In recent years,research on nursing interruptions has been conducted at various levels in emergency departments,intensive care units,hemodialysis centers,operating rooms,and sterilization and supply centers.Nursing in...In recent years,research on nursing interruptions has been conducted at various levels in emergency departments,intensive care units,hemodialysis centers,operating rooms,and sterilization and supply centers.Nursing interruptions are closely related to adverse nursing events,and interruptions in operating room nursing can significantly impact the success of a patient’s surgery.However,there is a lack of in-depth theoretical research on safety risk assessment and response decision-making by operating room nurses when faced with nursing interruptions.This article reviews the concept,current status,and impact of nursing interruptions in the operating room,analyzes the cognitive level,coping strategies,and negative emotions of operating room nurses,and elaborates on management strategies to provide references for research and management of nursing interruptions in the operating room.展开更多
Interrupted Aortic Arch(IAA)combined with aortic stenosis(AS)is a rare and complex congenital cardiac anomaly that presents significant challenges in clinical management.In this letter,we aim to share our experience i...Interrupted Aortic Arch(IAA)combined with aortic stenosis(AS)is a rare and complex congenital cardiac anomaly that presents significant challenges in clinical management.In this letter,we aim to share our experience in performing hybrid procedures on an infant diagnosed with IAA combined with bicuspid AS.This child exhibited significant recovery during follow-up.展开更多
BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare anatomical defect of the pituitary gland falling under the spectrum of holoprosencephaly phenotypes.It is characterized by a deficiency in anterior pitui...BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare anatomical defect of the pituitary gland falling under the spectrum of holoprosencephaly phenotypes.It is characterized by a deficiency in anterior pituitary hormones,such as growth hormone,gonadotropins,and thyroid hormones.Due to the syndrome's rarity and nonspecific manifestations,there is a lack of standardized treatment strategies.Consequently,early diagnosis through imaging and on-time intervention are crucial for improving patients’outcomes.CASE SUMMARY A 30-year-old man presented with absent secondary sexual characteristics and azoospermia.Laboratory evaluation revealed a deficiency in gonadotropins,while thyroid function was mostly within normal ranges.Magnetic resonance imaging of the pituitary gland showed pituitary stalk agenesis,hypoplasia of the anterior pituitary,and ectopic posterior pituitary,leading to the diagnosis of PSIS.Initially,the patient underwent 6 mo of gonadotropin therapy without significant changes in hormone levels and secondary sexual characteristics.Pulsatile gonadotropin-releasing hormone therapy was then administered,resulting in the detection of sperm in the semen analysis within 3 mo.After 6 mo,routine semen tests showed normal semen quality.The couple faced challenges in conceiving due to abstinence and underwent three cycles of artificial insemination,which was unsuccessful.They also attempted in vitro fertilization,but unfortunately,the woman experienced a miscarriage 10 wk after the embryo transfer.CONCLUSION Early detection,accurate diagnosis,and timely treatment are crucial in improving the quality of life and fertility of PSIS patients.展开更多
BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare disorder,often characterized by delayed growth and development,short stature,and hypogonadism as the main clinical manifestations.It is not clear whether...BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare disorder,often characterized by delayed growth and development,short stature,and hypogonadism as the main clinical manifestations.It is not clear whether PSIS can lead to liver cirrhosis.CASE SUMMARY This paper reported a case of liver cirrhosis of unknown origin.The patient was admitted to Beijing Ditan Hospital Affiliated to Capital Medical University in November 2023.The diagnosis of PSIS complicated with liver cirrhosis was established after a series of blood tests and pituitary magnetic resonance imaging examination.CONCLUSION We also reviewed the literature from both domestic and international sources to deepen the clinical understanding of PSIS in conjunction with liver cirrhosis among medical practitioners.展开更多
Catalytic syntheses of silaoxycarbocyclics from an interrupted Catellani reaction of 3-iodochromones with bridged olefins and octamethyl-1,4-dioxacyclohexasilane is described.This protocol involves the oxidative addit...Catalytic syntheses of silaoxycarbocyclics from an interrupted Catellani reaction of 3-iodochromones with bridged olefins and octamethyl-1,4-dioxacyclohexasilane is described.This protocol involves the oxidative addition of chromonyl-norbornyl-palladacycle generated through successive oxidative addition of Pd(0)to 3-iodochromones,migratory insertion of NBE and intramolecular ortho-C(sp^(2))-H activation to the tetrasilane,thus motivating a(4+6)annulation and ring expansion.The synthetic practicality of current strategy is further proved by the late-stage modification of pharmaceuticals and natural products,gram-scale experiments,as well as the transformations of functional groups of silaoxycarbocyclics.展开更多
BACKGROUND Gastric subepithelial lesions(SELs)are elevated lesions originating from the muscularis mucosa,submucosa,or muscularis propria,and may also include extraluminal lesions.For small SELs(less than 5 cm),comple...BACKGROUND Gastric subepithelial lesions(SELs)are elevated lesions originating from the muscularis mucosa,submucosa,or muscularis propria,and may also include extraluminal lesions.For small SELs(less than 5 cm),complete endoscopic excision is the preferred treatment.Endoscopic full-thickness resection(EFTR)has proven to be an effective approach.AIM To evaluate the efficacy of the interrupted closure technique compared to the traditional closure technique in EFTR for gastric SELs.METHODS This single-center,prospective,randomized controlled trial was conducted at a tertiary hospital from September 2023 to September 2024.A total of 90 patients who underwent EFTR for gastric SELs were randomly allocated to either the interrupted closure group(n=44)or the traditional closure group(n=46).RESULTS All patients had complete resection and wound closure without any severe postoperative complications.The incidence of intraoperative gas-related complications was significantly lower in the interrupted closure group than in the traditional closure group(2.27%vs 26.09%,P=0.001),demonstrating interrupted closure technique can reduce the incidence of gas-related issues.Statistical analysis revealed that the incidence of postoperative infection was significantly lower in the experimental group than in the control group(15.91%vs 41.30%,P=0.008).Additionally,the median duration of antibiotic use was lower in the experimental group(3.5 days vs 5 days,P=0.013).Abdominal pain levels on postoperative days 1 and 4 were also lower in the experimental group compared to the control group(P<0.001).CONCLUSION The interrupted closure technique in EFTR for treating gastric SELs is safe and effective,reducing the incidence of intraoperative gas complications and postoperative infections.展开更多
