Value of improved nursing measures and enhanced nursing management to reduce the occurrence of adverse events in pediatric infusion

BACKGROUND Intravenous infusion is a common method of drug administration in clinical practice.Errors in any aspect of the infusion process,from the verification of medical orders,preparation of the drug solution,to infusion by nursing staff,may cause adverse infusion events.AIM To analyzed the value of improving nursing measures and enhancing nursing management to reduce the occurrence of adverse events in pediatric infusion.METHODS The clinical data of 130 children who received an infusion in the pediatric department of our hospital from May 2020 to May 2021 were analyzed and divided into two groups according to the differences in nursing measures and nursing management:65 patients in the control group received conventional nursing and nursing management interventions,while 65 patients in the observation group received improved nursing measure interventions and enhanced nursing management.The occurrence of adverse events,compliance of children,satisfaction of children’s families,and complaints regarding the transfusion treatment were recorded in both groups.RESULTS The incidence of fluid extravasation and infusion set dislodgement in the observation group were 3.08%and 1.54%,respectively,which were significantly lower than 12.31%and 13.85%in the control group(P<0.05),while repeated punctures and medication addition errors in the observation group were 3.08%and 0.00%,respectively,which were lower than 9.23%and 3.08%in the control group,but there was no significant difference(P>0.05).The compliance rate of children in the observation group was 98.46%(64/65),which was significantly higher than 87.69%(57/65)in the control group,and the satisfaction rate of children’s families was 96.92%(63/65),which was significantly higher than 86.15%(56/65)in the control group(P<0.05).The observation group did not receive any complaints from the child’s family,whereas the control group received four complaints,two of which were due to the crying of the child caused by repeated punctures,one due to the poor attitude of the nurse,and one due to medication addition errors,with a cumulative complaint rate of 6.15%.The cumulative complaint rate of the observation group was significantly lower than that of the control group(P<0.05).CONCLUSION Improving nursing measures and enhancing nursing management can reduce the incidence of fluid extravasation and infusion set dislodgement in pediatric patients,improve children’s compliance and satisfaction of their families,and reduce family complaints.

Study on the Countermeasures to Improve the Public Outdoor Leisure and Fitness Function on the Two Rivers and Four Banks in the Main Urban Area of Chongqing

The main urban area of Chongqing is surrounded by two rivers and set against each other.With its unique waterfront landscape,it has the resource conditions to become a leisure tourism destination.Intending to enhance people’s happiness,improve city quality,and promote Chongqing’s main urban area to become a tourist destination,this paper finds out the existing problems in the construction of public outdoor leisure and fitness facilities on the two rivers and four banks of Chongqing’s main urban area through investigation and analysis based on relevant experiences at home and abroad,takes the value chain theory as the guidance,and to find solutions to the problem.On this basis,combined with the law of economic operation,this paper puts forward the guiding ideology,principles,development goals,functional orientation,and development path for the improvement of public outdoor leisure and fitness on two rivers and four banks in the main city of Chongqing,and accordingly puts forward the policy system and guarantee measures for its improvement.

Analysis of the factors affecting the fuel rate in the COREX process and improvement measures

Increasing production capacity and operating rate, reducing fuel rates and costs of hot metal （HM） are the urgent tasks for the COREX process. In this study ,the various factors on the fuel consumption of COREX are researched from the theoretical analysis based on the calculations of material balances and heat balances. Combined with the production performances and practices of COREX-2000 （ Saldanha, India） and COREX-3000 （ Baosteel ）, the technical measures of reducing the fuel rate are analyzed and the way forward of technical innovation is addressed and discussed with the standpoint of the COREX process improvement.

