Catalytic syntheses of silaoxycarbocyclics from an interrupted Catellani reaction of 3-iodochromones with bridged olefins and octamethyl-1,4-dioxacyclohexasilane is described.This protocol involves the oxidative addit...Catalytic syntheses of silaoxycarbocyclics from an interrupted Catellani reaction of 3-iodochromones with bridged olefins and octamethyl-1,4-dioxacyclohexasilane is described.This protocol involves the oxidative addition of chromonyl-norbornyl-palladacycle generated through successive oxidative addition of Pd(0)to 3-iodochromones,migratory insertion of NBE and intramolecular ortho-C(sp^(2))-H activation to the tetrasilane,thus motivating a(4+6)annulation and ring expansion.The synthetic practicality of current strategy is further proved by the late-stage modification of pharmaceuticals and natural products,gram-scale experiments,as well as the transformations of functional groups of silaoxycarbocyclics.展开更多
BACKGROUND Gastric subepithelial lesions(SELs)are elevated lesions originating from the muscularis mucosa,submucosa,or muscularis propria,and may also include extraluminal lesions.For small SELs(less than 5 cm),comple...BACKGROUND Gastric subepithelial lesions(SELs)are elevated lesions originating from the muscularis mucosa,submucosa,or muscularis propria,and may also include extraluminal lesions.For small SELs(less than 5 cm),complete endoscopic excision is the preferred treatment.Endoscopic full-thickness resection(EFTR)has proven to be an effective approach.AIM To evaluate the efficacy of the interrupted closure technique compared to the traditional closure technique in EFTR for gastric SELs.METHODS This single-center,prospective,randomized controlled trial was conducted at a tertiary hospital from September 2023 to September 2024.A total of 90 patients who underwent EFTR for gastric SELs were randomly allocated to either the interrupted closure group(n=44)or the traditional closure group(n=46).RESULTS All patients had complete resection and wound closure without any severe postoperative complications.The incidence of intraoperative gas-related complications was significantly lower in the interrupted closure group than in the traditional closure group(2.27%vs 26.09%,P=0.001),demonstrating interrupted closure technique can reduce the incidence of gas-related issues.Statistical analysis revealed that the incidence of postoperative infection was significantly lower in the experimental group than in the control group(15.91%vs 41.30%,P=0.008).Additionally,the median duration of antibiotic use was lower in the experimental group(3.5 days vs 5 days,P=0.013).Abdominal pain levels on postoperative days 1 and 4 were also lower in the experimental group compared to the control group(P<0.001).CONCLUSION The interrupted closure technique in EFTR for treating gastric SELs is safe and effective,reducing the incidence of intraoperative gas complications and postoperative infections.展开更多
The incremental capacity analysis(ICA)technique is notably limited by its sensitivity to variations in charging conditions,which constrains its practical applicability in real-world scenarios.This paper introduces an ...The incremental capacity analysis(ICA)technique is notably limited by its sensitivity to variations in charging conditions,which constrains its practical applicability in real-world scenarios.This paper introduces an ICA-compensation technique to address this limitation and propose a generalized framework for assessing the state of health(SOH)of batteries based on ICA that is applicable under differing charging conditions.This novel approach calculates the voltage profile under quasi-static conditions by subtracting the voltage increase attributable to the additional polarization effects at high currents from the measured voltage profile.This approach's efficacy is contingent upon precisely acquiring the equivalent impedance.To obtain the equivalent impedance throughout the batteries'lifespan while minimizing testing costs,this study employs a current interrupt technique in conjunction with a long short-term memory(LSTM)network to develop a predictive model for equivalent impedance.Following the derivation of ICA curves using voltage profiles under quasi-static conditions,the research explores two scenarios for SOH estimation:one utilizing only incremental capacity(IC)features and the other incorporating both IC features and IC sampling.A genetic algorithm-optimized backpropagation neural network(GABPNN)is employed for the SOH estimation.The proposed generalized framework is validated using independent training and test datasets.Variable test conditions are applied for the test set to rigorously evaluate the methodology under challenging conditions.These evaluation results demonstrate that the proposed framework achieves an estimation accuracy of 1.04%for RMSE and 0.90%for MAPE across a spectrum of charging rates ranging from 0.1 C to 1 C and starting SOCs between 0%and 70%,which constitutes a major advancement compared to established ICA methods.It also significantly enhances the applicability of conventional ICA techniques in varying charging conditions and negates the necessity for separate testing protocols for each charging scenario.展开更多
In recent years,research on nursing interruptions has been conducted at various levels in emergency departments,intensive care units,hemodialysis centers,operating rooms,and sterilization and supply centers.Nursing in...In recent years,research on nursing interruptions has been conducted at various levels in emergency departments,intensive care units,hemodialysis centers,operating rooms,and sterilization and supply centers.Nursing interruptions are closely related to adverse nursing events,and interruptions in operating room nursing can significantly impact the success of a patient’s surgery.However,there is a lack of in-depth theoretical research on safety risk assessment and response decision-making by operating room nurses when faced with nursing interruptions.This article reviews the concept,current status,and impact of nursing interruptions in the operating room,analyzes the cognitive level,coping strategies,and negative emotions of operating room nurses,and elaborates on management strategies to provide references for research and management of nursing interruptions in the operating room.展开更多
