检索结果-南通市图书馆

在线全文

学校读者我要写书评

暂无评论

全科医学中的不确定性及管理策略

中华全科医学 2024年第8期22卷 1267-1271页

作者：高可音史威力王留义郑州大学人民医院全科医学科河南郑州450000

在当今医学领域,不确定性普遍而广泛存在于医疗保健系统。其可以出现在诊疗的各个环节,以各种形式,通过不同方式影响医生和患者,进而影响诊疗效果,是医疗服务过程中的极大挑战。达成面对医疗不确定性的共识,有利于建立持久的、以信赖为... 详细信息

在当今医学领域,不确定性普遍而广泛存在于医疗保健系统。其可以出现在诊疗的各个环节,以各种形式,通过不同方式影响医生和患者,进而影响诊疗效果,是医疗服务过程中的极大挑战。达成面对医疗不确定性的共识,有利于建立持久的、以信赖为基础的医患关系,实现双方利益平衡。全科医生作为一般患者的首诊医生,面临着多样化疾病谱和患者个体差异等挑战,如何管理不确定性问题成为全科医生日常工作的一部分,掌握不确定性的管理策略对于全科医生显得尤为重要。然而,目前对医学不确定性的系统研究非常有限,国内大部分研究局限于不确定性在某项技术或某个过程中的应用,缺乏相关综合性论述,对不确定性管理策略的分析整合鲜少提及,为此笔者作了一项系统文献综述,以探索适用于全科医学的不确定性管理策略。本文从医学不确定性的来源和影响对其进行分析,进而对如何在临床决策中管理医学不确定性,在不确定性中制定适宜的临床决策进行讨论。笔者认为各种来源的医学不确定性会导致医患双方情绪、行为、反应的负面效应,通过采取合适的管理策略有可能减轻医学不确定性及其造成的影响,对不确定性背景下的临床决策有一定的参考意义。

关键词：医学不确定性全科医生管理策略临床决策

在线全文

学校读者我要写书评

暂无评论

老年心房颤动合并骨骼肌减少症的研究进展

中华全科医师杂志 2024年第2期23卷 191-195页

作者：李亚楠曾德飞任琢琢李兵王留义刘晓宇河南大学人民医院、河南省人民医院全科医学科郑州450003

心房颤动(房颤)和骨骼肌减少症(肌少症)均是老年患者的常见疾病,两者存在共同的危险因素和病理生理发病机制,在其发生发展过程中相互作用和影响。文章主要对老年房颤合并肌少症的流行病学、危险因素、发病机制、筛查、评估和综合管理等... 详细信息

心房颤动(房颤)和骨骼肌减少症(肌少症)均是老年患者的常见疾病,两者存在共同的危险因素和病理生理发病机制,在其发生发展过程中相互作用和影响。文章主要对老年房颤合并肌少症的流行病学、危险因素、发病机制、筛查、评估和综合管理等方面的研究进展进行综述。

关键词：心房颤动骨骼肌减少症老年人筛查

机械介入取栓术联合重组组织型纤溶酶原激活剂治疗急性脑梗死的疗效观察

在线全文

学校读者我要写书评

暂无评论

中国神经免疫学和神经病学杂志 2024年第3期31卷 204-209页

作者：师媛王柳毅惠辉屈文英师宁王乐延安大学附属医院脑血管科 716000 陕西省人民医院神经内科 710068

目的观察机械介入取栓术联合重组组织型纤溶酶原激活剂(recombinant tissue plasminogen activator,rt-PA)治疗急性脑梗死(ACI)的疗效。方法选取作者医院2020年1月至2021年12月收治的107例ACI患者作为回顾性队列研究对象,按治疗方法将... 详细信息

