BACKGROUND Within the normal range,elevated alanine aminotransferase(ALT)levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To investigate the associations ...BACKGROUND Within the normal range,elevated alanine aminotransferase(ALT)levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To investigate the associations between repeated high-normal ALT measurements and the risk of new-onset MAFLD prospectively.METHODS A cohort of 3553 participants followed for four consecutive health examinations over 4 years was selected.The incidence rate,cumulative times,and equally and unequally weighted cumulative effects of excess high-normal ALT levels(ehALT)were measured.Cox proportional hazards regression was used to analyse the association between the cumulative effects of ehALT and the risk of new-onset MAFLD.RESULTS A total of 83.13%of participants with MAFLD had normal ALT levels.The incidence rate of MAFLD showed a linear increasing trend in the cumulative ehALT group.Compared with those in the low-normal ALT group,the multivariate adjusted hazard ratios of the equally and unequally weighted cumulative effects of ehALT were 1.651[95%confidence interval(CI):1.199-2.273]and 1.535(95%CI:1.119-2.106)in the third quartile and 1.616(95%CI:1.162-2.246)and 1.580(95%CI:1.155-2.162)in the fourth quartile,respectively.CONCLUSION Most participants with MAFLD had normal ALT levels.Long-term high-normal ALT levels were associated with a cumulative increased risk of new-onset MAFLD.展开更多
Repeated blast impacts on personnel in explosive environments can exacerbate craniocerebral trauma.Most existing studies focus on the injury effects of a single blast,lacking in-depth analysis on the injury effects an...Repeated blast impacts on personnel in explosive environments can exacerbate craniocerebral trauma.Most existing studies focus on the injury effects of a single blast,lacking in-depth analysis on the injury effects and cumulative effects of repeated blasts.Therefore,rats were used as the experimental samples to suffer from explosion blasts with different peak air overpressures(167 kPa~482 kPa)and varying number of repeated blasts.The cumulative effect of craniocerebral trauma was most pronounced for moderate repeated blast,showing approximately 95%increase of trauma severity with penta blast,and an approximately 85%increase of trauma severity with penta minor blast.The cumulative effect of craniocerebral trauma from severe,repeated blast has a smaller rate of change compared to the other two conditions.The severity of trauma from penta blast increased by approximately 69%compared to a single blast.Comprehensive physiological,pathological and biochemical analysis show that the degree of neurological trauma caused by repeated blasts is higher than that of single blasts,and the pathological trauma to brain tissue is more extensive and severe.The trauma degree remains unchanged after double blast,increases by one grade after triple or quadruple blast,and increases by two grades after penta blast.展开更多
This paper provides a method of the process of computation called the cumulative method, it is based upon repeated cumulative process. The cumulative method is being adapted to the purposes of computation, particularl...This paper provides a method of the process of computation called the cumulative method, it is based upon repeated cumulative process. The cumulative method is being adapted to the purposes of computation, particularly multiplication and division. The operations of multiplication and division are represented by algebraic formulas. An advantage of the method is that the cumulative process can be performed on decimal numbers. The present paper aims to establish a basic and useful formula valid for the two fundamental arithmetic operations of multiplication and division. The new cumulative method proved to be more flexible and made it possible to extend the multiplication and division based on repeated addition/subtraction to decimal numbers.展开更多
Cumulative assessment is a tool for the project developer to try and take into consideration not only their contribution to cumulative impacts but also other projects and external factors that may place their developm...Cumulative assessment is a tool for the project developer to try and take into consideration not only their contribution to cumulative impacts but also other projects and external factors that may place their developments at risk.This study assessed the cumulative impacts of air emissions from 22 major power plants in southeast Bangladesh planned to generate 21,550 MW of electricity.It also includes anticipated growth in small to medium size industries,brickfields,highway traffic,inland water transport,transhippers,jetty,and vessel transports used for transporting fuel resources for these power plants.A 50 km by 50 km airshed is considered for air quality modeling.Cumulative analysis indicates that predicted MGLCs(Maximum Ground Level Concentrations)of NO2 and CO are complying with both Bangladesh NAAQS(National Ambient Air Quality Standards)and WBG(World Bank Group)Guidelines.The daily average MGLC of PM_(2.5)(62.45µg/m^(3))from all sources complies with NAAQS,however,exceeds the WBG Guidelines.Annual PM_(2.5) concentration(15.45µg/m^(3))exceeds NAAQS and WBG Guidelines.The PM10 concentration complies with the NAAQS for both 24-hour and annual averaging times.Annual average concentration(23.12µg/m^(3))exceeds WBG Guidelines.Daily average SO2 concentration(102.49µg/m^(3))complies with the NAAQS however,it exceeds the WBG guideline values.High concentrations of PM_(2.5) and SO2 are due to the contribution of transboundary emissions and secondary pollutants in the atmosphere.This dispersion modeling outcome can be used by the policymakers for the pollution reduction strategy.展开更多
Aqueous zinc metal batteries feature intrinsic safety,but suffer from severe dendrite growth and water-derived side reactions.Many metal coatings have been explored for stabilizing Zn metal anode via a trialand-error ...Aqueous zinc metal batteries feature intrinsic safety,but suffer from severe dendrite growth and water-derived side reactions.Many metal coatings have been explored for stabilizing Zn metal anode via a trialand-error approach.Here,we propose an exercisable way to screen the potential metal coating on Zn anodes in view of de-polarization effect and dendrite-suppressing ability theoretically.As an output of this screening,cadmium(Cd) metal is checked experimentally.Therefore,symmetric ZnllZn cells using Cd coated Zn(Zn@Cd) exhibit an ultra-long cycle life of 3500 h(nearly 5 months) at a high current density of 10 mA cm^(-2),achieving a record-high cumulative capacity(35 A h cm^(-2)) compared to the previous reports.The full cells of Zn@Cd‖MnO_(2) display a markedly improved cycling performance under harsh conditions including a limited Zn supply(N/P ratio=1.7) and a high areal capacity(3.5 mA h cm^(-2)).The significance of this work lies in not only the first report of Cd coating for stabilizing Zn metal anode,but also a feasible way to screen the promising metal materials for other metal anodes.展开更多
