Assessment standard for green store building of national standard has been compiled. The index has been given by experts' subjective assignment based on experience. Analytic hierarchy process has been used,making ...Assessment standard for green store building of national standard has been compiled. The index has been given by experts' subjective assignment based on experience. Analytic hierarchy process has been used,making questionnaires of experts,using pairwise comparison and calculating the weight of each index. The weight of index in assessment would not only make quantitative evaluation on the whole situation of green store buildings,but also provide the foundation for compilation and revision.展开更多
1.Preface As the fast paced Chinese economy brings more and more direct and indirect affects into ourlives,environmental protection has become one ofthe most popular subjects of recent times.
Successful breakthroughs have been made in shale oil exploration in several lacustrine basins in China,indicating a promising future for shale oil exploration and production.Current exploration results have revealed t...Successful breakthroughs have been made in shale oil exploration in several lacustrine basins in China,indicating a promising future for shale oil exploration and production.Current exploration results have revealed the following major conditions of lacustrine shale oil accumulation:(1)stable and widely distributed shale with a high organic abundance and appropriate thermal maturity acts as a fundamental basis for shale oil retention.This shale exhibits several critical parameters,such as total organic carbon content greater than 2%,with optimal values ranging from 3% to 4%,kerogen Ⅰ and Ⅱ_(1) as the dominant organic matter types,and vitrinite reflectance(R_(o))values greater than 0.9%(0.8% for brackish water environments).(2)Various types of reservoirs exhibiting brittleness and a certain volume of micro-nanoscale pores are critical conditions for shale oil accumulation,and these reservoirs have porosities greater than 3% to 6%.Moreover,when diagenesis is incipient,pure shales are not favorable for medium-to-high maturity shale oil enrichment,whereas tight sandstone and hybrid rocks with clay content less than 20% are favorable;however,for medium-to-late-stage diagenesis,pure shales with a clay content of 40% are favorable.(3)The retention of a large amount of high-quality hydrocarbons is the factor that best guarantees shale oil accumulation with good mobility.Free hydrocarbon content exceeding a threshold value of 2 mg/g is generally required,and the optimum value is 4 mg/g to 6 mg/g.Moreover,a gas-oil ratio exceeding a threshold value of 80 m^(3)/m^(3) is required,with the optimal value ranging from 150 m^(3)/m^(3) to 300 m^(3)/m^(3).(4)High-quality roof and floor sealing conditions are essential for the shale oil enrichment interval to maintain the overpressure and retain a sufficient amount of hydrocarbons with good quality.Lacustrine shale oil distributions exhibit the following characteristics:(1)major enrichment areas of shale oil are located in semi-deep to deep lacustrine depositional areas with external materials,such as volcanic ash fallout,hydrothermal solutions,and radioactive substances with catalytic action,as inputs;(2)intervals with“four high values and one preservation condition”govern the distribution of shale oil enrichment intervals;and(3)favorable assemblages of lithofacies/lithologies determine the distribution of enrichment area.According to preliminary estimates,China has 131×10^(8) to 163×10^(8) t of total shale oil resources with medium-to-high thermal maturity,among which 67×10^(8) to 84×10^(8) t is commercial.These resources are primarily located in the Chang 7^(1+2) interval in the Ordos Basin,Qing 1+2 members in Gulong sag in the Songliao Basin,Kongdian and Shahejie formations of Cangdong sag,Qikou sag and the Jiyang depression in the Bohai Bay Basin,and Lucaogou Formation in the Junggar Basin.展开更多
Since the 1970s, outcome studies for children with hearing loss expanded from focusing on assessing auditory awareness and speech perception skills to evaluating language and speech development. Since the early 2000s,...Since the 1970s, outcome studies for children with hearing loss expanded from focusing on assessing auditory awareness and speech perception skills to evaluating language and speech development. Since the early 2000s, the multi-center large scale research systematically studied outcomes in the areas of auditory awareness, speech-perception, language development, speech development, educational achievements, cognitive development, and psychosocial development. These studies advocated the establishment of baseline and regular follow-up evaluations with a comprehensive framework centered on language development. Recent research interests also include understanding the vast differences in outcomes for children with hearing loss, understanding the relationships between neurocognitive development and language acquisition in children with hearing loss, and using outcome studies to guide evidence-based clinical practice. After the establishment of standardized Mandarin language assessments, outcomes research in China's Mainland has the potential to expand beyond auditory awareness and speech perception studies.展开更多
