Escape room游戏宣教对阴道分娩初产妇分娩恐惧及产程进展的影响

目的探究Escape room游戏宣教对阴道分娩初产妇分娩恐惧及产程进展的影响。方法采用便利抽样法,选取本院2021年1月—2022年6月收治的140例阴道分娩初产妇为研究对象,按随机数字表法将其分为对照组和观察组,每组各70例。对照组采取常规教育模式,观察组在常规护理基础上应用Escape room游戏宣教,比较两组初产妇分娩恐惧水平、产程进展。结果观察组分娩恐惧中高水平初产妇占比为57.14%小于对照组的80.00%,差异有统计学意义(P<0.05);观察组初产妇第一产程时间、第二产程时间均短于对照组,差异有统计学意义(P<0.05),两组第三产程时间比较差异无统计学意义(P>0.05)。结论Escape room游戏宣教在阴道分娩初产妇中的应用,能缓解产妇分娩恐惧情绪,可一定程度上加快产程进展。

Secondary electron emission and photoemission from a negative electron affinity semiconductor with large mean escape depth of excited electrons

The formulae for parameters of a negative electron affinity semiconductor(NEAS)with large mean escape depth of secondary electrons A(NEASLD)are deduced.The methods for obtaining parameters such asλ,B,E_(pom)and the maximumδandδat 100.0 keV≥E_(po)≥1.0 keV of a NEASLD with the deduced formulae are presented(B is the probability that an internal secondary electron escapes into the vacuum upon reaching the emission surface of the emitter,δis the secondary electron yield,E_(po)is the incident energy of primary electrons and E_(pom)is the E_(po)corresponding to the maximumδ).The parameters obtained here are analyzed,and it can be concluded that several parameters of NEASLDs obtained by the methods presented here agree with those obtained by other authors.The relation between the secondary electron emission and photoemission from a NEAS with large mean escape depth of excited electrons is investigated,and it is concluded that the presented method of obtaining A is more accurate than that of obtaining the corresponding parameter for a NEAS with largeλ_(ph)(λ_(ph)being the mean escape depth of photoelectrons),and that the presented method of calculating B at E_(po)>10.0 keV is more widely applicable for obtaining the corresponding parameters for a NEAS with largeλ_(ph).

Present-day Upper-crustal Strain Rate Field in Southeastern Tibet and its Geodynamic Implications:Constraints from GPS Measurements with ABIC Method

The Earth’s surface kinematics and deformation are fundamental to understanding crustal evolution.An effective research approach is to estimate regional motion field and deformation fields based on modern geodetic networks.If the discrete observed velocity field is obtained,the velocity related fields,such as dilatation rate and maximum shear strain rate,can be estimated by applying varied mathematical approaches.This study applied Akaike's Bayesian Information Criterion(ABIC)method to calculate strain rate fields constrained by GPS observations in the southeast Tibetan Plateau.Comparison with results derived from other three methods revealed that our ABIC-derived strain rate fields were more precise.The maximum shear strain rate highlighted the Xianshuihe–Xiaojiang fault system as the main boundary for the outward migration of material in southeastern Tibet,indicating rotation of eastern Tibet material around the eastern Himalaya rather than whole extrusion along a fixed channel.Additionally,distinct dilatation rate patterns in the northeast and southwest regions of the fault system were observed.The northeast region,represented by the Longmenshan area,exhibited negative dilatational anomalies;while the southwest region,represented by the Jinsha River area north of 29°N,displayed positive dilatational anomalies.This indicates compression in the former and extension in the latter.Combined with deep geophysical observations,we believe that the upper and lower crusts of the Jinsha River area north of 29°N are in an entire expanding state,probably caused by the escape-drag effect of material.The presence of a large,low-viscosity region south of 29°N may not enable the entire escape of the crust,but instead result in a differential escape of the lower crust faster than the upper crust.

