Impact of stage-specific limb function exercises guided by a selfmanagement education model on arteriovenous fistula maturation status

BACKGROUND The exercise of limb function is the most economical and safe method to promote the maturation of arteriovenous fistula(AVF).However,due to the lack of a uni-fied exercise standard in China,many patients have insufficient awareness of the importance of AVF,leading to poor effectiveness of limb function exercise.The self-management education model can effectively promote patients to take pro-active health-related actions.This study focuses on the characteristics of patients during the peri-AVF period and conducts a phased limb function exercise under the guidance of the self-management education model to observe changes in fac-tors such as the maturity of AVF.AIM To assess the impact of stage-specific limb function exercises,directed by a self-management education model,on the maturation status of AVFs.METHODS This study is a randomized controlled trial involving 74 patients with forearm AVFs from the Nephrology Department of a tertiary hospital in Sichuan Province,China.Patients were randomly divided into an observation group and a control group using a random number table method.The observation group underwent tailored stage-specific limb func-tion exercises,informed by a self-management education model which took into account the unique features of AVF at various stages,in conjunction with routine care.Conversely,the control group was given standard limb function exercises along with routine care.The assessment involves the maturity of AVFs post-intervention,post-operative complications,and the self-management level of the fistula in both groups patients.Analyses were conducted using SPSS version 23.0.Count data were represented by frequency and percentage and subjected to chi-square test comparisons.Measurement data adhering to a normal distribution were presented as mean±SD.The independent samples t-test was utilized for inter-group comparisons,while the paired t-test was used for intra-group comparisons.For measurement data not fitting a normal distribution,the median and interquartile range were presented and analyzed using the Wilcoxon rank sum test.RESULTS At the 8-wk postoperative mark,the observation group demonstrated significantly higher scores in AVF symptom recognition,symptom prevention,and self-management compared to the control group(P<0.05).However,the variance in symptom management scores between the observation and control groups lacked statistical signi-ficance(P>0.05).At 4 wk after the operation,the observation group displayed a superior vessel diameter and depth from the skin of the drainage vessels in comparison to the control group(P<0.05).While the observation group did manifest elevated blood flow rates in the drainage vessels relative to the control group,this distinction was not statistically significant(P>0.05).By the 8-wk postoperative interval,the observation group outperformed the control group with notable enhancements in blood flow rates,vessel diameter,and depth from the skin of drainage vessels(P<0.01).Seven days following the procedure,the observation group manifested significantly diminished limb swelling and an overall reduced complication rate in contrast to the control group(P<0.05).The evaluation of infection,thrombosis,embolism,arterial aneurysm stenosis,and incision bleeding showed no notable differences between the two groups(P>0.05).By the 4-wk postoperative juncture,complications between the observation and control groups were statistically indistinguishable(P>0.05).CONCLUSION Stage-specific limb function exercises,under the guidance of a self-management education model,amplify the capacity of AVF patients to discern and prevent symptoms.Additionally,they expedite AVF maturation and miti-gate postoperative limb edema,underscoring their efficacy as a valuable method for the care and upkeep of AVF in hemodialysis patients.

Bifurcation and Turing Pattern Formation in a Diffusion Modified Leslie-Gower Predator-Prey Model with Crowley-Martin Functional Response

In this paper, we study a modified Leslie-Gower predator-prey model with Smith growth subject to homogeneous Neumann boundary condition, in which the functional response is the Crowley-Martin functional response term. Firstly, for ODE model, the local stability of equilibrium point is given. And by using bifurcation theory and selecting suitable bifurcation parameters, we find many kinds of bifurcation phenomena, including Transcritical bifurcation and Hopf bifurcation. For the reaction-diffusion model, we find that Turing instability occurs. Besides, it is proved that Hopf bifurcation exists in the model. Finally, numerical simulations are presented to verify and illustrate the theoretical results.

