BACKGROUND Diabetic foot(DF)is a serious complication of type 2 diabetes.This study aimed to investigate the factors associated with DF occurrence and the role of delayed medical care in a cohort of patients with type...BACKGROUND Diabetic foot(DF)is a serious complication of type 2 diabetes.This study aimed to investigate the factors associated with DF occurrence and the role of delayed medical care in a cohort of patients with type 2 diabetes.AIM To reveal the impact of delayed medical treatment on the development of DF in patients with type 2 diabetes and to establish a predictive model for DF.METHODS In this retrospective cohort study,292 patients with type 2 diabetes who underwent examination at our hospital from January 2023 to December 2023 were selected and divided into the DF group(n=82,DF)and nondiabetic foot group(n=210,NDF).Differential and correlation analyses of demographic indicators,laboratory parameters,and delayed medical treatment were conducted for the two groups.Logistic regression was applied to determine influencing factors.Receiver operating characteristic(ROC)analysis was performed,and indicators with good predictive value were selected to establish a combined predictive model.RESULTS The DF group had significantly higher body mass index(BMI)(P<0.001),disease duration(P=0.012),plasma glucose levels(P<0.001),and HbA1c(P<0.001)than the NDF group.The NDF group had significantly higher Acute Thrombosis and Myocardial Infarction Health Service System(ATMHSS)scores(P<0.001)and a significantly lower delayed medical treatment rate(72.38%vs 13.41%,P<0.001).BMI,duration of diabetes,plasma glucose levels,HbA1c,diabetic peripheral neuropathy,and nephropathy were all positively correlated with DF occurrence.ATMHSS scores were negatively correlated with delayed time to seek medical treatment.The logistic regression model revealed that BMI,duration of diabetes,plasma glucose levels,HbA1c,presence of diabetic peripheral neuropathy and nephropathy,ATMHSS scores,and delayed time to seek medical treatment were influencing factors for DF.ROC analysis indicated that plasma glucose levels,HbA1c,and delayed medical treatment had good predictive value with an area under the curve of 0.933 for the combined predictive model.CONCLUSION Delayed medical treatment significantly affects the probability of DF occurrence in patients with diabetes.Plasma glucose levels,HbA1c levels,and the combined predictive model of delayed medical treatment demonstrate good predictive value.展开更多
HIV is a retrovirus that infects and impairs the cells and functions of the immune system. It has caused a great challenge to global public health systems and leads to Acquired Immunodeficiency Syndrome (AIDS), if not...HIV is a retrovirus that infects and impairs the cells and functions of the immune system. It has caused a great challenge to global public health systems and leads to Acquired Immunodeficiency Syndrome (AIDS), if not attended to in good time. Antiretroviral therapy is used for managing the virus in a patient’s lifetime. Some of the symptoms of the disease include lean body mass and many opportunistic infections. This study has developed a SIAT mathematical model to investigate the impact of inconsistency in treatment of the disease. The arising non-linear differential equations have been obtained and analyzed. The DFE and its stability have been obtained and the study found that it is locally asymptotically stable when the basic reproduction number is less than unity. The endemic equilibrium has been obtained and found to be globally asymptotically stable when the basic reproduction number is greater than unity. Numerical solutions have been obtained and analyzed to give the trends in the spread dynamics. The inconsistency in treatment uptake has been analyzed through the numerical solutions. The study found that when the treatment rate of those infected increases, it leads to an increase in treatment population, which slows down the spread of HIV and vice versa. An increase in the rate of treatment of those with AIDS leads to a decrease in the AIDS population, the reverse happens when this rate decreases. The study recommends that the community involvement in advocating for consistent treatment of HIV to curb the spread of the disease.展开更多
A non-linear HIV-TB co-infection has been formulated and analyzed. The positivity and invariant region has been established. The disease free equilibrium and its stability has been determined. The local stability was ...A non-linear HIV-TB co-infection has been formulated and analyzed. The positivity and invariant region has been established. The disease free equilibrium and its stability has been determined. The local stability was determined and found to be stable under given conditions. The basic reproduction number was obtained and according to findings, co-infection diminishes when this number is less than unity, and persists when the number is greater than unity. The global stability of the endemic equilibrium was calculated. The impact of HIV on TB was established as well as the impact of TB on HIV. Numerical solution was also done and the findings indicate that when the rate of HIV treatment increases the latent TB increases while the co-infected population decreases. When the rate of HIV treatment decreases the latent TB population decreases and the co-infected population increases. Encouraging communities to prioritize the consistent treatment of HIV infected individuals must be emphasized in order to reduce the scourge of HIV-TB co-infection.展开更多
The development of simulation model and benchmark work have expanded in the past decade and many models and soft ware are introduced. The leading software "Hearts’ developed by Prof Inoue[1] and several other ha...The development of simulation model and benchmark work have expanded in the past decade and many models and soft ware are introduced. The leading software "Hearts’ developed by Prof Inoue[1] and several other have proved the effectiveness as the pre-production simulation work at many part of heat treatment processes[2-10]. Although, numerous other models and simulation studies dealt with many fundamental factors are reported at many conferences except very few models have not completed three dimensional computation methods, or lack of validation work to evaluate their tools exactly. In this paper, several distortion case studies will be introduced and the needs of fundamental study of distortion and internationally collaborative program on model evaluation and construction of materials database are proposed.展开更多
Ameliorating waste treatment by technological improvements affects the economic and the ecological-environment benefits of intensive pig production. The objective of the research was to develop and test a method to de...Ameliorating waste treatment by technological improvements affects the economic and the ecological-environment benefits of intensive pig production. The objective of the research was to develop and test a method to determine the technical optimization to ameliorate waste treatment methods and gain insight into the relationship between technological options and the economic and ecological effects. We developed an integrated bio-economic model which incorporates the farming production and waste disposal systems to simulate the impact of technological improvements in pig manure treatment on economic and environmental benefits for the case of a pilot farm in Beijing, China. Based on different waste treatment technology options, three scenarios are applied for the simulation analysis of the model. The simulation results reveal that the economic-environmental benefits of the livestock farm could be improved by reducing the cropland manure application and increasing the composting production with the current technologies. Nevertheless, the technical efficiency, the waste treatment capacity and the economic benefits could be further improved by the introduction of new technologies. It implies that technological and economic support policies should be implemented comprehensively on waste disposal and resource utilization to promote sustainable development in intensive livestock production in China.展开更多
