Supportive care in transplantation: A patient-centered care model to better support kidney transplant candidates and recipients

Kidney transplantation(KT),although the best treatment option for eligible patients,entails maintaining and adhering to a life-long treatment regimen of medications,lifestyle changes,self-care,and appointments.Many patients experience uncertain outcome trajectories increasing their vulnerability and symptom burden and generating complex care needs.Even when transplants are successful,for some patients the adjustment to life post-transplant can be challenging and psychological difficulties,economic challenges and social isola-tion have been reported.About 50%of patients lose their transplant within 10 years and must return to dialysis or pursue another transplant or conservative care.This paper documents the complicated journey patients undertake before and after KT and outlines some initiatives aimed at improving patient-centered care in transplantation.A more cohesive approach to care that borrows its philosophical approach from the established field of supportive oncology may improve patient experiences and outcomes.We propose the"supportive care in transplantation"care model to operationalize a patient-centered approach in transplantation.This model can build on other ongoing initiatives of other scholars and researchers and can help advance patient-centered care through the entire care continuum of kidney transplant recipients and candidates.Multi-dimensionality,multi-disciplinarity and evidence-based approaches are proposed as other key tenets of this care model.We conclude by proposing the potential advantages of this approach to patients and healthcare systems.Core Tip:Kidney transplant recipients and candidates face several uncertainties in their care journey and have several expressed unmet healthcare needs.We recommend a structured and comprehensive approach to transplant care across the entire continuum of a transplant patient’s journey similar to what has been developed in the field of oncology.The supportive care in transplantation model can operationalize patient-centered care and build on the efforts of other researchers in the field.We postulate that such a model would significantly improve care delivery and patients’experiences and outcomes and potentially decrease healthcare utilization and cost.INTRODUCTION Patients with kidney failure benefit from(KT)[1,2],and experience improved survival rates when compared with dialysis[3-6].KT studies,using validated instruments,have also consistently demonstrated that kidney transplant recipients(KTRs)experience better health-related quality of life and several improvements in other disease-specific domains when compared with dialysis[7].In countries where dialysis is out of reach for many,the diagnosis of kidney failure would be futile without KT[8].Thus,increasing KT has been a priority for the nephrology and transplant communities.This priority has been reflected in recent global trends:Of the 79 countries where data were available,the International Society of Nephrology’s Global Kidney Atlas reported that the prevalence of KTRs in 2023 was 279 per million population which represented an increase of 9.4%from the data published four years prior[8].Despite this growth,KT can be a challenging journey for many patients and it is sometimes regarded as a‘cure’,which does not conform with the reality that many patients experience[9-13].KTRs must maintain a life-long treatment regimen of medications,lifestyle changes,self-care and medical appointments[14-17].As poignantly stated by a young female transplant recipient,“I thought everything would change once I got my kidney.I thought I would be healthy again”but after experiencing multiple side effects of immunosuppressive medications and graft loss,she stated,“I am just a different kind of patient now”[18].Indeed,a significant proportion of patients experience graft failure and return to dialysis;it is estimated that over 50%return to dialysis within 10 years of KT[19-23].Patients are often not prepared for this outcome and report several psychosocial and physical ramifications of graft failure[24,25].Overall,high symptom burden,adverse effects of immunosuppressants,risk of graft rejection or failure and mortality,contribute to complex needs,vulnerability and uncertainties for patients,increasing their care needs and treatment burden[26-30].In this paper,we highlight the complex journey that KTRs and candidates undertake that can generate varied outcome trajectories and complex healthcare needs.We highlight the need for a comprehensive patient-centered approach to care and conclude with a proposal for a“supportive care in transplantation”care model.