In the context of the Diagnosis Related Groups(DRGs)system,the orthopedic hospital implemented refined drug control to provide a pharmacological reference for promoting rational clinical drug use.A statistical analysi...In the context of the Diagnosis Related Groups(DRGs)system,the orthopedic hospital implemented refined drug control to provide a pharmacological reference for promoting rational clinical drug use.A statistical analysis was conducted on the hospital’s data from January to December 2021(prior to the implementation of control),focusing on the types of unreasonable prescriptions.A multi-dimensional analysis was also conducted to identify the underlying causes of inappropriate medication practices.Following this,refined drug control measures were introduced,and data from January to December 2022(post-control)were compared,examining factors such as the average drug cost,drug expenses for the IC29 diagnosis group,and the drug cost ratio.An interrupted time-series analysis was employed to evaluate the effects of these interventions.The results showed that after the implementation of refined drug control in the orthopedic department,significant reductions were observed in the average cost per patient,average drug cost per patient,drug cost ratio,cost consumption index,average length of hospital stay,and allocation ratio(P<0.05).In particular,the first month of control(January 2022)saw a marked decrease in average drug costs per patient by 1272.90 yuan(P<0.01),a reduction in the drug cost ratio by 0.98%,and a decline in drug costs for the IC29 diagnosis group by 616.79 yuan(P>0.05).Moreover,the rate of unreasonable inappropriate prescribing dropped dramatically from 40.48%in 2021 to 3.57%by December 2022.The refined control of drug use within the orthopedic hospital significantly improved the rationality of clinical prescribing practices,reduced the occurrence of adverse drug reactions,and enhanced patient adherence to prescribed treatments.These findings demonstrated considerable clinical value in promoting efficient and safe drug use.展开更多
Nonperiodic interrupted sampling repeater jamming(ISRJ)against inverse synthetic aperture radar(ISAR)can obtain two-dimensional blanket jamming performance by joint fast and slow time domain interrupted modulation,whi...Nonperiodic interrupted sampling repeater jamming(ISRJ)against inverse synthetic aperture radar(ISAR)can obtain two-dimensional blanket jamming performance by joint fast and slow time domain interrupted modulation,which is obviously dif-ferent from the conventional multi-false-target deception jam-ming.In this paper,a suppression method against this kind of novel jamming is proposed based on inter-pulse energy function and compressed sensing theory.By utilizing the discontinuous property of the jamming in slow time domain,the unjammed pulse is separated using the intra-pulse energy function diffe-rence.Based on this,the two-dimensional orthogonal matching pursuit(2D-OMP)algorithm is proposed.Further,it is proposed to reconstruct the ISAR image with the obtained unjammed pulse sequence.The validity of the proposed method is demon-strated via the Yake-42 plane data simulations.展开更多
The effects of interrupted aging on mechanical properties and corrosion resistance of 7A75 aluminum alloy extruded bar were investigated through various analyses,including electrical conductivity,mechanical properties...The effects of interrupted aging on mechanical properties and corrosion resistance of 7A75 aluminum alloy extruded bar were investigated through various analyses,including electrical conductivity,mechanical properties,local corrosion properties,and slow strain rate tensile stress corrosion tests.Microstructure characterization techniques such as metallographic microscopy,scanning electron microscopy(SEM),and transmission electron microscopy(TEM)were also employed.The results indicate that the tensile strength of the alloy produced by T6I6 aging is similar to that produced by T6I4 aging,and it even exceeds 700 MPa.Furthermore,the yield strength increases by 52.7 MPa,reaching 654.8 MPa after T6I6 aging treatment.The maximum depths of intergranular corrosion(IGC)and exfoliation corrosion(EXCO)decrease from 116.3 and 468.5μm to 89.5 and 324.3μm,respectively.The stress corrosion factor also decreases from 2.1%to 1.6%.These findings suggest that the alloy treated with T6I6 aging exhibits both high strength and excellent stress corrosion cracking resistance.Similarly,when the alloy is treated with T6I4,T6I6 and T6I7 aging,the sizes of grain boundary precipitates(GBPs)are found to be 5.2,18.4,and 32.8 nm,respectively.The sizes of matrix precipitates are 4.8,5.7 and 15.7 nm,respectively.The atomic fractions of Zn in GBPs are 9.92 at.%,8.23 at.%and 6.87 at.%,respectively,while the atomic fractions of Mg are 12.66 at.%,8.43 at.%and 7.00 at.%,respectively.Additionally,the atomic fractions of Cu are 1.83 at.%,2.47 at.%and 3.41 at.%,respectively.展开更多
Interrupted Aortic Arch(IAA)combined with aortic stenosis(AS)is a rare and complex congenital cardiac anomaly that presents significant challenges in clinical management.In this letter,we aim to share our experience i...Interrupted Aortic Arch(IAA)combined with aortic stenosis(AS)is a rare and complex congenital cardiac anomaly that presents significant challenges in clinical management.In this letter,we aim to share our experience in performing hybrid procedures on an infant diagnosed with IAA combined with bicuspid AS.This child exhibited significant recovery during follow-up.展开更多
BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare anatomical defect of the pituitary gland falling under the spectrum of holoprosencephaly phenotypes.It is characterized by a deficiency in anterior pitui...BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare anatomical defect of the pituitary gland falling under the spectrum of holoprosencephaly phenotypes.It is characterized by a deficiency in anterior pituitary hormones,such as growth hormone,gonadotropins,and thyroid hormones.Due to the syndrome's rarity and nonspecific manifestations,there is a lack of standardized treatment strategies.Consequently,early diagnosis through imaging and on-time intervention are crucial for improving patients’outcomes.CASE SUMMARY A 30-year-old man presented with absent secondary sexual characteristics and azoospermia.Laboratory evaluation revealed a deficiency in gonadotropins,while thyroid function was mostly within normal ranges.Magnetic resonance imaging of the pituitary gland showed pituitary stalk agenesis,hypoplasia of the anterior pituitary,and ectopic posterior pituitary,leading to the diagnosis of PSIS.Initially,the patient underwent 6 mo of gonadotropin therapy without significant changes in hormone levels and secondary sexual characteristics.Pulsatile gonadotropin-releasing hormone therapy was then administered,resulting in the detection of sperm in the semen analysis within 3 mo.After 6 mo,routine semen tests showed normal semen quality.The couple faced challenges in conceiving due to abstinence and underwent three cycles of artificial insemination,which was unsuccessful.They also attempted in vitro fertilization,but unfortunately,the woman experienced a miscarriage 10 wk after the embryo transfer.CONCLUSION Early detection,accurate diagnosis,and timely treatment are crucial in improving the quality of life and fertility of PSIS patients.展开更多
BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare disorder,often characterized by delayed growth and development,short stature,and hypogonadism as the main clinical manifestations.It is not clear whether...BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare disorder,often characterized by delayed growth and development,short stature,and hypogonadism as the main clinical manifestations.It is not clear whether PSIS can lead to liver cirrhosis.CASE SUMMARY This paper reported a case of liver cirrhosis of unknown origin.The patient was admitted to Beijing Ditan Hospital Affiliated to Capital Medical University in November 2023.The diagnosis of PSIS complicated with liver cirrhosis was established after a series of blood tests and pituitary magnetic resonance imaging examination.CONCLUSION We also reviewed the literature from both domestic and international sources to deepen the clinical understanding of PSIS in conjunction with liver cirrhosis among medical practitioners.展开更多
