Exploring the meaning of care among lived experiences of patients with blindness:an interpretive phenomenological study

Objective:To explore the meaning of care experienced by people with blindness in hospitals.Methods:Interpretive phenomenology along with the 6-step method of van Manen was used to conduct the study.Using purposeful sampling,15 people with legal blindness were interviewed.Thematic analysis was used to isolate the meaning of care.Results:Five themes emerged:(a)nurses in the eyes of patients with blindness;(b)negligence in the caring moments;(c)being cared for in ambiguity;(d)Uncoordinated care;and(e)Psychological discomfor t.These sub-themes were condensed into an overarching theme titled as“marginalized patients inside the stereotypical healthcare system.”Conclusions:Lived experiences of patients with blindness revealed that hospitals provide stereotypic or inappropriate care for this minority group in society.Health professionals par ticularly nurses should be skilled to provide person-centered and coordinated care for patients with blindness.

数字图像水印综述

随着数字化时代的到来,数字媒体信息的传播和复制变得非常容易,数字内容的版权问题越来越严重。为解决这一问题,数字水印技术应运而生,将信息嵌入到数字内容中,从而保护数字版权。将对数字水印技术的概念、分类、特点、应用及发展进行全面的综述,首先,总结了数字水印当前的技术特点,并进行分类;其次,介绍了数字水印的特点以及评价指标;然后,介绍了目前对水印的攻击方式以及数字水印的应用;最后,提出了数字水印的不足及未来发展趋势。

X80高钢级管道焊接残余应力测试研究

目的获得X80高钢级管道环焊缝焊接残余应力大小与分布模式。方法首先采用盲孔法对X80高钢级管道的环焊缝焊接残余应力进行了测试,然后将测试结果与X80管道焊接残余应力的相关文献试验数据以及国家标准《在用含缺陷压力容器安全评定》GB/T 19624—2019所规定的内容进行了对比分析,最后根据测试数据提出了X80高钢级管道环焊缝焊接残余应力σ_(R)与距焊缝中心距离x之间的函数关系式,进一步得到了X80管道环焊缝沿环向与轴向的焊接残余应力计算公式。结果X80管道环焊缝沿环向区域存在较大的残余拉应力,焊接残余应力在焊趾区域达到峰值,表现为随着距焊缝中心距离的增加,环向残余应力由拉应力小幅度增加达到峰值567 MPa后迅速转变为压应力,随后缓慢转变为拉应力并趋近于0。随着距焊缝中心距离的增加,轴向残余应力由压应力迅速转变为拉应力,其中压应力峰值为92 MPa,发生在焊缝熔合线位置,拉应力峰值为188 MPa,出现在远离熔合线16 mm位置。结论根据试验结果提出了适用于X80管道环焊缝沿环向与轴向的焊接残余应力分布模式,为含缺陷X80管道的安全评定及修复提供理论参考。

The gut-eye axis:from brain neurodegenerative diseases to age-related macular degeneration

Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are consequently lacking.The microbiome is defined as a large ecosystem of microorganisms living within and coexisting with a host.The intestinal microbiome undergoes dynamic changes owing to age,diet,genetics,and other factors.Such dysregulation of the intestinal flora can disrupt the microecological balance,resulting in immunological and metabolic dysfunction in the host,and affecting the development of many diseases.In recent decades,significant evidence has indicated that the intestinal flora also influences systems outside of the digestive tract,including the brain.Indeed,several studies have demonstrated the critical role of the gut-brain axis in the development of brain neurodegenerative diseases,including Alzheimer’s disease and Parkinson’s disease.Similarly,the role of the“gut-eye axis”has been confirmed to play a role in the pathogenesis of many ocular disorders.Moreover,age-related macular degeneration and many brain neurodegenerative diseases have been shown to share several risk factors and to exhibit comparable etiologies.As such,the intestinal flora may play an important role in age-related macular degeneration.Given the above context,the present review aims to clarify the gut-brain and gut-eye connections,assess the effect of intestinal flora and metabolites on age-related macular degeneration,and identify potential diagnostic markers and therapeutic strategies.Currently,direct research on the role of intestinal flora in age-related macular degeneration is still relatively limited,while studies focusing solely on intestinal flora are insufficient to fully elucidate its functional role in age-related macular degeneration.Organ-on-a-chip technology has shown promise in clarifying the gut-eye interactions,while integrating analysis of the intestinal flora with research on metabolites through metabolomics and other techniques is crucial for understanding their potential mechanisms.

