Effect of early stepwise cardiopulmonary rehabilitation on function and quality of life in sepsis patients

BACKGROUND Sepsis,as a non-limiting host infection disease,can be accompanied by serious complications such as organ failure,which seriously threatens patient quality of life.AIM To investigate the effect of early stepwise cardiopulmonary rehabilitation on cardiopulmonary function and quality of life in patients evacuated from mechanical ventilation with sepsis.METHODS A total of 80 patients with sepsis who were hospitalized in our hospital from January 2021 to January 2022 were selected and divided into the observation group(n=40)and the control group(n=40)according to the random number table method.The observation group was treated with early stepwise cardiopulmonary rehabilitation,and the control group was treated with a conventional treatment regimen.Cardiac function indexes(central venous pressure,cardiac troponin I,B-type brain natriuretic peptide),lung function indicators(diaphragmatic mobility,changes in central venous oxygen saturation,oxygenation index),and quality of life(Quality of Life Evaluation Scale)were compared between the two groups after treatment.RESULTS After treatment,the central venous pressure,diaphragm mobility,central venous oxygen saturation,oxygenation index,and Quality of Life Evaluation Scale scores in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The observation group was less than that of the control group for other parameters,and the differences were statistically significant(P<0.05).CONCLUSION Early stepwise cardiopulmonary rehabilitation can effectively enhance cardiac and pulmonary function and improve the quality of life in patients evacuated from mechanical ventilation with sepsis.

Cost-benefit and discriminant validity of a stepwise dementia case-finding approach in an Asian older adult community

Background Case-finding is a recommended approach for dementia early detection in the community.Aims To investigate the discriminant validity and cost-effectiveness of a stepwise dementia case-finding approach in a Singaporean older adult community.Methods The two-phase study was conducted in the community from 2009 to 2015 in Singapore.A total of 3780 participants(age≥60 years)completed phase I(a brief cognitive screening);918 completed phase II and were included in the final analysis.In phase I,all participants were administered the Abbreviated Mental Test(AMT)and the Progressive Forgetfulness Question(PFQ).Those who screened positive on either test were invited to phase II,whereby the Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA)and a formal neuropsychological battery were administered,followed by the research diagnosis of no cognitive impairment,cognitive impairment no dementia(CIND)-Mild(≤2 impaired cognitive domains),CIND-Moderate(>2 impaired domains)or dementia.Receiver operating characteristic curve analyses were conducted for the different cognitive instruments.All discriminant indices were calculated,including sensitivity,specificity,positive and negative predictive values(NPV)and accuracy.Cost-effectiveness analysis was conducted by estimating the amount of screening time needed and the number of older adults requiring re-evaluation in two case-finding scenarios,ie,with or without preselection by the PFQ.Results The stepwise case-finding approach(preselection by the PFQ,then MMSE or MoCA or AMT)showed an excellent NPV(>99%)and accuracy(>86%)for excluding dementia-free cases.Without preselection by the PFQ,screening time for the three cognitive tools were 317.5,317.5 and 254 hours,with 159,302 and 175 screen-positive older adults involved in further evaluation.By adopting the stepwise case-finding approach,total screening time were 156.5,156.5 and 126.2 hours,which decreased by 50.7%,50.7% and 50.3% as compared with those without preselection.Furthermore,after preselection,only 98,167 and 145 screen-positive older adults required further evaluation,corresponding to a reduction of 38.4%,44.7% and 17.1% in the numbers compared with those without preselection.Conclusions A stepwise approach for dementia case-finding should be implemented in the community to minimise the time and resources needed for large-scale early detection of dementia.

基于STEPWISE框架下《畜牧学》课程教学设计探讨

教学设计是教育改革和教师实施教学的一项核心内容。《畜牧学》是一门多学科交叉、多技能融合的课程。文章根据《畜牧学》课程在教学中存在的问题,按照STEPWISE框架教学理念,提出《畜牧学》课程设计思路,期望学生通过《畜牧学》课程学习,能够发现整理畜牧生产中存在的或潜在的问题,提出探究项目和研究思路,制定研究计划并开展项目研究。鼓励大学生参与课题项目研究,创新教学,促进实践,解决生产问题,提高畜牧科技教育,促进个人、社会和环境的健康发展。

