BACKGROUND Obstructed defecation syndrome(ODS)is a subtype of constipation that is consi-dered one of the major pelvic floor dysfunctions affecting the aging population,particularly women over 50 seeking medical care....BACKGROUND Obstructed defecation syndrome(ODS)is a subtype of constipation that is consi-dered one of the major pelvic floor dysfunctions affecting the aging population,particularly women over 50 seeking medical care.The condition is characterized by the urge to defecate but an impaired ability to expel the fecal bolus.ODS is associated with various anorectal abnormalities,which are not always apparent during a standard physical examination,requiring specialized imaging techniques for proper diagnosis.AIM To study the distribution of causes of ODS in patients with chronic constipation by magnetic resonance defecography(MRD).METHODS This observational study evaluated the causes of ODS in 57 patients with chronic constipation who presented to Bangabandhu Sheikh Mujib Medical University between July 2020 and June 2021.After obtaining institutional review board approval and informed consent,patients underwent history taking,physical exams,and relevant investigations.ODS was diagnosed using Rome III criteria,with colonoscopy ruling out organic causes.Standard MRD was performed in different phases,and images were analyzed by expert radiologists and reported in a stan-dardized format.RESULTS Pelvic floor descent and anorectal junction descent were the most frequent findings,each present in 94.7%of cases.Rectocele was observed in 78.9%of patients,while vaginal or uterine prolapse was seen in 59.4%of females.Less common abnormalities included paradoxical contraction(7%),and there were no cases of sigmoidocele.Functional measurements showed significant differences in pelvic floor dynamics between rest and defecation,particularly in the H-line,M-line,and descent of pelvic organs(P<0.05).CONCLUSION Pelvic floor descent and anorectal descent were the most common findings in patients suffering from ODS,fo-llowed by rectocele.Younger females(<30 years)were most affected.展开更多
Objective Cigarette smoking exacerbates the progression of pulmonary tuberculosis(TB).The role of tertiary lymphoid structures(TLS)in chronic lung diseases has gained attention;however,it remains unclear whether smoki...Objective Cigarette smoking exacerbates the progression of pulmonary tuberculosis(TB).The role of tertiary lymphoid structures(TLS)in chronic lung diseases has gained attention;however,it remains unclear whether smoking-exacerbated lung damage in TB is associated with TLS.This study aimed to analyze the characteristics of pulmonary TLS in smokers with TB and to explore the possible role of TLS in smoking-related lung injury in TB.Methods Lung tissues from 36 male patients(18 smokers and 18 non-smokers)who underwent surgical resection for pulmonary TB were included in this study.Pathological and immunohistological analyses were conducted to evaluate the quantity of TLS,and chest computed tomography(CT)was used to assess the severity of lung lesions.The correlation between the TLS quantity and TB lesion severity scores was analyzed.The immune cells and chemokines involved in TLS formation were also evaluated and compared between smokers and non-smokers.Results Smoker patients with TB had significantly higher TLS than non-smokers(P<0.001).The TLS quantity in both the lung parenchyma and peribronchial regions correlated with TB lesion severity on chest CT(parenchyma:r=0.5767;peribronchial:r=0.7373;both P<0.001).Immunohistochemical analysis showed increased B cells,T cells,and C-X-C motif chemokine ligand 13(CXCL13)expression in smoker patients with TB(P<0.001).Conclusion Smoker TB patients exhibited increased pulmonary TLS,which was associated with exacerbated lung lesions on chest CT,suggesting that cigarette smoking may exacerbate lung damage by promoting TLS formation.展开更多
Changes in the intestinal immune micro-environment of the gastrointestinal tract are indispensable in the occurrence and development of gastrointestinal cancer.Tertiary lymphoid structure(TLS)is an immune cell aggrega...Changes in the intestinal immune micro-environment of the gastrointestinal tract are indispensable in the occurrence and development of gastrointestinal cancer.Tertiary lymphoid structure(TLS)is an immune cell aggregation structure found around gastrointestinal cancer in recent years.More and more research proves that tertiary lymphoid structure plays a key biological role and clinical value in disease progression,patient prognosis,and adjuvant treatment.This review aims to explore the research progress,biological significance,and potential clinical applications of TLSs in gastrointestinal tumors.The formation,development,and interaction of TLSs with tumor microenvironment have been reviewed and analyzed in recent years.Meanwhile,this review not only evaluates the clinical value of TLSs as prognostic biomarkers and predictors of treatment response but also explores their role in guiding the formulation of immunotherapy strategies for gastrointestinal tumors.In addition,this review points out the main problems in the current research of TLSs and looks forward to their future development,especially their broad application prospects in the diagnosis,treatment,and prognostic evaluation of gastrointestinal tumors.展开更多
Non-aqueous absorbents(NAAs)have attracted increasing attention for CO_(2)capture because of their great energy-saving potential.Primary diamines which can provide high CO_(2)absorption loading are promising candidate...Non-aqueous absorbents(NAAs)have attracted increasing attention for CO_(2)capture because of their great energy-saving potential.Primary diamines which can provide high CO_(2)absorption loading are promising candidates for formulating NAAs but suffer disadvantages in regenerability.In this study,a promising strategy that using tertiary amines(TAs)as proton-transfer mediators was proposed to enhance the regenerability of an aminoethylethanolamine(AEEA,diamine)/dimethyl sulfoxide(DMSO)(A/D)NAA.Surprisingly,some employed TAs such as N,N-diethylaminoethanol(DEEA),N,N,N’,N’’,N’’-pentamethyldiethylenetriamine(PMDETA),3-dimethylamino-1-propanol(3DMA1P),and N,N-dimethylethanolamine(DMEA)enhanced not only the regenerability of the A/D NAA but also the CO_(2)absorption performance.Specifically,the CO_(2)absorption loading and cyclic loading were increased by about 12.7%and 15.5%-22.7%,respectively.The TA-enhanced CO_(2)capture mechanism was comprehensively explored via nuclear magnetic resonance technique and quantum chemical calculations.During CO_(2)absorption,the TA acted as an ultimate proton acceptor for AEEA-zwitterion and enabled more AEEA to form carbamate species(AEEACOO-)to store CO_(2),thus enhancing CO_(2)absorption.For CO_(2)desorption,the TA first provided protons directly to AEEACOO-as a proton donor;moreover,it functioned as a proton carrier and facilitated the low-energy step-wise proton transfer from protonated AEEA to AEEACOO-.Consequently,the presence of TA made it easier for AEEACOO-to obtain protons to decompose,resulting in enhanced CO_(2)desorption.In a word,introducing the TA as a proton-transfer mediator into the A/D NAA enhanced both the CO_(2)absorption performance and the regenerability,which was an efficient way to“kill two birds with one stone”.展开更多
