BACKGROUND Sessile serrated adenomas(SSAs)are important premalignant lesions that are difficult to detect during colonoscopy due to poor definition,concealment by mucous caps,and flat appearance.High definition(HD)col...BACKGROUND Sessile serrated adenomas(SSAs)are important premalignant lesions that are difficult to detect during colonoscopy due to poor definition,concealment by mucous caps,and flat appearance.High definition(HD)colonoscopy may uniquely aid in the detection of these inconspicuous lesions compared to standard definition(SD)colonoscopes.In the absence of existing clinical guidelines to obligate the use of HD colonoscopy for colorectal cancer screening in average-risk patients,demonstrating the benefit of HD colonoscopy on SSA detection rate(SSADR)may help strengthen the evidence to recommend its use in all settings.AIM To evaluate the benefit of HD colonoscopy compared to SD colonoscopy on SSADR in average-risk patients undergoing screening colonoscopy.METHODS Data from screening colonoscopies for patients aged 50-76 years two years before and two years after the transition from SD colonoscopy to HD colonoscopy at our large,academic teaching center were collected.Patients with symptoms of colorectal disease,positive occult blood test,history of colon polyps,cancer,polyposis syndrome,inflammatory bowel disease or family history of colon cancer or polyps were excluded.Patients whose endoscopists did not perform colonoscopies both before and after scope definition change were also excluded.Differences in individual endoscopist SSADR,average SSADR,and overall SSADR with SD colonoscopy vs HD colonoscopy were also evaluated for significance.RESULTS A total of 3657 colonoscopies met eligibility criteria with 2012 colonoscopies from the SD colonoscopy period and 1645 colonoscopies from the HD colonoscopy period from a pool of 11 endoscopists.Statistically significant improvements of 2.30%in mean SSADR and 2.53%in overall SSADR were noted with HD colonoscopy(P=0.00028 and P=0.00849,respectively).On the individual level,three endoscopists experienced statistically significant benefit with HD colonoscopy(+5.74%,P=0.0056;+4.50%,P=0.0278;+4.84%,P=0.03486).CONCLUSION Our study suggests that HD colonoscopy statistically significantly improves sessile serrated adenoma detection rate in the screening of average risk patients during screening colonoscopy.By improving the detection and removal of these lesions,adoption of HD colonoscopy may reduce the significant premalignant burden of sessile serrated adenomas.展开更多
During the last two decades fractional calculus has been increasingly applied to physics, especially to rheology.It is well known that there are obivious differences between Riemann-Liouville (R-L) definition and Capu...During the last two decades fractional calculus has been increasingly applied to physics, especially to rheology.It is well known that there are obivious differences between Riemann-Liouville (R-L) definition and Caputo definition,which are the two most commonly used definitions of fractional derivatives.The multiple definitions of fractional derivatives have hindered the application of fractional calculus in rheology.In this paper,we clarify that the R-L definition and Caputo definition are both Theolog...展开更多
BACKGROUND:A number of definitions have been used for delayed gastric emptying(DGE) after pancreatoduodenectomy and the reported rates varied widely.The International Study Group of Pancreatic Surgery(ISGPS) definitio...BACKGROUND:A number of definitions have been used for delayed gastric emptying(DGE) after pancreatoduodenectomy and the reported rates varied widely.The International Study Group of Pancreatic Surgery(ISGPS) definition is the current standard but it is not used universally.In this comprehensive review,we aimed to determine the acceptance rate of ISGPS definition of DGE,the incidence of DGE after pancreatoduodenectomy and the effect of various technical modifications on its incidence.DATA SOURCE:We searched PubM ed for studies regarding DGE after pancreatoduodenectomy that were published from 1 January 1980 to 1 July 2015 and extracted data on DGE definition,DGE rates and comparison of DGE rates among different technical modifications from all of the relevant articles.RESULTS:Out of 435 search results,178 were selected for data extraction.The ISGPS definition was used in 80% of the studies published since 2010 and the average rates of DGE and clinically relevant DGE were 27.7%(range:0-100%;median:18.7%) and 14.3%(range:1.8%-58.2%;median:13.6%),respectively.Pylorus preservation or retrocolic reconstruction were not associated with increased DGE rates.Although pyloric dilatation,Braun's entero-enterostomy and Billroth Ⅱ reconstruction were associated with significantly lower DGE rates,pyloric ring resection appears to be most promising with favorable results in 7 out of 10 studies.CONCLUSIONS:ISGPS definition of DGE has been used in majority of studies published after 2010.Clinically relevant DGE rates remain high at 14.3% despite a number of proposed surgical modifications.Pyloric ring resection seems to offer the most promising solution to reduce the occurrence of DGE.展开更多
