摘要：信息技术（information technology，IT）的流程支持已经被人称为改善卫生保健质量和安全性的重要障碍。有2个方面特别引起人们的注意和投资。第一个是临床决策支持系统，亦即为改善临床医生做出决定而设计的信息系统。第二个则是一种为减少用药错误而采用的计算机医嘱输入（Computerized Physician Order Entry，CPOE）系统。该领域的文献以频繁的成功报告为特征，并且经常预言一个光明的新（近期的）未来；然而，这个未来似乎永远不会到来。在统治会议进程的欢呼和高度期望的背后，在自动贩卖信息和大量科学文献的背后，其现实情况是，目前各地所用系统虽然拥有满意的使用者，但是对医疗质量和安全性做出有效贡献者罕见。

摘要：The High Resolution Model Intercomparison Project(HighResMIP)is a unique model intercomparison project in phase 6 of the Coupled Model Intercomparison Project(CMIP6),which is focused on the impact of horizontal *** outputs of the high-and low-resolution versions of CAS FGOALS-f3-H and CAS FGOALS-f3-L for the experiments of the HighResMIP simulations in CMIP6 are described in this *** models and their configurations,experimental settings,and postprocessing methods are all *** FGOALS-f3-H,with a 0.25°horizontal resolution,and CAS FGOALS-f3-L,with a 1°horizontal resolution,were forced by the standard external conditions,and two coordinated sets of simulations were conducted for 1950–2014 and 2015–50 with the Experiment IDs of‘highresSST-present’and‘highresSST-future’,*** model outputs contain multiple time scales including the required hourly mean,three-hourly mean,six-hourly transient,daily mean,and monthly mean *** is reported that the 0.25°CAS FGOALS-f3-H successfully simulates some of the key challenges in climate modeling,including the average lifetime of tropical cyclones,particularly in the western parts of the northern Pacific Ocean,and the diurnal cycle of hourly *** datasets will contribute to the benchmarking of current models for CMIP,and studies of the impacts of horizontal resolutions on climate modeling issues.

摘要：The long atmospheric residence time of CO2 creates an urgent need to add atmospheric carbon drawdown to CO2 regulatory *** and systems biology(SSB),which enables manipulation of cellular phenotypes,offers a powerful approach to amplifying and adding new possibilities to current land management practices aimed at reducing atmospheric *** participants(in attendance:Christina Agapakis,George Annas,Adam Arkin,George Church,Robert Cook-Deegan,Charles DeLisi,Dan Drell,Sheldon Glashow,Steve Hamburg,Henry Jacoby,Henry Kelly,Mark Kon,Todd Kuiken,Mary Lidstrom,Mike MacCracken,June Medford,Jerry Melillo,Ron Milo,Pilar Ossorio,Ari Patrinos,Keith Paustian,Kristala Jones Prather,Kent Redford,David Resnik,John Reilly,Richard ***,Daniel Segre,Susan Solomon,Elizabeth Strychalski,Chris Voigt,Dominic Woolf,Stan Wullschleger,and Xiaohan Yang)identified a range of possibilities by which SSB might help reduce greenhouse gas concentrations and which might also contribute to environmental sustainability and *** include,among other possibilities,engineering plants to convert CO2 produced by respiration into a stable carbonate,designing plants with an increased root-to-shoot ratio,and creating plants with the ability to self-fertilize.A number of serious ecological and societal challenges must,however,be confronted and resolved before any such application can be fully assessed,realized,and deployed.

摘要：背景:共有1360例临床确诊的肺内结核、肺外结核患者标本及其他非结核标本。目的:建立一种快速、敏感、特异的检测不同临床标本中结核分枝杆菌糖脂抗原的方法。研究设计:在1-乙基-3-3-二甲基氨丙基碳化二亚胺氢氯化物和N-羟基丁二酰胺溶液中将亲和纯化的兔抗糖脂抗体(IgG)结合在脂质体颗粒(0.2～0.4 um)上,制备TB/M检测板的反应试剂。结果:当检测样本中存在糖脂抗原时,连接抗体的脂质体在4 min内会出现1个深蓝色的凝集点。而正常健康人或其他疾病患者的样本未见凝集点。结果显示该方法检测活动性肺结核患者临床样本中的结核分枝杆菌糖脂抗原的敏感性可低至1 ng/ml,临床灵敏度为97.4%,特异性为96.9%。结论:TB/M检测试验比较经济(一次检测只需4个印度卢比或0.09美元)、快速(4 min),似乎有助于结核病流行国家大规模检测结核性脑膜炎、肺结核和其他肺外结核患者多种生物学标本(脑脊液、胸液、关节液、血清和组织活检标本)。

