Reassessing Growth

CHINA＇S economic growth slipped to 7.4 percent in the first quarter, signaling more downward pres-sure for the world＇s second largest economy, However. authorities have ruled out the possibility of major stimulus to fight short-term dips in growth and plan to seek growth momentum through deep-seated reforms and reinvigorated domestic consumption.

Reassessing Power

Fukushima accident increases global concern over nuclear safety The accident at the Fukushima Daiichi Nuclear Power Plant in Japan has had an immediate impact on resurgent interest in nuclear power worldwide.Numerous governments have announced plans to re-examine nuclear energy policy and review the safety of their reactors and the adequacy of their regulatory frameworks.

Outcome of Patients with Lower Limbs Deep Vein Thrombosis at the University Hospital of Brazzaville (The Republic of the Congo)

The aim of this study was to describe the characteristics of patients with deep vein thrombosis (DVT) of the pelvic limbs at the time of diagnosis, and their course after hospitalization, in order to improve the management of DVT in our context. This was a descriptive longitudinal study, based on cases of deep vein thrombosis recorded between 1 January 2015 and 30 September 2018, in the cardiology and internal medicine department of the Brazzaville University Hospital Centre. During the study period, 4678 patients were hospitalized, including 52 with DVT. Thirty-three were reassessed. The frequency of DVT was 1.1% and the average hospitalization rate was 13.9 cases/year. The 33 patients were divided into 20 women and 13 men (sex ratio: 0.65). The mean age of the patients was 51.4 ± 17.8 years (extremes: 16 and 85 years). The main aetiological factors were cancer (19.1%), sickle cell disease (3%) and HIV immunosuppression (3%). The predominant risk factors were: prolonged immobilization (42.9%), pregnancy, long travel and obesity in the same number of cases (n = 3, i.e. 14.2%). The DVT involved the left pelvic limb in 75.8% of cases. Anticoagulants were administered in all patients, and compression stockings were worn in 97% of cases. The mean time to re-evaluation was 10.9 ± 9.4 months (extremes: three and 35 months). The mean measurements of the limb where the thrombosis had occurred at diagnosis and reassessment showed a significant difference. Venous Doppler showed compressible veins (60.6%), varicosities (36.3%), incompressible veins (30.3%) and thrombus (21.2%). Complications were: post-phlebitic disease (42.4%), death (21.2%), pulmonary embolism (18.2%), recurrence (18.2%). The DVT remains relatively rare, and its conventional therapeutic management is satisfactory. Systematic venous Doppler ultrasound reassessment should enable patients at risk of recurrence to be identified.

Analysis of Ornidazole Injection in Clinical Use at Post-marketing Stage by Centralized Hospital Monitoring System

This study aims to analyze the clinical use of ornidazole injection at the post-marketing stage by centralized hospital monitoring system method,and investigate its widespread use in patients,in order to regulate and guide the rational drug use,improve the drug specificity and provide a basis for drug therapy.The study adopts a prospective,multi-center,large sample size,centralized hospital monitoring system.We selected five leading hospitals in Hubei province,and observed the inpatients who received the ornidazole injection from July 1,2015 to October 31,2015.The basic information of patients was recorded,as well as the drug use and adverse events.The statistical analysis was performed based on these data.A total of 4396 individuals were enrolled in this study,most of them were middle-aged female patients and the ornidazole injection was mainly used as prophylactic prior to surgery to prevent the infections,and surgical treatment of anaerobic infections,abdominal infections and pelvic infections.The irrational drug use existed mainly in the prescribing and administration process,including unreasonable dosing frequency,rapid intravenous drip speed and extended duration of drug use.Eleven cases of adverse reactions were collected during the monitoring,incidence rate of adverse reactions was 2.5‰;adverse drug reactions occurred within 30 min.The study results fully reflected the usage of ornidazole injection in the real world.Based on the study,we calculated the adverse reaction incidence of ornidazole and identified the risk factors which may affect the safety of ornidazole injection.Study results strongly recommend that the manufacturers should publish standards for inpatient use and doctors should prescribe with caution accordingly.

Clinical Application Analysis of Andrographolide Total Ester Sulfonate Injection,a Traditional Chinese Medicine Licensed in China

Andrographolide total ester sulfonate（ATES） injection is one of the products of traditional Chinese medicine（TCM） currently used against viral infection in China.ATES injection was approved for manufacturing and marketing in January 2002.It is indicated for acute respiratory infections,tonsillitis,chronic obstructive pulmonary disease,influenza,foot and mouth disease,bronchiolitis,herpangina,mumps,infectious mononucleosis and psychosis.However,its usage also carries risk.We investigated the use of ATES at the Wuhan Union Hospital from January 2014 to December 2014 and evaluated its real-world clinical application using the hospital centralized monitoring method.A total of 848 cases were enrolled in this study.In these cases,it was mainly used for postoperative anti-inflammation and treating upper respiratory infection,pneumonia and bronchitis.Among them,39.86% were contraindicated.Irregular medication of adults and children accounted for 1.91% and 23.38%,respectively.Improper choice of solvent accounted for 3.18%.The choice of intravenous drip versus aerosol inhalation was reasonable.A case of adverse events（AEs） was observed in the monitoring period,and the incidence of adverse drug reaction（ADR） of ATES injection was 0.12%.ATES injection in our hospital is relatively safe with a low incidence of adverse reactions.The study assesses the clinical usage and adverse reactions of ATES injection,and provides suggestions for rational use in clinical practice.

