state-of-the-art review

最新审查
  • 文章类型: Journal Article
    单向碳纤维增强聚合物(CFRP)可以在升高的温度下在横向方向上表现出显著的机械软化。虽然由于锚具的夹紧力,CFRP上存在显著的横向压应力,CFRP电缆在遭受意外火灾时可能会出现锚固故障。CFRP电缆锚具的耐高温性能至关重要,明确CFRP锚索系统在高温下的性能劣化和失效机理是明确其抗火性能的基础。本文从两个方面综述了CFRP索锚固系统耐高温性能的研究现状,包括所包括的材料和锚固系统的耐高温性。从两个方面对所含材料的高温性能进行了综述。首先,分析了粘结环氧树脂在高温下的力学性能下降以及填料对其力学性能的影响。其次,总结了CFRP复合材料在高温下的力学性能,考虑到CFRP电缆在锚固装置约束下的应力状态。关于锚固系统的耐高温性的综述还包括两个方面。首先,总结和讨论了锚固系统的温度场求解方法。其次,总结和讨论了高温锚固性能的研究现状。基于这些评论,总结了CFRP电缆锚固系统耐高温性能的研究不足,并建议进一步研究。
    Unidirectional carbon fiber-reinforced polymer (CFRP) may exhibit significant mechanical softening in the transverse direction at an elevated temperature. While significant transverse compressive stress exists on CFRP due to the clamping force from anchorage, a CFRP cable may exhibit anchorage failure when suffering an accidental fire disaster. The high-temperature resistance of a CFRP cable anchorage is critical, and clarifying the performance deterioration and failure mechanism of a CFRP cable anchorage system at elevated temperature is fundamental for clarifying its fire resistance. This paper reviews the current research status of the high-temperature resistance of CFRP cable anchorage systems from two aspects, including the high-temperature resistance of the comprising materials and the anchorage system. The reviews on the high-temperature properties of the comprising materials are summarized from two aspects. Firstly, the mechanical performance degradation of bonding epoxy resin at elevated temperatures and the effect of a filler on its mechanical-thermal properties are analyzed. Secondly, the mechanical performances of CFRP composites at elevated temperatures are summarized, with consideration of the stress state of the CFRP cable under the constraint of an anchorage device. The reviews on the high-temperature resistance of the anchorage system also include two aspects. Firstly, the temperature field solution method for the anchorage system is summarized and discussed. Secondly, the current research status of the anchorage performance at elevated temperatures is also summarized and discussed. Based on these reviews, the research shortage of the high-temperature resistance of CFRP cable anchorage systems is summarized, and further research is recommended.
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  • 文章类型: Journal Article
    自然图像字幕(NIC)是一个跨学科的研究领域,位于计算机视觉(CV)和自然语言处理(NLP)的交叉。已经提出了一些关于这个主题的作品,从早期的基于模板的方法到最近的基于深度学习的方法。本文在NIC领域进行了调查,特别是专注于其在放射学领域的医学图像字幕(MIC)和诊断字幕(DC)的应用。对最新技术进行了综述,总结了NIC和DC的关键研究工作,以提供有关该主题的广泛概述。这些作品包括现有的NIC和MIC模型,数据集,评估指标,以及专业文献中的先前评论。对修改后的工作进行了深入的分析和讨论,强调现有方法的局限性及其在实际临床实践中的潜在影响。同样,根据检测到的局限性,概述了未来潜在的研究路线。
    Natural Image Captioning (NIC) is an interdisciplinary research area that lies within the intersection of Computer Vision (CV) and Natural Language Processing (NLP). Several works have been presented on the subject, ranging from the early template-based approaches to the more recent deep learning-based methods. This paper conducts a survey in the area of NIC, especially focusing on its applications for Medical Image Captioning (MIC) and Diagnostic Captioning (DC) in the field of radiology. A review of the state-of-the-art is conducted summarizing key research works in NIC and DC to provide a wide overview on the subject. These works include existing NIC and MIC models, datasets, evaluation metrics, and previous reviews in the specialized literature. The revised work is thoroughly analyzed and discussed, highlighting the limitations of existing approaches and their potential implications in real clinical practice. Similarly, future potential research lines are outlined on the basis of the detected limitations.
