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。

Investigation of three-pulse photon echo in thick crystal using finite-difference time-domain method

This paper investigates the phenomenon of three-pulse photon echo in thick rare-earth ions doped crystal whose thickness is far larger than 0.002 cm which is adopted in previous works.The influence of thickness on the three-pulse photon echo＇s amplitude and efficiency is analyzed with the Maxwell-Bloch equations solved by finite-difference timedomain method.We demonstrate that the amplitude of three-pulse echo will increase with the increasing of thickness and the optimum thickness to generate three-pulse photon echo is 0.3 cm for Tm^（3＋）：YAG when the attenuation of the input pulse is taken into account.Meanwhile,we find the expression 0.09 exp（α＇L）,which is previously employed to describe the relationship between echo＇s efficiency and thickness,should be modified as 1.3 · 0.09 exp（2.4 ·α＇L） with the propagation of echo considered.

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.

Time-domain dynamic constitutive model suitable for mucky soil site seismic response

Soil nonlinear behavior displays noticeable effects on the site seismic response.This study proposes a new functional expression of the skeleton curve to replace the hyperbolic skeleton curve.By integrating shear modulus and combining the dynamic skeleton curve and the damping degradation coefficient,the constitutive equation of the logarithmic dynamic skeleton can be obtained,which considers the damping effect in a soil dynamics problem.Based on the finite difference method and the multi-transmitting boundary condition,a 1D site seismic response analysis program called Soilresp1D has been developed herein and used to analyze the time-domain seismic response in three types of sites.At the same time,this study also provides numerical simulation results based on the hyperbolic constitutive model and the equivalent linear method.The results verify the rationality of the new soil dynamic constitutive model.It can analyze the mucky soil site nonlinear seismic response,reflecting the deformation characteristics and damping effect of the silty soil.The hysteresis loop area is more extensive,and the residual strain is evident.

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.

Time-Domain Analysis of Body Freedom Flutter Based on 6DOF Equation

The reduced weight and improved efficiency of modern aeronautical structures result in a decreasing separation of frequency ranges of rigid and elastic modes.Particularly,a high-aspect-ratio flexible flying wing is prone to body freedomflutter(BFF),which is a result of coupling of the rigid body short-periodmodewith 1st wing bendingmode.Accurate prediction of the BFF characteristics is helpful to reflect the attitude changes of the vehicle intuitively and design the active flutter suppression control law.Instead of using the rigid body mode,this work simulates the rigid bodymotion of the model by using the six-degree-of-freedom(6DOF)equation.A dynamicmesh generation strategy particularly suitable for BFF simulation of free flying aircraft is developed.An accurate Computational Fluid Dynamics/Computational Structural Dynamics/six-degree-of-freedom equation(CFD/CSD/6DOF)-based BFF prediction method is proposed.Firstly,the time-domain CFD/CSD method is used to calculate the static equilibrium state of the model.Based on this state,the CFD/CSD/6DOF equation is solved in time domain to evaluate the structural response of themodel.Then combinedwith the variable stiffnessmethod,the critical flutter point of the model is obtained.This method is applied to the BFF calculation of a flyingwing model.The calculation results of the BFF characteristics of the model agree well with those fromthe modalmethod andNastran software.Finally,the method is used to analyze the influence factors of BFF.The analysis results show that the flutter speed can be improved by either releasing plunge constraint or moving the center ofmass forward or increasing the pitch inertia.

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.

连云港市一起ECHO_(30)病毒性脑膜炎爆发流行病学调查

目的分析2006年江苏省连云港市病毒性脑膜炎爆发的流行特征、影响因素和病因。方法采用统一的流行病学调查表对病例进行调查,收集2004年以来全市各县区病毒性脑膜炎住院病例资料,采用1:2配比病例对照研究的方法分析流行因素;24份脑脊液标本送江苏省疾病控制中心检测,并进行病毒分离。结果2004-2005年全市各县区病毒性脑膜炎病例呈现散发状态;2006年1～7月份共查出病例数为968例,从6月份起出现疫情上升,1县2区出现爆发,7月份达高峰,爆发病例为473例,占全市总病例数的48.86%;主要累及15岁以下儿童,占94.44%;男性多于女性,男女比为2.65:1;主要临床表现为发热、头痛、呕吐、脑膜刺激征阳性、脑脊液有核细胞增多。饭前洗手与多吃瓜果为保护因素,说明该病与不良卫生习惯有关系。23份脑脊液经PCR检测,16份ECHO_(30)肠道病毒阳性。结论2006年夏季江苏省连云港市病毒性脑膜炎出现一次爆发并波及1县2区,致病病原体为埃可30型肠道病毒(Echovirus 30,ECHO_(30))肠道病毒,不良卫生习惯可能是导致该病发生流行的危险因素。

