Objective:To determine and compare the abilities of Shot Blocker and cryotherapy for reducing pain and anxiety associated with subcutaneous injections.Subcutaneous injection has been used excessively for continuous,lo...Objective:To determine and compare the abilities of Shot Blocker and cryotherapy for reducing pain and anxiety associated with subcutaneous injections.Subcutaneous injection has been used excessively for continuous,low-dose administration of drugs.Considering that these drugs may require prolonged administration,new devices and methods of injection are needed to decrease pain and anxiety associated with repeated drug injections.Methods:A quasi-experimental study design on a purposive sample of 54 patients comprised of both sexes has been utilized.The subjects were divided into 2 equal groups(group 1,Shot Blocker;group 2,cryotherapy),and 3 tools were used,namely the sociodemographic and medical data sheet,Verbal Descriptor Scale for measuring pain,and Beck Anxiety Inventory.Results:A significant reduction in pain and anxiety mean scores was observed after using cryotherapy and Shot Blocker techniques during subcutaneous injection.In addition,the Shot Blocker group exhibited significantly lower pain and anxiety mean scores compared with the cryotherapy group.Conclusions:Our findings revealed that Shot Blocker and cryotherapy were effective non-pharmacological methods for reducing pain and anxiety levels associated with repeated subcutaneous injections.展开更多
To assess the effect of the injection duration of subcutaneous low-molecular-weight heparin(LMWH)on pain and bruising in patients.Randomized controlled trials and quasiexperimental studies were searched for in four el...To assess the effect of the injection duration of subcutaneous low-molecular-weight heparin(LMWH)on pain and bruising in patients.Randomized controlled trials and quasiexperimental studies were searched for in four electronic databases.The pooled effect size was expressed as relative risk(RR)andmeandifference(MD)with95%confidence intervals(CI)for dichotomous and continuous data.Cochrane Q and p value were used to assess heterogeneity and the I2 statistic was adopted to quantify the level.Finally,eight studies involving a total of 532 participants met our inclusion criteria.The slow(30 second)injection was associated with a reduction in pain intensity and duration,and lower bruising occurrence at 48-72 hours and 48 hours post injection.The bruising area was also smaller at 48 hours and 60 hours post injection.Nodifferenceswere identified betweenthe slowand fast(10 second)injectionin bruising area and bruising occurrence at 24 hours and 60 hours post injection.With present evidences,slow injection of LMWH is beneficial to the patient's well being,but further studies to identify the feasibility and standardization of the technique is recommended.展开更多
In a further aging society,excellent eyesight is an integral part of overall well-being and quality of life.Preserving good vision is crucial to maintaining mobility,independence,and mental health.There can be several...In a further aging society,excellent eyesight is an integral part of overall well-being and quality of life.Preserving good vision is crucial to maintaining mobility,independence,and mental health.There can be several reasons for visual impairment in elderly people,these include age-related macular degeneration,the leading cause of vision loss among older adults,cataract,glaucoma,diabetic retinopathy,retinal detachment,and others.展开更多
Asphaltene deposition is a significant problem during gas injection processes,as it can block the porous medium,the wellbore,and the involved facilities,significantly impacting reservoir productivity and ultimate oil re...Asphaltene deposition is a significant problem during gas injection processes,as it can block the porous medium,the wellbore,and the involved facilities,significantly impacting reservoir productivity and ultimate oil recovery.Only a few studies have investigated the numerical modeling of this potential effect in porous media.This study focuses on asphaltene deposition due to natural gas and CO_(2) injection.Predictions of the effect of gas injection on asphaltene deposition behavior have been made using a 3D numerical simulation model.The results indicate that the injection of natural gas exacerbates asphaltene deposition,leading to a significant reduction in permeability near the injection well and throughout the reservoir.This reduction in permeability strongly affects the ability of gas toflow through the reservoir,resulting in an improvement of the displacement front.The displacement effi-ciency of the injection gas process increases by up to 1.40%when gas is injected at 5500 psi,compared to the scenario where the asphaltene model is not considered.CO_(2) injection leads to a miscible process with crude oil,extracting light and intermediate components,which intensifies asphaltene precipitation and increases the viscosity of the remaining crude oil,ultimately reducing the recovery rate.展开更多
Dear Editor,Treating psoriatic arthritis(PsA)is always difficult.Systemic treatments can be administered either orally or through intramuscular and intra-articular injection,including conventional synthetics,biologics...Dear Editor,Treating psoriatic arthritis(PsA)is always difficult.Systemic treatments can be administered either orally or through intramuscular and intra-articular injection,including conventional synthetics,biologics and targeted synthetic disease-modifying antirheumatic drugs[1].The alternatives,topical external therapies,are not effective on joint lesions due to drug permeability issues.Drugs injected into the articular cavity are also unsuitable for small peripheral joint lesions,the most common manifestations of PsA.The limited treatment options for PsA present a challenge.展开更多
