Carbenes as one of the most important class of intermediates have been widely utilized in various organic synthetic transformations.Carbene insertion-initiated ring-opening reactions of cyclic ethers offer a valuable ...Carbenes as one of the most important class of intermediates have been widely utilized in various organic synthetic transformations.Carbene insertion-initiated ring-opening reactions of cyclic ethers offer a valuable strategy for constructing new carbon-oxygen bonds.In comparison with traditional thermal or metal-mediated carbene transfer reactions,visible-light-promoted multi-component reaction strategy provides a mild and eco-friendly approach to access densely functionalized molecules.Recently,visible-light-induced multi-component carbene transfer reactions of diazo compounds have been rapidly developed and attracted a great deal of research interest of chemists owing to their advantages of simple operation,mild condition,high atom economy and rich structural diversity.This paper summarizes the recent research progress on the visible-light-promoted multi-component carbene transfer reactions of diazo compounds via ring-opening of cyclic ethers with various nucleophiles.The reaction patterns of different nucleophiles and their corresponding mechanism are described in this review.The future research direction and challenges in this area are also discussed.展开更多
Objectives:We systematically reviewed the rational use of medicines using the World Health Organization/International Network of Rational Use of Drugs(WHO/INRUD)core drug use indicators.We also assessed the impact of ...Objectives:We systematically reviewed the rational use of medicines using the World Health Organization/International Network of Rational Use of Drugs(WHO/INRUD)core drug use indicators.We also assessed the impact of the coronavirus disease 2019 pandemic and the National Drug Policy(NDP)2005 on the rational use of medicines.Methods:Searches were conducted in PubMed,Scopus,and Google Scholar databases to identify studies that met our eligibility criteria.Assessment of the quality of studies was conducted using the Joanna Briggs Institute criteria for analytical studies.We reported and compared the median values of WHO/INRUD core drug use indicators with standard thresholds.Data were presented with median,interquartile range(IQR),and percentages.MannWhitney and Kruskal-Wallis tests were conducted to assess for statistical significance(P<0.05)across variables.Results:Thirty-one studies were included in the review,comprising 50,931 patient encounters across 268 health facilities.Within prescribing indicators,average number of medicines per patient encountered[3.4(IQR:3.0to 4.0)],percentage of medicines prescribed by generic[50.4%(IQR:47.4%to 65.0%)],percentage of encounters with antibiotic prescribed[40.2%(IQR:30.5%to 52.7%)],percentage of encounters with injection prescribed[18%(IQR:3.2%to 30.0%)]and the percentage of medicines prescribed from essential medicines list[82.0%(IQR:66.4%to 89.3%)].The median percentage of encounters with antibiotics(P=0.04)and the median percentage of medicines prescribed by generics(P=0.03)increased during and after the COVID-19 pandemic.Prescribing indicators were worse in primary and secondary health facilities,with significant differences in the median percentage of encounters with antibiotics(P=0.007)and injections(P=0.0002)across primary,secondary,and tertiary health facilities.There were improvements across all prescribing indicators after the implementation of NDP 2005.Conclusions:Core drug use indicators in Nigerian health facilities deviated from the WHO/INRUD thresholds,with noticeable improvement after the implementation of NDP 2005.More efforts are needed to improve rational drug use in Nigerian hospitals.展开更多
Background: The irrational use of medicines remains a key health problem in many developing countries. The overuse of antibiotics is a key driver of antimicrobial resistance (AMR). This study surveyed antibiotic use a...Background: The irrational use of medicines remains a key health problem in many developing countries. The overuse of antibiotics is a key driver of antimicrobial resistance (AMR). This study surveyed antibiotic use and adherence to the World Health Organization (WHO) prescribing indicators at the Request Muntanga Hospital in the Kalomo District of Southern Province, Zambia. Materials and Methods: This cross-sectional study was conducted from July 2023 to September 2023 at Request Muntanga Hospital in Zambia and reviewed 600 medical record prescriptions which were issued from July 1, 2022 to June 30, 2023 using the WHO prescribing indicators. The collected data were analyzed using Statistical Package for Social Sciences version 23.0. Results: From the 600 prescriptions sampled, 1246 medicines were prescribed, with antibiotics making up 86.7% of the encounters. Additionally, the average number of drugs prescribed per encounter was 2.1 and the prevalence of polypharmacy was 61.3%. Further, 17.8% of medicines were prescribed as injectables. Furthermore, 76.7% of the drugs were prescribed from the Zambia Essential Medicines List and 38.9% by generic names. Conclusions: This study found a high use of antibiotics and deviations from the WHO/International Network of Rational Use of Drugs (INRUD) core prescribing indicators at the Request Muntanga Hospital indicating non-adherence to the prescribing indicators. There is a need to promote adherence to the WHO/INRUD core prescribing indicators to promote the rational use of antibiotics and prevent the emergence and spread of AMR.展开更多
BACKGROUND Nutritional and inflammatory indicators are crucial in assessing the nutritional health and immune function of patients with cancer,which are factors closely associated with the diagnosis and treatment of c...BACKGROUND Nutritional and inflammatory indicators are crucial in assessing the nutritional health and immune function of patients with cancer,which are factors closely associated with the diagnosis and treatment of colorectal cancer(CRC).AIM To explore the relationship between nutritional and inflammatory indicators and microsatellite stability(MSS)status in CRC.METHODS The clinical data of 56 patients who underwent surgical treatment for CRC were collected.Furthermore,the expressions of nutritional(levels of serum albumin,triglycerides,serum cholesterol,and body mass index)and inflammatory response indicators(absolute neutrophil count,absolute lymphocyte count,absolute monocyte count,neutrophil-to-lymphocyte ratio,and lymphocyte-to-monocyte ratio)as well as their correlation with microsatellite instability(MSI)status were investigated in patients with CRC.RESULTS Compared to the patients with MSS tumors,those with MSI tumors demonstrated significantly lower levels of two nutritional indicators,namely serum albumin and body mass index(P<0.05).Moreover,patients in the MSI group demonstrated significantly lower absolute lymphocyte counts and higher neutrophil-to-lymphocyte ratio than those in the MSS group(P<0.05),indicating pronounced differences in inflammatory responses and immune states between the two groups.CONCLUSION Certain nutritional and inflammatory indicators exhibit significant differences among patients with MSI and MSS CRC,highlighting their potential role in the clinical treatment and health management of this specific population.展开更多
In the realm of nonlinear integrable systems,the presence of decompositions facilitates the establishment of linear superposition solutions and the derivation of novel coupled systems exhibiting nonlinear integrabilit...In the realm of nonlinear integrable systems,the presence of decompositions facilitates the establishment of linear superposition solutions and the derivation of novel coupled systems exhibiting nonlinear integrability.By focusing on single-component decompositions within the potential BKP hierarchy,it has been observed that specific linear superpositions of decomposition solutions remain consistent with the underlying equations.Moreover,through the implementation of multi-component decompositions within the potential BKP hierarchy,successful endeavors have been undertaken to formulate linear superposition solutions and novel coupled Kd V-type systems that resist decoupling via alterations in dependent variables.展开更多
