Effects of nursing team communication and collaboration on treatment outcomes in intensive care unit patients with severe pneumonia

BACKGROUND Severe pneumonia is a common severe respiratory infection worldwide,and its treatment is challenging,especially for patients in the intensive care unit(ICU).AIM To explore the effect of communication and collaboration between nursing teams on the treatment outcomes of patients with severe pneumonia in ICU.METHODS We retrospectively analyzed 60 patients with severe pneumonia who were treated at the ICU of the hospital between January 1,2021 and December 31,2023.We compared and analyzed the respiratory mechanical indexes[airway resistance(Raw),mean airway pressure(mPaw),peak pressure(PIP)],blood gas analysis indexes(arterial oxygen saturation,arterial oxygen partial pressure,and oxygenation index),and serum inflammatory factor levels[C-reactive protein(CRP),procalcitonin(PCT),cortisol(COR),and high mobility group protein B1(HMGB1)]of all patients before and after treatment.RESULTS Before treatment,there was no significant difference in respiratory mechanics index and blood gas analysis index between 2 groups(P>0.05).However,after treatment,the respiratory mechanical indexes of patients in both groups were significantly improved,and the improvement of Raw,mPaw,plateau pressure,PIP and other indexes in the combined group after communication and collaboration with the nursing team was significantly better than that in the single care group(P<0.05).The serum CRP and PCT levels of patients were significantly decreased,and the difference was statistically significant compared with that of nursing group alone(P<0.05).The levels of serum COR and HMGB1 before and after treatment were also significantly decreased between the two groups.CONCLUSION The communication and collaboration of the nursing team have a significant positive impact on respiratory mechanics indicators,blood gas analysis indicators and serum inflammatory factor levels in the treatment of severe pneumonia patients in ICU.

Subcarrier Intensity Modulated Optical Wireless Communications:A Survey from Communication Theory Perspective

Subcarrier intensity modulation with direet detection is a modulatiou/detection technique tbr optical wireless communication systems, where a pre-modulated and properly biased radio frequency signal is modulated on the intensity of the optical carrier. The most important benefits of subcarrier intensity modulation are as follows： 1） it does not provide irreducible error floor like the conventional on-off keying intensity modulation with a fixed detection threshold; 2） it provides improved spectral efficiency and supports higher order modulation schemes; and 3） it has much less implementation complexity compared to coherent optical wireless communications with heterodyne or homodyne detection. In this paper, we present an up-to-date review of subcarrier intensity modulated optical wireless communication systems. We survey the error rate and outage performance of subcarrier intensity modulations in the atmospheric turbulence channels considering different modulation and coding schemes. We also explore different contemporary atmospheric turbulence fading mitigation solutions that can be employed for subcarrier intensity modulation. These solutions include diversity combining, adaptive transmission, relay assisted transmission, multiple-subcarrier intensity modulations, and optical orthogonal frequency division multiplexing. Moreover, we review the performance of subcarrier intensity modulations due to the pointing error and synchronization error.

Interventions to improve communication between nurses and physicians in the intensive care unit: An integrative literature review

Effective communication among healthcare professionals in the intensive care unit (ICU) is a particular imperative,with accurate and efficient interdisciplinary communication being a critical prerequisite for high-quality care.Nurses and physicians are highly important parts of the healthcare system workforce.Thus,identifying strategies that would improve communication between these two groups can provide evidence for practical improvement in the ICU,which will ultimately improve patient outcomes.This integrative literature review aimed to identify interventions that improve communication between nurses and physicians in ICUs.Three databases (Medline,CINAHL,and Science Direct) were searched between September 2014 and June 2016 using 11 search terms,namely,nurse,doctor,physician,resident,clinician,ICU,intensive care unit,communication,teamwork,collaboration,and relationship.A manual search of the reference lists of found papers was also conducted.Eleven articles met the inclusion criteria.These studies reported on the use of communication tools/checklists,team training,multidisciplinary structured work shift evaluation,and electronic situation-background-assessment -recommendation documentation templates to improve communication.Although which intervention strategies are most effective remains unclear,this review suggests that these strategies improve communication to some extent.Future studies should be rigorously designed and outcome measures should be specific and validated to capture and reflect the effects of effective communication.