In nature,to realize the smooth motion for different speeds,the continuous gait transition is usually required for the quadrupeds.Thus,the gait simulation of quadrupeds is a requisite step to obtain the stable and ene...In nature,to realize the smooth motion for different speeds,the continuous gait transition is usually required for the quadrupeds.Thus,the gait simulation of quadrupeds is a requisite step to obtain the stable and energy-efficient gait for the walking machines.In this paper,the definitions of the two gait parameters,phasic difference and duty factor are presented,which can determine the gait of the quadrupeds.Then,several typical gaits of the quadrupeds are analyzed such that the seven standard gaits and corresponding parameters are summarized.Additionally,the variance law of the two parameters,which determine the relationship of gait transition,is analyzed.Furthermore,the quadruped gait derivative spectrum (QGDS) is proposed and the gait definition of the quadrupeds is presented.To minimize the power consumption,the choice criterion of gait,the optimal gait in terms of the motion speed,duty factory,and power consumption for the walking machines,is developed.Last,the continuous variance of the gait is implemented by the simulation of the gait transition from walk to trot,which evaluate the choice criterion and transition of gait.展开更多
BACKGROUND Despite the emerging knowledge about colorectal anastomotic leakage(CAL)through the increasing number of clinical and experimental studies, there is no generally accepted definition of CAL. Because of the w...BACKGROUND Despite the emerging knowledge about colorectal anastomotic leakage(CAL)through the increasing number of clinical and experimental studies, there is no generally accepted definition of CAL. Because of the wide variety of definitions used in literature, comparison of study outcomes and quality of care is complicated.AIM To reach consensus on the definition of CAL using a modified Delphi method.METHODS The RAND/UCLA appropriateness method was used. The expert panel consisted of international colorectal surgeons and researchers who had published three or more articles about CAL. The consensus process consisted of two online distributed questionnaires and a third round with a recommendation. In the questionnaires participants were asked to rate the appropriateness of statements using a 1-9 Likert scale. Consensus was defined as a panel median between 1-3 or 7-9 without disagreement. In the final round a recommendation was formed regarding the definition of CAL and the expert panel was asked if they agreed or disagreed.RESULTSTwenty-three authors participated in the first round and twenty-one finished the second round. After two rounds consensus was reached on 37 items(80%) in nine different categories. The International Study Group of Rectal Cancer definition is the most frequently advised general definition by our panel. Consensus was reached regarding the clinical symptoms of CAL, which serum markers contributes to the suspicion of CAL, which radiological and perioperative findings should be considered as CAL, which grading system is appropriate and if there should be a range of postoperative days in the definition. Eventually, 19 experts completed all three rounds of which 16(84%) agreed with our final recommendations for the definition of CAL.CONCLUSION A consensus-based recommendation for the definition of CAL was formed using our modified Delphi method that can be widely incorporated in the field.展开更多
The concept, definition, and diagnosis of amyotrophic lateral sclerosis(ALS) currently present some problems. This article systematically reviews the literature on the history, current concepts, definition, and diagno...The concept, definition, and diagnosis of amyotrophic lateral sclerosis(ALS) currently present some problems. This article systematically reviews the literature on the history, current concepts, definition, and diagnosis of ALS, and discloses the present problems based on the retrieved literature and the authors' clinical experience. The current concepts and definitions of ALS have not yet been unified or standardized in clinical practice, and are sometimes vague or inaccurate, which can cause difficulties for neurologists in the clinical treatment of ALS. The concept and definition of ALS need to be further ascertained, and the current diagnostic criteria for ALS require further development. The identification of effective and objective biomarkers may be a feasible method for the early and accurate diagnosis of ALS. Therefore, future research should focus on the identification of reliable biomarkers—especially neuroimaging biomarkers—through autopsy. Standardizing the concept and definition of ALS and formulating clear diagnostic criteria will largely avoid many uncertainties in the future clinical research and treatment of ALS, which will greatly benefit patients.展开更多