Multi-component transition group metal borides(MMB_(2))have become a research hotspot due to their new composition design concepts and superior properties compared with conventional ceramics.Most of the current method...Multi-component transition group metal borides(MMB_(2))have become a research hotspot due to their new composition design concepts and superior properties compared with conventional ceramics.Most of the current methods,however,are complicated and time-consuming,the mass production remains a chal-lenge.Herein,we proposed a new high-efficiency strategy for synthesis of MMB_(2)using molten aluminum as the medium for the first time.The prepared Al-containing multi-component borides(TiZrHfNbTa)B_(2)microcrystals had a homogeneous composition with a hexagonal AlB_(2)structure and ultra-high hardness value of∼35.3 GPa,which was much higher than data reported in the literature and the rule of mix-ture estimations.Furthermore,combined with the First-principles calculation results,we found that the Poisson’s ratio(v)values exhibit a clearly ascending trend from 0.17 at VEC=3.5 to 0.18 at VEC=3.4,then to 0.201 at VEC=3.2 with the increasing of Al content.This indicates that the intrinsic toughness of multi-component boride microcrystals is obviously enhanced by the trace-doped Al elements.Besides,the fabricated Al-containing multi-component boride microcrystals have superior oxidation activation en-ergy and structural stability.The enhanced oxidation resistance is mainly attributed to the formation of a protective Al2 O3 oxide layer and the lattice distortion,both of which lead to sluggish diffusion of O_(2).These findings propose a new unexplored avenue for the fabrication of MMB_(2)materials with supe-rior comprehensive performance including ultra-hardness and intrinsically improved thermo-mechanical properties.展开更多
The hardening mechanism of multi-component carbide ceramic has been investigated in detail through a combination of experiments,first-principles calculations,and ab initio molecular dynamics(AIMD).Eight dense carbide ...The hardening mechanism of multi-component carbide ceramic has been investigated in detail through a combination of experiments,first-principles calculations,and ab initio molecular dynamics(AIMD).Eight dense carbide ceramics were prepared by spark plasma sintering.Compulsorily,all the multi-component carbide samples have similar carbon content,grain size,and uniform compositional distribution by optimizing the sintering process and adjusting the initial raw materials.Hence the interference of other factors on the hardness of multi-component carbide ceramics is minimized.The effects of changes in the elemental species on the lattice distortion,bond strength,bonding properties,and electronic structure of multi-component carbide ceramics were thoroughly analyzed.These results show that the hardening of multi-component carbide ceramic can be attributed to the coupling of solid solution strengthening caused by lattice distortion and covalent bond strengthening.Besides,the“host lattice”of multi-component carbide ceramics is defined based on the concept of supporting lattice.The present work is of great significance for a deeper understanding of the hardening mechanism of multi-component carbide ceramics and the design of superhard multi-component carbides.展开更多
Colonoscopy remains the cornerstone of colorectal cancer prevention and survei-llance,but the procedure’s effectiveness is entirely dependent upon various quali-ty indicators,such as detection rates,withdrawal time,a...Colonoscopy remains the cornerstone of colorectal cancer prevention and survei-llance,but the procedure’s effectiveness is entirely dependent upon various quali-ty indicators,such as detection rates,withdrawal time,adequate bowel prepara-tion,cecal intubation rate and patient outcomes.Despite progress in endoscopic techniques,challenges persist in maintaining endoscopists’consistent perfor-mance and improving quality metrics.Artificial intelligence(AI)has emerged as a“game changer”in the gastroenterology field,offering the opportunity to signifi-cantly increase colonoscopy quality.This review highlights the role of AI-driven technologies such as deep learning,computer vision,and real-time feedback me-chanisms in optimizing key quality indicators of colonoscopy.The implementa-tion of AI in colonoscopy may reduce human error,improve endoscopist’s consis-tency in real-time decision making,ensuring higher reliability and standardiza-tion during the procedure.Furthermore,AI has the potential to reshape how en-doscopists perform and evaluate procedures,while improved lesion characte-rization may enable more precise selection for resection,reducing morbidity and the incidence of interval cancers.The review also addresses challenges and limi-tations in AI integration,including cost-effectiveness and its impact on endosco-pist training.AI holds substantial promise for advancing colonoscopy quality and elevating overall patient care,paving the way for more effective and personalized medical approaches.展开更多
This study provides a systematic investigation into the influence of feature selection methods on cryptocurrency price forecasting models employing technical indicators.In this work,over 130 technical indicators—cove...This study provides a systematic investigation into the influence of feature selection methods on cryptocurrency price forecasting models employing technical indicators.In this work,over 130 technical indicators—covering momentum,volatility,volume,and trend-related technical indicators—are subjected to three distinct feature selection approaches.Specifically,mutual information(MI),recursive feature elimination(RFE),and random forest importance(RFI).By extracting an optimal set of 20 predictors,the proposed framework aims to mitigate redundancy and overfitting while enhancing interpretability.These feature subsets are integrated into support vector regression(SVR),Huber regressors,and k-nearest neighbors(KNN)models to forecast the prices of three leading cryptocurrencies—Bitcoin(BTC/USDT),Ethereum(ETH/USDT),and Binance Coin(BNB/USDT)—across horizons ranging from 1 to 20 days.Model evaluation employs the coefficient of determination(R2)and the root mean squared logarithmic error(RMSLE),alongside a walk-forward validation scheme to approximate real-world trading contexts.Empirical results indicate that incorporating momentum and volatility measures substantially improves predictive accuracy,with particularly pronounced effects observed at longer forecast windows.Moreover,indicators related to volume and trend provide incremental benefits in select market conditions.Notably,an 80%–85% reduction in the original feature set frequently maintains or enhances model performance relative to the complete indicator set.These findings highlight the critical role of targeted feature selection in addressing high-dimensional financial data challenges while preserving model robustness.This research advances the field of cryptocurrency forecasting by offering a rigorous comparison of feature selection methods and their effects on multiple digital assets and prediction horizons.The outcomes highlight the importance of dimension-reduction strategies in developing more efficient and resilient forecasting algorithms.Future efforts should incorporate high-frequency data and explore alternative selection techniques to further refine predictive accuracy in this highly volatile domain.展开更多
Objective: To analyze the effectiveness of blood test indicators in the differential diagnosis of anemia. Methods: Sixty patients diagnosed with anemia (disease group) from June 2021 to June 2024 were selected. Based ...Objective: To analyze the effectiveness of blood test indicators in the differential diagnosis of anemia. Methods: Sixty patients diagnosed with anemia (disease group) from June 2021 to June 2024 were selected. Based on the type of disease, the group was subdivided into iron deficiency anemia (IDA) with 31 cases, hemolytic anemia (HA) with 11 cases, and aplastic anemia (AA) with 18 cases. Based on the severity of the disease, the group was divided into mild anemia (30 cases), moderate anemia (19 cases), and severe anemia (11 cases). Sixty healthy individuals (control group) were also included, and all underwent blood tests. Comparisons were made between the red blood cell (RBC) indicators of the disease group and the control group, the blood test indicators of different types of anemia, and the serum iron levels of varying severity of anemia. Results: Except for red cell distribution width (RDW), the RBC indicators in the disease group were lower than those in the control group (P < 0.05). Comparisons of RBC indicators among different types of anemia showed significant differences (P < 0.05). Serum iron levels varied significantly among different degrees of anemia severity (P < 0.05). Conclusion: Blood tests can detect anemia, distinguish types of anemia, and assess anemia severity, offering high diagnostic value.展开更多