Both of chromium and zinc could appear as either minor impurities or alloying elements in recycled and commercial aluminum alloys, and they could have detrimental effects on the final product properties if not control...Both of chromium and zinc could appear as either minor impurities or alloying elements in recycled and commercial aluminum alloys, and they could have detrimental effects on the final product properties if not controlled in an appropriate way. A Kampmann-Wagner numerical modeling approach, built on the basis of computational thermodynamics and diffusion kinetics, is employed to investigate the effect of these two minor impurities on dispersoids precipitation during homogenization heat treatment of AA3xxx alloys. The simulation results obtained from different simulation set-ups were compared. The aim is to demonstrate that the modeling approach has the potential to guide the design or optimization of the chemical compositions and heat treatment parameters of aluminum alloys.展开更多
According to the balance of carbon and oxygen, a decarburization model for the RH treatment has been developed. in which the influence of the mass transfer of carbon and oxygen in the liquid steel and the stirring ene...According to the balance of carbon and oxygen, a decarburization model for the RH treatment has been developed. in which the influence of the mass transfer of carbon and oxygen in the liquid steel and the stirring energy (ε) in the vacuum vessel on decarburization rate has been considered. The conclusion that the volumetric coefficients of the mass transfer of carbon is proportional to ε(1.5) is drawn. Industrical experiment proves this model is reliable. The influence of some factors on decarburization rate has been obtained. which can provide directions for RH treatment The decarburization behavior of steel with RH-OB treatment is also studied. The OB-or-not curve, the optimized OB time and OB amount are discussed.展开更多
Non-point source(NPS) pollution is considered to be one of the main threats of the aquatic environment. Mountainous regions are particularly important water sources for urban areas. The various driving factors of NPS ...Non-point source(NPS) pollution is considered to be one of the main threats of the aquatic environment. Mountainous regions are particularly important water sources for urban areas. The various driving factors of NPS pollution such as terrain, precipitation, and vegetation type in mountainous regions show clear spatial heterogeneity. Consequently, the management systems required for NPS pollution in mountainous regions are complex. In this study, we developed a framework to estimate and map the treatment costs for NPS pollution in mountainous regions and applied this method in Baoxing County, a typical mountainous county in Sichuan Province of southwest China. The export levels of total nitrogen(TN) and total phosphorus(TP) in Baoxing County were estimated using the water purification model in InVEST(Itegrated Valuation of Ecosystem Services and Tradeoffs) tool. NPS pollutant treatment costs were calculated based on the level of pollutants exports, water yield, water quality targets, and treatment costs of NPS pollutants per unit mass. The results show that at the watershed level the amounts of TN and TP exported in Baoxing County were below threshold limits. However, at the sub-watershed level, TN and TP excesses of 291.64 and 2.96 tons per year were found, respectively, with mean TN and TP treatment costs of 6.58 US$/hm^2 and 0.35 US$/hm^2. Appraising pollution treatment cost intuitively reflects the overall expenditure in NPS pollution reduction from an economic perspective. This study provides a foundation for the implementation of Payment for Ecosystem Service(PES) and the prevention and control of NPS pollution.展开更多
Extensive historical data of a sewage treatment works are required by numerical models in order to simulate the biological processes accurately. However, the data are recorded mostly for daily operational purpose. The...Extensive historical data of a sewage treatment works are required by numerical models in order to simulate the biological processes accurately. However, the data are recorded mostly for daily operational purpose. They are basically not comprehensive enough to meet the modelling’s requirements. A comprehensive sampling protocol to accurately characterise the influent is required in order to determine all model components, which is very time-consuming and expensive. In a project of evaluating a sewage treatment works in Chongqing by using BioWin 4.1 for mathematical modelling, sensitivity analysis was conducted to determine the most critical parameters for process monitoring. It was found that influent characteristics, wasted sludge flow rate, water temperatures, DO levels of the biological tanks and five bio-kinetic parameters were the most influential parameters governing the plant performance. Therefore, apart from monitoring the effluent quality, regular checking of the afore-mentioned influential parameters can help examine the performance of a sewage treatment works. Moreover, operators of the sewage treatment works can conduct “what-if” analysis to determine how these most influential parameters can be adjusted to improve the treatment performance of the sewage treatment works.展开更多
This paper proposes a vector-borne plant disease model with discontinuous treatment strategies. Constructing Lyapunov function and applying non-smooth theory to analyze discontinuous differential equations, the basic ...This paper proposes a vector-borne plant disease model with discontinuous treatment strategies. Constructing Lyapunov function and applying non-smooth theory to analyze discontinuous differential equations, the basic reproductive number R0 is proved, which determines whether the plant disease will be extinct or not. If R0 R0 > 1 , there exists a unique endemic equilibrium which is globally stable. The numerical simulations are provided to verify our theoretical results, which indicate that after infective individuals reach some level, strengthening treatment measures is proved to be beneficial in controlling disease transmission.展开更多
BACKGROUND:Hyperkalemia is common among patients in emergency department and is associated with mortality.While,there is a lack of good evaluation and prediction methods for the effi cacy of potassium-lowering treatme...BACKGROUND:Hyperkalemia is common among patients in emergency department and is associated with mortality.While,there is a lack of good evaluation and prediction methods for the effi cacy of potassium-lowering treatment,making the drug dosage adjustment quite diffi cult.We aimed to develop a predictive model to provide early forecasting of treating eff ects for hyperkalemia patients.METHODS:Around 80%of hyperkalemia patients(n=818)were randomly selected as the training dataset and the remaining 20%(n=196)as the validating dataset.According to the serum potassium(K+)levels after the fi rst round of potassium-lowering treatment,patients were classifi ed into the eff ective and ineff ective groups.Multivariate logistic regression analyses were performed to develop a prediction model.The receiver operating characteristic(ROC)curve and calibration curve analysis were used for model validation.RESULTS:In the training dataset,429 patients had favorable eff ects after treatment(eff ective group),and 389 had poor therapeutic outcomes(ineff ective group).Patients in the ineff ective group had a higher percentage of renal disease(P=0.007),peripheral edema(P<0.001),oliguria(P=0.001),or higher initial serum K+level(P<0.001).The percentage of insulin usage was higher in the effective group than in the ineff ective group(P=0.005).After multivariate logistic regression analysis,we found age,peripheral edema,oliguria,history of kidney transplantation,end-stage renal disease,insulin,and initial serum K+were all independently associated with favorable treatment eff ects.CONCLUSION:The predictive model could provide early forecasting of therapeutic outcomes for hyperkalemia patients after drug treatment,which could help clinicians to identify hyperkalemia patients with high risk and adjust the dosage of medication for potassium-lowering.展开更多
