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看美国卒中治疗改进措施,思考中国卒中医疗挑战

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中国卒中杂志 2012年第8期7卷 601-605页

作者： david z.wang INI Stroke Network OSF Healthcare SystemUniversity of Illinois College of Medicine-PeoriaPeoria.IL 61604USA

在美国，卒中医疗质量改进在所有的医疗卫生改进措施中起步最早。卒中是成人致残的第一大疾病，是成人死亡的第三大疾病，花费已超过5604L美元，常常是诊断相关组（diagnosisrelatedgrouD，DRG）入院的第5位原因。卒中医疗质量改进始于2... 详细信息

在美国，卒中医疗质量改进在所有的医疗卫生改进措施中起步最早。卒中是成人致残的第一大疾病，是成人死亡的第三大疾病，花费已超过5604L美元，常常是诊断相关组（diagnosisrelatedgrouD，DRG）入院的第5位原因。卒中医疗质量改进始于20世纪90年代末期。

关键词：卒中卫生保健质量优质医疗质量绩效

中国非瓣膜性心房颤动患者华法林使用不足的相关因素分析

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中国新药杂志 2012年第11期21卷 1203-1209页

作者：王春娟王春雪王拥军王伊龙赵性泉刘丽萍 david z.wang 李昊杨中华首都医科大学附属北京天坛医院神经内科北京100050 美国伊利诺伊大学医学院伊利诺伊卒中中心与卒中网皮奥利亚61605

目的:评估中国首发缺血性卒中或短暂性脑缺血发作(TIA)的已知非瓣膜性心房颤动(NVAF)患者华法林的使用情况及使用不足的相关因素。方法:从中国国家卒中登记数据库(CNSR)中连续筛选首发缺血性卒中或TIA的NVAF患者,筛选已知心房颤动和新... 详细信息

目的:评估中国首发缺血性卒中或短暂性脑缺血发作(TIA)的已知非瓣膜性心房颤动(NVAF)患者华法林的使用情况及使用不足的相关因素。方法:从中国国家卒中登记数据库(CNSR)中连续筛选首发缺血性卒中或TIA的NVAF患者,筛选已知心房颤动和新发心房颤动患者,评估华法林在适合抗凝治疗的已知心房颤动患者中的使用比例。采用多变量logistic回归模型评估华法林使用不足的相关因素。结果:在筛选出的11 080例首发缺血性卒中或TIA患者中,有996例(9.7%)患者存在NVAF且无抗凝治疗禁忌症,其中有592例既往已知存在心房颤动。在这些患者中,只有96例(16.2%)发病前服用了华法林,496例(83.8%)发病前未服用华法林。在服用华法林的患者中,只有1例患者入院时的国际标准化比值(INR)在治疗范围(2.0～3.0)内。依据CHADS2卒中风险评分,在卒中发生前的低危心房颤动患者中,有近20.2%的患者服用了华法林,而在中危及高危患者中,华法林的服用比例分别只有15.2%和16.4%。年老的和既往存在冠心病病史的患者服用华法林的可能性较小,而发病前服用抗血小板药物的患者更有可能服用华法林。结论:CNSR中首发缺血性卒中或TIA的NVAF患者中,适宜抗凝治疗的患者存在严重的华法林使用不足,即使接受抗凝治疗,达标率也极低。如果发病前给予合适的抗凝治疗并监测,许多由心房颤动导致的卒中和TIA就可避免。

关键词：首发卒中心房颤动抗凝治疗华法林抗栓治疗

Numerical Study of Flow Features Around Submerged Circular and Square Piles at Flat and Scoured Beds Using OpenFOAM

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Journal of Ocean University of China 2024年第4期23卷 897-914页

作者： wang Chaolin WU Guoxiang wang Dianhe DU Shengtao zHANG zhiyong JIN Heng zHU david z. LIANG Bingchen Donghai Academy School of Civil&Environmental Engineering and Geography ScienceNingbo UniversityNingbo 315211China Key Laboratory of Estuary and Coast of zhejiang Province and Zhejiang Institute of Hydraulics and EstuaryHangzhou 310020China Shandong Provincial Key Laboratory of Ocean Engineering and College of EngineeringOcean University of ChinaQingdao 266100China Shandong Water Conservancy Vocational College Rizhao 276826China School of Mechanical and Energy Engineering Ningbotech UniversityNingbo 315211China

