Antimicrobial resistance(AMR)has become a critical global public health challenge in the 21st century.Since the initial isolation of a blaNDM-1-carrying and carbapenem-resistant Klebsiella pneumoniae from an Indian ho...Antimicrobial resistance(AMR)has become a critical global public health challenge in the 21st century.Since the initial isolation of a blaNDM-1-carrying and carbapenem-resistant Klebsiella pneumoniae from an Indian hospital in 2009[1],the escalating prevalence of New Delhi metallo-β-lactamase(NDM)-encoding genes(blaNDM)has transformed carbapenem resistance into a worldwide phenomenon,transcending national and regional boundaries[2].Up to 90 distinct NDM variants have been reported globally according to the NCBI GenBank Pathogens database.Plasmidmediated horizontal gene transfer(HGT),which occurs both within and across bacterial species,has significantly accelerated the global dissemination of blaNDM-related genes and the associated resistance[3].Carbapenem-resistant pathogens were responsible for 200,000 deaths globally in 2019[4].Although NDM-1 has been relatively well characterized[5],the epidemiological profiles of other NDM variants require continued surveillance and indepth investigation.The novel NDM-9 variant(GenBank accession no.KC999080)was first identified in 2013 from a clinically significant isolate of Klebsiella pneumoniae ST107 strain PPH1303 with a high level of resistance to carbapenems recovered from the urine culture of a pediatric patient in Beijing,China,who had acute lymphocytic leukemia and had undergone allogeneic stem cell transplantation[6].展开更多
AIM: To evaluate the epidemiology and outcomes of culture-positive spontaneous bacterial peritonitis (SBP) and spontaneous bacteremia (SB) in decompensated cirrhosis.METHODS: We prospectively collected clinical, labor...AIM: To evaluate the epidemiology and outcomes of culture-positive spontaneous bacterial peritonitis (SBP) and spontaneous bacteremia (SB) in decompensated cirrhosis.METHODS: We prospectively collected clinical, laboratory characteristics, type of administered antibiotic, susceptibility and resistance of bacteria to antibiotics in one hundred thirty cases (68.5% males) with positive ascitic fluid and/or blood cultures during the period from January 1, 2012 to May 30, 2014. All patients with SBP had polymorphonuclear cell count in ascitic fluid > 250/mm<sup>3</sup>. In patients with SB a thorough study did not reveal any other cause of bacteremia. The patients were followed-up for a 30-d period following diagnosis of the infection. The final outcome of the patients was recorded in the end of follow-up and comparison among 3 groups of patients according to the pattern of drug resistance was performed.RESULTS: Gram-positive-cocci (GPC) were found in half of the cases. The most prevalent organisms in a descending order were Escherichia coli (33), Enterococcus spp (30), Streptococcus spp (25), Klebsiella pneumonia (16), S. aureus (8), Pseudomanas aeruginosa (5), other Gram-negative-bacteria (GNB) (11) and anaerobes (2). Overall, 20.8% of isolates were multidrug-resistant (MDR) and 10% extensively drug-resistant (XDR). Health-care-associated (HCA) and/or nosocomial infections were present in 100% of MDR/XDR and in 65.5% of non-DR cases. Meropenem was the empirically prescribed antibiotic in HCA/nosocomial infections showing a drug-resistance rate of 30.7% while third generation cephalosporins of 43.8%. Meropenem was ineffective on both XDR bacteria and Enterococcus faecium (E. faecium). All but one XDR were susceptible to colistin while all GPC (including E. faecium) and the 86% of GNB to tigecycline. Overall 30-d mortality was 37.7% (69.2% for XDR and 34.2% for the rest of the patients) (log rank, P = 0.015). In multivariate analysis, factors adversely affecting outcome included XDR infection (HR = 2.263, 95%CI: 1.005-5.095, P = 0.049), creatinine (HR = 1.125, 95%CI: 1.024-1.236, P = 0.015) and INR (HR =1.553, 95%CI: 1.106-2.180, P = 0.011).CONCLUSION: XDR bacteria are an independent life-threatening factor in SBP/SB. Strategies aiming at restricting antibiotic overuse and rapid identification of the responsible bacteria could help improve survival.展开更多
BACKGROUND Bedaquiline is among the prioritized drugs recommended by the World Health Organization for the treatment of extensively drug-resistant tuberculosis(XDRTB).Many patients have not achieved better clinical im...BACKGROUND Bedaquiline is among the prioritized drugs recommended by the World Health Organization for the treatment of extensively drug-resistant tuberculosis(XDRTB).Many patients have not achieved better clinical improvement after bedaquiline is stopped at 24 wk.However,there is no recommendation or guideline on bedaquiline administration beyond 24 wk,which is an important consideration when balancing the benefit of prognosis for XDR-TB against the uncertain safety concerning the newer antibiotics.CASE SUMMARY This paper reported 2 patients with XDR-TB(a female of 58 years of age and a female of 18 years of age)who received bedaquiline for 36 wk,as local experience to be shared.The 2 cases had negative cultures after 24 wk of treatment,but lung imaging was still positive.After discussion among experts,the consensus was made to bedaquiline prolongation by another 12 wk.The 36-wk prolonged use of bedaquiline in both cases achieved a favorable response without increasing the risk of cardiac events or new safety signals.CONCLUSION Longer regimen,including 36-wk bedaquiline treatment,might be an option for patients with XDR-TB.More studies are needed to explore the effectiveness and safety of prolonged use of bedaquiline for 36 wk vs standard 24 wk in the treatment of multidrug-resistant/XDR-TB or to investigate further the biomarkers and criteria indicative for extension of bedaquline to facilitate clinical use of thisnovel drug.展开更多
BACKGROUND Pyogenic ventriculitis caused by extensively drug-resistant Acinetobacter baumannii(A.baumannii)is one of the most severe complications associated with craniotomy.However,limited therapeutic options exist f...BACKGROUND Pyogenic ventriculitis caused by extensively drug-resistant Acinetobacter baumannii(A.baumannii)is one of the most severe complications associated with craniotomy.However,limited therapeutic options exist for the treatment of A.baumannii ventriculitis due to the poor penetration rate of most antibiotics through the blood-brain barrier.CASE SUMMARY A 68-year-old male patient with severe traumatic brain injury developed pyogenic ventriculitis on postoperative day 24 caused by extensively drug-resistant A.baumannii susceptible to tigecycline only.Successful treatment was accomplished through multi-route administration of tigecycline,including intravenous combined with continuous ventricular irrigation plus intraventricular administration.The pus was cleared on the 3rd day post-irrigation,and cerebrospinal fluid cultures were negative after 12 d.CONCLUSION Our findings suggest that multi-route administration of tigecycline can be a therapeutic option against pyogenic ventriculitis caused by extensively drugresistant A.baumannii.展开更多
