Knowledge of the dynamic modulus of bituminous mixtures is practical and theoretically meaningful in pavement design,construction,and monitoring.The tests in the laboratory for the determination of asphalt concrete(AC...Knowledge of the dynamic modulus of bituminous mixtures is practical and theoretically meaningful in pavement design,construction,and monitoring.The tests in the laboratory for the determination of asphalt concrete(AC)moduli include the resilient modulus through the indirect tensile test(EN 12697-26),the complex modulus through the four point bending beam(EN 12697-26),the asphalt mixture performance tester(AMPT)and the simple performance tester(SPT)(AASHTO T342).Unfortunately,the tests above are time-consuming and quite expensive.On the other hand,the standard ASTM E1876 for resonant tests applies only to very thin(stocky)cylindrical samples(with a thickness-to-radius ratio,t/r,lower than 0.5)while the typical AC samples produced in the laboratory do not satisfy the ASTM E1876 requirements.Consequently,the main objective of this study is to set up and implement a tentative method to extend the range of applicability of the standard ASTM E1876 to common AC samples.The methodology was to carry out resonant tests on slender samples and to cut each of them into stocky samples(these latter complying with ASTM E1876 requirements in terms of t/r),deriving the master curve per material.These master curves allowed for deriving the value of the dynamic modulus for the given selected sample under its particular test conditions during the resonant test(i.e.,temperature and frequency).Consequently,simplified formulae were provided for AC samples.Results were compared to Witczak's estimates.These formulae provide an approximate tool to carry out low-cost and high-speed inferences at the laboratory stage on common AC samples,whatever their thickness is.Additional studies are needed to investigate the reliability of the method further and reduce uncertainties.展开更多
Joining dissimilar materials encounters significant engineering challenges due to the contrast in material properties that makes conventional welding not feasible.Magnetic Pulse Welding(MPW)offers a solidstate joining...Joining dissimilar materials encounters significant engineering challenges due to the contrast in material properties that makes conventional welding not feasible.Magnetic Pulse Welding(MPW)offers a solidstate joining technique that overcomes these issues by using impact to create strong bonds without melting the substrate materials.This study investigates the weldability of aluminum alloy Al-5754 with Al-7075 and MARS 380 steel,used in armouring solutions of defense systems,by the use of MPW.In this work,weldability windows are investigated by varying standoff distances between the coating material and its substrate(0.25-4.5 mm)and discharge energies(5-13 kJ)with both O-shape and U-shape inductors.Mechanical strength of the welded joints were assessed through single lap shear tests,identifying optimal welding parameters.Then,the velocity profiles of the flyer plates were measured using heterodyne velocimetry to understand the dynamics of the impact.Then,substructures assembled with the optimal welding conditions were subjected to ballistic testing using 7.62 mm×51 mm NATO and 9 mm×19 mm Parabellum munitions to evaluate the resilience of the welds under ballistic impact.The outcomes demonstrate that MPW effectively joins Al-5754 with both Al-7075 and MARS 380,producing robust welds capable of withstanding ballistic impacts under certain conditions.This research advances the application of MPW in lightweight ballistic protection of defense systems,contributing to the development of more resilient and lighter protective structures.展开更多
Abstract High altitude test facilities are required to test the high area ratio nozzles operating at the upper stages of rocket in the nozzle full flow conditions. It is typically achieved by creating the ambient pres...Abstract High altitude test facilities are required to test the high area ratio nozzles operating at the upper stages of rocket in the nozzle full flow conditions. It is typically achieved by creating the ambient pressure equal or less than the nozzle exit pressure. On average, air/GN2 is used as active gas for ejector system that is stored in the high pressure cylinders. The wind tunnel facilities are used for conducting aerodynamic simulation experiments at/under various flow velocities and operating conditions. However, constructing both of these facilities require more laboratory space and expensive instruments. Because of this demerit, a novel scheme is implemented for conducting wind tunnel experiments by using the existing infrastructure available in the high altitude testing （HAT） facility. This article presents the details about the methods implemented for suitably modifying the sub-scale HAT facility to conduct wind tunnel experiments. Hence, the design of nozzle for required area ratio A/A＊, realization of test section and the optimized configuration are focused in the present analysis. Specific insights into various rocket models including high thrust cryogenic engines and their holding mechanisms to conduct wind tunnel experiments in the HAT facility are analyzed. A detailed CFD analysis is done to propose this conversion without affecting the existing functional requirements of the HAT facility.展开更多
Background: Syncope is a relevant health problem in military environments. Reliable diagnosis is challenging. Tilt table testing is an important tool for syncope diagnosis. The aim of this study was to determine wheth...Background: Syncope is a relevant health problem in military environments. Reliable diagnosis is challenging. Tilt table testing is an important tool for syncope diagnosis. The aim of this study was to determine whether signs such as prodromal symptoms, co-morbidity, frequency of syncopal events, body length, body mass index, and electrocardiography(ECG) abnormalities can be used to predict the success of tilt table testing at diagnosing syncope.Methods: Data from 100 patients with histories of syncope or pre-syncope, who were diagnosed using head-up tilt table testing, were retrospectively analyzed in a cross-sectional analysis. The diagnostic procedure was based upon a modified version of the Westminster protocol without any pharmacological provocation. Results: Patients showing pathological reaction patterns during tilt table testing suffered from prodromal symptoms, such as dizziness and sweating, significantly more often. The patients reported more injuries resulting from syncopal events and more previous syncopal events, and the prevalence of co-morbidity was greater among patients presenting negative findings during tilt testing. An asthenic-leptosomal physique was not confirmed as a risk factor for syncopal events as is the case for idiopathic arterial hypotension. However, patients with pathological reaction patterns during tilt table testing were significantly taller. This finding was detected for both females and males. No significant predictors were found in the ECG patterns of patients showing syncope during tilt table testing.Conclusions: Frequency of prior syncope and prodromal symptoms, and increased body length with an otherwise good state of health influence the predictive value of tilt table testing for syncope diagnosis. In particular, if these factors are present, tilt table testing should be considered part of the diagnostic algorithm for soldiers with recurrent syncope.展开更多
