The reserved judgment can be broadly categorized into three types: Re-Do, Re-Set, and Natural Flowing Case (i.e. step by step in Re-Try). Hori et al. constructed the Bayes-Fuzzy Estimation and demonstrated that system...The reserved judgment can be broadly categorized into three types: Re-Do, Re-Set, and Natural Flowing Case (i.e. step by step in Re-Try). Hori et al. constructed the Bayes-Fuzzy Estimation and demonstrated that system theory can be applied to the possibility of Markov processes, and that decision-making approaches can be applied to sequential Bayes estimation. In this paper, we focus on the Natural Flowing Case within reserved judgment. Here, the possibility of oblique (or principal) factor rotation is considered as a part of the tandem fuzzy system that follows step by step for sequential Bayes estimation. Ultimately, we achieve a significant result whereby the expected utility can be calculated automatically without the need to construct a utility function for reserved judgment. There, this utility in Re-Do can be calculated by the prior utility, and that utility in Re-set does not exist by our research in this paper. Finally, we elucidate the relationship between fuzzy system theory and fuzzy decision theory through an applied example of Bayes-Fuzzy theory. Fuzzy estimation can be applied to only normal making decision, but it is impossible to apply abnormal decision problem. Our Vague, specially Type 2 Vague can be applied to abnormal case, too.展开更多
Numerous engineering cases have demonstrated that the expansive soil channel slope remains susceptible to damage with the implementation of a rigid or closed protective structure. It is common for the protective struc...Numerous engineering cases have demonstrated that the expansive soil channel slope remains susceptible to damage with the implementation of a rigid or closed protective structure. It is common for the protective structure to experience bulging failure due to excessive swelling pressure. To investigate the swelling pressure properties of expansive soil, the constant volume test was employed to study the influence of water content and reserved expansion deformation on the characteristics of swelling pressure in strong expansive soils, and also to explore the evolution mechanism of the swelling pressure. The findings demonstrate that the swelling pressure-time curve can be classified into swelling pressure-time softening and swelling pressure-time stability type. The swelling pressuretime curve of the specimen with low water content is the swelling pressure-time softening type, and the softening level will be weakened with increasing reserved expansion deformation. Besides, the maximum swelling pressure Psmax decreases with increasing water content and reserved expansion deformation, especially for expansion ratio η from 24% to 37%. The reserved deformation has little effect on reducing Psmax when it is beyond 7% of the expansion rate. The specimen with low water content has a more homogeneous structure due to the significant expansion-filling effect, and the fracture and reorganization of the aggregates in the specimens with low water content cause the swelling pressure-time softening behavior. In addition, the proposed swelling pressure-time curve prediction model has a good prediction on the test results. If necessary, a deformation space of about 7% expansion rate is recommended to be reserved in the engineering to reduce the swelling pressure except for keeping a stable water content.展开更多
BACKGROUND The neuroendoscopic approach has the advantages of a clear operative field,convenient tumor removal,and less damage,and is the development direction of modern neurosurgery.At present,transnasal surgery for ...BACKGROUND The neuroendoscopic approach has the advantages of a clear operative field,convenient tumor removal,and less damage,and is the development direction of modern neurosurgery.At present,transnasal surgery for sphenoidal pituitary tumor is widely used.But it has been found in clinical practice that some patients with this type of surgery may experience post-operative nausea and vomiting and other discomforts.AIM To explore the effect of reserved gastric tube application in the neuroendoscopic endonasal resection of pituitary tumors.METHODS A total of 60 patients who underwent pituitary adenoma resection via the endoscopic