General anesthetic agents can impact brain function through interactions with neurons and their effects on glial cells.Oligodendrocytes perform essential roles in the central nervous system,including myelin sheath for...General anesthetic agents can impact brain function through interactions with neurons and their effects on glial cells.Oligodendrocytes perform essential roles in the central nervous system,including myelin sheath formation,axonal metabolism,and neuroplasticity regulation.They are particularly vulnerable to the effects of general anesthetic agents resulting in impaired proliferation,differentiation,and apoptosis.Neurologists are increasingly interested in the effects of general anesthetic agents on oligodendrocytes.These agents not only act on the surface receptors of oligodendrocytes to elicit neuroinflammation through modulation of signaling pathways,but also disrupt metabolic processes and alter the expression of genes involved in oligodendrocyte development and function.In this review,we summarize the effects of general anesthetic agents on oligodendrocytes.We anticipate that future research will continue to explore these effects and develop strategies to decrease the incidence of adverse reactions associated with the use of general anesthetic agents.展开更多
In this paper,Let M_(n)denote the maximum of logarithmic general error distribution with parameter v≥1.Higher-order expansions for distributions of powered extremes M_(n)^(p)are derived under an optimal choice of nor...In this paper,Let M_(n)denote the maximum of logarithmic general error distribution with parameter v≥1.Higher-order expansions for distributions of powered extremes M_(n)^(p)are derived under an optimal choice of normalizing constants.It is shown that M_(n)^(p),when v=1,converges to the Frechet extreme value distribution at the rate of 1/n,and if v>1 then M_(n)^(p)converges to the Gumbel extreme value distribution at the rate of(loglogn)^(2)=(log n)^(1-1/v).展开更多
The traditional standard wet sieving method uses steel sieves with aperture?0.063 mm and can only determine the particle size distribution(PSD)of gravel and sand in general soil.This paper extends the traditional meth...The traditional standard wet sieving method uses steel sieves with aperture?0.063 mm and can only determine the particle size distribution(PSD)of gravel and sand in general soil.This paper extends the traditional method and presents an extended wet sieving method.The extended method uses both the steel sieves and the nylon filter cloth sieves.The apertures of the cloth sieves are smaller than 0.063 mm and equal 0.048 mm,0.038 mm,0.014 mm,0.012 mm,0.0063 mm,0.004 mm,0.003 mm,0.002 mm,and 0.001 mm,respectively.The extended method uses five steps to separate the general soil into many material sub-groups of gravel,sand,silt and clay with known particle size ranges.The complete PSD of the general soil is then calculated from the dry masses of the individual material sub-groups.The extended method is demonstrated with a general soil of completely decomposed granite(CDG)in Hong Kong,China.The silt and clay materials with different particle size ranges are further examined,checked and verified using stereomicroscopic observation,physical and chemical property tests.The results further confirm the correctness of the extended wet sieving method.展开更多
Discrete feedback control was designed to stabilize an unstable hybrid neutral stochastic differential delay system(HNSDDS) under a highly nonlinear constraint in the H_∞ and exponential forms.Nevertheless,the existi...Discrete feedback control was designed to stabilize an unstable hybrid neutral stochastic differential delay system(HNSDDS) under a highly nonlinear constraint in the H_∞ and exponential forms.Nevertheless,the existing work just adapted to autonomous cases,and the obtained results were mainly on exponential stabilization.In comparison with autonomous cases,non-autonomous systems are of great interest and represent an important challenge.Accordingly,discrete feedback control has here been adjusted with a time factor to stabilize an unstable non-autonomous HNSDDS,in which new Lyapunov-Krasovskii functionals and some novel technologies are adopted.It should be noted,in particular,that the stabilization can be achieved not only in the routine H_∞ and exponential forms,but also the polynomial form and even a general form.展开更多
BACKGROUND General anesthesia is commonly used in the surgical management of gastrointestinal tumors;however,it can lead to emergence agitation(EA).EA is a common complication associated with general anesthesia,often ...BACKGROUND General anesthesia is commonly used in the surgical management of gastrointestinal tumors;however,it can lead to emergence agitation(EA).EA is a common complication associated with general anesthesia,often characterized by behaviors,such as crying,struggling,and involuntary limb movements in patients.If treatment is delayed,there is a risk of incision cracking and bleeding,which can significantly affect surgical outcomes.Therefore,having a proper understanding of the factors influencing the occurrence of EA and implementing early preventive measures may reduce the incidence of agitation during the recovery phase from general anesthesia,which is beneficial for improving patient prognosis.AIM To analyze influencing factors and develop a risk prediction model for EA occurrence following general anesthesia for primary liver cancer.METHODS Retrospective analysis of clinical data from 200 patients who underwent hepatoma resection under general anesthesia at Wenzhou Central Hospital(January 2020 to December 2023)was conducted.Post-surgery,the Richmond Agitation-Sedation Scale was used to evaluate EA presence,noting EA incidence after general anesthesia.Patients were categorized by EA presence postoperatively,and the influencing factors were analyzed using logistic regression.A nomogram-based risk prediction model was constructed and evaluated for differentiation and fit using receiver operating characteristics and calibration curves.RESULTS EA occurred in 51(25.5%)patients.Multivariate analysis identified advanced age,American Society of Anesthesiologists(ASA)grade Ⅲ,indwelling catheter use,and postoperative pain as risk factors for EA(P<0.05).Conversely,postoperative analgesia was a protective factor against EA(P<0.05).The area under the curve of the nomogram was 0.972[95%confidence interval(CI):0.947-0.997]for the training set and 0.979(95%CI:0.951-1.000)for the test set.Hosmer-Lemeshow test showed a good fit(χ^(2)=5.483,P=0.705),and calibration curves showed agreement between predicted and actual EA incidence.CONCLUSION Age,ASA grade,catheter use,postoperative pain,and analgesia significantly influence EA occurrence.A nomogram constructed using these factors demonstrates strong predictive accuracy.展开更多
