AIM To investigate changes in polyp detection throughout fellowship training, and estimate colonoscopy volume required to achieve the adenoma detection rate(ADRs) and polyp detection rate(PDRs) of attending gastroente...AIM To investigate changes in polyp detection throughout fellowship training, and estimate colonoscopy volume required to achieve the adenoma detection rate(ADRs) and polyp detection rate(PDRs) of attending gastroenterologists.METHODS We reviewed colonoscopies from July 1, 2009 to June 30, 2014. Fellows' procedural logs were used to retrieve colonoscopy procedural volumes, and these were treated as the time variable. Findings from screening colonoscopies were used to calculate colonoscopy outcomes for each fellow for the prior 50 colonoscopies at each time point. ADR and PDR were plotted against colonoscopy procedural volumes to produce individual longitudinal graphs. Repeated measures linear mixed effects models were used to study the change of ADR and PDR with increasing procedural volume.RESULTS During the study period, 12 fellows completed full three years of training and were included in the analysis. The average ADR and PDR were, respectively, 31.5% and 41.9% for all fellows, and 28.9% and 38.2% for attendings alone. There was a statistically significant increase in ADR with increasing procedural volume(1.8%/100 colonoscopies, P = 0.002). Similarly, PDR increased 2.8%/100 colonoscopies(P = 0.0001), while there was no significant change in advanced ADR(0.04%/100 colonoscopies, P = 0.92). The ADR increase was limited to the right side of the colon, while the PDR increased in both the right and left colon. The adenoma per colon and polyp per colon also increased throughout training. Fellows reached the attendings' ADR and PDR after 265 and 292 colonoscopies, respectively.CONCLUSION We found that the ADR and PDR increase with increasing colonoscopy volume throughout fellowship. Our findings support recent recommendations of ≥ 275 colonoscopies for colonoscopy credentialing.展开更多
The purpose of the present study was to examine the effect of circuit training (CT) on resting heart rate variability (HRV) and other cardiovascular disease (CVD) risk factors such as blood lipids and blood glucose an...The purpose of the present study was to examine the effect of circuit training (CT) on resting heart rate variability (HRV) and other cardiovascular disease (CVD) risk factors such as blood lipids and blood glucose and on fitness components. Twenty-four healthy untrained adults (age 26.5 ± 5.1 years;height 1.67 ± 8.4 m;weight 66.8 ± 15.1 kg;26.3% ± 5.2%;maximum oxygen uptake (VO<sub>2max</sub>) 48.5 ± 10.0 ml.kg<sup>-1</sup>.min<sup>-1</sup>) were assigned to either CT (n = 12) involving bodyweight exercises, or control (CON, n = 12) groups. Prior to the start and following the end of the six-week training period, time-, frequency-domain and nonlinear measures of resting HRV, arterial blood pressure, body composition, fasting blood lipids, lipoproteins and glucose, VO<sub>2max</sub>, upper body muscular endurance (UBME) and abdominal and hip flexor (AHFME), back strength (BS) and handgrip were assessed. None of the resting HRV measures (P > 0.05) were affected by the CT intervention. However, diastolic blood pressure decreased (P = 0.03), lean body weight (P = 0.03) increased, VO<sub>2max</sub> (P = 0.03), UBME (P = 0.001), AHFME (P = 0.04), and BS (P = 0.03) were significantly higher following CT, whereas the other variables were not influenced by the CT. Six-week of CT involving bodyweight exercises has no significant impact on resting HRV. However, this type of training might decrease the risk for development of CVD by reducing arterial blood pressure and by improving body composition, aerobic capacity, muscular endurance and strength.展开更多