High rate of clinically relevant improvement following anatomical total shoulder arthroplasty for glenohumeral osteoarthritis

BACKGROUND The minimal clinically important difference(MCID)is defined as the smallest meaningful change in a health domain that a patient would identify as important.Thus,an improvement that exceeds the MCID can be used to define a successful treatment for the individual patient.AIM To quantify the rate of clinical improvement following anatomical total shoulder arthroplasty for glenohumeral osteoarthritis.METHODS Patients were treated with the Global Unite total shoulder platform arthroplasty between March 2017 and February 2019 at Herlev and Gentofte Hospital,Denmark.The patients were evaluated preoperatively and 3 months,6 months,12 months,and 24 months postoperatively using the Western Ontario Osteoarthritis of the Shoulder index(WOOS),Oxford Shoulder Score(OSS)and Constant-Murley Score(CMS).The rate of clinically relevant improvement was defined as the proportion of patients who had an improvement 24 months postoperatively that exceeded the MCID.Based on previous literature,MCID for WOOS,OSS,and CMS were defined as 12.3,4.3,and 12.8 respectively.RESULTS Forty-nine patients with a Global Unite total shoulder platform arthroplasty were included for the final analysis.Mean age at the time of surgery was 66 years(range 49.0-79.0,SD:8.3)and 65%were women.One patient was revised within the two years follow-up.The mean improvement from the preoperative assessment to the two-year follow-up was 46.1 points[95%confidence interval(95%CI):39.7-53.3,P<0.005]for WOOS,18.2 points(95%CI:15.5-21.0,P<0.005)for OSS and 37.8 points(95%CI:31.5-44.0,P<0.005)for CMS.Two years postoperatively,41 patients(87%)had an improvement in WOOS that exceeded the MCID,45 patients(94%)had an improvement in OSS that exceeded the MCID,and 42 patients(88%)had an improvement in CMS that exceeded the MCID.CONCLUSION Based on three shoulder-specific outcome measures we find that approximately 90%of patients has a clinically relevant improvement.This is a clear message when informing patients about their prognosis.

IGED:Towards Intelligent DDoS Detection Model Using Improved Generalized Entropy and DNN

As the scale of the networks continually expands,the detection of distributed denial of service(DDoS)attacks has become increasingly vital.We propose an intelligent detection model named IGED by using improved generalized entropy and deep neural network(DNN).The initial detection is based on improved generalized entropy to filter out as much normal traffic as possible,thereby reducing data volume.Then the fine detection is based on DNN to perform precise DDoS detection on the filtered suspicious traffic,enhancing the neural network’s generalization capabilities.Experimental results show that the proposed method can efficiently distinguish normal traffic from DDoS traffic.Compared with the benchmark methods,our method reaches 99.9%on low-rate DDoS(LDDoS),flooded DDoS and CICDDoS2019 datasets in terms of both accuracy and efficiency in identifying attack flows while reducing the time by 17%,31%and 8%.

An improved typhoon monitoring model based on precipitable water vapor and pressure

The potential of monitoring the movement of typhoons using the precipitable water vapor(PWV) has been confirmed. However, monitoring the movement of typhoon is focused on PWV, making it difficult to describe the movement of a typhoon in detail minutely and resulting in insufficient accuracy. Hence,based on PWV and meteorological data, we propose an improved typhoon monitoring mode. First, the European Centre for Medium-Range Weather Forecasts Reanalysis 5-derived PWV(ERA5-PWV) and the Global Navigation Satellite System-derived PWV(GNSS-PWV) were compared with the reference radiosonde PWV(RS-PWV). Then, using the PWV and atmospheric parameters derived from ERA5, we discussed the anomalous variations of PWV, pressure(P), precipitation, and wind speed during different typhoons. Finally, we compiled a list of critical factors related to typhoon movement, PWV and P. We developed an improved multi-factor typhoon monitoring mode(IMTM) with different models(i.e.,IMTM-I and IMTM-II) in different cases with a higher density of GNSS observation or only Numerical Weather Prediction(NWP) data. The IMTM was evaluated through the reference movement speeds of HATO and Mangkhut from the China Meteorological Observatory Typhoon Network(CMOTN). The results show that the root mean square(RMS) of the IMTM-I is 1.26 km/h based on ERA5-P and ERA5-PWV,and the absolute bias values are mostly within 2 km/h. Compared with the models considering the single factor ERA5-P/ERA5-PWV, the RMS of the IMTM-I is improved by 26.3% and 38.5%, respectively. The IMTM-II model manifests a residual of only 0.35 km/h. Compared with the single-factor model based on GNSS-PWV/P, the residual of the IMTM-II model is reduced by 90.8% and 84.1%, respectively. These results propose that the typhoon movement monitoring approach combining PWV and P has evident advantages over the single-factor model and is expected to supplement traditional typhoon monitoring.