Low-salinity waterflooding,as a promising enhanced oil recovery method,has exhibited exciting results in various experiments conducted at different scales.For carbonate rock,pore-scale understanding of the fluid distr...Low-salinity waterflooding,as a promising enhanced oil recovery method,has exhibited exciting results in various experiments conducted at different scales.For carbonate rock,pore-scale understanding of the fluid distribution and remaining oil after low-salinity waterflooding is essential,especially the geometry and topology analysis of oil clusters.We performed the tertiary low-salinity waterflooding and employed X-ray micro-CT to probe the pore-scale displacement mechanism,fluid configuration,oil recovery,and remaining oil distribution.We found that the core becomes less oil-wet after low-salinity waterflooding.Furthermore,we analyzed the oil-rock and oil-brine interfacial areas to further support the wettability alteration.By comparing images after high-salinity waterflooding and low-salinity waterflooding,it is proven that wettability alteration has a significant impact on the behavior of the two-phase flow.Our research demonstrates that low-salinity waterflooding is an effective tertiary enhanced oil recovery technology in carbonate,which changes the wettability of rock and results in less film and singlet oil.展开更多
Context: COVID-19 can spread rapidly in haemodialysis centres, leading to fatal outcomes. Implementing physical measures is crucial in limiting the spread of infection. Aims: To assess adherence to physical measures a...Context: COVID-19 can spread rapidly in haemodialysis centres, leading to fatal outcomes. Implementing physical measures is crucial in limiting the spread of infection. Aims: To assess adherence to physical measures against SARS-Cov2 in haemodialysis patients. Methods and Material: From 13 to 19 July 2021, we administered the questionnaire to haemodialysis patients during or immediately after the dialysis session. The dependent variables were adherence to wearing masks, hand washing outside the dialysis centre, social distancing of at least 1.5 meters, and cough and sneeze hygiene. Statistical Analysis Used: Data were analyzed using Epi info software;descriptive statistics were presented as mean, headcount, and percentage;related factors were determined by multi-logistic regression. The significance level was 5%. The Health Research Ethics Committee approved the research protocol. Results: 142 patients were included (mean age: 42.5 ± 14 years). Wearing masks, hand-washing, social distancing, and coughing and sneezing hygiene were observed by 88%, 75%, 47%, and 60% of patients, respectively. Conclusion: Wearing masks was the most respected physical measure, while social distancing was the least respected.展开更多
Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Sahara...Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Saharan Africa (SSA), AKI is community-acquired occurring in healthy young adults. We aimed to identify predictors of fatal outcomes in patients with AKI in two tertiary hospitals in Cameroon. Methods: Medical records of adults with confirmed AKI, from January 2018 to March 2020 were retrieved. The outcomes of interest were in-hospital deaths and presumed causes of death. We used multiple logistic regressions modeling to identify predictors of death. The study was approved by the ethics boards of both hospitals. Values were considered significant for a p-value of 0.05. Results: We included 285 patient records (37.2% females). The mean (SD) age was 50.1 (19.0) years. Hypertension (n = 97, 34.0%), organ failure (n = 88, 30.9%), and diabetes (n = 60, 21.1%) were the main comorbidities. The majority of patients had community-acquired AKI (78.6%, n = 224), were KDIGO stage 3 (88.8%, n = 253), and needed dialysis (52.6%, n = 150). Up to 16.7% (n = 25) did not receive what was needed. The in-hospital mortality rate was 29.1% (n = 83). Lack of access to dialysis (OR = 27.8;CI: 5.2 - 149.3, p = 0.001), hypotension (OR = 11.8;CI: 1.3 - 24.8;p = 0.001) and ICU admission (OR = 5.7;CI: 1.3 - 24.8, p = 0.001) were predictors of mortality. The presence of co-morbidities or underlying diseases (n = 46, 55%) were the main causes of death. Conclusions: In-hospital AKI mortality is high, as in other low- and middle-income economies. Lack of access to dialysis and the severity of the underlying illness are major predictors of death.展开更多
Background: The aim of this study was to evaluate the usefulness of two interferon-gamma release assays (IGRAs) (QuantiFERON-TB Plus (QFT-plus) and T-SPOT.TB assay) for patients suspected of having tuberculosis (TB) i...Background: The aim of this study was to evaluate the usefulness of two interferon-gamma release assays (IGRAs) (QuantiFERON-TB Plus (QFT-plus) and T-SPOT.TB assay) for patients suspected of having tuberculosis (TB) infection as supportive methods for diagnosing TB. Patients and Methods: The subjects consisted of 45 patients who required clinical differentiation of TB disease from June 2019 to August 2023. The final clinical diagnoses were: 14 patients with active TB disease, 4 with latent TB infection (LTBI), 17 with old (cured) TB disease, and 10 with pulmonary nontuberculous mycobacterial (NTM) disease. We used the two IGRAs for these patients and evaluated the data according to the manufacturer’s guidelines for interpretation or FDA-approved cutoffs. Results: Among the total of 14 patients with active TB disease (mean age: 64 years old, male: 9, and female: 5), a positive response was noted in 10 patients (71%) on QFT-plus and 9 (64%) on T-SPOT.TB. Four patients with a negative response on QFT-plus and T-SPOT.TB were elderly or cancer patients with lymphocytopenia or hypoalbuminemia. All four patients with LTBI showed a positive response (100%) on both QFT-plus and T-SPOT.TB. Among the seventeen patients with old (cured) TB disease, a positive response was noted in 8 patients (47%) on QFT-plus and 9 (53%) on T-SPOT.TB. All patients with pulmonary NTM disease showed a negative response on both QFT-plus and T-SPOT.TB. Conclusions: A false-negative response on QFT-plus as well as T-SPOT.TB was recognized in elderly patients and patients with an immunosuppressed condition, and half of patients with old (cured) TB showed no negative conversion after the completion of treatment through this study. Although it was recently reported that the positive response rate on QFT-plus of patients with active TB disease was high, we consider it necessary to be careful in diagnosing TB infection using IGRAs for patients with severe underlying diseases in a tertiary hospital based on the results.展开更多