Introduction: Gastroesophageal reflux disease (GERD) is a benign and chronic disease that can impair the quality of life. Objective: To study the epidemiological, clinical aspects and factors associated with typical G...Introduction: Gastroesophageal reflux disease (GERD) is a benign and chronic disease that can impair the quality of life. Objective: To study the epidemiological, clinical aspects and factors associated with typical GERD in the general population of Parakou in the Republic of Benin. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection which took place from May 1, 2019 to June 30, 2019. The study population consisted of any subject aged at least 15 years and living in Parakou. Subjects aged at least 15 years, present on the day of the survey and having given their free and informed verbal consent were included. The Short form of QRS®(Reflux-Qual Short form) questionnaire and the “Hospital Anxiety and Depression” score were used to assess the quality of life and anxiety/depression, respectively. The sampling was probabilistic through a 2-stage cluster sampling. The variable of interest was the presence of GERD. Results: Out of 390 subjects surveyed, 28 had symptoms of typical GERD, representing a prevalence of 7.18%. The average age of these subjects was 27.11 ± 7.88 years. Fifteen subjects (53.57%) were male, giving a sex ratio of 1.15. Fourteen (50%) had a secondary level of education, 12 (42.86%) were pupils/students, 18 (64.29%) were single. The monthly income of 22 subjects (78.57%) was lower than the guaranteed interprofessional minimum wage (40,000 FCFA). The average duration of progression of symptoms was 15.89 ± 4.97 months. Symptoms occurred less than twice a week in 22 subjects (78.57%). The clinical manifestations were both diurnal and nocturnal in 12 subjects (42.86%). None of the 28 subjects with GERD had clinical warning signs. Asthma, diabetes, consumption of high fat or spice foods, carbonated drinks, non-steroidal anti-inflammatory drugs, alcoholic beverages and tobacco were statistically associated with the occurrence of GERD. Each of the 28 subjects had at least one associated factor. A significant impair in quality of life was observed in 27 patients (96.43%). Conclusion: Typical GERD is relatively common in the general population of Parakou in the Republic of Benin. It often affects young males. Among the risk factors identified, the most common are carbonated drinks, spicy meals and diabetes. GERD significantly impairs quality of life. Raising awareness about the disease and its associated factors is necessary among the general population.展开更多
Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anest...Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anesthesia is required. The objective of the study was to evaluate the analgesic effectiveness of 4 analgesic techniques performed during cesarean section under general anesthesia in two centers with different anesthetic practices (North Franche Comté Hospital and Omar Bongo Ondimba Army Training Hospital). Method: This is a retrospective and descriptive study over 2 years, from January 1, 2019 to December 31, 2020. It involved evaluating the analgesic effectiveness and tolerance of morphine in the epidural catheter, wound infiltration, intravenous analgesia and Transversus Abdominous Plane block (TAP block) from the post-anesthesia care unit (PACU) until the 4<sup>th</sup> post-operative day. Results: Of the 354 cesarean sections performed, 84 (11.14%) received general anesthesia. The average age was 32.27 years. Acute fetal distress was the first indication for cesarean section (45.2%), followed by hemorrhagic placenta previa (10.7%) and prolapse of the cord (8.33%). Morphine in the epidural catheter was the most used (47.6%) followed by parietal infiltration (36.9%), intravenous analgesia (13.1%) and TAP block (2.38%). The analgesic effectiveness was comparable between the techniques from postoperative day 0 to day 4. No difference in side effects. Postoperative morphine consumption was significantly reduced (p = 0.011) in the infiltration (9 mg) and TAP block (9mg) groups compared to the epidural catheter (16 mg) and intravenous analgesia (17 mg). No difference in 02 rehabilitation criteria (ambulation, first bowel movement). No difference in the occurrence of chronic pain. Conclusion: In the event of a cesarean section under general anesthesia, there are effective and well-tolerated alternatives to neuraxial anesthesia, particularly regional anesthesia techniques (nerve blocks), particularly in countries with low availability of morphine.展开更多
Planck scale plays a vital role in describing fundamental forces. Space time describes strength of fundamental force. In this paper, Einstein’s general relativity equation has been described in terms of contraction a...Planck scale plays a vital role in describing fundamental forces. Space time describes strength of fundamental force. In this paper, Einstein’s general relativity equation has been described in terms of contraction and expansion forces of space time. According to this, the space time with Planck diameter is a flat space time. This is the only diameter of space time that can be used as signal transformation in special relativity. This space time diameter defines the fundamental force which belongs to that space time. In quantum mechanics, this space time diameter is only the quantum of space which belongs to that particular fundamental force. Einstein’s general relativity equation and Planck parameters of quantum mechanics have been written in terms of equations containing a constant “K”, thus found a new equation for transformation of general relativity space time in to quantum space time. In this process of synchronization, there is a possibility of a new fundamental force between electromagnetic and gravitational forces with Planck length as its space time diameter. It is proposed that dark matter is that fundamental force carrying particle. By grand unification equation with space-time diameter, we found a coupling constant as per standard model “α<sub>s</sub>” for that fundamental force is 1.08 × 10<sup>-23</sup>. Its energy calculated as 113 MeV. A group of experimental scientists reported the energy of dark matter particle as 17 MeV. Thorough review may advance science further.展开更多
A summary of the exploration of the teaching mode of the general practice teaching clinic, a summary of the deficiencies of the teaching clinic and a summary of the significance of the establishment of the general pra...A summary of the exploration of the teaching mode of the general practice teaching clinic, a summary of the deficiencies of the teaching clinic and a summary of the significance of the establishment of the general practice teaching clinic are presented with a view to promoting the development of general practice and cultivating more excellent successors in general practice.展开更多
