Background:Early systemic anticoagulation(SAC)is a common practice in acute necrotizing pancreatitis(ANP),and its impact on in-hospital clinical outcomes had been assessed.However,whether it affects long-term outcomes...Background:Early systemic anticoagulation(SAC)is a common practice in acute necrotizing pancreatitis(ANP),and its impact on in-hospital clinical outcomes had been assessed.However,whether it affects long-term outcomes is unknown.This study aimed to evaluate the effect of SAC on 90-day readmission and other long-term outcomes in ANP patients.Methods:During January 2013 and December 2018,ANP patients admitted within 7 days from the onset of abdominal pain were screened.The primary outcome was 90-day readmission after discharge.Cox proportional-hazards regression model and mediation analysis were used to define the relationship between early SAC and 90-day readmission.Results:A total of 241 ANP patients were enrolled,of whom 143 received early SAC during their hospitalization and 98 did not.Patients who received early SAC experienced a lower incidence of splanchnic venous thrombosis(SVT)[risk ratio(RR)=0.40,95%CI:0.26-0.60,P<0.01]and lower 90-day readmission with an RR of 0.61(95%CI:0.41-0.91,P=0.02)than those who did not.For the quality of life,patients who received early SAC had a significantly higher score in the subscale of vitality(P=0.03)while the other subscales were all comparable between the two groups.Multivariable Cox regression model showed that early SAC was an independent protective factor for 90-day readmission after adjusting for potential confounders with a hazard ratio of 0.57(95%CI:0.34-0.96,P=0.04).Mediation analysis showed that SVT mediated 37.0%of the early SAC-90-day readmission causality.Conclusions:The application of early SAC may reduce the risk of 90-day readmission in the survivors of ANP patients,and reduced SVT incidence might be the primary contributor.展开更多
BACKGROUND Venous thromboembolism significantly contributes to patient deterioration and mortality.Management of its etiology and anticoagulation treatment is intricate,necessitating a comprehensive consideration of v...BACKGROUND Venous thromboembolism significantly contributes to patient deterioration and mortality.Management of its etiology and anticoagulation treatment is intricate,necessitating a comprehensive consideration of various factors,including the bleeding risk,dosage,specific anticoagulant medications,and duration of therapy.Herein,a case of lower extremity thrombosis with multiple primary malignant tumors and high risk of bleeding was reviewed to summarize the shortcomings of treatment and prudent anticoagulation experience.CASE SUMMARY An 83-year-old female patient was admitted to the hospital due to a 2-wk history of left lower extremity edema that had worsened over 2 d.Considering her medical history and relevant post-admission investigations,it was determined that the development of left lower extremity venous thrombosis and pulmonary embolism in this case could be attributed to a combination of factors,including multiple primary malignant tumors,iliac venous compression syndrome,previous novel coronavirus infection,and inadequate treatment for prior thrombotic events.However,the selection of appropriate anticoagulant medications,determination of optimal drug dosages,and establishment of an appropriate duration of anticoagulation therapy were important because of concurrent thrombocytopenia,decreased quantitative fibrinogen levels,and renal insufficiency.CONCLUSION Anticoagulant prophylaxis should be promptly initiated in cases of high-risk thrombosis.Individualized anticoagulation therapy is required for complex thrombosis.展开更多
Background: Since 2012, the World Health Organization has recommended intermittent preventive treatment with sulfadoxine-pyrimethamine (IPT-SP) to prevent malaria-related complications in pregnant women. Ten years fol...Background: Since 2012, the World Health Organization has recommended intermittent preventive treatment with sulfadoxine-pyrimethamine (IPT-SP) to prevent malaria-related complications in pregnant women. Ten years following these recommendations, we conducted this study to estimate the coverage for three doses of IPT-SP (IPT3) as well as the prevalence of low birth weight (LBW), and its associated factors in Lomé (Togo) in 2021. Methods: A cross-sectional study was conducted between January and March 2021. An exhaustive recruitment of women and their newborns was carried out in the maternity wards of the Sylvanus Olympio University Hospital Center. Data from antenatal consultations and clinical data of the newborns were collected. Multivariate logistic regression was carried out to determine factors associated with LBW. Results: A total of 252 mother-child pairs were included in this study. Median age of the mothers was 27 years, IQR [24-31]. More than a third (35.3%) of the mothers were primigravida. IPT3 coverage was 66.7% and 14.7% of newborns had a LBW. The prevalence of LBW was 33.3% [23.3-43.4] in women who had received fewer than 3 doses of IPT-SP and 5.4% [2.0-8.8] in those who had received at least 3 doses of IPT-SP (p Conclusion: Ten years following recommendations of the WHO on IPT-SP, malaria prevention based on IPT-SP is not optimal among pregnant women in Lomé, and the proportion of LBW children remains high. Actions to strengthen the three-dose IPT-SP policy are needed to prevent malaria and its consequences among newborns in Togo.展开更多