Background:Tuberculosis(TB),caused by Mycobacterium tuberculosis,remains the second leading cause of death from a single infectious disease globally and poses a significant economic and clinical burden in the world in...Background:Tuberculosis(TB),caused by Mycobacterium tuberculosis,remains the second leading cause of death from a single infectious disease globally and poses a significant economic and clinical burden in the world in 2022.Of particular concern is the emergence of drug-resistant TB,accounting for 15%-20%of TB deaths.It is imperative to delve into the global trends of incidence and death rate for multidrug-resistant tuberculosis(MDRTB)and extensively drug-resistant tuberculosis(XDR-TB),drawing upon the comprehensive Global Burden of Disease(GBD)2021 drug-resistant tuberculosis dataset.Methods:From the GBD 2021,data on incidence,prevalence,disability-adjusted life years(DALYs),and death of MDR-TB and XDR-TB from 1990 to 2021 were collected.We calculated the estimated annual percentage changes in age standardized incidence rate(ASIR)and age-standardized death rate(ASDR),segmented by age,sex,and socio-demographic index(SDI).The impacts of various risk factors on MDR-TB and XDR-TB were also analyzed.Results:In 2021,there were an estimated 443,680(95%uncertainty interval[UI]:259,196-766,545)incident cases of MDR-TB,and an estimated 106,818(95%UI:41,612-211,854)death cases of MDR-TB,while there were an estimated 24,036(95%UI:17,144-34,587)incident cases of XDR-TB and 7,946(95%UI:3,326-14,859)death cases of XDR-TB.The incidence and death cases of MDR-TB were lowest in high SDI regions,whereas the incidence rates of XDR-TB in high-middle SDI regions were higher than those in middle SDI and high SDI regions.Conclusion:This study reported the disease burden of drug-resistant TB from 1990 to 2021.Until 2021,drugresistant TB is still a serious problem in low SDI countries,especially for high-risk age populations with highrisk factors.Controlling drug-resistant TB requires effective control strategies and healthcare systems.展开更多
Objective:To establish extensively drug-resistant Pseudomonas aeruginosa(XDR-PA)infection-induced pneumonia model in rats.Methods:Twenty-four male SD rats were randomly divided into blank group,low bacterial group,med...Objective:To establish extensively drug-resistant Pseudomonas aeruginosa(XDR-PA)infection-induced pneumonia model in rats.Methods:Twenty-four male SD rats were randomly divided into blank group,low bacterial group,medium bacterial group,and high bacterial group.The low,medium and high bacterial groups were given intratracheal instillation of 0.1 mL of bacterial suspension(bacterial concentration in turn is 7.5×10^(9),3×10^(10),6×10^(10)CFU/mL),while the blank group were given the same volume of sterile normal saline.After modeling,the general conditions of rats in each group were observed,including mental state,hair,respiration,activity,eating,weight,and the survival curve was drawn.The pathological characteristics of lung tissue and the infiltration of inflammatory cells were observed.Pathogenic identification of each group was carried out by bacterial culture of lung tissue homogenate.Results:The general state of the blank group was normal,and the rats in other groups showed signs of mental depression,bristling,shortness of breath,even oral and nasal bleeding,decreased food intake and activity,and significant weight loss,and different degrees of death within 48 hours,the difference was statistically significant(P<0.05).Pathological results showed that the alveolar structure of rats in the blank group was complete,and the alveolar space was clear without exudation.The lung tissue of the low and medium bacterial groups showed obvious inflammatory cell infiltration,alveolar structure destruction,alveolar septum thickening,interstitial edema,but the pathological damage of the medium group was more severe,with a mortality rate of up to 50%,and the mortality rate of the low bacterial group was 17%.In the high bacterial group,red blood cells,inflammatory cells and a large amount of fibrin-like exudation can be seen in the alveolar space,which has the pathological characteristics of acute respiratory failure,and the mortality rate is as high as 67%.The results of bacterial culture of lung tissue homogenate showed that the blank group had no bacterial colonies,while PA colony growth can be seen in low,medium and high bacterial groups.Conclusion:9 Intratracheal instillation of low bacterial count(0.1 mL of 7.5×10^(9) CFU/mL)XDR-PA bacterial suspension can successfully construct a rat pneumonia model of XDR-PA infection.展开更多
Emerging and rapidly spreading multidrug resistant bacteria constitute a rising public health concern worldwide. Acinetobacter baumannii is one of these bacteria that cause different infections including pneumonia, ba...Emerging and rapidly spreading multidrug resistant bacteria constitute a rising public health concern worldwide. Acinetobacter baumannii is one of these bacteria that cause different infections including pneumonia, bacteremia, meningitis, soft-tissue, and urinary tract infections, and are associated with high mortality and economic burden. We present a case of a 43-year-old woman, admitted at the department of orthopedics, regional hospital of Ourossogui, North-East of Senegal for soft-tissue injuries. Initially diagnosed with Yersinia pestis infection, the patient was well managed before being released. Supplementary sampling for confirmatory tests allowed the detection of an extensively drug-resistant Acinetobacter baumannii clone.展开更多
Rationale:Salmonella(S.)typhi is a rare cause of osteomyelitis in immunocompetent adults.Extensive drug resistance(XDR)may lead to more complicated cases of S.typhi osteomyelitis.Patient concern:A 55-year-old female p...Rationale:Salmonella(S.)typhi is a rare cause of osteomyelitis in immunocompetent adults.Extensive drug resistance(XDR)may lead to more complicated cases of S.typhi osteomyelitis.Patient concern:A 55-year-old female presented with a persistent low-grade fever and a swelling on her lower left chest with a sinus discharging purulent fluid for the past 8 months.Her symptoms had been unresponsive to previous anti-microbial therapy.Diagnosis:Rib osteomyelitis caused by XDR S.typhi.Interventions:Surgical wound debridement,left 7th-9th rib resection and intravenous Ⅳ meropenem were done.Outcome:Fever resolved and left-sided swelling resected without recurrence.Lessons:The prevalence of XDR S.typhi is growing in South Asia and should be considered as the differential diagnosis of chronic osteomyelitis.展开更多
Background Diagnosis and appropriate treatment of multidrug-resistant tuberculosis （MDR-TB） remain major challenges. We sought to elucidate that persons who share a household with drug resistance tuberculosis patien...Background Diagnosis and appropriate treatment of multidrug-resistant tuberculosis （MDR-TB） remain major challenges. We sought to elucidate that persons who share a household with drug resistance tuberculosis patients are at high risk for primary drug resistance tuberculosis and how to prevent these outbreaks. Methods We used 12-locus mycobactedal interspersed repetitive unit and 7-locus variable-number tandem repeat to identify household transmission of extensively drug resistant and multiple drug resistant Mycobacterium tuberculosis in three families admitted in Shanghai Pulmonary Hospital affiliated with Tongji University. Drug susceptibility tests were done by the modified proportion method in the MGIT 960 system in the same time. Clinical data were also obtained from the subjects＇ medical records. Results All of the six strains were defined as Beijing genotype by the deletion-targeted multiplex PCR （DTM-PCR） identification on the genomic deletion RD105. Strains from family-1 had the same minisatellite interspersed repetitive unit （MIRU） pattern （232225172531） and the same MIRU pattern （3677235）. Strains from family-2 had the same MIRU pattern （2212261553323） and the same MIRU pattern （3685134）. Strains from family-3 did not have the same MIRU pattern and they differed at only one locus （223326173533, 223325173533）, and did not have the same VNTR pattern with two locus differed （3667233, 3677234）. Conclusions Household transmission exists in the three families. A clear chain of tuberculosis transmission within family exists. Tuberculosis susceptibility should be considered when there is more than one tuberculosis patients in a familv. Household tuberculosis transmission could be prevented with adequate treatment of source Patients.展开更多