Introduction of Western Medicines into China and Improvement on Decoctions during Modern China

During the late Qing dynasty(1840 A.D.-1912 A.D.),a large quantity of Western medicines entered China,which continuously impacted the traditional Chinese medicine(TCM)market and revealed the shortcomings of Chinese medicines.Some personages in the TCM community followed the trend of learning from the West,and attempted to reform TCM,with the improvement on decoction becoming an important aspect of this effort.Through debates and trials,the improvement on decoction underwent three stages of conceptual evolution:“taking Chinese medicines as the foundation and referring to the dosage forms of Western medicines”,“introducing Western techniques to serve the preparation of decoctions”and“integrating the theories of TCM and Western medicine to improve decoctions”.The study highlights the effective complementarity between modern TCM and Western medicine in the field of pharmacy,and provides valuable experience and support for the reevaluation of the value of TCM in contemporary society.

A spatiotemporal evolution model of a short-circuit arc to a secondary arc based on the improved charge simulation method

The initial shape of the secondary arc considerably influences its subsequent shape.To establish the model for the arcing time of the secondary arc and modify the single-phase reclosing sequence,theoretical and experimental analysis of the evolution process of the short-circuit arc to the secondary arc is critical.In this study,an improved charge simulation method was used to develop the internal-space electric-field model of the short-circuit arc.The intensity of the electric field was used as an independent variable to describe the initial shape of the secondary arc.A secondary arc evolution model was developed based on this model.Moreover,the accuracy of the model was evaluated by comparison with physical experimental results.When the secondary arc current increased,the arcing time and dispersion increased.There is an overall trend of increasing arc length with increasing arcing time.Nevertheless,there is a reduction in arc length during arc ignition due to short circuits between the arc columns.Furthermore,the arcing time decreased in the range of 0°-90°as the angle between the wind direction and the x-axis increased.This work investigated the method by which short-circuit arcs evolve into secondary arcs.The results can be used to develop the secondary arc evolution model and to provide both a technical and theoretical basis for secondary arc suppression.

Research on Grid-Connected Control Strategy of Distributed Generator Based on Improved Linear Active Disturbance Rejection Control

The virtual synchronous generator(VSG)technology has been proposed to address the problem of system frequency and active power oscillation caused by grid-connected new energy power sources.However,the traditional voltage-current double-closed-loop control used in VSG has the disadvantages of poor disturbance immunity and insufficient dynamic response.In light of the issues above,a virtual synchronous generator voltage outer-loop control strategy based on improved linear autonomous disturbance rejection control(ILADRC)is put forth for consideration.Firstly,an improved first-order linear self-immunity control structure is established for the characteristics of the voltage outer loop;then,the effects of two key control parameters-observer bandwidthω_(0)and controller bandwidthω_(c)on the control system are analyzed,and the key parameters of ILADRC are optimally tuned online using improved gray wolf optimizer-radial basis function(IGWO-RBF)neural network.A simulationmodel is developed using MATLAB to simulate,analyze,and compare the method introduced in this paper.Simulations are performed with the traditional control strategy for comparison,and the results demonstrate that the proposed control method offers superior anti-interference performance.It effectively addresses power and frequency oscillation issues and enhances the stability of the VSG during grid-connected operation.

Adherence to Physical Measures during the SARS-COV2 Pandemic by Haemodialysis Patients in a Burkina Faso Tertiary Hospital: A Cross-Sectional Survey

Context: COVID-19 can spread rapidly in haemodialysis centres, leading to fatal outcomes. Implementing physical measures is crucial in limiting the spread of infection. Aims: To assess adherence to physical measures against SARS-Cov2 in haemodialysis patients. Methods and Material: From 13 to 19 July 2021, we administered the questionnaire to haemodialysis patients during or immediately after the dialysis session. The dependent variables were adherence to wearing masks, hand washing outside the dialysis centre, social distancing of at least 1.5 meters, and cough and sneeze hygiene. Statistical Analysis Used: Data were analyzed using Epi info software;descriptive statistics were presented as mean, headcount, and percentage;related factors were determined by multi-logistic regression. The significance level was 5%. The Health Research Ethics Committee approved the research protocol. Results: 142 patients were included (mean age: 42.5 ± 14 years). Wearing masks, hand-washing, social distancing, and coughing and sneezing hygiene were observed by 88%, 75%, 47%, and 60% of patients, respectively. Conclusion: Wearing masks was the most respected physical measure, while social distancing was the least respected.

