KLD)method and parametric sensitivity analysis of the RQ kernel.The simulation results demonstrate that the novel IRQ-HUKF algorithm is more robust and outperforms the existing advanced UKF with respect to the kernel method in reentry vehicle tracking scenarios under various noise environments.
基金Supported by National TCM Advantage Speciality Construction Project:Clinical Pharmacy(GZYYYZH[2024]90)Guizhou Provincial Key Discipline Construction Project of Traditional Chinese Medicine and Ethnic Medicine:Clinical Traditional Chinese pharmacy(QZYYZDXK(JS)-2023-04).
文摘[Objectives]This study was conducted to promote the rational use of special use level of antibiotics in clinic and delay the emergence of drug resistance.[Methods]The application of antibiotics for special use among inpatients of a hospital in 2019 was analyzed.The data in the drug information management system of the hospital were queried,and the collected expert consultation records of special-use antibiotics were sorted out.Indicators including the use rate of special-use antibiotics,antibiotic use density(AUD),defined daily dose system(DDDs)and defined daily dose system cost(DDDc)of each drug,the annual pathogen detection rate,disease distribution and pathogenic microorganism detection were summarized and analyzed for inpatients in the hospital retrospectively.[Results]In 2019,the average annual use rate of special-use antibiotics in the hospital was 1.53%,and the average annual use density was 1.59 DDDs.The antibiotics with the top three DDDs were imipenem and cilastatin,meropenem and cefepime.The antibiotics with the top three DDDc were voriconazole dispersible tablets,voriconazole for injection,and meropenem for injection.The average annual detection rate of microorganisms was 85.77%.The diseases were mainly diagnosed as respiratory infections such as pneumonia and secondary infections after radiotherapy and chemotherapy before medication,and the detected pathogens were mainly Candida and its subspecies,Escherichia coli,and Klebsiella and its subspecies.[Conclusions]The clinical use of special-use antibiotics in the hospital was basically reasonable,but there were still some problems.It is necessary to increase management efforts,strengthen training for relevant medical personnel,and provide management ideas for further standardizing the use of antibiotics in the hospital.
基金supported by the National Key Research and Development Program of China(2023YFB3811502)the National Science Foundation of China(62225108)+5 种基金the Fundamental Research Funds for the Central Universities(2242022k60003)the National Natural Science Foundation of China(62288101 and 62201139)the Jiangsu Province Frontier Leading Technology Basic Research Project(BK20212002)the Jiangsu Provincial Scientific Research Center of Applied Mathematics(BK20233002)the Fundamental Research Funds for the Central Universities(2242024RCB0005 and 2242024K30009)the 111 Project(111-2-05).
文摘With digital coding technology,reconfigurable intelligent surfaces(RISs)become powerful real-time sys-tems for manipulating electromagnetic(EM)waves.However,most automatic RIS designs involve exten-sive numerical simulations of the unit,including the passive pattern and active devices,requiring high data acquisition and training costs.In addition,for passive patterns,the widely employed random pixe-lated method presents design efficiency and effectiveness challenges due to the massive pixel combina-tions and blocked excitation current flow in discrete patterns.To overcome these two critical problems,we propose a versatile RIS design paradigm with efficient topology representation and a separate design architecture.First,a non-uniform rational B-spline(NURBS)is introduced to represent continuous pat-terns and solve excitation current flow issues.This representation makes it possible to finely tune con-tinuous patterns with several control points,greatly reducing the pattern solution space by 20-fold and facilitating RIS optimization.Then,employing multiport network theory to separate the passive pat-tern and active device from the unit,the separate design architecture significantly reduces the dataset acquisition cost by 62.5%.Through multistep multiport calculation,the multistate EM responses of the RIS under different structural combinations can be quickly obtained with only one prediction of pattern response,thereby achieving dataset and model reuse for different RIS designs.With a hybrid continuous-discrete optimization algorithm,three examples—including two typical high-performance RISs and an ultra-wideband multilayer RIS—are provided to validate the superiority of our paradigm.Our work offers an efficient solution for RIS automatic design,and the resulting structure is expected to boost RIS appli-cations in the fields of wireless communication and sensing.