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  • 文章类型: Journal Article
    大约五分之一的大麻使用者,最常用的非法物质,有大麻使用障碍(CUD)。精神病和自杀在这些患者中更为常见,据报告,残疾调整寿命年为69万。CUD的药物治疗是未满足的公共卫生需求,因为目前的循证疗法疗效有限。
    在解释了CUD的病理生理学之后,我们根据作用机制对从随机对照试验中获得的新兴药物干预对其治疗的影响进行了综述.优于控制大麻二酚,加巴喷丁,加兰他敏,纳比隆加唑吡坦,纳比肟,纳曲酮,PF-04457845,喹硫平,伐尼克林,通过大麻素观察到托吡酯,谷氨酸能,γ-氨基丁酸能,血清素能,去甲肾上腺素能,多巴胺能,opiopideric,和胆碱能系统。据报道,所有药物都是安全和可耐受的。
    在心理治疗中增加药物治疗是CUD的最佳治疗方法。药物开发是增加心理治疗的主要路径,但是时间和成本建议重新利用和重新定位现有的药物。考虑到样本量,后续行动,和效果大小,使用客观工具的进一步研究是必要的。CUD治疗的前景广阔。
    UNASSIGNED: About one-fifth of cannabis users, the most commonly used illicit substance, have cannabis use disorder (CUD). Psychiatric disorders and suicide are more common in these patients, and the disability-adjusted life years were reported to be 0.69 million. Pharmacotherapy for CUD is an unmet public health need, as current evidence-based therapies have limited efficacy.
    UNASSIGNED: After explaining the pathophysiology of CUD, the effects of emerging pharmacological interventions in its treatment obtained from randomized controlled trials were reviewed in light of mechanisms of action. Superiority over control of cannabidiol, gabapentin, galantamine, nabilone plus zolpidem, nabiximols, naltrexone, PF-04457845, quetiapine, varenicline, and topiramate were observed through the cannabinoid, glutamatergic, γ-aminobutyric acidergic, serotonergic, noradrenergic, dopaminergic, opioidergic, and cholinergic systems. All medications were reported to be safe and tolerable.
    UNASSIGNED: Adding pharmacotherapy to psychotherapy is the optimal treatment for CUD on a case-by-case basis. Drug development to add to psychotherapy is the main path, but time and cost suggest repurposing and repositioning existing drugs. Considering sample size, follow-up, and effect size, further studies using objective tools are necessary. The future of CUD treatment is promising.
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  • 文章类型: Journal Article
    弹性成像是一种利用超声成像来评估软组织的弹性和刚度的非侵入性方法。佩罗尼病(PD)是一种影响男性阴茎的慢性炎症,导致纤维斑块的形成。这改变了阴茎的弹性,并可能导致其形状的变化。超声弹性成像(UE)是PD诊断的重要进展。它不仅能识别斑块,但它也测量了它们的刚性,提供关键信息以监测治疗期间和之后的变化。我们对科学文献进行了叙述性回顾,以确定讨论弹性成像在PD诊断研究中的应用的文章。这项研究的目的是描述超声与弹性成像相结合的诊断使用中的“最新技术”,以突出诊断PD的任何益处。搜索PubMed后,我们找到了12条相关文章,Embase,和谷歌学者使用关键词“超声弹性成像”和“佩罗尼病”,包括八项临床研究,两个病例报告,和两篇评论文章。我们的评论结果表明,UE是识别Peyronie相关斑块的有用技术,特别是当使用标准超声或体格检查无法检测到它们时。它也有助于在保守治疗期间和之后监测改善。需要更多的研究来确认超声弹性成像在诊断Peyronie疾病中的有效性,并确定其是否优于传统超声。
    Elastography is a noninvasive method that utilizes ultrasound imaging to assess the elasticity and stiffness of soft tissue. Peyronie\'s disease (PD) is a chronic inflammatory condition that affects the male penis, causing the formation of fibrous plaques. This alters the penis\'s elasticity and can lead to changes in its shape. Ultrasound elastography (UE) is an important advancement in the diagnosis of PD. It not only identifies plaques, but it also measures their rigidity, providing crucial information to monitor changes during and after treatment. We conducted a narrative review of the scientific literature to identify articles that discuss the use of elastography in the diagnostic study of PD. The purpose of this study was to describe the \"state of the art\" in the diagnostic use of ultrasound in combination with elastography to highlight any benefits in the diagnosis of PD. We found 12 relevant articles after searching PubMed, Embase, and Google Scholar using the keywords \"ultrasound elastography\" and \"Peyronie\'s disease\", including eight clinical studies, two case reports, and two review articles. The results of our review indicate that UE is a useful technique for identifying Peyronie-related plaques, particularly when they are not detectable using a standard ultrasound or physical examination. It is also helpful in monitoring improvements during and after conservative treatments. More research is required to confirm the effectiveness of ultrasound elastography in diagnosing Peyronie\'s disease and to determine whether it is better than traditional ultrasound.
