Application of self-care based on full-course individualized health education in patients with chronic heart failure and its influencing factors

BACKGROUND The treatment of heart failure not only needs to relieve the clinical symptoms and improve the quality of life for patients but also needs to select scientific and reasonable ways to prevent or delay the progression of the disease,thus reducing the mortality and hospitalization rate.Although the previous regimen can effectively relieve symptoms in the early stage of treatment,long-term use may cause adverse events,such as arrhythmia,and even increase mortality.Therefore,conventional treatment cannot meet the actual health needs of patients,and scientific nursing intervention is very necessary.AIM To investigate the application of self-care based on full-course individualized health education (FCIHE) and its influencing factors in patients with chronic heart failure (CHF).METHODS We enrolled CHF patients who were admitted to our center between September 2015 and June 2016 and divided them into an intervention group (n = 50) and control group (n = 50) using a random number table.Routine nursing care was applied to the control group,and FCIHE was offered to the intervention group.The self-care behavior,6-min walking distance (6MWD),and 36-item short form health survey (SF-36) scores were compared between the two groups.The influencing factors of the self-care were also analyzed.RESULTS The 6MWD was not significantly different between the two groups at admission (P > 0.05);however,at 3 and 6 mo after discharge,6MWD was significantly increased,and it was significantly longer in the intervention group (P < 0.05).The scores for self-care behavior showed no significant difference at admission between the two groups (P > 0.05);however,at 3 and 6 mo after discharge,the total scores for self-care maintenance,management,confidence,and behavior of the intervention group were significantly higher than those of the control group (P < 0.05).There were no significant differences in the SF-36 scores at admission (P > 0.05);however,at 3 mo and 6 mo after discharge,the scores for all eight subscales,including physical functioning,role limitations due to physical problems,bodily pain,general health perceptions,vitality,social functioning,role-limitations due to emotional problems,and mental health,were significantly higher in the intervention group (P < 0.05).As shown by logistic regression analysis,the influencing factors of self-care mainly included age,cardiac function class,and education background (odds ratio > 1;all P < 0.05).CONCLUSION FCIHE improved self-care behavior and cardiac function in CHF patients.Age,cardiac function,and education level affected the implementation of self-care among CHF patients.

基于Agent的智能e-Education系统研究

为了在e-Education系统中充分发挥网络资源的优势,提高其智能性,实现自适应教学和个性化服务,设计并实现了基于Agent的智能e-Education系统模型.运用教学策略Agent和教学管理Agent,根据学生的学习进度,智能地选择教学策略,以实现教学的个性化,达到智能化教学的目的;使用移动Agent技术实现Agent之间的通信,提高了用户与系统的交互性.

Verifying the Effects of an Education Program Leveraging Information Technology to Promote Cervical Cancer Screening in Women Aged 20 - 29—A One-Year Longitudinal Study

The purpose of this research is to implement an IT-based education program in order to promote cervical cancer screenings for women aged 20 - 29 years, as well as to examine the results of said program. This is a longitudinal/comparative study of two groups, one for which the program was implemented (the intervention group), and the other for which it was not (the control group). The program consisted of attending a health lecture and encouragement to be screened one month, six months, and one year later sent through IT-based methods. The target was unmarried women aged 20 - 29 who had neither previously given birth nor had been screened for cervical cancer in a period one year prior. They were divided into two groups, the intervention group (n = 142) and control group (n = 145). The effectiveness of the program was assessed via an initial survey and further surveys six months and one year later. Results were based on the Japanese version of the Health Belief Model Scale for Cervical Cancer and the Pap Smear Test (HBMSCCPST), knowledge scores in the categories of Healthy Lifestyles, Cervical Cancer, Cervical Cancer Screening, and screening behavior. A two-way ANOVA of the HBMSCCPST subscales and knowledge scores in the initial, six-month, and one-year surveys was performed, showing interaction in Cervical Cancer (p = 0.00). Main effects were observed in Cervical Cancer Screening (p = 0.00) and Healthy Lifestyles (p = 0.00). Regarding the amount of change from the initial survey, knowledge scores in the Cervical Cancer (p = 0.027) and Cervical Cancer Screening (p = 0.016) categories were significantly higher in the intervention group than in the control group. There was no significant difference in cervical cancer screening rates (p = 0.26) between the two groups. However, a small-degree effect size was observed for Benefits, Seriousness, and Susceptibility subscales in both examinees and non-examinees. Although the educational program of this study was effective in improving the knowledge of women in their twenties, there was little improvement in HBMSCCPST and it did not lead to the promotion of cervical cancer screening. In order to raise interest in cervical cancer screening, it is necessary to consider useful content to guide women to consult with healthcare professionals, a long-term population approach, and organizational structure of consultation.

