基于DEMATEL-AISM的起重驾驶员态势感知与行为响应模型

为深入挖掘起重驾驶员态势感知信息-行为的因果关系,结合ENDSLEY态势感知模型与决策实验室分析(DEMATEL)-对抗解释结构模型(AISM)方法,构建起重驾驶员态势感知与行为响应模型。首先,以起重作业任务为研究对象,使用态势感知理论分析驾驶员行为响应过程,获取信息要素;其次,基于DEMATEL法,量化研究要素间的相互关系,得到综合影响矩阵,进而分析要素的属性及特征值,确定模型的关键要素;最后,采用AISM获得原因-结果属性稳定的层级结构,据此构建起重驾驶员态势感知与行为响应信息模型。结果表明:得到包含轨迹预测与规划、避碰等关键要素的22个要素及影响关系构成的5层信息模型;而且,模型明确了信息要素属性特征、影响关系及影响程度,较好地解释了驾驶员态势感知及行为响应过程。

Neuroimaging mechanisms of high-frequency repetitive transcranial magnetic stimulation for treatment of amnestic mild cognitive impairment:a double-blind randomized sham-controlled trial

Individuals with amnestic mild cognitive impairment(aMCI)have a high risk of developing Alzheimer’s disease.Although repetitive transcranial magnetic stimulation(rTMS)is considered a potentially effective treatment for cognitive impairment in patients with aMCI,the neuroimaging mechanisms are poorly understood.Therefore,we performed a double-blind randomized sham-controlled trial in which rTMS was applied to the left dorsolateral prefrontal cortex of aMCI patients recruited from a community near the Third Hospital Affiliated to Sun Yat-sen University,China.Twenty-four patients with aMCI were randomly assigned to receive true rTMS(treatment group,n=12,6 men and 6 women;age 65.08±4.89 years)or sham stimulation(sham group,n=12,5 men and 7 women;age 64.67±4.77 years).rTMS parameters included a stimulation frequency of 10 Hz,stimulation duration of 2 seconds,stimulation interval of 8 seconds,20 repetitions at 80%of the motor threshold,and 400 pulses per session.rTMS/sham stimulation was performed five times per week over a period of 4 consecutive weeks.Our results showed that compared with baseline,Montreal Cognitive Assessment scores were significantly increased and the value of the amplitude of low-frequency fluctuation(ALFF)was significantly increased at the end of treatment and 1 month after treatment.Compared with the sham group,the ALFF values in the right inferior frontal gyrus,triangular part of the inferior frontal gyrus,right precuneus,left angular gyrus,and right supramarginal gyrus were significantly increased,and the ALFF values in the right superior frontal gyrus were significantly decreased in the treatment group.These findings suggest that high-frequency rTMS can effectively improve cognitive function in aMCI patients and alter spontaneous brain activity in cognitive-related brain areas.This study was approved by the Ethics Committee of Shenzhen Baoan Hospital of Southern Medical University,China(approval No.BYL20190901)on September 3,2019 and registered in the Chinese Clinical Trials Registry(registration No.ChiCTR1900028180)on December 14,2019.

Use of the Crohn's disease activity index in clinical trials of biological agents

The Crohn＇s disease activity index （CDAI） has been commonly used to assess the effects of treatment with different agents in Crohn＇s disease （CD）. However, these studies may be compromised, if the results compared to a placebo or standard therapy group （in the absence of a placebo） substantially differ from the expected response. In addition, significant concerns have been raised regarding the reliability and validity of the CDAI. Reproducibility of the CDAI may be limited as significant inter-observer error has been recorded, even if measurements are done by experienced clinicians with expertise in the diagnosis and treatment of CD. Finally, many CDAI endpoints are open to subjective interpretation and have the potential for manipulation. This is worrisome as there is the potential for significant financial gain, if the results of a clinical trial appear to provide a positive result. Physicians caring for patients should be concerned about the positive results in clinical trials that are sponsored by industry, even if the trials involve respected centers and the results appear in highly ranked medical journals.