Stability Study of Low Voltage Electrical Distribution Network: Audit and Improvement of DJEGBE Mini Solar Photovoltaic Power Plant in the Commune of OUESSE (Benin)

The supply of quality energy is a major concern for distribution network managers. This is the case for the company ASEMI, whose subscribers on the DJEGBE mini-power station network are faced with problems of current instability, voltage drops, and repetitive outages. This work is part of the search for the stability of the electrical distribution network by focusing on the audit of the DJEGBE mini photovoltaic solar power plant electrical network in the commune of OUESSE (Benin). This aims to highlight malfunctions on the low-voltage network to propose solutions for improving current stability among subscribers. Irregularities were noted, notably the overloading of certain lines of the PV network, implying poor distribution of loads by phase, which is the main cause of voltage drops;repetitive outages linked to overvoltage caused by lightning and overcurrent due to overload;faulty meters, absence of earth connection at subscribers. Peaks in consumption were obtained at night, which shows that consumption is greater in the evening. We examined the existing situation and processed the data collected, then simulated the energy consumption profiles with the network analyzer “LANGLOIS 6830” and “Excel”. The power factor value recorded is an average of 1, and the minimum value is 0.85. The daily output is 131.08 kWh, for a daily demand of 120 kWh and the average daily consumption is 109.92 kWh, or 83.86% of the energy produced per day. These results showed that the dysfunctions are linked to the distribution and the use of produced energy. Finally, we proposed possible solutions for improving the electrical distribution network. Thus, measures without investment and those requiring investment have been proposed.

Real-Time Monitoring Method for Cow Rumination Behavior Based on Edge Computing and Improved MobileNet v3

[Objective]Real-time monitoring of cow ruminant behavior is of paramount importance for promptly obtaining relevant information about cow health and predicting cow diseases.Currently,various strategies have been proposed for monitoring cow ruminant behavior,including video surveillance,sound recognition,and sensor monitoring methods.How‐ever,the application of edge device gives rise to the issue of inadequate real-time performance.To reduce the volume of data transmission and cloud computing workload while achieving real-time monitoring of dairy cow rumination behavior,a real-time monitoring method was proposed for cow ruminant behavior based on edge computing.[Methods]Autono‐mously designed edge devices were utilized to collect and process six-axis acceleration signals from cows in real-time.Based on these six-axis data,two distinct strategies,federated edge intelligence and split edge intelligence,were investigat‐ed for the real-time recognition of cow ruminant behavior.Focused on the real-time recognition method for cow ruminant behavior leveraging federated edge intelligence,the CA-MobileNet v3 network was proposed by enhancing the MobileNet v3 network with a collaborative attention mechanism.Additionally,a federated edge intelligence model was designed uti‐lizing the CA-MobileNet v3 network and the FedAvg federated aggregation algorithm.In the study on split edge intelli‐gence,a split edge intelligence model named MobileNet-LSTM was designed by integrating the MobileNet v3 network with a fusion collaborative attention mechanism and the Bi-LSTM network.[Results and Discussions]Through compara‐tive experiments with MobileNet v3 and MobileNet-LSTM,the federated edge intelligence model based on CA-Mo‐bileNet v3 achieved an average Precision rate,Recall rate,F1-Score,Specificity,and Accuracy of 97.1%,97.9%,97.5%,98.3%,and 98.2%,respectively,yielding the best recognition performance.[Conclusions]It is provided a real-time and effective method for monitoring cow ruminant behavior,and the proposed federated edge intelligence model can be ap‐plied in practical settings.