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  • 文章类型: Journal Article
    Nyáltermelésünk folyamatos, a szájüregben összegyűlt nyálat rendszeresen nyeljük. A páciens váladékkezelési képessége ezért nyilvánvaló változónak tűnik a nyelési zavar megítélésében. Ennek ellenére még a validált, betegágy melletti felmérésekben is különböző formában és hangsúllyal jelenik meg. Irodalmi áttekintésünkben ezt a jelenséget, amelyet a szakirodalom nyálnyelésként vagy száraz nyelésként ismer, a ’state-of-the-art’ típusú irodalmi áttekintés módszertanával vizsgáltuk. Azokra a kérdésekre kerestük a választ, hogy hogyan írható le a száraz nyelés élettana, van-e olyan neuroanatómiai jellegzetessége, amely megkülönbözteti a táplálkozási célú nyeléstől. Továbbá milyen validált száraznyelés-vizsgálatok vannak a dysphagia/aspiratio szűrésében, amelyeket a hazai gyakorlatban is biztonsággal alkalmazhatunk? Vannak-e kifejezetten száraznyelés-vizsgálati protokollok, létezik-e egységes gyakorlat? Dolgozatunk eredményeként olyan alapelveket fogalmaztunk meg, amelyek több betegcsoportra is általánosíthatók, közvetlen gyakorlati hasznát vehetik a felnőtt betegpopuláció nyelészavar-ellátását végző szakemberek, és új kutatási területeket is kínálhatnak. A betegvizsgálat során figyelembe kell venni a spontán nyelési gyakoriságot. Spontán nyelési esemény hiányában stimulációval kell megkísérelni a nyálnyelés kiváltását, majd csak ezt követően történjen a felszólításra végrehajtott száraznyelés-teszt. Csak a nyálnyelés megfigyelését követően történjen nyelésvizsgálat különböző konzisztenciákkal. A nyálnyelési eredményeket mindig további, nyelészavarra utaló változókkal együtt javasolt értelmezni. Orv Hetil. 2024; 165(12): 443–454.
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  • 文章类型: Journal Article
    高级氧化工艺(AOPs)是废水处理技术,以其降解新兴关注污染物(CEC)的能力而脱颖而出。文献已经广泛地研究了用于不同水性基质的这些去除过程。一旦技术成熟,其中一些系统已经被认可可以大规模应用,因此,他们在环境和成本领域的系统性表现也已成为基本要求。这项研究证实了这一趋势,分析有关该主题的现有文献,以验证AOP领域的专家如何在2015-2023年期间调查这种整合。为此,通过应用系统评价(SR)方法处理出版物样本。这导致了83项研究的摘录,这些研究采用了生命周期逻辑来估计环境影响和过程成本,或将其评估为与每种处理技术的技术层面的补充。此分析发现,这两个维度均可用于在设计规模上选择或确定AOP的大小。然而,适当选择环境评估的影响类别并建立成本分析方法可以使该方法更加有效。此外,数量惊人的过程将扩大估计的现实和适用性,采用多标准分析方法可以解决安排设计过程中决策过程的重要方面。通过满足最初的目的,该研究扩大了设计AOPs和传播其在减轻CEC排放方面的使用的要求。
    Advanced oxidation processes (AOPs) are wastewater treatment technologies that stand out for their ability to degrade Contaminants of Emerging Concern (CECs). The literature has extensively investigated these removal processes for different aqueous matrices. Once technically mature, some of these systems have become accredited to be applied on a large scale, and therefore, their systemic performances in the environmental and cost spheres have also become essential requirements. This study proposed corroborating this trend, analyzing the available literature on the subject to verify how experts in the AOP area investigated this integration during 2015-2023. For this purpose, a sample of publications was treated by applying the Systematic Review (SR) methodology. This resulted in an extract of 83 studies that adopted life-cycle logic to estimate environmental impacts and process costs or evaluated them as complementary to the technical dimension of each treatment technology. This analysis found that both dimensions can be used for selecting or sizing AOPs at the design scale. However, the appropriate choice of the impact categories for the environmental assessment and establishing a methodology for cost analysis can make the approach still more effective. In addition, a staggering number of processes would broaden the reality and applicability of the estimates, and adopting multicriteria analysis methodologies could address essential aspects of decision-making processes during the design of the arrangements. By meeting the original purposes, the study broadened the requirements for designing AOPs and disseminating their use in mitigating the discharge of CECs.
