BACKGROUND Progressive familial intrahepatic cholestasis type 1(PFIC-1)is a genetic cholestatic disease causing end-stage liver disease,which needs liver transplantation(LT).Simultaneous biliary diversion(BD)was recom...BACKGROUND Progressive familial intrahepatic cholestasis type 1(PFIC-1)is a genetic cholestatic disease causing end-stage liver disease,which needs liver transplantation(LT).Simultaneous biliary diversion(BD)was recommended to prevent allograft steatosis after transplantation,while increasing the risk of infection.Here,an attempt was made to perform BD using appendix to prevent bacterial translocation after LT.CASE SUMMARY An 11-month-old boy diagnosed with PFIC-1 received ABO compatible living donor LT due to refractory jaundice and pruritus.His mother donated her left lateral segment with a graft-to-recipient weight ratio of 2.9%.Internal BD was constructed during LT using the appendix by connecting its proximal end with the intrahepatic biliary duct and the distal end with colon.Biliary leakage was suspected on the 5th day after transplantation and exploratory laparotomy indicated biliary leakage at the cutting surface of liver.The liver function returned to normal on the 9th day post-operation and maintained normal during the 15-month follow-up.Cholangiography at 10 months after transplantation confirmed the direct secretion of bile into colon.Computerized tomography scan(4 months and 10 months)and liver biopsy(10 months)indicated no steatosis in the allograft.No complaint of recurrent diarrhea,infection or growth retardation was reported during follow-up.CONCLUSION Internal BD using appendix during LT is effective in preventing allograft steatosis and post-transplant infection in PFIC-1 recipients.展开更多
Recently, the critical chain study has become a hot issue in the project management research field. The construction of the critical chain with multi-resource constraints is a new research subject. According to the sy...Recently, the critical chain study has become a hot issue in the project management research field. The construction of the critical chain with multi-resource constraints is a new research subject. According to the system analysis theory and project portfolio theory, this paper discusses the creation of project portfolios based on the similarity principle and gives the definition of priority in multi-resource allocation based on quantitative analysis. A model with multi-resource constraints, which can be applied to the critical chain construction of the A-bid section in the South-to-North Water Diversion Project, was proposed. Contrast analysis with the comprehensive treatment construction method and aggressive treatment construction method was carried out. This paper also makes suggestions for further research directions and subjects, which will be useful in improving the theories in relevant research fields.展开更多
Four rainwater diversion patterns including undisturbed soil ditch (T1), slope compaction (T2), asbestos sheet covering after compac- tion (T3) and plastic film covering after compaction (T4) were set in cornf...Four rainwater diversion patterns including undisturbed soil ditch (T1), slope compaction (T2), asbestos sheet covering after compac- tion (T3) and plastic film covering after compaction (T4) were set in cornfield in arid areas of Yunnan Province, and effects of various patterns on rainwater collection efficiency, water utilization efficiency and corn yield were studied. The results shows that rainwater collection efficiency, water utilization efficiency and corn yield of the four diversion patterns presented the same trend, namely T4 〉T3 〉T2 〉T1. Overall, rainwater collection efficiencies of the four diversion patterns ranged from 41.7% to 58.7% ; compared with T1, water utilization efficiencies of T2 ,T3 and T4 increased by 34.9%, 53.5% and 92.5%, and maize yields of them improved by 1 767.0, 1 981.5 and 2 385.0 kg/hm2.展开更多
Users’interests are often diverse and multi-grained,with their underlying intents even more so.Effectively captur-ing users’interests and uncovering the relationships between diverse interests are key to news recomm...Users’interests are often diverse and multi-grained,with their underlying intents even more so.Effectively captur-ing users’interests and uncovering the relationships between diverse interests are key to news recommendation.Meanwhile,diversity is an important metric for evaluating news recommendation algorithms,as users tend to reject excessive homogeneous information in their recommendation lists.However,recommendation models themselves lack diversity awareness,making it challenging to achieve a good balance