Functional dyspepsia(FD),characterized by persistent or recurrent dyspeptic symptoms without identifiable organic,systemic or metabolic causes,is an increasingly recognized global health issue.The objective of this gu...Functional dyspepsia(FD),characterized by persistent or recurrent dyspeptic symptoms without identifiable organic,systemic or metabolic causes,is an increasingly recognized global health issue.The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine(TCM).The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries.To address these queries,a systematic literature search was conducted across PubMed,EMBASE,the Cochrane Library,China National Knowledge Infrastructure(CNKI),VIP Database,China Biology Medicine(SinoMed)Database,Wanfang Database,Traditional Medicine Research Data Expanded(TMRDE),and the Traditional Chinese Medical Literature Analysis and Retrieval System(TCMLARS).The evidence from the literature was critically appraised using the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)approach.The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts,methodologists,pharmacologists,nursing specialists,and health economists,leveraging their collective expertise and empirical knowledge.The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects,including the pathogenesis according to TCM,diagnostic approaches,therapeutic interventions,efficacy assessments,and prognostic considerations.展开更多
OBJECTIVE:To compare two therapeutic methods:electroacupuncture + massage + blocking therapy,and blocking therapy alone in the treatment of external humeral epicondylitis.METHODS:Eighty-six patients were randomized in...OBJECTIVE:To compare two therapeutic methods:electroacupuncture + massage + blocking therapy,and blocking therapy alone in the treatment of external humeral epicondylitis.METHODS:Eighty-six patients were randomized into two groups with 43 in each. The treatment group received electroacupuncture + massage +blocking therapy, while the control group received blocking therapy only. A course of electroacupuncture treatment included therapy once a day for 10days. There were 10 treatments in a massage course and massage was given once a day, with a1-week interval given before the next course. A course of blocking treatment included therapy once a week, for twototaltreatments,andgenerallyno more than three times. The therapeutic effects were evaluated with the visual analog scale(VAS),grip strength index(GSI) score, and Mayo elbow performance score(MEPS) before treatment and at0, 6, 12, and 24 months after treatment to observe thetotaleffectiverate.RESULTS: In the treatment and control groups before treatment and at 0, 6, 12, and 24 months after treatment, the VAS scores were: 6.5±1.9 and 6.4±1.6; 4.6±1.3 and 4.6±1.7; 4.8±1.3 and 4.8±1.2; 4.6±1.2 and 6.6±1.6; and 6.5±1.6 and 6.5±1.3, respectively. The GSI scores were 63±8 and 63±8; 84±6and82±7;82±7and82±6;84±6and62±8;and64±6 and 64±7, respectively.The MEPS of both groups were65±7and66±8;85±6and84±7;84±5and84±7;80±7and66±6;and65±6and65±7,respectively.The total effective rates of the treatment and control groups at 0, 6, 12, and 24 months after treatment were 87.5% and 85.0%; 85.0% and 82.5%;80.0% and 12.5%; and 2.5% and 5.0%, respectively.Compared with the treatment group, the control group had greater joint function, better the rapeutic effect, and lower pain intensity(P<0.01), indicating a high recurrence rate in the 12th month after treatment.There were no differences inVAS, GSI, or MEPS at 0, 6, and 24 months after treatment(P>0.05)betweenthetwogroups.CONCLUSION: We found that both methods were effective for external humeral epicondylitis. After 6months of treatment,the effects were good in both groups. However, in the 12th month, the control group had a relatively severe relapse. After 24months, both groups relapsed. The effect of electroacupuncture, massage, and blocking therapy used in combination lasted longer, delaying the recurrence of the disease.展开更多
OBJECTIVE:To investigate the effect of salvianolic acid A and C component molecules,which are involved in drug compatibility,on inflammatory cytokine expression that affects human chemokine ligand 5(CCL5) and chemokin...OBJECTIVE:To investigate the effect of salvianolic acid A and C component molecules,which are involved in drug compatibility,on inflammatory cytokine expression that affects human chemokine ligand 5(CCL5) and chemokine ligand 10(CXCL10)levels in rats with unilateral ureteral obstruction(UUO).METHODS:Fifty Sprague Dawley rats were randomly divided into five groups:normal,model,salvianolic acid A,salvianolic acid C and salvianolic acid A and C groups.The normal group was used as the control,and the other groups of rats had a UUO model established.The control group had free access to food and water,and the other groups received the corresponding drugs for 2 weeks.After the last administration,urine β_2-microglobulin(β_2-MG) and N-acetyl-β-D-glucosaminidase(NAG) levels were analyzed.After 24 h,all rats were sacrificed and the serum was analyzed for creatinine(Cr) and blood urea nitrogen(BUN) levels.Rat kidneys were removed,and CCL5 and CXCL10 inflammatory cytokine mRNA expression was measured using real-time fluorescent quantitative reverse transcription-polymerase chain reaction(RT-PCR).Kidney fibrosis was observed using hematoxylin-eosin(HE)staining and Masson trichrome staining.RESULTS:In the salvianolic acid A and salvianolic acid C treatment groups,serum Cr and urine NAG levels were significantly lower than in the model group(both P < 0.05).In all treatment groups,urine pYMG levels were significantly lower than in the model group(all P < 0.05).Compared with model group,the pathological changes and collagen deposition improved to varying degrees(both P <0.05).CCL5 and CXCL10 mRNA expression decreased to different degrees compared with the model group(both P < 0.05).CONCLUSION:Salvianolic acid A and C are component molecules of drug compatibility,and they may protect renal function and improve tubular function and renal pathology to a certain degree in UUO.This improvement may be related to a reduction in inflammatory cytokines CCL5 and CXCL10 secretion in the UUO rat kidney.展开更多
Liver failure(LF)is prevalent in China and is characterized by complex path-ogenesis,challenging clinical management,poor prognosis,and rising incidence and mortality rates.The immune status is an important factor aff...Liver failure(LF)is prevalent in China and is characterized by complex path-ogenesis,challenging clinical management,poor prognosis,and rising incidence and mortality rates.The immune status is an important factor affecting LF prognosis.Interleukins(Ils)are a type of cytokine that act and interact with multiple cells,including immune cells.These signaling molecules play important roles in intercellular information transmission,including the regulation of immune cells;mediation of the activation,proliferation,and differentiation of T and B cells;and orchestration of the inflammatory response.To date,many studies have explored the correlation between IL expression and liver disease prognosis,but few studies have evaluated Ils as the prognostic biomarkers of LF.This article reviews the potential use of Ils as the prognostic biomarkers of LF.Particularly,it evaluates the predictive values of IL-21,IL-22,and IL-31,the three often overlooked yet promising prognostic biomarkers,in predicting suscept-ibility to LF.Harnessing biomarkers for early prognostic insights can facilitate tailored treatment strategies and enhance patient survival.Thus,this article focuses on the identification of IL-21,IL-22,and IL-33 as biomarkers in preclinical and clinical studies on LF and reviews their role as biomarkers in the pathogenesis and diagnosis of LF.展开更多
