Effects of comprehensive nutrition support on immune function,wound healing,hospital stay,and mental health in gastrointestinal surgery

BACKGROUND Postoperative patients undergoing gastrointestinal surgery often encounter challenges such as low immune function,delayed wound healing owing to surgical trauma,and increased nutritional demands during recovery.AIM To assess the effect of comprehensive nutritional support program on immune function and wound healing in patients undergoing gastrointestinal surgery.METHODS This retrospective comparative study included 60 patients who underwent gastrointestinal surgery,randomly assigned to either the experimental group(n=30)or the control group(n=30).The experimental group received comprehensive nutritional support,including a combination of enteral and parenteral nutrition,whereas the control group received only conventional comprehensive nutritional support.Evaluation indicators included immune function markers(e.g.,white blood cell count,lymphocyte subsets),wound healing(wound infection rate,healing time),pain score[visual analog scale(VAS)score],and psychological status(anxiety score,depression score)7 days post-surgery)and duration of stay.RESULTS The immune function of patients in the experimental group was significantly better than that in the control group.The white blood cell count was 8.52±1.19×109/L in the experimental group vs 6.74±1.31×109/L(P<0.05).The proportion of CD4+T cells was higher in the experimental group(40.09%±4.91%)than that in the control group(33.01%±5.08%)(P<0.05);the proportion of CD8+T cells was lower(21.79%±3.38%vs 26.29%±3.09%;P<0.05).The CD4+/CD8+ratio was 1.91±0.32 in the experimental group whereas 1.13±0.23 in the control group(P<0.05).The wound infection rate of the experi-mental group was significantly lower than that of the control group(10%vs 30%,P<0.05),and the wound healing time was shorter(10.35±2.42 days vs 14.42±3.15 days,P<0.05).The VAS score of the experimental group was 3.05±1.04,and that of the control group was 5.11±1.09(P<0.05);the anxiety score(Hamilton Anxiety Rating Scale)was 8.88±1.87,and that of the control group was 12.1±3.27(P<0.05);the depression score(Hamilton Depression Rating Scale)was 7.37±1.41,and that of the control group was 11.79±2.77(P<0.05).In addition,the hospitalization time of the experimental group was significantly shorter than that of the control group(16.16±3.12 days vs 20.93±4.84 days,P<0.05).CONCLUSION A comprehensive nutritional support program significantly enhances immune function,promote wound healing,reduces pain,improves psychological status,and shortens hospitalization stays in patients recovering from gastrointestinal surgery.

Impact of pre- and peri-operative risk factors on length of stay and hospital readmission following minimally-invasive partial nephrectomy

Objective:We conducted an analysis of the American College of Surgeons National Surgical Quality Improvement Program database for minimally-invasive partial nephrectomy cases reported with the goal to identify pre-and peri-operative variables associated with length of stay(LOS)greater than 3 days and readmission within 30 days.Methods:Records from 2008 to 2018 for“laparoscopy,surgical;partial nephrectomy”for prolonged LOS and readmission cohorts were compiled.Univariate analysis with Chi-square,t-tests,and multivariable logistic regression analysis with odds ratios(ORs),p-values,and 95%confidence intervals assessed statistical associations.Results:Totally,20306 records for LOS greater than 3 days and 15854 for readmission within 30 days were available.Univariate and multivariable analysis exhibited similar results.For LOS greater than 3 days,undergoing non-elective surgery(OR=5.247),transfusion of greater than four units within 72 h prior to surgery(OR=5.072),pre-operative renal failure or dialysis(OR=2.941),and poor pre-operative functional status(OR=2.540)exhibited the strongest statistically significant associations.For hospital readmission within 30 days,loss in body weight greater than 10%in 6 months prior to surgery(OR=2.227)and bleeding disorders(OR=2.081)exhibited strongest statistically significant associations.Conclusion:Multiple pre-and peri-operative risk factors are independently associated with prolonged LOS and hospital readmission within 30 days of surgery using the American College of Surgeons National Surgical Quality Improvement Program data.Recognizing the risks factors that can potentially be improved prior to minimally-invasive partial nephrectomy is crucial to informing patient selection,optimization strategies,and patient education.

