心房颤动患者射频消融术中首剂肝素ACT预测模型构建

目的:建立并验证心房颤动患者射频消融术中给予首剂肝素30 min后测得活化凝血时间(activated clotting time,ACT)(30 min-ACT)的列线图预测模型。方法:选择2020年1月—2022年12月于南京医科大学第一附属医院心内科导管室行导管射频消融治疗、非瓣膜性心房颤动患者1 090例,以3∶1比例随机分为训练集和测试集,对两组各项指标进行Kruskal-Wallis检验、卡方检验比较其基线特征。通过LASSO回归及单因素、多因素线性回归分析影响30 min-ACT的因素,据此建立心房颤动患者射频消融术中30 min-ACT的预测模型并评估其预测效果。结果:多因素结果分析提示卒中史、华法林、血小板计数、凝血酶原时间、基础ACT、基础ACT^(2)、首剂肝素剂量是房颤患者射频消融术中首剂肝素ACT的独立预测因素,据此构建的列线图预测模型预测具有一定的准确度(训练集65.9%,测试集74.6%)和较高的灵敏度(训练集77.4%,测试集83.0%)。结论:根据卒中史、华法林、血小板计数、凝血酶原时间、基础ACT、基础ACT^(2)、首剂肝素剂量构建的30 min-ACT列线图模型可以预测心房颤动患者射频消融术中首剂肝素的抗凝效果,对临床工作具有一定指导作用。

基于ACT反馈的延续性护理对老年间质性肺炎患者治疗依从性的影响评价

分析以ACT反馈为基础的延续性护理模式,对老年间质性肺炎患者的影响价值。方法 从2022年7月开始,截至2023年7月,本院总计选入老年间质性肺炎患者60例,经抽签法进行两组均分。30例对照组实施基础护理,30例研究组实施基于ACT反馈的延续性护理。比较两组护理后肺功能水平、临床恢复结果、生活质量以及总依从率。结果 研究组各肺功能结果、生活质量评分高于对照组;恢复时间短于对照组;总依从率高于对照组,差异有统计学意义(P<0.05)。结论 老年间质性肺炎患者,进行基于ACT反馈的延续性护理,可提升生活质量和依从性,稳定肺功能水平。

麦粒灸对神经根型颈椎病大鼠脊髓及神经根Activin A/ActRⅠ/Smad4表达的影响

目的:通过观察麦粒灸“大椎”穴对神经根型颈椎病大鼠激活素A(Act A)、ActⅠ型受体(ActRⅠ)及受体后信号传导蛋白Smad4表达的影响,探讨麦粒灸治疗神经根型颈椎病(CSR)的镇痛机制。方法:将30只SPF级雌雄各半SD大鼠随机分为空白组、模型组、麦粒灸组,每组10只。采用椎管插线法制备CSR模型。模型组及麦粒灸组均于造模后待伤口恢复7 d,第8天开始干预。空白组正常喂养且不做任何干预措施,模型组仅予腹腔注射1 ml的0.9%氯化钠溶液,麦粒灸组在模型组基础上予麦粒灸“大椎”穴,6壮/次,1次/d。连续干预7 d后,观察各组大鼠步态评分,测量机械痛阈值,采用蛋白免疫印迹检测脊髓及神经根组织Act A、ActRⅠ及Smad4的蛋白。PCR检测脊髓及神经根组织Act A和ActRⅠ的mRNA表达水平,苏木素-伊红染色观察脊髓及神经根组织的形态结构,免疫荧光染色观察Smad4阳性表达水平。结果:与空白组比较,模型组、麦粒灸组大鼠步态评分升高、机械痛阈降低(P<0.05)。与模型组比较,麦粒灸组大鼠脊髓及神经根组织Act A、ActRⅠ及其mRNA表达水平均升高(P<0.05)。Western blotting和免疫荧光结果均显示Smad4表达增加;HE染色观察麦粒灸组脊髓形态损伤较模型组有所减轻,灰质区神经元固缩,尼氏小体减少,神经胶质细胞和毛细血管数量比模型组减少。结论:麦粒灸“大椎”穴能改善CSR大鼠疼痛阈值和运动功能,促进神经元损伤后修复,这与激活Activin A/ActRⅠ/Smad4信号通路有关。