AIM To determine the level of consensus on the definition of colorectal anastomotic leakage(CAL) among Dutch and Chinese colorectal surgeons.METHODS Dutch and Chinese colorectal surgeons were asked to partake in an on...AIM To determine the level of consensus on the definition of colorectal anastomotic leakage(CAL) among Dutch and Chinese colorectal surgeons.METHODS Dutch and Chinese colorectal surgeons were asked to partake in an online questionnaire. Consensus in the online questionnaire was defined as > 80% agreement between respondents on various statements regarding a general definition of CAL,and regarding clinical and radiological diagnosis of the complication.RESULTS Fifty-nine Dutch and 202 Chinese dedicated colorectal surgeons participated in the online survey. Consensus was found on only one of the proposed elements of a general definition of CAL in both countries: ‘extravasation of contrast medium after rectal enema on a CT scan'. Another two were found relevant according to Dutch surgeons: ‘necrosis of the anastomosis found during reoperation',and ‘a radiological collection treated with percutaneous drainage'. No consensus was found for all other proposed elements that may be included in a general definition.CONCLUSION There is no universally accepted definition of CAL in the Netherlands and China. Diagnosis of CAL based on clinical manifestations remains a point of discussion in both countries. Dutch surgeons are more likely to report ‘subclinical' leaks as CAL,which partly explains the higher reported Dutch CAL rates.展开更多
In this paper,we review the creation,evolution and application of wetland definitions.Varying wetlands are found from the tundra to the tropics and on every continent except Antarctica in the planet.Wetlands have many...In this paper,we review the creation,evolution and application of wetland definitions.Varying wetlands are found from the tundra to the tropics and on every continent except Antarctica in the planet.Wetlands have many distinguishing features,the most notable of which are water presence,unique soil conditions,and biota that are adapted to or tolerant of saturated soils.Many wetland definitions have been developed by scientists,U.S.federal agencies,and the Ramsar Convention for both scientific and regulatory purposes.Wetlands are not easily defined but a well-conceived,science-based definition of wetlands is important for scientists and resource managers to understand the nature of wetlands and/or to use and protect wetlands.A scientific definition is the basis for wetland classification.Developing an effective wetland classification system requires a well-conceived,science-based definition and clearly explicit guidance on the appropriate use of various wetland indicators to verify the presence of wetlands on the ground.Based on a well-accepted wetland definition,both wetland classification and inventory further provide needed information and a working frame for wise use and management of wetlands.展开更多
A plant-based diet consists of all minimally processedfruits, vegetables, whole grains, legumes, nuts and seeds,herbs, and spices and excludes all animal products, includ-ing red meat, poultry, fish, eggs, and dairy p...A plant-based diet consists of all minimally processedfruits, vegetables, whole grains, legumes, nuts and seeds,herbs, and spices and excludes all animal products, includ-ing red meat, poultry, fish, eggs, and dairy products.展开更多
Pseudocapacitive materials generally offer both high capacitance and high rate capability, which has stimulated great efforts in developing the materials system and related energy storage devices. In recent years, how...Pseudocapacitive materials generally offer both high capacitance and high rate capability, which has stimulated great efforts in developing the materials system and related energy storage devices. In recent years, however, with the extensive use of nanomaterials in batteries, fast redox kinetics comparable to pseudocapacitive have been achieved in many kinds of battery materials due to the much shortened ion diffusion lengths and highly exposed surface/interface as a result of nanosize effect. Consequently, the terms"pseudocapacitive materials" and "battery materials" are becoming more and more confusing. In this review, different opinions on the definition of pseudocapacitive materials and the evolution of the definitions as well as the resulting confusion will be firstly reviewed. Then, to accurately distinguish pseudocapacitive and battery materials, method with the consideration of both the electrochemical signatures(CVs and GCD) and quantitative kinetics analysis as a supplement is proposed. Finally, we end this review by discussing the possible device configurations of asymmetric supercapacitors and hybrid supercapacitors. The present review will help understanding the differences between pseudocapacitive materials and battery materials, and thus avoiding the definition confusion.展开更多