A convenient photocatalytic multi-component reaction of alkenes,quinoxalin-2(1H)-ones,and diazo compounds has been developed in the presence of water.A number of ester-containing quinoxalin-2(1H)-ones could be efficie...A convenient photocatalytic multi-component reaction of alkenes,quinoxalin-2(1H)-ones,and diazo compounds has been developed in the presence of water.A number of ester-containing quinoxalin-2(1H)-ones could be efficiently obtained in moderate to good yields at room temperature.This metal-free visiblelight-driven tandem reaction was conducted through proton-coupled electron transfer(PCET)process using water as the hydrogen donor and 1,2,3,5-tetrakis(carbazol-9-yl)-4,6-dicyanobenzene(4CzIPN)as the photocatalyst.展开更多
China’s urbanization has entered a mid-to-late phase,and is characterized by high-density urban engineering projects that form systems coupled to geotechnical environments.These systems exhibit significant vulnerabil...China’s urbanization has entered a mid-to-late phase,and is characterized by high-density urban engineering projects that form systems coupled to geotechnical environments.These systems exhibit significant vulnerability due to strong spatiotemporal coupling,which hampers sustainable urban development.Traditional approaches to urban engineering design,construction,and maintenance tend to focus on individual projects and lack the ability to comprehensively evaluate system-level sustainability.Thus,with current methods,it is difficult to optimize the renewal and operation of high-density urban engineering systems.In this study,the constituent elements and key features of high-density urban engineering systems are discussed,and urban engineering system sustainability evaluation indicators are comprehensively reviewed.Viewed from perspectives of resilience,low-carbon development,and ecological impact,66 performance indicators describing urban engineering systems are selected.The decision-making trial and evaluation laboratory(DEMATEL)-based analytic network process(DANP)method and the entropy weight method(EWM)are utilized to calculate these indicators’subjective and objective weights,respectively.Furthermore,the coupling relationships between evaluation indicators are explored,aiding the construction of an urban engineering sustainability evaluation index system.Finally,empirical analysis is conducted across six megacities in China(Tianjin,Hangzhou,Shanghai,Wuhan,Chongqing,and Shenzhen)to validate the effectiveness of the evaluation indicators.The findings reveal significant imbalances in the sustainability of urban engineering systems in China.Accordingly,potential strategies and indicators for targeted enhancement of these systems are discussed.展开更多
The construction of a borehole correction library for the multi-component array induction tool in deviated boreholes involves extensive 3D forward modeling and typically requires significant computational resources.To...The construction of a borehole correction library for the multi-component array induction tool in deviated boreholes involves extensive 3D forward modeling and typically requires significant computational resources.To address this challenge,this paper proposes an efficient algorithm for the library construction based on the 3D finite volume method(FVM)and contraction high-order Born approximation(CHBA).First,the electromagnetic(EM)field solution region is divided into two symmetric subregions based on the symmetry of the correction library model and the EM field.Numerical solution on a single subregion,combined with the symmetry boundary extension technique,enhances the efficiency of the 3D numerical simulation.Second,three reference mud conductivities are selected based on the mud conductivity range,and the CHBA is applied to calculate the EM responses at all mud conductivity nodes rapidly.Third,the number of forward simulation operations is further reduced by exploiting the principle that models with different frequencies and different formation conductivities have equivalent EM responses.Numerical experiments demonstrate the correctness and feasibility of the proposed algorithm.Compared to conventional 3D modeling,the proposed algorithm achieves approximately a 20-fold speedup in library construction,effectively reducing computational resources and time consumption.展开更多
Objective Blood culture remains the gold standard for diagnosing bloodstream infections.Clinical laboratories must ensure the quality of blood culture processes from receipt to obtaining definitive results.We examined...Objective Blood culture remains the gold standard for diagnosing bloodstream infections.Clinical laboratories must ensure the quality of blood culture processes from receipt to obtaining definitive results.We examined laboratory analytical indicators associated with positive blood culture results.Methods Blood cultures collected from Peking Union Medical College Hospital between January 1,2020,and December 31,2022,were retrospectively analyzed.The mode of transportation(piping logistics delivery vs.staff),source of blood cultures(outpatient/emergency department vs.inpatient department),rotation of personnel,and time of reception(8:00–19:59 vs.20:00–07:59)were compared between blood culture-positive and-negative results.Results Between 2020 and 2022,the total positive rate of blood culture was 8.07%.The positive rate of blood cultures in the outpatient/emergency department was significantly higher than that in the inpatient department(12.46%vs.5.83%;P<0.0001).The time-to-detection of blood cultures was significantly affected by the delivery mode and personnel rotation.The blood culture positive rate of the total pre-analytical time within 1 h was significantly higher than that within 1–2 h or>2 h(P<0.0170).Conclusion Laboratory analytical indicators such as patient source,transportation mode,and personnel rotation significantly impacted the positive detection rate or time of blood culture.展开更多
Vegetation annual gross primary production(AGPP),the total yearly carbon assimilation via photosynthesis,serves as a key indicator of ecosystem carbon uptake.While AGPP variations are jointly influenced by both vegeta...Vegetation annual gross primary production(AGPP),the total yearly carbon assimilation via photosynthesis,serves as a key indicator of ecosystem carbon uptake.While AGPP variations are jointly influenced by both vegetation phenology and physiology,the effectiveness of satellite-derived indicators in capturing these variations has not been fully evaluated.This study develops and evaluates the satellite-derived phenology and physiology indicators for modeling AGPP variability.We assessed the performance of satellite-derived metrics,including solar-induced chlorophyll fluorescence(SIF),leaf area index(LAI),and enhanced vegetation index(EVI),in capturing AGPP variations.Among these,SIF-based indicators exhibited the highest accuracy(Pearson's r=0.79;root mean square error=414.7 gC·m^(-2)·year^(-1)),outperforming LAI-and EVI-based indicators.To further investigate the mechanisms driving AGPP variability,we used a structural equation model based on in situ observations to quantify the direct and indirect effects of climate on AGPP through phenology and physiology.Our results reveal that vegetation physiology,particularly the seasonal maximum gross primary production,plays a more dominant role in regulating AGPP than phenology.Furthermore,we found that globally,SIF-derived phenology indicators tend to be lower than those from LAI and EVI,whereas SIF-derived physiology indicators are elevated in tropical regions and the Southern Hemisphere.These findings highlight the potential of satellite-derived indicators in advancing AGPP modeling and emphasize the predominant role of vegetation physiology in regulating ecosystem carbon uptake.This study contributes to a refined understanding of global carbon cycle dynamics and provides insights for improving large-scale carbon assessments in the context of climate change.展开更多
