At present,one of the methods used to determine the height of points on the Earth’s surface is Global Navigation Satellite System(GNSS)leveling.It is possible to determine the orthometric or normal height by this met...At present,one of the methods used to determine the height of points on the Earth’s surface is Global Navigation Satellite System(GNSS)leveling.It is possible to determine the orthometric or normal height by this method only if there is a geoid or quasi-geoid height model available.This paper proposes the methodology for local correction of the heights of high-order global geoid models such as EGM08,EIGEN-6C4,GECO,and XGM2019e_2159.This methodology was tested in different areas of the research field,covering various relief forms.The dependence of the change in corrected height accuracy on the input data was analyzed,and the correction was also conducted for model heights in three tidal systems:"tide free","mean tide",and"zero tide".The results show that the heights of EIGEN-6C4 model can be corrected with an accuracy of up to 1 cm for flat and foothill terrains with the dimensionality of 1°×1°,2°×2°,and 3°×3°.The EGM08 model presents an almost identical result.The EIGEN-6C4 model is best suited for mountainous relief and provides an accuracy of 1.5 cm on the 1°×1°area.The height correction accuracy of GECO and XGM2019e_2159 models is slightly poor,which has fuzziness in terms of numerical fluctuation.展开更多
The availability of many high-degree Global Geopotential Models(GGMs), namely EGM2008, EIGEN-6C4,GECO, SGG-UGM-1, SGG-UGM-2, XGM2019e_2159, and GGMPlus, challenges users regarding which model is best for Vietnam. This...The availability of many high-degree Global Geopotential Models(GGMs), namely EGM2008, EIGEN-6C4,GECO, SGG-UGM-1, SGG-UGM-2, XGM2019e_2159, and GGMPlus, challenges users regarding which model is best for Vietnam. This study, therefore, evaluates their performance by comparing them with GNSS/leveling data over Vietnam. Results show that their absolute and relative performances are largely independent of topographic conditions and geographical location and can be ranked into three classes:(1)XGM2019e_2159 has the highest accuracy,(2) the models EIGEN-6C4, GECO, SGG-UGM-1, SGG-UGM-2, and GGMPlus, have a very similar level of medium accuracy, while(3) EGM2008 is found to be the least accurate. In an absolute sense, the differences between GNSS/leveling and EGM2008-based height anomalies have a standard deviation(STD) of 0.290 ± 0.010 m, whereas, for XGM2019e_2159, this is 0.156 ± 0.006 m.All other models have STDs of(0.18-0.19) ± 0.007 m. Regarding relative performance without fitting, all GGMs have comparable accuracies for baseline length of 5-20 km, while for baselines longer than 20 km,the STD of XGM2019e_2159 is 1.5 ppm-0.5 ppm(approximately 19%-40%) lower compared with EGM2008, and 0.5 ppm-0.25 ppm(approximately 7%-36%) lower compared with EIGEN6C4, GECO,SGG-UGM-1, SGG-UGM-2, and GGMPlus. In addition, the STDs decrease significantly from 20 to 12 ppm in the range of 5-10 km, slightly from 12 to 6 ppm for 10-35 km, very slightly from 6 to 2.5 ppm for35-200 km, and then remain almost unchanged for longer baselines. After fitting, the relative accuracies of all GGMs are at the same level with negligible STD/RMSE values. Furthermore, only EGM2008 experiences significant regional differences, while other GGMs show more homogeneous spatial variation of absolute accuracy over Vietnam. These findings can contribute to the development of local quasigeoid models in Vietnam and may be helpful with the improvement of GGMs in the future.展开更多
BACKGROUND Within the normal range,elevated alanine aminotransferase(ALT)levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To investigate the associations ...BACKGROUND Within the normal range,elevated alanine aminotransferase(ALT)levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To investigate the associations between repeated high-normal ALT measurements and the risk of new-onset MAFLD prospectively.METHODS A cohort of 3553 participants followed for four consecutive health examinations over 4 years was selected.The incidence rate,cumulative times,and equally and unequally weighted cumulative effects of excess high-normal ALT levels(ehALT)were measured.Cox proportional hazards regression was used to analyse the association between the cumulative effects of ehALT and the risk of new-onset MAFLD.RESULTS A total of 83.13%of participants with MAFLD had normal ALT levels.The incidence rate of MAFLD showed a linear increasing trend in the cumulative ehALT group.Compared with those in the low-normal ALT group,the multivariate adjusted hazard ratios of the equally and unequally weighted cumulative effects of ehALT were 1.651[95%confidence interval(CI):1.199-2.273]and 1.535(95%CI:1.119-2.106)in the third quartile and 1.616(95%CI:1.162-2.246)and 1.580(95%CI:1.155-2.162)in the fourth quartile,respectively.CONCLUSION Most participants with MAFLD had normal ALT levels.Long-term high-normal ALT levels were associated with a cumulative increased risk of new-onset MAFLD.展开更多
A method is proposed to fuse the velocity data of the global navigation satellite system(GNSS) and leveling height via combined adjustment with constraints. First, stable GNSS-leveling points are uniformly selected, a...A method is proposed to fuse the velocity data of the global navigation satellite system(GNSS) and leveling height via combined adjustment with constraints. First, stable GNSS-leveling points are uniformly selected, and the constraints of the geodetic height change velocity and normal height change velocity are given. Then, the GNSS vertical velocities and leveling height difference are used as observations of combined adjustment, and robust least-squares estimation are used to estimate the velocities of the unknown points. Finally, a vertical movement model is established with the GNSS vertical velocities and leveling vertical velocities obtained via combined adjustment. Data from the second-order leveling network and GNSS control points in Shandong Province are taken as test data, and eight calculation schemes are used for discussion. One of the schemes, the bifactor robust combined adjustment method based on variance component estimation with two kinds of vertical velocity constraints achieves the optimal results. The method applied in the scheme can be recommended for data fusion of GNSS and leveling, further improving the reliability of vertical crustal movement in Shandong Province.展开更多
