交互式数字叙事:加拿大Writing New Body Worlds阅读治疗新探索

文章基于相关研究文献与语料,对加拿大WNB阅读治疗实践进行梳理与归纳。WNB首次使用交互式数字叙事技术,构建面向公众的阅读治疗平台,以其交互式特征,融合了阅读和治疗引导两个过程,提供可访问的非临床方式,可面向大规模人群实现预防性健康干预。基于数据与计算的精准化阅读治疗是数字人文视角下的新变革,更具推广应用价值;以在线阅读平台建设为依托,推进实施平台化的阅读和治疗应成为未来发展方向之一;基于阅读形态与体验因技术赋能而改变的现状,图书馆应发挥引领作用,积极收集、创建或协助创建数字故事,推进阅读推广、服务与治疗的融合性发展,成为社区建设促进者、历史欣赏者和社区参与倡导者,也使阅读借助交互式数字叙事这一新载体,更好地发挥变革的力量,促进健康与幸福。

Childlife干预在儿童隐匿阴茎围术期护理中的应用

分析儿童隐匿阴茎围术期护理中采取Child life干预的效果。方法 选取2022年1月-2023年2月纳入的隐匿性阴茎儿童60例作为观察对象,经随机抽签法分组,对照组、观察组各有30例。两组分别采取常规护理、Child life干预,观察围术期患儿的心理状态,并评估患儿术后疼痛评分及护理满意度、护理依从性。结果 护理前,组间SAS及SDS评分相比,p>0.05;护理后,观察组SAS及SDS评分比对照组低,p<0.05;观察组Wong-Baker分值低于对照组,p<0.05;观察组依从性及护理满意度高于对照组,p<0.05。结论 在隐匿性阴茎儿童围术期护理中采取Child life护理模式可提升患儿的依从性、护理满意度,并改善患儿心理状态,减轻其疼痛感。

废冰箱回收利用环境效益评估——基于IMPACT WORLD+方法

废电器是产生量大且增速快的一类固体废物.我国构建的废电器回收体系是实施碳达峰?碳中和的重要举措,但废电器回收利用体系的环境效益尚不清楚.利用IMPACTWORLD+方法,从不同环境影响类型出发评估废电器回收处理的环境效益,并通过损害类型指标量化评价.结果表明,废冰箱回收利用的损害类型指标“人体健康”和“生态环境质量”的结果分别为-10592.501EUR2015和-8211.357EUR2015,合计为-18803.857EUR2015,即环境收益相当于18803.857EUR2015.据此估算,中国2021年废电器回收处理体系中仅废冰箱回收利用的环境收益可达12.82亿EUR2015.研究结果表明废电器回收处理的环境收益十分可观,有望为废电器回收行业的可持续发展提供新的助力.

Accurate and efficient remaining useful life prediction of batteries enabled by physics-informed machine learning

The safe and reliable operation of lithium-ion batteries necessitates the accurate prediction of remaining useful life(RUL).However,this task is challenging due to the diverse ageing mechanisms,various operating conditions,and limited measured signals.Although data-driven methods are perceived as a promising solution,they ignore intrinsic battery physics,leading to compromised accuracy,low efficiency,and low interpretability.In response,this study integrates domain knowledge into deep learning to enhance the RUL prediction performance.We demonstrate accurate RUL prediction using only a single charging curve.First,a generalisable physics-based model is developed to extract ageing-correlated parameters that can describe and explain battery degradation from battery charging data.The parameters inform a deep neural network(DNN)to predict RUL with high accuracy and efficiency.The trained model is validated under 3 types of batteries working under 7 conditions,considering fully charged and partially charged cases.Using data from one cycle only,the proposed method achieves a root mean squared error(RMSE)of 11.42 cycles and a mean absolute relative error(MARE)of 3.19%on average,which are over45%and 44%lower compared to the two state-of-the-art data-driven methods,respectively.Besides its accuracy,the proposed method also outperforms existing methods in terms of efficiency,input burden,and robustness.The inherent relationship between the model parameters and the battery degradation mechanism is further revealed,substantiating the intrinsic superiority of the proposed method.