This paper focuses on the procurement of construction projects in universities,conducting research on the influencing factors of procurement risks in such projects.By combining questionnaire surveys with expert interv...This paper focuses on the procurement of construction projects in universities,conducting research on the influencing factors of procurement risks in such projects.By combining questionnaire surveys with expert interviews,numerous factors affecting procurement are analyzed.Subsequently,these factors are refined and summarized to construct a procurement risk evaluation index system for construction projects,which includes three first-level indicators,such as process management risk and ethical/legal risk,and is further subdivided into 13 second-level indicators.展开更多
There are multiple types of risks involved in the service of long-span railway bridges.Classical methods are difficult to provide targeted alarm information according to different situations of load anomalies and stru...There are multiple types of risks involved in the service of long-span railway bridges.Classical methods are difficult to provide targeted alarm information according to different situations of load anomalies and structural anomalies.To accurately alarm different risks of long-span railway bridges by structural health monitoring systems,this paper proposes a cross-cooperative alarm method using principal and secondary indicators during high-wind periods.It provides the prior criterion for monitoring systems under special conditions,defining the principal and secondary indicators,alarm levels,and thresholds based on the relationship between dynamic equilibrium equations and multiple linear regression analysis.Analysis of one-year monitoring data from a longspan railway cable-stayed bridge shows that the 10-min average cross-bridge wind speed(excitation indicator)can be selected as the principal indicator,while lateral displacement(response indicator)can serve as the secondary indicator.The threshold levels of the secondary indicator prioritize the safety of bridge operation(mainly aiming at the safety of trains traversing bridges),with values significantly lower than structural safety thresholds.This approach enhances alarm timeliness and effectively distinguishes between load anomalies,structural anomalies,and equipment failures.Consequently,it improves alarm accuracy and provides timely decision support for bridge maintenance,train traversing,and emergency treatment.展开更多
BACKGROUND Post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis is a common complication of the procedure.The effective prevention of post-ERCP pancreatitis(PEP)remains a key focus of clinical researc...BACKGROUND Post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis is a common complication of the procedure.The effective prevention of post-ERCP pancreatitis(PEP)remains a key focus of clinical research.AIM To develop a prediction model for PEP based on multidimensional clinical indicators and evaluate its clinical application value.METHODS We retrospectively analyzed 183 patients with biliary tract diseases who underwent ERCP at Xuzhou Medical University from January 2020 to June 2023,divided into non-PEP(n=159)and PEP(n=24)groups based on PEP development.Baseline and intraoperative data were compared,and PEP-related factors examined via univariate and multivariate logistic regression.Using R,70%of patients were assigned to training and 30%to testing sets for PEP prediction model development.Model accuracy was evaluated using a calibration curve and receiver operating characteristic(ROC)area under the curve(AUC).RESULTS Age,total cholesterol level,history of pancreatitis,pancreatic ductography,bleeding,and intubation time differed significantly between the two groups when baseline data and intraoperative conditions were compared(P<0.05).Multifactorial logistic regression analysis demonstrated that age[odds ratio(OR)=0.192,95%confidence interval(CI):0.053-0.698],total cholesterol(OR=0.324,95%CI:0.152-0.694),history of pancreatitis(OR=6.159,95%CI:1.770-21.434),pancreatography(OR=3.726,95%CI:1.028-13.507),and bleeding(OR=3.059,95%CI:1.001-9.349)were independently associated with acute pancreatitis after ERCP.The predictive probabilities from the calibration curves had mean errors of 0.021 and 0.030,with ROC AUCs of 0.840 and 0.797 in the training and test sets,respectively.CONCLUSION Age,total cholesterol,pancreatitis history,pancreatic ductography,and bleeding influence the risk of acute PEP.A model incorporating these factors may aid early detection and intervention.展开更多
This editorial delves into the potential of systemic immune indicators(SIIs)as early predictors of renal damage in children with newly diagnosed type 1 diabetes mellitus.By exploring the recent study published by Cao ...This editorial delves into the potential of systemic immune indicators(SIIs)as early predictors of renal damage in children with newly diagnosed type 1 diabetes mellitus.By exploring the recent study published by Cao et al,this article aims to highlight the importance of early detection and intervention.This study compre-hensively analyzes various SIIs,examining their correlation with renal compli-cations in newly diagnosed type 1 diabetic children.The findings reveal a sig-nificant association between immune system dysregulation and the onset of renal damage,suggesting that certain immune indicators can be early markers for predicting renal complications.This editorial emphasizes the clinical implications and applications of utilizing SIIs for early detection in pediatric diabetes care.It underscores the importance of innovative diagnostic approaches and illustrates real-world applications and outcomes.Additionally,it addresses the challenges and considerations in adopting these indicators and outlines future research directions to enhance diabetes management in children.展开更多
Purpose-The indoor vibration compaction test(IVCT)was a key step in controlling the compaction quality for high-speed railway graded aggregate(HRGA),which currently had a research gap on the assessment indicators and ...Purpose-The indoor vibration compaction test(IVCT)was a key step in controlling the compaction quality for high-speed railway graded aggregate(HRGA),which currently had a research gap on the assessment indicators and compaction parameters.Design/methodology/approach-To address these issues,a novel multi-indicator IVCT method was proposed,including physical indicator dry density(ρd)and mechanical indicators dynamic stiffness(Krb)and bearing capacity coefficient(K20).Then,a series of IVCTs on HRGA under different compaction parameters were conducted with an improved vibration compactor,which could monitor the physical-mechanical indicators in real-time.Finally,the optimal vibration compaction parameters,including the moisture content(ω),the diameter-to-maximum particle size ratio(Rd),the thickness-to-maximum particle size ratio(Rh),the vibration frequency(f),the vibration mass(Mc)and the eccentric distance(re),were determined based on the evolution characteristics for the physical-mechanical indicators during compaction.Findings-All results indicated that theρd gradually increased and then stabilized,and the Krb initially increased and then decreased.Moreover,the inflection time of the Krb was present as the optimal compaction time(Tlp)during compaction.Additionally,optimal compaction was achieved whenωwas the water-holding content after mud pumping,Rd was 3.4,Rh was 3.5,f was the resonance frequency,and the ratio between the excitation force and the Mc was 1.8.Originality/value-The findings of this paper were significant for the quality control of HRGA compaction.展开更多
基金Science and Technology Foundation of Guizhou Province(No.QKHJC-ZK[2024]654)Guizhou Provincial University Key Laboratory of Advanced Functional Electronic Materials(No.QJ[2023]021).