专业认证背景下高校师范生知向行转化的逻辑路向--基于ACT认知模型视角

专业认证背景下高校师范生的“知”和“行”是师范生将“践行师德、学会教学、学会育人、学会发展”等“他知”内化后形成的结构化“我知”以及外化后生成的关联化教育行动。由“知”化“行”是师范生知识形态从陈述性向程序性自然变迁及其职业素养发展的基本要求。从ACT认知模型视角看,这种转化遵循“认知”“编辑”“调适”的逻辑发展规律。其中:“认知”是师范生以学习理解“他知”意义为任务,学以致知;“编辑”是师范生以整合碎片化意义为目标,学以致道;“调适”是师范生依托教育场域,应用“我知”,以知化形。

ACTED模式下综合康复训练在脑卒中患者住院-随访中的应用

目的探讨ACTED模式下综合康复训练在脑卒中患者住院-随访中的应用。方法选取2021年1月至2023年10月郑州大学第一附属医院康复医学科收治的150例脑卒中患者,按随机数字表法分为对照组和观察组,各75例。给予对照组常规康复训练,观察组在此基础上接受ACTED模式下综合康复训练。比较两组DE Morton活动指数(DEMMI)、平衡能力(BBS)、肢体功能(FMA)、步态参数、自我管理能力、生活质量(SIS)。结果观察组出院后3个月DEMMI、BBS、上下肢FMA评分高于对照组(P<0.05);观察组出院后3个月的步频、步长、步速高于对照组,双支撑期百分比低于对照组(P<0.05);观察组出院后3个月的自我管理能力、SIS评分评分高于对照组(P<0.05)。结论ACTED模式下综合康复训练能有效提高脑卒中患者自我效能与自我管理能力,改善患者运动功能,提高患者生活质量。

ACTED康复护理模式在肩袖损伤合并冻结肩术病人中的应用

目的:探讨ACTED康复护理模式在肩袖损伤合并冻结肩术病人中的应用效果。方法:选取2022年1月—12月医院收治的90例肩袖损伤合并冻结肩术病人为研究对象,采用随机数字表法将病人分为观察组、对照组,每组45例,对照组行常规康复训练,观察组实施ACTED康复护理模式,比较两组病人干预前后功能锻炼自我效能、依从性及康复效果[疼痛视觉模拟评分(VAS)、肩功能活动度、肩关节功能评分(CMS)、日常生活功能评分(ADL)]。结果:干预后观察组病人功能锻炼自我效能、依从性评分较对照组明显提升(P<0.05),疼痛情况、肩袖关节活动能力及日常生活能力改善效果明显优于对照组(P<0.05)。结论:ACTED康复护理模式可提升肩袖损伤合并冻结肩术病人术后功能锻炼自我效能及依从性,从而改善病人肩关节功能,提升病人日常生活能力。

ACTED康复护理模式在老年下肢骨折患者中的应用价值

目的分析ACTED康复护理模式在老年下肢骨折患者中的应用价值。方法选取2022年10月—2023年10月山东省潍坊市中医院收治的82例老年下肢骨折且行手术治疗的患者为研究对象,采用随机数字表法将其分为对照组和观察组,各41例。对照组采用常规康复护理,观察组采用ACTED康复护理。比较两组护理后的疼痛程度、愈合情况、医疗费用、并发症发生情况。结果干预1、2个月后,观察组疼痛视觉模拟评分均低于对照组,组间差异有统计学意义(P<0.05)。观察组骨痂形成时间、骨折愈合时间均短于对照组,医疗费用低于对照组,组间差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论将ACTED康复护理模式应用于老年下肢骨折患者,可减轻患者疼痛,促进骨愈合,并且可减少医疗费用,降低并发症发生率。

