Effect of comprehensive perioperative nursing on pain intensity,complication rates,and comfort levels in patients undergoing gallstone surgery

BACKGROUND Surgery is the gold standard for gallstone treatment.Nevertheless,the complications associated with the surgical procedure can exert diverse and adverse impacts on patients’health and quality of life to varying extents.Hence,it is essential to offer perioperative care to patients undergoing gallstone surgery.AIM To examine the impact of perioperative comprehensive nursing on pain intensity,complication rates,and patient comfort in individuals undergoing gallstone surgery.METHODS From February 2022 to February 2024,195 patients who underwent gallstone surgery at Sanmen People’s Hospital were selected and divided into two groups:A control group receiving routine nursing care(95 patients)and a research group receiving perioperative comprehensive nursing(100 patients).Key postoperative recovery indicators,including time to first postoperative anal exhaust,oral food intake,and ambulation,were observed,along with pain intensity(measured by the numeric rating scale),complication rate(bleeding,incision infection,recurrence),patient comfort(assessed using the visual analogue scale),and quality of life(measured by the World Health Organization Quality of Life-BREF).RESULTS The research group showed significantly shorter times to first postoperative anal exhaust,oral intake,and ambulation.Moreover,numeric rating scale pain scores in the research group were markedly lower post-nursing,and the total complication rate was significantly reduced compared to the control group.Furthermore,comfort levels improved considerably in the research group,and World Health Organization Quality of Life-BREF scores across the physical,psychological,social,and environmental domains were significantly higher compared to the control group following nursing care.CONCLUSION Perioperative comprehensive nursing effectively enhances postoperative recovery in patients undergoing gallstone surgery,reducing pain,lowering complications,and improving patient comfort and quality of life,which deserves clinical application.

Dynamic interactive bitwise meta-holography with ultra-high computational and display frame rates

Interactive holography offers unmatched levels of immersion and user engagement in the field of future display.Despite of the substantial progress has been made in dynamic meta-holography,the realization of real-time,highly smooth interactive holography remains a significant challenge due to the computational and display frame rate limitations.In this study,we introduced a dynamic interactive bitwise meta-holography with ultra-high computational and display frame rates.To our knowledge,this is the first reported practical dynamic interactive metasurface holographic system.We spa-tially divided the metasurface device into multiple distinct channels,each projecting a reconstructed sub-pattern.The switching states of these channels were mapped to bitwise operations on a set of bit values,which avoids complex holo-gram computations,enabling an ultra-high computational frame rate.Our approach achieves a computational frame rate of 800 kHz and a display frame rate of 23 kHz on a low-power Raspberry Pi computational platform.According to this methodology,we demonstrated an interactive dynamic holographic Tetris game system that allows interactive gameplay,color display,and on-the-fly hologram creation.Our technology presents an inspiration for advanced dynamic meta-holography,which is promising for a broad range of applications including advanced human-computer interaction,real-time 3D visualization,and next-generation virtual and augmented reality systems.

INTERFACE BEHAVIOR AND DECAY RATES OF COMPRESSIBLE NAVIER-STOKES SYSTEM WITH DENSITY-DEPENDENT VISCOSITY AND A VACUUM

In this paper,we study the one-dimensional motion of viscous gas near a vacuum,with the gas connecting to a vacuum state with a jump in density.The interface behavior,the pointwise decay rates of the density function and the expanding rates of the interface are obtained with the viscosity coefficientμ(ρ)=ρ^(α)for any 0<α<1;this includes the timeweighted boundedness from below and above.The smoothness of the solution is discussed.Moreover,we construct a class of self-similar classical solutions which exhibit some interesting properties,such as optimal estimates.The present paper extends the results in[Luo T,Xin Z P,Yang T.SIAM J Math Anal,2000,31(6):1175-1191]to the jump boundary conditions case with density-dependent viscosity.