With the continuous development of artificial intelligence technology,its application field has gradually expanded.To further apply the deep reinforcement learning technology to the field of dynamic pricing,we build a...With the continuous development of artificial intelligence technology,its application field has gradually expanded.To further apply the deep reinforcement learning technology to the field of dynamic pricing,we build an intelligent dynamic pricing system,introduce the reinforcement learning technology related to dynamic pricing,and introduce existing research on the number of suppliers(single supplier and multiple suppliers),environmental models,and selection algorithms.A two-period dynamic pricing game model is designed to assess the optimal pricing strategy for e-commerce platforms under two market conditions and two consumer participation conditions.The first step is to analyze the pricing strategies of e-commerce platforms in mature markets,analyze the optimal pricing and profits of various enterprises under different strategy combinations,compare different market equilibriums and solve the Nash equilibrium.Then,assuming that all consumers are naive in the market,the pricing strategy of the duopoly e-commerce platform in emerging markets is analyzed.By comparing and analyzing the optimal pricing and total profit of each enterprise under different strategy combinations,the subgame refined Nash equilibrium is solved.Finally,assuming that the market includes all experienced consumers,the pricing strategy of the duopoly e-commerce platform in emerging markets is analyzed.展开更多
The coastal marine habitats are often characterized by high biological activity. Therefore, monitoring programs and conservation plans of coastal environments are needed. So, in order to contribute to decision making ...The coastal marine habitats are often characterized by high biological activity. Therefore, monitoring programs and conservation plans of coastal environments are needed. So, in order to contribute to decision making process of the Brazilian Information System of Coastal Management, this paper presents a preliminary analysis of the effects of simulated deletions of individual organisms within a planktonic network as knowledge acquisition platform. An in situ scanning flow cytometer was used to data acquisition. A static and undirected food web is generated and represented by a fuzzy graph structure. Our results show through a series of indices the main changes of these networks. It was also verified similar traits and properties with other food webs found in the literature.展开更多
It is well known that fossil fuels are one of the major pollutants that contribute to climate change and there is a need to develop alternatives to their uses.One option is the use of a renewable fuel such as biogas o...It is well known that fossil fuels are one of the major pollutants that contribute to climate change and there is a need to develop alternatives to their uses.One option is the use of a renewable fuel such as biogas obtained from the breaking down of organic matter in the anaerobic digestion process.When biogas is cleaned up to a certain quality,it can substitute the use of natural gas.However,this slow process requires optimization to increase the amount of gas.There are chemical,physical and biological treatments for organic matter to increase the amount and quality of biogas.In the former research,a biological treatment was tested by adding a selection of microorganisms that showed hydrolytic activity to an anaerobic digester for its optimization.First,a selection of microorganisms with the ability to grow in fresh sewage sludge as only nutrient was selected.Then,the lipolytic,cellulolytic and PA(Proteolytic Activity)of microorganisms was tested using selective growth media.Finally,10 samples with the greatest hydrolytic activity were used to evaluate their effects in the increasing of biogas production in the anaerobic process.The results showed that 83%of the microorganisms with the ability to grow in sewage sludge were proteolytic,while the percentage of lipolytic and cellulolytic microorganisms was smaller.Furthermore,it was found that proteolytic microorganisms are the ones that increase biogas yield in a maximum of 80%with a COD(Chemical Oxygen Demand)reduction of 58%.展开更多
The authors consider the problem of estimating the ordered means of two normal distributions with unknown ordered variances. The authors discuss the estimation of two ordered means, individually, in terms of stochasti...The authors consider the problem of estimating the ordered means of two normal distributions with unknown ordered variances. The authors discuss the estimation of two ordered means, individually, in terms of stochastic domination and MSE （mean squared error）. The authors show that in estimating the mean with larger variance, the usual estimator under order restriction on means can be improved upon. However, in estimating the mean with smaller variance, the usual estimator can＇t be improved upon even under MSE. The authors also discuss simultaneous estimation problem of two ordered means when unknown variances are ordered.展开更多
The aim of this study was to analyze the chemical composition of landrace seeds of rice, maize and cassava grown in traditional communities in file state of Maranchao. The sample collection was based on file descripti...The aim of this study was to analyze the chemical composition of landrace seeds of rice, maize and cassava grown in traditional communities in file state of Maranchao. The sample collection was based on file description of the farmers for identification of varieties of plants, based on protein content, lipids, carbohydrates and mineral through Association of Official Analytical Chemists （AOAC） methods. Landrace seeds of nine maize cultivars, 13 rice and 40 cassava, with differences in centesimal composition in all varieties were analyzed. For maize landrace seeds file lipid values, carbohydrates and ash are in the average for the species. The protein contents and ash to file surveyed rice varieties were high, while the levels of lipids and carbohydrates are within average in relation to conventional varieties. The results obtained for cassava showed high percentages of protein, with a significant level for the feeding of the people of the community who consume their byproducts. Thus, differences in file chemical composition of file varieties studied showed file interference of genotype, management and environmental factors in their chemical and physiological quality, reinforcing file importance of file study of creole varieties for the development of new germplasm and for file guarantee of food sovereignty of traditional communities.展开更多
Bacterial populations isolated from treated soil,artificially contaminated with lead(Pb)and cadmium(Cd)and undergoing a phytoremediation process were studied to determine their potential application in soil remediatio...Bacterial populations isolated from treated soil,artificially contaminated with lead(Pb)and cadmium(Cd)and undergoing a phytoremediation process were studied to determine their potential application in soil remediation.The physicochemical parameters evaluated in the soil varied significantly.Ten bacterial strains were selected from each polluted soil to test tolerance and growth in contaminated media.The concentrations of heavy metals tested were 1,000 ppm for lead and 850 ppm for cadmium.These strains were morphologically identified through Gram staining.Four strains showing the most significant growth in both contaminants were then selected to verify their tolerance to different concentrations of heavy metals.The results demonstrated that the selected bacteria have high tolerance to Pb,resisting inhibition up to 2,000 ppm.In contrast,strains exposed to cadmium tended to slow their growth as the concentration increased.展开更多