In the context of the Diagnosis Related Groups(DRGs)system,the orthopedic hospital implemented refined drug control to provide a pharmacological reference for promoting rational clinical drug use.A statistical analysi...In the context of the Diagnosis Related Groups(DRGs)system,the orthopedic hospital implemented refined drug control to provide a pharmacological reference for promoting rational clinical drug use.A statistical analysis was conducted on the hospital’s data from January to December 2021(prior to the implementation of control),focusing on the types of unreasonable prescriptions.A multi-dimensional analysis was also conducted to identify the underlying causes of inappropriate medication practices.Following this,refined drug control measures were introduced,and data from January to December 2022(post-control)were compared,examining factors such as the average drug cost,drug expenses for the IC29 diagnosis group,and the drug cost ratio.An interrupted time-series analysis was employed to evaluate the effects of these interventions.The results showed that after the implementation of refined drug control in the orthopedic department,significant reductions were observed in the average cost per patient,average drug cost per patient,drug cost ratio,cost consumption index,average length of hospital stay,and allocation ratio(P<0.05).In particular,the first month of control(January 2022)saw a marked decrease in average drug costs per patient by 1272.90 yuan(P<0.01),a reduction in the drug cost ratio by 0.98%,and a decline in drug costs for the IC29 diagnosis group by 616.79 yuan(P>0.05).Moreover,the rate of unreasonable inappropriate prescribing dropped dramatically from 40.48%in 2021 to 3.57%by December 2022.The refined control of drug use within the orthopedic hospital significantly improved the rationality of clinical prescribing practices,reduced the occurrence of adverse drug reactions,and enhanced patient adherence to prescribed treatments.These findings demonstrated considerable clinical value in promoting efficient and safe drug use.展开更多
The incremental capacity analysis(ICA)technique is notably limited by its sensitivity to variations in charging conditions,which constrains its practical applicability in real-world scenarios.This paper introduces an ...The incremental capacity analysis(ICA)technique is notably limited by its sensitivity to variations in charging conditions,which constrains its practical applicability in real-world scenarios.This paper introduces an ICA-compensation technique to address this limitation and propose a generalized framework for assessing the state of health(SOH)of batteries based on ICA that is applicable under differing charging conditions.This novel approach calculates the voltage profile under quasi-static conditions by subtracting the voltage increase attributable to the additional polarization effects at high currents from the measured voltage profile.This approach's efficacy is contingent upon precisely acquiring the equivalent impedance.To obtain the equivalent impedance throughout the batteries'lifespan while minimizing testing costs,this study employs a current interrupt technique in conjunction with a long short-term memory(LSTM)network to develop a predictive model for equivalent impedance.Following the derivation of ICA curves using voltage profiles under quasi-static conditions,the research explores two scenarios for SOH estimation:one utilizing only incremental capacity(IC)features and the other incorporating both IC features and IC sampling.A genetic algorithm-optimized backpropagation neural network(GABPNN)is employed for the SOH estimation.The proposed generalized framework is validated using independent training and test datasets.Variable test conditions are applied for the test set to rigorously evaluate the methodology under challenging conditions.These evaluation results demonstrate that the proposed framework achieves an estimation accuracy of 1.04%for RMSE and 0.90%for MAPE across a spectrum of charging rates ranging from 0.1 C to 1 C and starting SOCs between 0%and 70%,which constitutes a major advancement compared to established ICA methods.It also significantly enhances the applicability of conventional ICA techniques in varying charging conditions and negates the necessity for separate testing protocols for each charging scenario.展开更多
Nonperiodic interrupted sampling repeater jamming(ISRJ)against inverse synthetic aperture radar(ISAR)can obtain two-dimensional blanket jamming performance by joint fast and slow time domain interrupted modulation,whi...Nonperiodic interrupted sampling repeater jamming(ISRJ)against inverse synthetic aperture radar(ISAR)can obtain two-dimensional blanket jamming performance by joint fast and slow time domain interrupted modulation,which is obviously dif-ferent from the conventional multi-false-target deception jam-ming.In this paper,a suppression method against this kind of novel jamming is proposed based on inter-pulse energy function and compressed sensing theory.By utilizing the discontinuous property of the jamming in slow time domain,the unjammed pulse is separated using the intra-pulse energy function diffe-rence.Based on this,the two-dimensional orthogonal matching pursuit(2D-OMP)algorithm is proposed.Further,it is proposed to reconstruct the ISAR image with the obtained unjammed pulse sequence.The validity of the proposed method is demon-strated via the Yake-42 plane data simulations.展开更多
In this paper, we present a new car-following model by taking into account the effects of the traffic interruption probability on the car-following behaviour of the following vehicle. The stability condition of the mo...In this paper, we present a new car-following model by taking into account the effects of the traffic interruption probability on the car-following behaviour of the following vehicle. The stability condition of the model is obtained by using the linear stability theory. The modified Korteweg-de Vries （KdV） equation is constructed and solved, and three types of traffic flows in the headway sensitivity space-stable, metastable, and unstable--are classified. Both the analytical and simulation results show that the traffic interruption probability indeed has an influence on driving behaviour, and the consideration of traffic interruption probability in the car-following model could stabilize traffic flow.展开更多
