This paper primarily concerns the effective coordination of the procedures and methods employed in open pit mining operations under the background of river management.The central objective of this study is to identify...This paper primarily concerns the effective coordination of the procedures and methods employed in open pit mining operations under the background of river management.The central objective of this study is to identify a viable approach for ensuring rational and efficient development of open pit mineral resources while simultaneously protecting and restoring the ecological environment of the river.This approach should facilitate the realization of a harmonious symbiosis between mining and river management.The intricate mutual influence relationship between river management and open pit mining is first analyzed in depth,which provides a solid foundation for the subsequent coordination strategy development.In light of the aforementioned considerations,a set of coordination procedures for open pit mining based on river management conditions is proposed.These procedures emphasize the integration of river protection into the overall layout of mining at the planning stage.The implementation of scientific mining schemes,accompanied by rigorous control of the scope and depth of mining operations,has proven to be an effective means of reducing the impact of mining activities on river environments.This approach has also facilitated the achievement of a balance and coordination between mining and river management.展开更多
Background: Vaginal discharge is one of most common and nagging problems that women face. About 20% - 25% of women who visit gynecology department complain of vaginal discharge and leucorrhoea. An orally administered ...Background: Vaginal discharge is one of most common and nagging problems that women face. About 20% - 25% of women who visit gynecology department complain of vaginal discharge and leucorrhoea. An orally administered combination kit, containing 2 g secnidazole, 1 g azithromycin and 150 mg fluconazole (Azimyn FS Kit), has been successfully evaluated in clinical trials and used in several countries for management syndromic vaginal discharge due to infections. Methods: This is a longitudinal study which aimed to verify the clinical efficacy of the combined oral kit containing secnidazole, azithromycin and fluconazole (Azimyn FS Kit<sup><sup>®</sup></sup>) in the syndromic treatment of abnormal vaginal discharge in patients received in outpatient consultations in Kinshasa/DR Congo from March to September 2023. Results: Majority of patients had whitish vaginal discharge (51.6%) of average abundance (56.2%), accompanied by pruritus in 72.1% of cases, and dyspareunia in 23.5% of cases and hypogastralgia in 40.2% of cases. One week after treatment with the Azimyn FS<sup><sup>®</sup></sup> combined kit, at the greatest majority of patients (97.3%), abnormal vaginal discharge had decreased by more than 50% (84.1%). Two weeks after treatment with the Azimyn FS<sup><sup>®</sup></sup> combined kit, almost all patients (97.3%) no longer had abnormal vaginal discharge which had completely disappeared. Conclusion: A single dose of secnidazole, azithromycin and fluconazole in the form of an oral combi-kit (Azimyn FS Kit) has shown excellent therapeutic effectiveness in the syndromic treatment of abnormal vaginal discharge wherein patients were treated without diagnostic confirmation.展开更多
Hepatitis B virus(HBV)reactivation is a clinically significant challenge in disease management.This review explores the immunological mechanisms underlying HBV reactivation,emphasizing disease progression and manageme...Hepatitis B virus(HBV)reactivation is a clinically significant challenge in disease management.This review explores the immunological mechanisms underlying HBV reactivation,emphasizing disease progression and management.It delves into host immune responses and reactivation’s delicate balance,spanning innate and adaptive immunity.Viral factors’disruption of this balance,as are interac-tions between viral antigens,immune cells,cytokine networks,and immune checkpoint pathways,are examined.Notably,the roles of T cells,natural killer cells,and antigen-presenting cells are discussed,highlighting their influence on disease progression.HBV reactivation’s impact on disease severity,hepatic flares,liver fibrosis progression,and hepatocellular carcinoma is detailed.Management strategies,including anti-viral and immunomodulatory approaches,are critically analyzed.The role of prophylactic anti-viral therapy during immunosuppressive treatments is explored alongside novel immunotherapeutic interventions to restore immune control and prevent reactivation.In conclusion,this compre-hensive review furnishes a holistic view of the immunological mechanisms that propel HBV reactivation.With a dedicated focus on understanding its implic-ations for disease progression and the prospects of efficient management stra-tegies,this article contributes significantly to the knowledge base.The more profound insights into the intricate interactions between viral elements and the immune system will inform evidence-based approaches,ultimately enhancing disease management and elevating patient outcomes.The dynamic landscape of management strategies is critically scrutinized,spanning anti-viral and immunomodulatory approaches.The role of prophylactic anti-viral therapy in preventing reactivation during immunosuppressive treatments and the potential of innovative immunotherapeutic interventions to restore immune control and proactively deter reactivation.展开更多
BACKGROUND Colorectal signet-ring cell carcinoma(CSRCC)is a rare clinical entity which accounts for approximately 1%of all colorectal cancers.Although multiple studies concerning this specific topic have been publishe...BACKGROUND Colorectal signet-ring cell carcinoma(CSRCC)is a rare clinical entity which accounts for approximately 1%of all colorectal cancers.Although multiple studies concerning this specific topic have been published in the past decades,the pathogenesis,associated risk factors,and potential implications on treatment are still poorly understood.Besides the low incidence,historically confusing histological criteria have resulted in confusing data.Nevertheless,the rising incidence of CSRCC along with relatively young age at presentation and associated dismal prognosis,highlight the actual interest to synthesize the known literature regarding CSRCC.AIM To provide an updated overview of risk factors,prognosis,and management of CSRCC.METHODS A literature search in the MEDLINE/PubMed database was conducted with the following search terms used:‘Signet ring cell carcinoma’and‘colorectal’.Studies in English language,published after January 1980,were included.Studies included in the qualitative synthesis were evaluated for content concerning epidemiology,risk factors,and clinical,diagnostic,histological,and molecular features,as well as metastatic pattern and therapeutic management.If possible,presented data was extracted in order to present a more detailed overview of the literature.RESULTS In total,67 articles were included for qualitative analysis,of which 54 were eligible for detailed data extraction.CSRCC has a reported incidence between 0.1%-2.4%and frequently presents with advanced disease stage at the time of diagnosis.CSRCC is associated with an impaired overall survival(5-year OS:0%-46%)and a worse stagecorrected outcome compared to mucinous and not otherwise specified adenocarcinoma.The systematic use of exploratory laparoscopy to determine the presence of peritoneal metastases has been advised.Surgery is the mainstay of treatment,although the rates of curative resection in CSRCC(21%-82%)are lower compared to those in other histological types.In case of peritoneal metastasis,cytoreductive surgery with hyperthermic intraperitoneal chemotherapy should only be proposed in selected patients.CONCLUSION CSRCC is a rare clinical entity most often characterized by young age and advanced disease at presentation.As such,diagnostic modalities and therapeutic approach should be tailored accordingly.展开更多