乳腺癌术后患者自我形象的Stepwise多元回归分析调查

目的探讨乳腺癌术后患者自我形象水平的影响因素。方法选择我院2018年9月至2019年9月接收的70例乳腺癌术后患者以及同期70例健康女性作为研究对象,应用自我形象量表(BIBCQ)评分,分析乳腺癌术后患者自我形象的相关因素,并采用多元线性回归分析,确定影响患者自我形象的独立因素。结果乳腺癌术后患者自我形象各维度评分明显高于健康女性(P<0.001),Stepwise多元线性回归分析显示,年龄、配偶态度、文化程度、抑郁焦虑是乳腺癌术后自我形象的独立影响因素。结论乳腺癌患者术后自我形象受配偶态度、年龄、文化程度等多种因素影响,临床应针对相关影响因素实施个性化护理服务。

Characterizing and estimating rice brown spot disease severity using stepwise regression,principal component regression and partial least-square regression

Detecting plant health conditions plays a key role in farm pest management and crop protection. In this study, measurement of hyperspectral leaf reflectance in rice crop (Oryzasativa L.) was conducted on groups of healthy and infected leaves by the fungus Bipolaris oryzae (Helminthosporium oryzae Breda. de Hann) through the wavelength range from 350 to 2 500 nm. The percentage of leaf surface lesions was estimated and defined as the disease severity. Statistical methods like multiple stepwise regression, principal component analysis and partial least-square regression were utilized to calculate and estimate the disease severity of rice brown spot at the leaf level. Our results revealed that multiple stepwise linear regressions could efficiently estimate disease severity with three wavebands in seven steps. The root mean square errors (RMSEs) for training (n=210) and testing (n=53) dataset were 6.5% and 5.8%, respectively. Principal component analysis showed that the first principal component could explain approximately 80% of the variance of the original hyperspectral reflectance. The regression model with the first two principal components predicted a disease severity with RMSEs of 16.3% and 13.9% for the training and testing dataset, respec-tively. Partial least-square regression with seven extracted factors could most effectively predict disease severity compared with other statistical methods with RMSEs of 4.1% and 2.0% for the training and testing dataset, respectively. Our research demon-strates that it is feasible to estimate the disease severity of rice brown spot using hyperspectral reflectance data at the leaf level.

THE STEPWISE EXCHANGE ACTION AND STERIC HINDRANCE EFFECT OF ORGANIC PHENOLS ON CLAYS IN SEAWATER

The exchange action of six types of organic phenols on clay surfaces in seawater is systematically studied in this work. The following significant conclusions are drawn from the experiments. (1) The interaction of organic phenols with montmorillonite, illite and kaolinite in seawater is monovalent anion exchage.(2) Their isotherms of stepwise exchage on clay surfaces belong to the Langmuir type or stepwise type.(3) The discovery of the"steric hindrance effects of stepwise exchange of organic phenols on clays surfaces", and revelation of an exchange mechanisrn diffeient from that in references are the greatest achieverments in this work.

Even-parity states of the Sm atom with stepwise excitation

Two-colour stepwise excitation and photoionization schemes are adopted to study the spectra of high-lying states of the Sm atom. These bound even-parity states are excited with three different excitation paths from the 4f66s6p7DJ （J = 1, 2, 3） intermediate states, respectively. They are probed by photoionization process with an extra photon driving them to the continuum states. In this experiment, 270 states are detected in an energy range from 36160 cm-1 to 42250 cm-1, 109 of which are newly discovered, while the rest of them are confirmed to be the energy levels reported previously. Furthermore, based on the J-momentum selection rules of three excitation paths, a unique assignment of J-momentum for all observed states is determined, eliminating all remaining ambiguities in the literature. Finally, 53 single-colour transitions originating from the scanning laser are also identified. For all the relevant transitions, the information about their relative intensities is also given in the paper.

