The economy of West African countries is mainly based on agriculture. However, the trace metal(loid)s contamination status in rivers is relatively unknown in the region. In this work, 45 surface sediments collected fr...The economy of West African countries is mainly based on agriculture. However, the trace metal(loid)s contamination status in rivers is relatively unknown in the region. In this work, 45 surface sediments collected from the Bandama, Comoé, and Bia Rivers in south and south eastern Côte d’Ivoire (West Africa), were analyzed for total metal concentrations and chemical speciation. The results showed that the river sediments were considerably contaminated by Cd and moderately contaminated by As, Cu, Pb, and Zn. Significant spatial variations were observed among the stations but not between the rivers. Metals Cd and Cu were likely to cause more ecological risks. The speciation analysis unravelled that the metal(loid)s partitioned mainly in the residual fraction, with the potential mobile fraction varying from 14% to 28%. The study calls for establishment of strict policies relative to the application of fertilizers and agrochemicals and mining activities to protect the environment and human health risks.展开更多
BACKGROUND:The quick sequential organ failure assessment(qSOFA)is recommended to identify sepsis and predict sepsis mortality.However,some studies have recently shown its poor performance in sepsis mortality predictio...BACKGROUND:The quick sequential organ failure assessment(qSOFA)is recommended to identify sepsis and predict sepsis mortality.However,some studies have recently shown its poor performance in sepsis mortality prediction.To enhance its effectiveness,researchers have developed various revised versions of the qSOFA by adding other parameters,such as the lactate-enhanced qSOFA(LqSOFA),the procalcitonin-enhanced qSOFA(PqSOFA),and the modified qSOFA(MqSOFA).This study aimed to compare the performance of these versions of the qSOFA in predicting sepsis mortality in the emergency department(ED).METHODS:This retrospective study analyzed data obtained from an electronic register system of adult patients with sepsis between January 1 and December 31,2019.Receiver operating characteristic(ROC)curve analyses were performed to determine the area under the curve(AUC),with sensitivity,specificity,and positive and negative predictive values calculated for the various scores.RESULTS:Among the 936 enrolled cases,there were 835 survivors and 101 deaths.The AUCs of the LqSOFA,MqSOFA,PqSOFA,and qSOFA were 0.740,0.731,0.712,and 0.705,respectively.The sensitivity of the LqSOFA,MqSOFA,PqSOFA,and qSOFA were 64.36%,51.40%,71.29%,and 39.60%,respectively.The specificity of the four scores were 70.78%,80.96%,61.68%,and 91.62%,respectively.The LqSOFA and MqSOFA were superior to the qSOFA in predicting in-hospital mortality.CONCLUSIONS:Among patients with sepsis in the ED,the performance of the PqSOFA was similar to that of the qSOFA and the values of the LqSOFA and MqSOFA in predicting in-hospital mortality were greater compared to qSOFA.As the added parameter of the MqSOFA was more convenient compared to the LqSOFA,the MqSOFA could be used as a candidate for the revised qSOFA to increase the performance of the early prediction of sepsis mortality.展开更多
BACKGROUND Acute pancreatitis(AP)is a common surgical condition,with severe AP(SAP)potentially lethal.Many prognostic indices,including;acute physiology and chronic health evaluation II score(APACHE II),bedside index ...BACKGROUND Acute pancreatitis(AP)is a common surgical condition,with severe AP(SAP)potentially lethal.Many prognostic indices,including;acute physiology and chronic health evaluation II score(APACHE II),bedside index of severity in acute pancreatitis(BISAP),Glasgow score,harmless acute pancreatitis score(HAPS),Ranson’s score,and sequential organ failure assessment(SOFA)evaluate AP severity and predict mortality.AIM To evaluate these indices'utility in predicting severity,intensive care unit(ICU)admission,and mortality.METHODS A retrospective analysis of 653 patients with AP from July 2009 to September 2016 was performed.The demographic,clinical profile,and patient outcomes were collected.SAP was defined as per the revised Atlanta classification.Values for APACHE II score,BISAP,HAPS,and SOFA within 24 h of admission were retrospectively obtained based on laboratory results and patient evaluation recorded on a secure hospital-based online electronic platform.Data with<10%missing