Assessment of past-climate simulations of regional climate models(RCMs)is important for understanding the reliability of RCMs when used to project future regional climate.Here,we assess the performance and discuss pos...Assessment of past-climate simulations of regional climate models(RCMs)is important for understanding the reliability of RCMs when used to project future regional climate.Here,we assess the performance and discuss possible causes of biases in a WRF-based RCM with a grid spacing of 50 km,named WRFG,from the North American Regional Climate Change Assessment Program(NARCCAP)in simulating wet season precipitation over the Central United States for a period when observational data are available.The RCM reproduces key features of the precipitation distribution characteristics during late spring to early summer,although it tends to underestimate the magnitude of precipitation.This dry bias is partially due to the model’s lack of skill in simulating nocturnal precipitation related to the lack of eastward propagating convective systems in the simulation.Inaccuracy in reproducing large-scale circulation and environmental conditions is another contributing factor.The too weak simulated pressure gradient between the Rocky Mountains and the Gulf of Mexico results in weaker southerly winds in between,leading to a reduction of warm moist air transport from the Gulf to the Central Great Plains.The simulated low-level horizontal convergence fields are less favorable for upward motion than in the NARR and hence,for the development of moist convection as well.Therefore,a careful examination of an RCM’s deficiencies and the identification of the source of errors are important when using the RCM to project precipitation changes in future climate scenarios.展开更多
We present a systematic summary of the geological characteristics,exploration and development history and current state of shale oil and gas in the United States.The hydrocarbon-rich shales in the major shale basins o...We present a systematic summary of the geological characteristics,exploration and development history and current state of shale oil and gas in the United States.The hydrocarbon-rich shales in the major shale basins of the United States are mainly developed in six geological periods:Middle Ordovician,Middle-Late Devonian,Early Carboniferous(Middle-Late Mississippi),Early Permian,Late Jurassic,and Late Cretaceous(Cenomanian-Turonian).Depositional environments for these shales include intra-cratonic basins,foreland basins,and passive continental margins.Paleozoic hydrocarbon-rich shales are mainly developed in six basins,including the Appalachian Basin(Utica and Marcellus shales),Anadarko Basin(Woodford Shale),Williston Basin(Bakken Shale),Arkoma Basin(Fayetteville Shale),Fort Worth Basin(Barnett Shale),and the Wolfcamp and Leonardian Spraberry/Bone Springs shale plays of the Permian Basin.The Mesozoic hydrocarbon-rich shales are mainly developed on the margins of the Gulf of Mexico Basin(Haynesville and Eagle Ford)or in various Rocky Mountain basins(Niobrara Formation,mainly in the Denver and Powder River basins).The detailed analysis of shale plays reveals that the shales are different in facies and mineral components,and"shale reservoirs"are often not shale at all.The United States is abundant in shale oil and gas,with the in-place resources exceeding 0.246×10^(12)t and 290×10^(12)m^(3),respectively.Before the emergence of horizontal well hydraulic fracturing technology to kick off the"shale revolution",the United States had experienced two decades of exploration and production practices,as well as theory and technology development.In 2007-2023,shale oil and gas production in the United States increased from approximately 11.2×10^(4)tons of oil equivalent per day(toe/d)to over 300.0×10^(4)toe/d.In 2017,the shale oil and gas production exceeded the conventional oil and gas production in the country.In 2023,the contribution from shale plays to the total U.S.oil and gas production remained above 60%.The development of shale oil and gas has largely been driven by improvements in drilling and completion technologies,with much of the recent effort focused on“cube development”or“co-development”.Other efforts to improve productivity and efficiency include refracturing,enhanced oil recovery,and drilling of“U-shaped”wells.Given the significant resources base and continued technological improvements,shale oil and gas production will continue to contribute significant volumes to total U.S.hydrocarbon production.展开更多
BACKGROUND Wilson disease(WD)is a progressive,potentially fatal degenerative disease affecting the liver and central nervous system.Given its low prevalence,collecting data on large cohorts of patients with WD is chal...BACKGROUND Wilson disease(WD)is a progressive,potentially fatal degenerative disease affecting the liver and central nervous system.Given its low prevalence,collecting data on large cohorts of patients with WD is challenging.Comprehensive insur-ance claims databases provide powerful tools to collect retrospective data on large numbers of patients with rare diseases.AIM To describe patients with WD in the United States,their treatment and clinical outcome,using a large insurance claims database.METHODS This retrospective,longitudinal study was performed in the Clarivate Real-World Data Product database.All patients with≥2 claims associated with an Interna-tional Classification of Diseases 10(ICD-10)diagnostic code for WD(E83.01)between 2016 and 2021 were included and followed until death or study end.Patients were divided into two groups by whether or not they were documented to have received a specific treatment for WD.Clinical manifestations,hospital-isations,liver transplantation and death were documented.RESULTS Overall,5376 patients with an ICD-10 diagnostic code for WD were identified.The mean age at inclusion was 41.2 years and 52.0%were men.A specific WD treatment was documented for 885 patients(15.1%),although the number of patients taking zinc salts may be underestimated due to over the counter purchase.At inclusion,the mean age of patients with a documented treatment was 36.6±17.8 years vs 42.2±19.6 years in those without a documented treatment.During follow-up,273 patients(5.1%)died.Compared with the American general population,the standardised mortality ratio was 2.19.The proportion of patients with a documented WD-specific treatment who died during follow-up was 4.0%and the mean age at death 52.7 years.CONCLUSION Patients treated for WD in the United States had an excess early mortality compared with the American population.These findings indicate that there is a significant unmet need for effective treatment for WD in the United States.展开更多
This study evaluates the distribution of travel-limiting disabilities across genders and geographic locations in the United States. This study aims to describe and compare the socioeconomic and demographic variables o...This study evaluates the distribution of travel-limiting disabilities across genders and geographic locations in the United States. This study aims to describe and compare the socioeconomic and demographic variables of the people with and without travel-limiting disabilities across geographic locations and gender. The study further evaluates the trip purpose and impact of Covid-19 fourth wave pandemic on the use of public transit and travel to physical workplace for the people with and without travel-limiting disabilities across gender and geographic locations. The study uses the 2022 weighted National Household Travel Survey dataset and employs descriptive statistics. Results reaffirm the findings from previous literature that there are more people with travel-limiting disabilities in urban areas and among women. Over 50 percent of people aged 65 and above have a form of travel-limiting disabilities. The most trip for people with travel-limiting disabilities is made for shopping and medical purposes. Across all categories, rural areas, urban areas, male and female for the people without travel-limiting disabilities, COVID-19 fourth wave did not change the pattern of trips made to physical workplace as pre-COVID-19 era. This pattern is also observable for the people with travel-limiting disabilities in rural and urban areas. Females with travel-limiting disabilities reported making less trips to physical workplaces while male reported doing the same as before COVID-19 era. The study concludes that the quantification of travel-limiting disabilities across geographic location and gender is vital in disability study and could drive policy implementation for improved accessibility for the vulnerable population.展开更多