Numerous studies conducted on educational leadership have generally emphasized the role of principal,whereas,research on middle leadership remains limited[1].The purpose of this paper is to explore and investigate the...Numerous studies conducted on educational leadership have generally emphasized the role of principal,whereas,research on middle leadership remains limited[1].The purpose of this paper is to explore and investigate the development of middle leadership and seeks to fill in the gap by providing the analysis from a Chinese context.The author found that middle leaders are positioning at a challenging role,in which they are required to take charge of responsibilities of both a leader and a teacher,and in the meantime,they also need to negotiate between the senior leader,the colleagues.and subordinates.Furthermore,personal factors such as self-awareness and resilience are discovered to be pivotal for middle-leadership development.Apart from that,the principal plays a critical role in establishing collaborative school culture that facilitates the development of middle leaders based on the influences from the school’s history,culture,and policies.展开更多
This paper reveals that the implementation of inclusive education is an unfinished challenge,both within the system and for individual self-improvement.This process of changing practices,by continually questioning the...This paper reveals that the implementation of inclusive education is an unfinished challenge,both within the system and for individual self-improvement.This process of changing practices,by continually questioning the school’s responsibility for the(re)production of inequalities,exclusion,and unequal social relations,is riddled with obstacles,unpredictable situations,and strong emotions.In particular,the researchers point out that many systemic mechanisms of school culture contribute to replicating and reifying hierarchical school experiences and exacerbating processes of institutional discrimination against immigrant backgrounds and/or racialized students.The empirical research presented also highlights the school staff’s deficit thinking toward immigrant students and their parents.The results show that staff tend to use linguistic and cultural gaps between students and the school system to explain academic failure.Be that as it may,the researchers as well as the school actors and students interviewed in this paper suggest multiple ways to improve inclusion in the school context,stressing the importance of giving voice to the various actors in order to move toward institutional transformation.展开更多
BACKGROUND Dentition defect,a common clinical oral disease developed in humans,not only causes masticatory dysfunction and articulation difficulties but also affects facial appearance and increases the burden on the i...BACKGROUND Dentition defect,a common clinical oral disease developed in humans,not only causes masticatory dysfunction and articulation difficulties but also affects facial appearance and increases the burden on the intestinal tract.Restorative treatment is the primary option for this disease.However,traditional restorations have many drawbacks,such as mismatch with the body,low reliability,and incomplete occlusal function recovery.AIM to analyze the efficacy of orthodontics combined with 3D printing guide plate implant restoration in treating patients with dentition defects and its influence on masticatory and phonic functions.METHODS A prospective study was carried out in 86 patients with dentition defects who received implant prosthesis after orthodontic treatment in our hospital between January 2018 and January 2019.Those patients were divided into a control group and an intervention group with 43 patients in each group using a random number table.The control group received traditional implant restoration,whereas the intervention group received 3D printing guide plate implant restoration.Treatment outcomes,cosmetic appearance,dental function,implant deviation,and quality of life were compared between the two groups.RESULTS The overall response rate in the intervention group was significantly higher than that in the control group(95.35%vs 81.40%,χ^(2)=4.071,P=0.044).The number of cases with neatly trimmed cosmetic appearance(χ^(2)=4.497,P=0.034),complete coverage(χ^(2)=4.170,P=0.041),and normal occlusion(χ^(2)=5.512,P=0.019)in the intervention group was higher than that in the control group.After treatment,mastication,swallowing,and articulation were significantly improved in both groups.Masticatory(t=2.980,P=0.004),swallowing(t=2.199,P=0.031),and phonic functions(t=3.950,P=0.004)were better in the intervention group than those in the control group.The deviation value and the deviation angle(t=5.440,P=0.000)at the top(t=6.320,P=0.000)and middle parts of the implants(t=22.295,P=0.000)in the intervention group were lower than those in the control group after treatment.Functional limitations,psychosocial and physical pain and discomfort,and total scores decreased in both groups.The functional limitation(t=2.379,P=0.020),psychosocial(t=2.420,P=0.000),physical pain and discomfort(t=6.581,P=0.000),and total scores(t=2.140,P=0.035)were lower in the intervention group than those in the control group.CONCLUSION Orthodontic treatment combined with 3D printing guide plate implant restoration can significantly improve the masticatory and phonic functions,quality of life,and psychological health of patients with dentition defects.Therefore,it is highly recommended in clinic application.展开更多
The Weibull distribution is regarded as among the finest in the family of failure distributions.One of the most commonly used parameters of the Weibull distribution(WD)is the ordinary least squares(OLS)technique,which...The Weibull distribution is regarded as among the finest in the family of failure distributions.One of the most commonly used parameters of the Weibull distribution(WD)is the ordinary least squares(OLS)technique,which is useful in reliability and lifetime modeling.In this study,we propose an approach based on the ordinary least squares and the multilayer perceptron(MLP)neural network called the OLSMLP that is based on the resilience of the OLS method.The MLP solves the problem of heteroscedasticity that distorts the estimation of the parameters of the WD due to the presence of outliers,and eases the difficulty of determining weights in case of the weighted least square(WLS).Another method is proposed by incorporating a weight into the general entropy(GE)loss function to estimate the parameters of the WD to obtain a modified loss function(WGE).Furthermore,a Monte Carlo simulation is performed to examine the performance of the proposed OLSMLP method in comparison with approximate Bayesian estimation(BLWGE)by using a weighted GE loss function.The results of the simulation showed that the two proposed methods produced good estimates even for small sample sizes.In addition,the techniques proposed here are typically the preferred options when estimating parameters compared with other available methods,in terms of the mean squared error and requirements related to time.展开更多
