Excess non-COVID-19-related mortality among inflammatory bowel disease decedents during the COVID-19 pandemic

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic disrupted healthcare in the United States.AIM To investigate COVID-19-related and non-COVID-19-related death and characteristics associated with excess death among inflammatory bowel disease(IBD)decedents.METHODS We performed a register-based study using data from the National Vital Statistics System,which reports death data from over 99%of the United States population,from January 1,2006 through December 31,2021.IBD-related deaths among adults 25 years and older were stratified by age,sex,race/ethnicity,place of death,and primary cause of death.Predicted and actual age-standardized mortality rates(ASMRs)per 100000 persons were compared.RESULTS 49782 IBD-related deaths occurred during the study period.Non-COVID-19-related deaths increased by 13.14%in 2020 and 18.12%in 2021[2020 ASMR:1.55 actual vs 1.37 predicted,95%confidence interval(CI):1.26-1.49;2021 ASMR:1.63 actual vs 1.38 predicted,95%CI:1.26-1.49].In 2020,non-COVID-19-related mortality increased by 17.65%in ulcerative colitis(UC)patients between the ages of 25 and 65 and 36.36%in non-Hispanic black(NHB)Crohn’s disease(CD)patients.During the pandemic,deaths at home or on arrival and at medical facilities as well as deaths due to neoplasms also increased.CONCLUSION IBD patients suffered excess non-COVID-19-related death during the pandemic.Excess death was associated with younger age among UC patients,and with NHB race among CD patients.Increased death at home or on arrival and due to neoplasms suggests that delayed presentation and difficulty accessing healthcare may have led to increased IBD mortality.

Excess pore pressure behavior and evolution in deep coalbed methane reservoirs

Deep coalbed methane(DCBM),an unconventional gas reservoir,has undergone significant advancements in recent years,sparking a growing interest in assessing pore pressure dynamics within these reservoirs.While some production data analysis techniques have been adapted from conventional oil and gas wells,there remains a gap in the understanding of pore pressure generation and evolution,particularly in wells subjected to large-scale hydraulic fracturing.To address this gap,a novel technique called excess pore pressure analysis(EPPA)has been introduced to the coal seam gas industry for the first time to our knowledge,which employs dual-phase flow principles based on consolidation theory.This technique focuses on the generation and dissipation for excess pore-water pressure(EPWP)and excess pore-gas pressure(EPGP)in stimulated deep coal reservoirs.Equations have been developed respectively and numerical solutions have been provided using the finite element method(FEM).Application of this model to a representative field example reveals that excess pore pressure arises from rapid loading,with overburden weight transferred under undrained condition due to intense hydraulic fracturing,which significantly redistributes the weight-bearing role from the solid coal structure to the injected fluid and liberated gas within artificial pores over a brief timespan.Furthermore,field application indicates that the dissipation of EPWP and EPGP can be actually considered as the process of well production,where methane and water are extracted from deep coalbed methane wells,leading to consolidation for the artificial reservoirs.Moreover,history matching results demonstrate that the excess-pressure model established in this study provides a better explanation for the declining trends observed in both gas and water production curves,compared to conventional practices in coalbed methane reservoir engineering and petroleum engineering.This research not only enhances the understanding of DCBM reservoir behavior but also offers insights applicable to production analysis in other unconventional resources reliant on hydraulic fracturing.

Density of excess modes below the first phonon mode in four-dimensional glasses

Glasses are known to possess low-frequency excess modes beyond the Debye prediction.For decades,it has been assumed that evolution of low-frequency density of excess modes D(ω) with frequency ω follows a power-law scaling:D(ω)~ω~γ.However,it remains debated on the value of γ at low frequencies below the first phonon-like mode in finitesize glasses.Early simulation studies reported γ=4 at low frequencies in two-(2D),three-(3D),and four-dimensional(4D)glasses,whereas recent observations in 2D and 3D glasses suggested γ=3.5 in a lower-frequency regime.It is uncertain whether the low-frequency scaling of D(ω)~ω^(3.5) could be generalized to 4D glasses.Here,we conduct numerical simulation studies of excess modes at frequencies below the first phonon-like mode in 4D model glasses.It is found that the system size dependence of D(ω) below the first phonon-like mode varies with spatial dimensions:D(ω) increases in2D glasses but decreases in 3D and 4D glasses as the system size increases.Furthermore,we demonstrate that the ω^(3.5)scaling,rather than the ω~4 scaling,works in the lowest-frequency regime accessed in 4D glasses,regardless of interaction potentials and system sizes examined.Therefore,our findings in 4D glasses,combined with previous results in 2D and 3D glasses,suggest a common low-frequency scaling of D(ω)~ ω^3.5) below the first phonon-like mode across different spatial dimensions,which would inspire further theoretical studies.

