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Enhanced diagnostic workup increases pathological findings in patients with acute ischaemic stroke:results of the prospective HEBRAS study

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Stroke & Vascular Neurology 2024年第2期9卷 145-152,I0414-I0425页

作者： Simon Hellwig Thomas Krause jan F Scheitz Juliane Herm Ulrike Grittner Nadja Jauert Jochen B Fiebach Mario Kasner Wolfram Doehner Matthias Endres Rolf Wachter Thomas Elgeti Christian H Nolte Karl Georg Haeusler Department of Neurology with Experimental Neurology Charité-Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt-Universität zu BerlinBerlinGermany Center for Stroke Research Berlin BerlinGermany Berlin Institute of Health at Charité–Universitätsmedizin Berlin BIH Biomedical Innovation AcademyBerlinGermany Department of Neurology Jüdisches Krankenhaus BerlinBerlinGermany German Center for Cardiovascular Diseases(DZHK) Partner Site BerlinBerlinGermany Institute of Biometry and Clinical Epidemiology Charité-Universitätsmedizin BerlinBerlinGermany BIH Center for Regenerative Therapies(BCRT) Berlin Institute of Health at Charité–Universitätsmedizin BerlinBerlinGermany Department of Cardiology Charité-Universitätsmedizin BerlinBerlinGermany Department of Cardiology Campus Benjamin FranklinCharité-Universitätsmedizin BerlinBerlinGermany German Center for Neurodegenerative Diseases(DZNE) Partner Site BerlinBerlinGermany Department of Cardiology University Hospital LeipzigLeipzigGermany Department of Radiology Charité-Universitätsmedizin BerlinBerlinGermany Department of Neurology University Hospital WürzburgWürzburgGermany

Background Stroke aetiology remains cryptogenic in a relevant proportion of patients with acute ischaemic stroke(AIS).We assessed whether enhanced diagnostic workup after AIS yields a higher rate of prespecified pathological findings compared with routine diagnostic care *** Hospitalised patients with AIS were prospectively enrolled in the investigator-initiated observational HEart and BRain Interfaces in Acute Ischaemic Stroke(HEBRAS)study at the Charité,Berlin,*** with AIS without known atrial fibrillation(AF)underwent cardiovascular MR imaging(CMR),MR-angiography of the aortic arch and prolonged Holter-ECG monitoring on top of routine diagnostic *** Among 356 patients with AIS(mean age 66 years,37.6%female),enhanced workup yielded a higher rate of prespecified pathological findings compared with routine care(17.7%vs 5.3%;p<0.001).Consequently,fewer patients were classified as cryptogenic after enhanced diagnostic workup(38.5%vs 45.5%,p<0.001).Routine care included echocardiography in 228(64.0%)*** was successfully performed in 292(82.0%)patients and revealed more often a prespecified pathological finding compared with routine echocardiography(16.1%vs 5.3%).Furthermore,study-related ECG monitoring(median duration 162 hours(IQR 98–210))detected AF in 16(4.5%)patients,while routine monitoring(median duration 51 hours(IQR 34–74))detected AF in seven(2.0%)*** Enhanced diagnostic workup revealed a higher rate of prespecified pathological findings in patients with AIS compared with routine diagnostic care and significantly reduced the proportion of patients with cryptogenic *** registration number NCT02142413.

关键词： routine patients prospective

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Solving the Water Resource Problems in Iraq

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Engineering（科研） 2024年第8期16卷 205-223页

作者： Nadhir Al-Ansari Nasrat Adamo Varoujan Sissakian jan Laue Salwan Ali Abed Department of Civil Environmental and Natural Resources Engineering Lulea University of Technology Lulea Sweden Consultant Engineer Norrkoping Sweden Komar University of Science and Technology Sulaymaniyah Iraq College of Science University of Al-Qadisiyah Diwaniyah Iraq

