Pinching estimates for negatively curved manifolds with nilpotent fundamental groups

合集下载

药学英语Unit7 Text A 注释及译文

药学英语Unit7 Text A 注释及译文

Unit SevenText A BiopharmaceuticsBefore the reader can appreciate the meaning and clinical significance of biopharmaceutics, it is necessary to introduce the concept of drug bioavailability.1. appreciate [ə'pri:ʃ ieit] vt.欣赏;感激;领会;鉴别vi.增值;涨价2. bioavailability ['baiəuə,veilə'biləti] n.生物利用度;生物药效率为了使读者能够理解生物药剂学的含义和其对于药物临床应用的重要意义,有必要先给大家介绍一下药物生物利用度的概念。

BioavailabilityThe therapeutic response of a drug is normally dependent on an adequate concentration of the drug being achieved and then maintained at the site or sites of action of the drug. In the case of systemically acting drugs ( i. e. drugs that reach these sites via the systemic circulation) it is generally accepted for clinical purposes that a dynamic equilibrium exists between the concentration of drug at its site(s) of action and the concentration of drug in blood plasma. An important consequence of this dynamic equilibrium is that it permits a therapeutically effective concentration of drug to be achieved at its site(s) of action by adjustment of the concentration of drug in blood plasma. Strictly speaking, the concentration of drug in plasma water (i. e. protein-free plasma) is a more accurate index of drug concentration at the site(s) of action than the concentration of drug in whole plasma since a drug may often bind in a reversible manner to plasma protein. Only drug which is unbound (i. e. dissolved in plasma water) can pass out of the plasma through the capillary endothelium and reach other body fluids and tissues and hence its site(s) of action. Drug concentration in whole blood is also not considered to be an accurate indirect index of the concentration of drug at its site(s) of action since drug can bind to and enter blood cells. However, to measure the concentration of an unbound drug in plasma water requires more complex and sensitive assay methods than to measure the total concentration of both unbound and bound drug in total plasma. Thus, for clinical purposes, drug concentration in blood plasma is usually measured and is regarded as an index of drug concentration at the site(s) of action of the drug and of the clinicaleffects of the drug. However, it should be realized that this is a simplification and may not always be valid. Indeed one should not draw inferences about the clinical effects of a drug from its plasma concentration until it has been established that the two are consistently correlated. It has been assumed that the plasma drug concentration is directly proportional to the clinical effect of that drug.1. systemically [ sistə'mætikəli ] adv.有系统地,有组织地,有条理地,全身地systemic [si'stemik; -'sti:-] adj.系统的;体系的;全身的2. purpose ['pə:pəs] n.目的;用途;意志vt. 决心;企图;打算3. dynamic equilibrium [dai'næmik] [,i:kwi'libriəm] 动态平衡;动力平衡4. plasma ['plæzmə] n.等离子体;血浆5. reversible [ri'və:səbl] adj.可逆的;可撤消的;可反转的n. 双面布料6. capillary endothelium [kə'piləri, 'kæpi-] [,endəu'θi:liəm] 毛细血管内皮7. assay [ə'sei] n.化验;试验vt.分析;化验;尝试vi.鉴定;经检验证明内含成分8. simplification [,sɪmpləfə'keʃən] n.简单化;单纯化9. valid ['vælid] adj.有效的,有根据的;正当的10. draw inferences ['infərəns] 作出推论11. consistently [kən'sistəntli] adv.一贯地;一致地;坚实地12. proportional to [prə'pɔ:ʃənəl] 与……相称,与……成比例通常情况下,药物达到其作用部位、并维持足够的药物浓度,才能发挥疗效。

约翰斯·霍普金斯指南:抗生素指南说明书

约翰斯·霍普金斯指南:抗生素指南说明书

Nursing Central™Your complete mobile andweb solution for nursing!The Johns Hopkins Guides are a series of comprehensivereferences, created by the experts at Johns HopkinsMedicine. Each of the resources can be downloadedas a mobile app to tablets and smartphones and containfrequently updated, evidence-based recommendationsthat help raise the standard of care.Johns Hopkins ABX Guide is the#1 Ranked Infectious Disease App– Clinical Infectious DiseasesJohns Hopkins ABX GuideThe official ABX (Antibiotic) Guide contains quick-to-read,detailed coverage of infectious diseases including drugs,vaccines, specific infections, pathogens, and more.NEW! Johns Hopkins Psychiatry GuideConsult the Psychiatry Guide for disease, drug, and treatmentdetails. Review recommendations from the renowned PHIPPSClinic consistent with the latest diagnostic criteria.From the Johns Hopkins POC-IT Center. For more information go to .© 2014 Unbound Medicine, Inc. All rights reserved.Subscriptions to any of the mobile guides include web access, allowing you to find the answers you need using any web browser.The official Johns Hopkins Guides website features the same evidence-based information contained in the apps along with access to selected MEDLINEJournals, the Johns Hopkins CME program, medical news, and more.Experience the official Johns Hopkins Guides at: The Johns Hopkins POC-IT ABX GuideEditor In Chief: John G. Bartlett, MD Managing Editor: Paul G. Auwaerter, MD Pharmacology Editor: Paul Pham, PharmD, BCPSThe Johns HopkinsPOC-IT Psychiatry GuideEditors In Chief:J. Raymond DePaulo, Jr., MD O. Joseph Bienvenu, MD, PhD Managing Editors: Paul Kim, MD, PhD Paul Nestadt, MD Matthew Peters, MD Traci Speed, MD, PhDPharmacology Editor:Sujin Lee Weinstein, PharmD, BCPPThe Johns Hopkins POC-IT Diabetes GuideEditor In Chief:Rita Rastogi Kalyani, MD, MHS Co-Editor: Thomas Donner, MDThe Johns Hopkins POC-IT HIV GuideEditor In Chief: Joel E. Gallant, MD, MPH Pharmacology Editor: Paul Pham, PharmD, BCPSGroup discounts and site licenses are available.For more information: *************************1.800.230.2423。

疫苗本指南英文

疫苗本指南英文

疫苗本指南英文The COVID-19 pandemic has been a global health crisis that has impacted every aspect of our lives. As we navigate this challenging time, the development and distribution of effective vaccines have become a critical priority. This guide aims to provide a comprehensive overview of the role of vaccines in combating the pandemic and offer insights into the science, safety, and importance of vaccination.Vaccines are one of the most powerful tools we have in our fight against infectious diseases. They work by exposing the body's immune system to a weakened or inactivated form of a pathogen, allowing it to develop antibodies and build immunity without causing the full-blown illness. This process helps the body recognize and respond more quickly to the real virus or bacteria, reducing the severity of the infection and preventing the spread of the disease.The development of COVID-19 vaccines has been a remarkable scientific achievement, with multiple vaccine candidates being approved for use in record time. These vaccines have been rigorously tested for safety and efficacy, undergoing extensive clinical trials involving tens of thousands of participants. The data from these trialshas demonstrated that the approved vaccines are highly effective in preventing severe illness, hospitalization, and death caused by COVID-19.One of the key concerns surrounding vaccines is their safety. However, the COVID-19 vaccines have undergone the same rigorous safety protocols as any other vaccine, with additional monitoring and surveillance measures in place to ensure their continued safety. The benefits of the vaccines far outweigh the potential risks, which are extremely rare and well-understood.It is important to note that the COVID-19 vaccines do not contain the live virus that causes the disease. Instead, they use different approaches to stimulate the immune system, such as using messenger RNA (mRNA) or viral vector technology. These methods have been extensively studied and have a proven track record of safety and efficacy in other vaccine applications.The successful rollout of COVID-19 vaccines has been a global collaborative effort, with governments, healthcare systems, and pharmaceutical companies working together to ensure equitable access and distribution. However, the pandemic has highlighted the need for more robust global health infrastructure and the importance of investing in pandemic preparedness.As we continue to navigate the challenges posed by COVID-19, it is crucial that we all do our part in promoting vaccination. By getting vaccinated, we not only protect ourselves but also contribute to the broader effort to control the spread of the virus and protect the most vulnerable members of our communities. Vaccination is a collective responsibility, and by working together, we can overcome this pandemic and build a healthier and more resilient future.In conclusion, the COVID-19 vaccines are a testament to the power of science, innovation, and global cooperation. They offer us a path forward, a way to regain our sense of normalcy and reconnect with the people and activities we cherish. By embracing vaccination, we can not only protect ourselves but also contribute to the greater good and help create a safer, healthier world for all.。

肌松药的临床应用PPT课件

肌松药的临床应用PPT课件
Burns Trauma Closed Head Injury Intra-Abdominal Infections Renal Failure Metabolic Acidosis
Increased Intraocular Pressure Increased Intragastric Pressure
Supplemental (maintenance) doses of nondepolarizers range from 20 to 30 percent of the initial dose in the case of long-acting drugs to 35 to 50 percent of the initial dose in the case of intermediate- and short-acting relaxants
无组胺释放作用,主要经肾排泄,可 松弛迷走神经
松弛迷走神经 中度 Pancuronium, Rapacuronium 轻度 Rocuronium 无 Pipecuronium, Vecuronium
亲脂/亲水的水平决定肝脏摄取
亲脂性强Vecuronium, Rocuronium and Rapacuronium 中短效、效能低、 作用快、肝脏摄取代谢比例大, Vecuronium30~40%经肝去乙酰基代 谢
Relaxation is generally inadequate for most situations if all four responses are clearly visible or palpable during TOF monitoring
If one or two responses are visible or palpable, relaxation should be sufficient for abdominal surgery under adequate depth of anesthesia

Scaling of discrete dislocation predictions for near-threshold fatigue crack growth

Scaling of discrete dislocation predictions for near-threshold fatigue crack growth

eff (⌬Kth / E)2Ϸb, where b is the Burgers vector magnitude and E is the Young’s modulus. The normalized effective fatigue threshold ⌬Keff th / E for a variety of metallic alloys is plotted in Fig. 1 as a function of the normalized yield strength sY / E from the data in Kang et al. [7]: ⌬Keff th is seen to be reasonably independent of the yield strength over nearly two orders of magnitude variation in sY / E. A variety of continuum plasticity models have been proposed to rationalize the fatigue behavior in regimes (A) and (B). Usami and Shida [8] postulated that the fatigue threshold corresponds to a critical plastic zone size while Donahue et al. [9] proposed that the threshold for the onset of crack growth occurs when the crack tip opening displacement attains a value comparable to a critical microstructural parameter. Models for the Paris law regime include the geometric models of Laird and Smith [10] and of McClintock [11], which presume that crack growth rates are proportional to the crack tip opening displacement, and the damage accumulation models of Weertman [12] and Rice [13]. A feature of all these models is that they predict a dependence of the crack growth rates on the yield strength of the material in contrast to experimental observations. More recently, Nguyen et al.