To identify a cost-efficient altemative antibody testing strategy for screening and confirmation of HIV infection by rapid simple tests （RSTs） and enzyme-linked immunosorbent assays （ELISAs）. Methods Four RSTs （R...To identify a cost-efficient altemative antibody testing strategy for screening and confirmation of HIV infection by rapid simple tests （RSTs） and enzyme-linked immunosorbent assays （ELISAs）. Methods Four RSTs （RST1, RST2, RST3, and RST4 ） and five ELISAs （ELISA1, ELISA2, ELISA3, ELISA4, and ELISA5） were evaluated in two phases by using banked and serum specimens prospectively collected at regional hospitals and voluntary counseling and testing （VCT） centers in Beijing. A total of 200 banked serum specimens were included in the first phase, including 62 HIV-positive, 127 HIV-negative and 11 indeterminate specimens. All specimens were tested by four RSTs and five ELISAs respectively. The second phase involved prospective testing of 389 routine specimens, including 92 HIV-positive, 287 HIV-negative, and 10 indeterminate specimens. All the specimens were tested by two RSTs （RST2 and RST4） and three ELISAs （ELISA1, ELISA3, and ELISA4）, which were selected for their respective excellent sensitivity and/or specificity. Westem blot （WB） was used as a gold standard for confirming the reactivity of all the specimens. Results Sensitivity, specificity, and efficacy were calculated for each assay in two phases. In the first phase, four assays （ELISA4, RST2, RST3, and RST4） had a specificity of 100%. For the determination of efficacy, ELISA4, RST2, and RST4 were selected in the second phase. ELISA1 and ELISA3 which have a sensitivity of 95.9% and 93.2% respectively also entered this phase. In the second phase, all the five assays （ELISA1, ELISA3, ELISA4, RST2, and RST4） had a sensitivity and specifity of over 90%. ELISA1 had a sensitivity of 99% and ELISA4 a specificity of 99%. Conclusion The sensitivity ELISA1 and the specificit of ELISA4 are comparable to ELISA/WB standard strategy. Application of this alternative testing strategy provides a cost-effective method for determining HIV prevalence in Beijing.展开更多
AIM:To identify key variables associated with colon cancer testing using the 2009 California Health Inventory Survey(CHIS).METHODS:The CHIS has been conducted biennially since 2001 using a two-stage,geographically str...AIM:To identify key variables associated with colon cancer testing using the 2009 California Health Inventory Survey(CHIS).METHODS:The CHIS has been conducted biennially since 2001 using a two-stage,geographically stratified random-digit-dial sample design to produce a representative sample of the entire State.For this study we used survey data from 2001-2009 inclusive.We restricted our analysis to White,Black,and Hispanic/Latinos aged 50-80 years.Weighted data was used to calculate the proportion of participants who underwent some form of colon cancer testing(colonoscopy,flexible sigmoidoscopy or fecal occult blood testing) within the previous 5 years stratified by race/ethnicity.For inferential analysis,boot-strapping with replacement was performed on the weighted sample to attain variance estimates at the 95%CI.For mean differences among categories we used t-tests and for comparisons of categorical data we used Pearson's χ 2.Binary logistic regression was used to identify independent variables associated with undergoing some form of testing.Trend analysis was performed to determine rates of testing over the study period stratified by race.RESULTS:The CHIS database for 2009 had 30 857 unique respondents corresponding to a weighted sample size of 10.6 million Californians.Overall,63.0%(63.0-63.1) underwent a colon cancer test within the previous 5 years;with 70.5%(70.5%-70.6%) of this subset having undergone colonoscopy.That is 44.5%(44.4%-44.5%) of all individuals 50-80 underwent colonoscopy.By multivariable regression,those tested were more likely to be male(OR = 1.06;95%CI:1.06-1.06),Black(OR = 1.30;95%CI:1.30-1.31),have a family member with colon cancer(OR = 1.71;95%CI:1.70-1.72),and have health insurance(OR = 2.71;95%CI:2.70-2.72).Progressive levels above the poverty line were also associated with receiving a test(100%-199%:1.21;1.20-1.21),(200%-299%:1.41;1.40-1.42),(> 300:1.69;1.68-1.70).The strongest variable was physician recommendation(OR = 3.90;95%CI:3.88-3.91).For the Hispanic/Latino group,additional variables associated with testing were success of physician-patient communication(OR = 2.44;95%CI:2.40-2.48) and naturalized citizenship status(OR = 1.91;95%CI:1.89-1.93).Trend analysis demonstrated increased colon cancer testing for all racial/ethnic subgroups from 2001-2009 although the rate remained considerably lower for the Hispanic/Latino subgroup.CONCLUSION:Using CHIS we identified California citizens most likely to undergo colon cancer testing.The strongest variable associated with testing for all groups was physician recommendation.展开更多
Background:Syncope is a relevant health problem in military environments.Reliable diagnosis is challenging.Tilt table testing is an important tool for syncope diagnosis.The aim of this study was to determine whether s...Background:Syncope is a relevant health problem in military environments.Reliable diagnosis is challenging.Tilt table testing is an important tool for syncope diagnosis.The aim of this study was to determine whether signs such as prodromal symptoms,co-morbidity,frequency of syncopal events,body length,body mass index,and electrocardiography abnormalities can be used to predict the success of tilt table testing at diagnosing syncope.Methods:Data from 100 patients with histories of syncope or pre-syncope,who were diagnosed using head-up tilt table testing,were retrospectively analyzed in a cross-sectional analysis.The diagnostic procedure was based upon a modified version of the Westminster protocol without any pharmacological provocation.Results:Patients showing pathological reaction patterns during tilt table testing suffered from prodromal symptoms,such as dizziness and sweating,significantly more often.The patients reported more injuries resulting from syncopal events and more previous syncopal events,and the prevalence of co-morbidity was greater among patients presenting negative findings during tilt testing.An asthenic-leptosomal physique was not confirmed as a risk factor for syncopal events as is the case for idiopathic arterial hypotension.However,patients with pathological reaction patterns during tilt table testing were significantly taller.This finding was detected for both females and males.No significant predictors were found in the electrocardiogram patterns of patients showing syncope during tilt table testing.Conclusions:Frequency of prior syncope and prodromal symptoms,and increased body length with an otherwise good state of health influence the predictive value of tilt table testing for syncope diagnosis.In particular,if these factors are present,tilt table testing should be considered part of the diagnostic algorithm for soldiers with recurrent syncope.展开更多
<strong>Introduction:</strong> Viral hepatitis is a major public health challenge that requires an urgent response. Reducing mortality requires major scale-up in prevention, testing and treatment access;co...<strong>Introduction:</strong> Viral hepatitis is a major public health challenge that requires an urgent response. Reducing mortality requires major scale-up in prevention, testing and treatment access;coverage in HBV vaccination, testing and treatment is low and must accelerate massively to achieve the 2030 targets. Less than 1% of HBV-infected individuals are diagnosed in Sub-Sahara Africa, despite the availability of rapid tests with good diagnostic accuracy. <strong>Materials and Methods:</strong> This was retrospective cross sectional study conducted in Federal Teaching Hospital Gombe, in North East Nigeria. All children and adults who presented to the out-patient departments, and those that were admitted irrespective of their HIV and or Hepatitis C virus status and had Hepatitis B and/or Hepatitis B envelope antigen test were conducted between 2000 to 2015. All children and adults were tested using the Hospital standard for Hepatitis B surface antigen test strip. <strong>Results:</strong> Between 2000 and 2014, 739,456 children and adults were admitted and reviewed in the outpatient units of the Federal Teaching Hospital Gombe;there were 685,552 adults and 53,904 children. Children constituted 7.3% (53,904/739,456) of admissions and outpatient consultations. 2.8% (210/7570), 3.3% (773/23,783), 3.6% (1145/32,142), 5.2% (1694/33,043), 3.3% (986/29,216), 1.9% (661/3321), 0.1% (53/41,626), 0.2% (113/46,634), 2.6% (1418/54,423), 5.4% (3717/69,696), 3.7% (2332/62,086), 3.5% (3241/90,623), 3.2% (2881/89,398), 3.8% (2428/62,687), 2.8% (1835/63,208) of children and adults were tested for HBsAg in 2000, 2001, 20002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013 and 2014 respectively. 23,487 children and adults were tested for HBsAg with a cumulative testing rate of 3%. Overall 4465/23,487 children and adults were seropositive for HBsAg giving a cumulative prevalence of 19%. <strong>Conclusion:</strong> HBV screening in our health facility is very low. Massive scale up in awareness and HBV vaccination are required. Provider initiated testing and counseling for HBV in health facilities needs support for implementation in Health Facilities in Sub Saharan Africa.展开更多
