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现代教学 2024年第1期 141-142页

作者：宋虹复旦大学附属闵行实验学校

我校英语学科深刻认识到学生德智体美劳全面发展的重要性,结合中国的二十四节气设计了“stay——跟着节气学英语”德育项目。在实施过程中,学生用英语视频和作品呈现的方式分享传播中国的节气文化,形成英语学科核心素养。

关键词：二十四节气 stay 英语学科核心素养

Patients with Crohn’s disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications’ rate

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World Journal of Gastrointestinal Surgery 2019年第5期11卷 261-270页

作者： 2015 European Society of Coloproctology(ESCP)collaborating group Alaa El-Hussuna 不详 Academic Research Consultant SurgeonDepartment of SurgeryAalborg University HospitalHobrovej 18-22Aalborg 9100Denmark

BACKGROUND Right hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn’s disease(CD)and malignant ones like colon cancer(CC).AIM To investigate differences in pre-and peri-operative factors and their impact on post-operative outcome in patients with CC and CD.METHODS This is a sub-group analysis of the European Society of Coloproctology’s prospective,multi-centre snapshot audit.Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included.Primary outcome measure was 30-d post-operative complications.Secondary outcome measures were post-operative length of stay(LOS)at and readmission.RESULTS Three hundred and seventy-five patients with CD and 2,515 patients with CC were included.Patients with CD were younger(median=37 years for CD and 71 years for CC(P<0.01),had lower American Society of Anesthesiology score(ASA)grade(P<0.01)and less comorbidity(P<0.01),but were more likely to be current smokers(P<0.01).Patients with CD were more frequently operated on by colorectal surgeons(P<0.01)and frequently underwent ileocecal resection(P<0.01)with higher rate of de-functioning/primary stoma construction(P<0.01).Thirty-day post-operative mortality occurred exclusively in the CC group(66/2515,2.3%).In multivariate analyses,the risk of post-operative complications was similar in the two groups(OR 0.80,95%CI:0.54-1.17;P=0.25).Patients with CD had a significantly longer LOS(Geometric mean 0.87,95%CI:0.79-0.95;P<0.01).There was no difference in re-admission rates.The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers.CONCLUSION Patients with CD were younger,with lower ASA grade,less comorbidity,operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complications'rate was not different between the two groups.

关键词： Crohn’s disease Colon cancer Complications Length of stay Bowel resection Right hemicolectomy

The emergency department length of stay: Is the time running out?

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Chinese Journal of Traumatology 2019年第3期22卷 125-128页

作者： Alexander Becker Gil Segal Yuri Berlin Dan Hershko Department of Surgery A Emek Medical CenterAfula 18101Israel

Purpose: To examine the relationships between emergency department length of stay (EDLOS) with hospital length of stay (HLOS) and clinical outcome in hemodynamically stable trauma patients. Methods: Prospective data collected for 2 years from consecutive trauma patients admitted to the trauma resuscitation bay. Only stable blunt trauma patients with appropriate trauma triage criteria requiring trauma teamactivationwere included in the study. EDLOSwas determined short if patient spent less than 2 h in the emergency department (ER) and long for more than 2 h. Results: A total of 248 patients were enrolled in the study. The mean total EDLOS was 125 min (range 78 e180). Injury severity score (ISS) were significantly higher in the long EDLOS group (17 ± 13 versus 11 ± 9, p < 0.001). However, when leveled according to ISS, there were no differences in mean in diagnostic workup, admission rate to intensive care unit (ICU) or HLOS between the short and long EDLOS groups. Conclusion: EDLOS is not a significant parameter for HLOS in stable trauma patients.

关键词： Emergency department length of stay Trauma patients Hospital length of stay

Concrete-Filled Steel Tube Arch Bridges in China

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Engineering 2018年第1期4卷 143-155页

作者： Jielian Zheng Jianjun wang College of Civil Engineering and Architecture Guangxi University Nanning 530004 China Guangxi Communications Investment Group Co. Ltd. Nanning 530022 China Guangxi Road and Bridge Engineering Group Co. Ltd. Nanning 530011 China