Effect of health education based on information-motivationbehavioral skills model on patients with unilateral vestibular dysfunction

BACKGROUND Vestibular dysfunction(VH)is a common concomitant symptom of late peri-pheral vestibular lesions,which can be trauma,poisoning,infection,heredity,and neurodegeneration,but about 50%of the causes are unknown.The study uses the information-motivation-behavioral skills(IMB)model for health education,effectively improve the quality of life,increase their self-confidence,reduce anxiety and depression,and effectively improve the psychological state of patients.AIM To explore the effect of health education based on the IMB model on the degree of vertigo,disability,anxiety and depression in patients with unilateral vestibular hypofunction.METHODS The clinical data of 80 patients with unilateral vestibular hypofunction from January 2019 to December 2021 were selected as the retrospective research objects,and they were divided into the control group and the observation group with 40 cases in each group according to different nursing methods.Among them,the control group was given routine nursing health education and guidance,and the observation group was given health education and guidance based on the IMB model.The changes in self-efficacy,anxiety and depression,and quality of life of patients with unilateral VH were compared between the two groups.RESULTS There was no significant difference in General Self-Efficacy Scale(GSES)scale scores between the two groups of patients before nursing(P>0.05),which was comparable;after nursing,the GSES scale scores of the two groups were higher than those before nursing.The nursing group was higher than the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the scores of Hospital Anxiety and Depression Scale(HADS)and anxiety and depression subscales between the two groups before nursing(P>0.05).After nursing,the HADS score,anxiety,and depression subscale scores of the two groups of patients were lower than those before nursing,and the nursing group was lower than the control group,and the difference was statistically significant(P<0.05).After nursing,the Dizziness Handicap Inventory(DHI)scale and DHI-P,DHI-E and DHI-F scores in the two groups were decreased,and the scores in the nursing group were lower than those in the control group,and the difference was statistically significant(P<0.05).CONCLUSION Health education based on the IMB model can effectively improve patients'quality of life,increase self-efficacy of patients with unilateral vestibular hypofunction,enhance patients'confidence,enable patients to resume normal work and life as soon as possible,reduce patients'anxiety and depression,and effectively improve patients'psychological status.

Effect of Shuanghuanglian Oral Solution on Liver Function in a Mouse Model of Non-alcoholic Steatohepatitis

[Objectives]To observe the effect of Shuanghuanglian oral solution on liver function in BABL/cJ mice in non-alcoholic steatohepatitis(NASH)model.[Methods]The BABL/cJ mice were randomly divided into three groups:a control group,a model group,and an experimental group.The experimental group was administered with 10%Shuanghuanglian oral solution at a dose of 0.1 mL/(10 g·d),while the control group and experimental group received an equivalent dosage of normal saline.All three groups were treated for a period of 28 d.The liver function of the mice in each group was examined after the treatment.[Results]The body mass,liver index,triacylglycerol(TG),total cholesterol(TC),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)levels were all significantly reduced compared to the model group(P<0.05).[Conclusions]Shuanghuanglian oral solution has a beneficial effect on liver function in BABL/cJ mice.

Smaller & Smarter: Score-Driven Network Chaining of Smaller Language Models

With the continuous evolution and expanding applications of Large Language Models (LLMs), there has been a noticeable surge in the size of the emerging models. It is not solely the growth in model size, primarily measured by the number of parameters, but also the subsequent escalation in computational demands, hardware and software prerequisites for training, all culminating in a substantial financial investment as well. In this paper, we present novel techniques like supervision, parallelization, and scoring functions to get better results out of chains of smaller language models, rather than relying solely on scaling up model size. Firstly, we propose an approach to quantify the performance of a Smaller Language Models (SLM) by introducing a corresponding supervisor model that incrementally corrects the encountered errors. Secondly, we propose an approach to utilize two smaller language models (in a network) performing the same task and retrieving the best relevant output from the two, ensuring peak performance for a specific task. Experimental evaluations establish the quantitative accuracy improvements on financial reasoning and arithmetic calculation tasks from utilizing techniques like supervisor models (in a network of model scenario), threshold scoring and parallel processing over a baseline study.