The aim of this study was to find a simple and effective way to screen patients for Covid 19, prior to them being submitted to neurophysiological or neuro-psycholoigical testing in order to protect employees from bein...The aim of this study was to find a simple and effective way to screen patients for Covid 19, prior to them being submitted to neurophysiological or neuro-psycholoigical testing in order to protect employees from being infected during the pandemic from patient contact. On May 18, 2020 when Michigan, a critically affected pandemic area, reopened for medical business after lockdown declared by the Governor on March 23, 2020, medical personnel in our office-which is an academic neurology practice-EEG and sleep technicians, medical Assistants, physician assistants and myself fretted about potential Covid 19 transmission during neuro-diagnostic procedures-EEG, video-EEG, ambulatory EEG, PSG, MSLT, CPAP titration, neuropsychological testing, EMG/NCV, VNG/Balance test and autonomic testing including the tilt table test, which require an intimate patient contact and risk of exposure. We screened all unselected and consecutive patients who were scheduled for neuro-diagnostic testing in our facility by infrared thermometer, a standard Covid 19 questionnaire and a single Covid 19 PCR nasal/throat swab prior to these tests. 542 consecutive unselected neurological or sleep/wake disorder patients aged 18 - 90, 65% males, 35% females were tested over six months as a part of this project. A total of 1109 diagnostic tests were performed. No test was limited in scope or duration. Standard PPE precautions were still taken despite the negative screening, room door left open and relatives’ presence limited during the test procedure. All were afebrile and negative on questionnaire and only 3 were found to be positive for Covid 19 PCR, indicating that a negative infrared temperature reading and a standard Covid 19 questionnaire is over 99 percent effective in prescreening for intimate neurological diagnostic testing. The technician, administering most of these tests, never contracted the virus. The technician collecting the nasal/throat swab never contracted the virus. One PA, two sleep technicians and one medical assistant came down with Covid 19 but were all felt to have contracted that from domestic exposure from family members or friends and not when at the job. All had mild disease and rapidly recovered. Infrared temperature testing and standard Covid 19 questionnaire are sufficient prior to intimate neuro-diagnostic testing when combined with standard PPE precautions to limit exposure to Covid 19 in medical personnel in a neurology office with on-site diagnostic testing.展开更多
Objectives: The study compared cardiac scintigraphy stress scanning practices applied in a National Maltese Nuclear Medicine centre and in international centres. This was achieved through the design of an online surve...Objectives: The study compared cardiac scintigraphy stress scanning practices applied in a National Maltese Nuclear Medicine centre and in international centres. This was achieved through the design of an online survey which investigated participant knowledge of stress testing, and current procedural practice. Methods: An online survey comprising 12 questions was prepared using Survey Monkey. Professional Nuclear Medicine groups such as the Medical-Physics-Engineering community and Virtual Radiopharmacy were targeted. Access to the survey remained open for eight months during which a periodic reminder was sent to optimise the response rate. Forty-three members responded from across Europe and Australasia. Chi-square tests and comparisons between multiple responses using IBM SPSS 20 were used to evaluate the results. Information related to Maltese practice was collated separately for review and comparative purposes. Results: The online survey participants comprised United Kingdom [72%], other European countries [18%] and Australasia [9%]. The majority of respondents [n = 39] reported pharmacological stress testing as being performed either alone or in conjunction with exercise stress testing as the preferred option. Most participants [60%] were aware of local stress test protocols but had limited knowledge in relation to guidelines designed for cases where patients were not suitable for pharmacological stress testing. Conclusion: The survey provided information about procedures within participating centres for scintigraphic cardiac stress scanning. Differences were identified with regards to the preferred radiopharmaceutical tracers and procedural protocols. Further investigation of examination techniques is warranted, with the aim of increasing standardisation of protocol compliance and the application of more suitable practice.展开更多
BACKGROUND Several genetic testing techniques have been recommended as a first-tier diagnostic tool in clinical practice for diagnosing autism spectrum disorder(ASD).However,the actual usage rate varies dramatically.T...BACKGROUND Several genetic testing techniques have been recommended as a first-tier diagnostic tool in clinical practice for diagnosing autism spectrum disorder(ASD).However,the actual usage rate varies dramatically.This is due to various reasons,including knowledge and attitudes of caregivers,patients,and health providers toward genetic testing.Several studies have therefore been conducted worldwide to investigate the knowledge,experiences,and attitudes toward genetic testing among caregivers of children with ASD,adolescent and adult ASD patients,and health providers who provide medical services for them.However,no systematic review has been done.AIM To systematically review research on knowledge,experiences,and attitudes towards genetic testing among caregivers of children with ASD,adolescent and adult ASD patients,and health providers.METHODS We followed the Preferred Reporting Items for Systematic Reviews and Metaanalyses guidelines and searched the literature in three English language databases(PubMed,Web of Science,and PsychInfo)and two Chinese databases(CNKI and Wanfang).Searched literature was screened independently by two reviewers and discussed when inconsistency existed.Information on characteristics of the study,characteristics of participants,and main findings regarding knowledge,experience,and attitudes of caregivers of children with ASD,adolescent and adult ASD patients,and health providers concerning ASD genetic testing were extracted from included papers into a charting form for analysis.RESULTS We included 30 studies published between 2012 and 2022 and conducted in 9 countries.Most of the studies(n=29)investigated caregivers of children with ASD,one study also included adolescent and adult patients,and two covered health providers.Most(51.0%-100%)of the caregivers/patients knew there was a genetic cause for ASD and 17.0%to 78.1%were aware of ASD genetic testing.However,they lacked full understanding of genetic testing.They acquired relevant and necessary information from physicians,the internet,ASD organizations,and other caregivers.Between 9.1%to 72.7%of caregivers in different studies were referred for genetic testing,and between 17.4%to 61.7%actually obtained genetic testing.Most caregivers agreed there are potential benefits following genetic testing,including benefits for children,families,and others.However,two studies compared perceived pre-test and post-test benefits with conflicting findings.Caregivers concerns included high costs,unhelpful results,negative influences(e.g.,causing family conflicts,causing stress/risk/pain to children etc.)prevented some caregivers from using genetic testing.Nevertheless,46.7%to 95.0%caregivers without previous genetic testing experience intended to obtain it in the future,and 50.5%to 59.6%of parents previously obtaining genetic testing would recommend it to other parents.In a single study of child and adolescent psychiatrists,54.9%of respondents had ordered ASD genetic testing for their patients in the prior 12 mo,which was associated with greater knowledge of genetic testing.CONCLUSION Most caregivers are willing to learn about and use genetic testing.However,the review showed their current knowledge is limited and usage rates varied widely in different studies.展开更多