endonasal approach were selected and randomly divided into the experimental and control groups,with 30 in each group.Experimental group:After anesthesia,a gastric tube was placed through the mouth under direct vision using a visual laryngoscope,and the fluid accumulated in the oropharynx was suctioned intermittently with low negative pressure throughout the whole process after nasal disinfection,during the operation,and when the patient recovered from anesthesia.Control group:Given the routine intraoperative care,no gastric tube was left.The number of cases of nausea/vomiting/aspiration within 24 h post-operation was counted and compared between the two groups;the scores of pharyngalgia after waking up,6 h post-operation,and 24 h postoperation.The frequency of postoperative cerebrospinal fluid leakage and intracranial infection were compared.The hospitalization days of the two groups were statistically compared.RESULTS The times of postoperative nausea and vomiting in the experimental group were lower than that in the control group,and the difference in the incidence of nausea was statistically significant(P<0.05).After the patient woke up,the scores of sore throat 6 h after the operation and 24 h after operation were lower than those in the control group,and the difference was statistically significant(P<0.05).The number of cases of postoperative cerebrospinal fluid leakage and intracranial infection was higher than that of the control group,but there was no statistically significant difference from the control group(P>0.05).The hospitalization days of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).CONCLUSION Reserving a gastric tube in the endoscopic endonasal resection of pituitary tumors,combined with intraoperative and postoperative gastrointestinal decompression,can effectively reduce the incidence of nausea,reduce the number of vomiting and aspiration in patients,and reduce the complications of sore throat The incidence rate shortened the hospitalization days of the patients.展开更多
This paper discusses a method for identifying states in a multistage Decision Making Problem in which an Indifferent Event is either predetermined or can be automatically derived after the fact. First, when they are p...This paper discusses a method for identifying states in a multistage Decision Making Problem in which an Indifferent Event is either predetermined or can be automatically derived after the fact. First, when they are pre-set, the amount of possible information about Indifferent Event tends to be large. Therefore, since the decision is risk tolerant, the Max-Product method of Tanaka et al. is used to calculate the expected utility possibility. Next, in the case of automatic derivation after the fact, the amount of information on the possibility of Indifferent Event is relatively small, so the expected utility possibility is derived using Zadeh’s Fuzzy Event Possibility Measure. Here, it is assumed that the setting of the utility function is independent of the information on the occurrence of the Indifferent Event and is identified by the decision maker by lot drawing using the certainty equivalence method. As a concrete example, we focus on the pass/fail decision of a recommendation test, which is a two choice question in the No-Data Problem, and illustrate the multistage state identification method. .展开更多
BACKGROUND Cartilage defects are some of the most common causes of arthritis.Cartilage lesions caused by inflammation,trauma or degenerative disease normally result in osteochondral defects.Previous studies have shown...BACKGROUND Cartilage defects are some of the most common causes of arthritis.Cartilage lesions caused by inflammation,trauma or degenerative disease normally result in osteochondral defects.Previous studies have shown that decellularized extracellular matrix(ECM)derived from autologous,allogenic,or xenogeneic mesenchymal stromal cells(MSCs)can effectively restore osteochondral integrity.AIM To determine whether the decellularized ECM of antler reserve mesenchymal cells(RMCs),a xenogeneic material from antler stem cells,is superior to the currently available treatments for osteochondral defects.METHODS We isolated the RMCs from a 60-d-old sika deer antler and cultured them in vitro to 70%confluence;50 mg/mL L-ascorbic acid was then added to the medium to stimulate ECM deposition.Decellularized