Research Problem: In Abu Dhabi, limited implementation of OSH Regulations contributes to the general unawareness among employees and workers about occupational hazards and safety measures, resulting in slow responsive...Research Problem: In Abu Dhabi, limited implementation of OSH Regulations contributes to the general unawareness among employees and workers about occupational hazards and safety measures, resulting in slow responsiveness toward enforcement measures and a lack of self-regulatory approaches within companies. Purpose: The purpose of this study is to examine the implementation methods practised in Abu Dhabi with those in developed countries with established OSH regulatory bodies. Methodology: Qualitative and quantitative research methods were employed to gather primary research data. Workers from various industries in Abu Dhabi were sampled on purpose and asked to respond to questionnaires and interviews on OSH protocol awareness and implementation, and circumstances of workplace incidence. Results: The findings of this study showed that the enforcement of OSH requirements in UAE positively correlated to a reduction in the rate of work-related injury and improved business performance. The quantitative research data showed that the energy sector had the highest score (15) while the tourism sector had the lowest score (5.3) in occupational health systems and improvements in business efficiency and productivity. Implications: The outcomes of this study shed light on the importance of implementing OSH Guidelines for companies to empower their safety managers to fully enforce OSH requirements in their organisations. In conclusion, effective OSH enforcement requires cooperation between general workers and OSH managers and facilitation from business owners.展开更多
Introduction: Maternal mortality rates have more than doubled in the U.S over the last two decades, making it one of the few places in the world where maternal mortality is increasing. Differences in maternal mortalit...Introduction: Maternal mortality rates have more than doubled in the U.S over the last two decades, making it one of the few places in the world where maternal mortality is increasing. Differences in maternal mortality among certain races and ethnicities are known but few studies examine maternal mortality among immigrants. Since immigrants represent 13.7% of the U.S. population, it is essential to examine immigrant subsets to understand maternal mortality among this vulnerable population. Methods: A literature search identified 318 articles on maternal mortality and immigrants, with 12 articles from the U.S. The keywords included maternal mortality, United States, migrants, asylum seekers, immigrants, and disparities. Maternal mortality statistics were obtained from the World Health Organization and Center for Disease Control. Results: Studies analyzed in this review found an overall lower maternal mortality rate among immigrant women compared to U.S.-born women, except for Hispanic immigrant women. Black women had the highest maternal mortality rate, regardless of immigration status. Conclusion: Although the literature points to lower maternal mortality among immigrants, the data is still somewhat mixed, making it challenging to draw comprehensive conclusions. Additional research examining maternal mortality among Im/migrants in the U.S. is needed to guide future training among healthcare professionals and policymakers.展开更多
BACKGROUND There is a substantial population of long-stay patients who non-emergently transfer directly from the neonatal intensive care unit(NICU)to the pediatric intensive care unit(PICU)without an interim discharge...BACKGROUND There is a substantial population of long-stay patients who non-emergently transfer directly from the neonatal intensive care unit(NICU)to the pediatric intensive care unit(PICU)without an interim discharge home.These infants are often medically complex and have higher mortality relative to NICU or PICUonly admissions.Given an absence of data surrounding practice patterns for nonemergent NICU to PICU transfers,we hypothesized that we would encounter a broad spectrum of current practices and a high proportion of dissatisfaction with current processes.AIM To characterize non-emergent NICU to PICU transfer practices across the United States and query PICU providers’evaluations of their effectiveness.METHODS A cross-sectional survey was drafted,piloted,and sent to one physician representative from each of 115 PICUs across the United States based on membership in the PARK-PICU research consortium and membership in the Children’s Hospital Association.The survey was administered via internet(REDCap).Analysis was performed using STATA,primarily consisting of descriptive statistics,though logistic regressions were run examining the relationship between specific transfer steps,hospital characteristics,and effectiveness of transfer.RESULTS One PICU attending from each of 81 institutions in the United States completed the survey(overall 70%response rate).Over half(52%)indicated their hospital transfers patients without using set clinical criteria,and only 33%indicated that their hospital has a standardized protocol to facilitate non-emergent transfer.Fewer than half of respondents reported that their institution’s nonemergent NICU to PICU transfer practices were effective for clinicians(47%)or patient families(38%).Respondents evaluated their centers’transfers as less effective when they lacked any transfer criteria(P=0.027)or set transfer protocols(P=0.007).Respondents overwhelmingly agreed that having set clinical criteria and standardized protocols for non-emergent transfer were important to the patient-family experience and patient safety.CONCLUSION Most hospitals lacked any clinical criteria or protocols for non-emergent NICU to PICU transfers.More positive perceptions of transfer effectiveness were found among those with set criteria and/or transfer protocols.展开更多
With the continued increase in the number of people that are food insecure globally, which could be increasing because of the ongoing Ukraine-Russia war, leading to reduction in international agribusinesses, coupled w...With the continued increase in the number of people that are food insecure globally, which could be increasing because of the ongoing Ukraine-Russia war, leading to reduction in international agribusinesses, coupled with drastic climate change exacerbating the problem of food insecurity, there is a constant need to come up with innovative approaches to solve this global issue. In this article, we articulated how precision agriculture can be a tool for ensuring food security in the United States. This study aims to reiterate the significance of precision agriculture in solving global food insecurity.展开更多
On 7 October,2022,the Biden administration released an updated version of the National Strategy for the Arctic Region based on new developments in the Arctic region and global affairs.This strategy emphasizes traditio...On 7 October,2022,the Biden administration released an updated version of the National Strategy for the Arctic Region based on new developments in the Arctic region and global affairs.This strategy emphasizes traditional security issues in the Arctic,attaches great importance to climate governance in the region,and advocates for restoring American leadership through international cooperation.In view of the strong influence of the United States(U.S.)in the Arctic region,the changes of the U.S.Arctic strategy will inevitably have an impact on China’s scientific researchrights,economic interests,and governance rights in the Arctic region.To respond to the new situation brought about by the changes in the U.S.Arctic strategy,China should take the initiative to maintain positive relationships with all Arctic countries,and continue its active participation in Arctic affairs.展开更多
