Glioblastoma multiforme(GBM)is the most common malignant primary brain tumor with a poor prognosis and limited survival.Patients with GBM have a high demand for palliative care.In our present case,a 21-year-old female...Glioblastoma multiforme(GBM)is the most common malignant primary brain tumor with a poor prognosis and limited survival.Patients with GBM have a high demand for palliative care.In our present case,a 21-year-old female GBM patient received inpatient palliative care services including symptom management,mental and psychological support for the patient,psychosocial and clinical decision support for her family members,and pre-and post-death bereavement management for the family.Furthermore,we provided the family members with comprehensive psychological preparation for the patient's demise and assisted the patient's family throughout the mourning period.The aim of this study is to provide a reference and insights for the clinical implementation of palliative care for patients with malignant brain tumors.展开更多
Atmospheric nitrogen(N)deposition is predicted to increase,especially in the subtropics.However,the responses of soil microorganisms to long-term N addition at the molecular level in N-rich subtropical forests have no...Atmospheric nitrogen(N)deposition is predicted to increase,especially in the subtropics.However,the responses of soil microorganisms to long-term N addition at the molecular level in N-rich subtropical forests have not been clarified.A long-term nutrient addition experiment was conducted in a subtropical evergreen old-growth forest in China.The four treatments were:control,low N(50 kg N ha^(-1)a^(-1)),high N(100 kg N ha^(-1)a^(-1)),and combined N and phosphorus(P)(100 kg N ha^(-1)a^(-1)+50 kg P ha^(-1)a^(-1)).Metagenomic sequencing characterized diversity and composition of soil microbial communities and used to construct bacterial/fungal co-occurrence networks.Nutrient-treated soils were more acidic and had higher levels of dissolved organic carbon than controls.There were no significant differences in microbial diversity and community composition across treatments.The addition of nutrients increased the abundance of copiotrophic bacteria and potentially beneficial microorganisms(e.g.,Gemmatimonadetes,Chaetomium,and Aureobasidium).Low N addition increased microbiome network connectivity.Three rare fungi were identified as module hubs under nutrient addition,indicating that low abundance fungi were more sensitive to increased nutrients.The results indicate that the overall composition of microbial communities was stable but not static to long-term N addition.Our findings provide new insights that can aid predictions of the response of soil microbial communities to long-term N addition.展开更多
The growing utilization of critical care echocardiography(CCE) by clinicians necessitates a meticulous review of clinical conditions in critically ill patients, both before and during the examination. The reviewing pr...The growing utilization of critical care echocardiography(CCE) by clinicians necessitates a meticulous review of clinical conditions in critically ill patients, both before and during the examination. The reviewing process of clinical conditions minimizes the risk of overlooking or misinterpreting crucial findings. This article proposes a comprehensive strategy, namely BILL strategy, to integrate into the CCE protocol, where "B" represents baseline respiratory and hemodynamic support, "I" signifies information gleaned from invasive monitoring, including central venous pressure and thermodilution-derived cardiac output, the first "L" denotes laboratory results such as central venous oxygen saturation, troponin, and brain natriuretic peptide, and the second "L" refers to lung ultrasound data. Combining the BILL strategy with CCE can enhance comprehensive understanding of critical conditions, potentially leading to improved diagnostic accuracy and patient outcomes.展开更多
