应用ECHO模型评价药物治疗管理服务在儿童支气管哮喘治疗中的效果

目的探究药物治疗管理(MTM)服务对儿童哮喘治疗的应用效果。方法选取2022年7—12月在河北省人民医院咳喘药学门诊就诊的5~11岁哮喘患儿107例,随机分成对照组(50例)和干预组(52例)。对照组患儿首诊时给予单次吸入制剂教育服务;干预组患儿给予全程规范化MTM服务。应用经济、临床与人文结果(ECHO)模型,分别于干预前、干预3个月及干预6个月后,统计2组患儿在经济(药物成本、成本-效用比),临床(ACT评分、吸入制剂使用正确率、哮喘发作次数)和人文(EQ-5D-5L效用值、Morisky用药依从性、患者满意度)结果中的差异,评价MTM服务在哮喘患儿中的应用效果。结果干预前2组各项评分指标差异无统计学意义;干预后干预组患儿经济结果、临床结果、人文结果3方面均优于对照组,差异有统计学意义(P<0.05)。结论药师主导的MTM服务可使哮喘患儿在经济、临床、人文多维度获益,既使哮喘患儿疾病得到长期有效控制,又提升药师药学专科服务能力。

Comparison of the reaction of polar mesosphere winter echoes and polar mesosphere summer echoes to high-frequency heating in terms of modulated characteristics

In this work,for the first time,we have analyzed and compared the responses of polar mesosphere winter echoes(PMWE)and their summer counterpart,polar mesosphere summer echoes(PMSE),to high-frequency(HF)heating in terms of modulated characteristics(i.e.,backscatter intensity reduction,recovery,and overshoot).Both PMWE and PMSE observations were from the same site(Tromsφ,Norway;69.6°N,19.2°E)and radar(EISCAT[European Incoherent Scatter Scientific Association]very high frequency,224 MHz).The heating patterns of both PMWE and PMSE were found to be similar;however,PMSE was more greatly affected by HF heating.Polar mesosphere summer echoes showed recovery and overshoot more frequently than did PMWE.In addition,the mean recovery and overshoot of PMSE were greater than those of PMWE.The associated electron temperature enhancement was estimated for both PMWE and PMSE and showed that,compared with PMWE,the electron temperature enhancement was more significant in PMSE.The strong heating effects on PMSE may be due to the considerable increase in electron temperature.

Gravitational wave echoes from strange quark stars in the equation of state with density-dependent quark masses

According to the recent studies,the gravitational wave(GW)echoes are expected to be generated by quark stars composed of ultrastiff quark matter.The ultrastiff equations of state(EOS)for quark matter were usually obtained either by a simple bag model with artificially assigned sound velocity or by employing interacting strange quark matter(SQM)depicted by simple reparameterization and rescaling.In this study,we investigate GW echoes with EOSs for SQM in the framework of the equivparticle model with density-dependent quark masses and pairing effects.We conclude that strange quark stars(SQSs)can be sufficiently compact to possess a photon sphere capable of generating GW echoes with frequencies in the range of approximately 20 kHz.However,SQSs cannot account for the observed 72 Hz signal in GW170817 event.Furthermore,we determined that quark-pairing effects play a crucial role in enabling SQSs to satisfy the necessary conditions for producing these types of echoes.

Exploring the associations between skeletal muscle echogenicity and physical function in aging adults:A systematic review with meta-analyses

