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How Infant Mortality Was Reduced in the Early Twentieth Century in Osaka 被引量:1
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作者 Emiko Higami Ken'ichi Tomob 《Sociology Study》 2014年第5期446-460,共15页
In 1983, the Vice Secretary-General of United Nations Children's Fund (UNICEF), Karl Knutsson, visited Japan and remarked that the method of reducing the Japanese infant mortality rate (IMR) was a model for every... In 1983, the Vice Secretary-General of United Nations Children's Fund (UNICEF), Karl Knutsson, visited Japan and remarked that the method of reducing the Japanese infant mortality rate (IMR) was a model for every country. In the early twentieth century, Osaka and at the time of UNICEF's plan in the 1980s, diarrhea was the cause of most babies' deaths, so we consider infant nutrition to be the central issue. The average IMR was 155.4 in rural areas in Japan, and IMR in Osaka city was 231.6 during 1906 to 1910. IMR in Osaka city might have been influenced by somewhat negative urban factors, which we can call the "urban penalty". Dr. Hiroshi Maruyama discovered the a-index in 1938. The a-index represents infant mortality number divided by neonatal mortality number. After all, Maruyama set one month after birth as a boundary to divide endogenous and exogenous. The a-index shows a qualitative measure of infant mortality. Post neonatal mortality was increased due to acquired diseases such as diarrhea, pneumonia, and beriberi. This shows that the effect of the urban penalty was raising the a-index. The a-index of the industrial zones shows that bad maternal conditions affected endogenous factors. Most mothers suffered from a deficiency of breast-feeding capability. 展开更多
关键词 Infant mortality rate (IMR) BREAST-FEEDING a-index IMR from diarrhea visiting nurses
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Effect of Ca addition on the microstructure and the mechanical properties of asymmetric double-sided friction stir welded AZ61 magnesium alloy 被引量:10
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作者 Mengran Zhou Yoshiaki Morisada Hidetoshi Fujii 《Journal of Magnesium and Alloys》 SCIE 2020年第1期91-102,共12页
The effects of 2%Ca addition on the microstructure and the mechanical properties of the asymmetric double-sided friction stir welded magnesium alloy AZ61 were investigated.Compared to the Ca-free AZ61magnesium alloy,t... The effects of 2%Ca addition on the microstructure and the mechanical properties of the asymmetric double-sided friction stir welded magnesium alloy AZ61 were investigated.Compared to the Ca-free AZ61magnesium alloy,the addition of 2%Ca significantly refines the grains in the stir zone after welding.Due to the existence of thermally stable Al2Ca particles,there is no noticeable change in the grain size in the stir zone regardless of the welding heat input.The electron backscattered diffraction analysis at the center of the stir zone confirmed the significant deterioration of the(0001)texture strength from the addition of 2%Ca.The tensile test of the joint suggested that the addition of 2%Ca provides stable tensile properties to the joint regardless of the welding parameters.The critical(0001)texture strength that determines the ultimate tensile strength decreased from 20 to 15 by the Ca addition.The addition of Ca enhanced the deterioration of the plastic elongation when the(0001)texture strength increased. 展开更多
关键词 Mg alloy Friction stir welding MICROSTRUCTURE Mechanical properties TEXTURE
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Inhibition of IRF3-dependent antiviral responses by cellular and viral proteins 被引量:3