Reducing Extended Hospital Lengths of Stay

In the United States, the costs of health care have become a major burden for the health care system. In order to address this problem, the hospitals of Syracuse, New York, developed programs to provide subacute and complex care. The Subacute programs provided patient transportation services for dialysis and other types of care outside hospitals. They also developed programs for services such as intravenous therapy in nursing homes. The Complex Care Programs, such as intravenous therapy and mental health services, have provided alternatives to extended care in hospitals. During the past five years, utilization of these programs has varied, declining between 2019 and 2022, and then increasing between 2022 and 2024. The programs have avoided the need for 1530 - 2974 patient days in hospitals. The programs saved the Syracuse hospitals approximately $600 per inpatient day. This amounted to savings of $918,000 - $1,784,400 per year. These programs demonstrated how relatively small mechanisms can save large amounts of health care resources.

旅游小城镇规划中的Long Stay要素分析

根据小城镇具有发展Long Stay的条件,在进行小城镇规划建设中考虑Long Stay要素的体现,并对旅游小城镇的效益进行了分析。结果表明:小城镇具有发展Long Stay的条件,在城镇的总体规划中体现出其作用,并能对城镇产生经济效益与社会效益。

“Long Stay”与分时度假的比较分析

"Long Stay"与分时度假是休闲旅游的两种特殊形式,"Long Stay"刚进入国人视野,前景看好,而分时度假在国内的发展陷入困境。通过对比两者的主体、客体以及在我国发展的适应性,发现两者具备一定的互补优势,协同发展可以实现产品价值最大化和企业利润最大化。

Effects of Water Stress on Stay Green of Sugarcane Innovative Materials Yunge F_2 Generation

[Objective] This study aimed to investigate the effect of water stress on stay green of Yunge F2 generation. [Method] Total 26 sugarcane innovative germplasm materials of Yunge F2 generation, along with their female parent, were selected as the experimental materials. Based on the observation on appearance of stray green and other five physiological and biochemical indexes, the drought resis- tance of the experimental materials was evaluated comprehensively by subordinate function method, grey relational analysis, and cluster analysis. [Result] The rank of drought resistance of the experimental materials was not exactly the same between subordinate function method and grey relational analysis. However, the drought .re- sistance evaluation results by isometric range-based cluster analysis were consistent with those by the two foregoing methods except Yunge F2 11-68 and Yunge F1 11- 254. At the Euclidean distance of 2.00, the tested materials were classified into four groups. The first group included 8 drought-strongly resistant materials, the third group included 6 drought-moderately resistant materials, the fourth group included 3 drought-poorly resistant materials, and the second group included drought-strongly resistant and drought-moderately resistant materials. The drought resistance coeffi- cients of green leaf numberLtotal leaf number and top four leaves chlorophyll content showed significantly positive correlation with drought resistance comprehensive eval- uation value, thus green leaf number/total leaf number and top four leaves chloro- phyll content could be used as the evaluation indexes of drought resistance in sug- arcane. [Conclusion] The excellent materials possess strong drought resistance and good green holding performance, such as Yunge F2 11-159, can be used as crucial parents and basic germplasm materials in drought resistance breeding of sugarcane. 7

Analysis of the Long Stay Elements in the Planning of Small Tourism Towns

According to the conditions to develop Long Stay in small tourism towns,the demonstration of Long Stay in the planning and construction of small towns was taken into consideration,and its benefits for tourism towns were analyzed.The results showed that small tourism towns were endowed with sound conditions to develop Long Stay,which played its role in the overall planning of towns and would benefit the economic development of these towns.