The Longmenshan-Longriba region is located on the eastern edge of the Tibetan Plateau, and is an ideal place to study the eastward extrusion and uplift mechanism of the plateau. Previous studies on this area mainly fo...The Longmenshan-Longriba region is located on the eastern edge of the Tibetan Plateau, and is an ideal place to study the eastward extrusion and uplift mechanism of the plateau. Previous studies on this area mainly focused on tectonic activity and seismic hazard, with few studies giving its overall deformation characteristics and dynamic mechanism. This paper uses the latest dense GPS data, combined with precise Leveling data to analyze the kinematic characteristics and deformation mode of the Longmenshan fault zone (LMSF) and the Longriba fault zone (LRBF). The results show that both the Longmenshan fault zone and the Longriba fault zone have certain right-lateral strike-slip and thrusting, indicating that they play an important role in adjusting strain distribution and absorbing tectonic deformation;The strain-rate field on the Longriba fault zone is broadly distributed, suggesting that the deformation field is at least partially coupled;while the strain-rate field on the Longmenshan fault zone presents a non-uniform distribution, indicating different dynamic sources acting on segments. The high strain rate areas revealed in this study points us to the high-risk area for future earthquakes. The present-day vertical motion velocity field in the region obtained from Leveling and GPS data shows a mismatch between the regional deformation field and active tectonics, which can be explained by the incomplete coupling of deformation between the lower and upper crust.展开更多
Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) ...Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.展开更多
Gravity Anomaly Correction(GAC)is a very important term in leveling data processing.In most cases,it is troublesome for field surveyors to measure gravity when leveling.In this paper,based on the complete Bouguer Grav...Gravity Anomaly Correction(GAC)is a very important term in leveling data processing.In most cases,it is troublesome for field surveyors to measure gravity when leveling.In this paper,based on the complete Bouguer Gravity Anomaly(BGA)map of WGM2012,the feasibility of replacing in-situ gravity surveying in China is investigated.For leveling application,that is to evaluate the accuracy of WGM2012 in China.Because WGM2012 is organized with a standard rectangle grid,two interpolation methods,bilinear interpolating and Inverse Distance Weighted(IDW)interpolating,are proposed.Four sample areas in China,i.e.,Hanzhong,Chengdu,Linzhi and Shantou,are selected to evaluate the systems bias and precision of WGM2012.Numerical results show the average system bias of WGM2012 BGA in west China is about-100.1 mGal(1 mGal=10^(-5) m/s^(2))and the standard deviation is about 30.7 mGal.Tests in Shantou indicate the system bias in plain areas is about-130.4 mGal and standard deviation is about 6.8 mGal.All these experiments means the accuracy of WGM2012 is limited in high mountain areas of western China,but in plain areas,such as Shantou,WGM2012 BGA map is quite good for most leveling applications after calibrating the system bias.展开更多
While the interaction between information and disease in static networks has been extensively investigated,many studies have ignored the characteristics of network evolution.In this study,we construct a new two-layer ...While the interaction between information and disease in static networks has been extensively investigated,many studies have ignored the characteristics of network evolution.In this study,we construct a new two-layer coupling model to explore the interactions between information and disease.The upper layer describes the diffusion of disease-related information,and the lower layer represents the disease transmission.We then use power-law distributions to examine the influence of asymmetric activity levels on dynamic propagation,revealing a mapping relationship characterizing the interconnected propagation of information and diseases among partial nodes within the network.Subsequently,we derive the disease outbreak threshold by using the microscopic Markov-chain approach(MMCA).Finally,we perform extensive Monte Carlo(MC)numerical simulations to verify the accuracy of our theoretical results.Our findings indicate that the activity levels of individuals in the disease transmission layer have a more significant influence on disease transmission compared with the individual activity levels in the information diffusion layer.Moreover,reducing the damping factor can delay disease outbreaks and suppress disease transmission,while improving individual quarantine measures can contribute positively to disease control.This study provides valuable insights into policymakers for developing outbreak prevention and control strategies.展开更多
The mechanical properties of residual coal pillars under the influence of upward mining disturbances significantly affect the safety of residual mining activities on working faces.This study conducted low-frequency di...The mechanical properties of residual coal pillars under the influence of upward mining disturbances significantly affect the safety of residual mining activities on working faces.This study conducted low-frequency disturbance dynamic uniaxial compression tests on coal specimens using a self-developed dynamic-static load coupling electro-hydraulic servo system,and studied the strength evolutions,surface deformations,acoustic emission(AE)characteristic parameters,and the failure modes of coal specimens with different static preloading levels were studied.The disturbance damage is positively correlated with the coal specimen static preload level.Specifically,the cumulative AE count rates of the initial accelerated damage stage for the coal specimens with static preloading level of 60%and 70%of the uniaxial compressive strength(UCS)were 2.66 and 3.19 times that of the 50%UCS specimens,respectively.Macroscopically,this behaviour manifested as a decrease in the compressive strength,and the mean strengths of the disturbance-damaged coal specimens with 60%and 70%of UCS static preloading decreased by 8.53%and 9.32%,respectively,compared to those of the specimens under pure static loading.The crack sources,such as the primary fissures,strongly control the dynamic response of the coal specimen.The difference between the dynamic responses of the coal specimens and that of dense rocks is significant.展开更多
In this study,we estimate the absolute vertical land motions at three tidal stations with collocated Global Navigation Satellite System(GNSS)receivers over French Polynesia during the period 2007-2020,and obtain,as an...In this study,we estimate the absolute vertical land motions at three tidal stations with collocated Global Navigation Satellite System(GNSS)receivers over French Polynesia during the period 2007-2020,and obtain,as ancillary results,estimates of the absolute changes in sea level at the same locations.To verify our processing approach to determining vertical motion,we first modeled vertical motion at the International GNSS Service(IGS)THTI station located in the capital island of Tahiti and compared our estimate with previous independent determinations,with a good agreement.We obtained the following estimates for the vertical land motions at the tide gauges:Tubuai island,Austral Archipelago-0.92±0.17 mm/yr,Vairao village,Tahiti Iti:-0.49±0.39 mm/yr,Rikitea,Gambier Archipelago-0.43±0.17 mm/yr.The absolute variations of the sea level are:Tubuai island,Austral Archipelago 5.25±0.60 mm/yr,Vairao village,Tahiti Iti:3.62±0.52 mm/yr,Rikitea,Gambier Archipelago 1.52±0.23 mm/yr.We discuss these absolute values in light of the values obtained from altimetric measurements and other means in French Polynesia.展开更多