In recent years,the national higher education reform has proposed the concept of curriculum ideological and political education as a major element.This integration into the standardized training of general practice re...In recent years,the national higher education reform has proposed the concept of curriculum ideological and political education as a major element.This integration into the standardized training of general practice residents(commonly referred to as general resident training)is an unavoidable trend in the teaching field.Based on the actual situation of our unit at The First Affiliated Hospital of Xi’an Medical University,this paper emphasizes the necessity of incorporating ideological and political education into the general resident training curriculum,despite the absence of pertinent practical experience in how to effectively incorporate such courses into comprehensive residential training.In our hospital,we must assess the ideological and political education in the curriculum of general resident training,proposing a scientific,reasonable ideological and political education concept system for general practice courses,integrating ideological and political education with general practice resident training,and strengthening the team of ideological and political education physicians to teach them to carry out such education,this would foster enthusiasm and initiative.Strengthening admission education and training for general practice resident training,as well as regularly hosting symposiums to share ideas and understand the mission of doctors can provide effective experience for ideological and political education in general resident training courses.展开更多
Introduction: Chest radiography is the most frequently prescribed imaging test in general practice in France. We aimed to assess the extent to which general practitioners follow the recommendations of the French Natio...Introduction: Chest radiography is the most frequently prescribed imaging test in general practice in France. We aimed to assess the extent to which general practitioners follow the recommendations of the French National Authority for Health in prescribing chest radiography. Methodology: We conducted a retrospective analysis study, in two radiology centers belonging to the same group in Saint-Omer and Aire-sur-la-Lys, of requests for chest radiography sent by general practitioners over the winter period between December 22, 2013, and March 21, 2014, for patients aged over 18 years. Results: One hundred and seventy-seven requests for chest X-rays were analyzed, 71.75% of which complied with recommendations. The most frequent reason was the search for bronchopulmonary infection, accounting for 70.08% of prescriptions, followed by 11.2% for requests to rule out pulmonary neoplasia, whereas the latter reason did not comply with recommendations. Chest X-rays contributed to a positive diagnosis in 28.81% of cases. The positive diagnosis was given by 36.22% of the recommended chest X-rays, versus 10% for those not recommended. Conclusion: In most cases, general practitioners follow HAS recommendations for prescribing chest X-rays. Non-recommended chest X-rays do not appear to make a major contribution to diagnosis or patient management, confirming the value of following the recommendations of the French National Authority for Health.展开更多
Objective:To analyze the importance of general practitioner residents using the combined teaching method(BOPPPS+mind maps).Methods:From September 2023 to August 2024,a study was conducted with 6 control group particip...Objective:To analyze the importance of general practitioner residents using the combined teaching method(BOPPPS+mind maps).Methods:From September 2023 to August 2024,a study was conducted with 6 control group participants receiving traditional teaching and 6 observation group participants receiving the combined teaching method(BOPPPS+mind maps).The study analyzed various indicators between the two groups(including mind map scores and assessment results).Results:Compared with the control group,the assessment scores of the observation group were significantly higher(P<0.05).Conclusion:The application of the combined teaching method(BOPPPS+mind maps)by general practitioner residents can significantly improve their comprehensive abilities.展开更多
This paper is a brief review of our work on the Planck quantized version of general relativity theory. It demonstrates several straightforward methods to rewrite the same equations that we have already presented in ot...This paper is a brief review of our work on the Planck quantized version of general relativity theory. It demonstrates several straightforward methods to rewrite the same equations that we have already presented in other papers. We also explore a relatively new general relativity-inspired field equation based on the original Newtonian mass, which is very different from today’s kilogram mass. Additionally, we examine two other field equations based on collision space-time, where both energy and matter can be described simply as space and time. We are thereby fulfilling Einstein’s dream of a theory where energy and mass are not needed, or are just aspects of space and time. If this is extended beyond the 4-dimensional space-time formalism of general relativity theory to a 6-dimensional framework with 3 space dimensions and 3 time dimensions, this ultimately reveals that they are two sides of the same coin. In reality, it is a three-dimensional space-time theory, where space and time are just two sides of the same coin.展开更多
Objective:To investigate and analyze the current situation of cognition,attitude,behavior,and influencing factors of Type 2 Diabetes Mellitus(T2DM)patients in Neijiang City,and to explore the effectiveness of the appl...Objective:To investigate and analyze the current situation of cognition,attitude,behavior,and influencing factors of Type 2 Diabetes Mellitus(T2DM)patients in Neijiang City,and to explore the effectiveness of the application of the education program based on the popularization of science in general medicine.Methods:Seventy cases of T2DM patients in Neijiang City were selected and randomly divided into 35 cases each in the observation group and the control group.The observation group received general medicine science education intervention and the control group received traditional health education.Indicators such as cognitive level,attitude,and behavioral change between the two groups were compared to assess the effect of general medical science education.Results:Before the intervention,there was no difference between the two groups in terms of knowledge,beliefs,and behaviors in general medicine,glycemic control,body mass index(BMI),and satisfaction with health education(P>0.05).After 3 months of the intervention,there was a highly significant difference in the aforementioned levels between the two groups(P<0.05).Conclusion:The approach of general medicine popularization had a significant effect on the treatment and management of T2DM patients in Neijiang City.It improved the patient’s cognitive level and self-management ability of the disease,increased their treatment adherence,and improved the therapeutic effect.展开更多
The paper is devoted to a spherically symmetric problem of General Relativity (GR) for a fluid sphere. The problem is solved within the framework of a special geometry of the Riemannian space induced by gravitation. A...The paper is devoted to a spherically symmetric problem of General Relativity (GR) for a fluid sphere. The problem is solved within the framework of a special geometry of the Riemannian space induced by gravitation. According to this geometry, the four-dimensional Riemannian space is assumed to be Euclidean with respect to the space coordinates and Riemannian with respect to the time coordinate. Such interpretation of the Riemannian space allows us to obtain complete set of GR equations for the external empty space and the internal spaces for incompressible and compressible perfect fluids. The obtained analytical solution for an incompressible fluid is compared with the Schwarzchild solution. For a sphere consisting of compressible fluid or gas, a numerical solution is presented and discussed.展开更多
