Intraoperative thermostatic nursing and failure mode and effects analysis enhance gastrectomies’ care quality

BACKGROUND Utilizing failure mode and effects analysis(FMEA)in operating room nursing provides valuable insights for the care of patients undergoing radical gastric cancer surgery.AIM To evaluate the impact of FMEA on the risk of adverse events and nursing-care quality in patients undergoing radical surgery.METHODS Among 230 patients receiving radical cancer surgery between May 2019 and May 2024,115 were assigned to a control group that received standard intraoperative thermoregulation,while the observation group benefited from FMEA-modeled operating room care.Clinical indicators,stress responses,postoperative gastroin-testinal function recovery,nursing quality,and the incidence of adverse events were compared between the two groups.RESULTS Significant differences were observed in bed and hospital stay durations between the groups(P<0.05).There were no significant differences in intraoperative blood loss or postoperative body temperature(P>0.05).Stress scores improved in both groups post-nursing(P<0.05),with the observation group showing lower stress scores than the control group(P<0.05).Gastrointestinal function recovery and nursing quality scores also differed significantly(P<0.05).Additionally,the incidence of adverse events such as stress injuries and surgical infections varied notably between the groups(P<0.05).CONCLUSION Incorporating FMEA into operating room nursing significantly enhances patient care by improving safety,expediting recovery,and reducing healthcare-associated risks.

Preoperative diagnosis and operative effect of intracranial aneurysm with three-dimensional computed tomography angiography

BACKGROUND ： Digital subtraction angiography （DSA） is always regarded as the golden standard for diagnosis of intracranial aneurysm; however, the procedure is complex, traumatic, expensive and easy to induce vascular complication. Three-dimensional computed tomography angiography （3D-CTA） can make up deficiencies of DSA; therefore, it is used in clinical therapy wider and wider. OBJECTIVE ： To evaluate the clinical effect of 3D-CTA on disruption and hemorrhage of intracranial aneurysm pre- and post-operation and compare with the effect of DSA. DESIGN ： Auto-control contrast observation SETTING ： Department of Neurosurgery, Shengjing Hospital of China Medical University PARTICIPANTS ： A number of 106 patients with disruption and hemorrhage of intracranial aneurysm were selected from the Department of Neurosurgery, Shengjing Hospital of China Medical University from January 2003 to April 2006. All patients were diagnosed with cranial operation and consent. There were 47 males and 59 females aged from 3-76 years with the mean age of （47±13） years. Among them, 82 patients had extensive subarachnoid hemorrhage （SAH）, 7 had hemorrhage at longitudinal fissure, and 17 had hemorrhage at ambiens cistema and lateral fissure. Moreover, intraventricular hematocele was accompanied on 13 patients and hematom on 9 patients. METHODS： （1） 3D-CTA examination： Siemens SOMATOM Sensation 64 CT was used in this study. The thickness was 1 mm and interval of reconstruction was 0.8 mm. Localizing section was plainly scanned as the standard of canthus line. Scan ranged from 30 mm below sella to 50 mm above sella. Non-ion contrast medium of Omnipaque 350 （concentration of iodine was 350 g/L） was inserted into anterior vein of elbow with 18G trochar retained with high-pressured injectoc pum. The speed was 4.5 mL/s and the total volume was 80-100 mL with the means of 90 mL. Scan started at 10-20 s after injection of contrast medium. Original image was dealt with Leonardo workstation and retreated with Syngo software. Volume rendering and maximum intensity projection were used to reconstructed images, （2） All 106 patients suffered from occlusion of aneurysm clamp. Before operation, 3D-CTA was undertaken and DSA was followed. After operation, patients were rechecked with 3D-CTA. MAIN OUTCOME MEASURES： Comparisons between 3D-CTA and DSA. RESULTS ： All 106 patients were involved in the final analysis. （1） Examination of 3D-CTA and DSA： Among 118 patients with aneurysm, 110 were checked with 3D-CTA and the detected rate was 93.2% （110/118）. Among other 8 cases, 3 were negative and checked again with DSA; 1 had pericallosal aneurysm, 1 ophthalmic aneurysm, and 1 anterior choroidal artery of aneurysm. 3D-CTA results of other 5 cases were suspicious, and then, they were regarded as having aneurysm with DSA. Before operation, correlation among site, body, neck of aneurysm and peripheral anatomic structure were shown sufficiently. After operation, 82 patients were rechecked with 3D-CTA, which was complete occlusion, precise, unobvious constriction, emphraxis or remains as compared with 3D-CTA those pre-operation. （2） Characteristics of 3D-CTA： With multiple vessels and angles, 3D-CTA observed the relationship between aneurysm neck and carried artery and showed thrombosis in cavity of aneurysm, calcification of aneurysm wall and peripheral structure of vessel at the same time. However, DSA could not detect the reactions mentioned above. It could delete image of cranium, simulate image of operative route, eliminate artifact induced by metal, but not distinguish blood stream direction. Meanwhile, posterior communicating artery was always poor during circle of Willis artery showing. CONCLUSION： （1） 3D-CTA is characterized by simple operation and non-invasive showing vascular stereo structure and correlation. Therefore, it is significant for diagnosis and designing plan of operative approach and focal location pre-operation and evaluating effect post-operation. （2） 3D-CTA does not completely replace DSA on the diagnosis of intracranial aneurysm.

