All-solid-state lithium ion batteries(ASSLIBs)have attracted much attention due to their high safety and increased energy density,which have become a substitute to conventional liquid electrolyte batteries[1].The deve...All-solid-state lithium ion batteries(ASSLIBs)have attracted much attention due to their high safety and increased energy density,which have become a substitute to conventional liquid electrolyte batteries[1].The development of high-performance solid electrolyte is the key to the development of solid-state battery technology.Solid-state electrolyte(SSE)materials should have high ionic conductivity,poor electronic conductivity,wide electrochemical window,and low electrode and electrolyte interface resistance.展开更多
Face centred cubic（FCC） TiB ceramic powder synthesized by Ti-boronizing method was used as conductive filler to make ceramic electrically conductive adhesives（ECAs） with the polymer matrix.Electrically conductive ...Face centred cubic（FCC） TiB ceramic powder synthesized by Ti-boronizing method was used as conductive filler to make ceramic electrically conductive adhesives（ECAs） with the polymer matrix.Electrically conductive properties of the ceramic ECAs were studied.The bulk electrical resistivity varied with the powder content of the FCC-TiB in ECAs.The FCC-TiB filled ECAs also showed the percolation behavior that usually occurred for the metal-filled ECAs,the percolation threshold was located at the content of 60%FCC-TiB.A minimum value of 0.1 Ω·cm was obtained at a content of 75%FCC-TiB.In order to check the reliability of mechanical property,tensile test was done to measure the shear strength,and the shear strength dropped with increasing the content of FCC-TiB powders.It is about 12.26 MPa at the content of 70%TiB powders.The Cu filled ECAs were also prepared for comparison.The properties of the oxidation resistance of the two ECAs were evaluated.The results show that the ceramic ECAs have excellent oxidation resistance and better stability compared with the Cu filled ECAs.展开更多
Patient-centred medicine is being adopted as national policies in many countries, encouraged by positive outcomes of the practice at clinical and organisational levels. This study examines the patient-centred health c...Patient-centred medicine is being adopted as national policies in many countries, encouraged by positive outcomes of the practice at clinical and organisational levels. This study examines the patient-centred health care reform in China, which has adopted the approach as a national policy for two decades but has yet to achieve the intended goals. Focusing on conflicting interpretations of the nature of patients at national, organisational, and individual levels, this article argues that such conflicts lead to clashes between the political agenda of the state, priorities of health organisations, professional choices of individual practitioners, and expectations of patients in the process of implementing, practicing, and receiving patient-centred health care in China. It reveals that the national health authority has intended patient-centredness as a universal, anti-market, people-centred approach, based on the health ideology of serving the people. But hospitals, compelled by financial restraints, have implemented it as a market approach centring on patients as consumers. Medical professionals and patients also possess contradictory views towards whether a patient should be perceived as a consumer. The discordance in the interpretation of the patient identity has caused great confusion in the implementation and provision of patient-centred health care. The study points out that the success of patient-centredness as national policy cannot be assumed on the basis of its success at clinical and organisational levels. More efforts are needed to coordinate the fundamental understanding of patient-centredness by different actors.展开更多
Let 0<A≤1/3 ,K(λ) be the attractor of an iterated function system {ψ1,ψ2} on the line, where 1(x)= AT, ψ1(x) = 1-λ+λx, x∈[0,1]. We call K(λ) the symmetry Cantor sets. In this paper, we obtained the exact H...Let 0<A≤1/3 ,K(λ) be the attractor of an iterated function system {ψ1,ψ2} on the line, where 1(x)= AT, ψ1(x) = 1-λ+λx, x∈[0,1]. We call K(λ) the symmetry Cantor sets. In this paper, we obtained the exact Hausdorff Centred measure of K(λ).展开更多
We use the Monte Carlo method to study an antiferromagnetical Ising spin system on a centred honeycomb lattice, which is composed of two kinds of 1/2 spin particles A and B. There exist two different bond energies JA-...We use the Monte Carlo method to study an antiferromagnetical Ising spin system on a centred honeycomb lattice, which is composed of two kinds of 1/2 spin particles A and B. There exist two different bond energies JA-A and JA--B in this lattice. Our study is focused on how the ratio of JA-B to JA--A influences the critical behaviour of this system by analysing the physical quantities, such as the energy, the order parameter, the specific heat, susceptibility, etc each as a function of temperature for a given ratio of JA-B to JA-A. Using these results together with the finite-size scaling method, we obtain a phase diagram for the ratio JA-B / JA--A. This work is helpful for studying the phase transition problem of crystals composed of compounds.展开更多