Background: An interrupted family history, as is the case after taking someone into care, can complicate collecting family anamnesis data. In addition, the interrupted family history itself could be considered part of...Background: An interrupted family history, as is the case after taking someone into care, can complicate collecting family anamnesis data. In addition, the interrupted family history itself could be considered part of a person’s risk profile. Aim and methods: Literature analysis was conducted to examine whether there are scientific studies on health development after placement in out-of-home-care in order to recognise any existing medical characteristics that may be relevant for internal medical care. Results: There are few scientific publications on the health development of people after being placed in out-of-home-care. Direct reactions to the stress of being taken into custody include nausea and fever. However, effects that go beyond the acute situation and last into adulthood have also been described, such as AD(H)D, asthma, diabetes, cancer, hypertension and cardiovascular diseases (myocardial infarction, stroke), epilepsy and increased overall mortality in adulthood. Studies show that not only previous experience but also the stress of being taken into care is triggers for this. Conclusion: Information about a previous institutionalisation can hence be important for internal medical practice. The available scientific literature shows heterogeneous study methodology and no group of people with experience of out-of-home-placement has yet been scientifically accompanied for a long time period. Further studies on this could help to better weigh up the consequences of omitting and conducting an intervention for child/youth protection as well as to improve the medical care for this group of people.展开更多
To study the congestion of interrupted flow on urban roads, a comprehensive evaluation method is proposed. First, based on the results of correlation analysis between different parameters of interrupted flow, the traf...To study the congestion of interrupted flow on urban roads, a comprehensive evaluation method is proposed. First, based on the results of correlation analysis between different parameters of interrupted flow, the traffic parameters of interrupted traffic flow are divided into two categories： the basic parameters and the operation parameters. Polynomial regression is used to formulize the nonlinear relationships between the basic parameters and the operation parameters. Then, the congestion model incorporating both operational and volume characteristics of traffic flow is proposed. The inputs of the model are the basic parameters, while the output is a dimensionless index value between 0 and 1. Finally, the proposed methods are compared with existing evaluation measures of congestion. Results show that the proposed indices can capture the variation of both the basic parameters and the operation parameters, which is more balanced compared with the existing evaluation measures.展开更多
To determine the feasibility and practicability of interrupt continuous wave (CW) approach proposed for real time simulating radar intermediate frequency(IF) video signal, theoretical analysis and computer simulation...To determine the feasibility and practicability of interrupt continuous wave (CW) approach proposed for real time simulating radar intermediate frequency(IF) video signal, theoretical analysis and computer simulation were used. Phases at two linked points between the end and beginning of adjoined frames are always consistent; the bias Doppler frequency for the time delay of A/D sampling start responds to that for target acceleration. No digital phase compensation is required at continuous points, and the interrupt CW approach has apparently practical values.展开更多
Under Chinese medicine and health care system, Medicine Catalogue for National Basic Medical Insurance（2009） was issued in 2009 in China to fulfill the basic drug demands of the insured Chinese and to control the me...Under Chinese medicine and health care system, Medicine Catalogue for National Basic Medical Insurance（2009） was issued in 2009 in China to fulfill the basic drug demands of the insured Chinese and to control the medical expenses. In this study, the influence of the list adjustment on drug utilization was investigated. With the comparison between inpatients＇ use of drugs before and after adjustment of Basic Medical Insurance Drug List, we classified the drugs adjusted in national list into six categories： class A to class B, class B to class A, class A to class C, class B to class C, class C to class A, and class C to class B（class A referring to overall insured drugs, class B referring to partial reimbursement drugs, class C referring to self-funded drugs in China）, and drug utilization and expenditure were analyzed with time series model. We analyzed the overall expenditure and average expenditure per 10 000 people based on the comparison before and after the adjustment of 2009 Basic Medical Insurance Drug List. The drug expenditure from class A to class B was decreased by 13.87% of overall expenditure and 16.37% of average expenditure per 10 000 people, and it was decreased by 38.74% and 48.03% from class A to class C; respectively, the drug expenditure from class B to class A was increased by 74.12% and 94.52%, while it was reduced by 19.79% and 14.52% from class B to class C; expenditure declined by 31.77% and 36.22% from class C to class A, and expenditure was increased by 12.42% and 22.05% from class C to class B, respectively, both were lower than before. The adjustment of National Basic Medical Insurance Drug List reduced the overall drug expenditure.展开更多
The interrupted sampling repeater jamming（ISRJ） is an effective deception jamming method for coherent radar, especially for the wideband linear frequency modulation（LFM） radar. An electronic counter-countermeasure...The interrupted sampling repeater jamming（ISRJ） is an effective deception jamming method for coherent radar, especially for the wideband linear frequency modulation（LFM） radar. An electronic counter-countermeasure（ECCM） scheme is proposed to remove the ISRJ-based false targets from the pulse compression result of the de-chirping radar. Through the time-frequency（TF） analysis of the radar echo signal, it can be found that the TF characteristics of the ISRJ signal are discontinuous in the pulse duration because the ISRJ jammer needs short durations to receive the radar signal. Based on the discontinuous characteristics a particular band-pass filter can be generated by two alternative approaches to retain the true target signal and suppress the ISRJ signal. The simulation results prove the validity of the proposed ECCM scheme for the ISRJ.展开更多