At present,the operation and maintenance of photovoltaic power generation systems mainly comprise regular maintenance,breakdown maintenance,and condition-based maintenance,which is very likely to lead to over-or under...At present,the operation and maintenance of photovoltaic power generation systems mainly comprise regular maintenance,breakdown maintenance,and condition-based maintenance,which is very likely to lead to over-or under-repair of equipment.Therefore,a preventive maintenance and replacement strategy for PV power generation systems based on reliability as a constraint is proposed.First,a hybrid failure function with a decreasing service age factor and an increasing failure rate factor is introduced to describe the deterioration of PV power generation equipment,and the equipment is replaced when its reliability drops to the replacement threshold in the last cycle.Then,based on the reliability as a constraint,the average maintenance cost and availability of the equipment are considered,and the non-periodic incomplete maintenance model of the PV power generation system is established to obtain the optimal number of repairs,each maintenance cycle and the replacement cycle of the PV power generation system components.Next,the inverter of a PV power plant is used as a research object.The model in this paper is compared and analyzed with the equal cycle maintenance model without considering reliability and the maintenance model without considering the equipment replacement threshold,Through model comparison,when the optimal maintenance strategy is(0.80,4),the average maintenance cost of this paper’s model are decreased by 20.3%and 5.54%and the availability is increased by 0.2395% and 0.0337%,respectively,compared with the equal-cycle maintenance model without considering the reliability constraint and the maintenance model without considering the equipment replacement threshold.Therefore,this maintenance model can ensure the high reliability of PV plant operation while increasing the equipment availability to improve the system economy.展开更多
Objective:To explore the preventive effect of comprehensive nursing intervention on arteriovenous fistula failure in patients in the hemodialysis room.Methods:82 patients with arteriovenous fistula in the hemodialysis...Objective:To explore the preventive effect of comprehensive nursing intervention on arteriovenous fistula failure in patients in the hemodialysis room.Methods:82 patients with arteriovenous fistula in the hemodialysis chamber treated in our hospital from July 2022 to October 2023 were selected as the research subjects.The random number table method divided them into a control group and an experimental group of 41 cases each.The control group received general nursing intervention measures,while the experimental group underwent comprehensive nursing intervention.The incidence of complications(internal fistula failure,bleeding,thrombosis,infection),psychological emotions(SAS scale,SDS scale),quality of life(physical pain,physiological function,emotional function,social function),and nursing satisfaction(very satisfied,basically satisfied,satisfied,dissatisfied)were compared between the two groups of patients.Results:The incidence of complications in the experimental group(4,9.76%)was significantly lower than that in the control group(29,70.73%);the SAS scores and SDS scores of the patients in the experimental group after intervention were both lower than those in the control group;the quality of life score(physical pain,physiological function,emotional function,and social function)was all higher than those of the control group;the post-intervention nursing satisfaction of the experimental group(40,97.57%)was also significantly higher than that of the control group(29,73.17%);and the listed differences were statistically significant(P<0.01).Conclusion:For patients with hemodialysis ventricular arteriovenous fistula failure,comprehensive nursing intervention can reduce the incidence of complications,relieve anxiety and stress,improve quality of life and nursing satisfaction,and achieve better preventive effects.展开更多
Continuous renal replacement therapy(CRRT)is widely used for treating critically-ill patients in the emergency department in China.Anticoagulant therapy is needed to prevent clotting in the extracorporeal circulation ...Continuous renal replacement therapy(CRRT)is widely used for treating critically-ill patients in the emergency department in China.Anticoagulant therapy is needed to prevent clotting in the extracorporeal circulation during CRRT.Regional citrate anticoagulation(RCA)has been shown to potentially be safer and more effective,and is now recommended as the preferred anticoagulant method for CRRT.However,there is still a lack of unified standards for RCA management in the world,and there are many problems in using this method in clinical practice.The Emergency Medical Doctor Branch of the Chinese Medical Doctor Association(CMDA)organized a panel of domestic emergency medicine experts and international experts of CRRT to discuss RCA-related issues,including the advantages and disadvantages of RCA in CRRT anticoagulation,the principle of RCA,parameter settings for RCA,monitoring of RCA(mainly metabolic acid-base disorders),and special issues during RCA.Based on the latest available research evidence as well as the paneled experts'clinical experience,considering the generalizability,suitability,and potential resource utilization,while also balancing clinical advantages and disadvantages,a total of 16 guideline recommendations were formed from the experts'consensus.展开更多
BACKGROUND Splanchnic vein thrombosis(SVT)is a major complication of moderate and severe acute pancreatitis.There is no consensus on whether therapeutic anticoagulation should be started in patients with acute pancrea...BACKGROUND Splanchnic vein thrombosis(SVT)is a major complication of moderate and severe acute pancreatitis.There is no consensus on whether therapeutic anticoagulation should be started in patients with acute pancreatitis and SVT.AIM To gain insight into current opinions and clinical decision making of pancreatologists regarding SVT in acute pancreatitis.METHODS A total of 139 pancreatologists of the Dutch Pancreatitis Study Group and Dutch Pancreatic Cancer Group were approached to complete an online survey and case vignette survey.The threshold to assume group agreement was set at 75%.RESULTS The response rate was 67%(n=93).Seventy-one pancreatologists(77%)regularly prescribed therapeutic anticoagulation in case