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61.
62.
Today a "just" health policy is balanced between the problem of the allocation of scarce resources and the priority setting of services, care and cures. Despite technologies and molecular medicine, with their tendency to reach absolute prediction of disease or absence of disease and to cure with predicted efficacy, a large portion of the public refuse the results of experimental procedures and prefer to place trust in so-called alternative medicine or in drugs which are not in the official guide-lines following the principles of evidence-based medicine according to DL Sackett. Juridical problems arise between the rights of free choice of cure and social dimension of Governmental care programs, which include the maximum of benefits (i.e. effective therapies) for a pre-fixed total budget. An explicit rationing only on budgetary bases without rationalisation of medical procedures reduces the rights to care of citizens-patients. Thus, an explicit rationing-rationalisation seems to be the only procedure compatible with the interest of patients in a social security system allocating "scarce" resources.  相似文献   
63.
Modeling of solid oxide fuel cells (SOFCs) has gained considerable significance in recent years. A detailed phenomenological model for SOFC can be used to understand performance limitations, optimization, in situ diagnostics and control. In this paper, we study the transport and various electrochemical phenomena in an anode-supported tubular SOFC using a steady-state model. In particular, we discuss the importance of modeling different phenomena vis-a-vis their impact on the prediction capability of the model. It is observed that even a reasonably simple model can be sufficiently predictive in a particular operating range. As the operating range of the cell is increased, the predictive capability of a model validated in a narrow range cannot be guarantied. It has also been observed that neglecting momentum conservation in the model for a tubular SOFC can affect the predictive capability of the model at higher overpotentials. An extensively validated model is used to study the percentage conversion of oxygen and oxygen concentration profile within a cell at different operating conditions. All of the simulation studies are supported by experimental data that spans a wide range of operation in terms of the DC polarization, reactant flow rates and operating temperatures.  相似文献   
64.
The spray formation and combustion characteristics of gasoline and E85 (85% ethanol, 15% gasoline) have been investigated using a multi-hole injector with asymmetric nozzle-hole arrangement. Experiments were carried out in a quiescent optical chamber using high-speed shadowgraphy (9 kHz) to characterise the spray sensitivity to both injector temperature and ambient pressure in the range of 20-120 °C and 0.5, 1.0 bar. Spray-tip penetrations and ‘umbrella’ spray cone angles were calculated for all conditions. Phase Doppler Anemometry was also used to measure droplet sizes in the core of one of the spray plumes, 25 mm below the injector tip. To study the effect of fuel properties on vaporisation and mixture preparation under realistic operating conditions, a separate set of experiments was carried out in a direct-injection spark-ignition optical engine. The engine was run at 1500 RPM under cold and fully warmed-up conditions (20 °C and 90 °C) at part load and full load (0.5 and 1.0 bar intake pressure). Floodlit laser Mie-scattering images of the sprays on two orthogonal planes corresponding to the swirl and tumble planes of in-cylinder flow motion were acquired to study the full injection event and post-injection mixing stage. These were used to make comparisons with the static chamber sprays and to quantify the liquid-to-vapour phase evaporation process for both fuels by calculating the projected ‘footprint’ of the sprays at different conditions. Analysis of the macroscopic structure and turbulent primary break-up properties of the sprays was undertaken in light of jet exit conditions described in terms of non-dimensional numbers. The effects on stoichiometric combustion were investigated by imaging the natural flame chemiluminescence through the engine’s piston crown (swirl plane) and by post-processing to derive flame growth rates and trajectories of flame motion.  相似文献   
65.
Apparent ileal digestibilities of amino acids were determined in pigs fed cornstarch-based diets with untreated or protease-treated soybean meal as the protein source. Sixteen pigs were fitted with a modified post valve T-cecum cannula on d 14, 15, and 16 after birth and then returned to their sows until d 20 when they were weaned. Twelve of the pigs were selected for the study, which was conducted according to a two-period balanced change-over design. Treatments consisted of soybean meal that was 1) untreated (SBM), 2) processed by incubation (1:2 wt/vol distilled water adjusted to pH 4.5, for 16 h at 50 degrees C; CI-SBM), 3) sprayed with protease (supplied at 1 microL/g of soybean meal; PS-SBM), and 4) processed by incubation, as for CI-SBM, with protease in the water at the rate of 1 microL/g of soybean meal (PI-SBM). Each period consisted of 5 d of adaptation to diets followed by three 8-h collection periods (total of 24 h) that alternated with 8-h periods in which digesta were not collected. Apparent CP digestibilities were similar (P > .05) at 70.4, 72.4, 65.2, and 70.3% for the SBM, CI-SBM, PS-SBM, and PI-SBM diets, respectively. Corresponding amino acid digestibilities were also similar (P > .05), ranging from 62.5, 67.5, 57.9, and 65.0% for alanine to 83.5, 83.4, 78.7, and 84.7% for arginine. Apparent digestibilities were less (P < .05) for Period 1 (on d 7 after weaning) than for Period 2 (on d 16 after weaning). In conclusion, protease treatment of soybean meal had no effect on ileal digestibilities of CP and amino acids in newly weaned pigs.  相似文献   
66.