AIM： To evaluate the efficacy of interruption of intrauterine infection of HBV with HBIG in pregnant women with positive HBeAg and HBsAg.METHODS： A prospective randomized controlled trial was adopted. Sixty cases wi...AIM： To evaluate the efficacy of interruption of intrauterine infection of HBV with HBIG in pregnant women with positive HBeAg and HBsAg.METHODS： A prospective randomized controlled trial was adopted. Sixty cases with positive HBeAg and HBsAg were coincident with the criteria of inclusion, and 8 cases were excluded. Fifty-two cases were analyzed （28 cases in trial group and 24 in control group）. All cases in trial group received 200 IU HBIG intravenously every 4 wk for 3 times from the 28^th wk. The cases of control group received placebo in the same way. All pregnant women were detected for HBeAg and HBV-DNA at the beginning of the trial and end of the trial （delivery）. The cord blood of all newborns were collected for detecting HBeAg and HBV-DNA simultaneously.RESULTS： For investigation of HBeAg of newborns in trial group, 6 of 28 cases of newborns had positive HBeAg, the HBeAg positive rate being 21.4%, the total rate of 95% CI being 8%-41%. In control group, 19 of 24 cases of newborns had positive HBeAg, HBeAg positive rate was 79.2%, the rate of 95%CI being 5%-93%. By statistical analysis, 2= 17.26, P 〈 0.01, RR = 0.27, 95% CI （6.3 × 10^-6, 8.6 × 10^-5）. For investigation of HBV-DNA of newborns in trial group, 7 of 28 cases of newborns had positive HBV-DNA, HBV-DNA positive rate being 25%, the total rate of 95% CI being 11%-45%. In control group, 20 of 24 cases of newborns had positive HBV-DNA, HBV-DNA positive rate was 83.3%, the total rate of 95% CI being 63%-95%. By statistical analysis, X^2 = 17.62, P 〈 0.01, RR = 0.30, 95% CI （1.5 × 10^-5, 1.7× 10^-4）. The results indicated that there was significant difference in HBeAg positive rate and HBV-DNA positive rate of newborns between the two groups. In trial group, 7 of 28 newborns had HBV-DNA positive, but the HBV-DNA load of newborns was lower than that of their mothers. In control group, 20 of 24 newborns still had HBV-DNA positive, and the HBV-DNA load of newborns was close to those of their mothers. Statistical analysis indicated that there was no significant difference in HBV- DNA load between postnatal women without HBIG intervention and their filial generations （T = 81.5, P 〉 0.1）. CONCLUSION： It is effective and safe to prevent intrauterine infection of HBV with HBIG from the 28^th wk in pregnant women with positive HBeAg and HBsAg. In clinical application, those pregnant women with negative HBeAg and positive HBV-DNA also need to be interrupted by HBIG.展开更多
Objectives:To explore the knowledge,attitude and practice of Chinese nurses regarding nursing interruptions and related factors.Methods:A total of 6,400 nurses from 31 hospitals in China were investigated by using the...Objectives:To explore the knowledge,attitude and practice of Chinese nurses regarding nursing interruptions and related factors.Methods:A total of 6,400 nurses from 31 hospitals in China were investigated by using the Knowledge,Attitude and Practice(KAP)Questionnaire of Nursing Interruptions.The questionnaire consists of three dimensions,knowledge,attitude and practice,containing 10,9 and 7 items,with full score of 50,45 and 28,respectively.Results:The mean overall KAP score regarding nursing interruptions of Chinese nurses was 74.05±16.65(range:26-123),with scores for the knowledge,attitude,and practice component being 21.74±9.80,34.83±6.98,and 17.49±4.97,respectively.Among the nurses,70.8%of them experienced an average level of KAP toward nursing interruptions while 15.5%were at a poor level.The knowledge,attitude,and practice of nursing interruptions were better in chief nurses,managers,nurses with a master degree or above,nurses ever received training,and nurses with a strong agreement to leadership compared to nurses in other groups(P<0.05).In addition,employment type,professional title,position,standardized training and leaders'attention were predictors of KAP in nurses.Conclusion:Chinese nurses have a moderate level of KAP regarding nursing interruptions.Leaders'attention,standardized training,position,professional title and employment type could predict nurses'KAP state of nursing interruptions.Thus,a targeted training program should be implemented for clinical nurses by nursing leaders,with a particular focus on feasibility and professionalism.展开更多
Water flow from an artesian well stopped on December 17, 2007 but recovered when the Wenchuan Ms 8.0 earthquake occurred on May 12, 2008. This well is located 90 km south of the epicenter in an extensional tectonic se...Water flow from an artesian well stopped on December 17, 2007 but recovered when the Wenchuan Ms 8.0 earthquake occurred on May 12, 2008. This well is located 90 km south of the epicenter in an extensional tectonic setting, where similar changes of water level and resistivity were observed at two other nearby sites. Our investigation suggests that this phenomenon was not caused by environmental disturbances, such as drought or borehole-drilling activity, but might be a precursor to the earthquake.展开更多
Revolving parts with complex surface structures are widely used in machinery and mechanical equipment. The ECM process provides its adequacy to cut hard materials with different shapes, and its applications are widely...Revolving parts with complex surface structures are widely used in machinery and mechanical equipment. The ECM process provides its adequacy to cut hard materials with different shapes, and its applications are widely increased, due to its outstanding advantages. In this paper, a new method for machining a convex strips structure on a cylinder by using site directed power interruption（SDPI） in the ECM process is presented. A variable correction value of the power-off time was defined and optimized to obtain the ideal interval for better machining accuracy and stability.The electric field distribution and the simulated convex profiles show that the stray current density can be reduced effectively by using the proposed method. The correction value has an important influence on the machining accuracy. A suitable correction value in the range of 0.6–1.2 s can effectively improve the machining accuracy of the convex strips structure. Experiments were also conducted to verify the proposed method. Results have confirmed that the stray corrosion on the convex strips surface is significantly reduced and the machining accuracy of convex strips structure is remarkably improved by using the proposed method with a suitable correction value in the ECM process. Finally, a convex strip with a height of 2 mm on a thin-wall revolving part was also produced successfully using a correction value of 0.9.展开更多
Considering the effects that the probability of traffic interruption and the friction between two lanes have on the car-following behaviour, this paper establishes a new two-lane microscopic car-following model. Based...Considering the effects that the probability of traffic interruption and the friction between two lanes have on the car-following behaviour, this paper establishes a new two-lane microscopic car-following model. Based on this microscopic model, a new macroscopic model was deduced by the relevance relation of microscopic and macroscopic scale parameters for the two-lane traffic flow. Terms related to lane change are added into the continuity equations and velocity dynamic equations to investigate the lane change rate. Numerical results verify that the proposed model can be efficiently used to reflect the effect of the probability of traffic interruption on the shock, rarefaction wave and lane change behaviour on two-lane freeways. The model has also been applied in reproducing some complex traffic phenomena caused by traffic accident interruption.展开更多