Elucidating the flow features around piles in local scouring processes is crucial for studies of local scouring mechanisms and scour depth *** study details the flow turbulence characteristics of two submerged piles that are determined by solving the Navier-Stokes equations with the improved delayed detached eddy simulation *** model is verified by comparing experimental and numerical results for hydrodynamic parameters with the literature for both square-crossing piles(SCPs)and circular-crossing piles(CCPs).Original topographies of flat and scoured beds(i.e.,the initial and equilibrium scouring stages)are based on experimental results obtained by the authors in the present *** and CCP flow features in the scouring process are *** results indicate that during the scouring process,the time-averaged drag coefficient and root mean square(rms)of the lift coefficient increase linearly in the CCP test,while the rms of the lift coefficient in the SCP test decreases ***,the minimum pressure coefficient is always located in the upstream corners in the SCP case but moves from 72.5°to 79.5°when the scour hole is completely developed in the CCP *** flow behind the pile,which is generated by separated boundary layers above the top face of the pile,can reach the sand bed and turn the separated shear layers into patches of small vortices in the near-wake ***,the high shear stress zones are mainly at the scour edges under scoured-bed conditions.

关键词： flat bed scoured bed local scour OpenFOAM bed shear stress

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未破裂脑动脉瘤的治疗选择

国际脑血管病杂志 2006年第4期14卷 247-251页

作者： david z.wang Huan wang Kenneth Fraser Giuseppe Lanzino 冯东侠高恒陈罡 From the OSF Saint Francis Stroke Center/Illinois Neurological Institute University of Illinois College of MedicineOne Illini DrivePeoriaIL61605USA. 东南大学微侵袭神经外科研究所

未破裂脑动脉瘤的处理存在争议。由于其自然史尚未完全明确,因此最佳的治疗策略也不清楚。目前对未破裂脑动脉瘤处理的共识包括观察、显微手术夹闭和血管内治疗。用于随访已知未破裂脑动脉瘤的方法学也有争议,可能取决于经治医生的偏好... 详细信息

未破裂脑动脉瘤的处理存在争议。由于其自然史尚未完全明确,因此最佳的治疗策略也不清楚。目前对未破裂脑动脉瘤处理的共识包括观察、显微手术夹闭和血管内治疗。用于随访已知未破裂脑动脉瘤的方法学也有争议,可能取决于经治医生的偏好。大多数动脉瘤由神经外科医师和介入神经放射科医师处理,但未破裂动脉瘤通常是由神经科医师在对患者进行其他神经系统疾病的筛查时首先发现的。因此,关于何时对患者进行筛查和如何对未破裂动脉瘤采取最佳处理的知识将对其日常医疗实践有直接的影响。未破裂动脉瘤经常导致包括缺血事件、癫和头痛在内的其他神经系统症状,这些症状可能促进更积极的干预治疗。由于缺乏设计完善真正基于人群的研究或随机试验,因此目前的最佳处理必须以现有文献和每例患者当时的具体情况为根据。

关键词：未破裂动脉瘤治疗

Post-layout simulation driven analog circuit sizing

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Science China(Information Sciences) 2024年第4期67卷 289-300页

作者： Xiaohan GAO Haoyi zHANG Siyuan YE Mingjie LIU david z.PAN Linxiao SHEN Runsheng wang Yibo LIN Ru HUANG School of Integrated Circuits Peking University School of Computer Science Peking University Department of Electrical and Computer Engineering University of Texas at Austin Institute of Electronic Design Automation Peking University

Post-layout simulation provides accurate guidance for analog circuit design, but post-layout performance is hard to be directly optimized at early design stages. Prior work on analog circuit sizing often utilizes pre-layout simulation results as the optimization objective. In this work, we propose a post-layoutsimulation-driven(post-simulation-driven for short) analog circuit sizing framework that directly optimizes the post-layout simulation performance. The framework integrates automated layout generation into the optimization loop of transistor sizing and leverages a coupled Bayesian optimization algorithm to search for the best post-simulation performance. Experimental results demonstrate that our framework can achieve over 20% better post-layout performance in competitive time than manual design and the method that only considers pre-layout optimization.