Fluorinated semi-interpenetrating polymer networks for enhancing the mechanical performance and storage stability of polymer-bonded explosives by controlling curing and phase separation rates

Herein, the effect of fluoropolymer binders on the properties of polymer-bonded explosives(PBXs) was comprehensively investigated. To this end, fluorinated semi-interpenetrating polymer networks(semiIPNs) were prepared using different catalyst amounts(denoted as F23-CLF-30-D). The involved curing and phase separation processes were monitored using Fourier-transform infrared spectroscopy, differential scanning calorimetry, a haze meter and a rheometer. Curing rate constant and activation energy were calculated using a theoretical model and numerical method, respectively. Results revealed that owing to its co-continuous micro-phase separation structure, the F23-CLF-30-D3 semi-IPN exhibited considerably higher tensile strength and elongation at break than pure fluororubber F2314 and the F23-CLF-30-D0 semi-IPN because the phase separation and curing rates matched in the initial stage of curing.An arc Brazilian test revealed that F23-CLF-30-D-based composites used as mock materials for PBXs exhibited excellent mechanical performance and storage stability. Thus, the matched curing and phase separation rates play a crucial role during the fabrication of high-performance semi-IPNs;these factors can be feasibly controlled using an appropriate catalyst amount.

Genetic and Agronomic Parameter Estimates of Growth, Yield and Related Traits of Maize (Zea mays L.) under Different Rates of Nitrogen Fertilization

This study evaluated the genetic and agronomic parameter estimates of maize under different nitrogen rates. The trial was established at the Njala Agricultural Research Centre experimental site during 2021 and 2022 in a split block design with three maize varieties (IWCD2, 2009EVDT, and DMR-ESR-Yellow) and seven nitrogen (0, 30, 60, 90, 120, 150 and 180 kg∙N∙ha−1) rates. Findings showed that cob diameter and anthesis silking time (ASI) had intermediate heritability, ASI had high genetic advance, ASI and grain yield had high genotypic coefficient of variation (GCV), while traits with high phenotypic coefficient of variation (PCV) were plant height, ASI, grain yield, number of kernel per cob, number of kernel rows, ear length, and ear height. The PCV values were higher than GCV, indicating the influence of the environment in the studied traits. Nitrogen rates and variety significantly (p < 0.05) influenced grain yield production. Mean grain yields and economic parameter estimates increased with increasing nitrogen rates, with the 30 and 180 kg∙N∙ha−1 plots exhibiting the lowest and highest grain yields of 1238 kg∙ha−1 and 2098 kg∙ha−1, respectively. Variety and nitrogen effects on partial factor productivity (PFPN), agronomic efficiency (AEN), net returns (NR), value cost ratio (VCR) and marginal return (MR) indicated that these parameters were significantly affected (p < 0.05) by these factors. The highest PFPN (41.3 kg grain kg−1∙N) and AEN (29.4 kg grain kg−1∙N) were obtained in the 30 kg∙N∙ha−1 plots, while the highest VCR (2.8) and MR (SLL 1.8 SLL−1 spent on N) were obtained in the 180 kg∙N∙ha−1. The significant influence of variety and nitrogen on traits suggests that increasing yields and maximizing profits require use of appropriate nitrogen fertilization and improved farming practices that could be exploited for increased productivity of maize.

Effect of temperature on the standard metabolic rates of juvenile and adult Exopalaemon carinicauda

Ridgetail white prawn （Exopalaemon carinicauda） are of significant economic importance in China where they are widely cultured. However, there is little information on the basic biology of this species. We evaluated the effect of temperature （16, 19, 22, 25, 28, 31, and 34℃） on the standard metabolic rates （SMRs） of juvenile and adult E. carinicauda in the laboratory under static conditions. The oxygen consumption rate （OCR）, ammonia-N excretion rate （AER）, and atornic ratio of oxygen consumed to nitrogen consumed （O：N ratio） of juvenile and adult E. carinicauda were significantly influenced by temperature （P〈0.05）. Both the OCR and AER of juveniles increased significantly with increasing temperature from 16 to 34℃, but the maximum OCR for adults was at 31℃. Juvenile shrimp exhibited a higher OCR than the adults from 19 to 34℃. There was no significant difference between the AERs of the two life-stages from 16 to 31 ℃ （P〉0.05）. The O：N ratio in juveniles was significantly higher than that in the adults over the entire temperature range （P〈0.05）. The temperature coefficient （Q_10） of OCR and AER ranged from 5.03 to 0.86 and 6,30 to 0.85 for the adults, respectively, and from 6,09-1.03 and 3.66-1.80 for the juveniles, respectively. The optimal temperature range for growth of the juvenile and adult shrimp was from 28 to 31℃, based on Q_10 and SMR values. Results from the present study may be used to guide pond culture production ofE. carinicauda.