Supportive care needs of women with gynecologic cancer and factors affecting in Turkiye: a cross sectional study

Background:Identifying and managing patients'supportive care needs is an essential component of health care.The cancer patients'needs are multidimensional and it is important to identify these needs.This study was conducted to assess supportive care needs of women with gynecologic cancer and affecting factors.Methods:This cross-sectional study consisted of 98 women with gynecologic cancer.The data of the study was gathered using“Personal Information Form”and the“James Supportive Care Screening”.Results:The most frequently reported unmet needs of gynecologic cancer patients were emotional issues,including uncertainty(87.6%),fears(85.7%),feeling down(86.7%),worry(87.6%),loss of interest in usual activities(73.3%)and physical symptoms including fatigue/lack of energy(81.9%),weakness(81.9%),lack of appetite(76.2%).The most frequently reported social/practical problems was transportation problems(50%).The mean scores for JSCS was 29.72±15.57.There were a statistically significant difference was found only between family type,stage of the disease,and time of diagnosis,and the total mean scores of the JSCS(p<0.05).Conclusion:It has been determined that patients with gynecological cancer mostly experience emotional and physical problems.Health professionals working in the oncology unit should be aware of unmet needs.Certain programs and services to address the identified unmet needs should be provided.

A Feature Learning-Based Model for Analyzing Students’ Performance in Supportive Learning

Supportive learning plays a substantial role in providing a quality edu-cation system.The evaluation of students’performance impacts their deeper insight into the subject knowledge.Specifically,it is essential to maintain the baseline foundation for building a broader understanding of their careers.This research concentrates on establishing the students’knowledge relationship even in reduced samples.Here,Synthetic Minority Oversampling TEchnique(SMOTE)technique is used for pre-processing the missing value in the provided input dataset to enhance the prediction accuracy.When the initial processing is not done substantially,it leads to misleading prediction accuracy.This research concentrates on modelling an efficient classifier model to predict students’perfor-mance.Generally,the online available student dataset comprises a lesser amount of sample,and k-fold cross-validation is performed to balance the dataset.Then,the relationship among the students’performance(features)is measured using the auto-encoder.The stacked Long Short Term Memory(s-LSTM)is used to learn the previous feedback connection.The stacked model handles the provided data and the data sequence for understanding the long-term dependencies.The simula-tion is done in the MATLAB 2020a environment,and the proposed model shows a better trade-off than the existing approaches.Some evaluation metrics like pre-diction accuracy,sensitivity,specificity,AUROC,F1-score and recall are evalu-ated using the proposed model.The performance of the s?LSTM model is compared with existing approaches.The proposed model gives 89% accuracy,83% precision,86%recall,and 87%F-score.The proposed model outperforms the existing systems in terms of the earlier metrics.

Routine Supportive Supervision and Management of Medicines and Other Health Products and Technologies in Vihiga County, Kenya

Health Products and Technologies (HPTs) are pivotal for an efficient health system. Availability and accessibility to affordable health products are critical indicators towards achieving universal health coverage. Routine supportive supervision, performance monitoring, recognition of efforts and client feedback are vital activities toward health supply chain system strengthening. This is a descriptive paper that describes a model of integrated commodity supportive supervision, and mentorship and its impact on various outcomes of health commodity management. Data were abstracted from the standardized scored checklists used during integrated commodity supportive supervision and supply chain audit in public health facilities in Vihiga County. Scores for the period 2020 to 2022 were analyzed on the eight key areas of interest. The analysis was done using Statistical Package for Social Sciences (SPSS version 26). Results are interpreted at 95% Confidence interval. This paper also shares findings from both quantitative and qualitative data from client exit and facility managers’ interviews. Six complete rounds of supervisions, three clients and service providers’ interviews, and three annual award events have been conducted. We observed trends across six data collections points and compared the results at first point or baseline (January-June 2020) to the results at the last point or end line (April-June 2022). Findings show significant improvements on the eight parameters in terms of mean scores as follows: resolution of issues from previous visits by 35.06% (46.75% - 81.81%);storage of HPTs by 17.41% (68.72% - 86.13%);inventory management by 28.16% (42.67% - 70.83%);availability and use of commodity data management information systems (MIS) tools by 22.39% (74.40% - 96.79%);verification of commodity data by 25.61% (65.56% - 91.17%);availability of guidelines and job aids for commodity management by 46.28% (36.65% - 82.93%). There was an improvement on the mean score on accountability by 20.22% (58.58% - 83.51%). The composite (final) score improved by 28.33% (56.19% - 84.52%). There was progressive narrowing of the standard deviations on all the indicators across the study period. This demonstrates that there is standardization of practices and positive competition among all the public health facilities. There were significant improvements on all the eight indicators. Routine integrated commodity supportive supervision has proven to be an effective high impact intervention in improving management of health products and technologies in Vihiga County, Kenya.