BACKGROUND Cerebral infarction,previously referred to as cerebral infarction or ischemic stroke,refers to the localized brain tissue experiencing ischemic necrosis or softening due to disorders in brain blood supply,i...BACKGROUND Cerebral infarction,previously referred to as cerebral infarction or ischemic stroke,refers to the localized brain tissue experiencing ischemic necrosis or softening due to disorders in brain blood supply,ischemia,and hypoxia.The precision rehabilitation nursing model for chronic disease management is a continuous,fixed,orderly,and efficient nursing model aimed at standardizing the clinical nursing process,reducing the wastage of medical resources,and improving the quality of medical services.AIM To analyze the value of a precise rehabilitation nursing model for chronic disease management in patients with cerebral infarction.METHODS Patients(n=124)admitted to our hospital with cerebral infarction between November 2019 and November 2021 were enrolled as the study subjects.The random number table method was used to divide them into a conventional nursing intervention group(n=61)and a model nursing intervention group(n=63).Changes in the nursing index for the two groups were compared after conventional nursing intervention and precise rehabilitation intervention nursing for chronic disease management.RESULTS Compared with the conventional intervention group,the model intervention group had a shorter time to clinical symptom relief(P<0.05),lower Hamilton Anxiety Scale and Hamilton Depression Scale scores,a lower incidence of total complications(P<0.05),a higher disease knowledge mastery rate,higher safety and quality,and a higher overall nursing satisfaction rate(P<0.05).CONCLUSION The precision rehabilitation nursing model for chronic disease management improves the clinical symptoms of patients with cerebral infarction,reducing the incidence of total complications and improving the clinical outcome of patients,and is worthy of application in clinical practice.展开更多
In this paper,the mission and the thermal environment of the Solar Close Observations and Proximity Experiments(SCOPE)spacecraft are analyzed,and an advanced thermal management system(ATMS)is designed for it.The relat...In this paper,the mission and the thermal environment of the Solar Close Observations and Proximity Experiments(SCOPE)spacecraft are analyzed,and an advanced thermal management system(ATMS)is designed for it.The relationship and functions of the integrated database,the intelligent thermal control system and the efficient liquid cooling system in the ATMS are elaborated upon.For the complex thermal field regulation system and extreme space thermal environment,a modular simulation and thermal field planning method are proposed,and the feasibility of the planning algorithm is verified by numerical simulation.A solar array liquid cooling system is developed,and the system simulation results indicate that the temperatures of the solar arrays meet the requirements as the spacecraft flies by perihelion and aphelion.The advanced thermal management study supports the development of the SCOPE program and provides a reference for the thermal management in other deep-space exploration programs.展开更多
Objective:To explore the role of specialized group management in the quality control of perioperative nursing.Methods:45 surgical nurses from our hospital were selected as the research subjects.Traditional operating r...Objective:To explore the role of specialized group management in the quality control of perioperative nursing.Methods:45 surgical nurses from our hospital were selected as the research subjects.Traditional operating room management was adopted from July 2019 to June 2020,and specialized group management was adopted from July 2020 to June 2021.The surgeon’s satisfaction,surgical nurses’core professional competence,and surgical patients’satisfaction were obtained through surveys and the results were analyzed.Results:Surgeon satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Besides,surgical nurses’core professional competency scores before the implementation of specialized group management were significantly lower than after its implementation(P<0.05).Lastly,surgical patients’satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Conclusion:Specialized group management helps to improve the quality of perioperative care and should be applied in clinical practice.展开更多
Finding sustainable energy resources is essential to face the increasing energy demand.Trees are an important part of ancient architecture but are becoming rare in urban areas.Trees can control and tune the pedestrian...Finding sustainable energy resources is essential to face the increasing energy demand.Trees are an important part of ancient architecture but are becoming rare in urban areas.Trees can control and tune the pedestrian-level wind velocity and thermal condition.In this study,a numerical investigation is employed to assess the role of trees planted in the windward direction of the building complex on the thermal and pedestrian wind velocity conditions around/inside a pre-education building located in the center of the complex.Compared to the previous studies(which considered only outside buildings),this work considers the effects of trees on microclimate change both inside/outside buildings.Effects of different parameters including the leaf area density and number of trees,number of rows,far-field velocity magnitude,and thermal condition around the main building are assessed.The results show that the flow velocity in the spacing between the first-row buildings is reduced by 30%-40% when the one-row trees with 2 m height are planted 15 m farther than the buildings.Furthermore,two rows of trees are more effective in higher velocities and reduce the maximum velocity by about 50%.The investigation shows that trees also could reduce the temperature by about 1℃around the building.展开更多
In permissioned blockchain networks,the Proof of Authority(PoA)consensus,which uses the election of authorized nodes to validate transactions and blocks,has beenwidely advocated thanks to its high transaction throughp...In permissioned blockchain networks,the Proof of Authority(PoA)consensus,which uses the election of authorized nodes to validate transactions and blocks,has beenwidely advocated thanks to its high transaction throughput and fault tolerance.However,PoA suffers from the drawback of centralization dominated by a limited number of authorized nodes and the lack of anonymity due to the round-robin block proposal mechanism.As a result,traditional PoA is vulnerable to a single point of failure that compromises the security of the blockchain network.To address these issues,we propose a novel decentralized reputation management mechanism for permissioned blockchain networks to enhance security,promote liveness,and mitigate centralization while retaining the same throughput as traditional PoA.This paper aims to design an off-chain reputation evaluation and an on-chain reputation-aided consensus.First,we evaluate the nodes’reputation in the context of the blockchain networks and make the reputation globally verifiable through smart contracts.Second,building upon traditional PoA,we propose a reputation-aided PoA(rPoA)consensus to enhance securitywithout sacrificing throughput.In particular,rPoA can incentivize nodes to autonomously form committees based on reputation authority,which prevents block generation from being tracked through the randomness of reputation variation.Moreover,we develop a reputation-aided fork-choice rule for rPoA to promote the network’s liveness.Finally,experimental results show that the proposed rPoA achieves higher security performance while retaining transaction throughput compared to traditional PoA.展开更多
Obesity is a prevalent chronic disease that has significant negative impacts on humans and our companion animals,including dogs and cats.Obesity occurs with multiple comorbidities,such as diabetes,hypertension,heart d...Obesity is a prevalent chronic disease that has significant negative impacts on humans and our companion animals,including dogs and cats.Obesity occurs with multiple comorbidities,such as diabetes,hypertension,heart disease and osteoarthritis in dogs and cats.A direct link between lipid metabolism dysregulation and obesity-associated diseases has been implicated.However,the understanding of such pathophysiology in companion animals is lim-ited.This review aims to address the role of lipid metabolism in various metabolic disorders associated with obesity,emphasizing the involvement of the gut microbiota.Furthermore,we also discuss the management of obesity,including approaches like nutritional interventions,thus providing novel insights into obesity prevention and treatment for canines and felines.展开更多
