Objective Acute aortic dissection （AAD） is a catastrophic event with high early mortality rate, but to date, no data on the incidence of AAD in China's Mainland is available. This study aimed to estimate the inc...Objective Acute aortic dissection （AAD） is a catastrophic event with high early mortality rate, but to date, no data on the incidence of AAD in China's Mainland is available. This study aimed to estimate the incidence of AAD in China and characterize the clinical profile, management and in-hospital outcomes of this vascular event. Methods We used the China Health Insurance Research Data （the CHIRA Data） 2011 which comprises all inpatient hospital records （300,886） during the period of Jan. 1st 2011 to Dec. 31 2011 of 3,335,000 randomly sampled beneficiaries （1,718,500 men and 1,616,500 women） from 25 cities and counties in different economic-geographic regions of China's Mainland. Patients with acute aortic dissection were identified according to International Classification of Disease 10m Revision （ICD-10） of I71.0, The estimated incidence of AAD was calculated using the equation： estimated incidence = 2.0 × （40% × hospital admission rate） ＋ 60% × hospital admission rate. Results The hospital admission rate was 2.0/100,000 （65/3,325,000, 95% CI： 1.2-2.8）. The estimated annual incidence of AAD was 2.8/100,000 （95% CI： 1.9-3.6） and was higher in male than in female （3.7 vs. 1.5, P 〈 0.001）. The mean age was 58.9 ± 13.4 years. During the mean hospital stay of 23 ±6 days, the overall in-hospital mortality was 13.9% （9/65）. Conclusions Our study showed relatively lower but not negligible incidence and in-hospital mortality of AAD in the mainland of China. The mean age of patients with AAD in Chinese was younger than that reported by researches from west countries, while the male to female incidence ratio is similar to those reported by other studies.展开更多
Using the Hill estimator, general multifractal characteristics of events in the New Zealand area have been dis-cussed. Results show that the spatial distribution of shallow events has apparent clustering characteristi...Using the Hill estimator, general multifractal characteristics of events in the New Zealand area have been dis-cussed. Results show that the spatial distribution of shallow events has apparent clustering characteristics, inde-pendent of the threshold magnitude; but for deep events these characteristics are not clear. While the time interval distribution has obvious clustering characteristics both for deep and shallow events, although with a different scal-ing range, the Hill estimates tend to indicate that the time interval distribution has a unifractal rather than a multifractal nature. All above reveal that the seismicity nature for shallow and deep events is apparently different.展开更多
BACKGROUND: Oligoanalgesia in emergency departments (EDs) is multifactorial. A previousstudy reported that emergency providers did not adequately manage patients with severe paindespite objective findings for surgical...BACKGROUND: Oligoanalgesia in emergency departments (EDs) is multifactorial. A previousstudy reported that emergency providers did not adequately manage patients with severe paindespite objective findings for surgical pathologies. Our study aims to investigate clinical andlaboratory factors, in addition to providers’ interventions, that might have been associated witholigoanalgesia in a group of ED patients with moderate and severe pains due to surgical pathologies.METHODS: We conducted a retrospective study of adult patients who were transferred directlyfrom referring EDs to the emergency general surgery (EGS) service at a quaternary academic centerbetween January 2014 and December 2016. Patients who were intubated, did not have adequaterecords, or had mild pain were excluded. The primary outcome was refractory pain, which wasdefi ned as pain reduction <2 units on the 0–10 pain scale between triage and ED departure.RESULTS: We analyzed 200 patients, and 58 (29%) had refractory pain. Patients with refractory painhad signifi cantly higher disease severity, serum lactate (3.4±2.0 mg/dL vs. 1.4±0.9 mg/dL, P=0.001), and lessfrequent pain medication administration (median [interquartile range], 3 [3–5] vs. 4 [3–7], P=0.001), whencompared to patients with no refractory pain. Multivariable logistic regression showed that the number of painmedication administration (odds ratio [OR] 0.80, 95% confi dence interval [95% CI] 0.68–0.98) and ED serumlactate levels (OR 3.80, 95% CI 2.10–6.80) were signifi cantly associated with the likelihood of refractory pain.CONCLUSIONS: In ED patients transferring to EGS service, elevated serum lactate levelswere associated with a higher likelihood of refractory pain.展开更多
This article aims to explore the current status of creative protection for artists in the field of art.With the further development of modern society,the development of the art market,and the continuous growth of the ...This article aims to explore the current status of creative protection for artists in the field of art.With the further development of modern society,the development of the art market,and the continuous growth of the market value of artist works,the protection of artistic creativity has also attracted increasing attention and become a focus.Firstly,the article will introduce the connotation and extension of artistic creativity,as well as the importance and significance of protection.Secondly,this article will explore the challenges faced by the protection of artistic creativity,including issues such as piracy and infringement,and propose corresponding tentative solutions.Finally,through specific analysis,the current status of artistic and creative protection will be summarized,and future development directions will be looked forward to.展开更多
Background:Male breast cancer(MBC)is a rare but significant health concern,accounting for less than 1%of all breast cancer cases.Despite its low incidence,it presents unique clinical,genetic,and psychosocial challenge...Background:Male breast cancer(MBC)is a rare but significant health concern,accounting for less than 1%of all breast cancer cases.Despite its low incidence,it presents unique clinical,genetic,and psychosocial challenges.Genetic predispositions,including BRCA2 mutations and hormonal imbalances,are key factors influencing the development of MBC.However,the rarity of the condition has led to limited research and fewer treatment guidelines specifically for male patients.Methods:A comprehensive literature review was conducted using PubMed,MEDLINE,and Embase databases to identify studies focusing on the epidemiology,risk factors,clinical presentation,diagnosis,treatment,and psychosocial impacts of male breast cancer.Articles were selected based on relevance,peer-review status,and focus on MBC in male patients.Data were synthesized narratively,and findings were contextualized based on the methodology and design of included studies.Results:The review identified several