文摘Carbenes as one of the most important class of intermediates have been widely utilized in various organic synthetic transformations.Carbene insertion-initiated ring-opening reactions of cyclic ethers offer a valuable strategy for constructing new carbon-oxygen bonds.In comparison with traditional thermal or metal-mediated carbene transfer reactions,visible-light-promoted multi-component reaction strategy provides a mild and eco-friendly approach to access densely functionalized molecules.Recently,visible-light-induced multi-component carbene transfer reactions of diazo compounds have been rapidly developed and attracted a great deal of research interest of chemists owing to their advantages of simple operation,mild condition,high atom economy and rich structural diversity.This paper summarizes the recent research progress on the visible-light-promoted multi-component carbene transfer reactions of diazo compounds via ring-opening of cyclic ethers with various nucleophiles.The reaction patterns of different nucleophiles and their corresponding mechanism are described in this review.The future research direction and challenges in this area are also discussed.
文摘Objectives:We systematically reviewed the rational use of medicines using the World Health Organization/International Network of Rational Use of Drugs(WHO/INRUD)core drug use indicators.We also assessed the impact of the coronavirus disease 2019 pandemic and the National Drug Policy(NDP)2005 on the rational use of medicines.Methods:Searches were conducted in PubMed,Scopus,and Google Scholar databases to identify studies that met our eligibility criteria.Assessment of the quality of studies was conducted using the Joanna Briggs Institute criteria for analytical studies.We reported and compared the median values of WHO/INRUD core drug use indicators with standard thresholds.Data were presented with median,interquartile range(IQR),and percentages.MannWhitney and Kruskal-Wallis tests were conducted to assess for statistical significance(P<0.05)across variables.Results:Thirty-one studies were included in the review,comprising 50,931 patient encounters across 268 health facilities.Within prescribing indicators,average number of medicines per patient encountered[3.4(IQR:3.0to 4.0)],percentage of medicines prescribed by generic[50.4%(IQR:47.4%to 65.0%)],percentage of encounters with antibiotic prescribed[40.2%(IQR:30.5%to 52.7%)],percentage of encounters with injection prescribed[18%(IQR:3.2%to 30.0%)]and the percentage of medicines prescribed from essential medicines list[82.0%(IQR:66.4%to 89.3%)].The median percentage of encounters with antibiotics(P=0.04)and the median percentage of medicines prescribed by generics(P=0.03)increased during and after the COVID-19 pandemic.Prescribing indicators were worse in primary and secondary health facilities,with significant differences in the median percentage of encounters with antibiotics(P=0.007)and injections(P=0.0002)across primary,secondary,and tertiary health facilities.There were improvements across all prescribing indicators after the implementation of NDP 2005.Conclusions:Core drug use indicators in Nigerian health facilities deviated from the WHO/INRUD thresholds,with noticeable improvement after the implementation of NDP 2005.More efforts are needed to improve rational drug use in Nigerian hospitals.
文摘Background: The irrational use of medicines remains a key health problem in many developing countries. The overuse of antibiotics is a key driver of antimicrobial resistance (AMR). This study surveyed antibiotic use and adherence to the World Health Organization (WHO) prescribing indicators at the Request Muntanga Hospital in the Kalomo District of Southern Province, Zambia. Materials and Methods: This cross-sectional study was conducted from July 2023 to September 2023 at Request Muntanga Hospital in Zambia and reviewed 600 medical record prescriptions which were issued from July 1, 2022 to June 30, 2023 using the WHO prescribing indicators. The collected data were analyzed using Statistical Package for Social Sciences version 23.0. Results: From the 600 prescriptions sampled, 1246 medicines were prescribed, with antibiotics making up 86.7% of the encounters. Additionally, the average number of drugs prescribed per encounter was 2.1 and the prevalence of polypharmacy was 61.3%. Further, 17.8% of medicines were prescribed as injectables. Furthermore, 76.7% of the drugs were prescribed from the Zambia Essential Medicines List and 38.9% by generic names. Conclusions: This study found a high use of antibiotics and deviations from the WHO/International Network of Rational Use of Drugs (INRUD) core prescribing indicators at the Request Muntanga Hospital indicating non-adherence to the prescribing indicators. There is a need to promote adherence to the WHO/INRUD core prescribing indicators to promote the rational use of antibiotics and prevent the emergence and spread of AMR.
基金Supported by Grants of the Suzhou Medical Key Discipline,No.SZXK202109Suzhou Clinical Key Disease Project,No.LCZX202111Suzhou Promoting Health through Science and Education Research Project,No.KJXW2021028.
文摘BACKGROUND Nutritional and inflammatory indicators are crucial in assessing the nutritional health and immune function of patients with cancer,which are factors closely associated with the diagnosis and treatment of colorectal cancer(CRC).AIM To explore the relationship between nutritional and inflammatory indicators and microsatellite stability(MSS)status in CRC.METHODS The clinical data of 56 patients who underwent surgical treatment for CRC were collected.Furthermore,the expressions of nutritional(levels of serum albumin,triglycerides,serum cholesterol,and body mass index)and inflammatory response indicators(absolute neutrophil count,absolute lymphocyte count,absolute monocyte count,neutrophil-to-lymphocyte ratio,and lymphocyte-to-monocyte ratio)as well as their correlation with microsatellite instability(MSI)status were investigated in patients with CRC.RESULTS Compared to the patients with MSS tumors,those with MSI tumors demonstrated significantly lower levels of two nutritional indicators,namely serum albumin and body mass index(P<0.05).Moreover,patients in the MSI group demonstrated significantly lower absolute lymphocyte counts and higher neutrophil-to-lymphocyte ratio than those in the MSS group(P<0.05),indicating pronounced differences in inflammatory responses and immune states between the two groups.CONCLUSION Certain nutritional and inflammatory indicators exhibit significant differences among patients with MSI and MSS CRC,highlighting their potential role in the clinical treatment and health management of this specific population.
基金sponsored by the National Natural Science Foundations of China under Grant Nos.12301315,12235007,11975131the Zhejiang Provincial Natural Science Foundation of China under Grant No.LQ20A010009。
文摘In the realm of nonlinear integrable systems,the presence of decompositions facilitates the establishment of linear superposition solutions and the derivation of novel coupled systems exhibiting nonlinear integrability.By focusing on single-component decompositions within the potential BKP hierarchy,it has been observed that specific linear superpositions of decomposition solutions remain consistent with the underlying equations.Moreover,through the implementation of multi-component decompositions within the potential BKP hierarchy,successful endeavors have been undertaken to formulate linear superposition solutions and novel coupled Kd V-type systems that resist decoupling via alterations in dependent variables.