An optimized protocol for stepwise optimization of real-time RT-PCR analysis

Computational tool-assisted primer design for real-time reverse transcription(RT)PCR(qPCR)analysis largely ignores the sequence similarities between sequences of homologous genes in a plant genome.It can lead to false confidence in the quality of the designed primers,which sometimes results in skipping the optimization steps for qPCR.However,the optimization of qPCR parameters plays an essential role in the efficiency,specificity,and sensitivity of each gene’s primers.Here,we proposed an optimized approach to sequentially optimizing primer sequences,annealing temperatures,primer concentrations,and cDNA concentration range for each reference(and target)gene.Our approach started with a sequence-specific primer design that should be based on the single-nucleotide polymorphisms(SNPs)present in all the homologous sequences for each of the reference(and target)genes under study.By combining the efficiency calibrated and standard curve methods with the 2−ΔΔCt method,the standard cDNA concentration curve with a logarithmic scale was obtained for each primer pair for each gene.As a result,an R 2≥0.9999 and the efficiency(E)=100±5% should be achieved for the best primer pair of each gene,which serve as the prerequisite for using the 2^(−ΔΔCt) method for data analysis.We applied our newly developed approach to identify the best reference genes in different tissues and at various inflorescence developmental stages of Tripidium ravennae,an ornamental and biomass grass,and validated their utility under varying abiotic stress conditions.We also applied this approach to test the expression stability of six reference genes in soybean under biotic stress treatment with Xanthomonas axonopodis pv.glycines(Xag).Thus,these case studies demonstrated the effectiveness of our optimized protocol for qPCR analysis.

Establishment Method of Shape Standard Curve Based on Stepwise Optimization and Its Compensation Models

There are very few researches on the shape standard curve currently,and they merely remain on the level of description of the general concept and production experiences,lacking of the in-depth theoretical analysis,and the concrete principle,method and steps for determining the shape standard curve are not put forward,therefore,they are not applicable in industrial production.This is the weakest spot in the research on the basic shape theory.In this paper,the basic shape standard curve and the transverse distribution curve of the exit thickness are attained with stepwise optimization,which is based on the theoretical calculation method of the shape standard curve of strip mills proposed by authors.By calculating the shape discrimination model and the shape forecast model separately,the simultaneous iterative calculation by the previous method is avoided,and the speed and stability of calculation are improved.The compensation models of the transverse temperature difference of the strip,the shape detection roller deflection and the shape of the strip coil are established,respectively,meantime,the basic shape standard curves are compensated,and the relatively perfect theoretical establishment method of the shape standard curve is formed.The simulation and calculation are done on a 1 220 mm five-stand cold strip tandem mill.The simulation and calculation result shows that the principle,method and steps for determining the shape standard curve are correct and feasible,and the correctness of theoretical analysis and calculation is verified.This paper proposes an idea and a method for the establishment of the shape standard curve in the rolling processes of cold strip mills,which develop the theory and model of the shape standard curve and improve the quality and efficiency of the shape control in the rolling processes of cold strip mills.

STUDIES ON THE SOLID STATE REACTIONS OF COORDINATION COMPOUNDS： LXIX STEPWISE REACTION OF CuCl_2．2H_2O WITH 2，2＇－BIPYRIDYL

Consecutive reaction between two solids, CuCl2.2H2O and 2,2'-bipyridyl in 1:2 molar ratio proceed in tWo steps: the salt first converts to the mediate, then the mediate turns to the final product.

TAYLOR POLYNOMIAL STEPWISE REFINEMENTALGORITHM FOR LIE AND HIGH SYMMETRIES OF PARTIAL DIFFERENTIAL EQUATIONS

In this article, based on the Taylor expansions of generating functions and stepwise refinement procedure, authors suggest a algorithm for finding the Lie and high (generalized) symmetries of partial differential equations (PDEs). This algorithm transforms the problem having to solve over-determining PDEs commonly encountered and difficulty part in standard methods into one solving to algebraic equations to which one easy obtain solution. so, it reduces significantly the difficulties of the problem and raise computing efficiency. The whole procedure of the algorithm is carried out automatically by using any computer algebra system. In general, this algorithm can yields many more important symmetries for PDEs.

Dendrite‑Free and Stable Lithium Metal Battery Achieved by a Model of Stepwise Lithium Deposition and Stripping