Guarantee of Individualized Education Right for Children with Disabilities in China: A Study on the Compulsory Education Stage

The Regulation on the Education of Persons with Disabilities, which came into effect in 2017, stipulates for the first time disabled children’s right to individualized education, clarifies the subjects who determine and influence the individualized education that disabled children receive, and determines the procedures for disabled children to receive individualized education. However, compared to the subjects that determine disabled children’s right to individualized education and procedural provisions as stipulated in the U.S. laws such as the Individuals with Disabilities Education Act of 1990, the Regulation on the Education of Persons with Disabilities in China has some problems, including inadequate participation of disabled children and their parents and incomplete relief settlement mechanism. China should further improve the legal provisions relating to disabled children’s right to individualized education, and safeguard the right of participation and the right to relief of disabled children and their parents.

Constraints on individual supermassive binary black holes using observations of PSR J1909-3744

We perform a search for gravitational waves(GWs) from several supermassive binary black hole(SMBBH) candidates(NGC 5548, Mrk 231, OJ 287, PG 1302–102, NGC 4151, Ark 120 and 3C 66B) in long-term timing observations of the pulsar PSR J1909-3744 obtained using the Parkes radio telescope.No statistically significant signals were found. We constrain the chirp masses of those SMBBH candidates and find the chirp mass of NGC 5548 and 3C 66B to be less than 2.4 × 10^9 M⊙ and 2.5 × 10^9 M⊙(with 95% confidence), respectively. Our upper limits remain a factor of 3 to 370 above the likely chirp masses for these candidates as estimated from other approaches. The observations processed here provide upper limits on the GW strain amplitude that improve upon the results from the first Parkes Pulsar Timing Array data release by a factor of 2 to 7. We investigate how information about the orbital parameters can help to improve the search sensitivity for individual SMBBH systems. Finally, we show that these limits are insensitive to uncertainties in the Solar System ephemeris model.

Impact of Education on Productivity:A Model in China

Improving the quality of human resources through edu-cation and training is of great strategic significance.However, few people have done in depth and systematicstudies on the relationship between education and pro-ducttvity in China. This study developed an educationproductivity transform model and empirically tested themodel using data on the most districts of China. The ba-sic notion is that the effect depends both on the capabilityresulted from education, and on the environment inwhich this capability can be exercised, the effect is a re-sult of two factors combined.

Objective Assessment in Continual Medical Education (CME) Medical Objective Assessment in System Control

Existing examinations in postgraduate education and continuing medical education (CME) are not perfect. Modern assessment does not reflect disadvantages of older responders, for whom more time for reply is needed. Specialists with wide clinical experience may choose more than one correct answer in alternative questions. Reduced ability to remember in older people restricts examination without additional sources of information. We offer an individualised system for testing doctors. It provides personalised choice of examination questions using multiple choice questions with weight characteristics and absence of distractors, interactive cooperation in case of negative answers and the final decision of an expert in relation to the person tested. A special algorithm is proposed for typical questions that combines the advantages of known approaches to testing. The questioning system is complex for the creators of tests, but is more convenient and objective than existing ones for medical doctors.