●AIM:To evaluate the effect of background diseases and number of previous intravitreal aflibercept injections(IVAIs)on immediate intraocular pressure(IOP)increase and vitreous reflux(VR)rate and to evaluate the corre...●AIM:To evaluate the effect of background diseases and number of previous intravitreal aflibercept injections(IVAIs)on immediate intraocular pressure(IOP)increase and vitreous reflux(VR)rate and to evaluate the correlation of both age and axial length with immediate IOP increase and VR rate.●METHODS:This study included 105 patients with cystoid macular edema secondary to retinal vein occlusion,35 patients with diabetic macular edema,69 patients with neovascular age-related macular degeneration(nAMD),and 12 patients with myopic choroidal neovascularization,which underwent first-time IVAI.The correlation of immediate IOP increase and VR rates with the four background diseases was investigated.Moreover,the correlation of age with immediate IOP increase and VR rate as well as correlation of axial length with immediate IOP increase and VR rate were evaluated.Further,54 patients with nAMD were treated with IVAI>10 times(multiple IVAIs).Moreover,the correlation of immediate IOP increase and VR rates with first-time and multiple IVAIs in nAMD was determined.●RESULTS:The immediate IOP increase(P=0.16)and VR rates(P=0.50)were almost similar among the four background diseases.The immediate postinjection IOP and age,VR rate and age,immediate postinjection IOP and axial length,or VR rate and axial length were not correlated in the four background diseases.The immediate IOP increase(P=0.66)and VR rates(P=0.28)did not significantly differ between first-time and multiple IVAIs in nAMD.●CONCLUSION:Background diseases and number of previous IVAIs have no effect on immediate IOP increase and VR rate.Further,age and axial length have no correlation on immediate IOP increase and VR rate.展开更多
The paper proposes a biomass cross-upgrading process that combines hydrothermal carbonization and pyrolysis to produce high-quality blast furnace injection fuel.The results showed that after upgrading,the volatile con...The paper proposes a biomass cross-upgrading process that combines hydrothermal carbonization and pyrolysis to produce high-quality blast furnace injection fuel.The results showed that after upgrading,the volatile content of biochar ranged from 16.19%to 45.35%,and the alkali metal content,ash content,and specific surface area were significantly reduced.The optimal route for biochar pro-duction is hydrothermal carbonization-pyrolysis(P-HC),resulting in biochar with a higher calorific value,C=C structure,and increased graphitization degree.The apparent activation energy(E)of the sample ranges from 199.1 to 324.8 kJ/mol,with P-HC having an E of 277.8 kJ/mol,lower than that of raw biomass,primary biochar,and anthracite.This makes P-HC more suitable for blast furnace injection fuel.Additionally,the paper proposes a path for P-HC injection in blast furnaces and calculates potential environmental benefits.P-HC of-fers the highest potential for carbon emission reduction,capable of reducing emissions by 96.04 kg/t when replacing 40wt%coal injec-tion.展开更多
Multi-gradient drilling is a new offshore drilling method.The accurate calculation of the related wellbore temperature is of great significance for the prediction of the gas hydrate formation area and the precise cont...Multi-gradient drilling is a new offshore drilling method.The accurate calculation of the related wellbore temperature is of great significance for the prediction of the gas hydrate formation area and the precise control of the wellbore pressure.In this study,a new heat transfer model is proposed by which the variable mass flow is properly taken into account.Using this model,the effects of the main factors influencing the wellbore temperature are analyzed.The results indicate that at the position where the separation injection device is installed,the temperature increase of the fluid in the drill pipe is mitigated due to the inflow/outflow of hollow spheres,and the temperature drop of the fluid in the annulus also decreases.In addition,a lower separation efficiency of the device,a shallower installation depth and a smaller circulating displacement tend to increase the temperature near the bottom of the annulus,thereby helping to reduce the hydrate generation area and playing a positive role in the prevention and control of hydrates in deepwater drilling.展开更多
This paper proposes a virtual position-offset injection based permanent magnet temperature estimation approach for permanent magnet synchronous machines(PMSMs). The concept of virtual position-offset injection is math...This paper proposes a virtual position-offset injection based permanent magnet temperature estimation approach for permanent magnet synchronous machines(PMSMs). The concept of virtual position-offset injection is mathematically transforming the machine model to a virtual frame with a position-offset. The virtual frame temperature estimation model is derived to calculate the permanent magnet temperature(PMT) directly from the measurements with computation efficiency. The estimation model involves a combined inductance term, which can simplify the establishment of saturation compensation model with less measurements. Moreover, resistance and inverter distorted terms are cancelled in the estimation model, which can improve the robustness to the winding temperature rise and inverter distortion. The proposed approach can achieve simplified computation in temperature estimation and reduced memory usage in saturation compensation. While existing model-based approaches could be affected by either the need of resistance and inverter information or complex saturation compensation. Experiments are conducted on the test machine to verify the proposed approach under various operating conditions.展开更多