“play+stay”理念在营口理工学院网球课中的应用研究

2007年2月ITF正式发起了一项意在增加全球网球参与性的运动——play+stay。它的目标是使网球这项运动更容易、更有趣和更健康。并保证每一位初学者在第一堂课中都能够掌握发球、对打和得分的能力。"play+stay"的理念主要包括5部分:网球是简单的;网球是有趣的;网球比赛是有趣的;网球是健康的;网球适合所有人。营口理工学院于2012年开始设置了网球课程,并与2014—2015学年引入了"play+stay"理念并结合自身的特点和教学经验进行了教学实验,得出以下结论:(1)"play+stay"理念非常适合高校网球教学。(2)同学们的学习热情显著提高,网球技能水平达到了教学目标的要求。(3)"play+stay"理念应与高校自身的特点相结合才能发挥最大的优势。

Study on the Development of "Farm Stay" Tourism in Yanan City of Shaanxi Province

'Farm stay' tourism is a kind of new tourism form in recent years,which can promote regional economic development.The study discusses the existing problems in the setting of tourism products,and puts forward some countermeasures for the development of 'farm stay' tourism in Yanan city.

Evaluation of the inclusive payment system based on the diagnosis procedure combination with respect to cataract operations in Japan------A comparison of lengths of hospital stay and medical payments among hospitals

Following the recommendations of a report submitted by the Central Social Insurance Medical Council concerning the 2002 revision of the Medical Service Fee Schedule, a new inclu-sive payment system, which is based on the Diagnosis Procedure Combination (DPC) sys-tem, was introduced in 82 special functioning hospitals in Japan, effective beginning in April 2003. Since April 2004, the system has been gradually extended to general hospitals that satisfy certain prerequisites. In this paper, the new inclusive payment system is analyzed. Data pertaining to 1,225 patients, who were hospital-ized for cataract diseases and underwent lens operations from July 2004 to September 2005, are used. The lengths of hospital stay and medical payments among hospitals are com-pared. Even after eliminating the influence of patient characteristics, there are large differ-ences among hospitals in average lengths of hospital stay and DPC-based inclusive pay-ments. The highest average inclusive payment is 3.5 times as high as the lowest payment. On the other hand, there are relatively small differ-ences in non-inclusive payments based on the conventional fee-for-service system—the larg-est deviation from the average of all hospitals is approximately 10%. Thus, although payments based on the DPC account for only one-third of the total medical payments for this disease, the major differences in medical payments among hospitals are caused by differences in their DPC-based inclusive payments. The results of the study strongly suggest that revisions of the payment system in Japan are necessary for the efficient use of medical resources in the future.

Parametrically excited oscillation of stay cable and its control in cable-stayed bridges＂

This paper presents a nonlinear dynamic model for simulation and analysis of a kind of parametrically excited vibration of stay cable caused by support motion in cable-stayed bridges. The sag, inclination angle of the stay cable are considered in the model, based on which, the oscillation mechanism and dynamic response characteristics of this kind of vibration are analyzed through numerical calculation. It is noted that parametrically excited oscillation of a stay cable with certain sag, inclination angle and initial static tension force may occur in cable-stayed bridges due to deck vibration under the condition that the natural frequency of a cable approaches to about half of the first model frequency of the bridge deck system. A new vibration control system installed on the cable anchorage is proposed as a possible damping system to suppress the cable parametric oscillation. The numerical calculation results showed that with the use of this damping system, the cable oscillation due to the vibration of the deck and/or towers will be considerably reduced.