In 2009,the World Health Organization included snakebite on the list of neglected tropical diseases,acknowledging it as a common occupational hazard for farmers,plantation workers,and others,causing tens of thousands ...In 2009,the World Health Organization included snakebite on the list of neglected tropical diseases,acknowledging it as a common occupational hazard for farmers,plantation workers,and others,causing tens of thousands of deaths and chronic physical disabilities every year.This guideline aims to provide practical information to help clinical professionals evaluate and treat snakebite victims.These recommendations are based on clinical experience and clinical research evidence.This guideline focuses on the following topics:snake venom,clinical manifestations,auxiliary examination,diagnosis,treatments,and prevention.展开更多
The footprints of water and nitrogen(WF and NF)provide a comprehensive overview of the type and quantity of water consumption and reactive nitrogen(Nr)loss in crop production.In this study,a field experiment over two ...The footprints of water and nitrogen(WF and NF)provide a comprehensive overview of the type and quantity of water consumption and reactive nitrogen(Nr)loss in crop production.In this study,a field experiment over two years(2019 and 2020)compared three integrated agronomic practice management(IAPM)systems:An improved management system(T2),a high-yield production system(T3),and an integrated soil-crop management system(ISCM)using a local smallholder farmer’s practice system(T1)as control,to investigate the responses of WF,Nr losses,water use efficiency(WUE),and nitrogen use efficiency(NUE)to IAPM.The results showed that IAPM optimized water distribution and promoted water use by summer maize.The evapotranspiration over the whole maize growth period of IAPM increased,but yield increased more,leading to a significant increase in WUE.The WUE of the T2,T3,and ISCM treatments was significantly greater than in the T1 treatment,in 2019 and 2020respectively,by 19.8-21.5,31.8-40.6,and 34.4-44.6%.The lowest WF was found in the ISCM treatment,which was 31.0%lower than that of the T1 treatment.In addition,the ISCM treatment optimized soil total nitrogen(TN)distribution and significantly increased TN in the cultivated layer.Excessive nitrogen fertilizer was applied in treatment T3,producing the highest maize yield,and resulting in the highest Nr losses.In contrast,the ISCM treatment used a reduced nitrogen fertilizer rate,sacrificing grain yield partly,which reduced Nr losses and eventually led to a significant increase in nitrogen use efficiency and nitrogen recovery.The Nr level in the ISCM treatment was34.8%lower than in the T1 treatment while NUE was significantly higher than in the T1 treatment by 56.8-63.1%in2019 and 2020,respectively.Considering yield,WUE,NUE,WF,and NF together,ISCM should be used as a more sustainable and clean system for sustainable production of summer maize.展开更多
This study investigates the factors that impact farmers'adoption of risk management strategies(RMS)in Pakistan during times of uncertainty.The study examines farmers'adoption of RMS using both multinomial prob...This study investigates the factors that impact farmers'adoption of risk management strategies(RMS)in Pakistan during times of uncertainty.The study examines farmers'adoption of RMS using both multinomial probit(MNP)and multivariate probit(MVP).Data were collected from 382 farmers sampled from four districts in KhyberPakhtunkhwa(KP)province of Pakistan via a multistage sampling technique.This study utilizes the MNP model,considering the assumption of Independence of Irrelevant Alternatives(IIA)and incorporating correlated error terms.The objective is to understand farmers'behavior in risky situations and determine if there is heterogeneity.Results are compared with the MVP model to assess robustness and gain deeper understanding of farmers'decisionmaking processes.The research findings reveal that our results are robust,and farmers behave homogeneously in various RMS scenarios.Farmers adopt RMS individually or in combination to mitigate the adverse effects of natural calamities on their livelihood.The risk-averse farmers,who perceive weather-related risks as a threat,access credits and information,and have farms close to a river are more likely to adopt RMS,irrespective of the format of the strategies available.Moreover,the predicted probabilities and correlation of the RMS and RM categories have strengthened our model estimation.These findings provide insights into the behavior of farmers in adopting RMS which are helpful for policymakers and stakeholders in developing strategies to mitigate the impacts of natural calamities on farmers.展开更多
Climate change and forest management are recognized as pivotal factors influencing forest ecosystem services and thus multifunctionality.However,the magnitude and the relative importance of climate change and forest m...Climate change and forest management are recognized as pivotal factors influencing forest ecosystem services and thus multifunctionality.However,the magnitude and the relative importance of climate change and forest management effects on the multifunctionality remain unclear,especially for natural mixed forests.In this study,our objective is to address this gap by utilizing simulations of climate-sensitive transition matrix growth models based on national forest inventory plot data.We evaluated the effects of seven management scenarios(combinations of various cutting methods and intensities)on the future provision of ecosystem services and multifunctionality in mixed conifer-broad-leaved forests in northeastern China,under four climate scenarios(SSP1-2.6,SSP2-4.5,SSP5-8.5,and constant climate).Provisioning,regulating,cultural,and supporting services were described by timber production,carbon storage,carbon sequestration,tree species diversity,deadwood volume,and the number of large living trees.Our findings indicated that timber production was significantly influenced by management scenarios,while tree species diversity,deadwood volume,and large living trees were impacted by both climate and management separately.Carbon storage and sequestration were notably influenced by both management and the interaction of climate and management.These findings emphasized the profound impact of forest management on ecosystem services,outweighing that of climate scenarios alone.We found no single management scenario maximized all six ecosystem service indicators.The upper story thinning by 5%intensity with 5-year interval(UST5)management strategy emerged with the highest multifunctionality,surpassing the lowest values by more than 20%across all climate scenarios.In conclusion,our results underlined the potential of climate-sensitive transition matrix growth models as a decision support tool and provided recommendations for long-term strategies for multifunctional forest management under future climate change context.Ecosystem services and multifunctionality of forests could be enhanced by implementing appropriate management measures amidst a changing climate.展开更多
Public urban greenery greatly contributes to the residential and tourist value of cities in the Gulf Region,but due to the hyper-arid climatic conditions,the cost of irrigation and plant maintenance is very high.Exist...Public urban greenery greatly contributes to the residential and tourist value of cities in the Gulf Region,but due to the hyper-arid climatic conditions,the cost of irrigation and plant maintenance is very high.Existing strategies to reduce the monetary and ecological costs involve the cultivation of native xerophytic plantations,and/or the use of soil improvers to increase water-and nutrient-holding capacity of the sandy soils.Various soil improvers based on mineral,organic,or synthetic materials have entered the United Arab Emirates(UAE)market in recent years,but there is considerable uncertainty about how they should best be used in combination with ornamental plant stands involving xerophytic native plants.The present study investigated the effect of soil amendment and deep pipe irrigation on perennial ornamental plant stands involving native plants(Tephrosia appolinea(Gel.)Link in combination with Aerva javanica(Burm.f.)Juss.ex Schult.)and native-exotic plants(T.appolinea in combination with Ruelia simplex C.Wright)either or not topsoil and subsoil amendment with bentonite and hydrophobic sand under the irrigation water supply of less than 50%of reference evapotranspiration(ET0).After one year of cultivation,T.appolinea and A.javanica(native vs.native)produced high biomass and exhibited high water use efficiency(WUE)as compared with T.appolinea and R.simplex(native vs.exotic)combination given that no significant differences were found under the soil amendment treatments.All stands thrived under irrigation water supply far below what is usually supplied to exotic ornamental stands in public parks of the Al Ain City,the UAE.However,subsoil amendment in combination with deep pipe irrigation reduced the occurrence of weeds and increased the overall plant rooting depth.Our results suggest that subsoil amendment and irrigation up to 60-80 cm depth can potentially control ephemeral weed infestation,which is a great challenge in various plant production systems of the Gulf Region.The results of the present study suggest that the impact of soil amendment on the WUE of exotic plants is marginal and might not be economically justified.Replacing exotic with native ornamental plant species seems to have a far greater water-saving potential than the amendment of the soil,while weeds can be suppressed in the absence of topsoil moisture.展开更多
