The microstructure of single crystal superalloy is relatively simple,consisting primarily ofγdendrites andγ/γ′eutectics.During the directional solidification process of Ni-based single crystal superalloys,withdraw...The microstructure of single crystal superalloy is relatively simple,consisting primarily ofγdendrites andγ/γ′eutectics.During the directional solidification process of Ni-based single crystal superalloys,withdrawal rate is a critical parameter affecting the spatial distribution ofγ/γ′eutectic along gravity direction.The results show that theγ/γ′eutectic fraction of the upper platform surface is always higher than that of the lower one,regardless of withdrawal rate.As the withdrawal rate decreases,there is a significant increase inγ/γ′eutectic fraction on the upper surface,while it decreases on the lower surface.The upward accumulation ofγ/γ′eutectic becomes more severe as the withdrawal rate decreases.It is also found that the percentage of Al+Ta is positively correlated with theγ/γ′eutectic fraction.Thermo-solute convection of Al and Ta solutes in the solidification front is the prime reason for the non-uniform distribution of eutectic.The non-uniform distribution ofγ/γ′eutectic cannot be eliminated even after subsequent solution heat treatment,resulting in excess eutectic on the upper surface and thus leading to the scrapping of the blade.展开更多
BACKGROUND Psychotic disorders are characterized by both positive symptoms(hallucinations,delusions)and negative symptoms(emotional blunting,anhedonia)that impair daily functioning.While antipsychotic drugs and psycho...BACKGROUND Psychotic disorders are characterized by both positive symptoms(hallucinations,delusions)and negative symptoms(emotional blunting,anhedonia)that impair daily functioning.While antipsychotic drugs and psychological interventions are effective when addressing positive symptoms,treatment of negative symptoms remains an ongoing challenge.Mindfulness-based interventions(MBIs)have been shown to reduce negative psychotic symptoms.However,as negative psychotic symptoms are assessed as a sole entity rather than a sum of manifestations,the effect of MBIs remains unclear.AIM To examine the effects of MBI in addition to integrated rehabilitation treatment(IRT)for people experiencing psychosis on each of the negative psychotic symptoms.METHODS A randomized controlled clinical trial with preintervention and postintervention measures was designed.The main outcome variable was negative psychotic symptoms assessed through the seven subscales of the Spanish version of the positive and negative syndrome scale.Data were analyzed using a repeated measures analysis of variance and reliable change index calculation.RESULTS There were no statistical differences between groups at the preintervention assessment.Statistically significant differences were found after MBI for the time in emotional withdrawal(F=37.75,P<0.001,η2=0.437)and social withdrawal(F=37.75,P<0.001,η2=0.437).CONCLUSION MBI added to IRT reduced the lack of interest and involvement with affective commitment to daily life activities,and interest and engagement in social activities increased.These negative psychotic symptoms were not improved by IRT alone.展开更多
BACKGROUND Adenoma detection rate(ADR),a key colonoscopy quality metric,varies with patient demographics and procedural factors.AIM To identify independent predictors of≥25%ADR,develop a risk model,and propose withdr...BACKGROUND Adenoma detection rate(ADR),a key colonoscopy quality metric,varies with patient demographics and procedural factors.AIM To identify independent predictors of≥25%ADR,develop a risk model,and propose withdrawal durations based on different insertion times.METHODS We retrospectively analyzed 830 cases using logistic regression and identified four key factors,validated in a prospective cohort of 5699 patients.Their importance was confirmed using random forest(RF),extreme gradient boosting(XGBoost)and light gradient boosting machine(LightGBM).Attempts to determine targetachieving withdrawal time by grouping cases based on insertion time and Cox regression were inconclusive.Using the 5699-case dataset,we developed a predictive model combining support vector machine(SVM)with XGBoost.We built a Shiny app using this model for clinical application.RESULTS Multivariate logistic regression identified age[odds ratio(OR)=1.05;95%confidence interval(CI):1.03-1.08;P<0.001],male(OR=1.79;95%CI:1.32-2.41;P=0.005),higher endoscopist experience(OR=1.79;95%CI:1.20-2.68;P=0.005),and longer withdrawal time(P<0.001)as independent risk factors for colorectal adenoma.A nomogram demonstrated strong discrimination[area under the curve(AUC)=0.720],with robust calibration and decision-curve performance.Feature importance via RF,XGBoost,and LightGBM confirmed key predictors.A hybrid model combining SVM regression for withdrawal-time estimation and XGBoost classification achieved stable results,with XGBoost reporting AUCs of 0.640 in training and 0.610 in testing,and similar validation outcomes.Deployed via a Shiny app for clinical use.However,model discrimination was modest(AUC:0.61-0.64),suggesting that clinical utility requires further refinement.CONCLUSION A hybrid SVM-XGBoost model using four key endoscopic factors was independently validated and is available as a Shiny app,delivering real-time decision support to streamline endoscopy and enhance clinical outcomes.展开更多
BACKGROUND 5-aminosalicylates(5-ASA)are the primary treatment for mild to moderate ulcerative colitis(UC).Maintenance therapy with 5-ASA has been shown to reduce both the risk of relapse and colorectal cancer.AIM To e...BACKGROUND 5-aminosalicylates(5-ASA)are the primary treatment for mild to moderate ulcerative colitis(UC).Maintenance therapy with 5-ASA has been shown to reduce both the risk of relapse and colorectal cancer.AIM To evaluate the outcomes of 5-ASA withdrawal due to non-adherence in UC patients while in remission on monotherapy.METHODS Adult patients with UC who were followed up between July 2019 and April 2025 were screened.Patients in remission receiving 5-ASA monotherapy who experienced treatment withdrawal due to non-adherence were included in this study.RESULTS Among 880 patients with UC,30(3.4%)had 5-ASA withdrawal due to nonadherence while in remission on monotherapy.Twelve patients(40%)had disease relapse after a median of 20 months.The rate of patients in remission was 89%in the first year,decreasing to 73%in the second year,and to 64%in the third year.There were no significant differences between patients with and without relapse in terms of demographics,disease extent,remission duration before 5-ASA withdrawal,previous medications,steroid dependence,5-ASA formulation,baseline inflammatory markers,or partial and endoscopic Mayo scores.Most patients(75%)who experienced relapse were successfully treated with 5-ASA monotherapy,while one-fourth of them required corticosteroids.No patients required biologic agents,hospitalization,or surgical intervention.CONCLUSION Intermittent therapy may be safe and feasible for UC patients,especially those in long-term remission,with treatment interruption up to one year considered acceptable.展开更多
This invited commentary discusses the recent study by Atay et al,which investigated relapse rates following the spontaneous withdrawal of maintenance 5-aminosalicylates in ulcerative colitis.The discussion focuses,in ...This invited commentary discusses the recent study by Atay et al,which investigated relapse rates following the spontaneous withdrawal of maintenance 5-aminosalicylates in ulcerative colitis.The discussion focuses,in this patient setting,on the possible reasons that might prompt clinicians to pursue such exit strategies,and on the importance of exercising caution in these decisions,given the extremely narrow subsets of patients for whom international guidelines allow any degree of leeway.展开更多
In order to grasp the relationship between farmers'willingness and behavior to withdraw from rural homesteads,based on the theory of planned behavior,a survey was conducted in Jizhou District,Tianjin using conveni...In order to grasp the relationship between farmers'willingness and behavior to withdraw from rural homesteads,based on the theory of planned behavior,a survey was conducted in Jizhou District,Tianjin using convenience sampling method.A total of 443 valid questionnaires were collected and they were analyzed by SPSS.The results are as follows.(i)The willingness of farmers to withdraw from rural homesteads is affected by pre-cognitive factors such as behavioral attitude,subject norm and perceived behavior control.(ii)Among the benefits that can be brought by the withdrawal of homesteads,farmers value the improvement of the housing environment the most.(iii)Family members'view and relatives and neighbors'withdrawing from homesteads also exerts greater pressure on farmers.(iv)Farmers generally lack trust in the village committees or government departments'claims.(v)The cost of relocation also restricts the perceived behavior control of farmers'homesteads withdrawing.Based on above result,the following suggestions are made:strengthening policy publicity,raising farmers'awareness of policies related to the withdrawal of homesteads,fully respecting farmers'wishes,promoting the withdrawal of rural homesteads in an orderly manner,expanding the scope of compensation for withdrawal of rural homesteads,and enriching compensation methods.展开更多
