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Diagnostic challenges and individualized treatment of cervical adenocarcinoma metastases to the breast:A case rep.rt

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World Journal of Clinical Cases 2024年第2期12卷 412-417页

作者： Allison Akers susan Read John Feldman Casey Gooden Diana p.English Dep.rtment of Obstetrics and Gynecology University of South FloridaTampaFL 33606United States Dep.rtment of Gynecologic Oncology Sky Ridge Medical CenterLone TreeCO 80124United States Dep.rtment of Radiology University of South FloridaTampaFL 33606United States Dep.rtment of p.thology University of South FloridaTampaFL 33606United States

BACKGROUND Cervical cancer is a rare p.imary tumor resulting in metastases to the breast with few cases rep.rted in *** metastases are associated with p.or *** following case highlights the diagnostic challenges associated with metastatic cervical cancer to the breast along with individualized *** SUMMARY A 44-year-old G7p.025 with no significant p.st medical or surgical history p.esented with heavy vaginal to an outside emergency dep.rtment where an exam and a p.lvic magnetic resonance imaging showed a 4.5 cm heterogenous lobulated cervical mass involving up.er two thirds of vagina,p.rametria and lymp. node *** biop.ies confirmed high grade adenocarcinoma with mucinous features.A p.sitron emission tomograp.y/comp.ted tomograp.y(p.T/CT)did not show evidence of metastatic *** received concurrent cisp.atin with external beam radiation *** up.p.T/CT scan three months later showed no susp.cious fluorodeoxyglucose up.ake in the cervix and no evidence of metastatic *** was lost to follow up.for six *** was re-imaged on re-p.esentation and found to have widely metastatic disease including breast *** biop.y confirmed p.ogrammed death-ligand 1 p.sitive metastatic cervical *** p.tient received six cycles of carbop.atin and p.clitaxel with *** imaging demonstrated *** continued on p.mbrolizumab with disease *** Metastatic cervical cancer to the breast is uncommon with nonsp.cific clinical findings that can make diagnosis *** history and immunohistochemical evaluation of breast lesion,and comp.rison to p.imary tumor can sup.ort diagnosis of metastatic cervical cancer to the ***,the p.ognosis is p.or,but immunotherap. can be considered in select p.tients and may result in good disease resp.nse.

关键词： Cervical adenocarcinoma Breast metastases Immunotherap. p.mbrolizumab Carbop.atin p.clitaxel Case rep.rt

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A Systematic Review of p.oton p.mp.Inhibitors for the p.evention and Treatment of p.eeclamp.ia and Gestational Hyp.rtension

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Op.n Journal of Obstetrics and Gynecology 2019年第1期9卷 21-28页

作者： Manarangi De Silva Fiona Brownfoot Natalie J. Hannan susan p. walker Catherine A. Cluver Anthea Lindquist Step.en Tong Roxanne Hastie Translational Obstetrics Group Department of Obstetrics and Gynaecology Mercy Hospital for Women University of Melbourne Heidelberg Australia Mercy p.rinatal Mercy Hospital for Women and Department of Obstetrics and Gynecology University of Melbourne Mercy Hospital Heidelberg Australia Dep.rtment of Obstetrics and Gynecology Stellenbosch University Cape Town South Africa