sheets of adipocyte-derived MSCs(aMSCs)and antlerogenic periosteal cells(another type of antler stem cells)were used as the controls.Three weeks after ascorbic acid stimulation,the ECM sheets were harvested and applied to the osteochondral defects in rat knee joints.RESULTS The defects were successfully repaired by applying the ECM-sheets.The highest quality of repair was achieved in the RMC-ECM group both in vitro(including cell attachment and proliferation),and in vivo(including the simultaneous regeneration of well-vascularized subchondral bone and avascular articular hyaline cartilage integrated with surrounding native tissues).Notably,the antler-stem-cell-derived ECM(xenogeneic)performed better than the aMSC-ECM(allogenic),while the ECM of the active antler stem cells was superior to that of the quiescent antler stem cells.CONCLUSION Decellularized xenogeneic ECM derived from the antler stem cell,particularly the active form(RMC-ECM),can achieve high quality repair/reconstruction of osteochondral defects,suggesting that selection of decellularized ECM for such repair should be focused more on bioactivity rather than kinship.展开更多
In this paper, the Automated Actuarial Loss Reserving Model is developed and extended using machine learning. The traditional actuarial reserving techniques are no longer compatible with the increase in technological ...In this paper, the Automated Actuarial Loss Reserving Model is developed and extended using machine learning. The traditional actuarial reserving techniques are no longer compatible with the increase in technological advancement currently at hand. As a result, the development of the alternative Artificial Intelligence Based Automated Actuarial Loss Reserving Methodology which captures diverse risk profiles for various policyholders through augmenting the Micro Finance services, Auto Insurance Services and Both Services lines of business on the same platform through the computation of the Comprehensive Automated Actuarial Loss Reserves (CAALR) has been implemented in this paper. The introduction of the four further types of actuarial loss reserves to those existing in the actuarial literature seems to significantly reduce lapse rates, reduce the reinsurance costs as well as expenses and outgo. As a matter of consequence, this helps to bring together a combination of new and existing policyholders in the insurance company. The frequency severity models have been extended in this paper using ten machine learning algorithms which ultimately leads to the derivation of the proposed machine learning-based actuarial loss reserving model which remarkably performed well when compared to the traditional chain ladder actuarial reserving method using simulated data.展开更多
背景机会性输卵管切除术(OS)可以作为卵巢癌(OC)的一级预防手段,但由于卵巢与输卵管拥有同源血供系统,OS可能会引起卵巢功能的损害,从而增加卵巢老化和更年期提前的风险。目的基于GRADE证据分级系统,评价OS对卵巢储备的短期影响。方法于...背景机会性输卵管切除术(OS)可以作为卵巢癌(OC)的一级预防手段,但由于卵巢与输卵管拥有同源血供系统,OS可能会引起卵巢功能的损害,从而增加卵巢老化和更年期提前的风险。目的基于GRADE证据分级系统,评价OS对卵巢储备的短期影响。方法于2022年9月,检索中国知网、万方数据知识服务平台、维普网、PubMed、Web of Science、Scopus,获取评估OS对卵巢储备短期影响的文献,检索时限均为建库至2022-09-10。由2名研究者独立筛选文献并提取数据,使用Jadad量表评价文献质量,Stata 17.0软件用于数据处理与荟萃分析,GRADEpro 3.2软件用于评估荟萃分析结果的证据质量。结果共纳入9项随机对照试验(RCT),包含482例患者,其中OS组238例、non-OS组244例。Jadad风险评估量表结果显示所纳入的RCT均为高质量文献。荟萃分析结果表明:相对于non-OS组,OS组抗苗勒氏激素(AMH)(WMD=-0.07,95%CI=-0.28~0.13,P=0.13)、卵泡刺激素(FSH)(WMD=-0.03,95%CI=-1.65~1.59,P=0.24)、黄体生成素(LH)(WMD=-0.39,95%CI=-1.62~0.83,P=0.08)、雌二醇(E2)(WMD=3.08,95%CI=-4.26~10.43,P=0.35)手术前后的变化差异无统计学意义(P>0.05)。GRADEpro软件对荟萃分析的结果显示,AMH的研究为高质量证据,FSH的研究为中等质量证据,E2和LH的研究为低质量证据。结论在短期内因良性疾病接受OS的未绝经女性的卵巢储备功能指标与未接受OS的女性无明显差异。已完成生育的绝经前女性通过OS来预防OC是合理的,但是这个结论仍有待于更长随访时间、设计更严谨且样本量更大的RCT来验证。展开更多
Tropical peat comprises decomposed dead plant material and acts like a sponge to absorb water,making it fully saturated.However,drought periods dry it readily and increases its vulnerability to fire.Peat fires emit gr...Tropical peat comprises decomposed dead plant material and acts like a sponge to absorb water,making it fully saturated.However,drought periods dry it readily and increases its vulnerability to fire.Peat fires emit greenhouse gases and particles contributing to haze,and prevention by constructing fire-break canals to reduce fire spread into forest reserves is crucial.This paper aims to determine peat physical and chemical properties near a fire-break canal at different fire frequency areas.Peat