Mediating role of inner strength in the relationship between medication literacy and medication adherence among kidney transplant patients

Objective:Compared with long-term renal replacement therapy,kidney transplantation is the ideal treatment for end-stage renal disease(ESRD),significantly extending patient life and improving quality of life.Kidney transplant patients need to adhere to lifelong immunosuppressive medication regimens,but their medication adherence is generally poor compared with other organ transplant recipients.Medication adherence is closely related to medication literacy and psychological status,yet related studies are limited.This study aims to investigate the current status of medication adherence,inner strength,and medication literacy in kidney transplant patients,analyze the relationships among these 3 factors,and explore the mediating role of inner strength in the relationship between medication literacy and medication adherence.Methods:A cross-sectional survey was conducted from March to October 2023 involving 421 patients aged≥18 years who visited kidney transplantation outpatient clinics at 4 tertiary hospitals in Hunan Province.The inner strength,medication literacy,and medication adherence of kidney transplant patients were investigated using the Inner Strength Scale(ISS),the Chinese version of the Medication Literacy Assessment in Spanish and English(MedLitRxSE),and the Chinese version of the Morisky Medication Adherence Scale-8(C-MMAS-8),respectively.Univariate analysis was performed to examine the effects of demographic and clinical data on medication adherence.Correlation analysis was conducted to explore the relationships among medication literacy,medication adherence,and inner strength.Significant variables from univariate and correlation analyses were further analyzed using multiple linear regression,and the mediating effect of inner strength was explored.Results:Among the 421 questionnaires collected,408 were valid,with an effective rate of 96.91%.The scores of C-MMAS-8,MedLitRxSE,and ISS were 6.64±1.16,100.63±14.67,and 8.47±4.03,respectively.Among the 408 patients,only 86(21.08%)patients had a high level of medication adherence,whereas 230(56.37%)patients had a medium level of medication adherence,and 92(22.55%)patients had poor medication adherence.Univariate analysis indicated that the kidney transplant patients’age,marital status,education levels,years since their kidney transplant operation,number of hospitalizations after the kidney transplant,and adverse drug reactions showed significant differences in medication adherence(all P<0.05).Correlation analysis showed that inner strength positively correlated with both medication literacy(r=0.183,P<0.001)and medication adherence(r=0.201,P<0.001).Additionally,there was a positive correlation between medication adherence and medication literacy(r=0.236,P<0.001).Inner strength accounted for 13.22%of the total effect in the mediating role between medication literacy and medication adherence.Conclusion:The level of medication adherence among kidney transplant patients needs improvement,and targeted intervention measures are essential.Inner strength mediates the relationship between medication literacy and medication adherence in these patients.Healthcare professionals should focus on enhancing medication literacy and supporting patients’inner strength to improve medication adherence.

Mechanical Properties and Thermal Shock Resistance of SrAl_(2)Si_(2)O_(8) Reinforced BN Ceramic Composites

Hexagonal boron nitride(h-BN)ceramics have become exceptional materials for heat-resistant components in hypersonic vehicles,owing to their superior thermal stability and excellent dielectric properties.However,their densification during sintering still poses challenges for researchers,and their mechanical properties are rather unsatisfactory.In this study,SrAl_(2)Si_(2)O_(8)(SAS),with low melting point and high strength,was introduced into the h-BN ceramics to facilitate the sintering and reinforce the strength and toughness.Then,BN-SAS ceramic composites were fabricated via hot press sintering using h-BN,SrCO_(3),Al_(2)O_(3),and SiO_(2) as raw materials,and effects of sintering pressure on their microstructure,mechanical property,and thermal property were investigated.The thermal shock resistance of BN-SAS ceramic composites was evaluated.Results show that phases of as-preparedBN-SAS ceramic composites are h-BN and h-SrAl_(2)Si_(2)O_(8).With the increase of sintering pressure,the composites’densities increase,and the mechanical properties shew a rising trend followed by a slight decline.At a sintering pressure of 20 MPa,their bending strength and fracture toughness are(138±4)MPa and(1.84±0.05)MPa·m^(1/2),respectively.Composites sintered at 10 MPa exhibit a low coefficient of thermal expansion,with an average of 2.96×10^(-6) K^(-1) in the temperature range from 200 to 1200℃.The BN-SAS ceramic composites prepared at 20 MPa display higher thermal conductivity from 12.42 to 28.42 W·m^(-1)·K^(-1) within the temperature range from room temperature to 1000℃.Notably,BN-SAS composites exhibit remarkable thermal shock resistance,with residual bending strength peaking and subsequently declining sharply under a thermal shock temperature difference ranging from 600 to 1400℃.The maximum residual bending strength is recorded at a temperature difference of 800℃,with a residual strength retention rate of 101%.As the thermal shock temperature difference increase,the degree of oxidation on the ceramic surface and cracks due to thermal stress are also increased gradually.