Background:Carbapenems are effective against severe Pseudomonas aeruginosa nosocomial infections.Therefore,carbapenem-resistant Pseudomonas aeruginosa is a serious public health threat.An understanding of the risk of ...Background:Carbapenems are effective against severe Pseudomonas aeruginosa nosocomial infections.Therefore,carbapenem-resistant Pseudomonas aeruginosa is a serious public health threat.An understanding of the risk of inappropriate exposure to different antimicrobials in resistant Pseudomonas aeruginosa infection could help in elucidating the effective approach towards using antimicrobials in vulnerable patients with CRPA infection.Object:To investigate the association between exposure ofβ-lactam antimicrobials and CRPA infection relative to control patients.Methods:The MEDLINE/PubMed and OVID/Embase databases were used to search case-control and cohort studies in English language which reported antimicrobial exposure as risk factors for CRPA infection.The pooled odds ratios(OR)were calculated using a random-effect and fixed-effect model,and forest plots from a cumulative meta-analysis method were used to better show how pooled OR changed as updated evidence accumulated.Results:A total of 24 studies comprising 7039 participants were included for cumulative meta-analysis.A positive correlation was found between development of CRPA infection and exposure of beta-lactam antimicrobials:carbapenems(OR=7.60,95%CI:3.95 to 14.62,P<0.0001),imipenem(OR=9.81,95%CI:5.56 to 17.33),ampicillin(OR=1.86,95%CI:1.14 to 2.41),piperacillin(OR=2.82,95%CI:1.46 to 2.43),penicillins(OR=1.42,95%CI:0.90 to 2.24),cephalosporins(OR=1.88,95%CI:1.46 to 2.43)andβlactamase inhibitors(OR=1.96,95%CI:1.44 to 2.67).Further,exposure of other antimicrobial agents like quinolone(OR=2.35,95%CI:1.78 to 3.10),ciprofloxacin(OR=2.35,95%CI:1.66 to 3.95),aminoglycoside(OR=2.17,95%CI:1.60 to 2.95),amikacin(OR=3.11,95%CI:2.10 to 4.61),glycopeptides(OR=3.02,95%CI:1.92 to 4.75)and vancomycin(OR=3.26,95%CI:1.48 to 7.18),were also found to be positively associated with development of CRPA infection.Conclusions:Exposure of all kinds ofβ-lactams is significantly associated with development of carbapenemresistant Pseudomonas aeruginosa infection.These findings provide an impetus to take a more active approach while usingβ-lactam antimicrobials in patients with resistant Pseudomonas aeruginosa infections.展开更多
To explore the cumulative deformation effect of the dynamic response of a tunnel crossing the hauling sliding surface under earthquakes,the shaking table test was conducted in this study.Combined with the numerical ca...To explore the cumulative deformation effect of the dynamic response of a tunnel crossing the hauling sliding surface under earthquakes,the shaking table test was conducted in this study.Combined with the numerical calculations,this study proposed magnification of the Arias intensity(MIa)to characterize the overall local deformation damage of the tunnel lining in terms of the deformation characteristics,frequency domain,and energy.Using the time‐domain analysis method,the plastic effect coefficient(PEC)was proposed to characterize the degree of plastic deformation,and the applicability of the seismic cumulative failure effect(SCFE)was discussed.The results show that the low‐frequency component(f1 and f2≤10 Hz)and the high‐frequency component(f3 and f4>10 Hz)acceleration mainly cause global and local deformation of the tunnel lining.The local deformation caused by the high‐frequency wave has an important effect on the seismic damage of the lining.The physical meaning of PEC is more clearly defined than that of the residual strain,and the SCFE of the tunnel lining can also be defined.The SCFE of the tunnel lining includes the elastic deformation effect stage(<0.15g),the elastic–plastic deformation effect stage(0.15g–0.30g),and the plastic deformation effect stage(0.30g–0.40g).This study can provide valuable theoretical and technical support for the construction of traffic tunnels in high‐intensity earthquake areas.展开更多
A cross-sectional exploratory assessment of the needs and challenges of petroleum industry in Nigeria, in assessing process safety cumulative risk for major accidents prevention was investigated. A purposive cum rando...A cross-sectional exploratory assessment of the needs and challenges of petroleum industry in Nigeria, in assessing process safety cumulative risk for major accidents prevention was investigated. A purposive cum random sampling technique was used in this study, among selected petroleum companies operating in Nigeria. Survey questionnaires were received from 216 participants made up of asset integrity engineers/operators, process safety experts, production safety professionals in the petroleum industry in Nigeria. Data analyses were carried out to cover descriptive and inferential statistics. Overall, the study recognized that assessing process safety cumulative risk is not a simple process due largely to the changing nature of safety critical barriers degradation data. The study result showed four main challenges faced by petroleum industries in Nigeria, in assessing process safety cumulative risk: 1) the study showed that 94% of the respondents agreed that there is limited accessibility to safety critical barriers degradation data (little automation). Also 2) 94% of the respondents accounted for poor knowledge of process safety cumulative risk is and agreed it to be of low rating. The result further showed that 3) 90% of the respondents demonstrated that there are no guidance and procedures in assessing process safety cumulative risk and finally 4) 92% of the respondents reported that there is no real-time risk visualization model/ tool. Addressing these issues and challenges by the petroleum industries in the study area, will lead to successful assessment of process safety cumulative risk, thereby reducing the risk of major accidents.展开更多
Based on the analysis of the evaluation problems associated with the risk control scheme for major engineering projects,the evaluation method of the risk control scheme considering the irrational behavior of evaluatio...Based on the analysis of the evaluation problems associated with the risk control scheme for major engineering projects,the evaluation method of the risk control scheme considering the irrational behavior of evaluation members in fuzzy random environment is proposed.Firstly,a maximum entropy model corresponding to any evaluation member is es-tablished by using triangular fuzzy random variables and grey correlation coefficient in order to obtain the weight of each risk factor of the member.Secondly,a nonlinear programming model is established according to the principle of minimiz-ing deviation to estimate the weight of different evaluation members on the evaluation of alternative risk control schemes.Lastly,the cumulative entropy model is used to calculate the weight of risk control schemes.Cumulative prospect theory obtains the comprehensive prospect utility value of each alternative to determine the optimal alternative.展开更多
The cumulative effect of cascade hydropower stations on river ecological environment has been widely concerned because of the significant streamflow hydrology change induced by dam constructions. The characteristics o...The cumulative effect of cascade hydropower stations on river ecological environment has been widely concerned because of the significant streamflow hydrology change induced by dam constructions. The characteristics of the change in the lower reaches of the Jinsha River, China are analyzed based on long-term(1952–2015) hydrological and sedimentological data. The averaging coefficient, reservoir regulation coefficient(RRC), incoming sediment coefficient(ISC), and sediment transport modulus(STM), which reflect the variation of streamflow and sediment regimes, are defined and calculated. The results show that the construction and regulation of reservoirs reduces flow in flood season, increases flow in dry season, significantly altering the monthly discharge regimes. These alterations also led directly to changes in the timing of extreme flows at Pingshan Station. The monthly flow records at the basin outlet are reconstructed using stepwise regression, to reduce reservoir impacts. Comparisons of observed and reconstructed monthly flows demonstrate that the previous studies overestimated the cumulative effects of cascade reservoirs on flow processes. Furthermore, this study clearly illustrates that the reduction in sediment trapping and sediment transportation capacity together lead to the sharp reduction in annual sediment yield at the Pingshan Station. The earlier constructed reservoirs have more obvious effects on the ISC and STM than the more recent reservoirs and the effect of sediment trapping is related to reservoir location, on the main stream versus tributaries.展开更多