Temperature regulating fibers(TRF_(s)) with high enthalpy and high form stability are the key factors for thermal management. However, the enthalpies of most TRFsare not high, and the preparation methods are still at ...Temperature regulating fibers(TRF_(s)) with high enthalpy and high form stability are the key factors for thermal management. However, the enthalpies of most TRFsare not high, and the preparation methods are still at the laboratory scale. It remains a great challenge to use industrial spinning equipment to achieve continuous processing of TRF_(s) with excellent thermal and mechanical properties. Here, polyamide 6(PA6) based TRF_(s) with a sheath-core structure were prepared by bicomponent melt-spinning. The sheath-core TRF(TRF_(sc)) are composed of PA6 as sheath and functional PA6 as core, which are filled with the shape stable phase change materials(ssPCM),dendritic silica@polyethylene glycol(SiO_(2)@PEG). With the aid of the sheath structure, the filling content of SiO_(2)@PEG can reach 30 %, so that the enthalpy of the TRF_(s) can be as high as 21.3 J/g. The ultra-high enthalpy guarantees the temperature regulation ability during the alternating process of cooling and heating. In hot environment, the temperature regulation time is 6.59 min, and the temperature difference is 12.93℃. In addition, the mechanical strength of the prepared TRF_(sc) reaches 2.26 cN/dtex, which can fully meet its application in the field of thermal management textiles and devices to manage the temperature regulation of the human body or precision equipment, etc.展开更多
The new energy vehicle plays a crucial role in green transportation,and the energy management strategy of hybrid power systems is essential for ensuring energy-efficient driving.This paper presents a state-of-the-art ...The new energy vehicle plays a crucial role in green transportation,and the energy management strategy of hybrid power systems is essential for ensuring energy-efficient driving.This paper presents a state-of-the-art survey and review of reinforcement learning-based energy management strategies for hybrid power systems.Additionally,it envisions the outlook for autonomous intelligent hybrid electric vehicles,with reinforcement learning as the foundational technology.First of all,to provide a macro view of historical development,the brief history of deep learning,reinforcement learning,and deep reinforcement learning is presented in the form of a timeline.Then,the comprehensive survey and review are conducted by collecting papers from mainstream academic databases.Enumerating most of the contributions based on three main directions—algorithm innovation,powertrain innovation,and environment innovation—provides an objective review of the research status.Finally,to advance the application of reinforcement learning in autonomous intelligent hybrid electric vehicles,future research plans positioned as“Alpha HEV”are envisioned,integrating Autopilot and energy-saving control.展开更多
Objective:To evaluate the application value of a refined quality control management model for a sterilization supply center.Methods:A retrospective analysis was conducted on the work situation of the sterilization sup...Objective:To evaluate the application value of a refined quality control management model for a sterilization supply center.Methods:A retrospective analysis was conducted on the work situation of the sterilization supply center from January 2021 to January 2023.The work situation before January 31,2022,was classified as the control group;a routine quality control management model was implemented,and the work situation after January 31,2022,was classified as the observation group.The quality of medical device management and department satisfaction between the two groups were compared.Results:The timely recovery and supply rate,classification and cleaning pass rate,disinfection pass rate,packaging pass rate,sterilization pass rate,and department satisfaction score in the observation group were all higher than those of the control group(P<0.05).Conclusion:Implementing a refined quality control management model in the sterilization supply center can improve the quality management level of medical devices and department satisfaction and is worthy of promotion.展开更多
To solve the problem of delayed update of spectrum information(SI) in the database assisted dynamic spectrum management(DB-DSM), this paper studies a novel dynamic update scheme of SI in DB-DSM. Firstly, a dynamic upd...To solve the problem of delayed update of spectrum information(SI) in the database assisted dynamic spectrum management(DB-DSM), this paper studies a novel dynamic update scheme of SI in DB-DSM. Firstly, a dynamic update mechanism of SI based on spectrum opportunity incentive is established, in which spectrum users are encouraged to actively assist the database to update SI in real time. Secondly, the information update contribution(IUC) of spectrum opportunity is defined to describe the cost of accessing spectrum opportunity for heterogeneous spectrum users, and the profit of SI update obtained by the database from spectrum allocation. The process that the database determines the IUC of spectrum opportunity and spectrum user selects spectrum opportunity is mapped to a Hotelling model. Thirdly, the process of determining the IUC of spectrum opportunities is further modelled as a Stackelberg game by establishing multiple virtual spectrum resource providers(VSRPs) in the database. It is proved that there is a Nash Equilibrium in the game of determining the IUC of spectrum opportunities by VSRPs. Finally, an algorithm of determining the IUC based on a genetic algorithm is designed to achieve the optimal IUC. The-oretical analysis and simulation results show that the proposed method can quickly find the optimal solution of the IUC, and ensure that the spectrum resource provider can obtain the optimal profit of SI update.展开更多
Mid-gastrointestinal bleeding accounts for approximately 5%-10%of all gastrointestinal bleeding cases,and vascular lesions represent the most frequent cause.The rebleeding rate for these lesions is quite high(about 42...Mid-gastrointestinal bleeding accounts for approximately 5%-10%of all gastrointestinal bleeding cases,and vascular lesions represent the most frequent cause.The rebleeding rate for these lesions is quite high(about 42%).We hereby recommend that scheduled outpatient management of these patients could reduce the risk of rebleeding episodes.展开更多
文摘This paper primarily concerns the effective coordination of the procedures and methods employed in open pit mining operations under the background of river management.The central objective of this study is to identify a viable approach for ensuring rational and efficient development of open pit mineral resources while simultaneously protecting and restoring the ecological environment of the river.This approach should facilitate the realization of a harmonious symbiosis between mining and river management.The intricate mutual influence relationship between river management and open pit mining is first analyzed in depth,which provides a solid foundation for the subsequent coordination strategy development.In light of the aforementioned considerations,a set of coordination procedures for open pit mining based on river management conditions is proposed.These procedures emphasize the integration of river protection into the overall layout of mining at the planning stage.The implementation of scientific mining schemes,accompanied by rigorous control of the scope and depth of mining operations,has proven to be an effective means of reducing the impact of mining activities on river environments.This approach has also facilitated the achievement of a balance and coordination between mining and river management.
