目的:系统评价培土生金中药联合西医常规疗法治疗支气管哮喘缓解期肺脾两虚证的疗效以及证据质量,为临床决策及疾病指南制订提供循证依据。方法:检索中国知网(CNKI)、万方数据库(Wangfang)、Pubmed、Web of Science等8大中英文数据库,由...目的:系统评价培土生金中药联合西医常规疗法治疗支气管哮喘缓解期肺脾两虚证的疗效以及证据质量,为临床决策及疾病指南制订提供循证依据。方法:检索中国知网(CNKI)、万方数据库(Wangfang)、Pubmed、Web of Science等8大中英文数据库,由2名研究者独立进行文献筛选、信息提取、偏倚风险评估及方法学质量评价,并对纳入研究的总有效率、中医证候积分、第一秒用力呼气容积(FEV1)、第一秒用力呼气容积/用力肺活量(FEV1/FVC)、哮喘控制测试(ACT)评分等结局指标进行Meta分析,最终依照GRADE评估证据质量。结果:共纳入14项研究,合计1263例患者。结果显示:(1)培土生金中药联合常规西医疗法可有效改善患者总有效率,降低患者中医证候积分,改善患者FEV1水平、FEV1/FVC及ACT评分。(2)总有效率证据质量较优,可信度高,其余指标证据质量较低,尚待更多高质量的研究支持以提升证据级别。结论:培土生金中药联合西医常规疗法治疗支气管哮喘缓解期肺脾两虚证优于单用西医常规治疗,且在总有效率上证据质量较高,具有一定的循证学意义。展开更多
Chemistry science popularization for lower grades(Grades 1-2)in primary schools is an important part of science enlightenment education.However,in practice,it generally faces practical dilemmas such as insufficient co...Chemistry science popularization for lower grades(Grades 1-2)in primary schools is an important part of science enlightenment education.However,in practice,it generally faces practical dilemmas such as insufficient content adaptability,a single implementation method,and a lack of coordination mechanisms.Based on Piaget’s Cognitive Development Theory and the STSE(Science,Technology,Society,Environment)educational concept,this study constructed a four-in-one strategy system of“content development-teaching implementation-collaborative linkage-guarantee support”through literature analysis,action research,and empirical comparison.An empirical study was conducted in two primary schools for one academic year.The results show that this strategy system can increase students’interest in participating in chemistry science popularization by 42 percentage points,the compliance rate of observation ability reaches 85%,and the collaborative participation of families,schools,and society rises to 85%.The core strategies formed in the study,including“age-appropriate content screening,interactive teaching implementation,three-dimensional collaborative promotion,and full-process guarantee support,”provide a replicable practical model for the standardized and efficient development of chemistry science popularization for lower grades in primary schools.They also offer empirical references for fulfilling the requirement of“strengthening the pertinence and effectiveness of science popularization”in the Law of the People’s Republic of China on Popularization of Science and Technology(revised in 2024).展开更多
BACKGROUND Despite the promising prospects of using artificial intelligence and machine learning(ML)for disease classification and prediction purposes,the complexity and lack of explainability of this method make it d...BACKGROUND Despite the promising prospects of using artificial intelligence and machine learning(ML)for disease classification and prediction purposes,the complexity and lack of explainability of this method make it difficult to apply the constructed models in clinical practice.We developed and validated an interpretable ML model based on magnetic resonance imaging(MRI)radiomics and clinical features for the preoperative prediction of the pathological grades of hepatocellular carcinomas(HCCs).This model will help clinicians better understand the situation and develop personalized treatment plans.AIM To develop and validate an interpretable ML model for preoperative pathological grade prediction in HCC patients via a combination of multisequence MRI radiomics and clinical features.METHODS MRI and clinical data derived from 125 patients with HCCs confirmed by postoperative pathological examinations were retrospectively analyzed.The patients were randomly split into training and validation groups(7:3 ratio).Univariate and multivariate logistic regression analyses were performed to identify independent clinical predictors.The tumor lesions observed on axial fatsuppressed T2-weighted imaging(FS-T2WI),arterial phase(AP),and portal venous phase(PVP)images were delineated in a slice-by-slice manner using 3D-slicer to generate volumetric regions of interest,and radiomic features were extracted.Interclass correlation coefficients were calculated,and least absolute selection and shrinkage operator regression were conducted for feature selection purposes.Six predictive models were subsequently developed for pathological grade prediction:FS-T2WI,AP,PVP,integrated radiomics,clinical,and combined radiomics-clinical(RC)models.The effectiveness of these models was assessed by calculating their area under the receiver operating characteristic curve(AUC)values.The clinical applicability of the models was evaluated via decision curve analysis.Finally,the contributions of the different features contained in the model with optimal performance were interpreted via a SHapley Additive exPlanations analysis.RESULTS Among the 125 patients,87 were assigned to the training group,and 38 were assigned to the validation group.The maximum tumor diameter,hepatitis B virus status,and monocyte count were identified as independent predictors of pathological grade.Twelve optimal radiomic features were ultimately selected.The AUC values obtained for the FS-T2WI model,AP model,PVP model,radiomics model,clinical model,and combined RC model in the training group were 0.761[95%confidence interval(CI):0.562-0.857],0.870(95%CI:0.714-0.918),0.868(95%CI:0.714-0.959),0.917(95%CI:0.857-0.959),0.869(95%CI:0.643-0.973),and 0.941(95%CI:0.857-0.945),respectively;in the validation group,the AUC values were 0.724(95%CI:0.625-0.833),0.802(95%CI:0.686-1.000),0.797(95%CI:0.688-1.000),0.901(95%CI:0.833-0.906),0.865(95%CI:0.594-1.000),and 0.932(95%CI:0.812-1.000),respectively.The combined RC model demonstrated the best performance.Additionally,the decision curve analysis revealed that the combined RC model had satisfactory prediction efficiency,and the SHapley Additive exPlanations value analysis revealed that the“FS-T2WI-wavelet-HLL_gldm_Large Dependence High Gray Level Emphasis”feature contributed the most to the model,exhibiting a positive effect.CONCLUSION An interpretable ML model based on MRI radiomics provides a noninvasive tool for predicting the pathological grade of HCCs,which will help clinicians develop personalized treatment plans.展开更多
With the increasing requirement for the protection of arable land, monitor- ing the grades of arable land quality is becoming more important, which can accu- rately and fully reflect the current situation and developm...With the increasing requirement for the protection of arable land, monitor- ing the grades of arable land quality is becoming more important, which can accu- rately and fully reflect the current situation and development trends of arable land quality. It is also an important measure for protecting the quality of arable land. in the present study, the distribution and changes of arable lands of different gradient types and grades in Lingchuan County, Guangxi Zhuang Autonomous Region in 2015 were monitored and evaluated, to analyze the trends and reasons for the changes in the quality and productivity of arable lands, and to provide references for dynamic monitoring of the quality of arable land.展开更多
