ASPECTS评分及多模态CT定量分析在AIS预后预测中的应用

目的探讨ASPECTS评分及多模态CT中各参数在急性缺血性脑卒中(AIS)预后预测的应用价值。方法收集2019年1月-2023年4月诊断为AIS并在蚌埠医学院第一附属医院就诊的患者,在治疗前均行多模态CT(包括NCCT、CTA、CTP)检查的患者93例,3个月后随访并根据改良Rankin量表评分(mRs)将患者分为预后良好组(mRs≤2)和预后不良组(mRs>2),收集两组患者的临床资料及多模态CT定量参数比较其在预测AIS中预后中有无意义。结果一般资料分析可见预后不良组患者入院基线NIHSS评分、远端侧支循环及ASPECTS评分均与预后良好组之间有一定的统计学差异(P<0.05);CT灌注定量参数分析可见预后不良组CBF较低,而MTT、Tmax、TTP较预后良好组延长,且具有统计学意义(P<0.05)。其中NIHSS、远端侧支循环及Tmax为影响AIS预后的独立危险因素。结论NIHSS、远端侧支循环、ASPECTS及多模态CT可以对AIS的预后进行评测。均具有较好的预测效能,其中Tmax及NIHSS预测效能最好。

颈动脉斑块MRI特征与同侧急性脑梗死患者DWIGASPECTS的相关性研究

目的:探讨颈动脉斑块MRI特征与同侧急性脑梗死患者DWI-ASPECTS的相关性。方法:回顾性搜集我院85例颈动脉斑块患者的临床及影像资料,所有患者均于出现脑血管症状2周内行颈动脉高分辨率MRI和常规颅脑MRI平扫。将患者分为DWI-ASPECTS≤7分组和DWI-ASPECTS>7分组,比较两组间临床、实验室资料和颈动脉斑块定量、定性指标的差异。通过Logistic回归筛选DWI-ASPECTS评分的预测因子。结果:25例(29.4%)DWI-ASPECTS≤7分,60例(70.6%)DWI-ASPECTS>7分。DWI-ASPECTS≤7分组患者纤维帽变薄/破裂(分别为80.0%和35.0%,P<0.001)、斑块内出血(分别为72.0%和21.7%,P<0.001)、钙化(分别为76.0%和45.0%,P=0.009)和富脂质坏死核心(分别为72.0%和45.0%,P=0.023)的发生率均高于DWI-ASPECTS>7分组;此外,DWI-ASPECTS≤7分组患者显示出更高的斑块负荷,DWI-ASPECTS≤7分组与DWI-ASPECTS>7分组的最大管壁厚度[分别为(4.38±1.68)和(3.47±1.78)mm,P=0.033]、平均管腔面积[分别为(15.33±11.57)和(22.88±13.95)mm 2,P=0.019]、最小管腔面积[分别为(11.52±11.23)和(18.98±13.52)mm 2,P=0.017]、平均管壁面积[分别为(62.81±14.32)、(55.66±14.93)mm 2,P=0.045]、最大管壁面积[分别为(66.70±14.57)、(59.56±15.19)mm 2,P=0.049]、平均标准化管壁面指数[分别为(81±14)%、(71±16)%,P=0.011]、最大标准化管壁指数[分别为(86±14)%、(76±16)%,P=0.012)]差异均有统计学意义。DWI-ASPECTS≤7分组中NIHSS评分>4分的患者比例更高(分别为48%和23.3%,P=0.025),高密度脂蛋白浓度更低[分别为(1.24±0.28)、(1.10±0.28)mmol/L,P=0.043]。Logistic回归分析结果显示,纤维帽变薄/破裂(OR=4.133,95%CI:1.151~14.836,P=0.030)和斑块内出血(OR=6.409,95%CI:1.737~23.646,P=0.005)与较低的DWI-ASPECTS评分显著相关。结论:颈动脉斑块中存在纤维帽变薄/破裂和斑块内出血的急性脑卒中患者DWI-ASPECTS评分更低,有助于评估患者的病情严重程度。

Labor Market Aspects of the ＂New Rurality＂： Employment, Commuting and Entrepreneurship in Rural Sweden

Around two thirds of the Swedish rural areas experienced positive net migration during the period 2003-2005. This paper examines the development in the Swedish rural areas from the perspective of the ＂new rurality＂ or the new rural economic order with regard to migratory movements. The paper analyzes determinants of net migration to rural areas in general and to different types of regions, and the impacts of in-migration on rural labor markets, self-employment and other socio-economic conditions. The determinants of the migration pattern were mainly the size of adjacent local and regional centers, income and education levels that all had positive impacts, while commuting distance and unemployment rate had contrary effects. In comparison with the original inhabitants, the newcomers had lower incomes, a lower employment ratio and a lower degree of entrepreneurial activities, but higher education levels. These differences might be explained by the age differences between stayers （older） and in-migrants （younger）. This indicates that the two groups were in different stages of their life cycles. One central conclusion drawn from the paper is that the effect of in-migration on the composition of the rural population is about the same in rural areas all over Sweden.