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作者 Tetsuo Tsuchida Faro Kawai Shizuo Akira 《Cell Research》 SCIE CAS CSCD 2009年第1期3-4,共2页
The host evokes innate immune responses to eliminate viruses by detecting the presence of infection. Host cells respond to nucleic acids derived from infected viruses to produce cytokines known as type I interferons ... The host evokes innate immune responses to eliminate viruses by detecting the presence of infection. Host cells respond to nucleic acids derived from infected viruses to produce cytokines known as type I interferons (IFNβ and multiple IFNα), which are the most important cytokines for host defense against viral infection. Type I interferons induce the synthesis of hundreds of IFN-inducible genes (ISG) that influence protein synthesis, growth arrest and cell death to induce the antiviral state as well as enhance dendritic cell maturation, natural killer cell activation, 展开更多
关键词 核酸 病毒感染 先天免疫能力 干扰素 蛋白质
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Mold Filling and Prevention of Gas Entrapment in High-pressure Die-casting 被引量:1
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作者 Itsuo Ohnaka Akira Sugiyama +1 位作者 Takashi Ikeda Hideyuki Yasuda 《Journal of Materials Science & Technology》 SCIE EI CAS CSCD 2008年第1期139-140,共2页
This paper presents some results of direct observation of mold filling in a specially designed die-casting by X-ray diffraction, including comparison with numerical simulation. Based on such work the authors discuss h... This paper presents some results of direct observation of mold filling in a specially designed die-casting by X-ray diffraction, including comparison with numerical simulation. Based on such work the authors discuss how to prevent gas entrapment and propose new methods. 展开更多
关键词 Direct observation Mold filling High-pressure die-casting Computer simulation Gas entrapment
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Ultrasonic echo signal fetures of dissimilar material bonding joints 被引量:2
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作者 刚铁 Yasuo TAKAHASHI 《中国有色金属学会会刊:英文版》 CSCD 2004年第6期1050-1054,共5页
An ultrasonic evaluation method of echo feature of diffusion bond joint between two dissimilar materials is presented. The echo signal was acquired by an automatic ultrasonic C-scan test system. It is found that the i... An ultrasonic evaluation method of echo feature of diffusion bond joint between two dissimilar materials is presented. The echo signal was acquired by an automatic ultrasonic C-scan test system. It is found that the intensity of echo and its phase can be used to evaluate the joint quality, and interface products of dissimilar materials bonding can be evaluated by ultrasonic method. 展开更多
关键词 超声波测试 异金属 扩散结合 非破坏性演化
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X(1835): A Possible Baryonium? 被引量:2
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作者 ZHU Shi-Lin GAO Chong-Shou 《Communications in Theoretical Physics》 SCIE CAS CSCD 2006年第2X期291-293,共3页
We point out that the large pp^- coupling of X(1835) and the suppression of the three-body strange final states strongly indicate that X(1835) may be a pp^- baryonium. We also point out that the branching ratio o... We point out that the large pp^- coupling of X(1835) and the suppression of the three-body strange final states strongly indicate that X(1835) may be a pp^- baryonium. We also point out that the branching ratio of X(1835) →ηππ should be bigger than that of X(1835) →η′ππ. We suggest BES search X(1835) in the ηππ channel Finally, X(1835) may be used a tetraquark generator if X(1835) is really established as a baryonium state. 展开更多
关键词 baryonium new hadron states
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二垩英与资源回收-Ⅱ燃烧过程二垩英抑制和生成基础研究