富硫化物隐伏矿地球化学勘查技术:含硫气体地球化学测量

含硫气体地球化学测量在找矿勘查中具有悠久的历史。但是由于含硫气体的高活动性和反应性、测试结果低重现性、分析测试高成本等缺点,含硫气体未能大规模应用于隐伏矿勘查。矿产勘查由近地表易发现矿转向隐伏矿以及便携式经济、高效和实时气体测量设备的成功研发,为气体地球化学勘查方法体系的完善升级和推广应用提供了一个新的契机。本文重点梳理了富硫化物隐伏矿气体地球化学测量研究进展、面临的挑战和未来发展方向。动力学平衡模拟、矿物(矿石)风化实验和矿区实例研究表明,富硫化物隐伏矿上方土壤中气体地球化学异常受多种因素影响,如矿体矿物组成、盖层特征、微生物作用、地球化学景观类型和含硫气体物理化学特征等。在土壤覆盖区可采用便携式多组分气体测量仪实现现场实时测量,若隐伏矿直接被运积层覆盖,则含硫气体异常与隐伏矿倾向于具有垂向对应关系。在基岩出露区则可采用岩石热解吸的方式测量含硫气体。隐伏矿与含硫气体异常的空间关系取决于断层和裂隙等渗透性通道的发育情况。案例研究统计表明,含硫气体地球化学测量不仅适用于半干旱-干旱地区,在半湿润-湿润地区也具有一定潜力。未来研究主要聚焦含硫气体在表生环境中的形成演化过程(查明主控因素)、不同地球化学景观区(尤其是半湿润-湿润气候区)含硫气体地球化学测量有效性以及便携式土壤气体测量设备小型化和智能化升级改造3个方面。

红外成像非均匀性校正算法研究

盲元以及非均匀性噪声的存在会导致红外图像的成像质量大幅下降。针对此问题设计了一种红外图像非均匀性校正算法。首先,介绍了两点校正算法的原理;然后对盲元的定义以及传统的常用盲元检测方法和盲元补偿方法进行了分析,并在此基础上提出了梯度阈值盲元检测法,即通过计算所有相邻像元之间的灰度差值得到盲元的判断阈值;接着采用改进的邻域代替法进行盲元补偿,并将上述算法用于某自研中波红外相机中;最后设计对黑体的成像实验,分别将本文盲元检测、补偿算法与现阶段的常用方法进行比较,对比校正前后图像的成像质量以及非均匀性指标。结果表明,本文提出的非均匀性校正算法可有效抑制盲元及噪声,校正后图像的非均匀性下降了65%,图像质量明显提高,可满足该自研中波红外相机的工作需求。

基于偏微分方程的盲去模糊超分辨率重建算法及实验

提出一种基于偏微分方程的图像盲去模糊超分辨率重建算法,旨在未知模糊核的情况下,将含噪声的低分辨率模糊图像重建为清晰的高分辨率图像.首先,针对图像退化过程构建变分问题,并借助变分方法推导出偏微分方程模型.其次,结合交替方向法和数值差分方法,通过设计时空全离散数值格式求解未知的模糊核和清晰的图像.再次,通过一系列数值实验,分析参数选择对图像重建效果的影响,确定合适的参数设置.最后,针对若干遥感图像进行实验,实验结果证明了所给模型的有效性与可靠性.

