In Botswana water is the most precious natural resource and the government, through various institutions, is making an attempt to control the development and usage of this resource which is critical in all future deve...In Botswana water is the most precious natural resource and the government, through various institutions, is making an attempt to control the development and usage of this resource which is critical in all future development planning. Virtually all water used in rural areas is extracted from groundwater by means of wells and boreholes. Information on these water points, together with other surface sources, play an important role in regional economic development. An attempt, using the available water points data and Arc View GIS software, has been made to build a Water Point Management System in Central District (WPMSCD), which has already been used by the local authorities to answer day-to-day inquiries related to water points in the District.展开更多
BACKGROUND: The current standard for con? rmation of correct supra-diaphragmatic central venous catheter(CVC) placement is with plain ? lm chest radiography(CXR). We hypothesized that a simple point-of-care ultrasound...BACKGROUND: The current standard for con? rmation of correct supra-diaphragmatic central venous catheter(CVC) placement is with plain ? lm chest radiography(CXR). We hypothesized that a simple point-of-care ultrasound(POCUS) protocol could effectively con? rm placement and reduce time to con? rmation.METHODS: We prospectively enrolled a convenience sample of patients in the emergency department and intensive care unit who required CVC placement. Correct positioning was considered if turbulent flow was visualized in the right atrium on sub-xiphoid, parasternal or apical cardiac ultrasound after injecting 5 cc of sterile, non-agitated, normal saline through the CVC.RESULTS: Seventy-eight patients were enrolled. POCUS had a sensitivity of 86.8%(95%CI 77.1%–93.5%) and speci? city of 100%(95%CI 15.8%–100.0%) for identifying correct central venous catheter placement. Median POCUS and CXR completion were 16 minutes(IQR 10–29) and 32 minutes(IQR 19–45), respectively.CONCLUSION: Ultrasound may be an effective tool to confirm central venous catheter placement in instances where there is a delay in obtaining a con? rmatory CXR.展开更多
目的:系统评价经颅直流电刺激对帕金森患者运动功能的康复疗效,并比较经颅直流电刺激作用于不同靶点对帕金森患者运动功能的疗效差异,为临床中经颅直流电刺激的靶点选择提供理论依据。方法:计算机检索Cochrane Library、PubMed、Web of ...目的:系统评价经颅直流电刺激对帕金森患者运动功能的康复疗效,并比较经颅直流电刺激作用于不同靶点对帕金森患者运动功能的疗效差异,为临床中经颅直流电刺激的靶点选择提供理论依据。方法:计算机检索Cochrane Library、PubMed、Web of Science、中国知网、维普和万方数据库,以“帕金森、经颅直流电刺激”为中文检索词,以“Parkinson,transcranial direct current stimulation”为英文检索词,收集从各数据库建库至2023年1月发表的关于经颅直流电刺激改善帕金森患者运动功能的随机对照试验。使用Cochrane 5.1.0偏倚风险评估工具和PEDro量表对纳入研究进行质量评价。采用RevMan 5.4和Stata 17.0软件对结局指标进行Meta分析。结果:①最终纳入15项随机对照试验,PEDro量表评估显示均为高质量或极高质量研究。②Meta分析显示,与对照组相比经颅直流电刺激可显著提高UPDRS-Ⅲ评分(MD=-2.49,95%CI:-4.42至-0.55,P<0.05)、步频评分(MD=0.07,95%CI:0.03-0.11,P<0.05)和步速评分(MD=0.02,95%CI:0.00-0.05,P<0.05),但对BBS评分(MD=2.57,95%CI:-0.74-5.87,P>0.05)的提高不明显。③网状Meta分析概率排序结果显示,在UPDRS-Ⅲ评分方面,刺激靶点疗效的概率排序结果为背外侧前额叶皮质(52.4%)>初级皮质运动区(45.8%)>大脑中央点(1.8%)>常规康复治疗(0%);在步频评分方面,刺激靶点疗效的概率排序结果为小脑(50.1%)>大脑中央点(45.8%)>背外侧前额叶皮质(3.9%)>初级皮质运动区(0.2%)>常规康复治疗(0%);在步速评分方面,刺激靶点疗效的概率排序结果为小脑(64.8%)>背外侧前额叶皮质(23.8%)>大脑中央点(9.4%)>初级皮质运动区(1.7%)>常规康复治疗(0.4%);在BBS评分方面,刺激靶点疗效的概率排序结果为:小脑(77.4%)>背外侧前额叶皮质(20.7%)>大脑中央点(0.7%)>常规康复治疗(0.2%)。结论:经颅直流电刺激可显著改善帕金森患者运动功能,其中刺激背外侧前额叶皮质区域对改善帕金森患者运动协调方面疗效更佳,而刺激小脑区域对改善帕金森患者步行和平衡方面疗效更佳。展开更多