of SVT,and 12 pancreatologists(13%)for narrowing of splanchnic vein lumen.The most common reason to treat SVT was to avoid complications(87%).Acute thrombosis was the most important factor to prescribe therapeutic anticoagulation(90%).Portal vein thrombosis was chosen as the most preferred location to initiate therapeutic anticoagulation(76%)and splenic vein thrombosis as the least preferred location(86%).The preferred initial agent was low molecular weight heparin(LMWH;87%).In the case vignettes,therapeutic anticoagulation was prescribed for acute portal vein thrombosis,with or without suspected infected necrosis(82%and 90%),and thrombus progression(88%).Agreement was lacking regarding the selection and duration of long-term anticoagulation,the indication for thrombophilia testing and upper endoscopy,and about whether risk of bleeding is a major barrier for therapeutic anticoagulation.CONCLUSION In this national survey,the pancreatologists seemed to agree on the use of therapeutic anticoagulation,using LMWH in the acute phase,for acute portal thrombosis and in the case of thrombus progression,irrespective of the presence of infected necrosis.展开更多
Healthcare practitioners have many anticoagulant options for treating various disease states pertaining to blood clots and blood clot formation. Each anticoagulant has pros and cons and the decision of which pharmacol...Healthcare practitioners have many anticoagulant options for treating various disease states pertaining to blood clots and blood clot formation. Each anticoagulant has pros and cons and the decision of which pharmacological agent to use can be confusing and difficult. In years past, Vitamin K antagonists have been the standard of care when treating specific disease states such as atrial fibrillation and venous thromboembolism based on habit and cost of care. The emergence of newer anticoagulants should be considered the new standard of care based on the evidence presented over the last several years.展开更多
Right heart thrombus(RHTh) with concurrent acute pulmonary embolism(PE) is rare and can seriously destabilize hemodynamics, leading to an emergency situation with high mortality. Diagnosis and treatment of RHTh with a...Right heart thrombus(RHTh) with concurrent acute pulmonary embolism(PE) is rare and can seriously destabilize hemodynamics, leading to an emergency situation with high mortality. Diagnosis and treatment of RHTh with acute PE are not yet standardized. There are few reports of acute PE concurrent with RHTh and even less is known about patients with a right heart mural thrombus. For physicians, the diagnostic choice and treatment of these patients are particularly difficult due to the lack of knowledge. Here, we report a rare case of partial mural RHTh(type C RHTh) with acute PE. The mural mass in the right heart was initially diagnosed as atrial myxoma according to transthoracic echocardiography(TTE), and both pulmonary embolus and the mural mass were completely absorbed after administering Rivaroxiban. This case suggests that TTE alone is insufficient to identify and diagnoses a right heart mural mass such as this. However, novel oral anticoagulants may be effective at alleviating PE with type C RHTh.展开更多
In this study,an optimization model of a single machine system integrating imperfect preventive maintenance planning and production scheduling based on game theory is proposed.The costs of the production department an...In this study,an optimization model of a single machine system integrating imperfect preventive maintenance planning and production scheduling based on game theory is proposed.The costs of the production department and the maintenance department are minimized,respectively.Two kinds of three-stage dynamic game models and a backward induction method are proposed to determine the preventive maintenance(PM)threshold.A lemma is presented to obtain the exact solution.A comprehensive numerical study is provided to illustrate the proposed maintenance model.The effectiveness is also validated by comparison with other two existed optimization models.展开更多
In the process of green and smart mine construction under the context of carbon neutrality,China's coal safety situation has been continuously improved in recent years.In order to recognize the development of coal...In the process of green and smart mine construction under the context of carbon neutrality,China's coal safety situation has been continuously improved in recent years.In order to recognize the development of coal production in China and prepare for future monitoring and prevention of safety incidents,this study mainly elaborated on the basic situation of coal resources and national mining accidents over the past five years(2017-2021),from four dimensions(accident level,type,region,and time),and then proposed the preventive measures based on accident statistical laws.The results show that the storage of coal resources has obvious geographic characteristics,mainly concentrated in the Midwest,with coal resources in Shanxi and Shaanxi accounting for about 49.4%.The proportion of coal consumption has dropped from 70.2%to 56%between 2011 and 2021,but still accounts for more than half of the all.Meanwhile,the accident-prone areas are positively correlated with the amount of coal production.Among different levels of coal mine accidents,general accidents had the highest number of accidents and deaths,with 692 accidents and 783 deaths,accounting for 87.6%and 54.64%respectively.The frequency of roof,gas,and transportation accidents is relatively high,and the number of single fatalities caused by gas accidents is the largest,about 4.18.In terms of geographical distribution of accidents,the safety situation in Shanxi Province is the most severe.From the time distribution of coal mine accidents,the accidents mainly occurred in July and August,and rarely occurred in February and December.Finally,the"4+4"safety management model is proposed,combining the statistical results with coal production in China.Based on the existing health and safety management systems,the manage-ments are divided into four sub-categories,and more specific measures are suggested.展开更多