英语作文-医学护肤品零售市场规模逐年攀升,消费者需求持续增长

英语作文-医学护肤品零售市场规模逐年攀升,消费者需求持续增长

英语作文-医学护肤品零售市场规模逐年攀升,消费者需求持续增长The retail market for medical skincare products has seen a remarkable growth trajectory over the past decade. This surge is primarily driven by a consistent increase in consumer demand, fueled by a growing awareness of skin health and the availability of advanced skincare solutions. The industry's expansion is not just a reflection of changing consumer habits but also indicative of broader trends in healthcare and wellness.In examining the factors contributing to this growth, one cannot overlook the impactof the digital revolution. The internet has democratized access to information, allowing consumers to educate themselves about skin conditions and treatment options. This empowerment has led to more informed decisions regarding skincare purchases, with a preference for products backed by scientific research and clinical trials.Moreover, the rise of social media influencers and beauty bloggers has played apivotal role in shaping consumer perceptions and demand. These online personalitiesoften share their skincare routines and product reviews, influencing their followers' purchasing decisions. The endorsement of medical-grade skincare products by dermatologists on these platforms further adds to their credibility and appeal.The aging population is another significant factor contributing to the market's growth. As people live longer, there is an increased focus on maintaining a youthful appearance, which includes investing in high-quality skincare products that promise anti-aging benefits. Products containing ingredients like retinoids, peptides, and antioxidants are particularly sought after for their proven efficacy in reducing signs of aging.In response to this growing demand, skincare companies have been expanding their product lines to include a wider range of treatments targeting various skin concerns. From acne and hyperpigmentation to rosacea and eczema, there is now a medical skincare product for nearly every condition. This specialization has not only catered to the diverse needs of consumers but also contributed to the market's overall growth.The retail landscape itself has undergone significant changes, with e-commerce becoming an increasingly popular channel for skincare purchases. The convenience of online shopping, coupled with the ability to compare products and prices, has made it a preferred option for many consumers. This shift has prompted skincare brands to invest in their online presence, optimizing their websites and leveraging digital marketing strategies to reach a broader audience.Despite the positive outlook, the medical skincare market faces challenges, such as navigating regulatory environments and addressing consumer concerns about product safety and efficacy. Companies must ensure compliance with health authorities' standards while maintaining transparency about their product formulations and benefits.In conclusion, the medical skincare retail market's growth is a multifaceted phenomenon, reflecting changes in consumer behavior, technological advancements, demographic shifts, and industry innovations. As the market continues to evolve, it presents opportunities for skincare brands to innovate and cater to the sophisticated needs of today's consumers. The focus on quality, efficacy, and consumer education will likely remain central to sustaining this growth in the years to come. 。