文摘Background: Vaginal discharge is one of most common and nagging problems that women face. About 20% - 25% of women who visit gynecology department complain of vaginal discharge and leucorrhoea. An orally administered combination kit, containing 2 g secnidazole, 1 g azithromycin and 150 mg fluconazole (Azimyn FS Kit), has been successfully evaluated in clinical trials and used in several countries for management syndromic vaginal discharge due to infections. Methods: This is a longitudinal study which aimed to verify the clinical efficacy of the combined oral kit containing secnidazole, azithromycin and fluconazole (Azimyn FS Kit<sup><sup>®</sup></sup>) in the syndromic treatment of abnormal vaginal discharge in patients received in outpatient consultations in Kinshasa/DR Congo from March to September 2023. Results: Majority of patients had whitish vaginal discharge (51.6%) of average abundance (56.2%), accompanied by pruritus in 72.1% of cases, and dyspareunia in 23.5% of cases and hypogastralgia in 40.2% of cases. One week after treatment with the Azimyn FS<sup><sup>®</sup></sup> combined kit, at the greatest majority of patients (97.3%), abnormal vaginal discharge had decreased by more than 50% (84.1%). Two weeks after treatment with the Azimyn FS<sup><sup>®</sup></sup> combined kit, almost all patients (97.3%) no longer had abnormal vaginal discharge which had completely disappeared. Conclusion: A single dose of secnidazole, azithromycin and fluconazole in the form of an oral combi-kit (Azimyn FS Kit) has shown excellent therapeutic effectiveness in the syndromic treatment of abnormal vaginal discharge wherein patients were treated without diagnostic confirmation.
文摘Hepatitis B virus(HBV)reactivation is a clinically significant challenge in disease management.This review explores the immunological mechanisms underlying HBV reactivation,emphasizing disease progression and management.It delves into host immune responses and reactivation’s delicate balance,spanning innate and adaptive immunity.Viral factors’disruption of this balance,as are interac-tions between viral antigens,immune cells,cytokine networks,and immune checkpoint pathways,are examined.Notably,the roles of T cells,natural killer cells,and antigen-presenting cells are discussed,highlighting their influence on disease progression.HBV reactivation’s impact on disease severity,hepatic flares,liver fibrosis progression,and hepatocellular carcinoma is detailed.Management strategies,including anti-viral and immunomodulatory approaches,are critically analyzed.The role of prophylactic anti-viral therapy during immunosuppressive treatments is explored alongside novel immunotherapeutic interventions to restore immune control and prevent reactivation.In conclusion,this compre-hensive review furnishes a holistic view of the immunological mechanisms that propel HBV reactivation.With a dedicated focus on understanding its implic-ations for disease progression and the prospects of efficient management stra-tegies,this article contributes significantly to the knowledge base.The more profound insights into the intricate interactions between viral elements and the immune system will inform evidence-based approaches,ultimately enhancing disease management and elevating patient outcomes.The dynamic landscape of management strategies is critically scrutinized,spanning anti-viral and immunomodulatory approaches.The role of prophylactic anti-viral therapy in preventing reactivation during immunosuppressive treatments and the potential of innovative immunotherapeutic interventions to restore immune control and proactively deter reactivation.
文摘BACKGROUND Colorectal signet-ring cell carcinoma(CSRCC)is a rare clinical entity which accounts for approximately 1%of all colorectal cancers.Although multiple studies concerning this specific topic have been published in the past decades,the pathogenesis,associated risk factors,and potential implications on treatment are still poorly understood.Besides the low incidence,historically confusing histological criteria have resulted in confusing data.Nevertheless,the rising incidence of CSRCC along with relatively young age at presentation and associated dismal prognosis,highlight the actual interest to synthesize the known literature regarding CSRCC.AIM To provide an updated overview of risk factors,prognosis,and management of CSRCC.METHODS A literature search in the MEDLINE/PubMed database was conducted with the following search terms used:‘Signet ring cell carcinoma’and‘colorectal’.Studies in English language,published after January 1980,were included.Studies included in the qualitative synthesis were evaluated for content concerning epidemiology,risk factors,and clinical,diagnostic,histological,and molecular features,as well as metastatic pattern and therapeutic management.If possible,presented data was extracted in order to present a more detailed overview of the literature.RESULTS In total,67 articles were included for qualitative analysis,of which 54 were eligible for detailed data extraction.CSRCC has a reported incidence between 0.1%-2.4%and frequently presents with advanced disease stage at the time of diagnosis.CSRCC is associated with an impaired overall survival(5-year OS:0%-46%)and a worse stagecorrected outcome compared to mucinous and not otherwise specified adenocarcinoma.The systematic use of exploratory laparoscopy to determine the presence of peritoneal metastases has been advised.Surgery is the mainstay of treatment,although the rates of curative resection in CSRCC(21%-82%)are lower compared to those in other histological types.In case of peritoneal metastasis,cytoreductive surgery with hyperthermic intraperitoneal chemotherapy should only be proposed in selected patients.CONCLUSION CSRCC is a rare clinical entity most often characterized by young age and advanced disease at presentation.As such,diagnostic modalities and therapeutic approach should be tailored accordingly.