In this manuscript,we study a new version of the optical recursional binormal microbeam model for a flexible binormal microscale beam in terms of a binormal normalized operator.Also,we give new explanations for the op...In this manuscript,we study a new version of the optical recursional binormal microbeam model for a flexible binormal microscale beam in terms of a binormal normalized operator.Also,we give new explanations for the optical recursional visco Landau-Lifshitz binormal electromagnetic binormal microscale beam.Finally,we obtain an optical application for the normalized visco Landau-Lifshitz electromagnetic binormal optimistic density with an optical binormal resonator.展开更多
The toxicity symptoms among 79migrant pesticide workers involved in open-field pesticide application in Oman were studied. Questionnaires addressing the workers＇ demographics, pesticide use and practices, use of prot...The toxicity symptoms among 79migrant pesticide workers involved in open-field pesticide application in Oman were studied. Questionnaires addressing the workers＇ demographics, pesticide use and practices, use of protective devices, disposal of empty containers, storage of pesticides and self-reported poisoning symptoms were administered face-to-face to the workers before commencement of work, during break or at home. A total of 28 toxicity symptoms were reported, skin rash being the symptom reported by a majority of the workers （78%）, followed by increased salivation （68%）. The gravity of toxicity symptoms was attributed principally to the non-use of protective devices during pesticide spraying. Other factors contributing to poisoning were the workers＇ poor post-application sanitation habits, improper disposal of empty pesticide containers and storage of partially used pesticides in bedrooms. In order to reduce the incidents of poisoning among the agropesticide workers, there is a need to educate them about the benefits of using PPE （personal protective equipment） and ensuring that they adopt good hygiene and sanitation habits at all stages of pesticide handling.展开更多
BACKGROUND As survival has been prolonged owing to surgical and medical improvements,liver failure has become a prognostic determinant in patients with congestive heart diseases.Congestive hepatopathy,an abnormal stat...BACKGROUND As survival has been prolonged owing to surgical and medical improvements,liver failure has become a prognostic determinant in patients with congestive heart diseases.Congestive hepatopathy,an abnormal state of the liver as a result of congestion,insidiously proceed toward end-stage liver disease without effective biomarkers evaluating pathological progression.Regular measurements of shear wave elastography cannot qualify liver fibrosis,which is a prognosticator in any type of chronic liver disease,in cases of congestion because congestion makes the liver stiff without fibrosis.We hypothesized that the effects of congestion and fibrosis on liver stiffness can be dissociated by inducing architectural deformation of the liver to expose structural rigidity.To establish a strategy measuring liver stiffness as a reflection of architectural rigidity under congestion.METHODS Two-dimensional shear wave elastography(2dSWE)was measured in the supine(Sp)and left decubitus(Ld)positions in 298 consecutive cases as they were subjected to an ultrasound study for various liver diseases.Regions of interest were placed at twelve sites,and the median and robust coefficient of variation were calculated.Numerical data were compared using the Mann-Whitney U or Kruskal-Wallis test followed by Dunn's post-hoc multiple comparisons.The inferior vena cava(IVC)diameters at different body positions were compared using the Wilcoxon matched pairs signed rank test.The number of cases with cardiothoracic ratios greater than or not greater than 50%was compared using Fisher’s exact test.A correlation of 2dSWE between different body positions was evaluated by calculating Spearman correlation coefficients.RESULTS The IVC diameter was significantly reduced in Ld in subjects with higher 2dSWE values in Ld(LdSWE)than in Sp(SpSWE)(P=0.007,(average±SD)13.9±3.6 vs 13.1±3.4 mm)but not in those with lower LdSWE values(P=0.32,13.3±3.5 vs 13.0±3.5 mm).In 81 subjects,SpSWE was increased or decreased in Ld beyond the magnitude of robust coefficient of variation,which suggests that body postural changes induced an alteration of liver stiffness significantly larger than the technical dispersion.Among these subjects,all 37 with normal SpSWE had a higher LdSWE than SpSWE(Normal-to-Hard,SpSWE-LdSWE(Δ2dSWE):(minimum-maximum)-0.74--0.08 m/sec),whereas in 44 residual subjects with abnormal SpSWE,LdSWE was higher in 27 subjects(Hard-to-Hard,-0.74--0.05 m/sec)and lower in 17 subjects(Hard-to-Soft,0.04-0.52 m/sec)than SpSWE.SpSWE was significantly correlated withΔ2dSWE only in Hard-to-Soft(P<0.0001).Δ2dSWE was larger in each lobe than in the entire liver.When Hard-to-Hard and Hard-to-Soft values were examined for each lobe,fibrosis-4 or platelet counts were significantly higher or lower only for Hard-to-Soft vs Normal-to-Hard cases.CONCLUSION Gravity alters the hepatic architecture during body postural changes,causing outflow blockage in hepatic veins.A rigid liver is resistant to structural deformation.Stiff-liver softening in the Ld position suggests a fibrous liver.展开更多
The coronavirus disease 2019 pandemic had deleterious effects on the healthcare systems around the world.To increase intensive care units(ICUs)bed capacities,multiple adaptations had to be made to increase surge capac...The coronavirus disease 2019 pandemic had deleterious effects on the healthcare systems around the world.To increase intensive care units(ICUs)bed capacities,multiple adaptations had to be made to increase surge capacity.In this editorial,we demonstrate the changes made by an ICU of a midwest community hospital in the United States.These changes included moving patients that used to be managed in the ICU to progressive care units,such as patients requiring noninvasive ventilation and high flow nasal cannula,ST-elevation myocardial infarction patients,and post-neurosurgery patients.Additionally,newer tactics were applied to the processes of assessing oxygen supply and demand,patient care rounds,and post-ICU monitoring.展开更多
Atmospheric microplastics(AMPs)can absorb and scatter radiation,which can be quantified by radiative forcing.Although the radiative forcing of AMPs is commonly positive at the global scale,regional environmental varia...Atmospheric microplastics(AMPs)can absorb and scatter radiation,which can be quantified by radiative forcing.Although the radiative forcing of AMPs is commonly positive at the global scale,regional environmental variables affect the radiative forcing of aerosols,potentially reversing its directions and causing opposite radiative impacts in the atmosphere.In this study,the total suspended particles were collected within one year in Tianjin,China,and the monthly average concentration of AMPs of 200.0-463.9 items/m^(3) was detected.Accordingly,the direct radiative forcing(DRF)of AMPs was calculated as0.03 to 0.03 W/m^(2) at the top of the atmosphere and0.09 to 0.72 W/m^(2) at the Earth's surface,respectively.The surface albedo significantly affects the direction of the DRF of AMPs.A low surface albedo leads to a cooling effect of AMPs in the atmosphere in Tianjin,while a high surface albedo causes a warming effect in the atmosphere.The DRF calculated under different surface albedo indicates that the potential impact of AMPs on atmospheric temperature is relatively complex.The temperature changes caused by AMPs in grassland and bare soil areas may be opposite to those in areas covered by snow and ice.展开更多
