The new method for simultaneous determination of the concentrations of fluorine and chlorine in river water with double indicative electrodes is developed, and the quantitative analysis formulas that the inputs of ele...The new method for simultaneous determination of the concentrations of fluorine and chlorine in river water with double indicative electrodes is developed, and the quantitative analysis formulas that the inputs of electrode were exchanged by using self-made joints were induced. With this method,the synthetic water samples and the water samples taken from Majiagou River were analyzed. The results of determinations are satisfactory. The relative errors were<10.0% for F and <3.0%for Cl. The recoveries werc 90-101% for F and 90-110% tbr Cl. The relative standard deviations were < 15.2% for F and < 10.1% for Cl-. The advantages of this method is accurate, rapid and simple.展开更多
The Uranium-238 (<sup>238</sup>U), Thorium-232 (<sup>232</sup>Th) families and Potassium-40 (<sup>40</sup>K) are of terrestrial origin and contribute generally to an individual’s e...The Uranium-238 (<sup>238</sup>U), Thorium-232 (<sup>232</sup>Th) families and Potassium-40 (<sup>40</sup>K) are of terrestrial origin and contribute generally to an individual’s external exposure through our presence in this environment. They also contribute to the internal exposure through the ingestion of products and beverages such as water that are close to the earth. The aim of this work is to determine the committed effective dose or Total Indicative Dose (TID) due to gamma radioactivity of the borehole water from the Nord Riviera (NR) well field operated by the Côte d’Ivoire Water Distribution Company (SODECI) for the supply of drinking water to part of the population of Abidjan. In addition, the populations, with their habits, could use these borehole waters directly as drinking water. To this end, water samples from the seven (07) functional boreholes were collected and analyzed on a gamma spectrometry chain, equipped with an HPGe detector in the laboratory of the Radiation Protection Institute (RPI) of the GHANA Atomic Energy Commission (GAEC). The results of the specific activities of <sup>238</sup>U, <sup>232</sup>Th and <sup>40</sup>K obtained were transcribed into TID. As the natural radioactivity of the borehole water is high [1], the TIDs calculated from the activity results of the natural radionuclides<sup>238</sup>U, <sup>232</sup>Th, and <sup>40</sup>K vary for the seven boreholes from 0.150 to 0.166 mSv/yr with an average of 0.161 ± 0.034 mSv/yr. The TID of the control tower, where the borehole water is mixed and treated for household use, is equal to 0.136 ± 0.03 mSv/yr. The TIDs obtained are therefore all slightly greater than the WHO reference dose value of 0.1 mSv/yr. But all remain below the UNSCEAR reference dose of 0.29 mSv/yr.展开更多
An abnormality tends to occur in the productivity indicative curves in the process of productivity test interpretation of multi-layer gas wells,resulting in the failure of solutions to their productivity equations and...An abnormality tends to occur in the productivity indicative curves in the process of productivity test interpretation of multi-layer gas wells,resulting in the failure of solutions to their productivity equations and absolute open flow rates.To figure out the reasons for such an abnormality,we established a full-hole calculation model considering the coupling of wellbore variable mass flows and reservoir seepages to calculate a gas production profile and wellbore pressure distribution of a multi-layer productive gas reservoir.Then,based on the analysis of the gas production profile and wellbore pressure distribution characteristics of gas wells at different gas production rates,the root cause for the abnormality in the productivity indicative curves of multi-layer gas wells was analyzed,and a corresponding correction method was proposed and validated based on some examples.And the following research results were obtained.First,there are two reasons for the abnormal productivity indicative curves of multi-layer gas wells.On the one hand,there is a variable mass pipe flow in the wellbore of multi-layer sections and a flowing pressure gradient decreases with the increase of well depth.And the flowing pressure in the middle of the reservoir which is converted based on the flowing pressure gradient above the pressure gauge is higher than the real value.On the other hand,the pressure in the multi-layer producing sections doesn't realize a balance after well shutdown for a short time,so the measured static pressure is greater than the one measured when the pressure of each layer gets balanced after well shutdown for a long time.Second,the flowing pressure obtained from the productivity test interpretation of multi-layer gas producer shall be converted based on the pressure measured by the pressure gauge within 200 m above the reservoir top and it is necessary to adopt the static pressure measured after the balance of wellbore pressure.Third,the reliability of the model,the rationality of the abnormality reason analysis and the validity of the correction method are verified based on calculation examples and cases.It is concluded that the research results provide a technical support for the productivity evaluation of multi-layer gas wells.展开更多
Recently there have been two causal modelling approaches to indicative conditionals,i.e.extrapolationist(Deng&Lee,2021)and filterist(Liang&Wang,2022),although they all take an interventionist position on subju...Recently there have been two causal modelling approaches to indicative conditionals,i.e.extrapolationist(Deng&Lee,2021)and filterist(Liang&Wang,2022),although they all take an interventionist position on subjunctive conditionals.Motivated by the so-called OK pairs,they try to provide a convincing explanation of the intuition underlying the OK pairs.As far as we know,what they have done is to provide not only an explanation of the OK pairs,but also a way of distinguishing between indicative and subjunctive conditionals.Although we agree with their success in explaining the OK pairs within a causal modelling framework,we argue that their ways of distinguishing between indicative and subjunctive conditionals fail.Instead,we argue that their approaches can be used to distinguish between two readings of conditionals,the epistemic reading and the ontic reading.which can be applied to both indicative and subjunctive conditionals.We conclude by arguing that these two readings are related to two approaches to asking and answering causal questions:the“auses-of-effects"approach and the"effects-of-causes"approach.展开更多
BACKGROUND Inappropriate selection of patients with early gastric cancer(EGC)for endoscopic submucosal dissection(ESD)may lead to non-curative resection,necessitating additional gastrectomy.Conversely,inappropriate se...BACKGROUND Inappropriate selection of patients with early gastric cancer(EGC)for endoscopic submucosal dissection(ESD)may lead to non-curative resection,necessitating additional gastrectomy.Conversely,inappropriate selection for gastrectomy may result in overtreatment,adversely affecting patients’quality of life.Few have systematically evaluated the concordance between therapeutic indications under current Japanese guidelines and pathological criteria in EGC.To minimize noncurative resection risks while sparing unnecessary surgery for low-risk patients’,we specifically assess the suitability of Japanese guidelines in non-Japanese populations.This work aims to optimize clinical practice by refining endoscopic treatment criteria for adoption beyond Japan.AIM To evaluate EGC clinical decision accuracy by comparing therapeutic indication with postoperative pathological criteria and analyzing factors influencing discrepancies.METHODS A retrospective analysis was conducted on 796 EGC cases diagnosed at Peking University Third Hospital between January 2010 and December 2022.Cases were categorized into three groups:Same-estimated(preoperative therapeutic indication with postoperative pathological criteria matched),underestimated(preoperative ESD indication but postoperative surgical criteria),and overestimated(preoperative surgical indication but postoperative ESD criteria).The rate of discrepancy and associated risk factors were assessed.RESULTS The accuracy rates of preoperative evaluation for ESD and gastrectomy indications were 73.0%(321/430)and 76.0%(278/366),respectively.The overall discrepancy rate was 25.6%(204/796).Multivariate analysis identified tumor location in the upper-third stomach(odds ratio=2.158,95%confidence interval:1.373-3.390,P=0.001)was significantly associated with a higher likelihood of being underestimated and undifferentiated histologic type on preoperative biopsy(odds ratio=2.005,95%confidence interval:1.036-3.879,P=0.039)was more likely to be overestimated.Significant differences were observed in tumor diameter(P<0.001),depth of infiltration(P<0.001),ulcerative findings(P<0.001),and histologic type(P<0.001)between preoperative and postoperative evaluations.CONCLUSION The accuracy of preoperative EGC indications is 74.4%.Upper-third stomach and undifferentiated histology are primary discrepancy predictors.Upper-third tumors are prone to underestimation,while undifferentiated tumors are prone to overestimation.展开更多