Patient Quality-of-Life, Providers with Incentive Payments, Real-World Evidence, and Reducing Healthcare Costs through New Innovations

Background: Value-Based Care is a program that was created by Professor Michael E. PORTER and Elizabeth O. TEISBERG which has been modified for implementation over the last seventeen years. This new program is paid by Commercial Health Insurers (Insurance Companies) and Centers for Medicare and Medicaid Services (Medicare). This program incorporates the patients, doctors, Life Sciences Companies, Insurance Companies, Holistic practice, traditional Chinese medicine, etc. with alternative traditional treatments and therapies for Real-World Evidence based and value-based treatment customized to patients’ needs and the patients benefit. Methods: The program was proposed to achieve value for patients and an improved healthcare system which is especially needed to provide treatment for patients in Serious or Life-threatening conditions or diseases. The program will accurately measure the outcomes of patients and provide a wider choice of treatments that matter to patients, also to measure the cost that successful alternative treatments provide which may lower the cost to Medicare and Insurance Companies. Conclusion: The proposed and now implemented program is to achieve value for patients. Golden Sunrise Nutraceutical (Golden Sunrise) provides a New Medical Innovation and treatment alternative to patients suffering from Serious or Life-threatening illnesses. By using Golden Sunrise Innovation and with the incorporation of Value-based Care patients will become the drivers or it could be said the patient Ambassadors of their own health. By incorporating Golden Sunrise Innovation, the doctors will have more diversity of treatments available for their patients. Payment should reflect value not volume, and the New Medical Innovation Golden Sunrise offers will help in reducing the costs to Insurance Companies accelerating the adoption of Value-Based Care.

Remaining Useful Life Prediction Method for Multi-Component System Considering Maintenance:Subsea Christmas Tree System as A Case Study

Maintenance is an important technical measure to maintain and restore the performance status of equipment and ensure the safety of the production process in industrial production,and is an indispensable part of prediction and health management.However,most of the existing remaining useful life(RUL)prediction methods assume that there is no maintenance or only perfect maintenance during the whole life cycle;thus,the predicted RUL value of the system is obviously lower than its actual operating value.The complex environment of the system further increases the difficulty of maintenance,and its maintenance nodes and maintenance degree are limited by the construction period and working conditions,which increases the difficulty of RUL prediction.An RUL prediction method for a multi-omponent system based on the Wiener process considering maintenance is proposed.The performance degradation model of components is established by a dynamic Bayesian network as the initial model,which solves the uncertainty of insufficient data problems.Based on the experience of experts,the degree of degradation is divided according to Poisson process simulation random failure,and different maintenance strategies are used to estimate a variety of condition maintenance factors.An example of a subsea tree system is given to verify the effectiveness of the proposed method.

Investigation of the quality of life,mental status in patients with gynecological cancer and its influencing factors

BACKGROUND Having a gynecological tumor or undergoing treatment can be a traumatic experience for women,as it affects their self-image and sexual relationships and can lead to psychological reactions.Psychological adjustment following cancer occurrence remains a key issue among the survivors.AIM To examine the current status of quality of life(QoL),anxiety,and depression in patients with gynecological cancer and to analyze the factors associated with it.METHODS Data for 160 patients with gynecological malignancies treated at Shanxi Bethune Hospital from June 2020 to June 2023 were collected and analyzed retrospectively.Patients’QoL was assessed using the European Organization for Research on Treatment of Cancer Quality of Life Questionnaire Core 30 and the Functional Assessment of Cancer Therapy-General Questionnaire.Their emotional status was evaluated using the Self-Rating Anxiety/Depression Scale.The associated factors of anxiety and depression were analyzed.RESULTS The overall QoL score of the patients 6 months after surgery was 76.39±3.63 points.This included low levels of social and emotional function and severe fatigue and pain.The scores for physiological,functional,emotional,social,and family well-being exhibited an upward trend following surgery compared with those before surgery.One month after surgery,some patients experienced anxiety and depression,with an incidence of 18.75%and 18.13%,respectively.Logistic analysis revealed that good sleep was a protective factor against anxiety and depression in patients with gynecological tumors,whereas physical pain was a risk factor.CONCLUSION Patients with gynecological malignancies often experience anxiety and depression.By analyzing the factors that affect patients’QoL,effective nursing measures can be administered.

