RESUMO
Objective: To explore the value of modified RANSON score in predicting mortality from severe acute pancreatitis (SAP). Methods: In this retrospective study, 461 SAP patients hospitalized from January 2016 to January 2020 were enrolled. AP (acute pancreatitis) patients from our hospital were employed as the training set. In addition, AP patients from the affiliated hospital of Nantong University were set as the validation set. The clinical characteristics of patients were compared between the two sets. The independent risk factors for SAP were determined through logistic regression. Moreover, the risk factors were derived for various prediction models by logistic regression. Multiple methods were adopted to assess the predictive ability of various models. Results: A total of 338 patients were assigned into the training set, while 123 patients were assigned into the validation set. The patients in the training and validation sets showed the consistent distribution trends (P>0.05). In the training set, significant differences between patients in the non-survival and survival groups were BMI, PCT, platelets (PLT), direct bilirubin (DBil) and RANSON scores (P<0.05). In further multivariate analysis, BMI, PCT and RANSON score were found as the independent risk factors for the mortality of SAP (OR=1.12, 1.25, 1.28, 95% CI:1.06-1.19, 1.08-1.44, 1.12-1.47, P<0.05). In the training set and validation set, ROC curve analysis showed that AUC of BMI+RANSON score was 0.778 and 0.789, respectively. In the calibration curve, the fitting degree of RANSON score+BMI and ideal assessment model was 0.975 and 0.854, respectively. The decision curve suggested that the net benefit per patient increased with the lengthening of the RANSON score+ BMI model curve. As revealed by the results of NRI and IDI indicators, RANSON score+BMI was optimized based on RANSON score (P<0.05). Conclusion: BMI+RANSON was confirmed as a modified model effective in predicting the mortality from SAP.
RESUMO
Electric double layers (EDLs) play a decisive role in the energy storage of supercapacitors. Recently, voltage/charge driven ordering transitions of ions in the lateral direction of the EDL were found to dramatically affect the capacitance in experiments and molecular dynamics (MD) simulations. However, the correlation between the lateral structure of the ions and the capacitance was not well understood. In this work, all-atom MD simulations were applied to investigate the lateral ordering of the [BMIM][PF6] ionic liquid on both anode and cathode surfaces. The lateral ordering of ions was systematically characterized using the 2D structure factor, radial distribution function and coordination number. It was found that the disorder to order transition of PF6- ions on the anode occurs when the number of first nearest neighboring ions converges to six. What's more, the local maximum of the differential capacitance profile not only appears at the disorder-order transition point, but also occurs at the splitting point of the radial distribution function peak and where the number of second and third nearest neighboring ions become converged and stable. On the cathode side, a long range ordered phase of BMIM+ ions does not exist due to its multi-adsorption states on the electrode. To understand the origin of the correlation between the lateral structure and the differential capacitance, the correlation between the structures in the lateral and normal directions was investigated. Such a structural correlation is closely related to the three-dimensional characteristics of the EDL structure and the over-screening phenomenon.
RESUMO
BACKGROUND: Patient related factors hindering optimal blood pressure (BP) control in patients with hypertension are unclear. OBJECTIVES: To investigate the barriers to optimal hypertension management. METHODS: A survey on the awareness and management of hypertension was conducted in 556 patients (365 males, mean age 60.9 ± 10.1) from a rural community. RESULTS: Of the 556 patients who had a clinical diagnosis of hypertension, 127 (22.8%) were unaware the existence of the condition and received no therapy. In the 429 patients who were aware the presence of hypertension, 206 (48.0%) did not receive any antihypertensive medication at the time of this study. Fifty-four (12.5%) had a BP of less than 140/90 mm Hg. Only 21 (4.9%) received formal counselling or education from health professionals and 74 (17.2%) were aware of the optimal level of BP. Difficulty in accessing a specialist doctor was reported by 126 (29.4%). In 279 (65.0%), missing regular antihypertensive medications was reported in the 4-week period prior to this study. Omitting prescribed antihypertensive drugs due to the costs was reported by 169 (39.4%). CONCLUSION: Inadequate counselling, lack of understanding on the disease, difficulties in accessing specialist care and poor medication adherence are the barriers to optimal BP control.