We used solidification/stabilization methods to remediate highly concentrated Zn^(2+)-contaminated soil.An industrial waste mixture of red mud,carbide slag,and phosphogypsum is combined with cement as the curing agent...We used solidification/stabilization methods to remediate highly concentrated Zn^(2+)-contaminated soil.An industrial waste mixture of red mud,carbide slag,and phosphogypsum is combined with cement as the curing agent.The mixing ratios of the four materials are determined by comparing the strength,permeability coefficient,pH,and Zn^(2+)-leaching concentration of the solidified soil.Microscopic characteristics of the solidified uncontaminated soil and solidified Zn^(2+)-contaminated soil were observed using scanning electron microscopy,X-ray diffraction,and Fourier-transform infrared spectroscopy.Furthermore,the heavy metals speciation in both pure cement and mixed-material solidified soil was examined,demonstrating the beneficial role of the mixed-type curing agent in stabilizing heavy metals.The research results indicate that Zn^(2+)degrade the strength of the solidified soil by up to 90%.The permeability coefficient,pH,and Zn^(2+)-leaching concentration of the solidified soil easily meet standard,especially with Zn^(2+)leaching concentration well below the environmental protection limit.Furthermore,most Zn^(2+)exists in forms with lower biological and chemical reactivity.Both the solidified Zn^(2+)-contaminated soil and uncontaminated soil resulted in the formation of hydrated products containing elements such as silicon,aluminum,calcium,and sulfur.Additionally,the solidified Zn^(2+)-contaminated soil produced zinc-containing compounds and a large amount of rod-shaped ettringite.展开更多
Wetland degradation is an escalating global challenge with profound impacts on animal diversity,particularly during successional processes.Birds,as highly mobile and environmentally sensitive organisms,serve as effect...Wetland degradation is an escalating global challenge with profound impacts on animal diversity,particularly during successional processes.Birds,as highly mobile and environmentally sensitive organisms,serve as effective indicators of ecological change.While previous studies have primarily focused on local community structures and species diversity during a specific season,there is a need to extend the research timeframe and explore broader spatial variations.Additionally,expanding from simple species diversity indices to more multidimensional diversity indices would provide a more comprehensive understanding of wetland health and resilience.To address these gaps,we investigated the effects of wetland degradation on bird diversity across taxonomic,phylogenetic,and functional dimensions in the Zoige Wetland,a plateau meadow wetland biodiversity hotspot.Surveys were conducted during both breeding(summer)and overwintering(winter)seasons across 20 transects in 5 sampling areas,representing 4 degradation levels(pristine,low,medium,and high).Our study recorded a total of 106 bird species from 32 families and 14 orders,revealing distinct seasonal patterns in bird community composition and diversity.Biodiversity indices were significantly higher in pristine and low-degraded wetlands,particularly benefiting waterfowl(Anseriformes,Ciconiiformes)and wading birds(Charadriiformes)in winter,when these areas provided superior food resources and habitat conditions.In contrast,medium and highly degraded wetlands supported increased numbers of terrestrial birds(Passeriformes)and raptors(Accipitriformes,Falconiformes).Seasonal differences in taxonomic,phylogenetic,and functional diversity indices highlighted the contrasting ecological roles of wetlands during breeding and overwintering periods.Furthermore,indicator species analysis revealed key species associated with specific degradation levels and seasons,providing valuable insights into wetland health.This study underscores the importance of spatiotemporal dynamics in understanding avian responses to wetland degradation.By linking seasonal patterns of bird diversity to habitat conditions,our findings contribute to conservation efforts and provide a framework for assessing wetland degradation and its ecological impacts.展开更多
Cardiovascular diseases(CVDs)remain the leading cause of morbidity and mortality worldwide,necessitating innovative diagnostic and prognostic strategies.Traditional biomarkers like C-reactive protein,uric acid,troponi...Cardiovascular diseases(CVDs)remain the leading cause of morbidity and mortality worldwide,necessitating innovative diagnostic and prognostic strategies.Traditional biomarkers like C-reactive protein,uric acid,troponin,and natriuretic peptides play crucial roles in CVD management,yet they are often limited by sensitivity and specificity constraints.This narrative review critically examines the emerging landscape of cardiac biomarkers and advocates for a multiple-marker approach to enhance early detection,prognosis,and risk stratification of CVD.In recent years,several novel biomarkers have shown promise in revolutionizing CVD diagnostics.Gamma-glutamyltransferase,microRNAs,endothelial microparticles,placental growth factor,trimethylamine N-oxide,retinol-binding protein 4,copeptin,heart-type fatty acid-binding protein,galectin-3,growth differentiation factor-15,soluble suppression of tumorigenicity 2,fibroblast growth factor 23,and adrenomedullin have emerged as significant indicators of CV health.These biomarkers provide insights into various pathophysiological processes,such as oxidative stress,endothelial dysfunction,inflammation,metabolic disturbances,and myocardial injury.The integration of these novel biomarkers with traditional ones offers a more comprehensive understanding of CVD mechanisms.This multiple-marker approach can improve diagnostic accuracy,allowing for better risk stratification and more personalized treatment strategies.This review underscores the need for continued research to validate the clinical utility of these biomarkers and their potential incorporation into routine clinical practice.By leveraging the strengths of both traditional and novel biomarkers,precise therapeutic plans can be developed,thereby improving the management and prognosis of patients with CVDs.The ongoing exploration and validation of these biomarkers are crucial for advancing CV care and addressing the limitations of current diagnostic tools.展开更多
The advent of precision medicine has underscored the importance of biomarkers in predicting therapy response for bladder cancer,a malignancy marked by considerable heterogeneity.This review critically examines the cur...The advent of precision medicine has underscored the importance of biomarkers in predicting therapy response for bladder cancer,a malignancy marked by considerable heterogeneity.This review critically examines the current landscape of biomarkers to forecast treatment outcomes in bladder cancer patients.We explore a range of biomarkers,including genetic,epigenetic,proteomic,and transcriptomic indicators,from multiple sample sources,including urine,tumor tissue and blood,assessing their efficacy in predicting responses to chemotherapy,immunotherapy,and targeted therapies.Despite promising developments,the translation of these biomarkers into clinical practice faces significant challenges,such as variability in biomarker performance,the necessity for large-scale validation studies,and the integration of biomarker testing into routine clinical workflows.We also highlight the need for standardized methodologies and robust assays to ensure consistency and reliability.Future directions point towards longitudinal studies and the development of combination biomarker panels to enhance predictive accuracy.This review emphasizes the transformative potential of predictive biomarkers in improving patient outcomes and advocates for continued collaborative efforts to overcome existing barriers in this rapidly evolving field.展开更多