密旋链霉菌Act12发酵液对石油胁迫下紫花苜蓿幼苗生长及生理特性的影响

[目的]考察密旋链霉菌Act12发酵液对石油胁迫下紫花苜蓿幼苗生长及生理特性的影响,探讨其缓解石油胁迫的作用机制。[方法]以‘中苜3号’紫花苜蓿为供试植物,采用盆栽试验,考察质量分数3%(W/W)石油胁迫和不同浓度(0、1%、10%和100%)Act12发酵液处理下紫花苜蓿幼苗生长、根系构型、光合特性、渗透调节物质含量和抗氧化能力等指标的变化。[结果]相较于对照组(CK),3%石油胁迫显著抑制了幼苗的光合作用和生物量,同时增加了丙二醛(MDA)的积累,降低了可溶性糖和可溶性蛋白含量,改变了超氧化物歧化酶(SOD)和过氧化物酶(POD)活性。中低浓度(1%和10%)的发酵液处理可以有效缓解石油胁迫对紫花苜蓿幼苗的毒害,并以10%的Act12发酵液效果最佳;与不施用Act12发酵液处理相比,10%Act12发酵液处理幼苗的株高、地上部干质量、地下部干质量、茎耐受指数、根耐受指数、总根长、根表面积、根体积和根尖数均显著增加,地上部分和地下部分MDA含量分别降低了42.49%和56.45%,可溶性糖含量分别增加了79.25%和89.83%,可溶性蛋白含量分别增加了167.63%和256.15%,根系SOD和POD活性分别提升了35.81%和57.33%。[结论]中低浓度密旋链霉菌Act12发酵液能有效增强石油胁迫下紫花苜蓿幼苗的抗氧化酶活性和渗透调节能力,降低MDA含量,提高光合作用能力,增加生物量,有效缓解石油胁迫对幼苗生长的抑制。

THE THEOREM OF THE STABILITY OF LINEAR NONAUTONOMOUS SYSTEMS UNDER THE FREQUENTLY-ACTING PERTURBATION AND ITS APPLICATION IN THE STABILITY ANALYSIS OF ROBOT

The necessary and sufficient condition of the stability of linear nonautonomous system under the frequently-acting perturbation has been given and proved on the basis of[1] and [2], and the theorem of the equivalence on the uniform and asymptotical stability in the sense of Liapunov ami the stability under the frequently-acting perturbation of linear nonautonomous system has been given in this paper. Besides, the analysis of the dynamic stabilitv of robot has been presented by applying the theorem in this paper, which is closer to reality

THE THEOREM OF THE STABILITY OF NONLINEAR NONAUTONOMOUS SYSTEMS UNDER THE FREQUENTLY-ACTING PERTURBATION—LIAPUNOV’S INDIRECT METHOD

In this paper the stability of nonlinear nonautonomous systems under the frequently-acting perturbation is studied. This study is a forward development of the study of the stability in the Liapunov sense; furthermore, it is of significance in practice since perturbations are often not single in the time domain. Malkin proved a general theorem about thesubject. To apply the theorem, however, the user has to construct a Liapunov function which satisfies specified conditions and it is difficult to find such a function for nonlinear nonautonomous systems. In the light of the principle of Liapunov's indirect method, which is an effective method to decide the stability of nonlinear systems in the Liapunov sense, the authors have achieved several important conclusions expressed in the form of theorems to determine the stability of nonlinear nonautonomous systems under the frequently-acting perturbation.

Unraveling the Impact of Direct-Acting Antivirals on Hepatitis-Linked Cirrhosis: A Comprehensive Analysis of Fibrosis, Child Score, and Disease Progression

The treatment of hepatitis C has undergone a significant boom since the advent of direct acting antivirals (DAA). Indeed, the interferon-ribavirin combination that has been used to treat hepatitis C has a virological response in only 45% of cases with significant side effects. The advent of direct-acting antivirals has changed the prognosis of cirrhotic patients with hepatitis C. DAAs have ensured a sustained viral response in the majority of patients. Our work aims to see the evolution of hepatitis C patients at the cirrhosis stage under DAA. We conducted a retrospective study over 15 years (January 2009, January 2024) including all patients with post-viral cirrhosis C, whom we divided into two groups: group A, cirrhotic patients who received ribavirin and interferon, and group B, patients on DAA. From January 2009 to January 2024, we conducted a study of 182 patients with viral hepatitis C, including 102 cirrhotic patients. The mean age was 55 years. 66% of patients were initially treated with the ribavirin interferon combination, while 34% received direct-acting antivirals (DAAs). Since the introduction of DAAs, the most commonly used regimens have been sofosbuvir/daclatasvir with or without ribavirin and sofosbuvir/ledipasvir with or without ribavirin. Group A achieved sustained virological response (SVR) in 60% of cases, with notable side effects. In Group B, SVR was 98.18%, with improved tolerability and fewer side effects than previous treatments. Fifteen patients developed hepatocellular carcinoma (HCC), with a significantly lower mortality rate in those treated with DAAs compared with pegylated dual therapy (p: 0.001).

