Obstetric Anesthesia Practice Significantly Evolved: A Field for Cesarean Delivery Parturient for the Provision of Safe Anesthesia in Urgent Circumstances

General anesthesia and Obstetric Anesthesia is the gold standard for a cesarean section but there are some cases where general anesthesia is unavoidable. The use of general anesthesia for cesarean delivery has decreased in recent years due to the widespread use of neuraxial techniques. The choice of anesthesia techniques for cesarean delivery depends on several factors, including the patient’s psychology and the attending physician’s experience. It is chosen because of its safety profile and its benefits to the mother and fetus. It may be indicated due to emergency, maternal refusal of regional techniques, or regional contraindications. Major complications include failed intubation, gastric content aspiration, and increased bleeding risk. This study aims to evaluate the impact of a newly launched team on obstetric anesthesia practice.

Impacts of Import Refusals on Agricultural Exports duri ng Pan demies: Implicatio ns for China

Pandemic outbreaks disrupt agricultural trade.The possible strengthening of import barriers to products from countries at the epicenter of a pandemic by their trade partners could aggravate this situation.This paper examines the responses of the US Food and Drug Administration(FDA),import refusals,and subsequent trade impacts on the agricultural exports from the developing countries that were the epicenters of four pandemics in the past two decades.Using monthly data for the period 2002-2020,we find increased import refusals and amplified trade-impeding impacts on agricultural exports during pandemic outbreaks.Increased import refusals and the amplification of the trade-impeding effect of import refusals were especially large when China was the epicenter.We further examine possible differences in these results across products and FDA inspection methods,and the main conclusions remain robust.This paper offers a better understanding of the economic outcomes of pandemic outbreaks and provides policy suggestions for China.

Speech Act of Refusal-A Proposal from an Interlanguage Pragmatic Perspective

This paper is to present a typology of refusal strategies which may be employed in the analysis of refusal performance from a discourse approach.Some previous research carried out is reviewed in order to classify non-native speakers' production of this speech act.Then,the suggested taxonomy will be described in a systematized way from an interlanguage pragmatic perspective and within a conversational analysis framework.Finally,it is emphasized that effective communicative competence plays an important role in the production of this face-threatening speech act of refusing.

基于通信顺序进程的并发DEDS的规范和证实

在实时通信顺序进程 ( TCSP)的基础上对离散事件动态系统 ( DEDS)进行建模、规范和证实 .介绍了 TCSP中与 DEDS相关的一些研究成果 ,根据离散事件的特点作了符号语义上的改进 ,就两个具体的例子——自动导引小车 ( AGV)和火车道口系统建立了 TCSP模型 ,给出了它们需要满足的特性 。

Decliners of provider-initiated HIV testing and counselling: Characteristics of participants who refused HIV testing in a population survey in Zambia

Objective: To assess the prevalence of HIV infection, to highlight HIV-testing refusal rates among participants in a population-based tuberculosis survey and to assess the implication for programme implementation.Methods: This cross-sectional study on the characteristics of participants who refused HIV testing was conducted in a national survey in Zambia. All eligible participants were aged above 15 years and included in the analysis.Results: Out of the 44 791 tuberculosis survey participants, 14 164(31.6%) refused to participate in HIV testing. The unemployed, rural dwellers, married, and those aged 15-24 years were associated with higher refusal rates.Conclusions: Strategies to improve HIV testing acceptance are necessary. Qualitative research is recommended to understand the reasons for testing refusals so that remedial interventions can be implemented.

On One Model of Complex Technical Queuing System with Unreliable Devices and with Time Redundancy

The given article deals with the development of analytical model of request service process by multichannel technical system with unreliable, repaired and reconfigured service facilities. It is assumed that the system is functioning in service mode of random length random request flows. The system considers the existence of time redundancy for afterservice of calls, the service of which is interrupted with refusal, non-depreciating the performed part of the task. Special probability functions are introduced which on the basis of probability reasoning allow to make the systems of integral equations describing the dynamics of request service process.

High-context and Low-context communication: A Case Study of A Chinese Refusal

Edward Hall offers us an effective means of examining cultural similarities and differences,that is the classification of high-context and low-context culture.The paper attempts to analyze a case of a Chinese refusal from the perspective of highcontext and low-context communication and explores the differences between the two types of communication.

