基于Childlife理念的叙事医学干预在隐睾患儿围手术期中的应用

目的探讨Child life理念的叙事医学干预在隐睾患儿围手术期中的应用效果。方法选取2021年1月至2023年8月安徽医科大学第一附属医院收治的120例住院择期手术的隐睾患儿作为研究对象,采用随机数字表法分为观察组和对照组,各60例。对照组采用泌尿外科常规围手术期干预,观察组在对照组基础上采用Child life理念的叙事医学干预。比较两组患儿和家长入院时、术后1 d和出院时的焦虑状态,以及患儿术后疼痛和家长满意度。结果两组患儿和家长焦虑评分组间、时间及交互比较,差异均具有统计学意义(P<0.001);对照组患儿和家长出院时焦虑评分均低于入院时、术后1 d,差异具有统计学意义(P<0.05);观察组患儿和家长术后1 d焦虑评分均低于入院时,出院时低于入院时、术后1 d,差异具有统计学意义(P<0.05);观察组患儿和家长术后1 d、出院时焦虑评分均低于对照组,差异具有统计学意义(P<0.05)。观察组患儿术后疼痛评分显著低于对照组,差异具有统计学意义(P<0.001)。观察组家长满意度显著高于对照组,差异具有统计学意义(P<0.001)。结论基于Child life理念的叙事医学干预可有效减轻隐睾患儿和家长围手术期的焦虑情绪,降低患儿术后疼痛感,提高家长满意度。

Discharge plasma for prebiotic chemistry: Pathways to life’s building blocks

Discharge plasmas, recognized as unique platforms for investigating the origins of chemical life, have garnered extensive interest for their potential to simulate prebiotic conditions. This paper embarks on a comprehensive overview of recent advancements in the plasma-enabled synthesis of life’s building blocks, charting the complex environmental parameters believed to have surrounded life’s inception. This discussion elaborates on the fundamental mechanisms of discharge plasmas and their likely role in fostering conditions necessary for the origin of life on early Earth. We consider a variety of chemical reactions facilitated by plasma, specifically the synthesis of vital organic molecules - amino acids, nucleobases, sugars, and lipids. Further, we delve into the impact of plasmas on prebiotic chemical evolution. We expect this review to open new horizons for future investigations in plasma-related prebiotic chemistry that could offer valuable insights for unraveling the mysteries of life's origin.

Remaining Useful Life for Heavy-Duty Railway Cast Steel Knuckles Based on Crack Growth Behavior with Hypothetical Distributions

The current research on the integrity of critical structures of rail vehicles mainly focuses on the design stage,which needs an effective method for assessing the service state.This paper proposes a framework for predicting the remaining useful life(RUL)of in-service structures with and without visible cracks.The hypothetical distribution and delay time models were used to apply the equivalent crack growth life data of heavy-duty railway cast steel knuckles,which revealed the evolution characteristics of the crack length and life scores of the knuckle under different fracture failure modes.The results indicate that the method effectively predicts the RUL of service knuckles in different failure modes based on the cumulative failure probability curves for different locations and surface crack lengths.This study proposes an RUL prediction framework that supports the dynamic overhaul and state maintenance of knuckle fatigue cracks.

探讨Chinese way术式在关节镜下治疗巨大肩袖损伤的应用价值

目的探讨Chinese way术式在关节镜下治疗巨大肩袖损伤的应用价值,为临床治疗提供参考。方法选取2022年3月至2024年3月于扬州市江都中医院接受治疗的70例巨大肩袖损伤患者的临床资料,进行回顾性分析。根据治疗方式不同分为双排锚钉缝线桥组和Chinese way组,每组35例。双排锚钉缝线桥组患者采用关节镜下双排锚钉缝线桥固定术治疗,Chinese way组患者采用关节镜下Chinese way术式治疗。比较两组患者肩关节活动度、并发症发生情况、Fugl-Meyer评定量表(FMA-UE)评分。结果术后3个月,两组患者前屈、后伸、内旋、外旋的肩关节活动度均增加,且Chinese way组均大于双排锚钉缝线桥组(均P<0.05)。Chinese way组患者并发症总发生率低于双排锚钉缝线桥组(均P<0.05)。术后3个月,两组患者运动功能、感觉功能、平衡功能、关节活动度、疼痛的各项FMA-UE评分均升高,且Chinese way组均高于双排锚钉缝线桥组(均P<0.05)。结论Chinese way术式在关节镜下治疗巨大肩袖损伤的效果较好,可有效提升患者肩关节活动度和上肢运动功能,且安全性较高,值得临床应用。