Management of Significant Environmental Aspects and Impacts in Accordance with the ISO 14001:2015 Standard during the Operation and Maintenance Phase of Senegal River Basin Development Authority Hydroelectric Works and Facilities: The Case of Manantali Dam

This study aims to determine the environmental aspects and impacts of the phase relating to the operation of Manantali’s hydroelectric structures and facilities according to the requirements of the ISO 14001 version 2015 standard. To do this, the mapping of the different work areas made it possible to identify all the activities within the framework of the farm. Based on the mapping, environmental measurements made including noise level, brightness, electric and magnetic fields, total particles, PM10, PM2.5, PM1 showed the work areas with the exposure limit values exceeded. The inventories of the waste produced show eighteen (18) types of waste, 67% of which are special industrial waste (SIW), 28% are ordinary industrial waste (OIW) and 5% are inert industrial waste (IIW). The identification and assessment of environmental aspects and impacts made it possible to determine sixteen (16) positive and negative significant environmental aspects (ESAs). The positive AES must be maintained, and for the negative ones, mitigation and mitigation measures must be put in place in order to manage them effectively. This will ultimately improve environmental management in the operation of hydroelectric structures and facilities.

Psychosocial Aspects of Male Infertility at the Service of Urology-Andrology of the Hospital of the Sino-Guinean Friendship

Objective: Describe the psychosocial aspects of male infertility at the hospital of the Sino-Guinean Friendship. Patients and method: It is a prospective study of a descriptive type covering a period of 6 months. The study covered 17 patients, all received for a desire to conceive after at least one year of regular sexual intercourse without contraception. The data were collected from patient interviews using a pre-established questionnaire. Results: The average age of the patients was 32.07 years with extremes of 23 years and 42 years. During this study, 64.70% of patients were no longer participating in community ceremonies. The patients’ relationships with their spouse and family deteriorated in 52.94% and 47.06%, respectively. Conversely, relations with the family of origin remained unchanged in 70.59 percent of cases. The reduction in economic activity was by 13 patients (76.48%). Conclusion: Male infertility causes a real psychic earthquake in men with its corollaries of negative feelings. The rather complex moral repercussions of male infertility affect not only the individual, his/her partner, and family, but also economic activity.

Actual Aspects of Rural Development Strategy and Policy in the European Union

The objective of the work is to define and evaluate the normative approach in the programming and implementation of rural development in the European Union countries. Main focus is to determine the objectives and methods of implementation and achieve these objectives in various ideological documents, strategies, programs, and development policies. The present work was created on the basis of documents and publications by community bodies and institutions as well as open literature on this subject. The study presents ways of defining rural areas, strategies, and development programs in Europe （Lisbon Strategy, Europe 2020 Strategy）, tasks of major Community policies towards rural areas （common agricultural policy, cohesion policy）, Cork ideological declarations, multifunctional development concepts and smart development. Innovative approaches include the concept of smart city, smart village, smart specializations of regions, and the urban-rural partnerships.