Let 0<λ_1,λ_2<1 and 1-λ_1-λ_2≥max｛λ_1,λ_2｝.Let ~K(λ_1,λ_2) be the attractor of the iterated function system ｛φ_1,φ_2｝on the line,where φ_1(x)=λ_1x and φ_2(x)=1-λ_2+λ_2x,x∈R.~K(λ_1,λ_2) is ...Let 0<λ_1,λ_2<1 and 1-λ_1-λ_2≥max｛λ_1,λ_2｝.Let ~K(λ_1,λ_2) be the attractor of the iterated function system ｛φ_1,φ_2｝on the line,where φ_1(x)=λ_1x and φ_2(x)=1-λ_2+λ_2x,x∈R.~K(λ_1,λ_2) is called a non-symmetry Cantor set. In this paper,it is proved that the exact Hausdorff centred measure of K(λ_1,λ_2) equals 2s(1-λ)s,where λ=max｛λ_1,λ_2｝ and s is the Hausdorff dimension of K(λ_1,λ_2).展开更多
For the sake of its inseparability to the science of language, English language teaching(ELT) tends to be researched,despite diverse voices within its domain, from the perspective of linguistics. It is noticeable, how...For the sake of its inseparability to the science of language, English language teaching(ELT) tends to be researched,despite diverse voices within its domain, from the perspective of linguistics. It is noticeable, however, that ELT in this research conducted is literally referred to as an educational conception, though pertinent linguistics knowledge is to be inevitably involved. Given this situation, ELT is categorised as an intra-discipline of education, establishing the basic ground of the academic enquiries throughout the context. Relevant issues are to be further examined concerning to what extent learner-centredness manifests its definition within modern pedagogical approaches and methods of ELT, so as to indicate the philosophical significance of education in language teaching. A critical insight is to be given into the limitations of learner- centredness in ELT practice through two case studies thereafter, which is expected to benefit the development of ELT professionalism in the changing practice of language education.展开更多
Located at 217 Queen sthreet in the heart of Singapore,the China Cultural Centre features gray-white walls with subtle cream accents,evoking the timeless charm of taditional Chinese architecture with its classic white...Located at 217 Queen sthreet in the heart of Singapore,the China Cultural Centre features gray-white walls with subtle cream accents,evoking the timeless charm of taditional Chinese architecture with its classic white walls and gray-tiled roof.Designed by famous singaporean architect Liu Thai Ker,the building blends traditional Chinese cultural elements with moder architectual concepts."From an aesthetic perspective,I believe it is essential to give the structure a moderm edge,Liu said in an interview with Xinhua."Therefore,the design should reflect a contempoary spirit while retaining the essence of Chinese culture."展开更多
On July 26,the International Forum on Standardization of Artificial Intelligence was held in Shanghai Expo Center.Guided by the WAIC organizing committee,the forum was hosted by the AIM Global Centre of Excellence(AIM...On July 26,the International Forum on Standardization of Artificial Intelligence was held in Shanghai Expo Center.Guided by the WAIC organizing committee,the forum was hosted by the AIM Global Centre of Excellence(AIM Global CoE),and jointly organized by China Electronics Standardization Institute(CESI),Shanghai Artificial Intelligence Research Institute(SAIRI),and Bank of China Shanghai Branch.Aimed at building a high-end AI dialogue platform for the world to promote international exchange and cooperation,the forum attracted more than 200 vips and representatives from international organizations,governmental departments,universities,research institutes,and industrial leading companies.They held in-depth discussions on topics of technical standards,ethics and governance,and global coordination,and strove to form an AI standardization framework with global consensus.展开更多
We construct a new first-order central-upwind numerical method for solving systems of hyperbolic equations in conservative form.It applies in multidimensional structured and unstructured meshes.The proposed method is ...We construct a new first-order central-upwind numerical method for solving systems of hyperbolic equations in conservative form.It applies in multidimensional structured and unstructured meshes.The proposed method is an extension of the UFORCEmethod developed by Stecca,Siviglia and Toro[25],in which the upwind bias for the modification of the staggered mesh is evaluated taking into account the smallest and largest wave of the entire Riemann fan.The proposed first-order method is shown to be identical to the Godunov upwindmethod in applications to a 2×2 linear hyperbolic system.The method is then extended to non-linear systems and its performance is assessed by solving the two-dimensional inviscid shallow water equations.Extension to second-order accuracy is carried out using an ADER-WENO approach in the finite volume framework on unstructured meshes.Finally,numerical comparison with current competing numerical methods enables us to identify the salient features of the proposed method.展开更多