Total hip arthroplasty （THA） is one of the most clinically successful surgeries. Despite the prevalence of THA, the number of revisions for septic or aseptic reasons continues to increase.
In this paper,we offer a new construction of Stefan’s homological spectral sequence for Hopf Galois extensions,by using the double complex argument.Under the faithfully flat condition,a method for computation of Hoch...In this paper,we offer a new construction of Stefan’s homological spectral sequence for Hopf Galois extensions,by using the double complex argument.Under the faithfully flat condition,a method for computation of Hochschild homology is given.展开更多
Mobile communications are reaching out to every aspect of our daily life,necessitating highefficiency data transmission and support for diverse data types and communication scenarios.Polar codes have emerged as a prom...Mobile communications are reaching out to every aspect of our daily life,necessitating highefficiency data transmission and support for diverse data types and communication scenarios.Polar codes have emerged as a promising solution due to their outstanding error-correction performance and low complexity.Unequal error protection(UEP)involves nonuniform error safeguarding for distinct data segments,achieving a fine balance between error resilience and resource allocation,which ultimately enhancing system performance and efficiency.In this paper,we propose a novel class of UEP rateless polar codes.The codes are designed based on matrix extension of polar codes,and elegant mapping and duplication operations are designed to achieve UEP property while preserving the overall performance of conventional polar codes.Superior UEP performance is attained without significant modifications to conventional polar codes,making it straightforward for compatibility with existing polar codes.A theoretical analysis is conducted on the block error rate and throughput efficiency performance.To the best of our knowledge,this work provides the first theoretical performance analysis of UEP rateless polar codes.Simulation results show that the proposed codes significantly outperform existing polar coding schemes in both block error rate and throughput efficiency.展开更多
Accurately recognizing driver distraction is critical for preventing traffic accidents,yet current detection models face two persistent challenges.First,distractions are often fine-grained,involving subtle cues such a...Accurately recognizing driver distraction is critical for preventing traffic accidents,yet current detection models face two persistent challenges.First,distractions are often fine-grained,involving subtle cues such as brief eye closures or partial yawns,which are easily missed by conventional detectors.Second,in real-world scenarios,drivers frequently exhibit overlapping behaviors,such as simultaneously holding a cup,closing their eyes,and yawning,leading tomultiple detection boxes and degradedmodel performance.Existing approaches fail to robustly address these complexities,resulting in limited reliability in safety critical applications.To overcome these pain points,we propose YOLO-Drive,a novel framework that enhances YOLO-based driver monitoring with EfficientViM and Polarized Spectral–Spatial Attention(PSSA)modules.Efficient ViMprovides lightweight yet powerful global–local feature extraction,enabling accurate recognition of subtle driver states.PSSA further amplifies discriminative features across spatial and spectral domains,ensuring robust separation of concurrent distraction cues.By explicitly modeling fine-grained and overlapping behaviors,our approach delivers significant improvements in both precision and robustness.Extensive experiments on benchmark driver distraction datasets demonstrate that YOLO-Drive consistently out-performs stateof-the-art models,achieving higher detection accuracy while maintaining real-time efficiency.These results validate YOLO-Drive as a practical and reliable solution for advanced driver monitoring systems,addressing long-standing challenges of subtle cue recognition and multi-cue distraction detection.展开更多
Article Article types Articles commonly fall into one of three main categories: Fulllength articles, Review articles and Short communications.Full-length articles are original, unpublished primary research. Extensions...Article Article types Articles commonly fall into one of three main categories: Fulllength articles, Review articles and Short communications.Full-length articles are original, unpublished primary research. Extensions of work that has been published previously in short form such as a Communication are usually acceptable.Short communications must contain original and highly significant work whose high novelty warrants rapid publication.Review articles may be an authoritative overview of a field, a comprehensive literature reviews, or tutorial-style reference materials. Reviews are usually invited by the editor, but a topic may be proposed by an author via the editorial office.展开更多
Article Article types Articles commonly fall into one of three main categories: Full-length articles, Review articles and Short communications.Full-length articles are original, unpublished primary research. Extension...Article Article types Articles commonly fall into one of three main categories: Full-length articles, Review articles and Short communications.Full-length articles are original, unpublished primary research. Extensions of work that has been published previously in short form such as a Communication are usually acceptable.Short communications must contain original and highly significant work whose high novelty warrants rapid publication.展开更多
BACKGROUND With the increasing use of laparoscopic techniques in living-donor kidney transplantation,limitations in donor vessel length,particularly of the right renal vein,pose significant challenges for vascular ana...BACKGROUND With the increasing use of laparoscopic techniques in living-donor kidney transplantation,limitations in donor vessel length,particularly of the right renal vein,pose significant challenges for vascular anastomosis to the recipient’s external iliac vein.These anatomical constraints can complicate graft implantation and increase the risk of postoperative complications.CASE SUMMARY To address the issue of short right renal veins,several surgical strategies have been proposed.In this report,we describe our experience with three cases in which venous extension was successfully achieved using a venous cuff interposition technique during back-table reconstruction.This approach was used to facilitate secure vascular anastomosis and improve graft positioning in anatomically complex transplant scenarios.CONCLUSION Venous cuff interposition represents an effective technique for managing short renal veins in living-donor kidney transplantation.It provides additional length and flexibility,easing anastomotic tension and supporting successful transplantation.展开更多