基于DEMATEL-AISM的矿山救护指挥员能力素质研究

为探究矿山救护指挥员能力素质要素及相互间的关系,促进矿山应急救援水平的进一步提升,通过文献研究和界值法分析,从政治素质、身体素质、业务素质、心理素质和管理素质5个方面筛选能力素质的核心要素,建立矿山救护指挥员能力素质指标体系,采用决策实验室算法和对抗解释结构模型联用的方法,构建因果关系和对抗多层拓扑结构,分析了矿山救护指挥员能力素质的多要素重要程度和耦合关系。结果表明,应急救援理论和知识、心理承受能力、纪律意识、对党忠诚是有效提高矿山救护指挥员能力素质的重要因素,避免队伍自身伤亡能力、临危不乱、应急救援决策能力和灾害事故研判能力是关键要素,避免队伍自身伤亡能力为帕累托最优集。

Vedolizumab for inflammatory bowel disease:from randomized controlled trials to real-life evidence

The biologic antitumor necrosis factor alpha(anti-TNFα) agents have revolutionised the treatment of inflammatorybowel disease(IBD). However,some patients experience primary nonresponse,loss of response,or intolerance. Therefore,introducing a newer class of therapy with a mechanism of action that acts on different inflammatory pathways involved in IBD pathogenesis is appealing. Vedolizumab is a fully humanised monoclonal antibody that selectively targets α4β7 integrin. Based on the results of the pivotal clinical GEMINI trials,vedolizumab was approved for the treatment of adult patients with moderately to severely active ulcerative colitis(UC) and Crohn's disease(CD) refractory or intolerant to either conventional therapy or TNFα inhibitors. This review describes the efficacy,safety,and tolerability of vedolizumab reported in both randomized,controlled,clinical trials and from real-world experience in patients with UC and CD in order to identify its place in treatment algorithms for IBD.

Change in Preoperative Nervousness: A Randomized Controlled Trial in Gynecological Cancer Patients

Patients are often nervous prior to surgery and females might suffer the most. Increased nervousness needs attention as it can negatively affect postoperative recovery. Support from nurses, i.e. being present, attentive, empowering and helpful to the patient, and talking about what is on the patient’s mind, might help to reduce nervousness. However, there is a lack of evidence as to the ideal level of attention and resources to reduce preoperative nervousness. The objective of the current study was to compare a range of care combinations with standard care to female patients prior to sedation and cancer surgery primarily on difference in change in nervousness from admission until sedation before cancer surgery, measured on a Visual Analouge Scale. Using simple randomization and numbers in sealed envelopes, adult gynaecological patients scheduled for open cancer surgery were allocated to care provided by a nurse anaesthetist and: A) a surgical nurse, B) no additional care, C) a known nurse , and D) a relative. Only the statistician was blinded. The trial stopped when the calculated numbers were included. In the full analysis set, compared to standard care A) (n = 61), we observed the following mean changes and [95% confidence intervals]: B) (n = 65) 1.05 [CI: 0.298 to 1.794] with p = 0.006, C) (n = 61): -0.38 [-1.140 to 0.385] with p = 0.330, D) (n = 71): 0.23 [-0.498 to 0.967] with p = 0.528. Female cancer patients will benefit from supportive care by a surgical nurse from the time of arrival on the operating ward plus supportive care from a nurse anesthetist from 5 - 10 minutes after entering the operating ward. It is not recommended at any time to rely fully on the support of relatives. The effect on adults of preoperative painful procedures and patients’ time alone on the operating ward should be further investigated.

Postoperative chemotherapy with S-1 plus oxaliplatin versus S-1alone in locally advanced gastric cancer(RESCUE-GC study): a protocol for a phase Ⅲ randomized controlled trial

Background： The ACTS-GC study had shown postoperative adiuvant therapy with S-1 improved survival of patients with locally advanced gastric cancer. Addition of oxaliplatin to S-1 is considered to be acceptable as one of the treatment options for gastric cancer patients after radical gastrectomy with D2 lymph node excision. Methods： We have commenced a randomized phase III trial in December 2016 to evaluate S-I plus oxaliplatin compared with S-1 alone in the adjuvant setting for locally advanced gastric cancer. A total of 564 patients will be accrued from 13 Chinese institutions in two years. The primary endpoint is 3-year relapse-free survival. The secondary endpoints are 5-year overall survival, proportion of patients who complete the postoperative chemotherapy and incidence of adverse events. Ethic and dissemination： The trial has been approved by the institutional review board of each participating institution and it was activated on December, 2016. The enrollment will be finished in December, 2018. Patient＇s follow-up will be ended until December, 2023. Trial registration： ClinicalTrials.gov, identifier： NCT02867839. Registered on August 4, 2016.