While the incidence of gastric cancer(GC)in general has decreased worldwide in recent decades,the incidence of diffuse cancer historically comprising poorly cohesive cells-GC(PCC-GC)and including signet ring cell canc...While the incidence of gastric cancer(GC)in general has decreased worldwide in recent decades,the incidence of diffuse cancer historically comprising poorly cohesive cells-GC(PCC-GC)and including signet ring cell cancer is rising.Literature concerning PCC-GC is scarce and unclear,mostly due to a large variety of historically used definitions and classifications.Compared to other histological subtypes of GC,PCC-GC is nevertheless characterized by a distinct set of epidemiological,histological and clinical features which require a specific diagnostic and therapeutic approach.The aim of this review was to provide an update on the definition,classification and therapeutic strategies of PCC-GC.We focus on the updated histological definition of PCC-GC,along with its implications on future treatment strategies and study design.Also,specific considerations in the diagnostic management are discussed.Finally,the impact of some recent developments in the therapeutic management of GC in general such as the recently validated taxane-based regimens(5-Fluorouracil,leucovorin,oxaliplatin and docetaxel),the use of hyperthermic intraperitoneal chemotherapy as well as pressurized intraperitoneal aerosol chemotherapy and targeted therapy have been reviewed in depth for their relative importance for PCC-GC in particular.展开更多
AIM: To study the accuracy of using high definition(HD) scope with narrow band imaging(NBI) vs standard white light colonoscope without NBI(ST), to predict the histology of the colon polyps, particularly those < 1 ...AIM: To study the accuracy of using high definition(HD) scope with narrow band imaging(NBI) vs standard white light colonoscope without NBI(ST), to predict the histology of the colon polyps, particularly those < 1 cm.METHODS: A total of 147 African Americans patients who were referred to Howard University Hospital for screening or, diagnostic or follow up colonoscopy, during a 12-mo period in 2012 were prospectively recruited. Some patients had multiple polyps and total number of polyps was 179. Their colonoscopies were performed by 3 experienced endoscopists who determined the size and stated whether the polyps being removed were hyperplastic or adenomatous polyps using standard colonoscopes or high definition colonoscopes with NBI. The histopathologic diagnosis was reported by pathologists as part of routine care. RESULTS: Of participants in the study, 55(37%) were male and median(interquartile range) of age was 56(19-80). Demographic, clinical characteristics, past medical history of patients, and the data obtained by two instruments were not significantly different and two methods detected similar number of polyps. In ST scope 89% of polyps were < 1 cm vs 87% in HD scope(P = 0.7). The ST scope had a positive predictive value(PPV) and positive likelihood ratio(PLR) of 86% and 4.0 for adenoma compared to 74% and 2.6 for HD scope. There was a trend of higher sensitivity for HD scope(68%) compare to ST scope(53%) with almost the same specificity. The ST scope had a PPV and PLR of 38% and 1.8 for hyperplastic polyp(HPP) compared to 42% and 2.2 for HD scope. The sensitivity and specificity of two instruments for HPP diagnosis were similar.CONCLUSION: Our results indicated that HD scope was more sensitive in diagnosis of adenoma than ST scope. Clinical diagnosis of HPP with either scope is less accurate compared to adenoma. Colonoscopy diagnosis is not yet fully matched with pathologic diagnosis of colon polyp. However with the advancement of both imaging and training, it may be possible to increase the sensitivity and specificity of the scopes and hence save money for eliminating time and the cost of Immunohistochemistry/pathology.展开更多
Comments are given on the various physical definitions of the force constant of propellant. As there are more or less defects in these definitions, two new definitions are presented to reflect the physical essence of ...Comments are given on the various physical definitions of the force constant of propellant. As there are more or less defects in these definitions, two new definitions are presented to reflect the physical essence of propellant force more perfectly and could well compatible with the mathematical expression.展开更多