[Objectives]The paper was to identify the characteristics and the potency of new fungicides to rice blast disease,and study their preventive and therapeutic effects on the disease.[Methods]Six new and conventional fun...[Objectives]The paper was to identify the characteristics and the potency of new fungicides to rice blast disease,and study their preventive and therapeutic effects on the disease.[Methods]Six new and conventional fungicides with different mechanisms of action were selected to compare their preventive and therapeutic effects on rice seedling blast in greenhouse.[Results]The agents which showed to be highly efficacious in blast prevention(greater than 90%)were 25%pyraclostrobin EC,20%fenoxanil SC,75%tricyclazole WP and 50%prochloraz-manganese WP sprayed at the dosages of 112.5-150,180-360,270-450 and 450-600 g/ha,respectively.The therapeutic effect of new fungicides 25%pyraclostrobin EC and 50%prochloraz-manganese WP on rice blast were above 90%when the dosages were 90-150 and 360-600 g/ha,respectively.The therapeutic effect of the conventional fungicide 40%isoprothiolane EC on rice blast was 69.04%when the dosage was 480 g/ha,while those of other fungicides were worse.[Conclusions]Both 25%pyraclostrobin EC and 50%prochloraz-manganese WP have good preventive and therapeutic effects on rice blast,which will provide a reference for the use of these fungicides in the field.展开更多
Delirium is an acute reversible neuropsychiatric syndrome caused by multiple factors.It is associated with many adverse clinical outcomes including cognitive impairment,functional decline,prolonged hospitalization,and...Delirium is an acute reversible neuropsychiatric syndrome caused by multiple factors.It is associated with many adverse clinical outcomes including cognitive impairment,functional decline,prolonged hospitalization,and increased nursing service.The prevalence of delirium was high in department of cardiology,geriatric,and intensive care unit of hospital.With the increase in the aged population,further increases in delirium seem likely.However,it remains poorly recognized in the clinical practice.This article comprehensively discusses the latest research perspectives on the epidemiological data,risk factors,preventive interventions,overlapping symptoms,and clinical measures of delirium,including specific measures to manage delirium in clinical real-world situations.This article helps readers improve their knowledge and understanding of delirium and helps clinicians quickly identify and implement timely therapeutic measures to address various delirium subtypes that occur in the clinical settings to ensure patients are treated as aggressively as possible.展开更多
Background: Coronavirus disease 2019, otherwise known as COVID-19, emerged in December of 2019. COVID-19 spreads through an airborne transmission route. Preventive measures were described to help decrease the spread o...Background: Coronavirus disease 2019, otherwise known as COVID-19, emerged in December of 2019. COVID-19 spreads through an airborne transmission route. Preventive measures were described to help decrease the spread of COVID-19 worldwide. There were a number of preventive measures that were globally adopted: social distance of at least 1 meter, mask wearing, washing hands for 20 seconds, and covering the mouth and nose if the person sneezes or coughs. Methods: A descriptive cross-sectional study among 362 students from the International University of Africa, Sudan, was carried out between August 2021 and September 2022. Statistical Package for Social Sciences version 26 was used for data analysis;frequency and percentage were used to describe the qualitative variables. A chi-square test was used for association analysis;a P-value ≤ 0.05 was considered statistically significant. Results: Among study participants, the females were 70.9%;most were 20 - 23 years old (73.6%). 54.2% were vaccinated against COVID-19;83.6% had good knowledge regarding the mode of transmission, and 76.1% stayed in during quarantine. 80.6% of participants understood social distancing correctly. 76.1% of males and 45.1% of females started or completed vaccination (P ≤ 0.05). 51.4% of males and 81.3% of females adhered to preventive measures (P ≤ 0.05). Conclusions: It is important to target health education campaigns and interventions to improve adherence to preventive measures among university students. Although the pandemic is coming to an end, a lesson should be learned from it, and future preparation should be employed.展开更多
This paper summarizes the Epidemic Lung Preventive Mixture from three aspects of research status, development trends and prospects, so as to deepen the understanding of Epidemic Lung Preventive Mixture and provide a m...This paper summarizes the Epidemic Lung Preventive Mixture from three aspects of research status, development trends and prospects, so as to deepen the understanding of Epidemic Lung Preventive Mixture and provide a more detailed theoretical basis for its further clinical research and development.展开更多