significant risk factors for MBC,including BRCA2 mutations,hormonal imbalances(particularly estrogen and testosterone levels),and family history of breast cancer.MBC is often diagnosed at later stages due to the absence of routine screening in men,resulting in poorer survival outcomes compared to female breast cancer.Treatment strategies for MBC largely mirror those for women,including surgery,radiation,chemotherapy,and hormonal therapies.However,the psychosocial impacts of MBC are unique to men,with issues such as stigma,body image concerns,and societal perceptions of masculinity.Conclusions:Male breast cancer remains an understudied area of oncology,with significant gaps in research related to early detection,targeted therapies,and long-term care.Collaborative international research efforts,such as the MERGE consortium and the International Male Breast Cancer Program,are essential for improving understanding and treatment outcomes.Genetic counseling,early screening,and personalized treatment approaches are crucial in managing the disease.Further research focusing on the molecular basis of MBC,along with the psychosocial needs of affected men,is necessary to enhance both survival rates and quality of life for male breast cancer patients.展开更多
The advent of point-of-care testing(POCT)has revolutionized the approach to patient management,especially for pediatric care.POCT provides rapid,on-the-spot biochemical and microbiological evaluations,bypassing delays...The advent of point-of-care testing(POCT)has revolutionized the approach to patient management,especially for pediatric care.POCT provides rapid,on-the-spot biochemical and microbiological evaluations,bypassing delays typically associated with central laboratory testing,enabling swift clinical decision-making.Additionally,POCT has proven to be a valuable prognostic tool for monitoring electrolyte,lactate,creatinine levels,often a marker of severe illness and poor outcomes.POCT enables its faster identification,allowing for prompt inter-ventions.This capability is essential in managing conditions like sepsis,where timely treatment can significantly impact survival rates.However,the implementation of POCT is not without its challenges.Variability in sample handling,particularly with heparinized syringes,can affect the accuracy of certain measurements,such as potassium levels.The absence of comprehensive follow-up data and cost-effectiveness analyses in some studies indicate the need for continued research to optimize the use of POCT.In conclusion,POCT is a trans-formative tool in critical care,offering prompt and reliable assessments that significantly enhance patient management.As technology advances,the inte-gration of POCT into emergency departments and intensive critical care units holds great promise for improving the quality of healthcare and patient survival rates.展开更多
Objective:To isolate and identify active constituents from Gracilaria chorda extract prepared under subcritical water conditions at 210℃(GCSW210)and evaluate their anti-obesity and anti-diabetic effects in 3T3-L1 adi...Objective:To isolate and identify active constituents from Gracilaria chorda extract prepared under subcritical water conditions at 210℃(GCSW210)and evaluate their anti-obesity and anti-diabetic effects in 3T3-L1 adipocytes and high-fat diet(HFD)-induced obese zebrafish larvae.Methods:GCSW210 was fractionated through solvent partitioning,ion-exchange chromatography,and silica gel medium-pressure liquid chromatography,followed by preparative high performance liquid chromatography.At each step,bioactivities were assessed in 3T3-L1 adipocytes by Oil Red O staining and 2-NBDG uptake assays.The most active fractions were further purified,and isolated compounds were tested in HFD-induced obese zebrafish larvae.Results:Liquid chromatography-hyphenated analysis with reference standards identified two major compounds in GCSW210:5-hydroxymethylfurfural and bis(5-formylfurfuryl)ether.Both compounds significantly inhibited lipid accumulation in 3T3-L1 adipocytes and modulated gene expression associated with adipogenesis,glucose metabolism,and inflammation in zebrafish.They also enhanced glucose uptake,reduced circulating glucose levels,and improved insulin sensitivity.Notably,the effects were comparable to those of the crude GCSW210 extract.In silico docking studies confirmed stable interactions of both compounds with key metabolic and inflammatory targets,with bis(5-formylfurfuryl)ether showing stronger binding affinities.Conclusions:These findings suggest that 5-hydroxymethylfurfural and bis(5-formylfurfuryl)ether are key contributors to the therapeutic activity of Gracilaria chorda,highlighting its potential as a functional food ingredient for the prevention or management of metabolic disorders.展开更多
BACKGROUND There is a lack of study on vitamin D and calcium levels in epileptic patients receiving therapy,despite the growing recognition of the importance of bone health in individuals with epilepsy.Associations on...BACKGROUND There is a lack of study on vitamin D and calcium levels in epileptic patients receiving therapy,despite the growing recognition of the importance of bone health in individuals with epilepsy.Associations one statistical method for finding correlations between variables in big datasets is called association rule mining(ARM).This technique finds patterns of common items or events in the data set,including associations.Through the analysis of patient data,including demographics,genetic information,and reactions with previous treatments,ARM can identify harmful drug reactions,possible novel combinations of medicines,and trends which connect particular individual features to treatment outcomes.AIM To investigate the evidence on the effects of anti-epileptic drugs(AEDs)on calcium metabolism and supplementing with vitamin D to help lower the likelihood of bone-related issues using ARM technique.METHODS ARM technique was used to analyze patients’behavior on calcium metabolism,vitamin D and anti-epileptic medicines.Epileptic sufferers of both sexes who attended neurological outpatient and in patient department clinics were recruited for the study.There were three patient groups:Group 1 received one AED,group 2 received two AEDs,and group 3 received more than two AEDs.The researchers analyzed the alkaline phosphatase,ionized calcium,total calcium,phosphorus,vitamin D levels,or parathyroid hormone values.RESULTS A total of 150 patients,aged 12 years to 60 years,were studied,with 50 in each group(1,2,and 3).60%were men,this gender imbalance may affect the study’s findings,as women have different bone metabolism dynamics influenced by hormonal variations,including menopause.The results may not fully capture the distinct effects of AEDs on female patients.A greater equal distribution of women should be the goal of future studies in order to offer a complete comprehension of the metabolic alterations brought on by AEDs.86 patients had generalized epilepsy,64 partial.42%of patients had AEDs for>5 years.Polytherapy reduced calcium and vitamin D levels compared to mono and dual therapy.Polytherapy elevated alkaline phosphatase and phosphorus levels.CONCLUSION ARM revealed the possible effects of variables like age,gender,and polytherapy on parathyroid hormone levels in individuals taking antiepileptic medication.展开更多