AIM:To analyze tumor regression grade(TRG)for prognosis of locally advanced rectal adenocarcinoma(LARA)treated with preoperative radiotherapy.METHODS:One hundred and ninety patients with clinical stageⅡ/ⅢLARA were s...AIM:To analyze tumor regression grade(TRG)for prognosis of locally advanced rectal adenocarcinoma(LARA)treated with preoperative radiotherapy.METHODS:One hundred and ninety patients with clinical stageⅡ/ⅢLARA were studied.All patients underwent radical surgery(between 2004 and 2010)after 30-Gy/10-fraction preoperative radiotherapy(preRT).All 190 patients received a short course of preRT and were reassessed for disease recurrence and survival;the slides of surgical specimens were reviewed and classified according to Mandard TRG.We compared patients with good response(Mandard TRG1 or TRG2)vs patients with bad/poor response(Mandard TRG3-5).Outcomes evaluated were 5-year overall survival(OS),5-year disease-free survival(DFS),and local,distant and mixed recurrence.Fisher’s exact test orχ2 test,logrank test and proportional hazards regression analysis were used to calculate the probability that Mandard TRG was associated with patient outcomes.RESULTS:One hundred and sixty-six of 190 patients(87.4%)were identified as Mandard bad responders(TRG3-5).High Mandard grade was correlated with tumor height(41.7%<6 cm vs 58.3%≥6 cm,P=0.050),yp T stage(75%yp T0-2 vs 25%yp T3-4,P=0.000),and yp N stage(75%yp N0 vs 25%yp N1,P=0.031).In univariate survival analysis,Mandard grade bad responders had significantly worse OS and DFSthan good responders(TRG1/2)(OS,83.1%vs 96.4%,P=0.000;DFS,72.3%vs 92.0%,P=0.002).In multivariate survival analysis,Mandard bad responders had significantly worse DFS than Mandard good responders(DFS 3.8 years(95%CI:1.2-12.2 years,P=0.026).CONCLUSION:Mandard grade good responders had a favorable prognosis.TRG may be a potential predictor for DFS in LARA after pre-RT.展开更多
Using observed daily precipitation data to classify five levels of rainy days by strength in South China （SC）,with an emphasis on the Pearl River Delta （PRD） region,the spatiotemporal variation of different grades...Using observed daily precipitation data to classify five levels of rainy days by strength in South China （SC）,with an emphasis on the Pearl River Delta （PRD） region,the spatiotemporal variation of different grades of precipitation during the period 1960-2010 was analyzed and the possible link with anthropogenic aerosols examined.Statistical analysis showed that drizzle and small precipitation has significantly decreased,whereas medium to heavy precipitation has increased slightly over the past 50 years （although not statistically significant）.Further data analysis suggested that the decline in drizzle and small precipitation probably has a strong link to increased concentrations of anthropogenic aerosols produced by large-scale human activities related to the rapid socioeconomic development of the PRD region.These aerosols may also have led to the obvious decreasing trend in horizontal visibility and sunshine duration in SC,which is statistically significant according to the t-test.展开更多
Objective:To identify the essential competencies for different grades of midwives in China.Methods:A nationwide modified Delphi process was implemented to amend and screen the indicators.Thirty expert panellists inclu...Objective:To identify the essential competencies for different grades of midwives in China.Methods:A nationwide modified Delphi process was implemented to amend and screen the indicators.Thirty expert panellists including practitioners (nurse-midwives),clinical managers,academic educators and obstetricians completed a two-round Delphi study through an electronic survey that was supplemented by an expert panel meeting for discussion of comments and suggestions.Results:All panellists completed two rounds of Delphi study and at least 75% of them achieved a consensus on 224 items (W1 =0.150,W2 =0.173).Seven domains were established,namely,'Professional quality','Antenatal care','Intrapartum care','Postnatal care','Neonatal care','Gynaecological care','Public health care & Integrative competency'.Generalised maternal and neonatal knowledge and perinatal care skills were set for'junior'midwives,pathological care for'senior'ones and supervisory abilities and promotion of discipline for'expert'ones.Conclusions:This research developed three grades of essential competencies for midwives in China.The next step will be assessment in clinical settings for further response.The set was in line with the concepts of International Confederation of Midwives under the domestic context.This set could be adopted as a reference in developing normalised midwifery practice,education and certification.展开更多
This study investigated the aroma-active compounds and compared the differences of three different grades of sesame-flavor Baijiu by headspace solid-phase microextraction(HS-SPME)coupled with gas chromatography-olfact...This study investigated the aroma-active compounds and compared the differences of three different grades of sesame-flavor Baijiu by headspace solid-phase microextraction(HS-SPME)coupled with gas chromatography-olfactometry-mass spectrometry(GC-O-MS).A total of 54 aroma-active compounds were detected.Principal component analysis showed that JZ1,JZ2,and JZ3 were well separated from each other.JZ1 as the premium-grade Baijiu had the highest aroma intensities,concentrations.According to aroma intensities and concentrations,dimethyl trisulfide,butanoic acid,phenylacetaldehyde,2-furylmethanethiol,ethyl hexanoate,2,6-dimethylpyrazine,etc.could be potentially applied as volatile makers to distinguish the three different grades of sesame-flavor Baijiu as their significant difference(P<0.05)in three Baijiu samples.Roasted aroma had the significant difference(P<0.05)in three sample base on aroma profiles.Meanwhile,2-furylmethanethiol,2,6-dimethylpyrazine were related to the roasted aroma,they may be had a significant contribution to the differences of three different grades of sesame-flavor Baijiu.This study has provided a comprehensive understanding of the differences of three different grades of sesame-flavor Baijiu.展开更多
Determining the hydrometallurgical cut-off grades specifies the destination of low grade materials and this is subjected to more benefits in mining. Copper production rate is considered as one of the fundamental issue...Determining the hydrometallurgical cut-off grades specifies the destination of low grade materials and this is subjected to more benefits in mining. Copper production rate is considered as one of the fundamental issues in hydrometallurgical cut-off grades determination. Slags are remarked as one of the main sources of copper. It is not only regarded as a waste but also identified as another resource extracting base metals. Slags are characterized by copper high grade. Thus, slag copper recovery can be led to different cut-off grades and net present value(NPV). The current research scrutinizes the effect of slag recovery by both flotation and hydrometallurgical methods on the hydrometallurgical cut-off grades. For this purpose, the optimum cut-off grade algorithms of hydrometallurgical methods are developed by considering associated environmental parameters, incomes and also the costs. Then, their optimum amounts are calculated with NPV maximization as an objective function. The results indicate that considering slag copper recovery in the hydrometallurgical cut-off grade algorithms reduces the environmental costs caused by slag dumping and leads to more NPV by 9%.展开更多