Point-of-care ultrasonography spotlight:Could venous excess ultrasound serve as a shared language for internists and intensivists?

Point-of-care ultrasonography(POCUS),particularly venous excess ultrasound(VExUS)is emerging as a valuable bedside tool to gain real-time hemodynamic insights.This modality,derived from hepatic vein,portal vein,and intrarenal vessel Doppler patterns,offers a scoring system for dynamic venous congestion assessment.Such an assessment can be crucial in effective management of patients with heart failure exacerbation.It facilitates diagnosis,quantification of congestion,prognostication,and monitoring the efficacy of decongestive therapy.As such,it can effectively help to manage cardiorenal syndromes in various clinical settings.Extended or eVExUS explores additional veins,potentially broadening its applications.While VExUS demonstrates promising outcomes,challenges persist,particularly in cases involving renal and liver parenchymal disease,arrhythmias,and situations of pressure and volume overload overlap.Proficiency in utilizing spectral Doppler is pivotal for clinicians to effectively employ this tool.Hence,the integration of POCUS,especially advanced applications like VExUS,into routine clinical practice necessitates enhanced training across medical specialties.

A Discussion on the Issue of Excessive Academic Burden among Middle School Students

At present,the heavy academic workload of middle school students is a common problem,which is still questioned by parents,concerned by the government,and hotly debated by society.This paper summarizes the following eight aspects:the difficult content of subject courses,excessive class hours,heavy homework burden,complicated exams,overwhelming study materials,fierce subject competition,prevalent off-campus tutoring,and poor physical and mental health.Recognizing these problems can help to optimize the education and teaching environment and achieve a sustainable enrollment rate.

资本主义生产相对过剩的形式流变与当代启示

在马克思对资本主义生产相对过剩的解释框架下,资本主义在不断发展的过程中对生产相对过剩的解决措施并未触及问题的根本,进而使得资本主义生产相对过剩产生了三重表现形式。首先是在资本主义生产无限扩张的趋势下,由生产比例失衡和社会购买力不足共同造成了工业产品过剩;其次是资本主义通过“时间修复”,在全社会大量构建“债权-债务”关系,由此在个人生产和消费、政府举债投资以及消费资料资本化的过程中造成了债务过剩;最后是当代资本主义脱离生产过程,通过泛滥的金融创新,暂时避免了积累和消费的矛盾所导致的价值实现的风险,使资本直接实现增殖,进而造成了资本的流动性过剩,而以美元霸权为基础的国际经济体系加剧了这种流动性过剩。资本主义生产相对过剩的形式流变为我国预防和解决相关问题提供了经验借鉴和启示,而资本主义本身的腐朽性则预示着其自身的黯淡前景。

一种通用的燃烧过量空气系数和实际干烟气量计算新方法

针对燃料燃烧计算现行方法的不足,从燃烧计算的机理模型出发,推导得到一种通用的燃料燃烧过量空气系数和实际干烟气量计算新方法,并提出了燃料成分因数和实际干烟气系数的概念。在新方法中,过量空气系数通过烟气成分和燃料成分因数求得,实际干烟气量通过实际干烟气系数和理论干烟气量求得。通过试验数据对新方法与现行方法进行了对比分析。结果表明,过量空气系数计算方法中,现行传统方法较为便捷但仅适用于燃料成分因数近似为零的燃料,现行改进方法精度高但需要进行迭代计算,而新方法是简便的通用计算模型,可适用于任何燃料,且计算结果与现行改进方法一致;实际干烟气量计算方法中,现行方法需要先求解过量空气系数,而新方法中实际干烟气量为独立求解,且计算结果与现行改进方法一致;实际干烟气系数的提出,使得燃料燃烧计算时,实际干空气量和实际干烟气量的求解模式类似,均可通过相应的理论量值和比例系数求积得到。