The value of system assimilation is to improve working relationships between tutors and learners while increasing workflow efficiency among tertiary institutions with low operational costs. E-skills could be described...The value of system assimilation is to improve working relationships between tutors and learners while increasing workflow efficiency among tertiary institutions with low operational costs. E-skills could be described as electronic education development, to assist ICT professionals to reach their future career goals and aim to help users boost their ICT skills. In a society that is expanding, it is also a crucial issue to take into account. Researchers have turned their attention to this topic because of its significance and contribution to the empowerment of graduates in digital education. Many scholars have proposed many methods for integrating e-skills into society with impressive results, but the rising rate of graduate unemployment in South Africa is gradually becoming a big worry in our society. A model based on Activity Theory (AT) and e-skills will be developed in our tertiary institution to equip graduates with skills that will increase their employability and provide more individualized work opportunities as part of this study’s effort to solve this issue. With the use of the Statistical Package for the Social Sciences (SPSS) and Cronbach’s Alpha for validity and reliability testing, the study will create an experimental performance to assess the approach taken to measure e-skills in tertiary institutions to empower graduates in South Africa. The study established that system development and e-skilled models for tertiary institutions are growing gradually, especially in South African institutions, that empower graduates with profitable employability with experiences to improve work operation in the industries. In conclusion, system development and e-skills are very demanding but important to empower graduate employability to determine competency in the professional workforce.展开更多
This study highlights the critical need for geoethics integration into higher education curricula across the Latin America and the Caribbean region,grappling with issues like sustainable development,responsible mining...This study highlights the critical need for geoethics integration into higher education curricula across the Latin America and the Caribbean region,grappling with issues like sustainable development,responsible mining,adaptation to climate change,and biodiversity conservation.Geoethics is essential for students to develop a holistic understanding of resources and ecosystems,promoting ethical attitudes and environmental responsibility.The proposed educational model includes geoethical principles,values,and case studies in geoscience courses,facing socio-economic-environmental impacts,sustainable resource management,and disaster risk reduction.The study identifies challenges in geoethics education,such as the lack of awareness of educators,insufficient resources,and fragmented efforts to develop the topic.Overcoming these obstacles requires a collaborative approach among educators,researchers,and professional bodies to develop educational materials,provide training,and facilitate knowledge exchange.The proposal of this study underscores the importance of collaborative initiatives among geoscience stakeholders in the region to ensure the successful incorporation of geoethics into educational frameworks.Education in geoethics is crucial for fostering informed and ethically conscious future geoscientists to better address the region's unique challenges.展开更多
Geoscience education is crucial globally,yet its delivery in Malaysian schools remains inadequate despite increasing demand for geological services.This study examines perceptions of 157 newly enrolled students in geo...Geoscience education is crucial globally,yet its delivery in Malaysian schools remains inadequate despite increasing demand for geological services.This study examines perceptions of 157 newly enrolled students in geoscience,geology,and other science-based programs regarding the challenges in bridging the geoscience education gap from primary to pre-university levels in Malaysia.Findings indicate a moderately significant improvement in students'geoscience knowledge,with moderate perspectives on geoscience education before and after entering university.展开更多
In the new scientific and technological revolution round,artificial intelligence(AI)technology has become a key leading force for industrial change.Research shows that AI not only promoted technical transformation and...In the new scientific and technological revolution round,artificial intelligence(AI)technology has become a key leading force for industrial change.Research shows that AI not only promoted technical transformation and industry upgrades but also played a significant role in the rapid development of emerging industries.Based on the installed number of industrial robots and the industrial data by the National Bureau of Statistics,this study establishes a theoretical framework with the econometric model and compares the impact of AI on different categories of industries through empirical analysis.Our results show that AI not only promotes economic growth but also plays a key role in promoting the tertiary industry.Hence,optimization of industrial structure and economic upgrade can be induced.展开更多
The collecting power of tertiary amines（DRN,DEN and DPN） on kaolinite follows the order of DENDPNDRN.After reacting with DRN,DEN and DPN,the surface potentials of kaolinite increase remarkably,and the recruitments c...The collecting power of tertiary amines（DRN,DEN and DPN） on kaolinite follows the order of DENDPNDRN.After reacting with DRN,DEN and DPN,the surface potentials of kaolinite increase remarkably,and the recruitments caused by collectors also follow the order of DENDPNDRN.The results of dynamics simulation show that the geometries of substituent groups bonding to N are deflected and twisted,and some of bond angles are changed when tertiary amines cations adsorb on kaolinite（001） surface.Based on the results of dynamics simulations and quantum chemistry calculations,the electrostatic forces between three tertiary amines cations and 4×4×3（001） plane of kaolinite are 1.38×10？7 N（DRN12H＋）,1.44×10-6 N（DEN12H＋）,1.383×10-6 N（DPN12H＋）,respectively.展开更多