Iraq covers an area of 437072 km2 in the northeastern part of the Middle East. Its population now is more than 40 million. It relies mainly on its water resources from the Tigris and Euphrates Rivers and their tributaries. Recently, Iraq has been experiencing a severe water scarcity problem. This is mainly due to climate change, increased hydrological projects in riparian countries, and water resources mismanagement inside Iraq itself. To overcome the problem, a new strategy should be implemented. Such strategy should consider two main courses of action: a) serious negotiations with riparian countries to reach an agreement giving Iraq equitable water shares from the Tigris and Euphrates Rivers and their tributaries. b) Prudent water management practices inside Iraq that consider adopting realistic distribution of water between the governorates, rational policies aiming at increased water use efficiencies within Irrigation networks, increased use of non-conventional sources of water, adjustment of water tariffs and their collection procedures, improving agricultural techniques, introduction of intensive guidance and public awareness programs, and promulgation of new legislations, in addition to creation of human resources development programs.

关键词： Tigris Rivers Euphrates Rivers Iraq

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Diagnostic delay in inflammatory bowel diseases in a German population

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World Journal of Gastroenterology 2024年第29期30卷 3465-3478页

作者： Elisabeth Blüthner Annalena Dehe Carsten Büning Britta Siegmund Matthias Prager Jochen Maul Alexander Krannich jan Preiß Bertram Wiedenmann Florian Rieder Raneem Khedraki Frank Tacke Andreas Sturm Anja Schirbel Department of Hepatology and Gastroenterology Campus Virchow-Klinikum and Campus CharitéMitteCharité-Universitätsmedizin BerlinBerlin 10117Germany Department of Gastroenterology Vivantes Klinikum im FriedrichshainBerlin 10249Germany Department of Internal Medicine Krankenhaus WaldfriedeBerlin 14163Germany Department of Gastroenterology Infectious Diseases and RheumatologyCharité-Universitätsmedizin BerlinBerlin 12203Germany Praxis für Gastroenterologie Berlin Zehlendorf Berlin 14195Germany Gastroenterologie am Bayrischen Platz Berlin 10825Germany Clinical Trial Office Charité-Universitätsmedizin BerlinBerlin 10117Germany Department of Gastroenterology Diabetology and HepatologyVivantes Klinikum NeuköllnBerlin 10117Germany Department of Gastroenterology Hepatology and NutritionDigestive Diseases and Surgery InstituteThe Cleveland Clinic FoundationClevelandOH 44195United States Department of Internal Medicine DRK Kliniken Berlin WestendBerlin 14050Germany Gastroenterologie im Havelland Straße der EinheitFalkensee 14612Germany

BACKGROUND Early diagnosis is key to prevent bowel damage in inflammatory bowel disease(IBD).Risk factor analyses linked with delayed diagnosis in European IBD patients are scarce and no data in German IBD patients *** To identify risk factors leading to prolonged diagnostic time in a German IBD *** Between 2012 and 2022,430 IBD patients from four Berlin hospitals were enrolled in a prospective study and asked to complete a 16-item questionnaire to determine features of the path leading to IBD *** diagnostic time was defined as the time from symptom onset to consulting a physician(patient waiting time)and from first consultation to IBD diagnosis(physician diagnostic time).Univariate and multivariate analyses were performed to identify risk factors for each time *** The total diagnostic time was significantly longer in Crohn’s disease(CD)compared to ulcerative colitis(UC)patients(12.0 vs 4.0 mo;P<0.001),mainly due to increased physician diagnostic time(5.5 vs 1.0 mo;P<0.001).In a multivariate analysis,the predominant symptoms diarrhea(P=0.012)and skin lesions(P=0.028)as well as performed gastroscopy(P=0.042)were associated with longer physician diagnostic time in CD *** UC,fever was correlated(P=0.020)with shorter physician diagnostic time,while fatigue(P=0.011)and positive family history(P=0.046)were correlated with longer physician diagnostic *** We demonstrated that CD patients compared to UC are at risk of long diagnostic *** efforts should focus on shortening the diagnostic delay for a better outcome in these patients.