Reevaluating health metrics:Unraveling the limitations of disabilityadjusted life years as an indicator in disease burden assessment

In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and qualitative data,is grounded in preferences regarding disability status.This review delineates the algorithm used to calculate the value of the proposed DALY synthetic indicator and elucidates key methodological challenges associated with its application.In contrast to the quality-adjusted life years approach,derived from multi-attribute utility theory,the DALY stands as an independent synthetic indicator that adopts the assumptions of the Time Trade Off utility technique to define Disability Weights.Claiming to rely on no mathematical or economic theory,DALY users appear to have exempted themselves from verifying whether this indicator meets the classical properties required of all indicators,notably content validity,reliability,specificity,and sensitivity.The DALY concept emerged primarily to facilitate comparisons of the health impacts of various diseases globally within the framework of the Global Burden of Disease initiative,leading to numerous publications in international literature.Despite widespread adoption,the DALY synthetic indicator has prompted significant methodological concerns since its inception,manifesting in inconsistent and non-reproducible results.Given the substantial diffusion of the DALY indicator and its critical role in health impact assessments,a reassessment is warranted.This reconsideration is imperative for enhancing the robustness and reliability of public health decisionmaking processes.

The Sequential Mediating Roles of Body Pain and Self-Reported Health Status in the Relationship between Sleep Duration and Life Satisfaction

Objective This study examines the sequential mediating roles of body pain and self-reported health in the association between sleep duration and self-reported life satisfaction among elderly Chinese adults.Methods Data from the fifth wave of the China Health and Retirement Longitudinal Survey(CHARLS)were used to analyse the relationships between sleep duration and body pain,self-reported health,and life satisfaction through logistic regression and Restricted Cubic Spline(RCS)analyses.The sequential mediation effects of body pain and self-reported health status were examined via chain mediation analysis.Results Logistic regression analysis showed that sleeping fewer than 6 hours or 6-7 hours was linked to higher risks of body pain,poor health,and dissatisfaction with life compared to sleeping 7-8 hours(all P<0.05).Additionally,those sleeping more than 9 hours also had increased risks of poor health and dissatisfaction with life compared to those sleeping 7-8 hours(all P<0.05).Chain mediation analysis showed that body pain and self-reported health status sequentially mediated 46.15%of the association between sleep duration and life satisfaction.Conclusion Body pain and self-reported health may shape the relationship between sleep duration and life satisfaction in elderly Chinese adults.

Distressing symptoms and health-related quality of life in patients with chronic kidney disease

BACKGROUND Chronic kidney disease(CKD)is an incapacitating illness associated with distressing symptoms(DS)that have negative impact on patients’health-related quality of life(HRQOL).AIM To assess the severity of DS and their relationships with HRQOL among patients with CKD in Jordan.METHODS A descriptive cross-sectional design was used.A convenience sampling approach was used to recruit the participants.Patients with CKD(n=140)who visited the outpatient clinics in four hospitals in Amman between November 2021 and December 2021 were included.RESULTS The Edmonton Symptom Assessment System was used to measure the severity of the DS while the Short Form-36 tool was used to measure the HRQOL.Participants’mean age was 50.9(SD=15.14).Most of them were males(n=92,65.7%),married(n=95,67.9%),and unemployed(n=93,66.4%).The highest DS were tiredness(mean=4.68,SD=2.98)and worse well-being(mean=3.69,SD=2.43).The highest HRQOL mean score was for the bodily pain scale with a mean score of 68.50 out of 100(SD=32.02)followed by the emotional well-being scale with mean score of 67.60(SD=18.57).CONCLUSION Patients with CKD had suboptimal HRQOL,physically and mentally.They suffer from multiple DS that have a strong association with diminished HRQOL such as tiredness and depression.Therefore,healthcare providers should be equipped with the essential knowledge and skills to promote individualized strategies that focusing on symptom management.