Background and Aims:The impact of coronavirus disease-2019(COVID-19)on liver function remains to be fully elucidated.This study was designed to investigate such and determine the clinical significance in determining m...Background and Aims:The impact of coronavirus disease-2019(COVID-19)on liver function remains to be fully elucidated.This study was designed to investigate such and determine the clinical significance in determining mortality risk.Methods:A retrospective study was conducted in patients with COVID-19 from March 2020 to July 2020.Clinical details were retrieved from electronic medical records to obtain clinical characteristics,medical history,laboratory tests,therapeutic intervention,and outcome data.Results:A total of 184 patients with COVID-19 were included(median age:45.5 years),comprised of 62.5%men.In total,22(12.0%)patients had severe infection and 162(88.0%)had mild to moderate infection.Overall,95(51.6%)showed abnormal liver function test(LFT)and 17(9.2%)showed normal LFT at admission.The median age,hospital stay,and LFT were significantly higher in severe vs.non-severe infection(p<0.001).Out of 12 deaths,the majority were due to severe infection(n=11).Deaths were also due to acute respiratory distress syndrome(n=5),cardiac reasons(n=3),and sepsis with multiorgan failure(n=3).The median age,hospital stay and number of intensive care unit admissions were higher in patients having abnormal LFT compared to normal LFT.Incidence of elevated aspartate aminotransferase(42.8%and 40.4%),alanine transaminase(43.7%and 41.6%),and hypoalbuminemia(71.4%and72.7%)at admission and discharge were more common in severe infection.The mean survival was significantly lower in severe infection compared to those with non-severe disease(17.2 vs.52.3 days;p<0.001).Conclusions:Incidence of abnormal liver function was higher in patients with severe COVID-19 and was associated with prolonged hospital stay;mortality was associated with severity of COVID-19.For ruling out the risk of liver injury,it is crucial to vigilantly monitor the liver function parameters in patients with COVID-19 admitted to hospital.展开更多
基金supported by the National Key R&D Program of China(No.2019YFC1712000),but independent of it。
文摘Functional dyspepsia(FD),characterized by persistent or recurrent dyspeptic symptoms without identifiable organic,systemic or metabolic causes,is an increasingly recognized global health issue.The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine(TCM).The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries.To address these queries,a systematic literature search was conducted across PubMed,EMBASE,the Cochrane Library,China National Knowledge Infrastructure(CNKI),VIP Database,China Biology Medicine(SinoMed)Database,Wanfang Database,Traditional Medicine Research Data Expanded(TMRDE),and the Traditional Chinese Medical Literature Analysis and Retrieval System(TCMLARS).The evidence from the literature was critically appraised using the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)approach.The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts,methodologists,pharmacologists,nursing specialists,and health economists,leveraging their collective expertise and empirical knowledge.The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects,including the pathogenesis according to TCM,diagnostic approaches,therapeutic interventions,efficacy assessments,and prognostic considerations.
文摘OBJECTIVE:To compare two therapeutic methods:electroacupuncture + massage + blocking therapy,and blocking therapy alone in the treatment of external humeral epicondylitis.METHODS:Eighty-six patients were randomized into two groups with 43 in each. The treatment group received electroacupuncture + massage +blocking therapy, while the control group received blocking therapy only. A course of electroacupuncture treatment included therapy once a day for 10days. There were 10 treatments in a massage course and massage was given once a day, with a1-week interval given before the next course. A course of blocking treatment included therapy once a week, for twototaltreatments,andgenerallyno more than three times. The therapeutic effects were evaluated with the visual analog scale(VAS),grip strength index(GSI) score, and Mayo elbow performance score(MEPS) before treatment and at0, 6, 12, and 24 months after treatment to observe thetotaleffectiverate.RESULTS: In the treatment and control groups before treatment and at 0, 6, 12, and 24 months after treatment, the VAS scores were: 6.5±1.9 and 6.4±1.6; 4.6±1.3 and 4.6±1.7; 4.8±1.3 and 4.8±1.2; 4.6±1.2 and 6.6±1.6; and 6.5±1.6 and 6.5±1.3, respectively. The GSI scores were 63±8 and 63±8; 84±6and82±7;82±7and82±6;84±6and62±8;and64±6 and 64±7, respectively.The MEPS of both groups were65±7and66±8;85±6and84±7;84±5and84±7;80±7and66±6;and65±6and65±7,respectively.The total effective rates of the treatment and control groups at 0, 6, 12, and 24 months after treatment were 87.5% and 85.0%; 85.0% and 82.5%;80.0% and 12.5%; and 2.5% and 5.0%, respectively.Compared with the treatment group, the control group had greater joint function, better the rapeutic effect, and lower pain intensity(P<0.01), indicating a high recurrence rate in the 12th month after treatment.There were no differences inVAS, GSI, or MEPS at 0, 6, and 24 months after treatment(P>0.05)betweenthetwogroups.CONCLUSION: We found that both methods were effective for external humeral epicondylitis. After 6months of treatment,the effects were good in both groups. However, in the 12th month, the control group had a relatively severe relapse. After 24months, both groups relapsed. The effect of electroacupuncture, massage, and blocking therapy used in combination lasted longer, delaying the recurrence of the disease.
基金Supported by the National Natural Science Foundation of China(Intervention Effect of Compatibility of Salvianolic Acid A,B,C on PDGF-C/PDGFR-A Signaling Pathway in Renal Fibrosis,No.81260603)
文摘OBJECTIVE:To investigate the effect of salvianolic acid A and C component molecules,which are involved in drug compatibility,on inflammatory cytokine expression that affects human chemokine ligand 5(CCL5) and chemokine ligand 10(CXCL10)levels in rats with unilateral ureteral obstruction(UUO).METHODS:Fifty Sprague Dawley rats were randomly divided into five groups:normal,model,salvianolic acid A,salvianolic acid C and salvianolic acid A and C groups.The normal group was used as the control,and the other groups of rats had a UUO model established.The control group had free access to food and water,and the other groups received the corresponding drugs for 2 weeks.After the last administration,urine β_2-microglobulin(β_2-MG) and N-acetyl-β-D-glucosaminidase(NAG) levels were analyzed.After 24 h,all rats were sacrificed and the serum was analyzed for creatinine(Cr) and blood urea nitrogen(BUN) levels.Rat kidneys were removed,and CCL5 and CXCL10 inflammatory cytokine mRNA expression was measured using real-time fluorescent quantitative reverse transcription-polymerase chain reaction(RT-PCR).Kidney fibrosis was observed using hematoxylin-eosin(HE)staining and Masson trichrome staining.RESULTS:In the salvianolic acid A and salvianolic acid C treatment groups,serum Cr and urine NAG levels were significantly lower than in the model group(both P < 0.05).In all treatment groups,urine pYMG levels were significantly lower than in the model group(all P < 0.05).Compared with model group,the pathological changes and collagen deposition improved to varying degrees(both P <0.05).CCL5 and CXCL10 mRNA expression decreased to different degrees compared with the model group(both P < 0.05).CONCLUSION:Salvianolic acid A and C are component molecules of drug compatibility,and they may protect renal function and improve tubular function and renal pathology to a certain degree in UUO.This improvement may be related to a reduction in inflammatory cytokines CCL5 and CXCL10 secretion in the UUO rat kidney.