文摘BACKGROUND Cerebral infarction,previously referred to as cerebral infarction or ischemic stroke,refers to the localized brain tissue experiencing ischemic necrosis or softening due to disorders in brain blood supply,ischemia,and hypoxia.The precision rehabilitation nursing model for chronic disease management is a continuous,fixed,orderly,and efficient nursing model aimed at standardizing the clinical nursing process,reducing the wastage of medical resources,and improving the quality of medical services.AIM To analyze the value of a precise rehabilitation nursing model for chronic disease management in patients with cerebral infarction.METHODS Patients(n=124)admitted to our hospital with cerebral infarction between November 2019 and November 2021 were enrolled as the study subjects.The random number table method was used to divide them into a conventional nursing intervention group(n=61)and a model nursing intervention group(n=63).Changes in the nursing index for the two groups were compared after conventional nursing intervention and precise rehabilitation intervention nursing for chronic disease management.RESULTS Compared with the conventional intervention group,the model intervention group had a shorter time to clinical symptom relief(P<0.05),lower Hamilton Anxiety Scale and Hamilton Depression Scale scores,a lower incidence of total complications(P<0.05),a higher disease knowledge mastery rate,higher safety and quality,and a higher overall nursing satisfaction rate(P<0.05).CONCLUSION The precision rehabilitation nursing model for chronic disease management improves the clinical symptoms of patients with cerebral infarction,reducing the incidence of total complications and improving the clinical outcome of patients,and is worthy of application in clinical practice.
文摘In this paper,the mission and the thermal environment of the Solar Close Observations and Proximity Experiments(SCOPE)spacecraft are analyzed,and an advanced thermal management system(ATMS)is designed for it.The relationship and functions of the integrated database,the intelligent thermal control system and the efficient liquid cooling system in the ATMS are elaborated upon.For the complex thermal field regulation system and extreme space thermal environment,a modular simulation and thermal field planning method are proposed,and the feasibility of the planning algorithm is verified by numerical simulation.A solar array liquid cooling system is developed,and the system simulation results indicate that the temperatures of the solar arrays meet the requirements as the spacecraft flies by perihelion and aphelion.The advanced thermal management study supports the development of the SCOPE program and provides a reference for the thermal management in other deep-space exploration programs.
基金Hebei University Affiliated Hospital Youth Fund Scientific Research Project Project Number:2019Q017。
文摘Objective:To explore the role of specialized group management in the quality control of perioperative nursing.Methods:45 surgical nurses from our hospital were selected as the research subjects.Traditional operating room management was adopted from July 2019 to June 2020,and specialized group management was adopted from July 2020 to June 2021.The surgeon’s satisfaction,surgical nurses’core professional competence,and surgical patients’satisfaction were obtained through surveys and the results were analyzed.Results:Surgeon satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Besides,surgical nurses’core professional competency scores before the implementation of specialized group management were significantly lower than after its implementation(P<0.05).Lastly,surgical patients’satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Conclusion:Specialized group management helps to improve the quality of perioperative care and should be applied in clinical practice.
文摘Finding sustainable energy resources is essential to face the increasing energy demand.Trees are an important part of ancient architecture but are becoming rare in urban areas.Trees can control and tune the pedestrian-level wind velocity and thermal condition.In this study,a numerical investigation is employed to assess the role of trees planted in the windward direction of the building complex on the thermal and pedestrian wind velocity conditions around/inside a pre-education building located in the center of the complex.Compared to the previous studies(which considered only outside buildings),this work considers the effects of trees on microclimate change both inside/outside buildings.Effects of different parameters including the leaf area density and number of trees,number of rows,far-field velocity magnitude,and thermal condition around the main building are assessed.The results show that the flow velocity in the spacing between the first-row buildings is reduced by 30%-40% when the one-row trees with 2 m height are planted 15 m farther than the buildings.Furthermore,two rows of trees are more effective in higher velocities and reduce the maximum velocity by about 50%.The investigation shows that trees also could reduce the temperature by about 1℃around the building.
基金supported by the Shenzhen Science and Technology Program under Grants KCXST20221021111404010,JSGG20220831103400002,JSGGKQTD20221101115655027,JCYJ 20210324094609027the National KeyR&DProgram of China under Grant 2021YFB2700900+1 种基金the National Natural Science Foundation of China under Grants 62371239,62376074,72301083the Jiangsu Specially-Appointed Professor Program 2021.
文摘In permissioned blockchain networks,the Proof of Authority(PoA)consensus,which uses the election of authorized nodes to validate transactions and blocks,has beenwidely advocated thanks to its high transaction throughput and fault tolerance.However,PoA suffers from the drawback of centralization dominated by a limited number of authorized nodes and the lack of anonymity due to the round-robin block proposal mechanism.As a result,traditional PoA is vulnerable to a single point of failure that compromises the security of the blockchain network.To address these issues,we propose a novel decentralized reputation management mechanism for permissioned blockchain networks to enhance security,promote liveness,and mitigate centralization while retaining the same throughput as traditional PoA.This paper aims to design an off-chain reputation evaluation and an on-chain reputation-aided consensus.First,we evaluate the nodes’reputation in the context of the blockchain networks and make the reputation globally verifiable through smart contracts.Second,building upon traditional PoA,we propose a reputation-aided PoA(rPoA)consensus to enhance securitywithout sacrificing throughput.In particular,rPoA can incentivize nodes to autonomously form committees based on reputation authority,which prevents block generation from being tracked through the randomness of reputation variation.Moreover,we develop a reputation-aided fork-choice rule for rPoA to promote the network’s liveness.Finally,experimental results show that the proposed rPoA achieves higher security performance while retaining transaction throughput compared to traditional PoA.
基金funded by research grants from the Jiangsu Provincial Double-Innovation Team Program(JSSCTD202147)Nutrition and Care of Maternal and Child Research Fund Project of the Biostime Institute of Nutrition and Care(Grant No.2022BINCMCF006)+1 种基金the Postgraduate Research&Practice Innovation Program of Jiangsu Province(KYCX22_3527)the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD).
文摘Obesity is a prevalent chronic disease that has significant negative impacts on humans and our companion animals,including dogs and cats.Obesity occurs with multiple comorbidities,such as diabetes,hypertension,heart disease and osteoarthritis in dogs and cats.A direct link between lipid metabolism dysregulation and obesity-associated diseases has been implicated.However,the understanding of such pathophysiology in companion animals is lim-ited.This review aims to address the role of lipid metabolism in various metabolic disorders associated with obesity,emphasizing the involvement of the gut microbiota.Furthermore,we also discuss the management of obesity,including approaches like nutritional interventions,thus providing novel insights into obesity prevention and treatment for canines and felines.