BACKGROUND Colorectal cavernous hemangioma is a rare vascular malformation resulting in recurrent lower gastrointestinal hemorrhage,and can be misinterpreted as colitis.Surgical resection is currently the mainstay of ...BACKGROUND Colorectal cavernous hemangioma is a rare vascular malformation resulting in recurrent lower gastrointestinal hemorrhage,and can be misinterpreted as colitis.Surgical resection is currently the mainstay of treatment,with an emphasis on sphincter preservation.CASE SUMMARY We present details of two young patients with a history of persistent hematochezia diagnosed with colorectal cavernous hemangioma by endoscopic ultrasound(EUS).Cavernous hemangioma was relieved by several EUS-guided lauromacrogol injections and the patients achieved favorable clinical prognosis.CONCLUSION Multiple sequential EUS-guided injections of lauromacrogol is a safe,effective,cost-efficient,and minimally invasive alternative for colorectal cavernous hemangioma.展开更多
In the process of ion-adsorption rare earth ore leaching,the migration characteristics of the wetting front in multi-hole injection holes and the influence of wetting front intersection effect on the migration distanc...In the process of ion-adsorption rare earth ore leaching,the migration characteristics of the wetting front in multi-hole injection holes and the influence of wetting front intersection effect on the migration distance of wetting fronts are still unclear.Besides,wetting front migration distance and leaching time are usually required to optimize the leaching process.In this study,wetting front migration tests of ionadsorption rare earth ores during the multi-hole fluid injection(the spacing between injection holes was 10 cm,12 cm and 14 cm)and single-hole fluid injection were completed under the constant water head height.At the pre-intersection stage,the wetting front migration laws of ion-adsorption rare earth ores during the multi-hole fluid injection and single-hole fluid injection were identical.At the postintersection stage,the intersection accelerated the wetting front migration.By using the Darcy’s law,the intersection effect of wetting fronts during the multi-hole liquid injection was transformed into the water head height directly above the intersection.Finally,based on the Green-Ampt model,a wetting front migration model of ion-adsorption rare earth ores during the multi-hole unsaturated liquid injection was established.Error analysis results showed that the proposed model can accurately simulate the infiltration process under experimental conditions.The research results enrich the infiltration law and theory of ion-adsorption rare earth ores during the multi-hole liquid injection,and this study provides a scientific basis for optimizing the liquid injection well pattern parameters of ion-adsorption rare earth in situ leaching in the future.展开更多
This paper introduces a novel multi-tiered defense architecture to protect language models from adversarial prompt attacks. We construct adversarial prompts using strategies like role emulation and manipulative assist...This paper introduces a novel multi-tiered defense architecture to protect language models from adversarial prompt attacks. We construct adversarial prompts using strategies like role emulation and manipulative assistance to simulate real threats. We introduce a comprehensive, multi-tiered defense framework named GUARDIAN (Guardrails for Upholding Ethics in Language Models) comprising a system prompt filter, pre-processing filter leveraging a toxic classifier and ethical prompt generator, and pre-display filter using the model itself for output screening. Extensive testing on Meta’s Llama-2 model demonstrates the capability to block 100% of attack prompts. The approach also auto-suggests safer prompt alternatives, thereby bolstering language model security. Quantitatively evaluated defense layers and an ethical substitution mechanism represent key innovations to counter sophisticated attacks. The integrated methodology not only fortifies smaller LLMs against emerging cyber threats but also guides the broader application of LLMs in a secure and ethical manner.展开更多
An intramuscular injection (IMI) is an injection given directly into the central area of a specific muscle. Certain medicines need to be administered by the gluteal route for these to be effective. The aim of this stu...An intramuscular injection (IMI) is an injection given directly into the central area of a specific muscle. Certain medicines need to be administered by the gluteal route for these to be effective. The aim of this study was to determine the influence of body mass index (BMI), subcutaneous fat, and muscular thickness of the dorsogluteal IMI site among healthy Japanese women. There were 39 healthy female subjects who volunteered and met the criteria. Their ages ranged from 40s to 60s (50.82 ± 6.04). With the data collected using the B-mode ultrasound images of the dorsogluteal site, it was found that the distance from the epidermis to the under-fascia (DEUF) of the gluteus maximus was dissimilar between the subject’s right and left buttocks. It was found that the distance from the epidermis to the iliac bone (DEI) was significantly more on the right than on the left buttocks. In the case of an adult Japanese woman with a BMI of 21 or more, the DEUF of the gluteus medius was found to be about 30 mm, and the DEI was approximately 50 mm or more. Based on these findings, it is recommended that a needle length of 38 mm (1.5 inches) can be safely used to administer IMIs to the gluteus medius muscle to effectively and efficiently deliver medications through the IMI route.展开更多
Objective:To investigate the effect of cryotherapy application before versus after subcutaneous anticoagulant injection(SCAI)on pain intensity and hematoma formation.Methods:A quasi-experimental design was utilized.A ...Objective:To investigate the effect of cryotherapy application before versus after subcutaneous anticoagulant injection(SCAI)on pain intensity and hematoma formation.Methods:A quasi-experimental design was utilized.A convenient sample of 105 adult patients,who were admitted to one of the biggest teaching hospitals in Cairo and receiving SCAI,were recruited over a period of six months.Patients were randomly allocated into three groups:A Control group who received the routine hospital care(G1,n=35)and two intervention group who received cryotherapy for 5-min(G2:cryotherapy applied before SCAI,n=35;G3:cryotherapy applied after SCAI,n=35).Demographic and medical history data sheet,Pain Numeric Rating Scale and Hematoma Formation and Size Assessment Scale were used to collect the data.Results:The pain intensity among the patients in the two intervention groups(G2:Median=1.0;G3:Median=0)was significantly lower than in the control group(G1,Median=3.0).No significant difference was found between G2 and G3(P=0.728).Applying cryotherapy after SCAI(G3)decreased the frequency of hematoma formation(48hrs=31.4%&72hrs=28.5%)compared to applying it before injection(G2,100%)or not applying it(G1,100%).The size of hematoma in G3 was smaller than that in G2(P<0.01).Conclusion:Applying cryotherapy significantly decreased pain intensity and hematoma occurrence/size.Applying cryotherapy after injection was more effective in preventing hematoma formation and decreasing its size than applying it before injection.展开更多