非典型精神病药物超适应症用药

非典型精神病药物超适应症用药

Comparative Effectiveness ReviewNumber 6Efficacy and Comparative Effectiveness of Off-Label Use of Atypical AntipsychoticsThis report is based on research conducted by the Southern California/RAND Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-02-0003). The findings and conclusions in this document are those of the author(s), who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of the Agency for Healthcare Research and Quality or of the U.S. Department of Health and Human Services.This report is intended as a reference and not as a substitute for clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information.This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.Comparative Effectiveness ReviewNumber 6Efficacy and Comparative Effectiveness ofOff-Label Use of Atypical AntipsychoticsPrepared for:Agency for Healthcare Research and QualityU.S. Department of Health and Human Services540 Gaither RoadRockville, MD 20850Contract No. 290-02-0003Prepared by:Southern California/RAND Evidence-based Practice CenterInvestigatorsPaul Shekelle, M.D., Ph.D. Lara Hilton, B.A.Director Programmer/Analyst Margaret Maglione, M.P.P. Annie Zhou, M.S.Project Manager/Policy Analyst StatisticianSteven Bagley, M.D., M.S. Susan Chen, B.A.Content Expert/Physician Reviewer Staff AssistantMarika Suttorp, M.S. Peter Glassman, M.B., B.S., M.Sc.Benefits ManagementStatistician PharmacyWalter A. Mojica, M.D., M.P.H. ExpertPhysician Reviewer Sydne Newberry, Ph.D.Jason Carter, B.A. Medical EditorCony Rolón, B.A.Literature Database ManagersAHRQ Publication No. 07-EHC003-EFJanuary 2007This document is in the public domain and may be used and reprinted without permission except those copyrighted materials noted for which further reproduction is prohibited without the specific permission of copyright holders.Suggested citation:Shekelle P, Maglione M, Bagley S, Suttorp M, Mojica WA, Carter J, Rolon C, Hilton L, Zhou A, Chen S, Glassman P. Comparative Effectiveness of Off-Label Use of Atypical Antipsychotics. Comparative Effectiveness Review No. 6. (Prepared by the Southern California/RAND Evidence-based Practice Center under Contract No. 290-02-0003.)Rockville, MD: Agency for Healthcare Research and Quality. January 2007. Available at: /reports/final.cfm.PrefaceThe Agency for Healthcare Research and Quality (AHRQ) conducts the Effective Health Care Program as part of its mission to organize knowledge and make it available to inform decisions about health care. As part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Congress directed AHRQ to conduct and support research on the comparative outcomes, clinical effectiveness, and appropriateness of pharmaceuticals, devices, and health care services to meet the needs of Medicare, Medicaid, and the State Children’s Health Insurance Program (SCHIP).AHRQ has an established network of Evidence-based Practice Centers (EPCs) that produce Evidence Reports/Technology Assessments to assist public- and private-sector organizations in their efforts to improve the quality of health care. The EPCs now lend their expertise to the Effective Health Care Program by conducting Comparative Effectiveness Reviews of medications, devices, and other relevant interventions, including strategies for how these items and services can best be organized, managed, and delivered.Systematic reviews are the building blocks underlying evidence-based practice; they focus attention on the strengths and limits of evidence from research studies about the effectiveness and safety of a clinical intervention. In the context of developing recommendations for practice, systematic reviews are useful because they define the strengths and limits of the evidence, clarifying whether assertions about the value of the intervention are based on strong evidence from clinical studies. For more information about systematic reviews, see/reference/purpose.cfm.AHRQ expects that Comparative Effectiveness Reviews will be helpful to health plans, providers, purchasers, government programs, and the health care system as a whole. In addition, AHRQ is committed to presenting information in different formats so that consumers who make decisions about their own and their family’s health can benefit from the evidence. Transparency and stakeholder input are essential to the Effective Health Care Program. Please visit the Web site () to see draft research questions and reports or to join an e-mail list to learn about new program products and opportunities for input. Comparative Effectiveness Reviews will be updated regularly.AcknowledgmentsWe would like to thank the Effective Health Care Scientific Resource Center, located at Oregon Health & Science University, for assisting in communicating with stakeholders and ensuring consistency of methods and format.We would like to acknowledge Di Valentine, J.D., Catherine Cruz, B.A., and Rena Garland, B.A., for assistance in abstraction of adverse events data.Technical Expert PanelMark S. Bauer, M.D., Brown University, Providence Veterans Affairs Medical Center, Providence, RIBarbara Curtis, R.N., M.S.N., Washington State Department of Corrections, Olympia, WACarol Eisen, L.A. County Department of Mental Health, Los Angeles, CABruce Kagan, M.D., Ph.D., UCLA Psychiatry and Biobehavioral Science – Neuropsychiatric Institute, Los Angeles, CAJamie Mai, Pharm.D., Office of the Medical Director, Tumwater, WAAlexander L. Miller, M.D., University of Texas, Department of Psychiatry, Health Science Center at San Antonio, San Antonio, TXAdelaide S. Robb, M.D., Children’s National Medical Center, Department of Psychiatry, Washington, DCCharles Schulz, M.D., University of Minnesota, Department of Psychiatry, Minneapolis, MNSarah J. Spence, M.D., Ph.D., UCLA, Autism Evaluation Clinic, Los Angeles, CA David Sultzer, M.D., UCLA and VA Greater L.A. Healthcare System, Department. of Psychiatry and Biobehavioral Sciences, Los Angeles, CAAHRQ ContactsBeth A. Collins-Sharp, Ph.D., R.N. Margaret Coopey, M.P.S., M.G.A., R.N. Director Task Order OfficerEvidence-based Practice Center Program Evidence-based Practice Center Program Center for Outcomes and Evidence Center for Outcomes and Evidence Agency for Healthcare Research and Agency for Healthcare Research and Quality Quality Rockville, MDRockville,MDContentsExecutive Summary (1)Introduction (11)Background (11)Scope and Key Questions (15)Methods (17)Topic Development (17)Search Strategy (17)Technical Expert Panel (18)Study Selection (18)Data Abstraction (18)Adverse Events (20)Quality Assessment (20)Applicability (21)Rating the Body of Evidence (21)Data Synthesis (22)Peer Review (24)Results (25)Literature Flow (25)Key Question 1: What are the leading off-label uses of antipsychotics in the literature? (28)Key Question 2: What does the evidence show regarding the effectiveness of antipsychotics for off-label indications, such as depression? How doantipsychotic medications compare with other drugs for treating off-labelindications? (28)Dementia (28)Depression (32)Obsessive-Compulsive Disorder (37)Posttraumatic Stress Disorder (40)Personality Disorders (43)Tourette’s Syndrome (47)Autism (50)Sensitivity Analysis (51)Publication Bias (51)Key Question 3: What subset of the population would potentially benefit from off-label uses? (52)Key Question 4: What are the potential adverse effects and/or complicationsinvolved with off-label antipsychotic prescribing? (52)Key Question 5: What is the appropriate dose and time limit for off-label indications? (62)Summary and Discussion (63)Limitations (63)Conclusions (64)Future Research (69)References (71)TablesTable 1. Efficacy outcomes abstracted (19)Table 2. Pooled results of placebo-controlled trials of atypical antipsychotics for patients with dementia and behavioral disturbances or agitation (29)Table 3. Trials of atypical antipsychotics as augmentation therapy for major depression (33)Table 4. Placebo-controlled trials of atypical antipsychotics as augmentation for obsessive compulsive disorder (39)Table 5. Posttraumatic Stress Disorder (42)Table 6. Personality Disorders (46)Table 7. Tourette’s Syndrome (49)Table 8. Cardiovascular adverse events among dementia patients – Atypical Antipsychotics Compared to Placebo (55)Table 9. Neurological adverse events among dementia patients – Atypical Antipsychotics Compared to Placebo (55)Table 10. Urinary adverse events among dementia patients – Atypical Antipsychotics Compared to Placebo (56)Table 11. Summary of Evidence – Efficacy (65)Table 12. Summary of adverse event and safety findings for which there is moderate or strong evidence (67)FiguresFigure 1. Literature flow (26)Figure 2. Pooled analysis of the effect of atypical antipsychotic medications versus placebo on “response” in patients with obsessive compulsive disorder (40)AppendixesAppendix A. Exact Search StringsAppendix B. Data Collection FormsAppendix C. Evidence and Quality TablesAppendix D. Excluded ArticlesAppendix E. Adverse Event AnalysisEfficacy and Comparative Effectiveness of Off-Label Use of Atypical AntipsychoticsExecutive SummaryThe Effective Health Care Program was initiated in 2005 to provide valid evidence about the comparative effectiveness of different medical interventions. The object is to help consumers, health care providers, and others in making informed choices among treatment alternatives. Through its Comparative Effectiveness Reviews, the program supports systematic appraisals of existing scientific evidence regarding treatments for high-priority health conditions. It also promotes and generates new scientific evidence by identifying gaps in existing scientific evidence and supporting new research. The program puts special emphasis on translating findings into a variety of useful formats for different stakeholders, including consumers.The full report and this summary are available at/reports/final.cfmBackgroundolanzapine, quetiapine, risperidone, and ziprasidone are atypical antipsychotics Aripiprazole,approved by the U.S. Food and Drug Administration (FDA) for treatment of schizophrenia and bipolar disorder. These drugs have been studied for off-label use in the following conditions: dementia and severe geriatric agitation, depression, obsessive-compulsive disorder, posttraumatic stress disorder, and personality disorders. The atypicals have also been studied for the management of Tourette’s syndrome and autism in children. The purpose of this report is to review the scientific evidence on the safety and effectiveness of such off-label uses.The Key Questions were:Key Question 1. What are the leading off-label uses of atypical antipsychotics in theliterature?Key Question 2. What does the evidence show regarding the effectiveness of atypicalantipsychotics for off-label indications, such as depression? How do atypical antipsychotic medications compare with other drugs for treating off-label indications?Key Question 3. What subset of the population would potentially benefit from off-label uses?Key Question 4. What are the potential adverse effects and/or complications involved with off-label prescribing of atypical antipsychotics?Key Question 5. What are the appropriate dose and time limit for off-label indications?ConclusionsEvidence on the efficacy of off-label use of atypical antipsychotics is summarized in Table A. Table B summarizes findings on adverse events and safety.Leading off-label uses of atypical antipsychotics•The most common off-label uses of atypical antipsychotics found in the literature were treatment of depression, obsessive-compulsive disorder, posttraumatic stress disorder,personality disorders, Tourette's syndrome, autism, and agitation in dementia. In October 2006, the FDA approved risperidone for the treatment of autism.Effectiveness and comparison with other drugsDementia-agitation and behavioral disorders• A recent meta-analysis of 15 placebo-controlled trials found a small but statistically significant benefit for risperidone and aripiprazole on agitation and psychosis outcomes.The clinical benefits must be balanced against side effects and potential harms. See“Potential adverse effects and complications” section.•Evidence from this meta-analysis shows a trend toward effectiveness of olanzapine for psychosis; results did not reach statistical significance. The authors found three studies of quetiapine; they were too dissimilar in their design and the outcomes studied to pool.• A large head-to-head placebo controlled trial (Clinical Antipsychotic Trials of Intervention Effectiveness-Alzheimer’s Disease; CATIE-AD) concluded there were nodifferences in time to discontinuation of medication between risperidone, olanzapine,quetiapine, and placebo. Efficacy outcomes favored risperidone and olanzapine, andtolerability outcomes favored quetiapine and placebo.•We found no studies of ziprasidone for treatment of agitation and behavioral disorders in patients with dementia.•Strength of evidence = moderate for risperidone, olanzapine, and quetiapine; low for aripiprazole.Depression•We identified seven trials where atypical antipsychotics were used to augment serotonin reuptake inhibitor (SRI) treatment in patients with initial poor response to therapy, twostudies in patients with depression with psychotic features, and four trials in patients with depression with bipolar disorder.•For SRI-resistant patients with major depressive disorder, combination therapy with an atypical antipsychotic plus an SRI antidepressant is not more effective than an SRI alone at 8 weeks.•In two trials enrolling patients with major depressive disorder with psychotic features, olanzapine and olanzapine plus fluoxetine were compared with placebo for 8 weeks.Neither trial indicated a benefit for olanzapine alone. In one trial, the combination group had significantly better outcomes than placebo or olanzapine alone, but the contribution of olanzapine cannot be determined, as the trial lacked a fluoxetine-only comparison arm.•For bipolar depression, olanzapine and quetiapine were superior to placebo in one study for each drug, but data are conflicting in two other studies that compared atypicalantipsychotics to conventional treatment.