This paper puts forword 11 cartographic generalization operator models and introduces their mathematical definitions,and thus a precise mathematical form and quantitative description has been given to these formerly l...This paper puts forword 11 cartographic generalization operator models and introduces their mathematical definitions,and thus a precise mathematical form and quantitative description has been given to these formerly limited qualitative concepts.The meaning of mathematical definition of operators for cartographic generalization and the application prospect in computer_aided cartography (CAC) is stated.ract The Jurassic strata in Jingyan of Sichuan containing the Mamenchinsaurus fauna are dealt with and divided in this paper. The Mamenchisaurus fossils contained there are compared in morphological features and stratigraphically with other types of the genus on by one. The comprehensive analysis show that the Mamenchisaurus fauna of Jingyan appeared in the early Late Jurassic and is primitive in morphology. The results of the morphological identification and stratigraphical study agree with each other. Their evolutionary processes in different apoches of the Late Jurassic also made clear. Key words Jingyan, Sichuan, Mamenchisaurus Fauna, stratigraphy, evolution展开更多
It is known that there exist obivious differences between the two most commonly used definitions of fractional derivatives-Riemann-Liouville (R-L) definition and Caputo definition. The multiple definitions of fracti...It is known that there exist obivious differences between the two most commonly used definitions of fractional derivatives-Riemann-Liouville (R-L) definition and Caputo definition. The multiple definitions of fractional derivatives in fractional calculus have hindered the application of fractional calculus in rheology. In this paper, we clarify that the R-L definition and Caputo definition are both rheologically imperfect with the help of mechanical analogues of the fractional element model (Scott-Blair model). We also clarify that to make them perfect rheologically, the lower terminals of both definitions should be put to ∞. We further prove that the R-L definition with lower terminal a →∞ and the Caputo definition with lower terminal a →∞ are equivalent in the differentiation of functions that are smooth enough and functions that have finite number of singular points. Thus we can define the fractional derivatives in rheology as the R-L derivatives with lower terminal a →∞ (or, equivalently, the Caputo derivatives with lower terminal a →∞) not only for steady-state processes, but also for transient processes. Based on the above definition, the problems of composition rules of fractional operators and the initial conditions for fractional differential equations are discussed, respectively. As an example we study a fractional oscillator with Scott-Blair model and give an exact solution of this equation under given initial conditions.展开更多
BACKGROUND Sessile serrated adenomas(SSAs)are important premalignant lesions that are difficult to detect during colonoscopy due to poor definition,concealment by mucous caps,and flat appearance.High definition(HD)col...BACKGROUND Sessile serrated adenomas(SSAs)are important premalignant lesions that are difficult to detect during colonoscopy due to poor definition,concealment by mucous caps,and flat appearance.High definition(HD)colonoscopy may uniquely aid in the detection of these inconspicuous lesions compared to standard definition(SD)colonoscopes.In the absence of existing clinical guidelines to obligate the use of HD colonoscopy for colorectal cancer screening in average-risk patients,demonstrating the benefit of HD colonoscopy on SSA detection rate(SSADR)may help strengthen the evidence to recommend its use in all settings.AIM To evaluate the benefit of HD colonoscopy compared to SD colonoscopy on SSADR in average-risk patients undergoing screening colonoscopy.METHODS Data from screening colonoscopies for patients aged 50-76 years two years before and two years after the transition from SD colonoscopy to HD colonoscopy at our large,academic teaching center were collected.Patients with symptoms of colorectal disease,positive occult blood test,history of colon polyps,cancer,polyposis syndrome,inflammatory bowel disease or family history of colon cancer or polyps were excluded.Patients whose endoscopists did not perform colonoscopies both before and after scope definition change were also excluded.Differences in individual endoscopist SSADR,average SSADR,and overall SSADR with SD colonoscopy vs HD colonoscopy were also evaluated for significance.RESULTS A total of 3657 colonoscopies met eligibility criteria with 2012 colonoscopies from the SD colonoscopy period and 1645 colonoscopies from the HD colonoscopy period from a pool of 11 endoscopists.Statistically significant improvements of 2.30%in mean SSADR and 2.53%in overall SSADR were noted with HD colonoscopy(P=0.00028 and P=0.00849,respectively).On the individual level,three endoscopists experienced statistically significant benefit with HD colonoscopy(+5.74%,P=0.0056;+4.50%,P=0.0278;+4.84%,P=0.03486).CONCLUSION Our study suggests that HD colonoscopy statistically significantly improves sessile serrated adenoma detection rate in the screening of average risk patients during screening colonoscopy.By improving the detection and removal of these lesions,adoption of HD colonoscopy may reduce the significant premalignant burden of sessile serrated adenomas.展开更多