PC-based artif icial neural network inversion for airborne time-domain electromagnetic data

Traditionally, airborne time-domain electromagnetic （ATEM） data are inverted to derive the earth model by iteration. However, the data are often highly correlated among channels and consequently cause ill-posed and over-determined problems in the inversion. The correlation complicates the mapping relation between the ATEM data and the earth parameters and thus increases the inversion complexity. To obviate this, we adopt principal component analysis to transform ATEM data into orthogonal principal components （PCs） to reduce the correlations and the data dimensionality and simultaneously suppress the unrelated noise. In this paper, we use an artificial neural network （ANN） to approach the PCs mapping relation with the earth model parameters, avoiding the calculation of Jacobian derivatives. The PC-based ANN algorithm is applied to synthetic data for layered models compared with data-based ANN for airborne time-domain electromagnetic inversion. The results demonstrate the PC-based ANN advantages of simpler network structure, less training steps, and better inversion results over data-based ANN, especially for contaminated data. Furthermore, the PC-based ANN algorithm effectiveness is examined by the inversion of the pseudo 2D model and comparison with data-based ANN and Zhody＇s methods. The results indicate that PC-based ANN inversion can achieve a better agreement with the true model and also proved that PC-based ANN is feasible to invert large ATEM datasets.

福建省2011年病毒性脑炎暴发病原Echo30分子流行病学分析

目的了解福建省2011年病毒性脑炎暴发的病原特点及福建省近10年Echo30分子流行病学特征。方法应用细胞培养法获得病毒株,微量血清中和试验或RT-PCR序列分析鉴定Echo30血清型,提取病毒RNA核酸,逆转录为cD-NA,分段扩增VP1基因序列全长,测定并分析扩增产物的序列。结果 2011年4月1日-6月2日,从福建省4个县(市)区病毒性脑炎病例标本中分离的病毒经鉴定均为Echo30;VP1基因序列分析显示,泉州市安溪和德化两地流行株高度同源(核苷酸与氨基酸序列同源性分别为99.0%和99.6%),同福安和厦门流行株(核苷酸与氨基酸序列同源性分别为98.5%和100%)核苷酸差异约9%,3个位点氨基酸出现了变异。近10年福建省Echo30分子流行病学分析显示,2011年泉州流行株并非由2005年当地流行株进化而来,而与2008年河南省分离株(HQ625646-Henan/04/2008)同源性最高;近10年福建省Echo30存在多基因型、多谱系的同时传播,并在2006年发现了两株第III新基因型病毒。结论造成2011年福建省病毒性脑炎暴发的病原为Echo30,且至少存在两条不同传播链病毒同时流行。Echo30福建株呈多基因型、多谱系分布流行特点。

一起ECHO 30病毒引发游泳队脑炎爆发调查

目的分析ECHO30病毒性脑炎在冬季体校游泳队爆发的特征。方法应用流行病学描述方法,对体校学生进行筛查;采集典型病例脑脊液(CSF)、血液样本和泳池水样进行实验室检测。结果病例均为体校游泳队学生,共发病37例,罹患率25.18%,性别间罹患率差异无统计学意义(x2=0.03,P>0.50),流行9d;游泳池水污染严重,6份CSF样本肠道病毒核糖核酸阳性,2份分离到ECHO30肠道病毒。结论游泳池循环净水和消毒设备应正常运转,日常监督监测应加强。

ECHO 19引起龙岩市儿童病毒性脑炎的流行病学调查

[目的]探讨龙岩市2004年儿童病毒性脑炎流行的病因、流行规律及特征.[方法]对142例病毒性脑炎病例进行流行病学调查,对其中30例的脑脊液标本进行病毒分离和型别鉴定.[结果]142例患者分布在我市的6个县(市、区),其中新罗区占(66.2%),另有广东省大埔县2例;年龄以5～12岁为多;男性68.3%,女性31.7%;5～6月为发病高峰.临床主要表现为突然发病、发热(92.4%)、头痛(83.1%)、呕吐(68.6%)等;脑电图以轻中度异常为主;67.8%血常规正常;脑脊液常规87.5%颅内压力增高,56.8%细胞数增加.疗程10天左右.从30份脑脊液中检出16株ECHO 19病毒.[结论]流行病学调查及实验室病原检测确认,龙岩市儿童病毒性脑炎病原为ECHO 19.