With the continuous expansion of medical student enrollment,the number of clinical teaching bases is gradually increasing.However,there are significant differences in clinical teaching management models and teaching l...With the continuous expansion of medical student enrollment,the number of clinical teaching bases is gradually increasing.However,there are significant differences in clinical teaching management models and teaching levels among different bases.Most clinical teaching bases have incomplete teaching management systems,inadequate teaching management institutions,insufficient teaching personnel,and inadequate implementation of teaching rules and regulations.This article combines the construction practice of three-level clinical teaching base of the General Medicine College and the First Affiliated Hospital of Xi’an Medical University.We establish a standardized management system for the three-level clinical teaching base;implement a teaching supervision system and strengthen the monitoring of teaching quality;adopt multiple evaluations to test the effectiveness of clinical teaching implementation;explore the path of homogenization construction of teaching bases in terms of unified teacher training,promoting the development of teacher teaching abilities with equal quality and excellence,and providing a reference for improving the quality of medical talent training.展开更多
This study explores the nuanced relationship between trait mindfulness and thriving at work among educators in Western China,emphasizing the mediating role of general self-efficacy.Employing a sample of 378 primary an...This study explores the nuanced relationship between trait mindfulness and thriving at work among educators in Western China,emphasizing the mediating role of general self-efficacy.Employing a sample of 378 primary and secondary school teachers,this research utilizes the Five Facet Mindfulness Questionnaire(FFMQ),Thriving at Work Scale(TWS),and the General Self-Efficacy Scale(GSES)to conduct a thorough investigation.The findings indicate a significant positive correlation between trait mindfulness and thriving at work,between trait mindfulness and general self-efficacy,and between general self-efficacy and thriving at work.Additionally,trait mindfulness was found to have a positive predictive effect on both thriving at work and general self-efficacy,with general self-efficacy also showing a positive predictive effect on thriving at work.Importantly,general self-efficacy was identified as playing a partial mediating role in the relationship between trait mindfulness and thriving at work.These results underscore the importance of cultivating mindfulness and self-efficacy among teachers to enhance their enthusiasm for work,suggesting potential pathways for professional development and well-being in the educational sector.展开更多
Objective:This study aims to investigate the impact of combining general anesthesia with bronchial intubation and thoracic paravertebral nerve block during surgery for patients with tuberculous pyothorax.Methods:Eight...Objective:This study aims to investigate the impact of combining general anesthesia with bronchial intubation and thoracic paravertebral nerve block during surgery for patients with tuberculous pyothorax.Methods:Eighty patients diagnosed with tuberculous pyothorax,admitted to the hospital between January 2023 and September 2023,were randomly selected for this study.The patients were divided into control and study groups using a numerical table method.The control group underwent general anesthesia with bronchial intubation,while the study group received general anesthesia with bronchial intubation in conjunction with thoracic paravertebral nerve block.Subsequently,the patients were monitored to assess mean arterial pressure,heart rate variations,and adverse reactions to anesthesia.Results:The study group exhibited significantly lower mean arterial pressure and heart rate levels during the post-surgical incision,immediate end of surgery,and immediate extubation periods compared to the control group(P<0.05).Furthermore,the Ricker and Ramsay scores in the study group were significantly lower than those in the control group(P<0.05).Conclusion:The combined use of general anesthesia via bronchial intubation and thoracic paravertebral nerve block has been found to stabilize mean arterial pressure and heart rate while providing effective sedation for surgical treatment in patients with tuberculous septic thorax.展开更多
BACKGROUND Radical gastrectomy(RG)is commonly used in the treatment of patients with gastric cancer(GC),but this procedure may lead to stress responses,postoperative cognitive dysfunction,and blood coagulation abnorma...BACKGROUND Radical gastrectomy(RG)is commonly used in the treatment of patients with gastric cancer(GC),but this procedure may lead to stress responses,postoperative cognitive dysfunction,and blood coagulation abnormalities in patients.AIM To investigate the influences of dexmedetomidine(DEX)on stress responses and postoperative cognitive and coagulation functions in patients undergoing RG under general anesthesia(GA).METHODS One hundred and two patients undergoing RG for GC under GA from February 2020 to February 2022 were retrospectively reviewed.Of these,50 patients had received conventional anesthesia intervention[control group(CG)]and 52 patients had received DEX in addition to routine anesthesia intervention[observation group(OG)].Inflammatory factor(IFs;tumor necrosis factor-α,TNF-α;interleukin-6,IL-6),stress responses(cortisol,Cor;adrenocorticotropic hormone,ACTH),cognitive function(CF;Mini-Mental State Examination,MMSE),neurological function(neuron-specific enolase,NSE;S100 calciumbinding protein B,S100B),and coagulation function(prothrombin time,PT;thromboxane B2,TXB2;fibrinogen,FIB)were compared between the two groups before surgery(T0),as well as at 6 h(T1)and 24 h(T2)after surgery.RESULTS Compared with T0,TNF-α,IL-6,Cor,ACTH,NSE,S100B,PT,TXB2,and FIB showed a significant increase in both groups at T1 and T2,but with even lower levels in OG vs CG.Both groups showed a significant reduction in the MMSE score at T1 and T2 compared with T0,but the MMSE score was notably higher in OG compared with CG.CONCLUSION In addition to a potent inhibitory effect on postoperative IFs and stress responses in GC patients undergoing RG under GA,DEX may also alleviate the coagulation dysfunction and improve the postoperative CF of these patients.展开更多