Objective To identify patterns of hand, foot and mouth disease （HFMD） incidence in China during declining incidence periods of 2008, 2009, and 2010. Methods Reported HFMD cases over a period of 25 months were extrac...Objective To identify patterns of hand, foot and mouth disease （HFMD） incidence in China during declining incidence periods of 2008, 2009, and 2010. Methods Reported HFMD cases over a period of 25 months were extracted from the National Disease Reporting System （NDRS） and analyzed. An interrupted time series （ITS） technique was used to detect changes in HFMD incidence rates in terms of level and slope between declining incidence periods of the three years. Results Over 3.58 million HFMD cases younger than 5 years were reported to the NDRS between May 1, 2008, and May 31, 2011. Males comprised 63.4% of the cases. ITS analyses demonstrated a significant increase in incidence rate level （P〈0.0001） when comparing the current period with the previous period. There were significant changes in declining slopes when comparing 2010 to 2009, and 2010 to 2008 （all P〈O.O05）, but not 2009 to 2008. Conclusion Incremental changes in incidence rate level during the declining incidence periods of 2009 and 2010 can potentially be attributed to a few factors. The more steeply declining slope in 2010 compared with previous years could be ascribed to the implementation of more effective interventions and preventive strategies in 2010. Further investigation is required to examine this possibility.展开更多
AIM： To evaluate the efficacy of interruption of intrauterine infection of HBV with HBIG in pregnant women with positive HBeAg and HBsAg.METHODS： A prospective randomized controlled trial was adopted. Sixty cases wi...AIM： To evaluate the efficacy of interruption of intrauterine infection of HBV with HBIG in pregnant women with positive HBeAg and HBsAg.METHODS： A prospective randomized controlled trial was adopted. Sixty cases with positive HBeAg and HBsAg were coincident with the criteria of inclusion, and 8 cases were excluded. Fifty-two cases were analyzed （28 cases in trial group and 24 in control group）. All cases in trial group received 200 IU HBIG intravenously every 4 wk for 3 times from the 28^th wk. The cases of control group received placebo in the same way. All pregnant women were detected for HBeAg and HBV-DNA at the beginning of the trial and end of the trial （delivery）. The cord blood of all newborns were collected for detecting HBeAg and HBV-DNA simultaneously.RESULTS： For investigation of HBeAg of newborns in trial group, 6 of 28 cases of newborns had positive HBeAg, the HBeAg positive rate being 21.4%, the total rate of 95% CI being 8%-41%. In control group, 19 of 24 cases of newborns had positive HBeAg, HBeAg positive rate was 79.2%, the rate of 95%CI being 5%-93%. By statistical analysis, 2= 17.26, P 〈 0.01, RR = 0.27, 95% CI （6.3 × 10^-6, 8.6 × 10^-5）. For investigation of HBV-DNA of newborns in trial group, 7 of 28 cases of newborns had positive HBV-DNA, HBV-DNA positive rate being 25%, the total rate of 95% CI being 11%-45%. In control group, 20 of 24 cases of newborns had positive HBV-DNA, HBV-DNA positive rate was 83.3%, the total rate of 95% CI being 63%-95%. By statistical analysis, X^2 = 17.62, P 〈 0.01, RR = 0.30, 95% CI （1.5 × 10^-5, 1.7× 10^-4）. The results indicated that there was significant difference in HBeAg positive rate and HBV-DNA positive rate of newborns between the two groups. In trial group, 7 of 28 newborns had HBV-DNA positive, but the HBV-DNA load of newborns was lower than that of their mothers. In control group, 20 of 24 newborns still had HBV-DNA positive, and the HBV-DNA load of newborns was close to those of their mothers. Statistical analysis indicated that there was no significant difference in HBV- DNA load between postnatal women without HBIG intervention and their filial generations （T = 81.5, P 〉 0.1）. CONCLUSION： It is effective and safe to prevent intrauterine infection of HBV with HBIG from the 28^th wk in pregnant women with positive HBeAg and HBsAg. In clinical application, those pregnant women with negative HBeAg and positive HBV-DNA also need to be interrupted by HBIG.展开更多
Objectives:To explore the knowledge,attitude and practice of Chinese nurses regarding nursing interruptions and related factors.Methods:A total of 6,400 nurses from 31 hospitals in China were investigated by using the...Objectives:To explore the knowledge,attitude and practice of Chinese nurses regarding nursing interruptions and related factors.Methods:A total of 6,400 nurses from 31 hospitals in China were investigated by using the Knowledge,Attitude and Practice(KAP)Questionnaire of Nursing Interruptions.The questionnaire consists of three dimensions,knowledge,attitude and practice,containing 10,9 and 7 items,with full score of 50,45 and 28,respectively.Results:The mean overall KAP score regarding nursing interruptions of Chinese nurses was 74.05±16.65(range:26-123),with scores for the knowledge,attitude,and practice component being 21.74±9.80,34.83±6.98,and 17.49±4.97,respectively.Among the nurses,70.8%of them experienced an average level of KAP toward nursing interruptions while 15.5%were at a poor level.The knowledge,attitude,and practice of nursing interruptions were better in chief nurses,managers,nurses with a master degree or above,nurses ever received training,and nurses with a strong agreement to leadership compared to nurses in other groups(P<0.05).In addition,employment type,professional title,position,standardized training and leaders'attention were predictors of KAP in nurses.Conclusion:Chinese nurses have a moderate level of KAP regarding nursing interruptions.Leaders'attention,standardized training,position,professional title and employment type could predict nurses'KAP state of nursing interruptions.Thus,a targeted training program should be implemented for clinical nurses by nursing leaders,with a particular focus on feasibility and professionalism.展开更多
In this paper, we present a new car-following model by taking into account the effects of the traffic interruption probability on the car-following behaviour of the following vehicle. The stability condition of the mo...In this paper, we present a new car-following model by taking into account the effects of the traffic interruption probability on the car-following behaviour of the following vehicle. The stability condition of the model is obtained by using the linear stability theory. The modified Korteweg-de Vries （KdV） equation is constructed and solved, and three types of traffic flows in the headway sensitivity space-stable, metastable, and unstable--are classified. Both the analytical and simulation results show that the traffic interruption probability indeed has an influence on driving behaviour, and the consideration of traffic interruption probability in the car-following model could stabilize traffic flow.展开更多
基金financial support from the National Natural Science Foundation of China(Nos.22261057 and 21901265)Guizhou Provincial Natural Science Foundation(No.QKHJC-2020-1Z072)+3 种基金the Science and Technology Department of Guizhou Province(Nos.QKHPTRC-CXTD[2022]012 and QKHPTRCGCC[2023]003)Zunyi Medical University(No.18ZY-002)Science and Technology Department of Zunyi(Nos.ZSKH-2018-3,ZSKHHZZ[2020]70,ZSKRPT-2020-5 and ZSKRPT-2021-5)Fifth Batch of Talent Base in Guizhou Province(No.S-030-1).