data was imputed via mean substitution.Other patient information such as demographics,disease etiology,and patient outcomes were also derived from electronic medical records.RESULTS The mean age was 58.7±17.5 years,with 58.7%males.Gallstones(n=404,61.9%),alcohol(n=38,5.8%),and hypertriglyceridemia(n=19,2.9%)were more common aetiologies.81(12.4%)patients developed SAP,20(3.1%)required ICU admission,and 12(1.8%)deaths were attributed to SAP.Ranson’s score and APACHE-II demonstrated the highest sensitivity in predicting SAP(92.6%,80.2%respectively),ICU admission(100%),and mortality(100%).While SOFA and BISAP demonstrated lowest sensitivity in predicting SAP(13.6%,24.7%respectively),ICU admission(40.0%,25.0%respectively)and mortality(50.0%,25.5%respectively).However,SOFA demonstrated the highest specificity in predicting SAP(99.7%),ICU admission(99.2%),and mortality(98.9%).SOFA demonstrated the highest positive predictive value,positive likelihood ratio,diagnostic odds ratio,and overall accuracy in predicting SAP,ICU admission,and mortality.SOFA and Ranson’s score demonstrated the highest area under receiver-operator curves at 48 h in predicting SAP(0.966,0.857 respectively),ICU admission(0.943,0.946 respectively),and mortality(0.968,0.917 respectively).CONCLUSION The SOFA and 48-h Ranson’s scores accurately predict severity,ICU admission,and mortality in AP,with more favorable statistics for the SOFA score.展开更多
Survivability has emerged as a new phase for the development of network security technique, and quantifying survivability for network system helps to evaluate it exactly for the system in different environments. In th...Survivability has emerged as a new phase for the development of network security technique, and quantifying survivability for network system helps to evaluate it exactly for the system in different environments. In this paper, we adopt a stochastic method called sequential Monte Carlo and try to reflect dynamic evolvement process of network survivability situation from several time sequences. The experiment results show that this method has the features of quantitative description, real-time calculation and dynamic tracking, and it is a good situation assessment solution for network survivability.展开更多
The structure of Pb,Zn,Cu and Cd in lead zinc ore tailing soils in Yongzhou,Hunan is analyzed by the optimized BCR sequential extraction procedure.The content and proportion of heavy metals of the mine are measured.Me...The structure of Pb,Zn,Cu and Cd in lead zinc ore tailing soils in Yongzhou,Hunan is analyzed by the optimized BCR sequential extraction procedure.The content and proportion of heavy metals of the mine are measured.Meanwhile,the ecological risks are evaluated with the Lars Hakanson＇s potential ecological risk exponential method.The analysis shows that the content of heavy metals is very high,reaching the level of serious pollution.The order of metal pollution degrees are Cd〉Pb〉Cu〉Zn.On the other hand,it is very possible that the heavy metals may combine together as compounds or cling to the crystal form of clay.Since the form of soluble acid and free metals are very little,it is not an easy job for metal elating or restoration of plants.Yet it is possible to take out those heavy metals adopting the chemical extraction technology.DTPA and EDTA,indicated by a research,both have iterative value and strong conformity effect.So they are effective elutriants to restore the polluted soil.A chemical extraction method is put forward in this paper.展开更多
The idea behind this work is developing an adaptive method for the environmental assessment of buildings, to configure different versions according to the variables affecting them (spatial, temporal and associated wit...The idea behind this work is developing an adaptive method for the environmental assessment of buildings, to configure different versions according to the variables affecting them (spatial, temporal and associated with building characteristics) to suit different evaluated projects. This method may be applied using an electronic tool, which is in a development stage. Amending different assessment versions of the adaptive method is done by including the variables effect, according to set of steps, such as modifying the formulation of the assessment items, adjusting their estimation weights, and amending their achievement evaluation levels and their returned scores. When using the adaptive method, the assessment result of a building using a certain version