Over the past two decades,our understanding of Lauraceae,a large family of woody plants,has undergone significant advances in phylogeny,taxonomy,and biogeography.Molecular systematic studies have elucidated the basic ...Over the past two decades,our understanding of Lauraceae,a large family of woody plants,has undergone significant advances in phylogeny,taxonomy,and biogeography.Molecular systematic studies have elucidated the basic relationships within the family with plastid phylogenomic analyses providing robust support for deep-level relationships between Lauraceae lineages,leading to the recognition of nine tribes:Hypodaphnideae,Cryptocaryeae,Cassytheae,Neocinnamomeae,Caryodaphnopsideae,Mezilaureae,Perseeae,Laureae,and Cinnamomeae,with Mezilaureae validated here.Nuclear genomes and comparative genomics studies have also clarified aspects of the family’s evolutionary history and metabolic diversity.Taxonomic studies have focused mainly on the most diverse regions,e.g.,tropical Asia,tropical America,and Africa(Madagascar),with six new genera described and five reinstated since the last major overview of the family.The extensive fossil record suggests that Lauraceae diversified globally during the Late Cretaceous and Early Cenozoic.Biogeographic studies indicate that different lineages of the family are sorted into Gondwanan and Laurasian lineages,with patterns resulting from the disruption of boreotropical flora and multiple long-distance dispersal events.Phylogeographic studies,predominantly from East Asia,have shown patterns of in situ survival and demographic stability or expansion during the Quaternary.Nevertheless,many systematic relationships within the family remain unresolved and further research is needed into the complex biogeographic history and ecological roles of Lauraceae.A multifaceted approach integrating genomic studies,field work,morphological and ecological investigations is therefore needed to understand the evolution and diversity of this ecologically and economically significant plant family.展开更多
Many advances in genetic selection, nutrition, housing and disease control have been incorporated into modern pork production since the 1950s resulting in highly prolific females and practices and technologies, which ...Many advances in genetic selection, nutrition, housing and disease control have been incorporated into modern pork production since the 1950s resulting in highly prolific females and practices and technologies, which significantly increased efficiency of reproduction in the breeding herd. The objective of this manuscript is to review the literature and current industry practices employed for reproductive management. In particular the authors focus on assisted reproduction technologies and their application for enhanced productivity. Modern maternal line genotypes have lower appetites and exceptional lean growth potential compared to females of 20 yr ago. Thus, nutrient requirements and management techniques and technologies, which affect gilt development and sow longevity, require continuous updating. Failure to detect estrus accurately has the greatest impact on farrowing rate and litter size. Yet, even accurate estrus detection will not compensate for the variability in the interval between onset of estrus and actual time of ovulation. However, administration of GnRH analogs in weaned sows and in gilts after withdrawal of altrenogest do overcome this variability and thereby synchronize ovulation, which makes fixed-time AI practical. Seasonal infertility, mediated by temperature and photoperiod, is a persistent problem. Training workers in the art of stockmanship is of increasing importance as consumers become more interested in humane animal care. Altrenogest, is used to synchronize the estrous cycle of gilts, to prolong gestation for 2-3 d to synchronize farrowing and to postpone post-weaning estrus. P.G. 600~ is used for induction of estrus in pre-pubertal gilts and as a treatment to overcome seasonal anestrous. Sperm cell numbers/dose of semen is significantly less for post cervical AI than for cervical AI. Real-time ultrasonography is used to determine pregnancy during wk 3-5. PGF2a effectively induces farrowing when administered within two d of normal gestation length. Ovulation synchronization, single fixed-time AI and induced parturition may lead to farrowing synchronization, which facilitates supervision and reduces stillbirths and piglet mortality. Attendance and assistance at farrowing is important especially to ensure adequate colostrum consumption by piglets immediately after birth. New performance terminologies are presented.展开更多
Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current...Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current guidelines. Methods： We searched the China Health Insurance Research Association （CHIRA） Database to identify patients with cancer who were 〉 18 years old and received either moderately or highly emetogenie chemotherapy （MEC and HEC, respectively） between 2008 and 2012. Patients＇ characteristics as well as usage of specific antiemetic regimens were analyzed using descriptive statistics. Results： Of the 14,548 patients included in the study, 6,477 received HEC while 8,071 were treated with MEC. Approximately 89.9% used antiemetics prophylactically to prevent acute CINV and 71.5% for delayed CINV while 9.0% were prescribed antiemetics as rescue therapy. A significantly lower proportion of patients treated with HEC received prophylactic antiemetic therapy for delayed CINV as compared to those treated with MEC （59.4% vs. 81.3 %; P〈0.001）. The HEC group had a slightly lower proportion of patients using a mixed regimen containing a 5-HT3 antagonist to prevent both acute and delayed CINV than the MEC group （P〈0.012）; however, a higher proportion received a mixed regimen containing eorticosteroids （P≤0.007）. Although more than half of the patients in the HEC group took three antiemeties to prevent acute and delayed CINV, these rates were significantly lower than those of the MEC group （both P〈0.001）. Finally, analysis of the regimens used revealed that there is over-utilization of drugs within the same class of antiemetic. Conclusions： These findings indicate that more attention is needed for treatment of delayed CINV, in terms of both overall use and the components of a typical treatment regimen.展开更多