Objective To explore the efficacy and safety of subcutaneous injection of bortezomib in the treatment of de novo multiple myeloma (MM) patients.Methods A total of 36 MM patients treated with bortezomib,adriamycin and ...Objective To explore the efficacy and safety of subcutaneous injection of bortezomib in the treatment of de novo multiple myeloma (MM) patients.Methods A total of 36 MM patients treated with bortezomib,adriamycin and dexamethason (PAD) from January 2012 to April2013 were analyzed.Among them,18 received improved PAD (improved PAD group) with the subcutaneous injection of bortezomib,another 18 received conventional PAD (PAD group) .The efficacy and safety of two展开更多
Objectives: Local digital nerve blockade is frequently used in many trauma cases. Two commonly used techniques of digital nerve block with local anesthetic are the two-injection dorsal technique and the single-injecti...Objectives: Local digital nerve blockade is frequently used in many trauma cases. Two commonly used techniques of digital nerve block with local anesthetic are the two-injection dorsal technique and the single-injection volar subcutaneous technique. In this study we compare various parameters of the single-injection volar subcutaneous block and the two-injection dorsal block. Pain score, amount of injected anesthetic, time of effect onset, patients’ and physicians’ satisfaction scores in each injection technique was compared. Methods: 128 participating patients were randomly divided into two equal experimental groups. Two-percentage Lidocaine was used as an anesthetic agent. Doses of 1.8 and 3-4 ml were used in the single-injection subcutaneous block and the two-injection dorsal block groups, respectively. Following injections, the patients were asked to score their discomfort experience on a standard visual analog scale of 0 (no pain) to 10 (most pain imaginable). They also were asked to score the rate of their satisfaction from 1(no satisfaction) to 5 (most satisfaction). The onset of effect was determined using the pinprick test. Results: Our results demonstrate that the two-injection dorsal block technique imposes more pain but the pain score difference was not statistically significant. Both patients and physicians were more comfortable with the single-injection subcutaneous digital block method. This satisfaction difference was statistically significant. Conclusions: The single-injection method is more efficient and the patients were more pleased. The advantages of this method are its safety, user friendly, need of lower amount of anesthetic drug and its easiness to teach and learn.展开更多
Objective:This study was aimed at analyzing the efficacy and safety of an injectable form of chlorogenic acid(CGA)in patients with recurrent high-grade glioma after standard of care treatments,through a first-in-human...Objective:This study was aimed at analyzing the efficacy and safety of an injectable form of chlorogenic acid(CGA)in patients with recurrent high-grade glioma after standard of care treatments,through a first-in-human,open-label,dose-escalation phase I trial.Methods:A total of 26 eligible patients were enrolled,received intramuscular CGA injections at 5 dose levels,and were followed up for 5 years.CGA was well tolerated,and the maximum tolerated dose was 5.5 mg/kg.Results:The most common treatment-related adverse events occurred at the sites of injection.No grade 3 or 4 adverse events(e.g.,drug allergy)were reported for these patients except for induration at the injection sites.A clinical pharmacokinetic study showed that CGA was rapidly eliminated from the plasma,with a t_(1/2)of 0.95–1.27 h on day 1 and 1.19–1.39 h on day 30,and no detectable CGA was observed on days 9,11,13,23,25,27,and 29 before CGA administration.After the first treatment cycle,52.2%of patients(12 of 23)achieved stable disease.Long-term follow-up indicated an estimated median overall survival of 11.3 months for all 23 evaluable patients.Of the 18 patients with grade 3 glioma,the median overall survival was 9.5 months.Two patients remained alive at the cutoff day.Conclusions:This phase I study demonstrated that CGA has a favorable safety profile(with no severe toxicity),and provides preliminary clinical benefits for patients with high grade glioma relapsing after prior standard therapies,thus shedding light on the potential clinical application of CGA for recurrent grade 4 glioma.展开更多
Dear Editor,Submacular hemorrhage(SMH)is the accumulation of blood in the macular region caused by changes in retinal or choroidal circulation[1].SMH may be caused by age-related macular degeneration(AMD),pathological...Dear Editor,Submacular hemorrhage(SMH)is the accumulation of blood in the macular region caused by changes in retinal or choroidal circulation[1].SMH may be caused by age-related macular degeneration(AMD),pathological myopia,polypoid choroidal angiopathy(PCV)or retinal macroaneurysm[2].展开更多
