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Appropriateness of Amikacin Dose Prescription, Monitoring and Safety during Hospitalization as an Impact of Clinical Pharmacologist Intervention, in the Israeli Regional Hospital
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作者 Renata Shihmanter Olga Lazar Lidia Arcavi 《Journal of Biosciences and Medicines》 2024年第3期337-354,共18页
Background: Use of inappropriate amikacin dose is one of the most important factors in inducing toxicity, prolonged hospitalization as well as in increasing patient’s mortality. Objective: The aims of this study are ... Background: Use of inappropriate amikacin dose is one of the most important factors in inducing toxicity, prolonged hospitalization as well as in increasing patient’s mortality. Objective: The aims of this study are the analysis of amikacin dose, serum level and the examination of the effectiveness of the clinical pharmacologist (CP) therapeutic drug monitoring (TDM) intervention to guarantee the safety of amikacin use. Methods: This is a one-year retrospective observational chart review study, which evaluates amikacin dose, serum drug level, development of adverse effects in patients on amikacin with or without CP TDM consultation. Results: Amikacin was prescribed for 393 complex patients, with median age 83. Amikacin group (AG) included 140 (32%) courses with CP consultation (AG1) and 292 (68%) courses without CP consultation (AG2). The distribution of most study characteristics in both groups was similar including amikacin dose (9-10 mg/kg/day), renal failure (14%) and mortality (12%). Acceptance for CP consultation was in 46% of amikacin courses and dose changes were done in 63% after CP intervention. Prolonged antibiotic course (4.6 ± 1.5 vs 3.8 ± 1.6 days, p < 0.0001) and the patient’s hemodynamic instability (15% vs 7%, p = 0.01) were more frequent in the AG1 compared to the AG2. There was a strong association between CP consultation and prolonged hospitalization (p = 0.005), while no association between it and amikacin adverse effects, renal failure or mortality. Conclusions: There was no trend to reducing amikacin toxicity, days of hospitaliza tion or mortality in patients with CP consultation. CP TDM intervention was more in the management of complicated clinical situations. However, it is necessary to optimize it. 展开更多
关键词 AMIKACIN Therapeutic Drug monitoring APPROPRIATE Clinical Pharmacologist safety Adverse Effects
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Efficacy and Safety of Lianhua Qingke Tablets in the Treatment of Long Coronavirus Disease (COVID) Cough: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Clinical Study
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作者 Xiaolong Xu Jie Ying +12 位作者 Taiping Tian Tengwen Liu Chunhua Chi Zhizhong Gong Jingpeng Gao Meiping Qian Wei Tan Ran Cao Shuixian Lv Zhougui Ling Shuo Wang Bo Li Qingquan Liu 《Engineering》 SCIE EI CAS CSCD 2024年第9期61-69,共9页
Lianhua Qingke tablets,a patented traditional Chinese medicine that has validated clinical efficacy for treating cough caused by severe acute respiratory syndrome coronavirus 2 infection,lack rigorous evidence-based r... Lianhua Qingke tablets,a patented traditional Chinese medicine that has validated clinical efficacy for treating cough caused by severe acute respiratory syndrome coronavirus 2 infection,lack rigorous evidence-based research evaluating their effect on long coronavirus disease(COVID)cough.A randomized,double-blind,placebo-controlled,multicenter clinical study was conducted among patients with long COVID cough from 19 hospitals and 23 community health centers in China.Patients were randomized 1:1 to receive either Lianhua Qingke tablets or placebo orally for 14 days(four tablets,1.84 g,three times a day).The primary endpoint indicator was the disappearance of cough,with the remission of cough also considered.Among 482 randomized patients,480(full analysis set 480;per-protocol set 470;safety set 480)were included in the primary analysis.According to the full analysis,the time until cough disappearance was significantly shorter in the trial group than in the control group,with a significant increase in the 14-day cough disappearance rate.Accordingly,the time to cough remission was significantly shorter in the trial group than in the control group.The change in the total symptom score was significantly greater in the trial group than in the control group on days 7 and 14,consistent with the results indicated by the visual analog scale(VAS)and cough evaluation test(CET)scores.No serious adverse events were recorded during the study.Lianhua Qingke tablets significantly improved the clinical symptoms of patients with long COVID cough. 展开更多