When China and Singapore exchanged formal handshakes in 1990,few could have imagined that 35 years later,a Data Science undergraduate named Hu Yunxin would be happily counting hawker-centre noodles while memorizing re...When China and Singapore exchanged formal handshakes in 1990,few could have imagined that 35 years later,a Data Science undergraduate named Hu Yunxin would be happily counting hawker-centre noodles while memorizing regression formulas along Clementi Road.Yet it is precisely these small,personal stories that breathe life into grand diplomatic milestones.In celebration of the anniversary,I spoke with Yunxin—freshly returned from her first year at the National University of Singapore(NUS)—to discover how the Lion City looks through Chinese eyes.展开更多
The Royal Tropical Institute (KIT) in Amsterdam is an independent centre of knowledge and expertise in the areas of international and intercultural cooperation, operating at the interface between theory and practice a...The Royal Tropical Institute (KIT) in Amsterdam is an independent centre of knowledge and expertise in the areas of international and intercultural cooperation, operating at the interface between theory and practice and between policy and implementation. The Institute contributes to sustainable development, poverty alleviation and cultural preservation and exchange.展开更多
The Royal Tropical Institute(KIT)in Amsterdam is an independent centre of knowledge and expertise in the areas of international and intercultural cooperation,operating at the interface between theory and practice and ...The Royal Tropical Institute(KIT)in Amsterdam is an independent centre of knowledge and expertise in the areas of international and intercultural cooperation,operating at the interface between theory and practice and between policy and implementation.The Institute contributes to sustainable development,poverty alleviation and cultural preservation and exchange.展开更多
Achieving universal eye health remains a global challenge,particularly in low-and middle-income countries where visual impairment and blindness are prevalent.While advances in tertiary eye care have improved outcomes,...Achieving universal eye health remains a global challenge,particularly in low-and middle-income countries where visual impairment and blindness are prevalent.While advances in tertiary eye care have improved outcomes,access to primary eye care(PEC)continues to be inadequate in rural and underserved regions.This gap necessitates innovative,scalable models that provide accessible,affordable,and comprehensive eye care.The Vision Centre(VC)model,pioneered by the Aravind Eye Care System(AECS),exemplifies a sustainable approach to delivering PEC.Designed as permanent facilities in rural communities,VCs are equipped with state-of-the-art diagnostic tools and staffed by trained allied ophthalmic personnel.The integration of teleophthalmology,electronic medical records,and artificial intelligence enhances the model’s capacity to address complex conditions like diabetic retinopathy and glaucoma.VCs have demonstrated significant impact in improving accessibility,reducing financial burdens,and increasing utilization of eye care services.In the fiscal year 2023-2024,AECS VCs recorded nearly one million outpatient visits,achieving a 25%population coverage rate and generating substantial cost savings of ₹647 million(US$7.8 million)for patients.The model's success is underpinned by community engagement,a focus on operational excellence,and a robust referral system to tertiary hospitals.This review explores the evolution,implementation,and impact of the AECS VC model,emphasizing its alignment with the Sustainable Development Goals and Universal Health Coverage.By addressing accessibility and affordability,the VC model serves as a scalable template for primary eye care delivery in resource-limited settings globally.展开更多
Health systems around the world are under continuing pressure for reform.Health system reform involves both content and process.Content deals with changes to the structures of the health system;process deals with the ...Health systems around the world are under continuing pressure for reform.Health system reform involves both content and process.Content deals with changes to the structures of the health system;process deals with the strategies of change.In this paper,we reflect on the development of the Australian healthcare system and draw out lessons regarding both structural and developmental principles.We review the historical development and functional performance of a range of‘programmes’which comprise the Australian health system.We use WHO’s 2016‘framework on integrated people‐centred health services’as a standard against which to evaluate the performance of the different programmes.A model of health system development featuring incremental change,windows of opportunity and policy coherence is used to frame some lessons from the Australian experience regarding reform strategy.Several of the programmes reviewed can be shown to have contributed positively to integrated and people-centred services.However,there have also been significant shortfalls in performance.The successes and the shortfalls of the programmes reviewed reflect both their histories and their contemporary context.Structural principles emerging from this review include the policy leverage available under single payer purchasing and on the other hand the fragmenting effects of privatisation and marketisation.Lessons regarding strategies of reform include cultivating‘reform readiness’across all of the locations and levels where opportunities for change may emerge while cultivating system wide coherence through a shared vision of how the system as a whole should develop.展开更多