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作者 Hirotoshi KAWABATA Tateo USUI Shigeta HARA Toshihiro TANAKA Hideki ONO-NAKAZATO Mashayuki TANABE Katsukiyo MARUKAWA 《钢铁》 CAS CSCD 北大核心 2003年第z1期76-78,共3页
氯来源、种类和燃烧物中氯浓度对燃烧过程中二垩英生成有重要影响.在实验燃烧炉中研究1 073K温度下上述三种因素对燃烧过程二垩英生成的影响.二垩英生成浓度在相同氯源和种类条件下与燃烧物中氯含量几乎成正比,且受氯源明显影响.如有机... 氯来源、种类和燃烧物中氯浓度对燃烧过程中二垩英生成有重要影响.在实验燃烧炉中研究1 073K温度下上述三种因素对燃烧过程二垩英生成的影响.二垩英生成浓度在相同氯源和种类条件下与燃烧物中氯含量几乎成正比,且受氯源明显影响.如有机氯化合物或无机氯化物.即使对无机氯化物,在有活性氯存在时也会生成高浓度二垩英,如由盐和面粉形成的水化物中的活性氯. 展开更多
关键词 氯源 氯种类 燃烧过程 二垩英/呋喃 水化物 PVC
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二垩英与资源回收-Ⅰ考虑到二垩英生成的资源与能量回收基础研究
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作者 Katsukiyo MARUKAWA Shigeta HARA Hirotoshi KAWABATA Hideki ONO-NAKAZATO Tateo USUI Toshihiro TANAKA Hongzhi SHI 《钢铁》 CAS CSCD 北大核心 2003年第z1期73-75,共3页
目前在日本,存在大量工业垃圾,包括各种塑料制品,ASR(汽车破碎垃圾),含有毒PCB(多氯联苯)的110变压器和PVC(聚氯乙稀)制品等.而来自城市垃圾焚烧炉的废气含有大量能量.因此,在充分考虑环境、避免二垩英生成的同时,安全回收来自工业垃圾... 目前在日本,存在大量工业垃圾,包括各种塑料制品,ASR(汽车破碎垃圾),含有毒PCB(多氯联苯)的110变压器和PVC(聚氯乙稀)制品等.而来自城市垃圾焚烧炉的废气含有大量能量.因此,在充分考虑环境、避免二垩英生成的同时,安全回收来自工业垃圾、城市和/或工业垃圾焚烧炉的资源和能量是个非常重要的课题,这也将对抑制CO2排放作出贡献.正确地阐明焚烧过程中二垩英的生成机理及详细研究含少量二垩英的焚烧废气在冷却过程中大量形成二垩英的临界温度是项很重要的工作.解决这个问题可有效实现资源和能量的回收.本报告介绍日本在二垩英排放方面目前采取的对策和存在的问题以及大阪大学为阻止二垩英生成所做的基础研究工作. 展开更多
关键词 焚烧过程 工业垃圾和废钢 二垩英生成机理 资助和能量回收 抑制二垩英生成
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二垩英与资源回收-Ⅲ燃烧过程二垩英生成热力学计算
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作者 Hideki Ono-Nakazato Hirotoshi Kawabata Tateo Usui Shigeta Hara Toshihiro Tanaka Mashayuki Tanabe Katsukiyo Marukawa 《钢铁》 CAS CSCD 北大核心 2003年第z1期79-81,共3页
进行相关热力学计算以研究高温燃烧过程二垩英生成的条件.计算得到:①在体系存在过剩氧即完全燃烧时不会产生二垩英;②当有固体碳沉积时也不会生成二垩英,因固体碳在热力学上比含二垩英的含碳物更稳定.另一方面,实际上即使在1 073 K完... 进行相关热力学计算以研究高温燃烧过程二垩英生成的条件.计算得到:①在体系存在过剩氧即完全燃烧时不会产生二垩英;②当有固体碳沉积时也不会生成二垩英,因固体碳在热力学上比含二垩英的含碳物更稳定.另一方面,实际上即使在1 073 K完全燃烧条件下(即体系显著过剩氧)也有二垩英生成,原因是在实际燃烧炉中含碳微粒不可能完全烧尽.从热力学角度假设不发生碳沉积,计算得出二垩英在1 073 K高温和高CO/CO2比范围内会生成.实际考虑的条件放在燃烧炉内含碳微粒的周围.在有含碳微粒存在条件下,即使反应2CO→C+CO2(碳沉积)发生,C+CO2→2CO反应(CO生成;含碳微粒被CO2氧化)也会同时发生,导致在含碳微粒周围保持一个高的CO/CO2比,由此产生二垩英.假设在含碳微粒周围存在高CO/CO2比的异质位置,则认为二垩英会形成. 展开更多
关键词 燃烧过程 二垩英生成 含碳微粒 热力学
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Comparative evaluation of processes for heavy metal removal from municipal solid waste incineration fly ash
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作者 Masafumi Tateda Michihiko Ike Masanori Fujita 《Journal of Environmental Sciences》 SCIE EI CAS CSCD 1998年第4期75-82,共8页
Hydrochloric acid leaching, chloride evaporation, acetic acid leaching, and biological leaching were evaluated and compared as processes of heavy metal removal for municipal solid waste incineration fly ash(MSWFA). ... Hydrochloric acid leaching, chloride evaporation, acetic acid leaching, and biological leaching were evaluated and compared as processes of heavy metal removal for municipal solid waste incineration fly ash(MSWFA). Six factors, namely, energy consumption, process efficiency, process handling, process cost estimation, cost reduction potential, and study progress, were used in order to find out their advantages and disadvantages and to help develop a better recovery process of heavy metals from MSWFA in terms of treatment of the waste material. Hydrochloric acid leaching process was found to be most balanced among the evaluated processes. It showed superiority on energy consumption, process cost estimation, and study progress. On the other hand, despite of its excellency in process efficiency, chloride evaporation process was most unfavorable mainly due to heavy energy dependence. Biological process, with huge potential of cost reduction, was concluded to be the second best process. 展开更多
关键词 municipal solid waste incineration fly ash heavy metal removal process process evaluation.
