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1.
U Vanhoefer S Cao H Minderman K Tóth RJ Scheper ML Slovak YM Rustum 《Canadian Metallurgical Quarterly》1996,2(2):369-377
For ethical decision-making near the end of life, autonomy is the moral North Star. At the same time, for some treatments, the burdens so clearly outweigh benefits that physicians may make a judgment not to offer the treatment. This is often clearer in surgery. A person with colon cancer and metastases may not insist on resection of the metastases. For some reason, some treatments have escaped these logical constraints. Attempted resuscitation of a dying patient is a good example. The circumstances in which a physician may make choices on behalf of a competent, terminally-ill patient without consent, and even without notification, are hotly debated, but data suggest that physicians do so frequently. Patients who lack capacity present even more difficult challenges. Advance directives, when available, can be extremely helpful, but even with them difficult problems can remain. If advance directives have not been established, family and close friends are an obvious source of guidance. Their legal role varies in different jurisdictions; in practice, they are crucial in bedside decision-making. Guardianship and alternatives to it remain a poor last resort. Euthanasia is a very difficult problem. We believe it is semantically misleading to lump under the term "passive euthanasia" those circumstances where potentially life-sustaining treatment is withheld or withdrawn. The tension between patient autonomy and medical common sense remains unresolved within the "futility" controversy. The authors believe it serves no purpose to discuss carefully with dying patients propositions that are nonsense. At the same time, physicians must not confuse decisions about quality of life with judgements about treatment effectiveness. We believe that what many, although not all, dying patients want are physicians with intelligent compassion who can take care of them through the dying process. 相似文献
2.
This paper is an attempt to improve on the approximation. First author citations (Cf)≈Total citations (Ct) of an author's publications without the work of making the complete citation count under the author and all co-author names. Using the bibliographies of all faculty from each of four large departments: Physics, Chemistry, Materials Sciences, and Biosciences, in the same university, both first author and complete citation counts were made, care being taken to avoid the most common errors in such counts. It is shown that the function Cf·T/F (where T and F are the total number of papers and F those with subject author's name first) correlates strongly (>90%) with Ct. We find also that Ct correlates strongly with T. The data also may be used as one more line of evidence to obtain normalizing ratios for possible comparisons of productivityacross different disciplinary universes. A very tentative ratio from different studies would be 8 (Chem.)=4 (Physics)=2.5 (Mat. Sci.)=2 (Mathematics)=4.5 (Biophysics-Biochemistry). 相似文献
3.
Hiroyasu Kido Sridhar Komarneni Rustum Roy 《Journal of the American Ceramic Society》1991,74(2):422-424
The La2 Zr2 O7 phase was prepared from metal acetylacetonates by a sol—gel route without any intermediate phase formation. X-ray peaks appeared at a temperature as low as 500°C at the positions expected for La2 Zr2 O7 , although they were broad. The crystal structure of La2 Zr2 O7 was found to be of the fluorite type below 900°C and of thepyrochlore type above 1000°C. The substitution of a small amount of Eu for La was carried out to investigate the crystal structure from the viewpoint of fluorescence, and these results confirmed the formation of fluorite type La2 Zr2 O7 below 900°C. 相似文献
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Subsolidus phase relations have been defined in three representative rare earth sesquioxide (La2O3, Gd2O3, Yb2O3)-thoria systems over a wide range of compositions by X-ray methods (from phase detection and precision lattice parameter measurements). Characterisation of the point defects in these fluorite structure materials shows good agreement between calculated anion vacancy models and density values measured. Currently accepted crystal chemical generalisations were found to be inadequate to rationalise phase equilibria and crystalline solubility limits in these systems. 相似文献
6.
Certain non-crystalline germanium films (> 10 μm in thickness) prepared by rf-sputtering crystallize “explosively” at room temperature when initiated by pricking the surface with a sharp point (or certain other methods). The propagation velocity of the crystallization at room temperature was found to be as fast a 1200 mm sec?1 depending somewhat on the conditions of film preparation, thickness, etc. The density of several such crystallizable films was determined as 5.05 g cm?3±1%. The crystallite size in the crystallized films, measured by X-ray broadening, was typically larger than 500 Å. A model for the crystallization process invokes a cascade energy transfer process, basically thermal in nature. 相似文献
7.
This is a review and an overview on hydrothermal synthesis of fine oxide powders. The term hydrothermal today includes methods
which involve water at pressures (from 1 atm-several kilobars) and high temperatures from 100–10,000°C. Hydrothermal is one
of the best methods to produce pure fine oxide powders. The authors describe (i) hydrothermal decomposition, (ii) hydrothermal
metal oxidation, (iii) hydrothermal reaction, (iv) hydrothermal precipitation and hydrothermal hydrolysis, (v) hydrothermal
electrochemical, (vi) reactive electrode submerged arc, (vii) hydrothermal microwave, (viii) hydrothermal sonochemical, etc
and also ideal and real powders 相似文献
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