Interest in the dynamics of soil respiration(R_(S))in subalpine forest ecosystems is increasing due to their high soil carbon density and potential sensitivity to environmental changes.However,as a principal silvicult...Interest in the dynamics of soil respiration(R_(S))in subalpine forest ecosystems is increasing due to their high soil carbon density and potential sensitivity to environmental changes.However,as a principal silvicultural practice,the long-term impacts of thinning on R_(S) and its heterotrophic and autotrophic respiration components(R_(h) and Ra,respectively)in subalpine plantations are poorly understood,espe-cially in winter.A 3-year field observation was carried out with consideration of winter CO_(2) efflux in middle-aged sub-alpine spruce plantations in northwestern China.A trench-ing method was used to explore the long-term impacts of thinning on Rs,Rn and R_(a).Seventeen years after thinning,mean annual Rs,Rn and R_(a) increased,while the contribu-tion of R_(h) to R_(s) decreased with thinning intensity.Thinning significantly decreased winter R,because of the reduction in R_(n) but had no significant effect on Ra.The temperature sensitivity(Q_(10))of R_(h) and R_(a) also increased with thinning intensity,with lower Q_(10) values for R_(h)(2.1-2.6)than for Ra(2.4-2.8).The results revealed the explanatory variables and pathways related to R_(n) and R_(a) dynamics.Thinning increased soil moisture and nitrate nitrogen(NO_(3)^(-)-N),and the enhanced nitrogen and water availability promoted R_(h) and R_(a) by improving fine root biomass and microbial activity.Our results highlight the positive roles of NO_(3)^(-)-N in stimulating R_(s) components following long-term thinning.Therefore,applications of nitrogen fertilizer are not recommended while thinning subalpine spruce plantations from the perspective of reducing soil CO_(2) emissions.The increased Q_(10) values of R_(s) components indicate that a large increase in soil CO_(2) emissions would be expected following thinning because of more pronounced climate warming in alpineregions.展开更多
Long-term navigation ability based on consumer-level wearable inertial sensors plays an essential role towards various emerging fields, for instance, smart healthcare, emergency rescue, soldier positioning et al. The ...Long-term navigation ability based on consumer-level wearable inertial sensors plays an essential role towards various emerging fields, for instance, smart healthcare, emergency rescue, soldier positioning et al. The performance of existing long-term navigation algorithm is limited by the cumulative error of inertial sensors, disturbed local magnetic field, and complex motion modes of the pedestrian. This paper develops a robust data and physical model dual-driven based trajectory estimation(DPDD-TE) framework, which can be applied for long-term navigation tasks. A Bi-directional Long Short-Term Memory(Bi-LSTM) based quasi-static magnetic field(QSMF) detection algorithm is developed for extracting useful magnetic observation for heading calibration, and another Bi-LSTM is adopted for walking speed estimation by considering hybrid human motion information under a specific time period. In addition, a data and physical model dual-driven based multi-source fusion model is proposed to integrate basic INS mechanization and multi-level constraint and observations for maintaining accuracy under long-term navigation tasks, and enhanced by the magnetic and trajectory features assisted loop detection algorithm. Real-world experiments indicate that the proposed DPDD-TE outperforms than existing algorithms, and final estimated heading and positioning accuracy indexes reaches 5° and less than 2 m under the time period of 30 min, respectively.展开更多
Approximately 40% of pheochromocytoma and paraganglioma(PPGL) cases are familial, typically presenting earlier with more complex symptoms. This paper synthesizes literature and guidelines to inform on clinical charact...Approximately 40% of pheochromocytoma and paraganglioma(PPGL) cases are familial, typically presenting earlier with more complex symptoms. This paper synthesizes literature and guidelines to inform on clinical characteristics and perioperative care for PPGL. Pheochromocytoma in von Hippel-Lindau(VHL) disease exhibits heightened secretion activity without significant perioperative hemodynamic changes. Tumors in multiple endocrine neoplasia type 2(MEN2) have a stronger endocrine function, which may induce hemodynamic fluctuations during surgery. Therefore, pheochromocytoma screening is essential at all stages of MEN2. Neurofibromatosis type 1(NF1) often presents multisystem lesions and can result in difficult airway. Pheochromocytoma should be evaluated when NF1 patients present hypertension. Pheochromocytoma and paraganglioma type 5 may present multiple lesions of pheochromocytoma or paraganglioma. In summary, hereditary PPGLs may present with severe lesions in other systems, beyond tumor function. A multi-disciplinary team(MDT) approach is often invaluable in perioperative management.展开更多