In the present study, a rat model of chronic neuropathic pain was established by ligation of the sciatic nerve and a model of learning and memory impairment was established by ovariectomy to investigate the analgesic ...In the present study, a rat model of chronic neuropathic pain was established by ligation of the sciatic nerve and a model of learning and memory impairment was established by ovariectomy to investigate the analgesic effect of repeated electroacupuncture stimulation at bilateral Zusanfi (ST36) and Yanglingquan (GB34). In addition, associated synaptic changes in neurons in the paraventricular nucleus of the hypothalamus were examined. Results indicate that the thermal pain threshold (paw withdrawal latency) was significantly increased in rats subjected to 2-week electroacupuncture intervention compared with 2-day electroacupuncture, but the analgesic effect was weakened remarkably in ovariectomized rats with chronic constrictive injury. 2-week electroacupuncture intervention substantially reversed the chronic constrictive injury-induced increase in the synaptic cleft width and thinning of the postsynaptic density. These findings indicate that repeated electroacupuncture at bilateral Zusanfi and Yanglingquan has a cumulative analgesic effect and can effectively relieve chronic neuropathic pain by remodeling the synaptic structure of the hypothalamic paraventricular nucleus.展开更多
Starting in mid-November,China was hit by several cold events during the early winter of 2020/21.The lowest temperature observed at Beijing station on 7 January reached−19.6°C.In this paper,we show that the outbr...Starting in mid-November,China was hit by several cold events during the early winter of 2020/21.The lowest temperature observed at Beijing station on 7 January reached−19.6°C.In this paper,we show that the outbreak of the record-breaking extreme cold event can be attributed to a huge merging Ural blocking(UB)ridge over the Eurasian region.The sea-ice cover in the Kara and East Siberia Seas(KESS)in autumn was at its lowest value since 1979,which could have served as a precursor signal.Further analysis shows that several successive UB episodes occurred from 1 September 2020 to 10 January 2021.The persistent UB that occurred in late September/early October 2020 may have made an important contribution to the October historical minimum of sea ice in the KESS region.Our results also show that,after each UB episode in winter,significant upward propagation of wave activity occurred around 60°E,which resulted in weakening the stratospheric vortex.Meanwhile,each UB episode also caused a significant reduction in sea-ice extent in KESS and a significant weakening of the westerly jet in mid-high-latitude Eurasia.Results suggest that the Arctic vortex,which is supposed to enhance seasonally,became weaker and more unstable than the climatic mean under the seasonal cumulative effects of UB episodes,KESS warming,and long-lasting negative-phase North Atlantic Oscillation(NAO-).Those seasonal cumulative effects,combined with the impact of La Niña winter,led to the frequent occurrence of extreme cold events.展开更多
BACKGROUND China has a high prevalence of hepatitis B virus(HBV),but most chronic hepatitis B(CHB)patients do not receive standardized antiviral therapy.There are few relevant reports addressing the outcomes of the la...BACKGROUND China has a high prevalence of hepatitis B virus(HBV),but most chronic hepatitis B(CHB)patients do not receive standardized antiviral therapy.There are few relevant reports addressing the outcomes of the large number of CHB patients who do not receive antiviral therapy.AIM To observe the outcomes of long-term follow-up of patients with CHB without antiviral treatment.METHODS This study included 362 patients with CHB and 96 with hepatitis B cirrhosis without antiviral treatment and with only liver protection and anti-inflammatory treatment from 1993 to 1998.The median follow-up times were 10 and 7 years,respectively.A total of 203 CHB and 129 hepatitis B cirrhosis patients receiving antiviral therapy were selected as the control groups.The median follow-up times were 8 and 7 years,respectively.Kaplan-Meier curves were used to analyze the cumulative incidence of hepatocellular carcinoma(HCC),and the Cox regression model was used to analyze the risk factors for HCC.RESULTS Among the patients in the non-antiviral group,16.9%had spontaneous decreases(HBeAg)seroconversion.In the antiviral group,87.2%of patients had undetectable HBV DNA,and 52%showed HBeAg seroconversion.Among CHB and hepatitis B cirrhosis patients,the cumulative incidence rates of HCC were 14.9%and 53.1%,respectively,in the non-antiviral group and were 10.7%and 31.9%,respectively,in the antiviral group.There was no difference between the two groups regarding the CHB patients(P=0.842),but there was a difference between the groups regarding the hepatitis B cirrhosis patients(P=0.026).The cumulative incidence rates of HCC were 1.6%and 22.3%(P=0.022)in the groups with and without spontaneous HBeAg seroconversion,respectively.The incidence rates of HCC among patients with and without spontaneous declines in HBV DNA to undetectable levels were 1.6%and 19.1%,respectively(P=0.051).There was no difference in the cumulative incidence of HCC between the two groups regarding the patients with drug-resistant CHB(P=0.119),but there was a significant difference between the two groups regarding the patients with cirrhosis(P=0.004).The Cox regression model was used for regression of the corrected REACH-B score,which showed that alanine aminotransferase>400 U/L,history of diabetes,and family history of liver cancer were risk factors for HCC among men aged>40 years(P<0.05).Multifactorial analysis showed that a family history of HCC among men was a risk factor for HCC.CONCLUSION Antiviral therapy and non-antiviral therapy with liver protection and antiinflammatory therapy can reduce the risk of HCC.Antiviral therapy may mask the spontaneous serological response of some patients during CHB.Therefore,the effect of early antiviral therapy on reducing the incidence of HCC cannot be overestimated.展开更多
Coalbed gas extraction is an important means of exploiting and utilizing gas resources,as well as a means of preventing coal mine disasters.In view of the low gas extraction rate from coalbeds with high gas content an...Coalbed gas extraction is an important means of exploiting and utilizing gas resources,as well as a means of preventing coal mine disasters.In view of the low gas extraction rate from coalbeds with high gas content and low permeability,a method of improving permeability through deep-hole cumulative blasting is applied to develop initial directional fractures using a jet flow.Under the action of the blasting stress wave and detonation gas wedge,the fractures extend over a large range within the coal,thereby improving coalbed permeability.This study focuses on the criteria of cumulative blasting-induced coalbed fracturing based on a literature review of the penetration effect of cumulative blasting.On this basis,we summarize the coal fracturing zone,crack extension process,and the key technologies of charging and hole sealing for cumulative blasting.In addition,the latest research progress in the optimization of field test drilling and blasting parameters for cumulative blasting is introduced.Research findings indicate that the permeability improvement mechanism of cumulative blasting could be further enhanced,and the technology and technical equipment are in urgent need of improvement.Finally,development trends in the cumulative blasting permeability improvement technique are identified.展开更多