The power system infrastructure, operations and market have gone through radical changes for the last couple of decades. The society has become more dependent to the continuous electric power supply and hence the conc...The power system infrastructure, operations and market have gone through radical changes for the last couple of decades. The society has become more dependent to the continuous electric power supply and hence the concept of electric power reliability has become more significant. At this point, understanding the economic outcomes of power outages is vital and imperative for both utilities and the customers. There are certain methodologies to understand the costs of power interruptions. This paper suggests a novel hybrid method that comprises of customer surveys and direct analytical methods to reach customer specific, objective and reliable results for the industry sector customers. The paper also brings a statistical approach to censor the zero and extreme responses given via the surveys.展开更多
Pituitary stalk interruption syndrome(PSIS)is a rare congenital abnormality characterized by thinning or disappearance of the pituitary stalk,hypoplasia of the anterior pituitary and an ectopic posterior pituitary.Alt...Pituitary stalk interruption syndrome(PSIS)is a rare congenital abnormality characterized by thinning or disappearance of the pituitary stalk,hypoplasia of the anterior pituitary and an ectopic posterior pituitary.Although the etiology of PSIS is still unclear,gene changes and perinatal adverse events such as breech delivery may play important roles in the pathogenesis of PSIS.PSIS can cause multiple hormone deficiencies,such as growth hormone,which then cause a series of changes in the human body.On the one hand,hormone changes affect growth and development,and on the other hand,they could affect human metabolism and subsequently the liver resulting in nonalcoholic fatty liver disease(NAFLD).Under the synergistic effect of multiple mechanisms,the progression of NAFLD caused by PSIS is faster than that due to other causes.Therefore,in addition to early identification of PSIS,timely hormone replacement therapy and monitoring of relevant hormone levels,clinicians should routinely assess the liver function while managing PSIS.展开更多
Nowadays,the microgrid cluster is an important application scenario for energy trading.In trading,one of the most important research directions is the issue of pricing.To determine reasonable pricing for the microgrid...Nowadays,the microgrid cluster is an important application scenario for energy trading.In trading,one of the most important research directions is the issue of pricing.To determine reasonable pricing for the microgrid cluster,data communication is used to create the cyber-physical system(CPS),which can improve the observability of microgrids.Then,the following works are carried out in the CPS.In the physical layer:1)Regarding trading between microgrids and the load,based on the generalized game theory,an optimal pricing strategy is proposed,which takes into account the interactive relationships among microgrids and transforms the pricing problem into a Nikaido-Isoda function to obtain the optimal prices conveniently;2)Regarding peer-to-peer trading between two microgrids,based on evolutionary game theory and the penalty mechanism,the optimal sale price of the seller is selected with boundary rationality.In the cyber layer,regarding the communication interruption issue existing in pricing(i.e.,the game process),based on the principle of matching the performance of the path with the importance degree of the data,a dynamic regulating method of paths is proposed,i.e.,adopting a new path to re-transmit the interrupted data to the destination.Finally,the effect of the proposed strategies is verified by case studies.展开更多
Background: This study assessed treatment interruption of tuberculosis (TB) patients managed by treatment supporters and health care workers and other predictors of treatment interruption. Methods: A descriptive cross...Background: This study assessed treatment interruption of tuberculosis (TB) patients managed by treatment supporters and health care workers and other predictors of treatment interruption. Methods: A descriptive cross-sectional study was conducted. Four hundred and seventy new smear positive TB patients above 14 years of age were consecutively recruited between October 1 and December 31 2012 from 34 (23 public and 11 private) directly observed treatment short course (DOTS) facilities that offered TB treatment and microscopy services. They were followed up till treatment was completed. Logistic regression was used to assess the predictors of treatment interruption. Results: A significantly higher proportion of smokers (58.6% vs 38.3%, p = 0.030), patients supervised by treatment supporters (44.4% vs 34.7%, p = 0.032), patients not counselled before initiation of treatment (55.6% vs 38.2%, p = 0.041), patients managed at private DOTS facilities (50% vs 36.3%, p = 0.010) and TB/HIV co-infected patients (54.2% vs 38.6%, p = 0.038) had treatment interruption. Predictors of treatment interruption were supervision by treatment supporters, smoking, lack of pre-treatment counselling and TB/HIV co-infection. Conclusion: A higher proportion of patients supervised by treatment supporters had treatment interruption than those supervised by health care workers. There may be a need to review the concept of treatment supervision by treatment supporters in Lagos state Nigeria.展开更多
基金Analysis of Lung Compliance Measurement and its Guided Therapeutic Effects in Patients with ARDS Secondary to Severe Multiple Trauma(Project No.:XSD-2023-002)。
文摘In recent years,research on nursing interruptions has been conducted at various levels in emergency departments,intensive care units,hemodialysis centers,operating rooms,and sterilization and supply centers.Nursing interruptions are closely related to adverse nursing events,and interruptions in operating room nursing can significantly impact the success of a patient’s surgery.However,there is a lack of in-depth theoretical research on safety risk assessment and response decision-making by operating room nurses when faced with nursing interruptions.This article reviews the concept,current status,and impact of nursing interruptions in the operating room,analyzes the cognitive level,coping strategies,and negative emotions of operating room nurses,and elaborates on management strategies to provide references for research and management of nursing interruptions in the operating room.