Background:Post-stroke dysphagia is one of the common clinical symptoms in the rehabilitation department of primary hospitals,which seriously affects the quality of life of patients and their families.Majority of medi...Background:Post-stroke dysphagia is one of the common clinical symptoms in the rehabilitation department of primary hospitals,which seriously affects the quality of life of patients and their families.Majority of medical workers have comprehensively studied post-stroke dysphagia as it easily induces inhalation pneumonia,asphyxia,and many other complications.At present,many methods for post-stroke dysphagia have been proved to be effective.With regard to comprehensive treatment effect,patient compliance,technology promotion difficulty,grassroots hospital operability,and other factors,we found that acupoint injection combined with nerve electrical stimulation is a good method worthy of promotion.Methods:A total of 130 patients with dysphagia after stroke were randomly divided into nerve electrical stimulation group(n=41),acupoint injection group(n=40),and comprehensive treatment group(nerve electrical stimulation plus acupoint injection,n=49).The therapeutic effect in each group was evaluated before treatment and 20 days after treatment using the improved water swallow test,video fluoroscopic swallowing study,and standardized swallowing assessment.Results:After 20 days of treatment,significant differences were noted in each group.The scores of improved water swallow test decreased from 4.10±0.74 to 2.12±0.95 in the nerve electrical stimulation group,4.00±0.78 to 2.28±1.04 in the acupoint injection group,and 4.16±0.77 to 1.73±0.79 in the comprehensive treatment group;video fluoroscopic swallowing study scores increased from 3.71±2.16 to 5.05±2.111 in the nerve electrical stimulation group,3.80±1.94 to 5.20±1.942 in the acupoint injection group,and 3.73±2.22 to 6.24±2.21 in the comprehensive treatment group;and standardized swallowing assessment scores of the three groups also decreased from 35.13±3.38 to 28.17±3.42,34.66±3.46,and 34.48±3.26 to 26.39±3.86,respectively.The overall scores of each group after treatment were significantly different from those before treatment(P<0.05),indicating that both nerve electrical stimulation and acupoint injection were effective for post-stroke dysphagia;the scores of nerve electrical stimulation group and acupoint injection group were similar,but those of the comprehensive treatment group were significantly better than the single treatments(P<0.05).It shows that the two treatment methods have synergistic effect,and combined treatments have more benefits.Conclusion:Nerve electrical stimulation and acupoint injection have a synergistic therapeutic effect on post-stroke dysphagia.The combined treatment is more beneficial to patients with post-stroke dysphagia than the single treatments.展开更多
An approach is presented to deal with a multi-attribute decision-making problem in which the attribute weights are unknown and the attribute values take the form of uncertain linguistic variables. First, a linguistic ...An approach is presented to deal with a multi-attribute decision-making problem in which the attribute weights are unknown and the attribute values take the form of uncertain linguistic variables. First, a linguistic assessment standard is set up to deal with the uncertain linguistic attributes, and the operation laws of uncertain linguistic variables and the uncertain linguistic weighting average(ULWA)operator are introduced. Then a ranking formula of uncertain linguistic variables based on expectation-variance is proposed. As for the case without weight information, a goal program based on a warp function is constructed to determine the attribute weights, and the ULWA operator is utilized to aggregate the assessment information of uncertain linguistic variables, and the corresponding alternatives are ranked by a formula based on expectation-variance. Finally, a numerical example is given, and the results demonstrate that it is much easier and faster for the ranking method based on expectation-variance when compared to the existing methods.展开更多
