Objective:To evaluate the sensitivity pattern of bacterial pathogens in the intensive care unit(ICU) of a tertiary care of Falmawati Hospital Jakarta Indonesia.Methods:A cross sectional retrospective study of bacteria...Objective:To evaluate the sensitivity pattern of bacterial pathogens in the intensive care unit(ICU) of a tertiary care of Falmawati Hospital Jakarta Indonesia.Methods:A cross sectional retrospective study of bacterial pathogen was carried out on a total of 722 patients that were admitted to the ICU of Fatmawati Hospital Jakarta Indonesia during January 2009 to March 2010. All bacteria were identified by standard microbiologic methods,and(heir antibiotic susceptibility testing was performed using disk diffusion method.Results:Specimens were collected from 385 patients who were given antimicrobial treatment,of which 249(64.68%) were cultured positive and 136(35.32%) were negative.The most predominant isolate was Pseudomonas aeruginosa(P.aeruginosa)(26.5%) followed by Klebsiella pneumoniae(K.pneumoniae)(15.3%) and Staphylococcus epidermidis(14.9%).P.aeruginosa isolates showed high rate of resistance to cephalexin(95.3%),cefotaxime(64.1%),and ceftriaxone(60.9%).Amikacin was the most effective(84.4%) antibiotic against P.aeruginosa followed by imipenem(81.2%),and meropenem(75.0%).K.pneumoniae showed resistance to cephalexin(86.5%),ceftriaxone(75.7%),ceftazidime(73.0%),cefpirome(73.0%) and cefotaxime(67.9%),respectively.Conclusions:Most bacteria isolated from ICU of Fatmawati Hospital Jakarta Indonesia were resistant to the third generation of cephalosporins,and quinolone antibiotics.Regular surveillance of antibiotic susceptibility pallerns is very important for setting orders to guide the clinician in choosing empirical or directed therapy of infected patients.展开更多
Background: The prognostic values of staging parameters require continual re?assessment amid changes in diag?nostic and therapeutic methods. This study aimed to identify the prognostic factors and failure patterns of ...Background: The prognostic values of staging parameters require continual re?assessment amid changes in diag?nostic and therapeutic methods. This study aimed to identify the prognostic factors and failure patterns of non?meta?static nasopharyngeal carcinoma(NPC) in the intensity?modulated radiotherapy(IMRT) era.Methods: We reviewed the data from 749 patients with newly diagnosed, biopsy?proven, non?metastatic NPC in our cancer center(South China, an NPC endemic area) between January 2003 and December 2007. All patients under?went magnetic resonance imaging(MRI) before receiving IMRT. The actuarial survival rates were estimated using the Kaplan–Meier method, and survival curves were compared using the log?rank test. Multivariate analyses with the Cox proportional hazards model were used to test for the independent prognostic factors by backward eliminating insigniicant explanatory variables.Results: The 5?year occurrence rates of local failure, regional failure, locoregional failure, and distant failure were 5.4, 3.0, 7.4, and 17.4%, respectively. The 5?year survival rates were as follows: local relapse?free survival, 94.6%; nodal relapse?free survival, 97.0%; distant metastasis?free survival, 82.6%; disease?free survival, 75.1%; and overall survival, 82.0%. Multivariate Cox regression analysis revealed that orbit involvement was the only signiicant prognostic fac?tor for local failure(P = 0.011). Parapharyngeal tumor extension, retropharyngeal lymph node involvement, and the laterality, longest diameter, and Ho's location of the cervical lymph nodes were signiicant prognostic factors for both distant failure and disease failure(all P < 0.05). Intracranial extension had signiicant prognostic value for distant failure(P = 0.040).Conclusions: The key failure pattern for NPC was distant metastasis in the IMRT era. With changes in diagnostic and therapeutic technologies as well as treatment modalities, the signiicant prognostic parameters for local control have also been altered substantially.展开更多
BACKGROUND Ventilator-associated pneumonia(VAP)is defined as pneumonia that occurs two calendar days following endotracheal intubation or after that.It is the most common infection encountered among intubated patients...BACKGROUND Ventilator-associated pneumonia(VAP)is defined as pneumonia that occurs two calendar days following endotracheal intubation or after that.It is the most common infection encountered among intubated patients.VAP incidence showed wide variability between countries.AIM To define the VAP incidence in the intensive care unit(ICU)in the central gove-rnment hospital in Bahrain and review the risk factors and the predominant bacterial pathogens with their antimicrobial susceptibility