Background: Zimbabwe recorded a 55% increase in HIV testing from 2011 to 2018 but with decreasing HIV-testing yields from 20% to 6% respectively as we aim to identify the narrowing gap of undiagnosed people living wit...Background: Zimbabwe recorded a 55% increase in HIV testing from 2011 to 2018 but with decreasing HIV-testing yields from 20% to 6% respectively as we aim to identify the narrowing gap of undiagnosed people living with HIV. As such adoption of screening tools during targeted HIV testing services improves efficiency by identifying individuals who are likely to test positive. Effective utilization of screening tools requires an understanding of health care worker perception and willingness to use the tools. Methods: We conducted a qualitative study among healthcare workers at 8 selected primary healthcare facilities in Zimbabwe. Interviewer-guided, in-depth interviews were conducted with healthcare workers and their immediate supervisors. Thematic analysis was performed following a framework built around the grounded theory model to describe perspectives that influence the utilization of HIV screening tools and suggestions for improved eligibility screening. Results: Behavioural factors facilitating the utilisation of the screening tool included motivation to adhere to standard practice, awareness of screening in targeting testing, and its ability to manage workload through screening out ineligible clients. This was evident across service delivery levels. Barriers included limited healthcare capacity, confidentiality space, multiple screening tools and opaque screening in/out criteria and the potential of clients not responding to screening questions truthfully. Conclusions: Across geographical and service delivery levels, placing screening tools at HIV testing entry points, healthcare worker knowledge on screening in/out criteria emerged as enablers for correct and consistent utilization. Further, standardizing the tools and adopting a decision aid algorithm would improve the accurate utilisation of screening tools.展开更多
Ammonium oxalate treatment, previously extensively studied on limestone in the laboratory, was applied to powdering historical stonework （limestone） situated on the shoreline in the Mediterranean Island of Malta. Th...Ammonium oxalate treatment, previously extensively studied on limestone in the laboratory, was applied to powdering historical stonework （limestone） situated on the shoreline in the Mediterranean Island of Malta. This paper presents the results obtained from onsite testing that aimed at evaluating the treatment in terms of its aesthetic performance, the depth of treatment, the mechanical properties of the consolidated stone and the influence on water transport. To this end, the testing program included colorimetry, DRMS （drilling resistance measurement system） and water absorption through the contact sponge method. This study is Part One of the final phase of a wider research program which included two previous phases progressing from treating this same very porous stone type in a laboratory-based controlled environment to uncontrolled site conditions, seeking to quantify this treatment＇s effectiveness in the field. Results showed that onsite consolidation was achieved and that although some changes in colour and water absorption were brought about by the treatment, these were within acceptable tolerance limits. Besides carrying out these treatments and evaluations directly on the coast, this study anticipates further studies which will look at rural and urban sites where the types and concentrations of salts are expected to be different.展开更多
Objectives This study aims to assess the impacts of hypertension on health-related quality of life (HRQOL), as well as cardiovascular functional status (CVFS). Methods An instrument was presented based on WHOQOL-BREF ...Objectives This study aims to assess the impacts of hypertension on health-related quality of life (HRQOL), as well as cardiovascular functional status (CVFS). Methods An instrument was presented based on WHOQOL-BREF and SP-16 questionnaire and exercise testing. 57 normotensive and 76 hypertensive subjects aged 35-65 year-old participated the health survey using this instrument. Based on the exercise testing results of the two groups, a discriminate function was established and used to investigate cardiovascular risk factors for hypertensive population. Results The results showed that persons with hypertension rated significantly lower scores on physical health (i.e. limitation in performing daily activities and problems with work or mobility) than did normotensives (P < 0.01). The discriminant score obtained from the exercise testing results was capable of reflecting the impacts of hypertension on CVFS. Conclusions The method presented in this paper provides a more powerful tool to estimate the effects of health interventions and medical therapy for hypertensive population than just self-rated HRQOL questionnaire.展开更多
Advances in the identification of molecular biomarkers and the development of targeted therapies have enhanced the prognosis of patients with advanced gastric cancer.Several established biomarkers have been widely int...Advances in the identification of molecular biomarkers and the development of targeted therapies have enhanced the prognosis of patients with advanced gastric cancer.Several established biomarkers have been widely integrated into routine clinical diagnostics of gastric cancer to guide personalized treatment.Human epidermal growth factor receptor 2(HER2)was the first molecular biomarker to be used in gastric cancer with trastuzumab being the first approved targeted therapy for HER2-positive gastric cancer.Programmed death-ligand 1 positivity and microsatellite instability can guide the use of immunotherapies,such as pembrolizumab and nivolumab.More recently,zolbetuximab has been approved for patients with claudin 18.2-positive diseases in some countries.More targeted therapies,including savolitinib for MET-positive patients,are currently under clinical investigation.However,the clinical application of these diagnostic approaches could be hampered by many existing challenges,including invasive and costly sampling methods,variability in immunohistochemistry interpretation,high costs and long turnaround times for next-generation sequencing,the absence of standardized and clinically validated diagnostic cut-off values for some biomarkers,and tumor heterogeneity.Novel testing and analysis techniques,such as artificial intelligence-assisted image analysis and multiplex immunohistochemistry,and emerging therapeutic strategies,including combination therapies that integrate immune checkpoint inhibitors with targeted therapies,offer potential solutions to some of these challenges.This article reviews recent progress in gastric cancer testing,outlines current challenges,and explores future directions for biomarker testing and targeted therapy for gastric cancer.展开更多