Observation of the Effect of Video Assessment Method on the Operation Skills of Individual Nurses

Objective:To explore the application effect of video assessment method in clinical nurses’nursing operation skills.Method:To select 58 nurses who participated in the individual soldier standard in the children’s hospital in 2019 and 2020 as the research objects,among which the nurses who participated in the individual soldier standard in 2019 were the nurses who participated in the individual soldier standard in 2019 and 2020.A total of 29 people in the first batch were set as the control group,using traditional assessment methods.In 2020,the second batch of 29 nurses who participated in the individual soldier standard reached the experimental group.Using the video assessment method,there was no significant difference in general information between the two groups(P>0.05).After the assessment,the scores,coping with work pressure,and proactiveness of the two groups of research subjects were compared.Results:The experimental group’s nursing operation assessment scores,coping with work pressure,and proactiveness were significantly better than those of the control group,the difference was statistically significant(P<0.05).Conclusion:The application of the video assessment method improves the passing rate of nurses’operational skills examination,enhances nurses’initiative in learning,reduces examination pressure,and can be accurately,timely,and safely applied to clinical nursing work,which is worthy of study and promotion.

Long-term postoperative outcomes of bilateral lateral rectus recession vs unilateral recession-resection for intermittent exotropia

AIM: To discuss the long-term postoperative results of bilateral lateral rectus recession(BLR) and unilateral lateral rectus recession-medial rectus resection(RR) in therapy of intermittent exotropia.METHODS: We retrospectively analyzed 213 cases of intermittent exotropia who underwent surgery between2008 and 2010. The patients were grouped into BLR group and RR group. Motor outcomes were divided into three groups on the basis of the angle of deviation after surgery: overcorrection(esotropia/phoria 】5△), orthophoria(esotropia/phoria ≤5△to exotropia/phoria ≤10△), and undercorrection/recurrence(exotropia/phoria 】10△).Titmus test was used to evaluate stereoacuity, the stereoacuity 【800s of arc meaned the patients had stereopsis. Surgical outcome including motor criteria and sensory status were compared at postoperative 6, 12,24 mo and at 36 mo examination between groups. RESULTS: At 12, 24 mo after surgery, the motor outcomes had no difference(P 】0.05) between groups.However, the motor outcomes at 6, 36 mo were signally different in each group, indicating the success rate in RR group at 6mo was higher than that in BLR group(83.02%vs 82.24%, P 【0.05) but the result was contrary at the 3y examination(60.75% vs 43.40%, P 【0.05). No statistical significance were found in the sensory outcomes between the groups at mean of 3.7y follow-up.CONCLUSION: The motor outcomes in RR group were better than in BLR group at 6mo after surgery, while the3 y outcomes were better in BLR group. This may be due to the recurrence rate of the BLR was lower than the RR group’s.