Background Boars fed a mixed form of inorganic and organic iron in excess of the NRC recommended levels still develop anemia,which suggested that the current level and form of iron supplementation in boar diets may be...Background Boars fed a mixed form of inorganic and organic iron in excess of the NRC recommended levels still develop anemia,which suggested that the current level and form of iron supplementation in boar diets may be inappropriate.Therefore,56 healthy Topeka E line boars aged 15–21 months were randomly divided into 5 groups:basal diet supplemented with 96 mg/kg ferrous sulfate(FeSO_(4))and 54 mg/kg glycine chelated iron(Gly-Fe,control);80 mg/kg or 115 mg/kg Gly-Fe;80 mg/kg or 115 mg/kg methionine hydroxyl analogue chelated iron(MHA-Fe,from CalimetFe)for 16 weeks.The effects of dietary iron supplementation with different sources and levels on semen quality in boars were investigated.Results 1)Serum Fe and hemoglobin concentrations were not affected by reduced dietary iron levels in the 80 mg/kg or 115 mg/kg Gly-Fe and MHA-Fe groups compared with the control group(P>0.05).2)Serum interleukin-6(IL-6)and sperm malondialdehyde(MDA)levels in the 80 mg/kg or 115 mg/kg MHA-Fe groups were lower than those in the control group(P<0.05),and higher serum superoxide dismutase levels and lower MDA levels in the 115 mg/kg MHA-Fe group(P<0.05).3)Boars in the 80 mg/kg or 115 mg/kg Gly-Fe and MHA-Fe groups had lower serum hepcidin(P<0.01),ferritin(P<0.05),and transferrin receptor(P<0.01)concentrations,and boars in the 115 mg/kg MHA-Fe group had higher seminal plasma Fe concentrations compared with the control group.4)Boars in the 80 mg/kg and 115 mg/kg MHA-Fe groups had lower abnormal sperm rate and in situ oscillating sperm ratio compared to the control group at weeks 12 and/or 16 of the trial.However,the effect of Gly-Fe on improving semen quality in boars was not evident.5)Serum IL-6 level was positively correlated with hepcidin concentration(P<0.05),which in turn was significantly positively correlated with abnormal sperm rate(P<0.05).Furthermore,significant correlations were also found between indicators of iron status and oxidative stress and semen quality parameters.Conclusions Dietary supplementation with 80 mg/kg or 115 mg/kg MHA-Fe did not induce iron deficiency,but rather reduced serum inflammatory levels and hepcidin concentration,alleviated oxidative stress,increased body iron utilization,and improved semen quality in adult boars.展开更多
Objective Pertussis cases have increased markedly since 2018 in Guangxi.The aim of this study was to evaluate antibody levels and the infection status of pertussis in the resident population.Method A total of 10,215 s...Objective Pertussis cases have increased markedly since 2018 in Guangxi.The aim of this study was to evaluate antibody levels and the infection status of pertussis in the resident population.Method A total of 10,215 serum samples from residents were collected from August-November 2018 and tested for anti-pertussis IgG and toxin IgG using the enzyme-linked immunosorbent assay(ELISA).Results Of the collected samples,1,833(17.94%)tested positive for anti-pertussis IgG,with the median concentration of 16.06 IU/mL.Antibody level<10 IU/mL accounted for more than 60%in children under 4 years of age,but declined with age,whereas the percentages of the other three levels(10-40,40-50,and≥50 IU/mL)increased almost with age(P<0.001).Moreover,7,924 samples were selected for anti-pertussis toxin IgG,of which 653(8.24%)tested positive(≥40 IU/mL)with the median concentration of 5.89 IU/mL,and 204 participants(2.56%)had recent pertussis infection(≥100 IU/mL).Among the different age groups,the highest rates of positivity and recent infection were observed at 11-20 years of age,the lowest positivity rate at 5 years of age,and the lowest recent infection rate at 4 years of age(P<0.001,P=0.005,respectively).Conclusion The survey results showed that all age groups in Guangxi lacked immunity against pertussis,which was one of the main factors contributing to the resurgence of pertussis in 2018.In addition,the prevalence of pertussis is relatively high in Guangxi,and its incidence is seriously underestimated,especially in adolescents and adults.展开更多
Heavy Menstrual Bleeding is one of the common Gynaecological issues. There are several causes. Some of the women presented with these issues found to have underling thyroid abnormality which was not discovered earlier...Heavy Menstrual Bleeding is one of the common Gynaecological issues. There are several causes. Some of the women presented with these issues found to have underling thyroid abnormality which was not discovered earlier. This research tries to find the prevalence of the Thyroid Disorder among the women present with Heavy menstrual bleeding in Sri Lankan women.展开更多
As the global temperature continues to increase, the sea level continues to rise at a rapid rate that has never been seen before. This becomes an issue for many facets of life but one of the most impacted is the trans...As the global temperature continues to increase, the sea level continues to rise at a rapid rate that has never been seen before. This becomes an issue for many facets of life but one of the most impacted is the transportation infrastructure. Many people living in low elevation coastal areas can become trapped by flooding with no way in or out. With Delaware being a coastal state, this would affect a large portion of the population and will have detrimental effects over time if nothing is done to combat sea level rise. The issue with sea level rise in transportation is that once the roads become flooded, they become virtually unusable and detour routes would be needed. If all the roads in a coastal area were to be affected by sea level rise, the options for detours would become limited. This article looks at direct solutions to combat sea level rise and indirect solutions that would specifically help transportation infrastructure and evacuation routes in Delaware. There is not one solution that can fix every problem, so many solutions are laid out to see what is applicable to each affected area. Some solutions include defense structures that would be put close to the coast, raising the elevation of vulnerable roads throughout the state and including pumping stations to drain the water on the surface of the road. With an understanding of all these solutions around the world, the ultimate conclusion came in the form of a six-step plan that Delaware should take in order to best design against sea level rise in these coastal areas.展开更多