When Fleeing Matters:Differences in Escape Behaviours of Three Northeast Asian Anurans

Prey species may have their own optimal escape strategy to balance predation risks and the energetic cost of fleeing.Some species have an advantage when maintaining a short fleeing distance,while others may favour an earlier escape based on microhabitat,size,or body condition.Here,we examined the escape behaviour of the three syntopic Northeast Asian anuran species:Mongolian toads(Strauchbufo raddei),Amur brown frogs(Rana amurensis),and Japanese treefrogs(Dryophytes japonicus)in Mongolia,Russia,China and DPR Korea.We examined flight initiation distance(FID;the distance from a potential predator to the point when the individual starts to flee)and distance fled(DF;distance between flight initiation and flight termination points)of each species and the effects of microhabitat,sex,and body size.Strauchbufo raddei and R.amurensis had a longer FID than D.japonicus,and S.raddei also had a longer DF than D.japonicus.These trends remained similar when dividing FID and DF by a size proxy(snout-vent length)for all individuals.This suggests that the treefrog D.japonicus used a strategy to stay immobile even when they were detected,and the toad S.raddei reacted quicker and more sensitively to predators despite the presence of toxin.Female S.raddei had a significantly longer FID than males suggesting that females are more sensitive to predation risk in this species,but body size was not significant for any of the three species.Our results indicate that the three sympatric species have different escaping strategies,likely related to differences in physiology and crypticity.

Correction:The escape mechanisms of the proto-atmosphere on terrestrial planets:“boil-off”escape,hydrodynamic escape and impact erosion

In the original publication of the article,the affiliation“College of Earth and Planetary Sciences,University of Chinese Academy of Sciences,Beijing,People’s Republic of China”for author Ziqi Wang was missing and included in this correction article.

改良ESCAPE集束化策略在急性呼吸衰竭有创机械通气脱机患者中的应用价值

目的:探讨改良ESCAPE集束化策略在急性呼吸衰竭有创机械通气脱机患者中的应用价值。方法:接受有创机械通气治疗的急性呼吸衰竭患者116例,随机分为观察组60例和对照组56例。对照组由主管医师制定整体治疗方案,采用常规治疗护理。观察组在常规治疗护理基础上,实施改良ESCAPE集束化策略。结果:观察组脱机后1 h、12 h、24 h时SaO_(2)分别为(96.7±3.7)%、(97.3±3.8)%和(97.4±3.3)%,高于对照组的(92.1±4.3)%、(92.5±2.1)%和(93.3±3.9)%,观察组脱机后1 h、12 h、24 h时PaO_(2)/FiO_(2)分别为255.5±33.5 mmHg、257.5±28.7 mmHg和271.3±32.6 mmHg,高于对照组的213.4±30.7 mmHg、218.1±30.4 mmHg和225.5±30.3 mmHg,差异均有统计学意义(P<0.05);观察组患者脱机后1 h RR 20.5±3.7次/min,低于对照组的25.6±4.1次/min,差异有统计学意义(P<0.05)。观察组机械通时间5.9±2.7 d,短于对照组的8.6±3.1 d,差异有统计学意义(P<0.05);观察组48 h内再插管5例(8.3%),对照组48 h内再插管6例(10.7%),两组再插管率的差异无统计学意义(P>0.05)。观察组谵妄发生率18.3%,低于对照组的35.7%,观察组ICU-AW发生率16.7%,低于对照组的25.0%,差异均有统计学意义(P<0.05);观察组ICU住院时间8.3±3.7 d,短于对照组的11.2±4.1 d,差异有统计学意义(P<0.05)。结论:改良ESCAPE策略可改善急性呼吸衰竭患者呼吸机撤机后的氧合指标,降低谵妄及ICU获得性衰弱的发生率,缩短机械通气时间和ICU住院时间。

Escape from the Besieged Fortress——An Analysis of Alice Munro's "Runaway"

Alice Munro is one of the famous Canadian writers and is renowned above all for the astonishing subtlety of her short stories.Her theme has often been the dilemmas of the female coming to terms with family, friends in a small town. This paper attempts to make a brief introduction about the stories of Alice Munro's Runaway and explores the protagonist's choices in the dilemma situation, and then exposes the cruelty of reality is that they cannot get rid of the ineluctable reality of life. Escape is only a temporary action which cannot save them from endless triviality of life. What they should do is not to escape from life, but to adapt to the reality of life.