关键词： Diagnostic time Diagnostic delay Crohn’s disease Ulcerative colitis Germany

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A probe into the acid deposition mitigation path in China over the last four decades and beyond

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National Science Review 2024年第4期11卷 84-92页

作者： Qian Yu Xiaodong Ge Haotian Zheng Jia Xing Lei Duan Dongwei Lv Dian Ding Zhaoxin Dong Yisheng Sun Posch Maximilian Danni Xie Yu Zhao Bin Zhao Shuxiao Wang jan Mulder Thorj?rn Larssen Jiming Hao State Key Laboratory of Environmental Simulation and Pollution Control School of EnvironmentTsinghua University State Key Laboratory of Pollution Control &Resource Reuse and School of the Environment Nanjing University State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex School of EnvironmentTsinghua University International Institute for Applied System Analysis(IIASA) School of Land Engineering Chang'an University Faculty of Environmental Sciences and Natural Resource Management Norwegian University of Life Sciences Norwegian Institute for Water Research

China currently has the highest acid deposition globally, yet research on its status, impacts, causes and controls is lacking. Here, we compiled data and calculated critical loads regarding acid deposition. The results showed that the abatement measures in China have achieved a sharp decline in the emissions of acidifying pollutants and a continuous recovery of precipitation p H, despite the drastic growth in the economy and energy consumption. However, the risk of ecological acidification and eutrophication showed no significant decrease. With similar emission reductions, the decline in areas at risk of acidification in China(7.0%) lags behind those in Europe(20%) or the USA(15%). This was because, unlike Europe and the USA, China's abatement strategies primarily target air quality improvement rather than mitigating ecological impacts. Given that the area with the risk of eutrophication induced by nitrogen deposition remained at 13%of the country even under the scenario of achieving the dual targets of air quality and carbon dioxide mitigation in 2035, we explored an enhanced ammonia abatement pathway. With a further 27% reduction in ammonia by 2035, China could largely eliminate the impacts of acid deposition. This research serves as a valuable reference for China's future acid deposition control and for other nations facing similar challenges.

关键词： acid deposition critical loads acidification eutrophication ammonia abatement

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Diagnosis and Management of Childhood Tuberculosis: A Cross-Sectional Study of Practices in Gilgit Baltistan, Pakistan

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Journal of Tuberculosis Research 2024年第2期12卷 57-72页

作者： Khalid Mahmood Razia Fatima Aashifa Yaqoob Faheem jan Zia Samad Mahboob Ul Haq National Tuberculosis Control Program Islamabad Pakistan

Background: Tuberculosis (TB) is one of the major killer diseases among infectious diseases. The success of TB control depends on the capability of the health care system to detect and accurately manage TB cases. Tuberculosis in children remained a low public health priority with limited epidemiologic studies. Struggles for TB control in children need to be enhanced as children are providing the reservoir for future cases to develop. Objectives: The study evaluated diagnostic and treatment practices related to childhood pulmonary tuberculosis in Gilgit Baltistan (GB), Pakistan. Methods: A descriptive, cross-sectional study based on retrospective record review of childhood Pulmonary Tuberculosis patients registered in the year 2020 with self-administered questionnaire. Results: Data of 557 childhood cases were collected. Most childhood cases were in age group 1 - 4 years (54%) with male predominance. More than 90% were diagnosed and treated at public sector facilities. 99% of the cases were clinically diagnosed with passive case finding. Cough was considered as a symptom of childhood Tuberculosis (TB) by 94% of physicians. Other important features included failure to thrive (13%), contact with a family history of TB (15%), Malnutrition(24%) and respiratory signs (21%). 99% physicians advised chest X-ray, Complete blood count (CBC) (95%) and Erythrocytes sedimentation rate (ESR) (72%) for diagnosis and fewer physicians (2%) used sputum smear microscopy and induced sputum (0.1%). Combining data on dosage, frequency and duration for drugs, 99% of the cases were found receiving correct regimen. The treatment outcomes of the cases were cured 4 (0.8%), treatment completed 551 (99.3%) and died 2 (0.4%) with no lost to follow up. Conclusions: The study highlights inappropriate diagnostic and treatment practices for managing childhood pulmonary TB among physicians in public and private sectors of Gilgit Baltistan. Most of the cases are managed by general practitioners with no

关键词： Childhood Tuberculosis Management Respiratory Signs

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Liquid crystal immunosensors for the selective detection of Escherichia coli with a fast analysis tool