基于《国际功能、残疾和健康分类》评价中国智能化辅盲设备的补偿功能

背景:辅盲设备及技术的应用是当今视力障碍人群常用的干预手段,可提高日常生活活动的参与及工作学习能力,帮助其回归家庭、回归社会。数字信息和智能化时代下辅盲设备的形式、技术和功能各有不同,其分类目前暂未能得到有效统一的讨论和评价。目的:基于《国际功能、残疾和健康分类》评价国内视力障碍人群智能化辅盲设备的补偿功能。方法:通过计算机检索中国知网、维普和万方数据库2013-01-01/2023-12-31收录的相关文献。基于《国际功能、残疾和健康分类》理论模式和框架结构,应用术语结构和编码程序归纳相关视力障碍评估类目,整理与分析国内视力障碍的智能化辅盲设备补偿功能研究与分类。结果与结论:①共纳入197篇文献:其中身体功能1篇,包含b2(b210);身体结构1篇,包含s2(s220);活动与参与共119篇,包含d1(10篇,d110、d115、d120、d140、d166),d3(4篇,d315、d325、d345、d360),d4(102篇,d465、d470),d8(3篇,d820、d825);环境因素共76篇,包含e1(72篇,e115、e120、e125、e130、e140、e150、e155、e160),e2(4篇,e210、e240);②基于《国际功能、残疾和健康分类》的视力障碍智能化辅盲设备补偿功能研究分类包含4个部分、8个分类、25个类目,领域涉及身体补偿类、生活用品类、教育学习类、出行导盲类、布局规划类。

“盲区削减”与“功能结构协调”双目标导向下的生态网络协同优化——以武汉市为例

构建和优化生态网络对解决当前生态问题、保障区域生态安全、实现可持续发展具有重要意义。然而,当前生态网络优化研究鲜有多目标优化研究,更是忽视了多个优化目标间协同优化的作用,缺乏系统的优化框架。因此,提出一种“生态盲区削减⁃网络功能结构协调”的双目标协同优化框架,并以武汉市为例开展实证研究。运用最小累积阻力模型构建初始生态网络,并开展生态盲区指导下的生态网络优化;然后,基于协调性分析,针对功能结构异配节点,提出针对性的优化措施;采用鲁棒性和结构指数对优化前后生态网络进行评价。结果表明:(1)武汉市初始生态网络含生态源地17个,生态廊道47条,空间分布呈不均衡性;(2)经调整型生态源地、新增型生态源地、补充生态廊道和非源地斑块优化后,生态盲区占比从31.77%降至15.37%;(3)新增17条廊道,实施三级差异化生态建设后,实现了生态网络协调性;(4)优化后的生态网络结构指数α、β、γ分别提高69.16%、56.16%和47.12%,鲁棒性也更强。研究得出,该双目标协同优化模型不仅能够实现各自的优化目标,还能增强生态网络的稳定性。该模型将为生态网络优化研究提供新视角和系统框架,案例结果将为武汉市削减生态盲区、建设功能与结构协调的生态网络提供理论和方法指导。

基于测量的盲量子计算研究进展

量子计算机具有广阔的前景和发展潜力,但其物理实现目前面临巨大挑战。基于测量的盲量子计算,由于其允许量子能力有限甚至没有量子能力的普通用户,可通过借助远程量子服务器,使用基于测量的量子计算模型完成计算任务,并保证其数据、算法和结果的私密性。因此,这种委托量子计算的方式将成为未来普通用户共享量子计算资源的一种重要应用模式。基于此,阐述了基于测量的量子计算模型包括的两种常用资源态—簇态和图态,以及测量模式的定义和形式化描述;分析了基于测量的盲量子计算的基本原理,包括通用资源态—Brickwork态的构造、盲量子计算测量模式和通用盲量子计算协议;梳理了解决基于测量的盲量子计算根本问题的不同技术路线和实验成果;探讨了其未来的发展方向。

基于盲源分离的多人呼吸信号检测方法

近年来,人们越来越关注多人环境下的呼吸监测,以及如何同时监测多人的健康状态。在多人呼吸检测的算法中,盲源分离算法因其无需先验信息并且对硬件性能依赖性较小而备受研究者关注。然而,在多人呼吸监测场景中,目前的盲源分离算法通常将相位信号作为源信号进行分离,该文引入FMCW雷达下距离维信号和相位信号的对比,推导出相位信号作为源信号存在近似误差,并通过仿真验证距离维信号作为源信号时分离效果更好。另外,该文提出了基于非圆复数独立成分分析的多人呼吸信号分离算法,分析了不同呼吸信号参数对分离效果的影响,仿真和实测实验表明,所提出的方法适用于天线个数不小于目标个数时多人呼吸信号的检测,并且在目标角度差为9.46°时,也能够准确分离呼吸信号。