文摘BACKGROUND Sessile serrated adenomas(SSAs)are important premalignant lesions that are difficult to detect during colonoscopy due to poor definition,concealment by mucous caps,and flat appearance.High definition(HD)colonoscopy may uniquely aid in the detection of these inconspicuous lesions compared to standard definition(SD)colonoscopes.In the absence of existing clinical guidelines to obligate the use of HD colonoscopy for colorectal cancer screening in average-risk patients,demonstrating the benefit of HD colonoscopy on SSA detection rate(SSADR)may help strengthen the evidence to recommend its use in all settings.AIM To evaluate the benefit of HD colonoscopy compared to SD colonoscopy on SSADR in average-risk patients undergoing screening colonoscopy.METHODS Data from screening colonoscopies for patients aged 50-76 years two years before and two years after the transition from SD colonoscopy to HD colonoscopy at our large,academic teaching center were collected.Patients with symptoms of colorectal disease,positive occult blood test,history of colon polyps,cancer,polyposis syndrome,inflammatory bowel disease or family history of colon cancer or polyps were excluded.Patients whose endoscopists did not perform colonoscopies both before and after scope definition change were also excluded.Differences in individual endoscopist SSADR,average SSADR,and overall SSADR with SD colonoscopy vs HD colonoscopy were also evaluated for significance.RESULTS A total of 3657 colonoscopies met eligibility criteria with 2012 colonoscopies from the SD colonoscopy period and 1645 colonoscopies from the HD colonoscopy period from a pool of 11 endoscopists.Statistically significant improvements of 2.30%in mean SSADR and 2.53%in overall SSADR were noted with HD colonoscopy(P=0.00028 and P=0.00849,respectively).On the individual level,three endoscopists experienced statistically significant benefit with HD colonoscopy(+5.74%,P=0.0056;+4.50%,P=0.0278;+4.84%,P=0.03486).CONCLUSION Our study suggests that HD colonoscopy statistically significantly improves sessile serrated adenoma detection rate in the screening of average risk patients during screening colonoscopy.By improving the detection and removal of these lesions,adoption of HD colonoscopy may reduce the significant premalignant burden of sessile serrated adenomas.
基金supported by NSFC under the grant number 10972117
文摘During the last two decades fractional calculus has been increasingly applied to physics, especially to rheology.It is well known that there are obivious differences between Riemann-Liouville (R-L) definition and Caputo definition,which are the two most commonly used definitions of fractional derivatives.The multiple definitions of fractional derivatives have hindered the application of fractional calculus in rheology.In this paper,we clarify that the R-L definition and Caputo definition are both Theolog...
文摘BACKGROUND:A number of definitions have been used for delayed gastric emptying(DGE) after pancreatoduodenectomy and the reported rates varied widely.The International Study Group of Pancreatic Surgery(ISGPS) definition is the current standard but it is not used universally.In this comprehensive review,we aimed to determine the acceptance rate of ISGPS definition of DGE,the incidence of DGE after pancreatoduodenectomy and the effect of various technical modifications on its incidence.DATA SOURCE:We searched PubM ed for studies regarding DGE after pancreatoduodenectomy that were published from 1 January 1980 to 1 July 2015 and extracted data on DGE definition,DGE rates and comparison of DGE rates among different technical modifications from all of the relevant articles.RESULTS:Out of 435 search results,178 were selected for data extraction.The ISGPS definition was used in 80% of the studies published since 2010 and the average rates of DGE and clinically relevant DGE were 27.7%(range:0-100%;median:18.7%) and 14.3%(range:1.8%-58.2%;median:13.6%),respectively.Pylorus preservation or retrocolic reconstruction were not associated with increased DGE rates.Although pyloric dilatation,Braun's entero-enterostomy and Billroth Ⅱ reconstruction were associated with significantly lower DGE rates,pyloric ring resection appears to be most promising with favorable results in 7 out of 10 studies.CONCLUSIONS:ISGPS definition of DGE has been used in majority of studies published after 2010.Clinically relevant DGE rates remain high at 14.3% despite a number of proposed surgical modifications.Pyloric ring resection seems to offer the most promising solution to reduce the occurrence of DGE.