Shifting the Paradigm:A Fresh Look at Physical Activity Frequency and Its Impact on Mental Health,Life Satisfaction,and Self-Rated Health in Adolescents

As adolescent mental health problems are becoming a more serious issue globally,this paper explores the relationship of physical activity in adolescents and its frequency on mental health as well as examines the mediating effects of life satisfaction and self-rated health in order to provide a reference for the promotion of mental health in adolescents.A sample of 3578 Chinese high school students completed questionnaires assessing their mental health,physical activity frequency,life satisfaction,and self-rated health.The mean SCL-90 value for adolescents was found to be 1.629%,and 24.73%of adolescents had varying degrees of mental health issue.Increased physical activity frequency is positively associated with improved mental health(p<0.001).Additionally,life satisfaction and self-rated health were found to play significant mediating roles in the relationship between physical activity frequency and mental health.Specifically,low-frequency physical activity had the most pronounced mediating effect on mental health through life satisfaction,while high-frequency physical activity exerted the most significant mediating effect on mental health through self-rated health.These findings underscore the importance of promoting physical activity among adolescents and highlight the distinct pathways through which physical activity frequency can influence mental health outcomes.Further research is needed to explore these relationships in diverse populations and settings,as well as to develop targeted intervention.

Effect of comprehensive nursing on the quality of life and swallowing function in individuals diagnosed with ischemic stroke

BACKGROUND Ischemic stroke(IS)is a widely recognized disease characterized by high preva-lence,mortality,morbidity,disability,and recurrence rates.It ranks prominently in terms of mortality,constituting 60%-80%of stroke cases.AIM To explore the impact of comprehensive nursing care on the quality of life and swallowing function in individuals diagnosed with IS.METHODS This study comprised 172 patients with IS admitted to our hospital between February 2018 to March 2021.The participants were divided into two groups,namely the control group(n=80)receiving routine care and the research group(n=92)receiving comprehensive care.Various assessment scales,including the standard swallowing function assessment scale(SSA),National Institutes of Health Stroke scale(NIHSS),European stroke scale(ESS),self-rating anxiety scale(SAS),self-rating depression scale(SDS),Barthel index(BI),and the motor func-tion assessment scale(MAS),were employed to evaluate the improvement in swallowing function,neurological deficits,clinical outcomes,anxiety,depression,daily living activities,and motor function before and after care.Furthermore,the study compared the occurrence of adverse reactions during the nursing period,life quality before and after the intervention,rehabilitation compliance,and nursing satisfaction between the two groups.RESULTS After the nursing intervention,the research group exhibited significantly improved SSA and NIHSS scores compared to the control group(P<0.05).Moreover,both groups demonstrated significant reductions in SAS and SDS scores(P<0.05),with the research group showing more obvious advantages(P<0.05).Compared to the control group,the research group displayed significantly better ESS,BI,and MAS scores(P<0.05),coupled with a lower incidence of adverse reactions(P<0.05).Additionally,the research group demonstrated markedly higher levels of life quality,rehabilitation compliance,and nursing satisfaction compared to the control group(P<0.05).CONCLUSION Comprehensive nursing effectively improved swallowing function,quality of life,and patient satisfaction,high-lighting its clinical significance.

Mental health in the virtual world:Challenges and opportunities in the metaverse era

Current rates of mental illness are worrisome.Mental illness mainly affects females and younger age groups.The use of the internet to deliver mental health care has been growing since 2020 and includes the implementation of novel mental health treatments using virtual reality,augmented reality,and artificial intelligence.A new three dimensional digital environment,known as the metaverse,has emerged as the next version of the Internet.Artificial intelligence,augmented reality,and virtual reality will create fully immersive,experiential,and interactive online environments in the metaverse.People will use a unique avatar to do anything they do in their“real”lives,including seeking and receiving mental health care.In this opinion review,we reflect on how the metaverse could reshape how we deliver mental health treatment,its opportunities,and its challenges.