Comparative Study on Structural Redundancy of Cable-Stayed and Extradosed Bridges Through Safety Assessment of Their Stay Cables

This study provides new insights into the comparison of cable-stayed and extradosed bridges based on the safety assessment of their stay cables.These bridges are often regarded as identical structures owing to the use of inclined cables;however,the international standards for bridge design stipulate different safety factors for stay cables of both types of bridges.To address this misconception,a comparative study was carried out on the safety factors of stay cables under fatigue and ultimate limit states by considering the effects of various untoward and damaging factors,such as overloading,cable loss,and corrosion.The primary goal of this study is to describe the structural disparities between both types of bridges and evaluate their structural redundancies by employing deterministic and nondeterministic methods.To achieve this goal,three-dimensional finite-element models of both bridges were developed based on the current design guidelines for stay cables in Japan.After the balanced states of the bridge models were achieved,static analyses were performed for different safety factors of stay cables in a parametric manner.Finally,the first-order reliability method and Monte Carlo method were applied to determine the reliability index of stay cables.The analysis results show that cable-stayed and extradosed bridges exhibit different structural redundancies for different safety factors under the same loading conditions.Moreover,a significant increase in structural redundancy occurs with an incremental increase in the safety factors of stay cables.

Clinical Predictors of Prolonged Hospital Stay after Acute Stroke: Relevance of Medical Complications

Purpose: This study aims to identify clinical predictors of prolonged hospital stay after acute stroke based on data collected from a prospective hospital-based acute stroke registry. Methods: All patients with first-ever ischemic stroke and primary intracerebral hemorrhage included in the Sagrat Cor Hospital of Barcelona stroke database over a 17-year period were assessed. Prolonged hospital stay was defined as hospitalization for longer than 12 days after admission. Demographic data, cardiovascular risk factors, clinical factors, neuroimaging findings, and outcome were compared in patients hospitalized for more or less than 12 days. Logistic regression analysis was used to assess the independent influence of statistically significant variables in the bivariate analysis and duration of hospitalization. Results: Of a total of 3112 acute stroke patients included in the study, prolonged hospital stay was recorded in 1536 (49.4%). Male sex (OR = 1.16), limb weakness (OR = 1.79), vascular complications (OR = 2.68), urinary complications (OR = 2.56), and infectious complications (OR = 1.78) were independently associated with longer stay, whereas symptom free at discharge (OR = 0.45) and lacunar infarction (OR = 0.43) were inversely associated with prolonged hospitalization. Conclusion: In-hospital medical complications (vascular, urinary, and infectious) are relevant factors influencing duration of hospitalization after acute stroke. Therefore, prevention of potentially modifiable risk factors for medical complications is an important aspect of the early management of patients with stroke.

Nonlinear dynamic response of stay cables under axial harmonic excitation

This paper proposes a new numerical simulation method for analyzing the parametric vibration of stay cables based on the theory of nonlinear dynamic response of structures under the asynchronous support excitation. The effects of important pa- rameters related to parametric vibration of cables, i.e., characteristics of structure, excitation frequency, excitation amplitude, damping effect of the air and the viscous damping coefficient of the cables, were investigated by using the proposed method for the cables with significant length difference as examples. The analysis results show that nonlinear finite element method is a powerful technique in analyzing the parametric vibration of cables, the behavior of parametric vibration of the two cables with different Irvine parameters has similar properties, the amplitudes of parametric vibration of cables are related to the frequency and amplitude of harmonic support excitations and the effect of distributed viscous damping on parametric vibration of the cables is very small.

Effect of dynamic light at the coronary care unit on the length of hospital stay and development of delirium： a retrospective cohort study