sampling was conducted at two forest reserves in Malaysia which represent low fire frequency and high fire frequency areas.The results show that peat properties were not affected by the construction of a fire-break canal,however lignin and cellulose content increased significantly from the distance of the canal in both areas.The study concluded that fire frequency did not significantly influence peat properties except for porosity.The higher fibre content in the high frequency area did not influence moisture content nor the ability to regain moisture.Thus,fire frequency might contribute differently to changes in physical and chemical properties,hence management efforts to construct fire-break canals and restoration efforts should protect peatlands from further degradation.These findings will benefit future management and planning for forest reserves.展开更多
It is well known that the system (1 + 1) can be unequal to 2, because this system has both observation error and system error. Furthermore, we must provide our mustered service within our cool head and warm heart, whe...It is well known that the system (1 + 1) can be unequal to 2, because this system has both observation error and system error. Furthermore, we must provide our mustered service within our cool head and warm heart, where two states of nature are existing upon us. Any system is regarded as the two-dimensional variable error model. On the other hand, we consider that the fuzziness is existing in this system. Though we can usually obtain the fuzzy number from the possibility theory, it is not fuzzy but possibility, because the possibility function is as same as the likelihood function, and we can obtain the possibility measure by the maximal likelihood method (i.e. max product method proposed by Dr. Hideo Tanaka). Therefore, Fuzzy is regarded as the only one case according to Vague, which has both some state of nature in this world and another state of nature in the other world. Here, we can consider that Type 1 Vague Event in other world can be obtained by mapping and translating from Type 1 fuzzy Event in this world. We named this estimation as Type 1 Bayes-Fuzzy Estimation. When the Vague Events were abnormal (ex. under War), we need to consider that another world could exist around other world. In this case, we call it Type 2 Bayes-Fuzzy Estimation. Where Hori et al. constructed the stochastic different equation upon Type 1 Vague Events, along with the general following probabilistic introduction method from the single regression model, multi-regression model, AR model, Markov (decision) process, to the stochastic different equation. Furthermore, we showed that the system theory approach is Possibility Markov Process, and that the making decision approach is Sequential Bayes Estimation, too. After all, Type 1 Bays-Fuzzy estimation is the special case in Bayes estimation, because the pareto solutions can exist in two stochastic different equations upon Type 2 Vague Events, after we ignore one equation each other (note that this is Type 1 case), we can obtain both its system solution and its decision solution. Here, it is noted that Type 2 Vague estimation can be applied to the shallow abnormal decision problem with possibility reserved judgement. However, it is very important problem that we can have no idea for possibility reserved judgement under the deepest abnormal envelopment (ex. under War). Expect for this deepest abnormal decision problem, Bayes estimation can completely cover fuzzy estimation. In this paper, we explain our flowing study and further research object forward to this deepest abnormal decision problem.展开更多
BACKGROUND Invasive functional evaluation by fractional flow reserve(FFR)is considered as a gold standard for the evaluation of intermediate coronary stenosis.However,in patients with diabetes due to accelerated progr...BACKGROUND Invasive functional evaluation by fractional flow reserve(FFR)is considered as a gold standard for the evaluation of intermediate coronary stenosis.However,in patients with diabetes due to accelerated progression of atherosclerosis the outcome may be worse even in the presence of negative functional testing.CASE SUMMARY We present a case of 55-year-old male diabetic patient who was admitted for chest pain.Diagnostic coronary angiography disclosed 2 intermediate stenoses of the obtuse marginal