Maintenance scheduling is essential and crucial for wind turbines (WTs) to avoid breakdowns andreduce maintenance costs. Many maintenance models have been developed for WTs’ maintenance planning, suchas corrective, p...Maintenance scheduling is essential and crucial for wind turbines (WTs) to avoid breakdowns andreduce maintenance costs. Many maintenance models have been developed for WTs’ maintenance planning, suchas corrective, preventive, and predictive maintenance. Due to communities’ dependence on WTs for electricityneeds, preventive maintenance is the most widely used method for maintenance scheduling. The downside tousing this approach is that preventive maintenance (PM) is often done in fixed intervals, which is inefficient. In thispaper, a more detailed maintenance plan for a 2 MW WT has been developed. The paper’s focus is to minimize aWT’s maintenance cost based on a WT’s reliability model. This study uses a two-layer optimization framework:Fibonacci and genetic algorithm. The first layer in the optimization method (Fibonacci) finds the optimal numberof PM required for the system. In the second layer, the optimal times for preventative maintenance and optimalcomponents to maintain have been determined to minimize maintenance costs. The Monte Carlo simulationestimates WT component failure times using their lifetime distributions from the reliability model. The estimatedfailure times are then used to determine the overall corrective and PM costs during the system’s lifetime. Finally,an optimal PM schedule is proposed for a 2 MW WT using the presented method. The method used in this papercan be expanded to a wind farm or similar engineering systems.展开更多
基金supported by grants from the National Natural Science Foundation of China (82070665 and 81900592)
文摘Background:Early systemic anticoagulation(SAC)is a common practice in acute necrotizing pancreatitis(ANP),and its impact on in-hospital clinical outcomes had been assessed.However,whether it affects long-term outcomes is unknown.This study aimed to evaluate the effect of SAC on 90-day readmission and other long-term outcomes in ANP patients.Methods:During January 2013 and December 2018,ANP patients admitted within 7 days from the onset of abdominal pain were screened.The primary outcome was 90-day readmission after discharge.Cox proportional-hazards regression model and mediation analysis were used to define the relationship between early SAC and 90-day readmission.Results:A total of 241 ANP patients were enrolled,of whom 143 received early SAC during their hospitalization and 98 did not.Patients who received early SAC experienced a lower incidence of splanchnic venous thrombosis(SVT)[risk ratio(RR)=0.40,95%CI:0.26-0.60,P<0.01]and lower 90-day readmission with an RR of 0.61(95%CI:0.41-0.91,P=0.02)than those who did not.For the quality of life,patients who received early SAC had a significantly higher score in the subscale of vitality(P=0.03)while the other subscales were all comparable between the two groups.Multivariable Cox regression model showed that early SAC was an independent protective factor for 90-day readmission after adjusting for potential confounders with a hazard ratio of 0.57(95%CI:0.34-0.96,P=0.04).Mediation analysis showed that SVT mediated 37.0%of the early SAC-90-day readmission causality.Conclusions:The application of early SAC may reduce the risk of 90-day readmission in the survivors of ANP patients,and reduced SVT incidence might be the primary contributor.
文摘BACKGROUND Venous thromboembolism significantly contributes to patient deterioration and mortality.Management of its etiology and anticoagulation treatment is intricate,necessitating a comprehensive consideration of various factors,including the bleeding risk,dosage,specific anticoagulant medications,and duration of therapy.Herein,a case of lower extremity thrombosis with multiple primary malignant tumors and high risk of bleeding was reviewed to summarize the shortcomings of treatment and prudent anticoagulation experience.CASE SUMMARY An 83-year-old female patient was admitted to the hospital due to a 2-wk history of left lower extremity edema that had worsened over 2 d.Considering her medical history and relevant post-admission investigations,it was determined that the development of left lower extremity venous thrombosis and pulmonary embolism in this case could be attributed to a combination of factors,including multiple primary malignant tumors,iliac venous compression syndrome,previous novel coronavirus infection,and inadequate treatment for prior thrombotic events.However,the selection of appropriate anticoagulant medications,determination of optimal drug dosages,and establishment of an appropriate duration of anticoagulation therapy were important because of concurrent thrombocytopenia,decreased quantitative fibrinogen levels,and renal insufficiency.CONCLUSION Anticoagulant prophylaxis should be promptly initiated in cases of high-risk thrombosis.Individualized anticoagulation therapy is required for complex thrombosis.
文摘Background: Since 2012, the World Health Organization has recommended intermittent preventive treatment with sulfadoxine-pyrimethamine (IPT-SP) to prevent malaria-related complications in pregnant women. Ten years following these recommendations, we conducted this study to estimate the coverage for three doses of IPT-SP (IPT3) as well as the prevalence of low birth weight (LBW), and its associated factors in Lomé (Togo) in 2021. Methods: A cross-sectional study was conducted between January and March 2021. An exhaustive recruitment of women and their newborns was carried out in the maternity wards of the Sylvanus Olympio University Hospital Center. Data from antenatal consultations and clinical data of the newborns were collected. Multivariate logistic regression was carried out to determine factors associated with LBW. Results: A total of 252 mother-child pairs were included in this study. Median age of the mothers was 27 years, IQR [24-31]. More than a third (35.3%) of the mothers were primigravida. IPT3 coverage was 66.7% and 14.7% of newborns had a LBW. The prevalence of LBW was 33.3% [23.3-43.4] in women who had received fewer than 3 doses of IPT-SP and 5.4% [2.0-8.8] in those who had received at least 3 doses of IPT-SP (p Conclusion: Ten years following recommendations of the WHO on IPT-SP, malaria prevention based on IPT-SP is not optimal among pregnant women in Lomé, and the proportion of LBW children remains high. Actions to strengthen the three-dose IPT-SP policy are needed to prevent malaria and its consequences among newborns in Togo.
基金This researchwas supported by the National Natural Science Foundation of China(Nos.51767017 and 51867015)the Basic Research and Innovation Group Project of Gansu(No.18JR3RA133)the Natural Science Foundation of Gansu(No.21JR7RA258).