The early life immune dynamics and cellular drivers at single-cell resolution in lamb forestomachs and abomasum

Background Four-chambered stomach including the forestomachs(rumen,reticulum,and omasum)and abomasum allows ruminants convert plant fiber into high-quality animal products.The early development of this four-chambered stomach is crucial for the health and well-being of young ruminants,especially the immune development.However,the dynamics of immune development are poorly understood.Results We investigated the early gene expression patterns across the four-chambered stomach in Hu sheep,at 5,10,15,and 25 days of age.We found that forestomachs share similar gene expression patterns,all four stomachs underwent widespread activation of both innate and adaptive immune responses from d 5 to 25,whereas the metabolic function were significantly downregulated with age.We constructed a cell landscape of the four-chambered stomach using single-cell sequencing.Integrating transcriptomic and single-cell transcriptomic analyses revealed that the immune-associated module hub genes were highly expressed in T cells,monocytes and macrophages,as well as the defense-associated module hub genes were highly expressed in endothelial cells in the four-stomach tissues.Moreover,the non-immune cells such as epithelial cells play key roles in immune maturation.Cell communication analysis predicted that in addition to immune cells,non-immune cells recruit immune cells through macrophage migration inhibitory factor signaling in the forestomachs.Conclusions Our results demonstrate that the immune and defense responses of four stomachs are quickly developing with age in lamb's early life.We also identified the gene expression patterns and functional cells associated with immune development.Additionally,we identified some key receptors and signaling involved in immune regulation.These results help to understand the early life immune development at single-cell resolution,which has implications to develop nutritional manipulation and health management strategies based on specific targets including key receptors and signaling pathways.

Analysis of factors impacting postoperative pain and quality of life in patients with mixed hemorrhoids:A retrospective study

BACKGROUND Hemorrhoids are among the most common and frequently encountered chronic anorectal diseases in anorectal surgery.They are venous clusters formed by con-gestion,expansion,and flexion of the venous plexus in the lower part of the rec-tum.Mixed hemorrhoids bleed easily and recurrently,and this can result in severe anemia.Hence,they may have a negative effect on the health of the patient and surgical treatment is required.Milligan-Morgan hemorrhoidectomy has been widely used since 1937 for the treatment of grade III and IV hemorrhoids.How-ever,most patients experience different degrees of postoperative pain that may cause anxiety.with mixed hemorrhoids post-surgery.METHODS The clinical data of patients with mixed hemorrhoids who underwent Milligan-Morgan hemorrhoidectomy were collected retrospectively.The basic character-istics of the enrolled patients with mixed hemorrhoids were recorded,and based on the Goligher clinical grading system,the hemorrhoids were classified as grades III or IV.The endpoint of this study was the disappearance of pain in all patients.Quantitative data were presented as mean±SD,such as age,pain score,and QoL score.Student’s t-test was used to compare the groups.RESULTS A total of 164 patients were enrolled.The distribution of the visual analog scale pain scores of all patients at 3,7,14 and 28 d after surgery showed that post-surgery pain was significantly reduced with the passage of time.Fourteen days after the operation,the pain had completely disappeared in some patients.Twenty-eight days after the surgery,none of the patients experienced any pain.Comparing the World Health Or-ganization Quality of Life-BREF self-reporting questionnaire scores of patients between 14 and 28 d after surgery,we observed that the quality-of-life scores of the patients post-surgery had significantly improved.There were six items that were compared at 14-and 28-d post-surgery.The mean QoL score 28 d after surgery(4.79±0.46)was higher than that at 14 d post-surgery(3.79±0.57).The mean health condition score 28 d after surgery(4.80±0.41)was also higher than that at 14 d post-surgery(4.01±0.62).The mean physical health score 28 d after surgery(32.10±2.96)was significantly higher than that at 14 d post-surgery(23.41±2.85).The mean psychological health score 28 d after surgery(27.22±1.62)was significantly higher than that at 14 d post-surgery(21.37±1.70).The mean social relations score 28 d after surgery(12.21±1.59)was significantly higher than that at 14 d post-surgery(6.32±1.66).The mean surrounding environment score 28 d after surgery(37.13±2.88)was significantly higher than that at 14 d post-surgery(28.42±2.86).The differences in quality-of-life scores at day 14 and day 28 post-surgery were ob-served to be statistically significant(P<0.001).CONCLUSION Milligan-Morgan hemorrhoidectomy can significantly improve the postoperative QoL of patients.Age,sex,and the number of surgical resections were important factors influencing Milligan-Morgan hemorrhoidectomy.