The objective of this research is to determine the effect earthquakes have on the performance of transportation network systems.To do this,bridge fragility curves,expressed as a function of peak ground acceleration(PG...The objective of this research is to determine the effect earthquakes have on the performance of transportation network systems.To do this,bridge fragility curves,expressed as a function of peak ground acceleration(PGA)and peak ground velocity(PGV),were developed.Network damage was evaluated under the 1994 Northridge earthquake and scenario earthquakes.A probabilistic model was developed to determine the effect of repair of bridge damage on the improvement of the network performance as days passed after the event.As an example,the system performance degradation measured in terms of an index,'Drivers Delay,'is calculated for the Los Angeles area transportation system,and losses due to Drivers Delay with and without retrofit were estimated.展开更多
Abstract A first study on the continuous adjoint formulation for aerodynamic optimization design of high pressure turbines based on S2 surface governed by the Euler equations with source terms is presented. The object...Abstract A first study on the continuous adjoint formulation for aerodynamic optimization design of high pressure turbines based on S2 surface governed by the Euler equations with source terms is presented. The objective function is defined as an integral function along the boundaries, and the adjoint equations and the boundary conditions are derived by introducing the adjoint variable vec- tors. The gradient expression of the objective function then includes only the terms related to phys- ical shape variations. The numerical solution of the adjoint equation is conducted by a finite- difference method with the Jameson spatial scheme employing the first and the third order dissipa- tive fluxes. A gradient-based aerodynamic optimization system is established by integrating the blade stagger angles, the stacking lines and the passage perturbation parameterization with the quasi-Newton method of Broyden Fletcher Goldfarb-Shanno （BFGS）. The application of the continuous adjoint method is validated through a single stage high pressure turbine optimization case. The adiabatic efficiency increases from 0.8875 to 0.8931, whilst the mass flow rate and the pressure ratio remain almost unchanged. The optimization design is shown to reduce the passage vortex loss as well as the mixing loss due to the cooling air injection.展开更多
Recently,ambient vibration test(AVT)is widely used tu estimate dynamic characteristics of large civil struc- tures.Dynamic characteristics ean be affected by various envirnnmental factors such as humidity,intensity of...Recently,ambient vibration test(AVT)is widely used tu estimate dynamic characteristics of large civil struc- tures.Dynamic characteristics ean be affected by various envirnnmental factors such as humidity,intensity of wind,and temperature.Besides these environmental conditions,tire mass of vehicles may change the measured valnes when traffic-in- duced vibration is used as a source of AVT tor bridges.The effect of vehicle mass on dynamic characteristics is investigated through traffic-induced vibration tests on three bridges;(1)three-span suspension bridge(128m+404m+128m),(2) five-span continuous steel box girder bridge(59m+3@ 95m+59m),(3)simply supported plate girder bridge(46m). Acceleration histories of each measurement location under normal traffic are recorded for 30 minutes at field.These recor- ded histories are divided into individual vibrations and are combined into two groups aceording to the level of vibration;one by heavy vehicles such as trucks and buses and the other by light vehicles such as passenger cars.Separate processing of the two groups of signals shows that,for the middle and long-span bridges,the difference can be hardly detected,but,for the short span bridges whose mass is relatively small,the measured natural frequencies can change up to 5.4%.展开更多
Application of pneumatic separators in coal beneficiation is increasing rapidly over the last decade primarily due to their low capital and operating costs, and waste handling problems associated with traditional wet ...Application of pneumatic separators in coal beneficiation is increasing rapidly over the last decade primarily due to their low capital and operating costs, and waste handling problems associated with traditional wet processing methods. Large amount of shale/rock that is extracted in coal production can be removed prior to transportation at the mine face by using this methodology. Due to the limited washing facilities in India, most of the thermal power plants burn raw coal from run-of-mine （ROM） to generate electricity. This practice causes poor utilization efficiency, high operating and maintenance costs, and high emission rates for the power plants. One potential method that can be utilized is the air-fluidized inclined vibrating deck technology. The technology was demonstrated on a pilot-scale at different coal washeries in India at a feed rate of 5-ton per hour. The pilot-scale evaluation showed that 20 %-25 % high-ash incombustible material can be eliminated from ROM feed with only minor losses in energy content （〈10 %） from respective ROM coal. Furthermore, a feasibility analysis showed significant economic gains in terms of transportation cost, improving power-plant efficiency, and reducing emissions rates by using the technology.展开更多
Light absorbing particles（LAP, e.g., black carbon, brown carbon, and dust） influence water and energy budgets of the atmosphere and snowpack in multiple ways. In addition to their effects associated with atmospheric...Light absorbing particles（LAP, e.g., black carbon, brown carbon, and dust） influence water and energy budgets of the atmosphere and snowpack in multiple ways. In addition to their effects associated with atmospheric heating by absorption of solar radiation and interactions with clouds, LAP in snow on land and ice can reduce the surface reflectance（a.k.a., surface darkening）, which is likely to accelerate the snow aging process and further reduces snow albedo and increases the speed of snowpack melt. LAP in snow and ice（LAPSI） has been identified as one of major forcings affecting climate change, e.g.in the fourth and fifth assessment reports of IPCC. However, the uncertainty level in quantifying this effect remains very high. In this review paper, we document various technical methods of measuring LAPSI and review the progress made in measuring the LAPSI in Arctic, Tibetan Plateau and other mid-latitude regions. We also report the progress in modeling the mass concentrations, albedo reduction, radiative forcing, and climatic and hydrological impact of LAPSI at global and regional scales. Finally we identify some research needs for reducing the uncertainties in the impact of LAPSI on global and regional climate and the hydrological cycle.展开更多
