A paradox in cancer research is that the majority of patients enrolled in clinical trials are relatively young and fit while typical patients in daily practice are elderly and have comorbidities and impaired organ fun...A paradox in cancer research is that the majority of patients enrolled in clinical trials are relatively young and fit while typical patients in daily practice are elderly and have comorbidities and impaired organ function. Given these differences, many major studies provide an imperfect guide to optimizing the treatment of the majority of patients. Since cancer incidence is highly correlated with age, and since the world's population is rapidly ageing, this problem can only increase. For this reason, oncologists and geriatricians need to collaborate in developing tools to systematically assess the health status of elderly patients and their fitness to receive cancer therapies of various intensity. Tailoring anti-cancer treatments and supportive care to individual needs should be seen as part of the move towards personalized medicine. Achieving this goal is as much of a challenge to developing and middle-income countries as it is to western nations. The 2015 annual conference of the International Society of Geriatric Oncology(SIOG) held in Prague, Czech Republic, November 2015 and had a global focus on advancing the science of geriatric oncology and supportive care. Central to this approach is the systematic assessment of life expectancy, independent functioning, and the physical and psychological health of older cancer patients. The assumption behind comprehensive geriatric assessment is that elderly cancer patients have complex needs. The implication is that effective intervention will require a multidisciplinary team. Examples of effective geriatric assessment, multidisciplinary working and supportive care were presented at the SIOG conference.展开更多
The corrosion under insulation dominates metal loss in the case of API (American Petroleum Institute) 5L Grade B geothermal pipeline, whereas, the other possible corrosion causes, such as stress corrosion and therma...The corrosion under insulation dominates metal loss in the case of API (American Petroleum Institute) 5L Grade B geothermal pipeline, whereas, the other possible corrosion causes, such as stress corrosion and thermal cracking, did not serve a role as critical factors regarding to pipeline degradation during 26-years working operation. Actually, the header pipe diameter 32 inches and 40 inches require priority for inspection due to higher corrosion rate compared to smaller pipe diameters. By simulation method on similar heavy duty service condition in which the working pressure of 15 bars and temperature of 183 ℃, it was proved that corrosion rate will severely occur at corrosion rate more than 10 mpy in the pipe diameters of 20 inches, 32 inches and 40 inches. Further,condensation factor may contribute more significant in the case of corrosion under insulation. Practically, the metal loss at a half initial thickness requires priority for inspection, intensive maintenance or possible partial replacement.展开更多
Objectives: Trauma is among the leading causes of death. Medical management of blunt abdominal trauma (BAT) relies on judging patients for whom laparotomy is mandatory. This study aimed to determine BAT patients' ...Objectives: Trauma is among the leading causes of death. Medical management of blunt abdominal trauma (BAT) relies on judging patients for whom laparotomy is mandatory. This study aimed to determine BAT patients' signs, as well as paraclinical data, and to clarify the accuracy, sensitivity, specificity, positive and negative predictive value of clinical abdominal scoring system (CASS), a new scoring system based on clinical signs, in predicting whether a BAT patient needs laparotomy or not. Methods: Totally 400 patients suspected of BAT that arrived at the emergency department of two university hospitals in Tehran from March 20, 2007 to March 19, 2009 were included in this study. They were evaluated for age, sex, type of trauma, systolic blood pressure, Glasgow coma scale (GCS), pulse rate, time of presentation after trauma, abdomial clinical findings, respiratory rate, temperature, hemoglobin (Hb) concentration, focused abdominal sonography in trauma (FAST) and CASS. Results: Our measurements showed that CASS had an accuracy of 94%, sensitivity of 100%, specificity of 88%, positive predictive value of 90% and negative predictive value of 100% in determining the necessity of laparotomy in BAT patients. Moreover, in our analysis, systolic blood pressure, GCS, pulse rate, Hb concentration, time of presentation after trauma, abdominal clinical findings and FAST were also shown to be helpful in confirming the need for laparotomy (P〈0.05). Conclusion: CASS is a promising scoring system in rapid detection of the need for laparotomy as well as in minimizing auxiliary expense for further evaluation in BAT patients, thus to promote the cost-benefit ratio and accuracy of diagnosis.展开更多
