僵尸网络(Botnet)是一种从传统恶意代码形态进化而来的新型攻击方式,为攻击者提供了隐匿、灵活且高效的一对多命令与控制信道(Command and Control channel,C&C)机制,可以控制大量僵尸主机实现信息窃取、分布式拒绝服务攻击和垃圾...僵尸网络(Botnet)是一种从传统恶意代码形态进化而来的新型攻击方式,为攻击者提供了隐匿、灵活且高效的一对多命令与控制信道(Command and Control channel,C&C)机制,可以控制大量僵尸主机实现信息窃取、分布式拒绝服务攻击和垃圾邮件发送等攻击目的。该文提出一种与僵尸网络结构和C&C协议无关,不需要分析数据包的特征负载的僵尸网络检测方法。该方法首先使用预过滤规则对捕获的流量进行过滤,去掉与僵尸网络无关的流量;其次对过滤后的流量属性进行统计;接着使用基于X-means聚类的两步聚类算法对C&C信道的流量属性进行分析与聚类,从而达到对僵尸网络检测的目的。实验证明,该方法高效准确地把僵尸网络流量与其他正常网络流量区分,达到从实际网络中检测僵尸网络的要求,并且具有较低的误判率。展开更多
Threshold decision is an important function of nuclear instrument control system based on physical parameters threshold decision. Because the conventional decision methods lack correlation with time and conditions, by...Threshold decision is an important function of nuclear instrument control system based on physical parameters threshold decision. Because the conventional decision methods lack correlation with time and conditions, by analyzing the existing methods, some optimized methods are adopted. Considering safety, those methods are improved in data processing algorithms, floating threshold with multiple values, association with specific working condition, etc. These measures im- prove the nuclear instrument control system in fault tolerance and fault diagnosis, especially, the shutdown number of nucle- ar power plant decreases.展开更多
BACKGROUND: Hemodialysis (HD) patients are at high risk of infection by hepatitis B virus (HBV) or hepatitis C virus (HCV). The present study was designed to determine the impact of quality control measures on the pre...BACKGROUND: Hemodialysis (HD) patients are at high risk of infection by hepatitis B virus (HBV) or hepatitis C virus (HCV). The present study was designed to determine the impact of quality control measures on the prevention of transmission of blood-borne viruses. METHODS: A total of 6182 adult maintenance HD patients from all HD units in Zhejiang Province were recruited on January 1, 2007. The baseline demographic and clinical characteristics were recorded and all patients were followed up until death or survival at 4 years later. The Quality Control Standards of Hemodialysis were gradually implemented in HD units. The HBV or HCV seroconversion rates of the recruited patients were calculated and compared every year during the observation period. RESULTS: The prevalence of HBV was 8.3% at the beginning of the study, and 6.6% for HCV. With the implementation of the HD quality control measures, the HBV seroconversion rate tended to decrease year by year (χ 2 =6.620, P=0.085), and the HCV seroconversion rate decreased significantly (χ 2 =10.41, P=0.015). Compared with the data in 2007, the HBV seroconversion rate (χ 2 =4.204, P=0.040, relative risk ratio 0.393, 95% CI 0.156-0.991) and the HCV seroconversion rate (χ 2 =7.373, P=0.007, relative risk ratio 0.386, 95% CI 0.189-0.787) decreased significantly in 2010. CONCLUSION: Quality control measures for HD decreased the seroconversion rates of HBV or HCV in HD patients, showing that updated quality control measures reduce the risk for transmission of blood-borne viruses in the HD population.展开更多
Recently, it has become clear that mild abnormal glucose tolerance increases the incidence of perinatal maternalinfant complications, and so the definition and diagnostic criteria of gestational diabetes mellitus(GDM)...Recently, it has become clear that mild abnormal glucose tolerance increases the incidence of perinatal maternalinfant complications, and so the definition and diagnostic criteria of gestational diabetes mellitus(GDM) have been changed. Therefore, in patients with GDM and pregnant women with diabetes mellitus, even stricter glycemic control than before is required to reduce the incidence of perinatal maternal-infant complications. Strict glycemic control cannot be attained without an indicator of glycemic control; this review proposes a reliable indicator. The gold standard indicator of glycemic control in patients with diabetes mellitus is hemoglobin A1c(Hb A1c); however, we have demonstrated that Hb A1 c does not reflect glycemic control accurately during pregnancy because of iron deficiency. It has also become clear that glycated albumin, another indicator of glycemic control, is not influenced by iron deficiency and therefore might be a better indicator of glycemic control in patients with GDM and pregnant women with diabetes mellitus. However, largepopulation epidemiological studies are necessary in order to confirm our proposal. Here, we outline the most recent findings about the indicators of glycemic control during pregnancy including fructosamine and 1,5-anhydroglucitol.展开更多