Stiffened structures have great potential for improvingmechanical performance,and the study of their stability is of great interest.In this paper,the optimization of the critical buckling load factor for curved grid s...Stiffened structures have great potential for improvingmechanical performance,and the study of their stability is of great interest.In this paper,the optimization of the critical buckling load factor for curved grid stiffeners is solved by using the level set based density method,where the shape and cross section(including thickness and width)of the stiffeners can be optimized simultaneously.The grid stiffeners are a combination ofmany single stiffenerswhich are projected by the corresponding level set functions.The thickness and width of each stiffener are designed to be independent variables in the projection applied to each level set function.Besides,the path of each single stiffener is described by the zero iso-contour of the level set function.All the single stiffeners are combined together by using the p-norm method to obtain the stiffener grid.The proposed method is validated by several numerical examples to optimize the critical buckling load factor.展开更多
Emission and capture characteristics of a deep hole trap(H1)in n-GaN Schottky barrier diodes(SBDs)have been investigated by optical deep level transient spectroscopy(ODLTS).Activation energy(Eemi)and capture cross-sec...Emission and capture characteristics of a deep hole trap(H1)in n-GaN Schottky barrier diodes(SBDs)have been investigated by optical deep level transient spectroscopy(ODLTS).Activation energy(Eemi)and capture cross-section(σ_(p))of H1 are determined to be 0.75 eV and 4.67×10^(−15)cm^(2),respectively.Distribution of apparent trap concentration in space charge region is demonstrated.Temperature-enhanced emission process is revealed by decrease of emission time constant.Electricfield-boosted trap emission kinetics are analyzed by the Poole−Frenkel emission(PFE)model.In addition,H1 shows point defect capture properties and temperature-enhanced capture kinetics.Taking both hole capture and emission processes into account during laser beam incidence,H1 features a trap concentration of 2.67×10^(15)cm^(−3).The method and obtained results may facilitate understanding of minority carrier trap properties in wide bandgap semiconductor material and can be applied for device reliability assessment.展开更多
Coastal hazards induced by meteo-marine forcing are exacerbated by sea level change along the West African coastline. Changes in sea level are induced by ocean processes such as ocean heat content and river discharge....Coastal hazards induced by meteo-marine forcing are exacerbated by sea level change along the West African coastline. Changes in sea level are induced by ocean processes such as ocean heat content and river discharge. However, although these processes control largely change in sea level, they remain poorly understood. This study analyzes changes in ocean heat content, river discharge, and sea level and establishes an interconnection between these parameters using several statistical methods over the 1993-2021 period. Results showed a significant correlation between sea level and ocean heat content at 2000 m depth. The yearly minimum value appears in July from Cote d’Ivoire to Benin, whilst this value appears in June in Nigeria. The temporal variability of ocean heat content, river discharge and sea level along the West African coastline exhibits three or four periods interrupted by some breakpoints with unequal duration. The results indicate that the 1993-2000 period was dominated by an increasing ocean heat content along the coastline, while the period after the 2000s exhibits mostly a decreasing trend. Positive and negative trends characterized river discharge and sea level along this coastline. The result of multiple linear regression between sea level, river discharge and ocean heat content is a good approximation of sea level trend along the West African coastline. The results of this study could be used to predict future sea level trends along the coast.展开更多
Manganese-based perovskite is popular for research on ferromagnetic materials,and its spectroscopic studies are essential for understanding its electronic structure,dielectric,electrical,and magnetic properties.In thi...Manganese-based perovskite is popular for research on ferromagnetic materials,and its spectroscopic studies are essential for understanding its electronic structure,dielectric,electrical,and magnetic properties.In this paper,the M-edge spectra of La ions and the M-edge,L-edge,and K-edge spectra of Mn ions in LaMnO3 are calculated by considering both the free-ion multiplet calculation and the crystal field effects.We analyze spectral shapes,identify peak origins,and estimate the oxidation states of La and Mn ions in LaMnO3 theoretically.It is concluded that La ions in LaMnO3 predominantly exist in the trivalent state,while Mn ions exist primarily in the trivalent state with a minor presence of tetravalent ions.Furthermore,the calculated spectra are in better conformity with the experimental spectra when the proportion of Mn3+is 90%and Mn4+is 10%.This article enhances our comprehension of the oxidation states of La and Mn within the crystal and also provides a valuable guidance for spectroscopic investigations of other manganates.展开更多
Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)globally.However,the level of scientific evidence supporting ESMO...Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)globally.However,the level of scientific evidence supporting ESMO CPG recommendations has not been systematically investigated.This study assessed ESMO CPG levels of evidence(LOE)and grades of recommendations(GOR),as well as their trends over time across various cancer settings.Methods:We manually extracted every recommendation with the Infectious Diseases Society of America(IDSA)classification from each CPG.We examined the distribution of LOE and GOR in all available ESMO CPG guidelines across different topics and cancer types.Results:Among the 1,823 recommendations in the current CPG,30%were classified as LOEⅠ,and 43%were classified as GOR A.Overall,there was a slight decrease in LOEⅠ(−2%)and an increase in the proportion of GOR A(+1%)in the current CPG compared to previous versions.The proportion of GOR A recommendations based on higher levels of evidence such as randomized trials(LOEⅠ–Ⅱ)shows a decrease(71%vs.63%,p=0.009)while recommendations based on lower levels of evidence(LOEⅢ–Ⅴ)show an increase(29%vs.37%,p=0.01)between previous and current version.In the current versions,the highest proportion of LOEⅠ(42%)was found in recommendations related to pharmacotherapy,while the highest proportion of GOR A recommendations was found in the areas of pathology(50%)and diagnostic(50%)recommendations.Significant variability in LOEⅠand GOR A recommendations and their changes over time was observed across different cancer types.Conclusion:One-third of the current ESMO CPG recommendations are supported by the highest level of evidence.More well-designed randomized clinical trials are needed to increase the proportion of LOEⅠand GOR A recommendations,ultimately leading to improved outcomes for cancer patients.展开更多
基金the International Center for Global Earth Models(ICGEM)for the height anomaly and gravity anomaly data and Bureau Gravimetrique International(BGI)for free-air gravity anomaly data from the World Gravity Map project(WGM2012)The authors are grateful to Głowny Urza˛d Geodezji i Kartografii of Poland for the height anomaly data of the quasi-geoid PL-geoid2021.