关键词 Long coronavirus disease(COVID)cough Traditional Chinese medicine Clinical trial Efficacy safety
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Training of Infection Prevention and Control to Healthcare Workers of Mining Health Facilities: A Shared Responsibility for Improving Safety of Mining Communities
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作者 Joseph C. Hokororo Laura E. Marandu +10 位作者 Ruth R. Ngowi Radenta P. Bahegwa Yohannes S. Msigwa Chrisogone J. German Omary A. Nasoro Erick S. Kinyenje Syabo M. Mwaisengela Mbwana M. Degeh Robert S. Mazengo Irene F. Ndauzi Eliudi S. Eliakimu 《Occupational Diseases and Environmental Medicine》 2024年第4期243-264,共22页
Introduction: Without appropriately trained healthcare workers (HCWs), infection prevention and control (IPC) cannot be implemented according to set standards. Although training is crucial, authorities rarely consider... Introduction: Without appropriately trained healthcare workers (HCWs), infection prevention and control (IPC) cannot be implemented according to set standards. Although training is crucial, authorities rarely consider those working in health facilities owned by the mining. We describe the training which was conducted in North Mara in Mara region mining health facilities. Methods: This was descriptive study on the training of IPC to HCWs of mining health facilities. The training was conducted to North Mara Gold Mine Limited on April 2024. We targeted the HCWs and supporting staff working in the health facilities of the mining communities. The duration of the training was five days. The sessions started with pre-training test to evaluate what participants understood before training and followed with training itself. The training was carried out using mixed adult learning methods like: illustrated lectures, demonstrations, brainstorming, small group activities, group discussions, role plays, case studies and simulations. The training was finalized with posttest. Results: A total of ten HCWs were trained out of 13 of the facility. In that training six were males and four were females. Also, out of the ten trained three were clinicians, four nurses, one lab technician, one pharmaceutical technician, one support staff. The average score of the results of the pretest was 70.7% with a range of 16% (minimum 64% and maximum 80%) and that of the posttest was 79.8% with a range of 12% (min 74% and max 88%). Conclusions: If HCWs are well trained to comply with IPC standards and transmission-based precautions, they have the ability to deliver safe health services and protect themselves, patients, environment and the community. Training of HCWs working at the mining, therefore, can be adapted in all mines to improve the quality of mining healthcare and respond to the need to improve the safety of mining communities. 展开更多
关键词 Healthcare Associated Infection Infection Prevention and control safety of Mining Community
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Guaranteed Cost Attitude Tracking Control for Uncertain Quadrotor Unmanned Aerial Vehicle Under Safety Constraints
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作者 Qian Ma Peng Jin Frank L.Lewis 《IEEE/CAA Journal of Automatica Sinica》 SCIE EI CSCD 2024年第6期1447-1457,共11页
In this paper,guaranteed cost attitude tracking con-trol for uncertain quadrotor unmanned aerial vehicle(QUAV)under safety constraints is studied.First,an augmented system is constructed by the tracking error system a... In this paper,guaranteed cost attitude tracking con-trol for uncertain quadrotor unmanned aerial vehicle(QUAV)under safety constraints is studied.First,an augmented system is constructed by the tracking error system and reference system.This transformation aims to convert the tracking control prob-lem into a stabilization control problem.Then,control barrier function and disturbance attenuation function are designed to characterize the violations of safety constraints and tolerance of uncertain disturbances,and they are incorporated into the reward function as penalty items.Based on the modified reward function,the problem is simplified as the optimal regulation problem of the nominal augmented system,and a new Hamilton-Jacobi-Bellman equation is developed.Finally,critic-only rein-forcement learning algorithm with a concurrent learning tech-nique is employed to solve the Hamilton-Jacobi-Bellman equa-tion and obtain the optimal controller.The proposed algorithm can not only ensure the reward function within an upper bound in the presence of uncertain disturbances,but also enforce safety constraints.The performance of the algorithm is evaluated by the numerical simulation. 展开更多
关键词 Attitude tracking control quadrotor unmanned aerial vehicle(QUAV) reinforcement learning safety constraints uncertain disturbances.