BACKGROUND Type 2 diabetes mellitus(T2DM),a chronic metabolic disease with a high global incidence,has become a serious public health challenge.China has the largest number of T2DM patients worldwide,imposing a signif...BACKGROUND Type 2 diabetes mellitus(T2DM),a chronic metabolic disease with a high global incidence,has become a serious public health challenge.China has the largest number of T2DM patients worldwide,imposing a significant economic burden on the healthcare system.T2DM is closely associated with insulin resistance,impaired pancreatic B cell function,and disordered glucose and lipid metabolism,which can lead to various complications,reducing patients'quality of life and increasing the risk of disability and death.Thus,finding effective preventive and intervention measures is crucial.Exercise therapy,a key part of diabetes management,has gained attention in recent years,with many studies indicating its benefits for blood glucose control and other aspects in diabetic patients.AIM To assess the effectiveness of combined resistance and aerobic exercise interventions on blood glucose control and metabolic indicators in patients with T2DM and to explore their application in diabetes management.METHODS Systematic searches were conducted using PubMed,EMBASE,Cochrane Library,and Chinese databases for relevant randomized controlled trials(RCTs).The inclusion criteria were participants aged≥18 years with T2DM and the intervention involved combined resistance and aerobic exercise for≥8 weeks.The primary outcome indicators were fasting blood glucose,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),triglycerides(TG),glycated hemoglobin A1c(HbA1c),and total cholesterol(TC)levels.Data analysis was performed using RevMan software,and the interventional effects were assessed using weighted mean differences or standardized mean differences(SMD).RESULTS Six RCTs meeting the inclusion criteria were included,with a total sample size of 366 participants.The meta-analysis results showed that combined resistance and aerobic exercise significantly improved several metabolic indicators in patients with T2DM.Specific results were as follows:(1)For fasting blood glucose,combined exercise was more effective than aerobic exercise alone[SMD=1.22;95%confidence interval(95%CI):0.70,1.74;P<0.00001];(2)LDL-C levels were significantly reduced by the combined intervention(SMD=1.45;95%CI:1.18-1.72;P<0.00001);(3)The combined intervention significantly increased HDL-C levels(SMD=1.42;95%CI:0.98-1.87;P<0.00001);(4)The combined intervention significantly reduced TG levels(SMD=1.12;95%CI:0.85-1.39;P<0.00001;(5)No statistically significant difference was observed in HbA1c between the combined and the aerobic exercise group(SMD=-0.03;95%CI:-1.09 to 1.04;P<0.00001);and(6)The combined exercise intervention group significantly reduced TC levels(SMD=2.66;95%CI:1.93-3.38;P<0.00001).The subgroup analysis results suggest that the effect of exercise interventions may be influenced by various factors,including the patient's age,baseline blood glucose levels,and exercise intensity.CONCLUSION Combined resistance and aerobic exercise intervention significantly improved fasting blood glucose,LDL-C,HDL-C,TG,and TC levels in patients with T2DM,especially in terms of blood glucose control and cardiovascular risk,demonstrating better outcomes than aerobic exercise alone.展开更多
BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU ad...BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU admissions are associated with increased morbidity and mortality and are an indicator of trauma service quality.Two different types of unplanned ICU admissions include upgrades(patients admitted to the floor then moved to the ICU)and bounce backs(patients admitted to the ICU,discharged to the floor,and then readmitted to the ICU).Previous studies have shown that geriatric trauma patients are at higher risk for unfavorable outcomes.AIM To analyze the characteristics,management and outcomes of trauma patients who had an unplanned ICU admission during their hospitalization.METHODS This institutional review board approved,retrospective cohort study examined 203 adult trauma patients with unplanned ICU admission at an urban level 1 trauma center over a six-year period(2017-2023).This included 134 upgrades and 69 bounce backs.Analyzed variables included:(1)Age;(2)Sex;(3)Comorbidities;(4)Mechanism of injury(MOI);(5)Injury severity score(ISS);(6)Glasgow Coma Scale(GCS);(7)Type of injury;(8)Transfusions;(9)Consultations;(10)Timing and reason for unplanned admission;(11)Intubations;(12)Surgical interventions;(13)ICU and hospital lengths of stay;and(14)Mortality.RESULTS Unplanned ICU admissions comprised 4.2%of total ICU admissions.Main MOI was falls.Mean age was 70.7 years,ISS was 12.8 and GCS was 13.9.Main injuries were traumatic brain injury(37.4%)and thoracic injury(21.7%),and main reason for unplanned ICU admission was respiratory complication(39.4%).The 47.3%underwent a surgical procedure and 46.8%were intubated.Average timing for unplanned ICU admission was 2.9 days.Bounce backs occurred half as often as upgrades,however had higher rates of transfusions(63.8%vs 40.3%,P=0.002),consultations(4.8 vs 3.0,P<0.001),intubations(63.8%vs 38.1%%,P=0.001),longer ICU lengths of stay(13.2 days vs 6.4 days,P<0.001)and hospital lengths of stay(26.7 days vs 13.0 days,P<0.001).Mortality was 25.6%among unplanned ICU admissions,31.9%among geriatric unplanned ICU admissions and 11.9%among all trauma ICU patients.CONCLUSION Unplanned ICU admissions constituted 4.2%of total ICU admissions.Respiratory complications were the main cause of unplanned ICU admissions.Bounce backs occurred half as often as upgrades,but were associated with worse outcomes.展开更多
Succinylcholine(SC)is a widely used depolarizing muscle relaxant,but improper use can lead to arrhythmias and,in severe cases,pose a life-threatening risk.Additionally,some criminals exploit SC for illicit activities....Succinylcholine(SC)is a widely used depolarizing muscle relaxant,but improper use can lead to arrhythmias and,in severe cases,pose a life-threatening risk.Additionally,some criminals exploit SC for illicit activities.Therefore,rapid SC detection is paramount for clinical practice and public safety.Currently,however,limited methods are available for the rapid detection of SC.A fluorescent indicator displacement assay sensor based on molecular recognition of an amide naphthotube was developed.This sensor enabled the rapid fluorescent detection of SC through competitive binding between SC and methylene blue with the amide naphthotube.The sensor exhibited exceptional sensitivity with a detection limit as low as 1.1μmol/L and a detection range of 1.1~60μmol/L,coupled with outstanding selectivity and robust stability.Furthermore,this sensor accurately determined SC levels in biological samples such as serum.In summary,this research provides a new solution for the rapid and accurate sensing of SC in complex matrices and offers new insights for the swift identification and detection of toxins.展开更多
In order to accurately forecast the main engine fuel consumption and reduce the Energy Efficiency Operational Indicator(EEOI)of merchant ships in polar ice areas,the energy transfer relationship between ship-machine-p...In order to accurately forecast the main engine fuel consumption and reduce the Energy Efficiency Operational Indicator(EEOI)of merchant ships in polar ice areas,the energy transfer relationship between ship-machine-propeller is studied by analyzing the complex force situation during ship navigation and building a MATLAB/Simulink simulation platform based on multi-environmental resistance,propeller efficiency,main engine power,fuel consumption,fuel consumption rate and EEOI calculation module.Considering the environmental factors of wind,wave and ice,the route is divided into sections,the calculation of main engine power,main engine fuel consumption and EEOI for each section is completed,and the speed design is optimized based on the simulation model for each section.Under the requirements of the voyage plan,the optimization results show that the energy efficiency operation index of the whole route is reduced by 3.114%and the fuel consumption is reduced by 9.17 t.展开更多
Objectives:We systematically reviewed the rational use of medicines using the World Health Organization/International Network of Rational Use of Drugs(WHO/INRUD)core drug use indicators.We also assessed the impact of ...Objectives:We systematically reviewed the rational use of medicines using the World Health Organization/International Network of Rational Use of Drugs(WHO/INRUD)core drug use indicators.We also assessed the impact of the coronavirus disease 2019 pandemic and the National Drug Policy(NDP)2005 on the rational use of medicines.Methods:Searches were conducted in PubMed,Scopus,and Google Scholar databases to identify studies that met our eligibility criteria.Assessment of the quality of studies was conducted using the Joanna Briggs Institute criteria for analytical studies.We reported and compared the median values of WHO/INRUD core drug use indicators with standard thresholds.Data were presented with median,interquartile range(IQR),and percentages.MannWhitney and Kruskal-Wallis tests were conducted to assess for statistical significance(P<0.05)across variables.Results:Thirty-one studies were included in the review,comprising 50,931 patient encounters across 268 health facilities.Within prescribing indicators,average number of medicines per patient encountered[3.4(IQR:3.0to 4.0)],percentage of medicines prescribed by generic[50.4%(IQR:47.4%to 65.0%)],percentage of encounters with antibiotic prescribed[40.2%(IQR:30.5%to 52.7%)],percentage of encounters with injection prescribed[18%(IQR:3.2%to 30.0%)]and the percentage of medicines prescribed from essential medicines list[82.0%(IQR:66.4%to 89.3%)].The median percentage of encounters with antibiotics(P=0.04)and the median percentage of medicines prescribed by generics(P=0.03)increased during and after the COVID-19 pandemic.Prescribing indicators were worse in primary and secondary health facilities,with significant differences in the median percentage of encounters with antibiotics(P=0.007)and injections(P=0.0002)across primary,secondary,and tertiary health facilities.There were improvements across all prescribing indicators after the implementation of NDP 2005.Conclusions:Core drug use indicators in Nigerian health facilities deviated from the WHO/INRUD thresholds,with noticeable improvement after the implementation of NDP 2005.More efforts are needed to improve rational drug use in Nigerian hospitals.展开更多