The impact of apolipoprotein E(ApoE)isoforms on sporadic Alzheimer's disease has long been studied;however,the influences of apolipoprotein E gene(APOE)on healthy and pathological human brains are not fully unders...The impact of apolipoprotein E(ApoE)isoforms on sporadic Alzheimer's disease has long been studied;however,the influences of apolipoprotein E gene(APOE)on healthy and pathological human brains are not fully understood.ApoE exists as three common isoforms(ApoE2,ApoE3,and ApoE4),which differ in two amino acid residues.Traditionally,ApoE binds cholesterol and phospholipids and ApoE isoforms display diffe rent affinities for their receptors,lipids transport and distribution in the brain and periphery.The role of ApoE in the human depends on ApoE isoforms,brain regions,aging,and neural injury.APOE E4 is the strongest genetic risk factor for sporadic Alzheimer's disease,considering its role in influencing amyloid-beta metabolism.The exact mechanisms by which APOE gene variants may increase or decrease Alzheimer's disease risk are not fully understood,but APOE was also known to affect directly and indirectly tau-mediated neurodegeneration,lipids metabolism,neurovascular unit,and microglial function.Consistent with the biological function of ApoE,ApoE4 isoform significantly alte red signaling pathways associated with cholesterol homeostasis,transport,and myelination.Also,the rare protective APOE variants confirm that ApoE plays an important role in Alzheimer's disease pathogenesis.The objectives of the present mini-review were to describe classical and new roles of various ApoE isoforms in Alzheimer's disease pathophysiology beyond the deposition of amyloid-beta and to establish a functional link between APOE,brain function,and memory,from a molecular to a clinical level.APOE genotype also exerted a heterogeneous effect on clinical Alzheimer's disease phenotype and its outcomes.Not only in learning and memory but also in neuro psychiatric symptoms that occur in a premorbid condition.Cla rifying the relationships between Alzheimer's disease-related pathology with neuropsychiatric symptoms,particularly suicidal ideation in Alzheimer's disease patients,may be useful for elucidating also the underlying pathophysiological process and its prognosis.Also,the effects of anti-amyloid-beta drugs,recently approved for the treatment of Alzheimer's disease,could be influenced by the APOE genotype.展开更多
Upregulation of vascular endothelial growth factor A/basic fibroblast growth factor(VEGFA/b FGF)expression in the penumbra of cerebral ischemia can increase vascular volume,reduce lesion volume,and enhance neural cell...Upregulation of vascular endothelial growth factor A/basic fibroblast growth factor(VEGFA/b FGF)expression in the penumbra of cerebral ischemia can increase vascular volume,reduce lesion volume,and enhance neural cell proliferation and differentiation,thereby exerting neuroprotective effects.However,the beneficial effects of endogenous VEGFA/b FGF are limited as their expression is only transiently increased.In this study,we generated multilayered nanofiber membranes loaded with VEGFA/b FGF using layer-by-layer self-assembly and electrospinning techniques.We found that a membrane containing 10 layers had an ideal ultrastructure and could efficiently and stably release growth factors for more than 1 month.This 10-layered nanofiber membrane promoted brain microvascular endothelial cell tube formation and proliferation,inhibited neuronal apoptosis,upregulated the expression of tight junction proteins,and improved the viability of various cellular components of neurovascular units under conditions of oxygen/glucose deprivation.Furthermore,this nanofiber membrane decreased the expression of Janus kinase-2/signal transducer and activator of transcription-3(JAK2/STAT3),Bax/Bcl-2,and cleaved caspase-3.Therefore,this nanofiber membrane exhibits a neuroprotective effect on oxygen/glucose-deprived neurovascular units by inhibiting the JAK2/STAT3 pathway.展开更多
Cerebral small vessel disease is a neurological disease that affects the brain microvasculature and which is commonly observed among the elderly.Although at first it was considered innocuous,small vessel disease is no...Cerebral small vessel disease is a neurological disease that affects the brain microvasculature and which is commonly observed among the elderly.Although at first it was considered innocuous,small vessel disease is nowadays regarded as one of the major vascular causes of dementia.Radiological signs of small vessel disease include small subcortical infarcts,white matter magnetic resonance imaging hyperintensities,lacunes,enlarged perivascular spaces,cerebral microbleeds,and brain atrophy;however,great heterogeneity in clinical symptoms is observed in small vessel disease patients.The pathophysiology of these lesions has been linked to multiple processes,such as hypoperfusion,defective cerebrovascular reactivity,and blood-brain barrier dysfunction.Notably,studies on small vessel disease suggest that blood-brain barrier dysfunction is among the earliest mechanisms in small vessel disease and might contribute to the development of the hallmarks of small vessel disease.Therefore,the purpose of this review is to provide a new foundation in the study of small vessel disease pathology.First,we discuss the main structural domains and functions of the blood-brain barrier.Secondly,we review the most recent evidence on blood-brain barrier dysfunction linked to small vessel disease.Finally,we conclude with a discussion on future perspectives and propose potential treatment targets and interventions.展开更多
In response to the problems of excessive greenhouse-gas and particulate emissions and the low traction efficiency of conventional diesel tractors in the field,a purely electric wheel-side drive tractor was studied,inc...In response to the problems of excessive greenhouse-gas and particulate emissions and the low traction efficiency of conventional diesel tractors in the field,a purely electric wheel-side drive tractor was studied,including an electric motor drive system,a battery ballast system,and an electro–hydraulic suspension system.This paper develops a dynamics model of an electric tractor-ploughing unit under complex soil conditions,leading to the proposal of an active control method for drive wheel torque and a joint control method for the traction force of the suspension system and the front-and rear-axle loads of a tractor.Finally,the tractor is prototyped and assembled,and ploughing tests are carried out.The ploughing results show that the active torque-distribution control method proposed in this study reduces the tractor slip by 14.83%and increases the traction efficiency by 10.28%compared with the average torquedistribution mode.Compared with the conventional traction control mode,the joint control method for traction and ballast proposed in this paper results in a 3.7%increase in traction efficiency,a 15.05%decrease in slip,and a 4.9%reduction in total drive motor energy consumption.This study will help to improve the operation quality and traction efficiency of electric tractors in complex soil conditions.展开更多
Background:Acute improvement in range of motion(ROM)is a widely reported effect of stretching and foam rolling,which is commonly explained by changes in pain threshold and/or musculotendinous stiffness.Interestingly,t...Background:Acute improvement in range of motion(ROM)is a widely reported effect of stretching and foam rolling,which is commonly explained by changes in pain threshold and/or musculotendinous stiffness.Interestingly,these effects were also reported in response to various other active and passive interventions that induce responses such as enhanced muscle temperature.Therefore,we hypothesized that acute ROM enhancements could be induced by a wide variety of interventions other than stretching or foam rolling that promote an increase in muscle temperature.Methods:After a systematic search in PubMed,Web of Science,and SPORTDiscus databases,38 studies comparing the effects of stretching and foam rolling with several other interventions on ROM and passive properties were included.These studies had 1134 participants in total,and the data analysis resulted in 140 effect sizes(ESs).ES calculations were performed using robust variance estimation model with R-package.Results:Study quality of the included studies was classified as fair(PEDro score=4.58)with low to moderate certainty of evidence.Results showed no significant differences in ROM(ES=0.01,p=0.88),stiffness(ES=0.09,p=0.67),or passive peak torque(ES=-0.30,p=0.14)between stretching or foam rolling and the other identified activities.Funnel plots revealed no publication bias.Conclusion:Based on current literature,our results challenge the established view on stretching and foam rolling as a recommended component of warm-up programs.The lack of significant difference between interventions suggests there is no need to emphasize stretching or foam rolling to induce acute ROM,passive peak torque increases,or stiffness reductions.展开更多