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Artificial-intelligent-powered safety and efficiency improvement for controlling and scheduling in integrated railway systems
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作者 Jun Liu Gehui Liu +1 位作者 Yu Wang Wanqiu Zhang 《High-Speed Railway》 2024年第3期172-179,共8页
The multi-mode integrated railway system,anchored by the high-speed railway,caters to the diverse travel requirements both within and between cities,offering safe,comfortable,punctual,and eco-friendly transportation s... The multi-mode integrated railway system,anchored by the high-speed railway,caters to the diverse travel requirements both within and between cities,offering safe,comfortable,punctual,and eco-friendly transportation services.With the expansion of the railway networks,enhancing the efficiency and safety of the comprehensive system has become a crucial issue in the advanced development of railway transportation.In light of the prevailing application of artificial intelligence technologies within railway systems,this study leverages large model technology characterized by robust learning capabilities,efficient associative abilities,and linkage analysis to propose an Artificial-intelligent(AI)-powered railway control and dispatching system.This system is elaborately designed with four core functions,including global optimum unattended dispatching,synergetic transportation in multiple modes,high-speed automatic control,and precise maintenance decision and execution.The deployment pathway and essential tasks of the system are further delineated,alongside the challenges and obstacles encountered.The AI-powered system promises a significant enhancement in the operational efficiency and safety of the composite railway system,ensuring a more effective alignment between transportation services and passenger demands. 展开更多
关键词 High-speed railway Multi-mode railway system Artificial intelligence Large-scale mode system framework safety and efficiency improvement
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Efficacy and safety of paclitaxel liposome versus paclitaxel in combination with carboplatin in the first-line chemotherapy for ovarian cancer:a multicenter,open-label,non-inferiority,randomized controlled trial
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作者 Rong Li Hongping Zhang +10 位作者 Qingshui Li Guangwen Yuan Yanjie Zhou Rutie Yin He Wang Chunyan Wang Yi Huang Wei Wang Xiaojian Yan Lingying Wu Qi Zhou 《Journal of the National Cancer Center》 2024年第2期135-141,共7页
Background:The paclitaxel liposome formulation,encapsulating paclitaxel within a phospholipid bilayer,ad-dresses the insolubility of traditional paclitaxel formulations,thereby reducing toxicity without compromising i... Background:The paclitaxel liposome formulation,encapsulating paclitaxel within a phospholipid bilayer,ad-dresses the insolubility of traditional paclitaxel formulations,thereby reducing toxicity without compromising its antitumor efficacy.Methods:This multicenter,open-label,non-inferiority randomized controlled trial(ChiCTR2000038555)evalu-ates the efficacy and safety of paclitaxel liposome in comparison to the standard regimen of paclitaxel combined with carboplatin(PLC vs.PC)as first-line therapy in patients with epithelial ovarian cancer.Results:An analysis of median progression-free survival(PFS)revealed non-inferior outcomes between 263 pa-tients in the PLC group and 260 patients in the PC group(32.3 vs.29.9 months,hazard ratio[HR],0.89[95%CI,0.64−1.25]),using a non-inferior margin of 1.3.Although the overall incidence of treatment-related adverse events was comparable between groups,the PLC group experienced significantly fewer non-hematologic toxicities than those treated with the PC regimen.Conclusion:The findings affirm the non-inferiority of paclitaxel liposome compared to the combination of pa-clitaxel and carboplatin regarding therapeutic efficacy,with an enhanced safety profile marked by reduced non-hematologic toxicities. 展开更多
关键词 Ovarian cancer Paclitaxel liposome First-line chemotherapy Efficacy safety
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Technical Analysis of Safety Monitoring and Evaluation of Existing Bridge Structures
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作者 Jiang Feng Qing Yang 《Journal of World Architecture》 2024年第2期17-24,共8页
Bridge structure safety monitoring and assessment has been a great concern for the government and the public,and bridge structure safety monitoring and assessment technology has also developed rapidly over the years.I... Bridge structure safety monitoring and assessment has been a great concern for the government and the public,and bridge structure safety monitoring and assessment technology has also developed rapidly over the years.Its goal is to equip relevant organizations and professionals with a deep understanding of the principles and practical applications of these technologies.By doing so,it seeks to facilitate the effective implementation of safety monitoring and assessment practices in bridge management.Ultimately,the aim is to foster the constructive development of road and bridge construction and operational management at a broader level. 展开更多
关键词 Bridge structure safety monitoring Defect diagnosis Theoretical modeling method
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Efficacy and safety of C-arm computed tomography-guided microwave ablation with percutaneous osteoplasty for flat bone metastases
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作者 Zhi-Peng Lin Xu-Gong Zou +4 位作者 Da-Bei Huang Yuan Chen Jia-Wen Lin Xiao-Qun Li Jian Zhang 《World Journal of Clinical Oncology》 2025年第3期40-48,共9页