Two sets of super-synchronization speed control assemblies for two 80 MVA motor-generator units have been developed successfully in order to satisfy the demand of the toroidal field system in the HL-2A tokamak. Based ...Two sets of super-synchronization speed control assemblies for two 80 MVA motor-generator units have been developed successfully in order to satisfy the demand of the toroidal field system in the HL-2A tokamak. Based on the three-phase logical no-circumfluence a.c./a.c. cycloconverter, the speeds of two 2500 kW double fed drive motors have been regulated by means of the vector control technology. The maximum operating speed of each motor- generator unit has been raised from 1488 rpm (revolutions per minute) to 1650 rpm and the released energy of each unit during a pulsed discharge can reach 500 MJ. As a result, the toroidal field system has the capacity to provide 2.8 tesla (T) in HL-2A experiments.展开更多
The benchmark for assessing quality of long-term glycemic control and adjustment of therapy is currently glycated hemoglobin(Hb A1c). Despite its importance as an indicator for the development of diabeticcomplications...The benchmark for assessing quality of long-term glycemic control and adjustment of therapy is currently glycated hemoglobin(Hb A1c). Despite its importance as an indicator for the development of diabeticcomplications, recent studies have revealed that this metric has some limitations; it conveys a rather complex message, which has to be taken into consideration for diabetes screening and treatment. On the basis of recent clinical trials, the relationship between Hb A1 c and cardiovascular outcomes in long-standing diabetes has been called into question. It becomes obvious that other surrogate and biomarkers are needed to better predict cardiovascular diabetes complications and assess efficiency of therapy. Glycated albumin, fructosamin, and 1,5-anhydroglucitol have received growing interest as alternative markers of glycemic control. In addition to measures of hyperglycemia, advanced glucose monitoring methods became available. An indispensible adjunct to Hb A1 c in routine diabetes care is selfmonitoring of blood glucose. This monitoring method is now widely used, as it provides immediate feedback to patients on short-term changes, involving fasting, preprandial, and postprandial glucose levels. Beyond the traditional metrics, glycemic variability has been identified as a predictor of hypoglycemia, and it might also be implicated in the pathogenesis of vascular diabetes complications. Assessment of glycemic variability is thus important, but exact quantification requires frequently sampled glucose measurements. In order to optimize diabetes treatment, there is a need for both key metrics of glycemic control on a day-to-day basis and for more advanced, user-friendly monitoring methods. In addition to traditional discontinuous glucose testing, continuous glucose sensing has become a useful tool to reveal insufficient glycemic management. This new technology is particularly effective in patients with complicated diabetes and provides the opportunity to characterize glucose dynamics. Several continuous glucose monitoring(CGM) systems, which have shown usefulness in clinical practice, are presently on the market. They can broadly be divided into systems providing retrospective or real-time information on glucose patterns. The widespread clinical application of CGM is still hampered by the lack of generallyaccepted measures for assessment of glucose profiles and standardized reporting of glucose data. In this article, we will discuss advantages and limitations of various metrics for glycemic control as well as possibilities for evaluation of glucose data with the special focus on glycemic variability and application of CGM to improve individual diabetes management.展开更多
Neonatal diabetes mellitus(NDM) is a type of diabetes mellitus caused by genetic abnormality which devel ops in insulin dependent state within 6 mo after birth HbA1c is widely used in clinical practice for diabetes me...Neonatal diabetes mellitus(NDM) is a type of diabetes mellitus caused by genetic abnormality which devel ops in insulin dependent state within 6 mo after birth HbA1c is widely used in clinical practice for diabetes mellitus as the gold standard glycemic control indica tor; however, fetal hemoglobin(HbF) is the main he moglobin in neonates and so HbA1c cannot be used as a glycemic control indicator in NDM. Glycated albumin(GA), another glycemic control indicator, is not affected by HbF. We reported that GA can be used as a glycemic control indicator in NDM. However, it was later found that because of increased metabolism of albumin, GA shows an apparently lower level in relation to plasma glucose in NDM; measures to solve this problem were needed. In this review, we outlined the most recen findings concerning glycemic control indicators in neo nates or NDM.展开更多