Suillus granulatus is a valuable wild edible mushroom with a strong umami taste.Different grades of S.granulatus were dried by different methods,including natural air drying(ND),hot air drying(HAD),vacuum drying(VD),a...Suillus granulatus is a valuable wild edible mushroom with a strong umami taste.Different grades of S.granulatus were dried by different methods,including natural air drying(ND),hot air drying(HAD),vacuum drying(VD),and freeze drying(FD).Results showed that VD samples of all grades had the highest equivalent umami concentration(EUC)value(P<0.05).The second grade of ND samples showed the highest EUC value(P<0.05).The first grade of HAD samples showed the highest EUC value(P<0.05).The third grade of FD samples showed the highest EUC value(P<0.05).The third grade of VD samples had a higher EUC value than the other grades of samples dried by VD.Electronic tongue results indicated no significant differences between samples of all grades dried by all methods.Thus,umami taste components are affected by drying method and grade.VD is an appropriate drying method for all sample grades.ND,HAD,and FD are suitable for second-,first-,and third-grade samples,respectively.展开更多
BACKGROUND The incidence of pancreatic neuroendocrine tumors (PNETs) is now increasing rapidly. The tumor grade of PNETs significantly affects the treatment strategy and prognosis. However, there is still no effective...BACKGROUND The incidence of pancreatic neuroendocrine tumors (PNETs) is now increasing rapidly. The tumor grade of PNETs significantly affects the treatment strategy and prognosis. However, there is still no effective way to non-invasively classify PNET grades. Machine learning (ML) algorithms have shown potential in improving the prediction accuracy using comprehensive data. AIM To provide a ML approach to predict PNET tumor grade using clinical data. METHODS The clinical data of histologically confirmed PNET cases between 2012 and 2018 were collected. A method of minimum P for the Chi-square test was used to divide the continuous variables into binary variables. The continuous variables were transformed into binary variables according to the cutoff value, while the P value was minimum. Four classical supervised ML models, including logistic regression, support vector machine (SVM), linear discriminant analysis (LDA) and multi-layer perceptron (MLP) were trained by clinical data, and the models were labeled with the pathological tumor grade of each PNET patient. The performance of each model, including the weight of the different parameters, were evaluated. RESULTS In total, 91 PNET cases were included in this study, in which 32 were G1, 48 were G2 and 11 were G3. The results showed that there were significant differences among the clinical parameters of patients with different grades. Patients with higher grades tended to have higher values of total bilirubin, alpha fetoprotein, carcinoembryonic antigen, carbohydrate antigen 19-9 and carbohydrate antigen 72-4. Among the models we used, LDA performed best in predicting the PNET tumor grade. Meanwhile, MLP had the highest recall rate for G3 cases. All of the models stabilized when the sample size was over 70 percent of the total, except for SVM. Different parameters varied in affecting the outcomes of the models. Overall, alanine transaminase, total bilirubin, carcinoembryonic antigen, carbohydrate antigen 19-9 and carbohydrate antigen 72-4 affected the outcome greater than other parameters. CONCLUSION ML could be a simple and effective method in non-invasively predicting PNET grades by using the routine data obtained from the results of biochemical and tumor markers.展开更多
AIM:To show that aluminum potassium sulfate and tannic acid(ALTA)sclerotherapy has a high success rate for GradeⅡandⅢhemorrhoids.METHODS:This study was based on the clinical data of 604 patients with hemorrhoids who...AIM:To show that aluminum potassium sulfate and tannic acid(ALTA)sclerotherapy has a high success rate for GradeⅡandⅢhemorrhoids.METHODS:This study was based on the clinical data of 604 patients with hemorrhoids who underwent ALTA sclerotherapy between January 2009 and February 2015.The objective of this study was to assess the efficacy of this treatment for GradesⅡandⅢhemorrhoids.Preoperative and postoperative symptoms,complications and success rate were all assessed retrospectively.Follow-up consisted of a simple questionnaire,physical examination and an anoscopy.Patients were followed-up at one day,one week,two weeks,one month,one year,two years,three years,four years and five years after the ALTA sclerotherapy.RESULTS:One hundred and sixty-nine patients were diagnosed with GradeⅡhemorrhoids and 435 patients were diagnosed with GradeⅢhemorrhoids.The one year,three year and five year cumulative success rates of ALTA sclerotherapy for GradesⅡandⅢhemo-rrhoids were 95.9%and 93.1%;89.3%and 83.7%;and 89.3%and 78.2%,respectively.No significant differences were observed in the cumulative success rates after ALTA sclerotherapy between GradesⅡandⅢhemorrhoids(P=0.09).There were forty-seven post-operative complications(low grade fever;anal pain;urinary retention;rectal ulcer;and others).No serious or life-threatening complications occurred and all cases improved through conservative treatment.At univariate analysis there were no predictive factors of failure.CONCLUSION:ALTA sclerotherapy has had a high success rate for GradeⅡandⅢhemorrhoids during five years of post-operative treatment.However,additional studies are needed to evaluate the efficacy of this ALTA sclerotherapy in the management of hemorrhoidal disease.展开更多