differs from the results using other versions, even in the same country, so configuring an appropriate version due to the variables affecting the assessment helps getting more accurate results than the ones currently provided. The main goal of that research is to introduce the adaptive method that is proposed to ensure a fairer assessment results from the perspective of Green Architecture, and allow a more credible and accuracy of results comparison according to the environmental performance of buildings. The researcher analyzed the different main features she used in developing the adaptive method, the Comparative aspects between it and the current assessment methods, and the expected reached advantages from its usage. The paper arrived to the importance of adapting the environmental assessment of buildings according to the different affecting variables, and recommended developing the adaptive method and its tool to the stage of application to benefit its advantages.展开更多
Some building components are responsible for achieving more than one environmental function, these functions are usually of different requirements that can never be done by the same actions, and they are usually conne...Some building components are responsible for achieving more than one environmental function, these functions are usually of different requirements that can never be done by the same actions, and they are usually connected to changeable internal and external environment characteristics that vary among them. Minimizing the conflict of achieving the different environmental functions is an important challenge for all designers. Achieving a continuous thermal and optical comfort in an internal building space using the same window is an example of this challenge, as they have different requirements that may be sometimes contrary. It should be notable that there are a lot of recent technologies that may be used to find solutions for such a conflict. The Environmental Assessment Methods of Buildings appeared to set the principles of the optimum relation between buildings and their environment, they also could be used to encourage designers to reach the best environmental relations, and award them by main or additional assessment points. The research paper proposes to use the Environmental Assessment Methods of Buildings to assess the building ability of minimizing its environmental functions achievement conflict. This proposal depends on determining the inconsistency assessment items that depend on common building components to be achieved, and then determining the time periods that these items are achieved together within, to indicate the time periods without conflicting. Thus, the paper aims to raise the building environmental value in the assessment when the designer succeeds to minimize the expected conflict of the building environmental functions.展开更多
目的评价新生儿序贯器官衰竭评分(nSOFA)对极低出生体重儿晚发败血症死亡风险的预测价值。方法采用单中心、回顾性病例对照性研究。收集2018—2021年于南京医科大学附属苏州医院(苏州市立医院)新生儿科重症监护室住院的首次患有晚发败...目的评价新生儿序贯器官衰竭评分(nSOFA)对极低出生体重儿晚发败血症死亡风险的预测价值。方法采用单中心、回顾性病例对照性研究。收集2018—2021年于南京医科大学附属苏州医院(苏州市立医院)新生儿科重症监护室住院的首次患有晚发败血症的95例极低出生体重儿确诊感染时及感染6 h后的nSOFA评分,上述患者以持续使用抗生素后发生的临床结局分为死亡组和存活组。采用受试者工作特征(ROC)曲线评估nSOFA评分对极低出生体重儿晚发败血症死亡风险的预测价值。结果感染后6 h晚发败血症死亡组nSOFA与存活组相比,差异有统计学意义(P<0.01),而在确诊感染时差异无统计学意义(P>0.05)。感染后6 h nSOFA评分预测模型ROC的AUC=0.873(95%CI 0.729~1.00,P=0.000),而确诊感染时AUC=0.541(95%CI 0.32~0.77,P=0.69)。感染后6 h nSOFA评分约登指数最大值为0.687,最佳截断值为6.5分。结论确诊败血症后6 h nSOFA能较好地预测极低出生体重儿的死亡风险。监测nSOFA对改善新生儿脓毒症预后有一定的临床价值。展开更多
文摘The economy of West African countries is mainly based on agriculture. However, the trace metal(loid)s contamination status in rivers is relatively unknown in the region. In this work, 45 surface sediments collected from the Bandama, Comoé, and Bia Rivers in south and south eastern Côte d’Ivoire (West Africa), were analyzed for total metal concentrations and chemical speciation. The results showed that the river sediments were considerably contaminated by Cd and moderately contaminated by As, Cu, Pb, and Zn. Significant spatial variations were observed among the stations but not between the rivers. Metals Cd and Cu were likely to cause more ecological risks. The speciation analysis unravelled that the metal(loid)s partitioned mainly in the residual fraction, with the potential mobile fraction varying from 14% to 28%. The study calls for establishment of strict policies relative to the application of fertilizers and agrochemicals and mining activities to protect the environment and human health risks.