Severe AWS （alcohol withdrawal syndrome） and AWD （alcohol withdrawal associated delirium） are common indications for intensive care unit admissions. Approximately 25% of patients with severe alcohol withdrawal req...Severe AWS （alcohol withdrawal syndrome） and AWD （alcohol withdrawal associated delirium） are common indications for intensive care unit admissions. Approximately 25% of patients with severe alcohol withdrawal require prolonged critical care hospital courses, often complicated by respiratory failure, need for mechanical ventilation due to administration of sedative continuous infusions and development of nosocomial infections. Although benzodiazepines are the mainstay of therapy for alcohol withdrawal, some patients exhibit benzodiazepine-refractory alcohol withdrawal. The use of phenobarbital as adjunct to benzodiazepines has been shown in studies to be effective in enhancing therapeutic responsiveness to benzodiazepines and reducing the need for mechanical ventilation. The objective of this study is to evaluate whether severe alcohol withdrawal treatment based on combining symptom-triggered benzodiazepine therapy with adjunctive phenobarbital will result in decreased mechanical ventilation rates, decreased use of continuous sedative infusions, decreased time to withdrawal symptom resolution and decreased length of stay in the intensive care unit. Chart reviews were utilized to determine total amount of benzodiazepine and phenobarbital use, need for mechanical ventilation, requirement of continuous lorazepam, dexmedetomidine or propofol infusions, average intensive care unit length of stay and incidence of adverse effects.展开更多
A nickel base single crystal （SC） superalloy was directionally solidified using liquid metal cooling （LMC） process at various withdrawal rates. The microstructure was refined as increasing the withdrawal rate from...A nickel base single crystal （SC） superalloy was directionally solidified using liquid metal cooling （LMC） process at various withdrawal rates. The microstructure was refined as increasing the withdrawal rate from 3 to 12 mm/min. However, higher withdrawal rate of 15 mm/min induced the formation of stray grains. Size and volume fraction of the eutectics were found to decrease with the increasing in withdrawal rate. After solution heat treatment at 1250℃, un-dissolved eutectic was observed in specimens. High temperature creep rupture life was observed to be very sensitive to the fraction of these remaining eutectics. Creep rupture tests at 1000℃/235 MPa showed that refined microstructure and low fraction of the remaining eutectic lead to significant improvement of the rupture life.展开更多
The amount of water withdrawn by wells is one of the quantitative variables that can be applied to estimate groundwater resources and further evaluate the human influence on groundwater systems. The accuracy for the c...The amount of water withdrawn by wells is one of the quantitative variables that can be applied to estimate groundwater resources and further evaluate the human influence on groundwater systems. The accuracy for the calculation of the amount of water withdrawal significantly influences the regional groundwater resource evaluation and management. However, the decentralized groundwater pumping, inefficient management, measurement errors and uncertainties have resulted in considerable errors in the groundwater withdrawal estimation. In this study, to improve the estimation of the groundwater withdrawal, an innovative approach was proposed using an inversion method based on a regional groundwater flow numerical model, and this method was then applied in the North China Plain. The principle of the method was matching the simulated water levels with the observation ones by adjusting the amount of groundwater withdrawal. In addition, uncertainty analysis of hydraulic conductivity and specific yield for the estimation of the groundwater withdrawal was conducted. By using the proposed inversion method, the estimated annual average groundwater withdrawal was approximately 24.92×10^9 m^3 in the North China Plain from 2002 to 2008. The inversion method also significantly improved the simulation results for both hydrograph and the flow field. Results of the uncertainty analysis showed that the hydraulic conductivity was more sensitive to the inversion results than the specific yield.展开更多
Two tests initiated by unscrammed control rod withdrawal were performed on the High Temperature GasCooled Reactor-Test Module(HTR-10) in November 2003 after the reactor achieved its full power, and the test conditions...Two tests initiated by unscrammed control rod withdrawal were performed on the High Temperature GasCooled Reactor-Test Module(HTR-10) in November 2003 after the reactor achieved its full power, and the test conditions represented a typical transient scenario of modular high-temperature reactors(HTRs), called pressurized loss of forced cooling, and anticipated transient without scram.Based on the test parameters, the HTR-10 thermal behaviors under the test conditions were studied with the help of the system analysis code THERMIX. The combination of the test results and the investigation results makes the HTR-10 safety potential better understood. Key phenomena, such as the helium natural circulation and the temperature redistribution in the reactor, were revealed. As the safety feature of most significance, there is a large margin between the maximum fuel temperature and its safety limit in each test. Temperatures of thermocouples in different components were calculated by THERMIX and compared with the test values. The applicability of the code was verified by good agreement obtained from the comparison.展开更多
The global community has prepared for the withdrawal of the U.S. from the Paris Agreement since Donald Trump was elected as the president of the U.S. However, Trump's formal declaration of withdrawal still caused ...The global community has prepared for the withdrawal of the U.S. from the Paris Agreement since Donald Trump was elected as the president of the U.S. However, Trump's formal declaration of withdrawal still caused worldwide reaction. Trump will use the withdrawal to build his political reputation and to renegotiate the Paris Agreement despite its negative effects on the political credibility, international relationships, and potential long-term economic growth of the U.S. In general, the withdrawal of the U.S. from the Paris Agreement will not change the development of low-carbon technologies and the transformation trend of the global climate governance regime. However, the long-term goals and international cooperation on climate change will be affected by budget cuts in American climate change research and the cancelation of donations from the multilateral environmental fund of the U.S. If the Paris Agreement is renegotiated, the common but differentiated principle of responsibility of the United Nations Framework Convention on Climate Change will be challenged again. Nevertheless, climate change governance remains a main theme of future sustainable development. Instead of national governments, local governments and non-governmental organizations will develop strategies for technical innovation and emphasize pragmatic cooperation, thus expanding their roles in climate change governance. The capacity building on climate change research and public awareness should be enhanced as a long-term objective of global climate change governance.展开更多
One-dimensional consolidation of visco-elastic aquitard due to withdrawal of deep-groundwater was studied.Merchant model was used to simulate visco-elastic characteristic of aquitard.General solutions of the governing...One-dimensional consolidation of visco-elastic aquitard due to withdrawal of deep-groundwater was studied.Merchant model was used to simulate visco-elastic characteristic of aquitard.General solutions of the governing equation were obtained by applying Laplace transform with respect to time,and then the pore-pressure,strain and deformation of the aquitard could be calculated by Laplace inversion.A case was analyzed to validate the correctness of the present method.Finally,some consolidation properties of the problem were analyzed.Comparison of the average degree of consolidation defined by pore pressure with that defined by settlement shows that they are different and the maximum difference is 22.8%.The influences of parameters of Merchant model and the rate of the water level on the consolidation are great.The smaller the viscosity coefficient is,the later the rate of consolidation decreases.The rate of consolidation is decreased with the decrease of the rate of the water level fall.Therefore,the lagged effect of land subsidence should be considered in the actual project.展开更多
