The number of students demanding computer science(CS)education is rapidly rising,and while faculty sizes are also growing,the traditional pipeline consisting of a CS major,a CS master’s,and then a move to industry or...The number of students demanding computer science(CS)education is rapidly rising,and while faculty sizes are also growing,the traditional pipeline consisting of a CS major,a CS master’s,and then a move to industry or a Ph.D.program is simply not scalable.To address this problem,the Department of Computing at the University of Illinois has introduced a multidisciplinary approach to computing,which is a scalable and collaborative approach to capitalize on the tremendous demand for computer science education.The key component of the approach is the blended major,also referred to as“CS+X”,where CS denotes computer science and X denotes a non-computing field.These CS+X blended degrees enable win-win partnerships among multiple subject areas,distributing the educational responsibilities while growing the entire university.To meet the demand from non-CS majors,another pathway that is offered is a graduate certificate program in addition to the traditional minor program.To accommodate the large number of students,scalable teaching tools,such as automatic graders,have also been developed.展开更多
BACKGROUND Stroke has become one of the most serious life-threatening diseases due to its high morbidity,disability,recurrence and mortality rates.AIM To explore the intervention effect of multi-disciplinary treatment...BACKGROUND Stroke has become one of the most serious life-threatening diseases due to its high morbidity,disability,recurrence and mortality rates.AIM To explore the intervention effect of multi-disciplinary treatment(MDT)extended nursing model on negative emotions and quality of life of young patients with post-stroke.METHODS A total of 60 young stroke patients who were hospitalized in the neurology department of our hospital from January 2020 to December 2021 were selected and randomly divided into a control group and an experimental group,with 30 patients in each group.The control group used the conventional care model and the experimental group used the MDT extended nursing model.After the inhospital and 3-mo post-discharge interventions,the differences in negative emotions and quality of life scores between the two groups were evaluated and analyzed at the time of admission,at the time of discharge and after discharge,respectively.RESULTS There are no statistically significant differences in the negative emotions scores between the two groups at admission,while there are statistically significant differences in the negative emotions scores within each group at admission and discharge,at discharge and post-discharge,and at discharge and post-discharge.In addition,the negative emotions scores were all statistically significant at discharge and after discharge when compared between the two groups.There was no statistically significant difference in quality of life scores at the time of admission between the two groups,and the difference between quality of life scores at the time of admission and discharge,at the time of discharge and post-discharge,and at the time of admission and post-discharge for each group of patients was statistically significant.CONCLUSION The MDT extended nursing mode can improve the negative emotion of patients and improve their quality of life.Therefore,it can be applied in future clinical practice and is worthy of promotion.展开更多
AIMTo assess the impact of multi-disciplinary teams (MDTs) management in optimising the outcome for rectal cancers. METHODSWe undertook a retrospective review of a prospectively maintained database of patients with re...AIMTo assess the impact of multi-disciplinary teams (MDTs) management in optimising the outcome for rectal cancers. METHODSWe undertook a retrospective review of a prospectively maintained database of patients with rectal cancers (defined as tumours ≤ 15 cm from anal verge) discussed at our MDT between Jan 2008 and Jan 2011. The data was validated against the national database to ensure completeness of dataset. The clinical course and follow-up data was validated using the institution’s electronic patient records. The data was analysed in terms of frequencies and percentages. Significance of any differences were analysed using χ<sup>2</sup> test. A Kaplan-Meier analysis was performed for overall survival and disease free survival. RESULTSFollowing appropriate staging, one hundred and thirty-three patients were suitable for potentially curative resections. Seventy two (54%) were upper rectal cancer (URC) - tumour was > 6 cm from the anal verge and 61 (46%) were lower rectal cancers (LRC) - lower extent of the tumour was palpable ≤ 6 cm. Circumferential resection margin (CRM) appeared threatened on pre-operative MRI in 19/61 (31%) patients with LRC requiring neo-adjuvant therapy (NAT). Of the 133 resections, 118 (89%) were attempted laparoscopically (5% conversion rate). CRM was positive in 9 (6.7%) patients; Median lymph node harvest was 12 (2-37). Major complications occurred in 8 (6%) patients. Median follow-up was 53 mo (0-82). The 90-d mortality was 2 (1.5%). Over the follow-up period, disease related mortality was 11 (8.2%) and overall mortality was 39 (29.3%). Four (3%) patients had local recurrence and 22 (16.5%) patients had distant metastases. CONCLUSIONManagement of rectal cancers can be optimized with multi-disciplinary input to attain acceptable long-term oncological outcomes even when incorporating a laparoscopic approach to rectal cancer resection.展开更多
Hepatocellular carcinoma(HCC)is a common malignant tumor in the Chinese population.Due to its high degree of malignancy,rapid progression,and poor prognosis,it mainly requires multi-disciplinary treatment(MDT)in the c...Hepatocellular carcinoma(HCC)is a common malignant tumor in the Chinese population.Due to its high degree of malignancy,rapid progression,and poor prognosis,it mainly requires multi-disciplinary treatment(MDT)in the clinic.In December 2019,COVID-19,a novel coronavirus pneumonia,broke out in Wuhan,China.It has rapidly spread across the country,with various places launching a level I response to major public health emergencies and traffic being restricted.Most patients with HCC were only able to attend primary hospitals,while the MDT model for HCC in provincial hospitals was restricted.Therefore,it was a huge task for clinicians in primary hospitals to ensure MDT was given to patients with HCC during the level I response to major public health emergencies.How to formulate a reasonable MDT mode for patients with HCC according to local conditions was worthy of consideration by hepatobiliary surgeons in primary hospitals.展开更多