The neurovascular unit and stem cell therapy in ischemic stroke:Ischemic stroke,accounts for approximately 85% of all stroke incidents and is a major global health burden.It is the leading cause of disability and deat...The neurovascular unit and stem cell therapy in ischemic stroke:Ischemic stroke,accounts for approximately 85% of all stroke incidents and is a major global health burden.It is the leading cause of disability and death worldwide,posing immense societal and economic challenges due to the long-term care required for stro ke survivors and the significant healthcare costs associated with its treatment and management(Amarenco et al.,2009).展开更多
Static Poisson’s ratio(vs)is crucial for determining geomechanical properties in petroleum applications,namely sand production.Some models have been used to predict vs;however,the published models were limited to spe...Static Poisson’s ratio(vs)is crucial for determining geomechanical properties in petroleum applications,namely sand production.Some models have been used to predict vs;however,the published models were limited to specific data ranges with an average absolute percentage relative error(AAPRE)of more than 10%.The published gated recurrent unit(GRU)models do not consider trend analysis to show physical behaviors.In this study,we aim to develop a GRU model using trend analysis and three inputs for predicting n s based on a broad range of data,n s(value of 0.1627-0.4492),bulk formation density(RHOB)(0.315-2.994 g/mL),compressional time(DTc)(44.43-186.9 μs/ft),and shear time(DTs)(72.9-341.2μ s/ft).The GRU model was evaluated using different approaches,including statistical error an-alyses.The GRU model showed the proper trends,and the model data ranges were wider than previous ones.The GRU model has the largest correlation coefficient(R)of 0.967 and the lowest AAPRE,average percent relative error(APRE),root mean square error(RMSE),and standard deviation(SD)of 3.228%,1.054%,4.389,and 0.013,respectively,compared to other models.The GRU model has a high accuracy for the different datasets:training,validation,testing,and the whole datasets with R and AAPRE values were 0.981 and 2.601%,0.966 and 3.274%,0.967 and 3.228%,and 0.977 and 2.861%,respectively.The group error analyses of all inputs show that the GRU model has less than 5% AAPRE for all input ranges,which is superior to other models that have different AAPRE values of more than 10% at various ranges of inputs.展开更多
BACKGROUND Lung cancer is a common disease with high mortality,and psychological support is very important in the diagnosis and treatment of postoperative patients with cancer pain.AIM To explore the application effec...BACKGROUND Lung cancer is a common disease with high mortality,and psychological support is very important in the diagnosis and treatment of postoperative patients with cancer pain.AIM To explore the application effect of the narrative nursing method in postoperative lung cancer patients in the intensive care unit.METHODS A total of 120 patients diagnosed with lung cancer and experiencing cancer-related pain were randomly allocated into two groups:an observation group and a control group,each consisting of 60 cases.The control group was given routine analgesic and psychological care,while the research group applied the five-step narrative nursing method based on routine care,comparing the visual analogue scale scores,sleep status,anxiety and depression status,and quality of life of the two groups of patients before and after the intervention.RESULTS The pain scores,anxiety scores,and depression scores of the study group were lower than those of the control group after the intervention using the narrative nursing method,and the difference was statistically significant(P<0.05).CONCLUSION Using narrative nursing methods to intervene in patients with lung cancer combined with cancerous pain can help patients to correctly recognize their disease,adjust their mentality,establish confidence,alleviate patients'subjective pain feelings,and improve their adverse emotions.展开更多
BACKGROUND Early in the coronavirus disease 2019(COVID-19)pandemic,there was a significant impact on routine medical care in the United States,including in fields of transplantation and oncology.AIM To analyze the imp...BACKGROUND Early in the coronavirus disease 2019(COVID-19)pandemic,there was a significant impact on routine medical care in the United States,including in fields of transplantation and oncology.AIM To analyze the impact and outcomes of early COVID-19 pandemic on liver transplantation(LT)for hepatocellular carcinoma(HCC)in the United States.METHODS WHO declared COVID-19 as a pandemic on March 11,2020.We retrospectively analyzed data from the United Network for Organ Sharing(UNOS)database regarding adult LT with confirmed HCC on explant in 2019 and 2020.We defined pre-COVID period from March 11 to September 11,2019,and early-COVID period as from March 11 to September 11,2020.RESULTS Overall,23.5%fewer LT for HCC were performed during the COVID period(518 vs 675,P<0.05).This decrease was most pronounced in the months of March-April 2020 with a rebound in numbers seen from May-July 2020.Among LT recipients for HCC,concurrent diagnosis of non-alcoholic steatohepatitis significantly increased(23 vs 16%)and alcoholic liver disease(ALD)significantly decreased(18 vs 22%)during the COVID period.Recipient age,gender,BMI,and MELD score were statistically similar between two groups,while waiting list time decreased during the COVID period(279 days vs 300 days,P=0.041).Among pathological characteristics of HCC,vascular invasion was more prominent during COVID period(P<0.01),while other features were the same.While the donor age and other characteristics remained same,the distance between donor and recipient hospitals was significantly increased(P<0.01)and donor risk index was significantly higher(1.68 vs 1.59,P<0.01)during COVID period.Among outcomes,90-day overall and graft survival were the same,but 180-day overall and graft were significantly inferior during COVID period(94.7 vs 97.0%,P=0.048).On multivariable Coxhazard regression analysis,COVID period emerged as a significant risk factor of post-transplant mortality(Hazard ratio 1.85;95%CI:1.28-2.68,P=0.001).CONCLUSION During COVID period,there was a significant decrease in LTs performed for HCC.While early postoperative outcomes of LT for HCC were same,the overall and graft survival of LTs for HCC after 180 days were significantly inferior.展开更多
Porous materials present significant advantages for absorbing radioactive isotopes in nuclear waste streams.To improve absorption efficiency in nuclear waste treatment,a thorough understanding of the diffusion-advecti...Porous materials present significant advantages for absorbing radioactive isotopes in nuclear waste streams.To improve absorption efficiency in nuclear waste treatment,a thorough understanding of the diffusion-advection process within porous structures is essential for material design.In this study,we present advancements in the volumetric lattice Boltzmann method(VLBM)for modeling and simulating pore-scale diffusion-advection of radioactive isotopes within geopolymer porous structures.These structures are created using the phase field method(PFM)to precisely control pore architectures.In our VLBM approach,we introduce a concentration field of an isotope seamlessly coupled with the velocity field and solve it by the time evolution of its particle population function.To address the computational intensity inherent in the coupled lattice Boltzmann equations for velocity and concentration fields,we implement graphics processing unit(GPU)parallelization.Validation of the developed model involves examining the flow and diffusion fields in porous structures.Remarkably,good agreement is observed for both the velocity field from VLBM and multiphysics object-oriented simulation environment(MOOSE),and the concentration field from VLBM and the finite difference method(FDM).Furthermore,we investigate the effects of background flow,species diffusivity,and porosity on the diffusion-advection behavior by varying the background flow velocity,diffusion coefficient,and pore volume fraction,respectively.Notably,all three parameters exert an influence on the diffusion-advection process.Increased background flow and diffusivity markedly accelerate the process due to increased advection intensity and enhanced diffusion capability,respectively.Conversely,increasing the porosity has a less significant effect,causing a slight slowdown of the diffusion-advection process due to the expanded pore volume.This comprehensive parametric study provides valuable insights into the kinetics of isotope uptake in porous structures,facilitating the development of porous materials for nuclear waste treatment applications.展开更多