BACKGROUND Flat bone metastases are common in patients with advanced cancers,often resulting in severe pain,limited mobility,and reduced quality of life(QOL).Traditional treatment options,such as radiotherapy or syste... BACKGROUND Flat bone metastases are common in patients with advanced cancers,often resulting in severe pain,limited mobility,and reduced quality of life(QOL).Traditional treatment options,such as radiotherapy or systemic therapies,often fail to provide sufficient pain relief or improve functional outcomes in these patients.Microwave ablation(MWA)offers advantages,such as shorter pro-cedure times and larger ablation zones,while percutaneous osteoplasty(PO)enhances bone stability and prevents pathological fractures.Despite these be-nefits,the combination of these techniques for treating flat bone metastases re-mains underexplored.AIM To evaluate the efficacy and safety of C-arm computed tomography(CT)-guided MWA combined with PO for managing painful flat bone metastases,focusing on pain relief,functional improvement,and QOL enhancement.METHODS A total of 45 patients with refractory moderate-to-severe pain resulting from flat bone metastases who underwent C-arm CT-guided MWA combined with PO between January 2015 and January 2021 were included.The efficacy of the pro-cedure was assessed by changes in the visual analog scale(VAS),Oswestry disability index(ODI),and QOL,as well as the occurrence of complications.Tumor response was evaluated using RECIST v1.1 and mRECIST criteria,with overall response rate(ORR)and disease control rate(DCR)as the primary end-points.RESULTS No serious complications were observed in any of the patients.A significant reduction in VAS and ODI was noted at 1 week,1 month,and 3 months post-procedure.A marked improvement in QOL was observed at all follow-up points.Bone cement extravasation was observed in 10 patients;however,none exhibited significant clinical symptoms.Based on RECIST v1.1,the ORR was 26.7%and the DCR was 88.9%.The mRECIST evaluation revealed a higher ORR of 51.1%and DCR of 88.9%.CONCLUSION C-arm CT-guided MWA with PO provides a dependable and effective strategy for managing flat bone metastases.It demonstrates significant pain relief,improved functional outcomes,and enhanced QOL.This treatment combination also shows promising tumor response rates with a low complication profile. 展开更多
关键词 Microwave ablation Percutaneous osteoplasty Bone metastases EFFICACY safety
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Safety and efficacy of sodium bicarbonate for treating metabolic acidosis in chronic kidney disease:A systematic review and metaanalysis
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作者 Abdul Hannan Siddiqui Fizzah Batool +12 位作者 Shayan Khan Syed Shabbeer Rizvi Saad Usman Huzaifa Jawed Muhammad Hammad Ali Tatheer Zehra Abdul Rafay Adil Masifah Anwar Areeba Hanif Saad Khalid Hassan Mark William Noble Abdul Moeed Salim Surani 《World Journal of Nephrology》 2025年第1期138-148,共11页
BACKGROUND Kidney dysfunction and reduced filtration capacity due to chronic kidney disease(CKD)lead to a shift in the body's acid-base balance,ultimately causing metabolic acidosis(MA).Sodium bicarbonate has been... BACKGROUND Kidney dysfunction and reduced filtration capacity due to chronic kidney disease(CKD)lead to a shift in the body's acid-base balance,ultimately causing metabolic acidosis(MA).Sodium bicarbonate has been used as a supplement to alleviate the symptoms and reverse the acidosis,and it may even slow the progression of CKD.However,its safety profile and overall effectiveness are uncertain.AIM To conduct a systematic review and meta-analysis of clinical trials assessing sodium bicarbonate's safety and efficacy for treating CKD-induced MA.METHODS Medline,Scopus,EMBASE,and Cochrane Central were systematically searched from inception until May 2024 to select all relevant randomized control trials(RCTs)and non-RCT(NRCTs)evaluating the effectiveness of sodium bicarbonate in correcting MA in end-stage renal disease patients.In addition,ClinicalTrials.gov,Medrxiv.org,and Google Scholar were searched for other literature.A random-effects meta-analysis was performed to derive mean differences(MD)and risk ratios(RR)with their 95%CI for continuous and dichotomous outcomes respectively.RESULTS Following a systematic search of the databases,20 RCTs and 2 and NRCTs comprising 2932 patients were included in our study.The results revealed that sodium bicarbonate significantly increased serum bicarbonate in CKD patients(MD:2.59,95%CI:0.95-4.22;P=0.02;I2=95%).However,there was a non-significant increase in estimated glomerular filtration rate(eGFR)in patients on sodium bicarbonate therapy(MD:0.93,95%CI:-1.88-3.75;P=0.52;I2=93%).Upon assessment of the safety profile of sodium bicarbonate,no significant association was found in the outcomes of death/prolonged hospitalization(RR:1.05,95%CI:0.84-1.32;P=0.66;I2=0%),or gastrointestinal disorders(RR:1.64,95%CI:0.35-7.66;P=0.53;I2=76%),or worsening edema(RR:1.26,95%CI:0.94-1.68;P=0.12;I2=37%)when compared to control.CONCLUSION Sodium bicarbonate therapy may halt worsening kidney function by correcting serum bicarbonate levels and treating MA.Although sodium bicarbonate does not significantly improve the eGFR,it may potentially prevent CKD progression while maintaining an overall favorable safety profile. 展开更多
关键词 Chronic kidney disease Metabolic acidosis safety and efficacy Sodium bicarbonate
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Safety and effectiveness of induction chemoimmunotherapy followed by definitive radiotherapy or concurrent chemoradiotherapy in esophageal squamous cell carcinoma