AIM To characterize the survival of cirrhotic patients with Barcelona Clinic Liver Cancer(BCLC) stage C hepatocellular carcinoma(HCC) and to ascertain the factors predicting the achievement of disease control(DC).METH...AIM To characterize the survival of cirrhotic patients with Barcelona Clinic Liver Cancer(BCLC) stage C hepatocellular carcinoma(HCC) and to ascertain the factors predicting the achievement of disease control(DC).METHODS The cirrhotic patients with BCLC stage C HCC evaluated by the Hepatocatt multidisciplinary group were subjected to the investigation. Demographic, clinical and tumor features, along with the best tumor response and overall survival were recorded. RESULTS One hundred and ten BCLC stage C patients were included in the analysis; the median overall survival was 13.4 mo(95%CI: 10.6-17.0). Only alphafetoprotein(AFP) serum level > 200 ng/m L and DC could independently predict survival but in a time dependent manner, the former was significantly associated with increased risk of mortality within the first 6 mo of follow-up(HR = 5.073, 95%CI: 2.159-11.916, P = 0.0002), whereas the latter showed a protective effect against death after one year(HR = 0.110, 95%CI: 0.038-0.314, P < 0.0001). Only patients showing microvascular invasion and/or extrahepatic spread recorded lower chances of achieving DC(OR = 0.263, 95%CI: 0.111-0.622, P = 0.002).CONCLUSION The BCLC stage C HCC includes a wide heterogeneous group of cirrhotic patients suitable for potentially curative treatments. The reverse and time dependent effect of AFP serum level and DC on patients' survival confers them as useful predictive tools for treatment management and clinical decisions.展开更多
In recent years,the exponential proliferation of smart devices with their intelligent applications poses severe challenges on conventional cellular networks.Such challenges can be potentially overcome by integrating c...In recent years,the exponential proliferation of smart devices with their intelligent applications poses severe challenges on conventional cellular networks.Such challenges can be potentially overcome by integrating communication,computing,caching,and control(i4C)technologies.In this survey,we first give a snapshot of different aspects of the i4C,comprising background,motivation,leading technological enablers,potential applications,and use cases.Next,we describe different models of communication,computing,caching,and control(4C)to lay the foundation of the integration approach.We review current stateof-the-art research efforts related to the i4C,focusing on recent trends of both conventional and artificial intelligence(AI)-based integration approaches.We also highlight the need for intelligence in resources integration.Then,we discuss the integration of sensing and communication(ISAC)and classify the integration approaches into various classes.Finally,we propose open challenges and present future research directions for beyond 5G networks,such as 6G.展开更多
In our previous work, the reactive dividing wall column(RDWC) was proposed and proved to be effective for selective hydrogenation and separation of C3 stream. In the present paper, the dynamics and control of the prop...In our previous work, the reactive dividing wall column(RDWC) was proposed and proved to be effective for selective hydrogenation and separation of C3 stream. In the present paper, the dynamics and control of the proposed RDWC are investigated. Four control structures including composition and temperature controls are proposed. The feed forward controllers are employed in the four control strategies to shorten the dynamic response time, reduce the maximum deviations and offer an immediate adjustment. The control structures are compared by applying them into the RDWC system with 20% disturbances in both the feed flow rate and the feed compositions, and the results are discussed.展开更多
基于March算法的存储器内建自测试电路能够获得很高的故障覆盖率,但在测试小规模的存储器时暴露出了面积相对比较大的缺点。针对大屏幕Timing Controller芯片"龙腾TC1"中4块640×18 bit SRAM"按地址递增顺序连续进...基于March算法的存储器内建自测试电路能够获得很高的故障覆盖率,但在测试小规模的存储器时暴露出了面积相对比较大的缺点。针对大屏幕Timing Controller芯片"龙腾TC1"中4块640×18 bit SRAM"按地址递增顺序连续进行写操作"的工作特点,提出了一种新的存储器内建自测试方法。该方法按照地址递增顺序向存储器施加测试矢量,避免了直接采用March C算法所带来的冗余测试,简化了内建自测试电路,大大减少了由管子的数量和布线带来的面积开销,可达到March C+算法相同的"测试效果"。展开更多
Background: MenAfriVac<sup>TM</sup> is the first of the World Health Organization (WHO)’s pre-qualified vaccines to be allowed to mass vaccination campaign at a temperature below or equal to 40°C dur...Background: MenAfriVac<sup>TM</sup> is the first of the World Health Organization (WHO)’s pre-qualified vaccines to be allowed to mass vaccination campaign at a temperature below or equal to 40°C during 4 days. This new vaccination practice has already been used in some African countries. This article described the opinion and use of this new technique by actors on the field, during a mass vaccination campaign in Côte d’Ivoire, in December 2014. Methods: We conducted a crosssectional study on the practice of CTC by actors on the field and their perception on the new practice, during a mass vaccination campaign in 2 of 25 health districts in Côte d’Ivoire, in December 2014. Findings: As results, in Séguéla 98.25% of respondents expressed a favourable opinion of CTC, citing advantages such as vaccine carriers requiring no ice packs (29.2%), financial benefit (12.28%) and lighter vaccine carriers (5.26%). In Bouna, respondents gave the same advantages in, respectively, 34%, 2% and 8% of cases. The peak of the total of vials used for immunization sessions reached 376 vials at day one, then dropped to 235 vials at day three and 220 vials at day six. Discussion: Vaccinators found some benefits related to CTC practice, but on the field, they were cautious in using CTC technique.展开更多