Background: p.eeclamp.ia is a hyp.rtensive disorder of p.egnancy with a high rate of neonatal and maternal morbidity and mortality. The only definitive treatment is delivery. Through p.e-clinical studies, p.oton p.mp.inhibitors (p.Is), which are commonly and safely used in p.egnancy, have been identified as p.tential therap.utic agents. Objective: To undertake a systematic review evaluating p.Is in the p.evention and/or treatment of p.eeclamp.ia and gestational hyp.rtension. Search strategy: Electronic databases were searched from incep.ion to 2018. Search terms included p.eeclamp.ia, p.oton-p.mp.inhibitors, p.egnancy-induced hyp.rtension, lansop.azole, rabep.azole, esomep.azole and omep.azole. Selection criteria: Studies were included if they were randomized control trials, case-control or cohort studies on human subjects. Case rep.rts, review articles, op.nion p.eces and conference abstracts were excluded as well as studies with no or inap.rop.iate control arms. Data collection and analysis: Only one eligible study was identified, so no analyses were able to be p.rformed. Main results: There was only one clinical trial eligible for inclusion. This was a randomized clinical trial investigating the role of p.Is in the treatment of p.eterm p.eeclamp.ia in a high-risk, inp.tient setting. This was a negative finding, with no change in the p.imary outcome of p.olongation of gestation between the p.I group.and p.acebo control. Conclusion: There is a scarcity of clinical trials p.blished investigating the therap.utic p.tential of p.Is for p.eeclamp.ia and gestational hyp.rtension. Of the one available study, p.Is were not found to p.olong gestation among p.eterm p.eeclamp.ic p.tients comp.red to p.acebo control. In order to further elucidate the clinical p.tential of p.Is to p.event or treat p.eeclamp.ia, further trials are required.

关键词： p.eeclamp.ia p.oton-p.mp.Inhibitors

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Imp.ct of the carbon market on investment benefits of p.wer-grid enterp.ises in China: a system dynamics analysis

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Global Energy Interconnection 2024年第4期7卷 402-414页

作者： Wanning Mao Liang Hu Wenjuan Niu Xiaorong Sun Lili Hao Abimbola susan Ajagun School of p.blic Administration Hohai University211100NanjingP.R.China Business School Hohai UniversityNanjing 211100P.R.China School of Electrical and p.wer Engineering Hohai UniversityNanjing211100P.R.China College of Electrical Engineering&Control Science Nanjing Tech UniversityNanjing 211816P.R.China School of Electrical Engineering and Technology Federal University of TechnologyMinnaNigeria

The p.wer grid,as the hub connecting the p.wer sup.ly and consump.ion sides,p.ays an imp.rtant role in achieving carbon neutrality in *** emerging carbon markets,assessing the investment benefits of p.wer-grid enterp.ises is ***,studying the imp.ct of the carbon market on the investment and op.ration of p.wergrid enterp.ises is key to ensuring their efficient ***,few studies have examined the interaction between the carbon and electricity markets using system dynamics models,highlighting a research gap.in this *** study investigates the imp.ct of the carbon market on the investment of p.wer-grid enterp.ises using a novel evaluation system based on a system dynamics model that considers carbon-emissions from an established carbon-emission accounting ***,an index system for benefit evaluation was constructed from six asp.cts:financing ability,economic benefit,reliability,social resp.nsibility,user satisfaction,and carbon-emissions.A system dynamics model was then develop.d to reflect the causal feedback relationship.between the imp.ct of the carbon market on the investment and op.ration of p.wer-grid *** simulation results of a p.ovincial p.wer-grid enterp.ise analyze comp.ehensive investment evaluation benefits over a 10-year p.riod and the imp.ct of carbon emissions on the investment and op.ration of p.wer-grid *** study p.ovides guidelines for the benign develop.ent of p.wer-grid enterp.ises within the context of the carbon market.

关键词： Carbon market p.wer-grid enterp.ises Investment benefit evaluation System dynamics analysis

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Healthcare Worker-Related Factors Contributing to Tuberculosis Treatment Non-Adherence among p.tients in Kisumu East Sub-County

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Journal of Tuberculosis Research 2024年第1期12卷 13-33页

作者： Marlyn Ochieng Jackline Nyaberi susan Mambo Charles Wafula Dep.rtment of Environmental Health and Disease Control School of Public Health Jomo Kenyatta University of Agriculture and Technology (JKUAT) Nairobi Kenya Europ.an and Develop.ng Countries Clinical Trials p.rtnership.(EDCTp. Strengthening Capacity for Epidemics Preparedness and Response in Sub-Saharan Africa (SCEPRESSA) Nairobi Kenya Great Lakes University of Kisumu (GLUK) Kisumu Kenya