The evolution of the microstructure and tensile rupture mechanism of laser welds in UNS N10003 alloy exposed to 700℃are investigated.Fine M_(6)C carbides precipitate around the primary eutectic M_(6)C-γcarbides in t...The evolution of the microstructure and tensile rupture mechanism of laser welds in UNS N10003 alloy exposed to 700℃are investigated.Fine M_(6)C carbides precipitate around the primary eutectic M_(6)C-γcarbides in the fusion zone after 100 h of exposure.During long-term thermal exposure,the size of the fine M_(6)C carbides increased.The eutectic M_(6)C-γcarbides in the as-welded fusion zone transformed into spherical M_(6)C carbides as the exposure time extends to 10000 h.Additionally,the spherical M_(6)C particles exhibit size coarsening with increasing exposure time.The tensile properties of the welded joints are not adversely affected by the evolution of eutectic M_(6)C-γcarbides and the coarsening of M_(6)C carbides.展开更多
BACKGROUND:The objective of this retrospective hospital-based study was to describe the epidemiological features of traumatic spinal cord injury(TSCI)in the intensive care unit(ICU)and assess the incidence and possibl...BACKGROUND:The objective of this retrospective hospital-based study was to describe the epidemiological features of traumatic spinal cord injury(TSCI)in the intensive care unit(ICU)and assess the incidence and possible risk factors for venous thromboembolism(VTE)following TSCI.METHODS:We retrospectively reviewed the medical records of 370 patients with TSCI who were admitted between January 2018 and March 2023.The following parameters were collected:age,sex,body mass index,occupation,underlying diseases,smoking history,education level,etiology of injury,injury segments,American Spinal Injury Association(ASIA)Impairment Scale score,severity of injury,injury severity score(ISS),VTE risk score(Caprini score),treatment,VTE prophylaxis,ICU length of stay,length of hospital stay,concomitant injuries,and complications.Descriptive statistics were used to summarize the demographic and clinical characteristics of the study participants.Logistic regression analysis was used to determine the risk factors for VTE.RESULTS:The mean age of patients with TSCI was 55.5±13.4 years,with a male-to-female ratio of 6.5:1.The leading cause of TSCI was falls from height(46.5%),followed by traffic accidents(36.5%).The cervical spinal cord was the most affected segment,followed by the thoracolumbar region.Among all the patients,362(97.8%)had concomitant injuries.Complications were observed in 255 patients(68.9%)during hospitalization.The incidence rate of VTE was 25.1%.Logistic regression analysis revealed that age(OR=1.721,95%CI:1.207-2.454,P=0.003),mechanical ventilation(OR=3.427,95%CI:1.873-6.271,P<0.001),and non-use of chemical prophylaxis(OR=2.986,95%CI:1.749-5.099,P<0.001)were risk factors for VTE.CONCLUSION:Falls from height and traffic accidents were the main causes of TSCIs in the ICU,especially for male patients with cervical spinal cord injuries.VTE is a frequent complication in patients with TSCI in the ICU.Age,mechanical ventilation,and non-use of chemical prophylaxis were found to be independent risk factors for VTE following TSCI.展开更多
The long-term strength retrogression of silica-enriched oil well cement poses a significant threat to wellbore integrity in deep and ultra-deep wells, which is a major obstacle for deep petroleum and geothermal energy...The long-term strength retrogression of silica-enriched oil well cement poses a significant threat to wellbore integrity in deep and ultra-deep wells, which is a major obstacle for deep petroleum and geothermal energy development. Previous attempts to address this problem has been unsatisfactory because they can only reduce the strength decline rate. This study presents a new solution to this problem by incorporating fly ash to the traditional silica-cement systems. The influences of fly ash and silica on the strength retrogression behavior of oil well cement systems directly set and cured under the condition of 200°C