Determination of the ED95 of intranasal sufentanil combined with intranasal dexmedetomidine for moderate sedation during endoscopic ultrasonography

BACKGROUND Sedation during endoscopic ultrasonography(EUS)poses many challenges and moderate-to-deep sedation are often required.The conventional method to preform moderate-to-deep sedation is generally intravenous benzodiazepine alone or in combination with opioids.However,this combination has some limitations.Intranasal medication delivery may be an alternative to this sedation regimen.AIM To determine,by continual reassessment method(CRM),the minimal effective dose of intranasal sufentanil(SUF)when combined with intranasal dexmedetomidine(DEX)for moderate sedation of EUS in at least 95%of patients(ED95).METHODS Thirty patients aged 18-65 and scheduled for EUS were recruited in this study.Subjects received intranasal DEX and SUF for sedation.The dose of DEX(1μg/kg)was fixed,while the dose of SUF was assigned sequentially to the subjects using CRM to determine ED95.The sedation status was assessed by modified observer’s assessment of alertness/sedation(MOAA/S)score.The adverse events and the satisfaction scores of patients and endoscopists were recorded.RESULTS The ED95 was intranasal 0.3μg/kg SUF when combined with intranasal 1μg/kg DEX,with an estimated probability of successful moderate sedation for EUS of 94.9%(95%confidence interval:88.1%-98.9%).When combined with intranasal 1μg/kg DEX,probabilities of successful moderate sedation at each dose level of intranasal SUF were as follows:0μg/kg SUF,52.8%;0.1μg/kg SUF,75.4%;0.2μg/kg SUF,89.9%;0.3μg/kg SUF,94.9%;0.4μg/kg SUF,98.0%;0.5μg/kg SUF,99.0%.CONCLUSION The ED95 needed for moderate sedation for EUS is intranasal 0.3μg/kg SUF when combined with intranasal 1μg/kg DEX,based on CRM.

Reassessment of the Resources of a Deep Aquifer System under Physical and Chemical Constraints:The Maastrichtian Aquifer

The deep and confined Maastrichtian aquifer contains considerable groundwater resources. It stretches over nearly 200,000 km2, from the northern part of Mauritania to the South of Guinea Bissau where it becomes shallow. The reservoir is composed mainly of coarse sands and sandstone interbedded with some clay units. The aquifer provides 40% of the total drinking water extracted from the different aquifers and nearly 800 wells equally distributed operate only in the top 50 m of the aquifer. Despite the importance of these resources for providing water in the rural and urban areas, the aquifer characteristics are not well defined. The present paper aims to define first the physical and chemical characteristics of the Maastrichtian aquifer. The reserve of the aquifer initially estimated at 350 billion m3, is reassessed using new data providing from cross sections realized as part of our research, through the Water Sectorial Project of the Ministry of Hydraulics. Data from oil wells and geophysical logging are used to investigate the geometry of the aquifer and the position of the fresh/salty water interface. The highest thickness of the aquifer is between 200 to 400 m and salty water is present below the fresh groundwater in the west side of the aquifer. In the Eastern side, potable water lies directly above the basement. The thickness of the aquifer increases from the west to the center, and then decreases towards the shallow basement rock in the South East. The average thickness is 250 m. Chemical data coming from pumping wells indicate high chloride (250 - 1600 mg/l) and fluoride content (1 - 5.5 mg/l). Therefore, the reassessment has to take into account the chemical aspect of the water.

Stepwise Method Based on Confidence Bound and Information Incorporation for Identifying the Maximum Tolerable Dose

The primary goal of a phase I clinical trial is to find the maximum tolerable dose of a treatment. In this paper, we propose a new stepwise method based on confidence bound and information incorporation to determine the maximum tolerable dose among given dose levels. On the one hand, in order to avoid severe even fatal toxicity to occur and reduce the experimental subjects, the new method is executed from the lowest dose level, and then goes on in a stepwise fashion. On the other hand, in order to improve the accuracy of the recommendation, the final recommendation of the maximum tolerable dose is accomplished through the information incorporation of an additional experimental cohort at the same dose level. Furthermore, empirical simulation results show that the new method has some real advantages in comparison with the modified continual reassessment method.