文摘Catalytic syntheses of silaoxycarbocyclics from an interrupted Catellani reaction of 3-iodochromones with bridged olefins and octamethyl-1,4-dioxacyclohexasilane is described.This protocol involves the oxidative addition of chromonyl-norbornyl-palladacycle generated through successive oxidative addition of Pd(0)to 3-iodochromones,migratory insertion of NBE and intramolecular ortho-C(sp^(2))-H activation to the tetrasilane,thus motivating a(4+6)annulation and ring expansion.The synthetic practicality of current strategy is further proved by the late-stage modification of pharmaceuticals and natural products,gram-scale experiments,as well as the transformations of functional groups of silaoxycarbocyclics.
基金Supported by the Shenyang Science and Technology,No.22-321-32-15Department of Science and Technology of Liaoning Province,No.2023JH2/101600015.
文摘BACKGROUND Gastric subepithelial lesions(SELs)are elevated lesions originating from the muscularis mucosa,submucosa,or muscularis propria,and may also include extraluminal lesions.For small SELs(less than 5 cm),complete endoscopic excision is the preferred treatment.Endoscopic full-thickness resection(EFTR)has proven to be an effective approach.AIM To evaluate the efficacy of the interrupted closure technique compared to the traditional closure technique in EFTR for gastric SELs.METHODS This single-center,prospective,randomized controlled trial was conducted at a tertiary hospital from September 2023 to September 2024.A total of 90 patients who underwent EFTR for gastric SELs were randomly allocated to either the interrupted closure group(n=44)or the traditional closure group(n=46).RESULTS All patients had complete resection and wound closure without any severe postoperative complications.The incidence of intraoperative gas-related complications was significantly lower in the interrupted closure group than in the traditional closure group(2.27%vs 26.09%,P=0.001),demonstrating interrupted closure technique can reduce the incidence of gas-related issues.Statistical analysis revealed that the incidence of postoperative infection was significantly lower in the experimental group than in the control group(15.91%vs 41.30%,P=0.008).Additionally,the median duration of antibiotic use was lower in the experimental group(3.5 days vs 5 days,P=0.013).Abdominal pain levels on postoperative days 1 and 4 were also lower in the experimental group compared to the control group(P<0.001).CONCLUSION The interrupted closure technique in EFTR for treating gastric SELs is safe and effective,reducing the incidence of intraoperative gas complications and postoperative infections.
基金funded by the Bavarian State Ministry of ScienceResearch and Art(Grant number:H.2-F1116.WE/52/2)。
文摘The incremental capacity analysis(ICA)technique is notably limited by its sensitivity to variations in charging conditions,which constrains its practical applicability in real-world scenarios.This paper introduces an ICA-compensation technique to address this limitation and propose a generalized framework for assessing the state of health(SOH)of batteries based on ICA that is applicable under differing charging conditions.This novel approach calculates the voltage profile under quasi-static conditions by subtracting the voltage increase attributable to the additional polarization effects at high currents from the measured voltage profile.This approach's efficacy is contingent upon precisely acquiring the equivalent impedance.To obtain the equivalent impedance throughout the batteries'lifespan while minimizing testing costs,this study employs a current interrupt technique in conjunction with a long short-term memory(LSTM)network to develop a predictive model for equivalent impedance.Following the derivation of ICA curves using voltage profiles under quasi-static conditions,the research explores two scenarios for SOH estimation:one utilizing only incremental capacity(IC)features and the other incorporating both IC features and IC sampling.A genetic algorithm-optimized backpropagation neural network(GABPNN)is employed for the SOH estimation.The proposed generalized framework is validated using independent training and test datasets.Variable test conditions are applied for the test set to rigorously evaluate the methodology under challenging conditions.These evaluation results demonstrate that the proposed framework achieves an estimation accuracy of 1.04%for RMSE and 0.90%for MAPE across a spectrum of charging rates ranging from 0.1 C to 1 C and starting SOCs between 0%and 70%,which constitutes a major advancement compared to established ICA methods.It also significantly enhances the applicability of conventional ICA techniques in varying charging conditions and negates the necessity for separate testing protocols for each charging scenario.
基金Analysis of Lung Compliance Measurement and its Guided Therapeutic Effects in Patients with ARDS Secondary to Severe Multiple Trauma(Project No.:XSD-2023-002)。
文摘In recent years,research on nursing interruptions has been conducted at various levels in emergency departments,intensive care units,hemodialysis centers,operating rooms,and sterilization and supply centers.Nursing interruptions are closely related to adverse nursing events,and interruptions in operating room nursing can significantly impact the success of a patient’s surgery.However,there is a lack of in-depth theoretical research on safety risk assessment and response decision-making by operating room nurses when faced with nursing interruptions.This article reviews the concept,current status,and impact of nursing interruptions in the operating room,analyzes the cognitive level,coping strategies,and negative emotions of operating room nurses,and elaborates on management strategies to provide references for research and management of nursing interruptions in the operating room.