Traditionally, in the field of bilingual lexicography, the main task for lexicographers is to provide lexical equivalents in bilingual dictionaries by all possible means. And accordingly, how to provide appropriate or...Traditionally, in the field of bilingual lexicography, the main task for lexicographers is to provide lexical equivalents in bilingual dictionaries by all possible means. And accordingly, how to provide appropriate or satisfying translation equivalents in bilingual dictionaries is always the centre of attention in bilingual metalexicography. However, the history of bilingual lexicography shows that it has never been an easy task, because of linguistic and cultural anisomorphism. The usual compromise made by most lexicographers is to introduce partial or explanatory equivalents. This recourse means that most bilingual lexicographers, unfortunately, more than often, fail to meet the needs of foreign language learners. Certain misconceptions about the translation equivalents emerge among the language learners, which explains the awkward situation that besets bilingual exicographers. The present contribution aims at perceiving lexicographical translation as a dynamic process by which an adequate semantic system in the target language would be set up to serve as a functionally equivalent defining system. By doing this, bilingual lexicographers should establish a powerful target language semantic network, in which lexicographical sections like verbal illustrations, usage notes and etymologies, etc. would be considered together with the translation equivalents as an integrated whole. This is an attempt to describe the essential features of lexicographical translation and its multi-disciplinary theoretical basis, in the hope that future practice in bilingual lexicography might be improved.展开更多
Metastatic pheochromocytoma/paraganglioma(MPP)is a rare endocrine tumor that originates from extra-adrenal chromaffin cells such as the paraganglia cells of sympathetic and parasympathetic nerves.It usually causes mul...Metastatic pheochromocytoma/paraganglioma(MPP)is a rare endocrine tumor that originates from extra-adrenal chromaffin cells such as the paraganglia cells of sympathetic and parasympathetic nerves.It usually causes multiple solid tumors and exhibits strong aggressiveness with poor prognosis,with a reported 5-year survival rate of less than 50%.Cases of brain and retroperitoneal metastases at the initial diagnosis have not yet been reported.We report a 41-year-old male patient initially diagnosed with MPP in the brain and retroperitoneum who underwent multi-disciplinary collaborative surgery and simultaneous removal of two tumors at our center.Postoperative pathology revealed infiltrative growth of a skull base tumor.The patient chose to receive the tyrosine kinase inhibitor sunitinib as a targeted treatment.A 3-month follow-up after surgery showed that the patient recovered well without signs of metastasis or recurrence.We present multi-disciplinary surgery under similar circumstances for enhanced treatment and postoperative management.The patient demonstrates a favorable prognosis during postoperative follow-up,indicating that simultaneous multidisciplinary surgery may offer greater benefits for MPP patients.展开更多
To enhance the comprehensive performance of artillery internal ballistics—encompassing power,accuracy,and service life—this study proposed a multi-stage multidisciplinary design optimization(MS-MDO)method.First,the ...To enhance the comprehensive performance of artillery internal ballistics—encompassing power,accuracy,and service life—this study proposed a multi-stage multidisciplinary design optimization(MS-MDO)method.First,the comprehensive artillery internal ballistic dynamics(AIBD)model,based on propellant combustion,rotation band engraving,projectile axial motion,and rifling wear models,was established and validated.This model was systematically decomposed into subsystems from a system engineering perspective.The study then detailed the MS-MDO methodology,which included Stage I(MDO stage)employing an improved collaborative optimization method for consistent design variables,and Stage II(Performance Optimization)focusing on the independent optimization of local design variables and performance metrics.The methodology was applied to the AIBD problem.Results demonstrated that the MS-MDO method in Stage I effectively reduced iteration and evaluation counts,thereby accelerating system-level convergence.Meanwhile,Stage II optimization markedly enhanced overall performance.These comprehensive evaluation results affirmed the effectiveness of the MS-MDO method.展开更多
This paper proposes a hybrid architecture based on Multi-disciplinary Design Optimization(MDO) with the Variable Complexity Modeling(VCM) method, to solve the problem of general design optimization for a stratosphere ...This paper proposes a hybrid architecture based on Multi-disciplinary Design Optimization(MDO) with the Variable Complexity Modeling(VCM) method, to solve the problem of general design optimization for a stratosphere airship. Firstly, MDO based on the Concurrent SubSpace Optimization(CSSO) strategy is improved for handling the subsystem coupling problem in stratosphere airship design which contains aerodynamics, structure, and energy. Secondly, the VCM method based on the surrogate model is presented for reducing the computational complexity in high-fidelity modeling without loss of accuracy. Moreover, the global-to-local optimization strategy is added to the architecture to enhance the process. Finally, the result gives a prominent stratosphere airship general solution that validates the feasibility and efficiency of the optimization architecture. Besides, a sensitivity analysis is conducted to outline the critical impact upon stratosphere airship design.展开更多
In this paper,an Uncertainty-based Multi-disciplinary Design Optimization (UMDO)method combining with fuzzy theory and Multi-Discipline Feasible (MDF) method is developed for the conceptual design of a Hybrid Rocket M...In this paper,an Uncertainty-based Multi-disciplinary Design Optimization (UMDO)method combining with fuzzy theory and Multi-Discipline Feasible (MDF) method is developed for the conceptual design of a Hybrid Rocket Motor (HRM) powered Launch Vehicle (LV).In the method proposed,membership functions are used to represent the uncertain factors,the fuzzy statistical experiment is introduced to analyze the propagation of uncertainties,and means,standard deviations and credibility measures are used to delineate uncertain responses.A geometric programming problem is solved to verify the feasibility of the Fuzzy-based Multi-Discipline Feasible(F-MDF) method.A multi-disciplinary analysis of a three-stage HRM powered LV involving the disciplines of propulsion,structure,aerodynamics and trajectory is implemented,and the mathematical models corresponding to the F-MDF method and the MDF method are established.A two-phase optimization method is proposed for multi-disciplinary design optimization of the LV,including the orbital capacity optimization phase based on the Ziolkowski formula,and the scheme trajectory verification phase based on the 3-degree-of-freedom point trajectory simulation.The correlation coefficients and the quadratic Response Surface Method (RSM) based on Latin Hypercube Sampling (LHS) are adopted for sensitive analysis of uncertain factors,and the Multi-Island Genetic Algorithm (MIGA) is adopted as the optimization algorithm.The results show that the F-MDF method is applicable in LV conceptual design,and the design with the F-MDF method is more reliable and robust than that with the MDF method.展开更多
