moderate

摘要： 澳大利亚之行,感受颇深。澳大利亚人的热情,真诚,深深地吸引住了我的心,漂洋过海交朋友不枉此行!

摘要： Multifunctional composite catalyst for carbonyl sulfide hydrolysis under moderate temperature was prepared by impregnation method. The hydrolysis and deoxidization ability of the prepared catalyst was investigated in a fixed bed reactor. It was found that deoxidization ability of the prepared catalyst was raised by the increase of the content of potassium loading catalyst and reaction temperature. And the concentration of H2S had no effect on deoxidization while COS improved the deoxidization ratio. And deoxidization rates were nearly scaled up with concentration of H2. The hydrolysis ability was decreased by the decrease of the surface basicity.

摘要： With the rapid development of social networks, there is a focus on marketing strategies and business models that are based on social media. In the academic world, scholars believe that online trust is a key factor contributing to online purchasing behavior. This article explored several factors in social media trust and verified the moderating role of offline familiarity by using relevant research on online trust in conjunction with a structure equation model. The results show that independent variables such as reputation, SNS interaction, information quality, reciprocity, satisfaction and shared values have a positive influence on trust, whereas perceived similarity does not, and information quality is the most important factor. In addition, offline familiarity significantly moderates the relations between information quality, reciprocity, reputation, shared values and social media trust. This information is important to assist companies in developing an effective social network marketing strategy.

摘要： Background: There are at least 5 very popular methods described for the correction of mild to moderate hallux valgus deformities. Despite of reported and self experienced good results in favorable fitting preoperative anatomical conditions of some of these methods;it seems that no one is really satisfying under “difficult” or non favorable preoperative anatomic conditions. How could an optimum operation method for a satisfying correction of a mild to moderate hallux valgus look like? The well known criteria for an optimally satisfying method to achieve full normalization of important forefoot parameters under all conditions should be a lateralization, plantarization and derotation of the Ist metatarsal head and also a normalization of the distal metatarsal articular angle (DMAA) in combination with a soft tissue correction. Methods: In order to achieve this outcome without the disadvantages of shortening or the need for unloading, we developed a new operation technique and new fixation devices. We performed a simple transverse lazy-L subcapital osteotomy and after an additional soft tissue release the Ist metatarsal head was restored to its preplaned optimum position in terms of narrowing the IM angle, plantarization, correction of the hallux valgus angle, derotation of a pronation l malrotation and improvement of the DMAA. Fixation was achieved with an intramedullary angel-stable transfixed 30 mm titanium plate. The rigidity of the implant rendered interfragmental compression or solid bone contact unnecessary. The goal was only an optimal correction. All patients were allowed to ambulate with full weightbearing immediately after the operation. Results: We retrospectively reviewed 346 patients (433 feet) who underwent subcapital osteotomy between May 2007 and December 2011;308 were women and 38 men;their mean age was 65 years. The follow-up investigation was performed on average after 6.5 years (78 months);range 5.5 to 10 years (66 to 120 months). The AOFAS Score improved from 61.18 to 96.82 (t = 55.13, p ° to 4.21° (t = 89.70, p ° to 7.75° (t = 51.68, p ° to 6.61° (t = 29.34, p < 0.001). Minimal shortening of the first metatarsal (0.33 mm) and no recurrence of the deformity was observed. Conclusion: A new access to hallux valgus surgery is presented. Our results show that interfragmental compression between the osteotomy partners or good interfragmental contact is not necessary when a rigid intramedullary fixation device is used. The goal of this approach to hallux valgus surgery was to achieve excellent correction and a very rigid intramedullary angle-stable locked implant. The procedure yielded excellent results and was associated with no recurrence of hallux valgus.