In this paper,we investigate sufficient and necessary conditions such that generalized Forelli-Rudin type operators T_(λ,τ,k),S_(λ,τ,k),Q_(λ,τ,k)and R_(λ,τ,k)are bounded between Lebesgue type spaces.In order t...In this paper,we investigate sufficient and necessary conditions such that generalized Forelli-Rudin type operators T_(λ,τ,k),S_(λ,τ,k),Q_(λ,τ,k)and R_(λ,τ,k)are bounded between Lebesgue type spaces.In order to prove the main results,we first give some bidirectional estimates for several typical integrals.展开更多
文摘Assessment of past-climate simulations of regional climate models(RCMs)is important for understanding the reliability of RCMs when used to project future regional climate.Here,we assess the performance and discuss possible causes of biases in a WRF-based RCM with a grid spacing of 50 km,named WRFG,from the North American Regional Climate Change Assessment Program(NARCCAP)in simulating wet season precipitation over the Central United States for a period when observational data are available.The RCM reproduces key features of the precipitation distribution characteristics during late spring to early summer,although it tends to underestimate the magnitude of precipitation.This dry bias is partially due to the model’s lack of skill in simulating nocturnal precipitation related to the lack of eastward propagating convective systems in the simulation.Inaccuracy in reproducing large-scale circulation and environmental conditions is another contributing factor.The too weak simulated pressure gradient between the Rocky Mountains and the Gulf of Mexico results in weaker southerly winds in between,leading to a reduction of warm moist air transport from the Gulf to the Central Great Plains.The simulated low-level horizontal convergence fields are less favorable for upward motion than in the NARR and hence,for the development of moist convection as well.Therefore,a careful examination of an RCM’s deficiencies and the identification of the source of errors are important when using the RCM to project precipitation changes in future climate scenarios.
基金supported by the State of Texas Advanced Resource Recovery(STARR)programthe Bureau of Economic Geology's Tight Oil Resource Assessment(TORA)Mudrock Systems Research Laboratory(MSRL)consortia。
文摘We present a systematic summary of the geological characteristics,exploration and development history and current state of shale oil and gas in the United States.The hydrocarbon-rich shales in the major shale basins of the United States are mainly developed in six geological periods:Middle Ordovician,Middle-Late Devonian,Early Carboniferous(Middle-Late Mississippi),Early Permian,Late Jurassic,and Late Cretaceous(Cenomanian-Turonian).Depositional environments for these shales include intra-cratonic basins,foreland basins,and passive continental margins.Paleozoic hydrocarbon-rich shales are mainly developed in six basins,including the Appalachian Basin(Utica and Marcellus shales),Anadarko Basin(Woodford Shale),Williston Basin(Bakken Shale),Arkoma Basin(Fayetteville Shale),Fort Worth Basin(Barnett Shale),and the Wolfcamp and Leonardian Spraberry/Bone Springs shale plays of the Permian Basin.The Mesozoic hydrocarbon-rich shales are mainly developed on the margins of the Gulf of Mexico Basin(Haynesville and Eagle Ford)or in various Rocky Mountain basins(Niobrara Formation,mainly in the Denver and Powder River basins).The detailed analysis of shale plays reveals that the shales are different in facies and mineral components,and"shale reservoirs"are often not shale at all.The United States is abundant in shale oil and gas,with the in-place resources exceeding 0.246×10^(12)t and 290×10^(12)m^(3),respectively.Before the emergence of horizontal well hydraulic fracturing technology to kick off the"shale revolution",the United States had experienced two decades of exploration and production practices,as well as theory and technology development.In 2007-2023,shale oil and gas production in the United States increased from approximately 11.2×10^(4)tons of oil equivalent per day(toe/d)to over 300.0×10^(4)toe/d.In 2017,the shale oil and gas production exceeded the conventional oil and gas production in the country.In 2023,the contribution from shale plays to the total U.S.oil and gas production remained above 60%.The development of shale oil and gas has largely been driven by improvements in drilling and completion technologies,with much of the recent effort focused on“cube development”or“co-development”.Other efforts to improve productivity and efficiency include refracturing,enhanced oil recovery,and drilling of“U-shaped”wells.Given the significant resources base and continued technological improvements,shale oil and gas production will continue to contribute significant volumes to total U.S.hydrocarbon production.
文摘BACKGROUND Wilson disease(WD)is a progressive,potentially fatal degenerative disease affecting the liver and central nervous system.Given its low prevalence,collecting data on large cohorts of patients with WD is challenging.Comprehensive insur-ance claims databases provide powerful tools to collect retrospective data on large numbers of patients with rare diseases.AIM To describe patients with WD in the United States,their treatment and clinical outcome,using a large insurance claims database.METHODS This retrospective,longitudinal study was performed in the Clarivate Real-World Data Product database.All patients with≥2 claims associated with an Interna-tional Classification of Diseases 10(ICD-10)diagnostic code for WD(E83.01)between 2016 and 2021 were included and followed until death or study end.Patients were divided into two groups by whether or not they were documented to have received a specific treatment for WD.Clinical manifestations,hospital-isations,liver transplantation and death were documented.RESULTS Overall,5376 patients with an ICD-10 diagnostic code for WD were identified.The mean age at inclusion was 41.2 years and 52.0%were men.A specific WD treatment was documented for 885 patients(15.1%),although the number of patients taking zinc salts may be underestimated due to over the counter purchase.At inclusion,the mean age of patients with a documented treatment was 36.6±17.8 years vs 42.2±19.6 years in those without a documented treatment.During follow-up,273 patients(5.1%)died.Compared with the American general population,the standardised mortality ratio was 2.19.The proportion of patients with a documented WD-specific treatment who died during follow-up was 4.0%and the mean age at death 52.7 years.CONCLUSION Patients treated for WD in the United States had an excess early mortality compared with the American population.These findings indicate that there is a significant unmet need for effective treatment for WD in the United States.
文摘This study evaluates the distribution of travel-limiting disabilities across genders and geographic locations in the United States. This study aims to describe and compare the socioeconomic and demographic variables of the people with and without travel-limiting disabilities across geographic locations and gender. The study further evaluates the trip purpose and impact of Covid-19 fourth wave pandemic on the use of public transit and travel to physical workplace for the people with and without travel-limiting disabilities across gender and geographic locations. The study uses the 2022 weighted National Household Travel Survey dataset and employs descriptive statistics. Results reaffirm the findings from previous literature that there are more people with travel-limiting disabilities in urban areas and among women. Over 50 percent of people aged 65 and above have a form of travel-limiting disabilities. The most trip for people with travel-limiting disabilities is made for shopping and medical purposes. Across all categories, rural areas, urban areas, male and female for the people without travel-limiting disabilities, COVID-19 fourth wave did not change the pattern of trips made to physical workplace as pre-COVID-19 era. This pattern is also observable for the people with travel-limiting disabilities in rural and urban areas. Females with travel-limiting disabilities reported making less trips to physical workplaces while male reported doing the same as before COVID-19 era. The study concludes that the quantification of travel-limiting disabilities across geographic location and gender is vital in disability study and could drive policy implementation for improved accessibility for the vulnerable population.