关键词： analog EDA transistor sizing Bayesian optimization post-layout simulation

A multi-sensor appiproach to calving detection

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Information Processing in Agriculture 2024年第1期11卷 45-64页

作者： Anita z.Chang david L.Swain Mark G.Trotter Institute for Future Farming Systems School of HealthMedicaland Applied SciencesCentral Queensland UniversityRockhamptonQueensland 4700Australia

The advent of remote livestock monitoring systems provides numerous possibilities for improving on-farm productivity,efficiency,and *** potential application for these systems is for the detection of calving *** study describes the integration of data from multiple sensor sources,including accelerometers,global navigation satellite systems(GNsS),an accelerometer-derived rumination algorithm,a walk-over-weigh unit,and a weather station for parturition detection using a support vector machine *** best performing model utilised data from GNsS,the ruminating algorithm,and weather stations to achieve 98.6%accuracy,with 88.5%sensitivity and 100%*** topranking features of this model were primarily GNSS *** study provides an overview as to how various sensor systems could be integrated on-farm to maximise calving detection for improved production and welfare outcomes.

关键词： Accelerometer GNSS GPS Rumination Sensor WOW

Quantification of perfluorinated compounds in atmospheric particulate shows potential connection with environmental event

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Journal of Environmental Sciences 2024年第2期136卷 237-247页

作者： Hua Tang Ying wang Shengling Si Hongli Li david Da Yong Chen National Institute of Metrology 18 BeisanhuandongluChaoyang DistrictBeijing 100029China School of Chemistry and Materials Science Nanjing Normal UniversityNanjing 210023China Si Chuan zhong Ce Biao Wu Technology Co.Ltd. Sichuan 610052China Department of Chemistry University of British ColumbiaVancouver V6T 1Z1BCCanada

A method of quantification of perfluorinated compounds(PFCs)from atmospheric particulate matter(APM)is described.A single step pretreatment method,selective pressurized liquid extraction(SPLE),was developed to reduce the high matrix background and avoid contamination from commonly used multiple sample pretreatment *** effective sorbent was selected to purify the PFCs during SPLE,followed by liquid chromatography-tandem mass spectrometry(LC–MS/MS),for quantification of *** affecting the SPLE efficiency,including temperature,static extraction time,and number of extraction cycles used,were *** optimum conditions were found to be 120℃,10 min,and 3 cycles,***-MS/MS method was developed to obtain the optimal sensitivity specific to *** method detection limits(MDLs)were 0.006 to 0.48 ng/g for the PFCs studied and the linear response range was from 0.1 to 100 ng/*** ensure accurate values were obtained,each step of the experiment was evaluated and controlled to prevent *** optimized method was tested by performing spiking experiments in natural particulate matter matrices and good rates of recovery and reproducibility were obtained for all target ***,the method was successfully used to measure 16 PFCs in the APM samples collected in Beijing over five years from 2015 to *** is observed that some PFCs follow the trend of total PFC changes,and can be attributed to the environment influencing events and policy enforcement,while others don't seem to change as much with time of the year or from year to year.

关键词： Selective pressurized liquid extraction Liquid chromatography-mass spectrometry Perfluorinated compounds Atmospheric particulate matter Pollution control

Rational molecular design of efficient yellow-red dendrimer TADF for solution-processed OLEDs: a combined effect of substitution position and strength of the donors

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Science China Chemistry 2024年第5期67卷 1613-1623页

作者： Changfeng Si Dianming Sun Tomas Matulaitis david B.Cordes Alexandra M.z.Slawin Eli zysman-Colman Organic Semiconductor Centre EaStCHEM School of ChemistryUniversity of St AndrewsSt AndrewsKY169STUK