The special issue deals with the Cretaceous-Tertiary deserts in southwestern China and relevant sedimentological problems about deserts. The study area is located between 101°10＇- 107°00＇E and 28°00＇...The special issue deals with the Cretaceous-Tertiary deserts in southwestern China and relevant sedimentological problems about deserts. The study area is located between 101°10＇- 107°00＇E and 28°00＇-30°40′ N. The ancient desert study is so little in China that there has not been a systematic report about it up to now. Based on the study in many ways on Cretaceous-Tertiary deserts in southwestern China, plentiful data have been obtained. Though it is still a bit rough, the study is a good beginning of the ancient desert study in China. The main ideas and conclusions are summarized as follows.展开更多
Effective teaching has always been a goal pursued by teachers as a part of education both from the western and eastern society,for it to some extend is considered an effective way to improve society.In this essay,both...Effective teaching has always been a goal pursued by teachers as a part of education both from the western and eastern society,for it to some extend is considered an effective way to improve society.In this essay,both Chinese and western conceptions of teaching and learning will be discussed.In doing so,their differences and similarities can be seen clearly,which will help the cross-cultural educators to understand their teaching environment and learning styles.展开更多
Starch/polyvinyl alcohol （PVA） blended materials for using as a solid carbon source （SCS） were prepared by blending PVA and gelatinized starch in an aqueous solution system, in which PVA served as framework materi...Starch/polyvinyl alcohol （PVA） blended materials for using as a solid carbon source （SCS） were prepared by blending PVA and gelatinized starch in an aqueous solution system, in which PVA served as framework material and starch as carbon source. The optimization of starch content and temperature effects were investigated. It was indicated that higher denitrification efficiency could be achieved with more starch in the materials. The average specific denitrification rates were 0.93, 0.66, 0.37 and 0.36 mg/（g·day） corresponding to starch content of 70%, 60%, 40% and 30% respectively at 37℃. The denitrification rates increased when operating temperature was raised from 23℃ to 30℃ and then 37℃. The mechanism of carbon release was analyzed incorporating the experimental results of abiotic release in deionized water. The organic carbon was mainly hydrolyzed by microbes, and the biological release efficiencies were at the range of 89.2% to 96.0%. A long-term experiment with a continuous flow reactor with SCS material containing 70% starch was conducted to gain some experience for practical application. When the influent nitrate concentration was in the range of 35.2 to 39.1 mg/L, hydraulic retention time of 4 hr, and operating temperature of 30℃, a nitrogen removal efficiency up to 94.6% and denitrification rate of 0.217 kg/（m3.day） was achieved. The starch-based materials developed in this study can be used as a solid carbon source for tertiary nitrogen removal from secondary effluent.展开更多
The stretching process of some Tertiary rift basins in eastern China is characterized by multiphase rifting. A multiple instantaneous uniform stretching model is proposed in this paper to simulate the formation of the...The stretching process of some Tertiary rift basins in eastern China is characterized by multiphase rifting. A multiple instantaneous uniform stretching model is proposed in this paper to simulate the formation of the basins as the rifting process cannot be accurately described by a simple (one episode) stretching model. The study shows that the multiphase stretching model, combined with the back-stripping technique, can be used to reconstruct the subsidence history and the stretching process of the lithosphere, and to evaluate the depth to the top of the asthenosphere and the deep thermal evolution of the basins. The calculated results obtained by applying the quantitative model to the episodic rifting process of the Tertiary Qiongdongnan and Yinggehai basins in the South China Sea are in agreement with geophysical data and geological observations. This provides a new method for quantitative evaluation of the geodynamic process of multiphase rifting occurring during the Tertiary in eastern China.展开更多
Tertiary amine cationic polyacrylamide with high cationization degree was used as a new cationic agent to pretreat cotton with dip-pad-bake method. The obtained cationic cotton was dyed with reactive dyes in the ab-se...Tertiary amine cationic polyacrylamide with high cationization degree was used as a new cationic agent to pretreat cotton with dip-pad-bake method. The obtained cationic cotton was dyed with reactive dyes in the ab-sence of electrolyte. The effects of the characteristics of the cationic agent and the pretreatment conditions on dye-ability of reactive dye were investigated. The results showed that the fixation and K/S values of the reactive dyes on the cationic cotton were improved compared with those on the untreated one in the presence of salt. Tests on fast-ness properties of the dyed cotton and fabric quality of the pretreated cotton were carried out and the results showed that wash and rub fastness of the salt-free dyeing were both satisfactory. And anti-crease property,tensile and tear strength,and handling of the cationic cotton were also good compared with that of the untreated one.展开更多
Potassium-ion batteries(KIBs)are a potential candidate to lithium-ion batteries(LIBs)but possess unsatisfactory capacity and rate properties.Herein,the metallic cobalt selenide quantum dots(Co0.85Se-QDs)encapsulated i...Potassium-ion batteries(KIBs)are a potential candidate to lithium-ion batteries(LIBs)but possess unsatisfactory capacity and rate properties.Herein,the metallic cobalt selenide quantum dots(Co0.85Se-QDs)encapsulated in mesoporous carbon matrix were designed via a direct hydrothermal method.Specifically,the cobalt selenide/carbon composite(Co0.85Se-QDs/C)possesses tertiary hierarchical structure,which is the primary quantum dots,the secondary petals flake,and the tertiary hollow micropolyhedron framework.Co0.85Se-QDs are homogenously embedded into the carbon petals flake,which constitute the hollow polyhedral framework.This unique structure can take the advantages of both nanoscale and microscale features:Co0.85Se-QDs can expand in a multidimensional and ductile carbon matrix and reduce the K-intercalation stress in particle dimensions;the micropetals can restrain the agglomeration of active materials and promote the transportation of potassium ion and electron.In addition,the hollow carbon framework buffers volume expansion,maintains the structural integrity,and increases the electronic conductivity.Benefiting from this tertiary hierarchical structure,outstanding K-storage performance(402 mAh g?1 after 100 cycles at 50 mA g?1)is obtained when Co0.85Se-QDs/C is used as KIBs anode.More importantly,the selenization process in this work is newly reported and can be generally extended to prepare other quantum dots encapsulated in edge-limited frameworks for excellent energy storage.展开更多