Background:Assessment and quantification of skeletal muscle within the aging population is vital for diagnosis,treatment,and injury/disease prevention.The clinical availability of assessing muscle quality through diagnostic ultrasound presents an opportunity to be utilized as a screening tool for function-limiting diseases.However,relationships between muscle echogenicity and clinical functional assessments require authoritative analysis.Thus,we aimed to(a) synthesize the literature to assess the relationships between skeletal muscle echogenicity and physical function in older adults(≥60 years),(b) perform pooled analyses of relationships between skeletal muscle echogenicity and physical function,and(c) perform sub-analyses to determine between-muscle relationships.Methods:CINAHL,Embase,MEDLINE,PubMed,and Web of Science databases were systematically searched to identify articles relating skeletal muscle echogenicity to physical function in older adults.Risk-of-bias assessments were conducted along with funnel plot examination.Meta-analyses with and without sub-analyses for individual muscles were performed utilizing Fisher's Z transformation for the most common measures of physical function.Fisher's Z was back-transformed to Pearson's r for interpretation.Results:Fifty-one articles(n=5095,female=~2759,male=~2301,72.5± 5.8 years,mean±SD(1 study did not provide sex descriptors))were extracted for review,with previously unpublished data obtained from the authors of 13 studies.The rectus femoris(n=34) and isometric knee extension strength(n=22) were the most accessed muscle and physical qualities,respectively.The relationship between quadriceps echogenicity and knee extensor strength was moderate(n=2924,r=-0.36(95% confidence interval:-0.38 to-0.32),p <0.001),with all other meta-analyses(grip strength,walking speed,sit-to-stand,timed up-and-go) resulting in slightly weaker correlations(r:-0.34 to-0.23,all p <0.001).Sub-analyses determined minimal differences in predictive ability between muscle groups,although combining muscles(e.g.,rectus femoris+vastus lateralis) often re sulted in stronger correlations with maximal strength.Conclusion:While correlations are modest,the affordable,portable,and noninvasive ultrasonic assessment of muscle quality is a consistent predictor of physical function in older adults.Minimal between-muscle differences suggest that echogenicity estimates of muscle quality are systemic.Therefore,practitioners may be able to scan a single muscle to estimate full-body skeletal muscle quality/composition,while researchers should consider combining multiple muscles to strengthen the model.

A Novel On-Site-Real-Time Method for Identifying Characteristic Parameters Using Ultrasonic Echo Groups and Neural Network

On-site and real-time non-destructive measurement of elastic constants for materials of a component in a in-service structure is a challenge due to structural complexities,such as ambiguous boundary,variable thickness,nonuniform material properties.This work develops for the first time a method that uses ultrasound echo groups and artificial neural network(ANN)for reliable on-site real-time identification of material parameters.The use of echo groups allows the use of lower frequencies,and hence more accommodative to structural complexity.To train the ANNs,a numerical model is established that is capable of computing the waveform of ultrasonic echo groups for any given set of material properties of a given structure.The waveform of an ultrasonic echo groups at an interest location on the surface the structure with material parameters varying in a predefined range are then computed using the numerical model.This results in a set of dataset for training the ANN model.Once the ANN is trained,the material parameters can be identified simultaneously using the actual measured echo waveform as input to the ANN.Intensive tests have been conducted both numerically and experimentally to evaluate the effectiveness and accuracy of the currently proposed method.The results show that the maximum identification error of numerical example is less than 2%,and the maximum identification error of experimental test is less than 7%.Compared with currently prevailing methods and equipment,the proposefy the density and thickness,in addition to the elastic constants.Moreover,the reliability and accuracy of inverse prediction is significantly improved.Thus,it has broad applications and enables real-time field measurements,which has not been fulfilled by any other available methods or equipment.

Research on Sleeve Grouting Density Detection Based on the Impact Echo Method

Grouting defects are an inherent challenge in construction practices,exerting a considerable impact on the operational structural integrity of connections.This investigation employed the impact-echo technique for the detection of grouting anomalies within connections,enhancing its precision through the integration of wavelet packet energy principles for damage identification purposes.A series of grouting completeness assessments were meticulously conducted,taking into account variables such as the divergent material properties of the sleeves and the configuration of adjacent reinforcement.The findings revealed that:(i)the energy distribution for the highstrength concrete cohort predominantly occupied the frequency bands 42,44,45,and 47,whereas for other groups,it was concentrated within the 37 to 40 frequency band;(ii)the delineation of empty sleeves was effectively discernible by examining the wavelet packet energy ratios across the spectrum of frequencies,albeit distinguishing between sleeves with 50%and full grouting density proved challenging;and(iii)the wavelet packet energy analysis yielded variable detection outcomes contingent on the material attributes of the sleeves,demonstrating heightened sensitivity when applied to ultrahigh-performance concrete matrices and GFRP-reinforced steel bars.

Enhanced air-coupled impact echo technique by phase analysis of signals from multiple sensors

This paper presents an air-coupled impact echo(IE)technique that relies on the phase spectrum of the collected data to find the frequencies corresponding to the reflections from delaminations.The proposed technique takes advantage of the fact that the IE compression wave is not a propagating wave,but it is the 1st order symmetrical(S1)mode Lamb wave at zero group velocity(S1-ZGV).Therefore,it searches the phase spectra of the data collected by multiple sensors to locate the frequency corresponding to the lowest phase difference.As a result,the technique reduces the effect of propagating waves,including the direct acoustic wave and ambient noise.It is named the Constant Phase IE(CPIE).The performance of the CPIE is experimentally compared with the regular amplitude spectrum-based IE technique and two other multisensor IE techniques.The CPIE shows a performance advantage,especially in a noisy environment.