Blended-Wing-Body(BWB) configuration, as an innovative transport concept, has become a worldwide research focus in the field of civil transports development. Relative to the conventional Tube-And-Wing(TAW) configurati...Blended-Wing-Body(BWB) configuration, as an innovative transport concept, has become a worldwide research focus in the field of civil transports development. Relative to the conventional Tube-And-Wing(TAW) configuration, the BWB shows integrated benefits and serves as a most promising candidate for future ‘‘green aviation'. The objective of the present work is to figure out the effects of the stability margin and Thrust Specific Fuel Consumption(TSFC) on the BWB design in the framework of Multi-Disciplinary Optimization(MDO). A physically-based platform was promoted to study the effect static stability margin and engine technology level. Low-order physically based models are applied to the evaluation of the weight and the aerodynamic performance. The modules and methods are illustrated in detail, and the validation of the methods shows feasibility and confidence for the conceptual design of BWB aircrafts. In order to find out the relation between planform changes and the selection of stability and engine technology level, two sets of optimizations are conducted separately. The study proves that these two factors have dominant effects towards the optimized BWB designs in both aerodynamic shapes, weight distribution, which needs to be considered during the MDO design process. A balance diagram analysis is applied to find out a reasonable static stability margin range. It can be concluded that a recommended stability margin of a practical BWB commercial aircraft can be half of that of a conventional TAW design.展开更多
We introduced a 61-year-old male with ductal adenocarcinoma of the prostate who underwent a tortuous diagnosis and treatment.Multi-disciplinary team meetings organized by our hospital have shown great value in the who...We introduced a 61-year-old male with ductal adenocarcinoma of the prostate who underwent a tortuous diagnosis and treatment.Multi-disciplinary team meetings organized by our hospital have shown great value in the whole process.The patient presented with gross hematuria accompanied by frequent urination initially,and was diagnosed with ductal adenocarcinoma of the prostate involving right seminal vesicle gland and urethra by urethroscopy biopsy.The clinical stage of tumor was T3bN0M0.After 4 cycles of neoadjuvant chemotherapy,the tumor shrank significantly and the patient underwent a laparoscopic radical prostatectomy.But the patient declined to continue chemotherapy postoperatively.After 10 months,the serum prostatic specific antigen increased to 0.05 ng/mL,and multiple metastases were found in the patient's bilateral lungs.However,an unexpected diagnosis of seminal vesicle adenocarcinoma was put forward from another hospital after supplementary pathologic immunohistochemical examination.Then,after careful discussion and demonstration by our multi-disciplinary team experts,we insisted on the diagnosis of ductal adenocarcinoma of the prostate and suggested that the original regimen of chemotherapy should be continued.Up-to-date,14 months after the operation,the patient continues to survive while undergoing ongoing active treatment as recommended.展开更多
First, we develop a unitary process that can explain all four physical activations: electromagnetic wave, electromagnetic force, repulsion, and attraction. Second, it is clarified that cosmological and physical entiti...First, we develop a unitary process that can explain all four physical activations: electromagnetic wave, electromagnetic force, repulsion, and attraction. Second, it is clarified that cosmological and physical entities relate to different levels of existence in the universe and, hence, cannot be considered under the same paradigm. We know that biological entities use physical substances as executants;analogously, physical entities use cosmological substances as executants. Therefore, we have introduced new terms for the cosmological substances used as executants in physical activities. Third, this study introduces the primary elements of the cosmological world, such as visibility, forcibility, fullness, and hollowness, and defines them according to their attributes. This study explains how different combinations and placements of primary elements create different cosmological fields. These fields are used in all physical activations. Finally, we explain the entity model and how all physical activations occur. This study concludes that all physical activations use primary elements and follow the same universal law. Therefore, this study addresses the untouched subject of the creation of repulsion and attraction (gravitation). Furthermore, it addresses several cosmic mysteries that are yet to be resolved.展开更多
In aircraft wings,aileron mass parameter presents a tremendous effect on the velocity and frequency of the flutter problem.For that purpose,we present the optimization of a composite design wing with an aileron,using ...In aircraft wings,aileron mass parameter presents a tremendous effect on the velocity and frequency of the flutter problem.For that purpose,we present the optimization of a composite design wing with an aileron,using machine-learning approach.Mass properties and its distribution have a great influence on the multi-variate optimization procedure,based on speed and frequency of flutter.First,flutter speed was obtained to estimate aileron impact.Additionally mass-equilibrated and other features were investigated.It can deduced that changing the position and mass properties of the aileron are tangible following the speed and frequency of the wing flutter.Based on the proposed optimization method,the best position of the aileron is determined for the composite wing to postpone flutter instability and decrease the existed stress.The represented coupled aero-structural model is emerged from subsonic aerodynamics model,which has been developed using the panel method in multidimensional space.The structural modeling has been conducted by finite element method,using the p-k method.The fluid-structure equations are solved and the results are extracted.展开更多