In the past 20 years, great progress has been achieved in China in the construction of concrete-filled steel tube (CFST) arch bridges and concrete arch bridges with a CFST skeleton. The span of these bridges has been increasing rapidly, which is rare in the history of bridge development. The large-scale construction of expressways and high-speed railways demands the development of long-span arch bridges, and advances in design and construction techniques have made it possible to construct such bridges. In the present study, the current status, development, and major innovative technologies of CFST arch bridges and concrete arch bridges with a CFST skeleton in China are elaborated. This paper covers the key construction technologies of CFST arch bridges, such as the design, manufacture, and installation of steel tube arch trusses, the preparation and pouring of in-tube concrete, and the construction of the world’s longest CFST arch bridge—the First Hejiang Yangtze River Bridge. The main construction technologies of reinforced concrete arch bridges are also presented, which include cable-stayed fastening-hanging cantilever assembly, adjusting the load by means of stay cables, surrounding the concrete for arch rib pouring, and so forth. In addition, the construction of two CFST skeleton concrete arch bridges—the Guangxi Yongning Yong River Bridge and the Yunnan–Guangxi Railway Nanpan River Bridge—is discussed. CFST arch bridges in China have already gained a world-leading position; with the continuous innovation of key technologies, China will become the new leader in promoting the development of arch bridges.

关键词： Concrete-filled steel tube (CFST) arch bridge Steel-reinforced concrete arch bridge Cable-stayed fastening-hanging cantileverassembly Vacuum-assisted pouring in-tube concrete Adjusting load by stay cables

Socio-demographic factors impact time to discharge following total knee arthroplasty

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World Journal of Orthopedics 2018年第12期9卷 285-291页

作者： Ugonna N Ihekweazu Garrett H Sohn Mitzi S Laughlin Robin N Goytia Vasilios Mathews Gregory W Stocks Anay R Patel Mark R Brinker Fondren Orthopedic Group Fondren Orthopedic Research Institute Fondren Orthopedic Group Department of Orthopedic Surgery Baylor College of Medicine

AIM To determine social, logistical and demographic factors that influence time to discharge in a short stay pathway(SSP) by following total knee arthroplasty(TKA). METHODS The study included primary TKA's performed in a highvolume arthroplasty center from January 2016 through December 2016. Potential variables associated with increased hospital length of stay(LOS) were obtained from patient medical records. These included age, gender, race, zip code, body mass index(BMI), number of pre-operative medications used, number of narcotic medications used, number of patient reported allergies(PRA), simultaneous bilateral surgery, tobacco use, marital status, living arrangements, distance traveled for surgery, employment history, surgical day of the week, procedure end time and whether the surgery was performed during a major holiday week. Multivariate step-wise regression determined the impact of social, logistical and demographic factors on LOS. RESULTS Eight hundred and six consecutive primary SSP TKA's were included in this study. Patients were discharged at a median of 49 h(post-operative day two). The following factors increased LOS: Simultaneous bilateral TKA [46.1 h longer(P < 0.001)], female gender [4.3 h longer(P = 0.012)], age [3.5 h longer per ten-year increase in age(P < 0.001)], patient-reported allergies [1.1 h longer per allergy reported(P = 0.005)], later procedure endtimes [0.8 h longer per hour increase in end-time(P = 0.004)] and Black or African American patients [6.1 h longer(P = 0.047)]. Decreased LOS was found in married patients [4.8 h shorter(P = 0.011)] and TKA's performed during holiday weeks [9.4 h shorter(P = 0.011)]. Non-significant factors included: BMI, median income, patient's living arrangement, smoking status, number of medications taken, use of pre-operative pain medications, distance traveled to hospital, and the day of surgery. CONCLUSION The cost of TKA is dependent upon LOS, which is affected by multiple factors. The clinical care team should acknowledge socio-demographic factors

关键词： Total knee replacement Total knee arthroplasty Cost Risk factors Length of stay

Post-silking nitrogen accumulation and remobilization are associated with green leaf persistence and plant density in maize

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Journal of Integrative Agriculture 2019年第8期18卷 1882-1892页