In this paper, we discuss the properties of lazy quantum walks. Our analysis shows that the lazy quantum walks have O(t n) order of the n-th moment of the corresponding probability distribution, which is the same as t...In this paper, we discuss the properties of lazy quantum walks. Our analysis shows that the lazy quantum walks have O(t n) order of the n-th moment of the corresponding probability distribution, which is the same as that for normal quantum walks. The lazy quantum walk with a discrete Fourier transform(DFT) coin operator has a similar probability distribution concentrated interval to that of the normal Hadamard quantum walk. Most importantly, we introduce the concepts of occupancy number and occupancy rate to measure the extent to which the walk has a(relatively) high probability at every position in its range. We conclude that the lazy quantum walks have a higher occupancy rate than other walks such as normal quantum walks, classical walks, and lazy classical walks.展开更多
AIM To investigate whether adenoma and polyp detection rates(ADR and PDR, respectively) in screening colonoscopies performed in the presence of fellows differ from those performed by attending physicians alone. METHOD...AIM To investigate whether adenoma and polyp detection rates(ADR and PDR, respectively) in screening colonoscopies performed in the presence of fellows differ from those performed by attending physicians alone. METHODS We performed a retrospective review of all patients who underwent a screening colonoscopy at Grady Memorial Hospital between July 1, 2009 and June 30, 2015. Patients with a history of colon polyps or cancer and those with poor colon preparation or failed cecal intubation were excluded from the analysis. Associations of fellowship training level with the ADR and PDR relative to attendings alone were assessed using unconditional multivariable logistic regression. Models were adjusted for sex, age, race, and colon preparationquality. RESULTS A total of 7503 colonoscopies met the inclusion criteria and were included in the analysis. The mean age of the study patients was 58.2 years; 63.1% were women and 88.2% were African American. The ADR was higher in the fellow participation group overall compared to that in the attending group: 34.5% vs 30.7%(P = 0.001), and for third year fellows it was 35.4% vs 30.7%(a OR = 1.23, 95%CI: 1.09-1.39). The higher ADR in the fellow participation group was evident for both the right and left side of the colon. For the PDR the corresponding figures were 44.5% vs 40.1%(P = 0.0003) and 45.7% vs 40.1%(a OR = 1.25, 95%CI: 1.12-1.41). The ADR and PDR increased with increasing fellow training level(P for trend < 0.05).CONCLUSION There is a stepwise increase in ADR and PDR across the years of gastroenterology training. Fellow participation is associated with higher adenoma and polyp detection.展开更多
Purpose-This paper aims to analyze the bearing characteristics of the high speed train window glass under aerodynamic load effects.Design/methodology/approach-In order to obtain the dynamic strain response of passenge...Purpose-This paper aims to analyze the bearing characteristics of the high speed train window glass under aerodynamic load effects.Design/methodology/approach-In order to obtain the dynamic strain response of passenger compartment window glass during high-speed train crossing the tunnel,taking the passenger compartment window glass of the CRH3 high speed train onWuhan-Guangzhou High Speed Railway as the research object,this study tests the strain dynamic response and maximum principal stress of the high speed train passing through the tunnel entrance and exit,the tunnel and tunnel groups as well as trains meeting in the tunnel at an average speed of 300 km$h-1.Findings-The results show that while crossing the tunnel,the passenger compartment window glass of high speed train is subjected to the alternating action of positive and negative air pressures,which shows the typical mechanic characteristics of the alternating fatigue stress of positive-negative transient strain.The maximum principal stress of passenger compartment window glass for high speed train caused by tunnel aerodynamic effects does not exceed 5 MPa,and the maximum value occurs at the corresponding time of crossing the tunnel groups.The high speed train window glass bears medium and low strain rates under the action of tunnel aerodynamic effects,while the maximum strain rate occurs at the meeting moment when the window glass meets the train head approaching from the opposite side in the tunnel.The shear modulus of laminated glass