Post competency training in standardized training of resident physicians and integrated postgraduates

We focus on the importance and necessity of post-competency-based training in medical education alongside its current challenges and opportunities.Integrating post competency training into standardized educational frameworks is increasingly recognized as a critical component of preparing residents and postgraduates for real-world clinical practice.Post competency training represents a commitment to excellence in medical education,striving to produce competent,skilled practitioners to meet the challenges of modern healthcare.

Spalling characteristics of high-temperature treated granitic rock at different strain rates

The dynamic spalling characteristics of rock are important for stability analysis in rock engineering.This paper presented an experimental investigation on the dynamic spalling characteristics of granite with different temperatures and strain rates.A series of dynamic spalling tests with different impact velocities were conducted on thermally treated granite at different temperatures.The dynamic spalling strengths of granite with different temperatures and strain rates were determined.A model was proposed to correlate the dynamic spalling strength of granite,high temperature and strain rate.The results show that the spalling strength of granite decreases with increasing temperature.Moreover,the spalling strength of granite with a higher strain rate is larger than that with a lower strain rate.The proposed model can describe the relationship among dynamic spalling strength of granite,high temperature and strain rate.

Comparison of microwave- and thermal-assisted rock fragmentation methods at different temperatures and loading rates

Understanding the effects of microwave irradiation and thermal treatment on the dynamic compression and fragmentation properties of rocks is essential to quantify energy consumption in rock engineering.In this study,Fangshan granite(FG)specimens were exposed to microwave irradiation and heat treatment.The damage of FG specimens induced by these two methods was compared using X-ray CT scanning and ultrasonic wave method.The temperatures of FG after microwave irradiation and thermal treatment were effectively evaluated using a newly proposed technique.A novelty method for precisely determining the geometric features of fragments is developed to estimate the fragmentation energy.Thus,the dynamic uniaxial compressive strength(UCS),the dynamic fragmentation characteristics,and the fragmentation energy of FG after these two pretreatment methods can be reasonably compared.The noticeable distinction of loading rate effect on the dynamic UCS of FG between these two pretreatment methods is first observed.A relationship is established between the dynamic UCS and the damage induced by microwave irradiation and heat treatment.Moreover,fragmentation energy fan analysis is introduced to accurately compare the fragmentation properties of FG after two pretreatment methods in dynamic compression tests.

Bioturbation coefficients and organic carbon degradation rates of deep-sea sediments in the central-eastern tropical Pacific

The biogeochemical processes of marine sediments are influenced by bioturbation and organic carbon decomposition,which is crucial for understanding global element cycles and climate change.Two sediment cores were acquired in 2017 from abyssal basins in the central-eastern tropical Pacific to determine the bioturbation and organic carbon degradation processes.The radioactivity concentrations of 210Pb and 226Ra in the sediment cores were measured,indicating the presence of significant excess 210Pb(210Pbex)signals in the sediment cores.Besides,a manganese nodule was discovered in one core,which had a substantial influence on the distribution of 210Pbex.With the exception of this anomalous finding,the bioturbation coefficients in the remaining core were estimated to be 10.6 cm^(2)/a using a steady-state diffusion model,greater than most of the deep-sea sediments from the equatorial eastern Pacific.By using a bio-diffusion model,we further calculated the degradation rates of organic carbon(8.02 ka-1),which is also higher than other areas of the Pacific.Our findings displayed the presence of a biologically active benthic ecosystem in the central-eastern tropical Pacific.

Success of susceptibility-guided eradication of Helicobacter pylori in a region with high secondary clarithromycin and levofloxacin resistance rates