The rapid progress in the construction of heavy-haul and high-speed railways has led to a surge in rail defects and unforeseen failures.Addressing this issue necessitates the implementation of more sophisticated rail ...The rapid progress in the construction of heavy-haul and high-speed railways has led to a surge in rail defects and unforeseen failures.Addressing this issue necessitates the implementation of more sophisticated rail inspection methods,specifically involving real-time,precise detection,and assessment of rail defects.Current applications fail to address the evolving requirements,prompting the need for advancements.This paper provides a summary of various types of rail defects and outlines both traditional and innovative non-destructive inspection techniques,examining their fundamental features,benefits,drawbacks,and practical suitability for railway track inspection.It also explores potential enhancements to equipment and software.The comprehensive review draws upon pertinent international research and review papers.Furthermore,the paper introduces a fusion of inspection methods aimed at enhancing the overall reliability of defect detection.展开更多
文摘Knowledge of the dynamic modulus of bituminous mixtures is practical and theoretically meaningful in pavement design,construction,and monitoring.The tests in the laboratory for the determination of asphalt concrete(AC)moduli include the resilient modulus through the indirect tensile test(EN 12697-26),the complex modulus through the four point bending beam(EN 12697-26),the asphalt mixture performance tester(AMPT)and the simple performance tester(SPT)(AASHTO T342).Unfortunately,the tests above are time-consuming and quite expensive.On the other hand,the standard ASTM E1876 for resonant tests applies only to very thin(stocky)cylindrical samples(with a thickness-to-radius ratio,t/r,lower than 0.5)while the typical AC samples produced in the laboratory do not satisfy the ASTM E1876 requirements.Consequently,the main objective of this study is to set up and implement a tentative method to extend the range of applicability of the standard ASTM E1876 to common AC samples.The methodology was to carry out resonant tests on slender samples and to cut each of them into stocky samples(these latter complying with ASTM E1876 requirements in terms of t/r),deriving the master curve per material.These master curves allowed for deriving the value of the dynamic modulus for the given selected sample under its particular test conditions during the resonant test(i.e.,temperature and frequency).Consequently,simplified formulae were provided for AC samples.Results were compared to Witczak's estimates.These formulae provide an approximate tool to carry out low-cost and high-speed inferences at the laboratory stage on common AC samples,whatever their thickness is.Additional studies are needed to investigate the reliability of the method further and reduce uncertainties.
基金funded on the one hand by Agence de l'Innovation de Défense(AID)grant reference number 2021650044on the other hand by Ecole Centrale de Nantes。
文摘Joining dissimilar materials encounters significant engineering challenges due to the contrast in material properties that makes conventional welding not feasible.Magnetic Pulse Welding(MPW)offers a solidstate joining technique that overcomes these issues by using impact to create strong bonds without melting the substrate materials.This study investigates the weldability of aluminum alloy Al-5754 with Al-7075 and MARS 380 steel,used in armouring solutions of defense systems,by the use of MPW.In this work,weldability windows are investigated by varying standoff distances between the coating material and its substrate(0.25-4.5 mm)and discharge energies(5-13 kJ)with both O-shape and U-shape inductors.Mechanical strength of the welded joints were assessed through single lap shear tests,identifying optimal welding parameters.Then,the velocity profiles of the flyer plates were measured using heterodyne velocimetry to understand the dynamics of the impact.Then,substructures assembled with the optimal welding conditions were subjected to ballistic testing using 7.62 mm×51 mm NATO and 9 mm×19 mm Parabellum munitions to evaluate the resilience of the welds under ballistic impact.The outcomes demonstrate that MPW effectively joins Al-5754 with both Al-7075 and MARS 380,producing robust welds capable of withstanding ballistic impacts under certain conditions.This research advances the application of MPW in lightweight ballistic protection of defense systems,contributing to the development of more resilient and lighter protective structures.
文摘Abstract High altitude test facilities are required to test the high area ratio nozzles operating at the upper stages of rocket in the nozzle full flow conditions. It is typically achieved by creating the ambient pressure equal or less than the nozzle exit pressure. On average, air/GN2 is used as active gas for ejector system that is stored in the high pressure cylinders. The wind tunnel facilities are used for conducting aerodynamic simulation experiments at/under various flow velocities and operating conditions. However, constructing both of these facilities require more laboratory space and expensive instruments. Because of this demerit, a novel scheme is implemented for conducting wind tunnel experiments by using the existing infrastructure available in the high altitude testing （HAT） facility. This article presents the details about the methods implemented for suitably modifying the sub-scale HAT facility to conduct wind tunnel experiments. Hence, the design of nozzle for required area ratio A/A＊, realization of test section and the optimized configuration are focused in the present analysis. Specific insights into various rocket models including high thrust cryogenic engines and their holding mechanisms to conduct wind tunnel experiments in the HAT facility are analyzed. A detailed CFD analysis is done to propose this conversion without affecting the existing functional requirements of the HAT facility.
文摘Background: Syncope is a relevant health problem in military environments. Reliable diagnosis is challenging. Tilt table testing is an important tool for syncope diagnosis. The aim of this study was to determine whether signs such as prodromal symptoms, co-morbidity, frequency of syncopal events, body length, body mass index, and electrocardiography(ECG) abnormalities can be used to predict the success of tilt table testing at diagnosing syncope.Methods: Data from 100 patients with histories of syncope or pre-syncope, who were diagnosed using head-up tilt table testing, were retrospectively analyzed in a cross-sectional analysis. The diagnostic procedure was based upon a modified version of the Westminster protocol without any pharmacological provocation. Results: Patients showing pathological reaction patterns during tilt table testing suffered from prodromal symptoms, such as dizziness and sweating, significantly more often. The patients reported more injuries resulting from syncopal events and more previous syncopal events, and the prevalence of co-morbidity was greater among patients presenting negative findings during tilt testing. An asthenic-leptosomal physique was not confirmed as a risk factor for syncopal events as is the case for idiopathic arterial hypotension. However, patients with pathological reaction patterns during tilt table testing were significantly taller. This finding was detected for both females and males. No significant predictors were found in the ECG patterns of patients showing syncope during tilt table testing.Conclusions: Frequency of prior syncope and prodromal symptoms, and increased body length with an otherwise good state of health influence the predictive value of tilt table testing for syncope diagnosis. In particular, if these factors are present, tilt table testing should be considered part of the diagnostic algorithm for soldiers with recurrent syncope.
基金As part of the AIDS Prevention Applied Research and Program of the Ministry of Health (WA2003-17)the present study is supportedby the Department of Reference,National Center for AIDS Control and Prevention,Chinese Center for Disease Control and Prevention.