Oligodendrocyte (OL) and myelin development are crucial for network integration and are associated with higher brain functions. Accumulating evidence has demonstrated structural and functional impairment of OLs and my...Oligodendrocyte (OL) and myelin development are crucial for network integration and are associated with higher brain functions. Accumulating evidence has demonstrated structural and functional impairment of OLs and myelin in serious mental illnesses. However, whether these deficits contribute to the brain dysfunction or pathogenesis of such diseases still lacks direct evidence. In this study, we conditionally deleted Olig2 in oligodendroglial lineage cells (Olig2 cKO) and screened the behavioral changes in adult mice. We found that Olig2 ablation impaired myelin development, which further resulted in severe hypomyelination in the anterior cingulate cortex. Strikingly, Olig2 cKO mice exhibited an anxious phenotype, aberrant responses to stress, and cognitive deficits. Moreover, Olig2 cKO mice showed increased vulnerability to social avoidance under the mild stress of social isolation. Together,these results indicate that developmental deficits in OL and myelin lead to cognitive impairment and increase the risk of phenotypes reminiscent of mental illnesses.展开更多
Anti-tumour necrosis factor α(anti-TNFα) therapy is an established treatment in inflammatory bowel disease.However, this treatment is associated with high costs and the possibility of severe adverse events represent...Anti-tumour necrosis factor α(anti-TNFα) therapy is an established treatment in inflammatory bowel disease.However, this treatment is associated with high costs and the possibility of severe adverse events representing a true challenge for patients, clinicians and health care systems.Consequently, a crucial question is raised namely if therapy can be stopped once remission is achieved and if so, how and in whom.Additionally, in a real-life clinical setting, discontinuation may also be considered for other reasons such as the patient's preference, pregnancy, social reasons as moving to countries or continents with less access, or different local policy or reimbursement.In contrast to initiation of anti-TNFα therapy guidelines regarding stopping of this treatment are missing.As a result, the decision of discontinuation is still a challenging aspect in the use of anti-TNFα therapy.Currently this is typically based on an estimated, case-by-case, benefit-risk ratio.This editorial is intended to provide an overview of recent data on this topic and shed light on the proposed drug withdrawal strategies.展开更多
BACKGROUND： Following morphine withdrawal, anxiety is associated with abnormal norepinephrine content change. However, increasing blood lactic acid content can induce anxiety or panic in patients with anxiety disorde...BACKGROUND： Following morphine withdrawal, anxiety is associated with abnormal norepinephrine content change. However, increasing blood lactic acid content can induce anxiety or panic in patients with anxiety disorder or endogenous opioid peptide functional disorder. OBJECTIVE： This study was designed to observe the effects of electro-acupuncture, at the ＂Sanyinjiao＂ point （SP 6）, on brain tissue norepinephrine and blood lactic acid content in anxiety-model mice after morphine withdrawal. DESIGN： A randomized controlled animal experiment. SETTING： This study was performed in the Laboratory of Acupuncture, Electro-acupuncture ＆ Tuina College, Chengdu University of Traditional Chinese Medicine, from June to September 2001. MATERIALS： A total of 50 healthy Kunming male mice were provided by the Laboratory Animal Center of Chengdu University of Traditional Chinese Medicine. The protocol was performed in accordance with ethical guidelines stated in the Guide for the use and care of laboratory animals, approved by the Committee on the Care and Use of Laboratory Animals of the Institute of Laboratory Animal Resources Commission on Life Sciences, National Research Council, China （1985）. Experimental reagents and equipment used were as follows： morphine hydrochloride （Lot No. 930503, Shenyang No.1 Pharmaceutical Factory, China）, norepinephrine （Sigma Chemical Company, USA）, fluorospectrophotometer （RF-510, Shimadzu Corporation, Japan）, Han electro-acupuncture apparatus （WQ 1002, No. zun （91）-227270-588, Beijing Anlong Photoelectricity-Technique Company, China）, and T-maze （self-made）. METHODS： A total of 50 mice were randomly divided into 5 groups, with 10 mice in each group： blank control, T-maze, model, model ＋ electro-acupuncture, and electro-acupuncture groups. Establishment of anxiety model after morphine withdrawal： the mouse hot plate assay was used to detect the activity of morphine. The median effective dose of morphine, 2.95 mg/kg, was defined as the base. Mice were subcutaneously administered morphine, 3 times a day, for 4 days successively （initially 2.95 mg/kg, then increased day by day, as described below）. Interventions： In the model ＋ electro-acupuncture group, after model induction, mice were subjected electro-acupuncture at bilateral ＂Sanyinjiao＂ （SP6） points using a Han electro-acupuncture apparatus with sparse-dense waves and frequency of 2-100 Hz, once a day, for 6 days. In the model group, after anxiety-model induction, mice were subjected to fixation as same as model ＋ electro-acupuncture group within 6 days of model induction. In the electro-acupuncture group, the anxiety model was not induced and mice were subjected to fixation, electro-acupuncture and the T-maze test. In the T-maze group, the anxiety model was not induced and mice were subjected to fixation. The T-maze test was performed in the 4 groups after experiment. In the blank control group, the anxiety model was not induced and mice were subjected to fixation only. MAIN OUTCOME MEASURES： Brain tissue norepinephrine content of morphine-withdrawal anxiety mice was detected by fluorospectrophotometry after 6 days of electro-acupuncture. Blood lactic acid content was detected by visible spectrophotometry. RESULTS： A total of 50 mice were included in the final analysis. Brain norepinephrine content was significantly greater in the model group compared to the T-maze, blank control, electro-acupuncture and model ＋ electro-acupuncture groups, （P 〈 0.05-0.01）. Brain norepinephrine content was similar between the model ＋ electro-acupuncture and the blank control groups （P 〉 0.05）. There was no significant difference in blood lactic acid content among the groups （P 〉 0.05）. CONCLUSION： Electro-acupuncture lowers brain norepinephrine content but does not influence peripheral blood lactic acid content in morphine-withdrawn, anxiety-modeled mice. These results demonstrate that anxiety-inhibiting effects of electro-acupuncture, after morphine withdrawal, might be related to regulation of norepinephrine release.展开更多
Based on the Computable General Equilibrium (CGE) model and scenario analysis, the impacts of the U.S. withdrawal from the Paris Agreement on the carbon emission space and mitigation cost in China, European Union (EU)...Based on the Computable General Equilibrium (CGE) model and scenario analysis, the impacts of the U.S. withdrawal from the Paris Agreement on the carbon emission space and mitigation cost in China, European Union (EU), and Japan are assessed under Nationally Determined Contributions (NDCs) and 2 C scenarios due to the changed emission pathway of the U.S. The results show that, under the condition of constant global cumulative carbon emissions and a fixed burden-sharing scheme among countries, the failure of the U.S. to honor its NDC commitment to different degrees will increase the U.S. carbon emission space and decrease its mitigation cost. However, the carbon emission space of other parties, including China, EU, and Japan, will be reduced and their mitigation costs will be increased. In 2030, under the 2 C target, the carbon price will increase by 4.4e14.6 US$ t1 in China, by 9.7e35.4 US$ t1 in the EU, and by 16.0e53.5 US$ t1 in Japan. In addition, China, EU, and Japan will incur additional Gross Domestic Production (GDP) loss. Under the 2 C target, the GDP loss of China would increase by US$22.0e71.1 billion (equivalent to 16.4e53.1 US$ per capita), the EU's GDP loss would increase by US$9.4e32.1 billion (equivalent to 20.7e71.1 US$ per capita), and Japan's GDP loss will increase by US$4.1e13.5 billion (equivalent to 34.3e111.6 US$ per capita).展开更多