Objectives:High-grade serous ovarian cancer(HGSOC),the most common subtype of epithelial ovarian cancer(EOC),exhibits a mesenchymal phenotype characterized by fibrotic stroma and poor prognosis.Human epididymis protei...Objectives:High-grade serous ovarian cancer(HGSOC),the most common subtype of epithelial ovarian cancer(EOC),exhibits a mesenchymal phenotype characterized by fibrotic stroma and poor prognosis.Human epididymis protein 4(HE4),a key diagnostic biomarker for ovarian cancer,is involved in fibrotic processes in several non-malignant diseases.Given the clinical significance of stromal fibrosis in HGSOC and the potential link between HE4 and fibrosis,this study aimed to investigate the role of HE4 in the formation of stromal fibrosis in HGSOC.Methods:A total of 126 patients with gynecological conditions were included and divided into normal,benign,and EOC groups.Tissue stiffness was quantitatively measured and analyzed for its correlation with clinicopathological features.We further investigated the correlation between tumor stiffness and the expression levels of HE4 and fibroblast activation markers(α-smooth muscle actin(α-SMA)and fibroblast activation protein(FAP))in tumor tissues from 22 HGSOC patients.In vitro,primary fibroblasts were treated with recombinant HE4(rHE4)or conditioned media from HE4-knockdown ovarian cancer cells to assess fibroblasts activation and matrix contractility(Collagen gel contraction assays).In vivo,a subcutaneous xenograft model using HE4-knockdown cells was established to evaluate the effects of HE4 suppression on tumor growth and extensive extracellular matrix(ECM)remodeling.Results:Ovarian cancer tissues showed significantly increased stiffness compared to benign/normal groups,showing positive correlation with serum HE4 levels.High-stiffness HGSOC tumors exhibited upregulated expression of HE4,α-SMA,FAP,and collagen I.rHE4 stimulated fibroblast activation and enhanced matrix contractility,whereas HE4 knockdown in cancer cells abrogated these pro-fibrotic effects.In vivo,HE4-silenced xenografts displayed restricted tumor growth accompanied by reduced stromal expression ofα-SMA,FAP,and collagen I.Conclusion:Our findings suggest that HE4 may facilitate ECM remodeling in HGSOC through promoting fibroblast activation and increasing collagen deposition.展开更多
Objective:To determine the incidence,risk factors,antibiotic resistance patterns,and outcomes of various nosocomial infections in Intensive Care Unit(ICU)patients.Methods:The present prospective observational study wa...Objective:To determine the incidence,risk factors,antibiotic resistance patterns,and outcomes of various nosocomial infections in Intensive Care Unit(ICU)patients.Methods:The present prospective observational study was conducted in the multidisciplinary ICU of a tertiary care hospital for 6 months.Incidence,risk factors,and outcome parameters were calculated using Mann Whitney U test,Chi-square test,and stepwise univariate and multivariate logistic regression analysis.Results:The overall incidence of nosocomial infections was 23.5%(74/314).Ventilator-associated pneumonia was the most common infection(54.1%,52/96),followed by catheter-related bloodstream infections(22.9%,22/96).Stress ulcer prophylaxis(aOR 7.691,95%CI 2.202-26.860,P=0.001),endotracheal intubation(aOR 3.251,95%CI 1.251-8.420,P=0.015),Foley’s catheter(aOR 11.917,95%CI 1.335-106.410,P=0.027),and ICU stay>7 days(aOR 30.915,95%CI 10.062-94.980,P=0.001)were statistically significant risk factors associated with nosocomial infection in ICU patients.Gram-negative bacteria showed a high degree of resistance to most of antibiotics except colistin and tigecycline.Infected group's mortality was significantly greater than the uninfected group(21.62%vs.5.83%P<0.001)and had considerably longer ICU length of stay[21(12)vs.7(4)days,P<0.001]and duration of mechanical ventilation[20(11)days vs.0(5)days,P<0.001].Conclusions:This study highlights the high incidence rate of ventilator-associated pneumonia,with extensive drug resistance in ICU patients,highlighting the need for an optimized antimicrobial stewardship program to develop effective strategies for the management of nosocomial infections.Multifaceted interventions targeting modifiable risk factors are essential to reduce the occurences of these nosocomial infections in ICU patients.展开更多
How the subduction direction of the Paleo-Pacific plate beneath the Eurasian plate changes in the Early Cretaceous remains highly controversial due to the disappearance of the subducted oceanic plate.Intraplate deform...How the subduction direction of the Paleo-Pacific plate beneath the Eurasian plate changes in the Early Cretaceous remains highly controversial due to the disappearance of the subducted oceanic plate.Intraplate deformation structures in the east Asian continent,however,provide excellent opportunities for reconstructing paleostress fields in continental interior in relation to the Paleo-Pacific/Eurasian plate interaction.Anisotropy of magnetic susceptibility(AMS),geological,and geochronological analyses of post-kinematic mafic dykes intruding the detachment fault zone of the Wulian metamorphic core complex(WL MCC)in Jiaodong Peninsula exemplify emplacement of mantle-sourced dykes in a WNW-ESE(301°-121°)oriented tectonic extensional setting at ca.120 Ma.In combination with the results from our previous kinematic analysis of the MCC,a ca.21°clockwise change in the direction of intraplate extension is obtained for early(135-122 Ma)extensional exhumation of the MCC to late(122-108 Ma)emplacement of the dykes.Such a change is suggested to be related to the variation in subduction direction of the Paleo-Pacific plate beneath the Eurasian plate,from westward(pre-122 Ma)to west-northwestward(post-122 Ma).展开更多
In order to solve the problems of high coupling and poor scalability of the traditional monomer early warning release system architecture,multi-level deployment in a complex network environment will lead to high inves...In order to solve the problems of high coupling and poor scalability of the traditional monomer early warning release system architecture,multi-level deployment in a complex network environment will lead to high investment in software and hardware and cannot achieve intensive multi-level deployment.This paper realizes the goal of system scalability by introducing micro service architecture and technology stack and realizes the goal of resource intensification by introducing the idea of a data forwarding agent.The designed architecture scheme has been practically applied in the“Jiangxi emergency early warning information release system software platform(phase I)project”(hereinafter referred to as“provincial emergency”),which meets the needs of flexible deployment of multi-level applications across meteorological wide area network(WAN),business private network of other commissions,offices,and bureaus,government extranet,Internet and other complex networks,and fully verifies the scientificity and rationality of the scheme.It has achieved the goal of intensive and scalable construction of provincial emergencies under the complex network environment,greatly improved the early warning capacity and communication capacity of emergencies and comprehensive disasters,provided a reliable guarantee for disaster prevention and reduction,and provided a reference for the construction of current and future early warning release system and capacity improvement project.展开更多
基金supported financially by the National Key Research and Science Program of the Ministry of Science and Technology of the People’s Republic of China(2022YFC2303900)the Beijing Natural Science Foundation(7232242).
