Racial, ethnic, and socioeconomic disparities present daunting hurdles that prevent equitable health outcomes for patients with end-stage kidney disease (ESKD) on hemodialysis. Additional resources, such as the Novel ...Racial, ethnic, and socioeconomic disparities present daunting hurdles that prevent equitable health outcomes for patients with end-stage kidney disease (ESKD) on hemodialysis. Additional resources, such as the Novel Intervention in Children’s Health (NICH) at Lucille Packard Children’s Hospital Stanford, provide individualized support to best assist families by assessing barriers to care with the goal of improving health outcomes. In this retrospective cohort study, we reviewed patients with ESKD on hemodialysis involved in NICH to explore if NICH serves as a liaison between the patients and multidisciplinary medical team and to explore if NICH helps patients better manage the challenges of end-stage kidney disease. Through the electronic medical record system, EPIC, we reviewed the patients’ surveys to identify barriers to care, which included school and life engagement difficulty, lack of mental health resources, food and transportation insecurity, and cultural/language barriers. We also tracked the number of hospitalizations and ED visits before and during the patients’ enrollment in NICH. We discovered that through NICH, the aforementioned barriers to care were eliminated, the number of hospitalizations and emergency department visits was reduced, and all patients transitioned from inactive to active on the transplant list. NICH successfully improved the health outcomes of these patients and empowered patients to be more engaged in their care.展开更多
Dark mudstones and shales of the Carboniferous Jiusi Formation are widely developed in northern Guizhou and Yunnan provinces, SW China. However, the distribution, reservoir characterization, and exploration potential ...Dark mudstones and shales of the Carboniferous Jiusi Formation are widely developed in northern Guizhou and Yunnan provinces, SW China. However, the distribution, reservoir characterization, and exploration potential of organic-rich shales in this area are yet to be quantified, thus limiting the prospect of shale gas in this area. This study investigates the basic geological conditions of Jiusi shale gas, using core data, well-logs, and some other test data, obtaining the following results. The organic-rich shales are mainly composed of deltaic-to-shallow-shelf deposits, with thickness ranging from 0 to 450 m, and above 350 m around the subsidence center. The organic matter is mainly type Ⅱ kerogen with TOC content of mostly 1%–2%, indicating a moderate maturity. The argillaceous shale reservoirs are indicative of strong heterogeneity, high clay minerals content, low porosity, low permeability, high specific surface area, and relatively developed secondary porosity. The gas-log anomaly intervals obtained from the survey wells have a cumulative thickness that is apparently greater than 200 m, and a few shale intervals showing high desorbed and adsorbed gas contents. Due to complex structures in the study area, conditions responsible for shale gas occurrence and trapping are generally moderate. However, areas having wide and gentle folds with moderate depth of burial reveals relatively favorable conditions of hydrocarbon traps. In contrast with typical marine-continental transitional shales, the Jiusi shale have better geological conditions for shale gas preservation. The analysis of the geological framework and hydrocarbon potential of Carboniferous Jiusi Formation provide more insight for the exploration of Carboniferous shale gas in southern China.展开更多
针对多模态多目标优化中种群多样性难以维持和所得等价Pareto最优解数量不足问题,提出一种融合聚类和小生境搜索的多模态多目标优化算法(multimodal multi-objective optimization algorithm with clustering and niching searching,CSS...针对多模态多目标优化中种群多样性难以维持和所得等价Pareto最优解数量不足问题,提出一种融合聚类和小生境搜索的多模态多目标优化算法(multimodal multi-objective optimization algorithm with clustering and niching searching,CSSMPIO)。首先利用基于聚类的特殊拥挤距离非支配排序方法(clustering-based special crowding distance,CSCD)初始化种群;引入自适应物种形成策略生成稳定的小生境,在不同的小生境子空间并行搜索和保持等价Pareto最优解;采用特殊拥挤距离非支配排序策略实现个体选优、精英学习策略避免过早收敛。通过在14个多模态多目标函数上进行测试,并与7种新提出的多模态多目标优化算法进行对比实验以及Wilcoxon秩和检验发现,CSSMPIO的总体性能优于对比算法。最后将算法用于基于地图的测试问题,进一步证明了算法的有效性。展开更多
