BACKGROUND Stroke is a common disabling disease,whether it is ischemic stroke or hemorrhagic stroke,both can result in neuronal damage,leading to various manifestations of neurological dysfunction.AIM To explore of th...BACKGROUND Stroke is a common disabling disease,whether it is ischemic stroke or hemorrhagic stroke,both can result in neuronal damage,leading to various manifestations of neurological dysfunction.AIM To explore of the application value of swallowing treatment device combined with swallowing rehabilitation training in the treatment of swallowing disorders after stroke.METHODS This study selected 86 patients with swallowing disorders after stroke admitted to our rehabilitation department from February 2022 to December 2023 as research subjects.They were divided into a control group(n=43)and an observation group(n=43)according to the treatment.The control group received swallowing rehabilitation training,while the observation group received swallowing treatment device in addition to the training.Both groups underwent continuous intervention for two courses of treatment.RESULTS The total effective rate in the observation group(93.02%)was higher than that in the control group(76.74%)(P=0.035).After intervention,the oral transit time,swallowing response time,pharyngeal transit time,and laryngeal closure time decreased in both groups compared to before intervention.In the observation group,the oral transit time,swallowing response time,and pharyngeal transit time were shorter than those in the control group after intervention.However,the laryngeal closure time after intervention in the observation group was compared with that in the control group(P=0.142).After intervention,average amplitude value and duration of the genioglossus muscle group during empty swallowing and swallowing 5 mL of water are reduced compared to before intervention in both groups.After intervention,the scores of the chin-tuck swallowing exercise and the Standardized Swallowing Assessment are both reduced compared to pre-intervention levels in both groups.However,the observation group scores lower than the control group after intervention.Additionally,the Functional Oral Intake Scale scores of both groups are increased after intervention compared to pre-intervention levels,with the observation group scoring higher than the control group after intervention(P<0.001).The cumulative incidence of complications in the observation group is 9.30%,which is lower than the 27.91%in the control group(P=0.027).CONCLUSION The combination of swallowing therapy equipment with swallowing rehabilitation training can improve the muscle movement level of the genioglossus muscle group,enhance swallowing function,and prevent the occurrence of swallowing-related complications after stroke.展开更多
Seafloor topography plays an important role in the evolution of submarine lobes.However,it is still not so clear how the shape of slope affects the three-dimensional(3-D)architecture of submarine lobes.In this study,w...Seafloor topography plays an important role in the evolution of submarine lobes.However,it is still not so clear how the shape of slope affects the three-dimensional(3-D)architecture of submarine lobes.In this study,we analyze the effect of topography factors on different hierarchical lobe architectures that formed during Pliocene to Quaternary in the Rovuma Basin offshore East Africa.We characterize the shape,size and growth pattern of different hierarchical lobe architectures using 3-D seismic data.We find that the relief of the topographic slope determines the location of preferential deposition of lobe complexes and single lobes.When the topography is irregular and presents topographic lows,lobe complexes first infill these depressions.Single lobes are deposited preferentially at positions with higher longitudinal(i.e.across-slope)slope gradients.As the longitudinal slope becomes higher,the aspect ratio of the single lobes increases.Lateral(i.e.along-slope)topography does not seem to have a strong influence on the shape of single lobe,but it seems to affect the overlap of single lobes.When the lateral slope gradient is relatively high,the single lobes tend to have a larger overlap surface.Furthermore,as the average of lateral slope and longitudinal slope gets greater,the width/thickness ratio of the single lobe is smaller,i.e.sediments tend to accumulate vertically.The results demonstrate that the shape of slopes more comprehensively influences the 3-D architecture of lobes in natural deep-sea systems than previously other lobe deposits and analogue experiments,which helps us better understand the development and evolution of the distal parts of turbidite systems.展开更多