The prevalence of non-alcoholic fatty liver disease(NAFLD)is thought to be on the rise globally(1).An updated meta-analysis reported that in 2019 the pooled global prevalence of NAFLD was 29.8%[95%confidence interval(...The prevalence of non-alcoholic fatty liver disease(NAFLD)is thought to be on the rise globally(1).An updated meta-analysis reported that in 2019 the pooled global prevalence of NAFLD was 29.8%[95%confidence interval(CI):28.6-31.1%]with the highest NAFLD prevalence observed in South America and North America(2).From 1991-2019,trend analysis also showed that NAFLD prevalence increased from~22%to 37%(with yearly increase of 0.7%),with South America showing the most rapid change of 2.7%per year followed by the Europe at 1.1%(2).展开更多
A consensus meeting of national experts from all major national hepatobiliary centres in the country was held on May 26,2023,at the Pakistan Kidney and Liver Institute&Research Centre(PKLI&RC)after initial con...A consensus meeting of national experts from all major national hepatobiliary centres in the country was held on May 26,2023,at the Pakistan Kidney and Liver Institute&Research Centre(PKLI&RC)after initial consultations with the experts.The Pakistan Society for the Study of Liver Diseases(PSSLD)and PKLI&RC jointly organised this meeting.This effort was based on a comprehensive literature review to establish national practice guidelines for hilar cholangiocarcinoma(hCCA).The consensus was that hCCA is a complex disease and requires a multidisciplinary team approach to best manage these patients.This coordinated effort can minimise delays and give patients a chance for curative treatment and effective palliation.The diagnostic and staging workup includes high-quality computed tomography,magnetic resonance imaging,and magnetic resonance cholangiopancreato-graphy.Brush cytology or biopsy utilizing endoscopic retrograde cholangiopancreatography is a mainstay for diagnosis.However,histopathologic confirmation is not always required before resection.Endoscopic ultrasound with fine needle aspiration of regional lymph nodes and positron emission tomography scan are valuable adjuncts for staging.The only curative treatment is the surgical resection of the biliary tree based on the Bismuth-Corlette classification.Selected patients with unresectable hCCA can be considered for liver transplantation.Adjuvant chemotherapy should be offered to patients with a high risk of recurrence.The use of preoperative biliary drainage and the need for portal vein embolisation should be based on local multidisciplinary discussions.Patients with acute cholangitis can be drained with endoscopic or percutaneous biliary drainage.Palliative chemotherapy with cisplatin and gemcitabine has shown improved survival in patients with irresectable and recurrent hCCA.展开更多
BACKGROUND Ostomy is a common surgery usually performed to protect patients from clinical symptoms caused by distal anastomotic leakage after colorectal cancer(CRC)surgery and perforation or to relieve intestinal obst...BACKGROUND Ostomy is a common surgery usually performed to protect patients from clinical symptoms caused by distal anastomotic leakage after colorectal cancer(CRC)surgery and perforation or to relieve intestinal obstruction.AIM To analyze the complications after transverse colostomy closure.METHODS Patients who underwent transverse colostomy closure from Jan 2015 to Jan 2022 were retrospectively enrolled in a single clinical center.The differences between the complication group and the no complication group were compared.Logistic regression analyses were conducted to find independent factors for overall complications or incision infection.RESULTS A total of 102 patients who underwent transverse colostomy closure were enrolled in the current study.Seventy(68.6%)patients underwent transverse colostomy because of CRC related causes.Postoperative complications occurred in 30(29.4%)patients and the most frequent complication occurring after transverse colostomy closure was incision infection(46.7%).The complication group had longer hospital stays(P<0.01).However,no potential risk factors were identified for overall complications and incision infection.CONCLUSION The most frequent complication occurring after transverse colostomy closure surgery in our center was incision infection.The operation time,interval from transverse colostomy to reversal,and method of anastomosis might have no impact on the postoperative complications.Surgeons should pay more attention to aseptic techniques.展开更多