目的观察机械介入取栓术联合重组组织型纤溶酶原激活剂(recombinant tissue plasminogen activator,rt-PA)治疗急性脑梗死(ACI)的疗效。方法选取作者医院2020年1月至2021年12月收治的107例ACI患者作为回顾性队列研究对象,按治疗方法将患者分为rt-PA静脉溶栓组(以下简称对照组,n=49)和机械介入取栓术联合rt-PA静脉溶栓组(以下简称观察组,n=58)。比较两组患者临床疗效、血清炎症因子、血清脂蛋白相关磷脂酶A2(Lp-PLA2)、血清总超氧化物歧化酶(T-SOD)、血清锰超氧化物歧化酶(Mn-SOD)、血清血管内皮功能指标以及脑血流灌注水平的差异。结果观察组临床总有效率高于对照组(96.55%比81.63%;χ^(2)=5.179,P=0.023);观察组治疗后肿瘤坏死因子α(TNF-α)、白细胞介素-1α(IL-1α)、IL-1β、IL-6、C反应蛋白(CRP)、Lp-PLA2、内皮素-1(ET-1)和血管内皮生长因子(VEGF)水平显著低于对照组(P<0.05),而T-SOD、Mn-SOD、一氧化氮水平及脑血容量(CBV)和脑血流量(CBF)水平明显高于对照组(P<0.05)。结论机械介入取栓术联合rt-PA治疗能够有效改善ACI患者神经功能、炎症状态及Lp-PLA2、T-SOD、Mn-SOD水平,增强脑组织血流灌注及血管内皮功能,整体提高临床疗效。

关键词：脑梗死卒中机械介入取栓术组织型纤溶酶原激活物炎症因子脂蛋白相关磷脂酶A2

Chemical characteristics of long-term acid rain and its impact on lake water chemistry:A case study in Southwest China

在线全文

学校读者我要写书评

暂无评论

Journal of Environmental Sciences 2024年第4期138卷 121-131页

作者： liuyi Zhang Jiawang Shuxiao wang Chunbo wang Fumo Yang Tingzhen Li Chongqing Key Laboratory of Water Environment Evolution and Pollution Control in Three Gorges Reservoir Chongqing Three Gorges UniversityWanzhou 404000China State Key Joint Laboratory of Environment Simulation and Pollution Control School of EnvironmentTsinghua UniversityBeijing 100084China College of Carbon Neutrality Future Technology Sichuan UniversityChengdu 610065China National Engineering Research Center on Flue Gas Desulfurization Chengdu 610065China

The chemical composition of acid rain and its impact on lake water chemistry in Chongqing,China,from 2000 to 2020 were studied in this *** regional acid rain intensity is affected jointly by the acid gas emissions and the neutralization of alkaline *** pH of precipitation experienced three stages of fluctuating decline,continuous improvement,and a slight *** pH showed inflection points in 2010,mainly due to the total control actions of SO_(2)and NO_(x)implemented in *** total ion concentrations in rural areas and urban areas were 489.08μeq/L and 618.57μeq/L,*** top four ions were SO_(4)^(2-),Ca^(2+),NH_(4)^(+)and NO_(3)^(-),which accounted for more than 90%of the total ion concentration,indicating the anthropogenic *** 2010,SO_(4)^(2-)fluctuated greatly while NO_(3)^(-)continued to rise;however,after 2010,both SO_(4)^(2-)and NO_(3)^(-)began to decline rapidly,with the rates of-12.03μeq/(L·year)and-4.11μeq/(L·year).Because the decline rate of SO_(4)^(2-)was 2.91 times that of NO_(3)^(-),the regional acid rain has changed from sulfuric acid rain to mixed sulfuric and nitric acid *** lake water is weakly acidic,with an average pH of 5.86,and the acidification frequency is 30.00%.Acidification of lake water is jointly affected by acid deposition and acid neutralization capacity of lake *** deposition has a profound impact on water acidification,and nitrogen(N)deposition,especially reduced N deposition,should be the focus of future research.

关键词： Acid rain Chemical composition Neutralization Nitrogen deposition Water acidification

Recent research progress of master mold manufacturing by nanoimprint technique for the novel microoptics devices

在线全文

学校读者我要写书评

暂无评论

Frontiers of Materials Science 2022年第3期16卷 83-100页

作者： Yuhang LIU Jianjun LIN Zuohuan HU Guoli GAO Bingyang wang liuyi wang Zhiyuan PAN Jianfei JIA Qinwei YIN Dengji GUO Xujin wang Institute of Semiconductor Manufacturing Research Shenzhen UniversityShenzhen 518060China Shenzhen Silver Basis Technology Co. Ltd.Shenzhen 523459China Institute of Microelectronics Shenzhen UniversityShenzhen 518060China Shenzhen Key Laboratory of High Performance Nontraditional Manufacturing College of Mechatronics and Control EngineeringShenzhen UniversityShenzhen 518060China