CT灌注成像ASPECTS在急性缺血性脑卒中溶栓再通中的应用

目的研究CT灌注成像(CTP)、Albertu脑卒中项目早期CT评分(ASPECTS)在检测可逆性脑组织缺血方面的作用。方法回顾62例患者临床和影像学资料,这些患者均因急性缺血性脑卒中(持续时间<3 h)接受了静脉溶栓治疗,脑卒中患者最初影像学评估包括非对比增强CT(NCCT),CT血管造影(CTA)和CTP。结果共25例患者存在CTP ASPECTS不匹配。CTP ASPECTS不匹配亚组最终脑梗死体积分别与NCCT 0 h-ASPECTS,平均间隔时间(MTT)-ASPECTS,脑血容量(CBV)-ASPECTS,NCCT 24 h-ASPECTS均呈负相关,ΔmRS分别与NCCT 0 h-ASPECTS,MTT-ASPECTS,CBV-ASPECTS,NCCT 24 h-ASPECTS间均呈负相关。与所有患者组或所有前循环事件的患者亚组相比,在CTP ASPECTS不匹配亚组,ASPECTS和临床结果之间的相关性较高。MTT-ASPECTS和CBV-ASPECTS分数与临床结果之间的相关性比NCCT 0 h-ASPECTS(即入院时NCCT-ASPECTS)与临床结果的相关性要强。二分ΔmRS,采用ΔmRS≤1表示良好的临床效果,MTT-NCCT 24 h ASPECTS不匹配的统计学显著性最低的阈值为2(P=0.04),该值预测良好的临床结果。在MTT-NCCT 24 h ASPECTS不匹配≥2的患者亚组(n=12),此参数和CTP-ASPECTS不匹配间有较强的相关性(r=0.79,P<0.001),并具有较强的线性相关性(R2=0.671)。结论 CTP ASPECTS不匹配可充分预测潜在的可挽救缺血脑组织的量。

CTP-ASPECTS评分在前循环梗死患者急性期预后判断中的应用

目的探讨前循环梗死患者入院时CT灌注成像(CTP)-ASPECTS评分与急性期预后的关系。方法回顾分析起病时间在4.5～8.0 h的34例急性前循环梗死患者头颅CT平扫、CTP及头颅血管造影(CTA)检查结果,根据患者缺血性中风1周内的预后(有无意识改变或死亡)分为预后较好组及预后较差组,多模CT检查获得脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)、达峰时间等参数图,并对各参数图进行ASPECTS评分,同时获得动态CT血管成像(CTA)。比较两组患者CTP参数ASPECTS评分的差异。结果 34例患者中预后较差组12例,预后较差组CBV-ASPECTS评分较低,与预后较好组比较差异有统计学意义(P<0.01),两组病变侧CBF-ASPECTS与MTT-ASPECTS比较差异无统计学意义(P>0.05)。结论 CBV-ASPECTS评分可以作为前循环梗死患者急性期预后的预测因子。

NIHSS/DWI-ASPECTS不匹配预测大脑中动脉供血区脑梗死早期神经功能恶化

目的 探究NIHSS/DWI-ASPECTS不匹配对大脑中动脉供血区脑梗死早期神经功能恶化的预测价值。方法 回顾性收集2017年3月~2018年5月因大脑中动脉供血区脑梗死在安徽医科大学第二附属医院神经内科住院的患者。收集其临床资料,根据入院时和住院72 h NIHSS评分,评估早期神经功能恶化(early neurological deterioration,END),将患者分为END组和非END组。所有患者在入院48 h内完成头部MRI检查,并行DWI-Alberta 卒中项目早期CT评分(DWI-ASPECTS),NIHSS/DWI-ASPECTS不匹配(NIHSS/DWI-ASPECTS Mismatch,NDM)定义为 NIHSS评分≥8且DWI-ASPECTS≥8,应用多变量Logistic回归分析NDM与大脑中动脉供血区脑梗死END的相关性。结果 共收集94例大脑中动脉供血区脑梗死患者,男性52例(55.3%),年龄(65.4±11.0)岁。符合END患者31例(33%)。NIHSS/DWI-ASPECTS不匹配(NDM)病例18例(19.1%),其中END组14例(45%),非END组4例(6.5%)。END组年龄大、NIHSS高、DWI-ASPECTS低、NDM患者比例显著高于非END组( P ≤0.05或 P ≤0.01)。多变量Logistic回归分析显示,在校正混杂因素后,DWI-ASPECTS(优势比0.637,95%置信区间0.409~0.994, P =0.047)和NDM(优势比13.175,95%置信区间1.539~112.824, P =0.019)是大脑中动脉供血区脑梗死END的预测因素。结论 NIHSS/DWI-ASPECTS不匹配对大脑中动脉供血区脑梗死早期神经功能恶化具有一定的预测价值。

The Synthesis of Aspects on the Management of Second Language Teaching

Principles which teachers should adhere to in second language class are based on the synthesis of linguistic,cultural and competent aspects.This paper first puts forward linguistic,cultural and competent aspects of second language teaching.Then,the principles which teachers should adhere to in second language class are introduced.Finally,the synthesis implication for second language teaching is presented.