The adaptability of features definition to applications is an essential condition for implementing feature based design. This paper makes attempt to present a hierarchical definition structure of features. The propos...The adaptability of features definition to applications is an essential condition for implementing feature based design. This paper makes attempt to present a hierarchical definition structure of features. The proposed scheme divides feature definition into application level, form level and geometric level, and provides links between different levels with feature semantics interpretation and enhanced geometric face adjacent graph. respectively. The results not only enable feature definition to abate from the specific dependence and become more extensive, but also provide a theoretical foundation for establishing the concurrent feature based design process model.展开更多
Benefiting from advances in feature technology for design and manufacture can not be expected before a formal methodology is established. This paper makes attempt to establish a definition formalism of machining featu...Benefiting from advances in feature technology for design and manufacture can not be expected before a formal methodology is established. This paper makes attempt to establish a definition formalism of machining features in design for manufacturability from two aspects: formal definition and manufacturability analysis. Some definitions for machining feature based upon the selection and sequencing of material removal operations for component in accordance with the design geometry are presented and a framework of feature based design for manufacturability is outlined correspondingly. The proposed scheme contributes to several aspects of feature based CAD/CAM integration, especially to encourage potentially a more generic approach to the automation of design.展开更多
During the last two decades fractional calculus has been increasingly applied to physics, especially to rheology.It is well known that there are obivious differences between Riemann-Liouville (R-L) definition and Capu...During the last two decades fractional calculus has been increasingly applied to physics, especially to rheology.It is well known that there are obivious differences between Riemann-Liouville (R-L) definition and Caputo definition,which are the two most commonly used definitions of fractional derivatives.The multiple definitions of fractional derivatives have hindered the application of fractional calculus in rheology.In this paper,we clarify that the R-L definition and Caputo definition are both Theologically unreasonable with the help of the mechanical analogues of the fractional element model.We also find that to make them more reasonable Theologically,the lower terminals of both definitions should be put to—∞.We further prove that the R-L definition with lower terminal—∞and the Caputo definition with lower terminal—∞are equivalent in the differentiation of functions that are smooth enough and functions that have finite number of singular points.Thus we can define the fractional derivatives in rheology as the R-L derivatives with lower terminal—∞(or,equivalently,the Caputo derivatives with lower terminal—∞) not only for steady-state processes,but also for transient processes.展开更多
BACKGROUND:A number of definitions have been used for delayed gastric emptying(DGE) after pancreatoduodenectomy and the reported rates varied widely.The International Study Group of Pancreatic Surgery(ISGPS) definitio...BACKGROUND:A number of definitions have been used for delayed gastric emptying(DGE) after pancreatoduodenectomy and the reported rates varied widely.The International Study Group of Pancreatic Surgery(ISGPS) definition is the current standard but it is not used universally.In this comprehensive review,we aimed to determine the acceptance rate of ISGPS definition of DGE,the incidence of DGE after pancreatoduodenectomy and the effect of various technical modifications on its incidence.DATA SOURCE:We searched PubM ed for studies regarding DGE after pancreatoduodenectomy that were published from 1 January 1980 to 1 July 2015 and extracted data on DGE definition,DGE rates and comparison of DGE rates among different technical modifications from all of the relevant articles.RESULTS:Out of 435 search results,178 were selected for data extraction.The ISGPS definition was used in 80% of the studies published since 2010 and the average rates of DGE and clinically relevant DGE were 27.7%(range:0-100%;median:18.7%) and 14.3%(range:1.8%-58.2%;median:13.6%),respectively.Pylorus preservation or retrocolic reconstruction were not associated with increased DGE rates.Although pyloric dilatation,Braun’s entero-enterostomy and Billroth Ⅱ reconstruction were associated with significantly lower DGE rates,pyloric ring resection appears to be most promising with favorable results in 7 out of 10 studies.CONCLUSIONS:ISGPS definition of DGE has been used in majority of studies published after 2010.Clinically relevant DGE rates remain high at 14.3% despite a number of proposed surgical modifications.Pyloric ring resection seems to offer the most promising solution to reduce the occurrence of DGE.展开更多