基金supported by the National Science Foundation of China(82160647)Hainan Clinical Medical Research Center Project(LCYX202310)+1 种基金Hainan Provincial Major Science and Technology Projects(ZDKJ202004)CAMS Innovation Fund for Medical Sciences(2019-I2M-5-023).
文摘In 2009,the World Health Organization included snakebite on the list of neglected tropical diseases,acknowledging it as a common occupational hazard for farmers,plantation workers,and others,causing tens of thousands of deaths and chronic physical disabilities every year.This guideline aims to provide practical information to help clinical professionals evaluate and treat snakebite victims.These recommendations are based on clinical experience and clinical research evidence.This guideline focuses on the following topics:snake venom,clinical manifestations,auxiliary examination,diagnosis,treatments,and prevention.
基金support of the National Key R&D Program of China(2023YFD2301500)the China Agriculture System of MOF and MARA(CARS-02)the Shandong Central Guiding the Local Science and Technology Development,China(YDZX20203700002548)。
文摘The footprints of water and nitrogen(WF and NF)provide a comprehensive overview of the type and quantity of water consumption and reactive nitrogen(Nr)loss in crop production.In this study,a field experiment over two years(2019 and 2020)compared three integrated agronomic practice management(IAPM)systems:An improved management system(T2),a high-yield production system(T3),and an integrated soil-crop management system(ISCM)using a local smallholder farmer’s practice system(T1)as control,to investigate the responses of WF,Nr losses,water use efficiency(WUE),and nitrogen use efficiency(NUE)to IAPM.The results showed that IAPM optimized water distribution and promoted water use by summer maize.The evapotranspiration over the whole maize growth period of IAPM increased,but yield increased more,leading to a significant increase in WUE.The WUE of the T2,T3,and ISCM treatments was significantly greater than in the T1 treatment,in 2019 and 2020respectively,by 19.8-21.5,31.8-40.6,and 34.4-44.6%.The lowest WF was found in the ISCM treatment,which was 31.0%lower than that of the T1 treatment.In addition,the ISCM treatment optimized soil total nitrogen(TN)distribution and significantly increased TN in the cultivated layer.Excessive nitrogen fertilizer was applied in treatment T3,producing the highest maize yield,and resulting in the highest Nr losses.In contrast,the ISCM treatment used a reduced nitrogen fertilizer rate,sacrificing grain yield partly,which reduced Nr losses and eventually led to a significant increase in nitrogen use efficiency and nitrogen recovery.The Nr level in the ISCM treatment was34.8%lower than in the T1 treatment while NUE was significantly higher than in the T1 treatment by 56.8-63.1%in2019 and 2020,respectively.Considering yield,WUE,NUE,WF,and NF together,ISCM should be used as a more sustainable and clean system for sustainable production of summer maize.
文摘This study investigates the factors that impact farmers'adoption of risk management strategies(RMS)in Pakistan during times of uncertainty.The study examines farmers'adoption of RMS using both multinomial probit(MNP)and multivariate probit(MVP).Data were collected from 382 farmers sampled from four districts in KhyberPakhtunkhwa(KP)province of Pakistan via a multistage sampling technique.This study utilizes the MNP model,considering the assumption of Independence of Irrelevant Alternatives(IIA)and incorporating correlated error terms.The objective is to understand farmers'behavior in risky situations and determine if there is heterogeneity.Results are compared with the MVP model to assess robustness and gain deeper understanding of farmers'decisionmaking processes.The research findings reveal that our results are robust,and farmers behave homogeneously in various RMS scenarios.Farmers adopt RMS individually or in combination to mitigate the adverse effects of natural calamities on their livelihood.The risk-averse farmers,who perceive weather-related risks as a threat,access credits and information,and have farms close to a river are more likely to adopt RMS,irrespective of the format of the strategies available.Moreover,the predicted probabilities and correlation of the RMS and RM categories have strengthened our model estimation.These findings provide insights into the behavior of farmers in adopting RMS which are helpful for policymakers and stakeholders in developing strategies to mitigate the impacts of natural calamities on farmers.
基金funded by the National Key R&D Program of China(Grant No.2022YFD2200500)the Forestry Public Welfare Scientific Research Project(Grant No.201504303)。
文摘Climate change and forest management are recognized as pivotal factors influencing forest ecosystem services and thus multifunctionality.However,the magnitude and the relative importance of climate change and forest management effects on the multifunctionality remain unclear,especially for natural mixed forests.In this study,our objective is to address this gap by utilizing simulations of climate-sensitive transition matrix growth models based on national forest inventory plot data.We evaluated the effects of seven management scenarios(combinations of various cutting methods and intensities)on the future provision of ecosystem services and multifunctionality in mixed conifer-broad-leaved forests in northeastern China,under four climate scenarios(SSP1-2.6,SSP2-4.5,SSP5-8.5,and constant climate).Provisioning,regulating,cultural,and supporting services were described by timber production,carbon storage,carbon sequestration,tree species diversity,deadwood volume,and the number of large living trees.Our findings indicated that timber production was significantly influenced by management scenarios,while tree species diversity,deadwood volume,and large living trees were impacted by both climate and management separately.Carbon storage and sequestration were notably influenced by both management and the interaction of climate and management.These findings emphasized the profound impact of forest management on ecosystem services,outweighing that of climate scenarios alone.We found no single management scenario maximized all six ecosystem service indicators.The upper story thinning by 5%intensity with 5-year interval(UST5)management strategy emerged with the highest multifunctionality,surpassing the lowest values by more than 20%across all climate scenarios.In conclusion,our results underlined the potential of climate-sensitive transition matrix growth models as a decision support tool and provided recommendations for long-term strategies for multifunctional forest management under future climate change context.Ecosystem services and multifunctionality of forests could be enhanced by implementing appropriate management measures amidst a changing climate.