文摘At present,one of the methods used to determine the height of points on the Earth’s surface is Global Navigation Satellite System(GNSS)leveling.It is possible to determine the orthometric or normal height by this method only if there is a geoid or quasi-geoid height model available.This paper proposes the methodology for local correction of the heights of high-order global geoid models such as EGM08,EIGEN-6C4,GECO,and XGM2019e_2159.This methodology was tested in different areas of the research field,covering various relief forms.The dependence of the change in corrected height accuracy on the input data was analyzed,and the correction was also conducted for model heights in three tidal systems:"tide free","mean tide",and"zero tide".The results show that the heights of EIGEN-6C4 model can be corrected with an accuracy of up to 1 cm for flat and foothill terrains with the dimensionality of 1°×1°,2°×2°,and 3°×3°.The EGM08 model presents an almost identical result.The EIGEN-6C4 model is best suited for mountainous relief and provides an accuracy of 1.5 cm on the 1°×1°area.The height correction accuracy of GECO and XGM2019e_2159 models is slightly poor,which has fuzziness in terms of numerical fluctuation.
文摘The availability of many high-degree Global Geopotential Models(GGMs), namely EGM2008, EIGEN-6C4,GECO, SGG-UGM-1, SGG-UGM-2, XGM2019e_2159, and GGMPlus, challenges users regarding which model is best for Vietnam. This study, therefore, evaluates their performance by comparing them with GNSS/leveling data over Vietnam. Results show that their absolute and relative performances are largely independent of topographic conditions and geographical location and can be ranked into three classes:(1)XGM2019e_2159 has the highest accuracy,(2) the models EIGEN-6C4, GECO, SGG-UGM-1, SGG-UGM-2, and GGMPlus, have a very similar level of medium accuracy, while(3) EGM2008 is found to be the least accurate. In an absolute sense, the differences between GNSS/leveling and EGM2008-based height anomalies have a standard deviation(STD) of 0.290 ± 0.010 m, whereas, for XGM2019e_2159, this is 0.156 ± 0.006 m.All other models have STDs of(0.18-0.19) ± 0.007 m. Regarding relative performance without fitting, all GGMs have comparable accuracies for baseline length of 5-20 km, while for baselines longer than 20 km,the STD of XGM2019e_2159 is 1.5 ppm-0.5 ppm(approximately 19%-40%) lower compared with EGM2008, and 0.5 ppm-0.25 ppm(approximately 7%-36%) lower compared with EIGEN6C4, GECO,SGG-UGM-1, SGG-UGM-2, and GGMPlus. In addition, the STDs decrease significantly from 20 to 12 ppm in the range of 5-10 km, slightly from 12 to 6 ppm for 10-35 km, very slightly from 6 to 2.5 ppm for35-200 km, and then remain almost unchanged for longer baselines. After fitting, the relative accuracies of all GGMs are at the same level with negligible STD/RMSE values. Furthermore, only EGM2008 experiences significant regional differences, while other GGMs show more homogeneous spatial variation of absolute accuracy over Vietnam. These findings can contribute to the development of local quasigeoid models in Vietnam and may be helpful with the improvement of GGMs in the future.
基金National Natural Science Foundation of China,No.72101236China Postdoctoral Science Foundation,No.2022M722900+1 种基金Collaborative Innovation Project of Zhengzhou City,No.XTCX2023006Nursing Team Project of the First Affiliated Hospital of Zhengzhou University,No.HLKY2023005.
文摘BACKGROUND Within the normal range,elevated alanine aminotransferase(ALT)levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To investigate the associations between repeated high-normal ALT measurements and the risk of new-onset MAFLD prospectively.METHODS A cohort of 3553 participants followed for four consecutive health examinations over 4 years was selected.The incidence rate,cumulative times,and equally and unequally weighted cumulative effects of excess high-normal ALT levels(ehALT)were measured.Cox proportional hazards regression was used to analyse the association between the cumulative effects of ehALT and the risk of new-onset MAFLD.RESULTS A total of 83.13%of participants with MAFLD had normal ALT levels.The incidence rate of MAFLD showed a linear increasing trend in the cumulative ehALT group.Compared with those in the low-normal ALT group,the multivariate adjusted hazard ratios of the equally and unequally weighted cumulative effects of ehALT were 1.651[95%confidence interval(CI):1.199-2.273]and 1.535(95%CI:1.119-2.106)in the third quartile and 1.616(95%CI:1.162-2.246)and 1.580(95%CI:1.155-2.162)in the fourth quartile,respectively.CONCLUSION Most participants with MAFLD had normal ALT levels.Long-term high-normal ALT levels were associated with a cumulative increased risk of new-onset MAFLD.
基金supported by the National Natural Science Foundation of China(41774004,41904040)the Technological Innovation of SHASG(SCK2020-11).
文摘A method is proposed to fuse the velocity data of the global navigation satellite system(GNSS) and leveling height via combined adjustment with constraints. First, stable GNSS-leveling points are uniformly selected, and the constraints of the geodetic height change velocity and normal height change velocity are given. Then, the GNSS vertical velocities and leveling height difference are used as observations of combined adjustment, and robust least-squares estimation are used to estimate the velocities of the unknown points. Finally, a vertical movement model is established with the GNSS vertical velocities and leveling vertical velocities obtained via combined adjustment. Data from the second-order leveling network and GNSS control points in Shandong Province are taken as test data, and eight calculation schemes are used for discussion. One of the schemes, the bifactor robust combined adjustment method based on variance component estimation with two kinds of vertical velocity constraints achieves the optimal results. The method applied in the scheme can be recommended for data fusion of GNSS and leveling, further improving the reliability of vertical crustal movement in Shandong Province.
