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World File Search Systemdifficult
› › 4Step iCare 计划是一种个性化的、简单的 4 步骤方法，可帮助您做出艰难的医疗决定。
询问您的医疗保健提供者：› › 根据我的预后和护理目标，有哪些治疗方案？› › 这些方案的益处和风险是什么？› › 还有哪些其他治疗方法或我应该咨询哪些医生？› › 哪些治疗或药物不再需要？› › 在什么情况下需要返回医院？› › 开始或继续人工营养（喂食管）和补液（静脉输液）在多大程度上符合我的目标？› › 我心肺复苏术 (CPR) 存活的几率有多大，像这样的紧急程序如何帮助我实现护理目标？› › 目前 NJ POLST* 表格适合我吗？
合并症模式对“难以治疗”的类风湿性关节炎患者的长期功能演变和疾病活动有不同的影响
摘要 背景 尚不清楚难以治疗 (D2T) 类风湿性关节炎患者的长期结果特征以及导致其发展的因素。在此，我们探讨了 D2T 长期结果的异质性和促成因素。 方法 患者纳入前瞻性单中心队列研究。应用 EULAR 对 D2T 的定义。使用潜在类别轨迹分析评估功能状态 (改良健康评估问卷 (mHAQ)) 和疾病活动性 (疾病活动评分-28 (DAS28)) 的纵向聚类。使用多元线性混合模型来检查合并症及其聚类对长期结果的影响。 结果 1264 名患者中有 251 名 (19.9%) 被确诊为 D2T。年龄较小、纤维肌痛、骨关节炎、首次使用生物或靶向合成抗风湿药物 (b/ts-DMARD) 时的 DAS28-红细胞沉降率 (ESR) 以及在 b/ts-DMARD 治疗的前 6 个月内未能降低 DAS28-ESR 评分是患者患上 D2T 的重要预测因素。长期随访（总计 5872 人年）显示功能状态演变分为四组：18.2% 的患者 mHAQ 稳定、轻度受损（平均 0.41），39.9% 的患者逐渐改善（1.21-0.87），两组患者缓慢恶化或功能障碍稳定且显著（HAQ>1）。同样，确定了四组不同的疾病活动演变。在评估的不同合并症群中，“心理健康和疼痛相关疾病”或“代谢疾病”的存在对 mHAQ 恶化（两者均为 p<0.0001）和 DAS28 演变（分别为 p<0.0001 和 p=0.018）有显著影响。结论 D2T 患者在长期病程方面代表了一个异质性群体。心理健康/疼痛相关疾病以及代谢疾病会导致长期不良后果，应针对性治疗，以优化此类类风湿性关节炎的预后。
糖尿病指南 - 为什么它们很难遵循？糖尿病的营养建议 - 为什么很难跟随它们？
营养是行为疗法的元素之一，是糖尿病患者的适当护理和教育的支柱。营养疗法的目的是促进和支持健康的饮食模式，满足患者的个人营养需求，保持食物诱发的愉悦感，并为患者提供糖尿病的工具，以提高饮食质量。应调整糖尿病中的饮食，以对糖血症，糖化血红蛋白浓度产生可效应的作用，并降低急性和慢性并发症的风险。与经验丰富的营养师合作对适当的营养计划的制定和实施非常有帮助[1，2]。没有一种普遍的饮食类型满足每个患者的需求。推荐的糖尿病饮食模型可能包括：地中海饮食，破折号饮食（饮食中的饮食方法来阻止高血压），柔韧性饮食，植物性饮食和低碳水化合物饮食。大多数上述饮食模型都假设非淀粉蔬菜中有很大一部分，最大程度地减少了糖和精制谷物，以及基于最小加工食品的饮食。根据众多糖尿病社会的建议，个性化的进餐计划应基于健康营养的原则，这也是针对健康人的[3-6]。由国家营养教育中心开发的健康饮食板以简单而透明的方式说明了这些建议[7]。关于糖尿病患者的版本，它基于非淀粉蔬菜（番茄，生菜，菠菜，黄瓜，萝卜，萝卜，kohlrabi，kohlrabi，bell辣椒，羽衣甘蓝，白菜，布鲁塞尔甘蓝，绿豆，绿豆）和果实，以及盘子的一半杯。建议2岁及以上的儿童在白天食用180克蔬菜和150克水果，对于4岁以上的儿童，蔬菜和水果的含量应超过400 g [4]。
低温磁铁测试站的低温挑战
4 T dipole with a new Top of 20 K (> 10 K of margin) Frenet-Serret frame used for the conductor (avoid hard way bending) Straight geometry just to start the study (HTS is already difficult enough) Two design options: 2-tapes (980 A) and 4-tapes cable (1990 A) Quench protection is demanded (Cu stabilizer added for this)
iii-V光电探测器单拼合地整合在硅互连应用上
Difficult to grow III-V on Si with high crystal quality due to mismatch in lattice constant & thermal expansion coefficient (CTE), and polarity Lattice constant mismatch: Crystal configuration (atom spacing) is different and higher for most of III-V compounds than Si CTE: Si and III-V compounds expand/contract differently Polarity: Si is non-polar, while III-V is polar
清洁技术日OClaro 7月9日-Pump Laser
• Technology leadership requires investment – Difficult in downturn… as well as in boom times • Funding MicroSwiss PE48: – Funding of technology development – „Entwicklung der Prozess- und Montagetechnologie für Hochleistungs-Halbleiterdioden“ • Targeting alternative products & markets – Diode MM Pumps for Fiber laser & amplifier – Diode Bar Pumps for solid state激光抽水 - 有效去除热量的组装过程
计数器麻醉品培训学院（NEA）