between the accuracy and diversity of news recommendations.In this paper,we propose a news recommendation algorithm that achieves good performance in both accuracy and diversity.Unlike most existing works that solely optimize accuracy or employ more features to meet diversity,the proposed algorithm leverages the diversity-aware capability of the model.First,we introduce an augmented user model to fully capture user intent and the behavioral guidance they might undergo as a result.Specifically,we focus on the relationship between the original clicked news and the augmented clicked news.Moreover,we propose an effective adversarial training method for diversity(AT4D),which is a pluggable component that can enhance both the accuracy and diversity of news recommendation results.Extensive experiments on real-world datasets confirm the efficacy of the proposed algorithm in improving both the accuracy and diversity of news recommendations.展开更多
The increase and spread of bacterial resistance to extended-spectrum beta-lactam antibiotics are reported in many infections and are a real public health problem worldwide. Drug pressure is a factor that favors the em...The increase and spread of bacterial resistance to extended-spectrum beta-lactam antibiotics are reported in many infections and are a real public health problem worldwide. Drug pressure is a factor that favors the emergence of a population of better adapted bacteria. However, there is no literature highlighting the genetic diversity and evolutionary structure of E. coli and K. pneumoniae in an environment with high selection pressure in Côte d’Ivoire. The objective of this study was to evaluate the genetic diversity of E. coli and K. pneumoniae strains circulating at the HKB Hospital in Abobo and at the Daloa Regional Hospital and its impact on the dissemination of extended spectrum beta-lactam resistance genes. A total of 39 strains isolated from the urinary tract of infected patients, including 30 strains of E. coli and 9 strains of K. pneumoniae were studied. A total of 39 strains isolated from the urinary tract of infected patients, including 30 strains of E. coli and 9 strains of K. pneumoniae were studied. From genomic DNA extracts, ESBL resistance genes were amplified by PCR and sequenced, in addition to genetic typing by ERIC-PCR. The data obtained were submitted to genetic and bioinformatics analyses. The results have shown a genetic diversity important in E. coli and K. pneumoniae with diversity indexs (SID) ranging from 0.5 to 0.77. The genetic structure of the bacterial species studied has shown a clonal distribution of strains with clones expressing TEM-9 and CTX-M-15 variants. Also, this clonal structure was correlated with the spread of resistance genes in E. coli and K. pneumoniae. The spread of resistant clones is a factor that might limit the fight against antibiotic resistance.展开更多
Background: Women and racial and ethnic minorities remain underrepresented in orthopedic surgery. Exploring factors that draw individuals from these demographics to pursue orthopedic surgery and their experiences duri...Background: Women and racial and ethnic minorities remain underrepresented in orthopedic surgery. Exploring factors that draw individuals from these demographics to pursue orthopedic surgery and their experiences during training can provide valuable insights into this disparity. We aimed to quantify the current state of diversity in terms of race, ethnicity, gender, and sexual orientation among orthopedic surgery residents and fellows, and to identify factors that influenced their decision to pursue orthopedic surgery. Methods: An institutionally validated survey was delivered via Qualtrics to national orthopedic surgery residency programs from January to April 2023. Topics addressed included gender identity, sexual orientation, racial and ethnic background, reasons for pursuing orthopedic surgery, and medical training experiences. Differences between gender and racial discrimination were assessed via Chi-square test. Results: A total of 119 orthopedic surgery residents and fellows responded. Of these, 62.2% (n = 74) identified as non-Hispanic White, 60.5% (n = 72) were male, and 86.6% (n = 103) identified as straight or heterosexual. Mentorship was cited by 79.9% (n = 95) of respondents as a critical factor in their decision to pursue orthopedic surgery. Additionally, 23% of female respondents and 4.2% of male respondents highlighted the presence of women and diverse faculty as very important. Gender identity negatively impacted the decision to pursue orthopedic surgery in 15.4% of female and 1.4% of male respondents (p = 0.004). Among