In the present study, we examined the analgesic effect of repeated electroacupuncture at bilateral Zusanfi (ST36) and Yanglingquan (GB34) once a day for 14 consecutive days in a rat model of chronic sciatic nerve ...In the present study, we examined the analgesic effect of repeated electroacupuncture at bilateral Zusanfi (ST36) and Yanglingquan (GB34) once a day for 14 consecutive days in a rat model of chronic sciatic nerve constriction injury-induced neuropathic pain. In addition, concomitant changes in calcium/calmodulin-dependent protein kinase II expression and synaptic ultrastructure of neurons in the hippocampal CA3 region were examined. The thermal pain threshold (paw withdrawal latency) was increased significantly in both groups at 2 weeks after electroacupuncture intervention compared with 2 days of electroacupuncture. In ovariectomized rats with chronic constriction injury, the analgesic effect was significantly reduced. Electroacupuncture for 2 weeks significantly diminished the injury-induced increase in synaptJc cleft width and thinning of the postsynaptJc density, and it significantly suppressed the down-regulation of intracellular calcium/ calmodulin-dependent protein kinase II expression in the hippocampal CA3 region. Repeated electroacupuncture intervention had a cumulative analgesic effect on injury-induced neuropathic pain reactions, and it led to synaptic remodeling of hippocampal neurons and upregulated calcium/calmodulin-dependent protein kJnase II expression in the hippocampal CA3 region.展开更多
Internal solitary wave propagation over a submarine ridge results in energy dissipation, in which the hydrodynamic interaction between a wave and ridge affects marine environment. This study analyzes the effects of ri...Internal solitary wave propagation over a submarine ridge results in energy dissipation, in which the hydrodynamic interaction between a wave and ridge affects marine environment. This study analyzes the effects of ridge height and potential energy during wave-ridge interaction with a binary and cumulative logistic regression model. In testing the Global Null Hypothesis, all values are p 〈0.001, with three statistical methods, such as Likelihood Ratio, Score, and Wald. While comparing with two kinds of models, tests values obtained by cumulative logistic regression models are better than those by binary logistic regression models. Although this study employed cumulative logistic regression model, three probability functions p^1, p^2 and p^3, are utilized for investigating the weighted influence of factors on wave reflection. Deviance and Pearson tests are applied to cheek the goodness-of-fit of the proposed model. The analytical results demonstrated that both ridge height (X1 ) and potential energy (X2 ) significantly impact (p 〈 0. 0001 ) the amplitude-based refleeted rate; the P-values for the deviance and Pearson are all 〉 0.05 (0.2839, 0.3438, respectively). That is, the goodness-of-fit between ridge height ( X1 ) and potential energy (X2) can further predict parameters under the scenario of the best parsimonious model. Investigation of 6 predictive powers ( R2, Max-rescaled R^2, Sorners' D, Gamma, Tau-a, and c, respectively) indicate that these predictive estimates of the proposed model have better predictive ability than ridge height alone, and are very similar to the interaction of ridge height and potential energy. It can be concluded that the goodness-of-fit and prediction ability of the cumulative logistic regression model are better than that of the binary logistic regression model.展开更多
Fatigue damage increases with the applied loading cycles in a cumulative manner and the material deteriorates with the corrosion time. A cumulative fatigue damage rule under the alternative of corrosion or cyclic load...Fatigue damage increases with the applied loading cycles in a cumulative manner and the material deteriorates with the corrosion time. A cumulative fatigue damage rule under the alternative of corrosion or cyclic loading was proposed. The specimens of aluminum alloy LY12-CZ soaked in corrosive liquid for different times were tested under the constant amplitude cyclic loading to obtain S-N curves. The test was carried out to verify the proposed cumulative fatigue damage rule under the different combinations among corrosion time, loading level, and the cycle numbers. It was shown that the predicted residual fatigue lives showed a good agreement with the experimental results and the proposed rule was simple and can be easily adopted.展开更多
The physical process of cumulative second-harmonic generation of Lamb waves propagating in a two-layered solid plate is presented by using the second-order perturbation and the technique of nonlinear reflection of aco...The physical process of cumulative second-harmonic generation of Lamb waves propagating in a two-layered solid plate is presented by using the second-order perturbation and the technique of nonlinear reflection of acoustic waves at an interface. In general, the cumulative second-harmonic generation of a dispersive guided wave propagation does not occur. However, the present paper shows that the second-harmonic of Lamb wave propagation arising from the nonlinear interaction of the partial bulk acoustic waves and the restriction of the three boundaries of the solid plates does have a cumulative growth effect if some conditions are satisfied. Through boundary condition and initial condition of excitation, the analytical expression of cumulative second-harmonic of Lamb waves propagation is determined. Numerical results show the cumulative effect of Lamb waves on second-harmonic field patterns.展开更多
Objectives: Delirium is a common acute cognitive impairment syndrome among intensive care unit (ICU) patients.This study was aimed to investigate the incidence,risk factors,and cumulative risk of delirium among ICU pa...Objectives: Delirium is a common acute cognitive impairment syndrome among intensive care unit (ICU) patients.This study was aimed to investigate the incidence,risk factors,and cumulative risk of delirium among ICU patients.Methods: A case-control study including clinical records of 452 patients were retrospectively analyzed.Delirium was assessed using the Confusion Assessment Method for the ICU and Richmond Agitation -Sedation Scale.Results: We found that 163 out of the 452 patients (36.1%) had delirium.Multivariate analysis showed that use of sedatives,length of ICU hospitalization,and physical restraint were independent risk factors for delirium.The additive effect of all three factors resulted to an odds ratio of 30.950.Conclusion: The incidence of delirium remained high.Thus,nurses shall strengthen the monitoring of delirium,regularly access the patient's level of calmness,and limit the use of physical restraint.展开更多
The indirect method for the continuous low-thrust near minimum cumulative longitude orbit transfer problem is addressed.The movement of the satellite is described by the Gauss equation using the modified equinoctial e...The indirect method for the continuous low-thrust near minimum cumulative longitude orbit transfer problem is addressed.The movement of the satellite is described by the Gauss equation using the modified equinoctial elements and replacing time as the system independent variable by the cumulative longitude.The maximum principle is adapted to design the optimal control in order to minimize the final cumulative longitude, and the twopoint-boundary-value problem is derived from the orbit transfer problem.The single shooting method is applied in a numerical experiment, and the simulations demonstrate that the orbit transfer mission is fulfilled and the product of the maximal thrust and the minimum cumulative longitude is near constant.展开更多
基金National Natural Science Foundation of China,No.72101236China Postdoctoral Science Foundation,No.2022M722900+1 种基金Collaborative Innovation Project of Zhengzhou City,No.XTCX2023006Nursing Team Project of the First Affiliated Hospital of Zhengzhou University,No.HLKY2023005.
