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An Exploration of How Practitioners Make Meaning in a Chinese Medicine Consultation and Treatment

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Chinese Medicine and Culture 2024年第1期7卷 63-71页

作者： Felicity clare Moir University of Westminster London W1B 2HWthe United Kingdom

In Chinese medicine, practitioners assess patients’ complaints, analyze their underlying problems, identify causes and come to a diagnosis, which then directs treatment. What is not obvious and not recorded in a consultation is the clinical reasoning process that practitioners use. The research filmed three practitioners in the UK while they conducted a consultation and treatment on new patients. The practitioners and researchers viewed the films and used them as aide-memoirs while the reasoning process throughout was discussed. In order to determine the pattern, practitioners used the four examinations to gather information from the patient in an iterative process;their aesthetic reasoning was highly developed. Through triangulation they checked the information they received against a detailed understanding of the qi-dynamic. They used highly analytical strategies of forward(inductive) and backward(deductive) reasoning against the prototypes of the signs and symptoms that indicate a specific Zheng. This was achieved through an abductive process that linked description with explanation and causal factors with pathological mechanisms. The feedback loop with the patient continued through the consultation and into the treatment. A process of translation and interpretation was needed to turn the patient’s story into the practitioner’s story of qi-dynamics that then directed the treatment. Awareness of our clinical reasoning process will mitigate against biases, improve our diagnoses and treatment choices and support the training of students.

关键词： Chinese medicine Clinical reasoning Abduction Translation and interpretation

New lump interaction complexitons to the(2+1)-dimensional Korteweg-de Vries equation with electrostatic wave potential in plasmas

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Journal of Ocean Engineering and Science 2024年第2期9卷 173-177页

作者： Tukur Abdulkadir Sulaiman Abdullahi Yusuf Alrazi Abdeljabbar Mustafa bayram Department of Computer Engineering Biruni UniversityIstanbulTurkey Department of Mathematics Federal University DutseJigawaNigeria Department of Mathematics Near East University TRNCMersin 10Turkey Department of Mathematics Khalifa University for Science and TechnologyAbu DhabiUAE

A soliton is a packet of self-reinforcing waves that maintains its structure when moving at a constant *** are caused by the cancellation of the medium’s nonlinear and dispersive *** plas-mas,the bilinear form of Hirota will be utilized to investigate the(2+1)-dimensional Korteweg-de Vries equation with electrostatic wave *** for complexiton lump interaction have been *** throw further light on the physical qualities of the recorded data,certain 3-dimensional and contour plots are presented to illustrate the interaction elements of these solutions.

关键词： (2+1)-dimensional Korteweg-de Vries equation Multi waves solutions Brether waves solutions Numerical simulations

The association of diet quality and physical activity with cardiovascular disease and mortality in 85,545 older Australians:A longitudinal study

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Journal of Sport and Health Science 2024年第6期13卷 841-850页

作者： Ding Ding Joe Van Buskirk Stephanie Partridge Philip clare Edward Giovannucci Adrian Bauman Nicole Freene Robyn Gallagher Binh Nguyen Sydney School of Public Health Faculty of Medicine and Healththe University of SydneyCamperdownNSW 2006Australia Charles Perkins Centre the University of SydneyCamperdownNSW 2006Australia Sydney Local Health District CamperdownNSW 2050Australia School of Health Sciences Faculty of Medicine and Healththe University of SydneyCamperdownNSW 2006Australia National Drug and Alcohol Research Centre UNSW SydneySydneyNSW 2052Australia Departments of Nutrition and Epidemiology Harvard T.H.Chan School of Public HealthBostonMA 02115USA Faculty of Health University of CanberraCanberraACT 2617Australia Susan Wakil School of Nursing and Midwifery the University of SydneyCamperdownNSW 2050Australia

Background:A quality diet and an active lifestyle are both important cornerstones of cardiovascular disease(CVD)***,despite their interlinked effects on metabolic health,the 2 behaviors are rarely considered jointly,particularly within the context of CVD *** examined the independent,interactive,and joint associations of diet and physical activity with CVD hospitalization,CVD mortality,and all-cause ***:CVD-free Australian participants aged 4574 years(n=85,545)reported physical activity,diet,sociodemographic,and lifestyle characteristics at baseline(20062009)and follow-up(20122015),and data were linked to hospitalization and death registries(03/31/2019 for CVD hospitalization and all-cause mortality and 12/08/2017 for CVD mortality).Diet quality was categorized as low,medium,and high based on meeting dietary *** activity was operationalized as(a)total moderate-to-vigorous physical activity(MVPA)as per guidelines,and(b)the composition of MVPA as the ratio of vigorous-intensity physical activity(VPA)to total *** used a left-truncated cause-specific Cox proportional hazards model using time-varying ***:During a median of 10.7 years of follow-up,6576 participants were admitted to the hospital for CVD and 6581 died from all causes(876 from CVD during 9.3 years).A high-quality diet was associated with a 17%lower risk of all-cause mortality than a low-quality diet,and the highest MVPA category(compared with the lowest)was associated with a 44%and 48%lower risk of CVD and all-cause mortality,*** interactions between diet and physical activity were *** all outcomes,the lowest risk combinations involved a high-quality diet and the highest MVPA *** for total MVPA,some VPA was associated with further risk reduction of CVD hospitalization and all-cause ***:For CVD prevention and longevity,one should adhere to both a healthy d