文摘Objective Acute aortic dissection （AAD） is a catastrophic event with high early mortality rate, but to date, no data on the incidence of AAD in China's Mainland is available. This study aimed to estimate the incidence of AAD in China and characterize the clinical profile, management and in-hospital outcomes of this vascular event. Methods We used the China Health Insurance Research Data （the CHIRA Data） 2011 which comprises all inpatient hospital records （300,886） during the period of Jan. 1st 2011 to Dec. 31 2011 of 3,335,000 randomly sampled beneficiaries （1,718,500 men and 1,616,500 women） from 25 cities and counties in different economic-geographic regions of China's Mainland. Patients with acute aortic dissection were identified according to International Classification of Disease 10m Revision （ICD-10） of I71.0, The estimated incidence of AAD was calculated using the equation： estimated incidence = 2.0 × （40% × hospital admission rate） ＋ 60% × hospital admission rate. Results The hospital admission rate was 2.0/100,000 （65/3,325,000, 95% CI： 1.2-2.8）. The estimated annual incidence of AAD was 2.8/100,000 （95% CI： 1.9-3.6） and was higher in male than in female （3.7 vs. 1.5, P 〈 0.001）. The mean age was 58.9 ± 13.4 years. During the mean hospital stay of 23 ±6 days, the overall in-hospital mortality was 13.9% （9/65）. Conclusions Our study showed relatively lower but not negligible incidence and in-hospital mortality of AAD in the mainland of China. The mean age of patients with AAD in Chinese was younger than that reported by researches from west countries, while the male to female incidence ratio is similar to those reported by other studies.
基金State Natural Science Foundation of China (40074013 and 40134010) New Zealand Marsden Foundation (00-SRA-002-MIS).
文摘Using the Hill estimator, general multifractal characteristics of events in the New Zealand area have been dis-cussed. Results show that the spatial distribution of shallow events has apparent clustering characteristics, inde-pendent of the threshold magnitude; but for deep events these characteristics are not clear. While the time interval distribution has obvious clustering characteristics both for deep and shallow events, although with a different scal-ing range, the Hill estimates tend to indicate that the time interval distribution has a unifractal rather than a multifractal nature. All above reveal that the seismicity nature for shallow and deep events is apparently different.
文摘BACKGROUND: Oligoanalgesia in emergency departments (EDs) is multifactorial. A previousstudy reported that emergency providers did not adequately manage patients with severe paindespite objective findings for surgical pathologies. Our study aims to investigate clinical andlaboratory factors, in addition to providers’ interventions, that might have been associated witholigoanalgesia in a group of ED patients with moderate and severe pains due to surgical pathologies.METHODS: We conducted a retrospective study of adult patients who were transferred directlyfrom referring EDs to the emergency general surgery (EGS) service at a quaternary academic centerbetween January 2014 and December 2016. Patients who were intubated, did not have adequaterecords, or had mild pain were excluded. The primary outcome was refractory pain, which wasdefi ned as pain reduction <2 units on the 0–10 pain scale between triage and ED departure.RESULTS: We analyzed 200 patients, and 58 (29%) had refractory pain. Patients with refractory painhad signifi cantly higher disease severity, serum lactate (3.4±2.0 mg/dL vs. 1.4±0.9 mg/dL, P=0.001), and lessfrequent pain medication administration (median [interquartile range], 3 [3–5] vs. 4 [3–7], P=0.001), whencompared to patients with no refractory pain. Multivariable logistic regression showed that the number of painmedication administration (odds ratio [OR] 0.80, 95% confi dence interval [95% CI] 0.68–0.98) and ED serumlactate levels (OR 3.80, 95% CI 2.10–6.80) were signifi cantly associated with the likelihood of refractory pain.CONCLUSIONS: In ED patients transferring to EGS service, elevated serum lactate levelswere associated with a higher likelihood of refractory pain.
文摘This article aims to explore the current status of creative protection for artists in the field of art.With the further development of modern society,the development of the art market,and the continuous growth of the market value of artist works,the protection of artistic creativity has also attracted increasing attention and become a focus.Firstly,the article will introduce the connotation and extension of artistic creativity,as well as the importance and significance of protection.Secondly,this article will explore the challenges faced by the protection of artistic creativity,including issues such as piracy and infringement,and propose corresponding tentative solutions.Finally,through specific analysis,the current status of artistic and creative protection will be summarized,and future development directions will be looked forward to.
文摘Background:Male breast cancer(MBC)is a rare but significant health concern,accounting for less than 1%of all breast cancer cases.Despite its low incidence,it presents unique clinical,genetic,and psychosocial challenges.Genetic predispositions,including BRCA2 mutations and hormonal imbalances,are key factors influencing the development of MBC.However,the rarity of the condition has led to limited research and fewer treatment guidelines specifically for male patients.Methods:A comprehensive literature review was conducted using PubMed,MEDLINE,and Embase databases to identify studies focusing on the epidemiology,risk factors,clinical presentation,diagnosis,treatment,and psychosocial impacts of male breast cancer.Articles were selected based on relevance,peer-review status,and focus on MBC in male patients.Data were synthesized narratively,and findings were contextualized based on the methodology and design of included studies.Results:The review identified several significant risk factors for MBC,including BRCA2 mutations,hormonal imbalances(particularly estrogen and testosterone levels),and family history of breast cancer.MBC is often diagnosed at later stages due to the absence of routine screening in men,resulting in poorer survival outcomes compared to female breast cancer.Treatment strategies for MBC largely mirror those for women,including surgery,radiation,chemotherapy,and hormonal therapies.However,the psychosocial impacts of MBC are unique to men,with issues such as stigma,body image concerns,and societal perceptions of masculinity.Conclusions:Male breast cancer remains an understudied area of oncology,with significant gaps in research related to early detection,targeted therapies,and long-term care.Collaborative international research efforts,such as the MERGE consortium and the International Male Breast Cancer Program,are essential for improving understanding and treatment outcomes.Genetic counseling,early screening,and personalized treatment approaches are crucial in managing the disease.Further research focusing on the molecular basis of MBC,along with the psychosocial needs of affected men,is necessary to enhance both survival rates and quality of life for male breast cancer patients.