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  • 文章类型: Journal Article
    自闭症谱系障碍(ASD)是一种早发性疾病,在儿童中的患病率为1%,据报道,残疾调整寿命为431万。易怒是一种与ASD相关的具有挑战性的行为,药物开发滞后。更具体地说,药物治疗的有效性可能是有限的高不良反应(考虑副作用和患者的药物敏感性);因此,药物干预的可能益处必须与每位患者的潜在不良事件相平衡.
    在回顾了ASD相关易怒的神经病理生理学之后,根据作用机制和作用目标,我们详细介绍了基于随机对照试验的新兴药物在治疗中的获益和耐受性.
    继续服用利培酮和阿立哌唑,美金刚的单一疗法可能是有益的。此外,N-乙酰半胱氨酸,加兰他敏,萝卜硫素,塞来昔布,棕榈酰乙醇胺,己酮可可碱,辛伐他汀,米诺环素,金刚烷胺,孕烯醇酮,泼尼松龙,利鲁唑,propentofylline,吡格列酮,还有托吡酯,利培酮的所有辅料,可乐定和哌醋甲酯优于安慰剂。这些作用是通过谷氨酸,γ-氨基丁酸能,炎症,氧化,胆碱能,多巴胺能,和血清素能系统。据报道,所有药物都是安全和可耐受的。考虑到样本量,后续行动,和效果大小,需要进一步的研究。随着药物的发展,建议重新定位和合并由作用机制支持的现有药物。
    UNASSIGNED: Autism spectrum disorder (ASD) is an early-onset disorder with a prevalence of 1% among children and reported disability-adjusted life years of 4.31 million. Irritability is a challenging behavior associated with ASD, for which medication development has lagged. More specifically, pharmacotherapy effectiveness may be limited against high adverse effects (considering side effect profiles and patient medication sensitivity); thus, the possible benefits of pharmacological interventions must be balanced against potential adverse events in each patient.
    UNASSIGNED: After reviewing the neuropathophysiology of ASD-associated irritability, the benefits and tolerability of emerging medications in its treatment based on randomized controlled trials were detailed in light of mechanisms and targets of action.
    UNASSIGNED: Succeeding risperidone and aripiprazole, monotherapy with memantine may be beneficial. In addition, N-acetylcysteine, galantamine, sulforaphane, celecoxib, palmitoylethanolamide, pentoxifylline, simvastatin, minocycline, amantadine, pregnenolone, prednisolone, riluzole, propentofylline, pioglitazone, and topiramate, all adjunct to risperidone, and clonidine and methylphenidate outperformed placebo. These effects were through glutamatergic, γ-aminobutyric acidergic, inflammatory, oxidative, cholinergic, dopaminergic, and serotonergic systems. All medications were reported to be safe and tolerable. Considering sample size, follow-up, and effect size, further studies are necessary. Along with drug development, repositioning and combining existing drugs supported by the mechanism of action is recommended.
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  • 文章类型: Journal Article
    BACKGROUND: An integral part of both undergraduate and postgraduate nursing and midwifery programmes, is the teaching and assessment of clinical psychomotor skills. In order to provide safe care, there is an expectation that technical nursing procedures are performed competently and effectively. Due to limited opportunities to practice clinical skills there is a challenge to advance and implement innovative teaching approaches. Technological advances provide us with alternative options, outside of the traditional teaching approaches, to teach these skills.