The treatment and general care for womendiagnosed with breast cancer has made a tremendous change andadvance in the last decades. Better methods for early detectionand screening of the disease, higher compliance of wo...The treatment and general care for womendiagnosed with breast cancer has made a tremendous change andadvance in the last decades. Better methods for early detectionand screening of the disease, higher compliance of women to gofor screening, an open social and political discourse of women andthe health care team and others, are just a few that both enabledand are a result of this change. Nurses have been highly involvedin these changes, which resulted in the specialization of nursingin the field of breast cancer. This article will focus on the mainfour points that influence the nursing specialist care, that is, thetailoring of treatment and the ability to offer women treatmentwhich is more specific to their own cancer; the importance of themultidisciplinary team as providing a State of the Art care; theinvolvement of women in the decision-making regarding theirtreatment and the specific developing role of the specialist breastcare nurse.展开更多
Extremely long Australian paediatric outpatient waiting lists have resulted in large numbers of children waiting to see a paediatrician. Analyses of the patient referrals suggest that a large proportion of children ma...Extremely long Australian paediatric outpatient waiting lists have resulted in large numbers of children waiting to see a paediatrician. Analyses of the patient referrals suggest that a large proportion of children may benefit from allied health input, in addition to being seen by the paediatrician. This paper provides an organisational strategy that involves streamlining Allied Health clinical services in an effort to assist with bringing down a Paediatric Out-patient waitlist. The paper describes principles to guide the formation of a Paediatric Allied Health Multi-Disciplinary team that proposes assessment and brief interventions. The service would focus on supporting the paediatricians through the use of structured procedures, telephone intakes, multidisciplinary triage, shared and standardised assessments, collaborative formulations and reports, brief interventions, clinical-community linkages, and allied health student support. A variety of additional important organisational principles are proposed to facilitate patient flow from the perspective of streamlining administrative processes, having adequate administrative support, shared responsibilities, teamwork, flexibility, carrying out intake assessments, determining which referrals were appropriate for allied health, and working closely with medical staff.展开更多
In the information time,the information technology and industry plays more and more important role in development of economy,promoting the world to be unified and emphasizing the globalization through such tendency of...In the information time,the information technology and industry plays more and more important role in development of economy,promoting the world to be unified and emphasizing the globalization through such tendency of their own.The IT application area also becomes larger and diverse through the mergence of multiple disciplines and multiple domains.IT industry demands the inter-disciplinary talent,who are believed to be industrialized,internationalized,and equipped with multi-disciplinary and inter-domain knowledge,and the ability of international competence.Facing the challenge of the new globalization tendency of international industry especially the IT and software industry,universities keep make great efforts to provide qualify graduates to fulfill the demand of industry.This paper introduces a novel joint Master programme which aims at establishing an international education system and platform.The schema,the characteristics,the execution principles are discussed wishing to share our practice and experience with our education colleagues.展开更多
Itch is a common problem and it can be debilitating. In the approach to managing chronic pruritic diseases, the key would be to identify the underlying cause and to adopt treatment specific to the condition. Unfortuna...Itch is a common problem and it can be debilitating. In the approach to managing chronic pruritic diseases, the key would be to identify the underlying cause and to adopt treatment specific to the condition. Unfortunately, in many cases, the cause/s can be occult. A careful examination for an underlying primary dermatosis is required, and repeated examinations at intervals may be needed. In generalized pruritus without a primary dermatosis, investigations to exclude a systemic disease are usually necessary. If the cause is still not determined, a trial of therapy may be very useful. The next step in the approach to chronic pruritus would be to use anti-pruritic agents specific to the type of pruritic disease. As we understand more about the patho-physiology of the various types of chronic pruritic diseases, we will be able to judiciously use treatment targeting the underlying mechanisms better and thereby achieve more favorable results. It is important to understand that itch is a sensation of multi-dimensional nature. In addition to its somatosensory aspect, it is closely linked to emotion and cognition. Very often, chronic pruritus originates from an organic disease but is amplified by the psychology of the patient. It is important to check if there are psycho-social issues that accompanies the presentation of chronic pruritus, and addressing them provides for a more effective and holistic management to the condition. A multi-disciplinary clinic would be suited to better address these aspects. Such a multidisciplinary clinic would typically comprise a dermatolo-gist, a nurse educator, a psychologist, a psychiatrist and medical social worker. In summary, our current clinical management of itch can be improved through careful identification of the underlying cause/s, using therapies specific for the disease and targeting the pathological mechanisms, and adopting a holistic approach to the clinical problem.展开更多
The engineering problems today become more and more complex particularly in the area of new product development. It requires the multi-disciplinary design method to solve complex problems. This paper presents an integ...The engineering problems today become more and more complex particularly in the area of new product development. It requires the multi-disciplinary design method to solve complex problems. This paper presents an integrated design system for solving complexity during multi-disciplinary design. Complexity could be solved if the design problems, given by any individuals who are concerned, are structured. The design system uses the multi-viewpoint concept to allow experts to share their information and knowledge in common views. Knowledge modules are used to store semantics from the experts of different disciplines. Then the system agent acts as an internal designer to help support the individuals to translate any semantics provided from one discipline and then propagate to other related disciplines. With these tools, the integrated design system can structure and solve the complexity of design problems.展开更多