Clinical practice guidelines(CPGs)contain evidence-based and economically reasonable medical treatment processes.Executable medical treatment processes in healthcare information systems can assist the treatment proces...Clinical practice guidelines(CPGs)contain evidence-based and economically reasonable medical treatment processes.Executable medical treatment processes in healthcare information systems can assist the treatment processes.To this end,business process modeling technologies have been exploited to model medical treatment processes.However,medical treatment processes are usually flexible and knowledge-intensive.To reduce the effort in modeling,we summarize several treatment patterns(i.e.,frequent behaviors in medical treatment processes in CPGs),and represent them by three process modeling languages(i.e.,BPMN,DMN,and CMMN).Based on the summarized treatment patterns,we propose a pattern-based integrated framework for modeling medical treatment processes.A modeling platform is implemented to support the use of treatment patterns,by which the feasibility of our approach is validated.An empirical analysis is discussed based on the coverage rates of treatment patterns.Feedback from interviewed physicians in a Chinese hospital shows that executable medical treatment processes of CPGs provide a convenient way to obtain guidance,thus assisting daily work for medical workers.展开更多
BACKGROUND Stroke has become one of the most serious life-threatening diseases due to its high morbidity,disability,recurrence and mortality rates.AIM To explore the intervention effect of multi-disciplinary treatment...BACKGROUND Stroke has become one of the most serious life-threatening diseases due to its high morbidity,disability,recurrence and mortality rates.AIM To explore the intervention effect of multi-disciplinary treatment(MDT)extended nursing model on negative emotions and quality of life of young patients with post-stroke.METHODS A total of 60 young stroke patients who were hospitalized in the neurology department of our hospital from January 2020 to December 2021 were selected and randomly divided into a control group and an experimental group,with 30 patients in each group.The control group used the conventional care model and the experimental group used the MDT extended nursing model.After the inhospital and 3-mo post-discharge interventions,the differences in negative emotions and quality of life scores between the two groups were evaluated and analyzed at the time of admission,at the time of discharge and after discharge,respectively.RESULTS There are no statistically significant differences in the negative emotions scores between the two groups at admission,while there are statistically significant differences in the negative emotions scores within each group at admission and discharge,at discharge and post-discharge,and at discharge and post-discharge.In addition,the negative emotions scores were all statistically significant at discharge and after discharge when compared between the two groups.There was no statistically significant difference in quality of life scores at the time of admission between the two groups,and the difference between quality of life scores at the time of admission and discharge,at the time of discharge and post-discharge,and at the time of admission and post-discharge for each group of patients was statistically significant.CONCLUSION The MDT extended nursing mode can improve the negative emotion of patients and improve their quality of life.Therefore,it can be applied in future clinical practice and is worthy of promotion.展开更多
Background:Choosing the appropriate antipsychotic drug(APD)treatment for patients with schizophrenia(SCZ)can be challenging,as the treatment response to APD is highly variable and difficult to predict due to the lack ...Background:Choosing the appropriate antipsychotic drug(APD)treatment for patients with schizophrenia(SCZ)can be challenging,as the treatment response to APD is highly variable and difficult to predict due to the lack of effective biomarkers.Previous studies have indicated the association between treatment response and genetic and epigenetic factors,but no effective biomarkers have been identified.Hence,further research is imperative to enhance precision medicine in SCZ treatment.Methods:Participants with SCZ were recruited from two randomized trials.The discovery cohort was recruited from the CAPOC trial(n=2307)involved 6 weeks of treatment and equally randomized the participants to the Olanzapine,Risperidone,Quetiapine,Aripiprazole,Ziprasidone,and Haloperidol/Perphenazine(subsequently equally assigned to one or the other)groups.The external validation cohort was recruited from the CAPEC trial(n=1379),which involved 8 weeks of treatment and equally randomized the participants to the Olanzapine,Risperidone,and Aripiprazole groups.Additionally,healthy controls(n=275)from the local community were utilized as a genetic/epigenetic reference.The genetic and epigenetic(DNA methylation)risks of SCZ were assessed using the polygenic risk score(PRS)and polymethylation score,respectively.The study also examined the genetic-epigenetic interactions with treatment response through differential methylation analysis,methylation quantitative trait loci,colocalization,and promoteranchored chromatin interaction.Machine learning was used to develop a prediction model for treatment response,which was evaluated for accuracy and clinical benefit using the area under curve(AUC)for classification,R^(2) for regression,and decision curve analysis.Results:Six risk genes for SCZ(LINC01795,DDHD2,SBNO1,KCNG2,SEMA7A,and RUFY1)involved in cortical morphology were identified as having a genetic-epigenetic interaction associated with treatment response.The developed and externally validated prediction model,which incorporated clinical information,PRS,genetic risk score(GRS),and proxy methylation level(proxyDNAm),demonstrated positive benefits for a wide range of patients receiving different APDs,regardless of sex[discovery cohort:AUC=0.874(95%CI 0.867-0.881),R^(2)=0.478;external validation cohort:AUC=0.851(95%CI 0.841-0.861),R^(2)=0.507].Conclusions:This study presents a promising precision medicine approach to evaluate treatment response,which has the potential to aid clinicians in making informed decisions about APD treatment for patients with SCZ.Trial registration Chinese Clinical Trial Registry(https://www.chictr.org.cn/),18 Aug 2009 retrospectively registered:CAPOC-ChiCTR-RNC-09000521(https://www.chictr.org.cn/showproj.aspx?proj=9014),CAPEC-ChiCTRRNC-09000522(https://www.chictr.org.cn/showproj.aspx?proj=9013).展开更多