AIM: To evaluate association(s) between withdrawal time and polyp detection in various bowel preparation qualities. METHODS: Retrospective cohort analysis of screening colonoscopies performed between January 2005 and ...AIM: To evaluate association(s) between withdrawal time and polyp detection in various bowel preparation qualities. METHODS: Retrospective cohort analysis of screening colonoscopies performed between January 2005 and June 2011 for patients with average risk of colorectal cancer. Exclusion criteria included patients with a personal history of adenomatous polyps or colon cancer, prior colonic resection, significant family history of colorectal cancer, screening colonoscopy after other abnormal screening tests such as flexible sigmoidoscopy or barium enema, and screening colonoscopies during in-patient care. All procedures were performed or directly supervised by gastroenterologists. Main measurements were number of colonic segments with polyps and total number of colonic polyps.RESULTS: Multivariate analysis of 8331 colonosco-pies showed longer withdrawal time was associated with more colonic segments with polyps in good(adjusted OR = 1.16; 95%CI: 1.13-1.19), fair(OR = 1.13; 95%CI: 1.10-1.17), and poor(OR = 1.18; 95%CI: 1.11-1.26) bowel preparation qualities. A higher number of total polyps was associated with longer withdrawal time in good(OR = 1.15; 95%CI: 1.13-1.18), fair(OR = 1.13; 95%CI: 1.10-1.16), and poor(OR = 1.20; 95%CI: 1.13-1.29) bowel preparation qualities. Longer withdrawal time was not associated with more colonic segments with polyps or greater number of colonic polyps in bowel preparations with excellent(OR = 1.07, 95%CI: 0.99-1.26; OR = 1.11, 95%CI: 0.99-1.24, respectively) and very poor(OR = 1.02, 95%CI: 0.99-1.12; OR = 1.05, 95%CI: 0.99-1.10, respectively) qualities.CONCLUSION: Longer withdrawal time is not associated with higher polyp number detected in colonoscopies with excellent or very poor bowel preparation quality.展开更多
Anti-virus prophylactic therapy may be not nec- essary for the prevention of hepatitis B virus （HBV） recur- rence after HBV-related liver transplantation （LT）. However, studies on completely stopping the hepatitis...Anti-virus prophylactic therapy may be not nec- essary for the prevention of hepatitis B virus （HBV） recur- rence after HBV-related liver transplantation （LT）. However, studies on completely stopping the hepatitis B immune globu- lin （HBIG） and nucleos（t）ide analogs （NUC） after LT are few. The aim of the current study was to evaluate the safety of anti- virus prophylaxis withdrawal in liver recipients whose serum hepatitis B e antigen （HBeAg） and HBV DNA are negative. We analyzed 190 patients undergone LT for HBV-related liver dis- ease from 2006 to 2012 and found that 10 patients completely stopped the HBIG and NUC due to poor compliance. These patients were liver biopsied and checked monthly with serum HBV markers, HBV DNA and liver function. Among the 10 patients, 9 did not show the signs of HBV recurrence after a mean follow-up of 51.6 months （range 20-73） after with- drawal of the HBIG and NUC. The average time from LT to the withdrawal of the anti-virus drug was 23.8 （13-42） months; one patient showed hepatitis B surface antigen-positive and detectable HBV DNA after stopping anti-virus drugs and this patient was successfully treated with entecavir. Our data sug- gested that complete withdrawal of anti-virus prophylaxis was safe and feasible for patients whose serum HBeAg and HBV DNA were negative at the time of LT.展开更多
The composition of a slag system has been shown to be particularly important and influential for the new technology of electroslag remelting withdrawal process.The oxidation of the GH984G alloy elements,in contact wit...The composition of a slag system has been shown to be particularly important and influential for the new technology of electroslag remelting withdrawal process.The oxidation of the GH984G alloy elements,in contact with different contents of CaF_(2)–CaO–Al_(2)O_(3)–MgO–TiO_(2)–SiO_(2)in various slag systems,has been investigated in the present study by performing slag–metal equilibrium experiments and ion and molecule coexistence theory analysis.The results show that CaF_(2)and MgO have only a minor effect on the oxidation rates of Al and Ti in the GH984G superalloys.However,it was found that SiO_(2)would intensify the oxidation degree of Al and Ti,and Al was found to become easier oxidized than Ti.Moreover,CaO was found to reduce the activity of SiO_(2)and,thereby,also the oxidation degree of Al and Ti.Also,TiO_(2)was found to reduce the oxidation rate of Ti and instead increase the oxidation rate of Al.Finally,the effect of Al_(2)O_(3)on the oxidation of Al and Ti was observed to be opposite to that of TiO_(2).The calculated results were found to be in good agreement with experimental measurements.Moreover,viscosity experiments showed that CaO would rapidly increase the viscosity of the slag at low temperatures,and that the viscosity of the slag would increase with an increase in SiO_(2)content.展开更多
Objective:This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture(EA)among male inpatients with a diagnosis of alcohol dependence and comorbid protrac...Objective:This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture(EA)among male inpatients with a diagnosis of alcohol dependence and comorbid protracted alcohol withdrawal symptoms(PAWS).Methods:A total of 62 participants who met the inclusion criteria were enrolled in a two-arm randomized,placebo controlled,patients-blind trial and allocated to an escitalopram with real-EA group(realEA group,patients=31)and an escitalopram with sham-EA group(sham-EA group,patients=31),respectively.In addition to the oral administration of escitalopram for total four weeks,patients in each group received corresponding EA treatment five days per week and two days off for consecutive four weeks.Both serum homocysteine(Hcy)test and electrophysiological tests,including event-related potentials(ERPs)and exploratory eye movement(EEM)were performed at pre-and post-treatment.Additionally,the global scores of Penn Alcohol Craving Scale(PACS),17-items Hamilton Depression Rating Scale(HAMD-17),and Hamilton Anxiety Scale(HAMA)were used for assessing the subjective emotion experience of patients,respectively.Meanwhile,adverse effects were monitored and recorded.Results:After four-week treatment,the global scores of PACS and HAMD-17 declined significantly in both groups(both P<0.05).Furthermore,the decline in the real-EA group was superior to that in the shamEA group(P<0.05).Meanwhile,the total scores of HAMA only decreased in the real-EA group(P<0.05)but not in the sham-EA group(P>0.05).According to the parameters of ERPs,significant declines for N2PL,P3PL,and P3amp were observed in both two groups(all P<0.05),and the decreases for P3PL and P3amp in the real-EA group was much superior to that in the sham-EA group(both P<0.05).According to the parameters of EEM,significant increase for NEF was observed only in the real-EA group(P<0.05).Besides,there was a dramatic decline for serum Hcy level only in the real-EA group(P<0.05).One case in the sham-EA group withdrew from the trial due to self-reported nausea and bitter taste,and outcomes of the remaining 61 patients were adopted for analysis.Conclusion:(1)Escitalopram with EA may be a potential alternative therapy for mitigating PAWS among male inpatients with alcohol dependence.(2)Escitalopram with EA might improve the alcoholdependence induced cognitive dysfunctions via upregulating the expression of Hcy.展开更多
基金Shenzhen Science and Technology Program(JSGG20220831092800001)。
文摘The microstructure of single crystal superalloy is relatively simple,consisting primarily ofγdendrites andγ/γ′eutectics.During the directional solidification process of Ni-based single crystal superalloys,withdrawal rate is a critical parameter affecting the spatial distribution ofγ/γ′eutectic along gravity direction.The results show that theγ/γ′eutectic fraction of the upper platform surface is always higher than that of the lower one,regardless of withdrawal rate.As the withdrawal rate decreases,there is a significant increase inγ/γ′eutectic fraction on the upper surface,while it decreases on the lower surface.The upward accumulation ofγ/γ′eutectic becomes more severe as the withdrawal rate decreases.It is also found that the percentage of Al+Ta is positively correlated with theγ/γ′eutectic fraction.Thermo-solute convection of Al and Ta solutes in the solidification front is the prime reason for the non-uniform distribution of eutectic.The non-uniform distribution ofγ/γ′eutectic cannot be eliminated even after subsequent solution heat treatment,resulting in excess eutectic on the upper surface and thus leading to the scrapping of the blade.