摘要： This study examined the effects of the Hizen Alcoholism Prevention Program (HAPPY) and the revised version of HAPPY (HAPPY Plus), and also compared the two programs to determine whether the HAPPY Plus achieved better outcomes for heavy drinkers in the workplace. The HAPPY Plus designed to strengthen participants’ recruitment, perception of threat, stress management, behavior modification by self-monitoring using a calendar-based diary, and to prevent dropout by telephone and e-mail follow-up by a trained nurse. Participants were men and women who consumed at least 20 g and 10 g of alcohol daily, respectively, and had not been diagnosed with alcohol dependence. A group intervention, 3-month randomized controlled trial was conducted. The control and intervention groups received the HAPPY and HAPPY Plus, respectively. The primary endpoint was average daily alcohol consumption. The Alcohol Use Disorders Identification Test (AUDIT), weight, body mass index, blood pressure, liver function, goal achievement rate, self-efficacy, and self-esteem were also measured. Out of 88 recruited employees, 83 (intervention group: 40;control group: 43) completed the study (completion rates were 100% and 93.4% respectively). As a result, average daily alcohol consumption decreased significantly in both groups (p < 0.001), but did not differ between groups. Even though behavior change rate was higher, and self-efficacy and confidence increased in the intervention group, AUDIT decreased in both groups but was significant only in the control group. Physiological indicators in the intervention group improved, but were not significant between the groups. Against the program revision, this study did not prove superiority of HAPPY Plus to the HAPPY regarding the indicators. However, better behavior modification and lower dropout were observed in the HAPPY Plus. Therefore, after further improvement is made, this group intervention program is applied to the workplace.

摘要： Background: Although several treatment strategies to enhance the efficacy of electroconvulsive therapy (ECT) have been discussed, there have been no reports on the combined use of these treatments. The purpose of this study was to evaluate the efficacy and safety of concurrent use of moderate hyperventilation and a reduced dose of propofol combined with divided remifentanil in ECT practice. Methods: Sixty patients scheduled to receive a total of 300 ECT treatments were randomly assigned to have the three interventions: a standard dose (1 mg/kg) of propofol (group P/N);a standard dose of propofol and moderate hyperventilation with end-tidal pressure of carbon dioxide (ETCO2) of 30 - 35 mmHg (group P/H);and a reduced dose (0.5 mg/kg) of propofol with divided supplemental remifentanil and moderate hyperventilation (group RP/H). Patients in group RP/H received remifentanil 1 μg/kg followed by propofol 0.5 mg/kg for unconsciousness and thereafter remifentanil 1 μg/kg immediately before the ECT stimulus. Results: Patients in group RP/H showed significantly longer durations of electroencephalographic (EEG) seizures in the early phase of ECT course (P < 0.01 and 0.05) and lower electrical stimulus in the late phase of ECT course (P < 0.05 in each) than those in groups P/N and P/H, respectively. Conclusions: The use of a reduced dose of propofol combined with divided supplemental remifentanil under moderate hyperventilation during ECT can offer advantages over the use of a standard dose of propofol with or without moderate hyperventilation in terms of more seizure augmentation and/or lower electrical stimulus.

摘要： Objective: We examined what was known about individuals in Canada who were assessed as being at moderate risk for future fracture. Methods: A scoping review was conducted. Eligible articles were Canadian studies published from 2010 onwards reporting on primary data that included patients at moderate risk for future fracture. We limited the search to Canada as fracture risk categorization is unique to each country. Studies were identified by searching relevant databases. Two reviewers independently reviewed titles and abstracts to determine each study’s eligibility. General information about each study, demographic information about the moderate risk groups (including tool used to determine moderate risk (Fracture Risk Assessment Tool (FRAX), Canadian Association of Radiologists and Osteoporosis Canada (CAROC)), and outcomes (number of patients: recommended treatment, prescribed treatment, initiating treatment, persisting with treatment after six months, who refractured, who died) were documented. Results: We identified 1193 papers which were further screened for eligibility. Of the 1193 identified, 7 were eligible for the review but only 4 articles contained demographic or outcome data on moderate risk patients. In one study, 1.8% of moderate risk patients died over a mean 5.3 years of observation and in three studies, the risk of fracture was 5.9% over a median of 3 years of follow-up, 8.3% over a mean of 5.4 years, and 14.7% over 10 years of follow-up. Conclusion: There is a wide knowledge gap in the literature concerning individuals who are assessed as moderate risk for future fracture in Canada.

摘要： The present study aims to further understanding of the principal reactions that occur during coal oxidation at moderate temperatures. Mass change and heat evolution of a sample were monitored by thermo-gravimetric analysis coupled with differential thermal analysis (TGA/DTA). Gaseous and solid products were traced using online or in situ Fourier trans- form infrared spectroscopy (FTIR). Measurements were conducted by heating the samples up to 400?C, with the O2 concentration in the reaction medium set at 0, 10, 21, and 40 vol%, respectively. It was observed that the mass increase of a sample between 150?C and ~275oC was a result of the accumulation of C=O containing species in the coal structure, whereas substantial mass loss and heat evolution of a sample at ~400oC can be attributed to the significant involvement of the direct “burn-off” reaction. Enrichment of O2 inthe reaction medium leads to the acceleration in oxygen chemi- sorption, formation and decomposition of the solid oxygenated complexes, as well as the “burn-off” reaction. With the temperature increasing, the oxidation process governed by oxygen chemisorption gradually shifts to that by significant decomposition reactions, and eventually to that by the direct “burn-off” reaction. Temperature boundaries of these stages can be determined using parameters defined based on a set of TG/DTA data. Shift in the governing reactions is essentially due to the diverse requirements of reactants of the reactions and their energy barriers to be overcome. In en- gineering practice, the phenomena of self-heating and spontaneous combustion of coal correspond to chemisorption and the direct “burn-off” reaction, respectively.