文摘Antimicrobial resistance(AMR)has become a critical global public health challenge in the 21st century.Since the initial isolation of a blaNDM-1-carrying and carbapenem-resistant Klebsiella pneumoniae from an Indian hospital in 2009[1],the escalating prevalence of New Delhi metallo-β-lactamase(NDM)-encoding genes(blaNDM)has transformed carbapenem resistance into a worldwide phenomenon,transcending national and regional boundaries[2].Up to 90 distinct NDM variants have been reported globally according to the NCBI GenBank Pathogens database.Plasmidmediated horizontal gene transfer(HGT),which occurs both within and across bacterial species,has significantly accelerated the global dissemination of blaNDM-related genes and the associated resistance[3].Carbapenem-resistant pathogens were responsible for 200,000 deaths globally in 2019[4].Although NDM-1 has been relatively well characterized[5],the epidemiological profiles of other NDM variants require continued surveillance and indepth investigation.The novel NDM-9 variant(GenBank accession no.KC999080)was first identified in 2013 from a clinically significant isolate of Klebsiella pneumoniae ST107 strain PPH1303 with a high level of resistance to carbapenems recovered from the urine culture of a pediatric patient in Beijing,China,who had acute lymphocytic leukemia and had undergone allogeneic stem cell transplantation[6].
文摘AIM: To evaluate the epidemiology and outcomes of culture-positive spontaneous bacterial peritonitis (SBP) and spontaneous bacteremia (SB) in decompensated cirrhosis.METHODS: We prospectively collected clinical, laboratory characteristics, type of administered antibiotic, susceptibility and resistance of bacteria to antibiotics in one hundred thirty cases (68.5% males) with positive ascitic fluid and/or blood cultures during the period from January 1, 2012 to May 30, 2014. All patients with SBP had polymorphonuclear cell count in ascitic fluid > 250/mm<sup>3</sup>. In patients with SB a thorough study did not reveal any other cause of bacteremia. The patients were followed-up for a 30-d period following diagnosis of the infection. The final outcome of the patients was recorded in the end of follow-up and comparison among 3 groups of patients according to the pattern of drug resistance was performed.RESULTS: Gram-positive-cocci (GPC) were found in half of the cases. The most prevalent organisms in a descending order were Escherichia coli (33), Enterococcus spp (30), Streptococcus spp (25), Klebsiella pneumonia (16), S. aureus (8), Pseudomanas aeruginosa (5), other Gram-negative-bacteria (GNB) (11) and anaerobes (2). Overall, 20.8% of isolates were multidrug-resistant (MDR) and 10% extensively drug-resistant (XDR). Health-care-associated (HCA) and/or nosocomial infections were present in 100% of MDR/XDR and in 65.5% of non-DR cases. Meropenem was the empirically prescribed antibiotic in HCA/nosocomial infections showing a drug-resistance rate of 30.7% while third generation cephalosporins of 43.8%. Meropenem was ineffective on both XDR bacteria and Enterococcus faecium (E. faecium). All but one XDR were susceptible to colistin while all GPC (including E. faecium) and the 86% of GNB to tigecycline. Overall 30-d mortality was 37.7% (69.2% for XDR and 34.2% for the rest of the patients) (log rank, P = 0.015). In multivariate analysis, factors adversely affecting outcome included XDR infection (HR = 2.263, 95%CI: 1.005-5.095, P = 0.049), creatinine (HR = 1.125, 95%CI: 1.024-1.236, P = 0.015) and INR (HR =1.553, 95%CI: 1.106-2.180, P = 0.011).CONCLUSION: XDR bacteria are an independent life-threatening factor in SBP/SB. Strategies aiming at restricting antibiotic overuse and rapid identification of the responsible bacteria could help improve survival.
文摘BACKGROUND Bedaquiline is among the prioritized drugs recommended by the World Health Organization for the treatment of extensively drug-resistant tuberculosis(XDRTB).Many patients have not achieved better clinical improvement after bedaquiline is stopped at 24 wk.However,there is no recommendation or guideline on bedaquiline administration beyond 24 wk,which is an important consideration when balancing the benefit of prognosis for XDR-TB against the uncertain safety concerning the newer antibiotics.CASE SUMMARY This paper reported 2 patients with XDR-TB(a female of 58 years of age and a female of 18 years of age)who received bedaquiline for 36 wk,as local experience to be shared.The 2 cases had negative cultures after 24 wk of treatment,but lung imaging was still positive.After discussion among experts,the consensus was made to bedaquiline prolongation by another 12 wk.The 36-wk prolonged use of bedaquiline in both cases achieved a favorable response without increasing the risk of cardiac events or new safety signals.CONCLUSION Longer regimen,including 36-wk bedaquiline treatment,might be an option for patients with XDR-TB.More studies are needed to explore the effectiveness and safety of prolonged use of bedaquiline for 36 wk vs standard 24 wk in the treatment of multidrug-resistant/XDR-TB or to investigate further the biomarkers and criteria indicative for extension of bedaquline to facilitate clinical use of thisnovel drug.