Use of piezocone tests to predict consolidation yield stress and overconsolidation ratio of lagoonal deposit soil

Existing empirical methods for interpreting the consolidation yield stress and the overconsolidation ratio （OCR） in clays from piezocone tests are briefly reviewed. It can be seen that no universal correlation exists for all worldwide sites. However, for a given clay deposit, there does exist a most appropriate method to reflect the consolidation yield stress and the OCR based on piezocone test data. Three empirical methods are compared based on the piezocone test data collected on Lixia River lagoonal deposit soil sites in the north of Jiangsu province. The objective of this study is to evaluate the validity of the existing relationships linking the consolidation yield stress to piezocone test data and identify the appropriate method for Lixia River lagoonal deposit soil. It is shown that the correlation based on the net tip resistance has much higher accuracy for estimating the consolidation yield stress of lagoonal deposit soil than other methods.

Mechanical properties of strengthened surface layer in Ti-6Al-4V alloy induced by wet peening treatment

A modified surface layer was formed on Ti-6Al-4V alloy by wet peening treatment. The variations of the residual stress,nano-hardness and microstructure of the modified layer with depth from surface were studied using X-ray diffraction analysis,nano-indentation analysis, scanning electron microscopy and transmission electron microscopy observations. The results show thatboth the compressive residual stress and hardness decrease with increasing depth, and the termination depths are 160 and 80 μm,respectively. The microstructure observation indicates that within 80 μm, the compressive residual stress and the hardness areenhanced by the co-action of the grain refinement strengthening and dislocation strengthening. Within 80–160 μm, the compressiveresidual stress mainly derives from the dislocation strengthening. The strengthened layer in Ti-6Al-4V alloy after wet peeningtreatment was quantitatively analyzed by a revised equation with respect to a relation between hardness and yield strength.

Characterization of discontinuous yielding phenomenon in isothermal compression of TC8 titanium alloy

The discontinuous yielding phenomenon （DYP） during high temperature deformation was investigated based on the isothermal compression of TC8 titanium alloy. The DYP of TC8 titanium alloy was characterized by quantifying the yield drop of the DYP （△σUL） and ending strain of flow oscillation （εOSC） based on the flow stress？strain curves, and then the effect of deformation parameters on the △σUL and εOSC values was analyzed. The results show that the △σUL and εOSC values increase with the increase of strain rate. The effect of deformation temperature on the ？σUL value depends on the strain rate. Finally, the transmission electron microscope （TEM） observation shows the evidence for the dynamic theory, which ascribes the DYP to the generation of mobile dislocation at the grain boundary. Meanwhile, the optical microscope （OM） observation shows that both the primary α grain and β grain become smaller with the increase of strain, which well interprets the effect of deformation parameters on the △σUL and εOSC values.

Mathematical Model Analysis of Quasi Preconsolidation Soft Clay

Soft clay may cause quasi preconsolidation effect under the constant hydrostatic pressure after some time. The result of drained triaxial test represents the effective stress yield surface, which can be described by simple binary linear fabric model. Therefore the pore pressure and deformation of clay can be decided. It also can be used to resolve the real boundary problems with finite element method.

On the Motion of Controllable Mechanical Systems Having Variable Mass

The differential equations of motion of a comtlaint system with parameters and variable mass, of a system with variable mass and servo constraints and those for the control problem on the forced motion of constraint systems with variable mass are given respectively. Finally, an example is presented.

Service delivery time guarantee decisions with consideration of the time and price sensitive customer

Based on the assumption that the customer is time and price sensitive and price is a piecewise function of the delivery time, a service delivery time guarantee decision model is proposed, and the existence of the optimal service delivery time guarantee L^＊ is proved. Furthermore, the impact of the correlation parameters on the optimal L^＊ is analyzed. It is revealed that if the optimal L^＊ is smaller than the industry level L0, the service provider with low cost should quote a shorter delivery time, and the service provider should increase the delivery time guarantee under the conditions of the decrease in customer time sensitivity or the increase in the difference of the customer reservation payment. When L^＊ 〉 L0, the service provider should quote a longer delivery time guarantee and should increase the delivery time guarantee and reduce the price under the conditions of the increase in the customer price sensitivity or the decrease in the mean customer reservation payment.