摘要： AIM:To investigate the correlation of facet joint osteoarthritis(FJOA) at lumbar levels L4/L5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS:The study involved lumbar MRIs of 591 patients with a mean age of 47.3 years.The MRIs of the lumbar spine were performed on a 1.5 Tesla scanner(Magnetom Avanto,Siemens AG,Erlangen,Germany) using a dedicated receive only spine coil.After initial blinding,each dataset was evaluated by 2 board certified radiologist with more than 5 years experience in musculoskeletal imaging.In total 2364 facet joints were graded.Degenerative changes of the facet joints were evaluated according to the 4-point scale as proposed by Weishaupt et al Functional status was assessed using the ODI.The index is scored from 0 to 100 and interpreted as follows:0%-20%,minimaldisability; 20%-40%,moderate disability; 40%-60%,severe disability; 60%-80%,crippled; 80%-100%,patients are bedbound.Spearman's coefficient of rank correlation was used for statistical analysis,with significance set at P < 0.05.RESULTS:In total 2364 facet joints at lumbar levels L4/5 and L5/S1 were analysed in 591 individuals.FJOA was present in 97%(L4/L5) and 98%(L5/S1).At level L4/5(left/right) 17/15(2.9%/2.5%) were described as grade 0,146/147(24.7%/24.9%) as grade 1,290/302(49.1%/51.1%) as grade 2 and 138/127(23.4%/21.5%) as grade 3.At level L5/S1(left/right) 10/11(1.7%/1.9%) were described as grade 0,136/136(23.0%/23.0%) as grade 1,318/325(53.8%/55.0%) as grade 2 and 127/119(21.5%/20.1%) as grade 3.Regarding the ODI scores,patients' disability had a minimum of 0% and a maximum of 91.11% with an arithmetic mean of 32.77% ± 17.02%.The majority of patients(48.39%) had moderate functional disability(21%-40%).There was no significant correlation between FJOA and ODI on both sides of lumbar level L4/5 and on the left side of lumbar level L5/S1.A weak positive correlation was evaluated between ODI and FJOA on the right side of lumbar level L5/S1.CONCLUSION:The missing correlation of FJOA and ODI confirms our clinical experience that imaging alone is an insufficient approach explaining low back pain.Clinical correlation is imperative for an adequate diagnostic advance in patients with low back pain.

摘要： Ischemic mitral regurgitation(IMR) represents a common complication after myocardial infarction. The valve is anatomically normal and the incompetence is the result of papillary muscles displacement and annular dilatation, causing leaflets tethering. Functionally the leaflets present a restricted systolic motion due to tethering forces that displaces the coaptation surface toward the left ventricle apex. The patients present poor left ventricular function at the time of surgery and the severity of the mitral regurgitation increases the risk of mortality. Currently there is general agreement to treat surgically severe IMR nevertheless strong evidences for patient with moderate insufficiency remains poor and proper treatment debated. The most effectivesurgical approach for the treatment of IMR remains debated. Some authors demonstrated that coronary artery bypass graft(CABG) alone is beneficial in patients with IMR. Conversely, in most patients, moderate IMR will persist or worsen after CABG alone which translate in higher long-term mortality as a function of residual mitral regurgitation severity. A probable reason for this unclear surgical management of functional MR is due to the contemporary suboptimal results of reparative techniques. The standard surgical treatment of chronic IMR is CABG associated with undersized annuloplasty using complete ring. Though, the recurrence of mitral regurgitation remains high(> 30%) because of continous left ventricle remodeling. To get better long term results, in the last decade, several subvalvular procedures in adjunct to mitral anuloplasty have been developed. Among them, surgical papillary muscle relocation represents the most appreciated option capable to restore normal left ventricle geometry. In the next future new preoperative predictors of increased mitral regurgitation recurrence are certainly needed to find an individual time period of treatment in each patient with moderate IMR.