Electrostatic Attraction and Repulsion Explained and Modelled Mathematically Using Classical Physics—A Detailed Mechanism Based on Particle Wave Functions

The phenomenon of electrical attraction and repulsion between charged particles is well known, and described mathematically by Coulomb’s Law, yet until now there has been no explanation for why this occurs. There has been no mechanistic explanation that reveals what causes the charged particles to accelerate, either towards or away from each other. This paper gives a detailed explanation of the phenomena of electrical attraction and repulsion based on my previous work that determined the exact wave-function solutions for both the Electron and the Positron. It is revealed that the effects are caused by wave interactions between the wave functions that result in Electromagnetic reflections of parts of the particle’s wave functions, causing a change in their momenta.

Effects of Continuous Precision Nursing Model on Knowledge, Attitudes, and Practices (KAP) Behavior and Cardiac Function in Patients after Percutaneous Coronary Angiography and Stent Implantation

Objective:To explore the impact of a continuous precision nursing model on patients’Knowledge,Attitudes,and Practices(KAP)and cardiac function during the nursing process of patients undergoing percutaneous coronary angiography and stent implantation.Methods:Ninety patients who underwent percutaneous coronary angiography and stent implantation in our hospital from April 2022 to April 2023 were selected and randomly divided into the control group(45 cases),in which routine nursing support was carried out during the treatment process,and the observation group(45 cases),in which continuous precision nursing model was carried out during the treatment process.Comparisons were made between the two groups of patients on their KAP,cardiac function,and quality of life during recovery.Results:There was no difference in the left ventricular ejection fraction(LVEF),cardiac output(CO),and cardiac index(CI)levels before intervention.After the intervention,the levels of cardiac function in the observation group were higher than those of the control group(P<0.05).There was no difference in the Exercise of Self-Care Agency(ESCA)self-care ability scale scores before the intervention.After the intervention,the observation group had higher ESCA scores than the control group(P<0.05).Conclusion:Implementation of a continuous precision nursing model in the care of patients undergoing percutaneous coronary angiography and stent implantation improved the patient’s cardiac function,and KAP,and promoted recovery.

Mathematical Wave Functions and 3D Finite Element Modelling of the Electron and Positron

The wave/particle duality of particles in Physics is well known. Particles have properties that uniquely characterize them from one another, such as mass, charge and spin. Charged particles have associated Electric and Magnetic fields. Also, every moving particle has a De Broglie wavelength determined by its mass and velocity. This paper shows that all of these properties of a particle can be derived from a single wave function equation for that particle. Wave functions for the Electron and the Positron are presented and principles are provided that can be used to calculate the wave functions of all the fundamental particles in Physics. Fundamental particles such as electrons and positrons are considered to be point particles in the Standard Model of Physics and are not considered to have a structure. This paper demonstrates that they do indeed have structure and that this structure extends into the space around the particle’s center (in fact, they have infinite extent), but with rapidly diminishing energy density with the distance from that center. The particles are formed from Electromagnetic standing waves, which are stable solutions to the Schrödinger and Classical wave equations. This stable structure therefore accounts for both the wave and particle nature of these particles. In fact, all of their properties such as mass, spin and electric charge, can be accounted for from this structure. These particle properties appear to originate from a single point at the center of the wave function structure, in the same sort of way that the Shell theorem of gravity causes the gravity of a body to appear to all originate from a central point. This paper represents the first two fully characterized fundamental particles, with a complete description of their structure and properties, built up from the underlying Electromagnetic waves that comprise these and all fundamental particles.

Three-talk决策模式干预对急性脑梗死病人神经功能恢复和心理状态的影响

目的:探讨Three-talk决策模式干预对急性脑梗死病人神经功能恢复和心理状态的影响。方法:选取急性脑梗死病人80例,随机分为对照组和观察组,各40例。对照组给予常规护理,观察组在常规护理基础上给予Three-talk决策模式(包括团队会谈、选择会谈、决策会谈)干预,比较2组病人干预前和干预1个月后的负性情绪、肢体肌力、运动功能、吞咽功能和自我护理能力(ESEA)评分。结果:干预前,2组病人焦虑、抑郁、肢体肌力、运动功能、吞咽功能和ESEA评分差异均无统计学意义(P>0.05);干预1个月后,观察组焦虑、抑郁和吞咽功能评分均明显低于对照组(P<0.01),肢体肌力、运动功能、ESEA评分均明显高于对照组(P<0.01)。结论:Three-talk决策模式干预有助于缓解急性脑梗死病人的焦虑、抑郁情绪,帮助病人实现肢体肌力、运动及吞咽功能的恢复,进而提高其自我护理能力。