The consumer demand for emerging technologies such as augmented reality(AR),autopilot,and three-dimensional(3D)internet has rapidly promoted the application of novel optical display devices in innovative ***,the micro/nanomanufacturing of high-resolution optical display devices is the primary issue restricting their *** manufacturing technology of micro/nanostructures,methods of display mechanisms,display materials,and mass production of display devices are major technical *** comprehensively understand the latest state-of-the-art and trigger new technological breakthroughs,this study reviews the recent research progress of master molds produced using nanoimprint technology for new optical devices,particularly AR glasses,new-generation light-emitting diode car lighting,and naked-eye 3D display mechanisms,and their manufacturing techniques of master *** focus is on the relationships among the manufacturing process,microstructure,and display of a new optical *** master molds are reviewed for the manufacturing and application of new optical devices,and the challenges and prospects of the new optical device diffraction grating nanoimprint technology are discussed.

关键词： master mold manufacturing nanoimprint technique augmented reality automotive lighting naked-eye 3D display

Real-Time Detection and Instance Segmentation of Strawberry in Unstructured Environment

在线全文

学校读者我要写书评

暂无评论

Computers, Materials & Continua 2024年第1期78卷 1481-1501页

作者： Chengjun wang Fan Ding Yiwen wang Renyuan Wu Xingyu Yao Chengjie Jiang liuyi Ling School of Artificial Intelligence Anhui University of Science and TechnologyHuainan232001China School of Mechanical Engineering Anhui University of Science and TechnologyHuainan232001China

The real-time detection and instance segmentation of strawberries constitute fundamental components in the development of strawberry harvesting ***-time identification of strawberries in an unstructured envi-ronment is a challenging *** instance segmentation algorithms for strawberries suffer from issues such as poor real-time performance and low *** this end,the present study proposes an Efficient YOLACT(E-YOLACT)algorithm for strawberry detection and segmentation based on the YOLACT *** key enhancements of the E-YOLACT encompass the development of a lightweight attention mechanism,pyramid squeeze shuffle attention(PSSA),for efficient feature ***,an attention-guided context-feature pyramid network(AC-FPN)is employed instead of FPN to optimize the architecture’s ***,a feature-enhanced model(FEM)is introduced to enhance the prediction head’s capabilities,while efficient fast non-maximum suppression(EF-NMS)is devised to improve non-maximum *** experimental results demonstrate that the E-YOLACT achieves a Box-mAP and Mask-mAP of 77.9 and 76.6,respectively,on the custom ***,it exhibits an impressive category accuracy of 93.5%.Notably,the E-YOLACT also demonstrates a remarkable real-time detection capability with a speed of 34.8 *** method proposed in this article presents an efficient approach for the vision system of a strawberry-picking robot.

关键词： YOLACT real-time detection instance segmentation attention mechanism strawberry

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

浅谈机器学习在土壤重金属监测中的应用进展

长江信息通信 2023年第11期36卷 63-65页

作者：王柳毅三峡大学计算机与信息学院湖北宜昌443000

随着我国工业化快速发展,土壤污染速度也随之加快,尤其是土壤重金属污染,土壤中的重金属会通过农产品进入人体,对人类的健康造成威胁。地统计模型基于土壤的空间特性对土壤重金属直接进行插值,但无法真正表征辅助变量对土壤重金属空间... 详细信息

随着我国工业化快速发展,土壤污染速度也随之加快,尤其是土壤重金属污染,土壤中的重金属会通过农产品进入人体,对人类的健康造成威胁。地统计模型基于土壤的空间特性对土壤重金属直接进行插值,但无法真正表征辅助变量对土壤重金属空间分异性的影响,现如今,机器学习在各个领域发挥着越来越重要的作用,而且机器学习算法能够将有效整合辅助变量和土壤重金属数据,因此探讨哪种机器学习算法能最大程度上提高对土壤重金属含量预测的精度具有重要的现实意义。文章对传统的机器学习算法进行梳理,浅谈机器学习在土壤重金属预测中的最新研究并进行相关分析,以期为后续土壤重金属预测相关研究提供参考。

关键词：土壤重金属地统计模型机器学习

Bio-mimetic drug delivery systems designed to help the senior population reconstruct melatonin plasma profiles similar to those of the healthy younger population