branch with no evidence of restenosis on previously implanted stent.Patient undergone invasive functional testing of intermediate lesion with preserved FFR(0.88),low coronary flow reserve(1.2)and very high index of microvascular resistance(84).Due to discrepancy in invasive functional parameters,intravascular imaging with optical coherence tomography showed fibrotic stenoses without signs of thin-sup fibroatheroma.Because of the preserved FFR and no signs of vulnerable plaque,the interventional procedure was deferred and the patient continued with optimal medications.CONCLUSION Combined functional and anatomic imaging of intermediate coronary stenosis in diabetic patients represent comprehensive contemporary decision pathway in the management of the patients.展开更多
文摘The reserved judgment can be broadly categorized into three types: Re-Do, Re-Set, and Natural Flowing Case (i.e. step by step in Re-Try). Hori et al. constructed the Bayes-Fuzzy Estimation and demonstrated that system theory can be applied to the possibility of Markov processes, and that decision-making approaches can be applied to sequential Bayes estimation. In this paper, we focus on the Natural Flowing Case within reserved judgment. Here, the possibility of oblique (or principal) factor rotation is considered as a part of the tandem fuzzy system that follows step by step for sequential Bayes estimation. Ultimately, we achieve a significant result whereby the expected utility can be calculated automatically without the need to construct a utility function for reserved judgment. There, this utility in Re-Do can be calculated by the prior utility, and that utility in Re-set does not exist by our research in this paper. Finally, we elucidate the relationship between fuzzy system theory and fuzzy decision theory through an applied example of Bayes-Fuzzy theory. Fuzzy estimation can be applied to only normal making decision, but it is impossible to apply abnormal decision problem. Our Vague, specially Type 2 Vague can be applied to abnormal case, too.
基金financially supported by the National Key R&D Program of China (Grant No. 2019YFC1509901)。
文摘Numerous engineering cases have demonstrated that the expansive soil channel slope remains susceptible to damage with the implementation of a rigid or closed protective structure. It is common for the protective structure to experience bulging failure due to excessive swelling pressure. To investigate the swelling pressure properties of expansive soil, the constant volume test was employed to study the influence of water content and reserved expansion deformation on the characteristics of swelling pressure in strong expansive soils, and also to explore the evolution mechanism of the swelling pressure. The findings demonstrate that the swelling pressure-time curve can be classified into swelling pressure-time softening and swelling pressure-time stability type. The swelling pressuretime curve of the specimen with low water content is the swelling pressure-time softening type, and the softening level will be weakened with increasing reserved expansion deformation. Besides, the maximum swelling pressure Psmax decreases with increasing water content and reserved expansion deformation, especially for expansion ratio η from 24% to 37%. The reserved deformation has little effect on reducing Psmax when it is beyond 7% of the expansion rate. The specimen with low water content has a more homogeneous structure due to the significant expansion-filling effect, and the fracture and reorganization of the aggregates in the specimens with low water content cause the swelling pressure-time softening behavior. In addition, the proposed swelling pressure-time curve prediction model has a good prediction on the test results. If necessary, a deformation space of about 7% expansion rate is recommended to be reserved in the engineering to reduce the swelling pressure except for keeping a stable water content.
基金Traditional Chinese Medicine Science and Technology Project in Jiangsu Province,No.YB2015113the Science and Technology Program of Nantong Health Committee,No.MA2019003,No.MA2021017,No.MB2021026,and No.MB2021027+1 种基金Science and Technology Program of Nantong City,No.Key003,No.MS12015016 and No.JCZ2022040Kangda College of Nanjing Medical University,No.KD2021JYYJYB025,No.KD2022KYJJZD019,No.KD2022KYJJZD022,and No.2023ZC127.