Contrast-enhanced computed tomography(CT)contributes to the increasing detection of pancreatic neuroendocrine neoplasms(PNENs).Nevertheless,its value for differentiating pathological tumor grades is not well recognize...Contrast-enhanced computed tomography(CT)contributes to the increasing detection of pancreatic neuroendocrine neoplasms(PNENs).Nevertheless,its value for differentiating pathological tumor grades is not well recognized.In this report,we have conducted a retrospective study on the relationship between the 2017 World Health Organization(WHO)classification and CT imaging features in 94 patients.Most of the investigated features eventually provided statistically significant indicators for discerning PNENs G3 from PNENs G1/G2,including tumor size,shape,margin,heterogeneity,intratumoral blood vessels,vascular invasion,enhancement pattern in both contrast phases,enhancement degree in both phases,tumor-to-pancreas contrast ratio in both phases,common bile duct dilatation,lymph node metastases,and liver metastases.Ill-defined tumor margin was an independent predictor for PNENs G3 with the highest area under the curve(AUC)of 0.906 in the multivariable logistic regression and receiver operating characteristic curve analysis.The portal enhancement ratio(PER)was shown the highest AUC of 0.855 in terms of quantitative features.Our data suggest that the traditional contrastenhanced CT still plays a vital role in differentiation of tumor grades and heterogeneity analysis prior to treatment.展开更多
Asthma is a common chronic inflammatory disorder that is more prevalent in children than in adults.China has seen an increasing prevalence of childhood asthma in recentdecades[1].Earlier studies have shown that air pa...Asthma is a common chronic inflammatory disorder that is more prevalent in children than in adults.China has seen an increasing prevalence of childhood asthma in recentdecades[1].Earlier studies have shown that air particulate matter (PM),particularly fine particulate matter(PM2.5)[2],is an important factor triggering childhood asthma. Since nationalPM2.5data were nota vailabl euntil 2013,展开更多
In this paper, prediction of copper and molybdenum grades and their recoveries of an industrial flotation plant are investigated using the Artificial Neural Networks (ANN) model. Process modeling has done based on 92 ...In this paper, prediction of copper and molybdenum grades and their recoveries of an industrial flotation plant are investigated using the Artificial Neural Networks (ANN) model. Process modeling has done based on 92 datasets collected at different operational conditions and feed characteristics. The prominent parameters investigated in this network were pH, collector, frother and F-Oil concentration, size percentage of feed passing 75 microns, moisture content in feed, solid percentage, and grade of copper, molybdenum, and iron in feed. A multilayer perceptron neural network, with 10:10:10:4 structure (two hidden layers), was used to estimate metallurgical performance. To obtain the optimal hidden layers and nodes in a layer, a trial and error procedure was done. In training and testing phases, it achieved quite correlations of 0.98 and 0.93 for Copper grade, of 0.99 and 0.92 for Copper recovery, of 0.99 and 0.92 for Molybdenum grade and of 0.99 and 0.94 for Molybdenum recovery prediction, respectively. The proposed neural network model can be applied to determine the most beneficial operational conditions for the expected Copper and Molybdenum grades and their recovery in final concentration of the industrial copper flotation process.展开更多
Four humic coal samples are extracted to obtain humic substances (HS), and then subdivided(or purified) to obtain sixteen grades of HS, four from each coal. The effectiveness of these sixteen HS samples as additives f...Four humic coal samples are extracted to obtain humic substances (HS), and then subdivided(or purified) to obtain sixteen grades of HS, four from each coal. The effectiveness of these sixteen HS samples as additives for producing coal water mixture (CWM) is tested (w (additive) = 1 % and the the coal used is from the Baiyi coal preparation plant). A linear regression analysis of viscosity versus the additive’s components shows: (1)humic acids(HA) and humin (HM) are much better than fulvic acids (HF) with HA being tbe best, and (2) tke effects of grades of HS on coal dispersion as measured by viscosity are quite different. CWM additive effectiveness correlates positively with the increase of E4/E6,ash content, acid groups, and carboxyl groups, and negatively with the increase of molecular weight, HS content and phenolic alcohol content.展开更多
On the basis of historical yearly drought and flood grades from A.D.1470 to A.D.1949, the ten-year mean precipitation in the rainy season in Wuhan district was reconstructed by means of statistical method. The re...On the basis of historical yearly drought and flood grades from A.D.1470 to A.D.1949, the ten-year mean precipitation in the rainy season in Wuhan district was reconstructed by means of statistical method. The reconstructing method was testified to be simple and effective.展开更多
In this paper, an experimental and analytical study of two half-scale steel X-braced flames with equal nominal shear strength under cyclic loading is described. In these tests, all members except the braces are simila...In this paper, an experimental and analytical study of two half-scale steel X-braced flames with equal nominal shear strength under cyclic loading is described. In these tests, all members except the braces are similar. The braces are made of various steel grades to monitor the effects of seismic excitation. Internal stiffeners are employed to limit the local buckling and increase the fracture life of the steel bracing. A heavy central core is introduced at the intersection of the braces to decrease their effective length. Recent seismic specifications are considered in the design of the X-braced frame members to verify their efficiency. The failure modes of the X-braced frames are also illustrated. It is observed that the energy dissipation capacity, ultimate load capacity and ductility of the system increase considerably by using lower grade steel and proposed detailing. Analytical modeling of the specimens using nonlinear finite element software supports the experimental findings.展开更多
The availability of automated evaluation methodologies that may reliably be used for determining students’ scholastic performance through assigning letter grades are of utmost practical importance to educators, stude...The availability of automated evaluation methodologies that may reliably be used for determining students’ scholastic performance through assigning letter grades are of utmost practical importance to educators, students, and do invariably have pivotal values to all stakeholders of the academic process. In particular, educators use letter grades as quantification metrics to monitor students’ intellectual progress within a framework of clearly specified learning objectives of a course. To students grades may be used as predictive measures and motivating drives for success in a study field. However due to numerous objective and subjective variables that may by be accounted for in a methodological process of assigning students’ grades, and since such a process is often tainted with personal philosophy and human psychology factors, it is essential that educators exercise extra care in maximizing positive account of all objective factors and minimizing negative ramifications of subjectively fuzzy factors. To this end, and in an attempt to make assigning students’ grades more reliable for assessing true-level of mastering specified learning outcomes, this paper will: i) provide a literature review on previous works on the most common methods that have traditionally been in use for assigning students’ grades, and a short account of the virtues and/or vices of such methods, and ii) present a user-friendly computer code that may be easily adapted for the purpose of assigning students’ grades. This would relieve educators from the overwhelming concerns associated with mechanistic aspects of determining educational metrics, and it would allow them to have more time and focus to obtain reliable assessments of true-level of students’ mastery of learning outcomes by accounting for all possible evaluation components.展开更多