Supportive care needs and health-related quality of life among Chinese lung cancer survivors

Purpose: The purpose of this study was to explore the supportive care needs and health-related quality of life (HRQoL) of lung cancer survivors, and to identify the association between patient characteristics, HRQoL and supportive care needs. Method: This was a sub-study of a larger scale survey of cancer survivors’ supportive care needs. A total of 48 lung cancer survivors were recruited from a regional teaching hospital, and a three-part structured questionnaire was used to collect 1) socio-demographic and clinical characteristics, 2) supportive care needs and 3) health-related quality of life data. Results: The three most commonly reported unmet needs were all in the health-system information domain: 1) being informed about your results as soon as possible (58%), 2) being informed about cancer which is under control or diminishing (50%), and 3) being informed about things you can do to help yourself get well (46%). The second most common unmet need domain was access to healthcare and ancillary support services. The survivors generally reported satisfactory HRQoL. However, household income and unmet physical and psychological needs were independently associated with HRQoL among these survivors. Conclusion: The high unmet needs in the health-system information area call for a review of the content and amount of information provided to lung cancer survivors. In addition, more attention should be given to lung cancer survivors with low incomes but high physical and psychological unmet needs, who require appropriate follow-up and long-term care of a physical, social and psychological kind.

Symptomatic and optimal supportive care of critical COVID-19:A case report and literature review

BACKGROUND Coronavirus disease 2019(COVID-19)severity is classified as asymptomatic,mild,moderate,severe,and critical.Mild cases account for a large percentage of cases in the epidemic and typically exhibit a favorable prognosis.However,a 49%-67%mortality is noted in critical cases.No COVID-19-specific drug has been reported to date,and symptomatic and optimal supportive care,including oxygenation,anti-coinfection treatments,and ventilation,represent the mainstay of treatment for this disease,especially in critical patients.CASE SUMMARY In the above-mentioned context,we share our experience with the treatment of one critical COVID-19 case and review the relevant literature.CONCLUSION Timely tracheal intubation,reasonable mechanical ventilation support,appropriate anti-infection treatment,and early anticoagulation and immunity support are key factors in the successful treatment of this case.

What is New in Supportive Care in Cancer？

The Annual Symposium of the Multinational Association of Supportive Care in Cancer （MASCC）/International Society of Oral Oncology （ISOO） was held in Vancouver, Canada,June 24-26, 2010. The symposium brought together health care professionals from many countries and many fields of expertise for an excellent forum of ideas, lectures and collegial interactions,and discussed methods to minimize cancer-induced side effects, the symptoms and complications of its treatment, and psychosocial issues facing cancer patients and their families. Some ideas and studies selected from the presentations of different fields of supportive care in cancer presented in this symposium are introduced in this paper.