文摘BACKGROUND The neuroendoscopic approach has the advantages of a clear operative field,convenient tumor removal,and less damage,and is the development direction of modern neurosurgery.At present,transnasal surgery for sphenoidal pituitary tumor is widely used.But it has been found in clinical practice that some patients with this type of surgery may experience post-operative nausea and vomiting and other discomforts.AIM To explore the effect of reserved gastric tube application in the neuroendoscopic endonasal resection of pituitary tumors.METHODS A total of 60 patients who underwent pituitary adenoma resection via the endoscopic endonasal approach were selected and randomly divided into the experimental and control groups,with 30 in each group.Experimental group:After anesthesia,a gastric tube was placed through the mouth under direct vision using a visual laryngoscope,and the fluid accumulated in the oropharynx was suctioned intermittently with low negative pressure throughout the whole process after nasal disinfection,during the operation,and when the patient recovered from anesthesia.Control group:Given the routine intraoperative care,no gastric tube was left.The number of cases of nausea/vomiting/aspiration within 24 h post-operation was counted and compared between the two groups;the scores of pharyngalgia after waking up,6 h post-operation,and 24 h postoperation.The frequency of postoperative cerebrospinal fluid leakage and intracranial infection were compared.The hospitalization days of the two groups were statistically compared.RESULTS The times of postoperative nausea and vomiting in the experimental group were lower than that in the control group,and the difference in the incidence of nausea was statistically significant(P<0.05).After the patient woke up,the scores of sore throat 6 h after the operation and 24 h after operation were lower than those in the control group,and the difference was statistically significant(P<0.05).The number of cases of postoperative cerebrospinal fluid leakage and intracranial infection was higher than that of the control group,but there was no statistically significant difference from the control group(P>0.05).The hospitalization days of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).CONCLUSION Reserving a gastric tube in the endoscopic endonasal resection of pituitary tumors,combined with intraoperative and postoperative gastrointestinal decompression,can effectively reduce the incidence of nausea,reduce the number of vomiting and aspiration in patients,and reduce the complications of sore throat The incidence rate shortened the hospitalization days of the patients.
文摘This paper discusses a method for identifying states in a multistage Decision Making Problem in which an Indifferent Event is either predetermined or can be automatically derived after the fact. First, when they are pre-set, the amount of possible information about Indifferent Event tends to be large. Therefore, since the decision is risk tolerant, the Max-Product method of Tanaka et al. is used to calculate the expected utility possibility. Next, in the case of automatic derivation after the fact, the amount of information on the possibility of Indifferent Event is relatively small, so the expected utility possibility is derived using Zadeh’s Fuzzy Event Possibility Measure. Here, it is assumed that the setting of the utility function is independent of the information on the occurrence of the Indifferent Event and is identified by the decision maker by lot drawing using the certainty equivalence method. As a concrete example, we focus on the pass/fail decision of a recommendation test, which is a two choice question in the No-Data Problem, and illustrate the multistage state identification method. .
基金National Natural Science Foundation of China,No.U20A20403This study was conducted in accordance with the Animal Ethics Committee of the Institute of Antler Science and Product Technology,Changchun Sci-Tech University(AEC No:CKARI202309).
文摘BACKGROUND Cartilage defects are some of the most common causes of arthritis.Cartilage lesions caused by inflammation,trauma or degenerative disease normally result in osteochondral defects.Previous studies have shown that decellularized extracellular matrix(ECM)derived from autologous,allogenic,or xenogeneic mesenchymal stromal cells(MSCs)can effectively restore osteochondral integrity.AIM To determine whether the decellularized ECM of antler reserve mesenchymal cells(RMCs),a xenogeneic material from antler stem cells,is superior to the currently available treatments for osteochondral defects.METHODS We isolated the RMCs from a 60-d-old sika deer antler and cultured them in vitro to 70%confluence;50 mg/mL L-ascorbic acid was then added to the medium to stimulate ECM deposition.Decellularized sheets of adipocyte-derived MSCs(aMSCs)and antlerogenic periosteal cells(another type of antler stem cells)were used as the controls.Three weeks after ascorbic acid stimulation,the ECM sheets were harvested and applied to the osteochondral defects in rat knee joints.RESULTS The defects were successfully repaired by applying the ECM-sheets.The highest quality of repair was achieved in the RMC-ECM group both in vitro(including cell attachment and proliferation),and in vivo(including the simultaneous regeneration of well-vascularized subchondral bone and avascular articular hyaline cartilage integrated with surrounding native tissues).Notably,the antler-stem-cell-derived ECM(xenogeneic)performed better than the aMSC-ECM(allogenic),while the ECM of the active antler stem cells was superior to that of the quiescent antler stem cells.CONCLUSION Decellularized xenogeneic ECM derived from the antler stem cell,particularly the active form(RMC-ECM),can achieve high quality repair/reconstruction of osteochondral defects,suggesting that selection of decellularized ECM for such repair should be focused more on bioactivity rather than kinship.