The development of high-performance solution-processed red organic light-emitting diodes(OLEDs) remains a challenge,particularly in terms of maintaining efficiency at high luminance. Here, we designed and synthesized four novel orange-red thermally activated delayed fluorescence(TADF) dendrimers that are solution-processable: 2GCz BP, 2DPACz BP, 2FBP2GCz and 2FBP2DPACz. We systematically investigated the effect of substitution position and strength of donors on the optoelectronic properties. The reverse intersystem crossing rate constant(kRISC) of the emitters having donors substituted at positions 11and 12 of the dibenzo[a,c]phenazine(BP) is more than 10-times faster than that of compounds substituted having donors substituted at positions 3 and 6. Compound 2DPACz BP, containing stronger donors than 2GCz BP, exhibits a red-shifted emission and smaller singlet-triplet energy splitting, ΔE_(ST), of 0.01 e V. The solution-processed OLED with 10 wt% 2DPACz BP doped in m CP emitted at 640 nm and showed a maximum external quantum efficiency(EQE_(max)) of 7.8%, which was effectively maintained out to a luminance of 1,000 cd m-2. Such a device's performance at relevant display luminance is among the highest for solution-processed red TADF OLEDs. The efficiency of the devices was improved significantly by using 4Cz IPN as an assistant dopant in a hyperfluorescence(HF) configuration, where the 2DPACz BP HF device shows an EQEmaxof 20.0% at λEL of 605 nm and remains high at 11.8% at a luminance of 1,000 cd m-2, which makes this device one of the highest efficiency orange-to-red HF SP-OLEDs to date.

关键词： thermally activated delayed fluorescence solution-processing red OLEDs dibenzo[a,c]phenazine dendrimers

Repeatability and reproducibility of corneal higher-order aberrations measurements after small incision lenticule extraction using the Scheimpfug-Placido topographer

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Eye and Vision 2024年第1期10卷 1-9页

作者： Rui Ning Rongrong Gao david PPiñero Jun zhang Qingyi Gao Yili Jin Yiran wang Chenxiao wang Jinhai Huang Eye Hospital and School of Ophthalmology and Optometry Wenzhou Medical UniversityWenzhouZhejiangChina Eye Institute and Department of Ophthalmology Eye and ENT HospitalFudan UniversityShanghaiChina Group of Optics and Visual Perception Department of OpticsPharmacology and AnatomyUniversity of AlicanteAlicanteSpain NHC Key Laboratory of Myopia(Fudan University) Key Laboratory of MyopiaChinese Academy of Medical SciencesShanghaiChina Shanghai Research Center of Ophthalmology and Optometry ShanghaiChina

Background:To evaluate the precision of corneal higher-order aberrations measurements after small incision lenticule extraction(SMILE)using the Sirius Scheimpfug-Placido topographer(CSO,Italy).Methods:Seventy-fve eyes from 75 postoperative subjects were included in this prospective *** consecutive corneal aberrometric measurements were obtained with the Scheimpfug-Placido topographer by two experienced operators to assess intra-and inter-observer *** within-subject standard deviation(Sw),test-retest repeatability(TRT)and the intraclass correlation coefcient(ICC)were ***:For intraobserver repeatability of anterior and total corneal aberrations,all ICCs were more than 0.922,except for trefoil(0.722 to 0.768).The ICCs of total root mean square(RMS),coma z(3,±1),and spherical aberration z(4,0)were over 0.810 while higher-order RMS,trefoil z(3,±3),and astigmatism II z(4,±2)were below 0.634 for posterior corneal surface *** Sw values for all types of aberrations were equal to or below 0.07μ*** interobserver reproducibility,all TRT values were no more than 0.12μm,0.05μm,and 0.11μm for anterior,posterior,and total corneal aberrations,*** ICC values ranged from 0.875 to 0.989,from 0.686 to 0.976 and over 0.834 for anterior,posterior,and total corneal aberrations,***:The repeatability of measurements of anterior and total corneal aberrations with the Sirius system in corneas after SMILE surgery was high,except for *** was some variability in posterior corneal aberrometric *** reproducibility of corneal aberrometric measurements was observed between measurements of both examiners,except for trefoil,with poor to moderate reproducibility.

关键词： Sirius Higher-order aberrations Repeatability Reproducibility Small incision lenticule extraction