基金Supported by the R+D Project funded by the Spanish Ministry of Science and Innovation MCIN/AEI/10.13039/501100011033 and by FEDER,EU,No.PID2021-122987OA-I00.
文摘BACKGROUND Psychotic disorders are characterized by both positive symptoms(hallucinations,delusions)and negative symptoms(emotional blunting,anhedonia)that impair daily functioning.While antipsychotic drugs and psychological interventions are effective when addressing positive symptoms,treatment of negative symptoms remains an ongoing challenge.Mindfulness-based interventions(MBIs)have been shown to reduce negative psychotic symptoms.However,as negative psychotic symptoms are assessed as a sole entity rather than a sum of manifestations,the effect of MBIs remains unclear.AIM To examine the effects of MBI in addition to integrated rehabilitation treatment(IRT)for people experiencing psychosis on each of the negative psychotic symptoms.METHODS A randomized controlled clinical trial with preintervention and postintervention measures was designed.The main outcome variable was negative psychotic symptoms assessed through the seven subscales of the Spanish version of the positive and negative syndrome scale.Data were analyzed using a repeated measures analysis of variance and reliable change index calculation.RESULTS There were no statistical differences between groups at the preintervention assessment.Statistically significant differences were found after MBI for the time in emotional withdrawal(F=37.75,P<0.001,η2=0.437)and social withdrawal(F=37.75,P<0.001,η2=0.437).CONCLUSION MBI added to IRT reduced the lack of interest and involvement with affective commitment to daily life activities,and interest and engagement in social activities increased.These negative psychotic symptoms were not improved by IRT alone.
基金Supported by the Young and Middle-Aged Talents Program of Wuxi Health Commission,No.BJ2020011Cohort Research Program of Wuxi Medical Center,Nanjing Medical University,No.WMCC202314Wuxi People’s Hospital 2024“Wild Goose Array Talent”Reserve Discipline Leader,No.2024-YZ-HBDTR-YC-2024.
文摘BACKGROUND Adenoma detection rate(ADR),a key colonoscopy quality metric,varies with patient demographics and procedural factors.AIM To identify independent predictors of≥25%ADR,develop a risk model,and propose withdrawal durations based on different insertion times.METHODS We retrospectively analyzed 830 cases using logistic regression and identified four key factors,validated in a prospective cohort of 5699 patients.Their importance was confirmed using random forest(RF),extreme gradient boosting(XGBoost)and light gradient boosting machine(LightGBM).Attempts to determine targetachieving withdrawal time by grouping cases based on insertion time and Cox regression were inconclusive.Using the 5699-case dataset,we developed a predictive model combining support vector machine(SVM)with XGBoost.We built a Shiny app using this model for clinical application.RESULTS Multivariate logistic regression identified age[odds ratio(OR)=1.05;95%confidence interval(CI):1.03-1.08;P<0.001],male(OR=1.79;95%CI:1.32-2.41;P=0.005),higher endoscopist experience(OR=1.79;95%CI:1.20-2.68;P=0.005),and longer withdrawal time(P<0.001)as independent risk factors for colorectal adenoma.A nomogram demonstrated strong discrimination[area under the curve(AUC)=0.720],with robust calibration and decision-curve performance.Feature importance via RF,XGBoost,and LightGBM confirmed key predictors.A hybrid model combining SVM regression for withdrawal-time estimation and XGBoost classification achieved stable results,with XGBoost reporting AUCs of 0.640 in training and 0.610 in testing,and similar validation outcomes.Deployed via a Shiny app for clinical use.However,model discrimination was modest(AUC:0.61-0.64),suggesting that clinical utility requires further refinement.CONCLUSION A hybrid SVM-XGBoost model using four key endoscopic factors was independently validated and is available as a Shiny app,delivering real-time decision support to streamline endoscopy and enhance clinical outcomes.
文摘BACKGROUND 5-aminosalicylates(5-ASA)are the primary treatment for mild to moderate ulcerative colitis(UC).Maintenance therapy with 5-ASA has been shown to reduce both the risk of relapse and colorectal cancer.AIM To evaluate the outcomes of 5-ASA withdrawal due to non-adherence in UC patients while in remission on monotherapy.METHODS Adult patients with UC who were followed up between July 2019 and April 2025 were screened.Patients in remission receiving 5-ASA monotherapy who experienced treatment withdrawal due to non-adherence were included in this study.RESULTS Among 880 patients with UC,30(3.4%)had 5-ASA withdrawal due to nonadherence while in remission on monotherapy.Twelve patients(40%)had disease relapse after a median of 20 months.The rate of patients in remission was 89%in the first year,decreasing to 73%in the second year,and to 64%in the third year.There were no significant differences between patients with and without relapse in terms of demographics,disease extent,remission duration before 5-ASA withdrawal,previous medications,steroid dependence,5-ASA formulation,baseline inflammatory markers,or partial and endoscopic Mayo scores.Most patients(75%)who experienced relapse were successfully treated with 5-ASA monotherapy,while one-fourth of them required corticosteroids.No patients required biologic agents,hospitalization,or surgical intervention.CONCLUSION Intermittent therapy may be safe and feasible for UC patients,especially those in long-term remission,with treatment interruption up to one year considered acceptable.
