Entry-Level Forward Surgical Team Training Is Associated with Increased Confidence of Primary Combat Surgeons

Background: In recent years, we have established an entry-level Forward Surgical Team (FST) training program in a Chinese military medical university for the 5th grade undergraduates, who would be deployed to different military medical services as primary combat surgeons. This study aimed to assess the role of this pre-service training in improving their confidence with combat medical skills, after several years since they received the training. Methods: We conducted a nationwide survey of 239 primary combat surgeons who have ever participated in an entry-level FST training program before deployment between June 2016 and June 2020, which was for evaluating on a 5-point Likert scale the benefits of entry-level FST training and conventional surgery training in improving their confidence with combat medical skills. The difference in scores was compared using the student t-test. Significance was considered as P Results: The total score was significantly higher for entry-level FST training than that for conventional surgery training (30.76 ± 4.33 vs. 28.95 ± 4.80, P There was no significant difference between the training for surgical skills confidence scores (18.03 ± 8.04 vs. 17.51 ± 8.30, P = 0.098), but for non-technical skills, the score of entry-level FST training was significantly higher than that of conventional surgery training (12.73 ± 5.39 vs. 11.44 ± 5.62, P The distributions of confidence scores were different under various subgroups by demographics. There were no significant differences in scores between the two training in all specific surgical skill sets except “life-saving surgery” (P = 0.011). Scores of all 4 non-technical skill sets were significantly higher for entry-level FST than those for conventional surgery training (P Conclusions: The training should be considered as an essential strategy to improve confidence in combat medical skills, especially life-saving surgery and non-technical skills, for primary combat surgeons.

Concept Analysis: Emergency Department Crowding and Length of Stay before and after an Increase in Catchment Area

Several notable issues arise from overcrowding in an emergency department (ED) for both patients and staff. Longer wait times, higher ambulance diversion rates, longer stays, higher incidence of medical errors, higher rates of patient mortality, and greater harm to hospitals due to financial losses are some of these problems. Collaboration is crucial in the healthcare industry since it determines the team’s hourly performance in managing patient care. By using Walker and Avant’s (2011) concept analysis method, the author reviewed the literature to better understand ED crowding, to ensure that patients receive safe treatment in a timely manner, and to highlight best practices that can be identified through concept analysis and practice evaluations. In conducting this concept analysis, Walker and Avant’s framework was applied to examine the nature of the findings selected for the advancement of the concept. Everyone working in the ED, from those who determine policy to those on the front lines continually encounter new obstacles, but has little or no time to formulate fresh concepts or reconsider how ED treatment is provided. Overcrowding occurs when the number of patients requiring attention, awaiting transfer, or undergoing diagnosis and treatment exceeds the physical capacity of ED staff. If a clear plan is not in place to increase and improve services in proportion to a growing population, this situation will persist.

基于新型聚类算法IncreaseK-Means的Blog相似度分析

针对现有聚类算法K-均值存在事先指定聚类类数及仿射传播存在计算复杂度偏高的缺陷,提出了一种新型的聚类算法IncreaseK-Means,并将其应用到Blog内容的相似度聚类分析中,较好地满足了社区发现和话题跟踪的需求.仿真结果表明:在Blog文本聚类分析中,IncreaseK-Means在时间上与K-Means相近,在精度上与仿射传播接近,适用于大规模网络文本的分析处理.

American Factories Continue to Increase Equipment Investment——Competitors in Asia also increased their consumption of machine tools.

去年美国金属加工工厂对新机床产品的需求量较 2004 年和 2003 年都有增加。消沉中的美国资本投资发生了一个转变,排在德国之前成为第三大消费国。然而对于美国机床业来说,不太好的消息是亚洲竞争对手同样增加了他们在机床的设备投资。来自第 41 次世界机床生产和消费的调查显示,中国、日本、韩国、印度以及中国台湾地区的机床消费都有显著增长。在 28 个国家和地区的调查中,四分之三的国家和地区消费都在增长,这同时也诠释了经济“表面消费”的含义。这一切表明美国的机床消费量还会继续保持增加,订购机器的数量会维持向上的势头,最新的数据也证明了这一点。此外,调查数据还罗列了其它国家,尤其是亚洲国家的机床生产情况(本刊2006 年第一期环球瞭望栏目文章图表中显示了世界主要机床生产状况):德国和日本领导着世界机床的生产;中国超过意大利成为第三大机床生产国;中国台湾地区排在第五位;美国机床的生产和出口排在台湾之后,保持小的增长;韩国与瑞士紧追其后;印度也毫不示弱。这28个被调查国家和地区的机床产量都比前一年平均增长了14% 。中国、日本、韩国、印度以及中国台湾地区占据了整个调查地区机床产量的 47.6% ,作为CECIMO 成员的由 15 个国家组成的西欧联盟占据了机床产量的 4 2 . 3 % 。