文摘The Longmenshan-Longriba region is located on the eastern edge of the Tibetan Plateau, and is an ideal place to study the eastward extrusion and uplift mechanism of the plateau. Previous studies on this area mainly focused on tectonic activity and seismic hazard, with few studies giving its overall deformation characteristics and dynamic mechanism. This paper uses the latest dense GPS data, combined with precise Leveling data to analyze the kinematic characteristics and deformation mode of the Longmenshan fault zone (LMSF) and the Longriba fault zone (LRBF). The results show that both the Longmenshan fault zone and the Longriba fault zone have certain right-lateral strike-slip and thrusting, indicating that they play an important role in adjusting strain distribution and absorbing tectonic deformation;The strain-rate field on the Longriba fault zone is broadly distributed, suggesting that the deformation field is at least partially coupled;while the strain-rate field on the Longmenshan fault zone presents a non-uniform distribution, indicating different dynamic sources acting on segments. The high strain rate areas revealed in this study points us to the high-risk area for future earthquakes. The present-day vertical motion velocity field in the region obtained from Leveling and GPS data shows a mismatch between the regional deformation field and active tectonics, which can be explained by the incomplete coupling of deformation between the lower and upper crust.
文摘Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.
基金“Wings of Quality”Program of QICS(No.2020-zlzy-015)。
文摘Gravity Anomaly Correction(GAC)is a very important term in leveling data processing.In most cases,it is troublesome for field surveyors to measure gravity when leveling.In this paper,based on the complete Bouguer Gravity Anomaly(BGA)map of WGM2012,the feasibility of replacing in-situ gravity surveying in China is investigated.For leveling application,that is to evaluate the accuracy of WGM2012 in China.Because WGM2012 is organized with a standard rectangle grid,two interpolation methods,bilinear interpolating and Inverse Distance Weighted(IDW)interpolating,are proposed.Four sample areas in China,i.e.,Hanzhong,Chengdu,Linzhi and Shantou,are selected to evaluate the systems bias and precision of WGM2012.Numerical results show the average system bias of WGM2012 BGA in west China is about-100.1 mGal(1 mGal=10^(-5) m/s^(2))and the standard deviation is about 30.7 mGal.Tests in Shantou indicate the system bias in plain areas is about-130.4 mGal and standard deviation is about 6.8 mGal.All these experiments means the accuracy of WGM2012 is limited in high mountain areas of western China,but in plain areas,such as Shantou,WGM2012 BGA map is quite good for most leveling applications after calibrating the system bias.
基金Project supported by the National Natural Science Foundation of China (Grant Nos. 72174121 and 71774111)the Program for Professor of Special Appointment (Eastern Scholar) at Shanghai Institutions of Higher Learningthe Project for the Natural Science Foundation of Shanghai, China (Grant No. 21ZR1444100)
文摘While the interaction between information and disease in static networks has been extensively investigated,many studies have ignored the characteristics of network evolution.In this study,we construct a new two-layer coupling model to explore the interactions between information and disease.The upper layer describes the diffusion of disease-related information,and the lower layer represents the disease transmission.We then use power-law distributions to examine the influence of asymmetric activity levels on dynamic propagation,revealing a mapping relationship characterizing the interconnected propagation of information and diseases among partial nodes within the network.Subsequently,we derive the disease outbreak threshold by using the microscopic Markov-chain approach(MMCA).Finally,we perform extensive Monte Carlo(MC)numerical simulations to verify the accuracy of our theoretical results.Our findings indicate that the activity levels of individuals in the disease transmission layer have a more significant influence on disease transmission compared with the individual activity levels in the information diffusion layer.Moreover,reducing the damping factor can delay disease outbreaks and suppress disease transmission,while improving individual quarantine measures can contribute positively to disease control.This study provides valuable insights into policymakers for developing outbreak prevention and control strategies.
基金Projects(51925402,52334005,52304094)supported by the National Natural Science Foundation of ChinaProject(20201102004)supported by the Shanxi Science and Technology Major Project,China。
文摘The mechanical properties of residual coal pillars under the influence of upward mining disturbances significantly affect the safety of residual mining activities on working faces.This study conducted low-frequency disturbance dynamic uniaxial compression tests on coal specimens using a self-developed dynamic-static load coupling electro-hydraulic servo system,and studied the strength evolutions,surface deformations,acoustic emission(AE)characteristic parameters,and the failure modes of coal specimens with different static preloading levels were studied.The disturbance damage is positively correlated with the coal specimen static preload level.Specifically,the cumulative AE count rates of the initial accelerated damage stage for the coal specimens with static preloading level of 60%and 70%of the uniaxial compressive strength(UCS)were 2.66 and 3.19 times that of the 50%UCS specimens,respectively.Macroscopically,this behaviour manifested as a decrease in the compressive strength,and the mean strengths of the disturbance-damaged coal specimens with 60%and 70%of UCS static preloading decreased by 8.53%and 9.32%,respectively,compared to those of the specimens under pure static loading.The crack sources,such as the primary fissures,strongly control the dynamic response of the coal specimen.The difference between the dynamic responses of the coal specimens and that of dense rocks is significant.