Background Disturbed circadian rhythm is a potential cause of delirium and is linked to disorganisation of the circadian rhythmicity. Dynamic light （DL） could reset the circadian rhythm by activation of the suprachiasmatic nucleus to prevent delirium. Evidence regarding the effects of light therapy is predominantly focused on psychiatric disorders and circadian rhythm sleep disorders. In this study, we investi- gated the effect of DL on the total hospital length of stay （LOS） and occurrence of delirium in patients admitted to the Coronary Care Unit （CCU）. Methods This was a retrospective cohort study. Patients older than 18 years, who were hospitalized longer than 12 h at the CCU and had a total hospital LOS for at least 24 h, were included. Patients were assigned to a room with DL （n = 369） or regular lighting condi- tions （n = 379）. DL was administered at the CCU by two ceiling-mounted light panels delivering light with a colour temperature between 2700 and 6500 degrees Kelvin. Reported outcome data were： total hospital LOS, delirium incidence, consultation of a geriatrician and the amount of prescripted antipsychotics. Results Between May 2015 and May 2016, data from 748 patients were collected. Baseline charac- teristics, including risk factors provoking delirium, were equal in both groups. Median total hospital LOS in the DL group was 100.5 （70.8-186.0） and 101.0 （73.0-176.4） h in the control group （P = 0.935）. The incidence of delirium in the DL and control group was 5.4% （20/369） and 5.0% （19/379）, respectively （P = 0.802）. No significant differences between the DL and control group were observed in secon- dary endpoints. Subgroup analysis based on age and CCU LOS also showed no differences. Conclusion Our study suggests exposure to DL as an early single approach does not result in a reduction of total hospital LOS or reduced incidence of delirium. When delirium was diagnosed, it was associated with poor hospital outcome.

The impact of emergency department length of stay on the outcomes of trauma patients requiring hospitalization: a retrospective observational study

BACKGROUND: We aimed to explore the impact of the emergency department length of stay(EDLOS) on the outcome of trauma patients.METHODS: A retrospective study was conducted on all trauma patients requiring hospitalization between 2015 and 2019. Patients were categorized into 4 groups based on the EDLOS(<4 h, 4–12 h,12–24 h, and >24 h). Data were analyzed using Chi-square test(categorical variables), Student’s t-test(continuous variables), correlation coefficient, analysis of variance and multivariate logistic regression analysis for identifying predictors of short EDLOS and hospital mortality.RESULTS: The study involved 7,026 patients with a mean age of 32.1±15.6 years. Onefifth of patients had a short EDLOS(<4 h) and had higher level trauma team T1 activation(TTA-1), higher Injury Severity Score(ISS), higher shock index(SI), and more head injuries than the other groups(P=0.001). Patients with an EDLOS >24 h were older(P=0.001) and had more comorbidities(P=0.001) and fewer deaths(P=0.001). Multivariate regression analysis showed that the predictors of short EDLOS were female gender, GCS, SI, hemoglobin level, ISS, and blood transfusion. The predictors of mortality were TTA-1(odds ratio [OR]=4.081, 95%CI: 2.364–7.045), head injury(OR=3.920, 95%CI: 2.413–6.368), blood transfusion(OR=2.773, 95%CI: 1.668–4.609), SI(OR=2.132, 95%CI: 1.364–3.332), ISS(OR=1.077, 95%CI: 1.057–1.096), and age(OR=1.040, 95%CI: 1.026–1.054). CONCLUSIONS: Patients with shorter EDLOS had different baseline characteristics and hospital outcomes compared with patients with longer EDLOS. Patients with prolonged EDLOS had better outcomes;however, the burden of prolonged boarding in the ED needs further elaboration.

Anomaly Detection Algorithm for Stay Cable Monitoring Data Based on Data Fusion

In order to improve the accuracy and consistency of data in health monitoring system,an anomaly detection algorithm for stay cables based on data fusion is proposed.The monitoring data of Nanjing No.3 Yangtze River Bridge is used as the basis of study.Firstly,an adaptive processing framework with feedback control is established based on the concept of data fusion.The data processing contains four steps:data specification,data cleaning,data conversion and data fusion.Data processing information offers feedback to the original data system,which further gives guidance for the sensor maintenance or replacement.Subsequently,the algorithm steps based on the continuous data distortion is investigated,which integrates the inspection data and the distribution test method.Finally,a group of cable force data is utilized as an example to verify the established framework and algorithm.Experimental results show that the proposed algorithm can achieve high detection accuracy,providing a valuable reference for other monitoring data processing.