Down-regulation of Hsp90 could change cell cycle distribution and increase drug sensitivity of tumor cells

:AIM To construct Hsp90 antisense RNAeukaryotic expression vector, transfect it intoSGC7901 and SGC7901/VCR of MDR-type humangastric cancer cell lines, HCC7402 of humanhepatic cancer and Eel09 of human esophagealcancer cell lines, and to study the cell cycledistribution of the gene transected cells andtheir response to chemotherapeutic drugs.METHODS A I .03kb cDNA sequence of Hsp90Pwas obtained from the primary plasmid phHsp90by EcoR 1 and BamH I nuclease digestion andwas cloned to the EcoR 1 and BamH 1 site ofthe pcDNA by T4DNA ligase and an antisenseorientation of Hsp900 expression vector wasconstructed. The constructs were transfectedwith lipofectamine and positive clones wereselected with G418. The expression of RNA wasdetermined with dot blotting and RNaseprotection assay, and the expression of Hsp90protein determined with Western blot. Cell cycledistribution of the transfectants was analyzedwith flow cytometry, and the drug sensitivity ofthe transfectants to adriamycin (ADR ),vincrinstine (VCR ), mitomycin (MMC ) andcyclophosphamide (CTX ) with MTT andintracellular drug concentration of thetransfectants was determined with flowcytometry.RESULTS In EcoR 1 and BamH I restrictionanalysis, the size and the direction of the clonedsequence of Hsp900 remained what had beendesigned and the gene constructs were namedpcDNA-Hsp90. AH^SGC7901, AH^SGC7901/ VCR,AH-HCC7402 and AH-Eel09 cell clones allexpressed Hsp90 anti--sense RNA. Theexpression of Hsp90 was down--regulated in AHSGC7901, AH--SGC7901/ VCR, AH-HCC7402 andAH--Eel09 cell clones. Cell cycle distribution waschanged differently. In AH-SGC7901/ VCR andAH-Ec109 cells, G, phase cells were increased; Sphase and G, phase cells were decreased ascompared with their parental cell lines. In AHSGC7901 cell, G, phase cells were decreased, Qphase cells increased and S phase cells were notchanged, and in AH-HCC7402 cells G,, S and qphase cells remained unchanged as comparedwith their parental cell lines. The sensitivity ofAH--SGC7901, AH--SGC7901/ VCR, AH-HCC7402 andAH-Ec109 to chemotherapeutic drugs, thesensitivity ot AH--SGC7901/ VCR to ADR, VCR,MMC and CTX the sensitivity of AH-HCC7402 toADR and VCR, and the sensitivity of Eel09 toADR, VCR and CTX all increased as comparedwith their parental cell lines. The meanfluorescence intensity of ADR in AH--SGC7901,AH-SGC7901/ VCR, AH--HCC7402 and AH-Ec109was also significantly elevated (P< 0. 05).CONCLUSION Down-regulation of HsP90 couldchange cell cycle distribution and increase thedrug sensitivity of tumor cells.

Increased plant density and reduced N rate lead to more grain yield and higher resource utilization in summer maize