Adults requiring total hip arthroplasty(THA)for childhood disorder sequelae present with shortening,limp,pain,and altered gait.THA,which can be particularly challenging due to altered anatomy,requires careful planning...Adults requiring total hip arthroplasty(THA)for childhood disorder sequelae present with shortening,limp,pain,and altered gait.THA,which can be particularly challenging due to altered anatomy,requires careful planning,assessment,and computed tomography evaluation.Preoperative templating is essential to establish the appropriate acetabular and femoral size.Information regarding neck length and offset is needed to ensure the proper options are available at THA.Hip centre restoration must be planned preoperatively and achieved intraoperatively with appropriate exposure,identification,and stable fixation with optimum-size components.Identifying the actual acetabular floor is essential as changes include altered anatomy,distortion of the margins and version changes.Proximal femur changes include anatomical variation,decreased canal diameter,cortical thickness,changes in anteversion,and metaphyseal and diaphyseal mismatch.Preoperative assessment should consist of limb assessment for variations due to prior surgical procedures.Evaluation of the shortening pattern with the relationship of the lesser trochanter to the teardrop would help identify and plan for subtrochanteric shortening osteotomy,especially in high-riding hips.The surgical approach must ensure adequate exposure and soft tissue release to achieve restoration of the anatomical hip centre.The femoral components may require modularity to enable restoration of anteversion and optimum fixation.展开更多
文摘All-solid-state lithium ion batteries(ASSLIBs)have attracted much attention due to their high safety and increased energy density,which have become a substitute to conventional liquid electrolyte batteries[1].The development of high-performance solid electrolyte is the key to the development of solid-state battery technology.Solid-state electrolyte(SSE)materials should have high ionic conductivity,poor electronic conductivity,wide electrochemical window,and low electrode and electrolyte interface resistance.
基金Project (51172088) supported by the National Natural Science Foundation of China
文摘Face centred cubic（FCC） TiB ceramic powder synthesized by Ti-boronizing method was used as conductive filler to make ceramic electrically conductive adhesives（ECAs） with the polymer matrix.Electrically conductive properties of the ceramic ECAs were studied.The bulk electrical resistivity varied with the powder content of the FCC-TiB in ECAs.The FCC-TiB filled ECAs also showed the percolation behavior that usually occurred for the metal-filled ECAs,the percolation threshold was located at the content of 60%FCC-TiB.A minimum value of 0.1 Ω·cm was obtained at a content of 75%FCC-TiB.In order to check the reliability of mechanical property,tensile test was done to measure the shear strength,and the shear strength dropped with increasing the content of FCC-TiB powders.It is about 12.26 MPa at the content of 70%TiB powders.The Cu filled ECAs were also prepared for comparison.The properties of the oxidation resistance of the two ECAs were evaluated.The results show that the ceramic ECAs have excellent oxidation resistance and better stability compared with the Cu filled ECAs.
文摘Patient-centred medicine is being adopted as national policies in many countries, encouraged by positive outcomes of the practice at clinical and organisational levels. This study examines the patient-centred health care reform in China, which has adopted the approach as a national policy for two decades but has yet to achieve the intended goals. Focusing on conflicting interpretations of the nature of patients at national, organisational, and individual levels, this article argues that such conflicts lead to clashes between the political agenda of the state, priorities of health organisations, professional choices of individual practitioners, and expectations of patients in the process of implementing, practicing, and receiving patient-centred health care in China. It reveals that the national health authority has intended patient-centredness as a universal, anti-market, people-centred approach, based on the health ideology of serving the people. But hospitals, compelled by financial restraints, have implemented it as a market approach centring on patients as consumers. Medical professionals and patients also possess contradictory views towards whether a patient should be perceived as a consumer. The discordance in the interpretation of the patient identity has caused great confusion in the implementation and provision of patient-centred health care. The study points out that the success of patient-centredness as national policy cannot be assumed on the basis of its success at clinical and organisational levels. More efforts are needed to coordinate the fundamental understanding of patient-centredness by different actors.