.NET平台利用AspectSharp实现权限验证

通过对AOP和OOP的简单分析提出了AOP的发展前景;介绍Dynam icProxy的基本原理和拦截机制以及.NET平台下AOP实现技术的研究;最后在此基础上提出利用AspectSharp实现权限验证的思路。

To Open Up a New Aspect of Rural Hydropower and Electrification——Excerpted from Speeches on Working Conferences of National Rural Hydropower and Electrification Counties Construction

The Role and status of rural hydropower and electrification are reviewed, and the situation and tasks are putforward simultaneously.

急性缺血性中风证候要素演变规律与ASPECTS影像特征的相关性研究

目的:探讨急性缺血性中风证候要素演变规律,并分析头颅影像学特征与证候演变的相关性。方法:从多中心、前瞻性、随机对照临床研究数据库中,选取120例符合纳入标准的发病24 h以内急性缺血性中风病例,通过ASPECTS评分方法对头颅磁共振图像进行评估,采用多因素Logistic回归分析方法,探索基于ASPECTS影像学特征与证候要素演变的相关性。结果:脑缺血损伤主要累及ASPECTS区域中的额顶叶皮层M5(55.0%),内囊(40.9%)和豆状核(30.8%);与发病7 d内证候演变有显著相关性的部位包括尾状核、内囊,以及岛叶、M1、M5、M6等皮层结构(P<0.05)。结论:基于ASPECTS的影像特征是影响中风病证候演变的重要因素。

ASPECTs联合ASITN/SIR模式评估超时间窗前循环脑梗死血管内治疗临床研究

目的探讨ASPECTs评分联合ASITN/SIR侧支循环评分模式评估前循环急性大动脉脑梗死患者超时间窗血管内治疗的临床效果。方法收集52例超时间窗急性大动脉闭塞脑梗死患者为研究组,以本中心63例标准治疗窗内患者为对照组,在三系统同轴下使用颅内血栓抽吸系统、支架取栓装置进行机械取栓治疗,纵向对比2组术后90 d良好恢复率(mRS≤2分)、安全性(症状性颅内出血转化、病死率),研究组间横向对比有效性,主要对比手术前后NIHSS评分。结果研究组与对照组患者术前NIHSS评分差异无统计学意义(P>0.05)。研究组与对照组术中mTICI分级血管再通率分别为90.4%(47/52)、92.1%(58/63),2组比较差异无统计学意义(P>0.05);2组术后良好恢复率(90 d mRS≤2分)[分别为42.3%(22/52)、40%(25/63)]、安全性[研究组症状性颅内出血转化、病死率分别为13.5%(7/52)、15.4%(8/52),对照组分别为11.1%(6/63)、12.7%(8/63)],2组比较差异均无统计学意义(P>0.05)。结论在ASPECTs评分联合ASITN/SIR侧支循环评估模式下急性缺血性脑卒中超时间窗血管内治疗临床疗效具有可行性。

Psychological and social aspects of infertility in men： an overview of the evidence and implications for psychologically informed clinical care and future research

Research concerning the psychosocial aspects of infertility and infertility treatment focuses more often on women than men. The aim of this review was to synthesize the English-language evidence related to the psychological and social aspects of infertility in men and discuss the implications of these reports for clinical care and future research. A structured search identified 73 studies that reported data concerning the desire for fatherhood and the psychological and social aspects of diagnosis, assisted reproductive technology （ART） treatment and unsuccessful treatment among men with fertility difficulties. The studies are diverse in conceptualisation, design, setting and data collection, but the findings were reasonably consistent. These studies indicated that fertile and infertile childless men of reproductive age have desires to experience parenthood that are similar to those of their female counterparts; in addition, diagnosis and initiation of treatment are associated with elevated infertility-specific anxiety, and unsuccessful treatment can lead to a state of lasting sadness. However, rates of clinically significant mental health problems among this patient population are no higher than in the general population. Infertile men who are socially isolated, have an avoidant coping style and appraise stressful events as overwhelming, are more vulnerable to severe anxiety than men without these characteristics. Men prefer oral to written treatment information and prefer to receive emotional support from infertility clinicians rather than from mental health professionals, self-help support groups or friends. Nevertheless, structured, facilitated psycho-educational groups that are didactic but permit informal sharing of experiences might be beneficial. There are gaps in knowledge about factors governing seeking, persisting with and deciding to cease treatment; experiences of invasive procedures; parenting after assisted conception; adoption and infertility-related grief and shame among men. Few resource-constrained countries have any data concerning male experiences of infertility.