•We found no studies of aripiprazole for depression.•Strength of evidence = moderate strength of evidence that olanzapine, whether used as monotherapy or augmentation, does not improve outcomes at 8 weeks in SRI-resistantdepression; low strength of evidence for all atypical antipsychotics for other depression indications due to small studies, inconsistent findings, or lack of comparisons to usualtreatment.Obsessive-compulsive disorder (OCD)•We identified 12 trials of risperidone, olanzapine, and quetiapine used as augmentation therapy in patients with OCD who were resistant to standard treatment.•Nine trials were sufficiently similar clinically to pool. Atypical antipsychotics have a clinically important benefit (measured by the Yale-Brown Obsessive-Compulsive Scale) when used as augmentation therapy for patients who fail to adequately respond to SRItherapy. Overall, patients taking atypical antipsychotics were 2.66 times as likely to“respond” as placebo patients (95-percent confidence interval (CI): 1.75 to 4.03).Relative risk of “responding” was 2.74 (95-percent CI: 1.50 to 5.01) for augmentationwith quetiapine and 5.45 (95-percent CI: 1.73 to 17.20) for augmentation withrisperidone. There were too few studies of olanzapine augmentation to permit separatepooling of this drug.•We found no trials of ziprasidone or aripiprazole for obsessive-compulsive disorder.•Strength of evidence = moderate for risperidone and quetiapine; low for olanzapine due to sparse and inconsistent results.Posttraumatic stress disorder (PTSD)•We found four trials of risperidone and two trials of olanzapine of at least 6 weeks duration in patients with PTSD.•There were three trials enrolling men with combat-related PTSD; these showed a benefit in sleep quality, depression, anxiety, and overall symptoms when risperidone orolanzapine was used to augment therapy with antidepressants or other psychotropicmedication.•There were three trials of olanzapine or risperidone as monotherapy for women with PTSD; the evidence was inconclusive regarding efficacy.•We found no studies of quetiapine, ziprasidone, or aripiprazole for PTSD.•Strength of evidence = low for risperidone and olanzapine for combat-related PTSD due to sparse data; very low for risperidone or olanzapine for treating non-combat-relatedPTSD.Personality disorders•We identified five trials of atypical antipsychotic medications as treatment for borderline personality disorder and one trial as treatment for schizotypal personality disorder.•Three randomized controlled trials (RCTs), each with no more than 60 subjects, provide evidence that olanzapine is more effective than placebo and may be more effective than fluoxetine in treating borderline personality disorder.•The benefit of adding olanzapine to dialectical therapy for borderline personality disorder was small.•Olanzapine caused significant weight gain in all studies.•Risperidone was more effective than placebo for the treatment of schizotypal personality disorder in one small 9-week trial.•Aripiprazole was more effective than placebo for the treatment of borderline personality in one small 8-week trial.•We found no studies of quetiapine or ziprasidone for personality disorders.•Strength of evidence = very low due to small effects, small size of studies, and limitations of trial quality (e.g., high loss to followup).Tourette’s syndrome•We found four trials of risperidone and one of ziprasidone for treatment of Tourette’s syndrome.•Risperidone was more effective than placebo in one small trial, and it was at least as effective as pimozide or clonidine for 8 to 12 weeks of therapy in the three remainingtrials.•The one available study of ziprasidone showed variable effectiveness compared to placebo.•We found no studies of olanzapine, quetiapine, or aripiprazole for Tourette’s syndrome.•Strength of evidence = low for risperidone; very low for ziprasidone.Autism•Just before this report was published, the FDA approved risperidone for use in autism.•Two trials of 8 weeks duration support the superiority of risperidone over placebo in improving serious behavioral problems in children with autism. The first trial showed agreater effect for risperidone than placebo (57-percent decrease vs. 14-percent decrease in the irritability subscale of the Aberrant Behavior Checklist). In the second trial, morerisperidone-treated than placebo-treated children improved on that subscale (65 percentvs. 31 percent).•We found no trials of olanzapine, quetiapine, ziprasidone, or aripiprazole for this indication.•Strength of evidence = low.Population that would benefit most from atypical antipsychotics •There was insufficient information to answer this question. It is included as a topic for future research.Potential adverse effects and complications•There is high-quality evidence that olanzapine patients are more likely to report weight gain than those taking placebo, other atypical antipsychotics, or conventionalantipsychotics. In two pooled RCTs of dementia patients, olanzapine users were 6.12times more likely to report weight gain than placebo users. In a head-to-head trial ofdementia patients, olanzapine users were 2.98 times more likely to gain weight thanrisperidone patients. In the CATIE trial, elderly patients with dementia who were treatedwith olanzapine, quetiapine, or risperidone averaged a monthly weight gain of 1.0, 0.7, and 0.4 pounds while on treatment, compared to a weight loss among placebo-treated patients of 0.9 pounds per month. Even greater weight gain relative to placebo has been reported in trials of non-elderly adults.•In two pooled RCTs for depression with psychotic features, olanzapine patients were 2.59 times as likely as those taking conventional antipsychotics to report weight gain.•In a recently published meta-analysis of 15 dementia treatment trials, death occurred in3.5 percent of patients randomized to receive atypical antipsychotics vs. 2.3 percent ofpatients randomized to receive placebo. The odds ratio for death was 1.54, with a 95-percent CI of 1.06 to 2.23. The difference in risk for death was small but statistically significant. Sensitivity analyses did not show evidence for differential risks forindividual atypical antipsychotics. Recent data from the DEcIDE (Developing Evidence to Inform Decisions about Effectiveness) Network suggest that conventionalantipsychotics are also associated with an increased risk of death in elderly patients with dementia, compared to placebo.•In another recently published meta-analysis of six trials of olanzapine in dementia patients, differences in mortality between olanzapine and risperidone were notstatistically significant, nor were differences between olanzapine and conventionalantipsychotics.•In our pooled analysis of three RCTs of elderly patients with dementia, risperidone was associated with increased odds of cerebrovascular accident compared to placebo (odds ratio (OR): 3.88; 95-percent CI: 1.49 to 11.91). This risk was equivalent to 1 additional stroke for every 31 patients treated in this patient population (i.e., number needed to harm of 31). The manufacturers of risperidone pooled four RCTs and found thatcerebrovascular adverse events were twice as common in dementia patients treated with risperidone as in the placebo patients.•In a separate industry-sponsored analysis of five RCTs of olanzapine in elderly dementia patients, the incidence of cerebrovascular adverse events was three times higher inolanzapine patients than in placebo patients.•We pooled three aripiprazole trials and four risperidone trials that reported extrapyramidal side effects (EPS) in elderly dementia patients. Both drugs wereassociated with an increase in EPS (OR: 2.53 and 2.82, respectively) compared toplacebo. The number needed to harm was 16 for aripiprazole and 13 for risperidone.•Ziprasidone was associated with an increase in EPS when compared to placebo in a pooled analysis of adults with depression, PTSD, or personality disorders (OR: 3.32; 95-percent CI: 1.12 to 13.41).•In the CATIE trial, risperidone, quetiapine, and olanzapine were each more likely to cause sedation than placebo (15-24 percent vs. 5 percent), while olanzapine andrisperidone were more likely to cause extrapyramidal signs than quetiapine or placebo(12 percent vs. 1-2 percent). Cognitive disturbance and psychotic symptoms were morecommon in olanzapine-treated patients than in the other groups (5 percent vs. 0-1percent).•There is insufficient evidence to compare atypical with conventional antipsychotics regarding EPS or tardive dyskinesia in patients with off-label indications.•Risperidone was associated with increased weight gain compared to placebo in our pooled analyses of three trials in children/adolescents. Mean weight gain in therisperidone groups ranged from 2.1 kg to 3.9 kg per study. Odds were also higher forgastrointestinal problems, increased salivation, fatigue, EPS, and sedation among theseyoung risperidone patients.•Compared to placebo, all atypicals were associated with sedation in multiple pooled analyses for all psychiatric conditions studied.Appropriate dose and time limit•There was insufficient information to answer this question. It is a topic for future research.Remaining IssuesMore research about how to safely treat agitation in dementia is urgently needed. The CATIE-AD study has substantially added to our knowledge, but more information is still necessary. We make this statement based on the prevalence of the condition and uncertainty about the balance between risks and benefits in these patients. While the increased risk of death in elderly dementia patients treated with atypical antipsychotics was small, the demonstrable benefits in the RCTs were also small. Information is needed on how the risk compares to risks for other treatments.An established framework for evaluating the relevance, generalizability, and applicability of research includes assessing the participation rate, intended target population, representativeness of the setting, and representativeness of the individuals, along with information about implementation and assessment of outcomes. As these data are reported rarely in the studies we reviewed, conclusions about applicability are necessarily weak. In many cases, enrollment criteria for these trials were highly selective (for example, requiring an open-label run-in period). Such highly selective criteria may increase the likelihood of benefit and decrease the likelihood of adverse events. At best, we judge these results to be only modestly applicable to the patients seen in typical office-based care.With few exceptions, there is insufficient high-grade evidence to reach conclusions about the efficacy of atypical antipsychotic medications for any of the off-label indications, either vs. placebo or vs. active therapy.More head-to-head trials comparing atypical antipsychotics are needed for off-label indications other than dementia.IntroductionBackgroundAntipsychotic medications, widely used for the treatment of schizophrenia and other psychotic disorders, are commonly divided into two classes, reflecting two waves of historical development. The conventional antipsychotics--also called typical antipsychotics, conventional neuroleptics, or dopamine antagonists--first appeared in the 1950s and continued to evolve over subsequent decades, starting with chlorpromazine (Thorazine), and were the first successful pharmacologic treatment for primary psychotic disorders, such as schizophrenia. While they provide treatment for psychotic symptoms - for example reducing the intensity and frequency of auditory hallucinations and delusional beliefs - they also commonly produce movement abnormalities, both acutely and during chronic treatment, arising from the drugs’ effects on the neurotransmitter dopamine. These side effects often require additional medications, and in some cases, necessitate antipsychotic dose reduction or discontinuation. Such motor system problems spurred the development of the second generation of antipsychotics, which have come to be known as the “atypical antipsychotics.”Currently, the U.S. Food and Drug Administration (FDA)-approved atypical antipsychotics are aripiprazole, clozapine, olanzapine, quetiapine, risperidone, and ziprasidone. Off-label use of the atypical antipsychotics has been reported for the following conditions: dementia and severe geriatric agitation, depression, obsessive-compulsive disorder, posttraumatic stress disorder, and personality disorders. The purpose of this Evidence Report is to review the evidence supporting such off-label uses of these agents. We were also asked to study the use of the atypical antipsychotics for the management of Tourette’s Syndrome and autism in children. The medications considered in this report are those listed above; however, we have excluded clozapine, which has been associated with a potentially fatal disorder of bone-marrow suppression and requires frequent blood tests for safety monitoring. Because of these restrictions, it is rarely used except for schizophrenia that has proven refractive to other treatment. Dementia and Severe Geriatric AgitationDementia is a disorder of acquired deficits in more than one domain of cognitive functioning. These domains are memory, language production and understanding, naming and recognition, skilled motor activity, and planning and executive functioning. The most common dementias – Alzheimer’s and vascular dementia - are distinguished by their cause. Alzheimer’s dementia occurs with an insidious onset and continues on a degenerative course to death after 8 to10 years; the intervening years are marked by significant disturbances of cognitive functioning and behavior, with severe debilitation in the ability to provide self-care. Vascular dementia refers to deficits of cognitive functioning that occur following either a cerebrovascular event – a stroke – leading to a macrovascular dementia, or, alternatively, more diffusely located changes in the smaller blood vessels, leading to a microvascular dementia. These (and other) dementia types commonly co-occur. Psychotic symptoms are frequent among dementia patients and include。