BACKGROUND Despite the emerging knowledge about colorectal anastomotic leakage(CAL)through the increasing number of clinical and experimental studies, there is no generally accepted definition of CAL. Because of the w...BACKGROUND Despite the emerging knowledge about colorectal anastomotic leakage(CAL)through the increasing number of clinical and experimental studies, there is no generally accepted definition of CAL. Because of the wide variety of definitions used in literature, comparison of study outcomes and quality of care is complicated.AIM To reach consensus on the definition of CAL using a modified Delphi method.METHODS The RAND/UCLA appropriateness method was used. The expert panel consisted of international colorectal surgeons and researchers who had published three or more articles about CAL. The consensus process consisted of two online distributed questionnaires and a third round with a recommendation. In the questionnaires participants were asked to rate the appropriateness of statements using a 1-9 Likert scale. Consensus was defined as a panel median between 1-3 or 7-9 without disagreement. In the final round a recommendation was formed regarding the definition of CAL and the expert panel was asked if they agreed or disagreed.RESULTSTwenty-three authors participated in the first round and twenty-one finished the second round. After two rounds consensus was reached on 37 items(80%) in nine different categories. The International Study Group of Rectal Cancer definition is the most frequently advised general definition by our panel. Consensus was reached regarding the clinical symptoms of CAL, which serum markers contributes to the suspicion of CAL, which radiological and perioperative findings should be considered as CAL, which grading system is appropriate and if there should be a range of postoperative days in the definition. Eventually, 19 experts completed all three rounds of which 16(84%) agreed with our final recommendations for the definition of CAL.CONCLUSION A consensus-based recommendation for the definition of CAL was formed using our modified Delphi method that can be widely incorporated in the field.展开更多
Through reviewing domestic and overseas literatures about the definition of urban-rural fringe,it can be found that the combination of qualitative and quantitative definition methods has become a dominant one.This pap...Through reviewing domestic and overseas literatures about the definition of urban-rural fringe,it can be found that the combination of qualitative and quantitative definition methods has become a dominant one.This paper makes out the principle and basis,uses the data of villages and towns,and establishes an index system from three angles:population,land use and landscape.And then the gravitational model is applied to define the urban-rural fringe with Beijing as an example.展开更多
In nature, to realize the smooth motion for different speeds, the continuous gait transition is usually required for the quadrupeds. Thus, the gait simulation of quadrupeds is a requisite step to obtain the stable and...In nature, to realize the smooth motion for different speeds, the continuous gait transition is usually required for the quadrupeds. Thus, the gait simulation of quadrupeds is a requisite step to obtain the stable and energy-efficient gait for the walking machines. In this paper, the definitions of the two gait parameters, phasic difference and duty factor are presented, which can determine the gait of the quadrupeds. Then, several typical gaits of the quadrupeds are analyzed such that the seven standard gaits and corresponding parameters are summarized. Additionally, the variance law of the two parameters, which determine the relationship of gait transition, is analyzed. Furthermore, the quadruped gait derivative spectrum (QGDS) is proposed and the gait definition of the quadrupeds is presented. To minimize the power consumption, the choice criterion of gait, the optimal gait in terms of the motion speed, duty factory, and power consumption for the walking machines, is developed. Last, the continuous variance of the gait is implemented by the simulation of the gait transition from walk to trot, which evaluate the choice criterion and transition of gait.展开更多
The concept, definition, and diagnosis of amyotrophic lateral sclerosis(ALS) currently present some problems. This article systematically reviews the literature on the history, current concepts, definition, and diagno...The concept, definition, and diagnosis of amyotrophic lateral sclerosis(ALS) currently present some problems. This article systematically reviews the literature on the history, current concepts, definition, and diagnosis of ALS, and discloses the present problems based on the retrieved literature and the authors' clinical experience. The current concepts and definitions of ALS have not yet been unified or standardized in clinical practice, and are sometimes vague or inaccurate, which can cause difficulties for neurologists in the clinical treatment of ALS. The concept and definition of ALS need to be further ascertained, and the current diagnostic criteria for ALS require further development. The identification of effective and objective biomarkers may be a feasible method for the early and accurate diagnosis of ALS. Therefore, future research should focus on the identification of reliable biomarkers—especially neuroimaging biomarkers—through autopsy. Standardizing the concept and definition of ALS and formulating clear diagnostic criteria will largely avoid many uncertainties in the future clinical research and treatment of ALS, which will greatly benefit patients.展开更多