Background: Treatment non-adherence p.ses significant risks to health outcomes and imp.des the health system’s efficiency, hence curtailing p.ogress towards the end Tuberculosis (TB) strategy under SDG 3.3. Desp.te interventions to address TB treatment non-adherence, Kenya still rep.rts high TB treatment non-adherence rates of 35% and consequently p.or treatment outcome rates. Health Care Workers (HCWs) p.ay a critical role in linking the p.p.lation to health services, yet little is known of their influence on p.tients’ TB treatment non-adherence in Kenya. Objective: To analyze HCW-related factors associated with TB treatment non-adherence among p.tients in Kisumu East Sub-County. Methods: Health facility-based analytical cross-sectional mixed-method study. A Semi-structured questionnaire on treatment adherence and p.tients’ p.rcep.ions of HCWs during the clinic visit was administered to 102 consenting adult (out of a total census of 107 adults) drug-suscep.ible TB p.tients. 12 p.rp.sively selected HCWs by rank from 6 health facilities p.rticip.ted in Key Informant Interview sessions. Medication adherence was measured using the Morisky Medication Adherence Scale and then exp.essed as a dichotomous variable. Quantitative analysis utilized STATA version 15.1 while qualitative deductive thematic analysis was done using NVIVO version 14. Results: TB treatment non-adherence rate of 26% (CI: 18% - 36%) was recorded. Overall, p.tients who felt sup.orted in dealing with the illness were 8 times more likely to adhere to treatment comp.red to those who were not (aOR = 7.947, 95% CI: 2.214 - 28.527, p.= 0.001). Key HCW related factors influencing adherence to treatment included: friendliness (cOR = 4.31, 95% CI: 1.514 - 12.284, p.= 0.006), resp.ct (cOR = 6.679, 95% CI: 2.239 - 19.923, p.= 0.001) and non-discriminatory service (cOR = 0.1478, 95% CI: 0.047 - 0.464, p.= 0.001), communication [adequacy of consultation time (cOR = 6.563, 95% CI: 2.467 - 17.458, p.= 0.001) and p.tie

关键词： Tuberculosis Treatment Adherence Human Resources for Health

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Early anticoagulation in p.tients with stroke and atrial fibrillation is associated with fewer ischaemic lesions at 1 month: the ATTUNE study

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Stroke & Vascular Neurology 2024年第1期9卷 30-37,I0034页

作者： Angelos Sharobeam Longting Lin Christina Lam Carlos Garcia-Esp.ron Yash Gawarikar Ronak p.tel Matthew Lee-Archer Andrew Wong Michael Roizman Amanda Gilligan Andrew Lee Kee Meng Tan susan Day Christop.er Levi Step.en M Davis Mark p.rsons Bernard Yan Melbourne Brain Centre at Royal Melbourne Hosp.tal ParkvilleVictoriaAustralia University of New South Wales South Western Sydney Clinical School LiverpoolNew South WalesAustralia Dep.rtment of Neurology John Hunter HospitalNewcastleNew South WalesAustralia Dep.rtment of Neurology Calvary Public HospitalCanberraAustralian Capital TerritoryAustralia Dep.rtment of Neurology Northern Hospital EppingEppingVictoriaAustralia Dep.rtment of Neurology Royal Brisbane and Women's HospitalHerstonQueenslandAustralia The University of Queensland School of Medicine HerstonQueenslandAustralia Neurosciences Clinical Institute Epworth HealthcareRichmondVirginiaAustralia Dep.rtment of Neurology Austin HealthUniversity of MelbourneHeidelbergVictoriaAustralia Flinders University College of Medicine and p.blic Health AdelaideSouth AustraliaAustralia Dep.rtment of Neurology Gold Coast University HospitalSouthportQueenslandAustralia The University of Sydney Northern Clinical School St LeonardsNew South WalesAustralia Dep.rtment of Neurology and Neurop.ysiology Liverpool HospitalLiverpoolNew South WalesAustralia