“岗位胜任力”背景下WORLD带教模式在中医住院医师规范化培训中的实践与探索

中医住院医师规范化培训与专业学位研究生并轨以来,中医住培制度的不足也慢慢凸显出来,如规培医师的临床参与度较少、责任不明确,学生单纯完成科室轮转,未得到核心能力的训练,毕业后岗位胜任力不足。为了最大限度地改善当前问题,从优化中医住培过程管理、提升学生综合素质、统筹部署、加强对临床带教老师的培训等方面入手研究问题,探讨WORLD带教模式在中医住院医师规范化培训中的实践,以更好地践行中医住院医师规范化培训的宗旨。

Origin and Basic Mechanism of Life

This paper presents in a concise way the main characteristics of life from the physical point of view and the most successful theories of biogenesis, together with a mathematical formulation and simulation of proto-biogenesis. We present here a calculation method for biochemical reactions based on the available reaction data base, and using this method, we calculate precise scenarios for the first life cycle, and for the first stages of terrestrial biological evolution.

Extraterrestrial Life in the Thermosphere: Plasmas, UAP, Pre-Life, Fourth State of Matter

“Plasmas” up to a kilometer in size and behaving similarly to multicellular organisms have been filmed on 10 separate NASA space shuttle missions, over 200 miles above Earth within the thermosphere. These self-illuminated “plasmas” are attracted to and may “feed on” electromagnetic radiation. They have different morphologies: 1) cone, 2) cloud, 3) donut, 4) spherical-cylindrical;and have been filmed flying towards and descending from the thermosphere into thunderstorms;congregating by the hundreds and interacting with satellites generating electromagnetic activity;approaching the Space Shuttles. Computerized analysis of flight path trajectories documents these plasmas travel at different velocities from different directions and change their angle of trajectory making 45°, 90°, and 180° shifts and follow each other. They’ve been filmed accelerating, slowing down, stopping, congregating, engaging in “hunter-predatory” behavior and intersecting plasmas leaving a plasma dust trail in their wake. Similar life-like behaviors have been demonstrated by plasmas created experimentally. “Plasmas” may have been photographed in the 1940s by WWII pilots (identified as “Foo fighters”);repeatedly observed and filmed by astronauts and military pilots and classified as Unidentified Aerial—Anomalous Phenomenon. Plasmas are not biological but may represent a form of pre-life that via the incorporation of elements common in space, could result in the synthesis of RNA. Plasmas constitute a fourth state of matter, are attracted to electromagnetic activity, and when observed in the lower atmosphere likely account for many of the UFO-UAP sightings over the centuries.

Impact of cancer diagnosis on life expectancy by area-level socioeconomic groups in New South Wales, Australia: a population-based study

Objective: Improvement in cancer survival over recent decades has not been accompanied by a narrowing of socioeconomic disparities. This study aimed to quantify the loss of life expectancy(LOLE) resulting from a cancer diagnosis and examine disparities in LOLE based on area-level socioeconomic status(SES).Methods: Data were collected for all people between 50 and 89 years of age who were diagnosed with cancer, registered in the NSW Cancer Registry between 2001 and 2019, and underwent mortality follow-up evaluations until December 2020. Flexible parametric survival models were fitted to estimate the LOLE by gender and area-level SES for 12 common cancers.Results: Of 422,680 people with cancer, 24% and 18% lived in the most and least disadvantaged areas, respectively. Patients from the most disadvantaged areas had a significantly greater average LOLE than patients from the least disadvantaged areas for cancers with high survival rates, including prostate [2.9 years(95% CI: 2.5±3.2 years) vs. 1.6 years(95% CI: 1.3±1.9 years)] and breast cancer [1.6 years(95% CI: 1.4±1.8 years) vs. 1.2 years(95% CI: 1.0±1.4 years)]. The highest average LOLE occurred in males residing in the most disadvantaged areas with pancreatic [16.5 years(95% CI: 16.1±16.8 years) vs. 16.2 years(95% CI: 15.7±16.7 years)] and liver cancer [15.5 years(95% CI: 15.0±16.0 years) vs. 14.7 years(95% CI: 14.0±15.5 years)]. Females residing in the least disadvantaged areas with thyroid cancer [0.9 years(95% CI: 0.4±1.4 years) vs. 0.6 years(95% CI: 0.2±1.0 years)] or melanoma [0.9 years(95% CI: 0.8±1.1 years) vs. 0.7 years(95% CI: 0.5±0.8 years)] had the lowest average LOLE.Conclusions: Patients from the most disadvantaged areas had the highest LOLE with SES-based differences greatest for patients diagnosed with cancer at an early stage or cancers with higher survival rates, suggesting the need to prioritise early detection and reduce treatment-related barriers and survivorship challenges to improve life expectancy.