作者： ZHANG Li-li ZHOU Xiang-li FAN Ye FU Jun HOU Peng YANG Hai-long QI Hua Agronomy College Shenyang Agricultural University Shenyang 110866 P.R.China Dandong Academy of Agricultural Sciences Fengcheng 118109 P.R.China College of Life Sciences Northwest A&F University Yangling 712100 P.R.China Institute of Crop Sciences Chinese Academy of Agricultural Sciences Beijing 100081 P.R.China

stay green(SG) maize was found to have higher grain yield and post-silking nitrogen(N) uptake(PostN) compared with a non-stay green(NSG) hybrid. To understand the effects of plant density on grain yield(GY) and N efficiency in modern maize hybrids, we compared two modern hybrids(SG hybrid DY508 and NSG hybrid NH101) with similar maturity ratings at three plant densities(45 000, 60 000, and 75 000 pl ha^–1) in 2014 and 2015. GY, leaf senescence, dry matter(DM) accumulation,N accumulation, PostN, and post-silking N remobilization(RemN) were analyzed. DY508 and NH101 had similar GY, but DY508 had higher thousand kernel weight(TKW) and lower kernel number(KN) than NH101. Plant density significantly increased GY in the two hybrids. On average, over the two years, plant density improved GY in DY508 and NH101 by 18.5 and 11.1%, respectively, but there were no differences in total dry matter(TDM) and post-silking DM(PostDM) between the two hybrids. Plant density improved leaf N, stem N, and grain N at the silking and maturity stages in 2014 and 2015. DY508 was lower in harvest index(HI), nitrogen harvest index(NHI), and grain N concentration(GNC) than NH101. Grain N in DY508 was 2.61 kg ha^–1 less than in NH101, and this was caused by lower GNC and leaf RemN. On the average, DY508 was 1.62 kg ha^–1 less in leaf remobilized N(leaf RemN) than NH101, but was similar in stem remobilized N(stem RemN;2.47 kg ha^–1 vs. 3.41 kg ha^–1). Maize hybrid DY508 shows delayed leaf senescence in the upper and bottom canopy layers in the later stages of growth. The present study provides evidence that the NH101, which has rapid leaf senescence at the late grain-filling stage, has gained equivalent GY and higher leaf RemN, and was more efficient in N utilization.

关键词： maize N remobilization post-silking N uptake stay green plant density

Anomaly Detection Algorithm for stay Cable Monitoring Data Based on Data Fusion

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Journal of Harbin Institute of Technology(New Series) 2016年第3期23卷 39-43页

作者： Xiaoling Liu Qiao Huang Yuan Ren School of Transportation Southeast University

In order to improve the accuracy and consistency of data in health monitoring system,an anomaly detection algorithm for stay cables based on data fusion is proposed.The monitoring data of Nanjing No.3 Yangtze River Bridge is used as the basis of study.Firstly,an adaptive processing framework with feedback control is established based on the concept of data fusion.The data processing contains four steps:data specification,data cleaning,data conversion and data fusion.Data processing information offers feedback to the original data system,which further gives guidance for the sensor maintenance or replacement.Subsequently,the algorithm steps based on the continuous data distortion is investigated,which integrates the inspection data and the distribution test method.Finally,a group of cable force data is utilized as an example to verify the established framework and algorithm.Experimental results show that the proposed algorithm can achieve high detection accuracy,providing a valuable reference for other monitoring data processing.

关键词： stay cable health monitoring anomaly detection data fusion manual inspection

Customized Prediction of Short Length of stay Following Elective Cardiac Surgery in Elderly Patients Using a Genetic Algorithm

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World Journal of Cardiovascular Surgery 2013年第5期3卷 163-170页

作者： Joon Lee Sapna Govindan Leo A. Celi Kamal R. Khabbaz Balachundhar Subramaniam Beth Israel Deaconess Medical Center Boston USA Harvard-MIT Division of Health Sciences and Technology Cambridge USA School of Public Health and Health Systems University of Waterloo Waterloo Canada