Prevalence and risk factors for eye diseases, blindness, and low vision in Lhasa, Tibet

AIM: To determine the prevalence and risk factors for eye diseases, blindness, and low vision in Tibet, and to assist the development of eye disease prevention and treatment schemes.METHODS: We carried out a survey of eye diseases among a population living at high altitude. A total of 1 115 Tibetan permanent residents aged 40 years or older from the towns and villages of Qushui County, Lhasa Prefecture, Tibet Autonomous Region, participated in this study. All participants completed a detailed questio-nnaire, and underwent presenting and pinhole visual acuity tests,and a comprehensive ophthalmic examination.RESULTS: There were 187 blind eyes (8.43%), 231 eyes with low vision (10.41% ). The leading cause of visual impairment was cataract of 55.0% (101/187) blindness and of 50.2% (116/231) low vision, followed by fundus lesions of 22.9% blindness and 23.8% low vision, while only a low prevalence of glaucoma of 9.6% blindness and 1.7% low vision was observed. The analysis of 2 219 eyes showed that the most common external eye disease was pterygium (27.2%) in Tibet.CONCLUSION: The high prevalence of blindness and low vision in the Tibetan population at high altitude is a serious public health issue. There is a need to establish and maintain an appropriate effective eye care program in Tibet.

Population-based survey of prevalence,causes,and risk factors for blindness and visual impairment in an aging Chinese metropolitan population

AIM： To assess the prevalence, causes, and risk factors for blindness and visual impairment among elderly （〉60 years of age） Chinese people in a metropolitan area of Shanghai, China. METHODS： Random cluster sampling was conducted to identify participants among residents ≥60 years of age living in the Xietu Block, Xuhui District, Shanghai, China. Presenting visual acuity （PVA） and best-corrected visual acuity （BCVA） were checked by the Early Treatment Diabetic Retinopathy Study （ETDRS） visual chart. All eligible participants underwent a comprehensive eye examination. Blindness and visual impairment were defined according to World Health Organization （WHO） criteria. RESULTS： A total of 4190 persons （1688 men and 2502 women） participated in the study, and the response rate was 91.1%. Based on PVA, the prevalence of blindness was 1.1% and that of visual impairment was 7.6%. Based on BCVA, the prevalence of blindness and visual impairment decreased to 0.9% and 3.9%, respectively. Older （〉80 years of age） women, with low educational levels and smoking habits, exhibited a significantly greater chance for blindness and visual impairment than did those with high educational levels and no smoking habits （P〈0.05）. Based on PVA and BCVA, the main causes of blindness were cataract, myopic maculopathy, and age-related macular degeneration （AMD）. CONCLUSION： Our findings help to identify the population in need of intervention, to highlight the need for additional eye healthcare services in urban China.

The Association of Socioeconomic Status with the Burden of Cataract-related Blindness and the Effect of Ultraviolet Radiation Exposure: An Ecological Study

Objective To assess the association of socioeconomic status with the burden of cataract blindness in terms of year lived with disability(YLD) rates and to determine whether ultraviolet radiation(UVR) levels modify the effect of socioeconomic status on this health burden.Methods National and subnational age-standardized YLD rates associated with cataract-related blindness were derived from the Global Burden of Disease(GBD) study 2017. The human development index(HDI) from the Human Development Report was used as a measure of socioeconomic status.Estimated ground-level UVR exposure was obtained from the Ozone Monitoring Instrument(OMI)dataset of the National Aeronautics and Space Administration(NASA).Results Across 185 countries, socioeconomic status was inversely associated with the burden of cataract blindness. Countries with a very high HDI had an 84% lower age-standardized YLD rate [95%confidence interval(CI): 60%–93%, P < 0.001] than countries with a low HDI;for high-HDI countries, the proportion was 76%(95% CI: 53%–88%, P < 0.001), and for medium-HDI countries, the proportion was48%(95% CI: 15%–68%, P = 0.010;P for trend < 0.001). The interaction analysis showed that UVR exposure played an interactive role in the association between socioeconomic status and cataract blindness burden(P value for interaction = 0.047).Conclusion Long-term high-UVR exposure amplifies the association of poor socioeconomic status with the burden of cataract-related blindness. The findings emphasize the need for strengthening UVR exposure protection interventions in developing countries with high-UVR exposure.