Multi-agency and interdisciplinary collaboration working across and within sectors and teams is critical to ensure that children are adequately protected from any risk of abuse. Research indicates that children are mo...Multi-agency and interdisciplinary collaboration working across and within sectors and teams is critical to ensure that children are adequately protected from any risk of abuse. Research indicates that children are most effectively protected when agencies and stakeholders work together. This is because it is almost impossible for a single agency to respond adequately to any allegation and the complex nature of child abuse. Countries in South East Europe are actively engaged in developing and refining their child protection systems over the last 20 years. Considerable efforts are placed on introducing and building the capacity of workers to respond to child abuse from a system and multi-agency perspective. Barriers to effective multi-agency working include: systems which are not designed or are overly complicated for the reality of the context; lack of training and resources; long-standing and entrenched attitudes towards other professionals and co-working; and a lack of accountability and ownership展开更多
文摘The number of students demanding computer science(CS)education is rapidly rising,and while faculty sizes are also growing,the traditional pipeline consisting of a CS major,a CS master’s,and then a move to industry or a Ph.D.program is simply not scalable.To address this problem,the Department of Computing at the University of Illinois has introduced a multidisciplinary approach to computing,which is a scalable and collaborative approach to capitalize on the tremendous demand for computer science education.The key component of the approach is the blended major,also referred to as“CS+X”,where CS denotes computer science and X denotes a non-computing field.These CS+X blended degrees enable win-win partnerships among multiple subject areas,distributing the educational responsibilities while growing the entire university.To meet the demand from non-CS majors,another pathway that is offered is a graduate certificate program in addition to the traditional minor program.To accommodate the large number of students,scalable teaching tools,such as automatic graders,have also been developed.
基金Supported by the Joint Guidance Project of Qiqihar Science and Technology Plan in 2020,No.LHYD-202054。
文摘BACKGROUND Stroke has become one of the most serious life-threatening diseases due to its high morbidity,disability,recurrence and mortality rates.AIM To explore the intervention effect of multi-disciplinary treatment(MDT)extended nursing model on negative emotions and quality of life of young patients with post-stroke.METHODS A total of 60 young stroke patients who were hospitalized in the neurology department of our hospital from January 2020 to December 2021 were selected and randomly divided into a control group and an experimental group,with 30 patients in each group.The control group used the conventional care model and the experimental group used the MDT extended nursing model.After the inhospital and 3-mo post-discharge interventions,the differences in negative emotions and quality of life scores between the two groups were evaluated and analyzed at the time of admission,at the time of discharge and after discharge,respectively.RESULTS There are no statistically significant differences in the negative emotions scores between the two groups at admission,while there are statistically significant differences in the negative emotions scores within each group at admission and discharge,at discharge and post-discharge,and at discharge and post-discharge.In addition,the negative emotions scores were all statistically significant at discharge and after discharge when compared between the two groups.There was no statistically significant difference in quality of life scores at the time of admission between the two groups,and the difference between quality of life scores at the time of admission and discharge,at the time of discharge and post-discharge,and at the time of admission and post-discharge for each group of patients was statistically significant.CONCLUSION The MDT extended nursing mode can improve the negative emotion of patients and improve their quality of life.Therefore,it can be applied in future clinical practice and is worthy of promotion.
文摘AIMTo assess the impact of multi-disciplinary teams (MDTs) management in optimising the outcome for rectal cancers. METHODSWe undertook a retrospective review of a prospectively maintained database of patients with rectal cancers (defined as tumours ≤ 15 cm from anal verge) discussed at our MDT between Jan 2008 and Jan 2011. The data was validated against the national database to ensure completeness of dataset. The clinical course and follow-up data was validated using the institution’s electronic patient records. The data was analysed in terms of frequencies and percentages. Significance of any differences were analysed using χ<sup>2</sup> test. A Kaplan-Meier analysis was performed for overall survival and disease free survival. RESULTSFollowing appropriate staging, one hundred and thirty-three patients were suitable for potentially curative resections. Seventy two (54%) were upper rectal cancer (URC) - tumour was > 6 cm from the anal verge and 61 (46%) were lower rectal cancers (LRC) - lower extent of the tumour was palpable ≤ 6 cm. Circumferential resection margin (CRM) appeared threatened on pre-operative MRI in 19/61 (31%) patients with LRC requiring neo-adjuvant therapy (NAT). Of the 133 resections, 118 (89%) were attempted laparoscopically (5% conversion rate). CRM was positive in 9 (6.7%) patients; Median lymph node harvest was 12 (2-37). Major complications occurred in 8 (6%) patients. Median follow-up was 53 mo (0-82). The 90-d mortality was 2 (1.5%). Over the follow-up period, disease related mortality was 11 (8.2%) and overall mortality was 39 (29.3%). Four (3%) patients had local recurrence and 22 (16.5%) patients had distant metastases. CONCLUSIONManagement of rectal cancers can be optimized with multi-disciplinary input to attain acceptable long-term oncological outcomes even when incorporating a laparoscopic approach to rectal cancer resection.