Along with the development of China's govern- ment performance management and budget reform, and also to further improve the management of NS- FC,performance evaluation of NSFC is necessary. This test introduces t...Along with the development of China's govern- ment performance management and budget reform, and also to further improve the management of NS- FC,performance evaluation of NSFC is necessary. This test introduces the NSF performance assess- ment system,and gives some thoughts about fur- ther development of the performance evaluation of NSFC(National Natural Science Foundation of Chi- na).展开更多
文摘A paradox in cancer research is that the majority of patients enrolled in clinical trials are relatively young and fit while typical patients in daily practice are elderly and have comorbidities and impaired organ function. Given these differences, many major studies provide an imperfect guide to optimizing the treatment of the majority of patients. Since cancer incidence is highly correlated with age, and since the world's population is rapidly ageing, this problem can only increase. For this reason, oncologists and geriatricians need to collaborate in developing tools to systematically assess the health status of elderly patients and their fitness to receive cancer therapies of various intensity. Tailoring anti-cancer treatments and supportive care to individual needs should be seen as part of the move towards personalized medicine. Achieving this goal is as much of a challenge to developing and middle-income countries as it is to western nations. The 2015 annual conference of the International Society of Geriatric Oncology(SIOG) held in Prague, Czech Republic, November 2015 and had a global focus on advancing the science of geriatric oncology and supportive care. Central to this approach is the systematic assessment of life expectancy, independent functioning, and the physical and psychological health of older cancer patients. The assumption behind comprehensive geriatric assessment is that elderly cancer patients have complex needs. The implication is that effective intervention will require a multidisciplinary team. Examples of effective geriatric assessment, multidisciplinary working and supportive care were presented at the SIOG conference.
文摘The corrosion under insulation dominates metal loss in the case of API (American Petroleum Institute) 5L Grade B geothermal pipeline, whereas, the other possible corrosion causes, such as stress corrosion and thermal cracking, did not serve a role as critical factors regarding to pipeline degradation during 26-years working operation. Actually, the header pipe diameter 32 inches and 40 inches require priority for inspection due to higher corrosion rate compared to smaller pipe diameters. By simulation method on similar heavy duty service condition in which the working pressure of 15 bars and temperature of 183 ℃, it was proved that corrosion rate will severely occur at corrosion rate more than 10 mpy in the pipe diameters of 20 inches, 32 inches and 40 inches. Further,condensation factor may contribute more significant in the case of corrosion under insulation. Practically, the metal loss at a half initial thickness requires priority for inspection, intensive maintenance or possible partial replacement.
文摘Objectives: Trauma is among the leading causes of death. Medical management of blunt abdominal trauma (BAT) relies on judging patients for whom laparotomy is mandatory. This study aimed to determine BAT patients' signs, as well as paraclinical data, and to clarify the accuracy, sensitivity, specificity, positive and negative predictive value of clinical abdominal scoring system (CASS), a new scoring system based on clinical signs, in predicting whether a BAT patient needs laparotomy or not. Methods: Totally 400 patients suspected of BAT that arrived at the emergency department of two university hospitals in Tehran from March 20, 2007 to March 19, 2009 were included in this study. They were evaluated for age, sex, type of trauma, systolic blood pressure, Glasgow coma scale (GCS), pulse rate, time of presentation after trauma, abdomial clinical findings, respiratory rate, temperature, hemoglobin (Hb) concentration, focused abdominal sonography in trauma (FAST) and CASS. Results: Our measurements showed that CASS had an accuracy of 94%, sensitivity of 100%, specificity of 88%, positive predictive value of 90% and negative predictive value of 100% in determining the necessity of laparotomy in BAT patients. Moreover, in our analysis, systolic blood pressure, GCS, pulse rate, Hb concentration, time of presentation after trauma, abdominal clinical findings and FAST were also shown to be helpful in confirming the need for laparotomy (P〈0.05). Conclusion: CASS is a promising scoring system in rapid detection of the need for laparotomy as well as in minimizing auxiliary expense for further evaluation in BAT patients, thus to promote the cost-benefit ratio and accuracy of diagnosis.
文摘Along with the development of China's govern- ment performance management and budget reform, and also to further improve the management of NS- FC,performance evaluation of NSFC is necessary. This test introduces the NSF performance assess- ment system,and gives some thoughts about fur- ther development of the performance evaluation of NSFC(National Natural Science Foundation of Chi- na).