The concepts of modernization and industrialization have different connotations that are specific to their historical backgrounds,and their theoretical innovation and development may benefit from China’s experiences....The concepts of modernization and industrialization have different connotations that are specific to their historical backgrounds,and their theoretical innovation and development may benefit from China’s experiences.Industrialization is the cornerstone of modernization,and holds the key to its success.China’s experiences in blazing a new trail of industrialization are challenging the traditional Western theory of industrialization and deepening the connotations of Chinese modernization.New industrialization is a key entry point for steering China’s modernization drive and theoretical innovations.This paper offers an overview of the theory of Chinese modernization and its evolving trend along China’s socialist industrialization path,as well as the rationale and pathway for new industrialization in the context of Chinese modernization.As our findings suggest,the new industrialization concept has taken hold in every key aspect of Chinese modernization.When combined with the theory of Chinese modernization,the theoretical implications of new industrialization play a crucial role in propelling Chinese modernization forward along a new journey in the new era.展开更多
Psychoactive substance use is characterized by the habitual use of substances that have significant effects in altering the activities of neurotransmitters in certain regions of the brain.Consequently,these alteration...Psychoactive substance use is characterized by the habitual use of substances that have significant effects in altering the activities of neurotransmitters in certain regions of the brain.Consequently,these alterations manifest as cognitive,emotional,perceptual and behavioural changes in affected individuals[1].展开更多
Current design rationale （DR） systems have not demonstrated the value of the approach in practice since little attention is put to the evaluation method of DR knowledge. To systematize knowledge management process f...Current design rationale （DR） systems have not demonstrated the value of the approach in practice since little attention is put to the evaluation method of DR knowledge. To systematize knowledge management process for future computer-aided DR applications, a prerequisite is to provide the measure for the DR knowledge. In this paper, a new knowledge network evaluation method for DR management is presented. The method characterizes the DR knowledge value from four perspectives, namely, the design rationale structure scale, association knowledge and reasoning ability, degree of design justification support and degree of knowledge representation conciseness. The DR knowledge comprehensive value is also measured by the proposed method. To validate the proposed method, different style of DR knowledge network and the performance of the proposed measure are discussed. The evaluation method has been applied in two realistic design cases and compared with the structural measures. The research proposes the DR knowledge evaluation method which can provide object metric and selection basis for the DR knowledge reuse during the product design process. In addition, the method is proved to be more effective guidance and support for the application and management of DR knowledge.展开更多
As the novel coronavirus disease 2019(COVID-19)and its variants continue to rage into the second year of a global pandemic,many success stories of applying Chinese herbal medicine(CHM)to treat COVID-19 patients contin...As the novel coronavirus disease 2019(COVID-19)and its variants continue to rage into the second year of a global pandemic,many success stories of applying Chinese herbal medicine(CHM)to treat COVID-19 patients continue to emerge from China and other part of the world.Herewith,from a systems medicine perspective,the authors analyze those experiences and categorize them into four major treatment principles:(1)focusing on eliminating toxins in the early stage of the disease,(2)tonifying deficiency of the body throughout the entire disease course,(3)treating the affected lung and intestine simultaneously based on visceral interactions,(4)cooling blood and removing blood stasis at the later stage,as well as interpret the rationale of these principles.This is helpful not only in reducing the complexity of promoting the CHM applications to enhance anti-COVID-19 efficacy,but also in ramping out the process of integrating traditional Chinese medicine with modern medical practices.展开更多
Pure endoscopic treatment of combined cholelithiasis and choledocholithiasis is possible due to the chance to use together both endoscopic retrograde cholangiopancreatography(ERCP)and endoscopic ultrasound(EUS)approac...Pure endoscopic treatment of combined cholelithiasis and choledocholithiasis is possible due to the chance to use together both endoscopic retrograde cholangiopancreatography(ERCP)and endoscopic ultrasound(EUS)approaches.This endotherapy permits to treat biliary stones in the main bile duct by standard ERCP and gallbladder stones by EUS-guided cholecystoduodenostomy eventually associated to intracorporeal lithotripsy to achieve optimal results.展开更多
Development zones(DZs)have emerged as a significant policy initiative for promoting regional coordination and facilitating resources allocation.They serve as an organizational framework for fostering industrial agglom...Development zones(DZs)have emerged as a significant policy initiative for promoting regional coordination and facilitating resources allocation.They serve as an organizational framework for fostering industrial agglomeration and driving high-quality development.DZs attract and accommodate resource factors,firms,and projects,thereby functioning as a central catalyst for economic growth.This study utilizes data collected at the“DZ,City and Countrycountry”levels through manual compilation,textual analysis,and innovation measurement.It aims to empirically examine the theoretical rationale and practical preferences for promoting business and investment in China’s DZs.This study considers several factors such as industry attribute,firm attribute,agglomeration theory,and industrial chain layout.Based on our research findings,DZs