Objective To investigate the appropriate waist circumference (WC) cutoff points for central obesity in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of the International Diabetes F...Objective To investigate the appropriate waist circumference (WC) cutoff points for central obesity in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of the International Diabetes Federation (IDF). Methods A total of 2,344 Beijing residents aged ≥40 years were investigated. They answered questionnaires, received physical examinations, and underwent plasma glucose and lipid profile measurement. Those non-diabetic subjects underwent a 75g oral glucose tolerance test. All data were analyzed to calculate the appropriate WC cutoff points for central obesity reaching the diagonsis of MS. Results 1) Both in males and females, the triglyceride (TG), systolic blood pressure, diastolic blood pressure and fasting plasma glucose (FPG) increased linearly with WC, and the high density lipoprotein cholesterol (HDL-C) decreased linearly with WC (P<0.05). 2)The prevalence of elevated TG, reduced HDL-C, elevated blood pressure, elevated FBG, or ≥ 2 of these factors increased with WC (P<0.05). 3) Based on the receiver operating characteristic (ROC) curve analysis and Youden index, the WC values for central obesity and for detecting BMI ≥ 25 kg/m2 were about 90 cm for men and 80 cm for women. 4) The odds ratio for the presence of two or more metabolic risk factors increased abruptly in men with WC ≥ 90 cm and in women with WC ≥ 80 cm. Conclusions The appropriate WC cutoff point for central obesity was determined to be 90 cm for men and 80 cm for women in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of IDF.展开更多
Exact solution of the nonlinear boundary value problem for the basic equation and boundary condition of circular membrane under central force was obtained by using new simple methods. The existence and uniqueness of t...Exact solution of the nonlinear boundary value problem for the basic equation and boundary condition of circular membrane under central force was obtained by using new simple methods. The existence and uniqueness of the solution were discussed by using of modern immovable point theorems. Although specific problem is treated, the basic principles of the methods can be applied to a considerable variety of nonlinear problems.展开更多
识别城市多中心空间结构,描述不同职能中心的空间集聚特征,刻画沈阳市中心城区制造业郊区化扩散趋势,为沈阳市中心城区产业结构转型升级和城市空间组织营造提供参考。基于不同职能的兴趣点(point of interest, POI)数据的城市职能分类基...识别城市多中心空间结构,描述不同职能中心的空间集聚特征,刻画沈阳市中心城区制造业郊区化扩散趋势,为沈阳市中心城区产业结构转型升级和城市空间组织营造提供参考。基于不同职能的兴趣点(point of interest, POI)数据的城市职能分类基准,采用ArcGIS10.7、GeoDa1.12和Crimestat3.3软件,运用核密度分析、空间热点聚类、标准差椭圆、空间自相关等方法,识别2020年城市多中心空间结构,测度不同功能类型设施的空间关联性,分析1998年、2008年和2020年制造业集聚特征。研究表明:1)2020年,城市空间结构表现为“多个中心、圈层放射”,通过“一主四副”的城市规划引导,大致形成了3个等级的城市中心体系,基本符合2011—2020年沈阳市城市总体规划。除了主城区的集聚组团式的单中心之外,各个副城也都形成了各自的次级中心,符合多中心的城市空间结构。2)1998—2020年,制造业企业不断向城市外围地区迁移扩散,主要分布在西、南方向的三四环城市郊区,形成了铁西产业新城、永安新城等产业集聚区域,基本符合2011—2020年沈阳市城市总体规划。3)沈阳市不同功能空间均呈现出西南—东北方向的延伸,不同功能类型之间存在明显的“中心—外围”的嵌套式城市功能体系。不同功能类型呈现出不同的空间相关性,以制造业为代表的工业功能区具有一定的排他性,制造业集聚区域的城市功能比较单一,居住设施、商业服务设施、公共管理与服务功能设施存在较强的空间相关性,形成多种功能混合的综合服务中心。因此,需要进一步提升城市功能和优化产业布局,完善以城市核心生产功能为主的工业区的生活服务功能。展开更多
文摘In Botswana water is the most precious natural resource and the government, through various institutions, is making an attempt to control the development and usage of this resource which is critical in all future development planning. Virtually all water used in rural areas is extracted from groundwater by means of wells and boreholes. Information on these water points, together with other surface sources, play an important role in regional economic development. An attempt, using the available water points data and Arc View GIS software, has been made to build a Water Point Management System in Central District (WPMSCD), which has already been used by the local authorities to answer day-to-day inquiries related to water points in the District.