and 50 MPa are investigated. Test results indicate that the slurries containing only silica or fly ash experience severe strength retrogression from 2 to 30 d curing, while the slurries containing both fly ash and silica experience strength enhancement from 2 to 90 d. The strength test results are corroborated by further evidences from permeability tests as well as microstructure analysis of set cement. Composition of set cement evaluated by quantitative X-ray diffraction analyses with partial or no known crystal structure(PONKCS) method and thermogravimetry analyses revealed that the conversion of amorphous C-(A)-S-H to crystalline phases is the primary cause of long-term strength retrogression.The addition of fly ash can reduce the initial amount of C-(A)-S-H in the set cement, and its combined use with silica can prevent the crystallization of C-(A)-S-H, which is believed to be the working mechanism of this new admixture in improving long-term strength stability of oil well cement systems.展开更多
目的对比分析2012—2022年中国学术期刊网络出版总库(CNKI)和Web of Science(WOS)数据库中脑卒中延续护理领域的研究差异。方法分别以CNKI和WOS数据库2012年1月1日至2022年12月31日收录的脑卒中延续护理领域文献为研究对象,应用CiteSpac...目的对比分析2012—2022年中国学术期刊网络出版总库(CNKI)和Web of Science(WOS)数据库中脑卒中延续护理领域的研究差异。方法分别以CNKI和WOS数据库2012年1月1日至2022年12月31日收录的脑卒中延续护理领域文献为研究对象,应用CiteSpace可视化软件对纳入文献进行分析,以确定国内外脑卒中延续护理相关研究的发展脉络及研究热点和研究趋势,并分析其差异。结果国内外对脑卒中延续护理方面的研究差异较大,国内的研究者中心性不高,主要研究团队相对分散,彼此间联系不够紧密,国外部分作者中心性相对较高,研究团队相对集中,但彼此之间合作也不够紧密。国内发文机构比较多,发文量最多的机构为郑州大学护理与健康学院,但各个机构间的合作不够紧凑。国外发文量最多的机构为多伦多大学,机构之间合作紧密,其中凯撒医院具有较高的影响力。国内的研究热点主要集中在对个体尤其是老年患者生理、心理及遵医依从性方面的影响,倾向于干预结果。国外研究热点更多地关注脑卒中患者的二级预防及治疗措施方面,探讨如何更好地从源头促进脑卒中患者的康复,倾向于过程及措施方面。国内的研究前沿主要集中在通过多媒体互联网平台来提高恢复期、偏瘫患者的自理能力等方面;国外的研究前沿集中在从源头切断病因更好地提高脑卒中患者的生存质量,减轻预后护理负担,但是对于脑卒中延续护理平台的选择依旧是趋于传统。结论脑卒中延续护理领域正处在快速发展阶段,我国应进一步加大研究力度,拓宽合作领域,聚焦相关研究热点及前沿,从国外研究中汲取精华,以更好地促进我国脑卒中延续护理的发展。展开更多
基金National High Level Hospital Clinical Research Funding(2022-PUMCH-B-113).
文摘Glioblastoma multiforme(GBM)is the most common malignant primary brain tumor with a poor prognosis and limited survival.Patients with GBM have a high demand for palliative care.In our present case,a 21-year-old female GBM patient received inpatient palliative care services including symptom management,mental and psychological support for the patient,psychosocial and clinical decision support for her family members,and pre-and post-death bereavement management for the family.Furthermore,we provided the family members with comprehensive psychological preparation for the patient's demise and assisted the patient's family throughout the mourning period.The aim of this study is to provide a reference and insights for the clinical implementation of palliative care for patients with malignant brain tumors.
基金supported by the National Science Foundation of China(No.31770672 and 3137062)the National Basic Research Program of China(No.2010CB950602)。
文摘Atmospheric nitrogen(N)deposition is predicted to increase,especially in the subtropics.However,the responses of soil microorganisms to long-term N addition at the molecular level in N-rich subtropical forests have not been clarified.A long-term nutrient addition experiment was conducted in a subtropical evergreen old-growth forest in China.The four treatments were:control,low N(50 kg N ha^(-1)a^(-1)),high N(100 kg N ha^(-1)a^(-1)),and combined N and phosphorus(P)(100 kg N ha^(-1)a^(-1)+50 kg P ha^(-1)a^(-1)).Metagenomic sequencing characterized diversity and composition of soil microbial communities and used to construct bacterial/fungal co-occurrence networks.Nutrient-treated soils were more acidic and had higher levels of dissolved organic carbon than controls.There were no significant differences in microbial diversity and community composition across treatments.The addition of nutrients increased the abundance of copiotrophic bacteria and potentially beneficial microorganisms(e.g.,Gemmatimonadetes,Chaetomium,and Aureobasidium).Low N addition increased microbiome network connectivity.Three rare fungi were identified as module hubs under nutrient addition,indicating that low abundance fungi were more sensitive to increased nutrients.The results indicate that the overall composition of microbial communities was stable but not static to long-term N addition.Our findings provide new insights that can aid predictions of the response of soil microbial communities to long-term N addition.