浅谈小学生班级管理

小学班级工作千头万绪,对于班主任而言应该是一名优秀的组织管理者,在他的组织协调下,建立完善的班级规章制度;深入学生的内心世界,确立和谐的师生关系;耐心聆听学会接纳;注重德育教育,努力营造互助互爱、民主和谐、健康向上的集体氛围,所以做好班级的管理工作是班主任的首要职责,让学生的“服”变成自己的“福”。

浅谈小学班主任管理的几点建议

现阶段,小学教育的重要性渐渐凸显出来,小学教育的有效性可以帮助学生养成良好的行为习惯,并且在小学班主任的日常管理中也会对学生的性格造成一定的影响,引导学生建立正确的价值观和世界观,在管理之中不仅仅让学生形成相应的学习意识,同时也会对学生各方面的能力培养有些重要的作用。所以小学班主任的管理工作对学生的发展有着重要的意义,让学生的“服”变成自己的“福”。

心脑神力口服液对小鼠抗氧化损伤作用的实验研究

目的研究心脑神力口服液对小鼠的抗氧化损伤作用。方法将50只昆明种小鼠随机分为对照组,新药低、中、高剂量组和旧药组,对照组给予蒸馏水,各给药组分别给予不同剂量的心脑神力口服液,给药途径均为灌胃,给药4周后,测定其血清SOD活力和MDA含量。结果与对照组相比,各给药组SOD活力增加;新药中、高剂量组MDA的含量低于对照组,差异有显著性。结论心脑神力口服液对小鼠具有抗氧化损伤作用,能增加SOD活力,降低MDA含量。

Plastic yielding of NiTi shape memory alloy under local canning compression

As a new attempt, local canning compression was applied in order to implement large plastic deformation of nickel-titanium shape memory alloy （NiTi SMA） at room temperature. The plastic mechanics of local canning compression of NiTi SMA was analyzed according to the slab method as the well as plastic yield criterion. Transmission electron microscopy （TEM）, high resolution transmission electron microscopy （HRTEM） and scanning electron microscopy （SEM） were used to study the microstructural evolution as well as deformation behavior of NiTi samples under local canning compression. Increasing the hydrostatic pressure with the increase in the outer diameters of the steel cans is responsible for suppressing the initiation and growth of the micro-cracks, which contributes to enhancing the plasticity ofNiTi SMA and avoiding the occurrence of brittle fracture. Plastic deformation of NiTi SMA under a three-dimensional compressive stress state meets von-Mises yield criterion at the true strains ranging from about 0.15 to 0.50, while in the case of larger plastic strain, von-Mises yield criterion is unable to be met since the amorphous phase arises in the deformed NiTi sample.

Value co-creation model based on IS application capabilities

To illustrate how firms and customers co-create value in business to business （B2B） e-commerce, an integrated value co-creation model is proposed based on information systems （IS） application capabilities from the relational view. IS application capabilities, relational assets, customer agility and relational value are constructed and tested by empirical analysis. The empirical research tests and verifies the mediating effect of customer agility, and the interactions of IS application capabilities and relational assets, as well as their effect on relational value. This model expands the research framework of value co-creation in service dominant logic, and reveals the mechanism of how f＇n＇ms and customers co-create value in B2B e-commerce based on IS application capabilities, which provides the basis for further theory development and a practice guide.

Research on service capacity of widened intersection based on traffic simulation

Delay analysis method is adopted to study the service capacity of a widened intersection. Traffic simulation software VISSIM is used for microscopic simulation of a widened intersection so as to obtain a delay curve. The delay-volume model of a widened intersection is established based on traffic simulation. The suggested value of basic service capacity of the widened left-turn lane is given along with how to determine correction factors and practical service capacity.