For high strength interstitial free （IF） steel containing P element, the salt and pepper （SP） defects exist on the strip surface and could not be eliminated effectively by optimizing the hot rolling process, such ...For high strength interstitial free （IF） steel containing P element, the salt and pepper （SP） defects exist on the strip surface and could not be eliminated effectively by optimizing the hot rolling process, such as temperature and cooling water. The combination effect of Si and P on the characteristic of tertiary scale has been studied comprehensively by scanning electron microscopy （SEM） and electron probe microanalysis （EPMA）, and the concept is proposed firstly that Si and P are of combination effect which can be utilized to eliminate the SP defect. The results show that the SP defects were induced by the rolled-in scale during finish rolling. P can be enriched at the interface between substrate and tertiary scale, which is easy to decrease the adhesion of tertiary scale. However, Si enrichment at the interface between substrate and tertiary scale can increase the adhesion. The SP defects can be eliminated completely, which is attributed to the accompanying enrichment of Si and P.展开更多
文摘BACKGROUND Obstructed defecation syndrome(ODS)is a subtype of constipation that is consi-dered one of the major pelvic floor dysfunctions affecting the aging population,particularly women over 50 seeking medical care.The condition is characterized by the urge to defecate but an impaired ability to expel the fecal bolus.ODS is associated with various anorectal abnormalities,which are not always apparent during a standard physical examination,requiring specialized imaging techniques for proper diagnosis.AIM To study the distribution of causes of ODS in patients with chronic constipation by magnetic resonance defecography(MRD).METHODS This observational study evaluated the causes of ODS in 57 patients with chronic constipation who presented to Bangabandhu Sheikh Mujib Medical University between July 2020 and June 2021.After obtaining institutional review board approval and informed consent,patients underwent history taking,physical exams,and relevant investigations.ODS was diagnosed using Rome III criteria,with colonoscopy ruling out organic causes.Standard MRD was performed in different phases,and images were analyzed by expert radiologists and reported in a stan-dardized format.RESULTS Pelvic floor descent and anorectal junction descent were the most frequent findings,each present in 94.7%of cases.Rectocele was observed in 78.9%of patients,while vaginal or uterine prolapse was seen in 59.4%of females.Less common abnormalities included paradoxical contraction(7%),and there were no cases of sigmoidocele.Functional measurements showed significant differences in pelvic floor dynamics between rest and defecation,particularly in the H-line,M-line,and descent of pelvic organs(P<0.05).CONCLUSION Pelvic floor descent and anorectal descent were the most common findings in patients suffering from ODS,fo-llowed by rectocele.Younger females(<30 years)were most affected.
基金supported by the Peking University Medicine Fund of Fostering Young Scholars'Scientific&Technological Innovation[grant number BMU2024YFJHPY014]the Fundamental Research Funds for the Central Universities+1 种基金the Key Clinical Projects of Peking University Third Hospital[grant number BYSYZD2022014]the Capital’s Funds for Health Improvement and Research[grant number 2022-2G-40910]。
文摘Objective Cigarette smoking exacerbates the progression of pulmonary tuberculosis(TB).The role of tertiary lymphoid structures(TLS)in chronic lung diseases has gained attention;however,it remains unclear whether smoking-exacerbated lung damage in TB is associated with TLS.This study aimed to analyze the characteristics of pulmonary TLS in smokers with TB and to explore the possible role of TLS in smoking-related lung injury in TB.Methods Lung tissues from 36 male patients(18 smokers and 18 non-smokers)who underwent surgical resection for pulmonary TB were included in this study.Pathological and immunohistological analyses were conducted to evaluate the quantity of TLS,and chest computed tomography(CT)was used to assess the severity of lung lesions.The correlation between the TLS quantity and TB lesion severity scores was analyzed.The immune cells and chemokines involved in TLS formation were also evaluated and compared between smokers and non-smokers.Results Smoker patients with TB had significantly higher TLS than non-smokers(P<0.001).The TLS quantity in both the lung parenchyma and peribronchial regions correlated with TB lesion severity on chest CT(parenchyma:r=0.5767;peribronchial:r=0.7373;both P<0.001).Immunohistochemical analysis showed increased B cells,T cells,and C-X-C motif chemokine ligand 13(CXCL13)expression in smoker patients with TB(P<0.001).Conclusion Smoker TB patients exhibited increased pulmonary TLS,which was associated with exacerbated lung lesions on chest CT,suggesting that cigarette smoking may exacerbate lung damage by promoting TLS formation.
文摘Changes in the intestinal immune micro-environment of the gastrointestinal tract are indispensable in the occurrence and development of gastrointestinal cancer.Tertiary lymphoid structure(TLS)is an immune cell aggregation structure found around gastrointestinal cancer in recent years.More and more research proves that tertiary lymphoid structure plays a key biological role and clinical value in disease progression,patient prognosis,and adjuvant treatment.This review aims to explore the research progress,biological significance,and potential clinical applications of TLSs in gastrointestinal tumors.The formation,development,and interaction of TLSs with tumor microenvironment have been reviewed and analyzed in recent years.Meanwhile,this review not only evaluates the clinical value of TLSs as prognostic biomarkers and predictors of treatment response but also explores their role in guiding the formulation of immunotherapy strategies for gastrointestinal tumors.In addition,this review points out the main problems in the current research of TLSs and looks forward to their future development,especially their broad application prospects in the diagnosis,treatment,and prognostic evaluation of gastrointestinal tumors.