文摘BACKGROUND Pyogenic ventriculitis caused by extensively drug-resistant Acinetobacter baumannii(A.baumannii)is one of the most severe complications associated with craniotomy.However,limited therapeutic options exist for the treatment of A.baumannii ventriculitis due to the poor penetration rate of most antibiotics through the blood-brain barrier.CASE SUMMARY A 68-year-old male patient with severe traumatic brain injury developed pyogenic ventriculitis on postoperative day 24 caused by extensively drug-resistant A.baumannii susceptible to tigecycline only.Successful treatment was accomplished through multi-route administration of tigecycline,including intravenous combined with continuous ventricular irrigation plus intraventricular administration.The pus was cleared on the 3rd day post-irrigation,and cerebrospinal fluid cultures were negative after 12 d.CONCLUSION Our findings suggest that multi-route administration of tigecycline can be a therapeutic option against pyogenic ventriculitis caused by extensively drugresistant A.baumannii.
基金supported by International Joint Laboratory on Tropical Diseases Control in Greater Mekong Subregion(grant number 21410750200)from Shanghai Municipality Government.
文摘Background:Tuberculosis(TB),caused by Mycobacterium tuberculosis,remains the second leading cause of death from a single infectious disease globally and poses a significant economic and clinical burden in the world in 2022.Of particular concern is the emergence of drug-resistant TB,accounting for 15%-20%of TB deaths.It is imperative to delve into the global trends of incidence and death rate for multidrug-resistant tuberculosis(MDRTB)and extensively drug-resistant tuberculosis(XDR-TB),drawing upon the comprehensive Global Burden of Disease(GBD)2021 drug-resistant tuberculosis dataset.Methods:From the GBD 2021,data on incidence,prevalence,disability-adjusted life years(DALYs),and death of MDR-TB and XDR-TB from 1990 to 2021 were collected.We calculated the estimated annual percentage changes in age standardized incidence rate(ASIR)and age-standardized death rate(ASDR),segmented by age,sex,and socio-demographic index(SDI).The impacts of various risk factors on MDR-TB and XDR-TB were also analyzed.Results:In 2021,there were an estimated 443,680(95%uncertainty interval[UI]:259,196-766,545)incident cases of MDR-TB,and an estimated 106,818(95%UI:41,612-211,854)death cases of MDR-TB,while there were an estimated 24,036(95%UI:17,144-34,587)incident cases of XDR-TB and 7,946(95%UI:3,326-14,859)death cases of XDR-TB.The incidence and death cases of MDR-TB were lowest in high SDI regions,whereas the incidence rates of XDR-TB in high-middle SDI regions were higher than those in middle SDI and high SDI regions.Conclusion:This study reported the disease burden of drug-resistant TB from 1990 to 2021.Until 2021,drugresistant TB is still a serious problem in low SDI countries,especially for high-risk age populations with highrisk factors.Controlling drug-resistant TB requires effective control strategies and healthcare systems.
基金Science and Technology Projects in Key Fields of Traditional Chinese Medicine in Tianjin(No.2021010)Discipline Development Fund of First Teaching Hospital of Tianjin University of Traditional Chinese Medicine(No.XKJJ201734)。
文摘Objective:To establish extensively drug-resistant Pseudomonas aeruginosa(XDR-PA)infection-induced pneumonia model in rats.Methods:Twenty-four male SD rats were randomly divided into blank group,low bacterial group,medium bacterial group,and high bacterial group.The low,medium and high bacterial groups were given intratracheal instillation of 0.1 mL of bacterial suspension(bacterial concentration in turn is 7.5×10^(9),3×10^(10),6×10^(10)CFU/mL),while the blank group were given the same volume of sterile normal saline.After modeling,the general conditions of rats in each group were observed,including mental state,hair,respiration,activity,eating,weight,and the survival curve was drawn.The pathological characteristics of lung tissue and the infiltration of inflammatory cells were observed.Pathogenic identification of each group was carried out by bacterial culture of lung tissue homogenate.Results:The general state of the blank group was normal,and the rats in other groups showed signs of mental depression,bristling,shortness of breath,even oral and nasal bleeding,decreased food intake and activity,and significant weight loss,and different degrees of death within 48 hours,the difference was statistically significant(P<0.05).Pathological results showed that the alveolar structure of rats in the blank group was complete,and the alveolar space was clear without exudation.The lung tissue of the low and medium bacterial groups showed obvious inflammatory cell infiltration,alveolar structure destruction,alveolar septum thickening,interstitial edema,but the pathological damage of the medium group was more severe,with a mortality rate of up to 50%,and the mortality rate of the low bacterial group was 17%.In the high bacterial group,red blood cells,inflammatory cells and a large amount of fibrin-like exudation can be seen in the alveolar space,which has the pathological characteristics of acute respiratory failure,and the mortality rate is as high as 67%.The results of bacterial culture of lung tissue homogenate showed that the blank group had no bacterial colonies,while PA colony growth can be seen in low,medium and high bacterial groups.Conclusion:9 Intratracheal instillation of low bacterial count(0.1 mL of 7.5×10^(9) CFU/mL)XDR-PA bacterial suspension can successfully construct a rat pneumonia model of XDR-PA infection.
文摘Emerging and rapidly spreading multidrug resistant bacteria constitute a rising public health concern worldwide. Acinetobacter baumannii is one of these bacteria that cause different infections including pneumonia, bacteremia, meningitis, soft-tissue, and urinary tract infections, and are associated with high mortality and economic burden. We present a case of a 43-year-old woman, admitted at the department of orthopedics, regional hospital of Ourossogui, North-East of Senegal for soft-tissue injuries. Initially diagnosed with Yersinia pestis infection, the patient was well managed before being released. Supplementary sampling for confirmatory tests allowed the detection of an extensively drug-resistant Acinetobacter baumannii clone.
文摘Rationale:Salmonella(S.)typhi is a rare cause of osteomyelitis in immunocompetent adults.Extensive drug resistance(XDR)may lead to more complicated cases of S.typhi osteomyelitis.Patient concern:A 55-year-old female presented with a persistent low-grade fever and a swelling on her lower left chest with a sinus discharging purulent fluid for the past 8 months.Her symptoms had been unresponsive to previous anti-microbial therapy.Diagnosis:Rib osteomyelitis caused by XDR S.typhi.Interventions:Surgical wound debridement,left 7th-9th rib resection and intravenous Ⅳ meropenem were done.Outcome:Fever resolved and left-sided swelling resected without recurrence.Lessons:The prevalence of XDR S.typhi is growing in South Asia and should be considered as the differential diagnosis of chronic osteomyelitis.