摘要：Background： Despite the rapid growth in the incidence of acute myocardial infarction （AMI） in China, there is limited information about patients＇ experiences after AMI hospitalization, especially on long-tern1 adverse events and patient-reported outcomes （PROs）. Methods： The China Patient-centered Evaluative Assessment of Cardiac Events （PEACE）-Prospective AMI Study will enroll 4000 consecutive AM I patients from 53 diverse hospitals across China and follow them longitudinally for 12 months to docunlent their treatment, recovery, and outcomes. Details of patients＇ medical history, treatment, and in-hospital outcomes are abstracted from medical charts. Comprehensive baseline interviews are being conducted to characterize patient demographics, risk factors, presentation, and healthcare utilization. As part of these interviews, validated instruments are administered to measure PROs, including quality of life, symptoms, mood, cognition, and sexual activity. Follow-up interviews, measuring PROs, medication adherence, risk factor control, and collecting hospitalization events are conducted at 1, 6, and 12 months after discharge. Supporting documents for potential outcomes are collected for adjudication by clinicians at the National Coordinating Center. Blood and urine samples are also obtained at baseline, 1 - and 12-month follow-up. In addition, we are conducting a survey of participating hospitals to characterize their organizational characteristics. Conclusion： The China PEACE-Prospective AMI study will be uniquely positioned to generate new information regarding patient＇s experiences and outcomes alter AMI in China and seiwe as a foundation for quality improveinent activities.

摘要：目的 对应用选择性环氧酶2(COX 2)抑制剂和非选择性的非甾体类抗炎药(NSAIDs)的老年患者上消化道出血的比率进行比较。 设计 观察性队列研究。 设置 利用来自加拿大安大略2000年4月17日～2001年3月31日的官方数据,以确认基于人群的、初次使用NSAID的队列患者。 对象 年龄≥66岁,开始服用非选择性NSAIDs(n=5391)、双氯芬酸(diclofenac)加米索前列醇(misoprostol)(n=5087)、罗非昔布(rofecoxib)(n=14 583)或塞来昔布(celecoxib)(n=18 908),以及随机选择的没有服用NSAIDs的对照组(n=100 000)。 衡量结局的主要指标 每个药物组因上消化道出血入院的比值比(经过调整潜在的混杂因子)。 结果 与对照组相比,多变量模型表明,在服用非选择性NSAIDs(调整比值比为4.0,95％,可信区间为2.3～6.9,)、双氯芬酸加米索前列醇(3.0,1.7～5.6)以及罗非昔布(1.9,1.3～2.8)时,上消化道出血的短期危险性是增加的,而塞来昔布并没有增加(1.0,0.7～1.6)。与塞来昔布相比,非选择性的NSAIDs(4.4,2.3～8.5)、双氯芬酸加 米索前列醇(3.2,1.6—6.5)以及罗非昔布(1.9,1.2～2.8)的上消化道出血危险性显著增加。与罗非昔布相比,非选择性NSAIDs的上消化道出血危险性显著增加(1.9,1.0～3.5)。 结论 选择性COX

摘要：The Giant Radio Array for Neutrino Detection(GRAND)is a planned large-scale observatory of ultra-high-energy(UHE)cosmic particles,with energies exceeding 10~8 Ge *** goal is to solve the long-standing mystery of the origin of UHE cosmic *** do this,GRAND will detect an unprecedented number of UHE cosmic rays and search for the undiscovered UHE neutrinos and gamma rays associated to them with unmatched *** will use large arrays of antennas to detect the radio emission coming from extensive air showers initiated by UHE particles in the *** design is modular:20 separate,independent sub-arrays,each of 10000 radio antennas deployed over 10000 km^2.A staged construction plan will validate key detection techniques while achieving important science goals *** we present the science goals,detection strategy,preliminary design,performance goals,and construction plans for GRAND.

摘要：目的：评价常见慢性疾病及疾病标志指标与肿瘤风险的独立和联合关系，同时探索体力活动能否降低慢性疾病或异常疾病指标的致癌风险。研究设计：回顾性研究。研究设定：中国台湾地区人群的标准医学普查计划。纳入人群：405878人纳入研究，平均随访时间8．7年。所有参与者均测量并记录以下指标：心血管标志指标（血压、总胆固醇和心率）、糖尿病、慢性肾脏疾病指标（蛋白尿和肾小球滤过率）、肺部疾病和痛风性关节炎指标（尿酸）。主要研终点：肿瘤发病率及病死率。