Background:Herbal remedies have been widely utilized in treating chronic hepatitis C (CHC) worldwide.Selecting appropriate outcomes to reflect both beneficial and harmful effects is a crucial step in designing randomi...Background:Herbal remedies have been widely utilized in treating chronic hepatitis C (CHC) worldwide.Selecting appropriate outcomes to reflect both beneficial and harmful effects is a crucial step in designing randomized controlled trials (RCTs).This study evaluated the outcomes reported in RCTs on herbal remedies for CHC with comparison to the core outcomes recommended by the Cochrane Hepato-Biliary Group (CHBG),to check the consistency of the outcomes and to provide recommendation for future researches.Methods:A systematic literature search was conducted in Western and Chinese databases to identify RCTs on herbal remedies for adults with CHC.For each trial,all the outcomes reported in the results section were collected.Comparison between trial outcomes and CHBG core outcomes were evaluated and summarized with descriptive statistics.Results:A total of 116 RCTs involving 9154 participants were included;27 outcomes were identified.Commonly reported outcomes included alanine aminotransferase (64 trials,55.2%),adverse events (58 trials,50.0%),and end-of-treatment virological response (50 trials,43.1%).All trials indicated that the herbal remedies under investigation had a positive effect and was markedly more effective than the control.Nearly half of the trials reported that the combination of herbal medicine and antiviral drugs could ameliorate adverse events.Very few trials reported primary core outcomes relating survival and quality of life.The most frequently reported core outcomes are non-serious adverse events (54 trials,46.6%),viral response (27 trials,23.3%),and biochemical response (24 trials,20.7%).Conclusion:The variation and inconsistency in trial outcomes impedes research synthesis efforts,and indicate the need for comparable outcomes through the development of core outcome sets in CHC.The low concordance of outcome reporting could be improved by following CHBG core outcomes recommendation.展开更多
Objective: The objective of this randomized controlled trial study was to evaluate the education training in relation to lifestyle improvement in patients with type 2 diabetes through its influence in the levels of gl...Objective: The objective of this randomized controlled trial study was to evaluate the education training in relation to lifestyle improvement in patients with type 2 diabetes through its influence in the levels of glycated hemoglobin(HbA1 c), blood pressure, triglyceride, cholesterol levels, and body mass index(BMI).Methods: The study included patients with type 2 diabetes randomly selected from 20 residential areas in Tirana, Albania where family physicians provide services. The sample size in total was 200 patients in both groups(control and intervention). The education training(four sessions) was conducted by trained nursing staff for 6 months. Patients were screened for the biochemical profile before and after the intervention. To compare the groups with respect to the interest outcomes, the t-test was used. The value of P < 0.05 was considered significant.Results: There were 104 male patients and 96 female patients. The mean age was 54.9 ± 8.7. No significant differences were found between the study groups in relation to clinical and biochemical data before the education sessions. After the intervention, in the intervention group, the mean level of HbA1 c was significantly lower than the value in the control group(6.2% vs 6.8%, P = 0.001) as well as for the mean values of BMI. The mean reduction(more than 15%) in HbA1 c after the intervention was 43% in the intervention group and 2% in the control group(OR = 36.9, P < 0.05). Differences in BMI, HbA1 c, triglycerides, and cholesterol were more significantly visible in the intervention group. However, the difference in systolic and diastolic blood pressure values was almost the same(P > 0.05).Conclusions: The results of this study further support that the approach for education of patients with type 2 diabetes on changing lifestyle benefit the patient in controlling diabetes. It is believed that the establishment of diabetes education classes in health centers is an important investment in improving the management of type 2 diabetes.展开更多