文摘Background Diagnosis and appropriate treatment of multidrug-resistant tuberculosis （MDR-TB） remain major challenges. We sought to elucidate that persons who share a household with drug resistance tuberculosis patients are at high risk for primary drug resistance tuberculosis and how to prevent these outbreaks. Methods We used 12-locus mycobactedal interspersed repetitive unit and 7-locus variable-number tandem repeat to identify household transmission of extensively drug resistant and multiple drug resistant Mycobacterium tuberculosis in three families admitted in Shanghai Pulmonary Hospital affiliated with Tongji University. Drug susceptibility tests were done by the modified proportion method in the MGIT 960 system in the same time. Clinical data were also obtained from the subjects＇ medical records. Results All of the six strains were defined as Beijing genotype by the deletion-targeted multiplex PCR （DTM-PCR） identification on the genomic deletion RD105. Strains from family-1 had the same minisatellite interspersed repetitive unit （MIRU） pattern （232225172531） and the same MIRU pattern （3677235）. Strains from family-2 had the same MIRU pattern （2212261553323） and the same MIRU pattern （3685134）. Strains from family-3 did not have the same MIRU pattern and they differed at only one locus （223326173533, 223325173533）, and did not have the same VNTR pattern with two locus differed （3667233, 3677234）. Conclusions Household transmission exists in the three families. A clear chain of tuberculosis transmission within family exists. Tuberculosis susceptibility should be considered when there is more than one tuberculosis patients in a familv. Household tuberculosis transmission could be prevented with adequate treatment of source Patients.
文摘Total hip arthroplasty （THA） is one of the most clinically successful surgeries. Despite the prevalence of THA, the number of revisions for septic or aseptic reasons continues to increase.
基金Supported by National Natural Science Foundation of China(Grant No.11971418).
文摘In this paper,we offer a new construction of Stefan’s homological spectral sequence for Hopf Galois extensions,by using the double complex argument.Under the faithfully flat condition,a method for computation of Hochschild homology is given.
基金supported by National Natural Science Foundation of China(No.62301008)China Postdoctoral Science Foundation(No.2022M720272)New Cornerstone Science Foundation through the XPLORER PRIZE。
文摘Mobile communications are reaching out to every aspect of our daily life,necessitating highefficiency data transmission and support for diverse data types and communication scenarios.Polar codes have emerged as a promising solution due to their outstanding error-correction performance and low complexity.Unequal error protection(UEP)involves nonuniform error safeguarding for distinct data segments,achieving a fine balance between error resilience and resource allocation,which ultimately enhancing system performance and efficiency.In this paper,we propose a novel class of UEP rateless polar codes.The codes are designed based on matrix extension of polar codes,and elegant mapping and duplication operations are designed to achieve UEP property while preserving the overall performance of conventional polar codes.Superior UEP performance is attained without significant modifications to conventional polar codes,making it straightforward for compatibility with existing polar codes.A theoretical analysis is conducted on the block error rate and throughput efficiency performance.To the best of our knowledge,this work provides the first theoretical performance analysis of UEP rateless polar codes.Simulation results show that the proposed codes significantly outperform existing polar coding schemes in both block error rate and throughput efficiency.
基金funded by the Guangzhou Development Zone Science and Technology Project(2023GH02)the University of Macao(MYRG2022-00271-FST)research grants by the Science and Technology Development Fund of Macao(0032/2022/A)and(0019/2025/RIB1).
文摘Accurately recognizing driver distraction is critical for preventing traffic accidents,yet current detection models face two persistent challenges.First,distractions are often fine-grained,involving subtle cues such as brief eye closures or partial yawns,which are easily missed by conventional detectors.Second,in real-world scenarios,drivers frequently exhibit overlapping behaviors,such as simultaneously holding a cup,closing their eyes,and yawning,leading tomultiple detection boxes and degradedmodel performance.Existing approaches fail to robustly address these complexities,resulting in limited reliability in safety critical applications.To overcome these pain points,we propose YOLO-Drive,a novel framework that enhances YOLO-based driver monitoring with EfficientViM and Polarized Spectral–Spatial Attention(PSSA)modules.Efficient ViMprovides lightweight yet powerful global–local feature extraction,enabling accurate recognition of subtle driver states.PSSA further amplifies discriminative features across spatial and spectral domains,ensuring robust separation of concurrent distraction cues.By explicitly modeling fine-grained and overlapping behaviors,our approach delivers significant improvements in both precision and robustness.Extensive experiments on benchmark driver distraction datasets demonstrate that YOLO-Drive consistently out-performs stateof-the-art models,achieving higher detection accuracy while maintaining real-time efficiency.These results validate YOLO-Drive as a practical and reliable solution for advanced driver monitoring systems,addressing long-standing challenges of subtle cue recognition and multi-cue distraction detection.
文摘Article Article types Articles commonly fall into one of three main categories: Fulllength articles, Review articles and Short communications.Full-length articles are original, unpublished primary research. Extensions of work that has been published previously in short form such as a Communication are usually acceptable.Short communications must contain original and highly significant work whose high novelty warrants rapid publication.Review articles may be an authoritative overview of a field, a comprehensive literature reviews, or tutorial-style reference materials. Reviews are usually invited by the editor, but a topic may be proposed by an author via the editorial office.
文摘Article Article types Articles commonly fall into one of three main categories: Full-length articles, Review articles and Short communications.Full-length articles are original, unpublished primary research. Extensions of work that has been published previously in short form such as a Communication are usually acceptable.Short communications must contain original and highly significant work whose high novelty warrants rapid publication.
文摘BACKGROUND With the increasing use of laparoscopic techniques in living-donor kidney transplantation,limitations in donor vessel length,particularly of the right renal vein,pose significant challenges for vascular anastomosis to the recipient’s external iliac vein.These anatomical constraints can complicate graft implantation and increase the risk of postoperative complications.CASE SUMMARY To address the issue of short right renal veins,several surgical strategies have been proposed.In this report,we describe our experience with three cases in which venous extension was successfully achieved using a venous cuff interposition technique during back-table reconstruction.This approach was used to facilitate secure vascular anastomosis and improve graft positioning in anatomically complex transplant scenarios.CONCLUSION Venous cuff interposition represents an effective technique for managing short renal veins in living-donor kidney transplantation.It provides additional length and flexibility,easing anastomotic tension and supporting successful transplantation.