文摘Research Problem: In Abu Dhabi, limited implementation of OSH Regulations contributes to the general unawareness among employees and workers about occupational hazards and safety measures, resulting in slow responsiveness toward enforcement measures and a lack of self-regulatory approaches within companies. Purpose: The purpose of this study is to examine the implementation methods practised in Abu Dhabi with those in developed countries with established OSH regulatory bodies. Methodology: Qualitative and quantitative research methods were employed to gather primary research data. Workers from various industries in Abu Dhabi were sampled on purpose and asked to respond to questionnaires and interviews on OSH protocol awareness and implementation, and circumstances of workplace incidence. Results: The findings of this study showed that the enforcement of OSH requirements in UAE positively correlated to a reduction in the rate of work-related injury and improved business performance. The quantitative research data showed that the energy sector had the highest score (15) while the tourism sector had the lowest score (5.3) in occupational health systems and improvements in business efficiency and productivity. Implications: The outcomes of this study shed light on the importance of implementing OSH Guidelines for companies to empower their safety managers to fully enforce OSH requirements in their organisations. In conclusion, effective OSH enforcement requires cooperation between general workers and OSH managers and facilitation from business owners.
文摘Introduction: Maternal mortality rates have more than doubled in the U.S over the last two decades, making it one of the few places in the world where maternal mortality is increasing. Differences in maternal mortality among certain races and ethnicities are known but few studies examine maternal mortality among immigrants. Since immigrants represent 13.7% of the U.S. population, it is essential to examine immigrant subsets to understand maternal mortality among this vulnerable population. Methods: A literature search identified 318 articles on maternal mortality and immigrants, with 12 articles from the U.S. The keywords included maternal mortality, United States, migrants, asylum seekers, immigrants, and disparities. Maternal mortality statistics were obtained from the World Health Organization and Center for Disease Control. Results: Studies analyzed in this review found an overall lower maternal mortality rate among immigrant women compared to U.S.-born women, except for Hispanic immigrant women. Black women had the highest maternal mortality rate, regardless of immigration status. Conclusion: Although the literature points to lower maternal mortality among immigrants, the data is still somewhat mixed, making it challenging to draw comprehensive conclusions. Additional research examining maternal mortality among Im/migrants in the U.S. is needed to guide future training among healthcare professionals and policymakers.
文摘BACKGROUND There is a substantial population of long-stay patients who non-emergently transfer directly from the neonatal intensive care unit(NICU)to the pediatric intensive care unit(PICU)without an interim discharge home.These infants are often medically complex and have higher mortality relative to NICU or PICUonly admissions.Given an absence of data surrounding practice patterns for nonemergent NICU to PICU transfers,we hypothesized that we would encounter a broad spectrum of current practices and a high proportion of dissatisfaction with current processes.AIM To characterize non-emergent NICU to PICU transfer practices across the United States and query PICU providers’evaluations of their effectiveness.METHODS A cross-sectional survey was drafted,piloted,and sent to one physician representative from each of 115 PICUs across the United States based on membership in the PARK-PICU research consortium and membership in the Children’s Hospital Association.The survey was administered via internet(REDCap).Analysis was performed using STATA,primarily consisting of descriptive statistics,though logistic regressions were run examining the relationship between specific transfer steps,hospital characteristics,and effectiveness of transfer.RESULTS One PICU attending from each of 81 institutions in the United States completed the survey(overall 70%response rate).Over half(52%)indicated their hospital transfers patients without using set clinical criteria,and only 33%indicated that their hospital has a standardized protocol to facilitate non-emergent transfer.Fewer than half of respondents reported that their institution’s nonemergent NICU to PICU transfer practices were effective for clinicians(47%)or patient families(38%).Respondents evaluated their centers’transfers as less effective when they lacked any transfer criteria(P=0.027)or set transfer protocols(P=0.007).Respondents overwhelmingly agreed that having set clinical criteria and standardized protocols for non-emergent transfer were important to the patient-family experience and patient safety.CONCLUSION Most hospitals lacked any clinical criteria or protocols for non-emergent NICU to PICU transfers.More positive perceptions of transfer effectiveness were found among those with set criteria and/or transfer protocols.
文摘With the continued increase in the number of people that are food insecure globally, which could be increasing because of the ongoing Ukraine-Russia war, leading to reduction in international agribusinesses, coupled with drastic climate change exacerbating the problem of food insecurity, there is a constant need to come up with innovative approaches to solve this global issue. In this article, we articulated how precision agriculture can be a tool for ensuring food security in the United States. This study aims to reiterate the significance of precision agriculture in solving global food insecurity.
基金This study was supported the National Social Science Foundation Major Research Project(Grant no.20VHQ011)Chinese Arctic and Antarctic Administration program“New Developments in the Arctic Strategy of Major Countries”in 2022.
文摘On 7 October,2022,the Biden administration released an updated version of the National Strategy for the Arctic Region based on new developments in the Arctic region and global affairs.This strategy emphasizes traditional security issues in the Arctic,attaches great importance to climate governance in the region,and advocates for restoring American leadership through international cooperation.In view of the strong influence of the United States(U.S.)in the Arctic region,the changes of the U.S.Arctic strategy will inevitably have an impact on China’s scientific researchrights,economic interests,and governance rights in the Arctic region.To respond to the new situation brought about by the changes in the U.S.Arctic strategy,China should take the initiative to maintain positive relationships with all Arctic countries,and continue its active participation in Arctic affairs.