文摘This invited commentary discusses the recent study by Atay et al,which investigated relapse rates following the spontaneous withdrawal of maintenance 5-aminosalicylates in ulcerative colitis.The discussion focuses,in this patient setting,on the possible reasons that might prompt clinicians to pursue such exit strategies,and on the importance of exercising caution in these decisions,given the extremely narrow subsets of patients for whom international guidelines allow any degree of leeway.
基金Tianjin Suburban Development Investigation and Research Project in 2019:Research on Rural Collective Property Rights System Reform and Development in Jizhou District.
文摘In order to grasp the relationship between farmers'willingness and behavior to withdraw from rural homesteads,based on the theory of planned behavior,a survey was conducted in Jizhou District,Tianjin using convenience sampling method.A total of 443 valid questionnaires were collected and they were analyzed by SPSS.The results are as follows.(i)The willingness of farmers to withdraw from rural homesteads is affected by pre-cognitive factors such as behavioral attitude,subject norm and perceived behavior control.(ii)Among the benefits that can be brought by the withdrawal of homesteads,farmers value the improvement of the housing environment the most.(iii)Family members'view and relatives and neighbors'withdrawing from homesteads also exerts greater pressure on farmers.(iv)Farmers generally lack trust in the village committees or government departments'claims.(v)The cost of relocation also restricts the perceived behavior control of farmers'homesteads withdrawing.Based on above result,the following suggestions are made:strengthening policy publicity,raising farmers'awareness of policies related to the withdrawal of homesteads,fully respecting farmers'wishes,promoting the withdrawal of rural homesteads in an orderly manner,expanding the scope of compensation for withdrawal of rural homesteads,and enriching compensation methods.
文摘Severe AWS （alcohol withdrawal syndrome） and AWD （alcohol withdrawal associated delirium） are common indications for intensive care unit admissions. Approximately 25% of patients with severe alcohol withdrawal require prolonged critical care hospital courses, often complicated by respiratory failure, need for mechanical ventilation due to administration of sedative continuous infusions and development of nosocomial infections. Although benzodiazepines are the mainstay of therapy for alcohol withdrawal, some patients exhibit benzodiazepine-refractory alcohol withdrawal. The use of phenobarbital as adjunct to benzodiazepines has been shown in studies to be effective in enhancing therapeutic responsiveness to benzodiazepines and reducing the need for mechanical ventilation. The objective of this study is to evaluate whether severe alcohol withdrawal treatment based on combining symptom-triggered benzodiazepine therapy with adjunctive phenobarbital will result in decreased mechanical ventilation rates, decreased use of continuous sedative infusions, decreased time to withdrawal symptom resolution and decreased length of stay in the intensive care unit. Chart reviews were utilized to determine total amount of benzodiazepine and phenobarbital use, need for mechanical ventilation, requirement of continuous lorazepam, dexmedetomidine or propofol infusions, average intensive care unit length of stay and incidence of adverse effects.
文摘A nickel base single crystal （SC） superalloy was directionally solidified using liquid metal cooling （LMC） process at various withdrawal rates. The microstructure was refined as increasing the withdrawal rate from 3 to 12 mm/min. However, higher withdrawal rate of 15 mm/min induced the formation of stray grains. Size and volume fraction of the eutectics were found to decrease with the increasing in withdrawal rate. After solution heat treatment at 1250℃, un-dissolved eutectic was observed in specimens. High temperature creep rupture life was observed to be very sensitive to the fraction of these remaining eutectics. Creep rupture tests at 1000℃/235 MPa showed that refined microstructure and low fraction of the remaining eutectic lead to significant improvement of the rupture life.
基金supported by the National Basic Research Program of China (No. 2010CB428804)the Public Welfare Industry Special Funds for Scientific Research from Ministry of Land and Resources of China (No. 201211079-4).
文摘The amount of water withdrawn by wells is one of the quantitative variables that can be applied to estimate groundwater resources and further evaluate the human influence on groundwater systems. The accuracy for the calculation of the amount of water withdrawal significantly influences the regional groundwater resource evaluation and management. However, the decentralized groundwater pumping, inefficient management, measurement errors and uncertainties have resulted in considerable errors in the groundwater withdrawal estimation. In this study, to improve the estimation of the groundwater withdrawal, an innovative approach was proposed using an inversion method based on a regional groundwater flow numerical model, and this method was then applied in the North China Plain. The principle of the method was matching the simulated water levels with the observation ones by adjusting the amount of groundwater withdrawal. In addition, uncertainty analysis of hydraulic conductivity and specific yield for the estimation of the groundwater withdrawal was conducted. By using the proposed inversion method, the estimated annual average groundwater withdrawal was approximately 24.92×10^9 m^3 in the North China Plain from 2002 to 2008. The inversion method also significantly improved the simulation results for both hydrograph and the flow field. Results of the uncertainty analysis showed that the hydraulic conductivity was more sensitive to the inversion results than the specific yield.
基金supported by the Chinese National S&T Major Project(No.ZX069)
文摘Two tests initiated by unscrammed control rod withdrawal were performed on the High Temperature GasCooled Reactor-Test Module(HTR-10) in November 2003 after the reactor achieved its full power, and the test conditions represented a typical transient scenario of modular high-temperature reactors(HTRs), called pressurized loss of forced cooling, and anticipated transient without scram.Based on the test parameters, the HTR-10 thermal behaviors under the test conditions were studied with the help of the system analysis code THERMIX. The combination of the test results and the investigation results makes the HTR-10 safety potential better understood. Key phenomena, such as the helium natural circulation and the temperature redistribution in the reactor, were revealed. As the safety feature of most significance, there is a large margin between the maximum fuel temperature and its safety limit in each test. Temperatures of thermocouples in different components were calculated by THERMIX and compared with the test values. The applicability of the code was verified by good agreement obtained from the comparison.
文摘The global community has prepared for the withdrawal of the U.S. from the Paris Agreement since Donald Trump was elected as the president of the U.S. However, Trump's formal declaration of withdrawal still caused worldwide reaction. Trump will use the withdrawal to build his political reputation and to renegotiate the Paris Agreement despite its negative effects on the political credibility, international relationships, and potential long-term economic growth of the U.S. In general, the withdrawal of the U.S. from the Paris Agreement will not change the development of low-carbon technologies and the transformation trend of the global climate governance regime. However, the long-term goals and international cooperation on climate change will be affected by budget cuts in American climate change research and the cancelation of donations from the multilateral environmental fund of the U.S. If the Paris Agreement is renegotiated, the common but differentiated principle of responsibility of the United Nations Framework Convention on Climate Change will be challenged again. Nevertheless, climate change governance remains a main theme of future sustainable development. Instead of national governments, local governments and non-governmental organizations will develop strategies for technical innovation and emphasize pragmatic cooperation, thus expanding their roles in climate change governance. The capacity building on climate change research and public awareness should be enhanced as a long-term objective of global climate change governance.
基金Project(50608038/E0806) supported by the National Natural Science Foundation of China
文摘One-dimensional consolidation of visco-elastic aquitard due to withdrawal of deep-groundwater was studied.Merchant model was used to simulate visco-elastic characteristic of aquitard.General solutions of the governing equation were obtained by applying Laplace transform with respect to time,and then the pore-pressure,strain and deformation of the aquitard could be calculated by Laplace inversion.A case was analyzed to validate the correctness of the present method.Finally,some consolidation properties of the problem were analyzed.Comparison of the average degree of consolidation defined by pore pressure with that defined by settlement shows that they are different and the maximum difference is 22.8%.The influences of parameters of Merchant model and the rate of the water level on the consolidation are great.The smaller the viscosity coefficient is,the later the rate of consolidation decreases.The rate of consolidation is decreased with the decrease of the rate of the water level fall.Therefore,the lagged effect of land subsidence should be considered in the actual project.