治疗疾病和疼痛英语作文

治疗疾病和疼痛英语作文

In the realm of medical science,the treatment of diseases and pain has always been a central focus.The goal is to alleviate the suffering of patients and improve their quality of life.Heres a detailed essay on the subject:Title:The Treatment of Diseases and PainIntroductionDiseases and pain are inevitable aspects of human life.They can range from minor discomforts to lifethreatening conditions.The medical field has made significant strides in understanding and treating various ailments,aiming to reduce the impact of these health issues on individuals and society.DiagnosisThe first step in treating any disease or pain is accurate diagnosis.Modern medicine utilizes a variety of diagnostic tools and techniques,such as blood tests,imaging studies like Xrays,MRI,and CT scans,and biopsies,to identify the root cause of a patients symptoms.Early and precise diagnosis is crucial for effective treatment. Pharmacological TreatmentsMedications are a primary method for treating diseases and managing pain. Pharmaceuticals can be classified into various categories,including analgesics for pain relief,antibiotics for bacterial infections,antivirals for viral infections,and chemotherapy drugs for cancer treatment.The development of new drugs is an ongoing process,with researchers constantly seeking more effective and less harmful treatments.Surgical InterventionsIn some cases,diseases or conditions that cause pain may require surgical intervention. Surgeons use various techniques to remove,repair,or replace damaged tissues and organs. Advances in surgical technology,such as minimally invasive procedures and robotic surgery,have improved patient outcomes and reduced recovery times.Physical Therapy and RehabilitationFor patients recovering from injuries or surgeries,or those living with chronic pain, physical therapy and rehabilitation play a vital role.These treatments help restore function,improve mobility,and manage pain through exercises,stretches,and othertherapeutic activities.Complementary and Alternative Medicine CAMIn addition to conventional treatments,many patients seek complementary and alternative medicine for pain management and disease treatment.This includes practices such as acupuncture,massage therapy,herbal medicine,and meditation.While the efficacy of these treatments can vary,they are often used in conjunction with traditional medical care to enhance overall wellbeing.Pain ManagementPain management is a specialized field focusing on the relief of pain and improvement of a patients functional capacity.It involves a multidisciplinary approach,combining pharmacological,interventional,and nonpharmacological methods tailored to the individuals needs.Preventive MeasuresPrevention is a key aspect of reducing the incidence of diseases and the associated pain. This includes vaccination programs,public health initiatives,and individual lifestyle choices such as a balanced diet,regular exercise,and avoiding harmful behaviors like smoking and excessive alcohol consumption.ConclusionThe treatment of diseases and pain is a complex and evolving field.It requires a combination of medical expertise,technological advancements,and patientcentered care. As our understanding of the human body and the causes of diseases continues to grow,so too does our ability to provide effective treatments that improve the lives of those affected by illness and pain.。

当代研究生英语 第七单元 B课文翻译

当代研究生英语 第七单元 B课文翻译

价格的利润生物公司正在吞噬可改变动物DNA序列的所有专利。

这是对阻碍医学研究发展的一种冲击。

木匠认为他们的贸易工具是理所当然的。

他们买木材和锤子后,他们可以使用木材和锤子去制作任何他们所选择的东西。

多年之后来自木材厂和工具储藏室的人并没有任何进展,也没有索要利润份额。

对于那些打造明日药物的科学家们来说,这种独立性是一种罕见的奢侈品。

发展或是发现这些生物技术贸易中的工具和稀有材料的公司,对那些其他也用这些工具和材料的人进行了严格的监控。

这些工具包括关键基因的DNA序列,人类、动物植物和一些病毒的基因的部分片段,例如,HIV,克隆细胞,酶,删除基因和用于快速扫描DNA样品的DNA 芯片。

为了将他们这些关键的资源得到手,医学研究人员进场不得不签署协议,这些协议可以制约他们如何使用这些资源或是保证发现这些的公司可以得到最终结果中的部分利益。

许多学者称这抑制了了解和治愈疾病的进程。

这些建议使Harold得到了警示,Harold是华盛顿附近的美国国家卫生研究院的院长,在同年早期,他建立了一个工作小组去调查此事。

由于他的提早的调查,下个月出就能发布初步的报告。

来自安阿伯密歇根大学的法律教授,该工作组的主席Rebecea Eisenberg说,她们的工作组已经听到了好多研究者的抱怨,在它们中有一份由美国联合大学技术管理组提交的重量级的卷宗。

为了帮助收集证据,NIH建立了一个网站,在这个网站上研究者们可以匿名举报一些案件,这些案件他们相信他们的工作已经被这些限制性许可证严重阻碍了。

迫使研究人员在出版之前需要将他们的手稿展示给公司的这一保密条款和协议是投诉中最常见的原因之一。

另一个问题是一些公司坚持保有自动许可证的权利,该许可证是有关利用他们物质所生产的任何未来将被发现的产品,并且这些赋予他们对任何利用他们的工具所赚取的利润的支配权利的条款也有保有的权利。