文摘In this paper, the Automated Actuarial Loss Reserving Model is developed and extended using machine learning. The traditional actuarial reserving techniques are no longer compatible with the increase in technological advancement currently at hand. As a result, the development of the alternative Artificial Intelligence Based Automated Actuarial Loss Reserving Methodology which captures diverse risk profiles for various policyholders through augmenting the Micro Finance services, Auto Insurance Services and Both Services lines of business on the same platform through the computation of the Comprehensive Automated Actuarial Loss Reserves (CAALR) has been implemented in this paper. The introduction of the four further types of actuarial loss reserves to those existing in the actuarial literature seems to significantly reduce lapse rates, reduce the reinsurance costs as well as expenses and outgo. As a matter of consequence, this helps to bring together a combination of new and existing policyholders in the insurance company. The frequency severity models have been extended in this paper using ten machine learning algorithms which ultimately leads to the derivation of the proposed machine learning-based actuarial loss reserving model which remarkably performed well when compared to the traditional chain ladder actuarial reserving method using simulated data.
文摘背景机会性输卵管切除术(OS)可以作为卵巢癌(OC)的一级预防手段,但由于卵巢与输卵管拥有同源血供系统,OS可能会引起卵巢功能的损害,从而增加卵巢老化和更年期提前的风险。目的基于GRADE证据分级系统,评价OS对卵巢储备的短期影响。方法于2022年9月,检索中国知网、万方数据知识服务平台、维普网、PubMed、Web of Science、Scopus,获取评估OS对卵巢储备短期影响的文献,检索时限均为建库至2022-09-10。由2名研究者独立筛选文献并提取数据,使用Jadad量表评价文献质量,Stata 17.0软件用于数据处理与荟萃分析,GRADEpro 3.2软件用于评估荟萃分析结果的证据质量。结果共纳入9项随机对照试验(RCT),包含482例患者,其中OS组238例、non-OS组244例。Jadad风险评估量表结果显示所纳入的RCT均为高质量文献。荟萃分析结果表明:相对于non-OS组,OS组抗苗勒氏激素(AMH)(WMD=-0.07,95%CI=-0.28~0.13,P=0.13)、卵泡刺激素(FSH)(WMD=-0.03,95%CI=-1.65~1.59,P=0.24)、黄体生成素(LH)(WMD=-0.39,95%CI=-1.62~0.83,P=0.08)、雌二醇(E2)(WMD=3.08,95%CI=-4.26~10.43,P=0.35)手术前后的变化差异无统计学意义(P>0.05)。GRADEpro软件对荟萃分析的结果显示,AMH的研究为高质量证据,FSH的研究为中等质量证据,E2和LH的研究为低质量证据。结论在短期内因良性疾病接受OS的未绝经女性的卵巢储备功能指标与未接受OS的女性无明显差异。已完成生育的绝经前女性通过OS来预防OC是合理的,但是这个结论仍有待于更长随访时间、设计更严谨且样本量更大的RCT来验证。
基金This research was funded by the Ministry of Higher Education Malaysia via the Fundamental Research Grant Scheme(FRGS/1/2020/WAB03/UPM/02/1)。
文摘Tropical peat comprises decomposed dead plant material and acts like a sponge to absorb water,making it fully saturated.However,drought periods dry it readily and increases its vulnerability to fire.Peat fires emit greenhouse gases and particles contributing to haze,and prevention by constructing fire-break canals to reduce fire spread into forest reserves is crucial.This paper aims to determine peat physical and chemical properties near a fire-break canal at different fire frequency areas.Peat sampling was conducted at two forest reserves in Malaysia which represent low fire frequency and high fire frequency areas.The results show that peat properties were not affected by the construction of a fire-break canal,however lignin and cellulose content increased significantly from the distance of the canal in both areas.The study concluded that fire frequency did not significantly influence peat properties except for porosity.The higher fibre content in the high frequency area did not influence moisture content nor the ability to regain moisture.Thus,fire frequency might contribute differently to changes in physical and chemical properties,hence management efforts to construct fire-break canals and restoration efforts should protect peatlands from further degradation.These findings will benefit future management and planning for forest reserves.
