Aim: Many centres have adopted a straight to test approach to deliver a fast-track service for suspected lower GI cancer. We undertook a prospective comparison between patients having a straight to test (STT) flexible...Aim: Many centres have adopted a straight to test approach to deliver a fast-track service for suspected lower GI cancer. We undertook a prospective comparison between patients having a straight to test (STT) flexible sigmoidoscopy and those attending an outpatient appointment (OPA). The study aimed to determine whether STT reduced diagnostic time without additional investigations. Methods: An observational study of 200 consecutive fast-track colorectal referrals was undertaken. Data collected included: patient demographics, whether STT or OPA, investigations undertaken (including dates) and final diagnosis. Outcomes were compared by adjusted linear regression and logistic regression, for numerical and binary outcomes respectively. Potential confounding factors included were: age, gender and whether NICE referral criteria were achieved. Results: 186 out of 200 referrals attended their appointment, 62% (116/186) went STT and 38% (70/186) had an OPA. No significant difference was seen in the number of days to final investigation, adjusted coefficient -3.71, 95% C.I. -8.92 to 1.50. The STT group had 0.4 more tests per patient, adjusted 95% C.I. 0.07 to 0.73, than the OPA group. Significantly more patients in the STT group had a flexible sigmoidoscopy in addition to whole colonic imaging (all modalities), compared to the OPA group, adjusted OR of 93.47 (95% C.I. 29.26 to 298.54). Conclusion: This study highlights the potential disadvantages of STT flexible sigmoidoscopy for patients referred under the two-week-rule with suspected lower GI cancer. Despite the previously published work highlighting the potential cost and time benefits, it may come at the sacrifice of exposing patients to additional investigations.展开更多
A bogus typhoon scheme,designed for the initialization of a typhoon track prediction model,is developed in thispaper.This scheme includes both effects of axisymmetric wind and asymmetric wind.Experimental forecasts us...A bogus typhoon scheme,designed for the initialization of a typhoon track prediction model,is developed in thispaper.This scheme includes both effects of axisymmetric wind and asymmetric wind.Experimental forecasts using atwo-way interactive movable nested mesh model show that the forecast skill of typhoon tracks has clearly improvedafter introducing the bogus typhoon into the initial fields.展开更多
The locomotive traction motor is described as a rotor-bearing system coupling the kinetic equations of the traction shaft and its support bearings with the determination of their elastic deformations in this study.Und...The locomotive traction motor is described as a rotor-bearing system coupling the kinetic equations of the traction shaft and its support bearings with the determination of their elastic deformations in this study.Under the effect of excitations induced by the dynamic rotor eccentric distance and time-varying mesh stiffness,the elastic structure deformations of the shaft and support bearings are formulated in the vibration environment of the locomotive.In addition,the nonlinear contact forces between the components of the rolling bearing,the lubricating oil film,and radial clearance are comprehensively considered in this study.The results indicate that the elastic deformations of the shaft and bearings can change the dynamic responses of the traction motor and its support bearings.There are large differences between the ranges of the rotor motion calculated by the rigid and the flexible traction motor models when the intensified wheel-rail interaction is considered.With the increase of the rotor eccentricity,the results underscore the role of the elasticity of traction shaft and support bearings in dynamic researches of the traction motor.The critical value of the initial eccentric distance for the rub-impact phenomenon decreases from 1.23 mm to 1.15 mm considering the flexible effect of the shaft and bearings.This dynamics model of the traction motor can provide more accurate and reasonable simulation results for correlational dynamic researches.展开更多
文摘Aim: Many centres have adopted a straight to test approach to deliver a fast-track service for suspected lower GI cancer. We undertook a prospective comparison between patients having a straight to test (STT) flexible sigmoidoscopy and those attending an outpatient appointment (OPA). The study aimed to determine whether STT reduced diagnostic time without additional investigations. Methods: An observational study of 200 consecutive fast-track colorectal referrals was undertaken. Data collected included: patient demographics, whether STT or OPA, investigations undertaken (including dates) and final diagnosis. Outcomes were compared by adjusted linear regression and logistic regression, for numerical and binary outcomes respectively. Potential confounding factors included were: age, gender and whether NICE referral criteria were achieved. Results: 186 out of 200 referrals attended their appointment, 62% (116/186) went STT and 38% (70/186) had an OPA. No significant difference was seen in the number of days to final investigation, adjusted coefficient -3.71, 95% C.I. -8.92 to 1.50. The STT group had 0.4 more tests per patient, adjusted 95% C.I. 0.07 to 0.73, than the OPA group. Significantly more patients in the STT group had a flexible sigmoidoscopy in addition to whole colonic imaging (all modalities), compared to the OPA group, adjusted OR of 93.47 (95% C.I. 29.26 to 298.54). Conclusion: This study highlights the potential disadvantages of STT flexible sigmoidoscopy for patients referred under the two-week-rule with suspected lower GI cancer. Despite the previously published work highlighting the potential cost and time benefits, it may come at the sacrifice of exposing patients to additional investigations.
文摘A bogus typhoon scheme,designed for the initialization of a typhoon track prediction model,is developed in thispaper.This scheme includes both effects of axisymmetric wind and asymmetric wind.Experimental forecasts using atwo-way interactive movable nested mesh model show that the forecast skill of typhoon tracks has clearly improvedafter introducing the bogus typhoon into the initial fields.
基金National Natural Science Foundation of China(Grant Nos.52022083,51775453,and 51735012).
文摘The locomotive traction motor is described as a rotor-bearing system coupling the kinetic equations of the traction shaft and its support bearings with the determination of their elastic deformations in this study.Under the effect of excitations induced by the dynamic rotor eccentric distance and time-varying mesh stiffness,the elastic structure deformations of the shaft and support bearings are formulated in the vibration environment of the locomotive.In addition,the nonlinear contact forces between the components of the rolling bearing,the lubricating oil film,and radial clearance are comprehensively considered in this study.The results indicate that the elastic deformations of the shaft and bearings can change the dynamic responses of the traction motor and its support bearings.There are large differences between the ranges of the rotor motion calculated by the rigid and the flexible traction motor models when the intensified wheel-rail interaction is considered.With the increase of the rotor eccentricity,the results underscore the role of the elasticity of traction shaft and support bearings in dynamic researches of the traction motor.The critical value of the initial eccentric distance for the rub-impact phenomenon decreases from 1.23 mm to 1.15 mm considering the flexible effect of the shaft and bearings.This dynamics model of the traction motor can provide more accurate and reasonable simulation results for correlational dynamic researches.