基金Supported by Zhejiang University Scientific Research Development Project(2021FZZX005-06).
文摘Interrupted Aortic Arch(IAA)combined with aortic stenosis(AS)is a rare and complex congenital cardiac anomaly that presents significant challenges in clinical management.In this letter,we aim to share our experience in performing hybrid procedures on an infant diagnosed with IAA combined with bicuspid AS.This child exhibited significant recovery during follow-up.
基金Weifang Fundamental Research Projects,No.WFWSJK-2023-052.
文摘BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare anatomical defect of the pituitary gland falling under the spectrum of holoprosencephaly phenotypes.It is characterized by a deficiency in anterior pituitary hormones,such as growth hormone,gonadotropins,and thyroid hormones.Due to the syndrome's rarity and nonspecific manifestations,there is a lack of standardized treatment strategies.Consequently,early diagnosis through imaging and on-time intervention are crucial for improving patients’outcomes.CASE SUMMARY A 30-year-old man presented with absent secondary sexual characteristics and azoospermia.Laboratory evaluation revealed a deficiency in gonadotropins,while thyroid function was mostly within normal ranges.Magnetic resonance imaging of the pituitary gland showed pituitary stalk agenesis,hypoplasia of the anterior pituitary,and ectopic posterior pituitary,leading to the diagnosis of PSIS.Initially,the patient underwent 6 mo of gonadotropin therapy without significant changes in hormone levels and secondary sexual characteristics.Pulsatile gonadotropin-releasing hormone therapy was then administered,resulting in the detection of sperm in the semen analysis within 3 mo.After 6 mo,routine semen tests showed normal semen quality.The couple faced challenges in conceiving due to abstinence and underwent three cycles of artificial insemination,which was unsuccessful.They also attempted in vitro fertilization,but unfortunately,the woman experienced a miscarriage 10 wk after the embryo transfer.CONCLUSION Early detection,accurate diagnosis,and timely treatment are crucial in improving the quality of life and fertility of PSIS patients.
文摘BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare disorder,often characterized by delayed growth and development,short stature,and hypogonadism as the main clinical manifestations.It is not clear whether PSIS can lead to liver cirrhosis.CASE SUMMARY This paper reported a case of liver cirrhosis of unknown origin.The patient was admitted to Beijing Ditan Hospital Affiliated to Capital Medical University in November 2023.The diagnosis of PSIS complicated with liver cirrhosis was established after a series of blood tests and pituitary magnetic resonance imaging examination.CONCLUSION We also reviewed the literature from both domestic and international sources to deepen the clinical understanding of PSIS in conjunction with liver cirrhosis among medical practitioners.
基金financial support from the National Natural Science Foundation of China(Nos.22261057 and 21901265)Guizhou Provincial Natural Science Foundation(No.QKHJC-2020-1Z072)+3 种基金the Science and Technology Department of Guizhou Province(Nos.QKHPTRC-CXTD[2022]012 and QKHPTRCGCC[2023]003)Zunyi Medical University(No.18ZY-002)Science and Technology Department of Zunyi(Nos.ZSKH-2018-3,ZSKHHZZ[2020]70,ZSKRPT-2020-5 and ZSKRPT-2021-5)Fifth Batch of Talent Base in Guizhou Province(No.S-030-1).
文摘Catalytic syntheses of silaoxycarbocyclics from an interrupted Catellani reaction of 3-iodochromones with bridged olefins and octamethyl-1,4-dioxacyclohexasilane is described.This protocol involves the oxidative addition of chromonyl-norbornyl-palladacycle generated through successive oxidative addition of Pd(0)to 3-iodochromones,migratory insertion of NBE and intramolecular ortho-C(sp^(2))-H activation to the tetrasilane,thus motivating a(4+6)annulation and ring expansion.The synthetic practicality of current strategy is further proved by the late-stage modification of pharmaceuticals and natural products,gram-scale experiments,as well as the transformations of functional groups of silaoxycarbocyclics.
基金Supported by the Shenyang Science and Technology,No.22-321-32-15Department of Science and Technology of Liaoning Province,No.2023JH2/101600015.
文摘BACKGROUND Gastric subepithelial lesions(SELs)are elevated lesions originating from the muscularis mucosa,submucosa,or muscularis propria,and may also include extraluminal lesions.For small SELs(less than 5 cm),complete endoscopic excision is the preferred treatment.Endoscopic full-thickness resection(EFTR)has proven to be an effective approach.AIM To evaluate the efficacy of the interrupted closure technique compared to the traditional closure technique in EFTR for gastric SELs.METHODS This single-center,prospective,randomized controlled trial was conducted at a tertiary hospital from September 2023 to September 2024.A total of 90 patients who underwent EFTR for gastric SELs were randomly allocated to either the interrupted closure group(n=44)or the traditional closure group(n=46).RESULTS All patients had complete resection and wound closure without any severe postoperative complications.The incidence of intraoperative gas-related complications was significantly lower in the interrupted closure group than in the traditional closure group(2.27%vs 26.09%,P=0.001),demonstrating interrupted closure technique can reduce the incidence of gas-related issues.Statistical analysis revealed that the incidence of postoperative infection was significantly lower in the experimental group than in the control group(15.91%vs 41.30%,P=0.008).Additionally,the median duration of antibiotic use was lower in the experimental group(3.5 days vs 5 days,P=0.013).Abdominal pain levels on postoperative days 1 and 4 were also lower in the experimental group compared to the control group(P<0.001).CONCLUSION The interrupted closure technique in EFTR for treating gastric SELs is safe and effective,reducing the incidence of intraoperative gas complications and postoperative infections.