关键词： Diet Physical activity Cardiovascular disease Mortality Cohort studies

The Effect of Uterine Artery Occlusion with Tourniquet on Ovarian Reserve during Open Myomectomy at a University Teaching Hospital in Southern Nigeria

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Advances in Reproductive Sciences 2024年第1期12卷 37-50页

作者： William Amebeobari Mube Justina Omoikhefe Alegbeleye Ngozi clare Orazulike Department of Obstetrics and Gynaecology University of Port Harcourt Teaching Hospital Rivers State Port Harcourt Nigeria

Background: The most common surgical treatment for symptomatic uterine fibroids, particularly in women with fertility concerns, is open myomectomy. Given the high vascularity of the uterus, haemorrhage during the procedure is a serious risk that is often mitigated with a uterine tourniquet. Aim and Objectives: To evaluate the effect of uterine artery occlusion with a tourniquet during open myomectomy on ovarian reserve using serial anti-Mullerian hormone (AMH) measurements. Materials and Methods: This was a prospective longitudinal study with a quasi-experimental design and a convenient sampling technique. The study enrolled 47 women who had abdominal myomectomy between September 1, 2021, and March 31, 2022, at the University of Port Harcourt Teaching Hospital. Blood samples were collected before anaesthesia was administered in theatre, on day two, and three months after open abdominal myomectomy for anti-Mullerian hormone assay. The data was collected using a semi-structured proforma, entered into an Excel spreadsheet, and analyzed using SPSS version 25.0 with a 95% confidence interval. Statistical significance level was set at 0.05. Results: The pre-surgery AMH mean value was 1.67 ± 1.44 ng/ml, while the values after using a uterine tourniquet at myomectomy on the second day and three months later were 1.22 ± 1.24 ng/ml and 1.59 ± 1.43 ng/ml, respectively. There was no statistically significant change in AMH levels, and there was no statistically significant relationship between blood loss and tourniquet time and AMH after open abdominal myomectomy. Conclusion: The use of a uterine tourniquet and blood loss during open myomectomy has no effect on ovarian reserve.

关键词： Uterine Tourniquet Open Abdominal Myomectomy Ovarian Reserve Anti-Mullerian Hormone Nigeria

Quasi-Static, Poiseuille Flow of Analgesics from an Elastomeric Pump: Theoretical Determination of Infusion Times and Toxicity Conditions

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Journal of Biosciences and Medicines 2024年第9期12卷 251-265页

作者： clare B. Lipscombe Trevor C. Lipscombe Don S. Lemons Division of General Surgery Vanderbilt University Medical Center Nashville TN USA Catholic University of America Press Washington DC USA Department of Physics Bethel College North Newton KS USA

Background: Elastomeric pumps (elastic balls into which analgesics or antibiotics can be inserted) push medicines through a catheter to a nerve or blood vessel. Since elastomeric pumps are small and need no power source, they fit easily into a pocket during infusion, allowing patient mobility. Elastomeric pumps are widely used and widely studied experimentally, but they have well-known problems, such as maintaining reliable flow rates and avoiding toxicity or other peak-and-trough effects. Objectives: Our research objective is to develop a realistic theoretical model of an elastomeric pump, analyze its flow rates, determine its toxicity conditions, and otherwise improve its operation. We believe this is the first such theoretical model of an elastomeric pump consisting of an elastic, medicine-filled ball attached to a horizontal catheter. Method: Our method is to model the system as a quasi-Poiseuille flow driven by the pressure drop generated by the elastic sphere. We construct an engineering model of the pressure exerted by an elastic sphere and match it to a solution of the one-dimensional radial Navier-Stokes equation that describes flow through a horizontal, cylindrical tube. Results: Our results are that the model accurately reproduces flow rates obtained in clinical studies. We also discover that the flow rate has an unavoidable maximum, which we call the “toxicity bump”, when the radius of the sphere approaches its terminal, unstretched value—an effect that has been observed experimentally. Conclusions: We conclude that by choosing the properties of an elastomeric pump, the toxicity bump can be restricted to less than 10% of the earlier, relatively constant flow rate. Our model also produces a relation between the length of time that the analgesic fluid infuses and the physical properties of the fluid, of the elastomeric sphere and the tube, and of the blood vessel into which the analgesic infuses. From these, we conclude that elastomeric pumps can be design

关键词： Elastomeric Pump Infusion Therapy Bio-Fluids Medical Devices Antibiotic Delivery Analgesic Delivery

Trajectory Tracking of a Planer Parallel Manipulator by Using Computed Force Control Method

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Chinese Journal of Mechanical Engineering 2017年第2期30卷 449-458页