Reduced spin-down rate of PSR J0738–4042 explained as due to an asteroid disruption event

Long term observations by Brook et al. reveal that the derivative of rotational frequency of PSR J0738-4042 changed abruptly in 2005. Originally, the spin-down rate was relatively stable, with the rotational frequency derivative being - 1.14 x 10-14 s-2. After September 2005, the derivative began to rise. About 1000 days later, it arrived at another relatively stable value of about -0.98 x 10-24 s-2, indicating that the pulsar is spinning-down relatively slowly. To explain the observed change in spin-down rate, we resort to an asteroid disrupted by PSR J0738-4042. In our model, the orbital angular momentum of the asteroid is assumed to be parallel to that of the rotating pulsar, so that the pronounced reduction in the spin-down rate can be naturally explained as due to the transfer of angular momentum from the disrupted material to the central pulsar. The derived magnetospheric radius is about 7.0 x 109 cm, which is smaller than the tidal disruption radius （8.7 x 10^10cm）. Our model is self-consistent. It is shown that the variability in the spin-down rate of PSR J0738-4042 can be quantitatively accounted for by accretion from the asteroid disrupted by the central pulsar.

Study of Type-B QPOs Observed in Black Hole X-Ray Binary Swift J1728.9-3613

We report the detection of type-B quasi-periodic oscillation(QPO)of the black hole X-ray binary Swift J1728.9-3613 observed by NICER during the 2019 outburst.A type-B QPO was observed for the first two days and it disappeared as flux increased,but again appeared at∼7.70 Hz when flux was dramatically decreased.The source was found in the soft intermediate state during these observations.We further studied the energy dependence of the QPO.We found that QPO was observed only for a higher energy range implying that the origin of QPO is possibly due to the corona emitting higher energy photons by the inverse Compton process.The variation of spectral parameters can be explained with the disk truncation model.The fractional rms was found to be monotonically increased with energy.The phase lag spectrum followed the“U-shaped”curve.The rms and phase lag spectrum are modeled and explained with the single-component Comptonization model vkompthdk.

Observation of Complex Organic Molecules Containing Peptide-like Bonds Toward Hot Core G358.93-0.03 MM1

In star formation regions,the complex organic molecules(COMs)that contain peptide bonds(-NH-C(=O)-)play a major role in the metabolic process because-NH-C(=O)-is connected to amino acids(R-CHNH_2-COOH).Over the past few decades,many COMs containing peptide-like bonds have been detected in hot molecular cores(HMCs),hot corinos,and cold molecular clouds,however,their prebiotic chemistry is poorly understood.We present the first detection of the rotational emission lines of formamide(NH_2CHO)and isocyanic acid(HNCO),which contain peptide-like bonds toward the chemically rich HMC G358.93-0.03 MM1,using high-resolution and high-sensitivity Atacama Large Millimeter/submillimeter Array bands 6 and 7.We estimate that the column densities of NH_2CHO and HNCO toward G358.93-0.03 MM1 are(2.80±0.29)×10~(15)cm~(-2)and(1.80±0.42)×10~(16)cm~(-2)with excitation temperatures of 165±21 K and 170±32 K,respectively.The fractional abundances of NH_2CHO and HNCO toward G358.93-0.03 MM1 are(9.03±1.44)×10~(-10)and(5.80±2.09)×10^(-9).We compare the estimated abundances of NH_2CHO and HNCO with the existing threephase warm-up chemical model abundance values and notice that the observed and modeled abundances are very close.We conclude that NH_2CHO is produced by the reaction of NH_2and H_2CO in the gas phase toward G358.93-0.03 MM1.Likewise,HNCO is produced on the surface of grains by the reaction of NH and CO toward G358.93-0.03 MM1.We also find that NH_2CHO and HNCO are chemically linked toward G358.93-0.03 MM1.

On the Formation of the Double Neutron Star Binary PSR J1846-0513

The double neutron star PSR J1846-0513 is discovered by the Five-hundred-meter Aperture Spherical radio Telescope(FAST)in Commensal Radio Astronomy FAST Survey.The pulsar is revealed to be harbored in an eccentric orbit with e=0.208 and an orbital period of 0.613 day.The total mass of the system is constrained to b2.6287(35)M_(⊙),with a mass upper limit of 1.3455 M_(⊙)for the pulsar and a mass lower limit of 1.2845 M_(⊙)for th companion star.To reproduce its evolution history,we perform a 1D model for the formation of PSR J1846-0513whose progenitor is assumed to be neutron star—helium(He)star system via MESA code.Since the larg eccentricity is widely believed to originate from an asymmetric supernova explosion,we also investigate th dynamical effects of the supernova explosion.Our simulated results show that the progenitor of PSR J1846-0513could be a binary system consisting of a He star of 3.3-4.0 M_(⊙)and a neutron star in a circular orbit with an initia period of~0.5 day.