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作者 Zhuo-Jun Wei Lin Wang +4 位作者 Rui-Qi Wang Yu Wang Huan Chen Hong-Lian Ma Yu-Jin Xu 《World Journal of Clinical Oncology》 2025年第3期30-39,共10页
BACKGROUND Esophageal squamous cell carcinoma(ESCC)is a common malignancy in China,often diagnosed at an advanced stage,with poor prognosis.Standard treatments such as definitive chemoradiotherapy offer limited surviv... BACKGROUND Esophageal squamous cell carcinoma(ESCC)is a common malignancy in China,often diagnosed at an advanced stage,with poor prognosis.Standard treatments such as definitive chemoradiotherapy offer limited survival benefits.Recent advances in immune checkpoint inhibitors combined with chemotherapy have shown promise,but their effectiveness and safety in conjunction with radio-therapy for unresectable ESCC require further exploration.AIM To assess the safety and effectiveness of induction chemoimmunotherapy fo-llowed by definitive radiotherapy or concurrent chemoradiotherapy(CCRT)in locally advanced unresectable ESCC.METHODS This retrospective study included 80 patients with locally advanced unresectable ESCC who underwent induction chemoimmunotherapy followed by definitive radiotherapy,recruited from Zhejiang Cancer Hospital.All patients received 2-4 cycles of chemotherapy plus programmed cell death 1/programmed cell death ligand 1 inhibitor,were re-evaluated to be inoperable,then received definitive radiotherapy or CCRT.Primary endpoint was treatment safety and tolerance.SPSS 26.0 software was used for data analysis.Th Kaplan-Meier method was used for survival analysis.RESULTS Thirty-seven(46.3%)patients received CCRT and 43(53.7%)received radiotherapy alone.The most common treatment-related adverse events included radiation esophagitis(32/80,40.0%)and anemia(49/80,61.3%),with 22(27.5%)experiencing grade≥3 adverse events.No treatment-related deaths occurred.After median follow-up of 16.5 months,the median progression-free survival(PFS)was 14.2 months,and median overall survival(OS)was 19.9 months.The 1-year and 2-year PFS and OS were 55.8%and 31.6%,and 67.5%and 44.1%,respectively.Patients with partial response had better outcomes than those with stable disease:1-year PFS 69.4%vs 43.9%(P=0.011)and OS 83.2%vs 48.8%(P=0.007).Induction therapy effectiveness and immunotherapy maintenance were independent prognostic factors for OS.CONCLUSION Chemotherapy combined with programmed cell death 1/programmed cell death ligand 1 inhibitor followed by definitive radiotherapy or CCRT in patients with locally advanced ESCC was safe and effective. 展开更多
关键词 Esophageal squamous cell carcinoma RADIOTHERAPY Immune checkpoint inhibitors CHEMOTHERAPY Patient safety Treatment outcome
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Microwave ablation for liver metastases from colorectal cancer:A comprehensive review of clinical efficacy and safety
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作者 Fang Li Yuan-Yuan Zhang +1 位作者 Ming Li Sheng-Kai Chen 《World Journal of Gastrointestinal Surgery》 2025年第1期32-40,共9页
Microwave ablation(MWA)is emerging as a highly effective treatment for colorectal liver metastases(CRLMs).This review explores the advantages of MWA compared to other ablative techniques such as radiofrequency ablatio... Microwave ablation(MWA)is emerging as a highly effective treatment for colorectal liver metastases(CRLMs).This review explores the advantages of MWA compared to other ablative techniques such as radiofrequency ablation and cryoablation and highlights its clinical efficacy,safety,and technical considerations.MWA offers significant benefits,including higher intratumoral temperatures,larger ablation zones,and reduced susceptibility to the heat-sink effect,which make it particularly suitable for tumors near large blood vessels.This review details the patient selection criteria,procedural approaches,and the use of advanced imaging techniques to improve the precision and effectiveness of MWA.Clinical outcomes indicate that MWA achieves high rates of complete tumor ablation and long-term survival with a favorable safety profile.This review is significant because it provides updated insights into the expanding role of MWA in treating unresectable CRLM and its potential as an alternative to surgical resection for resectable tumors.By summarizing recent studies and clinical trials,this review highlights the comparative effectiveness,safety,and integration with systemic therapies of MWA.In conclusion,MWA is a promising treatment option for CRLM and offers outcomes comparable to or better than those of other ablative techniques.Future research should focus on optimizing technical parameters,integrating MWA with systemic therapies,and conducting large-scale randomized controlled trials to establish standardized treatment protocols.Advancing our understanding of MWA will enhance its application and improve long-term survival and quality of life for patients with CRLM. 展开更多
关键词 Microwave ablation Colorectal liver metastases Thermal ablation techniques Clinical outcomes Tumor ablation safety
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Vibration safety assessment and parameter analysis of buried oil pipelines based on vibration isolation holes under strong surface impact
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作者 Wang Guobo Mei Hua +4 位作者 Wang Jianning He Wei Yin Yao Zhai Yuxin Zuo Pengfei 《Earthquake Engineering and Engineering Vibration》 2025年第1期69-82,共14页