Clinical randomized comparative trial of DICE regimen and CHOP regimen in treating intermediate and high grade non-Hodgkin’s lymphoma

Objective: To compare efficacies and safeties of DICE and CHOP regimens in treating intermediate and high grade non-Hodgkin's lymphoma (NHL), and indicate the standard treatment for it. Methods: A total of 74 patients with moder- ately or highly malignant NHL, verified by pathology or histology, were randomized into the trial group (37 patients treated with DICE regimen) and the control group (37 patients treated with CHOP regimen). Survival rate was analyzed by Kaplan-Meier method. Chi-square test was performed between groups. Results: The complete response rate, partial response rate, and response rate were significantly higher in DICE group than in CHOP group (40.5% vs. 29.7%, 37.8% vs. 27.0%, and 78.3% vs. 56.7%, respectively, P < 0.05). The 1-, 3-, and 5-year survival rates were significantly higher in DICE group than in CHOP group (89.2% vs. 81.2%, 76.0% vs. 52.6%%, and 46.7% vs. 36.4%, respectively, P < 0.05). The major side effects, appeared with no differences (P > 0.05) in incidences between the two groups, were leukopenia, thrombocytopenia, and nausea. There were only three episodes of clinical cystitis or gross haematuria in DICE regimen. Conclusion: The results showed higher efficacy of DICE regimen over CHOP regimen. DICE regimen may prolong the survival time of patients with moderately and highly malignant NHL.

Women Bodies at Trial by Ordeal since Christianity to Trier Movies

In his Antichrist and Nymphomaniac, Lars von Trier seems to defy norms on sex and women＇s desires. However he actually reproduces Christianity＇s perspective that women are sinful by their dispositions. According to the classical creation story, Eve falls into temptation and then, convinces Adam to commit the same crime. All Abrahamic religions but especially Christianity identifies women with the body and bodily desires, rather than the mind which comes from nonmaterial and divine substance. Accordingly, women can easily be deceived by Satan since they contain a lesser amount of mental substance compared to men. In Antichrist, Trier reiterates the story of Adam and Eve in a different context. The woman writes her dissertation on women who are burnt with the accusation of being a witch. But she realizes that her body is sinful and deserving of punishment, too. She finds her salvation when she cuts her clitoris. In Nymphomaniac, the main character gets her clitoris whipped. While she resists traditional and bourgeois morality, she defines herself as morally evil because of her unmanageable sexual desires. Thus, reputed as critical of all social structures and morality, Trier in fact simply rehashes the classical sexist and misogynist perspective.

Study on intestinal flora of acupoint catgut embedding intervention in female patients with abdominal obesity: study protocol for a randomized controlled trial

Background:Obesity,as an epidemic public health issue in the world today,not only brings a heavy medical burden to society but also seriously affects people’s quality of life.In the context of new evidence for the efficacy of acupoint catgut embedding(ACE)in abdominal obesity(AO),it is necessary to elucidate the mechanism of ACE for AO.The intestinal flora is closely associated with obesity,and the study of its intestinal flora may provide evidence to clarify the mechanism of obesity treatment by ACE.Methods:75 participants will be recruited in this study,including 60 eligible female patients diagnosed with AO and 15 healthy female participants.60 female AO patients will be randomized to ACE group,sham ACE group,and waiting list(WL)group in a ratio of 1:1:1.Patients in two ACE groups will receive one ACE treatment per week for 12 consecutive weeks,and in the WL group will not receive any treatment;only their data will be extracted.The primary outcome is the mean change in body mass index.Secondary effects include waist circumference,body weight,the visual analog score of appetite,and the Gastrointestinal Symptom Rating Scale.High-throughput 16S ribosomal ribonucleic acid gene sequencing will be used to detect intestinal flora in each group before and after the intervention.Conclusion:The results of this trial are expected to identify the critical intestinal flora causing AO and the target intestinal flora of AO regulated by ACE,providing further theoretical support for ACE in the clinical treatment of obesity.