基金financially supported by the National Natural Science Foundation of China(Nos.52271033 and 52071179)the Key program of National Natural Science Foundation of China(No.51931003)+2 种基金Natural Science Foundation of Jiangsu Province,China(No.BK20221493)Jiangsu Province Leading Edge Technology Basic Research Major Project(No.BK20222014)Foundation of“Qinglan Project”for Colleges and Universities in Jiangsu Province.
文摘Multi-component transition group metal borides(MMB_(2))have become a research hotspot due to their new composition design concepts and superior properties compared with conventional ceramics.Most of the current methods,however,are complicated and time-consuming,the mass production remains a chal-lenge.Herein,we proposed a new high-efficiency strategy for synthesis of MMB_(2)using molten aluminum as the medium for the first time.The prepared Al-containing multi-component borides(TiZrHfNbTa)B_(2)microcrystals had a homogeneous composition with a hexagonal AlB_(2)structure and ultra-high hardness value of∼35.3 GPa,which was much higher than data reported in the literature and the rule of mix-ture estimations.Furthermore,combined with the First-principles calculation results,we found that the Poisson’s ratio(v)values exhibit a clearly ascending trend from 0.17 at VEC=3.5 to 0.18 at VEC=3.4,then to 0.201 at VEC=3.2 with the increasing of Al content.This indicates that the intrinsic toughness of multi-component boride microcrystals is obviously enhanced by the trace-doped Al elements.Besides,the fabricated Al-containing multi-component boride microcrystals have superior oxidation activation en-ergy and structural stability.The enhanced oxidation resistance is mainly attributed to the formation of a protective Al2 O3 oxide layer and the lattice distortion,both of which lead to sluggish diffusion of O_(2).These findings propose a new unexplored avenue for the fabrication of MMB_(2)materials with supe-rior comprehensive performance including ultra-hardness and intrinsically improved thermo-mechanical properties.
基金financially supported by the National Natural Science Foundation of China(Nos.52032002,52372060,51972081,and U22A20128)the National Safety Academic Foundation(No.U2130103)+1 种基金the National Key Laboratory of Precision Hot Processing of Metals(No.61429092300305)Heilongjiang Touyan Team Program are gratefully acknowledged.
文摘The hardening mechanism of multi-component carbide ceramic has been investigated in detail through a combination of experiments,first-principles calculations,and ab initio molecular dynamics(AIMD).Eight dense carbide ceramics were prepared by spark plasma sintering.Compulsorily,all the multi-component carbide samples have similar carbon content,grain size,and uniform compositional distribution by optimizing the sintering process and adjusting the initial raw materials.Hence the interference of other factors on the hardness of multi-component carbide ceramics is minimized.The effects of changes in the elemental species on the lattice distortion,bond strength,bonding properties,and electronic structure of multi-component carbide ceramics were thoroughly analyzed.These results show that the hardening of multi-component carbide ceramic can be attributed to the coupling of solid solution strengthening caused by lattice distortion and covalent bond strengthening.Besides,the“host lattice”of multi-component carbide ceramics is defined based on the concept of supporting lattice.The present work is of great significance for a deeper understanding of the hardening mechanism of multi-component carbide ceramics and the design of superhard multi-component carbides.
文摘Colonoscopy remains the cornerstone of colorectal cancer prevention and survei-llance,but the procedure’s effectiveness is entirely dependent upon various quali-ty indicators,such as detection rates,withdrawal time,adequate bowel prepara-tion,cecal intubation rate and patient outcomes.Despite progress in endoscopic techniques,challenges persist in maintaining endoscopists’consistent perfor-mance and improving quality metrics.Artificial intelligence(AI)has emerged as a“game changer”in the gastroenterology field,offering the opportunity to signifi-cantly increase colonoscopy quality.This review highlights the role of AI-driven technologies such as deep learning,computer vision,and real-time feedback me-chanisms in optimizing key quality indicators of colonoscopy.The implementa-tion of AI in colonoscopy may reduce human error,improve endoscopist’s consis-tency in real-time decision making,ensuring higher reliability and standardiza-tion during the procedure.Furthermore,AI has the potential to reshape how en-doscopists perform and evaluate procedures,while improved lesion characte-rization may enable more precise selection for resection,reducing morbidity and the incidence of interval cancers.The review also addresses challenges and limi-tations in AI integration,including cost-effectiveness and its impact on endosco-pist training.AI holds substantial promise for advancing colonoscopy quality and elevating overall patient care,paving the way for more effective and personalized medical approaches.
文摘This study provides a systematic investigation into the influence of feature selection methods on cryptocurrency price forecasting models employing technical indicators.In this work,over 130 technical indicators—covering momentum,volatility,volume,and trend-related technical indicators—are subjected to three distinct feature selection approaches.Specifically,mutual information(MI),recursive feature elimination(RFE),and random forest importance(RFI).By extracting an optimal set of 20 predictors,the proposed framework aims to mitigate redundancy and overfitting while enhancing interpretability.These feature subsets are integrated into support vector regression(SVR),Huber regressors,and k-nearest neighbors(KNN)models to forecast the prices of three leading cryptocurrencies—Bitcoin(BTC/USDT),Ethereum(ETH/USDT),and Binance Coin(BNB/USDT)—across horizons ranging from 1 to 20 days.Model evaluation employs the coefficient of determination(R2)and the root mean squared logarithmic error(RMSLE),alongside a walk-forward validation scheme to approximate real-world trading contexts.Empirical results indicate that incorporating momentum and volatility measures substantially improves predictive accuracy,with particularly pronounced effects observed at longer forecast windows.Moreover,indicators related to volume and trend provide incremental benefits in select market conditions.Notably,an 80%–85% reduction in the original feature set frequently maintains or enhances model performance relative to the complete indicator set.These findings highlight the critical role of targeted feature selection in addressing high-dimensional financial data challenges while preserving model robustness.This research advances the field of cryptocurrency forecasting by offering a rigorous comparison of feature selection methods and their effects on multiple digital assets and prediction horizons.The outcomes highlight the importance of dimension-reduction strategies in developing more efficient and resilient forecasting algorithms.Future efforts should incorporate high-frequency data and explore alternative selection techniques to further refine predictive accuracy in this highly volatile domain.