Planting at an optimum density and supplying adequate nitrogen(N) to achieve higher yields is a common practice in crop production, especially for maize(Zea mays L.); however, excessive N fertilizer supply in maize production results in reduced N use efficiency(NUE) and severe negative impacts on the environment. This research was conducted to determine the effects of increased plant density and reduced N rate on grain yield, total N uptake, NUE, leaf area index(LAI), intercepted photosynthetically active radiation(IPAR), and resource use efficiency in maize. Field experiments were conducted using a popular maize hybrid Zhengdan 958(ZD958) under different combinations of plant densities and N rates to determine an effective approach for maize production with high yield and high resource use efficiency. Increasing plant density was clearly able to promote N absorption and LAI during the entire growth stage, which allowed high total N uptake and interception of radiation to achieve high dry matter accumulation(DMA), grain yield, NUE, and radiation use efficiency(RUE). However, with an increase in plant density, the demand of N increased along with grain yield. Increasing N rate can significantly increase the DMA, grain yield, LAI, IPAR, and RUE. However, this increase was non-linear and due to the input of too much N fertilizers, the efficiency of N use at NCK(320 kg ha^(–1)) was low. An appropriate reduction in N rate can therefore lead to higher NUE despite a slight loss in grain production. Taking into account both the need for high grain yield and resource use efficiency, a 30% reduction in N supply, and an increase in plant density of 3 plants m^(–2), compared to LD(5.25 plants m^(–2)), would lead to an optimal balance between yield and resource use efficiency.

Improving school physical education to increase physical activity and promote healthy growth of Chinese school-aged children Time for action

Throughout its more than 5000-year history,China has a long tradition of encouraging active engagement in physical and sport activities.1,2This enduring tradition,however,has been facing some major headwinds as China continues to experience demographic and environmental changes related to aging,urbanization,and lifestyle shifts.3-5Mounting evidence indicates increasing levels of sedentary behaviors。

NUMERICAL SIMULATION OF THE RELATIONSHIP BETWEEN THE MAINTENANCE AND INCREASE IN HEAVY RAINFALL OF THE LANDING TROPICAL STORM BILIS AND MOISTURE TRANSPORT FROM LOWER LATITUDES

The NCEP/NCAR reanalysis, Japan Meteorological Agency(JMA) tropical cyclone tracks and intensive surface observations are used to diagnose the features of moisture transport of tropical storm Bilis(No. 0604), which is simulated by the WRF(weather research and forecasting) mesoscale numerical model. It is shown that the Bilis was linked with the moisture channel in the lower latitudes after its landing. Meanwhile, the cross-equatorial flows over 80°-100°E and Somali were active and brought abundant water vapor into the tropical storm, facilitating the maintenance of the landing storm with intensified heavy rainfall along its path. The simulation suggested that the decreased water vapor from lower latitudes prevents the maintenance of Bilis and the development of rainfall. While the cross-equatorial flows over 80°-100°E and Somali were in favor of keeping the cyclonic circulation over land. If the moisture supply fro m the Somali jet stream was reduced, the strength and area of heavy rainfall in tropical cyclone would be remarkably weakened. Consequently, the decreased water vapor from lower latitudes can remarkably suppress the deep convection in tropical storm, then Bilis was damped without the persistent energy support and the rainfall was diminished accordingly.

Spatial distribution modeling of temperature increase for the uplifted mountain terrains and its characteristics in Southwest China

Local temperature changes in mountain areas are significantly affected by the uplifted mountain terrains. Understanding how temperature increase with mountain terrains is an important component in accurately modeling the spatial distribution of temperature. The study, after minimizing the effect of elevation and latitude, quantitatively simulated the temperature increase in the uplifted mountain terrains, described the characteristics in the spatial distribution of warming areas with different magnitudes, and identified the correlated indices of mountain bodies for warming. Selecting Yunnan Province in southwest China as the study area, we simulated the warming field on a baseline surface at the average elevation of 2000 m and average latitude of 24.96°. The results indicated that the warming magnitudes in different local areas varied with the change in the spatial locations, and the warming process concentrated in the mountainous regions. Throughout the entire study area, the warming field presented a general pattern of three terraces from the regions of high mountains to middle mountains and then low mountains. The areasof high warming magnitude mainly surrounded large mountain bodies and were distributed on the upper part. The areas of low warming magnitude clustered in the valleys and basins of the middle mountain region, mostly on the lower part of the large mountain bodies and its branches. The areas with zero warming magnitude occurred in the low mountains and broad valleys, which were distributed largely on the lower parts of the middle mountains and in most of the valleys. Quantified sampling analysis demonstrated good positive correlation between the warming magnitudes in uplifted mountain terrains and the volume index of the mountain body, as well as elevation difference, with the coefficients corresponding to 0.82 and 0.91, respectively.