    OBJECTIVE: The aim of this state-of-the-art review was to examine and provide an overview of the current use of educational technologies in nursing and midwifery education in teaching clinical psychomotor skills.
    METHODS: A-state-of -the-art literature review was carried out, as this type of evidence synthesis design reveals the current knowledge on a topic and identifies gaps for future research. We used a focused search strategy with the expertise of a research librarian. Data extraction included research designs and educational theories guiding the included studies along with the type of technologies studied. A descriptive summary of each study\'s findings in relation to the educational outcomes was performed.
    RESULTS: Sixty studies were sourced which met this reviews\' eligibility criteria. Technologies in which most research was carried out included; simulation, video and virtual reality. The most common research design noted included randomized or quasi-experimental studies. The vast majority of studies (n = 47) did not elaborate whether educational theories guided them, while of the remaining thirteen studies, eleven theoretical frameworks were reported.
    CONCLUSIONS: Technology use in nursing and midwifery educational research surrounding psychomotor skills education is present. The educational outcomes reported by the majority of studies on the use of educational technology in teaching and/or assessing clinical psychomotor skills are encouraging. Additionally, the majority of studies noted that students evaluated the technology positively and were satisfied with its use in their education. Future research may include evaluating the technologies in both undergraduate and postgraduate populations. Finally, opportunities exist to expand the evaluation of student learning or assessment of these skills using technologies from the educational environment to the clinical environment.
    BACKGROUND: Not registered.
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  • 文章类型: Journal Article
    在这篇叙述性评论中,讨论危重患者治疗性血浆置换(TPE)的相关问题。对于许多条件,最佳适应症,设备类型,频率,持续时间,更换液的类型和停止TPE的标准不确定。TPE是一种可能挽救生命的侵入性手术,有不良事件和并发症的风险,需要经验丰富的团队密切监测。在重症监护病房(ICU),TPE的适应症可以分为(1)绝对,建立良好,以证据为基础,TPE被认为是一线治疗,(2)相对的,TPE是公认的二线治疗(单独或联合)和(3)抢救治疗,其中TPE与有限或理论证据基础一起使用。新的迹象正在出现和持续的知识差距,特别是关于在危重病期间使用TPE,支持建立专门用于重症监护医学的TPE注册表。
    In this narrative review, we discuss the relevant issues of therapeutic plasma exchange (TPE) in critically ill patients. For many conditions, the optimal indication, device type, frequency, duration, type of replacement fluid and criteria for stopping TPE are uncertain. TPE is a potentially lifesaving but also invasive procedure with risk of adverse events and complications and requires close monitoring by experienced teams. In the intensive care unit (ICU), the indications for TPE can be divided into (1) absolute, well-established, and evidence-based, for which TPE is recognized as first-line therapy, (2) relative, for which TPE is a recognized second-line treatment (alone or combined) and (3) rescue therapy, where TPE is used with a limited or theoretical evidence base. New indications are emerging and ongoing knowledge gaps, notably regarding the use of TPE during critical illness, support the establishment of a TPE registry dedicated to intensive care medicine.
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  • 文章类型: Journal Article
    在本文中,我们回顾了旨在研究前列腺癌的1H-MR光谱成像(MRSI)方法的进展,涵盖特定硬件等关键方面,用于数据采集和数据处理和量化技术的专用脉冲序列。重点是MRSI方法的最新进展,以及未来的发展,这可以克服与临床常规中常用的MRSI方法相关的困难。这包括替换用于批量选择的标准PRESS序列,我们认为这不足以用于临床应用,通过sLASER序列和实施1HMRSI无水信号抑制。这些可以对MRSI在前列腺癌管理中的补充作用和意义进行新的评估。
    In this paper, we review the developments of 1H-MR spectroscopic imaging (MRSI) methods designed to investigate prostate cancer, covering key aspects such as specific hardware, dedicated pulse sequences for data acquisition and data processing and quantification techniques. Emphasis is given to recent advancements in MRSI methodologies, as well as future developments, which can lead to overcome difficulties associated with commonly employed MRSI approaches applied in clinical routine. This includes the replacement of standard PRESS sequences for volume selection, which we identified as inadequate for clinical applications, by sLASER sequences and implementation of 1H MRSI without water signal suppression. These may enable a new evaluation of the complementary role and significance of MRSI in prostate cancer management.
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