同方期刊数据库博看期刊评论

在线全文

学校读者我要写书评

暂无评论

Acta Pharmaceutica Sinica B 2014年第1期4卷 60-66页

作者： Ying Li liuyi wang Li Wu Xueju Zhang Xue Li Zhen Guo Haiyan Li Peter York Shuangying Gui Jiwen Zhang Anhui University of Chinese Medicine Hefei 230038China Center for Drug Delivery Systems Shanghai Institute of Materia MedicaChinese Academy of SciencesShanghai 201203China Hainan Weikang Pharmaceutical(Qianshan)Co. LtdAnqing 246000China College of Life Sciences Jilin UniversityChangchun 130012China

The secretion of melatonin(MT)is obviously different in the younger and the senior sectors of the population,and the maximum plasma concentration of seniors is only half of that in the younger population *** exogenous MT can be supplied to senior citizens based on the secretion rate and amount of endogenous MT in the younger population by a bio-mimetic drug delivery system(DDS),an improved therapeutic effect and reduced side effects can be *** upon this hypothesis,the pharmacokinetic parameters of MT,namely,the absorption rate constant(ka),the elimination rate constant(ke),and the ratio of absorption rate(F)to the apparent volume of distribution(V)were obtained by a residual method depending on the plasma concentration curve of immediate release preparations in the healthy younger *** dose-division method was applied to calculate the cumulative release profiles of MT achieved by oral administration of a controlled release drug delivery system(DDS)to generate plasma MT profiles similar to the physiological level-time *** in vivo release of MT deduced from the healthy younger population physiological MT profiles as the pharmacokinetic output of the bio-mimetic DDS showed a two-phase profile with two different zero order release rates,namely,4.919μg/h during 0-4 h(r=0.9992),and 11.097μg/h during 4-12 h(r=0.9886),*** the osmotic pump type of DDS generally exhibits a good correlation between in vivo and in vitro release behaviors,an osmotic pump controlled delivery system was designed in combination with dry coating technology targeting on the cumulative release characteristics to mimic the physiological MT profiles in the healthy younger *** high similarity between the experimental drug release profiles and the theoretical profiles(similarity factor f_(2)>50)and the high correlation between the predicted plasma concentration profiles and the theoretical plasma concentration profiles(r=0.9366,0.9163,0.9264)ind

关键词： Bio-mimetic DDS Melatonin Dose-division method Osmotic pump Residual method

Theoretical and experimental investigations on single-atom catalysis:Pt1/FeOx for water-gas shift reaction Shan-Fei wang1,§,Yangyang Li2,3,§,Haiyan wang1,Jin-Xia Liang1(✉),Chun Zhu1

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Nano Research 2024年第9期17卷 8627-8637页

作者： Shan-Fei wang Yangyang Li Haiyan wang Jin-Xia Liang Chun Zhu Botao Qiao School of Chemistry and Chemical Engineering Guizhou UniversityGuiyang 550025China CAS Key Laboratory of Science and Technology on Applied Catalysis Dalian Institute of Chemical PhysicsChinese Academy of SciencesDalian 116023China University of Chinese Academy of Sciences Beijing 100049China

Oxide-supported metal single-atom catalysts(SACs)have exhibited excellent catalytic performance for water-gas shift(WGS)***,we report the single-atom catalyst Pt1/FeOx exhibits excellent medium temperature catalytic performance for WGS reactions by the density functional theory(DFT)calculations and experimental *** calculations indicate that H_(2)O molecules are easily dissociated at oxygen vacancies,and the formed*OH and*O are adsorbed on Pt1 single atoms and the adjacent O atoms,*** studying four possible reaction mechanisms,it is found that the optimal WGS reaction pathway is proceeded along the carboxyl mechanism(pathway III),in which the formation of*COOH intermediates can promote the stability of Pt1/FeOx SAC and the easier occurrence of WGS *** energy barrier of the rate-determining step during the entire reaction cycle is only 1.16 eV,showing the high activity for the medium temperature WGS reaction on Pt1/FeOx SAC,which was verified by experimental ***,the calculated turnover frequencies(TOFs)of CO_(2)and H_(2)formation on Pt1/FeOx at 610 K(337℃)can reach up to 1.14×10^(-3)s^(-1)·site^(-1)through carboxyl *** this work,we further expand the application potential of Pt1/FeOx SAC in WGS reaction.

关键词： water-gas shift(WGS)reaction single-atom catalyst(SAC) density functional theory(DFT) thermocatalysis