BACKGROUND Many cases of emphysema associated with blow-out fractures occur before surgery due to trauma.However,emphysema can occur even after surgery,and most of such cases are managed conservatively and allowed to ...BACKGROUND Many cases of emphysema associated with blow-out fractures occur before surgery due to trauma.However,emphysema can occur even after surgery,and most of such cases are managed conservatively and allowed to resolve.Swelling in the periorbital area due to emphysema that occurs after surgery can make early recovery difficult.CASE SUMMARY Herein,we describe a case of postoperative subcutaneous emphysema that was treated using a simple needle aspiration method.A 48-year-old male patient visited the hospital with a blow-out fracture of the left medial orbital wall and nasal bone fracture.One day postoperatively,swelling and crepitus in the left periorbital area were observed,and follow-up computed tomography showed emphysema in the left periorbital subcutaneous area.Needle aspiration using an 18-gauge needle and syringe was used to relieve the emphysema.The symptoms of sudden swelling improved immediately,and no recurrence was observed.CONCLUSION We conclude that needle aspiration is a useful method that could help in relieving symptom,resolving discomfort,and enabling early return to daily life in patients with postoperative subcutaneous emphysema.展开更多
文摘Objective:To determine and compare the abilities of Shot Blocker and cryotherapy for reducing pain and anxiety associated with subcutaneous injections.Subcutaneous injection has been used excessively for continuous,low-dose administration of drugs.Considering that these drugs may require prolonged administration,new devices and methods of injection are needed to decrease pain and anxiety associated with repeated drug injections.Methods:A quasi-experimental study design on a purposive sample of 54 patients comprised of both sexes has been utilized.The subjects were divided into 2 equal groups(group 1,Shot Blocker;group 2,cryotherapy),and 3 tools were used,namely the sociodemographic and medical data sheet,Verbal Descriptor Scale for measuring pain,and Beck Anxiety Inventory.Results:A significant reduction in pain and anxiety mean scores was observed after using cryotherapy and Shot Blocker techniques during subcutaneous injection.In addition,the Shot Blocker group exhibited significantly lower pain and anxiety mean scores compared with the cryotherapy group.Conclusions:Our findings revealed that Shot Blocker and cryotherapy were effective non-pharmacological methods for reducing pain and anxiety levels associated with repeated subcutaneous injections.
文摘To assess the effect of the injection duration of subcutaneous low-molecular-weight heparin(LMWH)on pain and bruising in patients.Randomized controlled trials and quasiexperimental studies were searched for in four electronic databases.The pooled effect size was expressed as relative risk(RR)andmeandifference(MD)with95%confidence intervals(CI)for dichotomous and continuous data.Cochrane Q and p value were used to assess heterogeneity and the I2 statistic was adopted to quantify the level.Finally,eight studies involving a total of 532 participants met our inclusion criteria.The slow(30 second)injection was associated with a reduction in pain intensity and duration,and lower bruising occurrence at 48-72 hours and 48 hours post injection.The bruising area was also smaller at 48 hours and 60 hours post injection.Nodifferenceswere identified betweenthe slowand fast(10 second)injectionin bruising area and bruising occurrence at 24 hours and 60 hours post injection.With present evidences,slow injection of LMWH is beneficial to the patient's well being,but further studies to identify the feasibility and standardization of the technique is recommended.
基金supported by FoRUM(Ruhr-University Bochum,Germany,to SCJ)the Deutsche Forschungsgemeinschaft(DFG,Germany,RE-4543/1-1,to SR).
文摘In a further aging society,excellent eyesight is an integral part of overall well-being and quality of life.Preserving good vision is crucial to maintaining mobility,independence,and mental health.There can be several reasons for visual impairment in elderly people,these include age-related macular degeneration,the leading cause of vision loss among older adults,cataract,glaucoma,diabetic retinopathy,retinal detachment,and others.
基金funded by CNOOC Production Research Project(CCL2022SZPS0076).
文摘Asphaltene deposition is a significant problem during gas injection processes,as it can block the porous medium,the wellbore,and the involved facilities,significantly impacting reservoir productivity and ultimate oil recovery.Only a few studies have investigated the numerical modeling of this potential effect in porous media.This study focuses on asphaltene deposition due to natural gas and CO_(2) injection.Predictions of the effect of gas injection on asphaltene deposition behavior have been made using a 3D numerical simulation model.The results indicate that the injection of natural gas exacerbates asphaltene deposition,leading to a significant reduction in permeability near the injection well and throughout the reservoir.This reduction in permeability strongly affects the ability of gas toflow through the reservoir,resulting in an improvement of the displacement front.The displacement effi-ciency of the injection gas process increases by up to 1.40%when gas is injected at 5500 psi,compared to the scenario where the asphaltene model is not considered.CO_(2) injection leads to a miscible process with crude oil,extracting light and intermediate components,which intensifies asphaltene precipitation and increases the viscosity of the remaining crude oil,ultimately reducing the recovery rate.
基金supported by the National Natural Science Foundation of China(Grant No.82073439).
文摘Dear Editor,Treating psoriatic arthritis(PsA)is always difficult.Systemic treatments can be administered either orally or through intramuscular and intra-articular injection,including conventional synthetics,biologics and targeted synthetic disease-modifying antirheumatic drugs[1].The alternatives,topical external therapies,are not effective on joint lesions due to drug permeability issues.Drugs injected into the articular cavity are also unsuitable for small peripheral joint lesions,the most common manifestations of PsA.The limited treatment options for PsA present a challenge.