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Research on welding simulation methods and software development
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作者 Hidekazu Murakawa Ninshu Ma 《China Welding》 EI CAS 2014年第1期19-26,共8页
To develop highly efficient and useful software, we need to understand the essential feature of the welding phenomenon. From the mechanical point view, welding is a transient nonlinear problem in which small but stron... To develop highly efficient and useful software, we need to understand the essential feature of the welding phenomenon. From the mechanical point view, welding is a transient nonlinear problem in which small but strongly nonlinear region is moving with the welding torch. Noting this characteristic, ISM (Iterative Substructure Method) was developed for the thermal-elastic-plastic analysis of large scale structures. It is also known that the welding distortion and the residual stress are produced by inherent strain. The inherent strain is the sum of irreversible strains such as plastic strain due to welding thermal cycles or phase transformation and creep strain. In addition to the inherent strain, the mismatch produced by cutting error and fitting is also an important cause of the welding distortions and residual stresses. Based on this understanding, an elastic FEM introducing the inherent strain and mismatch is developed. The potential capabilities of these methods are demonstrated through some examples. 展开更多
关键词 WELDING DISTORTION residual stress FEM large structure practical method
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Investigation of air pollution concentration in Kathmandu valley during winter season
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作者 KONDO Akira KAGA Akikazu +4 位作者 IMAMURA Kiyoshi INOUE Yoshio SUGISAWA Masahiko SHRESTHA Manohar Lal SAPKOTA Balkrishan 《Journal of Environmental Sciences》 SCIE EI CAS CSCD 2005年第6期1008-1013,共6页
The monthly concentrations of NO2, NOx, SO2 and O3 measured by a passive sampler from February 2003 to January 2004 showed that the air pollution during the winter season in Kathmandu valley was higher than the summer... The monthly concentrations of NO2, NOx, SO2 and O3 measured by a passive sampler from February 2003 to January 2004 showed that the air pollution during the winter season in Kathmandu valley was higher than the summer season. The O3 level was found the highest during April, May and June due to strong radiation. The hourly concentrations of NO2, NOx, O3 and suspended particulate matter(SPM) were also measured by automatic instruments on December 2003. Temperature at the height of 60 m and 400 m at Raniban Mountain in the northwest of Kathmandu valley was measured on February 2001 in the winter season and the average potential temperature gradient was estimated from observed temperature. Wind speed was also measured at the department of hydrology, airport section, from 18 February to 6 March 2001. It was found that the stable layer and the calm condition in the atmosphere strongly affected the appearance of the maximum concentrations of NO2 and SPM in the morning, and that the unstable layer and the windy condition in the atmosphere was considerably relevant to the decrease of air pollution concentrations at daytime. The emission amounts of NOx, HCs and total suspended particle(TSP) from transport sector in 2003 were estimated from the increasing rate of vehicles on the basis of the emission amounts in 1993 to be 3751 t/a, 30570 t/a and 1317 t/a, respectively. The diurnal concentrations in 2003 calculated by the two-layers box model reproduced the characteristics of air pollution in Kathmandu valley such as the maximum value of O3 and its time, the maximum value of NO in the morning, and the decrease of NO and NO2 at daytime. The comparison with the concentrations in 1993 calculated suggested that the main cause of air pollution was the emission from transport sector. 展开更多
关键词 air pollution concentration Kathmandu vallay box model
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Coagulation and ablation of biological soft tissue byquantum cascade laser with peak wavelength of 5.7μm
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作者 Keisuke Hashimura Katsunori Ishii +3 位作者 Naota Akikusa Tadataka Edamura Harumasa Yoshida Kunio Awazu 《Journal of Innovative Optical Health Sciences》 SCIE EI CAS 2014年第3期115-123,共9页