A novel 4H-Si C trench insulated gate bipolar transistor(IGBT)with a controllable hole-extracting(CHE)path is proposed and investigated in this paper.The CHE path is controlled by metal semiconductor gate(MES gate)and...A novel 4H-Si C trench insulated gate bipolar transistor(IGBT)with a controllable hole-extracting(CHE)path is proposed and investigated in this paper.The CHE path is controlled by metal semiconductor gate(MES gate)and metal oxide semiconductor gate(MOS gate)in the p-shield region.The grounded p-shield region can significantly suppress the high electric field around gate oxide in Si C devices,but it weakens the conductivity modulation in the Si C trench IGBT by rapidly sweeping out holes.This effect can be eliminated by introducing the CHE path.The CHE path is pinched off by the high gate bias voltage at on-state to maintain high conductivity modulation and obtain a comparatively low on-state voltage(VON).During the turn-off transient,the CHE path is formed,which contributes to a decreased turn-off loss(EOFF).Based on numerical simulation,the EOFFof the proposed IGBT is reduced by 89%compared with the conventional IGBT at the same VONand the VONof the proposed IGBT is reduced by 50%compared to the grounded p-shield IGBT at the same EOFF.In addition,the average power reduction for the proposed device can be 51.0%to 81.7%and 58.2%to 72.1%with its counterparts at a wide frequency range of 500 Hz to 10 k Hz,revealing a great improvement of frequency characteristics.展开更多
This paper deals with the problem of approximate controllability of infinite dimensional linear systems in nonreflexive state spaces. A necessary and sufficient condition for approximate controllability via L^p([0, T...This paper deals with the problem of approximate controllability of infinite dimensional linear systems in nonreflexive state spaces. A necessary and sufficient condition for approximate controllability via L^p([0, T], U), 1≤p〈∞ is obtained,where L^p( [0, T], U) is the control function space.展开更多
文摘僵尸网络(Botnet)是一种从传统恶意代码形态进化而来的新型攻击方式,为攻击者提供了隐匿、灵活且高效的一对多命令与控制信道(Command and Control channel,C&C)机制,可以控制大量僵尸主机实现信息窃取、分布式拒绝服务攻击和垃圾邮件发送等攻击目的。该文提出一种与僵尸网络结构和C&C协议无关,不需要分析数据包的特征负载的僵尸网络检测方法。该方法首先使用预过滤规则对捕获的流量进行过滤,去掉与僵尸网络无关的流量;其次对过滤后的流量属性进行统计;接着使用基于X-means聚类的两步聚类算法对C&C信道的流量属性进行分析与聚类,从而达到对僵尸网络检测的目的。实验证明,该方法高效准确地把僵尸网络流量与其他正常网络流量区分,达到从实际网络中检测僵尸网络的要求,并且具有较低的误判率。
基金Research Project of Hunan Province Education Department(No.14C0972)
文摘Threshold decision is an important function of nuclear instrument control system based on physical parameters threshold decision. Because the conventional decision methods lack correlation with time and conditions, by analyzing the existing methods, some optimized methods are adopted. Considering safety, those methods are improved in data processing algorithms, floating threshold with multiple values, association with specific working condition, etc. These measures im- prove the nuclear instrument control system in fault tolerance and fault diagnosis, especially, the shutdown number of nucle- ar power plant decreases.
基金Supported by National Natural Science Foundation of China,No.81302593,No.81271848 and No.81101589the Grant of Beijing Nova Program of China,No.Z121107002512071+1 种基金the National Key Basic Research Program of China,No.2009CB522507the National Grand Program on Key Infectious Disease,No.2009ZX10005-017 and No.2012ZX10002007
文摘AIM: To investigate the risk factors for liver-related mortality in chronic hepatitis C (CHC) patients.
基金supported by grants from Zhejiang Health Bureau (2008B073)Zhejiang Education Bureau (Y200909640)
文摘BACKGROUND: Hemodialysis (HD) patients are at high risk of infection by hepatitis B virus (HBV) or hepatitis C virus (HCV). The present study was designed to determine the impact of quality control measures on the prevention of transmission of blood-borne viruses. METHODS: A total of 6182 adult maintenance HD patients from all HD units in Zhejiang Province were recruited on January 1, 2007. The baseline demographic and clinical characteristics were recorded and all patients were followed up until death or survival at 4 years later. The Quality Control Standards of Hemodialysis were gradually implemented in HD units. The HBV or HCV seroconversion rates of the recruited patients were calculated and compared every year during the observation period. RESULTS: The prevalence of HBV was 8.3% at the beginning of the study, and 6.6% for HCV. With the implementation of the HD quality control measures, the HBV seroconversion rate tended to decrease year by year (χ 2 =6.620, P=0.085), and the HCV seroconversion rate decreased significantly (χ 2 =10.41, P=0.015). Compared with the data in 2007, the HBV seroconversion rate (χ 2 =4.204, P=0.040, relative risk ratio 0.393, 95% CI 0.156-0.991) and the HCV seroconversion rate (χ 2 =7.373, P=0.007, relative risk ratio 0.386, 95% CI 0.189-0.787) decreased significantly in 2010. CONCLUSION: Quality control measures for HD decreased the seroconversion rates of HBV or HCV in HD patients, showing that updated quality control measures reduce the risk for transmission of blood-borne viruses in the HD population.