文摘BACKGROUND: The current standard for con? rmation of correct supra-diaphragmatic central venous catheter(CVC) placement is with plain ? lm chest radiography(CXR). We hypothesized that a simple point-of-care ultrasound(POCUS) protocol could effectively con? rm placement and reduce time to con? rmation.METHODS: We prospectively enrolled a convenience sample of patients in the emergency department and intensive care unit who required CVC placement. Correct positioning was considered if turbulent flow was visualized in the right atrium on sub-xiphoid, parasternal or apical cardiac ultrasound after injecting 5 cc of sterile, non-agitated, normal saline through the CVC.RESULTS: Seventy-eight patients were enrolled. POCUS had a sensitivity of 86.8%(95%CI 77.1%–93.5%) and speci? city of 100%(95%CI 15.8%–100.0%) for identifying correct central venous catheter placement. Median POCUS and CXR completion were 16 minutes(IQR 10–29) and 32 minutes(IQR 19–45), respectively.CONCLUSION: Ultrasound may be an effective tool to confirm central venous catheter placement in instances where there is a delay in obtaining a con? rmatory CXR.
文摘目的:系统评价经颅直流电刺激对帕金森患者运动功能的康复疗效,并比较经颅直流电刺激作用于不同靶点对帕金森患者运动功能的疗效差异,为临床中经颅直流电刺激的靶点选择提供理论依据。方法:计算机检索Cochrane Library、PubMed、Web of Science、中国知网、维普和万方数据库,以“帕金森、经颅直流电刺激”为中文检索词,以“Parkinson,transcranial direct current stimulation”为英文检索词,收集从各数据库建库至2023年1月发表的关于经颅直流电刺激改善帕金森患者运动功能的随机对照试验。使用Cochrane 5.1.0偏倚风险评估工具和PEDro量表对纳入研究进行质量评价。采用RevMan 5.4和Stata 17.0软件对结局指标进行Meta分析。结果:①最终纳入15项随机对照试验,PEDro量表评估显示均为高质量或极高质量研究。②Meta分析显示,与对照组相比经颅直流电刺激可显著提高UPDRS-Ⅲ评分(MD=-2.49,95%CI:-4.42至-0.55,P<0.05)、步频评分(MD=0.07,95%CI:0.03-0.11,P<0.05)和步速评分(MD=0.02,95%CI:0.00-0.05,P<0.05),但对BBS评分(MD=2.57,95%CI:-0.74-5.87,P>0.05)的提高不明显。③网状Meta分析概率排序结果显示,在UPDRS-Ⅲ评分方面,刺激靶点疗效的概率排序结果为背外侧前额叶皮质(52.4%)>初级皮质运动区(45.8%)>大脑中央点(1.8%)>常规康复治疗(0%);在步频评分方面,刺激靶点疗效的概率排序结果为小脑(50.1%)>大脑中央点(45.8%)>背外侧前额叶皮质(3.9%)>初级皮质运动区(0.2%)>常规康复治疗(0%);在步速评分方面,刺激靶点疗效的概率排序结果为小脑(64.8%)>背外侧前额叶皮质(23.8%)>大脑中央点(9.4%)>初级皮质运动区(1.7%)>常规康复治疗(0.4%);在BBS评分方面,刺激靶点疗效的概率排序结果为:小脑(77.4%)>背外侧前额叶皮质(20.7%)>大脑中央点(0.7%)>常规康复治疗(0.2%)。结论:经颅直流电刺激可显著改善帕金森患者运动功能,其中刺激背外侧前额叶皮质区域对改善帕金森患者运动协调方面疗效更佳,而刺激小脑区域对改善帕金森患者步行和平衡方面疗效更佳。