Data-Driven Method for Predicting Remaining Useful Life of Bearings Based on Multi-Layer Perception Neural Network and Bidirectional Long Short-Term Memory Network

The remaining useful life prediction of rolling bearing is vital in safety and reliability guarantee.In engineering scenarios,only a small amount of bearing performance degradation data can be obtained through accelerated life testing.In the absence of lifetime data,the hidden long-term correlation between performance degradation data is challenging to mine effectively,which is the main factor that restricts the prediction precision and engineering application of the residual life prediction method.To address this problem,a novel method based on the multi-layer perception neural network and bidirectional long short-term memory network is proposed.Firstly,a nonlinear health indicator(HI)calculation method based on kernel principal component analysis(KPCA)and exponential weighted moving average(EWMA)is designed.Then,using the raw vibration data and HI,a multi-layer perceptron(MLP)neural network is trained to further calculate the HI of the online bearing in real time.Furthermore,The bidirectional long short-term memory model(BiLSTM)optimized by particle swarm optimization(PSO)is used to mine the time series features of HI and predict the remaining service life.Performance verification experiments and comparative experiments are carried out on the XJTU-SY bearing open dataset.The research results indicate that this method has an excellent ability to predict future HI and remaining life.

Childlife干预在儿童隐匿阴茎围术期护理中的应用

分析儿童隐匿阴茎围术期护理中采取Child life干预的效果。方法 选取2022年1月-2023年2月纳入的隐匿性阴茎儿童60例作为观察对象,经随机抽签法分组,对照组、观察组各有30例。两组分别采取常规护理、Child life干预,观察围术期患儿的心理状态,并评估患儿术后疼痛评分及护理满意度、护理依从性。结果 护理前,组间SAS及SDS评分相比,p>0.05;护理后,观察组SAS及SDS评分比对照组低,p<0.05;观察组Wong-Baker分值低于对照组,p<0.05;观察组依从性及护理满意度高于对照组,p<0.05。结论 在隐匿性阴茎儿童围术期护理中采取Child life护理模式可提升患儿的依从性、护理满意度,并改善患儿心理状态,减轻其疼痛感。

A Probe into Ernest Hemingway's Suicide Enigma Through His Works and Life Experiences

Ernest Hemingway, one of the brightest stars on the literary stage of both American and the whole world literature in the twentieth century, had gained an everlasting reputation by the image of"the tough man"he created in lots of his works.Hence, to readers, Hemingway must be a strong man both physically and mentally. Though Hemingway had passed away, he left us an inestimable literary treasure, and we can draw some lessons from his suicide tragedy. To modern people who are

On Hemingway's Iceberg Theory——From The Short Happy Life of Francis Macomber

Ernest Hemingway's world-wide influence and distinctive writing style-the Iceberg Style-caused a stylistic revolution in the field of literature all over the world.Hemingway always tries his best to avoid depicting things by piling gorgeously big words;on the contrary,he adopts direct description and short sentences which are precise,laconic,bright and vivid.For instance,the novel titled The Short and Happy Life of Francis Macomber is universally acknowledged as his masterpiece,in which "Iceberg Theory"is skillfully presented.With a full analysis of the story,the uniqueness of "Iceberg Theory"will be emphasized in this paper.

Fatigue life evaluation on key components of high-speed railway catenary system

The fatigue load spectrum and operation life evaluation of key components in the catenary system under the high speed train running condition were investigated.Firstly,based on the catenary model and pantograph model,the couple dynamic equations of pantograph–catenary were built with the Lagrange’s method;then the dynamic contact force was obtained by the Newmark method at the train speeds of 250,280 and 300 km/h,respectively.Secondly,the finite element model(FEM)of one anchor section’s catenary was built to analyze its transient response under the contact force as train running;then the loading time history of messenger wire base,steady arm,registration tube,oblique cantilever,and straight cantilever were extracted.Finally,the key components’fatigue spectrum was carried out by the rain-flow counting method,and operation life was estimated in consideration of such coefficients,such as stress concentration,shape and dimension,surface treatment.The results show that the fatigue life of the catenary system reduces with the increasing of train speed;specifically,the evaluated fatigue life of the steady arm is shorter than other components.

The Study of Contact Pressure Analyses and Prediction of Dynamic Fatigue Life for Linear Guideways System

The application of the linear guideways is very extensive, such as automation equipment, heavy-duty carry equipment, heavy-cut machining tool, CNC grinding machine, large-scale planning machine and machining center with the demand of high rigidity and heavy load. By means of the study of contact behavior between the roller/guideway and roller/slider, roller type linear guideways can improve the machining accuracy. The goal of this paper is to construct the fatigue life model of the linear guideway, with the help of the contact mechanics of rollers. In beginning, the analyses of the rigidity of a single roller compressed between guideway and slider was conducted. Then, the normal contact pressure of linear guideways was obtained by using the superposition method, and verified by the FEM software (ANSYS workbench). Finally, the bearing life theory proposed by Lundberg and Palmgren was used to describe the contact fatigue life.