Eisenberg说:“如果你不得不签署了许多这样的条款的话,那真的是一个大麻烦”。

吃肉多易患糖尿病 少吃酸性食物

吃肉多易患糖尿病 少吃酸性食物

英国《每日邮报》报道,法国的一项最新研究发现,肉、奶酪及其他“酸性饮食”中的某些成分与2型糖尿病关系密切。

与吃酸性食物最少的女性相比,吃酸性食物多的女性糖尿病发病率高出56%。

新研究中,法国国家健康与医学研究院科学家对6.6万余名女性参试者的饮食与健康进行了为期14年的跟踪研究。

研究结束时,共有1372名女性参试者确诊患有糖尿病,爱吃酸性饮食的女性糖尿病危险更大。

这些酸性食物包括肉类、奶酪、面包和软饮料等。

酸性较少的食物包括:咖啡、水果和蔬菜。

另外,虽然橙子和柠檬吃起来感觉很酸,但消化之后,在体内却可以降低酸度。

另外,桃、苹果、梨、香蕉等大多数水果都具有降酸功效。

科学家分析指出,爱吃肉食等酸性食物会增加糖尿病风险,即使多吃水果和蔬菜也不能完全抵消这种负面影响。

酸性食物进入人体会导致酸的积累,这些酸会阻碍人体将食物中的糖转化为能量,因而大大增加罹患糖尿病的几率。

British "Daily Mail" reported, a new study found that some components ofFrance,meat, cheese and other "acid diet" in close relationship with type 2pared with the fewest women eating acidic foods, eat acidic food many women the incidence of diabetes is higher than 56%.In the new study, the French National Institute of health and medical researchscientists trying to diet and health were tracked for a period of 14 years to more than 6.6 women. At the end of the study, a total of 1372 women participants diagnosed with diabetes, eating acidic food diabetic women greater danger. These acidic foodsincluding meat, cheese, bread and soft drinks. Acid less food includes: Coffee, fruits and vegetables. In addition, although the oranges and lemons tastes verysour, butdigested, in vivo can reduce the acidity. Inaddition, peach, apple, pear, banana, most fruits are acid reduction effect.Scientists pointed out , to eat carnivorous and other acidic foods will increase the risk of diabetes, even to eat more fruit and vegetables can not be completely offsetthe negative effect. Acidic food enters the human body will leadto accumulation of acid, the acid would hinder the body will be food in the sugar into energy, thus greatlyincreases the risk of diabetes.。

新冠疫苗针次 专业英语

新冠疫苗针次 专业英语

新冠疫苗针次专业英语**English Content:**The COVID-19 pandemic has brought about a global health crisis, and the race to develop a vaccine has been a race against time. The success of this race has resulted in the development of several vaccines, with varying requirements for the number of doses needed to achieve optimal immunity. Understanding the terminology and concepts related to COVID-19 vaccine doses is crucial for effective communication and informed decision-making.**1. Types of COVID-19 Vaccines*** **mRNA Vaccines (e.g., Pfizer-BioNTech, Moderna):** These vaccines use messenger RNA (mRNA) to instruct our cells to make a piece of the virus's spike protein. Our immune system recognizes this protein and learns to attack the real virus if it later infects us. Both Pfizer-BioNTech and Moderna vaccines require two doses for full immunization. * **Vector Vaccines (e.g., AstraZeneca, Johnson & Johnson):** These vaccines use a harmless virus to deliver genetic material from the COVID-19 virus intoour cells. The cells then produce the virus's spike protein, stimulating an immune response. The AstraZeneca vaccine typically requires two doses, while the Johnson & Johnson vaccine is a single-dose vaccine. * **Protein Subunit Vaccines (e.g., Novavax):** These vaccines contain onlypart of the COVID-19 virus (the spike protein) that hasbeen made in a laboratory. Our immune system learns to recognize and attack this protein. The Novavax vaccine requires two doses for optimal protection.**2. Importance of Completing the Vaccine Course**It is crucial to complete the recommended doses of the COVID-19 vaccine to achieve the desired level of immunity. Skipping doses or delaying the second dose can reduce the vaccine's effectiveness and increase the risk of infection. **3. Terminology Related to Vaccine Doses*** **Primary Series:** Refers to the initial set ofdoses required to achieve basic immunity against the virus. For most vaccines, this involves two doses. * **Booster Dose:** An additional dose given to individuals who have already completed the primary series to boost their immune response and extend vaccine protection. * **IntervalBetween Doses:** The recommended time period between two doses of a vaccine. For some vaccines, this may be a few weeks, while for others, it may be several months.**4. Considerations for Vaccine Administration**When administering COVID-19 vaccines, it is important to consider factors such as age, health conditions, and previous exposure to the virus. Some vaccines may not be suitable for certain individuals due to these factors. Itis crucial to consult with a healthcare provider before getting vaccinated.In conclusion, understanding the terminology and concepts related to COVID-19 vaccine doses is essential for informed decision-making and effective communication. As the global rollout of vaccines continues, it is important to stay updated on the latest recommendations and guidelines to ensure the safety and effectiveness of the vaccination process.**Chinese Content:**新冠疫苗针次的专业英语解析新冠疫苗的研发是一场与时间赛跑的全球健康危机。

世界卫生组织儿童标准处方集

世界卫生组织儿童标准处方集

WHO Model Formulary for ChildrenBased on the Second Model List of Essential Medicines for Children 2009世界卫生组织儿童标准处方集基于2009年儿童基本用药的第二个标准目录WHO Library Cataloguing-in-Publication Data:WHO model formulary for children 2010.Based on the second model list of essential medicines for children 2009.1.Essential drugs.2.Formularies.3.Pharmaceutical preparations.4.Child.5.Drug utilization. I.World Health Organization.ISBN 978 92 4 159932 0 (NLM classification: QV 55)世界卫生组织实验室出版数据目录:世界卫生组织儿童标准处方集基于2009年儿童基本用药的第二个标准处方集1.基本药物 2.处方一览表 3.药品制备 4儿童 5.药物ISBN 978 92 4 159932 0 (美国国立医学图书馆分类:QV55)World Health Organization 2010All rights reserved. Publications of the World Health Organization can be obtained fromWHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: ******************). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the aboveaddress(fax:+41227914806;e-mail:*******************).世界卫生组织2010版权所有。

压力限制肿瘤增长翻译 中英

压力限制肿瘤增长翻译 中英

最后译文:压力限制肿瘤生长法国物理学家发现了简单的力压在医学上可应用于降低肿瘤的生长速度并限制其生长大小。

通过使用老鼠细胞来完成这项工作的研究者说这个结果可以引生出更好的癌症诊断工具并很可能最终实现用药物治疗癌症。

众所周知当生长细胞中的DNA发生突变时就会形成肿瘤并发展为癌症, .但是这种发展是如何受到肿瘤周围环境的影响仍是一个需要讨论的课题。

由巴黎居里学院的让.弗朗斯科乔尼和其他一些院校进行了一项新的调查,研究肿瘤的生长是如何受到它所经受的压力的限制的,如同按压周围的健康组织一样。

很难把基因学、生物化学和力学在生物机体内的肿瘤中所扮演的角色分离出来。

为了解释这一问题,乔尼的团队用老鼠细胞中的一个直径十余毫米的类似肿瘤的球在实验台上进行了这项工作,工作者们把这个模拟肿瘤放入一个由半渗透聚合物制成的几毫米长的袋子中,这之后就进入到一个滋生细胞的包含营养物的研究方案中。

肿瘤在这种自由的状态下会继续生长两周或者三周, 直到达到细胞的死亡和分裂刚好平衡的稳态。

糖分的严厉打击为了找出在这个生长过程中是什么影响到了压力, 小组在此方案中加入了很多糖分这些糖分由于颗粒太大而无法穿过袋子的微小孔洞所以仍在袋子外面,造成了一种浓度的不平衡,而使其迫切的要解决掉袋子外的溶液以努力恢复其浓度的平衡,袋子外较大浓度的溶液随即对袋子产生了力度的压迫,并且这种压迫被里面的肿瘤所感应到。

这种方法被重复用于同样的肿瘤上,每个不同袋子中的肿瘤被不同浓度的糖分溶液所浸透,因此揭示出每个肿瘤都受到了不同的压力。

该小组发现压力越大,肿瘤生长越慢并且最终尺寸越小。

比如施加500帕的压力,仅仅百分之两点五的气压),便可将肿瘤的增长率和稳态量减半。

为了精准地确立压力是如何减弱增长的,乔恩和他的同事将肿瘤冰冻起来,将其切成非常薄的薄片,.并在薄片上覆盖两种抗体,这个方法显示出了在每个肿瘤上已死亡而被分离的细胞----这两种细胞发出的荧光波长不同-。

临床试验状态 英语

临床试验状态 英语

临床试验状态英语The clinical trial is currently in the recruitment phase, actively seeking volunteers who meet the eligibility criteria. The researchers are hopeful to have a diverse pool of participants to ensure the results are as accurate and representative as possible.The status of the clinical trial is exciting as we're moving into the next phase. Soon, the first set of participants will start receiving the treatment, and we're all eager to see how it progresses.You know, keeping track of the clinical trial status is crucial. The team meets regularly to discuss any updates, challenges, or progress made. We want to ensure everything is running smoothly.The participants in the clinical trial are being monitored closely. Their health and well-being are our top priority. Regular check-ups and assessments are beingconducted to ensure the treatment is safe and effective.It's always a bit nerve-wracking waiting for theresults of a clinical trial, but we're confident in the research team and the protocol. We're hoping for positive outcomes that could potentially benefit many in the future.The clinical trial is now in its final stages, andwe're analyzing the data collected. It's a crucial time as we work to interpret the results.。

疫苗接种有望吗英文作文

疫苗接种有望吗英文作文

疫苗接种有望吗英文作文英文:Is there hope for vaccine deployment? Absolutely! The ongoing efforts in vaccine development and distribution globally are indeed promising. Let's dive into the reasons behind this optimism.Firstly, the rapid advancement in vaccine technology has been astounding. Scientists have been able to develop vaccines against COVID-19 in record time, thanks to advancements in mRNA and vector-based vaccine platforms. For instance, vaccines like Pfizer-BioNTech and Moderna have demonstrated high efficacy rates in clinical trials, offering significant protection against the virus.Secondly, the collaboration between governments, pharmaceutical companies, and research institutions has been unprecedented. This cooperation has accelerated vaccine production and distribution processes, ensuringthat doses reach those in need across the globe. Countries have come together to share resources, knowledge, and manufacturing capabilities to ramp up vaccine production and address supply chain challenges.Furthermore, the successful vaccination campaigns in many countries provide tangible evidence of progress. Millions of people have already received their vaccine doses, leading to a decline in COVID-19 cases and a gradual return to normalcy. This success encourages others to get vaccinated, contributing to herd immunity and ultimately controlling the spread of the virus.Moreover, ongoing research and development efforts are focused on addressing emerging variants of the virus. Scientists are closely monitoring the evolution of thevirus and adapting vaccines accordingly to ensure continued effectiveness. This proactive approach demonstrates our commitment to staying ahead of the virus and safeguarding public health.In conclusion, the prospects for vaccine deployment arebright. With continued scientific innovation, collaboration, and global solidarity, we are well-positioned to overcomethe challenges posed by the pandemic. Vaccination remains our most powerful tool in the fight against COVID-19, and I am optimistic about the future.中文:疫苗接种有望吗?当然有!全球疫苗研发和分发的持续努力确实令人鼓舞。