underrepresented minorities (URMs), 24.4% reported negative experiences during training compared to 4.1% of non-Hispanic White participants (p = 0.002). Discrimination experiences ranged from 2.6% due to sexual orientation, 20.7% due to race and ethnicity, and 26.3% due to gender and gender identity. Conclusions: Discrimination based on race, ethnicity, and gender continues to pose significant challenges for orthopedic surgery trainees. The presence of mentors, particularly women and individuals from diverse backgrounds, remains crucial in fostering interest in orthopedic surgery among underrepresented groups. Sustained efforts are needed to create a more inclusive and supportive environment all trainees.展开更多
At high cycles of steam huff&puff,oil distribution in reservoirs becomes stronger heterogeneity due to steam channeling.Thermal solidification agent can be used to solve this problem.Its solution is a lowviscosity...At high cycles of steam huff&puff,oil distribution in reservoirs becomes stronger heterogeneity due to steam channeling.Thermal solidification agent can be used to solve this problem.Its solution is a lowviscosity liquid at normal temperature,but it can be solidified above 80℃.The plugging degree is up to 99%at 250℃.The sweep efficiency reaches 59.2%,which is 7.3%higher than pure steam injection.In addition,simultaneous injection of viscosity reducer and/or nitrogen foams can further enhance oil recovery.The mechanism of this technology depends on its strong plugging ability,which changes the flowing pattern of steam to effectively mobilize remaining oil.Viscosity reducer and nitrogen foams further expand the sweep range and extends the effective period.Therefore,thermal solidification agent can plug steam channeling paths and adjust steam flowing direction to significantly enhance oil recovery at high cycles of steam huff&puff.展开更多
This study conducted temporary plugging and diversion fracturing(TPDF)experiments using a true triaxial fracturing simulation system within a laboratory setting that replicated a lab-based horizontal well completion w...This study conducted temporary plugging and diversion fracturing(TPDF)experiments using a true triaxial fracturing simulation system within a laboratory setting that replicated a lab-based horizontal well completion with multi-cluster sand jetting perforation.The effects of temporary plugging agent(TPA)particle size,TPA concentration,single-cluster perforation number and cluster number on plugging pressure,multi-fracture diversion pattern and distribution of TPAs were investigated.A combination of TPAs with small particle sizes within the fracture and large particle sizes within the segment is conducive to increasing the plugging pressure and promoting the diversion of multi-fractures.The addition of fibers can quickly achieve ultra-high pressure,but it may lead to longitudinal fractures extending along the wellbore.The temporary plugging peak pressure increases with an increase in the concentration of the TPA,reaching a peak at a certain concentration,and further increases do not significantly improve the temporary plugging peak pressure.The breaking pressure and temporary plugging peak pressure show a decreasing trend with an increase in single-cluster perforation number.A lower number of single-cluster perforations is beneficial for increasing the breaking pressure and temporary plugging peak pressure,and it has a more significant control on the propagation of multi-cluster fractures.A lower number of clusters is not conducive to increasing the total number and complexity of artificial fractures,while a higher number of clusters makes it difficult to achieve effective plugging.The TPAs within the fracture is mainly concentrated in the complex fracture areas,especially at the intersections of fractures.Meanwhile,the TPAs within the segment are primarily distributed near the perforation cluster apertures which initiated complex fractures.展开更多
为掌握江苏湖泊鳙群体的遗传资源状况,利用COⅠ基因序列研究了6个湖泊(太湖、滆湖、长荡湖、高邮湖、洪泽湖和骆马湖)鳙群体的遗传多样性及遗传结构。结果显示,在分析的630 bp COⅠ基因片段中,碱基A+T含量(55.3%)高于C+G含量(44.7%)。22...为掌握江苏湖泊鳙群体的遗传资源状况,利用COⅠ基因序列研究了6个湖泊(太湖、滆湖、长荡湖、高邮湖、洪泽湖和骆马湖)鳙群体的遗传多样性及遗传结构。结果显示,在分析的630 bp COⅠ基因片段中,碱基A+T含量(55.3%)高于C+G含量(44.7%)。223条COⅠ序列检测出14个变异位点,定义9个单倍型,6个群体的单倍型多样性为0.494~0.665,核苷酸多样性为0.0009~0.0019,总体单倍型多样性和核苷酸多样性分别为0.576和0.0012,具有高单倍型多样性和低核苷酸多样性的特点,表明6个湖泊鳙群体遗传多样性较低。分子方差分析结果显示,遗传变异主要来自于群体内(99.39%),总遗传分化指数为0.0061,群体间遗传分化指数为-0.0228~0.0445,遗传距离为0.0012~0.0027,表明群体间没有明显的遗传分化。单倍型系统发育树和网络结构图显示,单倍型在6个群体中混杂分布,未形成特定的湖泊分支。中性检验和歧点分布分析表明,整个鳙群体经历过显著的种群扩张。结果表明,江苏湖泊鳙群体的遗传多样性较低,遗传结构趋于同质化,需要采取措施提高鳙的遗传多样性。展开更多
基金Supported by the National Natural Science Foundation of China,No.82471804.