文摘BACKGROUND:The quick sequential organ failure assessment(qSOFA)is recommended to identify sepsis and predict sepsis mortality.However,some studies have recently shown its poor performance in sepsis mortality prediction.To enhance its effectiveness,researchers have developed various revised versions of the qSOFA by adding other parameters,such as the lactate-enhanced qSOFA(LqSOFA),the procalcitonin-enhanced qSOFA(PqSOFA),and the modified qSOFA(MqSOFA).This study aimed to compare the performance of these versions of the qSOFA in predicting sepsis mortality in the emergency department(ED).METHODS:This retrospective study analyzed data obtained from an electronic register system of adult patients with sepsis between January 1 and December 31,2019.Receiver operating characteristic(ROC)curve analyses were performed to determine the area under the curve(AUC),with sensitivity,specificity,and positive and negative predictive values calculated for the various scores.RESULTS:Among the 936 enrolled cases,there were 835 survivors and 101 deaths.The AUCs of the LqSOFA,MqSOFA,PqSOFA,and qSOFA were 0.740,0.731,0.712,and 0.705,respectively.The sensitivity of the LqSOFA,MqSOFA,PqSOFA,and qSOFA were 64.36%,51.40%,71.29%,and 39.60%,respectively.The specificity of the four scores were 70.78%,80.96%,61.68%,and 91.62%,respectively.The LqSOFA and MqSOFA were superior to the qSOFA in predicting in-hospital mortality.CONCLUSIONS:Among patients with sepsis in the ED,the performance of the PqSOFA was similar to that of the qSOFA and the values of the LqSOFA and MqSOFA in predicting in-hospital mortality were greater compared to qSOFA.As the added parameter of the MqSOFA was more convenient compared to the LqSOFA,the MqSOFA could be used as a candidate for the revised qSOFA to increase the performance of the early prediction of sepsis mortality.
文摘BACKGROUND Acute pancreatitis(AP)is a common surgical condition,with severe AP(SAP)potentially lethal.Many prognostic indices,including;acute physiology and chronic health evaluation II score(APACHE II),bedside index of severity in acute pancreatitis(BISAP),Glasgow score,harmless acute pancreatitis score(HAPS),Ranson’s score,and sequential organ failure assessment(SOFA)evaluate AP severity and predict mortality.AIM To evaluate these indices'utility in predicting severity,intensive care unit(ICU)admission,and mortality.METHODS A retrospective analysis of 653 patients with AP from July 2009 to September 2016 was performed.The demographic,clinical profile,and patient outcomes were collected.SAP was defined as per the revised Atlanta classification.Values for APACHE II score,BISAP,HAPS,and SOFA within 24 h of admission were retrospectively obtained based on laboratory results and patient evaluation recorded on a secure hospital-based online electronic platform.Data with<10%missing data was imputed via mean substitution.Other patient information such as demographics,disease etiology,and patient outcomes were also derived from electronic medical records.RESULTS The mean age was 58.7±17.5 years,with 58.7%males.Gallstones(n=404,61.9%),alcohol(n=38,5.8%),and hypertriglyceridemia(n=19,2.9%)were more common aetiologies.81(12.4%)patients developed SAP,20(3.1%)required ICU admission,and 12(1.8%)deaths were attributed to SAP.Ranson’s score and APACHE-II demonstrated the highest sensitivity in predicting SAP(92.6%,80.2%respectively),ICU admission(100%),and mortality(100%).While SOFA and BISAP demonstrated lowest sensitivity in predicting SAP(13.6%,24.7%respectively),ICU admission(40.0%,25.0%respectively)and mortality(50.0%,25.5%respectively).However,SOFA demonstrated the highest specificity in predicting SAP(99.7%),ICU admission(99.2%),and mortality(98.9%).SOFA demonstrated the highest positive predictive value,positive likelihood ratio,diagnostic odds ratio,and overall accuracy in predicting SAP,ICU admission,and mortality.SOFA and Ranson’s score demonstrated the highest area under receiver-operator curves at 48 h in predicting SAP(0.966,0.857 respectively),ICU admission(0.943,0.946 respectively),and mortality(0.968,0.917 respectively).CONCLUSION The SOFA and 48-h Ranson’s scores accurately predict severity,ICU admission,and mortality in AP,with more favorable statistics for the SOFA score.
基金Supported by Specialized Research Fund for theDoctoral Programof Higher Education of China(20050217007)
文摘Survivability has emerged as a new phase for the development of network security technique, and quantifying survivability for network system helps to evaluate it exactly for the system in different environments. In this paper, we adopt a stochastic method called sequential Monte Carlo and try to reflect dynamic evolvement process of network survivability situation from several time sequences. The experiment results show that this method has the features of quantitative description, real-time calculation and dynamic tracking, and it is a good situation assessment solution for network survivability.
基金This work is supported by Chinese National Programs for High Technology Research and Development （Grant No. 2001AA644020）；Natural Science Foundation of Hunan Province （Grant No. 04JJ3013）.