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Photonics Research 2024年第7期12卷 1564-1573页

作者： SANDRO C.OLIVEIRA MARIA S.SOARES BÁRBARA V.GONÇALVES ANDREIA C.M.RODRIGUES AMADEU M.V.M.SOARES RITA G.SOBRAL NUNO F.SANTOS jan NEDOMA PEDRO L.ALMEIDA CARLOS MARQUES CICECO-Aveiro Institute of Materials Physics DepartmentUniversity of Aveiro3810-193 AveiroPortugal i3N Physics DepartmentUniversity of Aveiro3810-193 AveiroPortugal Associate Laboratory i4HB-Institute for Health and Bioeconomy School of Sciences and TechnologyNOVA University of Lisbon1099-085 LisbonPortugal CESAM-Centre for Environmental and Marine Studies and Department of Biology University of Aveiro3810-193 AveiroPortugal Department of Telecommunications VSB-Technical University of OstravaOstrava 70800Czech Republic i3N-CENIMAT School of Sciences and TechnologyNOVA University of Lisbon1099-085 LisbonPortugal UnIRE ISELPolytechnic Institute of Lisbon1549-020 LisbonPortugal Department of Physics VSB-Technical University of OstravaOstrava 70800Czech Republic

The consumption of contaminated food may cause serious illnesses,and traditional methods to detect Escherichia coli are still associated with long waiting times and high costs given the necessity to transport samples to specialized *** is a need to develop new technologies that allow cheap,fast,and direct monitoring at the site of ***,in this work,we developed optical immunosensors for the selective detection of ***,based on liquid crystal technology,whose molecules can align in different manners depending on the boundary conditions (such as substrates) as well as the environment that they *** glass substrate was functionalized with *** antibody using cysteamine as an intermediate,and a vertical alignment was imposed on the liquid crystal molecules by using DMOAP during *** presence of bacteria disrupts the alignment of the liquid crystal molecules,changing the intensity of light emerging between cross polarizers,measured using a polarized optical microscope and a *** was possible to detect *** in suspensions in the concentration range from 2.8 cells/mL to 2.8×10^(9) cells∕*** was also evaluated,and the sensors were used to analyze contaminated water samples.A prototype was developed to allow faster,in-situ,and easier analysis avoiding bulky instruments.

关键词： crystal alignment analysis

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Elevated fluid and glycosaminoglycan content in the Achilles tendon contribute to higher intratendinous pressures:Implications for Achilles tendinopathy

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Journal of Sport and Health Science 2024年第6期13卷 863-871页

作者： Lauren Pringels Gert-jan Van Valckenborgh Patrick Segers Amelie Chevalier Hedwig Stepman Evi Wezenbeek Arne Burssens Luc Vanden Bossche Department of Physical and Rehabilitation Medicine Ghent University HospitalGhent 9000Belgium Department of Rehabilitation Sciences and Physiotherapy Ghent UniversityGhent 9000Belgium Department of Electronics and Information Systems Ghent UniversityGhent 9000Belgium Department of Electromechanics University of AntwerpAntwerp 2020Belgium Department of Laboratory Medicine Ghent University HospitalGhent 9000Belgium Department of Orthopedic Surgery Ghent University HospitalGhent 9000Belgium

Background:Tendinopathy alters the compositional properties of the Achilles tendon by increasing fluid and glycosaminoglycan *** has been speculated that these changes may affect intratendinous pressure,but the extent of this relationship remains ***,we aimed to investigate the impact of elevated fluid and glycosaminoglycan content on Achilles tendon intratendinous pressure and to determine whether hyaluronidase(HYAL) therapy can intervene in this potential ***:Twenty paired fresh-frozen cadaveric Achilles tendons were mounted in a tensile-testing machine and loaded up to 5% *** resting(at 0% strain) and dynamic pressure(at 5% strain) were assessed using the microcapillary infusion ***,intratendinous pressure was measured under native conditions before and after infusion of 2 mL physiological ***,80 mg of glycosaminoglycans were administered bilaterally to the paired *** right tendons were additionally treated with 1500 units of ***,both groups were retested,and the glycosaminoglycan content was ***:It was found that both elevated fluid and glycosaminoglycan content resulted in higher intratendinous resting and dynamic pressures(p <0.001).HYAL treatment induced a 2.3-fold reduction in glycosaminoglycan content(p=0.002) and restored intratendinous ***:The results of this study demonstrated that elevated fluid and glycosaminoglycan content in Achilles tendinopathy contribute to increased intratendinous re sting and dynamic pressures,which can be explained by the associated increased volume and reduced permeability of the tendon matrix,*** degrades glycosaminoglycans sufficiently to lower intratendinous pressures and may,therefore,serve as a promising treatment.