文摘Hepatocellular carcinoma(HCC)is a common malignant tumor in the Chinese population.Due to its high degree of malignancy,rapid progression,and poor prognosis,it mainly requires multi-disciplinary treatment(MDT)in the clinic.In December 2019,COVID-19,a novel coronavirus pneumonia,broke out in Wuhan,China.It has rapidly spread across the country,with various places launching a level I response to major public health emergencies and traffic being restricted.Most patients with HCC were only able to attend primary hospitals,while the MDT model for HCC in provincial hospitals was restricted.Therefore,it was a huge task for clinicians in primary hospitals to ensure MDT was given to patients with HCC during the level I response to major public health emergencies.How to formulate a reasonable MDT mode for patients with HCC according to local conditions was worthy of consideration by hepatobiliary surgeons in primary hospitals.
文摘Traditionally, in the field of bilingual lexicography, the main task for lexicographers is to provide lexical equivalents in bilingual dictionaries by all possible means. And accordingly, how to provide appropriate or satisfying translation equivalents in bilingual dictionaries is always the centre of attention in bilingual metalexicography. However, the history of bilingual lexicography shows that it has never been an easy task, because of linguistic and cultural anisomorphism. The usual compromise made by most lexicographers is to introduce partial or explanatory equivalents. This recourse means that most bilingual lexicographers, unfortunately, more than often, fail to meet the needs of foreign language learners. Certain misconceptions about the translation equivalents emerge among the language learners, which explains the awkward situation that besets bilingual exicographers. The present contribution aims at perceiving lexicographical translation as a dynamic process by which an adequate semantic system in the target language would be set up to serve as a functionally equivalent defining system. By doing this, bilingual lexicographers should establish a powerful target language semantic network, in which lexicographical sections like verbal illustrations, usage notes and etymologies, etc. would be considered together with the translation equivalents as an integrated whole. This is an attempt to describe the essential features of lexicographical translation and its multi-disciplinary theoretical basis, in the hope that future practice in bilingual lexicography might be improved.
基金This study was supported by the National Key Research and Development Program of China(No.2018YFC2002202)the National High-Level Hospital Clinical Research Funding(No.BJ-2021-184).
文摘Metastatic pheochromocytoma/paraganglioma(MPP)is a rare endocrine tumor that originates from extra-adrenal chromaffin cells such as the paraganglia cells of sympathetic and parasympathetic nerves.It usually causes multiple solid tumors and exhibits strong aggressiveness with poor prognosis,with a reported 5-year survival rate of less than 50%.Cases of brain and retroperitoneal metastases at the initial diagnosis have not yet been reported.We report a 41-year-old male patient initially diagnosed with MPP in the brain and retroperitoneum who underwent multi-disciplinary collaborative surgery and simultaneous removal of two tumors at our center.Postoperative pathology revealed infiltrative growth of a skull base tumor.The patient chose to receive the tyrosine kinase inhibitor sunitinib as a targeted treatment.A 3-month follow-up after surgery showed that the patient recovered well without signs of metastasis or recurrence.We present multi-disciplinary surgery under similar circumstances for enhanced treatment and postoperative management.The patient demonstrates a favorable prognosis during postoperative follow-up,indicating that simultaneous multidisciplinary surgery may offer greater benefits for MPP patients.
基金supported by the“National Natural Science Foundation of China”(Grant Nos.52105106,52305155)the“Jiangsu Province Natural Science Foundation”(Grant Nos.BK20210342,BK20230904)the“Young Elite Scientists Sponsorship Programby CAST”(Grant No.2023JCJQQT061).
文摘To enhance the comprehensive performance of artillery internal ballistics—encompassing power,accuracy,and service life—this study proposed a multi-stage multidisciplinary design optimization(MS-MDO)method.First,the comprehensive artillery internal ballistic dynamics(AIBD)model,based on propellant combustion,rotation band engraving,projectile axial motion,and rifling wear models,was established and validated.This model was systematically decomposed into subsystems from a system engineering perspective.The study then detailed the MS-MDO methodology,which included Stage I(MDO stage)employing an improved collaborative optimization method for consistent design variables,and Stage II(Performance Optimization)focusing on the independent optimization of local design variables and performance metrics.The methodology was applied to the AIBD problem.Results demonstrated that the MS-MDO method in Stage I effectively reduced iteration and evaluation counts,thereby accelerating system-level convergence.Meanwhile,Stage II optimization markedly enhanced overall performance.These comprehensive evaluation results affirmed the effectiveness of the MS-MDO method.
基金supported in part by the National Key R&D Program of China(No.2016YFB1200100)
文摘This paper proposes a hybrid architecture based on Multi-disciplinary Design Optimization(MDO) with the Variable Complexity Modeling(VCM) method, to solve the problem of general design optimization for a stratosphere airship. Firstly, MDO based on the Concurrent SubSpace Optimization(CSSO) strategy is improved for handling the subsystem coupling problem in stratosphere airship design which contains aerodynamics, structure, and energy. Secondly, the VCM method based on the surrogate model is presented for reducing the computational complexity in high-fidelity modeling without loss of accuracy. Moreover, the global-to-local optimization strategy is added to the architecture to enhance the process. Finally, the result gives a prominent stratosphere airship general solution that validates the feasibility and efficiency of the optimization architecture. Besides, a sensitivity analysis is conducted to outline the critical impact upon stratosphere airship design.