基于全对抗解释结构建模方法的房建施工安全管理CSFs研究

为了研究房建施工安全管理的关键成功因素(Critical Success Factors,CSFs),提升房建工程施工安全管理水平,以房建工程施工项目为基础,综合运用决策试验与实验室评估法(Decision Making Trial and Evaluation Laboratory,DEMATEL)和全模糊可达对抗解释结构模型(Total Fuzzy Reachable Adversarial Interpretive Structural Model,T FR AISM)方法识别房建施工安全管理体的CSFs,并进一步解析这些CSFs的结构层次,以挖掘影响因素的驱动结构和作用机制。结果表明,安全管理体系完备性、安全资金投入、主体结构标准层安全管理、二次结构安全管理、经济环境、业主的支付能力和合作企业的资源条件是房建工程施工安全管理的关键影响因素。我国房建施工安全管理工作可以通过分析CSFs的特征进一步构建更科学的安全管理体系,以应对以后房建施工工程出现的更复杂的安全问题。

Washed microbiota transplantation for Crohn’s disease:A metagenomic,metatranscriptomic,and metabolomic-based study

BACKGROUND Fecal microbiota transplantation(FMT)is a promising therapeutic approach for treating Crohn’s disease(CD).The new method of FMT,based on the automatic washing process,was named as washed microbiota transplantation(WMT).Most existing studies have focused on observing the clinical phenomena.However,the mechanism of action of FMT for the effective management of CD-particularly in-depth multi-omics analysis involving the metagenome,metatranscriptome,and metabolome-has not yet been reported.AIM To assess the efficacy of WMT for CD and explore alterations in the microbiome and metabolome in response to WMT.METHODS We conducted a prospective,open-label,single-center clinical study.Eleven CD patients underwent WMT.Their clinical responses(defined as a decrease in their CD Activity Index score of>100 points)and their microbiome(metagenome,metatranscriptome)and metabolome profiles were evaluated three months after the procedure.RESULTS Seven of the 11 patients(63.6%)showed an optimal clinical response three months post-WMT.Gut microbiome diversity significantly increased after WMT,consistent with improved clinical symptoms.Comparison of the metagenome and metatranscriptome analyses revealed consistent alterations in certain strains,such as Faecalibac-terium prausnitzii,Roseburia intestinalis,and Escherichia coli.In addition,metabolomics analyses demonstrated that CD patients had elevated levels of various amino acids before treatment compared to the donors.However,levels of vital amino acids that may be associated with disease progression(e.g.,L-glutamic acid,gamma-glutamyl-leucine,and prolyl-glutamine)were reduced after WMT.CONCLUSION WMT demonstrated therapeutic efficacy in CD treatment,likely due to the effective reconstruction of the patient’s microbiome.Multi-omics techniques can effectively help decipher the potential mechanisms of WMT in treating CD.

GAN-DIRNet:A Novel Deformable Image Registration Approach for Multimodal Histological Images

Multi-modal histological image registration tasks pose significant challenges due to tissue staining operations causing partial loss and folding of tissue.Convolutional neural network(CNN)and generative adversarial network(GAN)are pivotal inmedical image registration.However,existing methods often struggle with severe interference and deformation,as seen in histological images of conditions like Cushing’s disease.We argue that the failure of current approaches lies in underutilizing the feature extraction capability of the discriminator inGAN.In this study,we propose a novel multi-modal registration approach GAN-DIRNet based on GAN for deformable histological image registration.To begin with,the discriminators of two GANs are embedded as a new dual parallel feature extraction module into the unsupervised registration networks,characterized by implicitly extracting feature descriptors of specific modalities.Additionally,modal feature description layers and registration layers collaborate in unsupervised optimization,facilitating faster convergence and more precise results.Lastly,experiments and evaluations were conducted on the registration of the Mixed National Institute of Standards and Technology database(MNIST),eight publicly available datasets of histological sections and the Clustering-Registration-Classification-Segmentation(CRCS)dataset on the Cushing’s disease.Experimental results demonstrate that our proposed GAN-DIRNet method surpasses existing approaches like DIRNet in terms of both registration accuracy and time efficiency,while also exhibiting robustness across different image types.