基金supported by the Natural Science Foundation of Guangxi Province(Nos.2023GXNSFAA026381 and 2020GXNSFBA297071)the National Natural Science Foundation of China(Nos.22006027 and 52260023)。
文摘Non-aqueous absorbents(NAAs)have attracted increasing attention for CO_(2)capture because of their great energy-saving potential.Primary diamines which can provide high CO_(2)absorption loading are promising candidates for formulating NAAs but suffer disadvantages in regenerability.In this study,a promising strategy that using tertiary amines(TAs)as proton-transfer mediators was proposed to enhance the regenerability of an aminoethylethanolamine(AEEA,diamine)/dimethyl sulfoxide(DMSO)(A/D)NAA.Surprisingly,some employed TAs such as N,N-diethylaminoethanol(DEEA),N,N,N’,N’’,N’’-pentamethyldiethylenetriamine(PMDETA),3-dimethylamino-1-propanol(3DMA1P),and N,N-dimethylethanolamine(DMEA)enhanced not only the regenerability of the A/D NAA but also the CO_(2)absorption performance.Specifically,the CO_(2)absorption loading and cyclic loading were increased by about 12.7%and 15.5%-22.7%,respectively.The TA-enhanced CO_(2)capture mechanism was comprehensively explored via nuclear magnetic resonance technique and quantum chemical calculations.During CO_(2)absorption,the TA acted as an ultimate proton acceptor for AEEA-zwitterion and enabled more AEEA to form carbamate species(AEEACOO-)to store CO_(2),thus enhancing CO_(2)absorption.For CO_(2)desorption,the TA first provided protons directly to AEEACOO-as a proton donor;moreover,it functioned as a proton carrier and facilitated the low-energy step-wise proton transfer from protonated AEEA to AEEACOO-.Consequently,the presence of TA made it easier for AEEACOO-to obtain protons to decompose,resulting in enhanced CO_(2)desorption.In a word,introducing the TA as a proton-transfer mediator into the A/D NAA enhanced both the CO_(2)absorption performance and the regenerability,which was an efficient way to“kill two birds with one stone”.
基金the National Key Research and Development Program of China(2022YFE0203400)the National Natural Science Foundation of China(Nos.U23A20595,52034010,52288101)+2 种基金the Qingdao Natural Science Foundation(No.23-2-1-230-zyyd-jch)the Fundamental Research Funds for the Central Universities(No.23CX10004A)the Program for Changjiang Scholars and Innovative Research Team in University(No.IRT_16R69)。
文摘Low-salinity waterflooding,as a promising enhanced oil recovery method,has exhibited exciting results in various experiments conducted at different scales.For carbonate rock,pore-scale understanding of the fluid distribution and remaining oil after low-salinity waterflooding is essential,especially the geometry and topology analysis of oil clusters.We performed the tertiary low-salinity waterflooding and employed X-ray micro-CT to probe the pore-scale displacement mechanism,fluid configuration,oil recovery,and remaining oil distribution.We found that the core becomes less oil-wet after low-salinity waterflooding.Furthermore,we analyzed the oil-rock and oil-brine interfacial areas to further support the wettability alteration.By comparing images after high-salinity waterflooding and low-salinity waterflooding,it is proven that wettability alteration has a significant impact on the behavior of the two-phase flow.Our research demonstrates that low-salinity waterflooding is an effective tertiary enhanced oil recovery technology in carbonate,which changes the wettability of rock and results in less film and singlet oil.
文摘Context: COVID-19 can spread rapidly in haemodialysis centres, leading to fatal outcomes. Implementing physical measures is crucial in limiting the spread of infection. Aims: To assess adherence to physical measures against SARS-Cov2 in haemodialysis patients. Methods and Material: From 13 to 19 July 2021, we administered the questionnaire to haemodialysis patients during or immediately after the dialysis session. The dependent variables were adherence to wearing masks, hand washing outside the dialysis centre, social distancing of at least 1.5 meters, and cough and sneeze hygiene. Statistical Analysis Used: Data were analyzed using Epi info software;descriptive statistics were presented as mean, headcount, and percentage;related factors were determined by multi-logistic regression. The significance level was 5%. The Health Research Ethics Committee approved the research protocol. Results: 142 patients were included (mean age: 42.5 ± 14 years). Wearing masks, hand-washing, social distancing, and coughing and sneezing hygiene were observed by 88%, 75%, 47%, and 60% of patients, respectively. Conclusion: Wearing masks was the most respected physical measure, while social distancing was the least respected.
文摘Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Saharan Africa (SSA), AKI is community-acquired occurring in healthy young adults. We aimed to identify predictors of fatal outcomes in patients with AKI in two tertiary hospitals in Cameroon. Methods: Medical records of adults with confirmed AKI, from January 2018 to March 2020 were retrieved. The outcomes of interest were in-hospital deaths and presumed causes of death. We used multiple logistic regressions modeling to identify predictors of death. The study was approved by the ethics boards of both hospitals. Values were considered significant for a p-value of 0.05. Results: We included 285 patient records (37.2% females). The mean (SD) age was 50.1 (19.0) years. Hypertension (n = 97, 34.0%), organ failure (n = 88, 30.9%), and diabetes (n = 60, 21.1%) were the main comorbidities. The majority of patients had community-acquired AKI (78.6%, n = 224), were KDIGO stage 3 (88.8%, n = 253), and needed dialysis (52.6%, n = 150). Up to 16.7% (n = 25) did not receive what was needed. The in-hospital mortality rate was 29.1% (n = 83). Lack of access to dialysis (OR = 27.8;CI: 5.2 - 149.3, p = 0.001), hypotension (OR = 11.8;CI: 1.3 - 24.8;p = 0.001) and ICU admission (OR = 5.7;CI: 1.3 - 24.8, p = 0.001) were predictors of mortality. The presence of co-morbidities or underlying diseases (n = 46, 55%) were the main causes of death. Conclusions: In-hospital AKI mortality is high, as in other low- and middle-income economies. Lack of access to dialysis and the severity of the underlying illness are major predictors of death.