exhibit distinct preferences.First,industry attribute:DZs align with both national and regional strategic planning and adhere to the industrial endowments of the respective areas.Second,firm attribute:DZs prioritize attracting firms that are productive and innovative,and have an international presence,rather than those that primarily contribute to taxes and job creation.Third,DZs are guided by the agglomeration theory,which suggests that they prefer firms that generate strong agglomeration externalities.Lastly,DZs also consider the industrial chain layout,aiming to attract firms that not only align with their existing industrial strengths but also extend to the upstream and downstream supply chain links.These conclusions are substantiated by the performance of robustness test.The success of DZs in China can be attributed to the five key principles:Adherence to national and regional strategic planning,prioritizing the actual industrial foundation,incorporating the theory of agglomeration externalities,strengthening corporate competitiveness,and expanding industrial chains.展开更多
Nurses must be enlightened that clinical reasoning, clinical decision making, and clinical judgement are the key elements in providing safe patient care. It must be incorporated and applied all throughout the nursing ...Nurses must be enlightened that clinical reasoning, clinical decision making, and clinical judgement are the key elements in providing safe patient care. It must be incorporated and applied all throughout the nursing process. The impact of patients’ positive outcomes relies on how nurses are effective in clinical reasoning and put into action once clinical decision making occurs. Thus, nurses with poor clinical reasoning skills frequently fail to see and notice patient worsening condition, and misguided decision making arises that leads to ineffective patient care and adding patients suffering. Clinical judgment on the other hand denotes on the outcome after the cycle of clinical reasoning. Within this context, nurses apply reflection about their actions from the clinical decision making they made. The process of applying knowledge, skills and expertise in the clinical field through clinical reasoning is the work of art in the nursing profession in promoting patient safety in the course of delivering routine nursing interventions. Nurses must be guided with their sound clinical reasoning to have an optimistic outcome and prevent iatrogenic harm to patients. Nurses must be equipped with knowledge, skills, attitude and values but most importantly prepared to face the bigger picture of responsibility to care for every patient in the clinical field.展开更多
The approach for probabilistic rationale of artificial intelligence systems actions is proposed.It is based on an implementation of the proposed interconnected ideas 1-7 about system analysis and optimization focused ...The approach for probabilistic rationale of artificial intelligence systems actions is proposed.It is based on an implementation of the proposed interconnected ideas 1-7 about system analysis and optimization focused on prognostic modeling.The ideas may be applied also by using another probabilistic models which supported by software tools and can predict successfulness or risks on a level of probability distribution functions.The approach includes description of the proposed probabilistic models,optimization methods for rationale actions and incremental algorithms for solving the problems of supporting decision-making on the base of monitored data and rationale robot actions in uncertainty conditions.The approach means practically a proactive commitment to excellence in uncertainty conditions.A suitability of the proposed models and methods is demonstrated by examples which cover wide applications of artificial intelligence systems.展开更多
In the proposal, a construction project memory process based on the semantic annotation is presented. A project Mem-ory concerns the representation and the identification of the experience acquired during projects rea...In the proposal, a construction project memory process based on the semantic annotation is presented. A project Mem-ory concerns the representation and the identification of the experience acquired during projects realization. The main feature of this approach is that the semantic annotation is used to build a continuous semantic design rationale process. We propose in this paper, a semantic traceability in four stages (identifying, structuring, annotating and integrating). The identification and the structuring phases use a model called Extended Marguerite model which fully considers the objectives of the project memory. The annotation phase exploits the results of precedent phase to prepare the final phase. Examples are presented from a case study in an Algerian firm called ENMTP. The architecture supporting the modelling engine is presented. Finally, an evaluation of the degree of the semantic annotation brought by proposed process is given.展开更多
Web Quest is an advanced tool which could provide the significant scaffolding to support instructors through incorporating learning objects within systematic designs of learning activities. The focus of this article i...Web Quest is an advanced tool which could provide the significant scaffolding to support instructors through incorporating learning objects within systematic designs of learning activities. The focus of this article is to explore how a Webquest is designed reasonably and what rationales are implied in such a design through a case study of Webquest design for a group of ESL/EFL learners in Grade 12. The result indicates that a Webquest which is guided by the principles of constructivist problem solving, social interaction and scaffolding learning can be regarded as a desirable Webquest.展开更多