Effect of Supportive Measures Guidelines on Nurses’ Practices during Labor

Objectives: To investigate the effect of supportive measures guidelines on nurses’ practices during labor. Methods: A quasi-experimental design (an interventional pre and post-test study). Setting: The study was conducted at obstetric wards and intrapartum units at Nasser Institute Hospital. Sample: All nurses provide guided direct care, there were 40 nurses included in the study. Tools: Three tools were used to collect data named self-administered questionnaire sheet, labor supportive measures’ observational checklists, and nurses’ satisfaction sheet. Results: There was a highly significant improvement in total knowledge and total practical skills among the studied sample pre-intervention compared to immediate post and follow-up intervention (p ≤ 0.01). Additionally, 95% of the studied sample was satisfied with the advanced knowledge included in the guidelines. Conclusion: The supportive measures guidelines had an efficient improving nurses’ knowledge and practices post-intervention. Also, the majority of the studied sample was satisfied with the implemented guidelines. Recommendations: Implementation of labor supportive measure guidelines in different childbirth units to improve nurses’ practice. Further research is required to investigate parturient woman’s satisfaction with the childbirth process after implementing labor supportive measures and the effect of labor supportive measures on childbirth process outcome.

Supportive tactics for innovative and sustainability performance in emerging SMEs

For this research,we examined the influence of access to domestic and international financing on sustainability performance with a mediating role of innovative performance and a moderating role of access to government support.Data were collected from 317 small and medium-sized enterprises(SMEs)through structured questionnaires.The results indicated that access to domestic and international financing significantly contributes to sustainability and innovative performances.Accordingly,we found a partial mediating role of innovative performance between access to domestic financing and sustainability performance as well as between access to international financing and sustainability performance.Access to government support significantly moderates the relationship between access to domestic finances and innovative performance as well as between access to international finances and innovative performance.Practitioners and policymakers should encourage national and international financial institutions and banks to facilitate SMEs by lending them funds for innovative activities and sustainability performance.Moreover,the government should support SMEs,so that they can contribute to economic growth and the gross domestic product.The implications from these matters will be further discussed in this paper.

Web Based Supportive Intervention for Families Living with Schizophrenia—An Open Trial

Background: Web based modalities should be explored to support families living with mental illness. A web based tool including a psychoeducative module, a diary and a password protected forum was developed aimed at relatives’ of a person with schizophrenia to alleviate daily life. Aim: The aim of the present study was to explore participants’ use of the web based tool with focus on the forum and its potential health and psychosocial benefits. Methods: Nineteen persons participated in this explorative open trial. The forum posts were analyzed using content analysis. Self-rating instruments assessing caregiver burden, stigma and the tool’s usability were analyzed with descriptive statistics. Results: The qualitative analysis resulted in four main categories and subcategories describing relatives’ situation and interaction in the forum: Caring for a Person with Schizophrenia, Crisis and Care, Secrecy vs Openness, and Interaction and Social Support. Experiences of caregiver burden, but also fulfillment with caregiving tasks were reported. Concealing or hiding the family’s mental illness was common, but also the ability to use inner strength to cope with stigma and discrimination. The mean usability score was 59 (70 = good). Conclusion: Web based support can help address some of the families’ needs of support, although it encompasses certain limitations. Patient rights and the availability of resources, especially in cases of emergency, need to be made easily visible and accessible to alleviate families’ burden.

Offering Smoking Cessation Support to Cancer Patients:The Role of Associations Providing Supportive Care in Cancer.Example of the Ligue Contre le Cancer Gironde

Aims:This article aims to explore the interventional and contextual components of smoking cessation support for cancer patients in the context of supportive care in cancer provided by an association,that is viable and effective in the French context,and to describe the partnership research process in which they were developed.Procedure:The intervention was developed from a dataset collected during a viability study for the development of a smoking cessation intervention carried out at the Ligue Contre le Cancer Gironde,a scoping review of evidence-based interventions and two narrative reviews on the determinants and ethical issues of smoking cessation in cancer.Results:The results confirmed a tangible opportunity to develop smoking cessation services within the relevant case because of the obstacles that can be overcome,the facilitators that can be mobilized,and the gaps existing in this field.In addition,they enabled the design of an intervention adapted to the context,guided by a voluntarist,multidisciplinary approach,and focused on patients’well-being.Conclusion:The associations providing supportive care in cancer can initiate and participate in the process of smoking cessation.They can play a key role in mediating between oncology and addictology.