文摘●AIM:To evaluate the effect of background diseases and number of previous intravitreal aflibercept injections(IVAIs)on immediate intraocular pressure(IOP)increase and vitreous reflux(VR)rate and to evaluate the correlation of both age and axial length with immediate IOP increase and VR rate.●METHODS:This study included 105 patients with cystoid macular edema secondary to retinal vein occlusion,35 patients with diabetic macular edema,69 patients with neovascular age-related macular degeneration(nAMD),and 12 patients with myopic choroidal neovascularization,which underwent first-time IVAI.The correlation of immediate IOP increase and VR rates with the four background diseases was investigated.Moreover,the correlation of age with immediate IOP increase and VR rate as well as correlation of axial length with immediate IOP increase and VR rate were evaluated.Further,54 patients with nAMD were treated with IVAI>10 times(multiple IVAIs).Moreover,the correlation of immediate IOP increase and VR rates with first-time and multiple IVAIs in nAMD was determined.●RESULTS:The immediate IOP increase(P=0.16)and VR rates(P=0.50)were almost similar among the four background diseases.The immediate postinjection IOP and age,VR rate and age,immediate postinjection IOP and axial length,or VR rate and axial length were not correlated in the four background diseases.The immediate IOP increase(P=0.66)and VR rates(P=0.28)did not significantly differ between first-time and multiple IVAIs in nAMD.●CONCLUSION:Background diseases and number of previous IVAIs have no effect on immediate IOP increase and VR rate.Further,age and axial length have no correlation on immediate IOP increase and VR rate.
基金the National Key R&D Program of China(No.2022YFE0208100)the National Natural Science Foundation of China(No.5274316)+1 种基金the Key Research and Development Plan of Anhui Province,China(No.202210700037)the Major Science and Technology Project of Xinjiang Uygur Autonomous Region,China(No.2022A01003).
文摘The paper proposes a biomass cross-upgrading process that combines hydrothermal carbonization and pyrolysis to produce high-quality blast furnace injection fuel.The results showed that after upgrading,the volatile content of biochar ranged from 16.19%to 45.35%,and the alkali metal content,ash content,and specific surface area were significantly reduced.The optimal route for biochar pro-duction is hydrothermal carbonization-pyrolysis(P-HC),resulting in biochar with a higher calorific value,C=C structure,and increased graphitization degree.The apparent activation energy(E)of the sample ranges from 199.1 to 324.8 kJ/mol,with P-HC having an E of 277.8 kJ/mol,lower than that of raw biomass,primary biochar,and anthracite.This makes P-HC more suitable for blast furnace injection fuel.Additionally,the paper proposes a path for P-HC injection in blast furnaces and calculates potential environmental benefits.P-HC of-fers the highest potential for carbon emission reduction,capable of reducing emissions by 96.04 kg/t when replacing 40wt%coal injec-tion.
基金funded by the Key Program of National Natural Science Foundation of China (Grant No.51734010)the Startup Fund of Changzhou University Science Research (Grant No.ZMF22020060).
文摘Multi-gradient drilling is a new offshore drilling method.The accurate calculation of the related wellbore temperature is of great significance for the prediction of the gas hydrate formation area and the precise control of the wellbore pressure.In this study,a new heat transfer model is proposed by which the variable mass flow is properly taken into account.Using this model,the effects of the main factors influencing the wellbore temperature are analyzed.The results indicate that at the position where the separation injection device is installed,the temperature increase of the fluid in the drill pipe is mitigated due to the inflow/outflow of hollow spheres,and the temperature drop of the fluid in the annulus also decreases.In addition,a lower separation efficiency of the device,a shallower installation depth and a smaller circulating displacement tend to increase the temperature near the bottom of the annulus,thereby helping to reduce the hydrate generation area and playing a positive role in the prevention and control of hydrates in deepwater drilling.
基金supported in part by the National Natural Science Foundation of China under Grant 52105079 and 62103455。
文摘This paper proposes a virtual position-offset injection based permanent magnet temperature estimation approach for permanent magnet synchronous machines(PMSMs). The concept of virtual position-offset injection is mathematically transforming the machine model to a virtual frame with a position-offset. The virtual frame temperature estimation model is derived to calculate the permanent magnet temperature(PMT) directly from the measurements with computation efficiency. The estimation model involves a combined inductance term, which can simplify the establishment of saturation compensation model with less measurements. Moreover, resistance and inverter distorted terms are cancelled in the estimation model, which can improve the robustness to the winding temperature rise and inverter distortion. The proposed approach can achieve simplified computation in temperature estimation and reduced memory usage in saturation compensation. While existing model-based approaches could be affected by either the need of resistance and inverter information or complex saturation compensation. Experiments are conducted on the test machine to verify the proposed approach under various operating conditions.
基金Supported by Natural Science Foundation of Zhejiang Province,No.LY20H030010Medical Health Science and Technology Project of Zhejiang Provincial Health Commission,No.2019-KY1-001-181.