Huanglongbing(HLB)is a disease that has devastated the Florida citrus industry,threatens the entire U.S.citrus industry,and globally is rapidly spreading.Florida’s citrus production is 90%sweet orange,which is quite ...Huanglongbing(HLB)is a disease that has devastated the Florida citrus industry,threatens the entire U.S.citrus industry,and globally is rapidly spreading.Florida’s citrus production is 90%sweet orange,which is quite sensitive to HLB.The heavy reliance on sweet orange for Florida citrus production makes the industry especially vulnerable to diseases that are damaging to this type of citrus.Furthermore,90%of Florida oranges are used in producing orange juice that is defined by a federal regulation known as the“orange juice standard”,specifying that at least 90%of“orange juice”must be derived from Citrus sinensis.Genomic analyses definitively reveal that sweet orange is not a true species,but just one of many introgression hybrids of C.reticulata and C.maxima,with phenotypic diversity resulting from accumulated mutations in this single hybrid,the“sweet orange”.No other fruit industry is limited by law to such a narrow genetic base.Fortunately,there are new citrus hybrids displaying reduced sensitivity to HLB,and in some cases they produce juice,alone or in blends,that consumers would recognize as“orange juice”.Reconsidering current regulations on orange juice standards may permit use of such hybrids in“orange juice”,providing greater latitude for commercialization of these hybrids,leading to higher-quality orange juice and a more sustainable Florida orange juice industry.展开更多
Today,our world is undergoing profound changes unseen in a century.Global security landscape is becoming ever more unstable and uncertain.In the face of growing deficits in security,Chinese President Xi Jinping ...Today,our world is undergoing profound changes unseen in a century.Global security landscape is becoming ever more unstable and uncertain.In the face of growing deficits in security,Chinese President Xi Jinping put forward the Global Security Initiative(GSI),offering a clear answer to the question of the times:what kind of security concept does the world need,and how can we achieve common security?It is of great significance to fully grasp the relevance of and the rationale for the GSI,and push for its strategic delivery,so as to contribute to the long-term peace and stability of the world.展开更多
Background and purpose Recombinant human TNK tissue-type plasminogen activator(rhTNK-tPA)was not inferior to alteplase for ischaemic stroke within 4.5hours.Our study aimed to investigate the efficacy and safety of rhT...Background and purpose Recombinant human TNK tissue-type plasminogen activator(rhTNK-tPA)was not inferior to alteplase for ischaemic stroke within 4.5hours.Our study aimed to investigate the efficacy and safety of rhTNK-tPA in patients who had an ischaemic stroke due to large vessel occlusion(LVO)of anterior circulation beyond 4.5hours.Methods and design Tenecteplase Reperfusion Therapy in Acute Ischaemic Cerebrovascular Events-III(TRACE III)is a multicentre,prospective,randomised,open-label,blind endpoint,controlled clinical trial.Patients who had an ischaemic stroke due to anterior circulation LVO(internal carotid artery,middle cerebral artery M1 and M2 segments)within 4.5–24hours from last known well(including wake-up stroke and no witness stroke)and with salvageable tissue(ischaemic core volume<70mL,mismatch ratio≥1.8 and mismatch volume≥15mL)based on CT perfusion or MRI perfusion-weighted imaging(PWI)were included and randomised to rhTNK-tPA 0.25mg/kg(single bolus)to a maximum of 25mg or standard medical therapy.Specially,we will exclude patients who are intended for direct thrombectomy.All will be followed up for 90 days.Study outcomes Primary efficacy outcome is modified Rankin Scale(mRS)score≤1 at 90 days.Secondary efficacy outcomes include ordinal distribution of mRS at 90 days,major neurological improvement defined by a decrease≥8 points compared with the initial deficit or a score≤1 on the National Institutes of Health Stroke Scale(NIHSS)at 72 hours,mRS score≤2 at 90 days,the rate of improvement on Tmax>6s at 24 hours and NIHSS score change from baseline at 7days.Safety outcomes are symptomatic intracerebral haemorrhage within 36 hours and mortality at 90 days.Discussion TRACE III will provide evidence for the efficacy and safety of rhTNK-tPA in patients who had an ischaemic strokes due to anterior circulation LVO beyond 4.5hours.Trial registration number NCT05141305.展开更多
Rationale The effect of the head position as a non-pharmacological therapy on acute ischaemic stroke(AIS)remains inconclusive.Our recent Head dOwn-Position for acutE moderate ischaemic Stroke with large artery atheros...Rationale The effect of the head position as a non-pharmacological therapy on acute ischaemic stroke(AIS)remains inconclusive.Our recent Head dOwn-Position for acutE moderate ischaemic Stroke with large artery atherosclerosis(HOPES 2)suggested the safety,feasibility and potential benefit of the head-down position(HDP)in AIS.Aim To investigate the benefit of HDP in acute moderate ischaemic stroke patients with large artery atherosclerosis(LAA).Sample size estimates Based on a two-sided 0.05 level of significance,600 patients are expected to yield the superiority hypothesis with 80%power,stratified by age,sex,history of diabetes,baseline systolic blood pressure,location of index vessel,National Institutes of Health Stroke Scale Score at randomisation,onset to randomisation time,progression to moderate neurological deficit due to early neurological deterioration and degree of responsible vessel stenosis.Design Head dOwn-Position for acutE moderate ischaemic Stroke with large artery atherosclerosis(HOPES 3)is a prospective,randomised,open-label,blinded endpoint and multicentre study.Eligible patients who had an ischaemic stroke will be randomly assigned(1:1)into the HDP group receiving-20°Trendelenburg plus standard medical care in compliance with national guidelines,or control group only receiving standard medical care in compliance with national guidelines.Outcome The primary outcome is favourable functional outcome,defined as modified Rankin Scale 0–2 at 90 days.Safety outcomes are HDP-related adverse events.All outcomes will have blinded assessment and will be analysed on the intention-to-treat basis.Conclusions The results of HOPES 3 will provide evidence for the effect of HDP in acute moderate ischaemic stroke patients with LAA within 24 hours of onset or in patients with progression from mild neurological deficit within 24 hours.Trial registration number NCT06010641.展开更多