基金the University of French Polynesiafunding by several successive“Decision Aide a la Recherche”(DAR)grants to the Geodesy Observatory of Tahiti from the French Space Agency(CNES)+2 种基金fundings from the local government of French Polynesia(Observatoire Polynesien du Rechauffement Climatique)funding by“National Natural Science Foundation of China”(Grand No.41931075)funding by“the Fundamental Research Funds for the Central Universities"(Grand No.2042022kf1198)。
文摘In this study,we estimate the absolute vertical land motions at three tidal stations with collocated Global Navigation Satellite System(GNSS)receivers over French Polynesia during the period 2007-2020,and obtain,as ancillary results,estimates of the absolute changes in sea level at the same locations.To verify our processing approach to determining vertical motion,we first modeled vertical motion at the International GNSS Service(IGS)THTI station located in the capital island of Tahiti and compared our estimate with previous independent determinations,with a good agreement.We obtained the following estimates for the vertical land motions at the tide gauges:Tubuai island,Austral Archipelago-0.92±0.17 mm/yr,Vairao village,Tahiti Iti:-0.49±0.39 mm/yr,Rikitea,Gambier Archipelago-0.43±0.17 mm/yr.The absolute variations of the sea level are:Tubuai island,Austral Archipelago 5.25±0.60 mm/yr,Vairao village,Tahiti Iti:3.62±0.52 mm/yr,Rikitea,Gambier Archipelago 1.52±0.23 mm/yr.We discuss these absolute values in light of the values obtained from altimetric measurements and other means in French Polynesia.
基金China Agriculture Research System(CARS-36)Major Project of Technical Innovation in Hubei Province(No.2022BBA0056)+1 种基金Dekon-Huazhong Agricultural University Project Co-operation AgreementSchool-Enterprise Cooperation Project-Micronutrient Nutrition and Mechanism of Breeding Pigs。
文摘Background Boars fed a mixed form of inorganic and organic iron in excess of the NRC recommended levels still develop anemia,which suggested that the current level and form of iron supplementation in boar diets may be inappropriate.Therefore,56 healthy Topeka E line boars aged 15–21 months were randomly divided into 5 groups:basal diet supplemented with 96 mg/kg ferrous sulfate(FeSO_(4))and 54 mg/kg glycine chelated iron(Gly-Fe,control);80 mg/kg or 115 mg/kg Gly-Fe;80 mg/kg or 115 mg/kg methionine hydroxyl analogue chelated iron(MHA-Fe,from CalimetFe)for 16 weeks.The effects of dietary iron supplementation with different sources and levels on semen quality in boars were investigated.Results 1)Serum Fe and hemoglobin concentrations were not affected by reduced dietary iron levels in the 80 mg/kg or 115 mg/kg Gly-Fe and MHA-Fe groups compared with the control group(P>0.05).2)Serum interleukin-6(IL-6)and sperm malondialdehyde(MDA)levels in the 80 mg/kg or 115 mg/kg MHA-Fe groups were lower than those in the control group(P<0.05),and higher serum superoxide dismutase levels and lower MDA levels in the 115 mg/kg MHA-Fe group(P<0.05).3)Boars in the 80 mg/kg or 115 mg/kg Gly-Fe and MHA-Fe groups had lower serum hepcidin(P<0.01),ferritin(P<0.05),and transferrin receptor(P<0.01)concentrations,and boars in the 115 mg/kg MHA-Fe group had higher seminal plasma Fe concentrations compared with the control group.4)Boars in the 80 mg/kg and 115 mg/kg MHA-Fe groups had lower abnormal sperm rate and in situ oscillating sperm ratio compared to the control group at weeks 12 and/or 16 of the trial.However,the effect of Gly-Fe on improving semen quality in boars was not evident.5)Serum IL-6 level was positively correlated with hepcidin concentration(P<0.05),which in turn was significantly positively correlated with abnormal sperm rate(P<0.05).Furthermore,significant correlations were also found between indicators of iron status and oxidative stress and semen quality parameters.Conclusions Dietary supplementation with 80 mg/kg or 115 mg/kg MHA-Fe did not induce iron deficiency,but rather reduced serum inflammatory levels and hepcidin concentration,alleviated oxidative stress,increased body iron utilization,and improved semen quality in adult boars.
基金approved by the Ethics Committee of the Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention(GXIRB 2018-0005),and the participants signed informed consent forms.
文摘Objective Pertussis cases have increased markedly since 2018 in Guangxi.The aim of this study was to evaluate antibody levels and the infection status of pertussis in the resident population.Method A total of 10,215 serum samples from residents were collected from August-November 2018 and tested for anti-pertussis IgG and toxin IgG using the enzyme-linked immunosorbent assay(ELISA).Results Of the collected samples,1,833(17.94%)tested positive for anti-pertussis IgG,with the median concentration of 16.06 IU/mL.Antibody level<10 IU/mL accounted for more than 60%in children under 4 years of age,but declined with age,whereas the percentages of the other three levels(10-40,40-50,and≥50 IU/mL)increased almost with age(P<0.001).Moreover,7,924 samples were selected for anti-pertussis toxin IgG,of which 653(8.24%)tested positive(≥40 IU/mL)with the median concentration of 5.89 IU/mL,and 204 participants(2.56%)had recent pertussis infection(≥100 IU/mL).Among the different age groups,the highest rates of positivity and recent infection were observed at 11-20 years of age,the lowest positivity rate at 5 years of age,and the lowest recent infection rate at 4 years of age(P<0.001,P=0.005,respectively).Conclusion The survey results showed that all age groups in Guangxi lacked immunity against pertussis,which was one of the main factors contributing to the resurgence of pertussis in 2018.In addition,the prevalence of pertussis is relatively high in Guangxi,and its incidence is seriously underestimated,especially in adolescents and adults.
文摘Heavy Menstrual Bleeding is one of the common Gynaecological issues. There are several causes. Some of the women presented with these issues found to have underling thyroid abnormality which was not discovered earlier. This research tries to find the prevalence of the Thyroid Disorder among the women present with Heavy menstrual bleeding in Sri Lankan women.
文摘As the global temperature continues to increase, the sea level continues to rise at a rapid rate that has never been seen before. This becomes an issue for many facets of life but one of the most impacted is the transportation infrastructure. Many people living in low elevation coastal areas can become trapped by flooding with no way in or out. With Delaware being a coastal state, this would affect a large portion of the population and will have detrimental effects over time if nothing is done to combat sea level rise. The issue with sea level rise in transportation is that once the roads become flooded, they become virtually unusable and detour routes would be needed. If all the roads in a coastal area were to be affected by sea level rise, the options for detours would become limited. This article looks at direct solutions to combat sea level rise and indirect solutions that would specifically help transportation infrastructure and evacuation routes in Delaware. There is not one solution that can fix every problem, so many solutions are laid out to see what is applicable to each affected area. Some solutions include defense structures that would be put close to the coast, raising the elevation of vulnerable roads throughout the state and including pumping stations to drain the water on the surface of the road. With an understanding of all these solutions around the world, the ultimate conclusion came in the form of a six-step plan that Delaware should take in order to best design against sea level rise in these coastal areas.