双重股权结构有利于激励企业家创新吗——激励适度性视角的再讨论

双重股权结构作为“同股同利,同股不同票”的所有权权益结构不对等的主动安排,是激励了超额控制权人的能力发挥还是加剧了委托代理倾向存在争议。文章基于第二类委托代理问题的基础视角,以企业创新为着眼点,从双重股权结构剩余索取权与控制权的不对等偏离对超额控制权人产生的激励效应及其适度性问题进行了探讨。结果发现:尽管整体上看,双重股权结构有利于促进企业创新,但存在激励适度性问题而导致的企业家超额控制权对企业创新的倒U型影响,即适度的超额控制权给企业家提供了适度的激励而有利于促进企业创新,过度的超额控制权则加剧了企业家的委托代理倾向而抑制企业创新。因而企业家的人力资本投入和企业经营表现与企业家超额控制权呈现出倒U型关系,从而对企业创新产生倒U型影响。并且这一倒U型影响在非高科技行业企业、低成长企业、低盈利企业中更加突出。

饱和土不排水计算理论与方法探究

饱和土不排水强度及变形计算是岩土工程中颇具难度的复杂课题,至今业内对其多方面的问题仍存争议。结合笔者多年的相关学习研究,对此课题进行了较系统深入的探究。首先讨论了饱和土不排水计算的总应力法与有效应力法及各自的局限,并从有限元基本方程阐述了孔隙水压的处理,指出不管采用何种方法均应注意区分两类孔隙水压和两种总应力,即“土水分算”。随后,审视了Skempton-Henkel超静水压计算公式对不同应力路径的计算准确性,将它与MC强度准则相结合构建了饱和土不排水强度模型,对等向固结与不等向固结下饱和土不排水强度特性进行了分析,可为实际工程计算中强度参数选取提供参考。建议实际不排水计算采用广义Tresca强度准则,针对采用MC强度准则按有效应力法进行不排水计算会有较大误差的问题,除指出应直接输入不排水强度外,还给出一种采用等代强度参数的处理方法。在上述讨论基础上,剖析了固结不排水强度指标(CU指标)的缺陷,指出仅当土中总应力路径与测定CU指标的试验中相同时,用此指标直接计算才能给出准确的结果,特别是对地基承载力问题直接用此指标计算会给出严重偏危险的结果。还对基坑工程中主动、被动土水压力采用CU指标并土水合算的问题进行了分析,建议了合理计算方法及相应公式;对发生不排水极限土压时的滑移面倾角这一业内多人深感困惑的问题也进行了探讨。最后,针对饱和地基承载力及短期沉降计算,剖析了业内现行方法的问题,在深入解读有关因素影响机理的基础上给出新的计算方法。所给承载力计算公式,可较准确统一计算排水和不排水条件下的承载力,能更好保证设计的安全经济;所给沉降计算新方法能较准确计算饱和地基的短期沉降,对地基的排水沉降也可望取得较好结果,值得进一步发展完善。

小Excess与开流形的拓扑(英文)

本文中 ,我们应用比较几何的方法研究开流形的Excess与其拓扑之间的关系 .我们证明了对于一个曲率下有界的开流形 ,当它的Excess被其临界半径的某个函数所界定时 ,它就有有限拓扑型或微分同胚于n维z欧氏空间 .

缺血性脑卒中痰热腑实证大鼠模型的建立与评价

背景:中医药在治疗缺血性脑卒中痰热腑实证中具有丰富的经验和独特的优势,为深入挖掘中医药对该病的治疗靶点和治疗机制,建立稳定、可靠的缺血性脑卒中痰热腑实证病证结合动物模型是关键。目的:探讨缺血性脑卒中痰热腑实证大鼠模型的建立方法及评价体系。方法:采用随机数字表法将60只SD大鼠随机分为4组:空白对照组(n=12)、缺血性脑卒中组(n=18)给予普通饲料喂养25 d,病证结合组(n=18)、痰热腑实证组(n=12)给予高脂饲料喂养25 d;第26天,空白对照组、缺血性脑卒中组灌胃给予生理盐水,病证结合组、痰热腑实证组灌胃给予自体粪便混悬液,连续灌胃3 d(灌胃期间继续给予高脂饲料);灌胃结束后,缺血性脑卒中组、病证结合组采用线栓法建立缺血性脑卒中模型,记录各组大鼠饮食量、饮水量、体质量、体温、粪便性状、鼻分泌物、喉中痰鸣、舌象等表征变化。造模结束后24 h,进行神经功能缺损评分、舌象表征、血脂水平检测、脑组织及颈动脉形态学观察以及血清胃动素和生长抑素水平检测。结果与结论:(1)与空白对照组比较,病证结合组大鼠呼吸急促、精神萎靡、烦躁、行动迟缓,鼻周可见大量分泌物、可闻及厚重的喉中痰鸣,饮食量、饮水量下降,体质量、体温及舌下脉络评分升高,粪便粒数、Bristol评分及粪便含水率降低;血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇及生长抑素水平升高,胃动素水平降低,神经功能缺损评分升高,颈动脉发生显著病理改变,脑组织显示明显缺血形态学改变。缺血性脑卒中组仅能造成缺血性脑组织病理改变,不能复制出痰热腑实证的证候特征。痰热腑实证组能复制出典型的中医证候特征,但不能构建出缺血性脑卒中的脑组织病理改变。(2)结果表明,高脂诱导结合线栓法及自体粪便灌胃的多因素复合造模方法,可建立缺血性脑卒中痰热腑实证病证结合动物模型。