Changes in the energy price system will determine the direction of evolution of the energy industry structure.As a country where coal is the dominant energy source,what is the effect of coal price fluctuations on Chin...Changes in the energy price system will determine the direction of evolution of the energy industry structure.As a country where coal is the dominant energy source,what is the effect of coal price fluctuations on China’s industry development costs and energy consumption structure?To investigate this problem,this paper utilized an economy–energy–environment computable general equilibrium model.In this study,four aspects were analyzed:Energy supply side,proportion of renewable energy consumption,macroeconomy,and changes in CO_(2) emissions.The results of this study show that an increase of 10%–20%in coal prices contributes to a shift into using renewable energy,which leads to energy saving and emission reduction.Renewable energy and clean energy rose by 0.57%–4.47%in the energy structure,but this has a certain negative impact on the macroeconomy.The gross domestic product(GDP)fell by 0.07%–0.18%.As a result,the decline in coal prices became an obstacle to renewable energy substitution and energy conservation.In addition,we put forward policy suggestions according to the results in energy,economic,and environmental effects.展开更多
基金supported by the Natural Science Foundation of Zhejiang Province(LZ22H090002,2014C33170)National Natural Science Foundation of China(82171260,81641042,81471240)。
文摘General anesthetic agents can impact brain function through interactions with neurons and their effects on glial cells.Oligodendrocytes perform essential roles in the central nervous system,including myelin sheath formation,axonal metabolism,and neuroplasticity regulation.They are particularly vulnerable to the effects of general anesthetic agents resulting in impaired proliferation,differentiation,and apoptosis.Neurologists are increasingly interested in the effects of general anesthetic agents on oligodendrocytes.These agents not only act on the surface receptors of oligodendrocytes to elicit neuroinflammation through modulation of signaling pathways,but also disrupt metabolic processes and alter the expression of genes involved in oligodendrocyte development and function.In this review,we summarize the effects of general anesthetic agents on oligodendrocytes.We anticipate that future research will continue to explore these effects and develop strategies to decrease the incidence of adverse reactions associated with the use of general anesthetic agents.
文摘In this paper,Let M_(n)denote the maximum of logarithmic general error distribution with parameter v≥1.Higher-order expansions for distributions of powered extremes M_(n)^(p)are derived under an optimal choice of normalizing constants.It is shown that M_(n)^(p),when v=1,converges to the Frechet extreme value distribution at the rate of 1/n,and if v>1 then M_(n)^(p)converges to the Gumbel extreme value distribution at the rate of(loglogn)^(2)=(log n)^(1-1/v).
基金The work described in this paper was partially supported by grants from the Research Grant Council of the Hong Kong Special Administrative Region,China(Project Nos.HKU 17207518 and R5037-18).
文摘The traditional standard wet sieving method uses steel sieves with aperture?0.063 mm and can only determine the particle size distribution(PSD)of gravel and sand in general soil.This paper extends the traditional method and presents an extended wet sieving method.The extended method uses both the steel sieves and the nylon filter cloth sieves.The apertures of the cloth sieves are smaller than 0.063 mm and equal 0.048 mm,0.038 mm,0.014 mm,0.012 mm,0.0063 mm,0.004 mm,0.003 mm,0.002 mm,and 0.001 mm,respectively.The extended method uses five steps to separate the general soil into many material sub-groups of gravel,sand,silt and clay with known particle size ranges.The complete PSD of the general soil is then calculated from the dry masses of the individual material sub-groups.The extended method is demonstrated with a general soil of completely decomposed granite(CDG)in Hong Kong,China.The silt and clay materials with different particle size ranges are further examined,checked and verified using stereomicroscopic observation,physical and chemical property tests.The results further confirm the correctness of the extended wet sieving method.
基金supported by the National Natural Science Foundation of China(61833005)the Humanities and Social Science Fund of Ministry of Education of China(23YJAZH031)+1 种基金the Natural Science Foundation of Hebei Province of China(A2023209002,A2019209005)the Tangshan Science and Technology Bureau Program of Hebei Province of China(19130222g)。
文摘Discrete feedback control was designed to stabilize an unstable hybrid neutral stochastic differential delay system(HNSDDS) under a highly nonlinear constraint in the H_∞ and exponential forms.Nevertheless,the existing work just adapted to autonomous cases,and the obtained results were mainly on exponential stabilization.In comparison with autonomous cases,non-autonomous systems are of great interest and represent an important challenge.Accordingly,discrete feedback control has here been adjusted with a time factor to stabilize an unstable non-autonomous HNSDDS,in which new Lyapunov-Krasovskii functionals and some novel technologies are adopted.It should be noted,in particular,that the stabilization can be achieved not only in the routine H_∞ and exponential forms,but also the polynomial form and even a general form.
文摘BACKGROUND General anesthesia is commonly used in the surgical management of gastrointestinal tumors;however,it can lead to emergence agitation(EA).EA is a common complication associated with general anesthesia,often characterized by behaviors,such as crying,struggling,and involuntary limb movements in patients.If treatment is delayed,there is a risk of incision cracking and bleeding,which can significantly affect surgical outcomes.Therefore,having a proper understanding of the factors influencing the occurrence of EA and implementing early preventive measures may reduce the incidence of agitation during the recovery phase from general anesthesia,which is beneficial for improving patient prognosis.AIM To analyze influencing factors and develop a risk prediction model for EA occurrence following general anesthesia for primary liver cancer.METHODS Retrospective analysis of clinical data from 200 patients who underwent hepatoma resection under general anesthesia at Wenzhou Central Hospital(January 2020 to December 2023)was conducted.Post-surgery,the Richmond Agitation-Sedation Scale was used to evaluate EA presence,noting EA incidence after general anesthesia.Patients were categorized by EA presence postoperatively,and the influencing factors were analyzed using logistic regression.A nomogram-based risk prediction model was constructed and evaluated for differentiation and fit using receiver operating characteristics and calibration curves.RESULTS EA occurred in 51(25.5%)patients.Multivariate analysis identified advanced age,American Society of Anesthesiologists(ASA)grade Ⅲ,indwelling catheter use,and postoperative pain as risk factors for EA(P<0.05).Conversely,postoperative analgesia was a protective factor against EA(P<0.05).The area under the curve of the nomogram was 0.972[95%confidence interval(CI):0.947-0.997]for the training set and 0.979(95%CI:0.951-1.000)for the test set.Hosmer-Lemeshow test showed a good fit(χ^(2)=5.483,P=0.705),and calibration curves showed agreement between predicted and actual EA incidence.CONCLUSION Age,ASA grade,catheter use,postoperative pain,and analgesia significantly influence EA occurrence.A nomogram constructed using these factors demonstrates strong predictive accuracy.