On the Polygonal Wear Evolution of Heavy-Haul Locomotive Wheels due to Wheel/Rail Flexibility and Its Mitigation Measures

Wheel polygonal wear can immensely worsen wheel/rail interactions and vibration performances of the train and track,and ultimately,lead to the shortening of service life of railway components.At present,wheel/rail medium-or high-frequency frictional interactions are perceived as an essential reason of the high-order polygonal wear of railway wheels,which are potentially resulted by the flexible deformations of the train/track system or other external excitations.In this work,the effect of wheel/rail flexibility on polygonal wear evolution of heavy-haul locomotive wheels is explored with aid of the long-term wheel polygonal wear evolution simulations,in which different flexible modeling of the heavy-haul wheel/rail coupled system is implemented.Further,the mitigation measures for the polygonal wear of heavy-haul locomotive wheels are discussed.The results point out that the evolution of polygonal wear of heavy-haul locomotive wheels can be veritably simulated with consideration of the flexible effect of both wheelset and rails.Execution of mixed-line operation of heavy-haul trains and application of multicut wheel re-profiling can effectively reduce the development of wheel polygonal wear.This research can provide a deep-going understanding of polygonal wear evolution mechanism of heavy-haul locomotive wheels and its mitigation measures.

Influencing factors and preventive measures of infectious complications after intestinal resection for Crohn’s disease

The incidence of Crohn’s disease(CD)has increased in recent years,with most patients requiring intestinal resection.Complications after intestinal resection for CD can lead to poor prognosis and recurrence,among which infectious complic-ations are the most common.This study aimed to investigate the common risk factors,including medications,preoperative nutritional status,surgery-related factors,microorganisms,lesion location and type,and so forth,causing infectious complications after intestinal resection for CD,and to propose corresponding preventive measures.The findings provided guidance for identifying suscept-ibility factors and the early intervention and prevention of infectious complic-ations after intestinal resection for CD in clinical practice.

Effect of Station Improvement Measures on Customer Satisfaction

Stations are often regarded as change engines--places where passengers have to change as quickly and efficiently as possible from one mode of transport to another. Underpinned by research, NS （Netherlands Railways） currently takes the view that stations should be transformed into dynamic urban portals that not only facilitate a speedy transfer but also make the stay at the station more enjoyable. To discover which aspects the customer perceives as important, NS developed a research method that is based on enviromnental psychology and with which the impact of passengers＇ waiting and station experience can be measured. This article addresses the measures taken, the method of measurement and the measurement results. Examples of such measures are： experimenting with colour, light, music, infotainment and increasing and repositioning the shopping facilities. Our studies not only showed an increase in the score for the general evaluation of a test station （Leiden Central Station） with one full point but also significant positive effects on various aspects of waiting and experience.

On Adaptation Measures to Solve Tel-Aviv’s Environmental Problems with “Sunny Rain”

Adaptation measures were proposed using“Sunny Rain”to solve Tel Aviv’s environmental problems to cool the air in the city and save humanity from climate catastrophe and fight air pollution;the Yarkon,“Tel Aviv’s main river”will no longer be a dirty ditch;the fog from Ben-Gurion Airport was cleaned;neighborhoods,parks,around Tel Aviv were greened and all green spaces were irrigated with“Sunny Rain”.

Improvement of hepatic fibrosis after tenofovir disoproxil fumarate switching to tenofovir alafenamide for three years

BACKGROUND Both tenofovir alafenamide(TAF)and tenofovir disoproxil fumarate(TDF)are the first-line treatments for chronic hepatitis B(CHB).We have showed switching from TDF to TAF for 96 weeks resulted in further alanine aminotransferase(ALT)improvement,but data remain lacking on the long-term benefits of TDF switching to TAF on hepatic fibrosis.AIM To assess the benefits of TDF switching to TAF for 3 years on ALT,aspartate aminotransferase(AST),and hepatic fibrosis improvement in patients with CHB.METHODS A single center retrospective study on 53 patients with CHB who were initially treated with TDF,then switched to TAF to determine dynamic patterns of ALT,AST,AST to platelet ratio index(APRI),fibrosis-4(FIB-4)scores,and shear wave elastography(SWE)reading improvement at switching week 144,and the associated factors.RESULTS The mean age was 55(28-80);45.3%,males;15.1%,clinical cirrhosis;mean baseline ALT,24.8;AST,25.7 U/L;APRI,0.37;and FIB-4,1.66.After 144 weeks TDF switching to TAF,mean ALT and AST were reduced to 19.7 and 21,respectively.From baseline to switching week 144,the rates of ALT and AST<35(male)/25(female)and<30(male)/19(female)were persistently increased;hepatic fibrosis was also improved by APRI<0.5,from 79.2%to 96.2%;FIB-4<1.45,from 52.8%to 58.5%,respectively;mean APRI was reduced to 0.27;FIB-4,to 1.38;and mean SWE reading,from 7.05 to 6.30 kPa after a mean of 109 weeks switching.The renal function was stable and the frequency of patients with glomerular filtration rate>60 mL/min was increased from 86.5%at baseline to 88.2%at switching week 144.CONCLUSION Our data confirmed that switching from TDF to TAF for 3 years results in not only persistent ALT/AST improvement,but also hepatic fibrosis improvement by APRI,FIB-4 scores,as well as SWE reading,the important clinical benefits of long-term hepatitis B virus antiviral treatment with TAF.