AIM To determine the level of consensus on the definition of colorectal anastomotic leakage(CAL) among Dutch and Chinese colorectal surgeons.METHODS Dutch and Chinese colorectal surgeons were asked to partake in an on...AIM To determine the level of consensus on the definition of colorectal anastomotic leakage(CAL) among Dutch and Chinese colorectal surgeons.METHODS Dutch and Chinese colorectal surgeons were asked to partake in an online questionnaire. Consensus in the online questionnaire was defined as > 80% agreement between respondents on various statements regarding a general definition of CAL,and regarding clinical and radiological diagnosis of the complication.RESULTS Fifty-nine Dutch and 202 Chinese dedicated colorectal surgeons participated in the online survey. Consensus was found on only one of the proposed elements of a general definition of CAL in both countries: ‘extravasation of contrast medium after rectal enema on a CT scan'. Another two were found relevant according to Dutch surgeons: ‘necrosis of the anastomosis found during reoperation',and ‘a radiological collection treated with percutaneous drainage'. No consensus was found for all other proposed elements that may be included in a general definition.CONCLUSION There is no universally accepted definition of CAL in the Netherlands and China. Diagnosis of CAL based on clinical manifestations remains a point of discussion in both countries. Dutch surgeons are more likely to report ‘subclinical' leaks as CAL,which partly explains the higher reported Dutch CAL rates.展开更多
A plant-based diet consists of all minimally processedfruits, vegetables, whole grains, legumes, nuts and seeds,herbs, and spices and excludes all animal products, includ-ing red meat, poultry, fish, eggs, and dairy p...A plant-based diet consists of all minimally processedfruits, vegetables, whole grains, legumes, nuts and seeds,herbs, and spices and excludes all animal products, includ-ing red meat, poultry, fish, eggs, and dairy products.展开更多
文摘This paper puts forword 11 cartographic generalization operator models and introduces their mathematical definitions,and thus a precise mathematical form and quantitative description has been given to these formerly limited qualitative concepts.The meaning of mathematical definition of operators for cartographic generalization and the application prospect in computer_aided cartography (CAC) is stated.ract The Jurassic strata in Jingyan of Sichuan containing the Mamenchinsaurus fauna are dealt with and divided in this paper. The Mamenchisaurus fossils contained there are compared in morphological features and stratigraphically with other types of the genus on by one. The comprehensive analysis show that the Mamenchisaurus fauna of Jingyan appeared in the early Late Jurassic and is primitive in morphology. The results of the morphological identification and stratigraphical study agree with each other. Their evolutionary processes in different apoches of the Late Jurassic also made clear. Key words Jingyan, Sichuan, Mamenchisaurus Fauna, stratigraphy, evolution
基金supported by the National Natural Science Foundation of China (10972117)
文摘It is known that there exist obivious differences between the two most commonly used definitions of fractional derivatives-Riemann-Liouville (R-L) definition and Caputo definition. The multiple definitions of fractional derivatives in fractional calculus have hindered the application of fractional calculus in rheology. In this paper, we clarify that the R-L definition and Caputo definition are both rheologically imperfect with the help of mechanical analogues of the fractional element model (Scott-Blair model). We also clarify that to make them perfect rheologically, the lower terminals of both definitions should be put to ∞. We further prove that the R-L definition with lower terminal a →∞ and the Caputo definition with lower terminal a →∞ are equivalent in the differentiation of functions that are smooth enough and functions that have finite number of singular points. Thus we can define the fractional derivatives in rheology as the R-L derivatives with lower terminal a →∞ (or, equivalently, the Caputo derivatives with lower terminal a →∞) not only for steady-state processes, but also for transient processes. Based on the above definition, the problems of composition rules of fractional operators and the initial conditions for fractional differential equations are discussed, respectively. As an example we study a fractional oscillator with Scott-Blair model and give an exact solution of this equation under given initial conditions.