Strong surface impact will produce strong vibration,which will pose a threat to the safety of nearby buried pipelines and other important lifeline projects.Based on the verified numerical method,a comprehensive numeri... Strong surface impact will produce strong vibration,which will pose a threat to the safety of nearby buried pipelines and other important lifeline projects.Based on the verified numerical method,a comprehensive numerical parameter analysis is conducted on the key influencing factors of the vibration isolation hole(VIH),which include hole diameter,hole net spacing,hole depth,hole number,hole arrangement,and soil parameters.The results indicate that a smaller ratio of net spacing to hole diameter,the deeper the hole,the multi-row hole,the hole adoption of staggered arrangements,and better site soil conditions can enhance the efficiency of the VIH barrier.The average maximum vibration reduction efficiency within the vibration isolation area can reach 42.2%.The vibration safety of adjacent oil pipelines during a dynamic compaction projection was evaluated according to existing standards,and the measurement of the VIH was recommended to reduce excessive vibration.The single-row vibration isolation scheme and three-row staggered arrangement with the same hole parameters are suggested according to different cases.The research findings can serve as a reference for the vibration safety analysis,assessment,and control of adjacent underground facilities under the influence of strong surface impact loads. 展开更多
关键词 vibration isolation hole buried oil pipeline strong surface impact vibration velocity vibration safety assessment
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Advances and challenges in peroral endoscopic myotomy:Safety,precision,and post-procedure management
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作者 Grigorios Christodoulidis Kyriaki Tsagkidou +1 位作者 Konstantinos Eleftherios Koumarelas Marina Nektaria Kouliou 《World Journal of Gastroenterology》 2025年第5期1-6,共6页
Peroral endoscopic myotomy(POEM)has revolutionized the treatment of upper gastrointestinal tract motility disorders,particularly achalasia.This editorial explores the efficacy,safety,and challenges of POEM,emphasizing... Peroral endoscopic myotomy(POEM)has revolutionized the treatment of upper gastrointestinal tract motility disorders,particularly achalasia.This editorial explores the efficacy,safety,and challenges of POEM,emphasizing its role as a primary treatment with excellent long-term outcomes and minimal adverse events.The evolution of POEM underscores the need for precision in myotomy techniques and the importance of interdisciplinary collaboration,especially regar-ding anesthetic considerations.Despite significant advances,challenges remain in standardizing safety protocols and managing complications.As POEM appli-cations expand,precision endoscopy continues to enhance therapeutic outcomes,promising a transformative impact on gastrointestinal motility disorder manage-ment. 展开更多
关键词 Peroral endoscopic myotomy Complications after peroral endoscopic myoto-my Procedural safety Interdisciplinary collaboration Adverse events Therapeutic out-comes
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Renal effects and safety of tirzepatide in subjects with and without diabetes:A systematic review and meta-analysis
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作者 ABM Kamrul-Hasan Shinjan Patra +4 位作者 Deep Dutta Lakshmi Nagendra AFM Muntahi-Reza Sanja Borozan Joseph M Pappachan 《World Journal of Diabetes》 2025年第2期270-283,共14页
BACKGROUND Type 2 diabetes(T2D),as well as obesity,are risk factors for chronic kidney disease(CKD)and end-stage renal disease.The renal impacts of glucose-lowering and weight-lowering drugs and their potential benefi... BACKGROUND Type 2 diabetes(T2D),as well as obesity,are risk factors for chronic kidney disease(CKD)and end-stage renal disease.The renal impacts of glucose-lowering and weight-lowering drugs and their potential benefits in preventing CKD often guide clinicians in choosing them appropriately.Only limited data based on randomized controlled trials(RCTs)is currently available on the renal effects and safety profile of tirzepatide.AIM To explore the renal benefits and safety of tirzepatide vs controls.METHODS RCTs involving patients receiving tirzepatide for any indication in the intervention arm and placebo or active comparator in the control arm were searched through multiple electronic databases.The co-primary outcomes were percent change from baseline(CFB)in urine albumin-to-creatinine ratio(UACR)and absolute CFB in estimated glomerular filtration rate(eGFR;in mL/min/1.73 m^(2));the secondary outcome was tirzepatide’s renal safety profile.RevMan web was used to conduct meta-analysis using random-effects models.Outcomes were presented as mean differences(MD)or risk ratios with 95%confidence intervals.RESULTS Fifteen RCTs(n=14471)with mostly low risk of bias(RoB)were included.Over 26-72 weeks,tirzepatide 10 mg[MD-26.95%(-40.13,-13.76),P<0.0001]and 15 mg[MD-18.03%(-28.58,-7.47),P=0.0008]were superior to placebo in percent reductions of UACR.Tirzepatide,at all doses,outperformed insulin in percent reductions of UACR.Compared to the placebo,the percent UACR reduction was greater in subjects with T2D than those with obesity but without T2D(MD-33.25%vs-7.93%;P=0.001).The CFB in eGFR with all doses of tirzepatide was comparable[5 mg:MD 0.36(-1.41,2.14);10 mg:MD 1.17(-0.22,2.56);15 mg:MD 1.42(-0.04,2.88)];P>0.05 for all vs insulin.Tirzepatide(pooled and separate doses)did not increase the risks of adverse renal events,urinary tract infection,nephrolithiasis,acute kidney injury,and renal cancer compared to the placebo,insulin,and glucagon-like peptide-1 receptor agonists.CONCLUSION Short-term data from RCTs with low RoB suggests that tirzepatide positively impacts UACR without detrimental effects on eGFR in subjects with T2D and obesity without T2D,with a reassuring renal safety profile.Larger RCTs are warranted to prove the longer-term renal benefits of tirzepatide,which might also prevent eGFR decline and worsening of CKD. 展开更多