文摘Objective: To analyze the effectiveness of blood test indicators in the differential diagnosis of anemia. Methods: Sixty patients diagnosed with anemia (disease group) from June 2021 to June 2024 were selected. Based on the type of disease, the group was subdivided into iron deficiency anemia (IDA) with 31 cases, hemolytic anemia (HA) with 11 cases, and aplastic anemia (AA) with 18 cases. Based on the severity of the disease, the group was divided into mild anemia (30 cases), moderate anemia (19 cases), and severe anemia (11 cases). Sixty healthy individuals (control group) were also included, and all underwent blood tests. Comparisons were made between the red blood cell (RBC) indicators of the disease group and the control group, the blood test indicators of different types of anemia, and the serum iron levels of varying severity of anemia. Results: Except for red cell distribution width (RDW), the RBC indicators in the disease group were lower than those in the control group (P < 0.05). Comparisons of RBC indicators among different types of anemia showed significant differences (P < 0.05). Serum iron levels varied significantly among different degrees of anemia severity (P < 0.05). Conclusion: Blood tests can detect anemia, distinguish types of anemia, and assess anemia severity, offering high diagnostic value.
基金supported by Sichuan Science and Technology Program(No.2023NSFSC0101)the 2024 Provincial platform project of Chengdu Normal University(No.GNFZ202404)+1 种基金Natural Science Foundation of Shandong Province(No.ZR2021MB065)National Natural Science Foundation of China(No.22101237)。
文摘A convenient photocatalytic multi-component reaction of alkenes,quinoxalin-2(1H)-ones,and diazo compounds has been developed in the presence of water.A number of ester-containing quinoxalin-2(1H)-ones could be efficiently obtained in moderate to good yields at room temperature.This metal-free visiblelight-driven tandem reaction was conducted through proton-coupled electron transfer(PCET)process using water as the hydrogen donor and 1,2,3,5-tetrakis(carbazol-9-yl)-4,6-dicyanobenzene(4CzIPN)as the photocatalyst.
基金supported by the Fundamental Research Funds for the Central Universities(No.226-2024-00242)the Excellent Research Groups Project(No.52588202)the National Science Fund for Distinguished Young Scholars of China(No.52125803).
文摘China’s urbanization has entered a mid-to-late phase,and is characterized by high-density urban engineering projects that form systems coupled to geotechnical environments.These systems exhibit significant vulnerability due to strong spatiotemporal coupling,which hampers sustainable urban development.Traditional approaches to urban engineering design,construction,and maintenance tend to focus on individual projects and lack the ability to comprehensively evaluate system-level sustainability.Thus,with current methods,it is difficult to optimize the renewal and operation of high-density urban engineering systems.In this study,the constituent elements and key features of high-density urban engineering systems are discussed,and urban engineering system sustainability evaluation indicators are comprehensively reviewed.Viewed from perspectives of resilience,low-carbon development,and ecological impact,66 performance indicators describing urban engineering systems are selected.The decision-making trial and evaluation laboratory(DEMATEL)-based analytic network process(DANP)method and the entropy weight method(EWM)are utilized to calculate these indicators’subjective and objective weights,respectively.Furthermore,the coupling relationships between evaluation indicators are explored,aiding the construction of an urban engineering sustainability evaluation index system.Finally,empirical analysis is conducted across six megacities in China(Tianjin,Hangzhou,Shanghai,Wuhan,Chongqing,and Shenzhen)to validate the effectiveness of the evaluation indicators.The findings reveal significant imbalances in the sustainability of urban engineering systems in China.Accordingly,potential strategies and indicators for targeted enhancement of these systems are discussed.
基金funded by the Forward-looking Basic Science and Technology Research Project of PetroChina Company Limited(2025DJ104)the National Natural Science Foundation of China(42174150)the National Science and Technology Major Project for Deep Earth Probe and Mineral Resources Exploration(2024ZD1003005).
文摘The construction of a borehole correction library for the multi-component array induction tool in deviated boreholes involves extensive 3D forward modeling and typically requires significant computational resources.To address this challenge,this paper proposes an efficient algorithm for the library construction based on the 3D finite volume method(FVM)and contraction high-order Born approximation(CHBA).First,the electromagnetic(EM)field solution region is divided into two symmetric subregions based on the symmetry of the correction library model and the EM field.Numerical solution on a single subregion,combined with the symmetry boundary extension technique,enhances the efficiency of the 3D numerical simulation.Second,three reference mud conductivities are selected based on the mud conductivity range,and the CHBA is applied to calculate the EM responses at all mud conductivity nodes rapidly.Third,the number of forward simulation operations is further reduced by exploiting the principle that models with different frequencies and different formation conductivities have equivalent EM responses.Numerical experiments demonstrate the correctness and feasibility of the proposed algorithm.Compared to conventional 3D modeling,the proposed algorithm achieves approximately a 20-fold speedup in library construction,effectively reducing computational resources and time consumption.
基金supported by grants from the National High Level Hospital Clinical Research Funding(2022-PUMCH-B-074)Peking Union Medical College Hospital Research Funding for Postdoc(kyfyjj202320).
文摘Objective Blood culture remains the gold standard for diagnosing bloodstream infections.Clinical laboratories must ensure the quality of blood culture processes from receipt to obtaining definitive results.We examined laboratory analytical indicators associated with positive blood culture results.Methods Blood cultures collected from Peking Union Medical College Hospital between January 1,2020,and December 31,2022,were retrospectively analyzed.The mode of transportation(piping logistics delivery vs.staff),source of blood cultures(outpatient/emergency department vs.inpatient department),rotation of personnel,and time of reception(8:00–19:59 vs.20:00–07:59)were compared between blood culture-positive and-negative results.Results Between 2020 and 2022,the total positive rate of blood culture was 8.07%.The positive rate of blood cultures in the outpatient/emergency department was significantly higher than that in the inpatient department(12.46%vs.5.83%;P<0.0001).The time-to-detection of blood cultures was significantly affected by the delivery mode and personnel rotation.The blood culture positive rate of the total pre-analytical time within 1 h was significantly higher than that within 1–2 h or>2 h(P<0.0170).Conclusion Laboratory analytical indicators such as patient source,transportation mode,and personnel rotation significantly impacted the positive detection rate or time of blood culture.
基金support from the National Natural Science Foundation of China(Nos.42450226,42371483,and 42171308)the Natural Science Foundation of Guangdong Province,China(No.2025A1515010770)the Postdoctoral Fellowship Program of CPSF(No.GZB20240880).