文摘BACKGROUND Sessile serrated adenomas(SSAs)are important premalignant lesions that are difficult to detect during colonoscopy due to poor definition,concealment by mucous caps,and flat appearance.High definition(HD)colonoscopy may uniquely aid in the detection of these inconspicuous lesions compared to standard definition(SD)colonoscopes.In the absence of existing clinical guidelines to obligate the use of HD colonoscopy for colorectal cancer screening in average-risk patients,demonstrating the benefit of HD colonoscopy on SSA detection rate(SSADR)may help strengthen the evidence to recommend its use in all settings.AIM To evaluate the benefit of HD colonoscopy compared to SD colonoscopy on SSADR in average-risk patients undergoing screening colonoscopy.METHODS Data from screening colonoscopies for patients aged 50-76 years two years before and two years after the transition from SD colonoscopy to HD colonoscopy at our large,academic teaching center were collected.Patients with symptoms of colorectal disease,positive occult blood test,history of colon polyps,cancer,polyposis syndrome,inflammatory bowel disease or family history of colon cancer or polyps were excluded.Patients whose endoscopists did not perform colonoscopies both before and after scope definition change were also excluded.Differences in individual endoscopist SSADR,average SSADR,and overall SSADR with SD colonoscopy vs HD colonoscopy were also evaluated for significance.RESULTS A total of 3657 colonoscopies met eligibility criteria with 2012 colonoscopies from the SD colonoscopy period and 1645 colonoscopies from the HD colonoscopy period from a pool of 11 endoscopists.Statistically significant improvements of 2.30%in mean SSADR and 2.53%in overall SSADR were noted with HD colonoscopy(P=0.00028 and P=0.00849,respectively).On the individual level,three endoscopists experienced statistically significant benefit with HD colonoscopy(+5.74%,P=0.0056;+4.50%,P=0.0278;+4.84%,P=0.03486).CONCLUSION Our study suggests that HD colonoscopy statistically significantly improves sessile serrated adenoma detection rate in the screening of average risk patients during screening colonoscopy.By improving the detection and removal of these lesions,adoption of HD colonoscopy may reduce the significant premalignant burden of sessile serrated adenomas.
文摘The adaptability of features definition to applications is an essential condition for implementing feature based design. This paper makes attempt to present a hierarchical definition structure of features. The proposed scheme divides feature definition into application level, form level and geometric level, and provides links between different levels with feature semantics interpretation and enhanced geometric face adjacent graph. respectively. The results not only enable feature definition to abate from the specific dependence and become more extensive, but also provide a theoretical foundation for establishing the concurrent feature based design process model.
文摘Benefiting from advances in feature technology for design and manufacture can not be expected before a formal methodology is established. This paper makes attempt to establish a definition formalism of machining features in design for manufacturability from two aspects: formal definition and manufacturability analysis. Some definitions for machining feature based upon the selection and sequencing of material removal operations for component in accordance with the design geometry are presented and a framework of feature based design for manufacturability is outlined correspondingly. The proposed scheme contributes to several aspects of feature based CAD/CAM integration, especially to encourage potentially a more generic approach to the automation of design.