文摘BACKGROUND Within the normal range,elevated alanine aminotransferase(ALT)levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To investigate the associations between repeated high-normal ALT measurements and the risk of new-onset MAFLD prospectively.METHODS A cohort of 3553 participants followed for four consecutive health examinations over 4 years was selected.The incidence rate,cumulative times,and equally and unequally weighted cumulative effects of excess high-normal ALT levels(ehALT)were measured.Cox proportional hazards regression was used to analyse the association between the cumulative effects of ehALT and the risk of new-onset MAFLD.RESULTS A total of 83.13%of participants with MAFLD had normal ALT levels.The incidence rate of MAFLD showed a linear increasing trend in the cumulative ehALT group.Compared with those in the low-normal ALT group,the multivariate adjusted hazard ratios of the equally and unequally weighted cumulative effects of ehALT were 1.651[95%confidence interval(CI):1.199-2.273]and 1.535(95%CI:1.119-2.106)in the third quartile and 1.616(95%CI:1.162-2.246)and 1.580(95%CI:1.155-2.162)in the fourth quartile,respectively.CONCLUSION Most participants with MAFLD had normal ALT levels.Long-term high-normal ALT levels were associated with a cumulative increased risk of new-onset MAFLD.
基金supported by the National Natural Science Foundation of China(Grant No.12372356)Postgraduate Scientific Research In-novation Project of Hunan Province(Grant No.CX20221044).
文摘Repeated blast impacts on personnel in explosive environments can exacerbate craniocerebral trauma.Most existing studies focus on the injury effects of a single blast,lacking in-depth analysis on the injury effects and cumulative effects of repeated blasts.Therefore,rats were used as the experimental samples to suffer from explosion blasts with different peak air overpressures(167 kPa~482 kPa)and varying number of repeated blasts.The cumulative effect of craniocerebral trauma was most pronounced for moderate repeated blast,showing approximately 95%increase of trauma severity with penta blast,and an approximately 85%increase of trauma severity with penta minor blast.The cumulative effect of craniocerebral trauma from severe,repeated blast has a smaller rate of change compared to the other two conditions.The severity of trauma from penta blast increased by approximately 69%compared to a single blast.Comprehensive physiological,pathological and biochemical analysis show that the degree of neurological trauma caused by repeated blasts is higher than that of single blasts,and the pathological trauma to brain tissue is more extensive and severe.The trauma degree remains unchanged after double blast,increases by one grade after triple or quadruple blast,and increases by two grades after penta blast.
文摘This paper provides a method of the process of computation called the cumulative method, it is based upon repeated cumulative process. The cumulative method is being adapted to the purposes of computation, particularly multiplication and division. The operations of multiplication and division are represented by algebraic formulas. An advantage of the method is that the cumulative process can be performed on decimal numbers. The present paper aims to establish a basic and useful formula valid for the two fundamental arithmetic operations of multiplication and division. The new cumulative method proved to be more flexible and made it possible to extend the multiplication and division based on repeated addition/subtraction to decimal numbers.
文摘Cumulative assessment is a tool for the project developer to try and take into consideration not only their contribution to cumulative impacts but also other projects and external factors that may place their developments at risk.This study assessed the cumulative impacts of air emissions from 22 major power plants in southeast Bangladesh planned to generate 21,550 MW of electricity.It also includes anticipated growth in small to medium size industries,brickfields,highway traffic,inland water transport,transhippers,jetty,and vessel transports used for transporting fuel resources for these power plants.A 50 km by 50 km airshed is considered for air quality modeling.Cumulative analysis indicates that predicted MGLCs(Maximum Ground Level Concentrations)of NO2 and CO are complying with both Bangladesh NAAQS(National Ambient Air Quality Standards)and WBG(World Bank Group)Guidelines.The daily average MGLC of PM_(2.5)(62.45µg/m^(3))from all sources complies with NAAQS,however,exceeds the WBG Guidelines.Annual PM_(2.5) concentration(15.45µg/m^(3))exceeds NAAQS and WBG Guidelines.The PM10 concentration complies with the NAAQS for both 24-hour and annual averaging times.Annual average concentration(23.12µg/m^(3))exceeds WBG Guidelines.Daily average SO2 concentration(102.49µg/m^(3))complies with the NAAQS however,it exceeds the WBG guideline values.High concentrations of PM_(2.5) and SO2 are due to the contribution of transboundary emissions and secondary pollutants in the atmosphere.This dispersion modeling outcome can be used by the policymakers for the pollution reduction strategy.
基金supported by the National Nature Science Foundation of China (22105118)the Nature Science Foundation of Shandong Provinces (ZR2021QB095)the China Postdoctoral Science Foundation (2020TQ0183 and 2021M701979)。
文摘Aqueous zinc metal batteries feature intrinsic safety,but suffer from severe dendrite growth and water-derived side reactions.Many metal coatings have been explored for stabilizing Zn metal anode via a trialand-error approach.Here,we propose an exercisable way to screen the potential metal coating on Zn anodes in view of de-polarization effect and dendrite-suppressing ability theoretically.As an output of this screening,cadmium(Cd) metal is checked experimentally.Therefore,symmetric ZnllZn cells using Cd coated Zn(Zn@Cd) exhibit an ultra-long cycle life of 3500 h(nearly 5 months) at a high current density of 10 mA cm^(-2),achieving a record-high cumulative capacity(35 A h cm^(-2)) compared to the previous reports.The full cells of Zn@Cd‖MnO_(2) display a markedly improved cycling performance under harsh conditions including a limited Zn supply(N/P ratio=1.7) and a high areal capacity(3.5 mA h cm^(-2)).The significance of this work lies in not only the first report of Cd coating for stabilizing Zn metal anode,but also a feasible way to screen the promising metal materials for other metal anodes.