文摘目的:系统评价培土生金中药联合西医常规疗法治疗支气管哮喘缓解期肺脾两虚证的疗效以及证据质量,为临床决策及疾病指南制订提供循证依据。方法:检索中国知网(CNKI)、万方数据库(Wangfang)、Pubmed、Web of Science等8大中英文数据库,由2名研究者独立进行文献筛选、信息提取、偏倚风险评估及方法学质量评价,并对纳入研究的总有效率、中医证候积分、第一秒用力呼气容积(FEV1)、第一秒用力呼气容积/用力肺活量(FEV1/FVC)、哮喘控制测试(ACT)评分等结局指标进行Meta分析,最终依照GRADE评估证据质量。结果:共纳入14项研究,合计1263例患者。结果显示:(1)培土生金中药联合常规西医疗法可有效改善患者总有效率,降低患者中医证候积分,改善患者FEV1水平、FEV1/FVC及ACT评分。(2)总有效率证据质量较优,可信度高,其余指标证据质量较低,尚待更多高质量的研究支持以提升证据级别。结论:培土生金中药联合西医常规疗法治疗支气管哮喘缓解期肺脾两虚证优于单用西医常规治疗,且在总有效率上证据质量较高,具有一定的循证学意义。
基金Projects of Shaanxi Provincial Department of Science and Technology(2020JQ-886,2022JM-075)Education Science Planning Project of Shaanxi Province during the“14th Five-Year Plan”Period(SGH22Y1392)+6 种基金Scientific Research Program of Shaanxi Provincial Department of Education(23JP146,23JP147)Science and Technology Program of Xi’an(No.22GXFW0112)Three-Year Action Plan Project of Xi’an University(21XJZZ0001-11)Basic Education Research Project of Xi’an in 2022(2022JYZX28)2022“Xi’an University-Xi’an Academy of Social Sciences”Strategic Cooperation Projects(22ZL10,22ZL11)Doctoral Start-up Fund of Xi’an University(06005017)Key Discipline of Analytical Chemistry in Shaanxi Province(09009001)。
文摘Chemistry science popularization for lower grades(Grades 1-2)in primary schools is an important part of science enlightenment education.However,in practice,it generally faces practical dilemmas such as insufficient content adaptability,a single implementation method,and a lack of coordination mechanisms.Based on Piaget’s Cognitive Development Theory and the STSE(Science,Technology,Society,Environment)educational concept,this study constructed a four-in-one strategy system of“content development-teaching implementation-collaborative linkage-guarantee support”through literature analysis,action research,and empirical comparison.An empirical study was conducted in two primary schools for one academic year.The results show that this strategy system can increase students’interest in participating in chemistry science popularization by 42 percentage points,the compliance rate of observation ability reaches 85%,and the collaborative participation of families,schools,and society rises to 85%.The core strategies formed in the study,including“age-appropriate content screening,interactive teaching implementation,three-dimensional collaborative promotion,and full-process guarantee support,”provide a replicable practical model for the standardized and efficient development of chemistry science popularization for lower grades in primary schools.They also offer empirical references for fulfilling the requirement of“strengthening the pertinence and effectiveness of science popularization”in the Law of the People’s Republic of China on Popularization of Science and Technology(revised in 2024).
文摘BACKGROUND Despite the promising prospects of using artificial intelligence and machine learning(ML)for disease classification and prediction purposes,the complexity and lack of explainability of this method make it difficult to apply the constructed models in clinical practice.We developed and validated an interpretable ML model based on magnetic resonance imaging(MRI)radiomics and clinical features for the preoperative prediction of the pathological grades of hepatocellular carcinomas(HCCs).This model will help clinicians better understand the situation and develop personalized treatment plans.AIM To develop and validate an interpretable ML model for preoperative pathological grade prediction in HCC patients via a combination of multisequence MRI radiomics and clinical features.METHODS MRI and clinical data derived from 125 patients with HCCs confirmed by postoperative pathological examinations were retrospectively analyzed.The patients were randomly split into training and validation groups(7:3 ratio).Univariate and multivariate logistic regression analyses were performed to identify independent clinical predictors.The tumor lesions observed on axial fatsuppressed T2-weighted imaging(FS-T2WI),arterial phase(AP),and portal venous phase(PVP)images were delineated in a slice-by-slice manner using 3D-slicer to generate volumetric regions of interest,and radiomic features were extracted.Interclass correlation coefficients were calculated,and least absolute selection and shrinkage operator regression were conducted for feature selection purposes.Six predictive models were subsequently developed for pathological grade prediction:FS-T2WI,AP,PVP,integrated radiomics,clinical,and combined radiomics-clinical(RC)models.The effectiveness of these models was assessed by calculating their area under the receiver operating characteristic curve(AUC)values.The clinical applicability of the models was evaluated via decision curve analysis.Finally,the contributions of the different features contained in the model with optimal performance were interpreted via a SHapley Additive exPlanations analysis.RESULTS Among the 125 patients,87 were assigned to the training group,and 38 were assigned to the validation group.The maximum tumor diameter,hepatitis B virus status,and monocyte count were identified as independent predictors of pathological grade.Twelve optimal radiomic features were ultimately selected.The AUC values obtained for the FS-T2WI model,AP model,PVP model,radiomics model,clinical model,and combined RC model in the training group were 0.761[95%confidence interval(CI):0.562-0.857],0.870(95%CI:0.714-0.918),0.868(95%CI:0.714-0.959),0.917(95%CI:0.857-0.959),0.869(95%CI:0.643-0.973),and 0.941(95%CI:0.857-0.945),respectively;in the validation group,the AUC values were 0.724(95%CI:0.625-0.833),0.802(95%CI:0.686-1.000),0.797(95%CI:0.688-1.000),0.901(95%CI:0.833-0.906),0.865(95%CI:0.594-1.000),and 0.932(95%CI:0.812-1.000),respectively.The combined RC model demonstrated the best performance.Additionally,the decision curve analysis revealed that the combined RC model had satisfactory prediction efficiency,and the SHapley Additive exPlanations value analysis revealed that the“FS-T2WI-wavelet-HLL_gldm_Large Dependence High Gray Level Emphasis”feature contributed the most to the model,exhibiting a positive effect.CONCLUSION An interpretable ML model based on MRI radiomics provides a noninvasive tool for predicting the pathological grade of HCCs,which will help clinicians develop personalized treatment plans.