pattern.METHODS The research was a prospective cross-sectional observational study over six months from November 2019 to June 2020.It included adult and adolescent patients(>14 years old)admitted to the ICU and required intubation and mechanical ventilation.VAP was diagnosed when it occurred after 48 h after endotracheal intubation using the clinical pulmonary infection score,which considers the clinical,laboratory,microbiological,and radiographic evidence.RESULTS The total number of adult patients admitted to the ICU who required intubation and mechanical ventilation during the study period was 155.Forty-six patients developed VAP during their ICU stay(29.7%).The calculated VAP rate was 22.14 events per 1000 ventilator days during the study period,with a mean age of 52 years±20.Most VAP cases had late-onset VAP with a mean number of ICU days before the development of VAP of 9.96±6.55.Gram-negative contributed to most VAP cases in our unit,with multidrug-resistant Acinetobacter being the most identified pathogen.CONCLUSION The reported VAP rate in our ICU was relatively high compared to the international benchmark,which should trigger a vital action plan for reinforcing the implementation of the VAP prevention bundle.展开更多
Speckle patterns are a fundamental tool in a variety of physical and optical applications. Here, we investigate a method of precisely tuning the intensity statistics of random speckle patterns into a desirable pattern...Speckle patterns are a fundamental tool in a variety of physical and optical applications. Here, we investigate a method of precisely tuning the intensity statistics of random speckle patterns into a desirable pattern that possesses the same spatial correlation length and similar statistics distribution. This tuning mechanism relies on the derivation of the transform function and transmission matrix, which achieves different contrasts while maintaining the same average value or energy level. The statistics properties of the generated speckle patterns are further investigated by analyzing the standard deviation under different fitting parameters. Precisely tuning the intensity statistics of random speckle patterns could be useful for both fundamental research and practical applications, such as microscopy, imaging, and optical manipulation.展开更多
<strong>Background: </strong><span style="font-family:;" "=""><span style="font-family:Verdana;">An intensive care unit (ICU) is a special unit of a hospital ...<strong>Background: </strong><span style="font-family:;" "=""><span style="font-family:Verdana;">An intensive care unit (ICU) is a special unit of a hospital that provides intensive treatment for patients with severe or life-threatening illnesses and injuries, which require constant care and close monitoring with life support equipment. The mortality rate is still very high in most ICUs especially in the developing countries due to late presentation of patients, unavailability of well trained staff and lack of life support equipment. There has not been any previous study on the mortality pattern in ICU of Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA). It is against this background that we embarked on this retrospective descriptive hospital based study of the mortality pattern in ICU of a Tertiary Hospital in Abakaliki, South-eastern Nigeria. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">This is a retrospective descriptive hospital based study. The admission and discharge registers of the ICU ward were used to extract information on biodata, diagnosis, duration and outcome of all admissions from January to December 2019 (12</span></span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">months). </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 174 (male 113, female 71) patients were admitted over the 12</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">months period with mean age of 46.31</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">12.28</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">years. Seventy</span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">one (40.8%) of the patients died from predominantly stroke, acute abdomen, trauma, sepsis, renal failure, acute diabetic complications and cancer in descending order. Acute diabetic complications had 100% case fatality rate, followed by stroke (71%), renal failure (62.5%), cancer (60%), sepsis (55.5%), acute abdomen (34%) and trauma (23%). The mean duration of ICU admission was 4.2 days for the non-survivors and 6.3 days for survivors. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The ICU mortality rate was high and constituted of mainly stroke, acute abdomen and trauma which are essentially preventable. Female sex, medical diagnosis and ICU admission duration of less than 6 days were associated with higher ICU mortality.</span></span>展开更多