Relationship of inflammatory indices with left atrial appendage thrombus or spontaneous echo contrast in patients with atrial fibrillation

BACKGROUND Inflammatory indices derived from complete blood tests have been reported to be associated with poor outcomes in patients with atrial fibrillation(AF).The data about the relationship between inflammatory indices and left atrial appendage thrombus(LAAT)or dense spontaneous echo contrast(SEC)are limited.AIM To explore the value of inflammatory indices for predicting the presence of LAAT or dense SEC in nonvalvular AF patients.METHODS A total of 406 patients with nonvalvular AF who underwent transesophageal echocardiography were included and divided into two groups based on the presence(study group)or absence(control group)of LAAT or dense SEC.Inflammatory indices,including the neutrophil-to-lymphocyte ratio(NLR),platelet–tolymphocyte ratio(PLR),and lymphocyte-to-monocyte ratio(LMR),were calculated from complete blood analysis.The associations of inflammatory indices RESULTS LAAT and dense SEC were detected in 11(2.7%)and 42(10.3%)patients,respectively.The PLR only showed an association with LAAT/dense SEC in the univariate model.Elevated NLR(odds ratio[OR]=1.48,95%confidence interval[CI]:1.11-1.98,P=0.007)and reduced LMR(OR=0.59,95%CI:0.41-0.83,P=0.003)were found to be independent risk factors for the presence of LAAT/dense SEC.The areas under the NLR and LMR curves for predicting LAAT/dense SEC were 0.73(95%CI:0.66-0.80,P<0.001)and 0.73(95%CI:0.65-0.81,P<0.001),respectively,while the cutoff values were 2.8(sensitivity:69.8%;specificity:64.0%)and 2.4(sensitivity:71.7%;specificity:60.6%),respectively.CONCLUSION Increased NLR and decreased LMR may predict LAAT/dense SEC in patients with nonvalvular AF.

CHARACTERISTICS AND RELATIONS OF LIGHTNING AND RADAR ECHOES FOR STRONG CONVECTIVE RAINSTORMS IN YUNNAN

Based on cloud-ground lightning data and Doppler weather radar echo products, both thecharacteristics and the relations of lightning and radar echoes for strong convective rainstorms over Yunnanare analyzed during the flood season of 2007. The results show that most rainstorms are convective in whichlightning is mostly negative and the negative lightning number accounts for more than 90% of the total.Although the correlation between precipitation and the lightning number is small on the rainstorm day, thelarge day-lightning frequency usually produces heavy precipitation. Hourly evolution of precipitation andlightning frequency shows peak-style characteristics. And their evolution is very coherent in strongrainstorm, but lightning often occurs before precipitation, whose peaks are in phase with or 1-to-2-hourlagged behind that of lightning frequency. Meanwhile the peaks of positive frequency are in phase with orfall behind that of precipitation. When the wind field is heterogeneous in radial velocity, it is conducive toboth the development of convection echoes and occurrence of lightning. Strong lightning-producingconvective rainstorms correspond to strong echo fields and usually result in reflectivity above 30 dBZ andecho top ET of more than 9 km, respectively.

Investigation of PMSE echoes characteristics using the discontinuous EISCAT UHF observation and its relation with space environment

The observations of Polar Mesosphere Summer Echoes (PMSE) were carried out using the sporadic data of EISCAT UHF radar during the summer season from 2004 to 2015. There were 25 h of PMSE echoes with EISCAT UHF radar. PMSE echoes were mostly observed only during the early morning and fore-noon time. Moreover, the PMSE echoes are positively correlated with Lymanα radiation, but the correlation is non-significant. The occurrence of PMSE echoes in the early morning and fore-noon time and there positive correlation with Lymanαradiation suggests that solar radiations might be one important factor for PMSE echoes in this study. Very weak positive, but statistically non-significant correlation is found between PMSE occurrence rate and the local geomagneticK-indices. It is found that there is a matching between the variation in the occurrence rate of PMSE and noctilucent clouds (NLC) up to some extent and they are positively correlated. This positive correlation might support the earlier proposed idea about the role of ice particle size in producing PMSE echoes at higher frequencies.