文摘With the increasing requirement for the protection of arable land, monitor- ing the grades of arable land quality is becoming more important, which can accu- rately and fully reflect the current situation and development trends of arable land quality. It is also an important measure for protecting the quality of arable land. in the present study, the distribution and changes of arable lands of different gradient types and grades in Lingchuan County, Guangxi Zhuang Autonomous Region in 2015 were monitored and evaluated, to analyze the trends and reasons for the changes in the quality and productivity of arable lands, and to provide references for dynamic monitoring of the quality of arable land.
基金Supported by National Natural Science Foundation of China,No.81372593,No.81030040 and No.81201965Beijing Natural Science Foundation,No.7132052+2 种基金the National High Technology Research and Development Program of China(863 Program),No.2012AA02A506 and No.SS2014AA020801Beijing Municipal Administration of Hospitals Special Fund for Clinical Medicine Development,No.ZY201410Beijing Science and Technology Commission,No.D0905001000011 and No.D101100050010068
文摘AIM:To analyze tumor regression grade(TRG)for prognosis of locally advanced rectal adenocarcinoma(LARA)treated with preoperative radiotherapy.METHODS:One hundred and ninety patients with clinical stageⅡ/ⅢLARA were studied.All patients underwent radical surgery(between 2004 and 2010)after 30-Gy/10-fraction preoperative radiotherapy(preRT).All 190 patients received a short course of preRT and were reassessed for disease recurrence and survival;the slides of surgical specimens were reviewed and classified according to Mandard TRG.We compared patients with good response(Mandard TRG1 or TRG2)vs patients with bad/poor response(Mandard TRG3-5).Outcomes evaluated were 5-year overall survival(OS),5-year disease-free survival(DFS),and local,distant and mixed recurrence.Fisher’s exact test orχ2 test,logrank test and proportional hazards regression analysis were used to calculate the probability that Mandard TRG was associated with patient outcomes.RESULTS:One hundred and sixty-six of 190 patients(87.4%)were identified as Mandard bad responders(TRG3-5).High Mandard grade was correlated with tumor height(41.7%<6 cm vs 58.3%≥6 cm,P=0.050),yp T stage(75%yp T0-2 vs 25%yp T3-4,P=0.000),and yp N stage(75%yp N0 vs 25%yp N1,P=0.031).In univariate survival analysis,Mandard grade bad responders had significantly worse OS and DFSthan good responders(TRG1/2)(OS,83.1%vs 96.4%,P=0.000;DFS,72.3%vs 92.0%,P=0.002).In multivariate survival analysis,Mandard bad responders had significantly worse DFS than Mandard good responders(DFS 3.8 years(95%CI:1.2-12.2 years,P=0.026).CONCLUSION:Mandard grade good responders had a favorable prognosis.TRG may be a potential predictor for DFS in LARA after pre-RT.
基金supported by the Knowledge Innovation Program of the Chinese Academy of Sciences (Grant No. KZCX2-EW-QN208)the National Basic Research Program of China (Grant No. 2010CB428502)+3 种基金the open fund of the State Key Laboratory of Remote Sensing Science (Grant No. OFSLRSS201113)the CAS Strategic Priority Research Program (Grant No. XDA05110103)the R&D Special Fund for Public Welfare Industry (meteorology) by the Ministry of Financethe Ministry of Science and Technology (Grant No. GYHY20100601404)
文摘Using observed daily precipitation data to classify five levels of rainy days by strength in South China （SC）,with an emphasis on the Pearl River Delta （PRD） region,the spatiotemporal variation of different grades of precipitation during the period 1960-2010 was analyzed and the possible link with anthropogenic aerosols examined.Statistical analysis showed that drizzle and small precipitation has significantly decreased,whereas medium to heavy precipitation has increased slightly over the past 50 years （although not statistically significant）.Further data analysis suggested that the decline in drizzle and small precipitation probably has a strong link to increased concentrations of anthropogenic aerosols produced by large-scale human activities related to the rapid socioeconomic development of the PRD region.These aerosols may also have led to the obvious decreasing trend in horizontal visibility and sunshine duration in SC,which is statistically significant according to the t-test.
基金the UNFPA(CHN7U204)Chinese Maternal and Child Health Association for financial support.
文摘Objective:To identify the essential competencies for different grades of midwives in China.Methods:A nationwide modified Delphi process was implemented to amend and screen the indicators.Thirty expert panellists including practitioners (nurse-midwives),clinical managers,academic educators and obstetricians completed a two-round Delphi study through an electronic survey that was supplemented by an expert panel meeting for discussion of comments and suggestions.Results:All panellists completed two rounds of Delphi study and at least 75% of them achieved a consensus on 224 items (W1 =0.150,W2 =0.173).Seven domains were established,namely,'Professional quality','Antenatal care','Intrapartum care','Postnatal care','Neonatal care','Gynaecological care','Public health care & Integrative competency'.Generalised maternal and neonatal knowledge and perinatal care skills were set for'junior'midwives,pathological care for'senior'ones and supervisory abilities and promotion of discipline for'expert'ones.Conclusions:This research developed three grades of essential competencies for midwives in China.The next step will be assessment in clinical settings for further response.The set was in line with the concepts of International Confederation of Midwives under the domestic context.This set could be adopted as a reference in developing normalised midwifery practice,education and certification.