Solution and Analysis of Chatter Stability for End Milling in the Time-domain

In this paper, the instantaneous undeformed chip thickness is modeled to include the dynamic modulation caused by the tool vibration while the dynamic regenerative effects are taken into account. The numerical method is used to solve the differential equations goveming the dynamics of the milling system. Several chatter detection criteria are applied synthetically to the simulated signals and the stability diagram is obtained in time-domain. The simulation results in time-domain show a good agreement with the analytical prediction, which is validated by the cutting experiments. By simulating the chatter stability lobes in the time-domain and analyzing the influences of different spindle speeds on the vibration amplitudes of the tool under a Fixed chip-load condition, conclusions could be drawn as follows： In rough milling, higher machining efficiency can be achieved by selecting a spindle speed corresponding to the axial depth of cut in accordance with the simulated chatter stability lobes, and in Fmish milling, lower surface roughness can be achieved by selecting a spindle speed well beyond the resonant frequency of machining system.

急性弛缓性麻痹病例中ECHO11病毒的基因特征分析

该文首次分析了我国ECHO11病毒的分子流行病学资料。1999～2004年，ECHO11病毒是山东省急性弛缓性麻痹（AFP）病例中分离到的优势毒株，2003年从山东省482例AFP病例中共分离到11株ECHO11病毒，其中相关的10例病例分布跨越山东省大部分地区，但发病日期集中在7月和12月。该研究试图通过对VP1编码基因全序列的测定和分析，为探讨ECHO11病毒与AFP之间的病因关系提供线索。分子流行病学研究提示，11株ECHO11毒株都位于同一传播链，核苷酸同源性为97．2％～100％，氨基酸同源性为99．6％～100％，其中7月和12月的分离株之间相层8～9个核苷酸，氨基酸序列一致。这说明山东省2003年7月和12月分别发生了ECHO11病毒流行，但这些毒株与AFP的病因关系尚需进一步研究。11株病毒组成了A基因型中的一个新亚型，在进化树上单独呈密切相关的一簇，与同基因型内的其它亚型的核苷酸同源性为82．2％～84．7％，氨基酸同源性为94.8％～97．6％．

Radar Echo and Lightning Characteristics Analysis on A Strong Thunderstorm Weather in Fuxin

Based on the radar data and lightning position indicator data of strong thunderstorm weather which happened in Fuxin on July 8,2007,the relationship between the lightning activity and the radar echo was analyzed.The results showed that Fuxin area located in the cross position of T-shaped trough and was affected by the cold air which continuously glided down.The corresponding warm front on the ground advanced southward and arrived here.It was the weather background of this thunderstorm weather.The position variation of lightning occurrence was closely related to the strong echo movement of squall line,and the velocity echo clearly reflected and predicted the movement tendency of the radar echo.

Comparison of the time-domain electromagnetic field from an infinitesimal point charge and dipole source

An electromagnetic field is generated through the accelerating movement of two equal but opposite charges of a single dipole. An electromagnetic field can also be generated by a time-varying infinitesimal point charge. In this study, a comparison between the electromagnetic fields of an infinitesimal point charge and a dipole has been presented. First, the time-domain potential function of a point source in a 3D conductive medium is derived. Then the electric and magnetic fields in a 3D homogeneous lossless space are derived via the relation between the potential and field. The field differences between the infinitesimal point charge and the dipole in the step-off time, far-source, and near-source zones are analyzed, and the accuracy of the solutions from these sources is investigated. It is also shown that the field of the infinitesimal point charge in the near-source zone is different from that of the dipole, whereas the far-source zone fields of these two sources are identical. The comparison of real and simulated data shows that the infinitesimal point charge represents the real source better than the divole source.

Numerical modeling of the 2D time-domain transient electromagnetic secondary field of the line source of the current excitation

To effectively minimize the electromagnetic field response in the total field solution, we propose a numerical modeling method for the two-dimensional （2D） time- domain transient electromagnetic secondary field of the line source based on the DuFort- Frankel finite-difference method. In the proposed method, we included the treatment of the earth-air boundary conductivity, calculated the normalized partial derivative of the induced electromotive force （Emf）, and determined the forward time step. By extending upward the earth-air interface to the air grid nodes and the zero-value boundary conditions, not only we have a method that is more efficient but also simpler than the total field solution. We computed and analyzed the homogeneous half-space model and the fiat layered model with high precision--the maximum relative error is less than 0.01% between our method and the analytical method--and the solution speed is roughly three times faster than the total-field solution. Lastly, we used the model of a thin body embedded in a homogeneous half-space at different delay times to depict the downward and upward spreading characteristics of the induced eddy current, and the physical interaction processes between the electromagnetic field and the underground low-resistivity body.

一次由双重抗原型ECHO病毒引起的无菌性脑膜炎流行

1987年2～8月,山东省招远县发生一起不明病因的无菌性脑膜炎流行,全县有2646人发病.病死3人。从收集的22人份粪便中分离到3株病毒,经鉴定为耐酸的RNA型病毒.检测13例患者的双份血清,恢复期血清对该病毒中和抗体呈4倍以上升高者5例,抗体阳转者2例,抗体呈4倍降低者1例.经血清学定型该病毒为ECHO29和ECHO2型双重抗原性的病毒。