Background Our recent pilot study suggests intra-arterial tenecteplase(TNK)during the first pass of endovascular treatment(EVT)seems safe,may increase first-pass reperfusion and good outcome in acute ischaemic stroke(...Background Our recent pilot study suggests intra-arterial tenecteplase(TNK)during the first pass of endovascular treatment(EVT)seems safe,may increase first-pass reperfusion and good outcome in acute ischaemic stroke(AIS)patients with large-vessel occlusion(LVO).Aims To determine the efficacy and safety of intra-arterial TNK administration during EVT in AIS-LVO patients presenting up to 24 hours from symptom onset.Sample size estimates A maximum of 380 patients are required to test the superiority hypothesis with 80%power according to a two-side 0.05 level of significance,stratified by age,gender,baseline systolic blood pressure,prestroke modified Rankin Scale(mRS),baseline National Institute of Health stroke scale,baseline ASPECTS,time from onset to groin puncture,intravenous thrombolysis before EVT,stroke territory and stroke aetiology.Design Intra-arterial TNK during thrombectomy for acute stroke(BRETIS-TNK II)study is a prospective,randomised,adaptive enrichment,open-label,blinded end point,multicentre study.Eligible AIS-LVO patients are randomly assigned into the experimental group and control group with a ratio of 1:1.The experimental group will be treated with intra-arterial infusion of TNK during EVT.The control group will be treated with standard EVT.Outcome The primary end point is a favourable outcome,defined as an mRS score of 0–2 at 90 days.The primary safety end point is symptomatic intracranial haemorrhage within 48 hours,which is defined as an increase in the National Institutes of Health Stroke Scale score of≥4 points as a result of the intracranial haemorrhage.Conclusions The results of BRETIS-TNK II will provide evidence for the efficacy and safety of intra-arterial TNK administration during EVT in AIS patients with LVO.展开更多
Background and purpose Tenecteplase(TNK)has demonstrated non-inferiority to alteplase in patients who had an acute ischaemic stroke presenting within 4.5 hours from symptom onset.The trial is aimed to explore the effi...Background and purpose Tenecteplase(TNK)has demonstrated non-inferiority to alteplase in patients who had an acute ischaemic stroke presenting within 4.5 hours from symptom onset.The trial is aimed to explore the efficacy and safety of TNK in Chinese patients who had an acute ischaemic stroke with large/medium vessel occlusion in an extended time window.Methods and design Chinese Acute Tissue-Based Imaging Selection for Lysis In Stroke TenecteplaseⅡ(CHABLIS-TⅡ)is a multicentre,prospective,block-randomised,open-label,blinded-endpoint,phaseⅡb study.Eligible patients are 1:1 randomised into two groups:0.25 mg/kg TNK versus best medical management(excluding TNK).The safety and efficacy of 0.25 mg/kg TNK are assessed through reperfusion status and presence of symptomatic intracranial haemorrhage(sICH).Study outcomes The primary outcome is major reperfusion without sICH at 24–48 hours after randomisation.Major reperfusion is defined as restoration of blood flow to greater than 50%of the involved ischaemic territory assessed by catheter angiography or repeated perfusion imaging.Secondary outcomes include post-thrombolytic recanalisation,neurological improvements,change in the National Institutes of Health Stroke Scale score,haemorrhagic transformation at 24–48 hours,systematic bleeding at discharge,modified Rankin Scale(mRS)0–1,mRS 0–2,mRS 5–6,mRS distribution and Barthel index at 90 days.Discussion CHABLIS-TⅡwill provide important evidence of intravenous thrombolysis with TNK for patients who had an acute stroke in an extended time window.展开更多
One of the major changes that has taken place over the past twenty to thirty years has been the extension of the legal recognition and protections for same-sex relationships in a wide range of countries. A number of j...One of the major changes that has taken place over the past twenty to thirty years has been the extension of the legal recognition and protections for same-sex relationships in a wide range of countries. A number of jurisdictions, including China, are considering the approach that they will adopt. This article seeks firstly to consider the justifications for the legal recognition of same-sex relationships by the state. Three main, compelling rationales are identified which are rooted in notions of the equality of all persons, the dignity and liberty of individuals to form close personal relationships, and the social benefits of recognizing close, personal relationships of same-sex couples. The second part of this article then turns to consider the maimer in which same-sex relationships should be recognized. Four models are identified： a ＂Partial Rights＂ model; a ＂Civil Partnerships＂ model; a ＂Marriage Equality＂ model, and a ＂Diversity of Relationships＂ model. Reasons for and against these particular models will be examined. In the conclusion, it shall be argued that the choice of model that has been adopted can be seen to depend on a number of factors： the manner in which equality is conceived in that society; the understanding of same-sex relationships therein, and the religious and cultural opposition to same-sex relationships in that society. The models are also not states of affairs that are fixed for all time and many countries have progressed from less extensive forms of recognition to wider recognition over time. Ultimately, it shall be argued that the rationales underlying the recognition of close personal relationships in the law support the ＂Marriage Equality＂ model or the ＂Diversity of Relationships＂ model. This article thus seeks to provide an understanding of the rationales and models for recognizing same-sex relationships that have been adopted around the world： Its focus is thus comparative but may, in this way, be useful to lawmakers and advocates for legal reform in this area in China and other jurisdictions around the world.展开更多