文摘At present,the operation and maintenance of photovoltaic power generation systems mainly comprise regular maintenance,breakdown maintenance,and condition-based maintenance,which is very likely to lead to over-or under-repair of equipment.Therefore,a preventive maintenance and replacement strategy for PV power generation systems based on reliability as a constraint is proposed.First,a hybrid failure function with a decreasing service age factor and an increasing failure rate factor is introduced to describe the deterioration of PV power generation equipment,and the equipment is replaced when its reliability drops to the replacement threshold in the last cycle.Then,based on the reliability as a constraint,the average maintenance cost and availability of the equipment are considered,and the non-periodic incomplete maintenance model of the PV power generation system is established to obtain the optimal number of repairs,each maintenance cycle and the replacement cycle of the PV power generation system components.Next,the inverter of a PV power plant is used as a research object.The model in this paper is compared and analyzed with the equal cycle maintenance model without considering reliability and the maintenance model without considering the equipment replacement threshold,Through model comparison,when the optimal maintenance strategy is(0.80,4),the average maintenance cost of this paper’s model are decreased by 20.3%and 5.54%and the availability is increased by 0.2395% and 0.0337%,respectively,compared with the equal-cycle maintenance model without considering the reliability constraint and the maintenance model without considering the equipment replacement threshold.Therefore,this maintenance model can ensure the high reliability of PV plant operation while increasing the equipment availability to improve the system economy.
文摘Objective:To explore the preventive effect of comprehensive nursing intervention on arteriovenous fistula failure in patients in the hemodialysis room.Methods:82 patients with arteriovenous fistula in the hemodialysis chamber treated in our hospital from July 2022 to October 2023 were selected as the research subjects.The random number table method divided them into a control group and an experimental group of 41 cases each.The control group received general nursing intervention measures,while the experimental group underwent comprehensive nursing intervention.The incidence of complications(internal fistula failure,bleeding,thrombosis,infection),psychological emotions(SAS scale,SDS scale),quality of life(physical pain,physiological function,emotional function,social function),and nursing satisfaction(very satisfied,basically satisfied,satisfied,dissatisfied)were compared between the two groups of patients.Results:The incidence of complications in the experimental group(4,9.76%)was significantly lower than that in the control group(29,70.73%);the SAS scores and SDS scores of the patients in the experimental group after intervention were both lower than those in the control group;the quality of life score(physical pain,physiological function,emotional function,and social function)was all higher than those of the control group;the post-intervention nursing satisfaction of the experimental group(40,97.57%)was also significantly higher than that of the control group(29,73.17%);and the listed differences were statistically significant(P<0.01).Conclusion:For patients with hemodialysis ventricular arteriovenous fistula failure,comprehensive nursing intervention can reduce the incidence of complications,relieve anxiety and stress,improve quality of life and nursing satisfaction,and achieve better preventive effects.
文摘Continuous renal replacement therapy(CRRT)is widely used for treating critically-ill patients in the emergency department in China.Anticoagulant therapy is needed to prevent clotting in the extracorporeal circulation during CRRT.Regional citrate anticoagulation(RCA)has been shown to potentially be safer and more effective,and is now recommended as the preferred anticoagulant method for CRRT.However,there is still a lack of unified standards for RCA management in the world,and there are many problems in using this method in clinical practice.The Emergency Medical Doctor Branch of the Chinese Medical Doctor Association(CMDA)organized a panel of domestic emergency medicine experts and international experts of CRRT to discuss RCA-related issues,including the advantages and disadvantages of RCA in CRRT anticoagulation,the principle of RCA,parameter settings for RCA,monitoring of RCA(mainly metabolic acid-base disorders),and special issues during RCA.Based on the latest available research evidence as well as the paneled experts'clinical experience,considering the generalizability,suitability,and potential resource utilization,while also balancing clinical advantages and disadvantages,a total of 16 guideline recommendations were formed from the experts'consensus.
文摘BACKGROUND Splanchnic vein thrombosis(SVT)is a major complication of moderate and severe acute pancreatitis.There is no consensus on whether therapeutic anticoagulation should be started in patients with acute pancreatitis and SVT.AIM To gain insight into current opinions and clinical decision making of pancreatologists regarding SVT in acute pancreatitis.METHODS A total of 139 pancreatologists of the Dutch Pancreatitis Study Group and Dutch Pancreatic Cancer Group were approached to complete an online survey and case vignette survey.The threshold to assume group agreement was set at 75%.RESULTS The response rate was 67%(n=93).Seventy-one pancreatologists(77%)regularly prescribed therapeutic anticoagulation in case of SVT,and 12 pancreatologists(13%)for narrowing of splanchnic vein lumen.The most common reason to treat SVT was to avoid complications(87%).Acute thrombosis was the most important factor to prescribe therapeutic anticoagulation(90%).Portal vein thrombosis was chosen as the most preferred location to initiate therapeutic anticoagulation(76%)and splenic vein thrombosis as the least preferred location(86%).The preferred initial agent was low molecular weight heparin(LMWH;87%).In the case vignettes,therapeutic anticoagulation was prescribed for acute portal vein thrombosis,with or without suspected infected necrosis(82%and 90%),and thrombus progression(88%).Agreement was lacking regarding the selection and duration of long-term anticoagulation,the indication for thrombophilia testing and upper endoscopy,and about whether risk of bleeding is a major barrier for therapeutic anticoagulation.CONCLUSION In this national survey,the pancreatologists seemed to agree on the use of therapeutic anticoagulation,using LMWH in the acute phase,for acute portal thrombosis and in the case of thrombus progression,irrespective of the presence of infected necrosis.