基金The National Natural Science Foundation of China,No.82260907,No.82260899,and No.82274434.
文摘Liver failure(LF)is prevalent in China and is characterized by complex path-ogenesis,challenging clinical management,poor prognosis,and rising incidence and mortality rates.The immune status is an important factor affecting LF prognosis.Interleukins(Ils)are a type of cytokine that act and interact with multiple cells,including immune cells.These signaling molecules play important roles in intercellular information transmission,including the regulation of immune cells;mediation of the activation,proliferation,and differentiation of T and B cells;and orchestration of the inflammatory response.To date,many studies have explored the correlation between IL expression and liver disease prognosis,but few studies have evaluated Ils as the prognostic biomarkers of LF.This article reviews the potential use of Ils as the prognostic biomarkers of LF.Particularly,it evaluates the predictive values of IL-21,IL-22,and IL-31,the three often overlooked yet promising prognostic biomarkers,in predicting suscept-ibility to LF.Harnessing biomarkers for early prognostic insights can facilitate tailored treatment strategies and enhance patient survival.Thus,this article focuses on the identification of IL-21,IL-22,and IL-33 as biomarkers in preclinical and clinical studies on LF and reviews their role as biomarkers in the pathogenesis and diagnosis of LF.
基金His work is supported by Scientific research planning project of Jilin Provincial Department of education in 2020:Analysis of the impact of industrial upgrading on employment of college students in Jilin Province(No.JJKH20200505JY).
文摘With the continuous development of artificial intelligence technology,its application field has gradually expanded.To further apply the deep reinforcement learning technology to the field of dynamic pricing,we build an intelligent dynamic pricing system,introduce the reinforcement learning technology related to dynamic pricing,and introduce existing research on the number of suppliers(single supplier and multiple suppliers),environmental models,and selection algorithms.A two-period dynamic pricing game model is designed to assess the optimal pricing strategy for e-commerce platforms under two market conditions and two consumer participation conditions.The first step is to analyze the pricing strategies of e-commerce platforms in mature markets,analyze the optimal pricing and profits of various enterprises under different strategy combinations,compare different market equilibriums and solve the Nash equilibrium.Then,assuming that all consumers are naive in the market,the pricing strategy of the duopoly e-commerce platform in emerging markets is analyzed.By comparing and analyzing the optimal pricing and total profit of each enterprise under different strategy combinations,the subgame refined Nash equilibrium is solved.Finally,assuming that the market includes all experienced consumers,the pricing strategy of the duopoly e-commerce platform in emerging markets is analyzed.
文摘The coastal marine habitats are often characterized by high biological activity. Therefore, monitoring programs and conservation plans of coastal environments are needed. So, in order to contribute to decision making process of the Brazilian Information System of Coastal Management, this paper presents a preliminary analysis of the effects of simulated deletions of individual organisms within a planktonic network as knowledge acquisition platform. An in situ scanning flow cytometer was used to data acquisition. A static and undirected food web is generated and represented by a fuzzy graph structure. Our results show through a series of indices the main changes of these networks. It was also verified similar traits and properties with other food webs found in the literature.
文摘It is well known that fossil fuels are one of the major pollutants that contribute to climate change and there is a need to develop alternatives to their uses.One option is the use of a renewable fuel such as biogas obtained from the breaking down of organic matter in the anaerobic digestion process.When biogas is cleaned up to a certain quality,it can substitute the use of natural gas.However,this slow process requires optimization to increase the amount of gas.There are chemical,physical and biological treatments for organic matter to increase the amount and quality of biogas.In the former research,a biological treatment was tested by adding a selection of microorganisms that showed hydrolytic activity to an anaerobic digester for its optimization.First,a selection of microorganisms with the ability to grow in fresh sewage sludge as only nutrient was selected.Then,the lipolytic,cellulolytic and PA(Proteolytic Activity)of microorganisms was tested using selective growth media.Finally,10 samples with the greatest hydrolytic activity were used to evaluate their effects in the increasing of biogas production in the anaerobic process.The results showed that 83%of the microorganisms with the ability to grow in sewage sludge were proteolytic,while the percentage of lipolytic and cellulolytic microorganisms was smaller.Furthermore,it was found that proteolytic microorganisms are the ones that increase biogas yield in a maximum of 80%with a COD(Chemical Oxygen Demand)reduction of 58%.
文摘The authors consider the problem of estimating the ordered means of two normal distributions with unknown ordered variances. The authors discuss the estimation of two ordered means, individually, in terms of stochastic domination and MSE （mean squared error）. The authors show that in estimating the mean with larger variance, the usual estimator under order restriction on means can be improved upon. However, in estimating the mean with smaller variance, the usual estimator can＇t be improved upon even under MSE. The authors also discuss simultaneous estimation problem of two ordered means when unknown variances are ordered.
文摘The aim of this study was to analyze the chemical composition of landrace seeds of rice, maize and cassava grown in traditional communities in file state of Maranchao. The sample collection was based on file description of the farmers for identification of varieties of plants, based on protein content, lipids, carbohydrates and mineral through Association of Official Analytical Chemists （AOAC） methods. Landrace seeds of nine maize cultivars, 13 rice and 40 cassava, with differences in centesimal composition in all varieties were analyzed. For maize landrace seeds file lipid values, carbohydrates and ash are in the average for the species. The protein contents and ash to file surveyed rice varieties were high, while the levels of lipids and carbohydrates are within average in relation to conventional varieties. The results obtained for cassava showed high percentages of protein, with a significant level for the feeding of the people of the community who consume their byproducts. Thus, differences in file chemical composition of file varieties studied showed file interference of genotype, management and environmental factors in their chemical and physiological quality, reinforcing file importance of file study of creole varieties for the development of new germplasm and for file guarantee of food sovereignty of traditional communities.
文摘Bacterial populations isolated from treated soil,artificially contaminated with lead(Pb)and cadmium(Cd)and undergoing a phytoremediation process were studied to determine their potential application in soil remediation.The physicochemical parameters evaluated in the soil varied significantly.Ten bacterial strains were selected from each polluted soil to test tolerance and growth in contaminated media.The concentrations of heavy metals tested were 1,000 ppm for lead and 850 ppm for cadmium.These strains were morphologically identified through Gram staining.Four strains showing the most significant growth in both contaminants were then selected to verify their tolerance to different concentrations of heavy metals.The results demonstrated that the selected bacteria have high tolerance to Pb,resisting inhibition up to 2,000 ppm.In contrast,strains exposed to cadmium tended to slow their growth as the concentration increased.