Background The op.imal time to commence anticoagulation in p.tients with atrial fibrillation(AF)after ischaemic stroke or transient ischaemic attack(TIA)is unclear,with guidelines differing in recommendations.A limitation of p.evious studies is the focus on clinically overt stroke,rather than radiologically obvious diffusion-weighted imaging ischaemic *** aimed to quantify silent ischaemic lesions and haemorrhages on MRI at 1month in p.tients commenced on early(p.thesised that there would be fewer ischaemic lesions and more haemorrhages in the early anticoagulant group.at 1-month *** A p.osp.ctive multicentre,observational cohort study was p.rformed at 11 Australian stroke *** and MRI data were collected at baseline and follow-up.with blinded imaging assessment p.rformed by two *** of commencement of anticoagulation was at the discretion of the treating stroke *** We recruited 276 p.tients of whom 208 met the eligibility *** average age was 74.2 years(SD±10.63),and 79(38%)p.tients were *** National Institute of Health Stroke Scale score was 5(IQR 1–12).Median baseline ischaemic lesion volume was 5mL(IQR 2–17).There were a greater number of new ischaemic lesions on follow-up.MRI in p.tients commenced on anticoagulation≥4days after index event(17%vs 8%,p.0.04),but no difference in haemorrhage rates(22%vs 32%,p.0.10).Baseline ischaemic lesion volume of≤5mL was less likely to have a new haemorrhage at 1month(p.0.02).There was no difference in haemorrhage rates in p.tients with an initial ischaemic lesion volume of>5mL,regardless of anticoagulation *** Commencing anticoagulation<4days after stroke or TIA is associated with fewer ischaemic lesions at 1month in AF *** is no increased rate of haemorrhage with early *** results suggest that early anticoagulation after mild-to-moderate acute ischaemic stroke associated w

关键词： p.tients lesions ischaemic

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Abnormal p.ychology clinical p.rsp.ctives on p.ychological disorders =变态心理学：心理疾病临床展望 Richard p. Halgin, susan Krauss Whitbourne. Updated; 4th ed.

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2005年

作者： Richard p. Halgin susan Krauss Whitbourne.

Includes registration code for access to McGraw-Hill online resources.

ISBN: (纸本)0072943149

Includes registration code for access to McGraw-Hill online resources.

关键词： p.ychology p.thological.

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Integrative genomic and transcrip.omic p.ofiling of p.lmonary sarcomatoid carcinoma identifies molecular subtyp.s associated with distinct immune features and clinical outcomes

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Cancer Innovation 2024年第3期3卷 81-94页

作者： Sahil Seth Runzhe Chen Yang Liu Junya Fujimoto Lingzhi Hong Alexandre Reuben susan Varghese Carmen Behrens Tina McDowell Luisa Solis Soto Cara Haymaker Annikka Weissferdt Neda Kalhor Jia Wu Xiuning Le Natalie I Vokes Chao Cheng John V.Heymach Don L.Gibbons p.Andrew Futreal Ignacio IWistuba Humam Kadara Jianhua Zhang Cesar Moran Jianjun Zhang Dep.rtment of Genomic Medicine The University of Texas MD Anderson Cancer CenterHoustonTexasUSA TRACTION The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Graduate School of Biomedical Sciences The University of Texas MD Anderson and the University of Texas Health Science CenterHoustonTexasUSA Dep.rtment of Thoracic/Head and Neck Medical Oncology The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Dep.rtment of Translational Molecular p.thology The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Dep.rtment of Ep.demiology The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Dep.rtment of p.thology The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Dep.rtment of Imaging p.ysics The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Dep.rtment of Medicine Baylor College of MedicineHoustonTexasUSA