The uncontrolled formation of lithium(Li)dendrites and the unnecessary consumption of electrolyte during the Li plating/stripping process have been major obstacles in developing safe and stable Li metal batteries.Herein,we report a cucumber-like lithiophilic composite skeleton(CLCS)fabricated through a facile oxidationimmersion-reduction method.The stepwise Li deposition and stripping,determined using in situ Raman spectra during the galvanostatic Li charging/discharging process,promote the formation of a dendrite-free Li metal anode.Furthermore,numerous pyridinic N,pyrrolic N,and CuxN sites with excellent lithiophilicity work synergistically to distribute Li ions and suppress the formation of Li dendrites.Owing to these advantages,cells based on CLCS exhibit a high Coulombic efficiency of 97.3%for 700 cycles and an improved lifespan of 2000 h for symmetric cells.The full cells assembled with LiFePO_(4)(LFP),SeS_(2) cathodes and CLCS@Li anodes demonstrate high capacities of 110.1 mAh g^(−1) after 600 cycles at 0.2 A g^(−1) in CLCS@Li|LFP and 491.8 mAh g^(−1) after 500 cycles at 1 A g^(−1) in CLCS@Li|SeS2.The unique design of CLCS may accelerate the application of Li metal anodes in commercial Li metal batteries.

Occurrences of Excess ^(40)Ar in Hydrothermal Tourmaline: Interpretations from ^(40)Ar-^(39)Ar Dating Results by Stepwise Heating

The occurrences of excess ^40Ar within a hydrothermal tourmaline is discussed in term of the analysis data of syngenetic muscovite and tourmaline from the Lushui hydrothermal tin-tungsten deposit in western Yunnan, China, using the ^40Ar-^39Ar stepwise heating technique. About 80% excess ^40 Ar was released in the last step when the tourmaline was fused, corresponding to a release of only -3% ^39 Ar （K）, which indicates that most excess ^40 Ar was held in the mineral lattice rather than in the channels parallel to the Z-axis. This suggests that the excess ^40 Ar was incorporated during crystallization and not diffused into the tourmaline during the post-crystallization history.

Precision Analysis and Parameter Inversion in the Stepwise Deployment of a Mixed Constellation

Along with the planning and implementation of the COMPASS satellite navigation system, first as a regional then a global system, there is a need to probe into the positioning performance of the mixed constellation in the stepwise deployment scheme. Both the increase in the number of the MEO satellites in the constellation and the decrease in the user equivalent ranging error of the GEO satellites will improve the overall positioning performance of the system. Using the weighted dilution of precision as the evaluation criterion, we study the theoretical relationship between the internal parameters and the positioning precision during the evolution of the system. On one hand, the influence of each factor on the positioning performance is quantitatively analyzed under the circumstances of various constellation deployment schemes and user types. On the other hand, for given positioning performance indices, simulations are carried out to present the inversion of parameters. Our conclusions provide useful suggestions to the system design and stepwise deployment scheme of satellites.

Analysis of York Pigs Feeding Behavior Using Stepwise Regression and Principal Component Regression

A statistical analysis was conducted on the feeding behavior of 106 York breeding pigs.Pearson correlation analysis,principal component correlation analysis and multiple stepwise regression equation methods were applied to establish regression equations of the York breeding pigs total feed intake per time and average feed intake per time with corrected fat thickness,feed conversion rate,and corrected daily gain.The results showed that:①there were three peak feed intake periods for the pigs,and the correlation coefficient between the feed intake and the corrected fat thickness of the pigs in the 24 h period was positive or negative,that is,increasing the number of feeding times and the feed intake was not necessarily conducive to the fat thickness accumulation,but the breeding goal of fat thickness could be achieved by controlling the feeding times and feed intake;②the average feed intake of pigs in the 60-90 kg body weight stage was 30%-50%higher than that of the 30-60 kg body weight stage,but the number of feeding times decreased,the peak feeding time was more concentrated,and the feeding duration per time was 3.0 min longer,indicating that as the weight of pigs increased,the feed intake increased significantly;and③the stepwise regression equations and the principal component equations showed that the feeding behavior of York pigs in the 30-90 kg growth stage was not only affected by the feeding time within 24 h,but also by environmental factors such as temperature and humidity.The feeding behavior of York pigs is a complex process of interaction between environmental factors and animal factors.

Stepwise Confidence Interval Method for MTD Studies with Binomial Populations

Now we extend one method into a sequence of binomial data, propose a stepwise confidence interval method for toxic-ity study, and also in our paper, two methods of constructing intervals for the risk difference are proposed. The first one is based on the well-known conditional confidence intervals for odds ratio, and the other one comes from Santner“small-sample confidence intervals for the difference of two success probabilities”, and it produces exact intervals, through employing our method.