文摘Recently, it has become clear that mild abnormal glucose tolerance increases the incidence of perinatal maternalinfant complications, and so the definition and diagnostic criteria of gestational diabetes mellitus(GDM) have been changed. Therefore, in patients with GDM and pregnant women with diabetes mellitus, even stricter glycemic control than before is required to reduce the incidence of perinatal maternal-infant complications. Strict glycemic control cannot be attained without an indicator of glycemic control; this review proposes a reliable indicator. The gold standard indicator of glycemic control in patients with diabetes mellitus is hemoglobin A1c(Hb A1c); however, we have demonstrated that Hb A1 c does not reflect glycemic control accurately during pregnancy because of iron deficiency. It has also become clear that glycated albumin, another indicator of glycemic control, is not influenced by iron deficiency and therefore might be a better indicator of glycemic control in patients with GDM and pregnant women with diabetes mellitus. However, largepopulation epidemiological studies are necessary in order to confirm our proposal. Here, we outline the most recent findings about the indicators of glycemic control during pregnancy including fructosamine and 1,5-anhydroglucitol.
基金the Tenth-Five-Year Nuclear Energy Development of the Commission of Science and TechnologyNational Defense Industry of the China National Nuclear Corporation
文摘Two sets of super-synchronization speed control assemblies for two 80 MVA motor-generator units have been developed successfully in order to satisfy the demand of the toroidal field system in the HL-2A tokamak. Based on the three-phase logical no-circumfluence a.c./a.c. cycloconverter, the speeds of two 2500 kW double fed drive motors have been regulated by means of the vector control technology. The maximum operating speed of each motor- generator unit has been raised from 1488 rpm (revolutions per minute) to 1650 rpm and the released energy of each unit during a pulsed discharge can reach 500 MJ. As a result, the toroidal field system has the capacity to provide 2.8 tesla (T) in HL-2A experiments.
文摘The benchmark for assessing quality of long-term glycemic control and adjustment of therapy is currently glycated hemoglobin(Hb A1c). Despite its importance as an indicator for the development of diabeticcomplications, recent studies have revealed that this metric has some limitations; it conveys a rather complex message, which has to be taken into consideration for diabetes screening and treatment. On the basis of recent clinical trials, the relationship between Hb A1 c and cardiovascular outcomes in long-standing diabetes has been called into question. It becomes obvious that other surrogate and biomarkers are needed to better predict cardiovascular diabetes complications and assess efficiency of therapy. Glycated albumin, fructosamin, and 1,5-anhydroglucitol have received growing interest as alternative markers of glycemic control. In addition to measures of hyperglycemia, advanced glucose monitoring methods became available. An indispensible adjunct to Hb A1 c in routine diabetes care is selfmonitoring of blood glucose. This monitoring method is now widely used, as it provides immediate feedback to patients on short-term changes, involving fasting, preprandial, and postprandial glucose levels. Beyond the traditional metrics, glycemic variability has been identified as a predictor of hypoglycemia, and it might also be implicated in the pathogenesis of vascular diabetes complications. Assessment of glycemic variability is thus important, but exact quantification requires frequently sampled glucose measurements. In order to optimize diabetes treatment, there is a need for both key metrics of glycemic control on a day-to-day basis and for more advanced, user-friendly monitoring methods. In addition to traditional discontinuous glucose testing, continuous glucose sensing has become a useful tool to reveal insufficient glycemic management. This new technology is particularly effective in patients with complicated diabetes and provides the opportunity to characterize glucose dynamics. Several continuous glucose monitoring(CGM) systems, which have shown usefulness in clinical practice, are presently on the market. They can broadly be divided into systems providing retrospective or real-time information on glucose patterns. The widespread clinical application of CGM is still hampered by the lack of generallyaccepted measures for assessment of glucose profiles and standardized reporting of glucose data. In this article, we will discuss advantages and limitations of various metrics for glycemic control as well as possibilities for evaluation of glucose data with the special focus on glycemic variability and application of CGM to improve individual diabetes management.
文摘Neonatal diabetes mellitus(NDM) is a type of diabetes mellitus caused by genetic abnormality which devel ops in insulin dependent state within 6 mo after birth HbA1c is widely used in clinical practice for diabetes mellitus as the gold standard glycemic control indica tor; however, fetal hemoglobin(HbF) is the main he moglobin in neonates and so HbA1c cannot be used as a glycemic control indicator in NDM. Glycated albumin(GA), another glycemic control indicator, is not affected by HbF. We reported that GA can be used as a glycemic control indicator in NDM. However, it was later found that because of increased metabolism of albumin, GA shows an apparently lower level in relation to plasma glucose in NDM; measures to solve this problem were needed. In this review, we outlined the most recen findings concerning glycemic control indicators in neo nates or NDM.