Identification and Removal of Non-meteorological Echoes in Dual-polarization Radar Data Based on a Fuzzy Logic Algorithm

A major issue in radar quantitative precipitation estimation is the contamination of radar echoes by non-meteorological targets such as ground clutter,chaff,clear air echoes etc.In this study,a fuzzy logic algorithm for the identification of non-meteorological echoes is developed using optimized membership functions and weights for the dual-polarization radar located at Mount Sobaek.For selected precipitation and non-meteorological events,the characteristics of the precipitation and non-meteorological echo are derived by the probability density functions of five fuzzy parameters as functions of reflectivity values.The membership functions and weights are then determined by these density functions.Finally,the nonmeteorological echoes are identified by combining the membership functions and weights.The performance is qualitatively evaluated by long-term rain accumulation.The detection accuracy of the fuzzy logic algorithm is calculated using the probability of detection（POD）,false alarm rate（FAR）,and clutter–signal ratio（CSR）.In addition,the issues in using filtered dual-polarization data are alleviated.

Reflection Characteristics of Layered Media in Polar Mesopause Related to Polar Mesosphere Summer Echoes

Polar mesosphere summer echoes （PMSE） are very strong radar echoes from alti- tudes close to the polar summer mesopause. The data from sounding rocket campaigns indicate that the radar signal to noise ratio （SNR）, electron density and dust charge density of polar meso- sphere in summer show obvious layered structure. In this paper the theory of wave propagation in layered media is used to study the reflectance and SNR at each layer in polar mesosphere. The calculated SNR using theory of dusty plasma is found in good agreement with the experimental result, which may imply that the intensity of the radar echoes reflected by the layered structure in polar mesosphere where polar mesosphere summer echoes used to occur can interpret partially the phenomenon of PMSE. In other words, reflection may play an important role in the occurrence of PMSE.

Aspect sensitivity of polar mesosphere summer echoes observed with the EISCAT VHF radar

The European Incoherent Scatter Scientific Association(EISCAT) Very High Frequency(224 MHz) Radar has been used to investigate the aspect sensitivity of polar mesosphere summer echoes(PMSE) in the period 13–15 July 2010. The aspect sensitivity of PMSE using this radar and at such a high frequency has not been previously reported. Data concerning the aspect sensitivity of PMSE were collected by traversing the antenna beam from the zenith direction, and comparing the received power. Surprisingly, as the intensity received by the oblique beam was often larger than that of the vertical beam, suggesting the presence of tilted dusty plasma layers as a potential cause, a theoretical model was developed to confirm the existence of these layers and their formation process. The experimental results and theoretical model presented help elucidate the structural properties of the possible generation mechanism of strong radar echoes in the polar summer mesosphere region.

Classification of Underwater Target Echoes Based on Auditory Perception Characteristics

In underwater target detection, the bottom reverberation has some of the same properties as the target echo, which has a great impact on the performance. It is essential to study the difference between target echo and reverberation. In this paper, based on the unique advantage of human listening ability on objects distinction, the Gammatone filter is taken as the auditory model. In addition, time-frequency perception features and auditory spectral features are extracted for active sonar target echo and bottom reverberation separation. The features of the experimental data have good concentration characteristics in the same class and have a large amount of differences between different classes, which shows that this method can effectively distinguish between the target echo and reverberation.

Automatic Identification of Clear-Air Echoes Based on Millimeter-wave Cloud Radar Measurements

Millimeter-wave cloud radar(MMCR)provides the capability of detecting the features of micro particles inside clouds and describing the internal microphysical structure of the clouds.Therefore,MMCR has been widely applied in cloud observations.However,due to the influence of non-meteorological factors such as insects,the cloud observations are often contaminated by non-meteorological echoes in the clear air,known as clear-air echoes.It is of great significance to automatically identify the clear-air echoes in order to extract effective meteorological information from the complex weather background.The characteristics of clear-air echoes are studied here by combining data from four devices:an MMCR,a laser-ceilometer,an L-band radiosonde,and an all-sky camera.In addition,a new algorithm,which includes feature extraction,feature selection,and classification,is proposed to achieve the automatic identification of clear-air echoes.The results show that the recognition algorithm is fairly satisfied in both simple and complex weather conditions.The recognition accuracy can reach up to 95.86%for the simple cases when cloud echoes and clear-air echoes are separate,and 88.38%for the complicated cases when low cloud echoes and clear-air echoes are mixed.