Increased plasma galectin-1 correlates with advanced glycation end products and interleukin-1β in patients with proliferative diabetic retinopathy

Dear Editor,Galectin-1, one of galactoside-binding lectin family proteins, has been shown to regulate cell growth, migration, and proliferation, where it binds many receptors depending on their glycosylation profile, rather than its specific receptors.

Tea Consumption is Associated with Increased Risk of Kidney Stones in Northern Chinese： A Cross-sectional Study

Kidney stones are a common urinary system condition that can progress to kidney disease.Previous studies on the association between tea consumption and kidney stones are inconsistent.A cross‐sectional study to investigate the association between tea consumption and kidney stones was conducted from 2013 to 2014 and recruited 9,078northern Chinese adults.A total of 8,807participants were included in the final analysis.

Obstructive sleep apnea increases heart rhythm disorders and worsens subsequent outcomes in elderly patients with subacute myocardial infarction

OBJECTIVE Obstructive sleep apnea(OSA)is a potential cardiovascular risk.We aimed to investigate the association of OSA with heart rhythm disorders and prognosis in elderly patients with new-onset acute myocardial infarction(AMI).METHODS We prospectively enrolled 252 AMI elderly patients(mean age,68.5±6.9 years)who were undergoing revascularization and completed a sleep study during their hospitalization.All subjects were categorized into non-OSA(apnea–hypopnea index(AHI)<15,n=130)and OSA(AHI≥15,n=122)groups based on the AHI.The changes in the autonomic nervous system,incidence of arrhythmia during nocturnal sleep,and major adverse cardiovascular and cerebrovascular events(MACCEs)were compared between the groups.RESULTS The mean AHI value in all AMI patients was 22.8±10.9.OSA patients showed higher levels of body mass index and peak high-sensitivity C-reactive protein and lower levels of minimum nocturnal oxygen saturation(Min Sa O2),as well as greater proportion of multivessel coronary artery disease(all P<0.05).The OSA group also showed significant increases in heart rate variability and heart rate turbulence onset(both P<0.05)and higher incidence of arrhythmia(including sinus,atrial,and ventricular in origin).At a median follow-up of 6 months(mean 0.8–1.6 years),OSA(AHI≥15)combined with hypoxia(Min Sa O2≤80%)was independently associated with the incidence of MACCEs(hazard ratio[HR]:4.536;95%confidence interval[CI]:1.461-14.084,P=0.009)after adjusting for traditional risk factors.CONCLUSIONS OSA and OSA-induced hypoxia may correlate with the severity of myocardial infarction,increase the occurrence of heart rhythm disorders in elderly subacute MI patients,and worsen their short-term poor outcomes.

Increase of Income of Farmers and Herdsmen in Tibet in the New Period

The disposable income per capita of rural residents in Tibet was 7471 yuan in 2014. There is a high gap with the national average disposable income per capita of rural residents( 10489 yuan). Thus,it is urgent to increase income of farmers and herdsmen in Tibet. On the basis of literature in recent years,this paper analyzed methods for increasing income of farmers and herdsmen in Tibet,major factors restricting increase of their income,and approaches for increasing their income. It is expected to provide certain reference for further expanding ideas of increase of their income in the new period.

Changes in Myofibrillar and Mitochondrial Compartments during Increased Activity: Dependance from Oxidative Capacity of Muscle

Striated muscle tissue contains fibers with high oxidative capacity (heart muscle), higher oxidative capacity (type I and IIA fibers of skeletal muscle) and low oxidative capacity (type IIB/X fibers of skeletal muscle). Muscle fibers with higher oxidative capacity contain large mitochondria tightly packed with cristae as well as small forms of mitochondria containing relatively few cristae. The intensive development of the mitochondrial apparatus in the post-activity period reflects the adaptive processes, which is intended to supply the increased energy requirements of muscle fibers with higher oxidative capacity. Muscle fibers with low oxidative capacity contain significantly less mitochondria than fibers with higher capacity. It is typical to type IIB fibers that after intensive muscle activity there are damaged myofibrils in a relatively small area, some myofibrils are twisted and lose the connection with the neighboring structures. It is still not fully known how skeletal muscles with different oxidative capacity respond to an increased functional activity and what differences exist in these fibers between oxidative capacity and function of myofibrils. The aim of the present short review was to compare structural-functional changes in mitochondrial and myofibrillar compartments of heart and skeletal muscle fibers with different oxidative capacity and the effect of increased functional activity on the interaction of these compartments.