A Possible γ-Ray Pulsation from PSR J1740-5340B in the Globular Cluster NGC 6397

Recently, a new radio millisecond pulsar(MSP) J1740-5340B, hosted in the globular cluster(GC) NGC 6397,was reported with a 5.78 ms spin period in an eclipsing binary system with a 1.97 days orbital period. Based on a modified radio ephemeris updated by tool tempo2, we analyze the ~15 yr γ-ray data obtained from the Large Area Telescope on board the Fermi Gamma-ray Space Telescope and detect PSR J1740-5340B's γ-ray pulsation at a confidence level of ~4σ with a weighted H-test value of ~26. By performing a phase-resolved analysis, the γ-ray luminosity in on-pulse interval of PSR J1740-5340B is L_(γ)~ 3.8 × 10^(33) erg s^(-1) using NGC 6397's distance of 2.48 kpc. And γ-rays from the on-pulse part of PSR J1740-5340B contribute ~90% of the total observed γ-ray emissions from NGC 6397. No significant γ-ray pulsation of another MSP J1740-5340A in the GC is detected.Considering that the previous four cases of MSPs in GCs, more data in γ-ray, X-ray, and radio are encouraged to finally confirm the γ-ray emissions from MSP J1740-5340B, especially starving for a precise ephemeris.

GRB 200612A:An Ultralong Gamma-Ray Burst Powered by Magnetar Spinning Down

GRB 200612A could be classified as an ultralong gamma-ray burst due to its prompt emission lasting up to~1020 s and the true timescale of the central engine activity t_(burst)≥4×10^(4) s.The late X-ray light curve with a decay index ofα=7.53 is steeper than the steepest possible decay from an external shock model.We propose that this X-ray afterglow can be driven by dipolar radiation from the magnetar spindown during its early stage,while the magnetar collapsed into the black hole before its spindown,resulting in a very steep decay of the late X-ray light curve.The optical data show that the light curve is still rising after 1.1 ks,suggesting a late onset.We show that GRB 200612A’s optical afterglow light curve is fitted with the forward shock model by Gaussian structured off-axis jet.This is a special case among GRBs,as it may be an ultralong gamma-ray burst powered by a magnetar in an off-axis observation scenario.

Study of Complex Nitrogen and Oxygen-bearing Molecules toward the High-mass Protostar IRAS 18089–1732

The observation of oxygen(O)-and nitrogen(N)-bearing molecules gives an idea about the complex prebiotic chemistry in the interstellar medium.Recent millimeter and submillimeter wavelength observations have shown the presence of complex O-and N-bearing molecules in the star formation regions.So,the investigation of those molecules is crucial to understanding the chemical complexity in the star-forming regions.In this article,we present the identification of the rotational emission lines of N-bearing molecules ethyl cyanide(C_(2)H_(5)CN)and cyanoacetylene(HC_(3)N),and O-bearing molecule methyl formate(CH_(3)OCHO)toward high-mass protostar IRAS18089–1732 using the Atacama Compact Array.We also detected the emission lines of both the N-and O-bearing molecule formamide(NH_(2)CHO)in the envelope of IRAS 18089–1732.We have detected the v=0 and 1 state rotational emission lines of CH_(3)OCHO.We also detected the two vibrationally excited states of HC_(3)N(v7=1 and v7=2).The estimated fractional abundances of C_(2)H_(5)CN,HC_(3)N(v7=1),HC_(3)N(v7=2),and NH_(2)CHO toward IRAS 18089–1732 are(1.40±0.5)×10^(-10),(7.5±0.7)×10^(-11),(3.1±0.4)×10^(-11),and(6.25±0.82)×10^(-11)respectively.Similarly,the estimated fractional abundances of CH_(3)OCHO(v=0)and CH_(3)OCHO(v=1)are(1.90±0.9)×10^(-9)and(8.90±0.8)×10^(-10),respectively.We also created the integrated emission maps of the detected molecules,and the observed molecules may have originated from the extended envelope of the protostar.We show that C_(2)H_(5)CNand HC_(3)N are most probably formed via the subsequential hydrogenation of the CH_(2)CHCNand the reaction between C_(2)H_(2)and CN on the grain surface of IRAS 18089–1732.We found that NH_(2)CHO is probably produced due to the reaction between NH_(2)and H_(2)CO in the gas phase.Similarly,CH_(3)OCHO is possibly created via the reaction between radical CH_(3)O and radical HCO on the grain surface of IRAS 18089–1732.