基金Jiangxi Provincial Hospital Pharmacy Special Research Fund Project(Grant No.2024-ZXYJ02).
文摘In the context of the Diagnosis Related Groups(DRGs)system,the orthopedic hospital implemented refined drug control to provide a pharmacological reference for promoting rational clinical drug use.A statistical analysis was conducted on the hospital’s data from January to December 2021(prior to the implementation of control),focusing on the types of unreasonable prescriptions.A multi-dimensional analysis was also conducted to identify the underlying causes of inappropriate medication practices.Following this,refined drug control measures were introduced,and data from January to December 2022(post-control)were compared,examining factors such as the average drug cost,drug expenses for the IC29 diagnosis group,and the drug cost ratio.An interrupted time-series analysis was employed to evaluate the effects of these interventions.The results showed that after the implementation of refined drug control in the orthopedic department,significant reductions were observed in the average cost per patient,average drug cost per patient,drug cost ratio,cost consumption index,average length of hospital stay,and allocation ratio(P<0.05).In particular,the first month of control(January 2022)saw a marked decrease in average drug costs per patient by 1272.90 yuan(P<0.01),a reduction in the drug cost ratio by 0.98%,and a decline in drug costs for the IC29 diagnosis group by 616.79 yuan(P>0.05).Moreover,the rate of unreasonable inappropriate prescribing dropped dramatically from 40.48%in 2021 to 3.57%by December 2022.The refined control of drug use within the orthopedic hospital significantly improved the rationality of clinical prescribing practices,reduced the occurrence of adverse drug reactions,and enhanced patient adherence to prescribed treatments.These findings demonstrated considerable clinical value in promoting efficient and safe drug use.
基金funded by the Bavarian State Ministry of ScienceResearch and Art(Grant number:H.2-F1116.WE/52/2)。
文摘The incremental capacity analysis(ICA)technique is notably limited by its sensitivity to variations in charging conditions,which constrains its practical applicability in real-world scenarios.This paper introduces an ICA-compensation technique to address this limitation and propose a generalized framework for assessing the state of health(SOH)of batteries based on ICA that is applicable under differing charging conditions.This novel approach calculates the voltage profile under quasi-static conditions by subtracting the voltage increase attributable to the additional polarization effects at high currents from the measured voltage profile.This approach's efficacy is contingent upon precisely acquiring the equivalent impedance.To obtain the equivalent impedance throughout the batteries'lifespan while minimizing testing costs,this study employs a current interrupt technique in conjunction with a long short-term memory(LSTM)network to develop a predictive model for equivalent impedance.Following the derivation of ICA curves using voltage profiles under quasi-static conditions,the research explores two scenarios for SOH estimation:one utilizing only incremental capacity(IC)features and the other incorporating both IC features and IC sampling.A genetic algorithm-optimized backpropagation neural network(GABPNN)is employed for the SOH estimation.The proposed generalized framework is validated using independent training and test datasets.Variable test conditions are applied for the test set to rigorously evaluate the methodology under challenging conditions.These evaluation results demonstrate that the proposed framework achieves an estimation accuracy of 1.04%for RMSE and 0.90%for MAPE across a spectrum of charging rates ranging from 0.1 C to 1 C and starting SOCs between 0%and 70%,which constitutes a major advancement compared to established ICA methods.It also significantly enhances the applicability of conventional ICA techniques in varying charging conditions and negates the necessity for separate testing protocols for each charging scenario.
基金supported by the National Natural Science Foundation of China(62001481,61890542,62071475)the Natural Science Foundation of Hunan Province(2022JJ40561)the Research Program of National University of Defense Technology(ZK22-46).
文摘Nonperiodic interrupted sampling repeater jamming(ISRJ)against inverse synthetic aperture radar(ISAR)can obtain two-dimensional blanket jamming performance by joint fast and slow time domain interrupted modulation,which is obviously dif-ferent from the conventional multi-false-target deception jam-ming.In this paper,a suppression method against this kind of novel jamming is proposed based on inter-pulse energy function and compressed sensing theory.By utilizing the discontinuous property of the jamming in slow time domain,the unjammed pulse is separated using the intra-pulse energy function diffe-rence.Based on this,the two-dimensional orthogonal matching pursuit(2D-OMP)algorithm is proposed.Further,it is proposed to reconstruct the ISAR image with the obtained unjammed pulse sequence.The validity of the proposed method is demon-strated via the Yake-42 plane data simulations.
基金supported by the National Natural Science Foundation of China (Grant Nos 70701002 and 70521001)the National Basic Research Program of China (Grant No 2006CB705503)the Research Grants Council of the Hong Kong Special Administrative Region of China (Grant No HKU7187/05E)
文摘In this paper, we present a new car-following model by taking into account the effects of the traffic interruption probability on the car-following behaviour of the following vehicle. The stability condition of the model is obtained by using the linear stability theory. The modified Korteweg-de Vries （KdV） equation is constructed and solved, and three types of traffic flows in the headway sensitivity space-stable, metastable, and unstable--are classified. Both the analytical and simulation results show that the traffic interruption probability indeed has an influence on driving behaviour, and the consideration of traffic interruption probability in the car-following model could stabilize traffic flow.