A Longitudinal Study on the Development of Pre-request Practices by a Four Years Old Girl

Requests and requesting language have been a popular topic for researchers from a wide range of fields including linguistic philosophy,pragmatics,social-pragmatics,and discourse analysis since 1960s.Requesting is a dynamic process which is the combination of requests and pre-requests,as well as request negotiations.By now,studies mostly focused on the study of how request was initiated and what were the factors lying behind specific choice of one request form over others,and how request-makers pursued their demands when grants were not given as expected.However,limited studies have been published about the development of the strategies children took to avoid predictable refusals.This paper aims to make a contribution to this topic by conducting a longitudinal study lasting for approximately one year with a four-year-old Chinese girl as the subject.By contrasting and comparing the subject’s natural linguistic performance,the author tried to reveal the developmental procedure,and profound cognitive and cultural factors.

A Genre——based Analysis of English Refusal Letters

The present study analyzes ten English refusal letters of two subcategories based on Swales' genre analysis model and finds that difference exists in the generic features of the two subcategorized types. Teachers should reveal the underlying rationale behind linguistic features of a specific genre so that students can not only identify genre but also apply it appropriately.

The Erasure of Signifiers and Refusal of Signification in Philip Larkin's Poem“High Window”

This paper tries to analyze Philip Larkin's poem"High Window"from a deconstructive perspective. It is to show that in the poem the key words/signifiers are always under erasure, and thus the chain of signification is endless since the poem is self-deconstructing. Then, the paper argues that the linguistic features of the poem paradoxically meaningful in the sense that it reflects the poet's skepticism and anxiety.

Autophagy and inflammation in ischemic stroke

Appropriate autophagy has protective effects on ischemic nerve tissue,while excessive autophagy may cause cell death.The inflammatory response plays an important role in the survival of nerve cells and the recovery of neural tissue after ischemia.Many studies have found an interaction between autophagy and inflammation in the pathogenesis of ischemic stroke.This study outlines recent advances regarding the role of autophagy in the post-stroke inflammatory response as follows.(1)Autophagy inhibits inflammatory responses caused by ischemic stimulation through mTOR,the AMPK pathway,and inhibition of inflammasome activation.(2)Activation of inflammation triggers the formation of autophagosomes,and the upregulation of autophagy levels is marked by a significant increase in the autophagy-forming markers LC3-II and Beclin-1.Lipopolysaccharide stimulates microglia and inhibits ULK1 activity by direct phosphorylation of p38 MAPK,reducing the flux and autophagy level,thereby inducing inflammatory activity.(3)By blocking the activation of autophagy,the activation of inflammasomes can alleviate cerebral ischemic injury.Autophagy can also regulate the phenotypic alternation of microglia through the nuclear factor-κB pathway,which is beneficial to the recovery of neural tissue after ischemia.Studies have shown that some drugs such as resveratrol can exert neuroprotective effects by regulating the autophagy-inflammatory pathway.These studies suggest that the autophagy-inflammatory pathway may provide a new direction for the treatment of ischemic stroke.

Effect of leachate recycle and inoculation on microbial characteristics of municipal refuse in landfill bioreactors

Population development of key groups of anaerobic and aerobic bacteria involved in municipal refuse decomposition under laboratory landfill bioreactors with and without leachate recycle and inoculation was measured since modeling municipal refuse was landfilled in bioreactors for about 210 days. Hydrolytic fermentative bacteria (HFB), hydrogen producing acetogenic bacteria (HPAB), methane producing bacteria (MPB), sulfate reducing bacteria (SRB), anaerobic and aerobic cellulolytic bacteria and denitrabacteria were enumerated by the most probable number technique. The results showed that the dominant microorganism groups were the methanogenic bacteria including hydrolytic fermentative, hydrogen producing acetogenic and methane producing bacteria. They were present in fresh refuse but at low values and positively affected by leachate recycle and refuse inoculation. The amounts of HFB or HPAB in digesters D4 and D5 operated with inoculation and leachate recycle reached their maximum values of 10 10 -10 12 cells/g dry refuse for HFB or 10 5-10 6 cells/g dry refuse for HPAB on day 60, in digester D3 operated with leachate recycle on day 120 for HFB (10\+9 cells/g dry refuse) or on day 90 for HPAB (10\+5 cells/g dry refuse), and in digesters D1 and D2 on day 210 for HFB (10 9 cells/g dry refuse) or on day 90 for HPAB (10 4-10 6 cells/g dry refuse). The population of methane producing bacteria in digesters D4 and D5 sharply increased on days 60 and 90 respectively, however in digesters D1, D2 and D3 on day 120. Leachate recycle and inoculation changed the cellulolytic microorganisms composition of refuse ecosystem, the higher amounts of anaerobic cellulolytic bacteria were measured in digesters D4 and D5 (10 7 cells/g dry refuse), followed by digesters D3 (10 6 cells/g dry refuse), D2 or D1(10 4 cells/g dry refuse). However, the amounts of aerobic cellulolytic bacteria were much lower than that of anaerobic cellulolytic bacteria. And it was higher in digester D3 than those in digesters D1, D2, D4 and D5 The amounts of SRB and denitrabacteria were also higher in digester D5 than those in digesters D1, D2, D3 and D4 Refuse decomposition could be accelerated by leachate recycle and inoculation in the view of microorganism development.