文摘Background:Carbapenems are effective against severe Pseudomonas aeruginosa nosocomial infections.Therefore,carbapenem-resistant Pseudomonas aeruginosa is a serious public health threat.An understanding of the risk of inappropriate exposure to different antimicrobials in resistant Pseudomonas aeruginosa infection could help in elucidating the effective approach towards using antimicrobials in vulnerable patients with CRPA infection.Object:To investigate the association between exposure ofβ-lactam antimicrobials and CRPA infection relative to control patients.Methods:The MEDLINE/PubMed and OVID/Embase databases were used to search case-control and cohort studies in English language which reported antimicrobial exposure as risk factors for CRPA infection.The pooled odds ratios(OR)were calculated using a random-effect and fixed-effect model,and forest plots from a cumulative meta-analysis method were used to better show how pooled OR changed as updated evidence accumulated.Results:A total of 24 studies comprising 7039 participants were included for cumulative meta-analysis.A positive correlation was found between development of CRPA infection and exposure of beta-lactam antimicrobials:carbapenems(OR=7.60,95%CI:3.95 to 14.62,P<0.0001),imipenem(OR=9.81,95%CI:5.56 to 17.33),ampicillin(OR=1.86,95%CI:1.14 to 2.41),piperacillin(OR=2.82,95%CI:1.46 to 2.43),penicillins(OR=1.42,95%CI:0.90 to 2.24),cephalosporins(OR=1.88,95%CI:1.46 to 2.43)andβlactamase inhibitors(OR=1.96,95%CI:1.44 to 2.67).Further,exposure of other antimicrobial agents like quinolone(OR=2.35,95%CI:1.78 to 3.10),ciprofloxacin(OR=2.35,95%CI:1.66 to 3.95),aminoglycoside(OR=2.17,95%CI:1.60 to 2.95),amikacin(OR=3.11,95%CI:2.10 to 4.61),glycopeptides(OR=3.02,95%CI:1.92 to 4.75)and vancomycin(OR=3.26,95%CI:1.48 to 7.18),were also found to be positively associated with development of CRPA infection.Conclusions:Exposure of all kinds ofβ-lactams is significantly associated with development of carbapenemresistant Pseudomonas aeruginosa infection.These findings provide an impetus to take a more active approach while usingβ-lactam antimicrobials in patients with resistant Pseudomonas aeruginosa infections.
基金National Key R&D Program of China,Grant/Award Number:2018YFC1504901Science and technology program of Gansu Province,Grant/Award Numbers:21JR7RA738,21JR7RA739+1 种基金Science and Technology Development Project of China Railway Research Institute Co.Ltd,Grant/Award Number:2017‐KJ008‐Z008‐XBNatural Science Foundation of Gansu Province,Grant/Award Number:145RJZA068。
文摘To explore the cumulative deformation effect of the dynamic response of a tunnel crossing the hauling sliding surface under earthquakes,the shaking table test was conducted in this study.Combined with the numerical calculations,this study proposed magnification of the Arias intensity(MIa)to characterize the overall local deformation damage of the tunnel lining in terms of the deformation characteristics,frequency domain,and energy.Using the time‐domain analysis method,the plastic effect coefficient(PEC)was proposed to characterize the degree of plastic deformation,and the applicability of the seismic cumulative failure effect(SCFE)was discussed.The results show that the low‐frequency component(f1 and f2≤10 Hz)and the high‐frequency component(f3 and f4>10 Hz)acceleration mainly cause global and local deformation of the tunnel lining.The local deformation caused by the high‐frequency wave has an important effect on the seismic damage of the lining.The physical meaning of PEC is more clearly defined than that of the residual strain,and the SCFE of the tunnel lining can also be defined.The SCFE of the tunnel lining includes the elastic deformation effect stage(<0.15g),the elastic–plastic deformation effect stage(0.15g–0.30g),and the plastic deformation effect stage(0.30g–0.40g).This study can provide valuable theoretical and technical support for the construction of traffic tunnels in high‐intensity earthquake areas.
文摘A cross-sectional exploratory assessment of the needs and challenges of petroleum industry in Nigeria, in assessing process safety cumulative risk for major accidents prevention was investigated. A purposive cum random sampling technique was used in this study, among selected petroleum companies operating in Nigeria. Survey questionnaires were received from 216 participants made up of asset integrity engineers/operators, process safety experts, production safety professionals in the petroleum industry in Nigeria. Data analyses were carried out to cover descriptive and inferential statistics. Overall, the study recognized that assessing process safety cumulative risk is not a simple process due largely to the changing nature of safety critical barriers degradation data. The study result showed four main challenges faced by petroleum industries in Nigeria, in assessing process safety cumulative risk: 1) the study showed that 94% of the respondents agreed that there is limited accessibility to safety critical barriers degradation data (little automation). Also 2) 94% of the respondents accounted for poor knowledge of process safety cumulative risk is and agreed it to be of low rating. The result further showed that 3) 90% of the respondents demonstrated that there are no guidance and procedures in assessing process safety cumulative risk and finally 4) 92% of the respondents reported that there is no real-time risk visualization model/ tool. Addressing these issues and challenges by the petroleum industries in the study area, will lead to successful assessment of process safety cumulative risk, thereby reducing the risk of major accidents.
文摘Based on the analysis of the evaluation problems associated with the risk control scheme for major engineering projects,the evaluation method of the risk control scheme considering the irrational behavior of evaluation members in fuzzy random environment is proposed.Firstly,a maximum entropy model corresponding to any evaluation member is es-tablished by using triangular fuzzy random variables and grey correlation coefficient in order to obtain the weight of each risk factor of the member.Secondly,a nonlinear programming model is established according to the principle of minimiz-ing deviation to estimate the weight of different evaluation members on the evaluation of alternative risk control schemes.Lastly,the cumulative entropy model is used to calculate the weight of risk control schemes.Cumulative prospect theory obtains the comprehensive prospect utility value of each alternative to determine the optimal alternative.
基金financially supported by the National 973 Program of China (2015CB452701)the National Natural Science Foundation of China (Grant No. 51579161)
文摘The cumulative effect of cascade hydropower stations on river ecological environment has been widely concerned because of the significant streamflow hydrology change induced by dam constructions. The characteristics of the change in the lower reaches of the Jinsha River, China are analyzed based on long-term(1952–2015) hydrological and sedimentological data. The averaging coefficient, reservoir regulation coefficient(RRC), incoming sediment coefficient(ISC), and sediment transport modulus(STM), which reflect the variation of streamflow and sediment regimes, are defined and calculated. The results show that the construction and regulation of reservoirs reduces flow in flood season, increases flow in dry season, significantly altering the monthly discharge regimes. These alterations also led directly to changes in the timing of extreme flows at Pingshan Station. The monthly flow records at the basin outlet are reconstructed using stepwise regression, to reduce reservoir impacts. Comparisons of observed and reconstructed monthly flows demonstrate that the previous studies overestimated the cumulative effects of cascade reservoirs on flow processes. Furthermore, this study clearly illustrates that the reduction in sediment trapping and sediment transportation capacity together lead to the sharp reduction in annual sediment yield at the Pingshan Station. The earlier constructed reservoirs have more obvious effects on the ISC and STM than the more recent reservoirs and the effect of sediment trapping is related to reservoir location, on the main stream versus tributaries.