Empirical Study on the Benefit Increase of New Contract Farming 1+3+X Model

For a long time,the development model of traditional rice planting industry has been single,linear,and focusing on production first and then market.However,with the low price of rice,such problems as slow technological upgrading,meager profits,and unstable rice quality in the primary industry planting units and farmers have become increasingly prominent.The integration and development of the rural primary,secondary,and tertiary industries and industrial integration have the same root.They are integrated industrial development based on technological or model innovation,vertical and horizontal integration.Three agricultural leading companies(Nanjing Tianwei Agricultural Technology Co.,Ltd.,Nanjing CHYKINGYOUNG Biological Technology Co.,Ltd.,and Jiangsu Jingshan Eco-organic Agriculture Co.,Ltd.)established an industrialization complex,and used their respective technical,operational,and market advantages to integrate and form a rice contract farming 1+3+X model.This model effectively integrates scattered rice planting,rice processing,and rice sales in Nanjing City of Jiangsu Province,and Chuzhou City of Anhui Province,and unifies planting regulations and supply of production materials,safeguards the supply of green and high-quality rice and realizes high quality and high price.In addition,it integrates farmers into the entire industrial chain of contract farming,summons up the production enthusiasm of farmers and greatly increases their income from planting production.

Use of a new clone of Artemia parthenogenetica （OP1） to increase genetic variation

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The supporting capability of Water and land resources for sustainable increase of yield in North China Plain

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DNS Study on Volume Vorticity Increase in Boundary Layer Transition

The issue whether transition from laminar flow to turbulent flow on a flat plate should be characterized as a vorticity redistribution process or a vorticity increasing process is investigated by a high-order direct numerical simulation on a flat plate boundary layer.The local vorticity can either increase or decrease due to tilting and stretching of vortex filaments according to the vorticity transport equation while the total vorticity cannot be changed in a boundary layer flow in conforming to the Fppl theorem of total vorticity conservation.This seemingly contradictory problem can be well resolved by the introduction of a new term:volume vorticity of a vorticity tube,defined as vorticity flux timed by the vorticity tube length.It has been shown that,although vorticity flux must keep conserved,the total volume vorticity is significantly increased during boundary layer transition according to our direct numerical simulation(DNS)computation,which directly results from the lengthening(stretching and tilting)of vortex filaments.Therefore,the flow transition is a process with appreciable increase of volume vorticity,and cannot be only viewed as a vorticity redistribution process.

Increased intracranial pressure and macular thickening:is there a link?

Dear Editor,I am Dr. Hamid Sajjadi, director of Neuro-Ophthalmology at San Jose Eye and Laser Medical Center in California USA and director of Department of Ophthalmology, Acacia Medical Center, Dubai, UAE. I write to present three cases of macular thickening (MT) and micro-papilledema associated with increased intracranial pressure (IICP).

Roles of Fenlong Technology in the Increase of Grain Yield and Construction of a Huge "Underground Reservoir"

Fenlong farming technology was introduced. It has characteristics of very deep tillage and evenly smashing soil,and can evenly smash soil without disturbing soil layers to complete the task of soil preparation. It can be widely used in cultivated land,saline-alkali land,lime concretion black soil,degraded grassland,etc. After the application of the technology in 34 crops in 24 provinces,it can increase yield by 10%-50% and improve quality by above 5%. Fenlong technology can increase soil reservoir capacity,enhance the infiltration rate of rainwater in soil and make " surplus" effect obvious. If the country plans and promotes the technology in 160 million hm^2 of land( including 67 million hm^2 of cultivated land,20 million hm^2 of saline-alkali land,6. 7 million hm^2 of marginal land and 67 million hm^2 of degraded grassland),the total volume of loosened soil in arable land will increase from 198. 1 billion to 840. 0 billion m^3,and the capacity of a " underground reservoir" will increase by 675 million m^3,while natural precipitation reserves will increase by 162 billion m^3. It can effectively solve food security problems and water resource problems such as drought,floods,and industrial,agricultural and domestic water shortages,as well as serious disaster hazards caused by groundwater that has been evacuated in China.