基金This work is supported partially by the foundation of the National Education Ministry, National
文摘Let 0<A≤1/3 ,K(λ) be the attractor of an iterated function system {ψ1,ψ2} on the line, where 1(x)= AT, ψ1(x) = 1-λ+λx, x∈[0,1]. We call K(λ) the symmetry Cantor sets. In this paper, we obtained the exact Hausdorff Centred measure of K(λ).
基金supported by the National Natural Science Foundation of China(Grant No 10571091)the National Science and Technology Supporting Program of China(Grant No 2006BAD11A07)
文摘We use the Monte Carlo method to study an antiferromagnetical Ising spin system on a centred honeycomb lattice, which is composed of two kinds of 1/2 spin particles A and B. There exist two different bond energies JA-A and JA--B in this lattice. Our study is focused on how the ratio of JA-B to JA--A influences the critical behaviour of this system by analysing the physical quantities, such as the energy, the order parameter, the specific heat, susceptibility, etc each as a function of temperature for a given ratio of JA-B to JA-A. Using these results together with the finite-size scaling method, we obtain a phase diagram for the ratio JA-B / JA--A. This work is helpful for studying the phase transition problem of crystals composed of compounds.
文摘Let 0<λ_1,λ_2<1 and 1-λ_1-λ_2≥max｛λ_1,λ_2｝.Let ~K(λ_1,λ_2) be the attractor of the iterated function system ｛φ_1,φ_2｝on the line,where φ_1(x)=λ_1x and φ_2(x)=1-λ_2+λ_2x,x∈R.~K(λ_1,λ_2) is called a non-symmetry Cantor set. In this paper,it is proved that the exact Hausdorff centred measure of K(λ_1,λ_2) equals 2s(1-λ)s,where λ=max｛λ_1,λ_2｝ and s is the Hausdorff dimension of K(λ_1,λ_2).
文摘For the sake of its inseparability to the science of language, English language teaching(ELT) tends to be researched,despite diverse voices within its domain, from the perspective of linguistics. It is noticeable, however, that ELT in this research conducted is literally referred to as an educational conception, though pertinent linguistics knowledge is to be inevitably involved. Given this situation, ELT is categorised as an intra-discipline of education, establishing the basic ground of the academic enquiries throughout the context. Relevant issues are to be further examined concerning to what extent learner-centredness manifests its definition within modern pedagogical approaches and methods of ELT, so as to indicate the philosophical significance of education in language teaching. A critical insight is to be given into the limitations of learner- centredness in ELT practice through two case studies thereafter, which is expected to benefit the development of ELT professionalism in the changing practice of language education.
文摘Located at 217 Queen sthreet in the heart of Singapore,the China Cultural Centre features gray-white walls with subtle cream accents,evoking the timeless charm of taditional Chinese architecture with its classic white walls and gray-tiled roof.Designed by famous singaporean architect Liu Thai Ker,the building blends traditional Chinese cultural elements with moder architectual concepts."From an aesthetic perspective,I believe it is essential to give the structure a moderm edge,Liu said in an interview with Xinhua."Therefore,the design should reflect a contempoary spirit while retaining the essence of Chinese culture."
文摘On July 26,the International Forum on Standardization of Artificial Intelligence was held in Shanghai Expo Center.Guided by the WAIC organizing committee,the forum was hosted by the AIM Global Centre of Excellence(AIM Global CoE),and jointly organized by China Electronics Standardization Institute(CESI),Shanghai Artificial Intelligence Research Institute(SAIRI),and Bank of China Shanghai Branch.Aimed at building a high-end AI dialogue platform for the world to promote international exchange and cooperation,the forum attracted more than 200 vips and representatives from international organizations,governmental departments,universities,research institutes,and industrial leading companies.They held in-depth discussions on topics of technical standards,ethics and governance,and global coordination,and strove to form an AI standardization framework with global consensus.
文摘We construct a new first-order central-upwind numerical method for solving systems of hyperbolic equations in conservative form.It applies in multidimensional structured and unstructured meshes.The proposed method is an extension of the UFORCEmethod developed by Stecca,Siviglia and Toro[25],in which the upwind bias for the modification of the staggered mesh is evaluated taking into account the smallest and largest wave of the entire Riemann fan.The proposed first-order method is shown to be identical to the Godunov upwindmethod in applications to a 2×2 linear hyperbolic system.The method is then extended to non-linear systems and its performance is assessed by solving the two-dimensional inviscid shallow water equations.Extension to second-order accuracy is carried out using an ADER-WENO approach in the finite volume framework on unstructured meshes.Finally,numerical comparison with current competing numerical methods enables us to identify the salient features of the proposed method.