文摘In nature,to realize the smooth motion for different speeds,the continuous gait transition is usually required for the quadrupeds.Thus,the gait simulation of quadrupeds is a requisite step to obtain the stable and energy-efficient gait for the walking machines.In this paper,the definitions of the two gait parameters,phasic difference and duty factor are presented,which can determine the gait of the quadrupeds.Then,several typical gaits of the quadrupeds are analyzed such that the seven standard gaits and corresponding parameters are summarized.Additionally,the variance law of the two parameters,which determine the relationship of gait transition,is analyzed.Furthermore,the quadruped gait derivative spectrum (QGDS) is proposed and the gait definition of the quadrupeds is presented.To minimize the power consumption,the choice criterion of gait,the optimal gait in terms of the motion speed,duty factory,and power consumption for the walking machines,is developed.Last,the continuous variance of the gait is implemented by the simulation of the gait transition from walk to trot,which evaluate the choice criterion and transition of gait.
基金Supported by the Dutch Research Council(NWO)research programme Vidi project,No.91719343。
文摘BACKGROUND Despite the emerging knowledge about colorectal anastomotic leakage(CAL)through the increasing number of clinical and experimental studies, there is no generally accepted definition of CAL. Because of the wide variety of definitions used in literature, comparison of study outcomes and quality of care is complicated.AIM To reach consensus on the definition of CAL using a modified Delphi method.METHODS The RAND/UCLA appropriateness method was used. The expert panel consisted of international colorectal surgeons and researchers who had published three or more articles about CAL. The consensus process consisted of two online distributed questionnaires and a third round with a recommendation. In the questionnaires participants were asked to rate the appropriateness of statements using a 1-9 Likert scale. Consensus was defined as a panel median between 1-3 or 7-9 without disagreement. In the final round a recommendation was formed regarding the definition of CAL and the expert panel was asked if they agreed or disagreed.RESULTSTwenty-three authors participated in the first round and twenty-one finished the second round. After two rounds consensus was reached on 37 items(80%) in nine different categories. The International Study Group of Rectal Cancer definition is the most frequently advised general definition by our panel. Consensus was reached regarding the clinical symptoms of CAL, which serum markers contributes to the suspicion of CAL, which radiological and perioperative findings should be considered as CAL, which grading system is appropriate and if there should be a range of postoperative days in the definition. Eventually, 19 experts completed all three rounds of which 16(84%) agreed with our final recommendations for the definition of CAL.CONCLUSION A consensus-based recommendation for the definition of CAL was formed using our modified Delphi method that can be widely incorporated in the field.