An Acoustic Doppler Current Profiler （ADCP） observation site was set up in the Western South Yellow Sea from 2012 to 2013 to study the local suspended particle matters （SPM） distribution pattern. The SPM concentra...An Acoustic Doppler Current Profiler （ADCP） observation site was set up in the Western South Yellow Sea from 2012 to 2013 to study the local suspended particle matters （SPM） distribution pattern. The SPM concentration could be semi-quantitatively represented by backscatter intensity （Sv）, converted by the echo intensity （E/） of ADCP. Results show two types of SPM in the water column： the quasi-biological SPM and quasi-mineral SPM. The quasi-biological SPM mainly exists in summer half year and is con- centrated above the thermocline. It has periodically diurnal variations with high concentration at night and low concentration in the daytime. The quasi-mineral SPM is located in lower part of the water column, with similar relation to monthly tidal current variation all year round. However, the daily quasi-mineral SPM distribution patterns vary between summer and winter half year. The sunlight is thought to be the origin factor leading to the diurnally vertical motion of the biological features, which might cause the diurnal Sv variation. Unlike in winter half year when tidal current is relatively single driving force of the monthly SPM pattern, the high speed current near the thermocline is also responsible for the concentration of quasi-mineral SPM in summer half year. The sediment input difference between summer and winter half year contribute to the varied daily variation of quasi-mineral SPM with re-suspended SPM ir~ winter and sediments from Yellow Sea Mud Area （YSMA） in summer. The seasonal variations in hydrodynamics, water structure and heavy-wind incidents are the primary factors influencing the differential seasonal SPM distribution patterns.展开更多
The impact of thermal conditions of the ground on ventilation in the interior courtyard and rooms of enclosed building is very important to improve the air quality in courtyard. The computational fluid dynamics( CFD) ...The impact of thermal conditions of the ground on ventilation in the interior courtyard and rooms of enclosed building is very important to improve the air quality in courtyard. The computational fluid dynamics( CFD) model was used to investigate the flow field of a certain courtyard and analyze the static differential pressure between the two sides of the vent and ventilation conditions of the courtyard. The results indicate that thermal effects not only changed the air flow pattern of the interior courtyard but also obviously increased the flow velocity of the upper space of the courtyard. For the most of courtyard rooms,the absolute value of static differential pressure increases as the thermal intensity of the ground increases. In all wind directions,the air exchange rate of the courtyard increases with the higher thermal intensity of the ground which makes a greater influence on the increasing of the ventilation rate of the roof opening than that on the gate opening.展开更多
Based on the gist of anti-planning,evaluation standards and methods of intensive land utilization were re-examined according to the inverse planning procedures.Significant role of compulsory non-development zone(simil...Based on the gist of anti-planning,evaluation standards and methods of intensive land utilization were re-examined according to the inverse planning procedures.Significant role of compulsory non-development zone(similar to the traditional"non-construction land")among the planning fruits in the intensive utilization of urban land resources and relevant index weights in the evaluation system were re-weighed.In land evaluation,relevant control indexes of compulsory non-development zone were first calculated and evaluated,healthy and sustainable development coefficients of land were obtained and regarded as the core content of the whole evaluation system.展开更多