文摘BACKGROUND Progressive familial intrahepatic cholestasis type 1(PFIC-1)is a genetic cholestatic disease causing end-stage liver disease,which needs liver transplantation(LT).Simultaneous biliary diversion(BD)was recommended to prevent allograft steatosis after transplantation,while increasing the risk of infection.Here,an attempt was made to perform BD using appendix to prevent bacterial translocation after LT.CASE SUMMARY An 11-month-old boy diagnosed with PFIC-1 received ABO compatible living donor LT due to refractory jaundice and pruritus.His mother donated her left lateral segment with a graft-to-recipient weight ratio of 2.9%.Internal BD was constructed during LT using the appendix by connecting its proximal end with the intrahepatic biliary duct and the distal end with colon.Biliary leakage was suspected on the 5th day after transplantation and exploratory laparotomy indicated biliary leakage at the cutting surface of liver.The liver function returned to normal on the 9th day post-operation and maintained normal during the 15-month follow-up.Cholangiography at 10 months after transplantation confirmed the direct secretion of bile into colon.Computerized tomography scan(4 months and 10 months)and liver biopsy(10 months)indicated no steatosis in the allograft.No complaint of recurrent diarrhea,infection or growth retardation was reported during follow-up.CONCLUSION Internal BD using appendix during LT is effective in preventing allograft steatosis and post-transplant infection in PFIC-1 recipients.
基金supported by the National Science and Technology Plan (Major Project of the Eleventh Five-Year Plan,Grant No. 2006BAB04A13)the Philosophy and Social Science Fund of the Education Department of Jiangsu Province (Grant No.07SJD630006)+2 种基金the Third Key Discipline (Techno-Economics and Management) of the 211 Projectthe Key Discipline of Jiangsu Province (Engineering and Project Management)the Office of the South-to-North Water Diversion Project Construction Committee under the State Council
文摘Recently, the critical chain study has become a hot issue in the project management research field. The construction of the critical chain with multi-resource constraints is a new research subject. According to the system analysis theory and project portfolio theory, this paper discusses the creation of project portfolios based on the similarity principle and gives the definition of priority in multi-resource allocation based on quantitative analysis. A model with multi-resource constraints, which can be applied to the critical chain construction of the A-bid section in the South-to-North Water Diversion Project, was proposed. Contrast analysis with the comprehensive treatment construction method and aggressive treatment construction method was carried out. This paper also makes suggestions for further research directions and subjects, which will be useful in improving the theories in relevant research fields.
基金Supported by the National Key Technology R&D Program(2012BAD40B02)
文摘Four rainwater diversion patterns including undisturbed soil ditch (T1), slope compaction (T2), asbestos sheet covering after compac- tion (T3) and plastic film covering after compaction (T4) were set in cornfield in arid areas of Yunnan Province, and effects of various patterns on rainwater collection efficiency, water utilization efficiency and corn yield were studied. The results shows that rainwater collection efficiency, water utilization efficiency and corn yield of the four diversion patterns presented the same trend, namely T4 〉T3 〉T2 〉T1. Overall, rainwater collection efficiencies of the four diversion patterns ranged from 41.7% to 58.7% ; compared with T1, water utilization efficiencies of T2 ,T3 and T4 increased by 34.9%, 53.5% and 92.5%, and maize yields of them improved by 1 767.0, 1 981.5 and 2 385.0 kg/hm2.
基金This research was funded by Beijing Municipal Social Science Foundation(23YTB031)the Fundamental Research Funds for the Central Universities(CUC23ZDTJ005).