PVB film that makes up high speed train window glass is sensitive to the temperature and action time.The dynamically equivalent thickness and stiffness of the laminated glass and the dynamic bearing capacity of the window glass decrease with the increase of the action time under tunnel aerodynamic pressure.Thus,the influence of the loading action time and fatigue under tunnel aerodynamic effects on the glass strength should be considered in the design for the bearing performance of high speed train window glass.Originality/value-The research results provide data support for the analysis of mechanical characteristics,damage mechanism,strength design and structural optimization of high speed train glass.展开更多
基金Supported by(in part) National Center for Advancing Translational Sciences of the National Institutes of Health,No.UL1TR000454
文摘AIM To investigate changes in polyp detection throughout fellowship training, and estimate colonoscopy volume required to achieve the adenoma detection rate(ADRs) and polyp detection rate(PDRs) of attending gastroenterologists.METHODS We reviewed colonoscopies from July 1, 2009 to June 30, 2014. Fellows' procedural logs were used to retrieve colonoscopy procedural volumes, and these were treated as the time variable. Findings from screening colonoscopies were used to calculate colonoscopy outcomes for each fellow for the prior 50 colonoscopies at each time point. ADR and PDR were plotted against colonoscopy procedural volumes to produce individual longitudinal graphs. Repeated measures linear mixed effects models were used to study the change of ADR and PDR with increasing procedural volume.RESULTS During the study period, 12 fellows completed full three years of training and were included in the analysis. The average ADR and PDR were, respectively, 31.5% and 41.9% for all fellows, and 28.9% and 38.2% for attendings alone. There was a statistically significant increase in ADR with increasing procedural volume(1.8%/100 colonoscopies, P = 0.002). Similarly, PDR increased 2.8%/100 colonoscopies(P = 0.0001), while there was no significant change in advanced ADR(0.04%/100 colonoscopies, P = 0.92). The ADR increase was limited to the right side of the colon, while the PDR increased in both the right and left colon. The adenoma per colon and polyp per colon also increased throughout training. Fellows reached the attendings' ADR and PDR after 265 and 292 colonoscopies, respectively.CONCLUSION We found that the ADR and PDR increase with increasing colonoscopy volume throughout fellowship. Our findings support recent recommendations of ≥ 275 colonoscopies for colonoscopy credentialing.
文摘The purpose of the present study was to examine the effect of circuit training (CT) on resting heart rate variability (HRV) and other cardiovascular disease (CVD) risk factors such as blood lipids and blood glucose and on fitness components. Twenty-four healthy untrained adults (age 26.5 ± 5.1 years;height 1.67 ± 8.4 m;weight 66.8 ± 15.1 kg;26.3% ± 5.2%;maximum oxygen uptake (VO<sub>2max</sub>) 48.5 ± 10.0 ml.kg<sup>-1</sup>.min<sup>-1</sup>) were assigned to either CT (n = 12) involving bodyweight exercises, or control (CON, n = 12) groups. Prior to the start and following the end of the six-week training period, time-, frequency-domain and nonlinear measures of resting HRV, arterial blood pressure, body composition, fasting blood lipids, lipoproteins and glucose, VO<sub>2max</sub>, upper body muscular endurance (UBME) and abdominal and hip flexor (AHFME), back strength (BS) and handgrip were assessed. None of the resting HRV measures (P > 0.05) were affected by the CT intervention. However, diastolic blood pressure decreased (P = 0.03), lean body weight (P = 0.03) increased, VO<sub>2max</sub> (P = 0.03), UBME (P = 0.001), AHFME (P = 0.04), and BS (P = 0.03) were significantly higher following CT, whereas the other variables were not influenced by the CT. Six-week of CT involving bodyweight exercises has no significant impact on resting HRV. However, this type of training might decrease the risk for development of CVD by reducing arterial blood pressure and by improving body composition, aerobic capacity, muscular endurance and strength.