Background: Pain is the common experience among post operative patients admitted to the intensive care unit. Inadequate management can lead to undesired complications which can increase risk for morbidity and mortalit...Background: Pain is the common experience among post operative patients admitted to the intensive care unit. Inadequate management can lead to undesired complications which can increase risk for morbidity and mortality. Objective: The aim of this study was to assess pain management and factors associated with its severity among post surgical patients admitted in intensive care unit at MNH. Method: A prospective study was conducted from October 2017 to February 2018 involving a total of 123 post operative patients aged 18 years and above admitted to the surgical and obstetric intensive care units. Structured questionnaires were used to obtain the required perioperative information. Severity of pain was assessed by using the Numerical Rating Scale (NRS). Data was analyzed using SPSS version 23.0. Frequency, percentages, tables and charts were used to summarize the study findings. Bivariate analysis and multivariate logistic regression were done. P-value of Results: The prevalence of severe post operative pain within 24 and 72 hours was 32.1% and 41.5% respectively. Pre operative use of analgesia (OR: 2.66, CI: 1.15 - 6.12, P value = 0.02), abdominal surgery (OR: 4.12 CI: 1.12 - 15.88, P value = 0.03) and thoracic surgeries (OR;7.42, CI: 1.54 - 35.88, P value = 0.01) was significantly associated with severe pain. Age, sex, ASA class, duration of surgery, and level of education did not show significant association with pain severity. Opioids prescribed postoperatively were pethidine (70.7%), morphine (11.4%) and fentanyl (11.4%). Other analgesics used were paracetamol (60.2%) and diclofenac (22%). Conclusion: The magnitude of post operative pain was high. Pre operative uses of analgesia, abdominal and thoracic surgery were the factors associated with severe pain. Pethidine and paracetamol were the most prescribed drugs, however the prescription pattern used was inadequate to control pain.展开更多
Relatively soon after their accident, patients suffering a spinal cord injury(SCI) begin generally experiencing the development of significant, often life-threatening secondary complications. Many of which are associa...Relatively soon after their accident, patients suffering a spinal cord injury(SCI) begin generally experiencing the development of significant, often life-threatening secondary complications. Many of which are associated with chronic physical inactivity-related immune function problems and increasing susceptibility to infection that repeatedly requires intensive care treatment. Therapies capable of repairing the spinal cord or restoring ambulation would normally prevent many of these problems but, as of now, there is no cure for SCI. Thus, management strategies and antibiotics remain the standard of care although antimicrobial resistance constitutes a significant challenge for patients with chronic SCI facing recurrent infections of the urinary tract and respiratory systems. Identifying alternative therapies capable of safe and potent actions upon these serious health concerns should therefore be considered a priority. This editorial presents some of the novel approaches currently in development for the prevention of specific infections after SCI. Among them, brain-permeable small molecule therapeutics acting centrally on spinal cord circuits that can augment respiratory capabilities or bladder functions. If eventually approved by regulatory authorities, some of these new avenues may potentially become clinically-relevant therapies capable of indirectly preventing the occurrence and/or severity of these lifethreatening complications in people with paraplegic or tetraplegic injuries.展开更多
The formation strength plateau of ceramics is addressed. A set of of 99A1203 are conducted, mechanism of the residual subjected to thermal shock thermal shock experiments where the thin specimens of 1 mm× 10 mm&...The formation strength plateau of ceramics is addressed. A set of of 99A1203 are conducted, mechanism of the residual subjected to thermal shock thermal shock experiments where the thin specimens of 1 mm× 10 mm×50 mm exhibit parallel through edge cracks, and thus permit quantitative measurements of the crack patterns. The cracks evolve with the severity of ther- mal shock. It is found that there is a correlation between the length and density of the thermal shock cracks. The increase of crack length weakens the residual strength, whereas the increase of crack density improves it. In a considerably wide temperature range, the two contrary effects just counteract each other; consequently a plateau appears in the variation curve of the residual strength. A comparison between the numerical and experimental results of the residual strength is made, and they are found in good agreement. This work is helpful to a deep understanding of the thermal shock failure of ceramics.展开更多