BACKGROUND Resistance to clarithromycin(CLA)and levofloxacin(LFX)of Helicobacter pylori(H.pylori)is increasing in severity,and successful eradication is essential.Presently,the eradication success rate has greatly declined,leaving a large number of patients with previous treatment histories.AIM To investigate secondary resistance rates,explore risk factors for antibiotic resistance,and assess the efficacy of susceptibility-guided therapy.METHODS We recruited 154 subjects positive for Urea Breath Test who attended The First Affiliated Hospital of China Medical University between July 2022 and April 2023.Participants underwent a string test after an overnight fast.The gastric juice was obtained and transferred to vials containing storage solution.Subsequently,DNA extraction and the specific DNA amplification were performed using quantitative polymerase chain reaction(qPCR).Demographic information was also analyzed as part of the study.Based on these results,the participants were administered susceptibility-guided treatment.Efficacy was compared with that of the empiric treatment group.RESULTS A total of 132 individuals tested positive for the H.pylori ureA gene by qPCR technique.CLA resistance rate reached a high level of 82.6%(n=109),LFX resistance rate was 69.7%(n=92)and dual resistance was 62.1%(n=82).Gastric symptoms[odds ratio(OR)=2.782;95%confidence interval(95%CI):1.076-7.194;P=0.035]and rural residence(OR=5.152;95%CI:1.407-18.861;P=0.013)were independent risk factors for secondary resistance to CLA and LFX,respectively.A total of 102 and 100 individuals received susceptibility-guided therapies and empiric treatment,respectively.The antibiotic susceptibility-guided treatment and empiric treatment groups achieved successful eradication rates of 75.5%(77/102)and 59.0%(59/411)by the intention-to-treat(ITT)analysis and 90.6%(77/85)and 70.2%(59/84)by the per-protocol(PP)analysis,respectively.The eradication rates of these two treatment strategies were significantly different in both ITT(P=0.001)and PP(P=0.012)analyses.CONCLUSION H.pylori presented high secondary resistance rates to CLA and LFX.For patients with previous treatment failures,treatments should be guided by antibiotic susceptibility tests or regional antibiotic resistance profile.

Gas Exchange Rates of Texas Persimmon (Diospyros texana) in Central Texas Woodlands

Diospyros texana (Texas persimmon) is a secondary species in most Juniperus ashei/Quercus fusiformis woodlands in central Texas. It has high density, but plants are mostly in the community understory. Light response curves at ambient and elevated levels of CO2 and temperature were measured for D. texana. The Anet (photosynthetic rate) increased significantly as both light level and CO2 levels increased but not temperature. The Amax (maximum photosynthetic rate) of D. texana in full sun at elevated levels of CO2 was increased for all treatments. Stomatal conductance increased with levels of CO2 but only if the interaction was removed from the model. Intercellular levels of CO2 increased with both temperature and CO2 treatments as did water use efficiency (WUE). Furthermore, light saturation (Lsat) increased with CO2 treatments and light compensation (Lcp) increased with temperature. The dark respiration (Rd) increased with both temperature and CO2 treatments. Markov population models suggested D. texana populations would remain ecologically similar in the future. However, sub-canopy light levels and herbivory should be considered when examining population projections. For example, Juniperus ashei juveniles are not recruited into any canopy unless there are high light levels. Herbivory reduces the success of Quercus juveniles from reaching the canopy. These factors do not seem to be a problem for D. texana juveniles which would allow them to reach the canopy without need of a high light gap and are not prevented by herbivory. Thus, Juniperus/Quercus woodlands will change in the future to woodlands with D. texana a more common species.

Rates, predictors, and causes of readmission after transcatheter aortic valve replacement in patients with chronic kidney disease

BACKGROUND Transcatheter aortic valve replacement(TAVR)is a revolutionary procedure for severe aortic stenosis.The coexistence of chronic kidney disease(CKD)and TAVR introduces a challenge that significantly impacts patient outcomes.AIM To define readmission rates,predictors,and causes after TAVR procedure in CKD stage 1-4 patients.METHODS We used the national readmission database 2018 and 2020 to look into readmission rates,causes and predictors after TAVR procedure in patients with CKD stage 1-4.RESULTS Out of 24758 who underwent TAVR and had CKD,7892(32.4%)patients were readmitted within 90 days,and had higher adjusted odds of being females(adjusted odds ratio:1.17,95%CI:1.02-1.31,P=0.02)with longer length of hospital stay>6 days,and more comorbidities including but not limited to diabetes mellitus,anemia,and congestive heart failure(CHF).CONCLUSION Most common causes of readmission included CHF(18.0%),sepsis,and complete atrioventricular block.Controlling readmission predictors with very close followup is warranted to prevent such high rate of readmission.