谁是教练？角色和责任，什么是培训？Training Cycle, Student-Centered Training, Principles of Adult Training, Safe Learning Environment, Experiential Learning Cycle, Learning Styles, Coping with Difficult Participants, Teaching Methods and Training Tools, Learning Areas Bloom's Taxonomy, Introduction to the Training Plan, Writing Training Objectives and Targets, Practice: Preparing the Training Plans, Debriefing: Presentation of the Training Plans, Participations演讲。
汽车测试解决方案
• Capable of testing the quasi-normal and abnormal systems of mobile networks, which is difficult to achieve with real networks • Easily creates complex test environments with wireless power fluctuations in driving environments • Mobile network environments from around the world can be built in the lab for operational verification • Easy-to-use GUI that requires no knowledge of mobile protocols • PSAP* simulator for evaluation of eCall certification tests for each country's laws and regulations and type批准
国内商业船只安全警报
o High voltage shocks o Direct jet flames o Fires develop in intensity quickly and rapidly reach their maximum intensity (typically within 2-3 minutes) o Toxic gases o Gas explosion (if the released gas accumulates for a while before being ignited) o Long lasting re-ignition risk (can ignite or re-ignite weeks, or maybe months after the provoking incident) o Once established fires are difficult to stop/extinguish o Thermal runaway
car damage detection using machine learning
Siruganur ,Trichy Abstract – Modern car insurance industries waste a lot of resources due to claim leakages, which determines the amount they pay. Currently,visual Inspections and Validations are done manually,which can delay the claim processes.Previous study have shown that classifying images is possible with a small data set,by transferring and re purposing knowledge from models trained for a different task. Our goal is to build a Car Damage classifier using a deep learning model that is able to detect the different damage types and give an accurate depiction given a car image. However, due to the limiting set of data, it can be result in being a determining factor.Training a Convolutional Network from scratch (with random initialization) is difficult because it is relatively rare to have a large enough dataset.In this project we explore the problem of classifying images containing damaged cars to try and assess the monetary value of the damage. Because of the nature of this problem,classifying this data may prove to be a difficult task since no standardized dataset exists and some of the clases utilized might not be discriminative enough. Utilizing a pretrained YOLOv8 model,we trained a classifier in order to categorize the dataset,testing 3 different cases: damaged or not (damage vs whole),damage location (front vs rear vs side),damage level (minor vs moderate vs severe). Index Terms - YOLO model,CNN