文摘The advent of point-of-care testing(POCT)has revolutionized the approach to patient management,especially for pediatric care.POCT provides rapid,on-the-spot biochemical and microbiological evaluations,bypassing delays typically associated with central laboratory testing,enabling swift clinical decision-making.Additionally,POCT has proven to be a valuable prognostic tool for monitoring electrolyte,lactate,creatinine levels,often a marker of severe illness and poor outcomes.POCT enables its faster identification,allowing for prompt inter-ventions.This capability is essential in managing conditions like sepsis,where timely treatment can significantly impact survival rates.However,the implementation of POCT is not without its challenges.Variability in sample handling,particularly with heparinized syringes,can affect the accuracy of certain measurements,such as potassium levels.The absence of comprehensive follow-up data and cost-effectiveness analyses in some studies indicate the need for continued research to optimize the use of POCT.In conclusion,POCT is a trans-formative tool in critical care,offering prompt and reliable assessments that significantly enhance patient management.As technology advances,the inte-gration of POCT into emergency departments and intensive critical care units holds great promise for improving the quality of healthcare and patient survival rates.
文摘Objective:To isolate and identify active constituents from Gracilaria chorda extract prepared under subcritical water conditions at 210℃(GCSW210)and evaluate their anti-obesity and anti-diabetic effects in 3T3-L1 adipocytes and high-fat diet(HFD)-induced obese zebrafish larvae.Methods:GCSW210 was fractionated through solvent partitioning,ion-exchange chromatography,and silica gel medium-pressure liquid chromatography,followed by preparative high performance liquid chromatography.At each step,bioactivities were assessed in 3T3-L1 adipocytes by Oil Red O staining and 2-NBDG uptake assays.The most active fractions were further purified,and isolated compounds were tested in HFD-induced obese zebrafish larvae.Results:Liquid chromatography-hyphenated analysis with reference standards identified two major compounds in GCSW210:5-hydroxymethylfurfural and bis(5-formylfurfuryl)ether.Both compounds significantly inhibited lipid accumulation in 3T3-L1 adipocytes and modulated gene expression associated with adipogenesis,glucose metabolism,and inflammation in zebrafish.They also enhanced glucose uptake,reduced circulating glucose levels,and improved insulin sensitivity.Notably,the effects were comparable to those of the crude GCSW210 extract.In silico docking studies confirmed stable interactions of both compounds with key metabolic and inflammatory targets,with bis(5-formylfurfuryl)ether showing stronger binding affinities.Conclusions:These findings suggest that 5-hydroxymethylfurfural and bis(5-formylfurfuryl)ether are key contributors to the therapeutic activity of Gracilaria chorda,highlighting its potential as a functional food ingredient for the prevention or management of metabolic disorders.
文摘BACKGROUND There is a lack of study on vitamin D and calcium levels in epileptic patients receiving therapy,despite the growing recognition of the importance of bone health in individuals with epilepsy.Associations one statistical method for finding correlations between variables in big datasets is called association rule mining(ARM).This technique finds patterns of common items or events in the data set,including associations.Through the analysis of patient data,including demographics,genetic information,and reactions with previous treatments,ARM can identify harmful drug reactions,possible novel combinations of medicines,and trends which connect particular individual features to treatment outcomes.AIM To investigate the evidence on the effects of anti-epileptic drugs(AEDs)on calcium metabolism and supplementing with vitamin D to help lower the likelihood of bone-related issues using ARM technique.METHODS ARM technique was used to analyze patients’behavior on calcium metabolism,vitamin D and anti-epileptic medicines.Epileptic sufferers of both sexes who attended neurological outpatient and in patient department clinics were recruited for the study.There were three patient groups:Group 1 received one AED,group 2 received two AEDs,and group 3 received more than two AEDs.The researchers analyzed the alkaline phosphatase,ionized calcium,total calcium,phosphorus,vitamin D levels,or parathyroid hormone values.RESULTS A total of 150 patients,aged 12 years to 60 years,were studied,with 50 in each group(1,2,and 3).60%were men,this gender imbalance may affect the study’s findings,as women have different bone metabolism dynamics influenced by hormonal variations,including menopause.The results may not fully capture the distinct effects of AEDs on female patients.A greater equal distribution of women should be the goal of future studies in order to offer a complete comprehension of the metabolic alterations brought on by AEDs.86 patients had generalized epilepsy,64 partial.42%of patients had AEDs for>5 years.Polytherapy reduced calcium and vitamin D levels compared to mono and dual therapy.Polytherapy elevated alkaline phosphatase and phosphorus levels.CONCLUSION ARM revealed the possible effects of variables like age,gender,and polytherapy on parathyroid hormone levels in individuals taking antiepileptic medication.