文摘Introduction: Gastroesophageal reflux disease (GERD) is a benign and chronic disease that can impair the quality of life. Objective: To study the epidemiological, clinical aspects and factors associated with typical GERD in the general population of Parakou in the Republic of Benin. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection which took place from May 1, 2019 to June 30, 2019. The study population consisted of any subject aged at least 15 years and living in Parakou. Subjects aged at least 15 years, present on the day of the survey and having given their free and informed verbal consent were included. The Short form of QRS®(Reflux-Qual Short form) questionnaire and the “Hospital Anxiety and Depression” score were used to assess the quality of life and anxiety/depression, respectively. The sampling was probabilistic through a 2-stage cluster sampling. The variable of interest was the presence of GERD. Results: Out of 390 subjects surveyed, 28 had symptoms of typical GERD, representing a prevalence of 7.18%. The average age of these subjects was 27.11 ± 7.88 years. Fifteen subjects (53.57%) were male, giving a sex ratio of 1.15. Fourteen (50%) had a secondary level of education, 12 (42.86%) were pupils/students, 18 (64.29%) were single. The monthly income of 22 subjects (78.57%) was lower than the guaranteed interprofessional minimum wage (40,000 FCFA). The average duration of progression of symptoms was 15.89 ± 4.97 months. Symptoms occurred less than twice a week in 22 subjects (78.57%). The clinical manifestations were both diurnal and nocturnal in 12 subjects (42.86%). None of the 28 subjects with GERD had clinical warning signs. Asthma, diabetes, consumption of high fat or spice foods, carbonated drinks, non-steroidal anti-inflammatory drugs, alcoholic beverages and tobacco were statistically associated with the occurrence of GERD. Each of the 28 subjects had at least one associated factor. A significant impair in quality of life was observed in 27 patients (96.43%). Conclusion: Typical GERD is relatively common in the general population of Parakou in the Republic of Benin. It often affects young males. Among the risk factors identified, the most common are carbonated drinks, spicy meals and diabetes. GERD significantly impairs quality of life. Raising awareness about the disease and its associated factors is necessary among the general population.
文摘Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anesthesia is required. The objective of the study was to evaluate the analgesic effectiveness of 4 analgesic techniques performed during cesarean section under general anesthesia in two centers with different anesthetic practices (North Franche Comté Hospital and Omar Bongo Ondimba Army Training Hospital). Method: This is a retrospective and descriptive study over 2 years, from January 1, 2019 to December 31, 2020. It involved evaluating the analgesic effectiveness and tolerance of morphine in the epidural catheter, wound infiltration, intravenous analgesia and Transversus Abdominous Plane block (TAP block) from the post-anesthesia care unit (PACU) until the 4<sup>th</sup> post-operative day. Results: Of the 354 cesarean sections performed, 84 (11.14%) received general anesthesia. The average age was 32.27 years. Acute fetal distress was the first indication for cesarean section (45.2%), followed by hemorrhagic placenta previa (10.7%) and prolapse of the cord (8.33%). Morphine in the epidural catheter was the most used (47.6%) followed by parietal infiltration (36.9%), intravenous analgesia (13.1%) and TAP block (2.38%). The analgesic effectiveness was comparable between the techniques from postoperative day 0 to day 4. No difference in side effects. Postoperative morphine consumption was significantly reduced (p = 0.011) in the infiltration (9 mg) and TAP block (9mg) groups compared to the epidural catheter (16 mg) and intravenous analgesia (17 mg). No difference in 02 rehabilitation criteria (ambulation, first bowel movement). No difference in the occurrence of chronic pain. Conclusion: In the event of a cesarean section under general anesthesia, there are effective and well-tolerated alternatives to neuraxial anesthesia, particularly regional anesthesia techniques (nerve blocks), particularly in countries with low availability of morphine.
文摘Planck scale plays a vital role in describing fundamental forces. Space time describes strength of fundamental force. In this paper, Einstein’s general relativity equation has been described in terms of contraction and expansion forces of space time. According to this, the space time with Planck diameter is a flat space time. This is the only diameter of space time that can be used as signal transformation in special relativity. This space time diameter defines the fundamental force which belongs to that space time. In quantum mechanics, this space time diameter is only the quantum of space which belongs to that particular fundamental force. Einstein’s general relativity equation and Planck parameters of quantum mechanics have been written in terms of equations containing a constant “K”, thus found a new equation for transformation of general relativity space time in to quantum space time. In this process of synchronization, there is a possibility of a new fundamental force between electromagnetic and gravitational forces with Planck length as its space time diameter. It is proposed that dark matter is that fundamental force carrying particle. By grand unification equation with space-time diameter, we found a coupling constant as per standard model “α<sub>s</sub>” for that fundamental force is 1.08 × 10<sup>-23</sup>. Its energy calculated as 113 MeV. A group of experimental scientists reported the energy of dark matter particle as 17 MeV. Thorough review may advance science further.
文摘A summary of the exploration of the teaching mode of the general practice teaching clinic, a summary of the deficiencies of the teaching clinic and a summary of the significance of the establishment of the general practice teaching clinic are presented with a view to promoting the development of general practice and cultivating more excellent successors in general practice.