基金supported by the National Natural Science Foundation of China (31671117).
文摘Oligodendrocyte (OL) and myelin development are crucial for network integration and are associated with higher brain functions. Accumulating evidence has demonstrated structural and functional impairment of OLs and myelin in serious mental illnesses. However, whether these deficits contribute to the brain dysfunction or pathogenesis of such diseases still lacks direct evidence. In this study, we conditionally deleted Olig2 in oligodendroglial lineage cells (Olig2 cKO) and screened the behavioral changes in adult mice. We found that Olig2 ablation impaired myelin development, which further resulted in severe hypomyelination in the anterior cingulate cortex. Strikingly, Olig2 cKO mice exhibited an anxious phenotype, aberrant responses to stress, and cognitive deficits. Moreover, Olig2 cKO mice showed increased vulnerability to social avoidance under the mild stress of social isolation. Together,these results indicate that developmental deficits in OL and myelin lead to cognitive impairment and increase the risk of phenotypes reminiscent of mental illnesses.
文摘Anti-tumour necrosis factor α(anti-TNFα) therapy is an established treatment in inflammatory bowel disease.However, this treatment is associated with high costs and the possibility of severe adverse events representing a true challenge for patients, clinicians and health care systems.Consequently, a crucial question is raised namely if therapy can be stopped once remission is achieved and if so, how and in whom.Additionally, in a real-life clinical setting, discontinuation may also be considered for other reasons such as the patient's preference, pregnancy, social reasons as moving to countries or continents with less access, or different local policy or reimbursement.In contrast to initiation of anti-TNFα therapy guidelines regarding stopping of this treatment are missing.As a result, the decision of discontinuation is still a challenging aspect in the use of anti-TNFα therapy.Currently this is typically based on an estimated, case-by-case, benefit-risk ratio.This editorial is intended to provide an overview of recent data on this topic and shed light on the proposed drug withdrawal strategies.
基金the Grant from Administration of Traditional Chinese Medicine of Sichuan Province, No. 2000-48
文摘BACKGROUND： Following morphine withdrawal, anxiety is associated with abnormal norepinephrine content change. However, increasing blood lactic acid content can induce anxiety or panic in patients with anxiety disorder or endogenous opioid peptide functional disorder. OBJECTIVE： This study was designed to observe the effects of electro-acupuncture, at the ＂Sanyinjiao＂ point （SP 6）, on brain tissue norepinephrine and blood lactic acid content in anxiety-model mice after morphine withdrawal. DESIGN： A randomized controlled animal experiment. SETTING： This study was performed in the Laboratory of Acupuncture, Electro-acupuncture ＆ Tuina College, Chengdu University of Traditional Chinese Medicine, from June to September 2001. MATERIALS： A total of 50 healthy Kunming male mice were provided by the Laboratory Animal Center of Chengdu University of Traditional Chinese Medicine. The protocol was performed in accordance with ethical guidelines stated in the Guide for the use and care of laboratory animals, approved by the Committee on the Care and Use of Laboratory Animals of the Institute of Laboratory Animal Resources Commission on Life Sciences, National Research Council, China （1985）. Experimental reagents and equipment used were as follows： morphine hydrochloride （Lot No. 930503, Shenyang No.1 Pharmaceutical Factory, China）, norepinephrine （Sigma Chemical Company, USA）, fluorospectrophotometer （RF-510, Shimadzu Corporation, Japan）, Han electro-acupuncture apparatus （WQ 1002, No. zun （91）-227270-588, Beijing Anlong Photoelectricity-Technique Company, China）, and T-maze （self-made）. METHODS： A total of 50 mice were randomly divided into 5 groups, with 10 mice in each group： blank control, T-maze, model, model ＋ electro-acupuncture, and electro-acupuncture groups. Establishment of anxiety model after morphine withdrawal： the mouse hot plate assay was used to detect the activity of morphine. The median effective dose of morphine, 2.95 mg/kg, was defined as the base. Mice were subcutaneously administered morphine, 3 times a day, for 4 days successively （initially 2.95 mg/kg, then increased day by day, as described below）. Interventions： In the model ＋ electro-acupuncture group, after model induction, mice were subjected electro-acupuncture at bilateral ＂Sanyinjiao＂ （SP6） points using a Han electro-acupuncture apparatus with sparse-dense waves and frequency of 2-100 Hz, once a day, for 6 days. In the model group, after anxiety-model induction, mice were subjected to fixation as same as model ＋ electro-acupuncture group within 6 days of model induction. In the electro-acupuncture group, the anxiety model was not induced and mice were subjected to fixation, electro-acupuncture and the T-maze test. In the T-maze group, the anxiety model was not induced and mice were subjected to fixation. The T-maze test was performed in the 4 groups after experiment. In the blank control group, the anxiety model was not induced and mice were subjected to fixation only. MAIN OUTCOME MEASURES： Brain tissue norepinephrine content of morphine-withdrawal anxiety mice was detected by fluorospectrophotometry after 6 days of electro-acupuncture. Blood lactic acid content was detected by visible spectrophotometry. RESULTS： A total of 50 mice were included in the final analysis. Brain norepinephrine content was significantly greater in the model group compared to the T-maze, blank control, electro-acupuncture and model ＋ electro-acupuncture groups, （P 〈 0.05-0.01）. Brain norepinephrine content was similar between the model ＋ electro-acupuncture and the blank control groups （P 〉 0.05）. There was no significant difference in blood lactic acid content among the groups （P 〉 0.05）. CONCLUSION： Electro-acupuncture lowers brain norepinephrine content but does not influence peripheral blood lactic acid content in morphine-withdrawn, anxiety-modeled mice. These results demonstrate that anxiety-inhibiting effects of electro-acupuncture, after morphine withdrawal, might be related to regulation of norepinephrine release.
基金This study was supported by the 2017 National Natural Science Foundation Project “The Impacts of U.S. Withdrawal from Paris Agreement on Global Climate Governance and China's Response”.
文摘Based on the Computable General Equilibrium (CGE) model and scenario analysis, the impacts of the U.S. withdrawal from the Paris Agreement on the carbon emission space and mitigation cost in China, European Union (EU), and Japan are assessed under Nationally Determined Contributions (NDCs) and 2 C scenarios due to the changed emission pathway of the U.S. The results show that, under the condition of constant global cumulative carbon emissions and a fixed burden-sharing scheme among countries, the failure of the U.S. to honor its NDC commitment to different degrees will increase the U.S. carbon emission space and decrease its mitigation cost. However, the carbon emission space of other parties, including China, EU, and Japan, will be reduced and their mitigation costs will be increased. In 2030, under the 2 C target, the carbon price will increase by 4.4e14.6 US$ t1 in China, by 9.7e35.4 US$ t1 in the EU, and by 16.0e53.5 US$ t1 in Japan. In addition, China, EU, and Japan will incur additional Gross Domestic Production (GDP) loss. Under the 2 C target, the GDP loss of China would increase by US$22.0e71.1 billion (equivalent to 16.4e53.1 US$ per capita), the EU's GDP loss would increase by US$9.4e32.1 billion (equivalent to 20.7e71.1 US$ per capita), and Japan's GDP loss will increase by US$4.1e13.5 billion (equivalent to 34.3e111.6 US$ per capita).