Life Cycle Assessment of CCA-Treated Wood Highway Guard Rail Posts in the US with Comparisons to Galvanized Steel Guard Rail Posts

A cradle-to-grave life cycle assessment is done to identify the environmental impacts of chromated copper arsenate (CCA)-treated timber used for highway guard rail posts, to understand the processes that contribute to the total impacts, and to determine how the impacts compare to the primary alternative product, galvanized steel posts. Guard rail posts are the supporting structures for highway guard rails. Transportation engineers, as well as public and regulatory interests, have increasing need to understand the environmental implications of guard rail post selection, in addition to factors such as costs and service performance. This study uses a life cycle inventory (LCI) to catalogue the input and output data from guard rail post manufacture, service life, and disposition, and a life cycle impact assessment (LCIA) to assess anthropogenic and net greenhouse gas (GHG), acidification, smog, ecotoxicity, and eutrophication potentially resulting from life cycle air emissions. Other indicators of interest also are tracked, such as fossil fuel and water use. Comparisons of guard rail post products are made at a functional unit of one post per year of service. This life cycle assessment (LCA) finds that the manufacture, use, and disposition of CCA-treated wood guard rails offers lower fossil fuel use and lower anthropogenic and net GHG emissions, acidification, smog potential, and ecotoxicity environmental impacts than impact indicator values for galvanized steel posts. Water use and eutrophication impact indicator values for CCA-treated guard rail posts are greater than impact indicator values for galvanized steel guard rail posts.

Basic studies on life circumstances and stress in persons with congenital physical disabilities using always wheelchairs

Many studies about the health problems of persons with physical disabilities have been performed, however few studies have focused on the life circumstances of persons with physical disabilities. This study aimed to clarify the relationship between stress and the life circumstances of persons with congenital physical disabilities who must use wheelchairs. The participants were 70 individuals who used the services of care workers employed by welfare service business offices. Participants used wheelchairs. In addition, those participants who used a standard manual wheelchair were not able to operate it alone. Participants were required to answer a two-part questionnaire with questions about factors related to basic lifestyle and stress, and about life factors related to the stress of individuals with physical disabilities. No significant relationship between lifestyle and stress was found in either males or females. Most persons with congenital physical disabilities using wheelchairs had some kind of stress in daily life. In particular, significantly more level of stress was found in females (90%) than that in males (65%). Levels of stress according to life factor differed between males and females. The most dramatic gender difference was that the level of stress caused by the mental or mind factor in females was significantly higher than that in males (p < 0.05). Most persons who must use wheelchairs have stress resulting from daily life, and in particular, females experience more mental stress than males.

Investigation of the quality of life,mental status in patients with gynecological cancer and its influencing factors

BACKGROUND Having a gynecological tumor or undergoing treatment can be a traumatic experience for women,as it affects their self-image and sexual relationships and can lead to psychological reactions.Psychological adjustment following cancer occurrence remains a key issue among the survivors.AIM To examine the current status of quality of life(QoL),anxiety,and depression in patients with gynecological cancer and to analyze the factors associated with it.METHODS Data for 160 patients with gynecological malignancies treated at Shanxi Bethune Hospital from June 2020 to June 2023 were collected and analyzed retrospectively.Patients’QoL was assessed using the European Organization for Research on Treatment of Cancer Quality of Life Questionnaire Core 30 and the Functional Assessment of Cancer Therapy-General Questionnaire.Their emotional status was evaluated using the Self-Rating Anxiety/Depression Scale.The associated factors of anxiety and depression were analyzed.RESULTS The overall QoL score of the patients 6 months after surgery was 76.39±3.63 points.This included low levels of social and emotional function and severe fatigue and pain.The scores for physiological,functional,emotional,social,and family well-being exhibited an upward trend following surgery compared with those before surgery.One month after surgery,some patients experienced anxiety and depression,with an incidence of 18.75%and 18.13%,respectively.Logistic analysis revealed that good sleep was a protective factor against anxiety and depression in patients with gynecological tumors,whereas physical pain was a risk factor.CONCLUSION Patients with gynecological malignancies often experience anxiety and depression.By analyzing the factors that affect patients’QoL,effective nursing measures can be administered.