基金supported by the National Natural Science Foundation of China,No.30560042,81160161 and 81360198(all to RSX)grants from the Education Department of Jiangxi Province,No.GJJ13198 and GJJ170021(both to RSX)+3 种基金grants from Jiangxi Provincial Department of Science and Technology,No.2014-47,20142BBG70062,and 20171BAB215022(all to RSX)a grant from Health and Family Planning Commission of Jiangxi Province,No.20181019(to RSX)a grant from Jiangxi Provincial Department of Science and Technology Gan Po Elite 555,No.2015108(to RSX)the Innovation Fund Designated for Graduate Students of Jiangxi Province,No.YC2016-B027 and YC2015-S097(both to RSX)。
文摘The concept, definition, and diagnosis of amyotrophic lateral sclerosis(ALS) currently present some problems. This article systematically reviews the literature on the history, current concepts, definition, and diagnosis of ALS, and discloses the present problems based on the retrieved literature and the authors' clinical experience. The current concepts and definitions of ALS have not yet been unified or standardized in clinical practice, and are sometimes vague or inaccurate, which can cause difficulties for neurologists in the clinical treatment of ALS. The concept and definition of ALS need to be further ascertained, and the current diagnostic criteria for ALS require further development. The identification of effective and objective biomarkers may be a feasible method for the early and accurate diagnosis of ALS. Therefore, future research should focus on the identification of reliable biomarkers—especially neuroimaging biomarkers—through autopsy. Standardizing the concept and definition of ALS and formulating clear diagnostic criteria will largely avoid many uncertainties in the future clinical research and treatment of ALS, which will greatly benefit patients.
文摘AIM To determine the level of consensus on the definition of colorectal anastomotic leakage(CAL) among Dutch and Chinese colorectal surgeons.METHODS Dutch and Chinese colorectal surgeons were asked to partake in an online questionnaire. Consensus in the online questionnaire was defined as > 80% agreement between respondents on various statements regarding a general definition of CAL,and regarding clinical and radiological diagnosis of the complication.RESULTS Fifty-nine Dutch and 202 Chinese dedicated colorectal surgeons participated in the online survey. Consensus was found on only one of the proposed elements of a general definition of CAL in both countries: ‘extravasation of contrast medium after rectal enema on a CT scan'. Another two were found relevant according to Dutch surgeons: ‘necrosis of the anastomosis found during reoperation',and ‘a radiological collection treated with percutaneous drainage'. No consensus was found for all other proposed elements that may be included in a general definition.CONCLUSION There is no universally accepted definition of CAL in the Netherlands and China. Diagnosis of CAL based on clinical manifestations remains a point of discussion in both countries. Dutch surgeons are more likely to report ‘subclinical' leaks as CAL,which partly explains the higher reported Dutch CAL rates.
基金funded by the National Nat-ural Science Foundation of China(No.40830535andNo.40871089)
文摘In this paper,we review the creation,evolution and application of wetland definitions.Varying wetlands are found from the tundra to the tropics and on every continent except Antarctica in the planet.Wetlands have many distinguishing features,the most notable of which are water presence,unique soil conditions,and biota that are adapted to or tolerant of saturated soils.Many wetland definitions have been developed by scientists,U.S.federal agencies,and the Ramsar Convention for both scientific and regulatory purposes.Wetlands are not easily defined but a well-conceived,science-based definition of wetlands is important for scientists and resource managers to understand the nature of wetlands and/or to use and protect wetlands.A scientific definition is the basis for wetland classification.Developing an effective wetland classification system requires a well-conceived,science-based definition and clearly explicit guidance on the appropriate use of various wetland indicators to verify the presence of wetlands on the ground.Based on a well-accepted wetland definition,both wetland classification and inventory further provide needed information and a working frame for wise use and management of wetlands.
文摘A plant-based diet consists of all minimally processedfruits, vegetables, whole grains, legumes, nuts and seeds,herbs, and spices and excludes all animal products, includ-ing red meat, poultry, fish, eggs, and dairy products.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.51672205,51872104 and 21673169)the National Key R&D Program of China(Grant No.2016YFA0202602)+1 种基金the Research Start-Up Fund from Wuhan University of Technologythe Fundamental Research Funds for the Central Universities(WUT:2016IVA083,2017IB005,185220011)
文摘Pseudocapacitive materials generally offer both high capacitance and high rate capability, which has stimulated great efforts in developing the materials system and related energy storage devices. In recent years, however, with the extensive use of nanomaterials in batteries, fast redox kinetics comparable to pseudocapacitive have been achieved in many kinds of battery materials due to the much shortened ion diffusion lengths and highly exposed surface/interface as a result of nanosize effect. Consequently, the terms"pseudocapacitive materials" and "battery materials" are becoming more and more confusing. In this review, different opinions on the definition of pseudocapacitive materials and the evolution of the definitions as well as the resulting confusion will be firstly reviewed. Then, to accurately distinguish pseudocapacitive and battery materials, method with the consideration of both the electrochemical signatures(CVs and GCD) and quantitative kinetics analysis as a supplement is proposed. Finally, we end this review by discussing the possible device configurations of asymmetric supercapacitors and hybrid supercapacitors. The present review will help understanding the differences between pseudocapacitive materials and battery materials, and thus avoiding the definition confusion.