BACKGROUND Nutritional and inflammatory indicators are crucial in assessing the nutritional health and immune function of patients with cancer,which are factors closely associated with the diagnosis and treatment of c...BACKGROUND Nutritional and inflammatory indicators are crucial in assessing the nutritional health and immune function of patients with cancer,which are factors closely associated with the diagnosis and treatment of colorectal cancer(CRC).AIM To explore the relationship between nutritional and inflammatory indicators and microsatellite stability(MSS)status in CRC.METHODS The clinical data of 56 patients who underwent surgical treatment for CRC were collected.Furthermore,the expressions of nutritional(levels of serum albumin,triglycerides,serum cholesterol,and body mass index)and inflammatory response indicators(absolute neutrophil count,absolute lymphocyte count,absolute monocyte count,neutrophil-to-lymphocyte ratio,and lymphocyte-to-monocyte ratio)as well as their correlation with microsatellite instability(MSI)status were investigated in patients with CRC.RESULTS Compared to the patients with MSS tumors,those with MSI tumors demonstrated significantly lower levels of two nutritional indicators,namely serum albumin and body mass index(P<0.05).Moreover,patients in the MSI group demonstrated significantly lower absolute lymphocyte counts and higher neutrophil-to-lymphocyte ratio than those in the MSS group(P<0.05),indicating pronounced differences in inflammatory responses and immune states between the two groups.CONCLUSION Certain nutritional and inflammatory indicators exhibit significant differences among patients with MSI and MSS CRC,highlighting their potential role in the clinical treatment and health management of this specific population.展开更多
The amount of impervious surface area increases with rapid urbanization.Remote sensing indices are used to detect impervious surface areas quickly,cheaply and accurately.This study used Landsat-OLI and Sentiel-2A MSI ...The amount of impervious surface area increases with rapid urbanization.Remote sensing indices are used to detect impervious surface areas quickly,cheaply and accurately.This study used Landsat-OLI and Sentiel-2A MSI images in the province of Ankara to compare six impervious surface extraction indices:Normalized Difference Builtup Index(NDBI),Combinational Biophysical Composition Index(CBCI),Normalized Impervious Surface Index(NISI),Urban Index(UI),Index-based Built-up Index(IBI),Enhanced Normalized Difference Impervious Surfaces Index(ENDISI).Spectral discrimination index(SDI)and error matrix were used to evaluate the performance of the indexes.In addition,a visual evaluation of the performance of the indices was made on different surface areas in the study area.展开更多
Understanding the active tectonic processes in the Nandakini Watershed is imperative for evaluating geological hazards and seismic risks,as well as for informing land-use planning and natural resource management strat...Understanding the active tectonic processes in the Nandakini Watershed is imperative for evaluating geological hazards and seismic risks,as well as for informing land-use planning and natural resource management strategies in the region.Tectonic geomorphology serves as a vital tool for characterizing recent tectonic movements.This research employs GIS techniques to elucidate tectonic activity and its influence on drainage patterns in the Nandakini Watershed,utilizing morphometric parameters derived from SRTM DEM data.Morphometric indices are employed to assess the tectonic movement within drainage basins,capturing both areal and linear factors such as drainage density,texture,circulatory and bifurcation ratios,and stream length ratios.The linear and areal morphometric indices are categorized into three classes representing varying degrees of active tectonic activity.These classifications are then utilized to compute the relative active tectonic index(IRAT).In addition,geomorphic parameters include hypsometric integral,stream length-gradient index,normalized steepness index,chi gradient index,and swath profiles.The majority of the studied region is in an extremely high to moderately active tectonic zone.Large-scale faults and thrusts within the basins are closely correlated with these zones that have been identified.The integrated methodology of GIS-based morphometric analysis and geomorphic study enables the identification of deformed landforms associated with ongoing tectonic activity.Furthermore,these results offer valuable insights for informing watershed management strategies and promoting sustainable land use planning initiatives.展开更多
Gastric cancer remains a major cause of cancer-related mortality worldwide,with immunotherapy emerging as a promising treatment strategy.Neoadjuvant im-mune checkpoint therapy has shown potential in enhancing antitumo...Gastric cancer remains a major cause of cancer-related mortality worldwide,with immunotherapy emerging as a promising treatment strategy.Neoadjuvant im-mune checkpoint therapy has shown potential in enhancing antitumor responses and improving surgical outcomes.However,its effects on systemic coagulation and thrombotic risk remain poorly understood.This study aims to investigate the relationship between neoadjuvant immune checkpoint therapy and coagulation dynamics in patients with gastric cancer,exploring potential mechanisms that may contribute to a hypercoagulable state.By assessing coagulation markers,thrombotic events,and inflammatory responses,this research seeks to provide insights into the interplay between immune modulation and hemostatic alte-rations.A better understanding of these interactions may help optimize patient management and guide thromboprophylaxis strategies in this clinical setting.展开更多
Green cover and human disturbance are important local factors shaping urban bird communities, while climatic and topographic variables can be important when analyzing cities in different biomes. However, the roles of ...Green cover and human disturbance are important local factors shaping urban bird communities, while climatic and topographic variables can be important when analyzing cities in different biomes. However, the roles of large-scale and local variables influencing bird species composition have been scarcely explored in urban areas. This study aimed to analyze the association of climatic, topographic, landscape, and local variables with bird species composition in streets dominated by buildings and urban parks. I expected park bird composition to be more related to large-scale variables, whereas bird species in streets to be more associated with local-scale variables. Bird surveys were conducted in nine cities along a climatic and topographic gradient. Bird species composition in urban parks and streets were related to climatic and topographic variables, local vegetation greenness, and distance to non-urban areas. However, bird composition in streets was also related to noise and pedestrian traffic. The classification of bird composition in urban parks aligned with the phytogeographic provinces, whereas the streets’ bird composition was unrelated to phytogeographic provinces. The results showed that urban habitats with increased vegetation cover allow the colonization of native bird communities and are more aligned with natural large-scale environmental gradients. In contrast, more urbanized sites are decoupled from climatic and topographic gradients and invaded by exotic and widespread native species.展开更多
文摘The new method for simultaneous determination of the concentrations of fluorine and chlorine in river water with double indicative electrodes is developed, and the quantitative analysis formulas that the inputs of electrode were exchanged by using self-made joints were induced. With this method,the synthetic water samples and the water samples taken from Majiagou River were analyzed. The results of determinations are satisfactory. The relative errors were<10.0% for F and <3.0%for Cl. The recoveries werc 90-101% for F and 90-110% tbr Cl. The relative standard deviations were < 15.2% for F and < 10.1% for Cl-. The advantages of this method is accurate, rapid and simple.