文摘Healthcare practitioners have many anticoagulant options for treating various disease states pertaining to blood clots and blood clot formation. Each anticoagulant has pros and cons and the decision of which pharmacological agent to use can be confusing and difficult. In years past, Vitamin K antagonists have been the standard of care when treating specific disease states such as atrial fibrillation and venous thromboembolism based on habit and cost of care. The emergence of newer anticoagulants should be considered the new standard of care based on the evidence presented over the last several years.
基金supported by the Sichuan Science and Technology Project(Grant No.2022YFS0105)。
文摘Right heart thrombus(RHTh) with concurrent acute pulmonary embolism(PE) is rare and can seriously destabilize hemodynamics, leading to an emergency situation with high mortality. Diagnosis and treatment of RHTh with acute PE are not yet standardized. There are few reports of acute PE concurrent with RHTh and even less is known about patients with a right heart mural thrombus. For physicians, the diagnostic choice and treatment of these patients are particularly difficult due to the lack of knowledge. Here, we report a rare case of partial mural RHTh(type C RHTh) with acute PE. The mural mass in the right heart was initially diagnosed as atrial myxoma according to transthoracic echocardiography(TTE), and both pulmonary embolus and the mural mass were completely absorbed after administering Rivaroxiban. This case suggests that TTE alone is insufficient to identify and diagnoses a right heart mural mass such as this. However, novel oral anticoagulants may be effective at alleviating PE with type C RHTh.
基金Sponsored by the National Natural Science Foundation of China(Grant Nos.72061022 and 72171037).
文摘In this study,an optimization model of a single machine system integrating imperfect preventive maintenance planning and production scheduling based on game theory is proposed.The costs of the production department and the maintenance department are minimized,respectively.Two kinds of three-stage dynamic game models and a backward induction method are proposed to determine the preventive maintenance(PM)threshold.A lemma is presented to obtain the exact solution.A comprehensive numerical study is provided to illustrate the proposed maintenance model.The effectiveness is also validated by comparison with other two existed optimization models.
基金supported by the National Key R&D Program of China (2022YFC3004701)the National Natural Science Foundation of China (52274242,51904293)+1 种基金the Natural Science Foundation of Jiangsu Province (BK20190627)the China Postdoctoral Science Foundation (2019M661998).
文摘In the process of green and smart mine construction under the context of carbon neutrality,China's coal safety situation has been continuously improved in recent years.In order to recognize the development of coal production in China and prepare for future monitoring and prevention of safety incidents,this study mainly elaborated on the basic situation of coal resources and national mining accidents over the past five years(2017-2021),from four dimensions(accident level,type,region,and time),and then proposed the preventive measures based on accident statistical laws.The results show that the storage of coal resources has obvious geographic characteristics,mainly concentrated in the Midwest,with coal resources in Shanxi and Shaanxi accounting for about 49.4%.The proportion of coal consumption has dropped from 70.2%to 56%between 2011 and 2021,but still accounts for more than half of the all.Meanwhile,the accident-prone areas are positively correlated with the amount of coal production.Among different levels of coal mine accidents,general accidents had the highest number of accidents and deaths,with 692 accidents and 783 deaths,accounting for 87.6%and 54.64%respectively.The frequency of roof,gas,and transportation accidents is relatively high,and the number of single fatalities caused by gas accidents is the largest,about 4.18.In terms of geographical distribution of accidents,the safety situation in Shanxi Province is the most severe.From the time distribution of coal mine accidents,the accidents mainly occurred in July and August,and rarely occurred in February and December.Finally,the"4+4"safety management model is proposed,combining the statistical results with coal production in China.Based on the existing health and safety management systems,the manage-ments are divided into four sub-categories,and more specific measures are suggested.
基金Agricultural Science and Technology Development and Resource and Environmental Protection Management Fund of Guangdong Provincial Rural Revitalization Strategy Project(2022KJ153-06)Special Fund for China Agricultural Industry Research System(CARS-01-32,2022KJ105)+1 种基金"The 14 th Five-Year Plan"New Discipline Team Building Project of Guangdong Academy of Agricultural Sciences(202116TD)Science and Technology Plan Project of Shaoguan(210804164531395).
文摘[Objectives]The paper was to identify the characteristics and the potency of new fungicides to rice blast disease,and study their preventive and therapeutic effects on the disease.[Methods]Six new and conventional fungicides with different mechanisms of action were selected to compare their preventive and therapeutic effects on rice seedling blast in greenhouse.[Results]The agents which showed to be highly efficacious in blast prevention(greater than 90%)were 25%pyraclostrobin EC,20%fenoxanil SC,75%tricyclazole WP and 50%prochloraz-manganese WP sprayed at the dosages of 112.5-150,180-360,270-450 and 450-600 g/ha,respectively.The therapeutic effect of new fungicides 25%pyraclostrobin EC and 50%prochloraz-manganese WP on rice blast were above 90%when the dosages were 90-150 and 360-600 g/ha,respectively.The therapeutic effect of the conventional fungicide 40%isoprothiolane EC on rice blast was 69.04%when the dosage was 480 g/ha,while those of other fungicides were worse.[Conclusions]Both 25%pyraclostrobin EC and 50%prochloraz-manganese WP have good preventive and therapeutic effects on rice blast,which will provide a reference for the use of these fungicides in the field.