文摘Numerous studies conducted on educational leadership have generally emphasized the role of principal,whereas,research on middle leadership remains limited[1].The purpose of this paper is to explore and investigate the development of middle leadership and seeks to fill in the gap by providing the analysis from a Chinese context.The author found that middle leaders are positioning at a challenging role,in which they are required to take charge of responsibilities of both a leader and a teacher,and in the meantime,they also need to negotiate between the senior leader,the colleagues.and subordinates.Furthermore,personal factors such as self-awareness and resilience are discovered to be pivotal for middle-leadership development.Apart from that,the principal plays a critical role in establishing collaborative school culture that facilitates the development of middle leaders based on the influences from the school’s history,culture,and policies.
文摘This paper reveals that the implementation of inclusive education is an unfinished challenge,both within the system and for individual self-improvement.This process of changing practices,by continually questioning the school’s responsibility for the(re)production of inequalities,exclusion,and unequal social relations,is riddled with obstacles,unpredictable situations,and strong emotions.In particular,the researchers point out that many systemic mechanisms of school culture contribute to replicating and reifying hierarchical school experiences and exacerbating processes of institutional discrimination against immigrant backgrounds and/or racialized students.The empirical research presented also highlights the school staff’s deficit thinking toward immigrant students and their parents.The results show that staff tend to use linguistic and cultural gaps between students and the school system to explain academic failure.Be that as it may,the researchers as well as the school actors and students interviewed in this paper suggest multiple ways to improve inclusion in the school context,stressing the importance of giving voice to the various actors in order to move toward institutional transformation.
文摘BACKGROUND Dentition defect,a common clinical oral disease developed in humans,not only causes masticatory dysfunction and articulation difficulties but also affects facial appearance and increases the burden on the intestinal tract.Restorative treatment is the primary option for this disease.However,traditional restorations have many drawbacks,such as mismatch with the body,low reliability,and incomplete occlusal function recovery.AIM to analyze the efficacy of orthodontics combined with 3D printing guide plate implant restoration in treating patients with dentition defects and its influence on masticatory and phonic functions.METHODS A prospective study was carried out in 86 patients with dentition defects who received implant prosthesis after orthodontic treatment in our hospital between January 2018 and January 2019.Those patients were divided into a control group and an intervention group with 43 patients in each group using a random number table.The control group received traditional implant restoration,whereas the intervention group received 3D printing guide plate implant restoration.Treatment outcomes,cosmetic appearance,dental function,implant deviation,and quality of life were compared between the two groups.RESULTS The overall response rate in the intervention group was significantly higher than that in the control group(95.35%vs 81.40%,χ^(2)=4.071,P=0.044).The number of cases with neatly trimmed cosmetic appearance(χ^(2)=4.497,P=0.034),complete coverage(χ^(2)=4.170,P=0.041),and normal occlusion(χ^(2)=5.512,P=0.019)in the intervention group was higher than that in the control group.After treatment,mastication,swallowing,and articulation were significantly improved in both groups.Masticatory(t=2.980,P=0.004),swallowing(t=2.199,P=0.031),and phonic functions(t=3.950,P=0.004)were better in the intervention group than those in the control group.The deviation value and the deviation angle(t=5.440,P=0.000)at the top(t=6.320,P=0.000)and middle parts of the implants(t=22.295,P=0.000)in the intervention group were lower than those in the control group after treatment.Functional limitations,psychosocial and physical pain and discomfort,and total scores decreased in both groups.The functional limitation(t=2.379,P=0.020),psychosocial(t=2.420,P=0.000),physical pain and discomfort(t=6.581,P=0.000),and total scores(t=2.140,P=0.035)were lower in the intervention group than those in the control group.CONCLUSION Orthodontic treatment combined with 3D printing guide plate implant restoration can significantly improve the masticatory and phonic functions,quality of life,and psychological health of patients with dentition defects.Therefore,it is highly recommended in clinic application.
基金The authors are grateful to the Deanship of Scientific Research at Prince Sattam bin Abdulaziz University Supporting Project Number(2020/01/16725),Prince Sattam bin Abdulaziz University,Saudi Arabia.
文摘The Weibull distribution is regarded as among the finest in the family of failure distributions.One of the most commonly used parameters of the Weibull distribution(WD)is the ordinary least squares(OLS)technique,which is useful in reliability and lifetime modeling.In this study,we propose an approach based on the ordinary least squares and the multilayer perceptron(MLP)neural network called the OLSMLP that is based on the resilience of the OLS method.The MLP solves the problem of heteroscedasticity that distorts the estimation of the parameters of the WD due to the presence of outliers,and eases the difficulty of determining weights in case of the weighted least square(WLS).Another method is proposed by incorporating a weight into the general entropy(GE)loss function to estimate the parameters of the WD to obtain a modified loss function(WGE).Furthermore,a Monte Carlo simulation is performed to examine the performance of the proposed OLSMLP method in comparison with approximate Bayesian estimation(BLWGE)by using a weighted GE loss function.The results of the simulation showed that the two proposed methods produced good estimates even for small sample sizes.In addition,the techniques proposed here are typically the preferred options when estimating parameters compared with other available methods,in terms of the mean squared error and requirements related to time.
文摘In this manuscript,we study a new version of the optical recursional binormal microbeam model for a flexible binormal microscale beam in terms of a binormal normalized operator.Also,we give new explanations for the optical recursional visco Landau-Lifshitz binormal electromagnetic binormal microscale beam.Finally,we obtain an optical application for the normalized visco Landau-Lifshitz electromagnetic binormal optimistic density with an optical binormal resonator.
文摘The toxicity symptoms among 79migrant pesticide workers involved in open-field pesticide application in Oman were studied. Questionnaires addressing the workers＇ demographics, pesticide use and practices, use of protective devices, disposal of empty containers, storage of pesticides and self-reported poisoning symptoms were administered face-to-face to the workers before commencement of work, during break or at home. A total of 28 toxicity symptoms were reported, skin rash being the symptom reported by a majority of the workers （78%）, followed by increased salivation （68%）. The gravity of toxicity symptoms was attributed principally to the non-use of protective devices during pesticide spraying. Other factors contributing to poisoning were the workers＇ poor post-application sanitation habits, improper disposal of empty pesticide containers and storage of partially used pesticides in bedrooms. In order to reduce the incidents of poisoning among the agropesticide workers, there is a need to educate them about the benefits of using PPE （personal protective equipment） and ensuring that they adopt good hygiene and sanitation habits at all stages of pesticide handling.