Continuous furnaces are widely used in the heat treatment of mass-produced parts. However, the heating up process of parts in continuous furnace is still decided by experience. In this paper the heat transfer in the c...Continuous furnaces are widely used in the heat treatment of mass-produced parts. However, the heating up process of parts in continuous furnace is still decided by experience. In this paper the heat transfer in the continuous furnace is formulated firstly. The heat balance in each zone is discussed and equations are given. Coupled with the model for heat transfer between workpieces and furnace and the heat transfer in the workload as well presented in the former developed CHT-6/ for batch furnaces, a program CHT- for continuous furnaces was developed. The model deals with two typical movements of parts: continuous or step by step. The moving speed of parts and load pattern can be optimized based on the calculated temperature distributions and curves, especially, the fastest heated and slowest-heated temperature-distance profiles. A case study is carried out for the heat treatment of a kind of hook-shaped part. The calculated results are analyzed and in good agreement with the measured ones.展开更多
Understanding the thermal conductivity of granite is critical for many geological and deep engineering applications.The heated granite was subjected to air-,water-,and liquid nitrogen(LN2-)coolings in this context.The...Understanding the thermal conductivity of granite is critical for many geological and deep engineering applications.The heated granite was subjected to air-,water-,and liquid nitrogen(LN2-)coolings in this context.The transient hot-wire technique was used to determine the equivalent thermal conductivity(ETC)of the granite before and after treatment.The deterioration mechanism of ETC is analyzed from the meso-perspective.Finally,the numerical model is used to quantitatively study the impact of cooling rate on the microcrack propagation and heat conduction characteristics of granite.The results show that the ETC of granite is not only related to the heating temperature,but also affected by the cooling rate.The ETC of granite decreases nonlinearly with increasing heating temperature.A faster cooling rate causes a greater decrease in ETC at the same heating temperature.The higher the heating temperature,the stronger the influence of cooling rate on ETC.The main explanation for the decrease in ETC of granite is the increase in porosity and microcrack density produced by the formation and propagation of pore structure and microcracks during heating and cooling.Further analysis displays that the damage of granite at the heating stage is induced by the difference in thermal expansion and elastic properties of mineral particles.At the cooling stage,the faster cooling rate causes a higher temperature gradient,which in turn produces greater thermal stress.As a result,it not only causes new cracks in the granite,but also aggravates the damage at the heating stage,which induces a further decrease in the heat conduction performance of granite,and this scenario is more obvious at higher temperatures.展开更多
BACKGROUND Integrating conventional ultrasound features with 2D shear wave elastography(2D-SWE)can potentially enhance preoperative hepatocellular carcinoma(HCC)predictions.AIM To develop a 2D-SWE-based predictive mod...BACKGROUND Integrating conventional ultrasound features with 2D shear wave elastography(2D-SWE)can potentially enhance preoperative hepatocellular carcinoma(HCC)predictions.AIM To develop a 2D-SWE-based predictive model for preoperative identification of HCC.METHODS A retrospective analysis of 884 patients who underwent liver resection and pathology evaluation from February 2021 to August 2023 was conducted at the Oriental Hepatobiliary Surgery Hospital.The patients were divided into the modeling group(n=720)and the control group(n=164).The study included conventional ultrasound,2D-SWE,and preoperative laboratory tests.Multiple logistic regression was used to identify independent predictive factors for RESULTS In the modeling group analysis,maximal elasticity(Emax)of tumors and their peripheries,platelet count,cirrhosis,and blood flow were independent risk indicators for malignancies.These factors yielded an area under the curve of 0.77(95%confidence interval:0.73-0.81)with 84%sensitivity and 61%specificity.The model demonstrated good calibration in both the construction and validation cohorts,as shown by the calibration graph and Hosmer-Lemeshow test(P=0.683 and P=0.658,respectively).Additionally,the mean elasticity(Emean)of the tumor periphery was identified as a risk factor for microvascular invasion(MVI)in malignant liver tumors(P=0.003).Patients receiving antiviral treatment differed significantly in platelet count(P=0.002),Emax of tumors(P=0.033),Emean of tumors(P=0.042),Emax at tumor periphery(P<0.001),and Emean at tumor periphery(P=0.003).CONCLUSION 2D-SWE’s hardness value serves as a valuable marker for enhancing the preoperative diagnosis of malignant liver lesions,correlating significantly with MVI and antiviral treatment efficacy.展开更多
Gallbladder cancer(GBC)is a rare and lethal malignancy;however,it represents the most common type of biliary tract cancer.Patients with GBC are often diagnosed at an advanced stage,thus,unfortunately,losing the opport...Gallbladder cancer(GBC)is a rare and lethal malignancy;however,it represents the most common type of biliary tract cancer.Patients with GBC are often diagnosed at an advanced stage,thus,unfortunately,losing the opportunity for curative surgical intervention.This situation leads to lower quality of life and higher mortality rates.In recent years,the rapid development of endoscopic equipment and techniques has provided new avenues and possibilities for the early and minimally invasive diagnosis and treatment of GBC.This editorial comments on the article by Pavlidis et al.Building upon their work,we explore the new needs and corresponding models for managing GBC from the endoscopic diagnosis and treatment perspective.展开更多
activities.Ex-periments on a synthetic log of the non-secondary hy-pertension MTP and empirical findings demonstrate the effectiveness of our approach.The results show that the process mining in our approach framework...activities.Ex-periments on a synthetic log of the non-secondary hy-pertension MTP and empirical findings demonstrate the effectiveness of our approach.The results show that the process mining in our approach framework can automatically generate more accurate MTP mod-els,and the subprocess models based on treatment pat-terns make the models easy to understand.展开更多
Objective:To explore the efficacy of intermittent preventive treatment in pregnancy(IPTp)with sulfadoxine and pyrimethamine(SP)against sensitive parasites.Methods:A pharmacological model was used to investigate the ef...Objective:To explore the efficacy of intermittent preventive treatment in pregnancy(IPTp)with sulfadoxine and pyrimethamine(SP)against sensitive parasites.Methods:A pharmacological model was used to investigate the effectiveness of the previous recommended at least two-dose regimen,currently recommended three-dose regimen and 4,6,8-weekly regimens with specific focus on the impact of various nonadherence patterns in multiple transmission settings.Results:The effectiveness of the recommended three-dose regimen is high in all the transmission intensities,i.e.>99%,98%and 92%in low,moderate and high transmission intensities respectively.The simulated 4 and 6 weekly IPTp-SP regimens were able to prevent new infections with sensitive parasites in almost all women(>99%)regardless of transmission intensity.However,8 weekly interval dose schedules were found to have 71%and 86%protective efficacies in high and moderate transmission areas,respectively.It highlights that patients are particularly vulnerable to acquiring new infections if IPTp-SP doses are missed.Conclusions:The pharmacological model predicts that full adherence to the currently recommended three-dose regimen should provide almost complete protection from malaria infection in moderate and high transmission regions.However,it also highlights that patients are particularly vulnerable to acquiring new infections if IPTp doses are spaced too widely or if doses are missed.Adherence to the recommended IPTp-SP schedules is recommended.展开更多