Single-pulse Emissions of PSRs J1611-0114 and J1617+1123

In this paper,the emissions from two pulsars,PSRs J1611-0114 and J1617+1123,were investigated using th Five-hundred-meter Aperture Spherical radio Telescope operating at a central frequency of 1250 MHz.Th average pulse profile of PSR J1611-0114 shows two components,the first of which is relatively weak in intensity The two-dimensional pulse stack exhibits an obvious nulling phenomenon,with an estimated nulling fraction o40.1%±5.4%.The durations of the nulls and bursts are consistent with power-law distributions,and no periodi nulling phenomenon is found.The results from PSR J1617+1123 demonstrate that the average pulse profile i composed of four components.The peak intensity of the fourth component varies significantly,causing an unstabl integrated profile.In addition,the modulation characteristics of J1611-0114 and J1617+1123 were studied by analyzing the modulation index,longitude resolved fluctuation spectrum and two-dimensional fluctuation spectrum using the software PSRSALSA.It was found that the two pulsars exhibit intensity modulation.In particular,J1611-0114 displays even-odd modulation,with the modulation period of approximately two pulses.The modulation period of J1617+1123 is relatively broad.There is an obvious subpulse drift phenomenon,and the value of P_(2)i~0.125c/P_(0),corresponding to 12 pulse longitude bins,and the drift rate(P_(2)/P_(3))is about 0.29.

基于Multi-Agent技术的教学资源个性化服务模型研究

从分析当前中小学教育资源供给模式的现状和需求出发,提出了一种全新的教育教学资源配送模式:基于Multi-Agent技术的教学资源个性化服务系统.它在一定程度上解决了用户(主要指教师和学生)日益提高的个性化资源需求与落后的服务模式之间的矛盾.

关注公民教育中特色教育资源的个性化服务--延安红色教育资源数字化服务模式构建

延安红色教育资源是新时期开展公民教育的特色教育资源。延安红色教育资源地处陕甘宁边区,在教育的价值与意义上,是中华民族共有的精神财富。为突破延安红色教育资源应用受地域的限制,在新媒体环境下提升公民教育中特色教育资源的个性化服务,利用互联网面向学校与社会公开共享特色教育资源,旨在促进红色教育资源在公民教育中的有效应用。延安红色教育资源数字化建设具有一定的特殊性,其个性化服务是一项长期系统的工程,原有的资源建设与应用模式很难适应新媒体环境下红色教育资源数字化服务的要求,因此需要重新构建延安红色教育资源开发与应用的新模型。基于该模型制定延安红色教育资源数字化建设的标准和规范,设计和分析红色教育网络平台模块的功能、素材建设等,实施网络平台开发;根据对网络教育平台的推广,研究红色教育资源应用模式,深化延安红色教育资源在学校和社会中有效应用的个性化服务。

基于Mini-CEX评分的个体化微课教学在住院医师规范化培训中的应用

目的探讨基于Mini-CEX评分的个体化微课教学在消化科规培中的应用价值。方法应用Mini-CEX对20名规培学员进行入科测评,依据测评结果制作微课,供学员自主学习。学员出科时再次接受Mini-CEX测评,并填写调查问卷,内容包括对基于Mini-CEX评分的个体化微课教学的满意度及意见。应用SPSS 26.0软件对数据进行配对样本t检验。结果规培学员出科时的各项评分均高于入科,临床岗位胜任力显著提高,差异有统计学意义(P<0.05)。问卷调查结果显示90%的规培学员对此种教学方法感到满意,认为其具有个体化、学习时间灵活等特点。结论基于Mini-CEX评分的个体化微课教学在消化科规培中不仅能有效解决目前临床带教中存在的突出问题,又能显著提高每一位规培学员的临床岗位胜任力,并获得规培学员的满意和认可。