Background: At the 13th St Gallen International Breast Cancer Conference in 2013, a new definition of luminal A-like and luminal B-like breast cancer was proposed, involving the expression of estrogen receptor (ER), p...Background: At the 13th St Gallen International Breast Cancer Conference in 2013, a new definition of luminal A-like and luminal B-like breast cancer was proposed, involving the expression of estrogen receptor (ER), progesterone receptor (PgR), and Ki-67. We examined the rate of concordance between the risk groups using the Oncotype DX recurrence score (RS) and the previous and newly proposed luminal subtypes with the standardized Ki-67 assessment. Method: The relationship between a previously and newly proposed, immunohistochemically defined luminal A and B subtype with the Oncotype DX RS of 41 cases of T1-2 N0-1 M0 (ER positive, HER2 negative) breast cancer was assessed. We first classified the patients into the previously defined luminal A and B subtypes, according to the level of Ki-67 as either “low” (<14%) or “high” (≥14%), as assessed by local pathologists. Next, to consider the necessity for standardizing Ki-67 measurement methods, we re-examined Ki-67 with a central review. By introducing PgR positivity (≥20%), we classified these patients to newly proposed luminal subtypes and compared them with the risk groups stratified by Oncotype DX RS. Results: In the previously proposed luminal subtypes, the concordance rate between luminal A and the low RS category was 76.5% according to local pathologists and 90.1% by central review, whereas the rate between luminal B and the intermediate to high RS category was 46.7% and 45.8%, respectively. In newly proposed luminal subtypes, the concordance rate between luminal A and low RS category was 100% and between the luminal B and intermediate to high RS category was 53.6%. Conclusions: Although this study was based on a retrospective chart review of a small sample size, the newly proposed luminal subtypes including addition of PgR positivity with the standardized Ki-67 assessment appeared to improve the concordance rate especially between luminal A and low RS category.展开更多
The trophic status assessment of lakes in different lake regions may provide important and fundamental information for lake trophic state classification and eutrophication control. In this study, a region-specific lak...The trophic status assessment of lakes in different lake regions may provide important and fundamental information for lake trophic state classification and eutrophication control. In this study, a region-specific lake eutrophication assessment standard was established through a frequency distribution method based on chlorophyll-a concentration. The assessment standards under the oligotrophic state for lakes in the Eastern plain, Yungui Plateau, Northeast Plain and Mountain Mongolia-Xinjiang regions are total phosphorus of 0.068, 0.005, 0.011, 0.005 mg/L; total nitrogen of 1.00, 0.16, 0.37, 0.60 mg/L; Secchi depth of 0.60, 8.00, 1.55, 3.00 m; and CODMn of 2.24, 1.00, 5.1 l, 4.00 mg/L, respectively. Moreover, a region-specific comprehensive trophic level index was developed to provide an understandable assessment method for the public. The results indicated that the frequency distribution analysis based on chlorophyll-a combined with trophic level index provided a useful metric for the assessment of the lake trophic status. In addition, the difference of eutrophication assessment standards in different lake regions was analyzed, which suggested that the sensitivities of algae to nutrients and the assessment standard of trophic status possessed significant regional differences for the four lake ecoregions. Lake eutrophication assessment standards would contribute to maximizing the effectiveness of future management strategies, to control and minimize lake eutrophication problems.展开更多
There has been a growing appreciation for freezing of gait as a disabling symptom that causes a significant burden in Parkinson’s disease. Previous research has highlighted some of the key components that underlie th...There has been a growing appreciation for freezing of gait as a disabling symptom that causes a significant burden in Parkinson’s disease. Previous research has highlighted some of the key components that underlie the phenomenon, but these reductionist approaches have yet to lead to a paradigm shift resulting in the development of novel treatment strategies. Addressing this issue will require greater integration of multi-modal data with complex computational modeling, but there are a number of critical aspects that need to be considered before embarking on such an approach. This paper highlights where the field needs to address current gaps and shortcomings including the standardization of definitions and measurement, phenomenology and pathophysiology, as well as considering what available data exist and how future studies should be constructed to achieve the greatest potential to better understand and treat this devastating symptom.展开更多
基金Sponsored by the National Project of Scientific and Technical Supporting Programs of Ministry of Science & Technology of China(Grant No.2012BAJ10B02)
文摘Assessment standard for green store building of national standard has been compiled. The index has been given by experts' subjective assignment based on experience. Analytic hierarchy process has been used,making questionnaires of experts,using pairwise comparison and calculating the weight of each index. The weight of index in assessment would not only make quantitative evaluation on the whole situation of green store buildings,but also provide the foundation for compilation and revision.
文摘1.Preface As the fast paced Chinese economy brings more and more direct and indirect affects into ourlives,environmental protection has become one ofthe most popular subjects of recent times.