文摘BACKGROUND Diabetic foot(DF)is a serious complication of type 2 diabetes.This study aimed to investigate the factors associated with DF occurrence and the role of delayed medical care in a cohort of patients with type 2 diabetes.AIM To reveal the impact of delayed medical treatment on the development of DF in patients with type 2 diabetes and to establish a predictive model for DF.METHODS In this retrospective cohort study,292 patients with type 2 diabetes who underwent examination at our hospital from January 2023 to December 2023 were selected and divided into the DF group(n=82,DF)and nondiabetic foot group(n=210,NDF).Differential and correlation analyses of demographic indicators,laboratory parameters,and delayed medical treatment were conducted for the two groups.Logistic regression was applied to determine influencing factors.Receiver operating characteristic(ROC)analysis was performed,and indicators with good predictive value were selected to establish a combined predictive model.RESULTS The DF group had significantly higher body mass index(BMI)(P<0.001),disease duration(P=0.012),plasma glucose levels(P<0.001),and HbA1c(P<0.001)than the NDF group.The NDF group had significantly higher Acute Thrombosis and Myocardial Infarction Health Service System(ATMHSS)scores(P<0.001)and a significantly lower delayed medical treatment rate(72.38%vs 13.41%,P<0.001).BMI,duration of diabetes,plasma glucose levels,HbA1c,diabetic peripheral neuropathy,and nephropathy were all positively correlated with DF occurrence.ATMHSS scores were negatively correlated with delayed time to seek medical treatment.The logistic regression model revealed that BMI,duration of diabetes,plasma glucose levels,HbA1c,presence of diabetic peripheral neuropathy and nephropathy,ATMHSS scores,and delayed time to seek medical treatment were influencing factors for DF.ROC analysis indicated that plasma glucose levels,HbA1c,and delayed medical treatment had good predictive value with an area under the curve of 0.933 for the combined predictive model.CONCLUSION Delayed medical treatment significantly affects the probability of DF occurrence in patients with diabetes.Plasma glucose levels,HbA1c levels,and the combined predictive model of delayed medical treatment demonstrate good predictive value.
文摘HIV is a retrovirus that infects and impairs the cells and functions of the immune system. It has caused a great challenge to global public health systems and leads to Acquired Immunodeficiency Syndrome (AIDS), if not attended to in good time. Antiretroviral therapy is used for managing the virus in a patient’s lifetime. Some of the symptoms of the disease include lean body mass and many opportunistic infections. This study has developed a SIAT mathematical model to investigate the impact of inconsistency in treatment of the disease. The arising non-linear differential equations have been obtained and analyzed. The DFE and its stability have been obtained and the study found that it is locally asymptotically stable when the basic reproduction number is less than unity. The endemic equilibrium has been obtained and found to be globally asymptotically stable when the basic reproduction number is greater than unity. Numerical solutions have been obtained and analyzed to give the trends in the spread dynamics. The inconsistency in treatment uptake has been analyzed through the numerical solutions. The study found that when the treatment rate of those infected increases, it leads to an increase in treatment population, which slows down the spread of HIV and vice versa. An increase in the rate of treatment of those with AIDS leads to a decrease in the AIDS population, the reverse happens when this rate decreases. The study recommends that the community involvement in advocating for consistent treatment of HIV to curb the spread of the disease.
文摘A non-linear HIV-TB co-infection has been formulated and analyzed. The positivity and invariant region has been established. The disease free equilibrium and its stability has been determined. The local stability was determined and found to be stable under given conditions. The basic reproduction number was obtained and according to findings, co-infection diminishes when this number is less than unity, and persists when the number is greater than unity. The global stability of the endemic equilibrium was calculated. The impact of HIV on TB was established as well as the impact of TB on HIV. Numerical solution was also done and the findings indicate that when the rate of HIV treatment increases the latent TB increases while the co-infected population decreases. When the rate of HIV treatment decreases the latent TB population decreases and the co-infected population increases. Encouraging communities to prioritize the consistent treatment of HIV infected individuals must be emphasized in order to reduce the scourge of HIV-TB co-infection.
文摘The development of simulation model and benchmark work have expanded in the past decade and many models and soft ware are introduced. The leading software "Hearts’ developed by Prof Inoue[1] and several other have proved the effectiveness as the pre-production simulation work at many part of heat treatment processes[2-10]. Although, numerous other models and simulation studies dealt with many fundamental factors are reported at many conferences except very few models have not completed three dimensional computation methods, or lack of validation work to evaluate their tools exactly. In this paper, several distortion case studies will be introduced and the needs of fundamental study of distortion and internationally collaborative program on model evaluation and construction of materials database are proposed.
基金supported by the International Cooperation Project of Ministry of Science and Technology of China(MOST:2009DFA32710,BMBF(FKZ):0330847F)the Natural Science Foundation of Zhejiang Province,China(Y13G030168)
文摘Ameliorating waste treatment by technological improvements affects the economic and the ecological-environment benefits of intensive pig production. The objective of the research was to develop and test a method to determine the technical optimization to ameliorate waste treatment methods and gain insight into the relationship between technological options and the economic and ecological effects. We developed an integrated bio-economic model which incorporates the farming production and waste disposal systems to simulate the impact of technological improvements in pig manure treatment on economic and environmental benefits for the case of a pilot farm in Beijing, China. Based on different waste treatment technology options, three scenarios are applied for the simulation analysis of the model. The simulation results reveal that the economic-environmental benefits of the livestock farm could be improved by reducing the cropland manure application and increasing the composting production with the current technologies. Nevertheless, the technical efficiency, the waste treatment capacity and the economic benefits could be further improved by the introduction of new technologies. It implies that technological and economic support policies should be implemented comprehensively on waste disposal and resource utilization to promote sustainable development in intensive livestock production in China.