Comparison of the precision of glacier flow rates derived from offset-tracking using Sentinel-2 and Landsat-8/9 imagery

Offset-tracking is an essential method for deriving glacier flow rates using optical imagery.Sentinel-2(S2)and Landsat-8/9(L8/9)are popular optical satellites or constellations for polar studies,offering high spatial resolution with relatively short revisit time,wide swath width,and free accessibility.To evaluate and compare the precision of offset-tracking results yielded with these two kinds of data,in this study S2 and L8/9 imagery observed in Petermann Glacier in Greenland,Karakoram in High-Mountains Asia,and Amery Ice Shelf in the Antarctic are analyzed.Outliers and various systematic error sources in the offset-tracking results including orbital and strip errors were analyzed and eliminated at the pre-process stage.Precision at the off-glacier(bare rock)region was evaluated by presuming that no deformation occurred;then for both glacierized and the off-glacier regions,precision of velocity time series was evaluated based on error propagation theory.The least squares method based on connected components was used to solve flow rates time series based on multi-pair images offset-tracking.The results indicated that S2 achieved slightly higher precision than L8/9 in terms of both single-pair derived displacements and least square solved daily flow rates time series.Generally,the RMSE of daily velocity is 26%lower for S2 than L8/9.Moreover,S2 provided higher temporal resolution for monitoring glacier flow rates.

Effects of King’s Theory of Goal Attainment Combined with Teach-Back Method on Improving Patients’ Standardization Rate of Eye Drop Use

Objective:To explore the effect of King’s Theory of Goal Attainment combined with teach-back method on improving the standardization rate of eye drop use in patients.Methods:A total of 200 patients who used more than two types of eye drops in the Department of Ophthalmology of our hospital were selected as the research subjects,and were randomly divided into an observation group and a control group.The control group was given routine health education,while the observation group was given King’s Theory of Goal Attainment combined with teach-back method on the basis of the control group.The standardization rate of eye drop use,knowledge awareness rate,and nursing satisfaction were compared between the two groups before and after the intervention.Results:After the intervention,the standardization rate of eye drop use,the awareness rate of eye drop knowledge,and the nursing satisfaction of the observation group were significantly higher than those of the control group(P<0.05).Conclusion:King’s Theory of Goal Attainment combined with teach-back method can effectively improve the standardization rate of eye drop use in patients,increase their awareness of eye drop knowledge,and improve nursing satisfaction,which is worthy of clinical application.

High-rate metal-free MXene microsupercapacitors on paper substrates

MXene is a promising energy storage material for miniaturized microbatteries and microsupercapacitors(MSCs).Despite its superior electrochemical performance,only a few studies have reported MXene-based ultrahigh-rate(>1000 mV s^(−1))on-paper MSCs,mainly due to the reduced electrical conductance of MXene films deposited on paper.Herein,ultrahigh-rate metal-free on-paper MSCs based on heterogeneous MXene/poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate)(PEDOT:PSS)-stack electrodes are fabricated through the combination of direct ink writing and femtosecond laser scribing.With a footprint area of only 20 mm^(2),the on-paper MSCs exhibit excellent high-rate capacitive behavior with an areal capacitance of 5.7 mF cm^(−2)and long cycle life(>95%capacitance retention after 10,000 cycles)at a high scan rate of 1000 mV s^(−1),outperforming most of the present on-paper MSCs.Furthermore,the heterogeneous MXene/PEDOT:PSS electrodes can interconnect individual MSCs into metal-free on-paper MSC arrays,which can also be simultaneously charged/discharged at 1000 mV s^(−1),showing scalable capacitive performance.The heterogeneous MXene/PEDOT:PSS stacks are a promising electrode structure for on-paper MSCs to serve as ultrafast miniaturized energy storage components for emerging paper electronics.