关键词 Tirzepatide Type 2 diabetes Obesity Urine albumin creatinine ratio Estimated glomerular filtration rate Renal safety Acute kidney injury Chronic kidney disease
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Rapid post-earthquake safety assessment of low-rise reinforced concrete structures
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作者 Koji Tsuchimoto Yasutaka Narazaki Billie F.Spencer,Jr. 《Earthquake Engineering and Engineering Vibration》 2025年第1期101-112,共12页
Many countries throughout the world have experienced large earthquakes,which cause building damage or collapse.After such earthquakes,structures must be inspected rapidly to judge whether they are safe to reoccupy.To ... Many countries throughout the world have experienced large earthquakes,which cause building damage or collapse.After such earthquakes,structures must be inspected rapidly to judge whether they are safe to reoccupy.To facilitate the inspection process,the authors previously developed a rapid building safety assessment system using sparse acceleration measurements for steel framed buildings.The proposed system modeled nonlinearity in the measurement data using a calibrated simplified lumped-mass model and convolutional neural networks(CNNs),based on which the buildinglevel damage index was estimated rapidly after earthquakes.The proposed system was validated for a nonlinear 3D numerical model of a five-story steel building,and later for a large-scale specimen of an 18-story building in Japan tested on the E-Defense shaking table.However,the applicability of the safety assessment system for reinforced concrete(RC)structures with complex hysteretic material nonlinearity has yet to be explored;the previous approach based on a simplified lumpedmass model with a Bouc-Wen hysteretic model does not accurately represent the inherent nonlinear behavior and resulting damage states of RC structures.This study extends the rapid building safety assessment system to low-rise RC moment resisting frame structures representing typical residential apartments in Japan.First,a safety classification for RC structures based on a damage index consistent with the current state of practice is defined.Then,a 3D nonlinear numerical model of a two-story moment frame structure is created.A simplified lumped-mass nonlinear model is developed and calibrated using the 3D model,incorporating the Takeda degradation model for the RC material nonlinearity.This model is used to simulate the seismic response and associated damage sensitive features(DSF)for random ground motion.The resulting database of responses is used to train a convolutional neural network(CNN)that performs rapid safety assessment.The developed system is validated using the 3D nonlinear analysis model subjected to historical earthquakes.The results indicate the applicability of the proposed system for RC structures following seismic events. 展开更多
关键词 rapid post-earthquake safety assessment ACCELERATION interstory drift angle damage sensitive feature convolutional neural network RC structure simplified non-linear analysis model Takeda degradation model
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Research Advance on Absorption Law of Cadmium by Rice and Safety Control Technology of Cadmium in Rice Grain 被引量:6
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作者 陈群芳 叶瑶瑶 +3 位作者 徐青 范克关 王飞娟 朱诚 《Agricultural Science & Technology》 CAS 2014年第10期1801-1804,共4页
Heavy metal pol ution, especial y cadmium pol ution, has threatened the safety production of rice. The research advance on law of absorption, distribution and accumulation of cadmium in rice and on recent safety contr... Heavy metal pol ution, especial y cadmium pol ution, has threatened the safety production of rice. The research advance on law of absorption, distribution and accumulation of cadmium in rice and on recent safety control technology of cadmium in rice grain was summarized in this paper. We hoped to lay a foundation for the safety production of rice. 展开更多
关键词 RICE CADMIUM Low accumulation safety control technology
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Genetic Regression Model for Dam Safety Monitoring 被引量:2
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作者 马震岳 陈维江 董毓新 《Transactions of Tianjin University》 EI CAS 2002年第3期196-199,共4页
Under-fitting problems usually occur in regression models for dam safety monitoring.To overcome the local convergence of the regression, a genetic algorithm (GA) was proposed using a real parameter coding, a ranking s... Under-fitting problems usually occur in regression models for dam safety monitoring.To overcome the local convergence of the regression, a genetic algorithm (GA) was proposed using a real parameter coding, a ranking selection operator, an arithmetical crossover operator and a uniform mutation operator, and calculated the least-square error of the observed and computed values as its fitness function. The elitist strategy was used to improve the speed of the convergence. After that, the modified genetic algorithm was applied to reassess the coefficients of the regression model and a genetic regression model was set up. As an example, a slotted gravity dam in the Northeast of China was introduced. The computational results show that the genetic regression model can solve the under-fitting problems perfectly. 展开更多