文摘Both of chromium and zinc could appear as either minor impurities or alloying elements in recycled and commercial aluminum alloys, and they could have detrimental effects on the final product properties if not controlled in an appropriate way. A Kampmann-Wagner numerical modeling approach, built on the basis of computational thermodynamics and diffusion kinetics, is employed to investigate the effect of these two minor impurities on dispersoids precipitation during homogenization heat treatment of AA3xxx alloys. The simulation results obtained from different simulation set-ups were compared. The aim is to demonstrate that the modeling approach has the potential to guide the design or optimization of the chemical compositions and heat treatment parameters of aluminum alloys.
文摘According to the balance of carbon and oxygen, a decarburization model for the RH treatment has been developed. in which the influence of the mass transfer of carbon and oxygen in the liquid steel and the stirring energy (ε) in the vacuum vessel on decarburization rate has been considered. The conclusion that the volumetric coefficients of the mass transfer of carbon is proportional to ε(1.5) is drawn. Industrical experiment proves this model is reliable. The influence of some factors on decarburization rate has been obtained. which can provide directions for RH treatment The decarburization behavior of steel with RH-OB treatment is also studied. The OB-or-not curve, the optimized OB time and OB amount are discussed.
基金sponsored by National Natural Science Foundation of China (Grant Nos. 41371539)Guangxi Natural Science Foundation Program (Grant Nos. 2018GXNSFBA138026)Guangxi Young and Middle-aged University Teachers’ Scientific Research Ability Enhancement Project (Grant Nos. 2018KY0360)
文摘Non-point source(NPS) pollution is considered to be one of the main threats of the aquatic environment. Mountainous regions are particularly important water sources for urban areas. The various driving factors of NPS pollution such as terrain, precipitation, and vegetation type in mountainous regions show clear spatial heterogeneity. Consequently, the management systems required for NPS pollution in mountainous regions are complex. In this study, we developed a framework to estimate and map the treatment costs for NPS pollution in mountainous regions and applied this method in Baoxing County, a typical mountainous county in Sichuan Province of southwest China. The export levels of total nitrogen(TN) and total phosphorus(TP) in Baoxing County were estimated using the water purification model in InVEST(Itegrated Valuation of Ecosystem Services and Tradeoffs) tool. NPS pollutant treatment costs were calculated based on the level of pollutants exports, water yield, water quality targets, and treatment costs of NPS pollutants per unit mass. The results show that at the watershed level the amounts of TN and TP exported in Baoxing County were below threshold limits. However, at the sub-watershed level, TN and TP excesses of 291.64 and 2.96 tons per year were found, respectively, with mean TN and TP treatment costs of 6.58 US$/hm^2 and 0.35 US$/hm^2. Appraising pollution treatment cost intuitively reflects the overall expenditure in NPS pollution reduction from an economic perspective. This study provides a foundation for the implementation of Payment for Ecosystem Service(PES) and the prevention and control of NPS pollution.
文摘Extensive historical data of a sewage treatment works are required by numerical models in order to simulate the biological processes accurately. However, the data are recorded mostly for daily operational purpose. They are basically not comprehensive enough to meet the modelling’s requirements. A comprehensive sampling protocol to accurately characterise the influent is required in order to determine all model components, which is very time-consuming and expensive. In a project of evaluating a sewage treatment works in Chongqing by using BioWin 4.1 for mathematical modelling, sensitivity analysis was conducted to determine the most critical parameters for process monitoring. It was found that influent characteristics, wasted sludge flow rate, water temperatures, DO levels of the biological tanks and five bio-kinetic parameters were the most influential parameters governing the plant performance. Therefore, apart from monitoring the effluent quality, regular checking of the afore-mentioned influential parameters can help examine the performance of a sewage treatment works. Moreover, operators of the sewage treatment works can conduct “what-if” analysis to determine how these most influential parameters can be adjusted to improve the treatment performance of the sewage treatment works.
文摘This paper proposes a vector-borne plant disease model with discontinuous treatment strategies. Constructing Lyapunov function and applying non-smooth theory to analyze discontinuous differential equations, the basic reproductive number R0 is proved, which determines whether the plant disease will be extinct or not. If R0 R0 > 1 , there exists a unique endemic equilibrium which is globally stable. The numerical simulations are provided to verify our theoretical results, which indicate that after infective individuals reach some level, strengthening treatment measures is proved to be beneficial in controlling disease transmission.
基金supported by the Key Research and Development Program of Zhejiang Province(2019C03076).
文摘BACKGROUND:Hyperkalemia is common among patients in emergency department and is associated with mortality.While,there is a lack of good evaluation and prediction methods for the effi cacy of potassium-lowering treatment,making the drug dosage adjustment quite diffi cult.We aimed to develop a predictive model to provide early forecasting of treating eff ects for hyperkalemia patients.METHODS:Around 80%of hyperkalemia patients(n=818)were randomly selected as the training dataset and the remaining 20%(n=196)as the validating dataset.According to the serum potassium(K+)levels after the fi rst round of potassium-lowering treatment,patients were classifi ed into the eff ective and ineff ective groups.Multivariate logistic regression analyses were performed to develop a prediction model.The receiver operating characteristic(ROC)curve and calibration curve analysis were used for model validation.RESULTS:In the training dataset,429 patients had favorable eff ects after treatment(eff ective group),and 389 had poor therapeutic outcomes(ineff ective group).Patients in the ineff ective group had a higher percentage of renal disease(P=0.007),peripheral edema(P<0.001),oliguria(P=0.001),or higher initial serum K+level(P<0.001).The percentage of insulin usage was higher in the effective group than in the ineff ective group(P=0.005).After multivariate logistic regression analysis,we found age,peripheral edema,oliguria,history of kidney transplantation,end-stage renal disease,insulin,and initial serum K+were all independently associated with favorable treatment eff ects.CONCLUSION:The predictive model could provide early forecasting of therapeutic outcomes for hyperkalemia patients after drug treatment,which could help clinicians to identify hyperkalemia patients with high risk and adjust the dosage of medication for potassium-lowering.