Excess函数的应用(英文)

在本文中,我们研究了曲率有下界的开流形的拓扑,并推广了文[7]中的结果,证明了截曲率有下界的开流形如果它的excess函数被它的临界半径的某个函数所界定时,它就具有有限拓扑型或者微分同胚于Rn.

Impacts of Excessive Soaking on N, P, and K in Substrates Plots and Seedling Growth

[Objective] The aim was to study on impacts of excessive soaking N, P, and K insubstrate plots of and seedling growth. [Method] Substrate was designed to add additional 1/2 water after saturation and expansion. Disposable excessive soak- ing and regression relation of nutrition infusion of substrate plots were studied by design of 13 time gradient. Plant nutrition absorption and growth effects after sub- strate plots immersed by water were investigated by growing tomato. [Result] Con- centration and time of the three nutrition immersed in water had the regression equation of each, as follows： N=-2E-05t2＋0.016 lt＋2.0553, P=0.002 2t＋2.248 5 and K=0.004 7t＋0.875 8. With nutrition loss of the three, however, loss amount was al- most same with variance analysis of regression equation, which may result from its volatilization. Regression equations of P and K were： P=0.125 7t-0.117, and K=0.022 5t.1514, which led to adverse impact on plant absorption of N and K above ground, whose equations were N=20.64e-4E-0.4t, and K=E-06t2-0.011 3t＋29.055. Meanwhile, un- der the condition, sound seedling index was not impacted a lot by excessive immer- sion. [Conclusion] This study has provided theoretical reference for guidance of sub- strate plot soaking method, cultivation and regulation, and breeding, as well as agri- cultural production.

超标横流作用下航道尺度加宽研究及应用

支流入汇常导致支流口干流航道局部横流加大,进而影响船舶通航安全。为研究超标横流入汇对干流航道尺度的影响,采用Fortran语言自主开发了平面二维水流数学模型和船舶操纵运动数学模型,对模型的合理性和可靠性进行验证后,通过模拟横流作用下的船舶运动,研究了超标横流对船舶横漂速度和漂角的影响,提出了超标横流安全范围和航道定量加宽值。实例应用表明:在传统航道尺度设计下,当支流口超标横流范围较小时可通过调整舵角实现航行安全;而当超标横流范围较大时则难以保障船舶安全通航,需进行河道加宽设计。提出的超标横流条件下航道加宽确定方法基本合理,对船舶操纵运动和航道设计具有一定参考价值。

ESG表现抑制企业过度金融化吗?

引导企业合理适度配置金融资产,为壮大实体经济注入资金动能,对于中国实现经济高质量发展和推进中国式现代化具有重要的现实意义。本文以2009—2021年沪深A股非金融上市公司为研究样本,实证研究ESG表现对实体企业过度金融化的影响及其内在机理,并考察外部金融监管以及管理者自利在ESG表现与企业过度金融化之间的交互效应。研究结果表明,ESG表现对企业过度金融化行为产生抑制效应,说明ESG具有可持续投资价值导向,能够引导企业合理配置企业资产、承担对利益相关方的多元责任。机制检验结果表明,ESG表现通过提升企业信息透明度抑制企业过度金融化行为。交互效应检验结果表明,外部金融化监管有效抑制企业过度金融化行为,替代了ESG表现对企业过度金融化的抑制效应;管理者自利导致管理者选择投资具有高额回报率的金融项目以获取更多的私利,削弱了ESG表现对企业过度金融化的抑制效应。异质性分析结果表明,ESG表现对企业过度金融化的抑制效应在位于东部地区的企业、民营企业以及不具有高管金融背景的企业中更为明显。本文的研究为政府政策以及企业战略的制定提供了启示。