Dynamic stability analysis of porous functionally graded beams under hygro-thermal loading using nonlocal strain gradient integral model

We present a study on the dynamic stability of porous functionally graded(PFG)beams under hygro-thermal loading.The variations of the properties of the beams across the beam thicknesses are described by the power-law model.Unlike most studies on this topic,we consider both the bending deformation of the beams and the hygro-thermal load as size-dependent,simultaneously,by adopting the equivalent differential forms of the well-posed nonlocal strain gradient integral theory(NSGIT)which are strictly equipped with a set of constitutive boundary conditions(CBCs),and through which both the stiffness-hardening and stiffness-softening effects of the structures can be observed with the length-scale parameters changed.All the variables presented in the differential problem formulation are discretized.The numerical solution of the dynamic instability region(DIR)of various bounded beams is then developed via the generalized differential quadrature method(GDQM).After verifying the present formulation and results,we examine the effects of different parameters such as the nonlocal/gradient length-scale parameters,the static force factor,the functionally graded(FG)parameter,and the porosity parameter on the DIR.Furthermore,the influence of considering the size-dependent hygro-thermal load is also presented.

Evaluation of the water conservation function in the Ili River Delta of Central Asia based on the InVEST model

The Ili River Delta(IRD)is an ecological security barrier for the Lake Balkhash and an important water conservation area in Central Asia.In this study,we selected the IRD as a typical research area,and simulated the water yield and water conservation from 1975 to 2020 using the water yield module of the Integrated Valuation of Ecosystem Services and Tradeoffs(InVEST)model.We further analyzed the temporal and spatial variations in the water yield and water conservation in the IRD from 1975 to 2020,and investigated the main driving factors(precipitation,potential evapotranspiration,land use/land cover change,and inflow from the Ili River)of the water conservation variation based on the linear regression,piecewise linear regression,and Pearson's correlation coefficient analyses.The results indicated that from 1975 to 2020,the water yield and water conservation in the IRD showed a decreasing trend,and the spatial distribution pattern was"high in the east and low in the west";overall,the water conservation of all land use types decreased slightly.The water conservation volume of grassland was the most reduced,although the area of grassland increased owing to the increased inflow from the Ili River.At the same time,the increased inflow has led to the expansion of wetland areas,the improvement of vegetation growth,and the increase of regional evapotranspiration,thus resulting in an overall reduction in the water conservation.The water conservation depth and precipitation had similar spatial distribution patterns;the change in climate factors was the main reason for the decline in the water conservation function in the delta.The reservoir in the upper reaches of the IRD regulated runoff into the Lake Balkhash,promoted vegetation restoration,and had a positive effect on the water conservation;however,this positive effect cannot offset the negative effect of enhanced evapotranspiration.These results provide a reference for the rational allocation of water resources and ecosystem protection in the IRD.

A methodology for damage evaluation of underground tunnels subjected to static loading using numerical modeling

We have proposed a methodology to assess the robustness of underground tunnels against potential failure.This involves developing vulnerability functions for various qualities of rock mass and static loading intensities.To account for these variations,we utilized a Monte Carlo Simulation(MCS)technique coupled with the finite difference code FLAC^(3D),to conduct two thousand seven hundred numerical simulations of a horseshoe tunnel located within a rock mass with different geological strength index system(GSIs)and subjected to different states of static loading.To quantify the severity of damage within the rock mass,we selected one stress-based(brittle shear ratio(BSR))and one strain-based failure criterion(plastic damage index(PDI)).Based on these criteria,we then developed fragility curves.Additionally,we used mathematical approximation techniques to produce vulnerability functions that relate the probabilities of various damage states to loading intensities for different quality classes of blocky rock mass.The results indicated that the fragility curves we obtained could accurately depict the evolution of the inner and outer shell damage around the tunnel.Therefore,we have provided engineers with a tool that can predict levels of damages associated with different failure mechanisms based on variations in rock mass quality and in situ stress state.Our method is a numerically developed,multi-variate approach that can aid engineers in making informed decisions about the robustness of underground tunnels.