文摘Users’interests are often diverse and multi-grained,with their underlying intents even more so.Effectively captur-ing users’interests and uncovering the relationships between diverse interests are key to news recommendation.Meanwhile,diversity is an important metric for evaluating news recommendation algorithms,as users tend to reject excessive homogeneous information in their recommendation lists.However,recommendation models themselves lack diversity awareness,making it challenging to achieve a good balance between the accuracy and diversity of news recommendations.In this paper,we propose a news recommendation algorithm that achieves good performance in both accuracy and diversity.Unlike most existing works that solely optimize accuracy or employ more features to meet diversity,the proposed algorithm leverages the diversity-aware capability of the model.First,we introduce an augmented user model to fully capture user intent and the behavioral guidance they might undergo as a result.Specifically,we focus on the relationship between the original clicked news and the augmented clicked news.Moreover,we propose an effective adversarial training method for diversity(AT4D),which is a pluggable component that can enhance both the accuracy and diversity of news recommendation results.Extensive experiments on real-world datasets confirm the efficacy of the proposed algorithm in improving both the accuracy and diversity of news recommendations.
文摘The increase and spread of bacterial resistance to extended-spectrum beta-lactam antibiotics are reported in many infections and are a real public health problem worldwide. Drug pressure is a factor that favors the emergence of a population of better adapted bacteria. However, there is no literature highlighting the genetic diversity and evolutionary structure of E. coli and K. pneumoniae in an environment with high selection pressure in Côte d’Ivoire. The objective of this study was to evaluate the genetic diversity of E. coli and K. pneumoniae strains circulating at the HKB Hospital in Abobo and at the Daloa Regional Hospital and its impact on the dissemination of extended spectrum beta-lactam resistance genes. A total of 39 strains isolated from the urinary tract of infected patients, including 30 strains of E. coli and 9 strains of K. pneumoniae were studied. A total of 39 strains isolated from the urinary tract of infected patients, including 30 strains of E. coli and 9 strains of K. pneumoniae were studied. From genomic DNA extracts, ESBL resistance genes were amplified by PCR and sequenced, in addition to genetic typing by ERIC-PCR. The data obtained were submitted to genetic and bioinformatics analyses. The results have shown a genetic diversity important in E. coli and K. pneumoniae with diversity indexs (SID) ranging from 0.5 to 0.77. The genetic structure of the bacterial species studied has shown a clonal distribution of strains with clones expressing TEM-9 and CTX-M-15 variants. Also, this clonal structure was correlated with the spread of resistance genes in E. coli and K. pneumoniae. The spread of resistant clones is a factor that might limit the fight against antibiotic resistance.
文摘Background: Women and racial and ethnic minorities remain underrepresented in orthopedic surgery. Exploring factors that draw individuals from these demographics to pursue orthopedic surgery and their experiences during training can provide valuable insights into this disparity. We aimed to quantify the current state of diversity in terms of race, ethnicity, gender, and sexual orientation among orthopedic surgery residents and fellows, and to identify factors that influenced their decision to pursue orthopedic surgery. Methods: An institutionally validated survey was delivered via Qualtrics to national orthopedic surgery residency programs from January to April 2023. Topics addressed included gender identity, sexual orientation, racial and ethnic background, reasons for pursuing orthopedic surgery, and medical training experiences. Differences between gender and racial discrimination were assessed via Chi-square test. Results: A total of 119 orthopedic surgery residents and fellows responded. Of these, 62.2% (n = 74) identified as non-Hispanic White, 60.5% (n = 72) were male, and 86.6% (n = 103) identified as straight or heterosexual. Mentorship was cited by 79.9% (n = 95) of respondents as a critical factor in their decision to pursue orthopedic surgery. Additionally, 23% of female respondents and 4.2% of male respondents highlighted the presence of women and diverse faculty as very important. Gender identity negatively impacted the decision to pursue orthopedic surgery in 15.4% of female and 1.4% of male respondents (p = 0.004). Among underrepresented minorities (URMs), 24.4% reported negative experiences during training compared to 4.1% of non-Hispanic White participants (p = 0.002). Discrimination experiences ranged from 2.6% due to sexual orientation, 20.7% due to race and ethnicity, and 26.3% due to gender and gender identity. Conclusions: Discrimination based on race, ethnicity, and gender continues to pose significant challenges for orthopedic surgery trainees. The presence of mentors, particularly women and individuals from diverse backgrounds, remains crucial in fostering interest in orthopedic surgery among underrepresented groups. Sustained efforts are needed to create a more inclusive and supportive environment all trainees.