内卷感知对大学生积极心理健康的影响:一项短期追踪研究

采用问卷调查法,通过5个月两阶段的纵向追踪探讨了627名中国大学生内卷感知对其积极心理健康的影响以及内在机制和边界条件。研究结果表明,内卷感知负向预测大学生的积极心理健康,自我调节疲劳在内卷感知和积极心理健康之间起中介作用,且自我调节疲劳和积极心理健康存在相互预测作用;自我概念清晰性调节了内卷感知对自我调节疲劳和积极心理健康的作用。为高等教育内卷现象中大学生心理健康的干预提供了理论依据,强调了大学生群体积极应对内卷压力、发展清晰的自我概念和保护自我调节资源的重要性。

艾灸治疗功能性便秘的研究进展

功能性便秘(FC)是一种难治性消化系统疾病,患病率随年龄增长而升高,且病程较长,严重影响患者的生活质量。对于FC,目前西医主要以对症治疗为主,但因其不良反应导致患者依从性差。临床可辨证选用艾灸治疗,其中虚秘可联合艾灸治疗,实秘多以大承气汤方隔药脐灸,虚实分治。艾灸治疗FC的机制主要涉及信使RNA表达、神经递质、受体酪氨酸激酶/干细胞因子、胃肠激素、肠道菌群等方面。深入研究艾灸在FC治疗中的作用机制,可以为疾病的治疗提供新思路。

Influence of a non-free field subsurface seismic history on the liquefaction resistance of sandy soils

Seismic-induced liquefaction of sandy soils can fail foundations in the vicinity of buildings.To investigate the effect of a non-free field subsurface seismic history on the ability of saturated sandy soils to resist liquefaction,four shaking events with different accelerations were input to the sandy soils in the non-free-field.The results of the study revealed that:(1)Shallow soils that are not free-field undergo acceleration amplification effects after being subjected to seismic loading.(2)Building overburden pressure reduces the sensitivity of the shallow soils directly below in small and moderate earthquakes,which are more prone to rearranging and forming unstable structures under strong seismic effects.The excess pore pressure response on the load side resembles that of a free site,with the depth range of the liquefaction strength of soils affected by the seismic history,increasing progressively as input seismic intensity increases.(3)After experiencing earthquakes of different intensities,the excess pore pressure directly below the building overburden pressure at 0.1 m and 0.2 m is greater than that at the side.At the same time,the side of the building structure is more prone to liquefaction than the soil directly below it.

维持性血液透析患者日间过度嗜睡的研究进展

日间过度嗜睡(excessive daytime sleepiness,EDS)在接受维持性血液透析(maintenance hemodialysis,MHD)的患者中很常见,其可能是合并症、药物副作用、睡眠不足综合征、阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)或原发性中枢性嗜睡症的结果。未被识别和未经治疗的日间过度嗜睡与心血管疾病发病率与死亡率有关。改善日间过度嗜睡症状可延长MHD患者寿命和提高其生活质量。本文就MHD患者日间嗜睡发生的原因、评估方法、治疗进展进行综述,以期提供一个系统的方法来帮助临床工作评估和管理MHD患者EDS症状。

柴芍承气汤保留灌肠联合九合丹外敷治疗肝胃实热证急性胰腺炎的效果观察

目的探讨柴芍承气汤保留灌肠联合九合丹外敷治疗肝胃实热证急性胰腺炎的效果。方法纳入2021年7月至2022年9月收治的60例肝胃实热证急性胰腺炎患者,采用随机数字表法分为观察组和对照组各30例,对照组给予常规西药联合九合丹外敷治疗,观察组在对照组基础上联合柴芍承气汤保留灌肠治疗,均治疗7 d。治疗后比较2组临床疗效,腹胀及腹痛缓解时间、进食时间、首次排便时间、肠鸣音恢复时间与住院时间;比较2组治疗前后中医证候积分及C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、血淀粉酶水平,以及2组不良反应发生情况。结果观察组总有效率为93.33%高于对照组的73.33%(P<0.05)。观察组治疗后腹胀及腹痛缓解时间、进食时间、首次排便时间、肠鸣音恢复时间与住院时间均短于对照组(P<0.01)。治疗后2组脘腹胀痛、大便黏滞不通、发热、胸闷不舒、烦渴引饮中医证候积分均下降,且观察组低于对照组(P<0.05)。治疗后2组CRP、IL-6、TNF-α、血淀粉酶均下降,且观察组低于对照组(P<0.05,P<0.01)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论柴芍承气汤保留灌肠联合九合丹外敷治疗肝胃实热证急性胰腺炎患者的效果良好,可有效减轻患者症状、促进胃肠功能恢复,降低炎性因子及血淀粉酶水平,且安全性较好。