This paper is a product of intensive reading teaching reform practice held in Shantou Universityin 1998,under the instruction of Mr.Black(professor of New York City University).It summarises therational and procedures...This paper is a product of intensive reading teaching reform practice held in Shantou Universityin 1998,under the instruction of Mr.Black(professor of New York City University).It summarises therational and procedures we used in the teaching practice of intensive reading.Modes of top-down and bot-tom-up processing are introduced,procedures such as skimming,scanning,careful reading,writing,role-playing,presentation and practice are described,particular importance is attached to group work orpair work.The rationale and procedures we put forward in this paper are not revolutionary but a combi-nation of traditional Chinese teacher-centred mode with contemporary western student-centred approachin the teaching of intensive reading in China.However,they have been proved highly efficient and prac-tical,which makes this paper worth reading.展开更多
Injection sclerotherapy is most effective for internal hemorrhoids,especially for patients with bleeding.Howev-er,traditional sclerotherapy via anoscope may cause iatrogenic risk and complications due to misplaced inj...Injection sclerotherapy is most effective for internal hemorrhoids,especially for patients with bleeding.Howev-er,traditional sclerotherapy via anoscope may cause iatrogenic risk and complications due to misplaced injections.[1]The flexible endoscopic sclerotherapy for internal hemorrhoids using a short needle without cap assistant was first reported in 1991 in the United States.[2]The flexible endoscopic injection using a short needle with cap assistant was reported in 2014 in Japan.[3]Cap-assisted endoscopic sclerotherapy(CAES)primarily using a long needle was reported in 2015[4]as an emerging flexible endoscopic therapy,and has been widely used for internal hemorrhoids and some prolapse in China.A panel of experts aimed to develop expert recommendations for CAES and derived guidelines on the key issues in hemorrhoidal disease,including rationale,new positioning methods for anus,indications,contraindications,techniques,post-procedure management,and core outcome set for evaluation[Figure 1].展开更多
文摘The concepts of modernization and industrialization have different connotations that are specific to their historical backgrounds,and their theoretical innovation and development may benefit from China’s experiences.Industrialization is the cornerstone of modernization,and holds the key to its success.China’s experiences in blazing a new trail of industrialization are challenging the traditional Western theory of industrialization and deepening the connotations of Chinese modernization.New industrialization is a key entry point for steering China’s modernization drive and theoretical innovations.This paper offers an overview of the theory of Chinese modernization and its evolving trend along China’s socialist industrialization path,as well as the rationale and pathway for new industrialization in the context of Chinese modernization.As our findings suggest,the new industrialization concept has taken hold in every key aspect of Chinese modernization.When combined with the theory of Chinese modernization,the theoretical implications of new industrialization play a crucial role in propelling Chinese modernization forward along a new journey in the new era.
文摘Psychoactive substance use is characterized by the habitual use of substances that have significant effects in altering the activities of neurotransmitters in certain regions of the brain.Consequently,these alterations manifest as cognitive,emotional,perceptual and behavioural changes in affected individuals[1].
基金Supported by National Natural Science Foundation of China(Grant Nos.51175019,61104169,51205321)
文摘Current design rationale （DR） systems have not demonstrated the value of the approach in practice since little attention is put to the evaluation method of DR knowledge. To systematize knowledge management process for future computer-aided DR applications, a prerequisite is to provide the measure for the DR knowledge. In this paper, a new knowledge network evaluation method for DR management is presented. The method characterizes the DR knowledge value from four perspectives, namely, the design rationale structure scale, association knowledge and reasoning ability, degree of design justification support and degree of knowledge representation conciseness. The DR knowledge comprehensive value is also measured by the proposed method. To validate the proposed method, different style of DR knowledge network and the performance of the proposed measure are discussed. The evaluation method has been applied in two realistic design cases and compared with the structural measures. The research proposes the DR knowledge evaluation method which can provide object metric and selection basis for the DR knowledge reuse during the product design process. In addition, the method is proved to be more effective guidance and support for the application and management of DR knowledge.
文摘As the novel coronavirus disease 2019(COVID-19)and its variants continue to rage into the second year of a global pandemic,many success stories of applying Chinese herbal medicine(CHM)to treat COVID-19 patients continue to emerge from China and other part of the world.Herewith,from a systems medicine perspective,the authors analyze those experiences and categorize them into four major treatment principles:(1)focusing on eliminating toxins in the early stage of the disease,(2)tonifying deficiency of the body throughout the entire disease course,(3)treating the affected lung and intestine simultaneously based on visceral interactions,(4)cooling blood and removing blood stasis at the later stage,as well as interpret the rationale of these principles.This is helpful not only in reducing the complexity of promoting the CHM applications to enhance anti-COVID-19 efficacy,but also in ramping out the process of integrating traditional Chinese medicine with modern medical practices.
文摘Pure endoscopic treatment of combined cholelithiasis and choledocholithiasis is possible due to the chance to use together both endoscopic retrograde cholangiopancreatography(ERCP)and endoscopic ultrasound(EUS)approaches.This endotherapy permits to treat biliary stones in the main bile duct by standard ERCP and gallbladder stones by EUS-guided cholecystoduodenostomy eventually associated to intracorporeal lithotripsy to achieve optimal results.
基金sponsored by the General Project of the National Natural Science Foundation of China(NSFC)(72073093)the General Project of the Scientific Research Fund of Renmin University of China(21XNA008)the Key Project of the National Social Science Fund of China(NSSFC)(20&ZD118).