基金partly funded by the Al Ain MunicipalityNational Water and Energy Center, United Arab Emirates University。
文摘Public urban greenery greatly contributes to the residential and tourist value of cities in the Gulf Region,but due to the hyper-arid climatic conditions,the cost of irrigation and plant maintenance is very high.Existing strategies to reduce the monetary and ecological costs involve the cultivation of native xerophytic plantations,and/or the use of soil improvers to increase water-and nutrient-holding capacity of the sandy soils.Various soil improvers based on mineral,organic,or synthetic materials have entered the United Arab Emirates(UAE)market in recent years,but there is considerable uncertainty about how they should best be used in combination with ornamental plant stands involving xerophytic native plants.The present study investigated the effect of soil amendment and deep pipe irrigation on perennial ornamental plant stands involving native plants(Tephrosia appolinea(Gel.)Link in combination with Aerva javanica(Burm.f.)Juss.ex Schult.)and native-exotic plants(T.appolinea in combination with Ruelia simplex C.Wright)either or not topsoil and subsoil amendment with bentonite and hydrophobic sand under the irrigation water supply of less than 50%of reference evapotranspiration(ET0).After one year of cultivation,T.appolinea and A.javanica(native vs.native)produced high biomass and exhibited high water use efficiency(WUE)as compared with T.appolinea and R.simplex(native vs.exotic)combination given that no significant differences were found under the soil amendment treatments.All stands thrived under irrigation water supply far below what is usually supplied to exotic ornamental stands in public parks of the Al Ain City,the UAE.However,subsoil amendment in combination with deep pipe irrigation reduced the occurrence of weeds and increased the overall plant rooting depth.Our results suggest that subsoil amendment and irrigation up to 60-80 cm depth can potentially control ephemeral weed infestation,which is a great challenge in various plant production systems of the Gulf Region.The results of the present study suggest that the impact of soil amendment on the WUE of exotic plants is marginal and might not be economically justified.Replacing exotic with native ornamental plant species seems to have a far greater water-saving potential than the amendment of the soil,while weeds can be suppressed in the absence of topsoil moisture.
基金financially supported by the National Natural Science Foundation of China (52073047)the Science and Technology Commission of Shanghai Municipality (20JC1414900)+1 种基金the Program of Shanghai Technology Research Leader (20XD1433700)the INTERNATIONAL COOPERATION Fund of the Science and Technology Commission of Shanghai Municipality (20520740800)。
文摘Temperature regulating fibers(TRF_(s)) with high enthalpy and high form stability are the key factors for thermal management. However, the enthalpies of most TRFsare not high, and the preparation methods are still at the laboratory scale. It remains a great challenge to use industrial spinning equipment to achieve continuous processing of TRF_(s) with excellent thermal and mechanical properties. Here, polyamide 6(PA6) based TRF_(s) with a sheath-core structure were prepared by bicomponent melt-spinning. The sheath-core TRF(TRF_(sc)) are composed of PA6 as sheath and functional PA6 as core, which are filled with the shape stable phase change materials(ssPCM),dendritic silica@polyethylene glycol(SiO_(2)@PEG). With the aid of the sheath structure, the filling content of SiO_(2)@PEG can reach 30 %, so that the enthalpy of the TRF_(s) can be as high as 21.3 J/g. The ultra-high enthalpy guarantees the temperature regulation ability during the alternating process of cooling and heating. In hot environment, the temperature regulation time is 6.59 min, and the temperature difference is 12.93℃. In addition, the mechanical strength of the prepared TRF_(sc) reaches 2.26 cN/dtex, which can fully meet its application in the field of thermal management textiles and devices to manage the temperature regulation of the human body or precision equipment, etc.
基金Supported by National Natural Science Foundation of China (Grant Nos.52222215,52072051)Fundamental Research Funds for the Central Universities in China (Grant No.2023CDJXY-025)Chongqing Municipal Natural Science Foundation of China (Grant No.CSTB2023NSCQ-JQX0003)。
文摘The new energy vehicle plays a crucial role in green transportation,and the energy management strategy of hybrid power systems is essential for ensuring energy-efficient driving.This paper presents a state-of-the-art survey and review of reinforcement learning-based energy management strategies for hybrid power systems.Additionally,it envisions the outlook for autonomous intelligent hybrid electric vehicles,with reinforcement learning as the foundational technology.First of all,to provide a macro view of historical development,the brief history of deep learning,reinforcement learning,and deep reinforcement learning is presented in the form of a timeline.Then,the comprehensive survey and review are conducted by collecting papers from mainstream academic databases.Enumerating most of the contributions based on three main directions—algorithm innovation,powertrain innovation,and environment innovation—provides an objective review of the research status.Finally,to advance the application of reinforcement learning in autonomous intelligent hybrid electric vehicles,future research plans positioned as“Alpha HEV”are envisioned,integrating Autopilot and energy-saving control.
文摘Objective:To evaluate the application value of a refined quality control management model for a sterilization supply center.Methods:A retrospective analysis was conducted on the work situation of the sterilization supply center from January 2021 to January 2023.The work situation before January 31,2022,was classified as the control group;a routine quality control management model was implemented,and the work situation after January 31,2022,was classified as the observation group.The quality of medical device management and department satisfaction between the two groups were compared.Results:The timely recovery and supply rate,classification and cleaning pass rate,disinfection pass rate,packaging pass rate,sterilization pass rate,and department satisfaction score in the observation group were all higher than those of the control group(P<0.05).Conclusion:Implementing a refined quality control management model in the sterilization supply center can improve the quality management level of medical devices and department satisfaction and is worthy of promotion.
文摘To solve the problem of delayed update of spectrum information(SI) in the database assisted dynamic spectrum management(DB-DSM), this paper studies a novel dynamic update scheme of SI in DB-DSM. Firstly, a dynamic update mechanism of SI based on spectrum opportunity incentive is established, in which spectrum users are encouraged to actively assist the database to update SI in real time. Secondly, the information update contribution(IUC) of spectrum opportunity is defined to describe the cost of accessing spectrum opportunity for heterogeneous spectrum users, and the profit of SI update obtained by the database from spectrum allocation. The process that the database determines the IUC of spectrum opportunity and spectrum user selects spectrum opportunity is mapped to a Hotelling model. Thirdly, the process of determining the IUC of spectrum opportunities is further modelled as a Stackelberg game by establishing multiple virtual spectrum resource providers(VSRPs) in the database. It is proved that there is a Nash Equilibrium in the game of determining the IUC of spectrum opportunities by VSRPs. Finally, an algorithm of determining the IUC based on a genetic algorithm is designed to achieve the optimal IUC. The-oretical analysis and simulation results show that the proposed method can quickly find the optimal solution of the IUC, and ensure that the spectrum resource provider can obtain the optimal profit of SI update.
文摘Mid-gastrointestinal bleeding accounts for approximately 5%-10%of all gastrointestinal bleeding cases,and vascular lesions represent the most frequent cause.The rebleeding rate for these lesions is quite high(about 42%).We hereby recommend that scheduled outpatient management of these patients could reduce the risk of rebleeding episodes.