EFFECT OF DIFFERENT OPERATION METHODS ON METHANE HYDRATE FORMATION

Three experiments of static state storage method, low-temperature and constant-pressure storage method and low-temperature and constant-pressure storage method were carried out to investigate which method was best in gas hydrate. The relationships of hydrate rate, capacity and liquid temperature versus time were derived and three results were contrasted. The experimental results show lowtemperature and constant-pressure method is better than the other two methods because it's operation period is shorter and storage capacity is larger than the other two. Low-temperature and constant-pressure method is the best method. So new method will be new research objective.

A cooperative interference resource allocation method based on improved firefly algorithm

To deal with the radio frequency threat posed by modern complex radar networks to aircraft,we researched the unmanned aerial vehicle(UAV)formations radar countermeasures,aiming at the solution of radar jamming resource allocation under system countermeasures.A jamming resource allocation method based on an improved firefly algorithm(FA)is proposed.Firstly,the comprehensive factors affecting the level of threat and interference efficiency of radiation source are quantified by a fuzzy comprehensive evaluation.Besides,the interference efficiency matrix and the objective function of the allocation model are determined to establish the interference resource allocation model.Finally,A mutation operator and an adaptive heuristic are integtated into the FA algorithm,which searches an interference resource allocation scheme.The simulation results show that the improved FA algorithm can compensate for the deficiencies of the FA algorithm.The improved FA algorithm provides a more scientific and reasonable decision-making plan for aircraft mission allocation and can effectively deal with the battlefield threats of the enemy radar network.Moreover,in terms of convergence accuracy and speed as well as algorithm stability,the improved FA algorithm is superior to the simulated annealing algorithm(SA),the niche genetic algorithm(NGA),the improved discrete cuckoo algorithm(IDCS),the mutant firefly algorithm(MFA),the cuckoo search and fireflies algorithm(CSFA),and the best neighbor firefly algorithm(BNFA).

Design and operation strategies of the system for destroying time-sensitive target based on system effectiveness

To improve the effect of destroying time-sensitive target （TST）, a method of operational effectiveness evaluation is presented and some influential factors are analyzed based on the combat flow of system for destroying TST. Considering the possible operation modes of the system, a waved operation mode and a continuous operation mode are put forward at first. At the same time, some relative formulas are modified. In examples, the influential factors and operation modes are analyzed based on the system effectiveness. From simulation results, some design and operation strategies of the system for destroying time sensitive targets are concluded, which benefit to the improvement of the system effectiveness.

Cooperative Communication with Asymmetric Channel State Information: A Contract Theoretic Modeling Approach

In relay-assisted cooperative communication,relay nodes help forwarding the information of a source node in case of link failure between the source and a destination.Although user cooperation improves the overall efficiency of the network,it requires incentive to stimulate potential relay nodes to assist the source by forwarding its data to the destination.Moreover,the potential relays are better informed than the source about their channel conditions to destination,which results in asymmetric information between the source and the relays.In this paper,we study the problem of lack of forwarding incentive in cooperative communication when channel state information of relays is private information and not known by the source.To tackle this problem,we apply the principle of contract theory to a cooperative wireless system.Source first designs incentive compatible and individually rational contract,consisting of a set of power-credit pairs.Then it broadcasts contract items to nearby nodes.Once the source node receives reply messages from the volunteer relays,it chooses one or more relays based on its requirements and communication starts.Simulation results show how credit assignment works in order to stimulate relays to cooperate and prevents relays from cheating behavior.

ADC-GERT network parameter estimation model for mission effectiveness of joint operation system

Effectiveness evaluation of the joint operation system is an important basis for the demonstration and development of weapon equipment.With the consideration that existing models of system effectiveness evaluation seldom describe the structural relationship among equipment clearly as well as reflect the dynamic,the analog-to-digital converter-graphical evaluation and review technique(ADC-GERT)network parameter estimation model is proposed based on the ADC model and the joint operation system structure.Firstly,analysis of the joint operation system structure and operation process is conducted to build the GERT network,where equipment subsystems are nodes and activities are directed arches.Then the mission effectiveness of equipment subsystems is calculated by the ADC model.The probability transfer parameters are modified by the mission effectiveness of equipment subsystems based on the Bayesian theorem,with the ADC-GERT network parameter estimation model constructed.Finally,a case study is used to validate the efficiency and dynamic of the ADC-GERT network parameter estimation model.