基金supported by the National Natural Science Foundation of China(31970222,31770569,31500454,31500165,32260060,32270217,32260056,31970223,32400180)the Science and Technology Basic Resources Investigation Program of China(2017FY100100,2017FY100102)+7 种基金Biodiversity Conservation Program of Chinese Academy of Sciences(ZSSD-013)National Key Research and Development Program of China(2022YFC2601200,2023YFF0805800)Yunnan Fundamental Research Projects(202201AS070055,202301AU070224)the 14th Five-Year Plan of Xishuangbanna Tropical Botanical Garden,Chinese Academy of Sciences(XTBG-1450101)Australian Research Council grant(DP130104314)RSNZ Marsden grant(11-UOO-043)Xingdian Talent Support Program(XDRC-QNRC-2022-0323)Shandong Provincial Natural Science Foundation(ZR2022QC214).
文摘Over the past two decades,our understanding of Lauraceae,a large family of woody plants,has undergone significant advances in phylogeny,taxonomy,and biogeography.Molecular systematic studies have elucidated the basic relationships within the family with plastid phylogenomic analyses providing robust support for deep-level relationships between Lauraceae lineages,leading to the recognition of nine tribes:Hypodaphnideae,Cryptocaryeae,Cassytheae,Neocinnamomeae,Caryodaphnopsideae,Mezilaureae,Perseeae,Laureae,and Cinnamomeae,with Mezilaureae validated here.Nuclear genomes and comparative genomics studies have also clarified aspects of the family’s evolutionary history and metabolic diversity.Taxonomic studies have focused mainly on the most diverse regions,e.g.,tropical Asia,tropical America,and Africa(Madagascar),with six new genera described and five reinstated since the last major overview of the family.The extensive fossil record suggests that Lauraceae diversified globally during the Late Cretaceous and Early Cenozoic.Biogeographic studies indicate that different lineages of the family are sorted into Gondwanan and Laurasian lineages,with patterns resulting from the disruption of boreotropical flora and multiple long-distance dispersal events.Phylogeographic studies,predominantly from East Asia,have shown patterns of in situ survival and demographic stability or expansion during the Quaternary.Nevertheless,many systematic relationships within the family remain unresolved and further research is needed into the complex biogeographic history and ecological roles of Lauraceae.A multifaceted approach integrating genomic studies,field work,morphological and ecological investigations is therefore needed to understand the evolution and diversity of this ecologically and economically significant plant family.
文摘Many advances in genetic selection, nutrition, housing and disease control have been incorporated into modern pork production since the 1950s resulting in highly prolific females and practices and technologies, which significantly increased efficiency of reproduction in the breeding herd. The objective of this manuscript is to review the literature and current industry practices employed for reproductive management. In particular the authors focus on assisted reproduction technologies and their application for enhanced productivity. Modern maternal line genotypes have lower appetites and exceptional lean growth potential compared to females of 20 yr ago. Thus, nutrient requirements and management techniques and technologies, which affect gilt development and sow longevity, require continuous updating. Failure to detect estrus accurately has the greatest impact on farrowing rate and litter size. Yet, even accurate estrus detection will not compensate for the variability in the interval between onset of estrus and actual time of ovulation. However, administration of GnRH analogs in weaned sows and in gilts after withdrawal of altrenogest do overcome this variability and thereby synchronize ovulation, which makes fixed-time AI practical. Seasonal infertility, mediated by temperature and photoperiod, is a persistent problem. Training workers in the art of stockmanship is of increasing importance as consumers become more interested in humane animal care. Altrenogest, is used to synchronize the estrous cycle of gilts, to prolong gestation for 2-3 d to synchronize farrowing and to postpone post-weaning estrus. P.G. 600~ is used for induction of estrus in pre-pubertal gilts and as a treatment to overcome seasonal anestrous. Sperm cell numbers/dose of semen is significantly less for post cervical AI than for cervical AI. Real-time ultrasonography is used to determine pregnancy during wk 3-5. PGF2a effectively induces farrowing when administered within two d of normal gestation length. Ovulation synchronization, single fixed-time AI and induced parturition may lead to farrowing synchronization, which facilitates supervision and reduces stillbirths and piglet mortality. Attendance and assistance at farrowing is important especially to ensure adequate colostrum consumption by piglets immediately after birth. New performance terminologies are presented.
基金supported by MSD Holding Co.,Ltd.The funding was only for the payment of using CHIRA database
文摘Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current guidelines. Methods： We searched the China Health Insurance Research Association （CHIRA） Database to identify patients with cancer who were 〉 18 years old and received either moderately or highly emetogenie chemotherapy （MEC and HEC, respectively） between 2008 and 2012. Patients＇ characteristics as well as usage of specific antiemetic regimens were analyzed using descriptive statistics. Results： Of the 14,548 patients included in the study, 6,477 received HEC while 8,071 were treated with MEC. Approximately 89.9% used antiemetics prophylactically to prevent acute CINV and 71.5% for delayed CINV while 9.0% were prescribed antiemetics as rescue therapy. A significantly lower proportion of patients treated with HEC received prophylactic antiemetic therapy for delayed CINV as compared to those treated with MEC （59.4% vs. 81.3 %; P〈0.001）. The HEC group had a slightly lower proportion of patients using a mixed regimen containing a 5-HT3 antagonist to prevent both acute and delayed CINV than the MEC group （P〈0.012）; however, a higher proportion received a mixed regimen containing eorticosteroids （P≤0.007）. Although more than half of the patients in the HEC group took three antiemeties to prevent acute and delayed CINV, these rates were significantly lower than those of the MEC group （both P〈0.001）. Finally, analysis of the regimens used revealed that there is over-utilization of drugs within the same class of antiemetic. Conclusions： These findings indicate that more attention is needed for treatment of delayed CINV, in terms of both overall use and the components of a typical treatment regimen.