文摘Objective To investigate the appropriate waist circumference (WC) cutoff points for central obesity in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of the International Diabetes Federation (IDF). Methods A total of 2,344 Beijing residents aged ≥40 years were investigated. They answered questionnaires, received physical examinations, and underwent plasma glucose and lipid profile measurement. Those non-diabetic subjects underwent a 75g oral glucose tolerance test. All data were analyzed to calculate the appropriate WC cutoff points for central obesity reaching the diagonsis of MS. Results 1) Both in males and females, the triglyceride (TG), systolic blood pressure, diastolic blood pressure and fasting plasma glucose (FPG) increased linearly with WC, and the high density lipoprotein cholesterol (HDL-C) decreased linearly with WC (P<0.05). 2)The prevalence of elevated TG, reduced HDL-C, elevated blood pressure, elevated FBG, or ≥ 2 of these factors increased with WC (P<0.05). 3) Based on the receiver operating characteristic (ROC) curve analysis and Youden index, the WC values for central obesity and for detecting BMI ≥ 25 kg/m2 were about 90 cm for men and 80 cm for women. 4) The odds ratio for the presence of two or more metabolic risk factors increased abruptly in men with WC ≥ 90 cm and in women with WC ≥ 80 cm. Conclusions The appropriate WC cutoff point for central obesity was determined to be 90 cm for men and 80 cm for women in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of IDF.
文摘Exact solution of the nonlinear boundary value problem for the basic equation and boundary condition of circular membrane under central force was obtained by using new simple methods. The existence and uniqueness of the solution were discussed by using of modern immovable point theorems. Although specific problem is treated, the basic principles of the methods can be applied to a considerable variety of nonlinear problems.
文摘识别城市多中心空间结构,描述不同职能中心的空间集聚特征,刻画沈阳市中心城区制造业郊区化扩散趋势,为沈阳市中心城区产业结构转型升级和城市空间组织营造提供参考。基于不同职能的兴趣点(point of interest, POI)数据的城市职能分类基准,采用ArcGIS10.7、GeoDa1.12和Crimestat3.3软件,运用核密度分析、空间热点聚类、标准差椭圆、空间自相关等方法,识别2020年城市多中心空间结构,测度不同功能类型设施的空间关联性,分析1998年、2008年和2020年制造业集聚特征。研究表明:1)2020年,城市空间结构表现为“多个中心、圈层放射”,通过“一主四副”的城市规划引导,大致形成了3个等级的城市中心体系,基本符合2011—2020年沈阳市城市总体规划。除了主城区的集聚组团式的单中心之外,各个副城也都形成了各自的次级中心,符合多中心的城市空间结构。2)1998—2020年,制造业企业不断向城市外围地区迁移扩散,主要分布在西、南方向的三四环城市郊区,形成了铁西产业新城、永安新城等产业集聚区域,基本符合2011—2020年沈阳市城市总体规划。3)沈阳市不同功能空间均呈现出西南—东北方向的延伸,不同功能类型之间存在明显的“中心—外围”的嵌套式城市功能体系。不同功能类型呈现出不同的空间相关性,以制造业为代表的工业功能区具有一定的排他性,制造业集聚区域的城市功能比较单一,居住设施、商业服务设施、公共管理与服务功能设施存在较强的空间相关性,形成多种功能混合的综合服务中心。因此,需要进一步提升城市功能和优化产业布局,完善以城市核心生产功能为主的工业区的生活服务功能。