文摘Background: The aim of this study was to evaluate the usefulness of two interferon-gamma release assays (IGRAs) (QuantiFERON-TB Plus (QFT-plus) and T-SPOT.TB assay) for patients suspected of having tuberculosis (TB) infection as supportive methods for diagnosing TB. Patients and Methods: The subjects consisted of 45 patients who required clinical differentiation of TB disease from June 2019 to August 2023. The final clinical diagnoses were: 14 patients with active TB disease, 4 with latent TB infection (LTBI), 17 with old (cured) TB disease, and 10 with pulmonary nontuberculous mycobacterial (NTM) disease. We used the two IGRAs for these patients and evaluated the data according to the manufacturer’s guidelines for interpretation or FDA-approved cutoffs. Results: Among the total of 14 patients with active TB disease (mean age: 64 years old, male: 9, and female: 5), a positive response was noted in 10 patients (71%) on QFT-plus and 9 (64%) on T-SPOT.TB. Four patients with a negative response on QFT-plus and T-SPOT.TB were elderly or cancer patients with lymphocytopenia or hypoalbuminemia. All four patients with LTBI showed a positive response (100%) on both QFT-plus and T-SPOT.TB. Among the seventeen patients with old (cured) TB disease, a positive response was noted in 8 patients (47%) on QFT-plus and 9 (53%) on T-SPOT.TB. All patients with pulmonary NTM disease showed a negative response on both QFT-plus and T-SPOT.TB. Conclusions: A false-negative response on QFT-plus as well as T-SPOT.TB was recognized in elderly patients and patients with an immunosuppressed condition, and half of patients with old (cured) TB showed no negative conversion after the completion of treatment through this study. Although it was recently reported that the positive response rate on QFT-plus of patients with active TB disease was high, we consider it necessary to be careful in diagnosing TB infection using IGRAs for patients with severe underlying diseases in a tertiary hospital based on the results.
文摘The value of system assimilation is to improve working relationships between tutors and learners while increasing workflow efficiency among tertiary institutions with low operational costs. E-skills could be described as electronic education development, to assist ICT professionals to reach their future career goals and aim to help users boost their ICT skills. In a society that is expanding, it is also a crucial issue to take into account. Researchers have turned their attention to this topic because of its significance and contribution to the empowerment of graduates in digital education. Many scholars have proposed many methods for integrating e-skills into society with impressive results, but the rising rate of graduate unemployment in South Africa is gradually becoming a big worry in our society. A model based on Activity Theory (AT) and e-skills will be developed in our tertiary institution to equip graduates with skills that will increase their employability and provide more individualized work opportunities as part of this study’s effort to solve this issue. With the use of the Statistical Package for the Social Sciences (SPSS) and Cronbach’s Alpha for validity and reliability testing, the study will create an experimental performance to assess the approach taken to measure e-skills in tertiary institutions to empower graduates in South Africa. The study established that system development and e-skilled models for tertiary institutions are growing gradually, especially in South African institutions, that empower graduates with profitable employability with experiences to improve work operation in the industries. In conclusion, system development and e-skills are very demanding but important to empower graduate employability to determine competency in the professional workforce.
文摘This study highlights the critical need for geoethics integration into higher education curricula across the Latin America and the Caribbean region,grappling with issues like sustainable development,responsible mining,adaptation to climate change,and biodiversity conservation.Geoethics is essential for students to develop a holistic understanding of resources and ecosystems,promoting ethical attitudes and environmental responsibility.The proposed educational model includes geoethical principles,values,and case studies in geoscience courses,facing socio-economic-environmental impacts,sustainable resource management,and disaster risk reduction.The study identifies challenges in geoethics education,such as the lack of awareness of educators,insufficient resources,and fragmented efforts to develop the topic.Overcoming these obstacles requires a collaborative approach among educators,researchers,and professional bodies to develop educational materials,provide training,and facilitate knowledge exchange.The proposal of this study underscores the importance of collaborative initiatives among geoscience stakeholders in the region to ensure the successful incorporation of geoethics into educational frameworks.Education in geoethics is crucial for fostering informed and ethically conscious future geoscientists to better address the region's unique challenges.
文摘Geoscience education is crucial globally,yet its delivery in Malaysian schools remains inadequate despite increasing demand for geological services.This study examines perceptions of 157 newly enrolled students in geoscience,geology,and other science-based programs regarding the challenges in bridging the geoscience education gap from primary to pre-university levels in Malaysia.Findings indicate a moderately significant improvement in students'geoscience knowledge,with moderate perspectives on geoscience education before and after entering university.
文摘In the new scientific and technological revolution round,artificial intelligence(AI)technology has become a key leading force for industrial change.Research shows that AI not only promoted technical transformation and industry upgrades but also played a significant role in the rapid development of emerging industries.Based on the installed number of industrial robots and the industrial data by the National Bureau of Statistics,this study establishes a theoretical framework with the econometric model and compares the impact of AI on different categories of industries through empirical analysis.Our results show that AI not only promotes economic growth but also plays a key role in promoting the tertiary industry.Hence,optimization of industrial structure and economic upgrade can be induced.
基金Project (2005CB623701) supported by the National Basic Research Program of China Project (201011031) supported by National Department Public Benefit Research Foundation from Ministry of Land and Resources of China+1 种基金 Project (2935) supported by the Foundation for the Author of Zhengzhou Institute of Multipurpose Utilization of Mineral Resources CAGS, China Project (1212011120304) supported by the Geological Surrey Program
文摘The collecting power of tertiary amines（DRN,DEN and DPN） on kaolinite follows the order of DENDPNDRN.After reacting with DRN,DEN and DPN,the surface potentials of kaolinite increase remarkably,and the recruitments caused by collectors also follow the order of DENDPNDRN.The results of dynamics simulation show that the geometries of substituent groups bonding to N are deflected and twisted,and some of bond angles are changed when tertiary amines cations adsorb on kaolinite（001） surface.Based on the results of dynamics simulations and quantum chemistry calculations,the electrostatic forces between three tertiary amines cations and 4×4×3（001） plane of kaolinite are 1.38×10？7 N（DRN12H＋）,1.44×10-6 N（DEN12H＋）,1.383×10-6 N（DPN12H＋）,respectively.
文摘The special issue deals with the Cretaceous-Tertiary deserts in southwestern China and relevant sedimentological problems about deserts. The study area is located between 101°10＇- 107°00＇E and 28°00＇-30°40′ N. The ancient desert study is so little in China that there has not been a systematic report about it up to now. Based on the study in many ways on Cretaceous-Tertiary deserts in southwestern China, plentiful data have been obtained. Though it is still a bit rough, the study is a good beginning of the ancient desert study in China. The main ideas and conclusions are summarized as follows.