关于安慰剂变更规格的情况说明范文

关于安慰剂变更规格的情况说明范文

关于安慰剂变更规格的情况说明范文英文回答:Placebo is a substance or treatment that has no therapeutic effect, but is given to patients with the intention of providing psychological or physiological benefits. Placebo changes in specifications refer to modifications made to the appearance or composition of the placebo, while maintaining its inert nature. This can be done for various reasons, such as improving patient compliance, reducing side effects, or enhancing the placebo effect.One example of placebo specification change is the useof different colors or shapes for placebo pills. Studies have shown that the color and shape of a pill can influence patients' perception of its effectiveness. For example, a red pill may be perceived as more stimulating or energizing, while a blue pill may be seen as more calming or sedating. By changing the color or shape of the placebo, researcherscan manipulate patients' expectations and potentially enhance the placebo effect.Another example of placebo specification change is the addition or removal of inactive ingredients. Placebos are often made of sugar or other inert substances, but they can also contain inactive ingredients such as food coloring or flavorings. These additional ingredients can influence patients' perception of the placebo and may contribute to the placebo effect. For example, a placebo with a sweet taste may be perceived as more effective in relieving pain than a tasteless placebo. By modifying the inactive ingredients, researchers can manipulate patients' expectations and potentially enhance the placebo effect.In addition to color, shape, and inactive ingredients, placebo specification changes can also involve modifications to the packaging or administration of the placebo. For example, a placebo may be packaged in a fancy box or labeled with a brand name, creating the perception of a high-quality or expensive treatment. Alternatively, a placebo may be administered through a more invasive orcomplex procedure, leading patients to believe that it is a potent intervention. These changes can influence patients' expectations and enhance the placebo effect.Overall, placebo specification changes are a means of harnessing the power of patients' expectations and beliefsto improve their outcomes. By manipulating the appearance, composition, packaging, or administration of the placebo, researchers can enhance the placebo effect and potentially provide greater relief or improvement for patients.中文回答:安慰剂是指一种没有治疗效果的物质或治疗方法,但是给予患者的目的是提供心理或生理上的益处。

处方药价格英语作文

处方药价格英语作文

处方药价格英语作文Prescription Drug Prices。

Prescription drug prices have been a hot topic in recent years. The cost of medication has risen significantly, leaving many people struggling to afford the drugs they need. This issue affects not only individuals but also the healthcare system as a whole. In this essay, I will explore the reasons behind the high prices of prescription drugs and the potential solutions to this problem.There are several factors that contribute to the high cost of prescription drugs. One of the main reasons is the research and development costs. Pharmaceutical companies spend billions of dollars on developing new drugs, and they need to recoup these costs through high prices. Additionally, the cost of marketing and advertising also adds to the price of drugs. Pharmaceutical companies spend a lot of money on promoting their products to healthcareproviders and consumers.Another factor that drives up the prices ofprescription drugs is the lack of competition. Many drugs have patents that protect them from generic competition, allowing the manufacturers to charge high prices. Even when the patents expire, the generic drug manufacturers may face obstacles in bringing their products to market, such as the lengthy FDA approval process.The high prices of prescription drugs have serious consequences for patients and the healthcare system. Many people cannot afford to pay for their medications, leading to non-adherence and worse health outcomes. This, in turn, leads to increased healthcare costs, as patients end up in the hospital or emergency room.So, what can be done to address this problem? One potential solution is to increase competition. The government could implement policies to make it easier for generic drug manufacturers to bring their products to market. Another solution is to negotiate drug prices withpharmaceutical companies. This approach has been successful in other countries, such as Canada, where the government negotiates drug prices on behalf of its citizens.In conclusion, the high prices of prescription drugs are a complex issue with no easy solutions. However, it is clear that action needs to be taken to ensure that patients can afford the medications they need. By increasing competition and negotiating drug prices, we can make healthcare more affordable and accessible for everyone.。

科学展新姿的英语作文

科学展新姿的英语作文

Science has always been a driving force for human progress,and in recent years,it has taken on a new posture that is more dynamic and influential than ever before.The advancements in various fields of science have not only revolutionized the way we live but have also opened up new avenues for exploration and understanding of the world around us.Innovations in Technology:The most striking aspect of the new posture of science is the rapid pace of technological innovation.From smartphones to artificial intelligence,the integration of technology in our daily lives has become seamless.The development of the Internet of Things IoT has connected everyday objects,allowing for smarter homes and cities.Autonomous vehicles are on the horizon,promising to transform transportation and reduce accidents caused by human error.Advancements in Medicine:Another significant area where science has taken on a new form is in medical research. Breakthroughs in genomics have led to personalized medicine,where treatments are tailored to an individuals genetic makeup.The use of CRISPRCas9for gene editing has opened up possibilities for curing genetic disorders and improving crop resistance to diseases.Environmental Science:Environmental science has gained prominence as the world faces the challenges of climate change.The new posture of science in this field includes a focus on sustainable practices,renewable energy sources,and the development of technologies to reduce carbon footprints.Solar and wind energy are becoming more efficient and affordable, leading to a shift away from fossil fuels.Space Exploration:The exploration of space has always been a frontier for scientific discovery.Today,with private companies like SpaceX and Blue Origin entering the arena,the pace of exploration has accelerated.The goal of colonizing Mars and the establishment of a lunar base are now more than just science fiction they are part of a tangible scientific vision for the future.Education and Accessibility:Science is no longer confined to laboratories and academic institutions.The advent of online platforms and opensource projects has democratized access to scientific knowledge.People from all walks of life can now participate in scientific discussions, contribute to research,and learn about the latest discoveries at their fingertips.Ethical Considerations:As science takes on this new posture,it also brings with it ethical considerations.The power to edit genes,the potential misuse of AI,and the environmental impact of new technologies are all subjects of intense debate.Science must now navigate these ethical landscapes to ensure that its advancements benefit humanity without causing harm. Conclusion:The new posture of science is one of excitement,innovation,and responsibility.It is a posture that embraces the potential of discovery while acknowledging the need for careful stewardship of our planet and its resources.As we continue to push the boundaries of what is possible,it is crucial that we do so with a keen eye on the implications of our actions for future generations.。

熊猫英语作文

熊猫英语作文

Pandas are one of the most beloved and iconic animals in the world,known for their distinctive black and white fur.They are native to China and are considered a national treasure there.Here is a detailed composition about these gentle creatures.Introduction:Pandas,scientifically known as Ailuropoda melanoleuca,are large mammals that belong to the bear family.They are recognized for their endearing appearance and are often referred to as gentle giants.Despite their size,pandas are herbivores,with their diet primarily consisting of bamboo.Habitat:Pandas are endemic to certain mountain ranges in central China,particularly in Sichuan, Shaanxi,and Gansu provinces.They inhabit dense bamboo forests,which provide them with their main source of food.The habitat of pandas is crucial for their survival,as it offers both food and protection from predators.Diet:Bamboo makes up over99%of a pandas diet.They consume a large quantity of bamboo daily,which can be up to1238kilograms,depending on the individuals size and activity level.Pandas have a unique digestive system adapted to process the fibrous plant material, but they still need to eat in large quantities to get enough nutrients.Behavior:Pandas are generally solitary animals.They are mostly inactive,spending much of their day eating and resting.They are known for their playful behavior,especially when they are young.Pandas communicate with each other using vocalizations and body language. Reproduction:Reproduction in pandas is a challenging process.Female pandas are only in estrus for a short period each year,making successful mating a rare event.The gestation period for pandas is about95to160days,and they usually give birth to one or two cubs,although the mother will typically raise only one.Conservation Status:Pandas are currently classified as Vulnerable on the IUCN Red List due to habitat loss, poaching,and a low birth rate.However,conservation efforts have been successful in increasing their population in recent years.The Chinese government and various international organizations have implemented programs to protect their habitat and support breeding programs.Cultural Significance:Pandas hold a special place in Chinese culture and are often used as symbols of peace and friendship.They have been gifted to other countries as a sign of goodwill,and they are a popular attraction in zoos worldwide.Conclusion:Pandas are fascinating creatures that face many challenges in the wild.Their unique characteristics and the efforts to conserve them highlight the importance of biodiversity and the need for continued conservation work.By understanding and appreciating pandas, we can contribute to the preservation of these magnificent animals for future generations to enjoy.。

  1. 1、下载文档前请自行甄别文档内容的完整性,平台不提供额外的编辑、内容补充、找答案等附加服务。
  2. 2、"仅部分预览"的文档,不可在线预览部分如存在完整性等问题,可反馈申请退款(可完整预览的文档不适用该条件!)。
  3. 3、如文档侵犯您的权益,请联系客服反馈,我们会尽快为您处理(人工客服工作时间:9:00-18:30)。