文摘It is well known that the system (1 + 1) can be unequal to 2, because this system has both observation error and system error. Furthermore, we must provide our mustered service within our cool head and warm heart, where two states of nature are existing upon us. Any system is regarded as the two-dimensional variable error model. On the other hand, we consider that the fuzziness is existing in this system. Though we can usually obtain the fuzzy number from the possibility theory, it is not fuzzy but possibility, because the possibility function is as same as the likelihood function, and we can obtain the possibility measure by the maximal likelihood method (i.e. max product method proposed by Dr. Hideo Tanaka). Therefore, Fuzzy is regarded as the only one case according to Vague, which has both some state of nature in this world and another state of nature in the other world. Here, we can consider that Type 1 Vague Event in other world can be obtained by mapping and translating from Type 1 fuzzy Event in this world. We named this estimation as Type 1 Bayes-Fuzzy Estimation. When the Vague Events were abnormal (ex. under War), we need to consider that another world could exist around other world. In this case, we call it Type 2 Bayes-Fuzzy Estimation. Where Hori et al. constructed the stochastic different equation upon Type 1 Vague Events, along with the general following probabilistic introduction method from the single regression model, multi-regression model, AR model, Markov (decision) process, to the stochastic different equation. Furthermore, we showed that the system theory approach is Possibility Markov Process, and that the making decision approach is Sequential Bayes Estimation, too. After all, Type 1 Bays-Fuzzy estimation is the special case in Bayes estimation, because the pareto solutions can exist in two stochastic different equations upon Type 2 Vague Events, after we ignore one equation each other (note that this is Type 1 case), we can obtain both its system solution and its decision solution. Here, it is noted that Type 2 Vague estimation can be applied to the shallow abnormal decision problem with possibility reserved judgement. However, it is very important problem that we can have no idea for possibility reserved judgement under the deepest abnormal envelopment (ex. under War). Expect for this deepest abnormal decision problem, Bayes estimation can completely cover fuzzy estimation. In this paper, we explain our flowing study and further research object forward to this deepest abnormal decision problem.
文摘BACKGROUND Invasive functional evaluation by fractional flow reserve(FFR)is considered as a gold standard for the evaluation of intermediate coronary stenosis.However,in patients with diabetes due to accelerated progression of atherosclerosis the outcome may be worse even in the presence of negative functional testing.CASE SUMMARY We present a case of 55-year-old male diabetic patient who was admitted for chest pain.Diagnostic coronary angiography disclosed 2 intermediate stenoses of the obtuse marginal branch with no evidence of restenosis on previously implanted stent.Patient undergone invasive functional testing of intermediate lesion with preserved FFR(0.88),low coronary flow reserve(1.2)and very high index of microvascular resistance(84).Due to discrepancy in invasive functional parameters,intravascular imaging with optical coherence tomography showed fibrotic stenoses without signs of thin-sup fibroatheroma.Because of the preserved FFR and no signs of vulnerable plaque,the interventional procedure was deferred and the patient continued with optimal medications.CONCLUSION Combined functional and anatomic imaging of intermediate coronary stenosis in diabetic patients represent comprehensive contemporary decision pathway in the management of the patients.