基金supported by the National Natural Science Foundation of China (32172340)
文摘This study investigated the aroma-active compounds and compared the differences of three different grades of sesame-flavor Baijiu by headspace solid-phase microextraction(HS-SPME)coupled with gas chromatography-olfactometry-mass spectrometry(GC-O-MS).A total of 54 aroma-active compounds were detected.Principal component analysis showed that JZ1,JZ2,and JZ3 were well separated from each other.JZ1 as the premium-grade Baijiu had the highest aroma intensities,concentrations.According to aroma intensities and concentrations,dimethyl trisulfide,butanoic acid,phenylacetaldehyde,2-furylmethanethiol,ethyl hexanoate,2,6-dimethylpyrazine,etc.could be potentially applied as volatile makers to distinguish the three different grades of sesame-flavor Baijiu as their significant difference(P<0.05)in three Baijiu samples.Roasted aroma had the significant difference(P<0.05)in three sample base on aroma profiles.Meanwhile,2-furylmethanethiol,2,6-dimethylpyrazine were related to the roasted aroma,they may be had a significant contribution to the differences of three different grades of sesame-flavor Baijiu.This study has provided a comprehensive understanding of the differences of three different grades of sesame-flavor Baijiu.
文摘Determining the hydrometallurgical cut-off grades specifies the destination of low grade materials and this is subjected to more benefits in mining. Copper production rate is considered as one of the fundamental issues in hydrometallurgical cut-off grades determination. Slags are remarked as one of the main sources of copper. It is not only regarded as a waste but also identified as another resource extracting base metals. Slags are characterized by copper high grade. Thus, slag copper recovery can be led to different cut-off grades and net present value(NPV). The current research scrutinizes the effect of slag recovery by both flotation and hydrometallurgical methods on the hydrometallurgical cut-off grades. For this purpose, the optimum cut-off grade algorithms of hydrometallurgical methods are developed by considering associated environmental parameters, incomes and also the costs. Then, their optimum amounts are calculated with NPV maximization as an objective function. The results indicate that considering slag copper recovery in the hydrometallurgical cut-off grade algorithms reduces the environmental costs caused by slag dumping and leads to more NPV by 9%.
基金Liaoning Provincial Department of Education Annual(2019)Scientific Research Fund Project(No.LSNZD201903)National Key R&D Program of China(No.2018YFD0400200)+1 种基金Liaoning Province,Shenyang Agricultural University,High-end Talent Introduction Fund Project(NO.SYAU20160003)Natural Science Foundation of Liaoning Province(No.20170540822).
文摘Suillus granulatus is a valuable wild edible mushroom with a strong umami taste.Different grades of S.granulatus were dried by different methods,including natural air drying(ND),hot air drying(HAD),vacuum drying(VD),and freeze drying(FD).Results showed that VD samples of all grades had the highest equivalent umami concentration(EUC)value(P<0.05).The second grade of ND samples showed the highest EUC value(P<0.05).The first grade of HAD samples showed the highest EUC value(P<0.05).The third grade of FD samples showed the highest EUC value(P<0.05).The third grade of VD samples had a higher EUC value than the other grades of samples dried by VD.Electronic tongue results indicated no significant differences between samples of all grades dried by all methods.Thus,umami taste components are affected by drying method and grade.VD is an appropriate drying method for all sample grades.ND,HAD,and FD are suitable for second-,first-,and third-grade samples,respectively.
基金Supported by “Miaopu”Innovation Foundation of the Chinese PLA General Hospital,No.17KMM07
文摘BACKGROUND The incidence of pancreatic neuroendocrine tumors (PNETs) is now increasing rapidly. The tumor grade of PNETs significantly affects the treatment strategy and prognosis. However, there is still no effective way to non-invasively classify PNET grades. Machine learning (ML) algorithms have shown potential in improving the prediction accuracy using comprehensive data. AIM To provide a ML approach to predict PNET tumor grade using clinical data. METHODS The clinical data of histologically confirmed PNET cases between 2012 and 2018 were collected. A method of minimum P for the Chi-square test was used to divide the continuous variables into binary variables. The continuous variables were transformed into binary variables according to the cutoff value, while the P value was minimum. Four classical supervised ML models, including logistic regression, support vector machine (SVM), linear discriminant analysis (LDA) and multi-layer perceptron (MLP) were trained by clinical data, and the models were labeled with the pathological tumor grade of each PNET patient. The performance of each model, including the weight of the different parameters, were evaluated. RESULTS In total, 91 PNET cases were included in this study, in which 32 were G1, 48 were G2 and 11 were G3. The results showed that there were significant differences among the clinical parameters of patients with different grades. Patients with higher grades tended to have higher values of total bilirubin, alpha fetoprotein, carcinoembryonic antigen, carbohydrate antigen 19-9 and carbohydrate antigen 72-4. Among the models we used, LDA performed best in predicting the PNET tumor grade. Meanwhile, MLP had the highest recall rate for G3 cases. All of the models stabilized when the sample size was over 70 percent of the total, except for SVM. Different parameters varied in affecting the outcomes of the models. Overall, alanine transaminase, total bilirubin, carcinoembryonic antigen, carbohydrate antigen 19-9 and carbohydrate antigen 72-4 affected the outcome greater than other parameters. CONCLUSION ML could be a simple and effective method in non-invasively predicting PNET grades by using the routine data obtained from the results of biochemical and tumor markers.
文摘AIM:To show that aluminum potassium sulfate and tannic acid(ALTA)sclerotherapy has a high success rate for GradeⅡandⅢhemorrhoids.METHODS:This study was based on the clinical data of 604 patients with hemorrhoids who underwent ALTA sclerotherapy between January 2009 and February 2015.The objective of this study was to assess the efficacy of this treatment for GradesⅡandⅢhemorrhoids.Preoperative and postoperative symptoms,complications and success rate were all assessed retrospectively.Follow-up consisted of a simple questionnaire,physical examination and an anoscopy.Patients were followed-up at one day,one week,two weeks,one month,one year,two years,three years,four years and five years after the ALTA sclerotherapy.RESULTS:One hundred and sixty-nine patients were diagnosed with GradeⅡhemorrhoids and 435 patients were diagnosed with GradeⅢhemorrhoids.The one year,three year and five year cumulative success rates of ALTA sclerotherapy for GradesⅡandⅢhemo-rrhoids were 95.9%and 93.1%;89.3%and 83.7%;and 89.3%and 78.2%,respectively.No significant differences were observed in the cumulative success rates after ALTA sclerotherapy between GradesⅡandⅢhemorrhoids(P=0.09).There were forty-seven post-operative complications(low grade fever;anal pain;urinary retention;rectal ulcer;and others).No serious or life-threatening complications occurred and all cases improved through conservative treatment.At univariate analysis there were no predictive factors of failure.CONCLUSION:ALTA sclerotherapy has had a high success rate for GradeⅡandⅢhemorrhoids during five years of post-operative treatment.However,additional studies are needed to evaluate the efficacy of this ALTA sclerotherapy in the management of hemorrhoidal disease.