Molecules such as water,proteins and lipids that are contained in biological tissue absorb mid-infrared(MR)light,which allows such light to be used in laser surgical treatment.Esters,amides and water exhibit strong ab... Molecules such as water,proteins and lipids that are contained in biological tissue absorb mid-infrared(MR)light,which allows such light to be used in laser surgical treatment.Esters,amides and water exhibit strong absorption bands in the 5-7μm wavelength range,but at present there are no lasers in clinical use that can emit in this range.Therefore,the present study focused on thequantum cascade laser(QCL),which is a new type of semiconductor laser that can emit at MIRwavelengths and has recentiy achieved high output power.A high-power QCL with a peakwavelength of 5.7μm was evaluated for use as a laser scalpel for ablating biological soft tissue.The interaction of the laser beam with chicken breast tissue was compared to a conventional CO_(2) laser,based on surface and cross-sectional images.The QCL was found to have sufficient power to ablate soft tissue,and its coagulation,carbonization and ablation effects were similar to those forthe CO_(2) laser.The QCL also induced comparable photothermal effects because it acted as apseudo-continuous wave laser due to its low peak power.A QCL can therefore be used as an effective laser scalpel,and also offers the possibility of less invasive treatment by targeting specificabsorption bands in t he MIR region. 展开更多
关键词 Quantum cascade laser mid-infrared wavelength CO laser biological soft tissue laser-tissue interaction.
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PRECIPITATION OF S'PHASE IN AN 8090 Al-Li ALLOY
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作者 Zheng Ziqiao Hori S. 《Transactions of Nonferrous Metals Society of China》 SCIE EI CAS CSCD 1992年第3期77-82,共6页
The precipitation of S'phase in an 8090 Al-Li alloy under various aging conditions was investigated by transmission electron microscopy.The results show that a small quantity of S'precipitates precipitated on ... The precipitation of S'phase in an 8090 Al-Li alloy under various aging conditions was investigated by transmission electron microscopy.The results show that a small quantity of S'precipitates precipitated on the grain and subgrain boundaries for the specimens aged to peak hardness during single aging.Cold working prior to aging promoted the widespread precipitation of S'phase because of increasing dislocation density.In natural aging the vacancies bound by Li atoms were released and formed dislocation loops.S'precipitates preferentially nucleated and grew on the dislocation loops. 展开更多
关键词 Al-Lialloys S'phase aging precipitation
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Exploring factors that motivate nursing students to engage in skills practice in a laboratory setting:A descriptive qualitative design
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作者 Yoko Nakayoshi Miyuki Takase +4 位作者 Mayumi Niitani Takiko Imai Mari Okada Kumiko Yamamoto Yuri Takei 《International Journal of Nursing Sciences》 CSCD 2021年第1期79-86,I0006,共9页
Objectives:The aim of this study was to explore factors that motivate students to engage in skills practice in a laboratory setting,and to identify their motivation types and the regulatory styles.Methods:Semi-structu... Objectives:The aim of this study was to explore factors that motivate students to engage in skills practice in a laboratory setting,and to identify their motivation types and the regulatory styles.Methods:Semi-structured interviews were conducted with 23 nursing students from three universities between November 2017 and January 2018.A thematic analysis was used to identify factors associated with students’motivation to engage in skills practice in a laboratory.The types and the regulatory styles of student motivation were identified based on the self-determination theory.Results:Seven motivating factors were identified.These factors included the students’desire“to acquire the skills necessary to work as a nurse”,the“desire to improve skills in preparation for clinical practicum”,and their felt“obligations to patients as a nurse”.Moreover,“the impetus to study arising from the objective evaluation of oneself and others”and“wanting to pass the skills