PillCam Colon 2 capsule in patients unable or unwilling to undergo colonoscopy

AIM: To assess the feasibility, accuracy and acceptability of PillCam Colon 2 in detection of significant lesions in colorectal cancer risk patients, unable or unwilling to perform colonoscopy. METHODS: This is a prospective, single center study using the second generation of PillCam Colon capsule. In all patients the readers were instructed to review the entire colon capsule endoscopy(CCE) examination using Rapid 7 software and additionally to note significant extra-colonic findings. Colonic significant findings were described according to European Society of Gastrointestinal Endoscopy guidelines. CCE procedure completion rate, level of bowel preparation and rate of adverse events were assessed. RESULTS: A total of 70 patients at risk of colorectal cancer were enrolled in the study. In three patients the procedure failed because the capsule was not functioning when entered the colon. PillCam Colon 2 showed positive findings in 23(34%, 95%CI: 21.6%-44.1%) of the remaining 67 patients. Six patients were diagnosedwith tumors: 4 with colon cancers, 1 with gastric cancer and 1 with a small bowel cancer. The capsule findings were confirmed after surgery in all these patients. The capsule excretion rate in twelve hours was 77% with 54 patients having a complete examination. The rectum was not explored during CCE procedure, in 16 patients(23%, 95%CI: 13.7%-34.1%). Every patient accepted CCE as an alternative exploration tool and 65/70(93%) agreed to have another future control by CCE. No complications were reported during or after CCE examination. CONCLUSION: PillCam Colon 2 capsule was effective in detecting significant lesions and might be considered an adequate alternative diagnostic tool in patients unable or unwilling to undergo colonoscopy.

Coal waste management practices in the USA:an overview

This paper provides an overview of coal waste management practices with two case studies and an estimate of management cost in 2010 US dollars.Processing of as-mined coal typically results in considerable amount of coarse and fine coal processing wastes because of in-seam and out-of-seam dilution mining.Processing plant clean coal recovery values run typically 50%-80%.Trace metals and sulfur may be present in waste materials that may result in leachate water with corrosive characteristics.Water discharges may require special measures such as liner and collection systems,and treatment to neutralize acid drainage and/or water quality for trace elements.The potential for variations in coal waste production and quality depends upon mining or processing,plus the long-term methods of waste placement.The changes in waste generation rates and engineering properties of the coal waste during the life of the facility must be considered.Safe,economical and environmentally acceptable management of coal waste involves consideration of geology,soil and rock mechanics,hydrology,hydraulics,geochemistry,soil science,agronomy and environmental sciences.These support all aspects of the regulatory environment including the design and construction of earth and rock embankments and dams,as well as a wide variety of waste disposal structures.Development of impoundments is critical and require considerations of typical water-impounding dams and additional requirements of coal waste disposal impoundments.The primary purpose of a coal waste disposal facility is to dispose of unusable waste materials from mining.However,at some sites coal waste impoundments serve to provide water storage capacity for processing and flood attenuation.

Froth flotation of refuse coal fines and process optimization using 2D surface plots

Refuse coal fines of size <500 μm was collected from a metallurgical coal preparation plant located in the eastern coalfield region of India. The coal was beneficiated using froth flotation technique to recover clean coal with ash content of about 20% with the highest possible yield. Diesel oil as collector and pine oil as frother were used. Box-Behnken statistical design was followed for analyzing the performance at varying pulp density, collector and frother dosage. Results were discussed using 2D surface plots. Response function predictions determined by the regression analysis show coefficient of correlation(R^2) for yield and the ash content as 0.72 and 0.86, respectively. The highest yield of 45.79% is obtained at pulp density 10%, collector dose 2 kg/t and frother dose 1.5 kg/t. The lowest ash content of 18.9% is obtained at pulp density 10%, collector dose 1 kg/t and frother dose 1 kg/t.