基金This study was supported by a grant from the Innovation Capability Development Project of Jiangsu Province(No.BM2015004).
文摘Contrast-enhanced computed tomography(CT)contributes to the increasing detection of pancreatic neuroendocrine neoplasms(PNENs).Nevertheless,its value for differentiating pathological tumor grades is not well recognized.In this report,we have conducted a retrospective study on the relationship between the 2017 World Health Organization(WHO)classification and CT imaging features in 94 patients.Most of the investigated features eventually provided statistically significant indicators for discerning PNENs G3 from PNENs G1/G2,including tumor size,shape,margin,heterogeneity,intratumoral blood vessels,vascular invasion,enhancement pattern in both contrast phases,enhancement degree in both phases,tumor-to-pancreas contrast ratio in both phases,common bile duct dilatation,lymph node metastases,and liver metastases.Ill-defined tumor margin was an independent predictor for PNENs G3 with the highest area under the curve(AUC)of 0.906 in the multivariable logistic regression and receiver operating characteristic curve analysis.The portal enhancement ratio(PER)was shown the highest AUC of 0.855 in terms of quantitative features.Our data suggest that the traditional contrastenhanced CT still plays a vital role in differentiation of tumor grades and heterogeneity analysis prior to treatment.
基金supported by the Development Foundation of Shanghai Meteorological and Health Key Laboratory [QXJK201606]the Investigation of Science&Technology Basic Resources Program of China [2017FY101206]the General Program Foundation of Hebei Meteorological Bureau [17KY10]
文摘Asthma is a common chronic inflammatory disorder that is more prevalent in children than in adults.China has seen an increasing prevalence of childhood asthma in recentdecades[1].Earlier studies have shown that air particulate matter (PM),particularly fine particulate matter(PM2.5)[2],is an important factor triggering childhood asthma. Since nationalPM2.5data were nota vailabl euntil 2013,
文摘In this paper, prediction of copper and molybdenum grades and their recoveries of an industrial flotation plant are investigated using the Artificial Neural Networks (ANN) model. Process modeling has done based on 92 datasets collected at different operational conditions and feed characteristics. The prominent parameters investigated in this network were pH, collector, frother and F-Oil concentration, size percentage of feed passing 75 microns, moisture content in feed, solid percentage, and grade of copper, molybdenum, and iron in feed. A multilayer perceptron neural network, with 10:10:10:4 structure (two hidden layers), was used to estimate metallurgical performance. To obtain the optimal hidden layers and nodes in a layer, a trial and error procedure was done. In training and testing phases, it achieved quite correlations of 0.98 and 0.93 for Copper grade, of 0.99 and 0.92 for Copper recovery, of 0.99 and 0.92 for Molybdenum grade and of 0.99 and 0.94 for Molybdenum recovery prediction, respectively. The proposed neural network model can be applied to determine the most beneficial operational conditions for the expected Copper and Molybdenum grades and their recovery in final concentration of the industrial copper flotation process.
文摘Four humic coal samples are extracted to obtain humic substances (HS), and then subdivided(or purified) to obtain sixteen grades of HS, four from each coal. The effectiveness of these sixteen HS samples as additives for producing coal water mixture (CWM) is tested (w (additive) = 1 % and the the coal used is from the Baiyi coal preparation plant). A linear regression analysis of viscosity versus the additive’s components shows: (1)humic acids(HA) and humin (HM) are much better than fulvic acids (HF) with HA being tbe best, and (2) tke effects of grades of HS on coal dispersion as measured by viscosity are quite different. CWM additive effectiveness correlates positively with the increase of E4/E6,ash content, acid groups, and carboxyl groups, and negatively with the increase of molecular weight, HS content and phenolic alcohol content.
文摘On the basis of historical yearly drought and flood grades from A.D.1470 to A.D.1949, the ten-year mean precipitation in the rainy season in Wuhan district was reconstructed by means of statistical method. The reconstructing method was testified to be simple and effective.
文摘In this paper, an experimental and analytical study of two half-scale steel X-braced flames with equal nominal shear strength under cyclic loading is described. In these tests, all members except the braces are similar. The braces are made of various steel grades to monitor the effects of seismic excitation. Internal stiffeners are employed to limit the local buckling and increase the fracture life of the steel bracing. A heavy central core is introduced at the intersection of the braces to decrease their effective length. Recent seismic specifications are considered in the design of the X-braced frame members to verify their efficiency. The failure modes of the X-braced frames are also illustrated. It is observed that the energy dissipation capacity, ultimate load capacity and ductility of the system increase considerably by using lower grade steel and proposed detailing. Analytical modeling of the specimens using nonlinear finite element software supports the experimental findings.
文摘The availability of automated evaluation methodologies that may reliably be used for determining students’ scholastic performance through assigning letter grades are of utmost practical importance to educators, students, and do invariably have pivotal values to all stakeholders of the academic process. In particular, educators use letter grades as quantification metrics to monitor students’ intellectual progress within a framework of clearly specified learning objectives of a course. To students grades may be used as predictive measures and motivating drives for success in a study field. However due to numerous objective and subjective variables that may by be accounted for in a methodological process of assigning students’ grades, and since such a process is often tainted with personal philosophy and human psychology factors, it is essential that educators exercise extra care in maximizing positive account of all objective factors and minimizing negative ramifications of subjectively fuzzy factors. To this end, and in an attempt to make assigning students’ grades more reliable for assessing true-level of mastering specified learning outcomes, this paper will: i) provide a literature review on previous works on the most common methods that have traditionally been in use for assigning students’ grades, and a short account of the virtues and/or vices of such methods, and ii) present a user-friendly computer code that may be easily adapted for the purpose of assigning students’ grades. This would relieve educators from the overwhelming concerns associated with mechanistic aspects of determining educational metrics, and it would allow them to have more time and focus to obtain reliable assessments of true-level of students’ mastery of learning outcomes by accounting for all possible evaluation components.