基金supported by Chinese National Key Research and Development Program(No.2017YFB1400604).
文摘Clinical practice guidelines(CPGs)contain evidence-based and economically reasonable medical treatment processes.Executable medical treatment processes in healthcare information systems can assist the treatment processes.To this end,business process modeling technologies have been exploited to model medical treatment processes.However,medical treatment processes are usually flexible and knowledge-intensive.To reduce the effort in modeling,we summarize several treatment patterns(i.e.,frequent behaviors in medical treatment processes in CPGs),and represent them by three process modeling languages(i.e.,BPMN,DMN,and CMMN).Based on the summarized treatment patterns,we propose a pattern-based integrated framework for modeling medical treatment processes.A modeling platform is implemented to support the use of treatment patterns,by which the feasibility of our approach is validated.An empirical analysis is discussed based on the coverage rates of treatment patterns.Feedback from interviewed physicians in a Chinese hospital shows that executable medical treatment processes of CPGs provide a convenient way to obtain guidance,thus assisting daily work for medical workers.
基金Supported by the Joint Guidance Project of Qiqihar Science and Technology Plan in 2020,No.LHYD-202054。
文摘BACKGROUND Stroke has become one of the most serious life-threatening diseases due to its high morbidity,disability,recurrence and mortality rates.AIM To explore the intervention effect of multi-disciplinary treatment(MDT)extended nursing model on negative emotions and quality of life of young patients with post-stroke.METHODS A total of 60 young stroke patients who were hospitalized in the neurology department of our hospital from January 2020 to December 2021 were selected and randomly divided into a control group and an experimental group,with 30 patients in each group.The control group used the conventional care model and the experimental group used the MDT extended nursing model.After the inhospital and 3-mo post-discharge interventions,the differences in negative emotions and quality of life scores between the two groups were evaluated and analyzed at the time of admission,at the time of discharge and after discharge,respectively.RESULTS There are no statistically significant differences in the negative emotions scores between the two groups at admission,while there are statistically significant differences in the negative emotions scores within each group at admission and discharge,at discharge and post-discharge,and at discharge and post-discharge.In addition,the negative emotions scores were all statistically significant at discharge and after discharge when compared between the two groups.There was no statistically significant difference in quality of life scores at the time of admission between the two groups,and the difference between quality of life scores at the time of admission and discharge,at the time of discharge and post-discharge,and at the time of admission and post-discharge for each group of patients was statistically significant.CONCLUSION The MDT extended nursing mode can improve the negative emotion of patients and improve their quality of life.Therefore,it can be applied in future clinical practice and is worthy of promotion.
基金supported by the National Natural Science Foundation of China(81825009,82071505,81901358)the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2MC&T-B-099,2019-I2M-5–006)+2 种基金the Program of Chinese Institute for Brain Research Beijing(2020-NKX-XM-12)the King’s College London-Peking University Health Science Center Joint Institute for Medical Research(BMU2020KCL001,BMU2019LCKXJ012)the National Key R&D Program of China(2021YFF1201103,2016YFC1307000).
文摘Background:Choosing the appropriate antipsychotic drug(APD)treatment for patients with schizophrenia(SCZ)can be challenging,as the treatment response to APD is highly variable and difficult to predict due to the lack of effective biomarkers.Previous studies have indicated the association between treatment response and genetic and epigenetic factors,but no effective biomarkers have been identified.Hence,further research is imperative to enhance precision medicine in SCZ treatment.Methods:Participants with SCZ were recruited from two randomized trials.The discovery cohort was recruited from the CAPOC trial(n=2307)involved 6 weeks of treatment and equally randomized the participants to the Olanzapine,Risperidone,Quetiapine,Aripiprazole,Ziprasidone,and Haloperidol/Perphenazine(subsequently equally assigned to one or the other)groups.The external validation cohort was recruited from the CAPEC trial(n=1379),which involved 8 weeks of treatment and equally randomized the participants to the Olanzapine,Risperidone,and Aripiprazole groups.Additionally,healthy controls(n=275)from the local community were utilized as a genetic/epigenetic reference.The genetic and epigenetic(DNA methylation)risks of SCZ were assessed using the polygenic risk score(PRS)and polymethylation score,respectively.The study also examined the genetic-epigenetic interactions with treatment response through differential methylation analysis,methylation quantitative trait loci,colocalization,and promoteranchored chromatin interaction.Machine learning was used to develop a prediction model for treatment response,which was evaluated for accuracy and clinical benefit using the area under curve(AUC)for classification,R^(2) for regression,and decision curve analysis.Results:Six risk genes for SCZ(LINC01795,DDHD2,SBNO1,KCNG2,SEMA7A,and RUFY1)involved in cortical morphology were identified as having a genetic-epigenetic interaction associated with treatment response.The developed and externally validated prediction model,which incorporated clinical information,PRS,genetic risk score(GRS),and proxy methylation level(proxyDNAm),demonstrated positive benefits for a wide range of patients receiving different APDs,regardless of sex[discovery cohort:AUC=0.874(95%CI 0.867-0.881),R^(2)=0.478;external validation cohort:AUC=0.851(95%CI 0.841-0.861),R^(2)=0.507].Conclusions:This study presents a promising precision medicine approach to evaluate treatment response,which has the potential to aid clinicians in making informed decisions about APD treatment for patients with SCZ.Trial registration Chinese Clinical Trial Registry(https://www.chictr.org.cn/),18 Aug 2009 retrospectively registered:CAPOC-ChiCTR-RNC-09000521(https://www.chictr.org.cn/showproj.aspx?proj=9014),CAPEC-ChiCTRRNC-09000522(https://www.chictr.org.cn/showproj.aspx?proj=9013).
文摘Continuous furnaces are widely used in the heat treatment of mass-produced parts. However, the heating up process of parts in continuous furnace is still decided by experience. In this paper the heat transfer in the continuous furnace is formulated firstly. The heat balance in each zone is discussed and equations are given. Coupled with the model for heat transfer between workpieces and furnace and the heat transfer in the workload as well presented in the former developed CHT-6/ for batch furnaces, a program CHT- for continuous furnaces was developed. The model deals with two typical movements of parts: continuous or step by step. The moving speed of parts and load pattern can be optimized based on the calculated temperature distributions and curves, especially, the fastest heated and slowest-heated temperature-distance profiles. A case study is carried out for the heat treatment of a kind of hook-shaped part. The calculated results are analyzed and in good agreement with the measured ones.