作者： Atilla bayram Department of Mechanical Engineering Yuzuncu YilUniversityVanTurkey

Despite small workspace, parallel manipulators have some advantages over their serial counterparts in terms of higher speed, acceleration, rigidity, accuracy, manufacturing cost and payload. Accordingly, this type of manipulators can be used in many applications such as in high-speed machine tools, tuning machine for feeding, sensitive cutting, assembly and packaging. This paper presents a special type of planar parallel manipulator with three degrees of freedom. It is constructed as a variable geometry truss generally known planar Stewart platform. The reachable and orientation workspaces are obtained for this manipulator. The inverse kinematic analysis is solved for the trajectory tracking according to the redundancy and joint limit avoidance. Then, the dynamics model of the manipulator is established by using Virtual Work method. The simulations are performed to follow the given planar trajectories by using the dynamic equations of the variable geometry truss manipulator and computed force control method. In computed force control method, the feedback gain matrices for PD control are tuned with fixed matrices by trail end error and variable ones by means of optimization with genetic algorithm.

关键词： Parallel manipulator Variable geometry truss manipulator Planar Stewart platform. Dynamic analysis Computed force control Genetic algorithm

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食物回收等级制度帮助处理剩余食物（英文）

英语画刊(高中版) 2024年第1期 12-14页

作者： Daisy Chung Ally J.Levine clare Trainor

每天,世界各个角落都会丢弃大量的剩余食物,比如吃不完的饭菜、发霉的面包和不能吃的果皮果核等。这不仅造成食物浪费,还会导致环境问题日益严重。Humans grow and waste food at a staggering(令人吃惊的)*** devote half the earth’s...

每天,世界各个角落都会丢弃大量的剩余食物,比如吃不完的饭菜、发霉的面包和不能吃的果皮果核等。这不仅造成食物浪费,还会导致环境问题日益严重。Humans grow and waste food at a staggering(令人吃惊的)*** devote half the earth’s habitable land to food production,while ultimately tossing one-third of that food.

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An ultra-sensitive non-enzymatic hydrogen peroxide sensor based on SiO2-APTES supported Au nanoparticles modified glassy carbon electrode

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Progress in Natural Science:Materials International 2019年第4期29卷 390-396页

作者： Lutfullah bayram Muhammet Guler Institute of Science Van Yüzüncü Yil University Department of Chemistry Faculty of Science Van Yüzüncü Yil University

A novel electrochemical sensor based on(3-aminopropyl)triethoxysilane(APTES) functionalized Si02supported Au nanoparticles and Nafion(Nf) as the protective membrane was fabricated for the electrochemical determination of H2O2in contact lens-cleaning *** modification steps of glassy carbon working electrode(GCE) were evaluated by electrochemical impedance spectroscopy(EIS) and cyclic voltammetry(CV).The amperometric results showed that Nf/Au@Si02-APTES/GCE sensor can be used to determine H2O2in contact lens solutions with the linear ranges of 14-180 μM and 0.18-7.15 mM,excellent sensitivities of 2514.6 and894.2 μA mM cm-2,and a low limit of detection(LOD) of 4.25 μM depending upon signal-to-noise ratio of ***/Au@Si02-APTES/GCE exhibited excellent repeatability with relative standard deviation(RDS) of 2.66% and acceptable reproducibility with RSD of 3.35%.The sensor displayed reasonable selectivity in the presence of uric acid,dopamine,ascorbic acid,glucose,mannose,glycine,fructose,histidine,and arginine with RSD less than2.5%.The fabricated Nf/Au@Si02-APTES/GCE sensor has been successfully applied to detect H2O2in contact lens cleaning solutions.

关键词： Au nanoparticles (3-aminopropyl)triethoxysilane SiO2 Nafion Hydrogen peroxide Modified electrode

Kinetic Ising model in a time-dependent oscillating external magnetic field:effective-field theory

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Chinese Physics B 2010年第5期19卷 187-194页

作者： bayram Deviren Osman Canko Mustafa Keskin Institute of Science Erciyes University38039 KayseriTurkey Department of Physics Nevsehir University50300 NevsehirTurkey Department of Physics Erciyes University38039 KayseriTurkey

Recently, Shiet al. [2008 Phys. Left. A 372 5922] have studied the dynamical response of the kinetic Ising model in the presence of a sinusoidal oscillating field and presented the dynamic phase diagrams by using an effective-field theory （EFT） and a mean-field theory （MFT）. The MFT results are in conflict with those of the earlier work of Tome and de Oliveira, [1990 Phys. Rev. A 41 4251]. We calculate the dynamic phase diagrams and find that our results are similar to those of the earlier work of Tome and de Oliveira; hence the dynamic phase diagrams calculated by Shiet al. are incomplete within both theories, except the low values of frequencies for the MFT calculation. We also investigate the influence of external field frequency （w） and static external field amplitude （h0） for both MFT and EFT calculations. We find that the behaviour of the system strongly depends on the values of w and h0.

关键词： kinetic Ising model effective-field theory mean-field theory