基金supported by NSFC under the grant number 10972117
文摘During the last two decades fractional calculus has been increasingly applied to physics, especially to rheology.It is well known that there are obivious differences between Riemann-Liouville (R-L) definition and Caputo definition,which are the two most commonly used definitions of fractional derivatives.The multiple definitions of fractional derivatives have hindered the application of fractional calculus in rheology.In this paper,we clarify that the R-L definition and Caputo definition are both Theologically unreasonable with the help of the mechanical analogues of the fractional element model.We also find that to make them more reasonable Theologically,the lower terminals of both definitions should be put to—∞.We further prove that the R-L definition with lower terminal—∞and the Caputo definition with lower terminal—∞are equivalent in the differentiation of functions that are smooth enough and functions that have finite number of singular points.Thus we can define the fractional derivatives in rheology as the R-L derivatives with lower terminal—∞(or,equivalently,the Caputo derivatives with lower terminal—∞) not only for steady-state processes,but also for transient processes.
文摘BACKGROUND:A number of definitions have been used for delayed gastric emptying(DGE) after pancreatoduodenectomy and the reported rates varied widely.The International Study Group of Pancreatic Surgery(ISGPS) definition is the current standard but it is not used universally.In this comprehensive review,we aimed to determine the acceptance rate of ISGPS definition of DGE,the incidence of DGE after pancreatoduodenectomy and the effect of various technical modifications on its incidence.DATA SOURCE:We searched PubM ed for studies regarding DGE after pancreatoduodenectomy that were published from 1 January 1980 to 1 July 2015 and extracted data on DGE definition,DGE rates and comparison of DGE rates among different technical modifications from all of the relevant articles.RESULTS:Out of 435 search results,178 were selected for data extraction.The ISGPS definition was used in 80% of the studies published since 2010 and the average rates of DGE and clinically relevant DGE were 27.7%(range:0-100%;median:18.7%) and 14.3%(range:1.8%-58.2%;median:13.6%),respectively.Pylorus preservation or retrocolic reconstruction were not associated with increased DGE rates.Although pyloric dilatation,Braun’s entero-enterostomy and Billroth Ⅱ reconstruction were associated with significantly lower DGE rates,pyloric ring resection appears to be most promising with favorable results in 7 out of 10 studies.CONCLUSIONS:ISGPS definition of DGE has been used in majority of studies published after 2010.Clinically relevant DGE rates remain high at 14.3% despite a number of proposed surgical modifications.Pyloric ring resection seems to offer the most promising solution to reduce the occurrence of DGE.
基金Supported by the Dutch Research Council(NWO)research programme Vidi project,No.91719343。
文摘BACKGROUND Despite the emerging knowledge about colorectal anastomotic leakage(CAL)through the increasing number of clinical and experimental studies, there is no generally accepted definition of CAL. Because of the wide variety of definitions used in literature, comparison of study outcomes and quality of care is complicated.AIM To reach consensus on the definition of CAL using a modified Delphi method.METHODS The RAND/UCLA appropriateness method was used. The expert panel consisted of international colorectal surgeons and researchers who had published three or more articles about CAL. The consensus process consisted of two online distributed questionnaires and a third round with a recommendation. In the questionnaires participants were asked to rate the appropriateness of statements using a 1-9 Likert scale. Consensus was defined as a panel median between 1-3 or 7-9 without disagreement. In the final round a recommendation was formed regarding the definition of CAL and the expert panel was asked if they agreed or disagreed.RESULTSTwenty-three authors participated in the first round and twenty-one finished the second round. After two rounds consensus was reached on 37 items(80%) in nine different categories. The International Study Group of Rectal Cancer definition is the most frequently advised general definition by our panel. Consensus was reached regarding the clinical symptoms of CAL, which serum markers contributes to the suspicion of CAL, which radiological and perioperative findings should be considered as CAL, which grading system is appropriate and if there should be a range of postoperative days in the definition. Eventually, 19 experts completed all three rounds of which 16(84%) agreed with our final recommendations for the definition of CAL.CONCLUSION A consensus-based recommendation for the definition of CAL was formed using our modified Delphi method that can be widely incorporated in the field.
文摘Through reviewing domestic and overseas literatures about the definition of urban-rural fringe,it can be found that the combination of qualitative and quantitative definition methods has become a dominant one.This paper makes out the principle and basis,uses the data of villages and towns,and establishes an index system from three angles:population,land use and landscape.And then the gravitational model is applied to define the urban-rural fringe with Beijing as an example.