Study on Catalytic Decomposition of Dioxins by Supported CeO_2-TiO_2-V_2O_5 Composite Catalyst

Loaded on the cordierite, the rare earth doped composite catalyst was prepared by sol-gel method combined with dipping technique. Taking Orthodichlorobenzene as model, the catalyst was used to remove the dioxins of the waste gas. The results showed that at 280 ℃ and gas space velocity being 8000 h-1, the orthodichlorobenzene could be removed effectivily by the prepared CeO_2-TiO2-V2O5 composite catalyst whose activity was remarkably enhanced by the doping of Ce, while the industrial side-stream test of dioxins from refuse incineration smoke indicated that the decomposition rate could reach above 93% under the same conditions.

Ecological Restoration Design of Refuse Landfill——A Case Study of Landscape Planning of Beichen Shuangkou Refuse Landfill in Tianjin City

Refuse landfill plays an important role in daily life,but also brings serious pollution.By investigating environment pollution of Beichen Shuangkou Refuse Landfill in Tianjin City,this paper put forward major problems of this refuse landfill,and suggestions for turning it into a landscape system with regeneration and renewing capacity,so as to provide references for ecological restoration and landscaping of similar damaged land resources.

Study of Engineering Characteristics of Coal Refuse Foundation

Coal refuse in a natural state is a kind of loose medium with inherent physical and chemical properties. It can be used after compaction as materials for foundation of buildings. Based on the results of numerical analysis and experiments, a study is successfully made in this paper to reveal the compression, load-bearing and anti-mining de formation characteristics. The obtained results are of great significance in guiding the miniug operations under surface buildings erected on pre-paved refuse foundations.

Use of coals and wastes in a co-gasification process aimed at producing hydrogen rich gas

The use of low-quality coals and flotoconcentrates is currently severely limited,and the problem of managing municipal waste from anthropogenic activities is currently a challenge.The problems of reducing carbon dioxide emissions,utilizing the energy potential of waste and increasing its recycling have an impact on the costs of electricity production.Considering the abundant streams of unused fuels,they can be considered as attractive energy materials,so environmentally-friendly and cost-effective options for their utilization should be developed.A study was conducted using steam co-gasification technology on selected coals,flotation concentrates and Refuse Derived Fuel(RDF)alternative fuel.Selected low-quality coals were combined with RDF alternative fuel in a process aimed at hydrogen production.The experiments produced gas with hydrogen concentrations ranging from 67%(vol.)to 68%(vol.)with low methane concentrations.It was observed that the addition of alternative fuels helped to increase the hydrogen concentration in syngas.Attention was paid to the catalytic ability of the metal oxides contained in the fuel blend,with particular reference to K_(2)O and Al_(2)O_(3)and TiO_(2).

Combustion Characteristics of Solid Refuse Fuels from Different Waste Sources

In the production(as co-fuel or alone)of solid refuse fuel(SRF),knowledge about the characteristics of the raw materials is required for an ecofriendly and effective combustion process.SRFs are commonly produced by drying combustible waste and removing incombustible matter,resulting in a higher combustibility as compared to the original waste.However,the characteristics of SRFs may highly vary depending on where and from which materials they were produced.Thus,we investigated the characteristics of various SRFs using thermogravimetric analysis(TGA).As a TGA sample is commonly small,on the scale of milligrams,and,unlike homogeneous fuels,SRFs are heterogeneous,individual SRF samples analysed with this method may not represent the bulk material,and sample properties may vary significantly between batches.Therefore,we further performed combustion experiments using a small-scale combustor and sample sizes from 1 to 10 g.To optimise SRF combustor design and determine the SRF characteristics,proximate,elemental,heating value,TG,and differential thermogravimetric analyses were conducted,and weight losses and gas concentrations at different temperatures were measured upon combustion.The lower heating values of the three analysed SRFs were 20,976,16,873,and 19,762 kJ/kg,and their Cl contents were 0.89,0.95,and 1.27 wt.%(legal criterion[Cl]<2.0 wt.%).TGA and small combustor experiments showed that complete weight loss was achieved below 500°C.However,CO was detected until 620°C.