文摘AIM: To evaluate association(s) between withdrawal time and polyp detection in various bowel preparation qualities. METHODS: Retrospective cohort analysis of screening colonoscopies performed between January 2005 and June 2011 for patients with average risk of colorectal cancer. Exclusion criteria included patients with a personal history of adenomatous polyps or colon cancer, prior colonic resection, significant family history of colorectal cancer, screening colonoscopy after other abnormal screening tests such as flexible sigmoidoscopy or barium enema, and screening colonoscopies during in-patient care. All procedures were performed or directly supervised by gastroenterologists. Main measurements were number of colonic segments with polyps and total number of colonic polyps.RESULTS: Multivariate analysis of 8331 colonosco-pies showed longer withdrawal time was associated with more colonic segments with polyps in good(adjusted OR = 1.16; 95%CI: 1.13-1.19), fair(OR = 1.13; 95%CI: 1.10-1.17), and poor(OR = 1.18; 95%CI: 1.11-1.26) bowel preparation qualities. A higher number of total polyps was associated with longer withdrawal time in good(OR = 1.15; 95%CI: 1.13-1.18), fair(OR = 1.13; 95%CI: 1.10-1.16), and poor(OR = 1.20; 95%CI: 1.13-1.29) bowel preparation qualities. Longer withdrawal time was not associated with more colonic segments with polyps or greater number of colonic polyps in bowel preparations with excellent(OR = 1.07, 95%CI: 0.99-1.26; OR = 1.11, 95%CI: 0.99-1.24, respectively) and very poor(OR = 1.02, 95%CI: 0.99-1.12; OR = 1.05, 95%CI: 0.99-1.10, respectively) qualities.CONCLUSION: Longer withdrawal time is not associated with higher polyp number detected in colonoscopies with excellent or very poor bowel preparation quality.
基金supported by grants from the National Natural Science Foundation of China(81373160 and 81400673)Zhejiang Provincial Natural Science Foundation of China(LQ15H030003 and LY14H160022)
文摘Anti-virus prophylactic therapy may be not nec- essary for the prevention of hepatitis B virus （HBV） recur- rence after HBV-related liver transplantation （LT）. However, studies on completely stopping the hepatitis B immune globu- lin （HBIG） and nucleos（t）ide analogs （NUC） after LT are few. The aim of the current study was to evaluate the safety of anti- virus prophylaxis withdrawal in liver recipients whose serum hepatitis B e antigen （HBeAg） and HBV DNA are negative. We analyzed 190 patients undergone LT for HBV-related liver dis- ease from 2006 to 2012 and found that 10 patients completely stopped the HBIG and NUC due to poor compliance. These patients were liver biopsied and checked monthly with serum HBV markers, HBV DNA and liver function. Among the 10 patients, 9 did not show the signs of HBV recurrence after a mean follow-up of 51.6 months （range 20-73） after with- drawal of the HBIG and NUC. The average time from LT to the withdrawal of the anti-virus drug was 23.8 （13-42） months; one patient showed hepatitis B surface antigen-positive and detectable HBV DNA after stopping anti-virus drugs and this patient was successfully treated with entecavir. Our data sug- gested that complete withdrawal of anti-virus prophylaxis was safe and feasible for patients whose serum HBeAg and HBV DNA were negative at the time of LT.
基金supported by the National Key Research and Development Program(2017YFB0305201)the National Natural Science Foundation of China(Grant Nos.51674070,51874085)"Innovation&Entrepreneurship Talents"Introduction Plan of Jiangsu Province in 2018.
文摘The composition of a slag system has been shown to be particularly important and influential for the new technology of electroslag remelting withdrawal process.The oxidation of the GH984G alloy elements,in contact with different contents of CaF_(2)–CaO–Al_(2)O_(3)–MgO–TiO_(2)–SiO_(2)in various slag systems,has been investigated in the present study by performing slag–metal equilibrium experiments and ion and molecule coexistence theory analysis.The results show that CaF_(2)and MgO have only a minor effect on the oxidation rates of Al and Ti in the GH984G superalloys.However,it was found that SiO_(2)would intensify the oxidation degree of Al and Ti,and Al was found to become easier oxidized than Ti.Moreover,CaO was found to reduce the activity of SiO_(2)and,thereby,also the oxidation degree of Al and Ti.Also,TiO_(2)was found to reduce the oxidation rate of Ti and instead increase the oxidation rate of Al.Finally,the effect of Al_(2)O_(3)on the oxidation of Al and Ti was observed to be opposite to that of TiO_(2).The calculated results were found to be in good agreement with experimental measurements.Moreover,viscosity experiments showed that CaO would rapidly increase the viscosity of the slag at low temperatures,and that the viscosity of the slag would increase with an increase in SiO_(2)content.
基金Sponsored by Scientific Research Project,Shanghai Science and Technology Committee:No.16401902600Special Project for Clinical Research,Shanghai Municipal Health Commission:No.20174Y0009。
文摘Objective:This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture(EA)among male inpatients with a diagnosis of alcohol dependence and comorbid protracted alcohol withdrawal symptoms(PAWS).Methods:A total of 62 participants who met the inclusion criteria were enrolled in a two-arm randomized,placebo controlled,patients-blind trial and allocated to an escitalopram with real-EA group(realEA group,patients=31)and an escitalopram with sham-EA group(sham-EA group,patients=31),respectively.In addition to the oral administration of escitalopram for total four weeks,patients in each group received corresponding EA treatment five days per week and two days off for consecutive four weeks.Both serum homocysteine(Hcy)test and electrophysiological tests,including event-related potentials(ERPs)and exploratory eye movement(EEM)were performed at pre-and post-treatment.Additionally,the global scores of Penn Alcohol Craving Scale(PACS),17-items Hamilton Depression Rating Scale(HAMD-17),and Hamilton Anxiety Scale(HAMA)were used for assessing the subjective emotion experience of patients,respectively.Meanwhile,adverse effects were monitored and recorded.Results:After four-week treatment,the global scores of PACS and HAMD-17 declined significantly in both groups(both P<0.05).Furthermore,the decline in the real-EA group was superior to that in the shamEA group(P<0.05).Meanwhile,the total scores of HAMA only decreased in the real-EA group(P<0.05)but not in the sham-EA group(P>0.05).According to the parameters of ERPs,significant declines for N2PL,P3PL,and P3amp were observed in both two groups(all P<0.05),and the decreases for P3PL and P3amp in the real-EA group was much superior to that in the sham-EA group(both P<0.05).According to the parameters of EEM,significant increase for NEF was observed only in the real-EA group(P<0.05).Besides,there was a dramatic decline for serum Hcy level only in the real-EA group(P<0.05).One case in the sham-EA group withdrew from the trial due to self-reported nausea and bitter taste,and outcomes of the remaining 61 patients were adopted for analysis.Conclusion:(1)Escitalopram with EA may be a potential alternative therapy for mitigating PAWS among male inpatients with alcohol dependence.(2)Escitalopram with EA might improve the alcoholdependence induced cognitive dysfunctions via upregulating the expression of Hcy.