Characteristics of escape mutations from occult hepatitis B virus infected patients with hematological malignancies in South Egypt

AIM To investigate the prevalence and virological characteristics of occult hepatitis B virus(HBV) infections in patients with hematological malignancies in South Egypt.METHODS Serum samples were collected from 165 patients with hematological malignancies to monitor titers of HBV DNA, hepatitis B surface antigen(HBs Ag), and antibodies to HBV core(anti-HBc) and surface antigens. Serum samples negative for HBs Ag and positive for anti-HBc were subjected to nucleic acid extraction and HBV DNA detection by real-time polymerase chain reaction. DNA sequences spanning the S region were analyzed in cases with occult HBV infection. In vitro comparative study of constructed 1.24-fold wild type and S protein mutant HBV genotype D clones was further performed. RESULTS HBV DNA was detected in 23(42.6%) of 54 patients with hematological malignancies who were HBsA g negative, but anti-HBc positive, suggesting the presence of occult HBV infection. The complete HBV genome was retrieved from 6 occult HBV patients, and P120 T and S143 L were detected in 3 and 2 cases, respectively. Site directed mutagenesis was done to produce 1.24-fold genotype D clones with amino acid mutations T120 and L143. The in vitro analyses revealed that a lower level of extracellular HBsA g was detected by chemiluminescence enzyme immunoassay(CLEIA) with the clone containing T120 mutation, compared with the wild type or the clone with S143 L mutation despite the similar levels of extracellular and intracellular HBs Ag detected by Western blot. Southern blot experiments showed that the levels of intracellular HBV DNA were not different between these clones. CONCLUSION Occult HBV infection is common in patients with hematological malignancies and associated with P120 T and S143 L mutations. 120 T mutation impairs the detection of HBsA g by CLEIA.

Possible mechanisms associated with immune escape and apoptosis on anti-hepatocellular carcinoma effect of Mu Ji Fang granules

BACKGROUND Hepatocellular carcinoma(HCC)is one of the most common digestive system cancers with high mortality rates worldwide.The main ingredients in Mu Ji Fang Granules(MJF)are alkaloids,flavonoids,and polysaccharides.MJF has been used in the clinical treatment of hepatitis,cirrhosis and HCC for more than 30 years.Few previous studies have focused on the mechanism of MJF on tumor immunology in the treatment of HCC.AIM To explore the mechanism of action of MJF on tumor immunology in the treatment of HCC.METHODS The absorbable ingredients of MJF were identified using Molecule Network related to High Performance Liquid Chromatography-Electron Spray Ionization-Time of Flight-Mass Spectrometry,and hub potential anti-HCC targets were screened using network pharmacology and pathway enrichment analysis.Forty male mice were randomly divided into the Blank,Model,and MJF groups(1.8,5.4,and 10.8 g/kg/d)following 7 d of oral administration.Average body weight gain,spleen and thymus indices were calculated,tumor tissues were stained with hematoxylin and eosin,and Interferon gamma(IFN-γ),Tumor necrosis factorα(TNF-α),Interleukin-2,aspartate aminotransferase,alanine aminotransferase,alpha-fetoprotein(AFP),Fas,and FasL were measured by Enzyme-linked Immunosorbent Assay.Relevant mRNA expression of Bax and Bcl2 was evaluated by Real Time Quantitative PCR(RTqPCR)and protein expression of Transforming growth factorβ1(TGF-β1)and Mothers against decapentaplegic homolog(SMAD)4 was assessed by Western blotting.The HepG2 cell line was treated with 10 mg/mL,20 mg/mL,30 mg/mL,40 mg/mL of MJF,and another 3 groups were treated with TGF-β1 inhibitor(LY364947)and different doses of MJF.Relevant mRNA expression of TNF-α,IFN-γ,Bax and Bcl2 was evaluated by RT-qPCR and protein expression of TGF-β1,SMAD2,p-SMAD2,SMAD4,and SMAD7 was assessed by Western blotting.RESULTS It was shown that MJF improved body weight gain and tumor inhibition rate in H22 tumorbearing mice,protected immune organs and liver function,reduced the HCC indicator AFP,affected immunity and apoptosis,and up-regulated the TGF-β1/SMAD signaling pathway,by increasing the relative expression of TGF-β1,SMAD2,p-SMAD2 and SMAD4 and decreasing SMAD7,reducing immune factors TNF-αand IFN-γ,decreasing apoptosis cytokines Fas,FasL and Bcl2/Bax,and inhibiting the effect of LY364947 in HepG2 cells.CONCLUSION MJF inhibits HCC by activating the TGF-β1/SMAD signaling pathway,and affecting immune and apoptotic cytokines,which may be due to MJF adjusting immune escape and apoptosis.