基金Supported by the NINGBO Medical&Health Leading Academic Discipline Project,No.2022-F28.
文摘Delirium is an acute reversible neuropsychiatric syndrome caused by multiple factors.It is associated with many adverse clinical outcomes including cognitive impairment,functional decline,prolonged hospitalization,and increased nursing service.The prevalence of delirium was high in department of cardiology,geriatric,and intensive care unit of hospital.With the increase in the aged population,further increases in delirium seem likely.However,it remains poorly recognized in the clinical practice.This article comprehensively discusses the latest research perspectives on the epidemiological data,risk factors,preventive interventions,overlapping symptoms,and clinical measures of delirium,including specific measures to manage delirium in clinical real-world situations.This article helps readers improve their knowledge and understanding of delirium and helps clinicians quickly identify and implement timely therapeutic measures to address various delirium subtypes that occur in the clinical settings to ensure patients are treated as aggressively as possible.
文摘Background: Coronavirus disease 2019, otherwise known as COVID-19, emerged in December of 2019. COVID-19 spreads through an airborne transmission route. Preventive measures were described to help decrease the spread of COVID-19 worldwide. There were a number of preventive measures that were globally adopted: social distance of at least 1 meter, mask wearing, washing hands for 20 seconds, and covering the mouth and nose if the person sneezes or coughs. Methods: A descriptive cross-sectional study among 362 students from the International University of Africa, Sudan, was carried out between August 2021 and September 2022. Statistical Package for Social Sciences version 26 was used for data analysis;frequency and percentage were used to describe the qualitative variables. A chi-square test was used for association analysis;a P-value ≤ 0.05 was considered statistically significant. Results: Among study participants, the females were 70.9%;most were 20 - 23 years old (73.6%). 54.2% were vaccinated against COVID-19;83.6% had good knowledge regarding the mode of transmission, and 76.1% stayed in during quarantine. 80.6% of participants understood social distancing correctly. 76.1% of males and 45.1% of females started or completed vaccination (P ≤ 0.05). 51.4% of males and 81.3% of females adhered to preventive measures (P ≤ 0.05). Conclusions: It is important to target health education campaigns and interventions to improve adherence to preventive measures among university students. Although the pandemic is coming to an end, a lesson should be learned from it, and future preparation should be employed.
基金Supported by Key R&D Plan of Guangxi Science and Technology Department(Gui Ke AB21196057)Self-Funded Scientific Research Project of Guangxi Zhuang Autonomous Region Administration of Traditional Chinese Medicine(Contract Number:GXZYA20220154)+3 种基金Qingmiao Talent Cultivation Project of Guangxi International Zhuang Medicine Hospital(2022001)Guangxi Traditional Chinese Medicine Multidisciplinary Innovation Team Project(GZKJ2309)High-level Key Discipline of Traditional Chinese Medicine(Zhuang Pharmacy)Construction Project of the State Administration of Traditional Chinese Medicine(Guo Zhong Yi Yao Ren Jiao Han[2022]No.226)Funding Project of High-level Talent Cultivation and Innovation Team of Guangxi University of Chinese Medicine(2022A008).
文摘This paper summarizes the Epidemic Lung Preventive Mixture from three aspects of research status, development trends and prospects, so as to deepen the understanding of Epidemic Lung Preventive Mixture and provide a more detailed theoretical basis for its further clinical research and development.
基金the Natural Sciences and Engineering Research Council of Canada(Grant No.RGPIN-2019-05361)and the University Research Grants Program.
文摘Maintenance scheduling is essential and crucial for wind turbines (WTs) to avoid breakdowns andreduce maintenance costs. Many maintenance models have been developed for WTs’ maintenance planning, suchas corrective, preventive, and predictive maintenance. Due to communities’ dependence on WTs for electricityneeds, preventive maintenance is the most widely used method for maintenance scheduling. The downside tousing this approach is that preventive maintenance (PM) is often done in fixed intervals, which is inefficient. In thispaper, a more detailed maintenance plan for a 2 MW WT has been developed. The paper’s focus is to minimize aWT’s maintenance cost based on a WT’s reliability model. This study uses a two-layer optimization framework:Fibonacci and genetic algorithm. The first layer in the optimization method (Fibonacci) finds the optimal numberof PM required for the system. In the second layer, the optimal times for preventative maintenance and optimalcomponents to maintain have been determined to minimize maintenance costs. The Monte Carlo simulationestimates WT component failure times using their lifetime distributions from the reliability model. The estimatedfailure times are then used to determine the overall corrective and PM costs during the system’s lifetime. Finally,an optimal PM schedule is proposed for a 2 MW WT using the presented method. The method used in this papercan be expanded to a wind farm or similar engineering systems.