基金supported by the National Natural Science Foundation of China(Grant Nos.51975227 and 12272144).
文摘Stiffened structures have great potential for improvingmechanical performance,and the study of their stability is of great interest.In this paper,the optimization of the critical buckling load factor for curved grid stiffeners is solved by using the level set based density method,where the shape and cross section(including thickness and width)of the stiffeners can be optimized simultaneously.The grid stiffeners are a combination ofmany single stiffenerswhich are projected by the corresponding level set functions.The thickness and width of each stiffener are designed to be independent variables in the projection applied to each level set function.Besides,the path of each single stiffener is described by the zero iso-contour of the level set function.All the single stiffeners are combined together by using the p-norm method to obtain the stiffener grid.The proposed method is validated by several numerical examples to optimize the critical buckling load factor.
基金supported by ShanghaiTech University Startup Fund 2017F0203-000-14the National Natural Science Foundation of China(Grant No.52131303)+1 种基金Natural Science Foundation of Shanghai(Grant No.22ZR1442300)in part by CAS Strategic Science and Technology Program(Grant No.XDA18000000).
文摘Emission and capture characteristics of a deep hole trap(H1)in n-GaN Schottky barrier diodes(SBDs)have been investigated by optical deep level transient spectroscopy(ODLTS).Activation energy(Eemi)and capture cross-section(σ_(p))of H1 are determined to be 0.75 eV and 4.67×10^(−15)cm^(2),respectively.Distribution of apparent trap concentration in space charge region is demonstrated.Temperature-enhanced emission process is revealed by decrease of emission time constant.Electricfield-boosted trap emission kinetics are analyzed by the Poole−Frenkel emission(PFE)model.In addition,H1 shows point defect capture properties and temperature-enhanced capture kinetics.Taking both hole capture and emission processes into account during laser beam incidence,H1 features a trap concentration of 2.67×10^(15)cm^(−3).The method and obtained results may facilitate understanding of minority carrier trap properties in wide bandgap semiconductor material and can be applied for device reliability assessment.
文摘Coastal hazards induced by meteo-marine forcing are exacerbated by sea level change along the West African coastline. Changes in sea level are induced by ocean processes such as ocean heat content and river discharge. However, although these processes control largely change in sea level, they remain poorly understood. This study analyzes changes in ocean heat content, river discharge, and sea level and establishes an interconnection between these parameters using several statistical methods over the 1993-2021 period. Results showed a significant correlation between sea level and ocean heat content at 2000 m depth. The yearly minimum value appears in July from Cote d’Ivoire to Benin, whilst this value appears in June in Nigeria. The temporal variability of ocean heat content, river discharge and sea level along the West African coastline exhibits three or four periods interrupted by some breakpoints with unequal duration. The results indicate that the 1993-2000 period was dominated by an increasing ocean heat content along the coastline, while the period after the 2000s exhibits mostly a decreasing trend. Positive and negative trends characterized river discharge and sea level along this coastline. The result of multiple linear regression between sea level, river discharge and ocean heat content is a good approximation of sea level trend along the West African coastline. The results of this study could be used to predict future sea level trends along the coast.
基金Project supported by the National Natural Science Foundation of China(Grant No.11974253).
文摘Manganese-based perovskite is popular for research on ferromagnetic materials,and its spectroscopic studies are essential for understanding its electronic structure,dielectric,electrical,and magnetic properties.In this paper,the M-edge spectra of La ions and the M-edge,L-edge,and K-edge spectra of Mn ions in LaMnO3 are calculated by considering both the free-ion multiplet calculation and the crystal field effects.We analyze spectral shapes,identify peak origins,and estimate the oxidation states of La and Mn ions in LaMnO3 theoretically.It is concluded that La ions in LaMnO3 predominantly exist in the trivalent state,while Mn ions exist primarily in the trivalent state with a minor presence of tetravalent ions.Furthermore,the calculated spectra are in better conformity with the experimental spectra when the proportion of Mn3+is 90%and Mn4+is 10%.This article enhances our comprehension of the oxidation states of La and Mn within the crystal and also provides a valuable guidance for spectroscopic investigations of other manganates.
文摘Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)globally.However,the level of scientific evidence supporting ESMO CPG recommendations has not been systematically investigated.This study assessed ESMO CPG levels of evidence(LOE)and grades of recommendations(GOR),as well as their trends over time across various cancer settings.Methods:We manually extracted every recommendation with the Infectious Diseases Society of America(IDSA)classification from each CPG.We examined the distribution of LOE and GOR in all available ESMO CPG guidelines across different topics and cancer types.Results:Among the 1,823 recommendations in the current CPG,30%were classified as LOEⅠ,and 43%were classified as GOR A.Overall,there was a slight decrease in LOEⅠ(−2%)and an increase in the proportion of GOR A(+1%)in the current CPG compared to previous versions.The proportion of GOR A recommendations based on higher levels of evidence such as randomized trials(LOEⅠ–Ⅱ)shows a decrease(71%vs.63%,p=0.009)while recommendations based on lower levels of evidence(LOEⅢ–Ⅴ)show an increase(29%vs.37%,p=0.01)between previous and current version.In the current versions,the highest proportion of LOEⅠ(42%)was found in recommendations related to pharmacotherapy,while the highest proportion of GOR A recommendations was found in the areas of pathology(50%)and diagnostic(50%)recommendations.Significant variability in LOEⅠand GOR A recommendations and their changes over time was observed across different cancer types.Conclusion:One-third of the current ESMO CPG recommendations are supported by the highest level of evidence.More well-designed randomized clinical trials are needed to increase the proportion of LOEⅠand GOR A recommendations,ultimately leading to improved outcomes for cancer patients.