文摘To identify a cost-efficient altemative antibody testing strategy for screening and confirmation of HIV infection by rapid simple tests （RSTs） and enzyme-linked immunosorbent assays （ELISAs）. Methods Four RSTs （RST1, RST2, RST3, and RST4 ） and five ELISAs （ELISA1, ELISA2, ELISA3, ELISA4, and ELISA5） were evaluated in two phases by using banked and serum specimens prospectively collected at regional hospitals and voluntary counseling and testing （VCT） centers in Beijing. A total of 200 banked serum specimens were included in the first phase, including 62 HIV-positive, 127 HIV-negative and 11 indeterminate specimens. All specimens were tested by four RSTs and five ELISAs respectively. The second phase involved prospective testing of 389 routine specimens, including 92 HIV-positive, 287 HIV-negative, and 10 indeterminate specimens. All the specimens were tested by two RSTs （RST2 and RST4） and three ELISAs （ELISA1, ELISA3, and ELISA4）, which were selected for their respective excellent sensitivity and/or specificity. Westem blot （WB） was used as a gold standard for confirming the reactivity of all the specimens. Results Sensitivity, specificity, and efficacy were calculated for each assay in two phases. In the first phase, four assays （ELISA4, RST2, RST3, and RST4） had a specificity of 100%. For the determination of efficacy, ELISA4, RST2, and RST4 were selected in the second phase. ELISA1 and ELISA3 which have a sensitivity of 95.9% and 93.2% respectively also entered this phase. In the second phase, all the five assays （ELISA1, ELISA3, ELISA4, RST2, and RST4） had a sensitivity and specifity of over 90%. ELISA1 had a sensitivity of 99% and ELISA4 a specificity of 99%. Conclusion The sensitivity ELISA1 and the specificit of ELISA4 are comparable to ELISA/WB standard strategy. Application of this alternative testing strategy provides a cost-effective method for determining HIV prevalence in Beijing.
基金Supported by Grant K24 DK83268 awarded to Friedenberg F
文摘AIM:To identify key variables associated with colon cancer testing using the 2009 California Health Inventory Survey(CHIS).METHODS:The CHIS has been conducted biennially since 2001 using a two-stage,geographically stratified random-digit-dial sample design to produce a representative sample of the entire State.For this study we used survey data from 2001-2009 inclusive.We restricted our analysis to White,Black,and Hispanic/Latinos aged 50-80 years.Weighted data was used to calculate the proportion of participants who underwent some form of colon cancer testing(colonoscopy,flexible sigmoidoscopy or fecal occult blood testing) within the previous 5 years stratified by race/ethnicity.For inferential analysis,boot-strapping with replacement was performed on the weighted sample to attain variance estimates at the 95%CI.For mean differences among categories we used t-tests and for comparisons of categorical data we used Pearson's χ 2.Binary logistic regression was used to identify independent variables associated with undergoing some form of testing.Trend analysis was performed to determine rates of testing over the study period stratified by race.RESULTS:The CHIS database for 2009 had 30 857 unique respondents corresponding to a weighted sample size of 10.6 million Californians.Overall,63.0%(63.0-63.1) underwent a colon cancer test within the previous 5 years;with 70.5%(70.5%-70.6%) of this subset having undergone colonoscopy.That is 44.5%(44.4%-44.5%) of all individuals 50-80 underwent colonoscopy.By multivariable regression,those tested were more likely to be male(OR = 1.06;95%CI:1.06-1.06),Black(OR = 1.30;95%CI:1.30-1.31),have a family member with colon cancer(OR = 1.71;95%CI:1.70-1.72),and have health insurance(OR = 2.71;95%CI:2.70-2.72).Progressive levels above the poverty line were also associated with receiving a test(100%-199%:1.21;1.20-1.21),(200%-299%:1.41;1.40-1.42),(> 300:1.69;1.68-1.70).The strongest variable was physician recommendation(OR = 3.90;95%CI:3.88-3.91).For the Hispanic/Latino group,additional variables associated with testing were success of physician-patient communication(OR = 2.44;95%CI:2.40-2.48) and naturalized citizenship status(OR = 1.91;95%CI:1.89-1.93).Trend analysis demonstrated increased colon cancer testing for all racial/ethnic subgroups from 2001-2009 although the rate remained considerably lower for the Hispanic/Latino subgroup.CONCLUSION:Using CHIS we identified California citizens most likely to undergo colon cancer testing.The strongest variable associated with testing for all groups was physician recommendation.
文摘Background:Syncope is a relevant health problem in military environments.Reliable diagnosis is challenging.Tilt table testing is an important tool for syncope diagnosis.The aim of this study was to determine whether signs such as prodromal symptoms,co-morbidity,frequency of syncopal events,body length,body mass index,and electrocardiography abnormalities can be used to predict the success of tilt table testing at diagnosing syncope.Methods:Data from 100 patients with histories of syncope or pre-syncope,who were diagnosed using head-up tilt table testing,were retrospectively analyzed in a cross-sectional analysis.The diagnostic procedure was based upon a modified version of the Westminster protocol without any pharmacological provocation.Results:Patients showing pathological reaction patterns during tilt table testing suffered from prodromal symptoms,such as dizziness and sweating,significantly more often.The patients reported more injuries resulting from syncopal events and more previous syncopal events,and the prevalence of co-morbidity was greater among patients presenting negative findings during tilt testing.An asthenic-leptosomal physique was not confirmed as a risk factor for syncopal events as is the case for idiopathic arterial hypotension.However,patients with pathological reaction patterns during tilt table testing were significantly taller.This finding was detected for both females and males.No significant predictors were found in the electrocardiogram patterns of patients showing syncope during tilt table testing.Conclusions:Frequency of prior syncope and prodromal symptoms,and increased body length with an otherwise good state of health influence the predictive value of tilt table testing for syncope diagnosis.In particular,if these factors are present,tilt table testing should be considered part of the diagnostic algorithm for soldiers with recurrent syncope.