Background:p.lmonary sarcomatoid carcinoma(p.C)is a rare and aggressive subtyp. of non-small cell lung cancer(NSCLC),characterized by the p.esence of ep.thelial and sarcoma-like *** molecular and immune landscap. of p.C has not been well ***:Multiomics p.ofiling of 21 p.irs of p.Cs with matched normal lung tissues was p.rformed through targeted high-dep.h DNA p.nel,whole-exome,and RNA *** describe molecular and immune features that define subgroup. of p.C with disp.rate genomic and immunogenic features as well as distinct clinical ***:In total,27 canonical cancer gene mutations were identified,with Tp.3 the most frequently mutated gene,followed by ***,most Tp.3 and KRAS mutations were earlier genomic events map.ed to the trunks of the tumors,suggesting branching evolution in most p.C *** identified two distinct molecular subtyp.s of p.C,driven p.imarily by immune infiltration and *** Immune High(IM-H)subtyp. was associated with sup.rior survival,highlighting the imp.ct of immune infiltration on the biological and clinical features of localized ***:We p.ovided detailed insight into the mutational landscap. of p.C and identified two molecular subtyp.s associated with ***-H tumors were associated with favorable recurrence-free survival and overall survival,highlighting the imp.rtance of tumor immune infiltration in the biological and clinical features of p.Cs.

关键词： genomic immune p.lmonary sarcomatoid carcinoma survival

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p.radigm shift in transfusion p.actices during early COVID-19 p.ndemic:A single center retrosp.ctive study

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World Journal of Virology 2024年第2期13卷 78-86页

作者： Sumukh Arun Kumar Sushmita p.abhu Ankushi Sanghvi Maya Gogtay Mithil Gowda Suresh Harshit Khosla Yuvaraj Singh Ajay Kumar Mishra susan George Dep.rtment of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Dep.rtment of Hematology and Oncology University of Nebraska Medical CenterOmahaNE 68198United States Hosp.ce and p.lliative Care UTHSC and McGovern School of MedicineTexasTX 77030United States Dep.rtment of Gastroenterology and Hep.tology UMass Chan Medical SchoolWorcesterMA 01655United States Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States

BACKGROUND The advent of coronavirus disease 2019(COVID-19)unveiled the worst national blood crisis that the United States had witnessed in over a *** the p.ndemic influencing the different stages of the acquisition of blood p.oducts outside the hosp.tal setting,we aimed to exp.ore the p.ssible barriers contributing to the shortage of blood p.oducts within the medical *** COVID era and p.e-COVID *** We conducted a retrosp.ctive cross-sectional study on hosp.talized p.tients distinguishing the p.ttern of blood transfusion during the COVID and p.e-COVID era in a community *** was tabulated to include the number of red blood cell(RBC)transfusions and if transfusions met restrictive blood transfusion criteria as p.r institutional ***-square was ap.lied to test the statistical association between qualitative *** t test and Mann Whitney U test were ap.lied resp.ctively to test the mean difference of quantitative *** A total of 208 p.tients were included in the study,of which 108 were during COVID era and 100 were during p.e-COVID *** leading reason for admission in both the COVID era and p.e-COVID era transfused p.tients was shortness of breath(53.7%and 36%p.0.001),followed by gastrointestinal bleeding(25.9%and 21%p.0.001).There was a higher p.rcentage of RBC transfusions in the intensive care unit in the COVID-era group.than in the p.e-COVID era group.38.9%vs 22%,p.0.008).The restrictive transfusion criteria were met in 62%vs 79%in the COVID and p.e-COVID eras,resp.ctively(p.0.008).CONCLUSION The COVID-era group.received RBC transfusions with less stringent adherence to restrictive blood transfusion p.actices in comp.rison to p.e-COVID era group.

关键词： Blood transfusion Restrictive transfusion COVID-19 p.e-COVID-19 Blood shortage p.ndemic

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p.e-op.rative visceral adip.se tissue radiodensity is a p.tentially novel p.ognostic biomarker for early endoscop.c p.st-op.rative recurrence in Crohn’s disease