Awareness of the Termination of Pregnancy Act of the Laws of Zambia among Women of Reproductive Age at Kanyama First Level Hospital in Lusaka District Zambia

Background: Termination of pregnancy (TOP) in Zambia is guided by the Termination of Pregnancy (TOP) Act of 1972 and as amended in 1994 of the laws of Zambia. However, despite provision of Comprehensive abortion care services with the liberal law, statistics at Kanyama First Level Hospital in relation to unsafe illegal abortions are alarming. This study sought to understand the Awareness on the TOP Act of the laws of Zambia among women of reproductive age 15 - 49 years at Kanyama First Level Hospital in Lusaka District. Purpose of the Study: To assess awareness on the TOP Act among women of reproductive age at Kanyama First Level Hospital in Lusaka, Zambia. Methodology: A convergent parallel mixed method design was conducted using both survey and in-depth interviews among women of reproductive age at Kanyama First Level Hospital in Lusaka District. The study surveyed 370 randomly sampled women aged 15 to 49 years old while the in-depth interviews included eight women purposively sampled from the survey population. Survey data was analyzed using descriptive and inferential statistics while qualitative data thematic analysis was used. Results: The study found that 37% of the participants were aware of the TOP Act while 63.8% viewed legalization of abortion for any reason as wrong. The study results also showed that widowed women were 8 times more likely to be aware of the TOP Act compared to single women (AOR: 8.262;95% CI: 1.105, 61.778). Women in business were significantly more likely to be aware of the TOP Act compared to those who reported having no occupation. (AOR: 2.61;95% CI: 1.246, 5.499). Limited access to information, the social stigma attached to abortion, health care providers’ attitudes, cultural norms, values and religious beliefs, restrictive legal requirements, and absence of a supportive network were some of the barriers affecting awareness and utilization of available safe abortion care services. Conclusions: The research findings concluded that a significant lack of awareness among women of reproductive age regarding the Termination of Pregnancy (TOP) Act. The majority of respondents held the view that abortion should only be legalized for medical reasons. Furthermore, there was a notable gap in knowledge concerning the penal code’s provisions on abortion.

User Perspective of Misplaced PPIUCD and Factors Resulting in PPIUCD Removal: Qualitative Pilot Study

Objective: The aim of the current study was to assess the impact of operative interventions for misplaced device among women who opted for PPIIUCD and the evaluation of reasons for PPIUCD removal within the follow up period of two years. Design: A descriptive exploratory study was conducted over three months among fourteen PPIUCD acceptors at a tertiary care health facility in Delhi, India. Face-to-face & telephonic in-depth interviews were conducted with a selected sample of PPIUCD acceptors who had later opted for its removal. Results: Participants (n = 14) aged 24 – 40 exhibited generally positive attitudes towards PPIUCDs indicating an indicate an understanding of the importance of PPIUCD in preventing unintended pregnancies. Menstrual disturbance and misplaced IUCD were major reasons for removal. despite their own experience necessitating the removal of IUCD, positive experience by other family members (mothers in law) in this study helped to keep the confidence on the contraceptive. Themes included (a) general experience of PPIUCD use (b) Health Facility accessed for removal of IUCD (c) Would she recommend it to others? (d) preferred contraceptive after removal of IUCD. Conclusion: Misplaced IUCD, missing thread, menstrual irregularities, and pain are all associated with PPIUCD and are important reasons for dissatisfaction. Appropriate, timely and supportive individualized care that address knowledge gaps, societal perceptions, and healthcare system challenges would certainly help in reducing dissatisfaction due to PPIUCD and thereby the removal rates.