Risk factors for prolonged intensive care unit stays in patients after cardiac surgery with cardiopulmonary bypass:A retrospective observational study

Objectives:Patients after cardiac surgery with cardiopulmonary bypass(CPB)require a stay in the ICU postoperatively.This study aimed to investigate the incidence of prolonged length of stay(LOS)in the ICU after cardiac surgery with CPB and identify associated risk factors.Methods:The current investigation was an observational,retrospective study that included 395 ICU patients who underwent cardiac surgery with CPB at a tertiary hospital in Guangzhou from June 2015 to June 2017.Data were obtained from the hospital database.Binary logistic regression modeling was used to analyze risk factors for prolonged ICU LOS.Results:Of 395 patients,137(34.7%)had a prolonged ICU LOS(>72.0 h),and the median ICU LOS was 50.9 h.Several variables were found associated with prolonged ICU LOS:duration of CPB,prolonged mechanical ventilation and non-invasive assisted ventilation use,PaO2/FiO2 ratios within 6 h after surgery,type of surgery,red blood cell infusion during surgery,postoperative atrial arrhythmia,postoperative ventricular arrhythmia(all P<0.05).Conclusions:These findings are clinically relevant for identifying patients with an estimated prolonged ICU LOS,enabling clinicians to facilitate earlier intervention to reduce the risk and prevent resulting delayed recovery.

Study on longitudinal wind load calculation method of cables for cable-stayed bridge

Along with the expanding of span of cable-stayed bridge,wind load becomes a more and more important controlling factor for bridge the design.A very large proportion of the wind load acting on cables has exceeded that acting on deck.There was not any detailed prescript in Chinese code for calculation of longitudinal wind load on cables due to lack of theoretical research and experiment,and conservative simplified calculation was adopted during design,which leads to conservative and uneconomical design of structures.To resolve this problem,cable force experiment was carried out during the design of Sutong Bridge.By comparing with international research results,the calculation formula of longitudinal wind drag coefficient for cables was advanced to fill the blank of bridge wind resistant code of China,and has already been adopted in the Highway Bridge Wind Resistant Design Code(JTG/T D60-01-2004)with great significance for bridge engineering.

Dynamic Characteristics Evaluation of Innovative UHPC Pedestrian Cable Stayed Bridge

KICT (Korea Institute of Construction Technology) is conducting a project called “SUPER BRIDGE 200—Development of Low Cost and Long Life Hybrid Cable Stayed Bridge”. This project aims to reduce the construction and main- tenance costs of long-span bridges by 20% and double their lifetime through the exploitation of ultra-high performance concrete (UHPC). This paper presents the design and construction of the first pedestrian cable stayed bridge using UHPC developed by KICT. UHPC, compared to conventional concrete, has not only high compressive and tensile strengths but also high ductility. The UHPC developed at KICT is a steel fiber-reinforced cement compound presenting design compressive strength larger than 180 MPa and design tensile strength exceeding 10 MPa with water-to-binder ratio below 0.24 and admixing of 2 volume percentage of steel fiber. To show the applicability of UHPC to structures, a pedestrian cable stayed bridge (Super Bridge I) exploiting the characteristics of the developed UHPC has been planned, designed and erected at KICT. The dimension of UHPC deck is 2.7 m × 7 m as a precast segment with a typical thickness of deck of only 7 cm. However, harmful crack was observed in the deck at the time of the fabrication of the deck segments. Accordingly, new fabrication method was conceived and applied to prevent cracking of the UHPC slender deck. Four UHPC deck segments were fabricated successfully without any crack. After construction, the dynamic characteristics (natural frequencies and mode shapes) were evaluated through vibration tests since several users felt excess vibration. A vertical tuned mass damper (TMD) was proposed and installed on the parapet of the bridge. The TMD reduces the acceleration by about 30% from 0.0316 g to 0.0244 g when two pedestrians are crossing the bridge.