Experimental validation of laser intensity is particularly important for the study of fundamental physics at extremely high intensities.However,reliable diagnosis of the focal spot and peak intensity faces huge challe...Experimental validation of laser intensity is particularly important for the study of fundamental physics at extremely high intensities.However,reliable diagnosis of the focal spot and peak intensity faces huge challenges.In this work,we demonstrate for the firs time that the coherent radiation farfiel patterns from laser–foil interactions can serve as an in situ,real-time,and easy-to-implement diagnostic for an ultraintense laser focus.The laser-driven electron sheets,curved by the spatially varying laser fiel and leaving the targets at nearly the speed of light,produce doughnut-shaped patterns depending on the shapes of the focal spot and the absolute laser intensities.Assisted by particle-in-cell simulations,we can achieve measurements of the intensity and the focal spot,and provide immediate feedback to optimize the focal spots for extremely high intensity.展开更多
文摘Objective:To evaluate the sensitivity pattern of bacterial pathogens in the intensive care unit(ICU) of a tertiary care of Falmawati Hospital Jakarta Indonesia.Methods:A cross sectional retrospective study of bacterial pathogen was carried out on a total of 722 patients that were admitted to the ICU of Fatmawati Hospital Jakarta Indonesia during January 2009 to March 2010. All bacteria were identified by standard microbiologic methods,and(heir antibiotic susceptibility testing was performed using disk diffusion method.Results:Specimens were collected from 385 patients who were given antimicrobial treatment,of which 249(64.68%) were cultured positive and 136(35.32%) were negative.The most predominant isolate was Pseudomonas aeruginosa(P.aeruginosa)(26.5%) followed by Klebsiella pneumoniae(K.pneumoniae)(15.3%) and Staphylococcus epidermidis(14.9%).P.aeruginosa isolates showed high rate of resistance to cephalexin(95.3%),cefotaxime(64.1%),and ceftriaxone(60.9%).Amikacin was the most effective(84.4%) antibiotic against P.aeruginosa followed by imipenem(81.2%),and meropenem(75.0%).K.pneumoniae showed resistance to cephalexin(86.5%),ceftriaxone(75.7%),ceftazidime(73.0%),cefpirome(73.0%) and cefotaxime(67.9%),respectively.Conclusions:Most bacteria isolated from ICU of Fatmawati Hospital Jakarta Indonesia were resistant to the third generation of cephalosporins,and quinolone antibiotics.Regular surveillance of antibiotic susceptibility pallerns is very important for setting orders to guide the clinician in choosing empirical or directed therapy of infected patients.
基金supported by grants from the Key Laboratory Construction Project of Guangzhou City,China (121800085)the Health & Medical Collaborative Innovation Project of Guangzhou City,China (201400000001)+2 种基金the National Science & Technology Pillar Program during the Twelfth Five-year Plan Period (2014BAI09B10)the National Natural Science Foundation of China (81201746)the Planned Science and Technology Project of Guangdong Province,China (2013B020400004)
文摘Background: The prognostic values of staging parameters require continual re?assessment amid changes in diag?nostic and therapeutic methods. This study aimed to identify the prognostic factors and failure patterns of non?meta?static nasopharyngeal carcinoma(NPC) in the intensity?modulated radiotherapy(IMRT) era.Methods: We reviewed the data from 749 patients with newly diagnosed, biopsy?proven, non?metastatic NPC in our cancer center(South China, an NPC endemic area) between January 2003 and December 2007. All patients under?went magnetic resonance imaging(MRI) before receiving IMRT. The actuarial survival rates were estimated using the Kaplan–Meier method, and survival curves were compared using the log?rank test. Multivariate analyses with the Cox proportional hazards model were used to test for the independent prognostic factors by backward eliminating insigniicant explanatory variables.Results: The 5?year occurrence rates of local failure, regional failure, locoregional failure, and distant failure were 5.4, 3.0, 7.4, and 17.4%, respectively. The 5?year survival rates were as follows: local relapse?free survival, 94.6%; nodal relapse?free survival, 97.0%; distant metastasis?free survival, 82.6%; disease?free survival, 75.1%; and overall survival, 82.0%. Multivariate Cox regression analysis revealed that orbit involvement was the only signiicant prognostic fac?tor for local failure(P = 0.011). Parapharyngeal tumor extension, retropharyngeal lymph node involvement, and the laterality, longest diameter, and Ho's location of the cervical lymph nodes were signiicant prognostic factors for both distant failure and disease failure(all P < 0.05). Intracranial extension had signiicant prognostic value for distant failure(P = 0.040).Conclusions: The key failure pattern for NPC was distant metastasis in the IMRT era. With changes in diagnostic and therapeutic technologies as well as treatment modalities, the signiicant prognostic parameters for local control have also been altered substantially.