文摘In recent years,the national higher education reform has proposed the concept of curriculum ideological and political education as a major element.This integration into the standardized training of general practice residents(commonly referred to as general resident training)is an unavoidable trend in the teaching field.Based on the actual situation of our unit at The First Affiliated Hospital of Xi’an Medical University,this paper emphasizes the necessity of incorporating ideological and political education into the general resident training curriculum,despite the absence of pertinent practical experience in how to effectively incorporate such courses into comprehensive residential training.In our hospital,we must assess the ideological and political education in the curriculum of general resident training,proposing a scientific,reasonable ideological and political education concept system for general practice courses,integrating ideological and political education with general practice resident training,and strengthening the team of ideological and political education physicians to teach them to carry out such education,this would foster enthusiasm and initiative.Strengthening admission education and training for general practice resident training,as well as regularly hosting symposiums to share ideas and understand the mission of doctors can provide effective experience for ideological and political education in general resident training courses.
文摘Introduction: Chest radiography is the most frequently prescribed imaging test in general practice in France. We aimed to assess the extent to which general practitioners follow the recommendations of the French National Authority for Health in prescribing chest radiography. Methodology: We conducted a retrospective analysis study, in two radiology centers belonging to the same group in Saint-Omer and Aire-sur-la-Lys, of requests for chest radiography sent by general practitioners over the winter period between December 22, 2013, and March 21, 2014, for patients aged over 18 years. Results: One hundred and seventy-seven requests for chest X-rays were analyzed, 71.75% of which complied with recommendations. The most frequent reason was the search for bronchopulmonary infection, accounting for 70.08% of prescriptions, followed by 11.2% for requests to rule out pulmonary neoplasia, whereas the latter reason did not comply with recommendations. Chest X-rays contributed to a positive diagnosis in 28.81% of cases. The positive diagnosis was given by 36.22% of the recommended chest X-rays, versus 10% for those not recommended. Conclusion: In most cases, general practitioners follow HAS recommendations for prescribing chest X-rays. Non-recommended chest X-rays do not appear to make a major contribution to diagnosis or patient management, confirming the value of following the recommendations of the French National Authority for Health.
文摘Objective:To analyze the importance of general practitioner residents using the combined teaching method(BOPPPS+mind maps).Methods:From September 2023 to August 2024,a study was conducted with 6 control group participants receiving traditional teaching and 6 observation group participants receiving the combined teaching method(BOPPPS+mind maps).The study analyzed various indicators between the two groups(including mind map scores and assessment results).Results:Compared with the control group,the assessment scores of the observation group were significantly higher(P<0.05).Conclusion:The application of the combined teaching method(BOPPPS+mind maps)by general practitioner residents can significantly improve their comprehensive abilities.
文摘This paper is a brief review of our work on the Planck quantized version of general relativity theory. It demonstrates several straightforward methods to rewrite the same equations that we have already presented in other papers. We also explore a relatively new general relativity-inspired field equation based on the original Newtonian mass, which is very different from today’s kilogram mass. Additionally, we examine two other field equations based on collision space-time, where both energy and matter can be described simply as space and time. We are thereby fulfilling Einstein’s dream of a theory where energy and mass are not needed, or are just aspects of space and time. If this is extended beyond the 4-dimensional space-time formalism of general relativity theory to a 6-dimensional framework with 3 space dimensions and 3 time dimensions, this ultimately reveals that they are two sides of the same coin. In reality, it is a three-dimensional space-time theory, where space and time are just two sides of the same coin.
基金Neijiang Science and Technology Program Project/Evaluation of the Effect of Generalization Based on General Medicine in Patients with Type 2 Diabetes Mellitus in Neijiang City(Z202311)。
文摘Objective:To investigate and analyze the current situation of cognition,attitude,behavior,and influencing factors of Type 2 Diabetes Mellitus(T2DM)patients in Neijiang City,and to explore the effectiveness of the application of the education program based on the popularization of science in general medicine.Methods:Seventy cases of T2DM patients in Neijiang City were selected and randomly divided into 35 cases each in the observation group and the control group.The observation group received general medicine science education intervention and the control group received traditional health education.Indicators such as cognitive level,attitude,and behavioral change between the two groups were compared to assess the effect of general medical science education.Results:Before the intervention,there was no difference between the two groups in terms of knowledge,beliefs,and behaviors in general medicine,glycemic control,body mass index(BMI),and satisfaction with health education(P>0.05).After 3 months of the intervention,there was a highly significant difference in the aforementioned levels between the two groups(P<0.05).Conclusion:The approach of general medicine popularization had a significant effect on the treatment and management of T2DM patients in Neijiang City.It improved the patient’s cognitive level and self-management ability of the disease,increased their treatment adherence,and improved the therapeutic effect.
文摘The paper is devoted to a spherically symmetric problem of General Relativity (GR) for a fluid sphere. The problem is solved within the framework of a special geometry of the Riemannian space induced by gravitation. According to this geometry, the four-dimensional Riemannian space is assumed to be Euclidean with respect to the space coordinates and Riemannian with respect to the time coordinate. Such interpretation of the Riemannian space allows us to obtain complete set of GR equations for the external empty space and the internal spaces for incompressible and compressible perfect fluids. The obtained analytical solution for an incompressible fluid is compared with the Schwarzchild solution. For a sphere consisting of compressible fluid or gas, a numerical solution is presented and discussed.
基金2022 Education and Teaching Reform Research Project of Xi’an Medical University“Construction and Practice of the Teaching Quality Assurance System in the Three-Level Teaching Base of General Practice Medicine Under the Internet+Model”(Project number:2022JG-05)。
文摘With the continuous expansion of medical student enrollment,the number of clinical teaching bases is gradually increasing.However,there are significant differences in clinical teaching management models and teaching levels among different bases.Most clinical teaching bases have incomplete teaching management systems,inadequate teaching management institutions,insufficient teaching personnel,and inadequate implementation of teaching rules and regulations.This article combines the construction practice of three-level clinical teaching base of the General Medicine College and the First Affiliated Hospital of Xi’an Medical University.We establish a standardized management system for the three-level clinical teaching base;implement a teaching supervision system and strengthen the monitoring of teaching quality;adopt multiple evaluations to test the effectiveness of clinical teaching implementation;explore the path of homogenization construction of teaching bases in terms of unified teacher training,promoting the development of teacher teaching abilities with equal quality and excellence,and providing a reference for improving the quality of medical talent training.