文摘The impact of apolipoprotein E(ApoE)isoforms on sporadic Alzheimer's disease has long been studied;however,the influences of apolipoprotein E gene(APOE)on healthy and pathological human brains are not fully understood.ApoE exists as three common isoforms(ApoE2,ApoE3,and ApoE4),which differ in two amino acid residues.Traditionally,ApoE binds cholesterol and phospholipids and ApoE isoforms display diffe rent affinities for their receptors,lipids transport and distribution in the brain and periphery.The role of ApoE in the human depends on ApoE isoforms,brain regions,aging,and neural injury.APOE E4 is the strongest genetic risk factor for sporadic Alzheimer's disease,considering its role in influencing amyloid-beta metabolism.The exact mechanisms by which APOE gene variants may increase or decrease Alzheimer's disease risk are not fully understood,but APOE was also known to affect directly and indirectly tau-mediated neurodegeneration,lipids metabolism,neurovascular unit,and microglial function.Consistent with the biological function of ApoE,ApoE4 isoform significantly alte red signaling pathways associated with cholesterol homeostasis,transport,and myelination.Also,the rare protective APOE variants confirm that ApoE plays an important role in Alzheimer's disease pathogenesis.The objectives of the present mini-review were to describe classical and new roles of various ApoE isoforms in Alzheimer's disease pathophysiology beyond the deposition of amyloid-beta and to establish a functional link between APOE,brain function,and memory,from a molecular to a clinical level.APOE genotype also exerted a heterogeneous effect on clinical Alzheimer's disease phenotype and its outcomes.Not only in learning and memory but also in neuro psychiatric symptoms that occur in a premorbid condition.Cla rifying the relationships between Alzheimer's disease-related pathology with neuropsychiatric symptoms,particularly suicidal ideation in Alzheimer's disease patients,may be useful for elucidating also the underlying pathophysiological process and its prognosis.Also,the effects of anti-amyloid-beta drugs,recently approved for the treatment of Alzheimer's disease,could be influenced by the APOE genotype.
基金supported by the National Natural Science Foundation of China,Nos.81974207(to JH),82001383(to DW)the Special Clinical Research Project of Health Profession of Shanghai Municipal Health Commission,No.20204Y0076(to DW)。
文摘Upregulation of vascular endothelial growth factor A/basic fibroblast growth factor(VEGFA/b FGF)expression in the penumbra of cerebral ischemia can increase vascular volume,reduce lesion volume,and enhance neural cell proliferation and differentiation,thereby exerting neuroprotective effects.However,the beneficial effects of endogenous VEGFA/b FGF are limited as their expression is only transiently increased.In this study,we generated multilayered nanofiber membranes loaded with VEGFA/b FGF using layer-by-layer self-assembly and electrospinning techniques.We found that a membrane containing 10 layers had an ideal ultrastructure and could efficiently and stably release growth factors for more than 1 month.This 10-layered nanofiber membrane promoted brain microvascular endothelial cell tube formation and proliferation,inhibited neuronal apoptosis,upregulated the expression of tight junction proteins,and improved the viability of various cellular components of neurovascular units under conditions of oxygen/glucose deprivation.Furthermore,this nanofiber membrane decreased the expression of Janus kinase-2/signal transducer and activator of transcription-3(JAK2/STAT3),Bax/Bcl-2,and cleaved caspase-3.Therefore,this nanofiber membrane exhibits a neuroprotective effect on oxygen/glucose-deprived neurovascular units by inhibiting the JAK2/STAT3 pathway.
基金supported by China Scholarship Council(202208210093,to RJ)。
文摘Cerebral small vessel disease is a neurological disease that affects the brain microvasculature and which is commonly observed among the elderly.Although at first it was considered innocuous,small vessel disease is nowadays regarded as one of the major vascular causes of dementia.Radiological signs of small vessel disease include small subcortical infarcts,white matter magnetic resonance imaging hyperintensities,lacunes,enlarged perivascular spaces,cerebral microbleeds,and brain atrophy;however,great heterogeneity in clinical symptoms is observed in small vessel disease patients.The pathophysiology of these lesions has been linked to multiple processes,such as hypoperfusion,defective cerebrovascular reactivity,and blood-brain barrier dysfunction.Notably,studies on small vessel disease suggest that blood-brain barrier dysfunction is among the earliest mechanisms in small vessel disease and might contribute to the development of the hallmarks of small vessel disease.Therefore,the purpose of this review is to provide a new foundation in the study of small vessel disease pathology.First,we discuss the main structural domains and functions of the blood-brain barrier.Secondly,we review the most recent evidence on blood-brain barrier dysfunction linked to small vessel disease.Finally,we conclude with a discussion on future perspectives and propose potential treatment targets and interventions.
基金supported by the National Key Research and Development Plan of China(2022YFD2001201)the Beijing Postdoctoral Research Foundation(2023-ZZ-112)+1 种基金the National Natural Science Foundation of China(52272444)the Natural Science Foundation of Jiangsu Province(BK20230548).
文摘In response to the problems of excessive greenhouse-gas and particulate emissions and the low traction efficiency of conventional diesel tractors in the field,a purely electric wheel-side drive tractor was studied,including an electric motor drive system,a battery ballast system,and an electro–hydraulic suspension system.This paper develops a dynamics model of an electric tractor-ploughing unit under complex soil conditions,leading to the proposal of an active control method for drive wheel torque and a joint control method for the traction force of the suspension system and the front-and rear-axle loads of a tractor.Finally,the tractor is prototyped and assembled,and ploughing tests are carried out.The ploughing results show that the active torque-distribution control method proposed in this study reduces the tractor slip by 14.83%and increases the traction efficiency by 10.28%compared with the average torquedistribution mode.Compared with the conventional traction control mode,the joint control method for traction and ballast proposed in this paper results in a 3.7%increase in traction efficiency,a 15.05%decrease in slip,and a 4.9%reduction in total drive motor energy consumption.This study will help to improve the operation quality and traction efficiency of electric tractors in complex soil conditions.
文摘Background:Acute improvement in range of motion(ROM)is a widely reported effect of stretching and foam rolling,which is commonly explained by changes in pain threshold and/or musculotendinous stiffness.Interestingly,these effects were also reported in response to various other active and passive interventions that induce responses such as enhanced muscle temperature.Therefore,we hypothesized that acute ROM enhancements could be induced by a wide variety of interventions other than stretching or foam rolling that promote an increase in muscle temperature.Methods:After a systematic search in PubMed,Web of Science,and SPORTDiscus databases,38 studies comparing the effects of stretching and foam rolling with several other interventions on ROM and passive properties were included.These studies had 1134 participants in total,and the data analysis resulted in 140 effect sizes(ESs).ES calculations were performed using robust variance estimation model with R-package.Results:Study quality of the included studies was classified as fair(PEDro score=4.58)with low to moderate certainty of evidence.Results showed no significant differences in ROM(ES=0.01,p=0.88),stiffness(ES=0.09,p=0.67),or passive peak torque(ES=-0.30,p=0.14)between stretching or foam rolling and the other identified activities.Funnel plots revealed no publication bias.Conclusion:Based on current literature,our results challenge the established view on stretching and foam rolling as a recommended component of warm-up programs.The lack of significant difference between interventions suggests there is no need to emphasize stretching or foam rolling to induce acute ROM,passive peak torque increases,or stiffness reductions.
基金supported by the NIH National Cancer Institute career development award(K25CA201545,to WL)。
文摘The neurovascular unit and stem cell therapy in ischemic stroke:Ischemic stroke,accounts for approximately 85% of all stroke incidents and is a major global health burden.It is the leading cause of disability and death worldwide,posing immense societal and economic challenges due to the long-term care required for stro ke survivors and the significant healthcare costs associated with its treatment and management(Amarenco et al.,2009).
基金The authors thank the Yayasan Universiti Teknologi PETRONAS(YUTP FRG Grant No.015LC0-428)at Universiti Teknologi PETRO-NAS for supporting this study.