基金supported by the National Natural Science Foundation of China,No.30472241,90709031 and 30973796the National Basic Research Program of China for Traditional Chinese Medicine Theory("973" Program),No.2007CB512505+1 种基金the Natural Foundation of Hainan Province(No.310054)a grant from the Health Department of Hainan Province(QiongWei 2010-45)
文摘In the present study, a rat model of chronic neuropathic pain was established by ligation of the sciatic nerve and a model of learning and memory impairment was established by ovariectomy to investigate the analgesic effect of repeated electroacupuncture stimulation at bilateral Zusanfi (ST36) and Yanglingquan (GB34). In addition, associated synaptic changes in neurons in the paraventricular nucleus of the hypothalamus were examined. Results indicate that the thermal pain threshold (paw withdrawal latency) was significantly increased in rats subjected to 2-week electroacupuncture intervention compared with 2-day electroacupuncture, but the analgesic effect was weakened remarkably in ovariectomized rats with chronic constrictive injury. 2-week electroacupuncture intervention substantially reversed the chronic constrictive injury-induced increase in the synaptic cleft width and thinning of the postsynaptic density. These findings indicate that repeated electroacupuncture at bilateral Zusanfi and Yanglingquan has a cumulative analgesic effect and can effectively relieve chronic neuropathic pain by remodeling the synaptic structure of the hypothalamic paraventricular nucleus.
基金the financial support from the National Natural Science Foundation of China(Grants Nos. 41975068, 41790473, and 41975099)the Chinese Academy of Sciences Strategic Priority Research Program (Grant No. XDA19070403).
文摘Starting in mid-November,China was hit by several cold events during the early winter of 2020/21.The lowest temperature observed at Beijing station on 7 January reached−19.6°C.In this paper,we show that the outbreak of the record-breaking extreme cold event can be attributed to a huge merging Ural blocking(UB)ridge over the Eurasian region.The sea-ice cover in the Kara and East Siberia Seas(KESS)in autumn was at its lowest value since 1979,which could have served as a precursor signal.Further analysis shows that several successive UB episodes occurred from 1 September 2020 to 10 January 2021.The persistent UB that occurred in late September/early October 2020 may have made an important contribution to the October historical minimum of sea ice in the KESS region.Our results also show that,after each UB episode in winter,significant upward propagation of wave activity occurred around 60°E,which resulted in weakening the stratospheric vortex.Meanwhile,each UB episode also caused a significant reduction in sea-ice extent in KESS and a significant weakening of the westerly jet in mid-high-latitude Eurasia.Results suggest that the Arctic vortex,which is supposed to enhance seasonally,became weaker and more unstable than the climatic mean under the seasonal cumulative effects of UB episodes,KESS warming,and long-lasting negative-phase North Atlantic Oscillation(NAO-).Those seasonal cumulative effects,combined with the impact of La Niña winter,led to the frequent occurrence of extreme cold events.
基金National Natural Science Foundation of China,No.81174263Sanming Project of Medicine in Shenzhen,Guangdong Province,China,No.SZSM201612074Shenzhen Science and Technology Project,Guangdong Province,China,No.201202154.
文摘BACKGROUND China has a high prevalence of hepatitis B virus(HBV),but most chronic hepatitis B(CHB)patients do not receive standardized antiviral therapy.There are few relevant reports addressing the outcomes of the large number of CHB patients who do not receive antiviral therapy.AIM To observe the outcomes of long-term follow-up of patients with CHB without antiviral treatment.METHODS This study included 362 patients with CHB and 96 with hepatitis B cirrhosis without antiviral treatment and with only liver protection and anti-inflammatory treatment from 1993 to 1998.The median follow-up times were 10 and 7 years,respectively.A total of 203 CHB and 129 hepatitis B cirrhosis patients receiving antiviral therapy were selected as the control groups.The median follow-up times were 8 and 7 years,respectively.Kaplan-Meier curves were used to analyze the cumulative incidence of hepatocellular carcinoma(HCC),and the Cox regression model was used to analyze the risk factors for HCC.RESULTS Among the patients in the non-antiviral group,16.9%had spontaneous decreases(HBeAg)seroconversion.In the antiviral group,87.2%of patients had undetectable HBV DNA,and 52%showed HBeAg seroconversion.Among CHB and hepatitis B cirrhosis patients,the cumulative incidence rates of HCC were 14.9%and 53.1%,respectively,in the non-antiviral group and were 10.7%and 31.9%,respectively,in the antiviral group.There was no difference between the two groups regarding the CHB patients(P=0.842),but there was a difference between the groups regarding the hepatitis B cirrhosis patients(P=0.026).The cumulative incidence rates of HCC were 1.6%and 22.3%(P=0.022)in the groups with and without spontaneous HBeAg seroconversion,respectively.The incidence rates of HCC among patients with and without spontaneous declines in HBV DNA to undetectable levels were 1.6%and 19.1%,respectively(P=0.051).There was no difference in the cumulative incidence of HCC between the two groups regarding the patients with drug-resistant CHB(P=0.119),but there was a significant difference between the two groups regarding the patients with cirrhosis(P=0.004).The Cox regression model was used for regression of the corrected REACH-B score,which showed that alanine aminotransferase>400 U/L,history of diabetes,and family history of liver cancer were risk factors for HCC among men aged>40 years(P<0.05).Multifactorial analysis showed that a family history of HCC among men was a risk factor for HCC.CONCLUSION Antiviral therapy and non-antiviral therapy with liver protection and antiinflammatory therapy can reduce the risk of HCC.Antiviral therapy may mask the spontaneous serological response of some patients during CHB.Therefore,the effect of early antiviral therapy on reducing the incidence of HCC cannot be overestimated.
基金The project was supported by the National Science Foundation of China(41430640,U1704242).