Effect of composition and sintering temperature on mechanical properties of ZrO_2 particulate-reinforced titanium-matrix composite

The titanium-based composites were synthesized by powder metallurgy method. The effects of composition and sintering temperature on the microstructure and properties of the titanium-based composites were investigated by X-ray diffraction, optical microscopy, scanning electron microscopy and mechanical properties tests. The results demonstrate that adding ZrO2 particles can improve the mechanical properties of powder metallurgy （P/M） titanium-based composites. The Ti composite with 4% （mole fraction） ZrO2 sintered at 1100 °C for 4 h shows an appropriate mechanical property with a relative density of 93.9%, a compressive strength of 1380 MPa （570 MPa higher than pure Ti） and good plasticity （an ultimate strain above 24%）.

Strategies to Promote the Urban Tourism Competitiveness in Shenyang Based on Modern Service Industry Framework

By describing the status quo of tourism industry in Shenyang and by eval- uating and comparatively analyzing the tourism competitiveness in the four cities of Shenyang, Dalian, Changchuan and Harbin, this paper points out advantages and existing problems in tourism competitiveness of Shenyang and finally comes up with strategies to promote the competitiveness of tourism in Shenyang.

Nonlinear control for a class of hydraulic servo system

The dynamics of hydraulic systems are highly nonlinear and the system may be subjected to non-smooth and discontinuous nonlinearities due to directional change of valve opening, friction, etc. Aside from the nonlinear nature of hydraulic dynamics, hydraulic servo systems also have large extent of model uncertainties. To address these challenging issues, a robust state-feedback controller is designed by employing backstepping design technique such that the system output tracks a given signal arbitrarily well, and all signals in the closed-loop system remain bounded. Moreover, a relevant disturbance attenuation inequality is satisfied by the closed-loop signals. Compared with previously proposed robust controllers, this paper's robust controller based on backstepping recursive design method is easier to design, and is more suitable for implementation.

Pharmacokinetics of 20(R)-Ginsenoside Rg3 in Human Volunteers

Objective: To study the pharmacokinetics of 20(R)-Ginsenoside Rg3 in the human body. Methods: High-performance liquid chromatography-ultraviolet detection method was used in this study. Results: The pharmacokinetics of Ginsenoside Rg3 in 14 healthy volunteers were investigated. After a single oral dose of 3.2 mg.g-1 Ginsenoside Rg3 in 8 male volunteers, the plasma concentration-time course fitted in well with a two-compartment open model, with the following pharmacokinetic parameters: Tmax 0.660.10 h, Cmax 166 ngmL-1, T1/2a 0.460.12 h, T1/2b 4.91.1 h, T1/2(Ka) 0.280.04 h, AUC0-∞ 7726 ngmL-1h, respectively. No kinetic analysis was made after an oral dose of 0.8 mg.g-1 Rg3 in other 6 volunteers because of the low concentration, but there was a good correlation between Cmax and dosage of the two groups. Conclusion: The absorption of Rg3 was rapid in the human body, and its elimination was rapid too after oral administration of Ginsenoside Rg3. The pharmacokinetic results shows that it exhibited the first-order kinetic characteristics.

Evaluation of Relationship Between Clothing Pressure of Men's Suit and Comfort

An investigation on relationship between clothing pressure of men's suit and wearing comfort is conducted. With the pressure measurements at different parts of men's suit under normal standing posture and in motion, the objective assessment of the total comfort are related to the subjective ratings of clothing pressure. There is a common strong sensation of pressure on shoulder with normal standing posture, and a strong relationship between total comfort and clothing pressure in back armhole and the front of upper arm with posture in motion.

Effect of Ce content on mechanical properties of Ce/Cr coated open-cell Ni-Cr-Fe alloy foams

The Ce/Cr coating was homogenously deposited onto the reticulated open-cell Ni?Cr?Fe alloy foam by the pack cementation process.The mechanical properties of the Ce/Cr coated alloy foams were investigated by the quasi-static compression test.Simultaneously,the deformation and failure mechanisms of Ce/Cr coated alloy foams were discussed.The results show that the adding amount of CeO2powders influences the mechanical properties of the Ce/Cr coated alloy foams.Despite an increase in density as compared to the uncoated foams,the Ce/Cr coated foams exhibit improvement in both yield strength and energy-absorption performance.Especially,the energy-absorption performance of2%Ce/Cr(mass fraction)coated alloy foam is averagely1.9times as high as that of the bare Ni?Cr?Fe alloy foam.In addition,the mechanical properties of the Ce/Cr coated alloy foams increase with the increase of strain rate.The distortion and cracking are mainly the deformation behavior of the Ce/Cr coated alloy foam,confirmed by SEM images.