基金supported by National Natural Science Foundation of China (No. 51305014)
文摘In this paper,an Uncertainty-based Multi-disciplinary Design Optimization (UMDO)method combining with fuzzy theory and Multi-Discipline Feasible (MDF) method is developed for the conceptual design of a Hybrid Rocket Motor (HRM) powered Launch Vehicle (LV).In the method proposed,membership functions are used to represent the uncertain factors,the fuzzy statistical experiment is introduced to analyze the propagation of uncertainties,and means,standard deviations and credibility measures are used to delineate uncertain responses.A geometric programming problem is solved to verify the feasibility of the Fuzzy-based Multi-Discipline Feasible(F-MDF) method.A multi-disciplinary analysis of a three-stage HRM powered LV involving the disciplines of propulsion,structure,aerodynamics and trajectory is implemented,and the mathematical models corresponding to the F-MDF method and the MDF method are established.A two-phase optimization method is proposed for multi-disciplinary design optimization of the LV,including the orbital capacity optimization phase based on the Ziolkowski formula,and the scheme trajectory verification phase based on the 3-degree-of-freedom point trajectory simulation.The correlation coefficients and the quadratic Response Surface Method (RSM) based on Latin Hypercube Sampling (LHS) are adopted for sensitive analysis of uncertain factors,and the Multi-Island Genetic Algorithm (MIGA) is adopted as the optimization algorithm.The results show that the F-MDF method is applicable in LV conceptual design,and the design with the F-MDF method is more reliable and robust than that with the MDF method.
基金supported by the Fundamental Research Funds for the Central Universities (Nos. 3102019JC009 and G2016KY0002)
文摘Blended-Wing-Body(BWB) configuration, as an innovative transport concept, has become a worldwide research focus in the field of civil transports development. Relative to the conventional Tube-And-Wing(TAW) configuration, the BWB shows integrated benefits and serves as a most promising candidate for future ‘‘green aviation'. The objective of the present work is to figure out the effects of the stability margin and Thrust Specific Fuel Consumption(TSFC) on the BWB design in the framework of Multi-Disciplinary Optimization(MDO). A physically-based platform was promoted to study the effect static stability margin and engine technology level. Low-order physically based models are applied to the evaluation of the weight and the aerodynamic performance. The modules and methods are illustrated in detail, and the validation of the methods shows feasibility and confidence for the conceptual design of BWB aircrafts. In order to find out the relation between planform changes and the selection of stability and engine technology level, two sets of optimizations are conducted separately. The study proves that these two factors have dominant effects towards the optimized BWB designs in both aerodynamic shapes, weight distribution, which needs to be considered during the MDO design process. A balance diagram analysis is applied to find out a reasonable static stability margin range. It can be concluded that a recommended stability margin of a practical BWB commercial aircraft can be half of that of a conventional TAW design.
文摘We introduced a 61-year-old male with ductal adenocarcinoma of the prostate who underwent a tortuous diagnosis and treatment.Multi-disciplinary team meetings organized by our hospital have shown great value in the whole process.The patient presented with gross hematuria accompanied by frequent urination initially,and was diagnosed with ductal adenocarcinoma of the prostate involving right seminal vesicle gland and urethra by urethroscopy biopsy.The clinical stage of tumor was T3bN0M0.After 4 cycles of neoadjuvant chemotherapy,the tumor shrank significantly and the patient underwent a laparoscopic radical prostatectomy.But the patient declined to continue chemotherapy postoperatively.After 10 months,the serum prostatic specific antigen increased to 0.05 ng/mL,and multiple metastases were found in the patient's bilateral lungs.However,an unexpected diagnosis of seminal vesicle adenocarcinoma was put forward from another hospital after supplementary pathologic immunohistochemical examination.Then,after careful discussion and demonstration by our multi-disciplinary team experts,we insisted on the diagnosis of ductal adenocarcinoma of the prostate and suggested that the original regimen of chemotherapy should be continued.Up-to-date,14 months after the operation,the patient continues to survive while undergoing ongoing active treatment as recommended.
文摘First, we develop a unitary process that can explain all four physical activations: electromagnetic wave, electromagnetic force, repulsion, and attraction. Second, it is clarified that cosmological and physical entities relate to different levels of existence in the universe and, hence, cannot be considered under the same paradigm. We know that biological entities use physical substances as executants;analogously, physical entities use cosmological substances as executants. Therefore, we have introduced new terms for the cosmological substances used as executants in physical activities. Third, this study introduces the primary elements of the cosmological world, such as visibility, forcibility, fullness, and hollowness, and defines them according to their attributes. This study explains how different combinations and placements of primary elements create different cosmological fields. These fields are used in all physical activations. Finally, we explain the entity model and how all physical activations occur. This study concludes that all physical activations use primary elements and follow the same universal law. Therefore, this study addresses the untouched subject of the creation of repulsion and attraction (gravitation). Furthermore, it addresses several cosmic mysteries that are yet to be resolved.
基金This work was supported by China Medical University.
文摘In aircraft wings,aileron mass parameter presents a tremendous effect on the velocity and frequency of the flutter problem.For that purpose,we present the optimization of a composite design wing with an aileron,using machine-learning approach.Mass properties and its distribution have a great influence on the multi-variate optimization procedure,based on speed and frequency of flutter.First,flutter speed was obtained to estimate aileron impact.Additionally mass-equilibrated and other features were investigated.It can deduced that changing the position and mass properties of the aileron are tangible following the speed and frequency of the wing flutter.Based on the proposed optimization method,the best position of the aileron is determined for the composite wing to postpone flutter instability and decrease the existed stress.The represented coupled aero-structural model is emerged from subsonic aerodynamics model,which has been developed using the panel method in multidimensional space.The structural modeling has been conducted by finite element method,using the p-k method.The fluid-structure equations are solved and the results are extracted.