文摘AIM To characterize the survival of cirrhotic patients with Barcelona Clinic Liver Cancer(BCLC) stage C hepatocellular carcinoma(HCC) and to ascertain the factors predicting the achievement of disease control(DC).METHODS The cirrhotic patients with BCLC stage C HCC evaluated by the Hepatocatt multidisciplinary group were subjected to the investigation. Demographic, clinical and tumor features, along with the best tumor response and overall survival were recorded. RESULTS One hundred and ten BCLC stage C patients were included in the analysis; the median overall survival was 13.4 mo(95%CI: 10.6-17.0). Only alphafetoprotein(AFP) serum level > 200 ng/m L and DC could independently predict survival but in a time dependent manner, the former was significantly associated with increased risk of mortality within the first 6 mo of follow-up(HR = 5.073, 95%CI: 2.159-11.916, P = 0.0002), whereas the latter showed a protective effect against death after one year(HR = 0.110, 95%CI: 0.038-0.314, P < 0.0001). Only patients showing microvascular invasion and/or extrahepatic spread recorded lower chances of achieving DC(OR = 0.263, 95%CI: 0.111-0.622, P = 0.002).CONCLUSION The BCLC stage C HCC includes a wide heterogeneous group of cirrhotic patients suitable for potentially curative treatments. The reverse and time dependent effect of AFP serum level and DC on patients' survival confers them as useful predictive tools for treatment management and clinical decisions.
基金supported in part by National Key R&D Program of China(2019YFE0196400)Key Research and Development Program of Shaanxi(2022KWZ09)+4 种基金National Natural Science Foundation of China(61771358,61901317,62071352)Fundamental Research Funds for the Central Universities(JB190104)Joint Education Project between China and Central-Eastern European Countries(202005)the 111 Project(B08038)。
文摘In recent years,the exponential proliferation of smart devices with their intelligent applications poses severe challenges on conventional cellular networks.Such challenges can be potentially overcome by integrating communication,computing,caching,and control(i4C)technologies.In this survey,we first give a snapshot of different aspects of the i4C,comprising background,motivation,leading technological enablers,potential applications,and use cases.Next,we describe different models of communication,computing,caching,and control(4C)to lay the foundation of the integration approach.We review current stateof-the-art research efforts related to the i4C,focusing on recent trends of both conventional and artificial intelligence(AI)-based integration approaches.We also highlight the need for intelligence in resources integration.Then,we discuss the integration of sensing and communication(ISAC)and classify the integration approaches into various classes.Finally,we propose open challenges and present future research directions for beyond 5G networks,such as 6G.
基金Supported by the National Basic Research Program of China(2012CB720500)the National Supporting Research Program of China(2013BAA03B01)+1 种基金the National Natural Science Foundation of China(21176178)China Scholarship Council(CSC[2015]3022)
文摘In our previous work, the reactive dividing wall column(RDWC) was proposed and proved to be effective for selective hydrogenation and separation of C3 stream. In the present paper, the dynamics and control of the proposed RDWC are investigated. Four control structures including composition and temperature controls are proposed. The feed forward controllers are employed in the four control strategies to shorten the dynamic response time, reduce the maximum deviations and offer an immediate adjustment. The control structures are compared by applying them into the RDWC system with 20% disturbances in both the feed flow rate and the feed compositions, and the results are discussed.
文摘Background: MenAfriVac<sup>TM</sup> is the first of the World Health Organization (WHO)’s pre-qualified vaccines to be allowed to mass vaccination campaign at a temperature below or equal to 40°C during 4 days. This new vaccination practice has already been used in some African countries. This article described the opinion and use of this new technique by actors on the field, during a mass vaccination campaign in Côte d’Ivoire, in December 2014. Methods: We conducted a crosssectional study on the practice of CTC by actors on the field and their perception on the new practice, during a mass vaccination campaign in 2 of 25 health districts in Côte d’Ivoire, in December 2014. Findings: As results, in Séguéla 98.25% of respondents expressed a favourable opinion of CTC, citing advantages such as vaccine carriers requiring no ice packs (29.2%), financial benefit (12.28%) and lighter vaccine carriers (5.26%). In Bouna, respondents gave the same advantages in, respectively, 34%, 2% and 8% of cases. The peak of the total of vials used for immunization sessions reached 376 vials at day one, then dropped to 235 vials at day three and 220 vials at day six. Discussion: Vaccinators found some benefits related to CTC practice, but on the field, they were cautious in using CTC technique.
基金the National Natural Science Foundation of China:Surface Project(81673828)National Natural Science Foundation of China(81830115)National Center for Complementary and Integrative Health(R24 AT001293).