Objective: To develop a customized short LOS (gery, using local data and a computational feature selection algorithm. Design: Utilization of a machine learning algorithm in a prospectively collected STS database consisting of patients who received cardiac surgery between January 2002 and June 2011. Setting: Urban tertiary-care center. Participants: Geriatric patients aged 70 years or older at the time of cardiac surgery. Interventions: None. Measurements and Main Results: Predefined morbidity and mortality events were collected from the STS database. 23 clinically relevant predictors were investigated for short LOS prediction with a genetic algorithm (GenAlg) in 1426 patients. Due to the absence of an STS model for their particular surgery type, STS risk scores were unavailable for 771 patients. STS prediction achieved an AUC of 0.629 while the GenAlg achieved AUCs of 0.573 (in those with STS scores) and 0.691 (in those without STS scores). Among the patients with STS scores, the GenAlg features significantly associated with shorter LOS were absence of congestive heart failure (CHF) (OR = 0.59, p = 0.04), aortic valve procedure (OR = 1.54, p = 0.04), and shorter cross clamp time (OR = 0.99, p = 0.004). In those without STS prediction, short LOS was significantly correlated with younger age (OR = 0.93, p 0.001), absence of CHF (OR = 0.53, p = 0.007), no preoperative use of beta blockers (OR = 0.66, p = 0.03), and shorter cross clamp time (OR = 0.99, p 0.001). Conclusion: While the GenAlg-based models did not outperform STS prediction for patients with STS risk scores, our local-data-driven approach reliably predicted short LOS for cardiac surgery types that do not allow STS risk calculation. We advocate that each institution with sufficient observational data should build their own cardiac surgery risk models.

关键词： Cardiac Surgery Elderly Length of stay Risk Prediction Genetic Algorithm

Early vs late endoscopic retrograde cholangiopancreatography in patients with acute cholangitis: A nationwide analysis

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World Journal of Gastrointestinal Endoscopy 2019年第1期11卷 41-53页

作者： Ramzi Mulki Rushikesh Shah Emad Qayed Department of Medicine Division of Digestive Diseases Emory University School of Medicine Grady Memorial Hospital Emory University

AIM To assess the effect of early vs late endoscopic retrograde cholangiopancreatography(ERCP) on mortality and readmissions in acute cholangitis, using a nationally representative sample.METHODS We used the 2014 National Readmissions Database to identify adult patients hospitalized with acute cholangitis who underwent therapeutic ERCP within one week of admission. Early ERCP was defined as ERCP performed on the same day of admission or the next day(days 0 or 1, stay was higher in the late ERCP group compared to the early ERCP group(6.9 d vs 4.5 d, P < 0.0001). The mean hospitalization cost was higher in the late ERCP group($21459 vs $16939, P < 0.0001).CONCLUSION Early ERCP is associated with lower in-hospital and 30-d mortality in those with or without severe cholangitis. Regardless of severity, we suggest performing early ERCP.

关键词： Cholangitis Endoscopic retrograde cholangiopancreatography Mortality Readmissions Severity cholangitis Length of stay Nationwide analysis

Gastrojejunostomy in patients with unresectable pancreatic head cancer-the use of Roux loop significantly shortens the hospital length of stay

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World Journal of Gastroenterology 2013年第45期19卷 8321-8325页

作者： Dariusz Szymanski Adam Durczynski Michal Nowicki Janusz Strzelczyk Department of General and Transplant Surgery Barlicki University Hospital Medical University of Lodz 0-153 Lodz Poland

AIM:To evaluate the use of the Roux loop on the postoperative course in patients submitted for gastroenteroanastomosis(GE).METHODS:Non-jaundiced patients(n=41)operated on in the Department of General and Transplant Surgery in Lodz,between January 2010 and December 2011 were enrolled.The tumor was considered unresectable when liver metastases or major vascular involvement were confirmed.Patients were randomized to receive Roux(n=21)or conventional GE(n=20)on a prophylactic basis.RESULTS:The mean time to nasogastric tube withdrawal in Roux GE group was shorter(1.4±0.75 vs2.8±1.1,P<0.001).Time to starting oral liquids,soft diet and regular diet were decreased(2.3±0.86 vs 3.45±1.19;P<0.001;3.3±0.73 vs 4.4±1.23,P<0.001and 4.5±0.76 vs 5.6±1.42,P=0.002;respectively).The Roux GE group had a lower use of prokinetics(10mg thrice daily for 2.2±1.8 d vs 3.7±2.6 d,P=0.044;total 62±49 mg vs 111±79 mg,P=0.025).The mean hospitalization time following Roux GE was shorter(7.7 d vs 9.6 d,P=0.006).Delayed gastric emptying(DGE)was confirmed in 20%after conventional GE but in none of the patients following Roux GE.CONCLUSION:Roux gastrojejunostomy during open abdomen exploration in patients with unresectable pancreatic cancer is easy to perform,decreases the incidence of DGE and lowers hospitalization time.

关键词： Unresectable pancreatic cancer Roux and conventional gastroeneteroanastomosis Gastroenteroanastomosis Delayed gastric emptying Hospital length of stay