文摘The treatment and general care for womendiagnosed with breast cancer has made a tremendous change andadvance in the last decades. Better methods for early detectionand screening of the disease, higher compliance of women to gofor screening, an open social and political discourse of women andthe health care team and others, are just a few that both enabledand are a result of this change. Nurses have been highly involvedin these changes, which resulted in the specialization of nursingin the field of breast cancer. This article will focus on the mainfour points that influence the nursing specialist care, that is, thetailoring of treatment and the ability to offer women treatmentwhich is more specific to their own cancer; the importance of themultidisciplinary team as providing a State of the Art care; theinvolvement of women in the decision-making regarding theirtreatment and the specific developing role of the specialist breastcare nurse.
文摘Extremely long Australian paediatric outpatient waiting lists have resulted in large numbers of children waiting to see a paediatrician. Analyses of the patient referrals suggest that a large proportion of children may benefit from allied health input, in addition to being seen by the paediatrician. This paper provides an organisational strategy that involves streamlining Allied Health clinical services in an effort to assist with bringing down a Paediatric Out-patient waitlist. The paper describes principles to guide the formation of a Paediatric Allied Health Multi-Disciplinary team that proposes assessment and brief interventions. The service would focus on supporting the paediatricians through the use of structured procedures, telephone intakes, multidisciplinary triage, shared and standardised assessments, collaborative formulations and reports, brief interventions, clinical-community linkages, and allied health student support. A variety of additional important organisational principles are proposed to facilitate patient flow from the perspective of streamlining administrative processes, having adequate administrative support, shared responsibilities, teamwork, flexibility, carrying out intake assessments, determining which referrals were appropriate for allied health, and working closely with medical staff.
文摘In the information time,the information technology and industry plays more and more important role in development of economy,promoting the world to be unified and emphasizing the globalization through such tendency of their own.The IT application area also becomes larger and diverse through the mergence of multiple disciplines and multiple domains.IT industry demands the inter-disciplinary talent,who are believed to be industrialized,internationalized,and equipped with multi-disciplinary and inter-domain knowledge,and the ability of international competence.Facing the challenge of the new globalization tendency of international industry especially the IT and software industry,universities keep make great efforts to provide qualify graduates to fulfill the demand of industry.This paper introduces a novel joint Master programme which aims at establishing an international education system and platform.The schema,the characteristics,the execution principles are discussed wishing to share our practice and experience with our education colleagues.
文摘Itch is a common problem and it can be debilitating. In the approach to managing chronic pruritic diseases, the key would be to identify the underlying cause and to adopt treatment specific to the condition. Unfortunately, in many cases, the cause/s can be occult. A careful examination for an underlying primary dermatosis is required, and repeated examinations at intervals may be needed. In generalized pruritus without a primary dermatosis, investigations to exclude a systemic disease are usually necessary. If the cause is still not determined, a trial of therapy may be very useful. The next step in the approach to chronic pruritus would be to use anti-pruritic agents specific to the type of pruritic disease. As we understand more about the patho-physiology of the various types of chronic pruritic diseases, we will be able to judiciously use treatment targeting the underlying mechanisms better and thereby achieve more favorable results. It is important to understand that itch is a sensation of multi-dimensional nature. In addition to its somatosensory aspect, it is closely linked to emotion and cognition. Very often, chronic pruritus originates from an organic disease but is amplified by the psychology of the patient. It is important to check if there are psycho-social issues that accompanies the presentation of chronic pruritus, and addressing them provides for a more effective and holistic management to the condition. A multi-disciplinary clinic would be suited to better address these aspects. Such a multidisciplinary clinic would typically comprise a dermatolo-gist, a nurse educator, a psychologist, a psychiatrist and medical social worker. In summary, our current clinical management of itch can be improved through careful identification of the underlying cause/s, using therapies specific for the disease and targeting the pathological mechanisms, and adopting a holistic approach to the clinical problem.
文摘The engineering problems today become more and more complex particularly in the area of new product development. It requires the multi-disciplinary design method to solve complex problems. This paper presents an integrated design system for solving complexity during multi-disciplinary design. Complexity could be solved if the design problems, given by any individuals who are concerned, are structured. The design system uses the multi-viewpoint concept to allow experts to share their information and knowledge in common views. Knowledge modules are used to store semantics from the experts of different disciplines. Then the system agent acts as an internal designer to help support the individuals to translate any semantics provided from one discipline and then propagate to other related disciplines. With these tools, the integrated design system can structure and solve the complexity of design problems.
文摘Multi-agency and interdisciplinary collaboration working across and within sectors and teams is critical to ensure that children are adequately protected from any risk of abuse. Research indicates that children are most effectively protected when agencies and stakeholders work together. This is because it is almost impossible for a single agency to respond adequately to any allegation and the complex nature of child abuse. Countries in South East Europe are actively engaged in developing and refining their child protection systems over the last 20 years. Considerable efforts are placed on introducing and building the capacity of workers to respond to child abuse from a system and multi-agency perspective. Barriers to effective multi-agency working include: systems which are not designed or are overly complicated for the reality of the context; lack of training and resources; long-standing and entrenched attitudes towards other professionals and co-working; and a lack of accountability and ownership