文摘Static Poisson’s ratio(vs)is crucial for determining geomechanical properties in petroleum applications,namely sand production.Some models have been used to predict vs;however,the published models were limited to specific data ranges with an average absolute percentage relative error(AAPRE)of more than 10%.The published gated recurrent unit(GRU)models do not consider trend analysis to show physical behaviors.In this study,we aim to develop a GRU model using trend analysis and three inputs for predicting n s based on a broad range of data,n s(value of 0.1627-0.4492),bulk formation density(RHOB)(0.315-2.994 g/mL),compressional time(DTc)(44.43-186.9 μs/ft),and shear time(DTs)(72.9-341.2μ s/ft).The GRU model was evaluated using different approaches,including statistical error an-alyses.The GRU model showed the proper trends,and the model data ranges were wider than previous ones.The GRU model has the largest correlation coefficient(R)of 0.967 and the lowest AAPRE,average percent relative error(APRE),root mean square error(RMSE),and standard deviation(SD)of 3.228%,1.054%,4.389,and 0.013,respectively,compared to other models.The GRU model has a high accuracy for the different datasets:training,validation,testing,and the whole datasets with R and AAPRE values were 0.981 and 2.601%,0.966 and 3.274%,0.967 and 3.228%,and 0.977 and 2.861%,respectively.The group error analyses of all inputs show that the GRU model has less than 5% AAPRE for all input ranges,which is superior to other models that have different AAPRE values of more than 10% at various ranges of inputs.
文摘BACKGROUND Lung cancer is a common disease with high mortality,and psychological support is very important in the diagnosis and treatment of postoperative patients with cancer pain.AIM To explore the application effect of the narrative nursing method in postoperative lung cancer patients in the intensive care unit.METHODS A total of 120 patients diagnosed with lung cancer and experiencing cancer-related pain were randomly allocated into two groups:an observation group and a control group,each consisting of 60 cases.The control group was given routine analgesic and psychological care,while the research group applied the five-step narrative nursing method based on routine care,comparing the visual analogue scale scores,sleep status,anxiety and depression status,and quality of life of the two groups of patients before and after the intervention.RESULTS The pain scores,anxiety scores,and depression scores of the study group were lower than those of the control group after the intervention using the narrative nursing method,and the difference was statistically significant(P<0.05).CONCLUSION Using narrative nursing methods to intervene in patients with lung cancer combined with cancerous pain can help patients to correctly recognize their disease,adjust their mentality,establish confidence,alleviate patients'subjective pain feelings,and improve their adverse emotions.
文摘BACKGROUND Early in the coronavirus disease 2019(COVID-19)pandemic,there was a significant impact on routine medical care in the United States,including in fields of transplantation and oncology.AIM To analyze the impact and outcomes of early COVID-19 pandemic on liver transplantation(LT)for hepatocellular carcinoma(HCC)in the United States.METHODS WHO declared COVID-19 as a pandemic on March 11,2020.We retrospectively analyzed data from the United Network for Organ Sharing(UNOS)database regarding adult LT with confirmed HCC on explant in 2019 and 2020.We defined pre-COVID period from March 11 to September 11,2019,and early-COVID period as from March 11 to September 11,2020.RESULTS Overall,23.5%fewer LT for HCC were performed during the COVID period(518 vs 675,P<0.05).This decrease was most pronounced in the months of March-April 2020 with a rebound in numbers seen from May-July 2020.Among LT recipients for HCC,concurrent diagnosis of non-alcoholic steatohepatitis significantly increased(23 vs 16%)and alcoholic liver disease(ALD)significantly decreased(18 vs 22%)during the COVID period.Recipient age,gender,BMI,and MELD score were statistically similar between two groups,while waiting list time decreased during the COVID period(279 days vs 300 days,P=0.041).Among pathological characteristics of HCC,vascular invasion was more prominent during COVID period(P<0.01),while other features were the same.While the donor age and other characteristics remained same,the distance between donor and recipient hospitals was significantly increased(P<0.01)and donor risk index was significantly higher(1.68 vs 1.59,P<0.01)during COVID period.Among outcomes,90-day overall and graft survival were the same,but 180-day overall and graft were significantly inferior during COVID period(94.7 vs 97.0%,P=0.048).On multivariable Coxhazard regression analysis,COVID period emerged as a significant risk factor of post-transplant mortality(Hazard ratio 1.85;95%CI:1.28-2.68,P=0.001).CONCLUSION During COVID period,there was a significant decrease in LTs performed for HCC.While early postoperative outcomes of LT for HCC were same,the overall and graft survival of LTs for HCC after 180 days were significantly inferior.
基金supported as part of the Center for Hierarchical Waste Form Materials,an Energy Frontier Research Center funded by the U.S.Department of Energy,Office of Science,Basic Energy Sciences under Award No.DE-SC0016574.
文摘Porous materials present significant advantages for absorbing radioactive isotopes in nuclear waste streams.To improve absorption efficiency in nuclear waste treatment,a thorough understanding of the diffusion-advection process within porous structures is essential for material design.In this study,we present advancements in the volumetric lattice Boltzmann method(VLBM)for modeling and simulating pore-scale diffusion-advection of radioactive isotopes within geopolymer porous structures.These structures are created using the phase field method(PFM)to precisely control pore architectures.In our VLBM approach,we introduce a concentration field of an isotope seamlessly coupled with the velocity field and solve it by the time evolution of its particle population function.To address the computational intensity inherent in the coupled lattice Boltzmann equations for velocity and concentration fields,we implement graphics processing unit(GPU)parallelization.Validation of the developed model involves examining the flow and diffusion fields in porous structures.Remarkably,good agreement is observed for both the velocity field from VLBM and multiphysics object-oriented simulation environment(MOOSE),and the concentration field from VLBM and the finite difference method(FDM).Furthermore,we investigate the effects of background flow,species diffusivity,and porosity on the diffusion-advection behavior by varying the background flow velocity,diffusion coefficient,and pore volume fraction,respectively.Notably,all three parameters exert an influence on the diffusion-advection process.Increased background flow and diffusivity markedly accelerate the process due to increased advection intensity and enhanced diffusion capability,respectively.Conversely,increasing the porosity has a less significant effect,causing a slight slowdown of the diffusion-advection process due to the expanded pore volume.This comprehensive parametric study provides valuable insights into the kinetics of isotope uptake in porous structures,facilitating the development of porous materials for nuclear waste treatment applications.
基金supported by the Natural Science Foundation of Hunan Province of China(2022JJ30369)the Education Department Important Foundation of Hunan Province in China(23A0095)。
文摘In this paper,we investigate sufficient and necessary conditions such that generalized Forelli-Rudin type operators T_(λ,τ,k),S_(λ,τ,k),Q_(λ,τ,k)and R_(λ,τ,k)are bounded between Lebesgue type spaces.In order to prove the main results,we first give some bidirectional estimates for several typical integrals.