文摘Racial, ethnic, and socioeconomic disparities present daunting hurdles that prevent equitable health outcomes for patients with end-stage kidney disease (ESKD) on hemodialysis. Additional resources, such as the Novel Intervention in Children’s Health (NICH) at Lucille Packard Children’s Hospital Stanford, provide individualized support to best assist families by assessing barriers to care with the goal of improving health outcomes. In this retrospective cohort study, we reviewed patients with ESKD on hemodialysis involved in NICH to explore if NICH serves as a liaison between the patients and multidisciplinary medical team and to explore if NICH helps patients better manage the challenges of end-stage kidney disease. Through the electronic medical record system, EPIC, we reviewed the patients’ surveys to identify barriers to care, which included school and life engagement difficulty, lack of mental health resources, food and transportation insecurity, and cultural/language barriers. We also tracked the number of hospitalizations and ED visits before and during the patients’ enrollment in NICH. We discovered that through NICH, the aforementioned barriers to care were eliminated, the number of hospitalizations and emergency department visits was reduced, and all patients transitioned from inactive to active on the transplant list. NICH successfully improved the health outcomes of these patients and empowered patients to be more engaged in their care.
基金supported by National Science and Technology Major Project entitled Test and Application Promotion of Shale Gas Exploration and Evaluation Techniques(No.2016ZX05034)a project organized by the China Geological Survey entitled Shale Gas Geological Survey in Northeastern Yunnan(No.DD20190080).
文摘Dark mudstones and shales of the Carboniferous Jiusi Formation are widely developed in northern Guizhou and Yunnan provinces, SW China. However, the distribution, reservoir characterization, and exploration potential of organic-rich shales in this area are yet to be quantified, thus limiting the prospect of shale gas in this area. This study investigates the basic geological conditions of Jiusi shale gas, using core data, well-logs, and some other test data, obtaining the following results. The organic-rich shales are mainly composed of deltaic-to-shallow-shelf deposits, with thickness ranging from 0 to 450 m, and above 350 m around the subsidence center. The organic matter is mainly type Ⅱ kerogen with TOC content of mostly 1%–2%, indicating a moderate maturity. The argillaceous shale reservoirs are indicative of strong heterogeneity, high clay minerals content, low porosity, low permeability, high specific surface area, and relatively developed secondary porosity. The gas-log anomaly intervals obtained from the survey wells have a cumulative thickness that is apparently greater than 200 m, and a few shale intervals showing high desorbed and adsorbed gas contents. Due to complex structures in the study area, conditions responsible for shale gas occurrence and trapping are generally moderate. However, areas having wide and gentle folds with moderate depth of burial reveals relatively favorable conditions of hydrocarbon traps. In contrast with typical marine-continental transitional shales, the Jiusi shale have better geological conditions for shale gas preservation. The analysis of the geological framework and hydrocarbon potential of Carboniferous Jiusi Formation provide more insight for the exploration of Carboniferous shale gas in southern China.
文摘针对多模态多目标优化中种群多样性难以维持和所得等价Pareto最优解数量不足问题,提出一种融合聚类和小生境搜索的多模态多目标优化算法(multimodal multi-objective optimization algorithm with clustering and niching searching,CSSMPIO)。首先利用基于聚类的特殊拥挤距离非支配排序方法(clustering-based special crowding distance,CSCD)初始化种群;引入自适应物种形成策略生成稳定的小生境,在不同的小生境子空间并行搜索和保持等价Pareto最优解;采用特殊拥挤距离非支配排序策略实现个体选优、精英学习策略避免过早收敛。通过在14个多模态多目标函数上进行测试,并与7种新提出的多模态多目标优化算法进行对比实验以及Wilcoxon秩和检验发现,CSSMPIO的总体性能优于对比算法。最后将算法用于基于地图的测试问题,进一步证明了算法的有效性。
