Effects of testosterone replacement therapy withdrawal and re-treatment in hypogonadal elderly men upon obesity,voiding function and prostate safety parameters

Whether testosterone replacement therapy (TRT) is a lifelong treatment for men with hypogonadism remains unknown. We investigated long-term TRT and TRT withdrawal on obesity and prostate-related parameters. Two hundred and sixty-two hypogonadal patients (mean age 59.5) received testosterone undecanoate in 12-week intervals for a maximum of 11 years. One hundred and forty-seven men had TRT interrupted for a mean of 16.9 months and resumed thereafter (Group A). The remaining 115 patients were treated continuously (Group B). Prostate volume, prostate-specific antigen (PSA), residual voiding volume, bladder wall thickness, C-reactive protein (CRP), aging male symptoms (AMS), International Index of erectile function – erectile function (IIEF-EF) and International Prostate Symptoms Scores (IPSS) were measured over the study period with anthropometric parameters of obesity, including weight, body mass index (BMI) and waist circumference. Prior to interruption, TRT resulted in improvements in residual voiding volume, bladder wall thickness, CRP, AMS, IIEF-EF, IPSS and obesity parameters while PSA and prostate volume increased. TRT interruption reduced total testosterone to hypogonadal levels in Group A and resulted in worsening of obesity parameters, AMS, IPSS, residual voiding volume and bladder wall thickness, IIEF-EF and PSA while CRP and prostate volume were unchanged until treatment resumed whereby these effects were reversed. TRT interruption results in worsening of symptoms. Hypogonadism may require lifelong TRT.     

门诊医患会话打断的语用功能研究

门诊医惠交际中的言语打断是医患双方为了获得话语权而试图与对方争夺话轮的言语行为。基于小型汉语门诊医患会话语料库,对汉语门诊互动中医患会话打断现象进行研究,从打断的类型和语用功能及其在打断过程中的三个功能一向上、向下和向前运行模式进行分析,试图揭示中国门诊医患会话打断的语用策略及其功能。     

The Multiscale Importance of Road Segments in a Network Disruption Scenario: A Risk‐Based Approach

This article addresses the problem of the multiscale importance of road networks, with the aim of helping to establish a more resilient network in the event of a road disruption scenario. A new model for identifying the most important roads is described and applied on a local and regional scale. The work presented here represents a step forward, since it focuses on the interaction between identifying the most important roads in a network that connect people and health services, the specificity of the natural hazards that threaten the normal functioning of the network, and an assessment of the consequences of three real‐world interruptions from a multiscale perspective. The case studies concern three different past events: road interruptions due to a flood, a forest fire, and a mass movement. On the basis of the results obtained, it is possible to establish the roads for which risk management should be a priority. The multiscale perspective shows that in a road interruption the regional system may have the capacity to reorganize itself, although the interruption may have consequences for local dynamics. Coordination between local and regional scales is therefore important. The model proposed here allows for the scaling of emergency response facilities and human and physical resources. It represents an innovative approach to defining priorities, not only in the prevention phase but also in terms of the response to natural disasters, such as awareness of the consequences of road disruption for the rescue services sent out to local communities.     

语言接触导致汉语方言分化的两种模式

民族语言在和汉语的接触中通过两种方式影响汉语。首先是汉语民族方言通过母语干扰有规则有系统地影响汉语,导致方言的形成,其次是汉语民族方言通过母语转换变成汉语方言。对话状态是认识这两种方式的关键,汉族说民族语言和民族说汉语是不同的对话状态。通常所说的混合语往往可以通过对应语素的有阶分布确定其早期对话状态,因此很多混合语可以看成转型汉语方言。孤岛条件下的母语干扰是形成转型汉语方言的重要条件。     

Improving Catastrophe Modeling for Business Interruption Insurance Needs

While catastrophe (CAT) modeling of property damage is well developed, modeling of business interruption (BI) lags far behind. One reason is the crude nature of functional relationships in CAT models that translate property damage into BI. Another is that estimating BI losses is more complicated because it depends greatly on public and private decisions during recovery with respect to resilience tactics that dampen losses by using remaining resources more efficiently to maintain business function and to recover more quickly. This article proposes a framework for improving hazard loss estimation for BI insurance needs. Improved data collection that allows for analysis at the level of individual facilities within a company can improve matching the facilities with the effectiveness of individual forms of resilience, such as accessing inventories, relocating operations, and accelerating repair, and can therefore improve estimation accuracy. We then illustrate the difference this can make in a case study example of losses from a hurricane.     

恶意失权：取得时效的视角转换与制度矫正

恶意失权通过强调权利人知道或应当知道有权利而长期不行使,导致社会秩序形成,来解释取得时效中权利人失去权利的本质原因,并最终回归到保护权利人这一民法权利法属性对取得时效制度的要求。通过将取得时效的理论视角转换为恶意失权,可以矫正现有取得时效制度过于偏向于占有人一方的制度设计,重新构造取得时效的起算点、中止、中断等具体制度。     

三级分布式系统中间级实时通讯的实现

本文结合织机监控管理系统介绍了三级分布式系统中间级进行上下位实时通迅的方法,保证了数据传递的准确性和可靠性.     

面向关键设备维修服务的PBC合同与营业中断险集成设计模型及分析

高可用度运行是关键设备系统运营企业产生收益的根本保障。为了减小因小概率突发故障造成的严重收益损失以及可能地继发资金流风险,既要设计合理的服务合同增强对服务供应商的激励,又要同时考虑收益损失减缓策略。基于性能合同（PBC）是根据服务结果给予补偿的新兴激励合同,而购买营业中断保险（BI）是减缓关键设备故障继发资金流风险的有效策略。本文以委托-代理理论为建模框架,研究BI保险与PBC合同集成设计模型,探讨购买保险与否两种情景下的PBC合同最优设计和供应商的最优服务能力决策,分析BI保险决策对PBC合同设计方案的影响规律,调查运营商购买BI保险的决策条件。该成果是维修服务运作与金融保险领域跨界研究的首次尝试,其理论分析结果有助于为关键设备运营企业跨部门决策提供指导。     

光电信息测量瞬时速度的研究

在科学研究和工业生产中,常常需要精确测量各种物理参量。如：重量、长度、速度、角度、体积、压力、——等等。对于测量正常物体的运动速度,一般情况下比较容易求得。但是,如果是求取运动物体的瞬间速度,如抛出物体或自由落体的瞬间速度、汽车座椅受冲击时的瞬时速度等等,就比较难了。目前国内尚无此测量仪器问世。本文论述的运动物体的瞬间速度测量原理和设计制作技术,对检测物体受冲击的灵敏程度有借鉴作用。     

稀土中碳低合金耐磨铸钢的组织及性能研究

本文研究了稀士中碳低合金耐磨铸钢．在四种不同的热处理工艺条件下．显微组织结构的变化．分析讨论了热处理工艺对稀土中碳低合金耐磨铸钢的硬度、显微组织、冲击韧性的影响．结果表明．稀土的加入并配合中断正火．获得下贝氏体占较大比例的贝氏体和马氏体的复合组织．使硬度和冲击韧性达到了最佳的配合．