基金the Natural Science Foundation of China(Grant No.42241145)supported by the Natural Science Foundation of China(Grant No.41941018)General Projects for Scientific and Technological Innovation of China Coal Science and Industry Group(Grant No.2022-MS001).
文摘Understanding the thermal conductivity of granite is critical for many geological and deep engineering applications.The heated granite was subjected to air-,water-,and liquid nitrogen(LN2-)coolings in this context.The transient hot-wire technique was used to determine the equivalent thermal conductivity(ETC)of the granite before and after treatment.The deterioration mechanism of ETC is analyzed from the meso-perspective.Finally,the numerical model is used to quantitatively study the impact of cooling rate on the microcrack propagation and heat conduction characteristics of granite.The results show that the ETC of granite is not only related to the heating temperature,but also affected by the cooling rate.The ETC of granite decreases nonlinearly with increasing heating temperature.A faster cooling rate causes a greater decrease in ETC at the same heating temperature.The higher the heating temperature,the stronger the influence of cooling rate on ETC.The main explanation for the decrease in ETC of granite is the increase in porosity and microcrack density produced by the formation and propagation of pore structure and microcracks during heating and cooling.Further analysis displays that the damage of granite at the heating stage is induced by the difference in thermal expansion and elastic properties of mineral particles.At the cooling stage,the faster cooling rate causes a higher temperature gradient,which in turn produces greater thermal stress.As a result,it not only causes new cracks in the granite,but also aggravates the damage at the heating stage,which induces a further decrease in the heat conduction performance of granite,and this scenario is more obvious at higher temperatures.
基金Supported by the National Natural Science Foundation of China Youth Training Project,No.2021GZR003and Medical-engineering Interdisciplinary Research Youth Training Project,No.2022YGJC001.
文摘BACKGROUND Integrating conventional ultrasound features with 2D shear wave elastography(2D-SWE)can potentially enhance preoperative hepatocellular carcinoma(HCC)predictions.AIM To develop a 2D-SWE-based predictive model for preoperative identification of HCC.METHODS A retrospective analysis of 884 patients who underwent liver resection and pathology evaluation from February 2021 to August 2023 was conducted at the Oriental Hepatobiliary Surgery Hospital.The patients were divided into the modeling group(n=720)and the control group(n=164).The study included conventional ultrasound,2D-SWE,and preoperative laboratory tests.Multiple logistic regression was used to identify independent predictive factors for RESULTS In the modeling group analysis,maximal elasticity(Emax)of tumors and their peripheries,platelet count,cirrhosis,and blood flow were independent risk indicators for malignancies.These factors yielded an area under the curve of 0.77(95%confidence interval:0.73-0.81)with 84%sensitivity and 61%specificity.The model demonstrated good calibration in both the construction and validation cohorts,as shown by the calibration graph and Hosmer-Lemeshow test(P=0.683 and P=0.658,respectively).Additionally,the mean elasticity(Emean)of the tumor periphery was identified as a risk factor for microvascular invasion(MVI)in malignant liver tumors(P=0.003).Patients receiving antiviral treatment differed significantly in platelet count(P=0.002),Emax of tumors(P=0.033),Emean of tumors(P=0.042),Emax at tumor periphery(P<0.001),and Emean at tumor periphery(P=0.003).CONCLUSION 2D-SWE’s hardness value serves as a valuable marker for enhancing the preoperative diagnosis of malignant liver lesions,correlating significantly with MVI and antiviral treatment efficacy.
基金the Education and Teaching Reform Project of the First Clinical College of Chongqing Medical University,No.CMER202305the Program for Youth Innovation in Future Medicine,Chongqing Medical University,No.W0138.
文摘Gallbladder cancer(GBC)is a rare and lethal malignancy;however,it represents the most common type of biliary tract cancer.Patients with GBC are often diagnosed at an advanced stage,thus,unfortunately,losing the opportunity for curative surgical intervention.This situation leads to lower quality of life and higher mortality rates.In recent years,the rapid development of endoscopic equipment and techniques has provided new avenues and possibilities for the early and minimally invasive diagnosis and treatment of GBC.This editorial comments on the article by Pavlidis et al.Building upon their work,we explore the new needs and corresponding models for managing GBC from the endoscopic diagnosis and treatment perspective.
基金Chinese National Key Research and Development Program(No.2017YFB1400604).
文摘activities.Ex-periments on a synthetic log of the non-secondary hy-pertension MTP and empirical findings demonstrate the effectiveness of our approach.The results show that the process mining in our approach framework can automatically generate more accurate MTP mod-els,and the subprocess models based on treatment pat-terns make the models easy to understand.
基金funded by the Bill and Melinda Gates Foundation(grant No.37999.01)the Medical Research Council(grant No.G110052)supported by the Liverpool School of Tropical Medicine
文摘Objective:To explore the efficacy of intermittent preventive treatment in pregnancy(IPTp)with sulfadoxine and pyrimethamine(SP)against sensitive parasites.Methods:A pharmacological model was used to investigate the effectiveness of the previous recommended at least two-dose regimen,currently recommended three-dose regimen and 4,6,8-weekly regimens with specific focus on the impact of various nonadherence patterns in multiple transmission settings.Results:The effectiveness of the recommended three-dose regimen is high in all the transmission intensities,i.e.>99%,98%and 92%in low,moderate and high transmission intensities respectively.The simulated 4 and 6 weekly IPTp-SP regimens were able to prevent new infections with sensitive parasites in almost all women(>99%)regardless of transmission intensity.However,8 weekly interval dose schedules were found to have 71%and 86%protective efficacies in high and moderate transmission areas,respectively.It highlights that patients are particularly vulnerable to acquiring new infections if IPTp-SP doses are missed.Conclusions:The pharmacological model predicts that full adherence to the currently recommended three-dose regimen should provide almost complete protection from malaria infection in moderate and high transmission regions.However,it also highlights that patients are particularly vulnerable to acquiring new infections if IPTp doses are spaced too widely or if doses are missed.Adherence to the recommended IPTp-SP schedules is recommended.