a rX iv:mat h /45579v2[mat h.DG ]24Mar25PINCHING ESTIMATES FOR NEGATIVELY CUR VED MANIFOLDS WITH NILPOTENT FUNDAMENTAL GROUPS IGOR BELEGRADEK AND VITALI KAPOVITCH Abstract.Let M be a complete Riemannian metric of sectional curvature within [−a 2,−1]whose fundamental group contains a k -step nilpotent sub-group of finite index.We prove that a ≥k answering a question of M.Gro-mov.Furthermore,we show that for any ǫ>0,the manifold M admits a complete Riemannian metric of sectional curvature within [−(k +ǫ)2,−1].1.Introduction If the fundamental group of a complete pinched negatively curved manifold is amenable,it must be finitely generated and virtually nilpotent [BS87,Bow93,BGS85].In this paper we relate the nilpotency degree of the group to the pinching of the negatively curved metric.Theorem 1.1.Let M be complete Riemannian manifold with sectional cur-vature satisfying −a 2≤sec(M )≤−1.If Γis a k -step nilpotent subgroup of π1(M ),then a ≥k .In particular,if a ∈[1,2),then Γis abelian.If the cohomological dimension cd(Γ)of Γequals to dim(M )−1,which if dim(M )>2is equivalent to assuming that Γacts cocompactly on horospheres,Theorem 1.1follows from the proof of Gromov’s theorem of almost flat mani-folds (see [BK81,Corollary 1.5.2]),by combining the commutator estimate in almost flat horosphere quotients with the displacement estimate coming from the exponential convergence of geodesics.More recently,Gromov sketched in [Gro91,p.309]a proof of the more general estimatea ≥k2 ,where [x ]denotes the largest integer satisfying ≤x .If k ≤r +1,the estimate gives no information,so Gromov asked [Gro91,p.309]whether it can be im-proved to an estimate that is nontrivial for all cd(G )<dim(M ).Theorem 1.12IGOR BELEGRADEK AND VITALI KAPOVITCHprovides a satisfying answer that involves no dimension assumptions whatso-ever.The proof of Theorem1.1follows the original Gromov’s idea in[BK81],ex-cept that the commutator estimate is run in a“central”orbit of an N-structure given by the collapsing theory of J.Cheeger,K.Fukaya,and Gromov[CFG92]. In[BK]we proved the following classification theorem:Theorem1.2.[BK]A smooth manifold M with amenable fundamental group admits a complete metric of pinched negative curvature if and only if it is dif-feomorphic to the M¨o bius band,or to the product of a line and the total spaceaflat Euclidean vector bundle over a compact infranilmanifold.The”if”direction in Theorem1.2involves an explicit warped product construc-tion of a negatively pinched metric on the product of R and the total space of aflat Euclidean bundle over a closed infranilmanifold.By improving this warped product construction,we show that the pinching bounds provided by Theorem1.1are essentially optimal.Theorem1.3.If M be a pinched negatively curved manifold such thatπ1(M) has a k-step nilpotent subgroup offinite index,then M admits a complete Riemannian metric of sec(M)∈[−(k+ǫ)2,−1]for anyǫ>0.The metric constructed in Theorem1.3has cohomogeneity one,specifically M/Iso(M)is diffeomorphic to R(with the only exception when M is the M¨o bius band equipped with a hyperbolic metric).We do not know whether M in Theorem1.3always admits a complete metric with sec(M)∈[−k2,−1].This does happen for k=1,since as we show in[BK]any complete pinched negatively curved manifolds with virtually abelian fundamental group admits a complete hyperbolic metric.Another way to phrase the optimality of Theorem1.1is via the concept of pinching.Given a smooth manifold M,we define pinch diff(M)to be the infimum of a2≥1such that M admits a complete Riemannian metric of −a2≤sec(M)≤−1.If M admits no complete metric of pinched negative cur-vature,it is convenient to let pinch(M)diff=+∞.We then define pinch top(M) to be the infimum of all pinch diff(N)where N is homeomorphic to M,and define pinch hom(M)to be the infimum of pinch diff(N)’s where N is mani-fold with dim(N)=dim(M)that is homotopy equivalent to M.Of course, pinch diff(N)≥pinch top(M)≥pinch hom(N)≥1.In general,the pinching invariants are hard to estimate and even harder to compute(see[Gro91]and[Bel01,Section5]for surveys).Combining Theo-rems1.1–1.3,we compute the invariants in caseπ1(M)is virtually nilpotent. Corollary1.4.If M be a pinched negatively curved manifold such thatπ1(M) has a k-step nilpotent subgroup offinite index,then pinch diff(M)=pinch top(M)= pinch hom(M)=k2.PINCHING ESTIMATES FOR NILPOTENT GROUPS3 This work was partially supported by the NSF grants#DMS-0352576(Bele-gradek)and#DMS-0204187(Kapovitch).We are thankful to J.Cheeger for a discussion on collapsing.2.Proof of Theorem1.1A Riemannian metric is called A-regular if A={A i}is a sequence of nonnega-tive reals such that the norm of the curvature tensor satisfies||∇i R||≤A i.We call a metric regular if it is A-regular for some A.The collapsing theory works best for regular metrics,and the Ricciflow can be used to deform any metric with bounded sectional curvature to a complete Riemannian metric that is close to the original metric in uniform C1topology,has almost the same sectional curvature bounds,and is regular.(This fact has been known to some experts, but thefirst written account only recently appeared in[Kap]).Thus wefix an arbitraryδ>0and replace the given metric on M by a nearby A-regular metric g with sec g∈[−(a+δ)2,−1],and then prove that a+δ≥k,which would imply a≥k becauseδis arbitrary.Since the Riemannian covering of(M,g)corresponding toΓ≤π1(M)has the same curvature bounds as(M,g),we can assume thatπ1(M)=Γ.Denote the universal cover of M by X.If k=1,all we assert is a≥1which is trivially true,so we assume from now on that k>1.ThenΓfixes a unique point at infinity of the universal cover X of M(see e.g.[BS87]);let c(t)be a ray asymptotic to the point.Since sec(X)is bounded below,the family (X,c(t),Γ)has a subsequence(X,c(t i),Γ)that converges in the equivariant GH-topology topology to(X∞,c∞,Γ∞).Now sec(X)is also bounded above, the metric is regular,and X has infinite injectivity radius,hence the conver-gence(X,c(t i))→(X∞,c∞)is in fact in C∞topology.Then the quotients (X/Γ,p i)converge in pointed GH-topology to(X∞/Γ∞,p∞),where p i,p∞are the projections of c(t i),c∞,respectively.We now review the main results of[CFG92]as they apply to our situation;we refer to[CFG92]for terminology.Fixǫ,λwith0<ǫ≪1≪λ.By[CFG92, Theorems1.3,1.7,Proposition7.21],there are positive constantsρ,κ,ν,σ, depending only on n,ǫ,A such that for each large i,the manifold M carries an N-structure N i and an N i-invariant(ρ,κ)-round metric g i that isǫ-close to g in uniform Cλ-topology.Furthermore,there exists an orbit O i of N i such that(i)the metric on O i induced by g i has diam(O i)→0as i→∞,(ii)p i lies in theρ-neighborhood V i of O i,(iii)the normal injectivity radius of O i is≥ρ,(iv)the norm of the second fundamental form of O i is≤ν,and|sec(O i)|≤σ. (v)if˜V i→V i is the Riemannian universal cover,then˜V i admits a isometric4IGOR BELEGRADEK AND VITALI KAPOVITCHeffective action of a connected nilpotent Lie group G i that acts transitively on the preimage˜O i of O i under˜V i→V i,and intersectsπ1(V i)∼=π1(O i)in a normal subgroup that is cocompact in G i and has index≤κinπ1(V i).The above results are stated in[CFG92]in a different form,and their proofs are often omitted or merely sketched,so for reader’s convenience we briefly explain in the appendix how to deduce(i)-(iv).For(v)see[CFG92,pp.364–365]. Now we show that the inclusion V i→M isπ1-surjective for all large i.Indeed, let¯V i be a connected component of the preimage of V i under the cover X→M,and as before let˜V i,˜O i be the universal covers of V i,O i,respectively. Fix˜q i∈˜O i,and its projections,¯q i∈¯V i and q i∈O i⊂V i.By(i)-(ii)the sequence q i subconverges to some q∞∈X∞/Γ∞,hence for anyγ∈Γ,we have d(γ(¯q i),¯q i)→0as i→∞.So sinceΓisfinitely generated,if i is sufficiently large,then(i)-(ii)implies that¯V i contains the images of¯q i under somefinite generating set S ofΓ.By(iii)we see that¯V i contains the geodesic segment [¯q i,s(¯q i)]with s∈S,whose projection to V i⊂M represent the generator of π1(M,q i)∼=Γcorresponding to s.Hence the surjectionπ1(O i)→Γtakesπ1(O i)∩G i onto a normal subgroup of Γof index≤κ.The intersection of all normal subgroups ofΓof index≤κis a subgroupΓ0offinite index≤nκ2where n=dim M.(In fact,|Γ:Γ0|≤κ·νκwhereνκis the number of normal subgroups of index≤κ.SinceΓis nilpotent of cd(Γ)<n,it can be generated by<n elements,so there is a surjection from a rank n free group F n ontoΓ,andνκequals to the number of normal subgroups of F n of index≤κ,i.e.the number of elements in Hom(F n,Zκ), which is at most nκ.)Denote d(¯q i,γ(¯q i))by dγ.Below this notation is used for different distance functions,and each time we specify which metric we use.Since|Γ:Γ0|<∞,the nilpotency degree ofΓ0is k.Thus there areγj∈Γ0, j=1,...,k satisfying[γ1,[γ2,[γ3,[...[γk−1,γk]...]=γ=1.SinceΓ0lies in the image ofπ1(O i)→Γ,we can think of eachγj as acting on¯O i⊂X,where¯O i is the preimage of O i under the cover X→M.Note that one can chooseγj’s so that in the intrinsic metric on¯O i induced by g i ≤2nκ2·diam(O i).(Indeed,theΓ0-action on¯O i⊂X has a we have dγjfundamental domain F i of diameter≤nκ2·diam(O i).ThenΓ0is generated by S={s∈Γ0:s(¯F i)∩¯F i=∅},and each element of S has displacement at most2nκ2·diam(O i).Then there is a nontrivial k-fold commutator formed by elements of S,because otherwise the identity[a,bc]=[a,b]·[b,[a,c]]·[a,c] implies that any k-fold commutator inΓ0is trivial,so its nilpotency degree is< k).In particular,for the intrinsic metric induced on O i by g i the displacements →0as i→0.ofγj’s satisfy dγjPINCHING ESTIMATES FOR NILPOTENT GROUPS5 By(i)and(iv)we see that each O i with intrinsic metric induced by g i is almost flat,so the commutator estimate of[BK81,Proposition3.5(iii),Theorem2.4.1 (iii)]for the intrinsic metric on O i induced by g i gives(2.1)dγ≤c j dγj,where the constant c depends only on n,a.By Rauch comparison for Jacobifields,the normal exponential map is bi-Lipschitz on theρ-neighborhood in the normal bundle to O i,with Lipschitz constants depending on a,n,ρ.Hence the nearest point projection of theρ-tubular neighborhood of¯O i onto¯O i is K-Lipschitz for K=K(a,n,ρ),so any g i-geodesic of length≤2ρwith endpoints on¯O i is projected by the nearest point projection to a curve of length≤2ρK.Since the intrinsic displacements ofγj’s are<2ρfor all large i,the estimate(2.1)holds with a different c,for the distance function of the extrinsic metric g i,and again c only depends on n,a,ǫ,λ.Finally,since the distance functions of g and g i are bi-Lipschitz on B1(p i)), we get the same estimate(2.1)for the original metric g,with c depending on n,a,ǫ,k,λ.For the rest of the proof we work with displacements in metric g.Passing to asubsequence of p i’s,we canfind j such that dγj ≥dγlfor all l,i.Taking logswe getln dγ≤ln C+ln dγ1+...+ln dγk≤ln C+k ln dγjSince ln dγj <0and lim i→∞dγj=0,we deducelim supt→∞ln dγln dγj+k=kOn the other hand,by exponential convergence of geodesic rays,for any two elements ofΓ,and in particular forγ,γj we getlim supt→∞ln dγ6IGOR BELEGRADEK AND VITALI KAPOVITCH(b)an upper bound of the rotational part ofγj by a constant multiple of dγj that uses almostflatness[BK81,Proposition3.5(i)]).An alternative way to get(b)in our case is via the rotation homomorphismφ:Γ→O(n),introduced by B.Bowditch[Bow93],which is the holonomyof aΓ-invariantflat connection on X.A key property ofφis thatφ(γ)approximates the rotational part of anyγ∈Γwith error≤dγ.Now sinceany nilpotent subgroup of O(n)is abelian,φmust have a kernel of nilpotencedegree k−1.Hence,there is a(k−1)-fold commutator inΓwhose entrieslie in the kernel ofφ,and hence their rotational parts are bounded by their displacements.Repeating the argument at the end of the proof of Theorem1.1 for this commutator,we get a≥k−1.3.Infranilmanifolds are horosphere quotientsLet G be a simply-connected nilpotent Lie group acting on itself by left trans-lations,and let K be a compact subgroup of Aut(G),so that the semidirectproduct G⋊K acts on G by affine transformations.The quotient of G bya discrete torsion free subgroup of G⋊K is called an infranilmanifold.Weshowed in[BK]that any pinched negatively curved manifold with amenable fundamental group is either the M¨o bius band or product of an infranilmani-fold with R,and conversely,each of these manifolds admits an explicit warped product metrics of pinched negative curvature.This section contains a slight improvement of the warped product construction,that yields Theorem1.3.Consider the product of the above G⋊K-action onG with the trivial G⋊K-action on R.For the G⋊K-action on G×R,weprove the following.Theorem3.1.If G has nilpotence degree k,then for anyǫ>0,G×R admits a complete G⋊K-invariant Riemannian metric of sectional curvature within [−(k+ǫ)2,−1].Proof.The Lie algebra L(G)can be written asL(G)=L1⊃L2⊃···⊃L k⊃L k+1=0where L i+1=[L1,L i].Note that[L i,L j]⊂L i+j+1.Indeed,assume i≤jand argue by induction on i.The case i=1is obvious and the inductionstep follows from the Jacobi identity and the induction hypothesis,because[L i,L j]=[[L1,L i−1],L j]lies inspan([[L i−1,L j],L1],[[L1,L j],L i−1])⊂span([L i+j,L1],[L j+1,L i−1])=L i+j+1 The group K preserves each L i,so we can choose a K-invariant inner product , 0on L.LetF i={X∈L i: X,Y 0=0for Y∈L i+1}.PINCHING ESTIMATES FOR NILPOTENT GROUPS7 Then L=F1⊕···⊕F k.Define a new K-invariant inner product , r on L by X,Y r=h i(r)2 X,Y 0for X,Y∈F i,and X,Y r=0if X∈F i,Y∈F j for i=j,where h i are some positive functions defined below.This defines a G⋊K-invariant Riemannian metric g r on G.Letαi=i with i=1,···,k and a=k.Givenρ>0,we define the warping function h i to be a positive,smooth,strictly convex,decreasing function that is equal to e−αi r if r≥ρ,and is equal to e−ar if r≤−ρ;such a functionexists since a≥a i for each i.Thus h′i<0<h′′i,and the functions h′ih i areuniformly bounded away from0and∞.Define the warped product metric on G×R by g=s2g r+dr2,where s>0is a constant;clearly g is a complete G⋊K-invariant metric.A straightforward tedious computation(mostly done e.g.in[BW])yields for g-orthonormal vector fields Y s∈F s thatR g(Y i,Y j)Y j,Y i g=1h i h j,R g(Y i,Y j)Y l,Y m g=1∂r )∂h i, R g(Y i,∂∂r),Y j g=0if i=j,R g(∂2h j+h′l∂r,Y i)Y j,Y l g→0as s→∞,because| [Y j,Y i],Y l g|=s2| [Y j,Y i],Y l gr |≤s2Ck2|Y j|gr|Y i|gr|Y l|gr≤Ck2/s,where the last inequality holds since s|Y|gr=1for any g-unit vector Y.8IGOR BELEGRADEK AND VITALI KAPOVITCHIt follows that as s→∞,then R g uniformly converges to a tensor¯R whose nonzero components are¯R(Yi,Y j,Y j,Y i)=−h′i h′j∂r,∂h i.Thus g has pinched negative curvature for all large s.Finally,we show that for anyǫ>0there existsρsuch that sec g∈[−(k+ǫ)2,−1].Note thath′ih i=ln(h i)′′+(ln(h i)′)2.By construction|ln(h i)′|≤k.Also letρbe large enough,so that one can choose h i on[−ρ,ρ]to satisfy|ln(h i)′′|≪ǫ.Then for all sufficiently large s, the sectional curvature of g is within[−(k+ǫ)2,−1]. Proof of Theorem1.3.By[BK]if a pinched negatively curved manifold contains has a virtually k-step nilpotent fundamental group,then it is diffeomorphic to the quotient of G×R by a discrete torsion free subgroup of G⋊K.Thus we are done by Theorem3.1.Appendix A.On collapsing theoryThe purpose of this appendix is to outline the proof of the claims(i)-(iv)made in the proof of Theorem1.1.Some details can be found in[CFG92].Since g is regular,so is the corresponding metric˜g on the frame bundle F M. The balls(F B1(x),˜g)form an O(n)-GH-precompact family,where F B1(x)de-notes the frame bundle over the unit ball B1(x),x∈M.By[Fuk88]the closure of the family consists of regular Riemannian manifolds.So for an arbitrary se-quence p i∈M,the manifolds(F B1(p i),˜g)subconverge in O(n)-GH-topology to a pointed regular Riemannian manifold(Y,y).By the local version of Fukaya’sfibration theorem for some sequenceδi>0 satisfyingδi→0as i→∞,there exists for each large i an O(n)-equivariant δi-almost Riemannian submersion F B1(p i)→Y with nilmanifolds asfibers, which is also an O(n)-δi-Hausdorffapproximation.Furthermore,each F B1(p i) carries an O(n)-invariant N-structure˜N i whose orbits are the nilmanifoldfibers of the above submersion,and because of the O(n)-invariance,the structure de-scends to an N-structure N i on B1(p i).By[CFG92,Proposition7.21]F B1(p i) carries a metric˜g i that isǫ-close to˜g in Cλ-topology,and is both O(n)-invariant and˜N i-invariant.Hence˜g i induces unique Riemannian submersion metrics¯g i on Y,and g i on B1(x).To see(ii)-(iv),note that if l≤λ−2,then||∇l R¯gi||is bounded independently of i,so the sequence¯g i is precompact in Cλ−2-topology.Then by[PT99,PINCHING ESTIMATES FOR NILPOTENT GROUPS9 Lemma2.7]¯g i is precompact in O(n)-Cλ−2-topology,i.e.after pulling back by self-diffeomorphisms of Y,the metrics smoothly subconverge and share the same isometric O(n)-action.Thus there existsρ>0such that for each large i,the point y∈(Y,¯g i)lies in aρ-neighborhood of an O(n)-orbit that has normal injectivity radius≥ρ.The preimage O i of the O(n)-orbit under the Riemannian submersion(F B1(p i),˜g i)→(Y,¯g i)satisfies(ii)-(iii).Finally,(iii) implies the second fundamental form bound in(iv),which by Gauss formula gives a bound on|sec(O i)|.To see(i)note that the˜g-diameter of any orbit of˜N i is≤δi,so since˜g and ˜g i are bi-Lipschitz,the˜g i-diameter of any orbit of˜N i tends to zero as i→∞, and the same holds for orbits of N i because F B1(p i)→B1(p i)is distance non-increasing.Finally,the ambient diameter bound implies the intrinsic diameter bound,because Rauch comparison for Jacobifields gives bounds on bi-Lipschitz constants of the normal exponential map of O i,and in particular,the Lipschitz constant of the nearest point projection of theρ-tubular neighborhood of O i onto O i depends only on a,n,ρ,ǫ,λ.References[Bel01]I.Belegradek,Pinching,Pontrjagin classes,and negatively curved vector bundles, Invent.Math.144(2001),353–379.[BGS85]W.Ballmann,M.Gromov,and V.Schroeder,Manifolds of nonpositive curvature, Progress in Mathematics,vol.61,Birkh¨a user Boston Inc.,Boston,MA,1985.MR87h:53050[BK]I.Belegradek and V.Kapovitch,Classification of negatively pinched manifolds with amenable fundamental groups,preprint,/abs/math.DG/0402268. [BK81]P.Buser and H.Karcher,Gromov’s almostflat manifolds,Ast´e risque,vol.81,Soci´e t´e Math´e matique de France,1981.[Bow93] B.H.Bowditch,Discrete parabolic groups,J.Differential Geom.38(1993),no.3, 559–583.[BS87]M.Burger and V.Schroeder,Amenable groups and stabilizers of measures on the boundary of a Hadamard manifold,Math.Ann.276(1987),no.3,505–514. [BW]I.Belegradek and G.Wei,Metrics of positive Ricci curvature on bundles,to appear in Int.Math.Res.Not.,/abs/math.DG/0109167.[CE75]J.Cheeger and D.G.Ebin,Comparison theorems in Riemannian geometry,North-Holland Publishing Co.,Amsterdam,1975,North-Holland Mathematical Library,Vol.9.[CFG92]J.Cheeger,K.Fukaya,and M.Gromov,Nilpotent structures and invariant metrics on collapsed manifolds,J.Amer.Math.Soc.5(1992),no.2,327–372.[Fuk88]K.Fukaya,A boundary of the set of the Riemannian manifolds with bounded curva-tures and diameters,J.Differential Geom.28(1988),no.1,1–21.[Gro91]M.Gromov,Foliated Plateau problem.II.Harmonic maps of foliations,Geom.Funct.Anal.1(1991),no.3,253–320.[Kap]V.Kapovitch,Curvature bounds via Ricci smoothing,preprint, /abs/math.DG/0405569.10IGOR BELEGRADEK AND VITALI KAPOVITCH[PT99] A.Petrunin and W.Tuschmann,Diffeomorphismfiniteness,positive pinching,and second homotopy,Geom.Funct.Anal.9(1999),no.4,736–774.Igor Belegradek,School of Mathematics,Georgia Institute of Technology,At-lanta,GA30332-0160E-mail address:ib@Vitali Kapovitch,Department of Mathematics,University of California,Santa Barbara,CA93110E-mail address:vitali@。

相关文档
最新文档