基金Jiangxi Provincial Hospital Pharmacy Special Research Fund Project(Grant No.2024-ZXYJ02).
文摘In the context of the Diagnosis Related Groups(DRGs)system,the orthopedic hospital implemented refined drug control to provide a pharmacological reference for promoting rational clinical drug use.A statistical analysis was conducted on the hospital’s data from January to December 2021(prior to the implementation of control),focusing on the types of unreasonable prescriptions.A multi-dimensional analysis was also conducted to identify the underlying causes of inappropriate medication practices.Following this,refined drug control measures were introduced,and data from January to December 2022(post-control)were compared,examining factors such as the average drug cost,drug expenses for the IC29 diagnosis group,and the drug cost ratio.An interrupted time-series analysis was employed to evaluate the effects of these interventions.The results showed that after the implementation of refined drug control in the orthopedic department,significant reductions were observed in the average cost per patient,average drug cost per patient,drug cost ratio,cost consumption index,average length of hospital stay,and allocation ratio(P<0.05).In particular,the first month of control(January 2022)saw a marked decrease in average drug costs per patient by 1272.90 yuan(P<0.01),a reduction in the drug cost ratio by 0.98%,and a decline in drug costs for the IC29 diagnosis group by 616.79 yuan(P>0.05).Moreover,the rate of unreasonable inappropriate prescribing dropped dramatically from 40.48%in 2021 to 3.57%by December 2022.The refined control of drug use within the orthopedic hospital significantly improved the rationality of clinical prescribing practices,reduced the occurrence of adverse drug reactions,and enhanced patient adherence to prescribed treatments.These findings demonstrated considerable clinical value in promoting efficient and safe drug use.
基金supported by the National Natural Science Foundation of China(62001481,61890542,62071475)the Natural Science Foundation of Hunan Province(2022JJ40561)the Research Program of National University of Defense Technology(ZK22-46).
文摘Nonperiodic interrupted sampling repeater jamming(ISRJ)against inverse synthetic aperture radar(ISAR)can obtain two-dimensional blanket jamming performance by joint fast and slow time domain interrupted modulation,which is obviously dif-ferent from the conventional multi-false-target deception jam-ming.In this paper,a suppression method against this kind of novel jamming is proposed based on inter-pulse energy function and compressed sensing theory.By utilizing the discontinuous property of the jamming in slow time domain,the unjammed pulse is separated using the intra-pulse energy function diffe-rence.Based on this,the two-dimensional orthogonal matching pursuit(2D-OMP)algorithm is proposed.Further,it is proposed to reconstruct the ISAR image with the obtained unjammed pulse sequence.The validity of the proposed method is demon-strated via the Yake-42 plane data simulations.
基金the Tianjin Key Laboratory of Fastening and Connection Technology Enterprises 2022—2023,China(No.TKLF2022-02-C-02)the technical support from the School of Materials Science and Engineering,Central South University,China.
文摘The effects of interrupted aging on mechanical properties and corrosion resistance of 7A75 aluminum alloy extruded bar were investigated through various analyses,including electrical conductivity,mechanical properties,local corrosion properties,and slow strain rate tensile stress corrosion tests.Microstructure characterization techniques such as metallographic microscopy,scanning electron microscopy(SEM),and transmission electron microscopy(TEM)were also employed.The results indicate that the tensile strength of the alloy produced by T6I6 aging is similar to that produced by T6I4 aging,and it even exceeds 700 MPa.Furthermore,the yield strength increases by 52.7 MPa,reaching 654.8 MPa after T6I6 aging treatment.The maximum depths of intergranular corrosion(IGC)and exfoliation corrosion(EXCO)decrease from 116.3 and 468.5μm to 89.5 and 324.3μm,respectively.The stress corrosion factor also decreases from 2.1%to 1.6%.These findings suggest that the alloy treated with T6I6 aging exhibits both high strength and excellent stress corrosion cracking resistance.Similarly,when the alloy is treated with T6I4,T6I6 and T6I7 aging,the sizes of grain boundary precipitates(GBPs)are found to be 5.2,18.4,and 32.8 nm,respectively.The sizes of matrix precipitates are 4.8,5.7 and 15.7 nm,respectively.The atomic fractions of Zn in GBPs are 9.92 at.%,8.23 at.%and 6.87 at.%,respectively,while the atomic fractions of Mg are 12.66 at.%,8.43 at.%and 7.00 at.%,respectively.Additionally,the atomic fractions of Cu are 1.83 at.%,2.47 at.%and 3.41 at.%,respectively.
基金Supported by Zhejiang University Scientific Research Development Project(2021FZZX005-06).
文摘Interrupted Aortic Arch(IAA)combined with aortic stenosis(AS)is a rare and complex congenital cardiac anomaly that presents significant challenges in clinical management.In this letter,we aim to share our experience in performing hybrid procedures on an infant diagnosed with IAA combined with bicuspid AS.This child exhibited significant recovery during follow-up.
基金Weifang Fundamental Research Projects,No.WFWSJK-2023-052.
文摘BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare anatomical defect of the pituitary gland falling under the spectrum of holoprosencephaly phenotypes.It is characterized by a deficiency in anterior pituitary hormones,such as growth hormone,gonadotropins,and thyroid hormones.Due to the syndrome's rarity and nonspecific manifestations,there is a lack of standardized treatment strategies.Consequently,early diagnosis through imaging and on-time intervention are crucial for improving patients’outcomes.CASE SUMMARY A 30-year-old man presented with absent secondary sexual characteristics and azoospermia.Laboratory evaluation revealed a deficiency in gonadotropins,while thyroid function was mostly within normal ranges.Magnetic resonance imaging of the pituitary gland showed pituitary stalk agenesis,hypoplasia of the anterior pituitary,and ectopic posterior pituitary,leading to the diagnosis of PSIS.Initially,the patient underwent 6 mo of gonadotropin therapy without significant changes in hormone levels and secondary sexual characteristics.Pulsatile gonadotropin-releasing hormone therapy was then administered,resulting in the detection of sperm in the semen analysis within 3 mo.After 6 mo,routine semen tests showed normal semen quality.The couple faced challenges in conceiving due to abstinence and underwent three cycles of artificial insemination,which was unsuccessful.They also attempted in vitro fertilization,but unfortunately,the woman experienced a miscarriage 10 wk after the embryo transfer.CONCLUSION Early detection,accurate diagnosis,and timely treatment are crucial in improving the quality of life and fertility of PSIS patients.