文摘The growing utilization of critical care echocardiography(CCE) by clinicians necessitates a meticulous review of clinical conditions in critically ill patients, both before and during the examination. The reviewing process of clinical conditions minimizes the risk of overlooking or misinterpreting crucial findings. This article proposes a comprehensive strategy, namely BILL strategy, to integrate into the CCE protocol, where "B" represents baseline respiratory and hemodynamic support, "I" signifies information gleaned from invasive monitoring, including central venous pressure and thermodilution-derived cardiac output, the first "L" denotes laboratory results such as central venous oxygen saturation, troponin, and brain natriuretic peptide, and the second "L" refers to lung ultrasound data. Combining the BILL strategy with CCE can enhance comprehensive understanding of critical conditions, potentially leading to improved diagnostic accuracy and patient outcomes.
基金supported by the National Natural Science Foundation of China (Grant Nos.41701296 and 42277481)the Natural Science Foundation of Gansu Province (GrantNo.22JR5RA058)the Youth Science and Technology Fund Program of Gansu Province (Grant No.22JR5RA087).
文摘Interest in the dynamics of soil respiration(R_(S))in subalpine forest ecosystems is increasing due to their high soil carbon density and potential sensitivity to environmental changes.However,as a principal silvicultural practice,the long-term impacts of thinning on R_(S) and its heterotrophic and autotrophic respiration components(R_(h) and Ra,respectively)in subalpine plantations are poorly understood,espe-cially in winter.A 3-year field observation was carried out with consideration of winter CO_(2) efflux in middle-aged sub-alpine spruce plantations in northwestern China.A trench-ing method was used to explore the long-term impacts of thinning on Rs,Rn and R_(a).Seventeen years after thinning,mean annual Rs,Rn and R_(a) increased,while the contribu-tion of R_(h) to R_(s) decreased with thinning intensity.Thinning significantly decreased winter R,because of the reduction in R_(n) but had no significant effect on Ra.The temperature sensitivity(Q_(10))of R_(h) and R_(a) also increased with thinning intensity,with lower Q_(10) values for R_(h)(2.1-2.6)than for Ra(2.4-2.8).The results revealed the explanatory variables and pathways related to R_(n) and R_(a) dynamics.Thinning increased soil moisture and nitrate nitrogen(NO_(3)^(-)-N),and the enhanced nitrogen and water availability promoted R_(h) and R_(a) by improving fine root biomass and microbial activity.Our results highlight the positive roles of NO_(3)^(-)-N in stimulating R_(s) components following long-term thinning.Therefore,applications of nitrogen fertilizer are not recommended while thinning subalpine spruce plantations from the perspective of reducing soil CO_(2) emissions.The increased Q_(10) values of R_(s) components indicate that a large increase in soil CO_(2) emissions would be expected following thinning because of more pronounced climate warming in alpineregions.