文摘While the incidence of gastric cancer(GC)in general has decreased worldwide in recent decades,the incidence of diffuse cancer historically comprising poorly cohesive cells-GC(PCC-GC)and including signet ring cell cancer is rising.Literature concerning PCC-GC is scarce and unclear,mostly due to a large variety of historically used definitions and classifications.Compared to other histological subtypes of GC,PCC-GC is nevertheless characterized by a distinct set of epidemiological,histological and clinical features which require a specific diagnostic and therapeutic approach.The aim of this review was to provide an update on the definition,classification and therapeutic strategies of PCC-GC.We focus on the updated histological definition of PCC-GC,along with its implications on future treatment strategies and study design.Also,specific considerations in the diagnostic management are discussed.Finally,the impact of some recent developments in the therapeutic management of GC in general such as the recently validated taxane-based regimens(5-Fluorouracil,leucovorin,oxaliplatin and docetaxel),the use of hyperthermic intraperitoneal chemotherapy as well as pressurized intraperitoneal aerosol chemotherapy and targeted therapy have been reviewed in depth for their relative importance for PCC-GC in particular.
基金Supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health(in part)Award No.G12MD007597
文摘AIM: To study the accuracy of using high definition(HD) scope with narrow band imaging(NBI) vs standard white light colonoscope without NBI(ST), to predict the histology of the colon polyps, particularly those < 1 cm.METHODS: A total of 147 African Americans patients who were referred to Howard University Hospital for screening or, diagnostic or follow up colonoscopy, during a 12-mo period in 2012 were prospectively recruited. Some patients had multiple polyps and total number of polyps was 179. Their colonoscopies were performed by 3 experienced endoscopists who determined the size and stated whether the polyps being removed were hyperplastic or adenomatous polyps using standard colonoscopes or high definition colonoscopes with NBI. The histopathologic diagnosis was reported by pathologists as part of routine care. RESULTS: Of participants in the study, 55(37%) were male and median(interquartile range) of age was 56(19-80). Demographic, clinical characteristics, past medical history of patients, and the data obtained by two instruments were not significantly different and two methods detected similar number of polyps. In ST scope 89% of polyps were < 1 cm vs 87% in HD scope(P = 0.7). The ST scope had a positive predictive value(PPV) and positive likelihood ratio(PLR) of 86% and 4.0 for adenoma compared to 74% and 2.6 for HD scope. There was a trend of higher sensitivity for HD scope(68%) compare to ST scope(53%) with almost the same specificity. The ST scope had a PPV and PLR of 38% and 1.8 for hyperplastic polyp(HPP) compared to 42% and 2.2 for HD scope. The sensitivity and specificity of two instruments for HPP diagnosis were similar.CONCLUSION: Our results indicated that HD scope was more sensitive in diagnosis of adenoma than ST scope. Clinical diagnosis of HPP with either scope is less accurate compared to adenoma. Colonoscopy diagnosis is not yet fully matched with pathologic diagnosis of colon polyp. However with the advancement of both imaging and training, it may be possible to increase the sensitivity and specificity of the scopes and hence save money for eliminating time and the cost of Immunohistochemistry/pathology.
文摘Comments are given on the various physical definitions of the force constant of propellant. As there are more or less defects in these definitions, two new definitions are presented to reflect the physical essence of propellant force more perfectly and could well compatible with the mathematical expression.