Mission reliability modeling and evaluation for reconfigurable unmanned weapon system-of-systems based on effective operation loop

The concept of unmanned weapon system-of-systems(UWSoS)involves a collection of various unmanned systems to achieve or accomplish a specific goal or mission.The mission reliability of UWSoS is represented by its ability to finish a required mission above the baselines of a given mission.However,issues with heterogeneity,cooperation between systems,and the emergence of UWSoS cannot be effectively solved by traditional system reliability methods.This study proposes an effective operation-loop-based mission reliability evaluation method for UWSoS by analyzing dynamic reconfiguration.First,we present a new connotation of an effective operation loop by considering the allocation of operational entities and physical resource constraints.Then,we propose an effective operationloop-based mission reliability model for a heterogeneous UWSoS according to the mission baseline.Moreover,a mission reliability evaluation algorithm is proposed under random external shocks and topology reconfiguration,revealing the evolution law of the effective operation loop and mission reliability.Finally,a typical 60-unmanned-aerial-vehicle-swarm is taken as an example to demonstrate the proposed models and methods.The mission reliability is achieved by considering external shocks,which can serve as a reference for evaluating and improving the effectiveness of UWSoS.

Influence of resilience on depression among nurses in clean operating departments:The mediating effect of life satisfaction

BACKGROUND A clean operating room is an important part of surgical and critical treatment in hospitals.The workload is substantial,the pace is rapid,and the working environment is intense;therefore,nurses who work in clean operating rooms are constantly challenged,which can lead to anxiety,depression,and other mental health issues.Life satisfaction and resilience are important factors that ensure mental health.Therefore,exploring the mediating role of life satisfaction in the influence of resilience on depression among nurses in clean operating rooms can help improve nursing services and teamwork.AIM To explore the mediating effect of satisfaction on the influence of resilience on depression among nurses in a clean operating department.METHODS From April to November 2022,196 nurses from the Department of Clean Operating at Harbin Medical University Cancer Hospital participated in this study.Participants were selected using convenience sampling.Participants’gender,age,marital status,position,length of service,personal monthly income,daily working hours,employment status,and professional title were collected,and the Connor-Davidson resilience scale,satisfaction with life scale,and selfrating depression scale were used to evaluate resilience,life satisfaction,and depression.The researchers conducted professional training in advance,introduced the research methods to the participants before the investigation,and explained the study’s significance and purpose.Surveys were distributed and collected on-site.Each questionnaire took 30 min to complete.RESULTS The average scores for life satisfaction,resilience,and depression were 3.13(±0.28),4.09(±0.78),and 56.21(±8.70),respectively.The correlation between resilience and depression was negative(r=-0.829,P<0.01).Life satisfaction was positively related to resilience(r=0.855,P<0.01)and negatively related to depression(r=-0.778,P<0.01).The relationship between resilience and depression was partially mediated by life satisfaction.The value of the mediating effect was-6.853(26.68%of the total effect).CONCLUSION Life satisfaction partially mediates the link between resilience and depression among nurses in clean operating departments.

Application and effect evaluation on Acknowledge-Introduce-Duration-Explanation-Thank you(AIDET)communication mode in cataract daytime operation nursing

Background:To explore the application effect of Acknowledge-Introduce-Duration-Explanation-Thank you(AIDET)communication mode in reducing anxiety and improving the care services satisfaction of the patients.Methods:The 100 cases undergoing cataract daytime operation from February to July 2019 were divided into test group and control group.The test group conducted health education and nursing care for patients during admission,pre-operation,post-operation,and discharge according to the AIDET communication mode.And the control group was given health education and nursing care to the patients according to the traditional way of communication.Results:The difference of the socioeconomic information between these two groups showed no statistical significance.The care services satisfaction score in the test group was statistically higher than that in the control group(P<0.05).The Self-Rating Anxiety Scale(SAS)score in the test group was significantly lower than that in the control group(P<0.01).This result indicated that the patients suffered less anxiety with the AIDET mode of communication.Conclusions:The application of AIDET communication mode to the nursing service of cataract daytime operation can reduce the tension and anxiety of the patients from the treatment and improve their satisfaction to care services.