关键词： Achilles tendon Achilles tendinopathy Intratendinous pressure Glycosaminoglycans Tendon fluid

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像海一样深邃的翡翠湖

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厦门航空 2024年第10期 66-71页

作者： Christo jan(文/摄影) 不详

在西北青甘大环线上,位于青海省海西蒙古族藏族自治州的大柴旦翡翠湖,以其鲜艳的绿色和独特的自然景观吸引了无数游客。这个湖泊被誉为“天然翡翠”,其清澈的湖水在阳光下闪耀出迷人的色彩,仿佛镶嵌在高原上的一块靓丽宝石。

关键词：大柴旦天然翡翠翡翠湖自然景观

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梅里雪山,光的盛宴等你来

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厦门航空 2024年第1期 38-43页

作者： Christo jan(文/摄影) 不详

梅里雪山,位于中国西南部的云南省,藏区八大神山之首,因其独特的地理条件和壮丽的自然景观而备受世人瞩目。它傲然立在蓝天白云间,雄伟壮丽,宛如一座巍峨的王冠。而它的另一面,却隐藏着一种摄人心魄的奇景——日照金山,金色的阳光洒满... 详细信息

梅里雪山,位于中国西南部的云南省,藏区八大神山之首,因其独特的地理条件和壮丽的自然景观而备受世人瞩目。它傲然立在蓝天白云间,雄伟壮丽,宛如一座巍峨的王冠。而它的另一面,却隐藏着一种摄人心魄的奇景——日照金山,金色的阳光洒满整个山峰,犹如一幅美轮美免的画卷。

关键词：梅里雪山雄伟壮丽摄人心魄自然景观另一面

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儿童家庭住宅中VOCs浓度及其来源分析

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建筑科学 2024年第8期40卷 185-192页

作者：王丽芳李琼何丽娟 SUNDELL jan 张寅平华北科技学院建筑工程学院河北廊坊065201 内蒙古科技大学能源与环境学院内蒙古包头014010 清华大学建筑技术科学系北京100084

室内挥发性有机化合物(VOCs)是危害儿童健康的主要污染物之一。本文调查了包头市123户学龄前儿童家庭住宅内VOCs浓度水平及其可能的来源。该研究是全国性调研“中国室内环境与儿童健康研究(China,Children,Homes,Health,简称CCHH)”中... 详细信息

室内挥发性有机化合物(VOCs)是危害儿童健康的主要污染物之一。本文调查了包头市123户学龄前儿童家庭住宅内VOCs浓度水平及其可能的来源。该研究是全国性调研“中国室内环境与儿童健康研究(China,Children,Homes,Health,简称CCHH)”中的一部分。研究结果显示,16种VOCs(检出率超过30%)为本调查对象的主要污染物。除苯的检出率达100%,超标率为2.4%外,其他种类VOCs均未超标。TVOC浓度范围为3.20~1297.1μg/m^(3),超标率为5%。采暖期VOCs浓度显著高于非采暖期,9种芳香族化合物在不同装修年限下存在显著性差异。通过主成分分析发现4个因子与VOCs来源相关,分别是室外机动车尾气排放、室内溶剂的散发、室内地板或皮革抛光剂的散发、室内杀虫剂或除臭剂的使用,且与非参数检验方法(Kruskal-Wallis检验)结果一致。本研究为深入认识西部干燥地区家庭住宅室内VOCs污染控制及风险评估提供科学参考。

关键词：家庭住宅 VOCs 室内环境影响因素污染源

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