Verify the Function of a Potential Growth-Regulating Gene in Marine Bivalve Using a Candidate Model Organism Mulinia lateralis

A better understanding of genetic bases of growth regulation is essential for bivalve breeding,which is helpful to improve the yield of the commercially important bivalves.While previous studies have identified some candidate genes accounting for variation in growth-related traits through genotype-phenotype association analyses,seldom of them have verified the functions of these putative,growth-related genes beyond the genomic level due to the difficulty of culturing commercial bivalves under laboratory conditions.Fortunately,dwarf surf clam Mulinia lateralis can serve as a model organism for studying marine bivalves given its short generation time,the feasibility of being grown under experimental conditions and the availability of genetic and biological information.Using dwarf surf clam as a model bivalve,we characterize E2F3,a gene that has been found to account for variation in growth in scallops by a previous genome-wide association study,and verify its function in growth regulation through RNA interference(RNAi)experiments.For the first time,E2F3 in dwarf surf clam,which is termed as MulE2F3,is characterized.The results reveal that dwarf surf clams with MulE2F3 knocked down exhibit a reduction in both shell size and soft-tissue weight,indicating the functions of MulE2F3 in positively regulating bivalve growth.More importantly,we demonstrate how dwarf surf clam can be used as a model organism to investigate gene functions in commercial bivalves,shedding light on genetic causes for variation in growth to enhance the efficiency of bivalve farming.

Development of an improved three-dimensional rough discrete fracture network model:Method and application

Structure plane is one of the important factors affecting the stability and failure mode of rock mass engineering.Rock mass structure characterization is the basic work of rock mechanics research and the important content of numerical simulation.A new 3-dimensional rough discrete fracture network(RDFN3D)model and its modeling method based on the Weierstrass-Mandelbrot(W-M)function were presented in this paper.The RDFN3D model,which improves and unifies the modelling methods for the complex structural planes,has been realized.The influence of fractal dimension,amplitude,and surface precision on the modeling parameters of RDFN3D was discussed.The reasonable W-M parameters suitable for the roughness coefficient of JRC were proposed,and the relationship between the mathematical model and the joint characterization was established.The RDFN3D together with the smooth 3-dimensional discrete fracture network(DFN3D)models were successfully exported to the drawing exchange format,which will provide a wide application in numerous numerical simulation codes including both the continuous and discontinuous methods.The numerical models were discussed using the COMSOL Multiphysics code and the 3-dimensional particle flow code,respectively.The reliability of the RDFN3D model was preliminarily discussed and analyzed.The roughness and spatial connectivity of the fracture networks have a dominant effect on the fluid flow patterns.The research results can provide a new geological model and analysis model for numerical simulation and engineering analysis of jointed rock mass.

Byte-Level Function-Associated Method for Malware Detection

The byte stream is widely used in malware detection due to its independence of reverse engineering.However,existing methods based on the byte stream implement an indiscriminate feature extraction strategy,which ignores the byte function difference in different segments and fails to achieve targeted feature extraction for various byte semantic representation modes,resulting in byte semantic confusion.To address this issue,an enhanced adversarial byte function associated method for malware backdoor attack is proposed in this paper by categorizing various function bytes into three functions involving structure,code,and data.The Minhash algorithm,grayscale mapping,and state transition probability statistics are then used to capture byte semantics from the perspectives of text signature,spatial structure,and statistical aspects,respectively,to increase the accuracy of byte semantic representation.Finally,the three-channel malware feature image is constructed based on different function byte semantics,and a convolutional neural network is applied for detection.Experiments on multiple data sets from 2018 to 2021 show that the method can effectively combine byte functions to achieve targeted feature extraction,avoid byte semantic confusion,and improve the accuracy of malware detection.