文摘The Uranium-238 (<sup>238</sup>U), Thorium-232 (<sup>232</sup>Th) families and Potassium-40 (<sup>40</sup>K) are of terrestrial origin and contribute generally to an individual’s external exposure through our presence in this environment. They also contribute to the internal exposure through the ingestion of products and beverages such as water that are close to the earth. The aim of this work is to determine the committed effective dose or Total Indicative Dose (TID) due to gamma radioactivity of the borehole water from the Nord Riviera (NR) well field operated by the Côte d’Ivoire Water Distribution Company (SODECI) for the supply of drinking water to part of the population of Abidjan. In addition, the populations, with their habits, could use these borehole waters directly as drinking water. To this end, water samples from the seven (07) functional boreholes were collected and analyzed on a gamma spectrometry chain, equipped with an HPGe detector in the laboratory of the Radiation Protection Institute (RPI) of the GHANA Atomic Energy Commission (GAEC). The results of the specific activities of <sup>238</sup>U, <sup>232</sup>Th and <sup>40</sup>K obtained were transcribed into TID. As the natural radioactivity of the borehole water is high [1], the TIDs calculated from the activity results of the natural radionuclides<sup>238</sup>U, <sup>232</sup>Th, and <sup>40</sup>K vary for the seven boreholes from 0.150 to 0.166 mSv/yr with an average of 0.161 ± 0.034 mSv/yr. The TID of the control tower, where the borehole water is mixed and treated for household use, is equal to 0.136 ± 0.03 mSv/yr. The TIDs obtained are therefore all slightly greater than the WHO reference dose value of 0.1 mSv/yr. But all remain below the UNSCEAR reference dose of 0.29 mSv/yr.
文摘An abnormality tends to occur in the productivity indicative curves in the process of productivity test interpretation of multi-layer gas wells,resulting in the failure of solutions to their productivity equations and absolute open flow rates.To figure out the reasons for such an abnormality,we established a full-hole calculation model considering the coupling of wellbore variable mass flows and reservoir seepages to calculate a gas production profile and wellbore pressure distribution of a multi-layer productive gas reservoir.Then,based on the analysis of the gas production profile and wellbore pressure distribution characteristics of gas wells at different gas production rates,the root cause for the abnormality in the productivity indicative curves of multi-layer gas wells was analyzed,and a corresponding correction method was proposed and validated based on some examples.And the following research results were obtained.First,there are two reasons for the abnormal productivity indicative curves of multi-layer gas wells.On the one hand,there is a variable mass pipe flow in the wellbore of multi-layer sections and a flowing pressure gradient decreases with the increase of well depth.And the flowing pressure in the middle of the reservoir which is converted based on the flowing pressure gradient above the pressure gauge is higher than the real value.On the other hand,the pressure in the multi-layer producing sections doesn't realize a balance after well shutdown for a short time,so the measured static pressure is greater than the one measured when the pressure of each layer gets balanced after well shutdown for a long time.Second,the flowing pressure obtained from the productivity test interpretation of multi-layer gas producer shall be converted based on the pressure measured by the pressure gauge within 200 m above the reservoir top and it is necessary to adopt the static pressure measured after the balance of wellbore pressure.Third,the reliability of the model,the rationality of the abnormality reason analysis and the validity of the correction method are verified based on calculation examples and cases.It is concluded that the research results provide a technical support for the productivity evaluation of multi-layer gas wells.
基金supported by China’s MOE project of Key Research Institute of Humanities and Social Sciences at Universities(22JJD720021)the project of Shandong University(11090087395308).
文摘Recently there have been two causal modelling approaches to indicative conditionals,i.e.extrapolationist(Deng&Lee,2021)and filterist(Liang&Wang,2022),although they all take an interventionist position on subjunctive conditionals.Motivated by the so-called OK pairs,they try to provide a convincing explanation of the intuition underlying the OK pairs.As far as we know,what they have done is to provide not only an explanation of the OK pairs,but also a way of distinguishing between indicative and subjunctive conditionals.Although we agree with their success in explaining the OK pairs within a causal modelling framework,we argue that their ways of distinguishing between indicative and subjunctive conditionals fail.Instead,we argue that their approaches can be used to distinguish between two readings of conditionals,the epistemic reading and the ontic reading.which can be applied to both indicative and subjunctive conditionals.We conclude by arguing that these two readings are related to two approaches to asking and answering causal questions:the“auses-of-effects"approach and the"effects-of-causes"approach.
基金Supported by China Health&Medical Development Foundation,No.M2021551.