环向排水盲管间距对富水区隧道衬砌水压力的影响

隧道环向排水盲管纵向间距设置过大会导致衬砌结构承受较大的水压力,设置过小则会导致排水过量、威胁隧址区生态环境。建立富水区隧道三维流固耦合模型,研究了设置环向排水盲管条件下衬砌水压力分布特征,引入平均卸压系数来分析环向排水盲管间距对衬砌水压力的影响。进一步提出在仰拱下方设置排水洞的体外排水方法,可有效降低高水压富水隧道衬砌底部水压力。研究结果表明:(1)二次衬砌水压力在环纵向排水管位置处最低,相邻环向排水盲管间衬砌水压力分布沿隧道纵向方向呈周期性变化。(2)衬砌最大水压力出现在仰拱中心位置,可在仰拱处设置泄水孔或排水管以降低仰拱水压力。(3)环向盲管的强影响区约为环向盲管两侧1 m区域。(4)隧道稳定排水量随环向盲管间距减小显著增加。富水区隧道环向排水盲管间距的设置需要综合考虑衬砌水压力和运营期排水系统的排水能力。

Mayombian ethnic,vegetables low intake,insulin treatment,diabetic nephropathy and severe diabetic retinopathy are determinants of blindness in diabetic Africans

· AIM: to determine the frequency and causes of blindness in diabetic Africans. ·METHODS: The study was a cross-sectional survey carried out among known black diabetics consecutively admitted at the Teaching Hospital, University of Kinshasa, between 2005 and 2007. Examination methods included interviewer -administered structured question - naire, eye examinations (visual acuity, tonometry, funduscopy), and fasting plasma glycaemia test. ·RESULTS: Of the 227 patients examined, 15.9% had blindness. Univariate analyses showed significant association between female, severity of diabetic retinopathy, Mayombian ethnic group, use of insulin treatment, low intake of vegetables, diabetic nephropathy, open angle glaucoma and blindness in all diabetics. After logistic regression, only diabetic nephropathy, use of insulin treatment, macular oedema, Mayombian ethnic group and vegetables low intake were the independent risk factors of blindness in all diabetics. However, after logistic regression in the sub -group with diabetic retinopathy, only open angle glaucoma and proliferative diabetic retinopathy were the independent determinants of blindness.·CONCLUSION: The majority of the causes of blindness in these diabetic Africans are avoidable. It is recommended that appropriate diabetes care, nutrition education, periodic eye examination and laser photocoagulation facilities should be provided for treating diabetics in sub-Saharan Africa. ·

低频脉冲磁场慢性暴露对健康成年股四头肌收缩力及形态的影响

背景:目前已有关于低频脉冲磁场对骨骼肌结构形态影响研究发现了骨骼肌质量变化,但对接受慢性暴露后的形态变化未见相关研究。目的:观察低频脉冲磁场慢性暴露对腿部股四头肌最大自主收缩力与形态指标的影响,为使用该技术作为肌肉功能改善策略提供组织形态变化的参考依据。方法:招募普通健康受试者70名,随机分为接受磁场刺激的试验组与进行假治疗的对照组,每组35名,试验时长共计4周,试验组受试者每隔48 h进行1次15 min的低频脉冲磁刺激干预,对照组进行假治疗,干预间隔与时长与试验组一致,干预4周后观察不同组别受试者股四头肌最大自主收缩力值变化,利用B型超声影像作为评估手段,观察肌肉厚度、肌肉横截面积及羽状角指标的变化。结果与结论:①经过4周的低频脉冲磁场慢性暴露,68名受试者完成试验,试验组受试者股四头肌最大自主收缩力测试值显著增长(P=0.000),提升幅度显著高于对照组(P=0.008);②试验组受试者的肌肉形态3项指标均显著高于试验前测(P=0.000),而对照组肌肉厚度指标呈显著性下降(P=0.020),羽状角无显著性变化,横截面积显著性提升(P=0.000);③组间对比发现,试验组关于肌肉形态的肌肉厚度(P=0.012)、羽状角(P=0.003)及横截面积(P=0.049)3项指标均显著高于对照组;④上述数据证实,健康成年受试者经过4周的低频脉冲磁场慢性暴露,股四头肌的最大自主收缩力显著提升,同时观察到试验组的肌肉厚度、横截面积及羽状角3项肌肉形态指标的显著增长,对使用该技术作为肌肉改善的运动替代与医疗策略提供了肌组织形态改善的支持依据。