文摘Objectives:High-grade serous ovarian cancer(HGSOC),the most common subtype of epithelial ovarian cancer(EOC),exhibits a mesenchymal phenotype characterized by fibrotic stroma and poor prognosis.Human epididymis protein 4(HE4),a key diagnostic biomarker for ovarian cancer,is involved in fibrotic processes in several non-malignant diseases.Given the clinical significance of stromal fibrosis in HGSOC and the potential link between HE4 and fibrosis,this study aimed to investigate the role of HE4 in the formation of stromal fibrosis in HGSOC.Methods:A total of 126 patients with gynecological conditions were included and divided into normal,benign,and EOC groups.Tissue stiffness was quantitatively measured and analyzed for its correlation with clinicopathological features.We further investigated the correlation between tumor stiffness and the expression levels of HE4 and fibroblast activation markers(α-smooth muscle actin(α-SMA)and fibroblast activation protein(FAP))in tumor tissues from 22 HGSOC patients.In vitro,primary fibroblasts were treated with recombinant HE4(rHE4)or conditioned media from HE4-knockdown ovarian cancer cells to assess fibroblasts activation and matrix contractility(Collagen gel contraction assays).In vivo,a subcutaneous xenograft model using HE4-knockdown cells was established to evaluate the effects of HE4 suppression on tumor growth and extensive extracellular matrix(ECM)remodeling.Results:Ovarian cancer tissues showed significantly increased stiffness compared to benign/normal groups,showing positive correlation with serum HE4 levels.High-stiffness HGSOC tumors exhibited upregulated expression of HE4,α-SMA,FAP,and collagen I.rHE4 stimulated fibroblast activation and enhanced matrix contractility,whereas HE4 knockdown in cancer cells abrogated these pro-fibrotic effects.In vivo,HE4-silenced xenografts displayed restricted tumor growth accompanied by reduced stromal expression ofα-SMA,FAP,and collagen I.Conclusion:Our findings suggest that HE4 may facilitate ECM remodeling in HGSOC through promoting fibroblast activation and increasing collagen deposition.
文摘Objective:To determine the incidence,risk factors,antibiotic resistance patterns,and outcomes of various nosocomial infections in Intensive Care Unit(ICU)patients.Methods:The present prospective observational study was conducted in the multidisciplinary ICU of a tertiary care hospital for 6 months.Incidence,risk factors,and outcome parameters were calculated using Mann Whitney U test,Chi-square test,and stepwise univariate and multivariate logistic regression analysis.Results:The overall incidence of nosocomial infections was 23.5%(74/314).Ventilator-associated pneumonia was the most common infection(54.1%,52/96),followed by catheter-related bloodstream infections(22.9%,22/96).Stress ulcer prophylaxis(aOR 7.691,95%CI 2.202-26.860,P=0.001),endotracheal intubation(aOR 3.251,95%CI 1.251-8.420,P=0.015),Foley’s catheter(aOR 11.917,95%CI 1.335-106.410,P=0.027),and ICU stay>7 days(aOR 30.915,95%CI 10.062-94.980,P=0.001)were statistically significant risk factors associated with nosocomial infection in ICU patients.Gram-negative bacteria showed a high degree of resistance to most of antibiotics except colistin and tigecycline.Infected group's mortality was significantly greater than the uninfected group(21.62%vs.5.83%P<0.001)and had considerably longer ICU length of stay[21(12)vs.7(4)days,P<0.001]and duration of mechanical ventilation[20(11)days vs.0(5)days,P<0.001].Conclusions:This study highlights the high incidence rate of ventilator-associated pneumonia,with extensive drug resistance in ICU patients,highlighting the need for an optimized antimicrobial stewardship program to develop effective strategies for the management of nosocomial infections.Multifaceted interventions targeting modifiable risk factors are essential to reduce the occurences of these nosocomial infections in ICU patients.
基金supported by the National Natural Science Foundation of China(Grant Nos:42130801,41430211,90814006,and 42072226)the“Deep-time Digital Earth”Science and Technology Leading Talents Team Funds for the Central Universities for the Frontiers Science Center for Deep-time Digital Earth,CUGB(Fundamental Research Funds for the Central UniversitiesGrant No:2652023001).
文摘How the subduction direction of the Paleo-Pacific plate beneath the Eurasian plate changes in the Early Cretaceous remains highly controversial due to the disappearance of the subducted oceanic plate.Intraplate deformation structures in the east Asian continent,however,provide excellent opportunities for reconstructing paleostress fields in continental interior in relation to the Paleo-Pacific/Eurasian plate interaction.Anisotropy of magnetic susceptibility(AMS),geological,and geochronological analyses of post-kinematic mafic dykes intruding the detachment fault zone of the Wulian metamorphic core complex(WL MCC)in Jiaodong Peninsula exemplify emplacement of mantle-sourced dykes in a WNW-ESE(301°-121°)oriented tectonic extensional setting at ca.120 Ma.In combination with the results from our previous kinematic analysis of the MCC,a ca.21°clockwise change in the direction of intraplate extension is obtained for early(135-122 Ma)extensional exhumation of the MCC to late(122-108 Ma)emplacement of the dykes.Such a change is suggested to be related to the variation in subduction direction of the Paleo-Pacific plate beneath the Eurasian plate,from westward(pre-122 Ma)to west-northwestward(post-122 Ma).
文摘In order to solve the problems of high coupling and poor scalability of the traditional monomer early warning release system architecture,multi-level deployment in a complex network environment will lead to high investment in software and hardware and cannot achieve intensive multi-level deployment.This paper realizes the goal of system scalability by introducing micro service architecture and technology stack and realizes the goal of resource intensification by introducing the idea of a data forwarding agent.The designed architecture scheme has been practically applied in the“Jiangxi emergency early warning information release system software platform(phase I)project”(hereinafter referred to as“provincial emergency”),which meets the needs of flexible deployment of multi-level applications across meteorological wide area network(WAN),business private network of other commissions,offices,and bureaus,government extranet,Internet and other complex networks,and fully verifies the scientificity and rationality of the scheme.It has achieved the goal of intensive and scalable construction of provincial emergencies under the complex network environment,greatly improved the early warning capacity and communication capacity of emergencies and comprehensive disasters,provided a reliable guarantee for disaster prevention and reduction,and provided a reference for the construction of current and future early warning release system and capacity improvement project.