基金Major Project of National Natural Science Foundation of China(42090020,42090025)Major Project of CNPC(2019E-2601)。
文摘Successful breakthroughs have been made in shale oil exploration in several lacustrine basins in China,indicating a promising future for shale oil exploration and production.Current exploration results have revealed the following major conditions of lacustrine shale oil accumulation:(1)stable and widely distributed shale with a high organic abundance and appropriate thermal maturity acts as a fundamental basis for shale oil retention.This shale exhibits several critical parameters,such as total organic carbon content greater than 2%,with optimal values ranging from 3% to 4%,kerogen Ⅰ and Ⅱ_(1) as the dominant organic matter types,and vitrinite reflectance(R_(o))values greater than 0.9%(0.8% for brackish water environments).(2)Various types of reservoirs exhibiting brittleness and a certain volume of micro-nanoscale pores are critical conditions for shale oil accumulation,and these reservoirs have porosities greater than 3% to 6%.Moreover,when diagenesis is incipient,pure shales are not favorable for medium-to-high maturity shale oil enrichment,whereas tight sandstone and hybrid rocks with clay content less than 20% are favorable;however,for medium-to-late-stage diagenesis,pure shales with a clay content of 40% are favorable.(3)The retention of a large amount of high-quality hydrocarbons is the factor that best guarantees shale oil accumulation with good mobility.Free hydrocarbon content exceeding a threshold value of 2 mg/g is generally required,and the optimum value is 4 mg/g to 6 mg/g.Moreover,a gas-oil ratio exceeding a threshold value of 80 m^(3)/m^(3) is required,with the optimal value ranging from 150 m^(3)/m^(3) to 300 m^(3)/m^(3).(4)High-quality roof and floor sealing conditions are essential for the shale oil enrichment interval to maintain the overpressure and retain a sufficient amount of hydrocarbons with good quality.Lacustrine shale oil distributions exhibit the following characteristics:(1)major enrichment areas of shale oil are located in semi-deep to deep lacustrine depositional areas with external materials,such as volcanic ash fallout,hydrothermal solutions,and radioactive substances with catalytic action,as inputs;(2)intervals with“four high values and one preservation condition”govern the distribution of shale oil enrichment intervals;and(3)favorable assemblages of lithofacies/lithologies determine the distribution of enrichment area.According to preliminary estimates,China has 131×10^(8) to 163×10^(8) t of total shale oil resources with medium-to-high thermal maturity,among which 67×10^(8) to 84×10^(8) t is commercial.These resources are primarily located in the Chang 7^(1+2) interval in the Ordos Basin,Qing 1+2 members in Gulong sag in the Songliao Basin,Kongdian and Shahejie formations of Cangdong sag,Qikou sag and the Jiyang depression in the Bohai Bay Basin,and Lucaogou Formation in the Junggar Basin.
文摘Since the 1970s, outcome studies for children with hearing loss expanded from focusing on assessing auditory awareness and speech perception skills to evaluating language and speech development. Since the early 2000s, the multi-center large scale research systematically studied outcomes in the areas of auditory awareness, speech-perception, language development, speech development, educational achievements, cognitive development, and psychosocial development. These studies advocated the establishment of baseline and regular follow-up evaluations with a comprehensive framework centered on language development. Recent research interests also include understanding the vast differences in outcomes for children with hearing loss, understanding the relationships between neurocognitive development and language acquisition in children with hearing loss, and using outcome studies to guide evidence-based clinical practice. After the establishment of standardized Mandarin language assessments, outcomes research in China's Mainland has the potential to expand beyond auditory awareness and speech perception studies.
基金This work was supported by the Jiangsu Provincial Administration of Traditional Chinese Medicine(No.YB201840).