Unmet supportive care needs in families of children with chronic health conditions: an Australian cross‑sectional study

Background The aim of this study was to identify similarities and diferences in the unmet supportive care needs(USCN)of families of children with major chronic health conditions(CHCs)using a universal need assessment tool.Methods A cross-sectional online survey involving parents of children with congenital heart disease(CHD),type 1 diabetes mellitus(T1D),cancer,and asthma diagnosed within the last 5 years recruited via social media and support organizations.Thirty-four items assessing the USCN across six domains(care needs,physical and social needs,informational needs,support needs,fnancial needs,child-related emotional needs)were responded to on a 4-point Likert scale[no need(1)to high need(4)].Descriptive statistics identifed the level of need,and linear regressions identifed factors associated with higher need domain scores.Due to small numbers,the asthma group was excluded from comparisons across CHCs.Results One hundred and ninety-four parents completed the survey(CHD:n=97,T1D:n=50,cancer:n=39,and asthma:n=8).Parents of children with cancer were most likely to report at least one USCN(92%),followed by parents of children with T1D(62%).The fve most commonly reported USCN across CHCs were drawn from four domains:child-related emotional,support,care,and fnancial.Three need items were included in the top fve needs for all conditions.A higher USCN was associated with a greater frequency of hospital visits and the absence of parental support.Conclusions Using a universal need assessment tool,this is one of the frst studies to characterize USCN in families of children diagnosed with common CHCs.While proportions endorsing diferent needs varied across conditions,the most endorsed needs were similar across the illness groups.This suggests that support programs or services could be shared across diferent CHCs.

A Voltage-supportive Controller for Ultra-fast Electric Vehicle Chargers in Islanded DC Microgrids

This paper presents a controller for fast and ultrafast electric vehicle(EV)charging stations.Without affecting the charging efficiency,the proposed controller enables the charger to provide support to the interconnection voltage to counter and damp its transients.Existing solutions are either hardware-based such as using supercapacitors and flywheels which increase the cost and bulkiness of the charging station,or software-based such as P/V droop methods which are still unable to provide a robust and strong voltage support.This paper proposes an emulated supercapacitor concept in the control system of the ultra-fast EV charger in an islanded DC microgrid.Thus,it converts the EV from a static load to a bus voltage supportive load,leading to reduced bus voltage oscillations during single and multiple ultra-fast EV charging operations,and rides through and provides supports during extreme external disturbances.Detailed analysis and design guidelines of the proposed controller are presented,and its effectiveness and improved performance compared with conventional techniques are shown for different case studies.

Lecturers’Efforts in Building Rapport in the English-Medium Instruction(EMI)Context:Focus on the Use of Communication Strategies

Past studies reveal the prevalence of anxiety,coupled with low motivation and disengagement among students in English-medium instruction(EMI)programs.Given the detrimental impact these negative emotions can have on learning outcomes,it is imperative that teachers establish positive emotional rapport with their students.This study explores how experienced and highly rated EMI lecturers at a Chinese university’s overseas campus use communication strategies to build rapport with their students during interactive academic activities.It identifies the strategies used by these lecturers and examines how the strategies facilitate the teaching-learning process.The data,consisting of 10 hours of tutorials and 10 hours of supervisor-student supervision meetings,is analyzed using an adapted Conversation Analysis(CA)approach.The analysis reveals three types of communication strategies(CSs)frequently used by lecturers:back-channeling,codeswitching,and co-creation of messages.By employing these strategies,the lecturers established a strong rapport with the students,which created an encouraging and supportive learning environment.Consequently,this positive atmosphere facilitated students’learning of content knowledge through English.The findings of this study have implications for the training of lecturers who encounter difficulties in establishing rapport with multilingual students in the EMI setting.