文摘When China and Singapore exchanged formal handshakes in 1990,few could have imagined that 35 years later,a Data Science undergraduate named Hu Yunxin would be happily counting hawker-centre noodles while memorizing regression formulas along Clementi Road.Yet it is precisely these small,personal stories that breathe life into grand diplomatic milestones.In celebration of the anniversary,I spoke with Yunxin—freshly returned from her first year at the National University of Singapore(NUS)—to discover how the Lion City looks through Chinese eyes.
文摘The Royal Tropical Institute (KIT) in Amsterdam is an independent centre of knowledge and expertise in the areas of international and intercultural cooperation, operating at the interface between theory and practice and between policy and implementation. The Institute contributes to sustainable development, poverty alleviation and cultural preservation and exchange.
文摘The Royal Tropical Institute(KIT)in Amsterdam is an independent centre of knowledge and expertise in the areas of international and intercultural cooperation,operating at the interface between theory and practice and between policy and implementation.The Institute contributes to sustainable development,poverty alleviation and cultural preservation and exchange.
文摘Achieving universal eye health remains a global challenge,particularly in low-and middle-income countries where visual impairment and blindness are prevalent.While advances in tertiary eye care have improved outcomes,access to primary eye care(PEC)continues to be inadequate in rural and underserved regions.This gap necessitates innovative,scalable models that provide accessible,affordable,and comprehensive eye care.The Vision Centre(VC)model,pioneered by the Aravind Eye Care System(AECS),exemplifies a sustainable approach to delivering PEC.Designed as permanent facilities in rural communities,VCs are equipped with state-of-the-art diagnostic tools and staffed by trained allied ophthalmic personnel.The integration of teleophthalmology,electronic medical records,and artificial intelligence enhances the model’s capacity to address complex conditions like diabetic retinopathy and glaucoma.VCs have demonstrated significant impact in improving accessibility,reducing financial burdens,and increasing utilization of eye care services.In the fiscal year 2023-2024,AECS VCs recorded nearly one million outpatient visits,achieving a 25%population coverage rate and generating substantial cost savings of ₹647 million(US$7.8 million)for patients.The model's success is underpinned by community engagement,a focus on operational excellence,and a robust referral system to tertiary hospitals.This review explores the evolution,implementation,and impact of the AECS VC model,emphasizing its alignment with the Sustainable Development Goals and Universal Health Coverage.By addressing accessibility and affordability,the VC model serves as a scalable template for primary eye care delivery in resource-limited settings globally.
文摘Health systems around the world are under continuing pressure for reform.Health system reform involves both content and process.Content deals with changes to the structures of the health system;process deals with the strategies of change.In this paper,we reflect on the development of the Australian healthcare system and draw out lessons regarding both structural and developmental principles.We review the historical development and functional performance of a range of‘programmes’which comprise the Australian health system.We use WHO’s 2016‘framework on integrated people‐centred health services’as a standard against which to evaluate the performance of the different programmes.A model of health system development featuring incremental change,windows of opportunity and policy coherence is used to frame some lessons from the Australian experience regarding reform strategy.Several of the programmes reviewed can be shown to have contributed positively to integrated and people-centred services.However,there have also been significant shortfalls in performance.The successes and the shortfalls of the programmes reviewed reflect both their histories and their contemporary context.Structural principles emerging from this review include the policy leverage available under single payer purchasing and on the other hand the fragmenting effects of privatisation and marketisation.Lessons regarding strategies of reform include cultivating‘reform readiness’across all of the locations and levels where opportunities for change may emerge while cultivating system wide coherence through a shared vision of how the system as a whole should develop.
文摘The prevalence of non-alcoholic fatty liver disease(NAFLD)is thought to be on the rise globally(1).An updated meta-analysis reported that in 2019 the pooled global prevalence of NAFLD was 29.8%[95%confidence interval(CI):28.6-31.1%]with the highest NAFLD prevalence observed in South America and North America(2).From 1991-2019,trend analysis also showed that NAFLD prevalence increased from~22%to 37%(with yearly increase of 0.7%),with South America showing the most rapid change of 2.7%per year followed by the Europe at 1.1%(2).