文摘Effective teaching has always been a goal pursued by teachers as a part of education both from the western and eastern society,for it to some extend is considered an effective way to improve society.In this essay,both Chinese and western conceptions of teaching and learning will be discussed.In doing so,their differences and similarities can be seen clearly,which will help the cross-cultural educators to understand their teaching environment and learning styles.
基金supported by the Ministry of Science and Technology of China (No.2009AA063805)
文摘Starch/polyvinyl alcohol （PVA） blended materials for using as a solid carbon source （SCS） were prepared by blending PVA and gelatinized starch in an aqueous solution system, in which PVA served as framework material and starch as carbon source. The optimization of starch content and temperature effects were investigated. It was indicated that higher denitrification efficiency could be achieved with more starch in the materials. The average specific denitrification rates were 0.93, 0.66, 0.37 and 0.36 mg/（g·day） corresponding to starch content of 70%, 60%, 40% and 30% respectively at 37℃. The denitrification rates increased when operating temperature was raised from 23℃ to 30℃ and then 37℃. The mechanism of carbon release was analyzed incorporating the experimental results of abiotic release in deionized water. The organic carbon was mainly hydrolyzed by microbes, and the biological release efficiencies were at the range of 89.2% to 96.0%. A long-term experiment with a continuous flow reactor with SCS material containing 70% starch was conducted to gain some experience for practical application. When the influent nitrate concentration was in the range of 35.2 to 39.1 mg/L, hydraulic retention time of 4 hr, and operating temperature of 30℃, a nitrogen removal efficiency up to 94.6% and denitrification rate of 0.217 kg/（m3.day） was achieved. The starch-based materials developed in this study can be used as a solid carbon source for tertiary nitrogen removal from secondary effluent.
文摘The stretching process of some Tertiary rift basins in eastern China is characterized by multiphase rifting. A multiple instantaneous uniform stretching model is proposed in this paper to simulate the formation of the basins as the rifting process cannot be accurately described by a simple (one episode) stretching model. The study shows that the multiphase stretching model, combined with the back-stripping technique, can be used to reconstruct the subsidence history and the stretching process of the lithosphere, and to evaluate the depth to the top of the asthenosphere and the deep thermal evolution of the basins. The calculated results obtained by applying the quantitative model to the episodic rifting process of the Tertiary Qiongdongnan and Yinggehai basins in the South China Sea are in agreement with geophysical data and geological observations. This provides a new method for quantitative evaluation of the geodynamic process of multiphase rifting occurring during the Tertiary in eastern China.
基金Supported by the National Science Foundation for Distinguished Young Scholar of China（20525620） the National Natural Science Foundation of China（20806013） the Program for Changjiang Scholar and Innovative Research Team in University（IRT 0711）
文摘Tertiary amine cationic polyacrylamide with high cationization degree was used as a new cationic agent to pretreat cotton with dip-pad-bake method. The obtained cationic cotton was dyed with reactive dyes in the ab-sence of electrolyte. The effects of the characteristics of the cationic agent and the pretreatment conditions on dye-ability of reactive dye were investigated. The results showed that the fixation and K/S values of the reactive dyes on the cationic cotton were improved compared with those on the untreated one in the presence of salt. Tests on fast-ness properties of the dyed cotton and fabric quality of the pretreated cotton were carried out and the results showed that wash and rub fastness of the salt-free dyeing were both satisfactory. And anti-crease property,tensile and tear strength,and handling of the cationic cotton were also good compared with that of the untreated one.
基金financially supported by Beijing Natural Science Foundation(No.2192034)China Postdoctoral Science Foundation(No.2018M631335)National Key R&D Program of China(No.2018YFB0905600).
文摘Potassium-ion batteries(KIBs)are a potential candidate to lithium-ion batteries(LIBs)but possess unsatisfactory capacity and rate properties.Herein,the metallic cobalt selenide quantum dots(Co0.85Se-QDs)encapsulated in mesoporous carbon matrix were designed via a direct hydrothermal method.Specifically,the cobalt selenide/carbon composite(Co0.85Se-QDs/C)possesses tertiary hierarchical structure,which is the primary quantum dots,the secondary petals flake,and the tertiary hollow micropolyhedron framework.Co0.85Se-QDs are homogenously embedded into the carbon petals flake,which constitute the hollow polyhedral framework.This unique structure can take the advantages of both nanoscale and microscale features:Co0.85Se-QDs can expand in a multidimensional and ductile carbon matrix and reduce the K-intercalation stress in particle dimensions;the micropetals can restrain the agglomeration of active materials and promote the transportation of potassium ion and electron.In addition,the hollow carbon framework buffers volume expansion,maintains the structural integrity,and increases the electronic conductivity.Benefiting from this tertiary hierarchical structure,outstanding K-storage performance(402 mAh g?1 after 100 cycles at 50 mA g?1)is obtained when Co0.85Se-QDs/C is used as KIBs anode.More importantly,the selenization process in this work is newly reported and can be generally extended to prepare other quantum dots encapsulated in edge-limited frameworks for excellent energy storage.
文摘For high strength interstitial free （IF） steel containing P element, the salt and pepper （SP） defects exist on the strip surface and could not be eliminated effectively by optimizing the hot rolling process, such as temperature and cooling water. The combination effect of Si and P on the characteristic of tertiary scale has been studied comprehensively by scanning electron microscopy （SEM） and electron probe microanalysis （EPMA）, and the concept is proposed firstly that Si and P are of combination effect which can be utilized to eliminate the SP defect. The results show that the SP defects were induced by the rolled-in scale during finish rolling. P can be enriched at the interface between substrate and tertiary scale, which is easy to decrease the adhesion of tertiary scale. However, Si enrichment at the interface between substrate and tertiary scale can increase the adhesion. The SP defects can be eliminated completely, which is attributed to the accompanying enrichment of Si and P.