基金Supported by the office of Science and Technology of Xinjiang,No.960505003
文摘AIM： To evaluate the efficacy of interruption of intrauterine infection of HBV with HBIG in pregnant women with positive HBeAg and HBsAg.METHODS： A prospective randomized controlled trial was adopted. Sixty cases with positive HBeAg and HBsAg were coincident with the criteria of inclusion, and 8 cases were excluded. Fifty-two cases were analyzed （28 cases in trial group and 24 in control group）. All cases in trial group received 200 IU HBIG intravenously every 4 wk for 3 times from the 28^th wk. The cases of control group received placebo in the same way. All pregnant women were detected for HBeAg and HBV-DNA at the beginning of the trial and end of the trial （delivery）. The cord blood of all newborns were collected for detecting HBeAg and HBV-DNA simultaneously.RESULTS： For investigation of HBeAg of newborns in trial group, 6 of 28 cases of newborns had positive HBeAg, the HBeAg positive rate being 21.4%, the total rate of 95% CI being 8%-41%. In control group, 19 of 24 cases of newborns had positive HBeAg, HBeAg positive rate was 79.2%, the rate of 95%CI being 5%-93%. By statistical analysis, 2= 17.26, P 〈 0.01, RR = 0.27, 95% CI （6.3 × 10^-6, 8.6 × 10^-5）. For investigation of HBV-DNA of newborns in trial group, 7 of 28 cases of newborns had positive HBV-DNA, HBV-DNA positive rate being 25%, the total rate of 95% CI being 11%-45%. In control group, 20 of 24 cases of newborns had positive HBV-DNA, HBV-DNA positive rate was 83.3%, the total rate of 95% CI being 63%-95%. By statistical analysis, X^2 = 17.62, P 〈 0.01, RR = 0.30, 95% CI （1.5 × 10^-5, 1.7× 10^-4）. The results indicated that there was significant difference in HBeAg positive rate and HBV-DNA positive rate of newborns between the two groups. In trial group, 7 of 28 newborns had HBV-DNA positive, but the HBV-DNA load of newborns was lower than that of their mothers. In control group, 20 of 24 newborns still had HBV-DNA positive, and the HBV-DNA load of newborns was close to those of their mothers. Statistical analysis indicated that there was no significant difference in HBV- DNA load between postnatal women without HBIG intervention and their filial generations （T = 81.5, P 〉 0.1）. CONCLUSION： It is effective and safe to prevent intrauterine infection of HBV with HBIG from the 28^th wk in pregnant women with positive HBeAg and HBsAg. In clinical application, those pregnant women with negative HBeAg and positive HBV-DNA also need to be interrupted by HBIG.
基金Paper extracted from The New Xiangya Talent Projects of the Third Xiangya Hospital of Central South University(NO:JY201720).
文摘Objectives:To explore the knowledge,attitude and practice of Chinese nurses regarding nursing interruptions and related factors.Methods:A total of 6,400 nurses from 31 hospitals in China were investigated by using the Knowledge,Attitude and Practice(KAP)Questionnaire of Nursing Interruptions.The questionnaire consists of three dimensions,knowledge,attitude and practice,containing 10,9 and 7 items,with full score of 50,45 and 28,respectively.Results:The mean overall KAP score regarding nursing interruptions of Chinese nurses was 74.05±16.65(range:26-123),with scores for the knowledge,attitude,and practice component being 21.74±9.80,34.83±6.98,and 17.49±4.97,respectively.Among the nurses,70.8%of them experienced an average level of KAP toward nursing interruptions while 15.5%were at a poor level.The knowledge,attitude,and practice of nursing interruptions were better in chief nurses,managers,nurses with a master degree or above,nurses ever received training,and nurses with a strong agreement to leadership compared to nurses in other groups(P<0.05).In addition,employment type,professional title,position,standardized training and leaders'attention were predictors of KAP in nurses.Conclusion:Chinese nurses have a moderate level of KAP regarding nursing interruptions.Leaders'attention,standardized training,position,professional title and employment type could predict nurses'KAP state of nursing interruptions.Thus,a targeted training program should be implemented for clinical nurses by nursing leaders,with a particular focus on feasibility and professionalism.
基金supported by the National Natural Science Foundation ofChina(40930637)Basic Science Research Special Item of the Instituteof Geology,China Earthquake Administration(DF-IGCEA-0608210)Special Research Program of China Earthquake Administration(200808079)
文摘Water flow from an artesian well stopped on December 17, 2007 but recovered when the Wenchuan Ms 8.0 earthquake occurred on May 12, 2008. This well is located 90 km south of the epicenter in an extensional tectonic setting, where similar changes of water level and resistivity were observed at two other nearby sites. Our investigation suggests that this phenomenon was not caused by environmental disturbances, such as drought or borehole-drilling activity, but might be a precursor to the earthquake.
基金supports provided by the State Key Program of the National Natural Science Foundation of China(No.51535006)Jiangsu Key Laboratory of Precision and Micro-Manufacturing Technology of China
文摘Revolving parts with complex surface structures are widely used in machinery and mechanical equipment. The ECM process provides its adequacy to cut hard materials with different shapes, and its applications are widely increased, due to its outstanding advantages. In this paper, a new method for machining a convex strips structure on a cylinder by using site directed power interruption（SDPI） in the ECM process is presented. A variable correction value of the power-off time was defined and optimized to obtain the ideal interval for better machining accuracy and stability.The electric field distribution and the simulated convex profiles show that the stray current density can be reduced effectively by using the proposed method. The correction value has an important influence on the machining accuracy. A suitable correction value in the range of 0.6–1.2 s can effectively improve the machining accuracy of the convex strips structure. Experiments were also conducted to verify the proposed method. Results have confirmed that the stray corrosion on the convex strips surface is significantly reduced and the machining accuracy of convex strips structure is remarkably improved by using the proposed method with a suitable correction value in the ECM process. Finally, a convex strip with a height of 2 mm on a thin-wall revolving part was also produced successfully using a correction value of 0.9.