文摘A consensus meeting of national experts from all major national hepatobiliary centres in the country was held on May 26,2023,at the Pakistan Kidney and Liver Institute&Research Centre(PKLI&RC)after initial consultations with the experts.The Pakistan Society for the Study of Liver Diseases(PSSLD)and PKLI&RC jointly organised this meeting.This effort was based on a comprehensive literature review to establish national practice guidelines for hilar cholangiocarcinoma(hCCA).The consensus was that hCCA is a complex disease and requires a multidisciplinary team approach to best manage these patients.This coordinated effort can minimise delays and give patients a chance for curative treatment and effective palliation.The diagnostic and staging workup includes high-quality computed tomography,magnetic resonance imaging,and magnetic resonance cholangiopancreato-graphy.Brush cytology or biopsy utilizing endoscopic retrograde cholangiopancreatography is a mainstay for diagnosis.However,histopathologic confirmation is not always required before resection.Endoscopic ultrasound with fine needle aspiration of regional lymph nodes and positron emission tomography scan are valuable adjuncts for staging.The only curative treatment is the surgical resection of the biliary tree based on the Bismuth-Corlette classification.Selected patients with unresectable hCCA can be considered for liver transplantation.Adjuvant chemotherapy should be offered to patients with a high risk of recurrence.The use of preoperative biliary drainage and the need for portal vein embolisation should be based on local multidisciplinary discussions.Patients with acute cholangitis can be drained with endoscopic or percutaneous biliary drainage.Palliative chemotherapy with cisplatin and gemcitabine has shown improved survival in patients with irresectable and recurrent hCCA.
基金The ethics committee of the First Affiliated Hospital of Chongqing Medical University approved this study,No.K2024-008-01.
文摘BACKGROUND Ostomy is a common surgery usually performed to protect patients from clinical symptoms caused by distal anastomotic leakage after colorectal cancer(CRC)surgery and perforation or to relieve intestinal obstruction.AIM To analyze the complications after transverse colostomy closure.METHODS Patients who underwent transverse colostomy closure from Jan 2015 to Jan 2022 were retrospectively enrolled in a single clinical center.The differences between the complication group and the no complication group were compared.Logistic regression analyses were conducted to find independent factors for overall complications or incision infection.RESULTS A total of 102 patients who underwent transverse colostomy closure were enrolled in the current study.Seventy(68.6%)patients underwent transverse colostomy because of CRC related causes.Postoperative complications occurred in 30(29.4%)patients and the most frequent complication occurring after transverse colostomy closure was incision infection(46.7%).The complication group had longer hospital stays(P<0.01).However,no potential risk factors were identified for overall complications and incision infection.CONCLUSION The most frequent complication occurring after transverse colostomy closure surgery in our center was incision infection.The operation time,interval from transverse colostomy to reversal,and method of anastomosis might have no impact on the postoperative complications.Surgeons should pay more attention to aseptic techniques.
文摘Adults requiring total hip arthroplasty(THA)for childhood disorder sequelae present with shortening,limp,pain,and altered gait.THA,which can be particularly challenging due to altered anatomy,requires careful planning,assessment,and computed tomography evaluation.Preoperative templating is essential to establish the appropriate acetabular and femoral size.Information regarding neck length and offset is needed to ensure the proper options are available at THA.Hip centre restoration must be planned preoperatively and achieved intraoperatively with appropriate exposure,identification,and stable fixation with optimum-size components.Identifying the actual acetabular floor is essential as changes include altered anatomy,distortion of the margins and version changes.Proximal femur changes include anatomical variation,decreased canal diameter,cortical thickness,changes in anteversion,and metaphyseal and diaphyseal mismatch.Preoperative assessment should consist of limb assessment for variations due to prior surgical procedures.Evaluation of the shortening pattern with the relationship of the lesser trochanter to the teardrop would help identify and plan for subtrochanteric shortening osteotomy,especially in high-riding hips.The surgical approach must ensure adequate exposure and soft tissue release to achieve restoration of the anatomical hip centre.The femoral components may require modularity to enable restoration of anteversion and optimum fixation.