基金supported by the National Natural Science Foundation of China(Grant Nos.61272057 and 61170270)the Higher Education Young Elite Teacher Project of Beijing,China(Grant No.YETP0475 and YETP0477)+1 种基金the BUPT Excellent Ph.D.Students Foundation(Grant Nos.CX201325 and CX201326)the China Scholarship Council(Grant No.201306470046)
文摘In this paper, we discuss the properties of lazy quantum walks. Our analysis shows that the lazy quantum walks have O(t n) order of the n-th moment of the corresponding probability distribution, which is the same as that for normal quantum walks. The lazy quantum walk with a discrete Fourier transform(DFT) coin operator has a similar probability distribution concentrated interval to that of the normal Hadamard quantum walk. Most importantly, we introduce the concepts of occupancy number and occupancy rate to measure the extent to which the walk has a(relatively) high probability at every position in its range. We conclude that the lazy quantum walks have a higher occupancy rate than other walks such as normal quantum walks, classical walks, and lazy classical walks.
文摘AIM To investigate whether adenoma and polyp detection rates(ADR and PDR, respectively) in screening colonoscopies performed in the presence of fellows differ from those performed by attending physicians alone. METHODS We performed a retrospective review of all patients who underwent a screening colonoscopy at Grady Memorial Hospital between July 1, 2009 and June 30, 2015. Patients with a history of colon polyps or cancer and those with poor colon preparation or failed cecal intubation were excluded from the analysis. Associations of fellowship training level with the ADR and PDR relative to attendings alone were assessed using unconditional multivariable logistic regression. Models were adjusted for sex, age, race, and colon preparationquality. RESULTS A total of 7503 colonoscopies met the inclusion criteria and were included in the analysis. The mean age of the study patients was 58.2 years; 63.1% were women and 88.2% were African American. The ADR was higher in the fellow participation group overall compared to that in the attending group: 34.5% vs 30.7%(P = 0.001), and for third year fellows it was 35.4% vs 30.7%(a OR = 1.23, 95%CI: 1.09-1.39). The higher ADR in the fellow participation group was evident for both the right and left side of the colon. For the PDR the corresponding figures were 44.5% vs 40.1%(P = 0.0003) and 45.7% vs 40.1%(a OR = 1.25, 95%CI: 1.12-1.41). The ADR and PDR increased with increasing fellow training level(P for trend < 0.05).CONCLUSION There is a stepwise increase in ADR and PDR across the years of gastroenterology training. Fellow participation is associated with higher adenoma and polyp detection.
基金supported by the National Natural Science Foundation of China (Grant Nos.52072356 and 52032011)the 2019 Zaozhuang High-level Talents Project (Grant No.ZZYF-01).
文摘Purpose-This paper aims to analyze the bearing characteristics of the high speed train window glass under aerodynamic load effects.Design/methodology/approach-In order to obtain the dynamic strain response of passenger compartment window glass during high-speed train crossing the tunnel,taking the passenger compartment window glass of the CRH3 high speed train onWuhan-Guangzhou High Speed Railway as the research object,this study tests the strain dynamic response and maximum principal stress of the high speed train passing through the tunnel entrance and exit,the tunnel and tunnel groups as well as trains meeting in the tunnel at an average speed of 300 km$h-1.Findings-The results show that while crossing the tunnel,the passenger compartment window glass of high speed train is subjected to the alternating action of positive and negative air pressures,which shows the typical mechanic characteristics of the alternating fatigue stress of positive-negative transient strain.The maximum principal stress of passenger compartment window glass for high speed train caused by tunnel aerodynamic effects does not exceed 5 MPa,and the maximum value occurs at the corresponding time of crossing the tunnel groups.The high speed train window glass bears medium and low strain rates under the action of tunnel aerodynamic effects,while the maximum strain rate occurs at the meeting moment when the window glass meets the train head approaching from the opposite side in the tunnel.The shear modulus of laminated glass PVB film that makes up high speed train window glass is sensitive to the temperature and action time.The dynamically equivalent thickness and stiffness of the laminated glass and the dynamic bearing capacity of the window glass decrease with the increase of the action time under tunnel aerodynamic pressure.Thus,the influence of the loading action time and fatigue under tunnel aerodynamic effects on the glass strength should be considered in the design for the bearing performance of high speed train window glass.Originality/value-The research results provide data support for the analysis of mechanical characteristics,damage mechanism,strength design and structural optimization of high speed train glass.