基于强制性运动治疗的ACTED护理模式在脑卒中偏瘫患者中的应用

目的研究基于强制性运动治疗的ACTED护理模式在脑卒中偏瘫患者中的应用效果。方法选取2020年3月—2023年5月本院收治的70例脑卒中偏瘫患者为研究对象,采用随机数字表法将其分为对照组、观察组。两组患者均实施强制性运动治疗,在此基础上,对照组采用常规护理模式,观察组采用ACTED护理模式。比较两组患者护理前后的神经功能、肢体功能和生活质量。结果护理后,两组患者的美国国立卫生研究院卒中量表评分、上肢功能评定表各维度(身体功能、疼痛症状、情绪与社会功能)评分及总分、生活质量综合评定问卷各维度(生活环境、心理健康、社会关系、躯体功能)评分均明显较护理前改善(P<0.05),且观察组的美国国立卫生研究院卒中量表评分、上肢功能评定表各维度评分及总分均低于对照组(P<0.05),生活质量综合评定问卷各维度评分均高于对照组,差异有统计学意义(P<0.05)。结论将基于强制性运动治疗的ACTED护理模式应用于脑卒中偏瘫患者中,可有效改善患者的神经功能及肢体功能,提高患者的生活质量,值得临床推广应用。

ACTED康复护理在重度子宫脱垂术后患者中的应用效果

目的:观察ACTED康复护理在重度子宫脱垂术后患者中的应用效果。方法:选取2019年12月至2022年7月该院收治的66例重度子宫脱垂术后患者进行前瞻性研究,按照随机数字表法将其分为观察组和对照组各33例。对照组采用常规康复护理,观察组在对照组基础上采用ACTED康复护理。比较两组康复优良率,护理前后盆底功能[盆底功能障碍问卷(PFDI-20)]、心理困扰程度[简易凯斯勒心理困扰量表(K10)]和健康行为能力[健康行为能力自评量表(SRAHP)]评分。结果:观察组康复优良率为93.94%(31/33),高于对照组的75.76%(25/33),差异有统计学意义(P<0.05);护理3个月后,两组膀胱、肠道、盆腔等各项PFDI-20评分均低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05);两组K10评分均低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05);两组SRAHP评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:ACTED康复护理应用于重度子宫脱垂术后患者,可提高康复优良率与健康行为能力,减轻盆底功能障碍和心理困扰程度,效果优于常规康复护理。

Occupational therapy's role in promoting the“Learn the Signs.Act Early.”developmental monitoring program to public health employees

Background:Occupational therapists can play a key role in early identifica-tion of delay at the population health level by providing education to public health employees on how to implement developmental monitoring with caregivers of children birth to age 5.Methods:A pretest posttest design was utilized to assess the online education and training that was provided to Department of Public Health employees(N=339),including Head Start,Special Supplemental Nutrition Program for Women,Infants and Children,Home Visiting,and Early Intervention.Results:Analysis of pretest‐posttest survey data showed significant results for all 12 key learning outcomes.Six out of 12 outcomes were found to have a large effect size(d>0.8),4 outcomes indicated a medium effect size(d>0.5),and 2 outcomes had a small effect size(d>0.2).Participants gained knowledge of the“Learn the Signs.Act Early.”(LTSAE)developmental monitoring program,the difference between developmental monitoring and screening,the state's referral system and age‐appropriate parental engagement activities through knowledge of child development.Conclusions:Occupational therapists are child development specialists who can provide education on developmental monitoring and activities for parental engagement.The online course proved to be an effective platform to promote LTSAE within state agencies.