Effect of Wave Accessibility on Lower Hybrid Wave Current Drive in Experimental Advanced Superconductor Tokamak with H-Mode Operation

The effect of the wave accessibility condition on the lower hybrid cm＇rent drive in the experimental advanced superconductor Tokamak （EAST） plasma with H-mode operation is studied. Based on a simplified model, a mode conversion layer of the lower hybrid wave between the fast wave branch and the slow wave branch is proved to exist in the plasma periphery for typical EAST H-mode parameters. Under the framework of the lower hybrid wave simulation code （LSC）, the wave ray trajectory and the associated current drive are calculated numerically. The results show that the wave accessibility condition plays an important role on the lower hybrid current drive in EAST plasma. For wave rays with parallel refractive index n｜｜= 2.1 or n｜｜ = 2.5 launched from the outside midplane, the wave rays may penetrate the core plasma due to the toroida] geometry effect, while numerous reflections of the wave ray trajectories in the plasma periphery occur. However, low current drive efficiency is obtained. Meanwhile, the wave accessibility condition is improved if a higher confined magnetic field is applied. The simulation results show that for plasma parameters under present EAST H-mode operation, a significant lower hybrid wave current drive could be obtained for the wave spectrum with peak value n｜｜ = 2.1 if a toroidal magnetic field BT =2.5 T is applied.

Ripple-effect analysis for operational architecture of air defense systems with supernetwork modeling

In order to solve the problem that the ripple-effect analy- sis for the operational architecture of air defense systems （OAADS） is hardly described in quantity with previous modeling approaches, a supernetwork modeling approach for the OAADS is put for- ward by extending granular computing. Based on that operational units and links are equal to different information granularities, the supernetwork framework of the OAADS is constructed as a “four- network within two-layer” structure by forming dynamic operating coalitions, and measuring indexes of the ripple-effect analysis for the OAADS are given combining with Laplace spectral radius. In this framework, via analyzing multidimensional attributes which inherit relations between operational units in different granular scales, an extended granular computing is put forward integrating with a topological structure. Then the operation process within the supernetwork framework, including transformation relations be- tween two layers in the vertical view and mapping relations among functional networks in the horizontal view, is studied in quantity. As the application case shows, comparing with previous modeling approaches, the supernetwork model can validate and analyze the operation mechanism in the air defense architecture, and the ripple-effect analysis can be used to confirm the key operational unit with micro and macro viewpoints.

Operational effectiveness evaluation based on the reduced conjunctive belief rule base

To address the issue of rule premise combination explosion in the construction of the traditional complete conjunctive belief rule base(BRB),this paper introduces an orthogonal design method to reduce the conjunctive BRB.The reasoning method based on reduced conjunctive BRB is designed with the help of the conversion technology from conjunctive BRB to disjunctive BRB.Finally,the operational mission effectiveness evaluation is taken as an example to verify the proposed method.The results show that the method proposed in this paper is feasible and effective.

Study on the operation effect of long term care insurance system in Qingdao

Population aging has become a global social problem, the problem in our country has become the core of the aging problem. With the gradual aging of the elderly, loss of energy, loss of energy has become the norm for the elderly or sick elderly. According to the Ministry of Civil Affairs statistics, as of the end of 2014, the number of disabled elderly in China reached 35 million, about 90% of the disabled elderly need professional care services and professional treatment to ease the pain. In order to deal with the social problems brought about by the aging of the population, in July 1, 2012, Qingdao City, the first in the country to establish a long-term health care insurance system, has taken a key step to crack the problem of aging. In this paper, the situation of Qingdao long term care insurance system as the research object, taking Qingdao city as study sites, according to statistical data analysis of the implementation effect of long-term local health care policy, and through questionnaires and interviews in the form of local residents to participate in the investigation of awareness, and perception. At the same time, the results of the survey on long-term health care insurance system in Qingdao, the operation effect of the overall analysis.