文摘BACKGROUND Inappropriate selection of patients with early gastric cancer(EGC)for endoscopic submucosal dissection(ESD)may lead to non-curative resection,necessitating additional gastrectomy.Conversely,inappropriate selection for gastrectomy may result in overtreatment,adversely affecting patients’quality of life.Few have systematically evaluated the concordance between therapeutic indications under current Japanese guidelines and pathological criteria in EGC.To minimize noncurative resection risks while sparing unnecessary surgery for low-risk patients’,we specifically assess the suitability of Japanese guidelines in non-Japanese populations.This work aims to optimize clinical practice by refining endoscopic treatment criteria for adoption beyond Japan.AIM To evaluate EGC clinical decision accuracy by comparing therapeutic indication with postoperative pathological criteria and analyzing factors influencing discrepancies.METHODS A retrospective analysis was conducted on 796 EGC cases diagnosed at Peking University Third Hospital between January 2010 and December 2022.Cases were categorized into three groups:Same-estimated(preoperative therapeutic indication with postoperative pathological criteria matched),underestimated(preoperative ESD indication but postoperative surgical criteria),and overestimated(preoperative surgical indication but postoperative ESD criteria).The rate of discrepancy and associated risk factors were assessed.RESULTS The accuracy rates of preoperative evaluation for ESD and gastrectomy indications were 73.0%(321/430)and 76.0%(278/366),respectively.The overall discrepancy rate was 25.6%(204/796).Multivariate analysis identified tumor location in the upper-third stomach(odds ratio=2.158,95%confidence interval:1.373-3.390,P=0.001)was significantly associated with a higher likelihood of being underestimated and undifferentiated histologic type on preoperative biopsy(odds ratio=2.005,95%confidence interval:1.036-3.879,P=0.039)was more likely to be overestimated.Significant differences were observed in tumor diameter(P<0.001),depth of infiltration(P<0.001),ulcerative findings(P<0.001),and histologic type(P<0.001)between preoperative and postoperative evaluations.CONCLUSION The accuracy of preoperative EGC indications is 74.4%.Upper-third stomach and undifferentiated histology are primary discrepancy predictors.Upper-third tumors are prone to underestimation,while undifferentiated tumors are prone to overestimation.
基金Funded by the National Natural Science Foundation of China(Nos.52378360,51978438)。
文摘We used solidification/stabilization methods to remediate highly concentrated Zn^(2+)-contaminated soil.An industrial waste mixture of red mud,carbide slag,and phosphogypsum is combined with cement as the curing agent.The mixing ratios of the four materials are determined by comparing the strength,permeability coefficient,pH,and Zn^(2+)-leaching concentration of the solidified soil.Microscopic characteristics of the solidified uncontaminated soil and solidified Zn^(2+)-contaminated soil were observed using scanning electron microscopy,X-ray diffraction,and Fourier-transform infrared spectroscopy.Furthermore,the heavy metals speciation in both pure cement and mixed-material solidified soil was examined,demonstrating the beneficial role of the mixed-type curing agent in stabilizing heavy metals.The research results indicate that Zn^(2+)degrade the strength of the solidified soil by up to 90%.The permeability coefficient,pH,and Zn^(2+)-leaching concentration of the solidified soil easily meet standard,especially with Zn^(2+)leaching concentration well below the environmental protection limit.Furthermore,most Zn^(2+)exists in forms with lower biological and chemical reactivity.Both the solidified Zn^(2+)-contaminated soil and uncontaminated soil resulted in the formation of hydrated products containing elements such as silicon,aluminum,calcium,and sulfur.Additionally,the solidified Zn^(2+)-contaminated soil produced zinc-containing compounds and a large amount of rod-shaped ettringite.
基金supported by the Southwest Minzu University Research Startup Funds (No.16011221038,RQD2022021)Double World-Class Project (No.CX2023010)。
文摘Wetland degradation is an escalating global challenge with profound impacts on animal diversity,particularly during successional processes.Birds,as highly mobile and environmentally sensitive organisms,serve as effective indicators of ecological change.While previous studies have primarily focused on local community structures and species diversity during a specific season,there is a need to extend the research timeframe and explore broader spatial variations.Additionally,expanding from simple species diversity indices to more multidimensional diversity indices would provide a more comprehensive understanding of wetland health and resilience.To address these gaps,we investigated the effects of wetland degradation on bird diversity across taxonomic,phylogenetic,and functional dimensions in the Zoige Wetland,a plateau meadow wetland biodiversity hotspot.Surveys were conducted during both breeding(summer)and overwintering(winter)seasons across 20 transects in 5 sampling areas,representing 4 degradation levels(pristine,low,medium,and high).Our study recorded a total of 106 bird species from 32 families and 14 orders,revealing distinct seasonal patterns in bird community composition and diversity.Biodiversity indices were significantly higher in pristine and low-degraded wetlands,particularly benefiting waterfowl(Anseriformes,Ciconiiformes)and wading birds(Charadriiformes)in winter,when these areas provided superior food resources and habitat conditions.In contrast,medium and highly degraded wetlands supported increased numbers of terrestrial birds(Passeriformes)and raptors(Accipitriformes,Falconiformes).Seasonal differences in taxonomic,phylogenetic,and functional diversity indices highlighted the contrasting ecological roles of wetlands during breeding and overwintering periods.Furthermore,indicator species analysis revealed key species associated with specific degradation levels and seasons,providing valuable insights into wetland health.This study underscores the importance of spatiotemporal dynamics in understanding avian responses to wetland degradation.By linking seasonal patterns of bird diversity to habitat conditions,our findings contribute to conservation efforts and provide a framework for assessing wetland degradation and its ecological impacts.
文摘Cardiovascular diseases(CVDs)remain the leading cause of morbidity and mortality worldwide,necessitating innovative diagnostic and prognostic strategies.Traditional biomarkers like C-reactive protein,uric acid,troponin,and natriuretic peptides play crucial roles in CVD management,yet they are often limited by sensitivity and specificity constraints.This narrative review critically examines the emerging landscape of cardiac biomarkers and advocates for a multiple-marker approach to enhance early detection,prognosis,and risk stratification of CVD.In recent years,several novel biomarkers have shown promise in revolutionizing CVD diagnostics.Gamma-glutamyltransferase,microRNAs,endothelial microparticles,placental growth factor,trimethylamine N-oxide,retinol-binding protein 4,copeptin,heart-type fatty acid-binding protein,galectin-3,growth differentiation factor-15,soluble suppression of tumorigenicity 2,fibroblast growth factor 23,and adrenomedullin have emerged as significant indicators of CV health.These biomarkers provide insights into various pathophysiological processes,such as oxidative stress,endothelial dysfunction,inflammation,metabolic disturbances,and myocardial injury.The integration of these novel biomarkers with traditional ones offers a more comprehensive understanding of CVD mechanisms.This multiple-marker approach can improve diagnostic accuracy,allowing for better risk stratification and more personalized treatment strategies.This review underscores the need for continued research to validate the clinical utility of these biomarkers and their potential incorporation into routine clinical practice.By leveraging the strengths of both traditional and novel biomarkers,precise therapeutic plans can be developed,thereby improving the management and prognosis of patients with CVDs.The ongoing exploration and validation of these biomarkers are crucial for advancing CV care and addressing the limitations of current diagnostic tools.
文摘The advent of precision medicine has underscored the importance of biomarkers in predicting therapy response for bladder cancer,a malignancy marked by considerable heterogeneity.This review critically examines the current landscape of biomarkers to forecast treatment outcomes in bladder cancer patients.We explore a range of biomarkers,including genetic,epigenetic,proteomic,and transcriptomic indicators,from multiple sample sources,including urine,tumor tissue and blood,assessing their efficacy in predicting responses to chemotherapy,immunotherapy,and targeted therapies.Despite promising developments,the translation of these biomarkers into clinical practice faces significant challenges,such as variability in biomarker performance,the necessity for large-scale validation studies,and the integration of biomarker testing into routine clinical workflows.We also highlight the need for standardized methodologies and robust assays to ensure consistency and reliability.Future directions point towards longitudinal studies and the development of combination biomarker panels to enhance predictive accuracy.This review emphasizes the transformative potential of predictive biomarkers in improving patient outcomes and advocates for continued collaborative efforts to overcome existing barriers in this rapidly evolving field.