文摘Background:Herbal remedies have been widely utilized in treating chronic hepatitis C (CHC) worldwide.Selecting appropriate outcomes to reflect both beneficial and harmful effects is a crucial step in designing randomized controlled trials (RCTs).This study evaluated the outcomes reported in RCTs on herbal remedies for CHC with comparison to the core outcomes recommended by the Cochrane Hepato-Biliary Group (CHBG),to check the consistency of the outcomes and to provide recommendation for future researches.Methods:A systematic literature search was conducted in Western and Chinese databases to identify RCTs on herbal remedies for adults with CHC.For each trial,all the outcomes reported in the results section were collected.Comparison between trial outcomes and CHBG core outcomes were evaluated and summarized with descriptive statistics.Results:A total of 116 RCTs involving 9154 participants were included;27 outcomes were identified.Commonly reported outcomes included alanine aminotransferase (64 trials,55.2%),adverse events (58 trials,50.0%),and end-of-treatment virological response (50 trials,43.1%).All trials indicated that the herbal remedies under investigation had a positive effect and was markedly more effective than the control.Nearly half of the trials reported that the combination of herbal medicine and antiviral drugs could ameliorate adverse events.Very few trials reported primary core outcomes relating survival and quality of life.The most frequently reported core outcomes are non-serious adverse events (54 trials,46.6%),viral response (27 trials,23.3%),and biochemical response (24 trials,20.7%).Conclusion:The variation and inconsistency in trial outcomes impedes research synthesis efforts,and indicate the need for comparable outcomes through the development of core outcome sets in CHC.The low concordance of outcome reporting could be improved by following CHBG core outcomes recommendation.
文摘Objective: The objective of this randomized controlled trial study was to evaluate the education training in relation to lifestyle improvement in patients with type 2 diabetes through its influence in the levels of glycated hemoglobin(HbA1 c), blood pressure, triglyceride, cholesterol levels, and body mass index(BMI).Methods: The study included patients with type 2 diabetes randomly selected from 20 residential areas in Tirana, Albania where family physicians provide services. The sample size in total was 200 patients in both groups(control and intervention). The education training(four sessions) was conducted by trained nursing staff for 6 months. Patients were screened for the biochemical profile before and after the intervention. To compare the groups with respect to the interest outcomes, the t-test was used. The value of P < 0.05 was considered significant.Results: There were 104 male patients and 96 female patients. The mean age was 54.9 ± 8.7. No significant differences were found between the study groups in relation to clinical and biochemical data before the education sessions. After the intervention, in the intervention group, the mean level of HbA1 c was significantly lower than the value in the control group(6.2% vs 6.8%, P = 0.001) as well as for the mean values of BMI. The mean reduction(more than 15%) in HbA1 c after the intervention was 43% in the intervention group and 2% in the control group(OR = 36.9, P < 0.05). Differences in BMI, HbA1 c, triglycerides, and cholesterol were more significantly visible in the intervention group. However, the difference in systolic and diastolic blood pressure values was almost the same(P > 0.05).Conclusions: The results of this study further support that the approach for education of patients with type 2 diabetes on changing lifestyle benefit the patient in controlling diabetes. It is believed that the establishment of diabetes education classes in health centers is an important investment in improving the management of type 2 diabetes.
基金Project supported by the Hunan Provincial Natural Science Foundation of China(Grant No.2021JJ30738)Scientific Research Fund of Hunan Provincial Education Department(Grant No.19K001)Hunan Provincial Key Laboratory of Flexible Electronic Materials Genome Engineering’s Open Fund Project-2020(Grant No.202016)。
文摘A novel 4H-Si C trench insulated gate bipolar transistor(IGBT)with a controllable hole-extracting(CHE)path is proposed and investigated in this paper.The CHE path is controlled by metal semiconductor gate(MES gate)and metal oxide semiconductor gate(MOS gate)in the p-shield region.The grounded p-shield region can significantly suppress the high electric field around gate oxide in Si C devices,but it weakens the conductivity modulation in the Si C trench IGBT by rapidly sweeping out holes.This effect can be eliminated by introducing the CHE path.The CHE path is pinched off by the high gate bias voltage at on-state to maintain high conductivity modulation and obtain a comparatively low on-state voltage(VON).During the turn-off transient,the CHE path is formed,which contributes to a decreased turn-off loss(EOFF).Based on numerical simulation,the EOFFof the proposed IGBT is reduced by 89%compared with the conventional IGBT at the same VONand the VONof the proposed IGBT is reduced by 50%compared to the grounded p-shield IGBT at the same EOFF.In addition,the average power reduction for the proposed device can be 51.0%to 81.7%and 58.2%to 72.1%with its counterparts at a wide frequency range of 500 Hz to 10 k Hz,revealing a great improvement of frequency characteristics.
文摘This paper deals with the problem of approximate controllability of infinite dimensional linear systems in nonreflexive state spaces. A necessary and sufficient condition for approximate controllability via L^p([0, T], U), 1≤p〈∞ is obtained,where L^p( [0, T], U) is the control function space.