Estimation of the minimum effective dose of tramadol for postoperative analgesia in infants using the continual reassessment method

Tramadol is a potent analgesic.However,the analgesia efficacy of tramadol,particularly its minimum effective dose(MED),is not clear.The aim of this study is to find MED of tramadol for postoperative analgesia in infants.The continual reassessment method(CRM)was performed to find MED.Infants undergoing surgeries were included in the 3 phases of this series.In each phase,24 participants were allocated a different tramadol dose.Pain intensity was measured by face,legs,activity,cry,consolability(FLACC)measurement at 3-hour intervals.Tramadol was considered ineffective if the FLACC score was higher than 4 in 10 at anytime.In phase 1,seven dose levels were used within the range 0.1-0.4 mg·kg^(-1)·h^(-1).Phase 1 was insufficient to identify the MED,and we increased the dose to 0.4-0.8 mg·kg^(-1)·h^(-1) in phase 2.Phase 2 was insufficient to identify the MED.In phase 3,local anesthetic wound infiltration was introduced,and the tramadol dose levels tested were the same as in phase 1.The successful analgesia probability of tramadol 0.4 mg·kg^(-1)·h^(-1) was 82.1%(95%CI,0.742-0.925)in phase 1.In phase 2,it was 84.7%(95%CI,0.789-0.991)with the dose 0.8 mg·kg^(-1)·h^(-1).Phase 1 and phase 2 were insufficient to identify the MED.In phase 3,the successful analgesia probability for dose 0.35 mg·kg^(-1)·h^(-1) was 96.7%(95%CI,0.853-0.997).We have demonstrated that tramadol provides insufficient analgesia for surgeries considered to cause moderate-to-severe postoperative pain in infants if used as the sole analgesic,and that local anesthetic wound infiltration enhances the efficacy of tramadol.

Thermodynamic reassessment of Ni–Ga binary system

New experimental measurements of the phase diagram and the mixing enthalpy of liquid phase along with the previous experimental data were used in a reassessment of the Ni–Ga system. A set of self-consistent thermodynamic parameters of the Ni–Ga system is obtained using the calculation of phase diagram (CALPHAD) technique, and the available phase diagram and thermodynamic data are reproduced well within experimental error limits. Some noticeable improvements are obtained in the present work compared with the previous assessment: (1) the calculated Ga-rich liquidus is more reasonable; (2) Ni3Ga7 is adopted as the most Ga-rich compound rather than NiGa4; (3) the Ni5Ga3 phase is treated as the nonstoichiometric compound with consideration of its narrow homogeneity range; (4) the phase transformation between B81.5_Ni3Ga2 and Ni13Ga9 is considered instead of treating them as Ni3Ga2 phase simply; (5) the latest experimental data of mixing enthalpy for the liquid phase are adopted. The present study can be used as a basis for the development of a thermodynamic database of the Ni-based semiconductor alloy systems.

A system for determining maximum tolerated dose in clinical trial

Toxicity study,especially in determining the maximum tolerated dose(MTD)in phase I clinical trial,is an important step in developing new life-saving drugs.In practice,toxicity levels may be categorised as binary grades,multiple grades,or in a more generalised case,continuous grades.In this study,we propose an overall MTD framework that includes all the aforementioned cases for a single toxicity outcome(response).The mechanism of determining MTD involves a function that is predetermined by user.Analytic properties of such a system are investigated and simu-lation studies are performed for various scenarios.The concept of the continual reassessment method(CRM)is also implied in the framework and Bayesian analysis,including Markov chain Monte Carlo(MCMC)methods are used in estimating the model parameters.

Development and Planning of Small Towns in China:Speculation, Reassessment, and Prospect

Small town development has been one of the most remarkable features of urbanization in China: This paper systematically examines different definitions of small towns and critically assesses various interpretations of the functions performed by Chinese towns in national development. Prior to the- 1980s, small towns were enthusiastically portrayed as storage reservoirs that can dam the flux of the surplus rural labor force into large cities. Existing problems associated with the growth and planning of small towns have resulted in a sober reassessment of the role played by the towns. Despite the partial retreat of enthusiasm about the town-based urbanization strategy, small towns continue to flourish spontaneously in the grassroots level of the Chinese countryside. A new pattern of ’urbanizationfrom below’, motivated primarily by the growth of township and village enterprises and centeredaround small towns, is quickly taking shape in the country patticularly in the coastal extended metropolitan regions.

A Reassessment of Diplomatic Interactions and Islamic Laws of Nations in The International System

The discourse on the evolution of the principles of international laws and laws amongst nations have always taken a Eurocentric approach.The common argument and perspectives is that contemporary international law evolved from the Christendom to the Spanish School and Grotius,while downplaying the influence of the Islamic law of nations in shaping issues of acculturation,accommodation,rules of engagement in war relating to international law.This paper tends to x-ray and investigate the impact of the Islamic law of nations,from the the Treaty of Hudaibiyyah to the Siyar of Muhammad ibn Shaybani.It tries to highlight the relevance of the Muslim East and its concrete contributions to Laws and treaties of the Middle Ages to recent times and also argues,using existing literature,that the European Christian society only adopted what already existed in the Muslim,Islamic laws and tried to Christianise them overtime.The paper finds that further investigation and interrogation will reveal much more of the influence of the Islamic laws on contemporary laws of relations amongst nations and beyond.