文摘Vegetation annual gross primary production(AGPP),the total yearly carbon assimilation via photosynthesis,serves as a key indicator of ecosystem carbon uptake.While AGPP variations are jointly influenced by both vegetation phenology and physiology,the effectiveness of satellite-derived indicators in capturing these variations has not been fully evaluated.This study develops and evaluates the satellite-derived phenology and physiology indicators for modeling AGPP variability.We assessed the performance of satellite-derived metrics,including solar-induced chlorophyll fluorescence(SIF),leaf area index(LAI),and enhanced vegetation index(EVI),in capturing AGPP variations.Among these,SIF-based indicators exhibited the highest accuracy(Pearson's r=0.79;root mean square error=414.7 gC·m^(-2)·year^(-1)),outperforming LAI-and EVI-based indicators.To further investigate the mechanisms driving AGPP variability,we used a structural equation model based on in situ observations to quantify the direct and indirect effects of climate on AGPP through phenology and physiology.Our results reveal that vegetation physiology,particularly the seasonal maximum gross primary production,plays a more dominant role in regulating AGPP than phenology.Furthermore,we found that globally,SIF-derived phenology indicators tend to be lower than those from LAI and EVI,whereas SIF-derived physiology indicators are elevated in tropical regions and the Southern Hemisphere.These findings highlight the potential of satellite-derived indicators in advancing AGPP modeling and emphasize the predominant role of vegetation physiology in regulating ecosystem carbon uptake.This study contributes to a refined understanding of global carbon cycle dynamics and provides insights for improving large-scale carbon assessments in the context of climate change.
文摘This paper focuses on the procurement of construction projects in universities,conducting research on the influencing factors of procurement risks in such projects.By combining questionnaire surveys with expert interviews,numerous factors affecting procurement are analyzed.Subsequently,these factors are refined and summarized to construct a procurement risk evaluation index system for construction projects,which includes three first-level indicators,such as process management risk and ethical/legal risk,and is further subdivided into 13 second-level indicators.
基金supported by the National Natural Science Foundation of China(Grants U23A20660,52008099,and 52378288)the Major Science and Technology Project of Yunnan Province,China(Grant 202502AD080007)the China Railway Engineering Corporation Science and Technology Research and Development Project(Grant 2022-Key-44).
文摘There are multiple types of risks involved in the service of long-span railway bridges.Classical methods are difficult to provide targeted alarm information according to different situations of load anomalies and structural anomalies.To accurately alarm different risks of long-span railway bridges by structural health monitoring systems,this paper proposes a cross-cooperative alarm method using principal and secondary indicators during high-wind periods.It provides the prior criterion for monitoring systems under special conditions,defining the principal and secondary indicators,alarm levels,and thresholds based on the relationship between dynamic equilibrium equations and multiple linear regression analysis.Analysis of one-year monitoring data from a longspan railway cable-stayed bridge shows that the 10-min average cross-bridge wind speed(excitation indicator)can be selected as the principal indicator,while lateral displacement(response indicator)can serve as the secondary indicator.The threshold levels of the secondary indicator prioritize the safety of bridge operation(mainly aiming at the safety of trains traversing bridges),with values significantly lower than structural safety thresholds.This approach enhances alarm timeliness and effectively distinguishes between load anomalies,structural anomalies,and equipment failures.Consequently,it improves alarm accuracy and provides timely decision support for bridge maintenance,train traversing,and emergency treatment.
文摘BACKGROUND Post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis is a common complication of the procedure.The effective prevention of post-ERCP pancreatitis(PEP)remains a key focus of clinical research.AIM To develop a prediction model for PEP based on multidimensional clinical indicators and evaluate its clinical application value.METHODS We retrospectively analyzed 183 patients with biliary tract diseases who underwent ERCP at Xuzhou Medical University from January 2020 to June 2023,divided into non-PEP(n=159)and PEP(n=24)groups based on PEP development.Baseline and intraoperative data were compared,and PEP-related factors examined via univariate and multivariate logistic regression.Using R,70%of patients were assigned to training and 30%to testing sets for PEP prediction model development.Model accuracy was evaluated using a calibration curve and receiver operating characteristic(ROC)area under the curve(AUC).RESULTS Age,total cholesterol level,history of pancreatitis,pancreatic ductography,bleeding,and intubation time differed significantly between the two groups when baseline data and intraoperative conditions were compared(P<0.05).Multifactorial logistic regression analysis demonstrated that age[odds ratio(OR)=0.192,95%confidence interval(CI):0.053-0.698],total cholesterol(OR=0.324,95%CI:0.152-0.694),history of pancreatitis(OR=6.159,95%CI:1.770-21.434),pancreatography(OR=3.726,95%CI:1.028-13.507),and bleeding(OR=3.059,95%CI:1.001-9.349)were independently associated with acute pancreatitis after ERCP.The predictive probabilities from the calibration curves had mean errors of 0.021 and 0.030,with ROC AUCs of 0.840 and 0.797 in the training and test sets,respectively.CONCLUSION Age,total cholesterol,pancreatitis history,pancreatic ductography,and bleeding influence the risk of acute PEP.A model incorporating these factors may aid early detection and intervention.
文摘This editorial delves into the potential of systemic immune indicators(SIIs)as early predictors of renal damage in children with newly diagnosed type 1 diabetes mellitus.By exploring the recent study published by Cao et al,this article aims to highlight the importance of early detection and intervention.This study compre-hensively analyzes various SIIs,examining their correlation with renal compli-cations in newly diagnosed type 1 diabetic children.The findings reveal a sig-nificant association between immune system dysregulation and the onset of renal damage,suggesting that certain immune indicators can be early markers for predicting renal complications.This editorial emphasizes the clinical implications and applications of utilizing SIIs for early detection in pediatric diabetes care.It underscores the importance of innovative diagnostic approaches and illustrates real-world applications and outcomes.Additionally,it addresses the challenges and considerations in adopting these indicators and outlines future research directions to enhance diabetes management in children.
基金funded by the National Key R&D Program“Transportation Infrastructure”project(No.2022YFB2603400)the Technology Research and Development Plan Program of China State Railway Group Co.,Ltd.(No.Q2024T001)the National project pre research project of Suzhou City University(No.2023SGY019).
文摘Purpose-The indoor vibration compaction test(IVCT)was a key step in controlling the compaction quality for high-speed railway graded aggregate(HRGA),which currently had a research gap on the assessment indicators and compaction parameters.Design/methodology/approach-To address these issues,a novel multi-indicator IVCT method was proposed,including physical indicator dry density(ρd)and mechanical indicators dynamic stiffness(Krb)and bearing capacity coefficient(K20).Then,a series of IVCTs on HRGA under different compaction parameters were conducted with an improved vibration compactor,which could monitor the physical-mechanical indicators in real-time.Finally,the optimal vibration compaction parameters,including the moisture content(ω),the diameter-to-maximum particle size ratio(Rd),the thickness-to-maximum particle size ratio(Rh),the vibration frequency(f),the vibration mass(Mc)and the eccentric distance(re),were determined based on the evolution characteristics for the physical-mechanical indicators during compaction.Findings-All results indicated that theρd gradually increased and then stabilized,and the Krb initially increased and then decreased.Moreover,the inflection time of the Krb was present as the optimal compaction time(Tlp)during compaction.Additionally,optimal compaction was achieved whenωwas the water-holding content after mud pumping,Rd was 3.4,Rh was 3.5,f was the resonance frequency,and the ratio between the excitation force and the Mc was 1.8.Originality/value-The findings of this paper were significant for the quality control of HRGA compaction.