关键词 dam safety monitoring under-fitting genetic regression model
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Research on Technological Support System of Control and Management of Rural Tourism Safety
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作者 高玲 《Journal of Landscape Research》 2011年第8期91-95,共5页
As the sources of overt and covert potential safety hazards were widespread, the safety control and management of rural tourism became more complicated and difficult, which required more for technological support of r... As the sources of overt and covert potential safety hazards were widespread, the safety control and management of rural tourism became more complicated and difficult, which required more for technological support of rural tourism safety management. Based on the latitude of technological support, from the perspective of management practice of rural tourism safety, through analysis on inner symbiosis of management and technological support of rural tourism safety, the paper had studied three parts of control and management system of rural tourism safety, which were rural tourism safety identification, rural tourism safety isolation and control, and rural tourism safety treatment and solution; and the connotation of technological support during safety management had been discussed from the three aspects. It hoped to serve as reference for tourism safety management and control, so as to promote healthy, stable and sustainable development of tourism. 展开更多
关键词 RURAL TOURISM safety control and MANAGEMENT TECHNOLOGICAL SUPPORT system
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A holistic strategy for quality and safety control of traditional Chinese medicines by the “iVarious” standard system 被引量:17
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作者 Anzhen Chen Lei Sun +3 位作者 Hang Yuan Aiying Wu Jingguang Lu Shuangcheng Ma 《Journal of Pharmaceutical Analysis》 SCIE CAS CSCD 2017年第5期271-279,共9页
An effective quality control system is the key to ensuring the quality, safety and efficacy of traditional Chinese medicines(TCMs). However, the current quality standard research lacks top-level design and systematic ... An effective quality control system is the key to ensuring the quality, safety and efficacy of traditional Chinese medicines(TCMs). However, the current quality standard research lacks top-level design and systematic design,mostly based on specific technologies or evaluation methods. To resolve the challenges and questions of quality control of TCMs, a brand-new quality standard system, named "iVarious", was proposed. The system comprises eight elements in a modular format. Meaning of every element was specifically illustrated via corresponding research instances. Furthermore, frankincense study was taken as an example for demonstrating standards and research process, based on the "i Various" system. This system highlighted a holistic strategy for effectiveness,security, integrity and systematization of quality and safety control standards of TCMs. The establishment of"i Various" integrates multi-disciplinary technologies and progressive methods, basis elements and key points of standard construction. The system provides a novel idea and technological demonstration for regulation establishment of TCMs quality standards. 展开更多
关键词 iVarious QUALITY standard system TRADITIONAL CHINESE MEDICINES (TCMs) QUALITY and safety control HOLISTIC STRATEGY
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Food safety controls in different governance structures in China's vegetable and fruit industry 被引量:13
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作者 ZHOU Jie-hong LI Kai LIANG Qiao 《Journal of Integrative Agriculture》 SCIE CAS CSCD 2015年第11期2189-2202,共14页
Food safety issues constitute an international topic discussed by many scholars. Although there is an extensive body of literature on comparisons of food safety control practices across different governance structures... Food safety issues constitute an international topic discussed by many scholars. Although there is an extensive body of literature on comparisons of food safety control practices across different governance structures, these studies have been conducted mainly in terms of qualitative and descriptive analysis. In addition, little attention has been given to family farms. This study addresses the food safety control practices adopted by firms with different governance structures in China. Food safety control is expressed by the following aspects, i.e., pollution-free, green, organic, and/or geographical indication prod- ucts certification, establishment of production records, and pesticide residue testing. Three types of governance structures that engage in agricultural production are distinguished: farmer cooperatives, agricultural companies, and family farms. The food safety control practices of various governance structures are investigated based on a database that comprises 600 vegetable and fruit enterprises in Zhejiang, China. The results show that (1) pesticide residue testing is adopted by the most firms, followed by products certification, and production records are adopted by the fewest firms, and (2) agricul- tural companies adopt more food safety control practices than family farms, while farmer cooperatives adopt the fewest food safety control practices. Governance structure features of a cooperative in terms of ownership, decision-making, and income distribution are the main reasons for the low level of food safety control in the cooperative. 展开更多
关键词 food safety control governance structure farmer cooperative agricultural company family farm
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