基金Supported by Research Project of Zhejiang Provincial Science and Technology Plan for Traditional Chinese Medicine,No.2024ZL753and Research Project of Zhejiang Provincial Medical and Health Science and Technology Plan,No.2024KY1406.
文摘BACKGROUND Type 2 diabetes mellitus(T2DM),a chronic metabolic disease with a high global incidence,has become a serious public health challenge.China has the largest number of T2DM patients worldwide,imposing a significant economic burden on the healthcare system.T2DM is closely associated with insulin resistance,impaired pancreatic B cell function,and disordered glucose and lipid metabolism,which can lead to various complications,reducing patients'quality of life and increasing the risk of disability and death.Thus,finding effective preventive and intervention measures is crucial.Exercise therapy,a key part of diabetes management,has gained attention in recent years,with many studies indicating its benefits for blood glucose control and other aspects in diabetic patients.AIM To assess the effectiveness of combined resistance and aerobic exercise interventions on blood glucose control and metabolic indicators in patients with T2DM and to explore their application in diabetes management.METHODS Systematic searches were conducted using PubMed,EMBASE,Cochrane Library,and Chinese databases for relevant randomized controlled trials(RCTs).The inclusion criteria were participants aged≥18 years with T2DM and the intervention involved combined resistance and aerobic exercise for≥8 weeks.The primary outcome indicators were fasting blood glucose,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),triglycerides(TG),glycated hemoglobin A1c(HbA1c),and total cholesterol(TC)levels.Data analysis was performed using RevMan software,and the interventional effects were assessed using weighted mean differences or standardized mean differences(SMD).RESULTS Six RCTs meeting the inclusion criteria were included,with a total sample size of 366 participants.The meta-analysis results showed that combined resistance and aerobic exercise significantly improved several metabolic indicators in patients with T2DM.Specific results were as follows:(1)For fasting blood glucose,combined exercise was more effective than aerobic exercise alone[SMD=1.22;95%confidence interval(95%CI):0.70,1.74;P<0.00001];(2)LDL-C levels were significantly reduced by the combined intervention(SMD=1.45;95%CI:1.18-1.72;P<0.00001);(3)The combined intervention significantly increased HDL-C levels(SMD=1.42;95%CI:0.98-1.87;P<0.00001);(4)The combined intervention significantly reduced TG levels(SMD=1.12;95%CI:0.85-1.39;P<0.00001;(5)No statistically significant difference was observed in HbA1c between the combined and the aerobic exercise group(SMD=-0.03;95%CI:-1.09 to 1.04;P<0.00001);and(6)The combined exercise intervention group significantly reduced TC levels(SMD=2.66;95%CI:1.93-3.38;P<0.00001).The subgroup analysis results suggest that the effect of exercise interventions may be influenced by various factors,including the patient's age,baseline blood glucose levels,and exercise intensity.CONCLUSION Combined resistance and aerobic exercise intervention significantly improved fasting blood glucose,LDL-C,HDL-C,TG,and TC levels in patients with T2DM,especially in terms of blood glucose control and cardiovascular risk,demonstrating better outcomes than aerobic exercise alone.
文摘BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU admissions are associated with increased morbidity and mortality and are an indicator of trauma service quality.Two different types of unplanned ICU admissions include upgrades(patients admitted to the floor then moved to the ICU)and bounce backs(patients admitted to the ICU,discharged to the floor,and then readmitted to the ICU).Previous studies have shown that geriatric trauma patients are at higher risk for unfavorable outcomes.AIM To analyze the characteristics,management and outcomes of trauma patients who had an unplanned ICU admission during their hospitalization.METHODS This institutional review board approved,retrospective cohort study examined 203 adult trauma patients with unplanned ICU admission at an urban level 1 trauma center over a six-year period(2017-2023).This included 134 upgrades and 69 bounce backs.Analyzed variables included:(1)Age;(2)Sex;(3)Comorbidities;(4)Mechanism of injury(MOI);(5)Injury severity score(ISS);(6)Glasgow Coma Scale(GCS);(7)Type of injury;(8)Transfusions;(9)Consultations;(10)Timing and reason for unplanned admission;(11)Intubations;(12)Surgical interventions;(13)ICU and hospital lengths of stay;and(14)Mortality.RESULTS Unplanned ICU admissions comprised 4.2%of total ICU admissions.Main MOI was falls.Mean age was 70.7 years,ISS was 12.8 and GCS was 13.9.Main injuries were traumatic brain injury(37.4%)and thoracic injury(21.7%),and main reason for unplanned ICU admission was respiratory complication(39.4%).The 47.3%underwent a surgical procedure and 46.8%were intubated.Average timing for unplanned ICU admission was 2.9 days.Bounce backs occurred half as often as upgrades,however had higher rates of transfusions(63.8%vs 40.3%,P=0.002),consultations(4.8 vs 3.0,P<0.001),intubations(63.8%vs 38.1%%,P=0.001),longer ICU lengths of stay(13.2 days vs 6.4 days,P<0.001)and hospital lengths of stay(26.7 days vs 13.0 days,P<0.001).Mortality was 25.6%among unplanned ICU admissions,31.9%among geriatric unplanned ICU admissions and 11.9%among all trauma ICU patients.CONCLUSION Unplanned ICU admissions constituted 4.2%of total ICU admissions.Respiratory complications were the main cause of unplanned ICU admissions.Bounce backs occurred half as often as upgrades,but were associated with worse outcomes.
文摘Succinylcholine(SC)is a widely used depolarizing muscle relaxant,but improper use can lead to arrhythmias and,in severe cases,pose a life-threatening risk.Additionally,some criminals exploit SC for illicit activities.Therefore,rapid SC detection is paramount for clinical practice and public safety.Currently,however,limited methods are available for the rapid detection of SC.A fluorescent indicator displacement assay sensor based on molecular recognition of an amide naphthotube was developed.This sensor enabled the rapid fluorescent detection of SC through competitive binding between SC and methylene blue with the amide naphthotube.The sensor exhibited exceptional sensitivity with a detection limit as low as 1.1μmol/L and a detection range of 1.1~60μmol/L,coupled with outstanding selectivity and robust stability.Furthermore,this sensor accurately determined SC levels in biological samples such as serum.In summary,this research provides a new solution for the rapid and accurate sensing of SC in complex matrices and offers new insights for the swift identification and detection of toxins.
文摘In order to accurately forecast the main engine fuel consumption and reduce the Energy Efficiency Operational Indicator(EEOI)of merchant ships in polar ice areas,the energy transfer relationship between ship-machine-propeller is studied by analyzing the complex force situation during ship navigation and building a MATLAB/Simulink simulation platform based on multi-environmental resistance,propeller efficiency,main engine power,fuel consumption,fuel consumption rate and EEOI calculation module.Considering the environmental factors of wind,wave and ice,the route is divided into sections,the calculation of main engine power,main engine fuel consumption and EEOI for each section is completed,and the speed design is optimized based on the simulation model for each section.Under the requirements of the voyage plan,the optimization results show that the energy efficiency operation index of the whole route is reduced by 3.114%and the fuel consumption is reduced by 9.17 t.