文摘The structure of Pb,Zn,Cu and Cd in lead zinc ore tailing soils in Yongzhou,Hunan is analyzed by the optimized BCR sequential extraction procedure.The content and proportion of heavy metals of the mine are measured.Meanwhile,the ecological risks are evaluated with the Lars Hakanson＇s potential ecological risk exponential method.The analysis shows that the content of heavy metals is very high,reaching the level of serious pollution.The order of metal pollution degrees are Cd〉Pb〉Cu〉Zn.On the other hand,it is very possible that the heavy metals may combine together as compounds or cling to the crystal form of clay.Since the form of soluble acid and free metals are very little,it is not an easy job for metal elating or restoration of plants.Yet it is possible to take out those heavy metals adopting the chemical extraction technology.DTPA and EDTA,indicated by a research,both have iterative value and strong conformity effect.So they are effective elutriants to restore the polluted soil.A chemical extraction method is put forward in this paper.
文摘The idea behind this work is developing an adaptive method for the environmental assessment of buildings, to configure different versions according to the variables affecting them (spatial, temporal and associated with building characteristics) to suit different evaluated projects. This method may be applied using an electronic tool, which is in a development stage. Amending different assessment versions of the adaptive method is done by including the variables effect, according to set of steps, such as modifying the formulation of the assessment items, adjusting their estimation weights, and amending their achievement evaluation levels and their returned scores. When using the adaptive method, the assessment result of a building using a certain version differs from the results using other versions, even in the same country, so configuring an appropriate version due to the variables affecting the assessment helps getting more accurate results than the ones currently provided. The main goal of that research is to introduce the adaptive method that is proposed to ensure a fairer assessment results from the perspective of Green Architecture, and allow a more credible and accuracy of results comparison according to the environmental performance of buildings. The researcher analyzed the different main features she used in developing the adaptive method, the Comparative aspects between it and the current assessment methods, and the expected reached advantages from its usage. The paper arrived to the importance of adapting the environmental assessment of buildings according to the different affecting variables, and recommended developing the adaptive method and its tool to the stage of application to benefit its advantages.
文摘Some building components are responsible for achieving more than one environmental function, these functions are usually of different requirements that can never be done by the same actions, and they are usually connected to changeable internal and external environment characteristics that vary among them. Minimizing the conflict of achieving the different environmental functions is an important challenge for all designers. Achieving a continuous thermal and optical comfort in an internal building space using the same window is an example of this challenge, as they have different requirements that may be sometimes contrary. It should be notable that there are a lot of recent technologies that may be used to find solutions for such a conflict. The Environmental Assessment Methods of Buildings appeared to set the principles of the optimum relation between buildings and their environment, they also could be used to encourage designers to reach the best environmental relations, and award them by main or additional assessment points. The research paper proposes to use the Environmental Assessment Methods of Buildings to assess the building ability of minimizing its environmental functions achievement conflict. This proposal depends on determining the inconsistency assessment items that depend on common building components to be achieved, and then determining the time periods that these items are achieved together within, to indicate the time periods without conflicting. Thus, the paper aims to raise the building environmental value in the assessment when the designer succeeds to minimize the expected conflict of the building environmental functions.
文摘目的评价新生儿序贯器官衰竭评分(nSOFA)对极低出生体重儿晚发败血症死亡风险的预测价值。方法采用单中心、回顾性病例对照性研究。收集2018—2021年于南京医科大学附属苏州医院(苏州市立医院)新生儿科重症监护室住院的首次患有晚发败血症的95例极低出生体重儿确诊感染时及感染6 h后的nSOFA评分,上述患者以持续使用抗生素后发生的临床结局分为死亡组和存活组。采用受试者工作特征(ROC)曲线评估nSOFA评分对极低出生体重儿晚发败血症死亡风险的预测价值。结果感染后6 h晚发败血症死亡组nSOFA与存活组相比,差异有统计学意义(P<0.01),而在确诊感染时差异无统计学意义(P>0.05)。感染后6 h nSOFA评分预测模型ROC的AUC=0.873(95%CI 0.729~1.00,P=0.000),而确诊感染时AUC=0.541(95%CI 0.32~0.77,P=0.69)。感染后6 h nSOFA评分约登指数最大值为0.687,最佳截断值为6.5分。结论确诊败血症后6 h nSOFA能较好地预测极低出生体重儿的死亡风险。监测nSOFA对改善新生儿脓毒症预后有一定的临床价值。