Power Aggregation Operators and Similarity Measures Based on Improved Intuitionistic Hesitant Fuzzy Sets and their Applications to Multiple Attribute Decision Making

Intuitionistic hesitant fuzzy set(IHFS)is amixture of two separated notions called intuitionistic fuzzy set(IFS)and hesitant fuzzy set(HFS),as an important technique to cope with uncertain and awkward information in realistic decision issues.IHFS contains the grades of truth and falsity in the formof the subset of the unit interval.The notion of IHFS was defined by many scholars with different conditions,which contain several weaknesses.Here,keeping in view the problems of already defined IHFSs,we will define IHFS in another way so that it becomes compatible with other existing notions.To examine the interrelationship between any numbers of IHFSs,we combined the notions of power averaging(PA)operators and power geometric(PG)operators with IHFSs to present the idea of intuitionistic hesitant fuzzy PA(IHFPA)operators,intuitionistic hesitant fuzzy PG(IHFPG)operators,intuitionistic hesitant fuzzy power weighted average(IHFPWA)operators,intuitionistic hesitant fuzzy power ordered weighted average(IHFPOWA)operators,intuitionistic hesitant fuzzy power ordered weighted geometric(IHFPOWG)operators,intuitionistic hesitant fuzzy power hybrid average(IHFPHA)operators,intuitionistic hesitant fuzzy power hybrid geometric(IHFPHG)operators and examined as well their fundamental properties.Some special cases of the explored work are also discovered.Additionally,the similarity measures based on IHFSs are presented and their advantages are discussed along examples.Furthermore,we initiated a new approach to multiple attribute decision making(MADM)problem applying suggested operators and a mathematical model is solved to develop an approach and to establish its common sense and adequacy.Advantages,comparative analysis,and graphical representation of the presented work are elaborated to show the reliability and effectiveness of the presented works.

A Boost to Inbound Tourism China sees surge in foreign travellers following introduction of visa-free transit measures

One of the viral terms on Chinese social media these days-“city bu city”–was actually created by a foreign tourist.The tourist,a blogger,used the term,which literally means city or not city,in a short video he filmed while visiting the Great Wall,wondering whether the place is like a fashionable big city.

An Investigation Into the Needs and Challenges of County-Level Family Education Guidance Services and Corresponding Improvement Measures

The delivery of targeted family education guidance services is essential for establishing a three-in-one education model that encompasses families,schools,and communities.It is also the key to creating a favorable educational environment that promotes the comprehensive and healthy development of individual students.To gain a comprehensive understanding of family education characteristics and trends in Chinese counties,accurately tap into the educational needs of parents,and effectively identify strengths and weaknesses in family education guidance services,this paper employed a quantitative research method based on a questionnaire survey and interview data from J district of C city after years of continuous monitoring of the quality of family education in the area,aiming to explore these issues and put forward several suggestions for improvement.The results indicate that the family learning environment and atmosphere in the district are generally favorable,while parental educational competence requires further improvement.Parents express a strong desire for interactive,systematic,and fragmented family education guidance from schools.Most parents acknowledge the significance of receiving guidance on family education,yet they are disinclined to actively engage in learning-related activities.While the operational mechanisms of county-level family education guidance services have been continuously improved,there is a need for greater overall coordination.Furthermore,the potential of school-led family education guidance services has yet to be fully tapped,and the scientific and professional standards of such guidance need to be further enhanced.Based on the aforementioned findings,we propose recommendations for improvement.Using J district’s effective improvement practices in management,curriculum,and teams as an example,we intend to explore practical ways to promote county-level family education guidance services and provide a valuable reference for the establishment of a comprehensive and effective system to improve such services.