On the radar frequency dependence of polar mesosphere summer echoes

Polar mesosphere summer echoes(PMSEs)are very strong radar echoes in the polar mesopause in local summer.Here we present the frequency dependence of the volume reflectivity and the effect of energetic particle precipitation on modulated PMSEs by using PMSEs observations carried out by European Incoherent SCATter(EISCAT)heating equipment simultaneously with very high frequency(VHF)radar and ultra high frequency(UHF)radar on 12 July 2007.According to the experimental observations,the PMSEs occurrence rate at VHF was much higher than that at UHF,and the altitude of the PMSEs maximum observed at VHF was higher than that at UHF.Overlapping regions were observed by VHF radar between high energetic particle precipitation and the PMSEs.In addition,highfrequency heating had a very limited impact on PMSEs when the UHF electron density was enhanced because of energetic particle precipitation.In addition,an updated qualitative method was used to study the relationship between volume reflectivity and frequency.The volume reflectivity was found to be inversely proportional to the fourth power of radar frequency.The theoretical and experimental results provide a definitive data foundation for further analysis and investigation of the physical mechanism of PMSEs.

Hybrid Method to Identify Second-trip Echoes Using Phase Modulation and Polarimetric Technology

For pulse Doppler radars,the widely used method for identifying second-trip echoes(STs)in the signal processing level yields significant misidentification in regions of high turbulence and severe wind shear.In the data processing level,although the novel algorithm for ST identification does not yield significant misidentification in specific regions,its overall identification performance is not ideal.Therefore,this paper proposes a hybrid method for the identification of STs using phase modulation(signal processing)and polarimetric technology(data processing).Through this approach,most of the STs are removed,whereas most of the first-trip echoes(FTs)remain untouched.Compared with the existing method using a signal quality index filter with an optimized threshold,the hybrid method exhibits superior performance(Heidke skill scores of 0.98 versus 0.88)on independent test datasets,especially in high-turbulence and severe-wind-shear regions,for which misidentification is significantly reduced.

Characteristic Analysis of Underwater Acoustic Scattering Echoes in the Wavelet Transform Domain

Underwater acoustic scattering echoes have time–space structures and are aliasing in time and frequency domains. Different series of echoes properties are not identified when incident angle is unknown. This article investigates variations in target echoes of monostatic sonar to address this problem. The mother wavelet with similar structures has been proposed on the basis of preprocessing signal waveform using matched filter, and the theoretical expressions between delay factor and incident angle are derived in the wavelet domain. Analysis of simulation data and experimental results in free-field pool show that this method can effectively separate geometrical scattering components of target echoes. The time delay estimation obtained from geometrical echoes at a single angle is consistent with target geometrical features, which provides a basis for object recognition without angle information. The findings provide valuable insights for analyzing elastic scattering echoes in actual ocean environment.

Numerical Analysis of Artificial Electron Heating Effects on Polar Mesospheric Winter Echoes

In this paper,an analytical model is used to analyze the modulated polar mesospheric winter echoes(PMWE).The winter parameters were introduced to simulate the effects of different parameters during the artificial electron heating of PMWE.The important role of the charged dust particle in the creation of PMWE is confirmed again.It is found that during the heating of PMWE,the increases of the dust size,dust charge,electron temperature,initial electron density,and ion-neutral collision frequency cause the increase of the electron density irregularity,and hence the PMWE strength.However,with increasing the dust density,the electron density irregularity and the PMWE strength decrease.

Preliminary Study on Active Modulation of Polar Mesosphere Summer Echoes with the Radio Propagation in Layered Space Dusty Plasma

Radar echoes intensity of polar mesosphere summer echoes（PMSE） is greatly affected by the temperature of dusty plasma and the frequency of electromagnetic wave about the radar.In this paper,a new method is developed to explain the active experiment results of PMSE.The theory of wave propagation in a layered media is used to study the propagation characteristics of an electromagnetic wave at different electron temperatures.The simulation results show that the variation tendency of the reflected power fraction almost agrees with the results observed by radar in the European Incoherent Scatter Scientific Association（EISCAT）.The radar echoes intensity of PMSE greatly decreases with the increase of the radio frequency and the enhancement of the electron temperature.