基金funded by the Gansu Provincial Higher Education Innovation Fund project titled"Study on the Influencing Factors and Training Effects of Internet Usage Habits among Teachers in Counties and Districts of Gansu Province"(Project No.:2021B-293).
文摘This study explores the nuanced relationship between trait mindfulness and thriving at work among educators in Western China,emphasizing the mediating role of general self-efficacy.Employing a sample of 378 primary and secondary school teachers,this research utilizes the Five Facet Mindfulness Questionnaire(FFMQ),Thriving at Work Scale(TWS),and the General Self-Efficacy Scale(GSES)to conduct a thorough investigation.The findings indicate a significant positive correlation between trait mindfulness and thriving at work,between trait mindfulness and general self-efficacy,and between general self-efficacy and thriving at work.Additionally,trait mindfulness was found to have a positive predictive effect on both thriving at work and general self-efficacy,with general self-efficacy also showing a positive predictive effect on thriving at work.Importantly,general self-efficacy was identified as playing a partial mediating role in the relationship between trait mindfulness and thriving at work.These results underscore the importance of cultivating mindfulness and self-efficacy among teachers to enhance their enthusiasm for work,suggesting potential pathways for professional development and well-being in the educational sector.
基金Research Project of the Xi’an Municipal Health Commission(No.2023yb40,Project leader:Duan Chunyu)。
文摘Objective:This study aims to investigate the impact of combining general anesthesia with bronchial intubation and thoracic paravertebral nerve block during surgery for patients with tuberculous pyothorax.Methods:Eighty patients diagnosed with tuberculous pyothorax,admitted to the hospital between January 2023 and September 2023,were randomly selected for this study.The patients were divided into control and study groups using a numerical table method.The control group underwent general anesthesia with bronchial intubation,while the study group received general anesthesia with bronchial intubation in conjunction with thoracic paravertebral nerve block.Subsequently,the patients were monitored to assess mean arterial pressure,heart rate variations,and adverse reactions to anesthesia.Results:The study group exhibited significantly lower mean arterial pressure and heart rate levels during the post-surgical incision,immediate end of surgery,and immediate extubation periods compared to the control group(P<0.05).Furthermore,the Ricker and Ramsay scores in the study group were significantly lower than those in the control group(P<0.05).Conclusion:The combined use of general anesthesia via bronchial intubation and thoracic paravertebral nerve block has been found to stabilize mean arterial pressure and heart rate while providing effective sedation for surgical treatment in patients with tuberculous septic thorax.
基金Supported by Project of Guangxi Health and Health Commission,No.Z20201268。
文摘BACKGROUND Radical gastrectomy(RG)is commonly used in the treatment of patients with gastric cancer(GC),but this procedure may lead to stress responses,postoperative cognitive dysfunction,and blood coagulation abnormalities in patients.AIM To investigate the influences of dexmedetomidine(DEX)on stress responses and postoperative cognitive and coagulation functions in patients undergoing RG under general anesthesia(GA).METHODS One hundred and two patients undergoing RG for GC under GA from February 2020 to February 2022 were retrospectively reviewed.Of these,50 patients had received conventional anesthesia intervention[control group(CG)]and 52 patients had received DEX in addition to routine anesthesia intervention[observation group(OG)].Inflammatory factor(IFs;tumor necrosis factor-α,TNF-α;interleukin-6,IL-6),stress responses(cortisol,Cor;adrenocorticotropic hormone,ACTH),cognitive function(CF;Mini-Mental State Examination,MMSE),neurological function(neuron-specific enolase,NSE;S100 calciumbinding protein B,S100B),and coagulation function(prothrombin time,PT;thromboxane B2,TXB2;fibrinogen,FIB)were compared between the two groups before surgery(T0),as well as at 6 h(T1)and 24 h(T2)after surgery.RESULTS Compared with T0,TNF-α,IL-6,Cor,ACTH,NSE,S100B,PT,TXB2,and FIB showed a significant increase in both groups at T1 and T2,but with even lower levels in OG vs CG.Both groups showed a significant reduction in the MMSE score at T1 and T2 compared with T0,but the MMSE score was notably higher in OG compared with CG.CONCLUSION In addition to a potent inhibitory effect on postoperative IFs and stress responses in GC patients undergoing RG under GA,DEX may also alleviate the coagulation dysfunction and improve the postoperative CF of these patients.
基金financial support from the Humanities and Social Science Fund of Ministry of Education of China(Project No.18YJAZH138)the National Natural Science Foundation of China(No.71403163)National Social Science Foundation of China(No.20BJL036).
文摘Changes in the energy price system will determine the direction of evolution of the energy industry structure.As a country where coal is the dominant energy source,what is the effect of coal price fluctuations on China’s industry development costs and energy consumption structure?To investigate this problem,this paper utilized an economy–energy–environment computable general equilibrium model.In this study,four aspects were analyzed:Energy supply side,proportion of renewable energy consumption,macroeconomy,and changes in CO_(2) emissions.The results of this study show that an increase of 10%–20%in coal prices contributes to a shift into using renewable energy,which leads to energy saving and emission reduction.Renewable energy and clean energy rose by 0.57%–4.47%in the energy structure,but this has a certain negative impact on the macroeconomy.The gross domestic product(GDP)fell by 0.07%–0.18%.As a result,the decline in coal prices became an obstacle to renewable energy substitution and energy conservation.In addition,we put forward policy suggestions according to the results in energy,economic,and environmental effects.