文摘<strong>Introduction:</strong> Viral hepatitis is a major public health challenge that requires an urgent response. Reducing mortality requires major scale-up in prevention, testing and treatment access;coverage in HBV vaccination, testing and treatment is low and must accelerate massively to achieve the 2030 targets. Less than 1% of HBV-infected individuals are diagnosed in Sub-Sahara Africa, despite the availability of rapid tests with good diagnostic accuracy. <strong>Materials and Methods:</strong> This was retrospective cross sectional study conducted in Federal Teaching Hospital Gombe, in North East Nigeria. All children and adults who presented to the out-patient departments, and those that were admitted irrespective of their HIV and or Hepatitis C virus status and had Hepatitis B and/or Hepatitis B envelope antigen test were conducted between 2000 to 2015. All children and adults were tested using the Hospital standard for Hepatitis B surface antigen test strip. <strong>Results:</strong> Between 2000 and 2014, 739,456 children and adults were admitted and reviewed in the outpatient units of the Federal Teaching Hospital Gombe;there were 685,552 adults and 53,904 children. Children constituted 7.3% (53,904/739,456) of admissions and outpatient consultations. 2.8% (210/7570), 3.3% (773/23,783), 3.6% (1145/32,142), 5.2% (1694/33,043), 3.3% (986/29,216), 1.9% (661/3321), 0.1% (53/41,626), 0.2% (113/46,634), 2.6% (1418/54,423), 5.4% (3717/69,696), 3.7% (2332/62,086), 3.5% (3241/90,623), 3.2% (2881/89,398), 3.8% (2428/62,687), 2.8% (1835/63,208) of children and adults were tested for HBsAg in 2000, 2001, 20002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013 and 2014 respectively. 23,487 children and adults were tested for HBsAg with a cumulative testing rate of 3%. Overall 4465/23,487 children and adults were seropositive for HBsAg giving a cumulative prevalence of 19%. <strong>Conclusion:</strong> HBV screening in our health facility is very low. Massive scale up in awareness and HBV vaccination are required. Provider initiated testing and counseling for HBV in health facilities needs support for implementation in Health Facilities in Sub Saharan Africa.
文摘The aim of this study was to find a simple and effective way to screen patients for Covid 19, prior to them being submitted to neurophysiological or neuro-psycholoigical testing in order to protect employees from being infected during the pandemic from patient contact. On May 18, 2020 when Michigan, a critically affected pandemic area, reopened for medical business after lockdown declared by the Governor on March 23, 2020, medical personnel in our office-which is an academic neurology practice-EEG and sleep technicians, medical Assistants, physician assistants and myself fretted about potential Covid 19 transmission during neuro-diagnostic procedures-EEG, video-EEG, ambulatory EEG, PSG, MSLT, CPAP titration, neuropsychological testing, EMG/NCV, VNG/Balance test and autonomic testing including the tilt table test, which require an intimate patient contact and risk of exposure. We screened all unselected and consecutive patients who were scheduled for neuro-diagnostic testing in our facility by infrared thermometer, a standard Covid 19 questionnaire and a single Covid 19 PCR nasal/throat swab prior to these tests. 542 consecutive unselected neurological or sleep/wake disorder patients aged 18 - 90, 65% males, 35% females were tested over six months as a part of this project. A total of 1109 diagnostic tests were performed. No test was limited in scope or duration. Standard PPE precautions were still taken despite the negative screening, room door left open and relatives’ presence limited during the test procedure. All were afebrile and negative on questionnaire and only 3 were found to be positive for Covid 19 PCR, indicating that a negative infrared temperature reading and a standard Covid 19 questionnaire is over 99 percent effective in prescreening for intimate neurological diagnostic testing. The technician, administering most of these tests, never contracted the virus. The technician collecting the nasal/throat swab never contracted the virus. One PA, two sleep technicians and one medical assistant came down with Covid 19 but were all felt to have contracted that from domestic exposure from family members or friends and not when at the job. All had mild disease and rapidly recovered. Infrared temperature testing and standard Covid 19 questionnaire are sufficient prior to intimate neuro-diagnostic testing when combined with standard PPE precautions to limit exposure to Covid 19 in medical personnel in a neurology office with on-site diagnostic testing.
文摘Objectives: The study compared cardiac scintigraphy stress scanning practices applied in a National Maltese Nuclear Medicine centre and in international centres. This was achieved through the design of an online survey which investigated participant knowledge of stress testing, and current procedural practice. Methods: An online survey comprising 12 questions was prepared using Survey Monkey. Professional Nuclear Medicine groups such as the Medical-Physics-Engineering community and Virtual Radiopharmacy were targeted. Access to the survey remained open for eight months during which a periodic reminder was sent to optimise the response rate. Forty-three members responded from across Europe and Australasia. Chi-square tests and comparisons between multiple responses using IBM SPSS 20 were used to evaluate the results. Information related to Maltese practice was collated separately for review and comparative purposes. Results: The online survey participants comprised United Kingdom [72%], other European countries [18%] and Australasia [9%]. The majority of respondents [n = 39] reported pharmacological stress testing as being performed either alone or in conjunction with exercise stress testing as the preferred option. Most participants [60%] were aware of local stress test protocols but had limited knowledge in relation to guidelines designed for cases where patients were not suitable for pharmacological stress testing. Conclusion: The survey provided information about procedures within participating centres for scintigraphic cardiac stress scanning. Differences were identified with regards to the preferred radiopharmaceutical tracers and procedural protocols. Further investigation of examination techniques is warranted, with the aim of increasing standardisation of protocol compliance and the application of more suitable practice.
基金the National Natural Science Foundation of China,No.81920108018(Li T and Sham P),No.82001409(Zhang YM)the Key R&D Program of Zhejiang,No.2022C03096(Li T)Project for Hangzhou Medical Disciplines of Excellence。
文摘BACKGROUND Several genetic testing techniques have been recommended as a first-tier diagnostic tool in clinical practice for diagnosing autism spectrum disorder(ASD).However,the actual usage rate varies dramatically.This is due to various reasons,including knowledge and attitudes of caregivers,patients,and health providers toward genetic testing.Several studies have therefore been conducted worldwide to investigate the knowledge,experiences,and attitudes toward genetic testing among caregivers of children with ASD,adolescent and adult ASD patients,and health providers who provide medical services for them.However,no systematic review has been done.AIM To systematically review research on knowledge,experiences,and attitudes towards genetic testing among caregivers of children with ASD,adolescent and adult ASD patients,and health providers.METHODS We followed the Preferred Reporting Items for Systematic Reviews and Metaanalyses guidelines and searched the literature in three English language databases(PubMed,Web of Science,and PsychInfo)and two Chinese databases(CNKI and Wanfang).Searched literature was screened independently by two reviewers and discussed when inconsistency existed.Information on characteristics of the study,characteristics of participants,and main findings regarding knowledge,experience,and attitudes of caregivers of children with ASD,adolescent and adult ASD patients,and health providers concerning ASD genetic testing were extracted from included papers into a charting form for analysis.RESULTS We included 30 studies published between 2012 and 2022 and conducted in 9 countries.Most of the studies(n=29)investigated caregivers of children with ASD,one study also included adolescent and adult patients,and two covered health providers.Most(51.0%-100%)of the caregivers/patients knew there was a genetic cause for ASD and 17.0%to 78.1%were aware of ASD genetic testing.However,they lacked full understanding of genetic testing.They acquired relevant and necessary information from physicians,the internet,ASD organizations,and other caregivers.Between 9.1%to 72.7%of caregivers in different studies were referred for genetic testing,and between 17.4%to 61.7%actually obtained genetic testing.Most caregivers agreed there are potential benefits following genetic testing,including benefits for children,families,and others.However,two studies compared perceived pre-test and post-test benefits with conflicting findings.Caregivers concerns included high costs,unhelpful results,negative influences(e.g.,causing family conflicts,causing stress/risk/pain to children etc.)prevented some caregivers from using genetic testing.Nevertheless,46.7%to 95.0%caregivers without previous genetic testing experience intended to obtain it in the future,and 50.5%to 59.6%of parents previously obtaining genetic testing would recommend it to other parents.In a single study of child and adolescent psychiatrists,54.9%of respondents had ordered ASD genetic testing for their patients in the prior 12 mo,which was associated with greater knowledge of genetic testing.CONCLUSION Most caregivers are willing to learn about and use genetic testing.However,the review showed their current knowledge is limited and usage rates varied widely in different studies.