The Application of "Infiltration" Intercultural Communication Teaching in English Intensive Reading Teaching

Due to the general promotion of the new English curriculum standards,the training of students'intercultural communication skills has become the main goal of the current English teaching reform.In English teaching,reading teaching includes all aspects of English country customs,human accidents,political diplomacy,etc.The intensive reading of English reading helps students to understand the culture of English-speaking countries.Therefore,in order to improve the quality of English intensive reading in China,starting from the important role and main principles of"infiltration"intercultural communication teaching in English intensive reading teaching,to explore the application of"infiltration"cross-cultural communication teaching in English intensive reading teaching.

Integrating Communicative Extensive Reading into Intensive Reading Course

With in-depth analysis of possible problems in Chinese traditional intensive reading courses,corresponding solutions are proposed according to the prevailing communicative practices in reading classes internationally to cope with the instruction-dominant and product-ended pedagogy in intensive reading course in China's Mainland.To integrate communicative extensive reading projects into intensive reading courses is believed applicable in the domestic context of teaching English reading with its strength in encouraging more exposure to authentic target language,in developing intrinsic motivation of learners and therefore enhancing learners' overall reading competence.

Relative Intensity Noise in the Single Quantum Well Diode

Based on the mathematical model of quantum well laser diode(QW LDs) developed, the paper presents a relative intensity noise(RIN) model, which employs Gaussian form random noise with its average being to zero. It can be straightforwardly used to describe the effect of the noise on the performance of QW LDs. The RIN becomes notable in the frequency range of interests and therefore affects the device modulation property. The results are in good agreement of the published data. The RIN model proposed and the results can be used for purpose of device technique improvement and performance simulation of optical communication systems and networks.

Space-division multiple access for CDMA multiuser underwater acoustic communications

Time reversal mirror （TRM） can use the physical characteristics of the underwater acoustic （UWA） channel to focus on the desired user in multi-user UWA communication. The active average sound intensity （AASI） detector can estimate all azimuths of users with the same frequency band at the same time in order to achieve directional communication by vector combination. Space-division multiple access （SDMA） based on TRM combined with the AASI detector is proposed in this paper, which can make the capacity of the code division multiple access （CDMA） UWA system significantly increase. The simulation and lake test results show that the 7-user UWA multi-user system can achieve low bit error communication.

Teaching Intensive Reading Communicatively

The course of Intensive Reading is one of the key courses for the students who major in English at the tertiary level in China. This paper presents the writers＇ experiment of the communicative approach adopted in the course and discusses its effectiveness. The experiment focuses on the teaching of texts. The effectiveness of the approach is discussed drawing on the analysis of the questionnaire.

YOU CAN' T SEE THE FOREST FOR THE TREES!"──REFLECTIONS ON THE TEACHING OF INTENSIVE READING AT TEACHERS' COLLEGES IN CHINA

In this article, we first identify one of the most common issues in the teaching of Intetive Reading at teachers’ colleges. That is, in the teaching of Intensive Reading, EFL teachers tend to teach linguistic knowledge to such extent that the importance of other language components-sociolinguistic, discourse, and strategic competence diminishes. We then try to analyze the main causative factors which inhibit EFL teachers from imlementing effectively new teaching methods such as Communicative Language Teachillg. Through theoretical discussion, we attempt to present some pedagogical implications for the solution to the problem identified. In conclusion,we comment briefly on the proposed solutions to the problem, hoping to improve the teaching of Intensive Reading at Teachers’ college in China.

Modulation Techniques for Li-Fi

Modulation techniques for light fidelity （Li-Fi） are reviewed in this paper. Li-Fi is the fully networked solution for nmltiple users that combines communication and illumination simultaneously. Light emitting diodes （LEDs） are used in Li-Fi as visible light transmitters, therefore, only intensity modulated direct detected modulation techniques can be achieved. Single carrier modulation techniques are straightforward to be used in Li-Fi, however, computationally complex equalization processes are required in fre- quency selective Li-Fi channels. On the other hand, multiearrier modulation techniques offer a viable solution for Li-Fi in terms of power, spectral and computational efficiency. In particular, orthogonal frequency division multiplexing （OFDM） based modulation techniques offer a practical solution for Li-Fi, especially when direct current （DC） wander, and adaptive bit and power loading techniques are considered. Li-Fi modulation techniques need to also satisfy illumination requirements. Flickering avoidance and dimming control are considered in the variant modulation techniques presented. This paper surveys the suitable modulation techniques for Li-Fi including those which explore time, frequency and colour domains.