文摘Development zones(DZs)have emerged as a significant policy initiative for promoting regional coordination and facilitating resources allocation.They serve as an organizational framework for fostering industrial agglomeration and driving high-quality development.DZs attract and accommodate resource factors,firms,and projects,thereby functioning as a central catalyst for economic growth.This study utilizes data collected at the“DZ,City and Countrycountry”levels through manual compilation,textual analysis,and innovation measurement.It aims to empirically examine the theoretical rationale and practical preferences for promoting business and investment in China’s DZs.This study considers several factors such as industry attribute,firm attribute,agglomeration theory,and industrial chain layout.Based on our research findings,DZs exhibit distinct preferences.First,industry attribute:DZs align with both national and regional strategic planning and adhere to the industrial endowments of the respective areas.Second,firm attribute:DZs prioritize attracting firms that are productive and innovative,and have an international presence,rather than those that primarily contribute to taxes and job creation.Third,DZs are guided by the agglomeration theory,which suggests that they prefer firms that generate strong agglomeration externalities.Lastly,DZs also consider the industrial chain layout,aiming to attract firms that not only align with their existing industrial strengths but also extend to the upstream and downstream supply chain links.These conclusions are substantiated by the performance of robustness test.The success of DZs in China can be attributed to the five key principles:Adherence to national and regional strategic planning,prioritizing the actual industrial foundation,incorporating the theory of agglomeration externalities,strengthening corporate competitiveness,and expanding industrial chains.
文摘Nurses must be enlightened that clinical reasoning, clinical decision making, and clinical judgement are the key elements in providing safe patient care. It must be incorporated and applied all throughout the nursing process. The impact of patients’ positive outcomes relies on how nurses are effective in clinical reasoning and put into action once clinical decision making occurs. Thus, nurses with poor clinical reasoning skills frequently fail to see and notice patient worsening condition, and misguided decision making arises that leads to ineffective patient care and adding patients suffering. Clinical judgment on the other hand denotes on the outcome after the cycle of clinical reasoning. Within this context, nurses apply reflection about their actions from the clinical decision making they made. The process of applying knowledge, skills and expertise in the clinical field through clinical reasoning is the work of art in the nursing profession in promoting patient safety in the course of delivering routine nursing interventions. Nurses must be guided with their sound clinical reasoning to have an optimistic outcome and prevent iatrogenic harm to patients. Nurses must be equipped with knowledge, skills, attitude and values but most importantly prepared to face the bigger picture of responsibility to care for every patient in the clinical field.
文摘The approach for probabilistic rationale of artificial intelligence systems actions is proposed.It is based on an implementation of the proposed interconnected ideas 1-7 about system analysis and optimization focused on prognostic modeling.The ideas may be applied also by using another probabilistic models which supported by software tools and can predict successfulness or risks on a level of probability distribution functions.The approach includes description of the proposed probabilistic models,optimization methods for rationale actions and incremental algorithms for solving the problems of supporting decision-making on the base of monitored data and rationale robot actions in uncertainty conditions.The approach means practically a proactive commitment to excellence in uncertainty conditions.A suitability of the proposed models and methods is demonstrated by examples which cover wide applications of artificial intelligence systems.
文摘In the proposal, a construction project memory process based on the semantic annotation is presented. A project Mem-ory concerns the representation and the identification of the experience acquired during projects realization. The main feature of this approach is that the semantic annotation is used to build a continuous semantic design rationale process. We propose in this paper, a semantic traceability in four stages (identifying, structuring, annotating and integrating). The identification and the structuring phases use a model called Extended Marguerite model which fully considers the objectives of the project memory. The annotation phase exploits the results of precedent phase to prepare the final phase. Examples are presented from a case study in an Algerian firm called ENMTP. The architecture supporting the modelling engine is presented. Finally, an evaluation of the degree of the semantic annotation brought by proposed process is given.
文摘Web Quest is an advanced tool which could provide the significant scaffolding to support instructors through incorporating learning objects within systematic designs of learning activities. The focus of this article is to explore how a Webquest is designed reasonably and what rationales are implied in such a design through a case study of Webquest design for a group of ESL/EFL learners in Grade 12. The result indicates that a Webquest which is guided by the principles of constructivist problem solving, social interaction and scaffolding learning can be regarded as a desirable Webquest.
文摘Huanglongbing(HLB)is a disease that has devastated the Florida citrus industry,threatens the entire U.S.citrus industry,and globally is rapidly spreading.Florida’s citrus production is 90%sweet orange,which is quite sensitive to HLB.The heavy reliance on sweet orange for Florida citrus production makes the industry especially vulnerable to diseases that are damaging to this type of citrus.Furthermore,90%of Florida oranges are used in producing orange juice that is defined by a federal regulation known as the“orange juice standard”,specifying that at least 90%of“orange juice”must be derived from Citrus sinensis.Genomic analyses definitively reveal that sweet orange is not a true species,but just one of many introgression hybrids of C.reticulata and C.maxima,with phenotypic diversity resulting from accumulated mutations in this single hybrid,the“sweet orange”.No other fruit industry is limited by law to such a narrow genetic base.Fortunately,there are new citrus hybrids displaying reduced sensitivity to HLB,and in some cases they produce juice,alone or in blends,that consumers would recognize as“orange juice”.Reconsidering current regulations on orange juice standards may permit use of such hybrids in“orange juice”,providing greater latitude for commercialization of these hybrids,leading to higher-quality orange juice and a more sustainable Florida orange juice industry.
文摘Today,our world is undergoing profound changes unseen in a century.Global security landscape is becoming ever more unstable and uncertain.In the face of growing deficits in security,Chinese President Xi Jinping put forward the Global Security Initiative(GSI),offering a clear answer to the question of the times:what kind of security concept does the world need,and how can we achieve common security?It is of great significance to fully grasp the relevance of and the rationale for the GSI,and push for its strategic delivery,so as to contribute to the long-term peace and stability of the world.