Therapeutic effects of flap operation on treating severe periodontitis and influence of it on inflammatory factors

Objective:To investigate therapeutic effects of Widman flap operation on treating severe chronic periodontitis and influence of it on inflammatory factors.Methods:A total of 129 cases of patients with severe chronic periodontitis treated in the dental department of our hospital from Nov2014 to Mar2016 were selected as investigate subjects. They were randomly divided to be 63 cases of control group and 66 cases of observation group. For control group, basic treatment was provided. For observation group, improved Widman flap operation was provided. Compared with the effects between two groups of patients, and analyzed the variation of each inflammatory factor before and after treatment.Results:Before treatment, no significant difference showed on PLI, SBI, CAL, PD indexes between two groups of patients. 6 weeks after treatment, PLI, SBI, PD in observation group were significantly decreased comparing with prior treatment, and PLI, SBI were significantly lower than control group at the same phase. 12 weeks after treatment, PLI in control group were significantly decreased comparing with prior treatment;PLI, SBI, CAL, PD in observation group were significantly decreased comparing with prior treatment, and were significantly lower than control group at the same phase. Before treatment, no significant difference showed on IL-1β, IL-6, TNF-α, CRP levels between two groups of patients. After treatment, 4 inflammatory factors in control group showed no significant variation comparing with the same group before treatment, 4 inflammatory factor levels in observation group were significantly lower than which before treatment, IL-1β, IL-6, TNF-α were significantly lower than control group at the same phase. Conclusion:Improving extent of modified Widman flap operation to periodontal indexes and inflammatory factors in patients with severe periodontitis were better than the basic treatment for control group. It could be a choice for treatment of severe periodontitis.

Study on the Operation Mechanism and Effect of the Yellow River Water and Sediment Regulation System

In order to scientifically deal with the problems of less water and more sediment in the Yellow River and the uncoordinated relationship between water and sediment,it is necessary to establish a perfect water and sediment regulation system.Through the calculation of the sediment transport capacity of the Yellow River and the application of the water and sediment regulation system,it is found that the sediment transport efficiency of the Yellow River will increase with the increase of water flow,and there will be an obvious inflection point near the flat discharge.The joint regulation of the backbone reservoir group can discharge the large discharge close to the minimum flat discharge of the downstream river,which improves the sediment transport capacity of the river and alleviates the problem of sediment deposition.In this paper,through the introduction of the Yellow River water and sediment regulation project system,regulation indicators and mechanisms,the author discusses in detail the Yellow River water and sediment regulation scheme and its operation effect,hoping to provide help promote the improvement of the Yellow River governance effect.

Modeling operation amplifier based on VHDL-AMS for TID effect

A model of the operational amplifier based on VHDL-AMS is proposed. According to needs of simulating the total ionizing dose(TID) radiation effect, parameters of operational amplifier are taken into account when the performance is specified. The operational amplifier model used for the TID radiation effect simulation is completed after verifying each modeled parameter. And a parameter for describing the external environment is introduced to make the model combined with TID. Finally, an example is used to illustrate the TID effect on the operational amplifier of MC14573, proving the validity of the model.

MHD Maxwell Fluid with Heat Transfer Analysis under Ramp Velocity and Ramp Temperature Subject to Non-Integer Differentiable Operators

The main focus of this study is to investigate the impact of heat generation/absorption with ramp velocity and ramp temperature on magnetohydrodynamic(MHD)time-dependent Maxwell fluid over an unbounded plate embedded in a permeable medium.Non-dimensional parameters along with Laplace transformation and inversion algorithms are used to find the solution of shear stress,energy,and velocity profile.Recently,new fractional differential operators are used to define ramped temperature and ramped velocity.The obtained analytical solutions are plotted for different values of emerging parameters.Fractional time derivatives are used to analyze the impact of fractional parameters(memory effect)on the dynamics of the fluid.While making a comparison,it is observed that the fractional-order model is best to explain the memory effect as compared to classical models.Our results suggest that the velocity profile decrease by increasing the effective Prandtl number.The existence of an effective Prandtl number may reflect the control of the thickness of momentum and enlargement of thermal conductivity.The incremental value of the M is observed for a decrease in the velocity field,which reflects to control resistive force.Further,it is noted that the Atangana-Baleanu derivative in Caputo sense(ABC)is the best to highlight the dynamics of the fluid.The influence of pertinent parameters is analyzed graphically for velocity and energy profile.Expressions for skin friction and Nusselt number are also derived for fractional differential operators.