文摘BACKGROUND As survival has been prolonged owing to surgical and medical improvements,liver failure has become a prognostic determinant in patients with congestive heart diseases.Congestive hepatopathy,an abnormal state of the liver as a result of congestion,insidiously proceed toward end-stage liver disease without effective biomarkers evaluating pathological progression.Regular measurements of shear wave elastography cannot qualify liver fibrosis,which is a prognosticator in any type of chronic liver disease,in cases of congestion because congestion makes the liver stiff without fibrosis.We hypothesized that the effects of congestion and fibrosis on liver stiffness can be dissociated by inducing architectural deformation of the liver to expose structural rigidity.To establish a strategy measuring liver stiffness as a reflection of architectural rigidity under congestion.METHODS Two-dimensional shear wave elastography(2dSWE)was measured in the supine(Sp)and left decubitus(Ld)positions in 298 consecutive cases as they were subjected to an ultrasound study for various liver diseases.Regions of interest were placed at twelve sites,and the median and robust coefficient of variation were calculated.Numerical data were compared using the Mann-Whitney U or Kruskal-Wallis test followed by Dunn's post-hoc multiple comparisons.The inferior vena cava(IVC)diameters at different body positions were compared using the Wilcoxon matched pairs signed rank test.The number of cases with cardiothoracic ratios greater than or not greater than 50%was compared using Fisher’s exact test.A correlation of 2dSWE between different body positions was evaluated by calculating Spearman correlation coefficients.RESULTS The IVC diameter was significantly reduced in Ld in subjects with higher 2dSWE values in Ld(LdSWE)than in Sp(SpSWE)(P=0.007,(average±SD)13.9±3.6 vs 13.1±3.4 mm)but not in those with lower LdSWE values(P=0.32,13.3±3.5 vs 13.0±3.5 mm).In 81 subjects,SpSWE was increased or decreased in Ld beyond the magnitude of robust coefficient of variation,which suggests that body postural changes induced an alteration of liver stiffness significantly larger than the technical dispersion.Among these subjects,all 37 with normal SpSWE had a higher LdSWE than SpSWE(Normal-to-Hard,SpSWE-LdSWE(Δ2dSWE):(minimum-maximum)-0.74--0.08 m/sec),whereas in 44 residual subjects with abnormal SpSWE,LdSWE was higher in 27 subjects(Hard-to-Hard,-0.74--0.05 m/sec)and lower in 17 subjects(Hard-to-Soft,0.04-0.52 m/sec)than SpSWE.SpSWE was significantly correlated withΔ2dSWE only in Hard-to-Soft(P<0.0001).Δ2dSWE was larger in each lobe than in the entire liver.When Hard-to-Hard and Hard-to-Soft values were examined for each lobe,fibrosis-4 or platelet counts were significantly higher or lower only for Hard-to-Soft vs Normal-to-Hard cases.CONCLUSION Gravity alters the hepatic architecture during body postural changes,causing outflow blockage in hepatic veins.A rigid liver is resistant to structural deformation.Stiff-liver softening in the Ld position suggests a fibrous liver.
文摘The coronavirus disease 2019 pandemic had deleterious effects on the healthcare systems around the world.To increase intensive care units(ICUs)bed capacities,multiple adaptations had to be made to increase surge capacity.In this editorial,we demonstrate the changes made by an ICU of a midwest community hospital in the United States.These changes included moving patients that used to be managed in the ICU to progressive care units,such as patients requiring noninvasive ventilation and high flow nasal cannula,ST-elevation myocardial infarction patients,and post-neurosurgery patients.Additionally,newer tactics were applied to the processes of assessing oxygen supply and demand,patient care rounds,and post-ICU monitoring.
基金supported by the National Natural Science Foundation of China(42077336)the Asia-Pacific Network for Global Change Research(CRRP2019-FP06-WANG)+1 种基金the 111 Program of the Ministry of Education,China(T2017002)the Fundamental Research Funds for the Central Universities of China.
文摘Atmospheric microplastics(AMPs)can absorb and scatter radiation,which can be quantified by radiative forcing.Although the radiative forcing of AMPs is commonly positive at the global scale,regional environmental variables affect the radiative forcing of aerosols,potentially reversing its directions and causing opposite radiative impacts in the atmosphere.In this study,the total suspended particles were collected within one year in Tianjin,China,and the monthly average concentration of AMPs of 200.0-463.9 items/m^(3) was detected.Accordingly,the direct radiative forcing(DRF)of AMPs was calculated as0.03 to 0.03 W/m^(2) at the top of the atmosphere and0.09 to 0.72 W/m^(2) at the Earth's surface,respectively.The surface albedo significantly affects the direction of the DRF of AMPs.A low surface albedo leads to a cooling effect of AMPs in the atmosphere in Tianjin,while a high surface albedo causes a warming effect in the atmosphere.The DRF calculated under different surface albedo indicates that the potential impact of AMPs on atmospheric temperature is relatively complex.The temperature changes caused by AMPs in grassland and bare soil areas may be opposite to those in areas covered by snow and ice.
文摘Background and Aims:The impact of coronavirus disease-2019(COVID-19)on liver function remains to be fully elucidated.This study was designed to investigate such and determine the clinical significance in determining mortality risk.Methods:A retrospective study was conducted in patients with COVID-19 from March 2020 to July 2020.Clinical details were retrieved from electronic medical records to obtain clinical characteristics,medical history,laboratory tests,therapeutic intervention,and outcome data.Results:A total of 184 patients with COVID-19 were included(median age:45.5 years),comprised of 62.5%men.In total,22(12.0%)patients had severe infection and 162(88.0%)had mild to moderate infection.Overall,95(51.6%)showed abnormal liver function test(LFT)and 17(9.2%)showed normal LFT at admission.The median age,hospital stay,and LFT were significantly higher in severe vs.non-severe infection(p<0.001).Out of 12 deaths,the majority were due to severe infection(n=11).Deaths were also due to acute respiratory distress syndrome(n=5),cardiac reasons(n=3),and sepsis with multiorgan failure(n=3).The median age,hospital stay and number of intensive care unit admissions were higher in patients having abnormal LFT compared to normal LFT.Incidence of elevated aspartate aminotransferase(42.8%and 40.4%),alanine transaminase(43.7%and 41.6%),and hypoalbuminemia(71.4%and72.7%)at admission and discharge were more common in severe infection.The mean survival was significantly lower in severe infection compared to those with non-severe disease(17.2 vs.52.3 days;p<0.001).Conclusions:Incidence of abnormal liver function was higher in patients with severe COVID-19 and was associated with prolonged hospital stay;mortality was associated with severity of COVID-19.For ruling out the risk of liver injury,it is crucial to vigilantly monitor the liver function parameters in patients with COVID-19 admitted to hospital.