文摘Long-term navigation ability based on consumer-level wearable inertial sensors plays an essential role towards various emerging fields, for instance, smart healthcare, emergency rescue, soldier positioning et al. The performance of existing long-term navigation algorithm is limited by the cumulative error of inertial sensors, disturbed local magnetic field, and complex motion modes of the pedestrian. This paper develops a robust data and physical model dual-driven based trajectory estimation(DPDD-TE) framework, which can be applied for long-term navigation tasks. A Bi-directional Long Short-Term Memory(Bi-LSTM) based quasi-static magnetic field(QSMF) detection algorithm is developed for extracting useful magnetic observation for heading calibration, and another Bi-LSTM is adopted for walking speed estimation by considering hybrid human motion information under a specific time period. In addition, a data and physical model dual-driven based multi-source fusion model is proposed to integrate basic INS mechanization and multi-level constraint and observations for maintaining accuracy under long-term navigation tasks, and enhanced by the magnetic and trajectory features assisted loop detection algorithm. Real-world experiments indicate that the proposed DPDD-TE outperforms than existing algorithms, and final estimated heading and positioning accuracy indexes reaches 5° and less than 2 m under the time period of 30 min, respectively.
文摘Approximately 40% of pheochromocytoma and paraganglioma(PPGL) cases are familial, typically presenting earlier with more complex symptoms. This paper synthesizes literature and guidelines to inform on clinical characteristics and perioperative care for PPGL. Pheochromocytoma in von Hippel-Lindau(VHL) disease exhibits heightened secretion activity without significant perioperative hemodynamic changes. Tumors in multiple endocrine neoplasia type 2(MEN2) have a stronger endocrine function, which may induce hemodynamic fluctuations during surgery. Therefore, pheochromocytoma screening is essential at all stages of MEN2. Neurofibromatosis type 1(NF1) often presents multisystem lesions and can result in difficult airway. Pheochromocytoma should be evaluated when NF1 patients present hypertension. Pheochromocytoma and paraganglioma type 5 may present multiple lesions of pheochromocytoma or paraganglioma. In summary, hereditary PPGLs may present with severe lesions in other systems, beyond tumor function. A multi-disciplinary team(MDT) approach is often invaluable in perioperative management.
基金supported by the Technology Star of Shanghai Institute of Applied Physics,Chinese Academy of Sciences(No.E2551130)the Youth Innovation Promotion Association,Chinese Academy of Sciences(No.E2292202).
文摘The evolution of the microstructure and tensile rupture mechanism of laser welds in UNS N10003 alloy exposed to 700℃are investigated.Fine M_(6)C carbides precipitate around the primary eutectic M_(6)C-γcarbides in the fusion zone after 100 h of exposure.During long-term thermal exposure,the size of the fine M_(6)C carbides increased.The eutectic M_(6)C-γcarbides in the as-welded fusion zone transformed into spherical M_(6)C carbides as the exposure time extends to 10000 h.Additionally,the spherical M_(6)C particles exhibit size coarsening with increasing exposure time.The tensile properties of the welded joints are not adversely affected by the evolution of eutectic M_(6)C-γcarbides and the coarsening of M_(6)C carbides.
基金supported in part by grants from the Science and Technology Plan Project of Linhai(2023YW05)Medical Health Science and Technology Project of Zhejiang(2024KY555).
文摘BACKGROUND:The objective of this retrospective hospital-based study was to describe the epidemiological features of traumatic spinal cord injury(TSCI)in the intensive care unit(ICU)and assess the incidence and possible risk factors for venous thromboembolism(VTE)following TSCI.METHODS:We retrospectively reviewed the medical records of 370 patients with TSCI who were admitted between January 2018 and March 2023.The following parameters were collected:age,sex,body mass index,occupation,underlying diseases,smoking history,education level,etiology of injury,injury segments,American Spinal Injury Association(ASIA)Impairment Scale score,severity of injury,injury severity score(ISS),VTE risk score(Caprini score),treatment,VTE prophylaxis,ICU length of stay,length of hospital stay,concomitant injuries,and complications.Descriptive statistics were used to summarize the demographic and clinical characteristics of the study participants.Logistic regression analysis was used to determine the risk factors for VTE.RESULTS:The mean age of patients with TSCI was 55.5±13.4 years,with a male-to-female ratio of 6.5:1.The leading cause of TSCI was falls from height(46.5%),followed by traffic accidents(36.5%).The cervical spinal cord was the most affected segment,followed by the thoracolumbar region.Among all the patients,362(97.8%)had concomitant injuries.Complications were observed in 255 patients(68.9%)during hospitalization.The incidence rate of VTE was 25.1%.Logistic regression analysis revealed that age(OR=1.721,95%CI:1.207-2.454,P=0.003),mechanical ventilation(OR=3.427,95%CI:1.873-6.271,P<0.001),and non-use of chemical prophylaxis(OR=2.986,95%CI:1.749-5.099,P<0.001)were risk factors for VTE.CONCLUSION:Falls from height and traffic accidents were the main causes of TSCIs in the ICU,especially for male patients with cervical spinal cord injuries.VTE is a frequent complication in patients with TSCI in the ICU.Age,mechanical ventilation,and non-use of chemical prophylaxis were found to be independent risk factors for VTE following TSCI.