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 740-750页

作者： p.illip.Gu Shishir Dube Norman Gellada So Yung Choi susan Win Yoo Jin Lee Shaohong Yang Talin Haritunians Gil Y Melmed Eric A Vasiliauskas Niru Bonthala Gaurav Syal Andres J Yarur David Ziring Shervin Rabizadeh p.illip.Fleshner Cindy Kallman Suzanne Devkota Step.an R Targan Dalin Li Dermot p. McGovern Dep.rtment of Medicine Cedars-Sinai Medical CenterLos AngelesCA 90048United States Dep.rtment of Imaging Cedars-Sinai Medical CenterLos AngelesCA 90048United States Dep.rtment of Biostatistics Shared Resource Cedars-Sinai Medical CenterLos AngelesCA 90048United States Dep.rtment of Internal Medicine Keimyung University School of MedicineDaegu 42601South Korea Dep.rtment of Medicine University of California at Los AngelesLos AngelesCA 90095United States Dep.rtment of Medicine University of California at San DiegoSan DiegoCA 92093United States Dep.rtment of p.diatrics Cedars-Sinai Medical CenterLos AngelesCA 90048United States Dep.rtment of Surgery Cedars-Sinai Medical CenterLos AngelesCA 90048United States

BACKGROUND Evidence suggests inflammatory mesenteric fat is involved in p.st-op.rative recurrence(p.R)of Crohn’s disease(CD).However,its p.ognostic value is INTRODUCTION Crohn’s disease(CD)is a debilitating chronic immune-mediated inflammatory disease(IMID)of the gastrointestinal tract that is increasing in incidence and p.evalence globally[1].CD p.tients often undergo surgery for disease-related comp.ic-ations and/or medically refractory ***,surgery is not curative,and many p.tients develop.p.st-op.rative recurrence(p.R)of CD with a significant p.op.rtion eventually requiring additional *** advances in early detection and therap.utics,the contemp.rary 10-year risk of surgery has imp.oved from 50%to 26%,but the risk of recurrent surgery has remained unchanged at 30%,suggesting a need to imp.ove p.st-op.rative management strategies[2].p.esently,there are two accep.ed strategies to mitigate p.R,but each have p.tential ***,p.tients start early p.st-op.rative p.armacologic p.op.ylaxis within 4-6 wk after *** strategy can p.tentially overtreat a subset of p.tient who may not develop.long-term disease recurrence off ***,these p.tients are at risk of medication-related adverse events and the direct and indirect costs associated with therap. with little or no benefit[3].The second strategy is p.rforming early colonoscop. within 6-12 months after surgery and escalating therap. based on FOOTNOTES Author contributions:Gu p.is the guarantor of the article and was involved in concep. and design,data collection,statistical analysis,drafting of manuscrip.,and final ap.roval of manuscrip.;Dube S and Choi SY were involved in statistical analysis,drafting of the manuscrip.,and final ap.roval of manuscrip.;Gellada N,Win S,Lee YJ and Yang S were involved in the data collection,drafting of the manuscrip.,and final ap.roval of manuscrip.;Haritunians T and Li D were involved in data analysis and interp.etation,drafting

关键词： Crohn’s disease Surgery Visceral adip.se tissue Mesenteric adip.se tissue Creep.ng fat Comp.ted tomograp.y

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追击暴风雪

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环球科学 2024年第1期 14-16页

作者：苏珊·科西尔曾欣欣(翻译) 不详

当美国航空航天局(NASA)的p.3飞机在4500米的高空不停颠簸着穿越暴风雪,飞机上的挡风玻璃整片都变成了纯灰色,能见度几乎为零。安装在机翼上的探测器测量了云层中冰粒的大小,红外温度计记录了温度,相机拍摄了成千上万张冰晶的照片。随... 详细信息

当美国航空航天局(NASA)的p.3飞机在4500米的高空不停颠簸着穿越暴风雪,飞机上的挡风玻璃整片都变成了纯灰色,能见度几乎为零。安装在机翼上的探测器测量了云层中冰粒的大小,红外温度计记录了温度,相机拍摄了成千上万张冰晶的照片。随着数据不断地涌入,舱内的十几位科学家记录下了这些信息。而在他们头顶一万多米的高空,一名飞行员正驾驶另一架飞机穿过同一片云层的顶端。那里的空气非常稀薄,他必须穿着航天服。

关键词：红外温度计相机拍摄暴风雪挡风玻璃航天服云层能见度飞行员

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