Teachers’ Perceptions of the Challenges and Strategies in Supporting Students with Reading Difficulties

The purpose of this study is to determine the teacher’s perceptions of the challenges and strategies in supporting students with reading difficulties.This study used qualitative method of research and descriptive approach as its research design,in addition to a set of structured interview questions administered through Google Forms to gather data from elementary teachers of Taal Central School,located at Taal Batangas.These structured interview questions were carefully designed to cover various dimensions of the study,including the types of challenges perceived by teachers,strategies employed,and possible solutions for addressing the problems encountered in the process of supporting students with reading difficulties.The results revealed that teachers faced several challenges when teaching students with reading difficulties such as emotional and motivational issues/factors,lack of resources or teaching aids,deficits in knowledge and skills,and problems with student engagement and participation.This study also showed common approaches utilized by the teachers in supporting students with reading difficulties,which were fostering a positive and supportive environment,adopting individualized and multifaceted approaches,and utilizing effective teaching tools and strategies.Lastly,teachers also concluded varied solutions in addressing the challenges perceived in teaching students with reading difficulties towards fostering reading proficiency.These include developing peer support,use of positive reinforcement,and parental involvement.Moreover,specialized resources,professional development for teachers,and specific teaching strategies are also highlighted as crucial components.By integrating these approaches,teachers concluded that it can create a supportive and effective learning environment tailored to the needs of students with reading difficulties.

Coalbursts in China: Theory, practice and management

Coalburst is one of the most serious disasters that threaten the safe production of coal mines, and this disaster is particularly serious in China. This paper presents an overview of coalbursts in China since 1980s. From the "stress and energy" and "regional and local" perspectives, the achievements in the theory, practice and management of coalbursts in China are systematically summarized. A theoretical system of coalbursts has been formed to reveal the deformational behavior of coalbursts and explain the mechanism of coalbursts. The occurrence conditions of coalbursts are put forward and the critical stress is obtained. The stress index method for risk evaluation of coalbursts before mining is proposed, and the deformation localization prediction method of coalbursts is put forward. The relationship between energy release and absorption in the process of coalbursts is found, and the prevention and control methods of coalbursts, including the regional method, the local method and support, are presented. The safety evaluation index of coalburst prevention and control is put forward. The integrated prevention and control method for coal and gas outbursts is proposed. The prevention and control technology and equipment of coalbursts have also been developed. Amongst them, the distribution law of the critical stress in China coalburst mines is discovered. The technology and equipment for monitoring, prevention and control of coalbursts, as well as for integrated prevention and control of combined coalbursts and other disasters, have been developed. The energy-absorbing and coalburst-preventing support technology for roadways is invented, and key engineering parameters of coalburst prevention and control are pointed out. In China, coalburst prevention and control laws and standards have been developed. Technical standards for coalbursts are formulated, statute and regulations for coal mines are established, and regulatory documents are promoted.

Machine learning-assisted efficient design of Cu-based shape memory alloy with specific phase transition temperature

The martensitic transformation temperature is the basis for the application of shape memory alloys(SMAs),and the ability to quickly and accurately predict the transformation temperature of SMAs has very important practical significance.In this work,machine learning(ML)methods were utilized to accelerate the search for shape memory alloys with targeted properties(phase transition temperature).A group of component data was selected to design shape memory alloys using reverse design method from numerous unexplored data.Component modeling and feature modeling were used to predict the phase transition temperature of the shape memory alloys.The experimental results of the shape memory alloys were obtained to verify the effectiveness of the support vector regression(SVR)model.The results show that the machine learning model can obtain target materials more efficiently and pertinently,and realize the accurate and rapid design of shape memory alloys with specific target phase transition temperature.On this basis,the relationship between phase transition temperature and material descriptors is analyzed,and it is proved that the key factors affecting the phase transition temperature of shape memory alloys are based on the strength of the bond energy between atoms.This work provides new ideas for the controllable design and performance optimization of Cu-based shape memory alloys.