基金supported by the National Natural Science Foundation of China(81870905,82171272)Beijing Municipal Science&Technology Committee(Z211100003521019)Beijing Hospitals Authority(PX2022019).
文摘Background and purpose Recombinant human TNK tissue-type plasminogen activator(rhTNK-tPA)was not inferior to alteplase for ischaemic stroke within 4.5hours.Our study aimed to investigate the efficacy and safety of rhTNK-tPA in patients who had an ischaemic stroke due to large vessel occlusion(LVO)of anterior circulation beyond 4.5hours.Methods and design Tenecteplase Reperfusion Therapy in Acute Ischaemic Cerebrovascular Events-III(TRACE III)is a multicentre,prospective,randomised,open-label,blind endpoint,controlled clinical trial.Patients who had an ischaemic stroke due to anterior circulation LVO(internal carotid artery,middle cerebral artery M1 and M2 segments)within 4.5–24hours from last known well(including wake-up stroke and no witness stroke)and with salvageable tissue(ischaemic core volume<70mL,mismatch ratio≥1.8 and mismatch volume≥15mL)based on CT perfusion or MRI perfusion-weighted imaging(PWI)were included and randomised to rhTNK-tPA 0.25mg/kg(single bolus)to a maximum of 25mg or standard medical therapy.Specially,we will exclude patients who are intended for direct thrombectomy.All will be followed up for 90 days.Study outcomes Primary efficacy outcome is modified Rankin Scale(mRS)score≤1 at 90 days.Secondary efficacy outcomes include ordinal distribution of mRS at 90 days,major neurological improvement defined by a decrease≥8 points compared with the initial deficit or a score≤1 on the National Institutes of Health Stroke Scale(NIHSS)at 72 hours,mRS score≤2 at 90 days,the rate of improvement on Tmax>6s at 24 hours and NIHSS score change from baseline at 7days.Safety outcomes are symptomatic intracerebral haemorrhage within 36 hours and mortality at 90 days.Discussion TRACE III will provide evidence for the efficacy and safety of rhTNK-tPA in patients who had an ischaemic strokes due to anterior circulation LVO beyond 4.5hours.Trial registration number NCT05141305.
基金Science and Technology Project Plan of Liaoning province(2022JH2/101500020).
文摘Rationale The effect of the head position as a non-pharmacological therapy on acute ischaemic stroke(AIS)remains inconclusive.Our recent Head dOwn-Position for acutE moderate ischaemic Stroke with large artery atherosclerosis(HOPES 2)suggested the safety,feasibility and potential benefit of the head-down position(HDP)in AIS.Aim To investigate the benefit of HDP in acute moderate ischaemic stroke patients with large artery atherosclerosis(LAA).Sample size estimates Based on a two-sided 0.05 level of significance,600 patients are expected to yield the superiority hypothesis with 80%power,stratified by age,sex,history of diabetes,baseline systolic blood pressure,location of index vessel,National Institutes of Health Stroke Scale Score at randomisation,onset to randomisation time,progression to moderate neurological deficit due to early neurological deterioration and degree of responsible vessel stenosis.Design Head dOwn-Position for acutE moderate ischaemic Stroke with large artery atherosclerosis(HOPES 3)is a prospective,randomised,open-label,blinded endpoint and multicentre study.Eligible patients who had an ischaemic stroke will be randomly assigned(1:1)into the HDP group receiving-20°Trendelenburg plus standard medical care in compliance with national guidelines,or control group only receiving standard medical care in compliance with national guidelines.Outcome The primary outcome is favourable functional outcome,defined as modified Rankin Scale 0–2 at 90 days.Safety outcomes are HDP-related adverse events.All outcomes will have blinded assessment and will be analysed on the intention-to-treat basis.Conclusions The results of HOPES 3 will provide evidence for the effect of HDP in acute moderate ischaemic stroke patients with LAA within 24 hours of onset or in patients with progression from mild neurological deficit within 24 hours.Trial registration number NCT06010641.
基金supported by grants from the Science and Technology Project Plan of Liao Ning Province(2022JH2/101500020)the Science and Technology Plan of Shen Yang(20-205-4-007).
文摘Background Our recent pilot study suggests intra-arterial tenecteplase(TNK)during the first pass of endovascular treatment(EVT)seems safe,may increase first-pass reperfusion and good outcome in acute ischaemic stroke(AIS)patients with large-vessel occlusion(LVO).Aims To determine the efficacy and safety of intra-arterial TNK administration during EVT in AIS-LVO patients presenting up to 24 hours from symptom onset.Sample size estimates A maximum of 380 patients are required to test the superiority hypothesis with 80%power according to a two-side 0.05 level of significance,stratified by age,gender,baseline systolic blood pressure,prestroke modified Rankin Scale(mRS),baseline National Institute of Health stroke scale,baseline ASPECTS,time from onset to groin puncture,intravenous thrombolysis before EVT,stroke territory and stroke aetiology.Design Intra-arterial TNK during thrombectomy for acute stroke(BRETIS-TNK II)study is a prospective,randomised,adaptive enrichment,open-label,blinded end point,multicentre study.Eligible AIS-LVO patients are randomly assigned into the experimental group and control group with a ratio of 1:1.The experimental group will be treated with intra-arterial infusion of TNK during EVT.The control group will be treated with standard EVT.Outcome The primary end point is a favourable outcome,defined as an mRS score of 0–2 at 90 days.The primary safety end point is symptomatic intracranial haemorrhage within 48 hours,which is defined as an increase in the National Institutes of Health Stroke Scale score of≥4 points as a result of the intracranial haemorrhage.Conclusions The results of BRETIS-TNK II will provide evidence for the efficacy and safety of intra-arterial TNK administration during EVT in AIS patients with LVO.