文摘BACKGROUND Colorectal cavernous hemangioma is a rare vascular malformation resulting in recurrent lower gastrointestinal hemorrhage,and can be misinterpreted as colitis.Surgical resection is currently the mainstay of treatment,with an emphasis on sphincter preservation.CASE SUMMARY We present details of two young patients with a history of persistent hematochezia diagnosed with colorectal cavernous hemangioma by endoscopic ultrasound(EUS).Cavernous hemangioma was relieved by several EUS-guided lauromacrogol injections and the patients achieved favorable clinical prognosis.CONCLUSION Multiple sequential EUS-guided injections of lauromacrogol is a safe,effective,cost-efficient,and minimally invasive alternative for colorectal cavernous hemangioma.
基金This research was funded by the National Natural Science Foundation of China(Grant No.52174113)the Young Jinggang Scholars Award Program in Jiangxi Province,China(Grant No.QNJG2018051)the“Thousand Talents”of Jiangxi Province,China(Grant No.jxsq2019201043).
文摘In the process of ion-adsorption rare earth ore leaching,the migration characteristics of the wetting front in multi-hole injection holes and the influence of wetting front intersection effect on the migration distance of wetting fronts are still unclear.Besides,wetting front migration distance and leaching time are usually required to optimize the leaching process.In this study,wetting front migration tests of ionadsorption rare earth ores during the multi-hole fluid injection(the spacing between injection holes was 10 cm,12 cm and 14 cm)and single-hole fluid injection were completed under the constant water head height.At the pre-intersection stage,the wetting front migration laws of ion-adsorption rare earth ores during the multi-hole fluid injection and single-hole fluid injection were identical.At the postintersection stage,the intersection accelerated the wetting front migration.By using the Darcy’s law,the intersection effect of wetting fronts during the multi-hole liquid injection was transformed into the water head height directly above the intersection.Finally,based on the Green-Ampt model,a wetting front migration model of ion-adsorption rare earth ores during the multi-hole unsaturated liquid injection was established.Error analysis results showed that the proposed model can accurately simulate the infiltration process under experimental conditions.The research results enrich the infiltration law and theory of ion-adsorption rare earth ores during the multi-hole liquid injection,and this study provides a scientific basis for optimizing the liquid injection well pattern parameters of ion-adsorption rare earth in situ leaching in the future.
文摘This paper introduces a novel multi-tiered defense architecture to protect language models from adversarial prompt attacks. We construct adversarial prompts using strategies like role emulation and manipulative assistance to simulate real threats. We introduce a comprehensive, multi-tiered defense framework named GUARDIAN (Guardrails for Upholding Ethics in Language Models) comprising a system prompt filter, pre-processing filter leveraging a toxic classifier and ethical prompt generator, and pre-display filter using the model itself for output screening. Extensive testing on Meta’s Llama-2 model demonstrates the capability to block 100% of attack prompts. The approach also auto-suggests safer prompt alternatives, thereby bolstering language model security. Quantitatively evaluated defense layers and an ethical substitution mechanism represent key innovations to counter sophisticated attacks. The integrated methodology not only fortifies smaller LLMs against emerging cyber threats but also guides the broader application of LLMs in a secure and ethical manner.
文摘An intramuscular injection (IMI) is an injection given directly into the central area of a specific muscle. Certain medicines need to be administered by the gluteal route for these to be effective. The aim of this study was to determine the influence of body mass index (BMI), subcutaneous fat, and muscular thickness of the dorsogluteal IMI site among healthy Japanese women. There were 39 healthy female subjects who volunteered and met the criteria. Their ages ranged from 40s to 60s (50.82 ± 6.04). With the data collected using the B-mode ultrasound images of the dorsogluteal site, it was found that the distance from the epidermis to the under-fascia (DEUF) of the gluteus maximus was dissimilar between the subject’s right and left buttocks. It was found that the distance from the epidermis to the iliac bone (DEI) was significantly more on the right than on the left buttocks. In the case of an adult Japanese woman with a BMI of 21 or more, the DEUF of the gluteus medius was found to be about 30 mm, and the DEI was approximately 50 mm or more. Based on these findings, it is recommended that a needle length of 38 mm (1.5 inches) can be safely used to administer IMIs to the gluteus medius muscle to effectively and efficiently deliver medications through the IMI route.
文摘Objective:To investigate the effect of cryotherapy application before versus after subcutaneous anticoagulant injection(SCAI)on pain intensity and hematoma formation.Methods:A quasi-experimental design was utilized.A convenient sample of 105 adult patients,who were admitted to one of the biggest teaching hospitals in Cairo and receiving SCAI,were recruited over a period of six months.Patients were randomly allocated into three groups:A Control group who received the routine hospital care(G1,n=35)and two intervention group who received cryotherapy for 5-min(G2:cryotherapy applied before SCAI,n=35;G3:cryotherapy applied after SCAI,n=35).Demographic and medical history data sheet,Pain Numeric Rating Scale and Hematoma Formation and Size Assessment Scale were used to collect the data.Results:The pain intensity among the patients in the two intervention groups(G2:Median=1.0;G3:Median=0)was significantly lower than in the control group(G1,Median=3.0).No significant difference was found between G2 and G3(P=0.728).Applying cryotherapy after SCAI(G3)decreased the frequency of hematoma formation(48hrs=31.4%&72hrs=28.5%)compared to applying it before injection(G2,100%)or not applying it(G1,100%).The size of hematoma in G3 was smaller than that in G2(P<0.01).Conclusion:Applying cryotherapy significantly decreased pain intensity and hematoma occurrence/size.Applying cryotherapy after injection was more effective in preventing hematoma formation and decreasing its size than applying it before injection.