Three-Component Model for Bidirectional Reflection Distribution Function of Thermal Coating Surfaces

We present a bidirectional reflection distribution function （BRDF） model for thermal coating surfaces based on a three-component reflection assumption, in which the specular reflection is given according to the microfacet theory and Snell＇s law, the multiple reflection is considered Nth cosine distributed, and the volume scattering is uniformly distributed in reflection angles according to the experimental results. This model describes the reflection characteristics of thermal coating surfaces more completely and reasonably. Simulation and measurement results of two thermal coating samples SR107 and S781 are given to validate that this three-component model significantly improves the modeling accuracy for thermal coating surfaces compared with the existing BRDF models.

Construction of Psychological Adjustment Function Model of Music Education Based on Emotional Tendency Analysis

In the face offierce competition in the social environment,mental health problems gradually get the attention of the public,in order to achieve accurate mental health data analysis,the construction of music education is based on emotional tendency analysis of psychological adjustment function model.Design emotional tendency analysis of music education psychological adjustment function architecture,music teaching goal as psychological adjust-ment function architecture building orientation,music teaching content as a foundation for psychological adjust-ment function architecture and music teaching process as a psychological adjustment function architecture building,music teaching evaluation as the key of building key regulating function architecture,Establish a core literacy oriented evaluation system.Different evaluation methods were used to obtain the evaluation results.Four levels of psychological adjustment function model of music education are designed,and the psychological adjust-ment function of music education is put forward,thus completing the construction of psychological adjustment function model of music education.The experimental results show that the absolute value of the data acquisition error of the designed model is minimum,which is not more than 0.2.It is less affected by a bad coefficient and has good performance.It can quickly converge to the best state in the actual prediction process and has a strong con-vergence ability.

Constructing Confidence Regions for Autoregressive-Model Parameters

We discuss formulas and techniques for finding maximum-likelihood estimators of parameters of autoregressive (with particular emphasis on Markov and Yule) models, computing their asymptotic variance-covariance matrix and displaying the resulting confidence regions;Monte Carlo simulation is then used to establish the accuracy of the corresponding level of confidence. The results indicate that a direct application of the Central Limit Theorem yields errors too large to be acceptable;instead, we recommend using a technique based directly on the natural logarithm of the likelihood function, verifying its substantially higher accuracy. Our study is then extended to the case of estimating only a subset of a model’s parameters, when the remaining ones (called nuisance) are of no interest to us.

Real-Time Analytical Solutions as Series Formulas and Heaviside off/on Switch Functions for Multiple Intermittent Intravenous Infusions in One- and Two-Compartment Models

Pharmacokinetic compartment models are the only models that can extract pharmacokinetic parameters from data collected in clinical studies but their estimates lack accuracy, explanations and physiological significance. The objective of this work was to develop particular solutions to drug concentration and AUC in the form of mathematical series and Heaviside functions for repetitive intermittent infusions in the one- and two-compartment models, as a function of dose number and total time using differential calculus. It was demonstrated that the central and peripheral compartment volumes determined from regression analysis of the aminoglycoside antibiotic Sisomicin concentration in plasma represent the actual physiological body fluid volumes accessible by the drug. The drug peak time and peak concentration in the peripheral compartment were also calculated as a function of dose number. It is also shown that the time of intercompartmental momentary distribution equilibrium can be used to determine the drug’s apparent volume of distribution within any dosing interval in multi-compartment models. These estimates were used to carry out simulations of plasma drug concentration with time in the one-compartment model. In conclusion, the two-compartment open mammillary pharmacokinetic model was fully explained for the aminoglycoside antibiotic sisomicin through the new concept of the apparent volume of distribution.

Dynamic Analysis of a Predator-Prey Model with Holling-II Functional Response

A predator-prey model with linear capture term Holling-II functional response was studied by using differential equation theory. The existence and the stabilities of non-negative equilibrium points of the model were discussed. The results show that under certain limited conditions, these two groups can maintain a balanced position, which provides a theoretical reference for relevant departments to make decisions on ecological protection.