基金Project supported by the National High Tech Research and Development Program of China (Grant No. 511-0910-1031)
文摘Considering the effects that the probability of traffic interruption and the friction between two lanes have on the car-following behaviour, this paper establishes a new two-lane microscopic car-following model. Based on this microscopic model, a new macroscopic model was deduced by the relevance relation of microscopic and macroscopic scale parameters for the two-lane traffic flow. Terms related to lane change are added into the continuity equations and velocity dynamic equations to investigate the lane change rate. Numerical results verify that the proposed model can be efficiently used to reflect the effect of the probability of traffic interruption on the shock, rarefaction wave and lane change behaviour on two-lane freeways. The model has also been applied in reproducing some complex traffic phenomena caused by traffic accident interruption.
文摘The power system infrastructure, operations and market have gone through radical changes for the last couple of decades. The society has become more dependent to the continuous electric power supply and hence the concept of electric power reliability has become more significant. At this point, understanding the economic outcomes of power outages is vital and imperative for both utilities and the customers. There are certain methodologies to understand the costs of power interruptions. This paper suggests a novel hybrid method that comprises of customer surveys and direct analytical methods to reach customer specific, objective and reliable results for the industry sector customers. The paper also brings a statistical approach to censor the zero and extreme responses given via the surveys.
基金Supported by The Innovative Talent Support Program of The Institution of Higher Learning in Liaoning Province,No.2018-478The Innovative Talents of Science and Technology Support Program of Young and Middle People of Shenyang,No.RC170446.
文摘Pituitary stalk interruption syndrome(PSIS)is a rare congenital abnormality characterized by thinning or disappearance of the pituitary stalk,hypoplasia of the anterior pituitary and an ectopic posterior pituitary.Although the etiology of PSIS is still unclear,gene changes and perinatal adverse events such as breech delivery may play important roles in the pathogenesis of PSIS.PSIS can cause multiple hormone deficiencies,such as growth hormone,which then cause a series of changes in the human body.On the one hand,hormone changes affect growth and development,and on the other hand,they could affect human metabolism and subsequently the liver resulting in nonalcoholic fatty liver disease(NAFLD).Under the synergistic effect of multiple mechanisms,the progression of NAFLD caused by PSIS is faster than that due to other causes.Therefore,in addition to early identification of PSIS,timely hormone replacement therapy and monitoring of relevant hormone levels,clinicians should routinely assess the liver function while managing PSIS.
基金This work was supported in part by the National Key Research and Development Program of China(2018YFA0702200)the National Natural Science Foundation of China(61933005,61833008)+6 种基金the Natural Science Foundation of Jiangsu Province of China(BK20220395)the Leading Technology Foundation Research Project of Jiangsu Province(BK20202011)the Natural Science Foundation of Jiangsu Universities(22KJB470024)Jiangsu Provincial Key Research and Development Program(BE2020001)Natural Science Foundation of Hebei Province of China(E2020203139)Natural Science Foundation of Nanjing University of Posts and Telecommunications(NY222032)the National Research Foundation of Korea(2020R1A2B5B02002002).
文摘Nowadays,the microgrid cluster is an important application scenario for energy trading.In trading,one of the most important research directions is the issue of pricing.To determine reasonable pricing for the microgrid cluster,data communication is used to create the cyber-physical system(CPS),which can improve the observability of microgrids.Then,the following works are carried out in the CPS.In the physical layer:1)Regarding trading between microgrids and the load,based on the generalized game theory,an optimal pricing strategy is proposed,which takes into account the interactive relationships among microgrids and transforms the pricing problem into a Nikaido-Isoda function to obtain the optimal prices conveniently;2)Regarding peer-to-peer trading between two microgrids,based on evolutionary game theory and the penalty mechanism,the optimal sale price of the seller is selected with boundary rationality.In the cyber layer,regarding the communication interruption issue existing in pricing(i.e.,the game process),based on the principle of matching the performance of the path with the importance degree of the data,a dynamic regulating method of paths is proposed,i.e.,adopting a new path to re-transmit the interrupted data to the destination.Finally,the effect of the proposed strategies is verified by case studies.
文摘Background: This study assessed treatment interruption of tuberculosis (TB) patients managed by treatment supporters and health care workers and other predictors of treatment interruption. Methods: A descriptive cross-sectional study was conducted. Four hundred and seventy new smear positive TB patients above 14 years of age were consecutively recruited between October 1 and December 31 2012 from 34 (23 public and 11 private) directly observed treatment short course (DOTS) facilities that offered TB treatment and microscopy services. They were followed up till treatment was completed. Logistic regression was used to assess the predictors of treatment interruption. Results: A significantly higher proportion of smokers (58.6% vs 38.3%, p = 0.030), patients supervised by treatment supporters (44.4% vs 34.7%, p = 0.032), patients not counselled before initiation of treatment (55.6% vs 38.2%, p = 0.041), patients managed at private DOTS facilities (50% vs 36.3%, p = 0.010) and TB/HIV co-infected patients (54.2% vs 38.6%, p = 0.038) had treatment interruption. Predictors of treatment interruption were supervision by treatment supporters, smoking, lack of pre-treatment counselling and TB/HIV co-infection. Conclusion: A higher proportion of patients supervised by treatment supporters had treatment interruption than those supervised by health care workers. There may be a need to review the concept of treatment supervision by treatment supporters in Lagos state Nigeria.