Coal mine fire and human escape simulation

Coal mine fire and human escape simulation system is developed based on 3D Max and EON software for the purpose of coal mine safety training.The models,such as miners,roadways,typical equipments,fire and smoke are all constructed in 3D Max.The roadway models derived from real data,functions of each part are determined for the roadway based on the data,and then corresponding tunnel typical equipments are added.Emergency refuge system model is not only an important system model,but also an important destination for fire simulation and human escape.The roaming of the miners through the roadways,the interactive functions between users and computer,the fire process of beginning,spreading,and destroying,the human escape interaction are simulated in EON virtual reality software after these models have been input into it.Besides,collision detection based on hierarchical bounding volumes is also utilized.Simulation results suggest that this strategy can produce realistic virtual state and fire effect.While as part of the coal mine safety simulation and training System(CMSSTS),this work is far from what we expected,and there is more intensive work that should be done.

A Fire Escape Simulation System Based on the Dijkstra Algorithm

Despite the support of all kinds of fire prevention measures and high-tech fire prevention equipment,fires still occur frequently because of both anthro-pogenic factors and natural disasters.This issue has drawn the attention of schools,all levels of government,and other organizations.Many types of organi-zations carry out fire drills throughout the year.Because this kind of drill cannot anticipate the specific circumstances of each fire,which are generally far more complicated than drills,most people cannot correctly choose the optimal escape route from real fires.Thus,a fire-scene virtual simulation system based on the Dijkstra algorithm is here proposed to address such problems as casualties caused by frequent fires and the inability of most people to correctly choose a fire escape route.This virtual fire escape simulation system uses Maya to carry out 3D recon-struction of the fire scene,the Unity engine to conduct interactive function design,and the Dijkstra algorithm to calculate the best escape route.The results of the example indicate that the simulation system solves the problems of the traditional simulation system,such as stiffness,lack of intelligence,and poor simulation.

Control of Deuteron Ions to Escape from the Magnetic Mirror Bottle by a Perpendicular Supplemental Mirror

We have inquired into a means to decrease the number of charged particles escaping from a loss cone of a magnetic mirror reactor as many as possible. We previously reported the way of installing a supplemental magnetic mirror (which has a cyclotron heating space within) at the exit of a main magnetic bottle. The cyclotron heating space was set to increase a reflection-efficiency of the supplemental mirror. We could not suppress the loss of the escaping deuteron ions sufficiently even with a very long mirror and a very powerful electric field. Then, in this work we propose a new plan of installing another supplemental mirror besides the previous supplemental mirror. A new mirror is set perpendicularly to the center axis of the main bottle. By the addition of the perpendicular mirror, an efficiency of sending back of escaping deuteron ions is considerably theoretically improved. Also in the previous work, since we did not touch how to supply a high-frequency electric field to the cyclotron heating space, here we consider supplying it by an extraordinary-wave with a cyclotron frequency. It is mentioned that propagation of an extraordinary-wave with an electron cyclotron frequency depends on a magnetic field strength and density of escaping electrons.

Noise color influence on escape times in nonlinear oscillators-experimental and numerical results

The interplay between noise and nonlinearites can lead to escape dynamics.Associated nonlinear phe-nomena have been observed in various applications ranging from climatology to biology and engineering.For reasons of computational ease,in most studies,Gaussian white noise is used.However,this noise model is not physical due to the associated infinite energy content.Here,the authors present extensive experimental investigations and numerical simulations conducted to examine the impact of noise color on escape times in nonlinear oscillators.With a careful parameterization of the numerical simulations,the authors are able to make quantitative comparisons with experimental results.Through the experi-ments and simulations,it is illustrated that the noise color can drastically influence escape times and escape probability.

A discussion of escape in <

通过对James Joyce的《A little Cloud》和Froster的《The Road from Colonus》的讨论,阐述了社会和环境对人的命运那种无可抗争的影响,精彩地阐述了在无奈的社会现实中顿悟的结局。

Meta-Analysis of the Effect of the Escape Room Teaching Method on Nursing Education

Objectives:A meta-analysis was conducted to systematically evaluate the effect of the escape room teaching method on nursing education.Methods:We searched PubMed,Medline,Web of Science,CNKI,VIP,and Wanfang databases,with a search time frame from the first day of database establishment to October 2022.Two researchers evaluated the quality of the obtained literature and extracted the data.The RevMan5.4 software was used for meta-analysis.Results:A total of 7 studies involving 1487 nursing students were included.Compared with the control group,the escape room teaching method improved the professional performance of nursing students[standardized mean difference(SMD)=0.98,95%confidence interval(CI;0.38,1.59),P<0.0001].The critical thinking ability of nursing students was enhanced[mean difference(MD)=12.64,95%CI(7.91,17.37),P<0.0001],and the investment level of nursing students in learning was improved[MD=4.18,95%CI(1.74,6.62),P<0.0001].Conclusion:The escape room teaching method can improve nursing students’professional performance,critical thinking ability,and learning engagement level.There is no significant difference in the impact of nursing teaching satisfaction,and there is still a lack of data support.This paper is limited by the quality and quantity of included literature,and more high-quality studies are still needed to further demonstrate the above conclusions.