The fabrication and characterization of silicon p-n junction solar cells with various glow discharge, unanalyzed, molecular implanted emitter regions is described. Total area simulated air mass one (AM1) power conversion efficiencies without AR coatings or back surface fields are at best 8.2% compared to 9.1% for conventionally implanted or POC13 thermally diffused cells on similar substrates. To achieve optimum performance, Q-switched ruby laser light was incorporated into the molecular implant annealing procedure. Conversion efficiencies greater than 8% were achieved with the four dopants BC13, PC13 AsF3 and POC13. For similar processing, conversion efficiency with BF3 implants was less than those of previous investigations, most likely due to poor crystalline regrowth of the heavily doped emitter regions. Cell quantum efficiency and mesa junction ideality are shown to be similar to those of conventional cells while molecular implant sheet resistance values varied, generally being directly related to the dopant molecular weight. Work submitted in partial fulfillment of Ph.D. in Electrical Engineering at the Univ. of Missouri, Columbia, MO 65211  相似文献   
67.
1. Nurses must monitor the quality of professional practice in order to safeguard the public's trust in nursing as a professional discipline and to ensure that nursing is self-regulating, accountable, and autonomous. 2. A peer review process indicates self-governance and advances the profession of nursing. 3. A peer review committee is responsible for gathering information, evaluating nursing practice, and reporting the findings to the nurse and the initiator of the review. Any deliberate or negligent acts or omissions of the nurse under review are reported to the state board of nursing.  相似文献   
68.
We studied major malformations in 5,581 infants with Down syndrome (DS) from three registers of congenital malformations. THe prevalence at birth of 23 different malformations was compared with the program-specific rates for each malformation in non-DS infants. An about 300 times risk increase was seen for annular pancreas, cataracts and duodenal atresia and an about 100 times risk increase for megacolon and small choanal atresia. Esophageal, anal and small bowel atresia, preaxial polydactyly, and omphalocele all showed risk increases between 10 and 30 times. Statistically significantly elevated risk ratios around 3-5 were seen for cleft palate, cleft lip/palate, and limb deficiencies. No increased risk was seen for neural tube defects, hydrocephaly, microtia, renal agenesis or severe dysgenesis, hypospadias or polydactyly other than preaxial. Oral clefts were more often present in DS in the Swedish material than in the other two materials. Cardiac defects were registered in 26% of all cases (varying between programs) but 28% of the cardiac defects were unspecified. DS infants born to women younger than 25 years had a significantly increased risk for megacolon and there was a trend increasing risk for esophageal or anal atresia with maternal age. A decreased risk for cardiac defect in DS infants born to teenage mothers was found, quite pronounced for endocardial cushion defects and ventricular septum defects. There were no statistically significant differences in the sex distribution of specific malformations in infants with DS and in non-DS infants.  相似文献   
69.
A finite difference method for solving mixed initial and boundary value problems governed by hyperbolic partial differential equations is described. The method has been developed specifically to calculate the flow field associated with any arbitrary two-dimensional or axi-symmetric body placed in a uniform supersonic stream. In order to preserve accuracy in the neighborhood of the body surface, the equations governing the motion are formulated so that
  • 1 Streamlines form one system of co-ordinate curves.
  • 2 Two of the equations of motion correspond to characteristic relations.
The boundary condition at the body is applied by omitting the equation associated with the characteristic curve reaching the body surface from inside. The method presented is a pseudo-viscous method and flow fields which include shock waves can be treated with ease. The method has been used to calculate the flow past a particular axi-symmetric waisted body. The shape of this body is such that a secondary internal shock wave is generated by coalescence of Mach lines behind the bow shock wave. The results obtained are compared with theoretical and experimental results obtained by other workers. The investigation has been carried out as part of a programme of work needed to validate the pseudo-viscous method used.  相似文献   
70.
Relative to intravenous drug self-administration, locomotor activity is easier to measure with high throughput, particularly in mice. Therefore its potential to predict differences in self-administration between genotypes (e.g., targeted mutations, recombinant inbred strains) is appealing, but such predictive value is unverified. The main goal of this study was to evaluate the utility of the locomotor assay for accurately predicting differences in cocaine self-administration. A second goal was to evaluate any correlation between activity in a novel environment, and cocaine-induced hyperactivity, between strains. We evaluated locomotor activity in male and female Sprague–Dawley rats and 15 mouse strains (129S1/SvImJ, 129S6/SvEvTac, 129X1/SvJ, A/J, BALB/cByJ, BALB/cJ, C3H/HeJ, C57BL/6J, CAST/EiJ, DBA/2J, FVB/NJ, SJL/J, SPRET/EiJ, and outbred Swiss Webster and CD-1/ICR), as well as cocaine self-administration in BALB substrains. All but BALB/cJ mice showed locomotor habituation and significant cocaine-induced hyperactivity. BALB/cJ mice also failed to self-administer cocaine. BALB/cByJ mice showed modest locomotor habituation, cocaine-induced locomotion, and cocaine self-administration. As previously reported, female rats showed greater cocaine-induced locomotion than males, but this was only observed in one of 15 mouse strains (FVB/NJ), and the reverse was observed in two strains (129X1/SvJ, BALB/cByJ). The intriguing phenotype of the BALB/cJ strain may indicate some correlation between all-or-none locomotion in a novel environment, and stimulant and reinforcing effects of cocaine. However, neither novelty- nor cocaine-induced activity offered a clear prediction of relative reinforcing effects among strains. Additionally, these results should aid in selecting mouse strains for future studies in which relative locomotor responsiveness to psychostimulants is a necessary consideration. (PsycINFO Database Record (c) 2011 APA, all rights reserved)  相似文献   
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