文摘Background:Post-stroke dysphagia is one of the common clinical symptoms in the rehabilitation department of primary hospitals,which seriously affects the quality of life of patients and their families.Majority of medical workers have comprehensively studied post-stroke dysphagia as it easily induces inhalation pneumonia,asphyxia,and many other complications.At present,many methods for post-stroke dysphagia have been proved to be effective.With regard to comprehensive treatment effect,patient compliance,technology promotion difficulty,grassroots hospital operability,and other factors,we found that acupoint injection combined with nerve electrical stimulation is a good method worthy of promotion.Methods:A total of 130 patients with dysphagia after stroke were randomly divided into nerve electrical stimulation group(n=41),acupoint injection group(n=40),and comprehensive treatment group(nerve electrical stimulation plus acupoint injection,n=49).The therapeutic effect in each group was evaluated before treatment and 20 days after treatment using the improved water swallow test,video fluoroscopic swallowing study,and standardized swallowing assessment.Results:After 20 days of treatment,significant differences were noted in each group.The scores of improved water swallow test decreased from 4.10±0.74 to 2.12±0.95 in the nerve electrical stimulation group,4.00±0.78 to 2.28±1.04 in the acupoint injection group,and 4.16±0.77 to 1.73±0.79 in the comprehensive treatment group;video fluoroscopic swallowing study scores increased from 3.71±2.16 to 5.05±2.111 in the nerve electrical stimulation group,3.80±1.94 to 5.20±1.942 in the acupoint injection group,and 3.73±2.22 to 6.24±2.21 in the comprehensive treatment group;and standardized swallowing assessment scores of the three groups also decreased from 35.13±3.38 to 28.17±3.42,34.66±3.46,and 34.48±3.26 to 26.39±3.86,respectively.The overall scores of each group after treatment were significantly different from those before treatment(P<0.05),indicating that both nerve electrical stimulation and acupoint injection were effective for post-stroke dysphagia;the scores of nerve electrical stimulation group and acupoint injection group were similar,but those of the comprehensive treatment group were significantly better than the single treatments(P<0.05).It shows that the two treatment methods have synergistic effect,and combined treatments have more benefits.Conclusion:Nerve electrical stimulation and acupoint injection have a synergistic therapeutic effect on post-stroke dysphagia.The combined treatment is more beneficial to patients with post-stroke dysphagia than the single treatments.
基金The National Natural Science Foundation of China(No.70671017)
文摘An approach is presented to deal with a multi-attribute decision-making problem in which the attribute weights are unknown and the attribute values take the form of uncertain linguistic variables. First, a linguistic assessment standard is set up to deal with the uncertain linguistic attributes, and the operation laws of uncertain linguistic variables and the uncertain linguistic weighting average(ULWA)operator are introduced. Then a ranking formula of uncertain linguistic variables based on expectation-variance is proposed. As for the case without weight information, a goal program based on a warp function is constructed to determine the attribute weights, and the ULWA operator is utilized to aggregate the assessment information of uncertain linguistic variables, and the corresponding alternatives are ranked by a formula based on expectation-variance. Finally, a numerical example is given, and the results demonstrate that it is much easier and faster for the ranking method based on expectation-variance when compared to the existing methods.
文摘Background: At the 13th St Gallen International Breast Cancer Conference in 2013, a new definition of luminal A-like and luminal B-like breast cancer was proposed, involving the expression of estrogen receptor (ER), progesterone receptor (PgR), and Ki-67. We examined the rate of concordance between the risk groups using the Oncotype DX recurrence score (RS) and the previous and newly proposed luminal subtypes with the standardized Ki-67 assessment. Method: The relationship between a previously and newly proposed, immunohistochemically defined luminal A and B subtype with the Oncotype DX RS of 41 cases of T1-2 N0-1 M0 (ER positive, HER2 negative) breast cancer was assessed. We first classified the patients into the previously defined luminal A and B subtypes, according to the level of Ki-67 as either “low” (<14%) or “high” (≥14%), as assessed by local pathologists. Next, to consider the necessity for standardizing Ki-67 measurement methods, we re-examined Ki-67 with a central review. By introducing PgR positivity (≥20%), we classified these patients to newly proposed luminal subtypes and compared them with the risk groups stratified by Oncotype DX RS. Results: In the previously proposed luminal subtypes, the concordance rate between luminal A and the low RS category was 76.5% according to local pathologists and 90.1% by central review, whereas the rate between luminal B and the intermediate to high RS category was 46.7% and 45.8%, respectively. In newly proposed luminal subtypes, the concordance rate between luminal A and low RS category was 100% and between the luminal B and intermediate to high RS category was 53.6%. Conclusions: Although this study was based on a retrospective chart review of a small sample size, the newly proposed luminal subtypes including addition of PgR positivity with the standardized Ki-67 assessment appeared to improve the concordance rate especially between luminal A and low RS category.