基金The Federal Highway Administration(FHWA)under Contract No.DTFH61-98-C-00094the California Department of Transportation(CALTRANS)
文摘The objective of this research is to determine the effect earthquakes have on the performance of transportation network systems.To do this,bridge fragility curves,expressed as a function of peak ground acceleration(PGA)and peak ground velocity(PGV),were developed.Network damage was evaluated under the 1994 Northridge earthquake and scenario earthquakes.A probabilistic model was developed to determine the effect of repair of bridge damage on the improvement of the network performance as days passed after the event.As an example,the system performance degradation measured in terms of an index,'Drivers Delay,'is calculated for the Los Angeles area transportation system,and losses due to Drivers Delay with and without retrofit were estimated.
基金funded by the Aeronautical Science Foundation of China–China(No.2010ZB51023)
文摘Abstract A first study on the continuous adjoint formulation for aerodynamic optimization design of high pressure turbines based on S2 surface governed by the Euler equations with source terms is presented. The objective function is defined as an integral function along the boundaries, and the adjoint equations and the boundary conditions are derived by introducing the adjoint variable vec- tors. The gradient expression of the objective function then includes only the terms related to phys- ical shape variations. The numerical solution of the adjoint equation is conducted by a finite- difference method with the Jameson spatial scheme employing the first and the third order dissipa- tive fluxes. A gradient-based aerodynamic optimization system is established by integrating the blade stagger angles, the stacking lines and the passage perturbation parameterization with the quasi-Newton method of Broyden Fletcher Goldfarb-Shanno （BFGS）. The application of the continuous adjoint method is validated through a single stage high pressure turbine optimization case. The adiabatic efficiency increases from 0.8875 to 0.8931, whilst the mass flow rate and the pressure ratio remain almost unchanged. The optimization design is shown to reduce the passage vortex loss as well as the mixing loss due to the cooling air injection.
基金the Ministry of Construction and Transportation,Korea Highway Corporation and Hyundai E&C Co.Ltd.under Project No.R&D/970003-2.
文摘Recently,ambient vibration test(AVT)is widely used tu estimate dynamic characteristics of large civil struc- tures.Dynamic characteristics ean be affected by various envirnnmental factors such as humidity,intensity of wind,and temperature.Besides these environmental conditions,tire mass of vehicles may change the measured valnes when traffic-in- duced vibration is used as a source of AVT tor bridges.The effect of vehicle mass on dynamic characteristics is investigated through traffic-induced vibration tests on three bridges;(1)three-span suspension bridge(128m+404m+128m),(2) five-span continuous steel box girder bridge(59m+3@ 95m+59m),(3)simply supported plate girder bridge(46m). Acceleration histories of each measurement location under normal traffic are recorded for 30 minutes at field.These recor- ded histories are divided into individual vibrations and are combined into two groups aceording to the level of vibration;one by heavy vehicles such as trucks and buses and the other by light vehicles such as passenger cars.Separate processing of the two groups of signals shows that,for the middle and long-span bridges,the difference can be hardly detected,but,for the short span bridges whose mass is relatively small,the measured natural frequencies can change up to 5.4%.
文摘Application of pneumatic separators in coal beneficiation is increasing rapidly over the last decade primarily due to their low capital and operating costs, and waste handling problems associated with traditional wet processing methods. Large amount of shale/rock that is extracted in coal production can be removed prior to transportation at the mine face by using this methodology. Due to the limited washing facilities in India, most of the thermal power plants burn raw coal from run-of-mine （ROM） to generate electricity. This practice causes poor utilization efficiency, high operating and maintenance costs, and high emission rates for the power plants. One potential method that can be utilized is the air-fluidized inclined vibrating deck technology. The technology was demonstrated on a pilot-scale at different coal washeries in India at a feed rate of 5-ton per hour. The pilot-scale evaluation showed that 20 %-25 % high-ash incombustible material can be eliminated from ROM feed with only minor losses in energy content （〈10 %） from respective ROM coal. Furthermore, a feasibility analysis showed significant economic gains in terms of transportation cost, improving power-plant efficiency, and reducing emissions rates by using the technology.
基金supported by the U.S.Department of Energy, Office of Science, Biological and Environmental Research, as part of the Earth System Modeling ProgramThe NASA Modeling, Analysis, and Prediction (MAP) Program by the Science Mission Directorate at NASA Headquarters supported the work contributed by Teppei J.YASUNARI and William K.M.LAU+2 种基金The NASA GEOS-5 simulation was implemented in the system for NASA Center for Climate Simulation (NCCS).M.G.Flanner was partially supported by NSF 1253154support from the China Scholarship FundThe Pacific Northwest National Laboratory is operated for DOE by Battelle Memorial Institute under contract DE-AC06-76RLO1830
文摘Light absorbing particles（LAP, e.g., black carbon, brown carbon, and dust） influence water and energy budgets of the atmosphere and snowpack in multiple ways. In addition to their effects associated with atmospheric heating by absorption of solar radiation and interactions with clouds, LAP in snow on land and ice can reduce the surface reflectance（a.k.a., surface darkening）, which is likely to accelerate the snow aging process and further reduces snow albedo and increases the speed of snowpack melt. LAP in snow and ice（LAPSI） has been identified as one of major forcings affecting climate change, e.g.in the fourth and fifth assessment reports of IPCC. However, the uncertainty level in quantifying this effect remains very high. In this review paper, we document various technical methods of measuring LAPSI and review the progress made in measuring the LAPSI in Arctic, Tibetan Plateau and other mid-latitude regions. We also report the progress in modeling the mass concentrations, albedo reduction, radiative forcing, and climatic and hydrological impact of LAPSI at global and regional scales. Finally we identify some research needs for reducing the uncertainties in the impact of LAPSI on global and regional climate and the hydrological cycle.