高强度间歇运动在慢性病防治中的作用及机制研究进展

慢性非传染性疾病(以下简称“慢性病”,noncommunicable chronic diseases, NCDs)是一种具有长期性、隐匿性与多发性等特征的疾病。流行病学调查显示,我国NCDs患病率呈不断上涨趋势,已成为威胁我国居民健康的重要卫生问题。因此,挖掘更多经济、有效并安全的NCDs防治方式是目前亟需解决的临床问题。诸多研究证实,高强度间歇运动(high-intensity interval training, HIIT)对NCDs具有积极的防治作用,且相较于其他类型运动表现出更好的经济性、趣味性和可坚持性。但就目前而言,HIIT与NCDs的内在联系与相关机制尚不十分明确。因此,梳理与总结HIIT与NCDs防治的相关研究与应用成果,以期为NCDs的临床治疗提供参考。

Development and pilot implementation of a patient-oriented discharge summary for critically Ill patients

BACKGROUND Patients leaving the intensive care unit(ICU)often experience gaps in care due to deficiencies in discharge communication,leaving them vulnerable to increased stress,adverse events,readmission to ICU,and death.To facilitate discharge communication,written summaries have been implemented to provide patients and their families with information on medications,activity and diet restrictions,follow-up appointments,symptoms to expect,and who to call if there are questions.While written discharge summaries for patients and their families are utilized frequently in surgical,rehabilitation,and pediatric settings,few have been utilized in ICU settings.AIM To develop an ICU specific patient-oriented discharge summary tool(PODS-ICU),and pilot test the tool to determine acceptability and feasibility.METHODS Patient-partners(i.e.,individuals with lived experience as an ICU patient or family member of an ICU patient),ICU clinicians(i.e.,physicians,nurses),and researchers met to discuss ICU patients’specific informational needs and design the PODS-ICU through several cycles of discussion and iterative revisions.Research team nurses piloted the PODS-ICU with patient and family participants in two ICUs in Calgary,Canada.Follow-up surveys on the PODS-ICU and its impact on discharge were administered to patients,family participants,and ICU nurses.RESULTS Most participants felt that their discharge from the ICU was good or better(n=13;87.0%),and some(n=9;60.0%)participants reported a good understanding of why the patient was in ICU.Most participants(n=12;80.0%)reported that they understood ICU events and impacts on the patient’s health.While many patients and family participants indicated the PODS-ICU was informative and useful,ICU nurses reported that the PODS-ICU was“not reasonable”in their daily clinical workflow due to“time constraint”.CONCLUSION The PODS-ICU tool provides patients and their families with essential information as they discharge from the ICU.This tool has the potential to engage and empower patients and their families in ensuring continuity of care beyond ICU discharge.However,the PODS-ICU requires pairing with earlier discharge practices and integration with electronic clinical information systems to fit better into the clinical workflow for ICU nurses.Further refinement and testing of the PODS-ICU tool in diverse critical care settings is needed to better assess its feasibility and its effects on patient health outcomes.

Enhanced asymmetrically clipped DC biased optical OFDM for intensity-modulated direct-detection systems

In this paper,we propose an EADO-OFDM(Enhanced Asymmetrically Clipped DC Biased Optical Orthogonal Frequency Division Multiplexing)method for IM/DD(Intensity-Modulated DirectDetection)optical systems,in which the AV-DCO-OFDM(Absolute Valued DC Biased Optical OFDM)symbols on the even subcarriers and ACO-OFDM(Asymmetrically Clipped Optical OFDM)symbols on the odd subcarriers are combined for simultaneous transmission.Moreover,we discuss the PDF(Probability Density Function)and electrical SNR(Signal to Noise Ratio)of the symbols,which are utilized to estimate the BER(Bit Error Ratio)performance and overall performance of EADO-OFDM.The Monte Carlo simulation results have validated the theoretical analysis and have also confirmed the EADO-OFDM is attractive considering the following benefits.Firstly,EADO-OFDM is more energy efficient compared to the power-efficient DCO-OFDM(DC Biased Optical OFDM),since the required DC bias is smaller when appropriate constellation size combinations are chosen.In addition,EADO-OFDM performs better than the conventional ADO-OFDM(Asymmetrically Clipped DC Biased Optical OFDM),because the absolute value operation causes no clipping distortion.