Consequences of early life stress on the structure and function of the adult mouse retina

Early-life stress(ELS)refers to a period of environmental/social deprivation,physica l,sexual or emotional abuse,neglect,severe and/or chronic trauma in the prenatal/early postnatal stage,which is closely related to many adverse psychiatric disorders later in life,such as depressive disorder,substance abuse,dysthymia,panic,anxiety,and suicidal behavior in adulthood(Waters and Gould,2022).

A cup of coffee for a brain long life

Coffee is one of the world's favorite and most popular beverages,the third most popular beverage after water and tea.For many people,it is an indispensable habit before going to work and a socialization tool for the rest of the day.In general,the average consum ption varies from 2 to6 cups per day.What are the health implications?Given this consum ption,the benefits are actually greater than the risks.This is the conclusion of a careful study published in the New England Journal of Medicine(van Dam et al.,2020).

“Child Life”护理理念对支气管肺炎患儿的应用效果

目的观察“Child Life”护理理念应用于支气管肺炎患儿的效果。方法选择2022年6月至2023年6月就诊的支气管肺炎儿童128例,随机数字表法分为试验组和对照组,每组64例。对照组给予支气管肺炎常规护理,试验组在对照组基础上加用“Child Life”护理干预,比较2组患儿心境状态指标、治疗依从优良率、疾病控制进度指标和肺功能情况进行。结果试验组患儿焦虑抑郁评分低于对照组,治疗依从优良率高于对照组,疾病控制进度指标与肺功能指标优于对照组(P<0.05)。结论“Child Life”护理理念应用于支气管肺炎患儿,有利于该类患儿焦虑抑郁情绪的平复、治疗依从度的提升、疾病控制进度的加速与肺功能的改善,值得推广。

Healthy life expectancy with cardiovascular disease among Chinese rural population based on the prospective cohort study

BACKGROUND Limited research has explored the impact of cardiovascular disease(CVD)on healthy life expectancy(HLE)especially in resource-limited areas.This study aimed to investigate the association between CVD and HLE in Chinese rural population.METHODS This study included 11,994 participants aged 45 years and older from the baseline and follow-up surveys of the Henan rural cohort study.Healthy status was measured via a Visual Analogue Scale.The multistate Markov model was applied to estimate the association between CVD and transitions in health,unhealthiness and death.Gender-specific total life expectancy,HLE and unhealthy life expectancy were calculated by the multistate life table method.RESULTS During a mean follow-up time of 3.85(3.84–3.86)years,there were 588 deaths recorded.For individuals with CVD,the risk of switching from health to unhealthiness status was increased by 71%[hazard ratio(HR)=1.71,95%CI:1.42–2.07],the chance of recovery was reduced by 30%(HR=0.70,95%CI:0.60–0.82).Men aged 45 years without CVD could gain an extra 7.08(4.15–10.01)years of HLE and lose 4.00(1.60–6.40)years of unhealthy life expectancy compared to their peers with CVD,respectively.The corresponding estimates among women were 8.62(5.55–11.68)years and 5.82(2.59–9.04)years,respectively.CONCLUSIONS This study indicated that CVD was significantly associated with poorer health status and lower HLE among Chinese rural population.It is an important public health policy to adopt targeted measures to reduce the CVD burden and enhance the quality of life and HLE in resource-limited areas.