基金supported by National Natural Science Foundation of China(52074321)Natural Science Foundation of Beijing Municipality,China(3192026)。
文摘At high cycles of steam huff&puff,oil distribution in reservoirs becomes stronger heterogeneity due to steam channeling.Thermal solidification agent can be used to solve this problem.Its solution is a lowviscosity liquid at normal temperature,but it can be solidified above 80℃.The plugging degree is up to 99%at 250℃.The sweep efficiency reaches 59.2%,which is 7.3%higher than pure steam injection.In addition,simultaneous injection of viscosity reducer and/or nitrogen foams can further enhance oil recovery.The mechanism of this technology depends on its strong plugging ability,which changes the flowing pattern of steam to effectively mobilize remaining oil.Viscosity reducer and nitrogen foams further expand the sweep range and extends the effective period.Therefore,thermal solidification agent can plug steam channeling paths and adjust steam flowing direction to significantly enhance oil recovery at high cycles of steam huff&puff.
基金Supported by the National Natural Science Foundation of China(51974332).
文摘This study conducted temporary plugging and diversion fracturing(TPDF)experiments using a true triaxial fracturing simulation system within a laboratory setting that replicated a lab-based horizontal well completion with multi-cluster sand jetting perforation.The effects of temporary plugging agent(TPA)particle size,TPA concentration,single-cluster perforation number and cluster number on plugging pressure,multi-fracture diversion pattern and distribution of TPAs were investigated.A combination of TPAs with small particle sizes within the fracture and large particle sizes within the segment is conducive to increasing the plugging pressure and promoting the diversion of multi-fractures.The addition of fibers can quickly achieve ultra-high pressure,but it may lead to longitudinal fractures extending along the wellbore.The temporary plugging peak pressure increases with an increase in the concentration of the TPA,reaching a peak at a certain concentration,and further increases do not significantly improve the temporary plugging peak pressure.The breaking pressure and temporary plugging peak pressure show a decreasing trend with an increase in single-cluster perforation number.A lower number of single-cluster perforations is beneficial for increasing the breaking pressure and temporary plugging peak pressure,and it has a more significant control on the propagation of multi-cluster fractures.A lower number of clusters is not conducive to increasing the total number and complexity of artificial fractures,while a higher number of clusters makes it difficult to achieve effective plugging.The TPAs within the fracture is mainly concentrated in the complex fracture areas,especially at the intersections of fractures.Meanwhile,the TPAs within the segment are primarily distributed near the perforation cluster apertures which initiated complex fractures.
文摘为掌握江苏湖泊鳙群体的遗传资源状况,利用COⅠ基因序列研究了6个湖泊(太湖、滆湖、长荡湖、高邮湖、洪泽湖和骆马湖)鳙群体的遗传多样性及遗传结构。结果显示,在分析的630 bp COⅠ基因片段中,碱基A+T含量(55.3%)高于C+G含量(44.7%)。223条COⅠ序列检测出14个变异位点,定义9个单倍型,6个群体的单倍型多样性为0.494~0.665,核苷酸多样性为0.0009~0.0019,总体单倍型多样性和核苷酸多样性分别为0.576和0.0012,具有高单倍型多样性和低核苷酸多样性的特点,表明6个湖泊鳙群体遗传多样性较低。分子方差分析结果显示,遗传变异主要来自于群体内(99.39%),总遗传分化指数为0.0061,群体间遗传分化指数为-0.0228~0.0445,遗传距离为0.0012~0.0027,表明群体间没有明显的遗传分化。单倍型系统发育树和网络结构图显示,单倍型在6个群体中混杂分布,未形成特定的湖泊分支。中性检验和歧点分布分析表明,整个鳙群体经历过显著的种群扩张。结果表明,江苏湖泊鳙群体的遗传多样性较低,遗传结构趋于同质化,需要采取措施提高鳙的遗传多样性。