Analysis of the interaction between bolt-reinforced rock and surface support in tunnels based on convergence-confinement method

To investigate the interaction of the bolt-reinforced rock and the surface support,an analytical model of the convergence-confinement type is proposed,considering the sequential installation of the fully grouted rockbolts and the surface support.The rock mass is assumed to be elastic-brittle-plastic material,obeying the linear Mohr-Coulomb criterion or the non-linear Hoek-Brown criterion.According to the strain states of the tunnel wall at bolt and surface support installation and the relative magnitude between the bolt length and the plastic depth during the whole process,six cases are categorized upon solving the problem.Each case is divided into three stages due to the different effects of the active rockbolts and the passive surface support.The fictitious pressure is introduced to quantify the threedimensional(3D)effect of the tunnel face,and thus,the actual physical location along the tunnel axis of the analytical section can be considered.By using the bolt-rock strain compatibility and the rocksurface support displacement compatibility conditions,the solutions of longitudinal tunnel displacement and the reaction pressure of surface support along the tunnel axis are obtained.The proposed analytical solutions are validated by a series of 3D numerical simulations.Extensive parametric studies are conducted to examine the effect of the typical parameters of rockbolts and surface support on the tunnel displacement and the reaction pressure of the surface support under different rock conditions.The results show that the rockbolts are more effective in controlling the tunnel displacement than the surface support,which should be installed as soon as possible with a suitable length.For tunnels excavated in weak rocks or with restricted displacement control requirements,the surface support should also be installed or closed timely with a certain stiffness.The proposed method provides a convenient alternative approach for the optimization of rockbolts and surface support at the preliminary stage of tunnel design.

Mechanism of high-preload support based on the NPR anchor cable in layered soft rock tunnels

The control of large deformation problems in layered soft rock tunnels needs to solve urgently.The roof problem is particularly severe among the deformation issues in tunnels.This study first analyzes the asymmetric deformation modes in layered soft rock tunnels with large deformations.Subsequently,we construct a mechanical model under ideal conditions for controlling the roof of layered soft rock tunnels through high preload with the support of NPR anchor cables.The prominent roles of long and short NPR anchor cables in the support system are also analyzed.The results indicate the significance of high preload in controlling the roof of layered soft rock tunnels.The short NPR anchor cables effectively improve the integrity of the stratified soft rock layers,while the long NPR anchor cables effectively mobilize the self-bearing capacity of deep-stable rock layers.Finally,the high-preload support method with NPR anchor cables is validated to have a good effect on controlling large deformations in layered soft rock tunnels through field monitoring data.

From concept to commercialization:A review of tubular solid oxide fuel cell technology

The reduced sealing difficulty of tubular solid oxide fuel cells(SOFCs)makes the stacking of tubular cell groups relatively easy,and the thermal stress constraints during stack operation are smaller,which helps the stack to operate stably for a long time.The special design of tubular SOFC structures can completely solve the problem of high-temperature sealing,especially in the design of multiple single-cell series integrated into one tube,where each cell tube is equivalent to a small electric stack,with unique characteristics of high voltage and low current output,which can significantly reduce the ohmic polarization loss of tubular cells.This paper provides an overview of typical tubular SOFC structural designs both domestically and internationally.Based on the geometric structure of tubular SOFCs,they can be divided into bamboo tubes,bamboo flat tubes,single-section tubes,and single-section flat tube structures.Meanwhile,this article provides an overview of commonly used materials and preparation methods for tubular SOFCs,including commonly used materials and preparation methods for support and functional layers,as well as a comparison of commonly used preparation methods for microtubule SOFCs,It introduced the three most important parts of building a fuel cell stack:manifold,current collector,and ceramic adhesive,and also provided a detailed introduction to the power generation systems of different tubular SOFCs,Finally,the development prospects of tubular SOFCs were discussed.