Multi－variate Stepwise Discriminant Analysis Research Affecting Portal Hypertension＇s Grade Factors of Liver Function

The idtal time for selecting portal hypertension operation is the accurate judgement of the grade of liver function.yet the present criterion in grading liver functicn is controversial.tco pztitnts vith 20 factoxs related to poxttl hypeitersor wexe undergone stepwise discriminant analysis by using SAS software on the IBM/PC computer(significance levtl α=0.05).The results show that ascites degree prothrombin tmie(PT),serum total bilirubin,serum albumin content,main portal vein flow are significant fators.In the light of above variates contributing to grading liver function as to estblish a discriminant eqation,it was found that the total agreement rate between replaceable discimination and original Child-Pugh classification is 86%.A test for agieement was performed between discriminant and original classificaton,showing that the two kinds of classification methods have a good agreement rates (Kppa=0.7856),indicating the discriminant classification is of practica values.

TRANSIENT AERODYNAMIC BEHAVIOURS ASSOCIATED WITH STEPWISE INCIDENCE VARIATION OF AIRFOILS

Transient aerodynamic characteristics of airfoil are important for the safety of airplanes, the development of helicopter rotors and many other applications of unsteady aerodynamics. For a better understanding of these phenomena, it is necessary to investigate the simultaneous relation between the characteristics and the flow field. The purpose of the present study is to clarify experimentally the fundamentals of the aerodynamic behaviours associated with stepwise incidence variations from 0 to some certain values, including high angles of attack, of symmetric airfoils at low speeds, Reynolds number being of the order of 104. Temporal variations of surface pressure distribution, lift, drag and . pitching moment, and the observation of the flow field will be discussed.

Screening agars for MRSA:evaluation of a stepwise diagnostic approach with two different selective agars for the screening for methicillin-resistant Staphylococcus aureus(MRSA)

Background: Colonization with methicillin-resistant Staphylococcus aureus(MRSA) poses a hygiene risk that does not spare field hospitals or military medical field camps during military deployments. Diagnostic options for unambiguously identifying MRSA isolates are usually scarce in military environments. In this study, we assessed the stepwise application of two different selective agars for the specific identification of MRSA in screening analyses.Methods: Nasal swabs from 1,541 volunteers were subjected to thioglycollate broth enrichment and subsequently screened on CHROMagar MRSA selective agar for the identification of MRSA. The MRSA identity of suspiciouslooking colonies was confirmed afterwards or excluded by another selective agar, chrom ID MRSA. All isolates from the selective agars with MRSA-specific colony morphology were identified by biochemical methods and mass spectrometry.Results: The initial CHROMagar MRSA screening identified suspicious colonies in 36 out of 1541 samples. A total of 25 of these 36 isolates showed MRSA-like growth on chrom ID agar. Out of these 25 isolates, 24 were confirmed as MRSA, while one isolate was identified as Staphylococcus kloosii. From the 11 strains that did not show suspicious growth on chrom ID agar, 3 were methicillin-sensitive Staphylococcus aureus(MSSA, with one instance of cocolonization with Corynebacterium spp.), 2 were confirmed as MRSA(with 1 instance of co-colonization with MSSA), 2 were lost during passaging and could not be re-cultured, one could not be identified by the applied approaches, and the remaining 3 strains were identified as Staphylococcus saprophyticus, Staphylococcus hominis(co-colonized with Macrococcus caseolyticus) and Staphylococcus cohnii, respectively.Conclusion: The application of the selective agar CHROMagar MRSA alone proved to be too non-specific to allow for a reliable diagnosis of the presence of MRSA. The combined use of two selective agars in a stepwise approach reduced this non-specificity with an acceptably low loss of sensitivity. Accordingly, such a stepwise screening approach might be an option for resource-restricted military medical field camps.

ARCHITECTURE OF LADDER,TUBULAR AND SIEVE-PLATE POLYMERS PREPARED BY STEPWISE COUPLING POLYMERIZATION

'Stepwise-coupling polymerization' (SCP) is a very useful approach for preparing microstructure-controllable ordered network polymers, including soluble one-dimensional ladderlike polymers (LP) and tubular polymers (TP), and two-dimensional sieve-plate polymers. The novel reactive LPs are important precursors of micro-structure controllable polymers such as 'fishbone-' or 'rowboat-' like mesomorphic polymers and their metal complexes as well as tubular polymers (TPs). They are full of great potential for use as advanced materials.