文摘Objective To explore the efficacy and safety of subcutaneous injection of bortezomib in the treatment of de novo multiple myeloma (MM) patients.Methods A total of 36 MM patients treated with bortezomib,adriamycin and dexamethason (PAD) from January 2012 to April2013 were analyzed.Among them,18 received improved PAD (improved PAD group) with the subcutaneous injection of bortezomib,another 18 received conventional PAD (PAD group) .The efficacy and safety of two
文摘Objectives: Local digital nerve blockade is frequently used in many trauma cases. Two commonly used techniques of digital nerve block with local anesthetic are the two-injection dorsal technique and the single-injection volar subcutaneous technique. In this study we compare various parameters of the single-injection volar subcutaneous block and the two-injection dorsal block. Pain score, amount of injected anesthetic, time of effect onset, patients’ and physicians’ satisfaction scores in each injection technique was compared. Methods: 128 participating patients were randomly divided into two equal experimental groups. Two-percentage Lidocaine was used as an anesthetic agent. Doses of 1.8 and 3-4 ml were used in the single-injection subcutaneous block and the two-injection dorsal block groups, respectively. Following injections, the patients were asked to score their discomfort experience on a standard visual analog scale of 0 (no pain) to 10 (most pain imaginable). They also were asked to score the rate of their satisfaction from 1(no satisfaction) to 5 (most satisfaction). The onset of effect was determined using the pinprick test. Results: Our results demonstrate that the two-injection dorsal block technique imposes more pain but the pain score difference was not statistically significant. Both patients and physicians were more comfortable with the single-injection subcutaneous digital block method. This satisfaction difference was statistically significant. Conclusions: The single-injection method is more efficient and the patients were more pleased. The advantages of this method are its safety, user friendly, need of lower amount of anesthetic drug and its easiness to teach and learn.
基金funded by Sichuan Jiuzhang Biological Science and Technology Co.,Ltd.the Drug Innovation Major Project in China(Grant No.2016ZX09101017)the National Nature Science Foundation(Grant No.81972338)。
文摘Objective:This study was aimed at analyzing the efficacy and safety of an injectable form of chlorogenic acid(CGA)in patients with recurrent high-grade glioma after standard of care treatments,through a first-in-human,open-label,dose-escalation phase I trial.Methods:A total of 26 eligible patients were enrolled,received intramuscular CGA injections at 5 dose levels,and were followed up for 5 years.CGA was well tolerated,and the maximum tolerated dose was 5.5 mg/kg.Results:The most common treatment-related adverse events occurred at the sites of injection.No grade 3 or 4 adverse events(e.g.,drug allergy)were reported for these patients except for induration at the injection sites.A clinical pharmacokinetic study showed that CGA was rapidly eliminated from the plasma,with a t_(1/2)of 0.95–1.27 h on day 1 and 1.19–1.39 h on day 30,and no detectable CGA was observed on days 9,11,13,23,25,27,and 29 before CGA administration.After the first treatment cycle,52.2%of patients(12 of 23)achieved stable disease.Long-term follow-up indicated an estimated median overall survival of 11.3 months for all 23 evaluable patients.Of the 18 patients with grade 3 glioma,the median overall survival was 9.5 months.Two patients remained alive at the cutoff day.Conclusions:This phase I study demonstrated that CGA has a favorable safety profile(with no severe toxicity),and provides preliminary clinical benefits for patients with high grade glioma relapsing after prior standard therapies,thus shedding light on the potential clinical application of CGA for recurrent grade 4 glioma.
文摘Dear Editor,Submacular hemorrhage(SMH)is the accumulation of blood in the macular region caused by changes in retinal or choroidal circulation[1].SMH may be caused by age-related macular degeneration(AMD),pathological myopia,polypoid choroidal angiopathy(PCV)or retinal macroaneurysm[2].
基金Supported by Soonchunhyang research fund,No.2023-0024.
文摘BACKGROUND Many cases of emphysema associated with blow-out fractures occur before surgery due to trauma.However,emphysema can occur even after surgery,and most of such cases are managed conservatively and allowed to resolve.Swelling in the periorbital area due to emphysema that occurs after surgery can make early recovery difficult.CASE SUMMARY Herein,we describe a case of postoperative subcutaneous emphysema that was treated using a simple needle aspiration method.A 48-year-old male patient visited the hospital with a blow-out fracture of the left medial orbital wall and nasal bone fracture.One day postoperatively,swelling and crepitus in the left periorbital area were observed,and follow-up computed tomography showed emphysema in the left periorbital subcutaneous area.Needle aspiration using an 18-gauge needle and syringe was used to relieve the emphysema.The symptoms of sudden swelling improved immediately,and no recurrence was observed.CONCLUSION We conclude that needle aspiration is a useful method that could help in relieving symptom,resolving discomfort,and enabling early return to daily life in patients with postoperative subcutaneous emphysema.