Abortion as a Moral Good? Contrasting Secular and Judeo-Christian Views and a Potential Pathway for Promoting Life

Objective: This review aims to summarize key facets of the Pro Choice and Pro Life perspectives and outline a resolution pathway that minimizes abortion. Main Results: Approximately 1.3 billion abortions occurred worldwide from 1990 through 2014. In the United States, more than 61 million abortions were performed between 1973 and 2017. The Pro Choice perspective posits that: 1) A fetus is not a person;therefore, a person is not harmed. 2) Forced childbearing includes significant health and psychological risks to the mother and can exacerbate poverty. Since a person is not harmed and the mother is benefited, abortion is a moral good. From a Judeo-Christian, Pro Life perspective: 1) God creates every person in his image and has a pre-conception life plan for them. 2) God commanded us to be fruitful and multiply and identified children as a blessing. Hence, abortion harms a person and is rebellion against God. Conclusion: In working toward a solution, agape love, which is sacrificial and giving, not selfish or condemning, is a good starting point. In that light, the Judeo-Christian community can begin bridging the chasm between the Pro Life and Pro Choice communities by sharing truth in love and helping to meet the material and emotional needs of pregnant women who see no alternative to abortion. Proactive, unconditional love provides the foundation for making the womb a sanctuary for life.

Psychotherapy: A Way Forward to Improve the Quality of Life in Otalgia Patients

Introduction: Otalgia is not only an indicator of impact of disease but also impairs the daily activities and personal behaviors as is unpleasant and disturbing for the patient. It leads to decrease in functional status up to the complete disability. Nowadays the main focus of physician is to eradicate the disease or the symptoms, leaving behind the humanistic element. In diseased state, the most important point is to assess and improve the quality of life by using multidisciplinary approach. Objective: The objective is to assess the quality of life in patients having otalgia, due to any cause. Methodology: A descriptive cross sectional study was conducted by using modified form of WHOQOL-100 and COQOL. Data was accepted, if CFI was greater than 0.9. Qualitative data were presented as frequency and percentages and quantitative data as mean with standard deviation. ANOVA was used to assess the variations among groups. Change in behavior was assessed by using the Likert scale for each domain of WHOQOL and COQOL by a ten-point scale. Results: Majority of participants about 60.2% were male and were from the age group of 16 - 30 years. Most of the sample population were from lower socioeconomic class. Looking over the WHOQOL-100, higher score represented the higher quality of life. Variation among different socioeconomic status was non-significant for positive attitudes but was highly significant (p = 0.0020) for negative attitudes. Analyzing the COQOL scoring system, higher score reported the worse symptoms. The patient with high COQOL showed strong correlation with poor WHOQOL-100 score that was p value Conclusion: The current study highlights the need of multidisciplinary approach for the better management and improving the quality of life in patients with otalgia.

Accurate and efficient remaining useful life prediction of batteries enabled by physics-informed machine learning

The safe and reliable operation of lithium-ion batteries necessitates the accurate prediction of remaining useful life(RUL).However,this task is challenging due to the diverse ageing mechanisms,various operating conditions,and limited measured signals.Although data-driven methods are perceived as a promising solution,they ignore intrinsic battery physics,leading to compromised accuracy,low efficiency,and low interpretability.In response,this study integrates domain knowledge into deep learning to enhance the RUL prediction performance.We demonstrate accurate RUL prediction using only a single charging curve.First,a generalisable physics-based model is developed to extract ageing-correlated parameters that can describe and explain battery degradation from battery charging data.The parameters inform a deep neural network(DNN)to predict RUL with high accuracy and efficiency.The trained model is validated under 3 types of batteries working under 7 conditions,considering fully charged and partially charged cases.Using data from one cycle only,the proposed method achieves a root mean squared error(RMSE)of 11.42 cycles and a mean absolute relative error(MARE)of 3.19%on average,which are over45%and 44%lower compared to the two state-of-the-art data-driven methods,respectively.Besides its accuracy,the proposed method also outperforms existing methods in terms of efficiency,input burden,and robustness.The inherent relationship between the model parameters and the battery degradation mechanism is further revealed,substantiating the intrinsic superiority of the proposed method.