examination”motivated the students to engage in skills practice.A“learning environment that facilitates students’learning”and the“supportive involvement of educators”facilitated their learning.Based on the self-determination theory,the students were found to embrace extrinsic motivation with four regulatory styles of motivation,namely integrated,identified,introjected,and external regulation.Conclusions:Nurse educators should understand the motivating factors of students,and help students embrace a more internally controlled motivation by helping them envision their future careers as nurses,and by fostering their ethical duty to care for patients. 展开更多
关键词 LABORATORIES Learning Motivation Nursing students Clinical competence
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2- 8 Confirmation of Astrophysically Important 6.15 MeV, 1- State in 18Ne via Resonant Scattering of 17F+p
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作者 Hu Jun He Jianjun +14 位作者 Xu Shiwei H. Yamaguchi Ma Peng D. Kahl Su Jun Wang Hongwei T. Nakao Y. Wakabayashi J. Y. Moon T. Teranishi H. S. Jung T. Hashimoto A. Chen D.Irvines S. Kubono 《IMP & HIRFL Annual Report》 2013年第1期43-44,共2页
关键词 英语 阅读 理解 物理研究
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An interactive approach to investigate brightness perception of daylighting in Immersive Virtual Environments:Comparing subjective responses and quantitative metrics 被引量:4
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作者 Muhammad Hegazy Kensuke Yasufuku Hirokazu Abe 《Building Simulation》 SCIE EI CSCD 2022年第1期41-68,共28页
Daylighting plays an eminent role in the performance of indoor environments and their occupants,thus necessitating the need to investigate daylight perception of potential occupants at early design stages.The present ... Daylighting plays an eminent role in the performance of indoor environments and their occupants,thus necessitating the need to investigate daylight perception of potential occupants at early design stages.The present study introduces an interactive approach to collect and visualize brightness perception of daylighting in a large-scale immersive virtual environment using a game engine as a daylight simulation tool.The developed system allows users to explore building models freely at different day times set in virtual reality and report their perceptions in real time.Following a validation study(N=36)to investigate the consistency of brightness perceptions in a real environment and its virtual replica,a set of 24 participants were recruited to use the system to report their brightness perception in a virtual model of a daylit art museum,through snapshotting the scenes where they perceive as one of the following in terms of daylighting:(very dark,dark,bright,or very bright).Using an output of 419 snapshots,a"Perceptual Light Map"(PLM)was developed to visualize the collective brightness perception of participants as a heat map.Subjective responses were found to be positively correlated with four daylight metrics,with the highest correlation to mean luminance and the lowest to luminance ratio.The findings of this exploratory study represent a step towards a user-oriented supplement tool to the existing quantitative daylight metrics,validating game engines’adequacy as a daylight simulation tool,and illustrating the potentials of immersion and interaction principles for the perception of daylit spaces in virtual reality. 展开更多
关键词 immersive virtual environment DAYLIGHTING game engine human perception mean luminance
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The roles of activated protein C in experimental trauma models 被引量:2
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作者 Satoshi Gando Toshihiko Mayumi Tomohiko Ukai 《Chinese Journal of Traumatology》 CAS CSCD 2018年第6期311-315,共5页
Trauma-induced coagulopathy is classified into primary and secondary coagulopathy, with the former elicited by trauma and traumatic shock itself and the latter being acquired coagulopathy induced by anemia, hypothermi... Trauma-induced coagulopathy is classified into primary and secondary coagulopathy, with the former elicited by trauma and traumatic shock itself and the latter being acquired coagulopathy induced by anemia, hypothermia, acidosis, and dilution. Primary coagulopathy consists of disseminated intravascular coagulation and acute coagulopathy of trauma shock (ACOTS). The pathophysiology of ACOTS is the suppression of thrombin generation and neutralization of plasminogen activator inhibitor-1 mediated by activated protein C that leads to hypocoagulation and hyperfibrinolysis in the circulation. This review tried to clarify the validity of activated protein C hypothesis that constitutes the main pathophysiology of the ACOTS in experimental trauma models. 展开更多