文摘Objectives:We systematically reviewed the rational use of medicines using the World Health Organization/International Network of Rational Use of Drugs(WHO/INRUD)core drug use indicators.We also assessed the impact of the coronavirus disease 2019 pandemic and the National Drug Policy(NDP)2005 on the rational use of medicines.Methods:Searches were conducted in PubMed,Scopus,and Google Scholar databases to identify studies that met our eligibility criteria.Assessment of the quality of studies was conducted using the Joanna Briggs Institute criteria for analytical studies.We reported and compared the median values of WHO/INRUD core drug use indicators with standard thresholds.Data were presented with median,interquartile range(IQR),and percentages.MannWhitney and Kruskal-Wallis tests were conducted to assess for statistical significance(P<0.05)across variables.Results:Thirty-one studies were included in the review,comprising 50,931 patient encounters across 268 health facilities.Within prescribing indicators,average number of medicines per patient encountered[3.4(IQR:3.0to 4.0)],percentage of medicines prescribed by generic[50.4%(IQR:47.4%to 65.0%)],percentage of encounters with antibiotic prescribed[40.2%(IQR:30.5%to 52.7%)],percentage of encounters with injection prescribed[18%(IQR:3.2%to 30.0%)]and the percentage of medicines prescribed from essential medicines list[82.0%(IQR:66.4%to 89.3%)].The median percentage of encounters with antibiotics(P=0.04)and the median percentage of medicines prescribed by generics(P=0.03)increased during and after the COVID-19 pandemic.Prescribing indicators were worse in primary and secondary health facilities,with significant differences in the median percentage of encounters with antibiotics(P=0.007)and injections(P=0.0002)across primary,secondary,and tertiary health facilities.There were improvements across all prescribing indicators after the implementation of NDP 2005.Conclusions:Core drug use indicators in Nigerian health facilities deviated from the WHO/INRUD thresholds,with noticeable improvement after the implementation of NDP 2005.More efforts are needed to improve rational drug use in Nigerian hospitals.
基金Supported by Grants of the Suzhou Medical Key Discipline,No.SZXK202109Suzhou Clinical Key Disease Project,No.LCZX202111Suzhou Promoting Health through Science and Education Research Project,No.KJXW2021028.
文摘BACKGROUND Nutritional and inflammatory indicators are crucial in assessing the nutritional health and immune function of patients with cancer,which are factors closely associated with the diagnosis and treatment of colorectal cancer(CRC).AIM To explore the relationship between nutritional and inflammatory indicators and microsatellite stability(MSS)status in CRC.METHODS The clinical data of 56 patients who underwent surgical treatment for CRC were collected.Furthermore,the expressions of nutritional(levels of serum albumin,triglycerides,serum cholesterol,and body mass index)and inflammatory response indicators(absolute neutrophil count,absolute lymphocyte count,absolute monocyte count,neutrophil-to-lymphocyte ratio,and lymphocyte-to-monocyte ratio)as well as their correlation with microsatellite instability(MSI)status were investigated in patients with CRC.RESULTS Compared to the patients with MSS tumors,those with MSI tumors demonstrated significantly lower levels of two nutritional indicators,namely serum albumin and body mass index(P<0.05).Moreover,patients in the MSI group demonstrated significantly lower absolute lymphocyte counts and higher neutrophil-to-lymphocyte ratio than those in the MSS group(P<0.05),indicating pronounced differences in inflammatory responses and immune states between the two groups.CONCLUSION Certain nutritional and inflammatory indicators exhibit significant differences among patients with MSI and MSS CRC,highlighting their potential role in the clinical treatment and health management of this specific population.
文摘The amount of impervious surface area increases with rapid urbanization.Remote sensing indices are used to detect impervious surface areas quickly,cheaply and accurately.This study used Landsat-OLI and Sentiel-2A MSI images in the province of Ankara to compare six impervious surface extraction indices:Normalized Difference Builtup Index(NDBI),Combinational Biophysical Composition Index(CBCI),Normalized Impervious Surface Index(NISI),Urban Index(UI),Index-based Built-up Index(IBI),Enhanced Normalized Difference Impervious Surfaces Index(ENDISI).Spectral discrimination index(SDI)and error matrix were used to evaluate the performance of the indexes.In addition,a visual evaluation of the performance of the indices was made on different surface areas in the study area.
文摘Understanding the active tectonic processes in the Nandakini Watershed is imperative for evaluating geological hazards and seismic risks,as well as for informing land-use planning and natural resource management strategies in the region.Tectonic geomorphology serves as a vital tool for characterizing recent tectonic movements.This research employs GIS techniques to elucidate tectonic activity and its influence on drainage patterns in the Nandakini Watershed,utilizing morphometric parameters derived from SRTM DEM data.Morphometric indices are employed to assess the tectonic movement within drainage basins,capturing both areal and linear factors such as drainage density,texture,circulatory and bifurcation ratios,and stream length ratios.The linear and areal morphometric indices are categorized into three classes representing varying degrees of active tectonic activity.These classifications are then utilized to compute the relative active tectonic index(IRAT).In addition,geomorphic parameters include hypsometric integral,stream length-gradient index,normalized steepness index,chi gradient index,and swath profiles.The majority of the studied region is in an extremely high to moderately active tectonic zone.Large-scale faults and thrusts within the basins are closely correlated with these zones that have been identified.The integrated methodology of GIS-based morphometric analysis and geomorphic study enables the identification of deformed landforms associated with ongoing tectonic activity.Furthermore,these results offer valuable insights for informing watershed management strategies and promoting sustainable land use planning initiatives.
文摘Gastric cancer remains a major cause of cancer-related mortality worldwide,with immunotherapy emerging as a promising treatment strategy.Neoadjuvant im-mune checkpoint therapy has shown potential in enhancing antitumor responses and improving surgical outcomes.However,its effects on systemic coagulation and thrombotic risk remain poorly understood.This study aims to investigate the relationship between neoadjuvant immune checkpoint therapy and coagulation dynamics in patients with gastric cancer,exploring potential mechanisms that may contribute to a hypercoagulable state.By assessing coagulation markers,thrombotic events,and inflammatory responses,this research seeks to provide insights into the interplay between immune modulation and hemostatic alte-rations.A better understanding of these interactions may help optimize patient management and guide thromboprophylaxis strategies in this clinical setting.
基金funded by the Agencia Nacional de Promoción de la Investigación,el Desarrollo Tecnológico y la Innovación,PICT 2018–03871.
文摘Green cover and human disturbance are important local factors shaping urban bird communities, while climatic and topographic variables can be important when analyzing cities in different biomes. However, the roles of large-scale and local variables influencing bird species composition have been scarcely explored in urban areas. This study aimed to analyze the association of climatic, topographic, landscape, and local variables with bird species composition in streets dominated by buildings and urban parks. I expected park bird composition to be more related to large-scale variables, whereas bird species in streets to be more associated with local-scale variables. Bird surveys were conducted in nine cities along a climatic and topographic gradient. Bird species composition in urban parks and streets were related to climatic and topographic variables, local vegetation greenness, and distance to non-urban areas. However, bird composition in streets was also related to noise and pedestrian traffic. The classification of bird composition in urban parks aligned with the phytogeographic provinces, whereas the streets’ bird composition was unrelated to phytogeographic provinces. The results showed that urban habitats with increased vegetation cover allow the colonization of native bird communities and are more aligned with natural large-scale environmental gradients. In contrast, more urbanized sites are decoupled from climatic and topographic gradients and invaded by exotic and widespread native species.