Quality Standard of Tibetan Medicine Nardostachys jatamansi Herba Based on"An Integrated Plant but Multi-purpose"

[Objectives]To establish the quality standard of Nardostachys jatamansi Herba.[Methods]The characters and microscopical identification of N.jatamansi Herba were carried out.The contents of moisture,total ash,acid-insoluble ash and extract were determined according to the relevant methods of the Chinese Pharmacopoeia(2020 edition).Using chlorogenic acid and 3,5-O-dicaffeoylquinic acid as quality control indexes,TLC and HPLC methods were established for qualitative and quantitative determination,and HPLC fingerprints were established.[Results]The characteristics of character identification,microscopic identification and thin layer identification were obvious.The moisture content ranged from 2.7%to 7.8%,with an average value of 5.4%.The total ash content ranged from 6.7%to 16.2%,with an average of 11.0%.The acid-insoluble ash content ranged from 0.7%to 8.5%,with an average of 3.6%.Extractives content ranged from 20.9%to 34.4%,with an average of 29.7%.Chlorogenic acid content was between 0.45%and 1.30%,with an average value of 0.77%.The content of 3,5-O-dicaffeoylquinic acid ranged from 0.18%to 0.58%,with an average of 0.31%.The similarity of each batch was between 0.930 and 0.994,indicating that the quality of medicinal materials from different producing areas was stable.[Conclusions]The quality standard of N.jatamansi Herba was established,which could provide quality control basis for rational,comprehensive and efficient utilization of N.jatamansi DC.resources and clinical use.

Formulation of Work-Study Combined and Result-Oriented Integrated Curriculum Standards

According to the Annex Technical Regulations for Integrated Curriculum Development(Trial)in Document No.30 of the General Office of the Ministry of Human Resources and Social Security(2012),this paper studies the formulation of the curriculum standards for the integration of Chinese medicinal materials production.We focus on the formulation ideas of the curriculum standards for the integration of Chinese medicinal materials production,the formulation process of the curriculum standards for the integration of Chinese medicinal materials production,including the description of typical work tasks,the determination of curriculum objectives,the analysis of study content,the description of referential study tasks,teaching implementation suggestions,assessment and evaluation suggestions,which can provide a reference for the development and research of other related integrated courses.

The effects of deformation parameters and cooling rates on the aging behavior of AZ80+0.4%Ce

The extruded AZ80+0.4%Ce magnesium alloy was twisted in the temperature range of 300-380℃by using a Gleeble 3500 thermal simulation test machine with a torsion unit.The deformed cylindrical specimens were cooled at a cooling rate of 10℃/s or 0.1℃/s,respectively,and aged at 170℃.The microstructure analysis results showed that the grain size decreased with increasing specimen radial position from center(SRPC),and that the strong initial basal texture of the extruded magnesium alloy was weakened.Both continuous and discontinuous dynamic recrystallization mechanisms were involved in contributing to the grain refinement for all specimens investigated.And a novel extension twinning induced dynamic recrystallization mechanism was proposed for specimen deformed at 300℃.For the specimens deformed at 300℃and 340℃followed by a slow cooling rate(0.1℃/s),precipitates of various shapes(β-Mg_(17)Al_(12)),with the dominant precipitates being on the grains boundaries,appeared on the surface section.For specimen deformed at 380℃,lamellar precipitates(LPS)in the interiors of the grains were predominant.After aging,the LPS still dominated for specimens twisted at 380℃;however,the LPS gradually decreased with decreasing deformation temperatures from 380℃to 300℃.Dynamically precipitatedβ,especially those decorating the grain boundaries,changed the competition pictures for the LPS and precipitates of other shapes after aging.Interestingly,LPS dominated the areas for the center section of the specimens after aging regardless of deformation temperatures.Low temperature deformation with high SRPC followed by rapid cooling rate increased the micro hardness of the alloy after aging due to refined grain,reduced precipitates size,decreased lamellar spacing as well as strain hardening.

The Rationale Behind Policymaker Hesitancy:Insight Into Correlation Between Disinflation and Interest Rates

This essay explores the reluctance of policymakers to reduce interest rates during disinflation,analyzing whether this hesitation aligns with prevailing economic theories.Drawing on historical and contemporary examples,the paper examines how monetary policy,particularly central bank credibility,plays a crucial role in shaping market expectations and guiding long-term economic behavior.It discusses the evolution of monetary strategies from the high inflation periods of the 1970s and 1980s to the modern focus on inflation targeting,financial stability,and the globalized economy.The analysis highlights key factors such as asymmetric risks,the challenge of managing low interest rates,and the potential for unintended consequences like a sset bubbles and distorted savings behavior.Ultimately,the paper concludes that central banks’cautious approach during disinflation reflects a commitment to maintaining price stability and protecting economic resilience in an increasingly interconnected global financial system.