基金National Natural Science Foundation of China(No.51974352 and No.52288101)China University of Petroleum(East China)(No.2018000025 and No.2019000011)。
文摘The long-term strength retrogression of silica-enriched oil well cement poses a significant threat to wellbore integrity in deep and ultra-deep wells, which is a major obstacle for deep petroleum and geothermal energy development. Previous attempts to address this problem has been unsatisfactory because they can only reduce the strength decline rate. This study presents a new solution to this problem by incorporating fly ash to the traditional silica-cement systems. The influences of fly ash and silica on the strength retrogression behavior of oil well cement systems directly set and cured under the condition of 200°C and 50 MPa are investigated. Test results indicate that the slurries containing only silica or fly ash experience severe strength retrogression from 2 to 30 d curing, while the slurries containing both fly ash and silica experience strength enhancement from 2 to 90 d. The strength test results are corroborated by further evidences from permeability tests as well as microstructure analysis of set cement. Composition of set cement evaluated by quantitative X-ray diffraction analyses with partial or no known crystal structure(PONKCS) method and thermogravimetry analyses revealed that the conversion of amorphous C-(A)-S-H to crystalline phases is the primary cause of long-term strength retrogression.The addition of fly ash can reduce the initial amount of C-(A)-S-H in the set cement, and its combined use with silica can prevent the crystallization of C-(A)-S-H, which is believed to be the working mechanism of this new admixture in improving long-term strength stability of oil well cement systems.
文摘目的对比分析2012—2022年中国学术期刊网络出版总库(CNKI)和Web of Science(WOS)数据库中脑卒中延续护理领域的研究差异。方法分别以CNKI和WOS数据库2012年1月1日至2022年12月31日收录的脑卒中延续护理领域文献为研究对象,应用CiteSpace可视化软件对纳入文献进行分析,以确定国内外脑卒中延续护理相关研究的发展脉络及研究热点和研究趋势,并分析其差异。结果国内外对脑卒中延续护理方面的研究差异较大,国内的研究者中心性不高,主要研究团队相对分散,彼此间联系不够紧密,国外部分作者中心性相对较高,研究团队相对集中,但彼此之间合作也不够紧密。国内发文机构比较多,发文量最多的机构为郑州大学护理与健康学院,但各个机构间的合作不够紧凑。国外发文量最多的机构为多伦多大学,机构之间合作紧密,其中凯撒医院具有较高的影响力。国内的研究热点主要集中在对个体尤其是老年患者生理、心理及遵医依从性方面的影响,倾向于干预结果。国外研究热点更多地关注脑卒中患者的二级预防及治疗措施方面,探讨如何更好地从源头促进脑卒中患者的康复,倾向于过程及措施方面。国内的研究前沿主要集中在通过多媒体互联网平台来提高恢复期、偏瘫患者的自理能力等方面;国外的研究前沿集中在从源头切断病因更好地提高脑卒中患者的生存质量,减轻预后护理负担,但是对于脑卒中延续护理平台的选择依旧是趋于传统。结论脑卒中延续护理领域正处在快速发展阶段,我国应进一步加大研究力度,拓宽合作领域,聚焦相关研究热点及前沿,从国外研究中汲取精华,以更好地促进我国脑卒中延续护理的发展。