文摘Background and purpose Tenecteplase(TNK)has demonstrated non-inferiority to alteplase in patients who had an acute ischaemic stroke presenting within 4.5 hours from symptom onset.The trial is aimed to explore the efficacy and safety of TNK in Chinese patients who had an acute ischaemic stroke with large/medium vessel occlusion in an extended time window.Methods and design Chinese Acute Tissue-Based Imaging Selection for Lysis In Stroke TenecteplaseⅡ(CHABLIS-TⅡ)is a multicentre,prospective,block-randomised,open-label,blinded-endpoint,phaseⅡb study.Eligible patients are 1:1 randomised into two groups:0.25 mg/kg TNK versus best medical management(excluding TNK).The safety and efficacy of 0.25 mg/kg TNK are assessed through reperfusion status and presence of symptomatic intracranial haemorrhage(sICH).Study outcomes The primary outcome is major reperfusion without sICH at 24–48 hours after randomisation.Major reperfusion is defined as restoration of blood flow to greater than 50%of the involved ischaemic territory assessed by catheter angiography or repeated perfusion imaging.Secondary outcomes include post-thrombolytic recanalisation,neurological improvements,change in the National Institutes of Health Stroke Scale score,haemorrhagic transformation at 24–48 hours,systematic bleeding at discharge,modified Rankin Scale(mRS)0–1,mRS 0–2,mRS 5–6,mRS distribution and Barthel index at 90 days.Discussion CHABLIS-TⅡwill provide important evidence of intravenous thrombolysis with TNK for patients who had an acute stroke in an extended time window.
文摘One of the major changes that has taken place over the past twenty to thirty years has been the extension of the legal recognition and protections for same-sex relationships in a wide range of countries. A number of jurisdictions, including China, are considering the approach that they will adopt. This article seeks firstly to consider the justifications for the legal recognition of same-sex relationships by the state. Three main, compelling rationales are identified which are rooted in notions of the equality of all persons, the dignity and liberty of individuals to form close personal relationships, and the social benefits of recognizing close, personal relationships of same-sex couples. The second part of this article then turns to consider the maimer in which same-sex relationships should be recognized. Four models are identified： a ＂Partial Rights＂ model; a ＂Civil Partnerships＂ model; a ＂Marriage Equality＂ model, and a ＂Diversity of Relationships＂ model. Reasons for and against these particular models will be examined. In the conclusion, it shall be argued that the choice of model that has been adopted can be seen to depend on a number of factors： the manner in which equality is conceived in that society; the understanding of same-sex relationships therein, and the religious and cultural opposition to same-sex relationships in that society. The models are also not states of affairs that are fixed for all time and many countries have progressed from less extensive forms of recognition to wider recognition over time. Ultimately, it shall be argued that the rationales underlying the recognition of close personal relationships in the law support the ＂Marriage Equality＂ model or the ＂Diversity of Relationships＂ model. This article thus seeks to provide an understanding of the rationales and models for recognizing same-sex relationships that have been adopted around the world： Its focus is thus comparative but may, in this way, be useful to lawmakers and advocates for legal reform in this area in China and other jurisdictions around the world.
文摘This paper is a product of intensive reading teaching reform practice held in Shantou Universityin 1998,under the instruction of Mr.Black(professor of New York City University).It summarises therational and procedures we used in the teaching practice of intensive reading.Modes of top-down and bot-tom-up processing are introduced,procedures such as skimming,scanning,careful reading,writing,role-playing,presentation and practice are described,particular importance is attached to group work orpair work.The rationale and procedures we put forward in this paper are not revolutionary but a combi-nation of traditional Chinese teacher-centred mode with contemporary western student-centred approachin the teaching of intensive reading in China.However,they have been proved highly efficient and prac-tical,which makes this paper worth reading.
基金the Nanjing Medical University Fan Daiming Research Funds for Holistic Integrative Medicine.the Tianyu Pharmaceutical Co.,Ltd and China Gut Conference for the meeting.
文摘Injection sclerotherapy is most effective for internal hemorrhoids,especially for patients with bleeding.Howev-er,traditional sclerotherapy via anoscope may cause iatrogenic risk and complications due to misplaced injections.[1]The flexible endoscopic sclerotherapy for internal hemorrhoids using a short needle without cap assistant was first reported in 1991 in the United States.[2]The flexible endoscopic injection using a short needle with cap assistant was reported in 2014 in Japan.[3]Cap-assisted endoscopic sclerotherapy(CAES)primarily using a long needle was reported in 2015[4]as an emerging flexible endoscopic therapy,and has been widely used for internal hemorrhoids and some prolapse in China.A panel of experts aimed to develop expert recommendations for CAES and derived guidelines on the key issues in hemorrhoidal disease,including rationale,new positioning methods for anus,indications,contraindications,techniques,post-procedure management,and core outcome set for evaluation[Figure 1].