文摘BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare disorder,often characterized by delayed growth and development,short stature,and hypogonadism as the main clinical manifestations.It is not clear whether PSIS can lead to liver cirrhosis.CASE SUMMARY This paper reported a case of liver cirrhosis of unknown origin.The patient was admitted to Beijing Ditan Hospital Affiliated to Capital Medical University in November 2023.The diagnosis of PSIS complicated with liver cirrhosis was established after a series of blood tests and pituitary magnetic resonance imaging examination.CONCLUSION We also reviewed the literature from both domestic and international sources to deepen the clinical understanding of PSIS in conjunction with liver cirrhosis among medical practitioners.
文摘Background: An interrupted family history, as is the case after taking someone into care, can complicate collecting family anamnesis data. In addition, the interrupted family history itself could be considered part of a person’s risk profile. Aim and methods: Literature analysis was conducted to examine whether there are scientific studies on health development after placement in out-of-home-care in order to recognise any existing medical characteristics that may be relevant for internal medical care. Results: There are few scientific publications on the health development of people after being placed in out-of-home-care. Direct reactions to the stress of being taken into custody include nausea and fever. However, effects that go beyond the acute situation and last into adulthood have also been described, such as AD(H)D, asthma, diabetes, cancer, hypertension and cardiovascular diseases (myocardial infarction, stroke), epilepsy and increased overall mortality in adulthood. Studies show that not only previous experience but also the stress of being taken into care is triggers for this. Conclusion: Information about a previous institutionalisation can hence be important for internal medical practice. The available scientific literature shows heterogeneous study methodology and no group of people with experience of out-of-home-placement has yet been scientifically accompanied for a long time period. Further studies on this could help to better weigh up the consequences of omitting and conducting an intervention for child/youth protection as well as to improve the medical care for this group of people.
基金The National High Technology Research and Development Program of China(863 Program)(No.2011AA110302-01)
文摘To study the congestion of interrupted flow on urban roads, a comprehensive evaluation method is proposed. First, based on the results of correlation analysis between different parameters of interrupted flow, the traffic parameters of interrupted traffic flow are divided into two categories： the basic parameters and the operation parameters. Polynomial regression is used to formulize the nonlinear relationships between the basic parameters and the operation parameters. Then, the congestion model incorporating both operational and volume characteristics of traffic flow is proposed. The inputs of the model are the basic parameters, while the output is a dimensionless index value between 0 and 1. Finally, the proposed methods are compared with existing evaluation measures of congestion. Results show that the proposed indices can capture the variation of both the basic parameters and the operation parameters, which is more balanced compared with the existing evaluation measures.
文摘To determine the feasibility and practicability of interrupt continuous wave (CW) approach proposed for real time simulating radar intermediate frequency(IF) video signal, theoretical analysis and computer simulation were used. Phases at two linked points between the end and beginning of adjoined frames are always consistent; the bias Doppler frequency for the time delay of A/D sampling start responds to that for target acceleration. No digital phase compensation is required at continuous points, and the interrupt CW approach has apparently practical values.
文摘Under Chinese medicine and health care system, Medicine Catalogue for National Basic Medical Insurance（2009） was issued in 2009 in China to fulfill the basic drug demands of the insured Chinese and to control the medical expenses. In this study, the influence of the list adjustment on drug utilization was investigated. With the comparison between inpatients＇ use of drugs before and after adjustment of Basic Medical Insurance Drug List, we classified the drugs adjusted in national list into six categories： class A to class B, class B to class A, class A to class C, class B to class C, class C to class A, and class C to class B（class A referring to overall insured drugs, class B referring to partial reimbursement drugs, class C referring to self-funded drugs in China）, and drug utilization and expenditure were analyzed with time series model. We analyzed the overall expenditure and average expenditure per 10 000 people based on the comparison before and after the adjustment of 2009 Basic Medical Insurance Drug List. The drug expenditure from class A to class B was decreased by 13.87% of overall expenditure and 16.37% of average expenditure per 10 000 people, and it was decreased by 38.74% and 48.03% from class A to class C; respectively, the drug expenditure from class B to class A was increased by 74.12% and 94.52%, while it was reduced by 19.79% and 14.52% from class B to class C; expenditure declined by 31.77% and 36.22% from class C to class A, and expenditure was increased by 12.42% and 22.05% from class C to class B, respectively, both were lower than before. The adjustment of National Basic Medical Insurance Drug List reduced the overall drug expenditure.
基金supported by the National Natural Science Foundation of China(61271442)
文摘The interrupted sampling repeater jamming（ISRJ） is an effective deception jamming method for coherent radar, especially for the wideband linear frequency modulation（LFM） radar. An electronic counter-countermeasure（ECCM） scheme is proposed to remove the ISRJ-based false targets from the pulse compression result of the de-chirping radar. Through the time-frequency（TF） analysis of the radar echo signal, it can be found that the TF characteristics of the ISRJ signal are discontinuous in the pulse duration because the ISRJ jammer needs short durations to receive the radar signal. Based on the discontinuous characteristics a particular band-pass filter can be generated by two alternative approaches to retain the true target signal and suppress the ISRJ signal. The simulation results prove the validity of the proposed ECCM scheme for the ISRJ.