Evaluation of reporting quality of randomized controlled trials for cognitive interventions among Alzheimer’s Disease using the CONSORT

Background:The increasing number of Alzheimer’s Disease has become a global health issue.Whether randomized controlled trials are fully reported has an immediate effect on the translation as well as implementation of research conclusions.However,the overall reporting quality of randomized controlled trials for cognitive interventions among Alzheimer’s Disease is unclear.Methods:Randomized controlled trials of cognitive inter-ventions among Alzheimer’s Dementia were searched from Cnki,Embase,Pubmed,Web of Science,WanFang Data,Cochrane Library,and VIP from their inception to December9th 2019.Firstly,the average CONSORT(Consolidated Standards of Reporting Trials)compliance of randomized controlled trials for cognitive interventions among Alzheimer’s Disease was estab-lished.Secondly,the compliance of per CONSORT item was calculated.Furthermore,the possible factors that determine the reporting quality were explored using univariate analysis and binary logistic regression.Results:A total of 55 studies were included.Mean CONSORT compliance of randomized controlled trials was 57.16%and standard deviation was 0.11.Univariate analysis showed that journal impact factor(p<0.001),sample size(p=0.002)as well as number of authors(p<0.001)were statistically significant,but post-2010 publication(p=0.206)as well as reporting of funding(p=0.221)had no significance.However,none of the above factors had statistical significance in binary logistic regression.Conclusions:The overall reporting quality was low,which would not be conducive to the evidence transformation and implementation.Furthermore,the reporting quality was not probably affected by aforementioned factors.

基于DEMATEL—AISM的数字化施工影响因素分析

本文以数字化施工为研究对象,在总结数字化施工影响因素体系的基础上,构建了基于DEMATEL-AISM方法的数字化施工影响因素模型,系统分析了影响因素,筛选出主要因素及其作用路径,并对其进行可视化研究。通过分析,明确了数字化施工各影响因素之间的重要程度、因果关系及层次结构,提出了推动我国数字化施工发展的对策建议,为相关研究提供了参考。

工厂化条件下外源添加剂对猪粪堆肥过程中NH_(3)和H_(2)S的减排效果

为了探究工厂化条件下不同添加剂对猪粪秸秆好氧堆肥过程中氮素和硫素转化规律的影响,掌握其对堆肥过程中NH_(3)和H_(2)S气体减排效果,本文共设置4个处理:沸石(质量分数10%)、过磷酸钙(质量分数5%)单独添加及二者同时添加,同时以无添加剂的处理作为对照。结果表明,不同添加剂对堆肥温度影响差异较小;与对照处理相比,单独添加沸石的堆肥产物全氮和全硫含量分别提高17.5%和17.1%,而单独添加过磷酸钙则分别提高26.1%和40.6%,二者同时添加保氮效果最佳,全氮含量提高32.1%,全硫增加52.8%;沸石通过吸附作用可以使堆肥过程中NH_(3)和H_(2)S的排放分别减少8.2%和9.4%。过磷酸钙能够通过提高堆体铵态氮含量,减少NH_(3)释放,减排率达37.6%,但由于过磷酸钙中含有较多的硫,导致H_(2)S排放量增加;两种添加剂同时添加对NH_(3)和H_(2)S减排效果与单独过磷酸钙添加处理差异较小。综合考虑堆肥品质和NH_(3)减排效果,工厂化堆肥过程中添加一定量过磷酸钙可以达到很好的除臭、保氮效果,过磷酸钙与沸石同时添加并没有协同强化作用,但过磷酸钙添加应该配合恰当的工艺参数,否则有增加H_(2)S释放的风险。