文摘BACKGROUND Ventilator-associated pneumonia(VAP)is defined as pneumonia that occurs two calendar days following endotracheal intubation or after that.It is the most common infection encountered among intubated patients.VAP incidence showed wide variability between countries.AIM To define the VAP incidence in the intensive care unit(ICU)in the central gove-rnment hospital in Bahrain and review the risk factors and the predominant bacterial pathogens with their antimicrobial susceptibility pattern.METHODS The research was a prospective cross-sectional observational study over six months from November 2019 to June 2020.It included adult and adolescent patients(>14 years old)admitted to the ICU and required intubation and mechanical ventilation.VAP was diagnosed when it occurred after 48 h after endotracheal intubation using the clinical pulmonary infection score,which considers the clinical,laboratory,microbiological,and radiographic evidence.RESULTS The total number of adult patients admitted to the ICU who required intubation and mechanical ventilation during the study period was 155.Forty-six patients developed VAP during their ICU stay(29.7%).The calculated VAP rate was 22.14 events per 1000 ventilator days during the study period,with a mean age of 52 years±20.Most VAP cases had late-onset VAP with a mean number of ICU days before the development of VAP of 9.96±6.55.Gram-negative contributed to most VAP cases in our unit,with multidrug-resistant Acinetobacter being the most identified pathogen.CONCLUSION The reported VAP rate in our ICU was relatively high compared to the international benchmark,which should trigger a vital action plan for reinforcing the implementation of the VAP prevention bundle.
基金Project supported by the National Natural Science Foundation of China(Grant No.61702347)the Natural Science Foundation of Hebei Province,China(Grant No.F2017210161)Education Department of Hebei Province,China(Grant No.QN2017132)
文摘Speckle patterns are a fundamental tool in a variety of physical and optical applications. Here, we investigate a method of precisely tuning the intensity statistics of random speckle patterns into a desirable pattern that possesses the same spatial correlation length and similar statistics distribution. This tuning mechanism relies on the derivation of the transform function and transmission matrix, which achieves different contrasts while maintaining the same average value or energy level. The statistics properties of the generated speckle patterns are further investigated by analyzing the standard deviation under different fitting parameters. Precisely tuning the intensity statistics of random speckle patterns could be useful for both fundamental research and practical applications, such as microscopy, imaging, and optical manipulation.
文摘<strong>Background: </strong><span style="font-family:;" "=""><span style="font-family:Verdana;">An intensive care unit (ICU) is a special unit of a hospital that provides intensive treatment for patients with severe or life-threatening illnesses and injuries, which require constant care and close monitoring with life support equipment. The mortality rate is still very high in most ICUs especially in the developing countries due to late presentation of patients, unavailability of well trained staff and lack of life support equipment. There has not been any previous study on the mortality pattern in ICU of Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA). It is against this background that we embarked on this retrospective descriptive hospital based study of the mortality pattern in ICU of a Tertiary Hospital in Abakaliki, South-eastern Nigeria. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">This is a retrospective descriptive hospital based study. The admission and discharge registers of the ICU ward were used to extract information on biodata, diagnosis, duration and outcome of all admissions from January to December 2019 (12</span></span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">months). </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 174 (male 113, female 71) patients were admitted over the 12</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">months period with mean age of 46.31</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">12.28</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">years. Seventy</span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">one (40.8%) of the patients died from predominantly stroke, acute abdomen, trauma, sepsis, renal failure, acute diabetic complications and cancer in descending order. Acute diabetic complications had 100% case fatality rate, followed by stroke (71%), renal failure (62.5%), cancer (60%), sepsis (55.5%), acute abdomen (34%) and trauma (23%). The mean duration of ICU admission was 4.2 days for the non-survivors and 6.3 days for survivors. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The ICU mortality rate was high and constituted of mainly stroke, acute abdomen and trauma which are essentially preventable. Female sex, medical diagnosis and ICU admission duration of less than 6 days were associated with higher ICU mortality.</span></span>
基金supported by the National Natural Science Foundation of China (Grant No. 41030856)National 973 Project of China (Grant No. 2005CB422304)+1 种基金the Project of Taishan Scholarsupport of the R/V Dongfanghong 2 and Shared Voyage of the National Nature Science Foundation of China
文摘An Acoustic Doppler Current Profiler （ADCP） observation site was set up in the Western South Yellow Sea from 2012 to 2013 to study the local suspended particle matters （SPM） distribution pattern. The SPM concentration could be semi-quantitatively represented by backscatter intensity （Sv）, converted by the echo intensity （E/） of ADCP. Results show two types of SPM in the water column： the quasi-biological SPM and quasi-mineral SPM. The quasi-biological SPM mainly exists in summer half year and is con- centrated above the thermocline. It has periodically diurnal variations with high concentration at night and low concentration in the daytime. The quasi-mineral SPM is located in lower part of the water column, with similar relation to monthly tidal current variation all year round. However, the daily quasi-mineral SPM distribution patterns vary between summer and winter half year. The sunlight is thought to be the origin factor leading to the diurnally vertical motion of the biological features, which might cause the diurnal Sv variation. Unlike in winter half year when tidal current is relatively single driving force of the monthly SPM pattern, the high speed current near the thermocline is also responsible for the concentration of quasi-mineral SPM in summer half year. The sediment input difference between summer and winter half year contribute to the varied daily variation of quasi-mineral SPM with re-suspended SPM ir~ winter and sediments from Yellow Sea Mud Area （YSMA） in summer. The seasonal variations in hydrodynamics, water structure and heavy-wind incidents are the primary factors influencing the differential seasonal SPM distribution patterns.
基金National Natural Science Foundation of China(No.40975093)the Innovation Foundation of Shanghai Education Commission,China(No.14ZZ073)the Chinese Universities Scientific Fund,China(No.CUSF-DH-D-2013051)
文摘The impact of thermal conditions of the ground on ventilation in the interior courtyard and rooms of enclosed building is very important to improve the air quality in courtyard. The computational fluid dynamics( CFD) model was used to investigate the flow field of a certain courtyard and analyze the static differential pressure between the two sides of the vent and ventilation conditions of the courtyard. The results indicate that thermal effects not only changed the air flow pattern of the interior courtyard but also obviously increased the flow velocity of the upper space of the courtyard. For the most of courtyard rooms,the absolute value of static differential pressure increases as the thermal intensity of the ground increases. In all wind directions,the air exchange rate of the courtyard increases with the higher thermal intensity of the ground which makes a greater influence on the increasing of the ventilation rate of the roof opening than that on the gate opening.
文摘Based on the gist of anti-planning,evaluation standards and methods of intensive land utilization were re-examined according to the inverse planning procedures.Significant role of compulsory non-development zone(similar to the traditional"non-construction land")among the planning fruits in the intensive utilization of urban land resources and relevant index weights in the evaluation system were re-weighed.In land evaluation,relevant control indexes of compulsory non-development zone were first calculated and evaluated,healthy and sustainable development coefficients of land were obtained and regarded as the core content of the whole evaluation system.