基于ACT反馈的延续性护理干预用于老年间质性肺炎中的效果分析

观察分析对老年间质性肺炎患者实施基于ACT反馈的延续性护理干预的临床效果和应用价值。方法:选择我院于2022年02月~2023年02月内就诊的60例老年间质性肺炎患者,随机均分为对照组(行常规护理)和实验组(行基于ACT反馈的延续性护理干预),收集分析护理效果。结果:实验组SAS、SDS评分,并发症发生率均明显低于对照组,生存质量评分、PaO2、FEV1、FVC、护理满意度均明显高于对照组,差异有统计学意义(P<0.05)。结论:基于ACT反馈的延续性护理干预可以有效减少老年间质性肺炎患者并发症发生率,缓解负性情绪,提高生存质量,改善肺功能,提高护理满意度,有较高的应用价值。

硅酸钾与密旋链霉菌Act12菌剂配施对连作草莓生长、果实产量及品质的影响

为了探索硅酸钾与生防放线菌配合施用对草莓连作障碍的修复效果,以"红太后"草莓为材料,采用日光温室栽培,研究了硅酸钾与密旋链霉菌Act12菌剂配施对连作草莓生长、果实产量及品质的影响。结果表明:(1)硅酸钾与密旋链霉菌Act12菌剂配施对日光温室连作草莓具有明显的防病促生作用,可使连作3年草莓1级苗比例提高44.7%,3级苗比例下降58.3%,连作4年草莓死亡率降至0%;连作3年草莓植株总鲜重、根鲜重、叶片数及叶片鲜重分别增加73.7%、71.3%、11.1%及38.7%。(2)硅酸钾与密旋链霉菌Act12菌剂配施对草莓开花、果实产量及品质有明显影响,可使连作3年草莓开花提前10 d,花蕾数提高17.0%,果实数、单果鲜重及单株产量分别增加18.6%、90.6%及126.2%,盛果期草莓果实可溶性固形物含量、糖酸比及维生素C含量分别提高21.7%、36.2%及27.0%;可显著提高连作4年草莓单果鲜重和单株产量(P<0.05),增幅分别为194.7%和359.1%。(3)硅酸钾与密旋链霉菌Act12菌剂配施可提高草莓的诱导抗性,草莓叶片可溶性蛋白含量和盛果期PPO酶活性分别提高67.4%和101.0%。由此可知,硅酸钾与密旋链霉菌Act12菌剂配施可显著促进连作草莓生长,提高果实产量及品质,增强植株抗病性,可有效缓解日光温室草莓连作障碍,在生产上具有较好应用潜力。

中华羊茅Epichloё内生真菌的actin序列分析

Epichloё内生真菌与禾本科植物很常见。现已有大量关于禾草Epichloё内生真菌系统演化研究的报道,但是尚未发现中华羊茅所带Epichloё内生真菌系统演化方面的研究。本研究经过检测采自青海、甘肃、四川等地中华羊茅8个种群的Epichloё内生真菌带菌率发现8个种群的Epichloё内生真菌均带有Epichloё内生真菌,带菌率为100%。该结果为研究中华羊茅所带Epichloё内生真菌系统演化的研究提供了优良的材料。因此,本研究通过克隆actin(act)序列,并与已报道Epichloё内生真菌act序列构建系统进化树。结果表明,供试菌act序列在进化树上成单支分布,表明该菌属于同一种Epichloё内生真菌,且可能是一个新种。此外,遗传距离分析也证明了供试菌为同一菌种。进化关系同时发现分布在相同或相近地理位置的Epichloё内生真菌聚集在同一个分支,表明它们之间的亲缘关系较近,表明Epichloё内生真菌亲缘关系与宿主采集地密切相关。

驾驶ACT-R认知行为建模

采用认知行为建模方法,建立符合真实驾驶认知行为的认知模型并应用于车辆辅助驾驶系统,达到减少交通事故的目的.基于对交通安全及驾驶行为研究发展历程的回顾,阐明认知科学是解决交通安全问题的重要理论,以及驾驶认知行为建模是驾驶任务研究的有效手段;通过对典型认知体系结构的比较和对ACT-R及其研究的分析,提出了认知体系驾驶认知行为建模方法;借助ACT-R建模工具,以高速公路驾驶超车认知行为为例,基于模型的驾驶行为预测以及基于实验的模型有效性验证,证明了认知行为建模方法具有较广的适用性和灵活性.通过对认知体系驾驶行为建模的优势分析表明,交通安全领域驾驶认知行为建模的应用可以有效地建立起来并发挥重要作用.