AN INITIAL ATTEMPT TO APPLY THE COMMUNICATIVE APPROACH TO THE INTENSIVE READING COURSE:An overall evaluation of the teaching practice on the Nankai University HTTC

IntroductionIn China,the significance of intensive reading in language learning and teaching is known to allconcerned.For a long period of time,roughly halfa century,there have been no great changes in the wayintensive reading is taught.As a result some schools and colleges continue to place too much emphasis onusage rather than use.The teacher spends a great deal of time explaining language points,paraphrasingdifficult sentence structures,and introducing the author’s background.Students,on the other hand,areaccustomed to accepting whatever is presented to them passively.

TEACHING STRATEGIES IN ENGLISH MAJOR COLLEGE STUDENTS TEACHING — HOW TO HAVE A SUCCESSFUL INTENSIVE READING ENGLISH CLASS

How to have a successful Intensive reading English class? The teacher should possess a lot of practice based on the theory of second language acquisition and teaching strategies. This paper mainly discusses the way of how to manage Intensive English classes in the perspective of teaching approach, class design and teaching procedure, etc. The three aspects are associated with each other very closely. If the teacher can combine these three factors successfully, he can be regarded as a competent teacher.

Multiparameter performance monitoring of pulse amplitude modulation channels using convolutional neural networks

A designed visual geometry group(VGG)-based convolutional neural network(CNN)model with small computational cost and high accuracy is utilized to monitor pulse amplitude modulation-based intensity modulation and direct detection channel performance using eye diagram measurements.Experimental results show that the proposed technique can achieve a high accuracy in jointly monitoring modulation format,probabilistic shaping,roll-off factor,baud rate,optical signal-to-noise ratio,and chromatic dispersion.The designed VGG-based CNN model outperforms the other four traditional machine-learning methods in different scenarios.Furthermore,the multitask learning model combined with MobileNet CNN is designed to improve the flexibility of the network.Compared with the designed VGG-based CNN,the MobileNet-based MTL does not need to train all the classes,and it can simultaneously monitor single parameter or multiple parameters without sacrificing accuracy,indicating great potential in various monitoring scenarios.

肺结核行机械通气患者序贯排痰方案的构建及应用

目的探讨序贯排痰方案在肺结核行机械通气治疗患者中的应用效果。方法选取2018年1月—12月南宁市某三级甲等传染病医院45例肺结核行机械通气患者为试验组,2017年1月—12月44例肺结核行机械通气患者为对照组,其中试验组采用序贯排痰方案,对照组使用常规排痰方案。干预24 h后,比较两组呼吸频率、平均动脉压、血氧饱和度、动脉血氧分压、氧合指数、动脉血CO2分压、气道峰压值、日排痰量。比较两组干预7 d后排痰效果、呼吸机相关性肺炎发生率、机械通气时间、ICU住院时间、脱机成功率等指标。结果干预24 h后,两组呼吸频率较干预前显著降低(P<0.05),两组平均动脉压波动较干预前无明显变化(P>0.05),试验组血氧饱和度、动脉血氧分压值、氧合指数较对照组及干预前有所升高(P<0.05),气道峰压和动脉血CO2分压较对照组及干预前均显著降低(P<0.05),试验组日排痰量(29.48±4.54)ml,对照组(12.56±2.287)ml,两组比较,差异具有统计学意义(P<0.001);干预7 d后,试验组排痰效果优于对照组(P<0.05);干预后试验组呼吸机相关性肺炎发生率、机械通气时间、ICU住院时间均低于对照组,脱机成功率高于对照组(P<0.05)。结论应用序贯排痰方案能促进肺结核机械通气患者痰液排出,改善患者的肺功能状态,提高生存质量,缩短ICU住院时间并减轻医疗负担。

An algorithm to solve autocorrelation matrix singular value based on SNR estimation

SNR estimation of communication signals is important to improve demodulation performance and channel quality of communication system,thus it is an important research issue of communication field.According to the core problem of autocorrelation matrix singular value in SNR estimation process,through making use of householder transforming autocorrelation matrix into tridiagonal matrix,and by using the relation of corresponding characteristic equation coefficients and singular value,a numerical algorithm is gi...