文摘Coalbed gas extraction is an important means of exploiting and utilizing gas resources,as well as a means of preventing coal mine disasters.In view of the low gas extraction rate from coalbeds with high gas content and low permeability,a method of improving permeability through deep-hole cumulative blasting is applied to develop initial directional fractures using a jet flow.Under the action of the blasting stress wave and detonation gas wedge,the fractures extend over a large range within the coal,thereby improving coalbed permeability.This study focuses on the criteria of cumulative blasting-induced coalbed fracturing based on a literature review of the penetration effect of cumulative blasting.On this basis,we summarize the coal fracturing zone,crack extension process,and the key technologies of charging and hole sealing for cumulative blasting.In addition,the latest research progress in the optimization of field test drilling and blasting parameters for cumulative blasting is introduced.Research findings indicate that the permeability improvement mechanism of cumulative blasting could be further enhanced,and the technology and technical equipment are in urgent need of improvement.Finally,development trends in the cumulative blasting permeability improvement technique are identified.
基金supported by the National Natural Science Foundation of China,No.30472241,90709031 and 30973796the Ministry of Science and Technology of China("973"Project),No.2007CB512505+1 种基金provided by the Foundation of Hainan Province,No.310054the Health Department of Hainan Province,Qiong-Wei-45
文摘In the present study, we examined the analgesic effect of repeated electroacupuncture at bilateral Zusanfi (ST36) and Yanglingquan (GB34) once a day for 14 consecutive days in a rat model of chronic sciatic nerve constriction injury-induced neuropathic pain. In addition, concomitant changes in calcium/calmodulin-dependent protein kinase II expression and synaptic ultrastructure of neurons in the hippocampal CA3 region were examined. The thermal pain threshold (paw withdrawal latency) was increased significantly in both groups at 2 weeks after electroacupuncture intervention compared with 2 days of electroacupuncture. In ovariectomized rats with chronic constriction injury, the analgesic effect was significantly reduced. Electroacupuncture for 2 weeks significantly diminished the injury-induced increase in synaptJc cleft width and thinning of the postsynaptJc density, and it significantly suppressed the down-regulation of intracellular calcium/ calmodulin-dependent protein kinase II expression in the hippocampal CA3 region. Repeated electroacupuncture intervention had a cumulative analgesic effect on injury-induced neuropathic pain reactions, and it led to synaptic remodeling of hippocampal neurons and upregulated calcium/calmodulin-dependent protein kJnase II expression in the hippocampal CA3 region.
基金This paper was financially supported by NSC96-2628-E-366-004-MY2 and NSC96-2628-E-132-001-MY2
文摘Internal solitary wave propagation over a submarine ridge results in energy dissipation, in which the hydrodynamic interaction between a wave and ridge affects marine environment. This study analyzes the effects of ridge height and potential energy during wave-ridge interaction with a binary and cumulative logistic regression model. In testing the Global Null Hypothesis, all values are p 〈0.001, with three statistical methods, such as Likelihood Ratio, Score, and Wald. While comparing with two kinds of models, tests values obtained by cumulative logistic regression models are better than those by binary logistic regression models. Although this study employed cumulative logistic regression model, three probability functions p^1, p^2 and p^3, are utilized for investigating the weighted influence of factors on wave reflection. Deviance and Pearson tests are applied to cheek the goodness-of-fit of the proposed model. The analytical results demonstrated that both ridge height (X1 ) and potential energy (X2 ) significantly impact (p 〈 0. 0001 ) the amplitude-based refleeted rate; the P-values for the deviance and Pearson are all 〉 0.05 (0.2839, 0.3438, respectively). That is, the goodness-of-fit between ridge height ( X1 ) and potential energy (X2) can further predict parameters under the scenario of the best parsimonious model. Investigation of 6 predictive powers ( R2, Max-rescaled R^2, Sorners' D, Gamma, Tau-a, and c, respectively) indicate that these predictive estimates of the proposed model have better predictive ability than ridge height alone, and are very similar to the interaction of ridge height and potential energy. It can be concluded that the goodness-of-fit and prediction ability of the cumulative logistic regression model are better than that of the binary logistic regression model.
基金supported by the National Natural Science Foundation of China(No.10377007)
文摘Fatigue damage increases with the applied loading cycles in a cumulative manner and the material deteriorates with the corrosion time. A cumulative fatigue damage rule under the alternative of corrosion or cyclic loading was proposed. The specimens of aluminum alloy LY12-CZ soaked in corrosive liquid for different times were tested under the constant amplitude cyclic loading to obtain S-N curves. The test was carried out to verify the proposed cumulative fatigue damage rule under the different combinations among corrosion time, loading level, and the cycle numbers. It was shown that the predicted residual fatigue lives showed a good agreement with the experimental results and the proposed rule was simple and can be easily adopted.
基金Project supported by the Shanghai Leading Academic Discipline Project, China (Grant No B503)
文摘The physical process of cumulative second-harmonic generation of Lamb waves propagating in a two-layered solid plate is presented by using the second-order perturbation and the technique of nonlinear reflection of acoustic waves at an interface. In general, the cumulative second-harmonic generation of a dispersive guided wave propagation does not occur. However, the present paper shows that the second-harmonic of Lamb wave propagation arising from the nonlinear interaction of the partial bulk acoustic waves and the restriction of the three boundaries of the solid plates does have a cumulative growth effect if some conditions are satisfied. Through boundary condition and initial condition of excitation, the analytical expression of cumulative second-harmonic of Lamb waves propagation is determined. Numerical results show the cumulative effect of Lamb waves on second-harmonic field patterns.
基金This research was supported by the Education Humanities and Social Sciences Project of Guizhou Province (2015SSD19)
文摘Objectives: Delirium is a common acute cognitive impairment syndrome among intensive care unit (ICU) patients.This study was aimed to investigate the incidence,risk factors,and cumulative risk of delirium among ICU patients.Methods: A case-control study including clinical records of 452 patients were retrospectively analyzed.Delirium was assessed using the Confusion Assessment Method for the ICU and Richmond Agitation -Sedation Scale.Results: We found that 163 out of the 452 patients (36.1%) had delirium.Multivariate analysis showed that use of sedatives,length of ICU hospitalization,and physical restraint were independent risk factors for delirium.The additive effect of all three factors resulted to an odds ratio of 30.950.Conclusion: The incidence of delirium remained high.Thus,nurses shall strengthen the monitoring of delirium,regularly access the patient's level of calmness,and limit the use of physical restraint.
基金supported by the National Natural Science Foundation of China (10832006 60874011)
文摘The indirect method for the continuous low-thrust near minimum cumulative longitude orbit transfer problem is addressed.The movement of the satellite is described by the Gauss equation using the modified equinoctial elements and replacing time as the system independent variable by the cumulative longitude.The maximum principle is adapted to design the optimal control in order to minimize the final cumulative longitude, and the twopoint-boundary-value problem is derived from the orbit transfer problem.The single shooting method is applied in a numerical experiment, and the simulations demonstrate that the orbit transfer mission is fulfilled and the product of the maximal thrust and the minimum cumulative longitude is near constant.