文摘Objective To identify patterns of hand, foot and mouth disease （HFMD） incidence in China during declining incidence periods of 2008, 2009, and 2010. Methods Reported HFMD cases over a period of 25 months were extracted from the National Disease Reporting System （NDRS） and analyzed. An interrupted time series （ITS） technique was used to detect changes in HFMD incidence rates in terms of level and slope between declining incidence periods of the three years. Results Over 3.58 million HFMD cases younger than 5 years were reported to the NDRS between May 1, 2008, and May 31, 2011. Males comprised 63.4% of the cases. ITS analyses demonstrated a significant increase in incidence rate level （P〈0.0001） when comparing the current period with the previous period. There were significant changes in declining slopes when comparing 2010 to 2009, and 2010 to 2008 （all P〈O.O05）, but not 2009 to 2008. Conclusion Incremental changes in incidence rate level during the declining incidence periods of 2009 and 2010 can potentially be attributed to a few factors. The more steeply declining slope in 2010 compared with previous years could be ascribed to the implementation of more effective interventions and preventive strategies in 2010. Further investigation is required to examine this possibility.
基金Supported by the office of Science and Technology of Xinjiang,No.960505003
文摘AIM： To evaluate the efficacy of interruption of intrauterine infection of HBV with HBIG in pregnant women with positive HBeAg and HBsAg.METHODS： A prospective randomized controlled trial was adopted. Sixty cases with positive HBeAg and HBsAg were coincident with the criteria of inclusion, and 8 cases were excluded. Fifty-two cases were analyzed （28 cases in trial group and 24 in control group）. All cases in trial group received 200 IU HBIG intravenously every 4 wk for 3 times from the 28^th wk. The cases of control group received placebo in the same way. All pregnant women were detected for HBeAg and HBV-DNA at the beginning of the trial and end of the trial （delivery）. The cord blood of all newborns were collected for detecting HBeAg and HBV-DNA simultaneously.RESULTS： For investigation of HBeAg of newborns in trial group, 6 of 28 cases of newborns had positive HBeAg, the HBeAg positive rate being 21.4%, the total rate of 95% CI being 8%-41%. In control group, 19 of 24 cases of newborns had positive HBeAg, HBeAg positive rate was 79.2%, the rate of 95%CI being 5%-93%. By statistical analysis, 2= 17.26, P 〈 0.01, RR = 0.27, 95% CI （6.3 × 10^-6, 8.6 × 10^-5）. For investigation of HBV-DNA of newborns in trial group, 7 of 28 cases of newborns had positive HBV-DNA, HBV-DNA positive rate being 25%, the total rate of 95% CI being 11%-45%. In control group, 20 of 24 cases of newborns had positive HBV-DNA, HBV-DNA positive rate was 83.3%, the total rate of 95% CI being 63%-95%. By statistical analysis, X^2 = 17.62, P 〈 0.01, RR = 0.30, 95% CI （1.5 × 10^-5, 1.7× 10^-4）. The results indicated that there was significant difference in HBeAg positive rate and HBV-DNA positive rate of newborns between the two groups. In trial group, 7 of 28 newborns had HBV-DNA positive, but the HBV-DNA load of newborns was lower than that of their mothers. In control group, 20 of 24 newborns still had HBV-DNA positive, and the HBV-DNA load of newborns was close to those of their mothers. Statistical analysis indicated that there was no significant difference in HBV- DNA load between postnatal women without HBIG intervention and their filial generations （T = 81.5, P 〉 0.1）. CONCLUSION： It is effective and safe to prevent intrauterine infection of HBV with HBIG from the 28^th wk in pregnant women with positive HBeAg and HBsAg. In clinical application, those pregnant women with negative HBeAg and positive HBV-DNA also need to be interrupted by HBIG.
基金Paper extracted from The New Xiangya Talent Projects of the Third Xiangya Hospital of Central South University(NO:JY201720).
文摘Objectives:To explore the knowledge,attitude and practice of Chinese nurses regarding nursing interruptions and related factors.Methods:A total of 6,400 nurses from 31 hospitals in China were investigated by using the Knowledge,Attitude and Practice(KAP)Questionnaire of Nursing Interruptions.The questionnaire consists of three dimensions,knowledge,attitude and practice,containing 10,9 and 7 items,with full score of 50,45 and 28,respectively.Results:The mean overall KAP score regarding nursing interruptions of Chinese nurses was 74.05±16.65(range:26-123),with scores for the knowledge,attitude,and practice component being 21.74±9.80,34.83±6.98,and 17.49±4.97,respectively.Among the nurses,70.8%of them experienced an average level of KAP toward nursing interruptions while 15.5%were at a poor level.The knowledge,attitude,and practice of nursing interruptions were better in chief nurses,managers,nurses with a master degree or above,nurses ever received training,and nurses with a strong agreement to leadership compared to nurses in other groups(P<0.05).In addition,employment type,professional title,position,standardized training and leaders'attention were predictors of KAP in nurses.Conclusion:Chinese nurses have a moderate level of KAP regarding nursing interruptions.Leaders'attention,standardized training,position,professional title and employment type could predict nurses'KAP state of nursing interruptions.Thus,a targeted training program should be implemented for clinical nurses by nursing leaders,with a particular focus on feasibility and professionalism.
基金supported by the National Natural Science Foundation of China (Grant Nos 70701002 and 70521001)the National Basic Research Program of China (Grant No 2006CB705503)the Research Grants Council of the Hong Kong Special Administrative Region of China (Grant No HKU7187/05E)
文摘In this paper, we present a new car-following model by taking into account the effects of the traffic interruption probability on the car-following behaviour of the following vehicle. The stability condition of the model is obtained by using the linear stability theory. The modified Korteweg-de Vries （KdV） equation is constructed and solved, and three types of traffic flows in the headway sensitivity space-stable, metastable, and unstable--are classified. Both the analytical and simulation results show that the traffic interruption probability indeed has an influence on driving behaviour, and the consideration of traffic interruption probability in the car-following model could stabilize traffic flow.