Positive aspects of caregiving in schizophrenia: A review

Schizophrenia is a severe mental illness which is associated with significant consequences for both the patients and their relatives. Due to chronicity of the illness, the relatives of patients of schizophrenia have to bear the main brunt of the illness. Studies across the world have evaluated various aspects of caregiving and caregivers such as burden, coping, quality of life, social support, expressed emotions, and psychological morbidity. In general the research has looked at caregiving as a negative phenomenon, however, now it is increasingly recognised that caregiving is not only associated with negative consequences only, also experience subjective gains and satisfaction. This review focus on the conceptual issues, instruments available to assess the positive aspects of caregiving and the various correlates of positive aspects of caregiving reported in relation to schizophrenia. The positive aspect of caregiving has been variously measured as positive caregiving experience, caregiving satisfaction, caregiving gains and finding meaning through caregiving scale and positive aspects of caregiving experience. Studies suggests that caregivers of patients with schizophrenia and psychotic disorders experience caregiving gains(in the form of becoming more sensitive to persons with disabilities, clarity about their priorities in life and a greater sense of inner strength), experience good aspects of relationship with the patient, do have personal positive experiences. Some of the studies suggest that those who experience greater negative caregiving experience also do experience positive caregiving experience.

人工智能在急性缺血性脑卒中早期ASPECTS评估中的研究进展

急性缺血性脑卒中(AIS)的早期诊断和及时干预对于降低脑卒中的致死致残率具有重要意义。目前,临床上采用阿尔伯塔卒中项目早期计算机断层扫描评分(ASPECTS)来评估AIS的严重程度,但人为评估方法主观性过强且耗时耗力,极易导致漏诊、误诊。因此,近年来涌现了许多基于人工智能算法对AIS进行ASPECTS自动评分的方法研究。本文对此进行综述,以期为进一步研究探索提供参考。首先,简述ASPECTS评分的可靠性;其次,重点介绍目前基于人工智能的脑区提取及脑区评分的方法,证实计算机辅助ASPECTS评分能够有效提高对病情判断的可靠性;最后,总结现有ASPECTS自动评分方法存在的不足,并对其未来的发展趋势进行展望。

Large Scale Aspects of India-China Summer Monsoon Rainfall

This study investigates the dominant modes of variability in monthly and seasonal rainfall over the India-China region mainly through Empirical Orthogonal Function (EOF) analysis. The EOFs have shown that whereas the rainfall over India varies as one coherent zone, that over China varies in east-west oriented bands. The influence of this banded structure extends well into India.Relationship of rainfall with large scale parameters such as the subtropical ridge over the Indian and the western Pacific regions, Southern Oscillation, the Northern Hemispheric surface air temperature and stratospheric winds have also been investigated. These results show that the rainfall over the area around 40°N, 110°E over China is highly related with rainfall over India. The subtropical ridge over the Indian region is an important predictor over India as well an over the northern China region. '

Psychosocial Aspects of Disability

In this paper, we will address common psychological reactions to disability such as anxiety, depression, denial, and anger in the framework of a stage model. In addition, this paper will discuss specific societal aspects that can impact reaction and adjustment to disability. In this vein, we will examine the specific effects of societal attitudes and stigma upon individuals with disabilities. Strategies for changing attitudes and facilitating adjustment to disability will also be discussed.

Multi-Level Knowledge Engineering Approach for Mapping Implicit Aspects to Explicit Aspects

Aspect’s extraction is a critical task in aspect-based sentiment analysis,including explicit and implicit aspects identification.While extensive research has identified explicit aspects,little effort has been put forward on implicit aspects extraction due to the complexity of the problem.Moreover,existing research on implicit aspect identification is widely carried out on product reviews targeting specific aspects while neglecting sentences’dependency problems.Therefore,in this paper,a multi-level knowledge engineering approach for identifying implicit movie aspects is proposed.The proposed method first identifies explicit aspects using a variant of BiLSTM and CRF(Bidirectional Long Short Memory-Conditional Random Field),which serve as a memory to process dependent sentences to infer implicit aspects.It can identify implicit aspects from four types of sentences,including independent and three types of dependent sentences.The study is evaluated on a largemovie reviews dataset with 50k examples.The experimental results showed that the explicit aspect identification method achieved 89%F1-score and implicit aspect extraction methods achieved 76%F1-score.In addition,the proposed approach also performs better than the state-of-the-art techniques(NMFIAD andML-KB+)on the product review dataset,where it achieved 93%precision,92%recall,and 93%F1-score.