定量和定性因子混合的罚盲克里金模型

克里金模型是一种十分有效的空间插值方法,被广泛研究并应用于地质学、环境科学及大气科学等工程领域观测的代理模型。针对含有定量和定性因子混合输入的高维观测样本,提出定量和定性因子混合的罚盲克里金模型。在罚盲克里金模型的基础上,对输入数据中含有定量和定性因子混合的情况,利用定量和定性因子混合的高斯相关模型,建立混合因子的罚盲克里金模型,并通过惩罚函数对均值函数进行因子选择。通过线性和非线性分段函数的数值实验验证定量和定性因子混合的罚盲克里金模型具有较高精度。结果表明,有限样本下一阶罚盲克里金模型和二阶罚盲克里金模型均具有较小的相对均方根误差、标准均方根误差和根均方百分比误差。

Unrecognized and unregistered blindness in people 70 or older in Jing'an district, Shanghai, China

AIM: To evaluate the efficacy of a registration system for the blind people and to monitor the blindness due to uncorrected refractive error and cataract in Jing’an district, Shanghai, China. ·METHODS: Five hundred and ten blind people, based on visual acuity screening in a population aged 70 or older were enrolled into the study. Four hundred and forty subjects were interviewed. The following data were collected on each patient: demographic data, number of hospital visits for eye related problems, distance visual acuity, visual fields, ophthalmic diagnoses, education and registration status. If the eligible subject was not registered as blind, the reason for non -registration was recorded. ·RESULTS: Ten point nine one percent blindness was due to cataract, 27.5% due to uncorrected refractive error, and only 61.59% met the eligible blindness criteria (uncorrected refractive error and cataract are not considered as eligible blindness). The first four leading causes of eligible blindness were age related macular degeneration (25.09% ), myopic macular degeneration (21.40%), glaucoma (18.82%) and corneal disease (8.12%). Only 68.27% eligible blind people were registered. The patients with macular degeneration and glaucoma tendednot to register. Blind people with an above primary school education were 2.59 times more likely to be registered than those who were illiterate or had only a primary school education (OR=2.59, 95%CI: 1.49-4.48, P 【0.01). Patients who had 4 or more visits to the hospital requesting eye care services in a year were 2.2 times more likely to be registered than those with less than 4 visits to the hospital (OR =2.54, 95% CI: 1.47 -4.38, P 【 0.001). The first two leading reasons of misregistration were unknowing the registration system (48% ) and unwilling to register (21%). ·CONCLUSION: Under-registration of the eligible blind people exists in the registry system. Education and the number of hospital visits for eye care services were factors associated with registration levels. Uncorrected refractive error and cataract are important causes of blindness.

重视人工角膜移植适应证的选择和并发症的预防及处理

角膜移植手术是治疗角膜盲的有效手段,人工角膜移植是高危角膜移植患者复明的最后手段。国产化的人工角膜在我国批准上市后,为我国终末角膜盲患者带来了复明的希望。然而该手术技术难度高,术后并发症种类多、发生率高,对患者术后护理和随访等方面都有较高的要求。应当重视人工角膜移植的适应证选择,做好患者沟通宣教和术后管理,积极预防和治疗手术并发症,使人工角膜技术稳步前进,为角膜盲患者造福。