文摘In nature, to realize the smooth motion for different speeds, the continuous gait transition is usually required for the quadrupeds. Thus, the gait simulation of quadrupeds is a requisite step to obtain the stable and energy-efficient gait for the walking machines. In this paper, the definitions of the two gait parameters, phasic difference and duty factor are presented, which can determine the gait of the quadrupeds. Then, several typical gaits of the quadrupeds are analyzed such that the seven standard gaits and corresponding parameters are summarized. Additionally, the variance law of the two parameters, which determine the relationship of gait transition, is analyzed. Furthermore, the quadruped gait derivative spectrum (QGDS) is proposed and the gait definition of the quadrupeds is presented. To minimize the power consumption, the choice criterion of gait, the optimal gait in terms of the motion speed, duty factory, and power consumption for the walking machines, is developed. Last, the continuous variance of the gait is implemented by the simulation of the gait transition from walk to trot, which evaluate the choice criterion and transition of gait.
基金supported by the National Natural Science Foundation of China,No.30560042,81160161 and 81360198(all to RSX)grants from the Education Department of Jiangxi Province,No.GJJ13198 and GJJ170021(both to RSX)+3 种基金grants from Jiangxi Provincial Department of Science and Technology,No.2014-47,20142BBG70062,and 20171BAB215022(all to RSX)a grant from Health and Family Planning Commission of Jiangxi Province,No.20181019(to RSX)a grant from Jiangxi Provincial Department of Science and Technology Gan Po Elite 555,No.2015108(to RSX)the Innovation Fund Designated for Graduate Students of Jiangxi Province,No.YC2016-B027 and YC2015-S097(both to RSX)。
文摘The concept, definition, and diagnosis of amyotrophic lateral sclerosis(ALS) currently present some problems. This article systematically reviews the literature on the history, current concepts, definition, and diagnosis of ALS, and discloses the present problems based on the retrieved literature and the authors' clinical experience. The current concepts and definitions of ALS have not yet been unified or standardized in clinical practice, and are sometimes vague or inaccurate, which can cause difficulties for neurologists in the clinical treatment of ALS. The concept and definition of ALS need to be further ascertained, and the current diagnostic criteria for ALS require further development. The identification of effective and objective biomarkers may be a feasible method for the early and accurate diagnosis of ALS. Therefore, future research should focus on the identification of reliable biomarkers—especially neuroimaging biomarkers—through autopsy. Standardizing the concept and definition of ALS and formulating clear diagnostic criteria will largely avoid many uncertainties in the future clinical research and treatment of ALS, which will greatly benefit patients.
文摘AIM To determine the level of consensus on the definition of colorectal anastomotic leakage(CAL) among Dutch and Chinese colorectal surgeons.METHODS Dutch and Chinese colorectal surgeons were asked to partake in an online questionnaire. Consensus in the online questionnaire was defined as > 80% agreement between respondents on various statements regarding a general definition of CAL,and regarding clinical and radiological diagnosis of the complication.RESULTS Fifty-nine Dutch and 202 Chinese dedicated colorectal surgeons participated in the online survey. Consensus was found on only one of the proposed elements of a general definition of CAL in both countries: ‘extravasation of contrast medium after rectal enema on a CT scan'. Another two were found relevant according to Dutch surgeons: ‘necrosis of the anastomosis found during reoperation',and ‘a radiological collection treated with percutaneous drainage'. No consensus was found for all other proposed elements that may be included in a general definition.CONCLUSION There is no universally accepted definition of CAL in the Netherlands and China. Diagnosis of CAL based on clinical manifestations remains a point of discussion in both countries. Dutch surgeons are more likely to report ‘subclinical' leaks as CAL,which partly explains the higher reported Dutch CAL rates.
文摘A plant-based diet consists of all minimally processedfruits, vegetables, whole grains, legumes, nuts and seeds,herbs, and spices and excludes all animal products, includ-ing red meat, poultry, fish, eggs, and dairy products.