百日咳病原新认识及其抗感染策略

百日咳是由百日咳鲍特菌感染引起的急性呼吸道传染病,本病历史悠久,任何年龄段的人群均可感染发病。百日咳再现已成为引起高度关注的全球性问题,包括我国在内。2022年起至今,我国报告百日咳病例数上升迅猛。当前百日咳鲍特菌流行株的主要抗原(百日咳毒素)的基因型已发生改变,相应抗原与疫苗株不同而产生免疫逃逸,是当前百日咳再现的重要原因之一。百日咳鲍特菌目前普遍对大环内酯类抗生素耐药是临床治疗失败的重要原因,因此不再推荐其作为百日咳抗感染治疗的首选用药。2月龄以上无磺胺禁忌症的患儿,百日咳卡他期和痉咳期推荐复方磺胺甲噁唑口服作为首选抗感染方案;对2月龄以下或症状危重的患儿,推荐哌拉西林或头孢哌酮-舒巴坦静滴治疗。改良或研发与流行株抗原一致的新一代百日咳疫苗将是提升易感人群免疫保护力、控制本病流行的长远策略。

失活X染色体基因逃逸与系统性红斑狼疮的性别二态性

X染色体失活可平衡女性中两条X染色体的基因剂量。越来越多的证据表明,失活X染色体上存在许多能够逃逸失活的基因。逃逸的机制涉及到DNA、RNA、组蛋白的表观修饰以及众多的调控蛋白和染色质的空间结构。失活X染色体基因逃逸的研究为人类疾病(特别是自身免疫性疾病)性别二态性的研究开辟了新的途径。目前已证实包括TLR7、CD40L、IRAK-1、CXCR3、CXorf21等失活X染色体基因逃逸是系统性红斑狼疮(systemic lupus erythematosus,SLE)女性好发的重要原因。本文主要综述了失活X染色体上基因逃逸以及与SLE性别二态性形成的分子机制。阐明SLE性别二态性形成的分子机制,不仅对疾病的诊断、治疗具有重要意义,而且对深入揭示人类免疫系统的发育及调控机理也有重要的理论意义。

盾尾刷-油脂腔密封系统油脂逃逸规律研究

油脂逃逸导致油脂腔内压力降低,由此诱发的盾尾密封系统漏水、漏浆等安全责任事故屡屡发生。研制盾尾刷密封系统油脂逃逸的单元体试验装置,采用逐级加压将油脂注入盾尾密封系统油脂腔内,每级压力持续420 s,记录不同盾尾间隙及不同油脂锥入度工况下腔内的密封油脂开始逃逸时的油脂注入压力值、以及逃逸后储油装置中密封油脂的稳定损耗速率,最终获得了盾尾密封系统的油脂逃逸规律,并总结了盾尾油脂的逃逸模式。研究结果表明:1)油脂逃逸速率主要受油脂锥入度和油脂压力的影响,根据油脂逃逸规律变化曲线,油脂逃逸速率可以分为不逃逸、低速逃逸、快速逃逸3个阶段。油脂不逃逸至低速逃逸的油脂压力称为油脂逃逸压力,油脂低速逃逸与快速逃逸之间的油脂压力值为油脂腔内外压差控制值;2)建立了油脂逃逸速率和工程中油脂消耗量的对应关系,结合工程中每环盾尾油脂允许消耗量可实时判断盾尾刷密封性能;3)当油脂锥入度小于286.4(1/10 mm),盾构姿态与管片姿态控制良好时(盾尾平均间隙为75 mm),在水土压力及同步注浆压力基础上最大可增加0.3 MPa的油脂压力,提出的油脂腔内外压差控制值可指导实际工程盾尾油脂压力设定最大值;4)油脂逃逸模式可划分为无逃逸、非均匀逃逸和均匀逃逸3种模式并得出其发生条件。该研究对于指导盾尾密封性的设计及施工有着基础性的意义。