Cone-beam computed tomography(CBCT) is mostly used for position verification during the treatment process. However,severe image artifacts in CBCT hinder its direct use in dose calculation and adaptive radiation therap...Cone-beam computed tomography(CBCT) is mostly used for position verification during the treatment process. However,severe image artifacts in CBCT hinder its direct use in dose calculation and adaptive radiation therapy re-planning for proton therapy. In this study, an improved U-Net neural network named CBAM-U-Net was proposed for CBCT noise reduction in proton therapy, which is a CBCT denoised U-Net network with convolutional block attention modules. The datasets contained 20 groups of head and neck images. The CT images were registered to CBCT images as ground truth. The original CBCT denoised U-Net network, sCTU-Net, was trained for model performance comparison. The synthetic CT(SCT) images generated by CBAM-U-Net and the original sCTU-Net are called CBAM-SCT and U-Net-SCT images, respectively. The HU accuracies of the CT, CBCT, and SCT images were compared using four metrics: mean absolute error(MAE), root mean square error(RMSE), peak signal-to-noise ratio(PSNR), and structure similarity index measure(SSIM). The mean values of the MAE, RMSE, PSNR, and SSIM of CBAM-SCT images were 23.80 HU, 64.63 HU, 52.27 dB, and 0.9919, respectively,which were superior to those of the U-Net-SCT images. To evaluate dosimetric accuracy, the range accuracy was compared for a single-energy proton beam. The γ-index pass rates of a 4 cm × 4 cm scanned field and simple plan were calculated to compare the effects of the noise reduction capabilities of the original U-Net and CBAM-U-Net on the dose calculation results. CBAM-U-Net reduced noise more effectively than sCTU-Net, particularly in high-density tissues. We proposed a CBAM-U-Net model for CBCT noise reduction in proton therapy. Owing to the excellent noise reduction capabilities of CBAM-U-Net, the proposed model provided relatively explicit information regarding patient tissues. Moreover, it maybe be used in dose calculation and adaptive treatment planning in the future.展开更多
BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and...BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.展开更多
应用环介导等温扩增(LAMP)技术建立了快速特异的检测副鸡禽杆菌的方法。利用在线引物设计软件Primer Explorer Version 4.0,针对副鸡禽杆菌16SRNA基因序列设计两组LAMP引物,并对副鸡禽杆菌特异性DNA的扩增条件进行优化,评价所建立LAMP...应用环介导等温扩增(LAMP)技术建立了快速特异的检测副鸡禽杆菌的方法。利用在线引物设计软件Primer Explorer Version 4.0,针对副鸡禽杆菌16SRNA基因序列设计两组LAMP引物,并对副鸡禽杆菌特异性DNA的扩增条件进行优化,评价所建立LAMP的特异性和灵敏性。结果显示,优化后的反应条件为65℃恒温反应60min,内引物1.60pmol/μL、外引物0.20pmol/μL。该LAMP对13株副鸡禽杆菌均发生了扩增反应,而对大肠埃希菌、禽多杀性巴氏杆菌、空肠弯曲杆菌等14株其他病原微生物没有扩增反应;该LAMP最低检出量为0.17pg/反应,敏感性远高于常规PCR的56pg/反应。结果表明,所建立的副鸡禽杆菌LAMP具有快速、高效、方便操作等特点,适用于基层兽医部门进行副鸡禽杆菌的快速检测。展开更多
文摘BACKGROUND Stroke is a common disabling disease,whether it is ischemic stroke or hemorrhagic stroke,both can result in neuronal damage,leading to various manifestations of neurological dysfunction.AIM To explore of the application value of swallowing treatment device combined with swallowing rehabilitation training in the treatment of swallowing disorders after stroke.METHODS This study selected 86 patients with swallowing disorders after stroke admitted to our rehabilitation department from February 2022 to December 2023 as research subjects.They were divided into a control group(n=43)and an observation group(n=43)according to the treatment.The control group received swallowing rehabilitation training,while the observation group received swallowing treatment device in addition to the training.Both groups underwent continuous intervention for two courses of treatment.RESULTS The total effective rate in the observation group(93.02%)was higher than that in the control group(76.74%)(P=0.035).After intervention,the oral transit time,swallowing response time,pharyngeal transit time,and laryngeal closure time decreased in both groups compared to before intervention.In the observation group,the oral transit time,swallowing response time,and pharyngeal transit time were shorter than those in the control group after intervention.However,the laryngeal closure time after intervention in the observation group was compared with that in the control group(P=0.142).After intervention,average amplitude value and duration of the genioglossus muscle group during empty swallowing and swallowing 5 mL of water are reduced compared to before intervention in both groups.After intervention,the scores of the chin-tuck swallowing exercise and the Standardized Swallowing Assessment are both reduced compared to pre-intervention levels in both groups.However,the observation group scores lower than the control group after intervention.Additionally,the Functional Oral Intake Scale scores of both groups are increased after intervention compared to pre-intervention levels,with the observation group scoring higher than the control group after intervention(P<0.001).The cumulative incidence of complications in the observation group is 9.30%,which is lower than the 27.91%in the control group(P=0.027).CONCLUSION The combination of swallowing therapy equipment with swallowing rehabilitation training can improve the muscle movement level of the genioglossus muscle group,enhance swallowing function,and prevent the occurrence of swallowing-related complications after stroke.
基金The study is funded by the Cooperation Project of China National Petroleum Company(CNPC)and China University of Petroleum-Beijing(CUPB)(No.RIPED-2021-JS-552)the National Natural Science Foundation of China(Nos.42002112,42272110)+2 种基金the Strategic Cooperation Technology Projects of CNPC and CUPB(No.ZLZX2020-02)the Science Foundation for Youth Scholars of CUPB(No.24620222BJRC006)We thank the China Scholarship Council(CSC)(No.202106440048)for having funded the research stay of Mei Chen at MARUM,University of Bremen.We thank Elda Miramontes for her constructive comments and suggestions that helped us improve our manuscript.