S-腺苷蛋氨酸治疗酒精性肝病的系统评价

目的系统评价S-腺苷蛋氨酸治疗酒精性肝病的效果和安全性。方法采用Cochrane系统评价方法,检索Cochrane图书馆临床对照试验数据库、PubMed、EMbase、CBM、CNKI、中文科技期刊数据库VIP、万方数据库等电子资料库。由2名评价者共同评价纳入研究的质量,对同质研究进行Meta分析。结果共纳入10个研究,745例酒精性肝病患者。其中1篇文献采用随机数字法分组并实施盲法,其余9篇文献未描述具体随机方法,未实施盲法。所有文献均未描述分配隐藏方法。按测量指标和干预措施进行亚组分析:①在降低ALT方面:疗程为20天时,S-腺苷蛋氨酸+一般治疗组与还原型谷胱甘肽+一般治疗组差异无统计学意义[WMD = -18.00,95%CI(-38.36,-2.36)];疗程为4周时,S-腺苷蛋氨酸+多烯磷脂酰胆碱组与门冬氨酸钾镁+多烯磷脂酰胆碱组差异无统计学意义[WMD = -8.39,95%CI(-19.81,3.02)];疗程为2年时,S-腺苷蛋氨酸组与安慰剂组差异无统计学意义[WMD = -7.30,95%CI(-15.49,0.89)],其余各研究组均优于对照组,差异有统计学意义;②在降低AST方面:疗程为4周时,S-腺苷蛋氨酸+多烯磷脂酰胆碱组与门冬氨酸钾镁+多烯磷脂酰胆碱组差异无统计学意义[WMD = -8.39,95%CI(-19.81,3.02)];疗程为2年时,S-腺苷蛋氨酸组与安慰剂组差异无统计学意义[WMD = -7.40,95%CI(-17.96,3.16)],其余各研究组均优于对照组,差异有统计学意义;③在降低GGT方面:疗程为4周时,S-腺苷蛋氨酸+还原型谷胱甘肽组与门冬氨酸钾镁+维生素C组差异无统计学意义[WMD = -20.10,95%CI(-40.77,0.57)];疗程为2年时,S-腺苷蛋氨酸组与安慰剂组差异无统计学意义[WMD = -8.70,95%CI(-36.42,19.02)],其余各研究组均优于对照组,差异有统计学意义;④在降低TG方面:研究组均优于对照组,差异有统计学意义[WMD = -1.04,95%CI(-1.23,-0.85)];⑤在降低肝纤维化指标(PC Ⅲ、HA)方面:各研究组均优于对照组,差异有统计学意义[分别为WMD = -127.00,95%CI(-161.81,-92.19);WMD = -162.00,95%CI(-226.10,-97.90)];⑥在生存率方面:Child-Pugh A级、Child-Pugh B级(Child-Pugh分级)酒精性肝硬化患者生存率研究组优于对照组,差异有统计学意义[RR = 0.45,95%CI(0.20,1.00)]。结论现有研究显示,S-腺苷蛋氨酸对酒精性肝病患者的ALT、AST、GGT、肝纤维化和TG的改善可能有效,对Child-Pugh A级、Child-Pugh B级酒精性肝硬化患者生存率改善可能有效,且无严重不良反应。但本系统评价所纳入的文献多为较低质量的小样本研究,且用药时间不同,因此无法进行总体的效应合并分析,尚需更大量的文献支持。

相对率的非劣效性试验检验效能及样本量的模拟计算方法及SAS实现

目的 :当评价指标为定性指标时 ,利用相对率作为标准判断非劣效性是一种方便易行的方法 ,本文目的在于解决这一背景下的样本量计算问题。方法 :利用随机模拟方法 ,在SAS下编写宏 ,估算样本量。结果 :设计出两个宏 ,分别计算给定样本量时的检验效能和限定检验效能时的样本量。结论 :探索出一条在临床研究中利用随机模拟方法估算样本量的途径 。

缺血性卒中A—S—C—O分型、TOAST分型及CISS分型的信度检验

目的评定缺血性卒中A-S-C-O分型、急性卒中治疗Org10172试验(trial of org 10172 in acutestroke treatment,TOAST)分型及中国缺血性卒中亚型(Chinese ischemic stroke subclassfication,CISS)的信度检验。方法连续收集我院新发缺血性卒中患者100例,由两位研究者对其进行分型,对3种分型分别进行信度检验。结果本研究A-S-C-O分型的Kappa值为0.504,P<0.01;TOAST分型的Kappa值为0.769,P<0.01;CISS分型的Kappa值为0.710,P<0.01。结论 A-S-C-O分型的一致性中等,TOAST分型及CISS分型的一致性良好。