基金supported by the Mega-projects of Science Research for Water Environment Improvement (No.2009ZX07106-0012012ZX07101-002)+1 种基金the National Natural Science Foundation of China (No.40901248)the China Environmental Public Welfare Program (No.2010009032)
文摘The trophic status assessment of lakes in different lake regions may provide important and fundamental information for lake trophic state classification and eutrophication control. In this study, a region-specific lake eutrophication assessment standard was established through a frequency distribution method based on chlorophyll-a concentration. The assessment standards under the oligotrophic state for lakes in the Eastern plain, Yungui Plateau, Northeast Plain and Mountain Mongolia-Xinjiang regions are total phosphorus of 0.068, 0.005, 0.011, 0.005 mg/L; total nitrogen of 1.00, 0.16, 0.37, 0.60 mg/L; Secchi depth of 0.60, 8.00, 1.55, 3.00 m; and CODMn of 2.24, 1.00, 5.1 l, 4.00 mg/L, respectively. Moreover, a region-specific comprehensive trophic level index was developed to provide an understandable assessment method for the public. The results indicated that the frequency distribution analysis based on chlorophyll-a combined with trophic level index provided a useful metric for the assessment of the lake trophic status. In addition, the difference of eutrophication assessment standards in different lake regions was analyzed, which suggested that the sensitivities of algae to nutrients and the assessment standard of trophic status possessed significant regional differences for the four lake ecoregions. Lake eutrophication assessment standards would contribute to maximizing the effectiveness of future management strategies, to control and minimize lake eutrophication problems.
基金a National Health and Medical Research Council Leadership Fellowship(1195830)has received research funding from The Michael J.Fox Foundation and the Australian Research Council.S.A.F.was supported by The Sartain Lanier Family Foundation.He has been a consultant for Lundbeck,Sunovion,Biogen,Impel,Acorda,and CereSpir.He has received education and research grants from Medtronic,Boston Scientific,Sun Pharmaceuticals Advanced Research Company,Biohaven,Impax,Lilly,US World Meds,Sunovion Therapeutics,Neurocrine,Vaccinex,Voyager,Jazz Pharmaceuticals,CHDI Foundation,The Michael J.Fox Foundation,National Institutes of Health(NIH),and Parkinson’s Foundation.He receives royalties from Demos,Blackwell Futura,Springer for textbooks,and UpToDate.Other support was from Signant(Bracket Global LLC)and CNS Ratings LLC.N.G.serves as consultant to Sionara,NeuroDerm,Pharma2B,Denali,Neuron23,Sanofi-Genzyme,Biogen,and AbbVie.He receives royalties from Lysosomal Therapeutics(LTI)and payment for lectures at AbbVie,Sanofi-Genzyme,and Movement Disorder Society.He received research support from The Michael J.Fox Foundation,the National Parkinson Foundation,European Union,and Israel Science Foundation,as well as from Teva NNE program,Biogen,and Ionis.He receives support from the Sieratzki Family Foundation and the Aufzien Academic Center in Tel-Aviv University.A.N.received funding from the European Commission,Research Foundation Flanders,King Baudouin Foundation,The Michael J.Fox Foundation,Jacques and Gloria Gossweiler Foundation,and KU Leuven Internal Research Funds.M.H.is an inventor of patents held by the NIH for an immunotoxin for the treatment of focal movement disorders and the H-coil for magnetic stimulationin relation to the latter,he has received license-fee payments from the NIH(from Brainsway).He is on the Medical Advisory Boards of CALA Health and Brainsway(both unpaid positions).He is on the editorial board of approximately 15 journals and receives royalties and/or honoraria from publishing from Cambridge University Press,Oxford University Press,Springer,Wiley,Wolters Kluwer,and Elsevier.He has research grants from Medtronic,Inc.for a study of deep brain stimulation for dystonia and CALA Health for studies of a device to suppress tremor.
文摘There has been a growing appreciation for freezing of gait as a disabling symptom that causes a significant burden in Parkinson’s disease. Previous research has highlighted some of the key components that underlie the phenomenon, but these reductionist approaches have yet to lead to a paradigm shift resulting in the development of novel treatment strategies. Addressing this issue will require greater integration of multi-modal data with complex computational modeling, but there are a number of critical aspects that need to be considered before embarking on such an approach. This paper highlights where the field needs to address current gaps and shortcomings including the standardization of definitions and measurement, phenomenology and pathophysiology, as well as considering what available data exist and how future studies should be constructed to achieve the greatest potential to better understand and treat this devastating symptom.