文摘Background: Pain is the common experience among post operative patients admitted to the intensive care unit. Inadequate management can lead to undesired complications which can increase risk for morbidity and mortality. Objective: The aim of this study was to assess pain management and factors associated with its severity among post surgical patients admitted in intensive care unit at MNH. Method: A prospective study was conducted from October 2017 to February 2018 involving a total of 123 post operative patients aged 18 years and above admitted to the surgical and obstetric intensive care units. Structured questionnaires were used to obtain the required perioperative information. Severity of pain was assessed by using the Numerical Rating Scale (NRS). Data was analyzed using SPSS version 23.0. Frequency, percentages, tables and charts were used to summarize the study findings. Bivariate analysis and multivariate logistic regression were done. P-value of Results: The prevalence of severe post operative pain within 24 and 72 hours was 32.1% and 41.5% respectively. Pre operative use of analgesia (OR: 2.66, CI: 1.15 - 6.12, P value = 0.02), abdominal surgery (OR: 4.12 CI: 1.12 - 15.88, P value = 0.03) and thoracic surgeries (OR;7.42, CI: 1.54 - 35.88, P value = 0.01) was significantly associated with severe pain. Age, sex, ASA class, duration of surgery, and level of education did not show significant association with pain severity. Opioids prescribed postoperatively were pethidine (70.7%), morphine (11.4%) and fentanyl (11.4%). Other analgesics used were paracetamol (60.2%) and diclofenac (22%). Conclusion: The magnitude of post operative pain was high. Pre operative uses of analgesia, abdominal and thoracic surgery were the factors associated with severe pain. Pethidine and paracetamol were the most prescribed drugs, however the prescription pattern used was inadequate to control pain.
文摘Relatively soon after their accident, patients suffering a spinal cord injury(SCI) begin generally experiencing the development of significant, often life-threatening secondary complications. Many of which are associated with chronic physical inactivity-related immune function problems and increasing susceptibility to infection that repeatedly requires intensive care treatment. Therapies capable of repairing the spinal cord or restoring ambulation would normally prevent many of these problems but, as of now, there is no cure for SCI. Thus, management strategies and antibiotics remain the standard of care although antimicrobial resistance constitutes a significant challenge for patients with chronic SCI facing recurrent infections of the urinary tract and respiratory systems. Identifying alternative therapies capable of safe and potent actions upon these serious health concerns should therefore be considered a priority. This editorial presents some of the novel approaches currently in development for the prevention of specific infections after SCI. Among them, brain-permeable small molecule therapeutics acting centrally on spinal cord circuits that can augment respiratory capabilities or bladder functions. If eventually approved by regulatory authorities, some of these new avenues may potentially become clinically-relevant therapies capable of indirectly preventing the occurrence and/or severity of these lifethreatening complications in people with paraplegic or tetraplegic injuries.
基金supported by the National Natural Science Foundations of China (10972020,11061130550)Fundamental Research Funds for the Central UniversitiesNational Agency for Research of France (International project T-shock)
文摘The formation strength plateau of ceramics is addressed. A set of of 99A1203 are conducted, mechanism of the residual subjected to thermal shock thermal shock experiments where the thin specimens of 1 mm× 10 mm×50 mm exhibit parallel through edge cracks, and thus permit quantitative measurements of the crack patterns. The cracks evolve with the severity of ther- mal shock. It is found that there is a correlation between the length and density of the thermal shock cracks. The increase of crack length weakens the residual strength, whereas the increase of crack density improves it. In a considerably wide temperature range, the two contrary effects just counteract each other; consequently a plateau appears in the variation curve of the residual strength. A comparison between the numerical and experimental results of the residual strength is made, and they are found in good agreement. This work is helpful to a deep understanding of the thermal shock failure of ceramics.
基金supported by the Guangdong High Level Innovation Research Institute(Grant No.2021B0909050006)the National Grand Instrument Project(Grant No.2019YFF01014402)+1 种基金the National Natural Science Foundation of China(Grant No.12205008)support from the National Science Fund for Distinguished Young Scholars(Grant No.12225501)。
文摘Experimental validation of laser intensity is particularly important for the study of fundamental physics at extremely high intensities.However,reliable diagnosis of the focal spot and peak intensity faces huge challenges.In this work,we demonstrate for the firs time that the coherent radiation farfiel patterns from laser–foil interactions can serve as an in situ,real-time,and easy-to-implement diagnostic for an ultraintense laser focus.The laser-driven electron sheets,curved by the spatially varying laser fiel and leaving the targets at nearly the speed of light,produce doughnut-shaped patterns depending on the shapes of the focal spot and the absolute laser intensities.Assisted by particle-in-cell simulations,we can achieve measurements of the intensity and the focal spot,and provide immediate feedback to optimize the focal spots for extremely high intensity.