关键词 Activated protein C COAGULOPATHY DISSEMINATED INTRAVASCULAR COAGULATION THROMBIN TRAUMA
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Survey of optimal motion planning 被引量:6
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作者 Yajue Yang Jia Pan Weiwei Wan 《IET Cyber-Systems and Robotics》 EI 2019年第1期13-19,共7页
Optimal motion planning becomes more and more important these days and is critical for motion planning algorithms developed in the academia to be applicable to real-world applications.The objective of this article is ... Optimal motion planning becomes more and more important these days and is critical for motion planning algorithms developed in the academia to be applicable to real-world applications.The objective of this article is to survey the current state-of-the-art on optimal motion planning algorithms in terms of their three main components:the decision variables and problem formulation,constraints,and objectives.A selection of proposed techniques is reviewed along with a discussion of their effectiveness and limitations.The side-by-side comparison presented in this survey helps to gain insight into the strengths and limitations of the reviewed approaches and assists with system-level design choices. 展开更多
关键词 LIMITATIONS PLANNING INSIGHT
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A Nomogram for Predicting the Likelihood of Obstructive Sleep Apnea to Reduce the Unnecessary Polysomnography Examinations 被引量:5
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作者 Miao Luo Hai-Yan Zheng +5 位作者 Ying Zhang Yuan Feng Dan-Qing Li Xiao-Lin Li Jian-Fang Han Tao-Ping Li 《Chinese Medical Journal》 SCIE CAS CSCD 2015年第16期2134-2140,共7页
Background:The currently available polysomnography (PSG) equipments and operating personnel are facing increasing pressure,such situation may result in the problem that a large number of obstructive sleep apnea (... Background:The currently available polysomnography (PSG) equipments and operating personnel are facing increasing pressure,such situation may result in the problem that a large number of obstructive sleep apnea (OSA) patients cannot receive timely diagnosis and treatment,we sought to develop a nomogram quantifying the risk of OSA for a better decision of using PSG,based on the clinical syndromes and the demographic and anthropometric characteristics.Methods:The nomogram was constructed through an ordinal logistic regression procedure.Predictive accuracy and performance characteristics were assessed with the area under the curve (AUC) of the receiver operating characteristics and calibration plots,respectively.Decision curve analyses were applied to assess the net benefit of the nomogram.Results:Among the 401 patients,73 (18.2%) were diagnosed and grouped as the none OSA (apnea-hypopnea index [AHI] 〈5),67 (16.7%) the mild OSA (5 ≤ AHI 〈 15),82 (20.4%) the moderate OSA (15 ≤ AHI 〈 30),and 179 (44.6%) the severe OSA (AHI ≥ 30).The multivariable analysis suggested the significant factors were duration of disease,smoking status,difficulty of falling asleep,lack of energy,and waist circumference.A nomogram was created for the prediction of OSA using these clinical parameters and was internally validated using bootstrapping method.The discrimination accuracies of the nomogram for any OSA,moderate-severe OSA,and severe OSA were 83.8%,79.9%,and 80.5%,respectively,which indicated good calibration.Decision curve analysis showed that using nomogram could reduce the unnecessary polysomnography (PSG) by 10% without increasing the false negatives.Conclusions:The established clinical nomogram provides high accuracy in predicting the individual risk of OSA.This tool may help physicians better make decisions on PSG arrangement for the patients referred to sleep centers. 展开更多
关键词 Decision Curve analysis NOMOGRAM OBSTRUCTIVE POLYSOMNOGRAPHY Risk Assessment Sleep Apnea
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