文摘Seafloor topography plays an important role in the evolution of submarine lobes.However,it is still not so clear how the shape of slope affects the three-dimensional(3-D)architecture of submarine lobes.In this study,we analyze the effect of topography factors on different hierarchical lobe architectures that formed during Pliocene to Quaternary in the Rovuma Basin offshore East Africa.We characterize the shape,size and growth pattern of different hierarchical lobe architectures using 3-D seismic data.We find that the relief of the topographic slope determines the location of preferential deposition of lobe complexes and single lobes.When the topography is irregular and presents topographic lows,lobe complexes first infill these depressions.Single lobes are deposited preferentially at positions with higher longitudinal(i.e.across-slope)slope gradients.As the longitudinal slope becomes higher,the aspect ratio of the single lobes increases.Lateral(i.e.along-slope)topography does not seem to have a strong influence on the shape of single lobe,but it seems to affect the overlap of single lobes.When the lateral slope gradient is relatively high,the single lobes tend to have a larger overlap surface.Furthermore,as the average of lateral slope and longitudinal slope gets greater,the width/thickness ratio of the single lobe is smaller,i.e.sediments tend to accumulate vertically.The results demonstrate that the shape of slopes more comprehensively influences the 3-D architecture of lobes in natural deep-sea systems than previously other lobe deposits and analogue experiments,which helps us better understand the development and evolution of the distal parts of turbidite systems.
基金Digital Medical Equipment Research and Development Project,Ministry of Science and Technology,China:The development of Synchrotron-based proton therapy system(2016YFC0105400).
文摘Cone-beam computed tomography(CBCT) is mostly used for position verification during the treatment process. However,severe image artifacts in CBCT hinder its direct use in dose calculation and adaptive radiation therapy re-planning for proton therapy. In this study, an improved U-Net neural network named CBAM-U-Net was proposed for CBCT noise reduction in proton therapy, which is a CBCT denoised U-Net network with convolutional block attention modules. The datasets contained 20 groups of head and neck images. The CT images were registered to CBCT images as ground truth. The original CBCT denoised U-Net network, sCTU-Net, was trained for model performance comparison. The synthetic CT(SCT) images generated by CBAM-U-Net and the original sCTU-Net are called CBAM-SCT and U-Net-SCT images, respectively. The HU accuracies of the CT, CBCT, and SCT images were compared using four metrics: mean absolute error(MAE), root mean square error(RMSE), peak signal-to-noise ratio(PSNR), and structure similarity index measure(SSIM). The mean values of the MAE, RMSE, PSNR, and SSIM of CBAM-SCT images were 23.80 HU, 64.63 HU, 52.27 dB, and 0.9919, respectively,which were superior to those of the U-Net-SCT images. To evaluate dosimetric accuracy, the range accuracy was compared for a single-energy proton beam. The γ-index pass rates of a 4 cm × 4 cm scanned field and simple plan were calculated to compare the effects of the noise reduction capabilities of the original U-Net and CBAM-U-Net on the dose calculation results. CBAM-U-Net reduced noise more effectively than sCTU-Net, particularly in high-density tissues. We proposed a CBAM-U-Net model for CBCT noise reduction in proton therapy. Owing to the excellent noise reduction capabilities of CBAM-U-Net, the proposed model provided relatively explicit information regarding patient tissues. Moreover, it maybe be used in dose calculation and adaptive treatment planning in the future.
基金The study was reviewed and approved by the Science and Research Office of Tong Ren Hospital(Shanghai), No. AF/SC-08/04.0.
文摘BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.
文摘应用环介导等温扩增(LAMP)技术建立了快速特异的检测副鸡禽杆菌的方法。利用在线引物设计软件Primer Explorer Version 4.0,针对副鸡禽杆菌16SRNA基因序列设计两组LAMP引物,并对副鸡禽杆菌特异性DNA的扩增条件进行优化,评价所建立LAMP的特异性和灵敏性。结果显示,优化后的反应条件为65℃恒温反应60min,内引物1.60pmol/μL、外引物0.20pmol/μL。该LAMP对13株副鸡禽杆菌均发生了扩增反应,而对大肠埃希菌、禽多杀性巴氏杆菌、空肠弯曲杆菌等14株其他病原微生物没有扩增反应;该LAMP最低检出量为0.17pg/反应,敏感性远高于常规PCR的56pg/反应。结果表明,所建立的副鸡禽杆菌LAMP具有快速、高效、方便操作等特点,适用于基层兽医部门进行副鸡禽杆菌的快速检测。