文摘Background: Zimbabwe recorded a 55% increase in HIV testing from 2011 to 2018 but with decreasing HIV-testing yields from 20% to 6% respectively as we aim to identify the narrowing gap of undiagnosed people living with HIV. As such adoption of screening tools during targeted HIV testing services improves efficiency by identifying individuals who are likely to test positive. Effective utilization of screening tools requires an understanding of health care worker perception and willingness to use the tools. Methods: We conducted a qualitative study among healthcare workers at 8 selected primary healthcare facilities in Zimbabwe. Interviewer-guided, in-depth interviews were conducted with healthcare workers and their immediate supervisors. Thematic analysis was performed following a framework built around the grounded theory model to describe perspectives that influence the utilization of HIV screening tools and suggestions for improved eligibility screening. Results: Behavioural factors facilitating the utilisation of the screening tool included motivation to adhere to standard practice, awareness of screening in targeting testing, and its ability to manage workload through screening out ineligible clients. This was evident across service delivery levels. Barriers included limited healthcare capacity, confidentiality space, multiple screening tools and opaque screening in/out criteria and the potential of clients not responding to screening questions truthfully. Conclusions: Across geographical and service delivery levels, placing screening tools at HIV testing entry points, healthcare worker knowledge on screening in/out criteria emerged as enablers for correct and consistent utilization. Further, standardizing the tools and adopting a decision aid algorithm would improve the accurate utilisation of screening tools.
文摘Ammonium oxalate treatment, previously extensively studied on limestone in the laboratory, was applied to powdering historical stonework （limestone） situated on the shoreline in the Mediterranean Island of Malta. This paper presents the results obtained from onsite testing that aimed at evaluating the treatment in terms of its aesthetic performance, the depth of treatment, the mechanical properties of the consolidated stone and the influence on water transport. To this end, the testing program included colorimetry, DRMS （drilling resistance measurement system） and water absorption through the contact sponge method. This study is Part One of the final phase of a wider research program which included two previous phases progressing from treating this same very porous stone type in a laboratory-based controlled environment to uncontrolled site conditions, seeking to quantify this treatment＇s effectiveness in the field. Results showed that onsite consolidation was achieved and that although some changes in colour and water absorption were brought about by the treatment, these were within acceptable tolerance limits. Besides carrying out these treatments and evaluations directly on the coast, this study anticipates further studies which will look at rural and urban sites where the types and concentrations of salts are expected to be different.
文摘Objectives This study aims to assess the impacts of hypertension on health-related quality of life (HRQOL), as well as cardiovascular functional status (CVFS). Methods An instrument was presented based on WHOQOL-BREF and SP-16 questionnaire and exercise testing. 57 normotensive and 76 hypertensive subjects aged 35-65 year-old participated the health survey using this instrument. Based on the exercise testing results of the two groups, a discriminate function was established and used to investigate cardiovascular risk factors for hypertensive population. Results The results showed that persons with hypertension rated significantly lower scores on physical health (i.e. limitation in performing daily activities and problems with work or mobility) than did normotensives (P < 0.01). The discriminant score obtained from the exercise testing results was capable of reflecting the impacts of hypertension on CVFS. Conclusions The method presented in this paper provides a more powerful tool to estimate the effects of health interventions and medical therapy for hypertensive population than just self-rated HRQOL questionnaire.
基金support by grants from Capital’s Funds for Health Improvement and Research(Grant No.2024-2-1024)Beijing Natural Science Foundation(Grant No.7232018).
文摘Advances in the identification of molecular biomarkers and the development of targeted therapies have enhanced the prognosis of patients with advanced gastric cancer.Several established biomarkers have been widely integrated into routine clinical diagnostics of gastric cancer to guide personalized treatment.Human epidermal growth factor receptor 2(HER2)was the first molecular biomarker to be used in gastric cancer with trastuzumab being the first approved targeted therapy for HER2-positive gastric cancer.Programmed death-ligand 1 positivity and microsatellite instability can guide the use of immunotherapies,such as pembrolizumab and nivolumab.More recently,zolbetuximab has been approved for patients with claudin 18.2-positive diseases in some countries.More targeted therapies,including savolitinib for MET-positive patients,are currently under clinical investigation.However,the clinical application of these diagnostic approaches could be hampered by many existing challenges,including invasive and costly sampling methods,variability in immunohistochemistry interpretation,high costs and long turnaround times for next-generation sequencing,the absence of standardized and clinically validated diagnostic cut-off values for some biomarkers,and tumor heterogeneity.Novel testing and analysis techniques,such as artificial intelligence-assisted image analysis and multiplex immunohistochemistry,and emerging therapeutic strategies,including combination therapies that integrate immune checkpoint inhibitors with targeted therapies,offer potential solutions to some of these challenges.This article reviews recent progress in gastric cancer testing,outlines current challenges,and explores future directions for biomarker testing and targeted therapy for gastric cancer.
文摘The rapid progress in the construction of heavy-haul and high-speed railways has led to a surge in rail defects and unforeseen failures.Addressing this issue necessitates the implementation of more sophisticated rail inspection methods,specifically involving real-time,precise detection,and assessment of rail defects.Current applications fail to address the evolving requirements,prompting the need for advancements.This paper provides a summary of various types of rail defects and outlines both traditional and innovative non-destructive inspection techniques,examining their fundamental features,benefits,drawbacks,and practical suitability for railway track inspection.It also explores potential enhancements to equipment and software.The comprehensive review draws upon pertinent international research and review papers.Furthermore,the paper introduces a fusion of inspection methods aimed at enhancing the overall reliability of defect detection.
