Analysis of the Effect of Problem-Oriented Nursing Intervention on Patients with Lower Extremity Arteriosclerosis Obliterans in Vascular Surgery

Objective: To analyze the effect of problem-oriented nursing intervention on patients with lower extremity arteriosclerosis obliterans (ASO) in vascular surgery. Methods: The clinical data of 128 patients with lower extremity ASO in vascular surgery were selected and randomly divided into groups A and B, with 64 cases each. Group A is the control group, and Group B is the observation group. Group A received the routine nursing intervention, and Group B received the problem-oriented nursing intervention. The compliance, self-care ability, psychological state, quality of life, and nursing satisfaction of the two groups of patients were evaluated based on various indicators. Results: After the intervention, the evaluation of self-care ability (ESCA) score of the patients in Group B was higher than that of Group A, and the symptom checklist-90 (SCL-90) score was lower than that of Group A. The differences were significant (t = 10.019, t = 3.118, P < 0.01). After the intervention, the World Health Organization Quality of Life Brief (WHOQOL-BREF) index scores of the two groups increased and the increase in Group B was significantly higher than Group A (P < 0.001). The compliance rate of Group B (62/ 96.88%) was higher than that of Group A (52/ 81.25%), and the difference was extremely significant (χ2 = 8.020, P < 0.01). Conclusion: Problem-oriented nursing intervention for patients with lower extremity ASO in vascular surgery improved the patient’s self-care ability, and quality of life, reduced the patient’s negative emotions, and enhanced their overall satisfaction.

Intervention Effect of Lower Limb Rehabilitation Robot with Task-Oriented Training on Stroke Patients and Its Influence on KFAROM Score

Objective: To explore the effect of lower limb rehabilitation robot combined with task-oriented training on stroke patients and its influence on KFAROM score. Methods: 100 stroke patients with hemiplegia admitted to our hospital from January 2023 to December 2023 were randomly divided into two groups, the control group (50 cases) was given task-oriented training assisted by nurses, and the observation group (50 cases) was given lower limb rehabilitation robot with task-oriented training. Lower limb balance, lower limb muscle strength, motor function, ankle function, knee flexion range of motion and walking ability were observed. Results: After treatment, the scores of BBS, quadriceps femoris and hamstrings in the observation group were significantly higher than those in the control group (P Conclusion: In the clinical treatment of stroke patients, the combination of task-oriented training and lower limb rehabilitation robot can effectively improve the lower limb muscle strength, facilitate the recovery of balance function, and have a significant effect on the recovery of motor function, which can improve the walking ability of stroke patients and the range of motion of knee flexion, and achieve more ideal therapeutic effectiveness.

一种改进Oriented RepPoints的遥感图像有向目标检测

为解决Oriented RepPoints算法在遥感图像有向目标检测中因遥感图像背景干扰信息较多和目标尺度大小不一所导致的检测精度不高、易漏检误检等问题,提出一种改进Oriented RepPoints的遥感图像有向目标检测方法MA-RPDet(Mixed Attention RepPoints Detector).首先,采用了PVTv2作为主干网络,该网络利用线性空间缩减自注意力机制提取出更具局部连续性的特征图,并保持与卷积运算类似的线性复杂度.其次,在特征融合阶段设计了串联性混合注意力模块,进一步强化了重要特征,促进了多尺度特征的高效交互.最后,引入平滑GIoU损失函数对模型学习策略进行优化,提高了检测精度.在两个遥感图像目标检测数据集DOTA和HRSC2016上的实验结果表明,所提方法的检测精度mAP分别达到了77.19%和90.3%,均高于其他对比算法,证明了本文方法的有效性.

基于改进Oriented R-CNN的旋转框麦穗检测与计数模型

为对干扰、遮挡等复杂的田野环境中麦穗进行精准定位与计数,该研究提出了一种改进的Oriented R-CNN麦穗旋转框检测与计数方法,首先在主干网络中引入跨阶段局部空间金字塔(spatial pyramid pooling cross stage partial networks,SPPCSPC)模块扩大模型感受野,增强网络感知能力;其次,在颈网络中结合路径聚合网络(PANet,path aggregation network)和混合注意力机制(E2CBAM,efficient two convolutional block attention module),丰富特征图包含的特征信息;最后采用柔性非极大值抑制算法(Soft-NMS,soft-non maximum suppression)优化预测框筛选过程。试验结果显示,改进的模型对复杂环境中的麦穗检测效果良好。相较原模型,平均精确度均值mAP提高了2.02个百分点,与主流的旋转目标检测模型Gliding vertex、R3det、Rotated Faster R-CNN、S2anet和Rotated Retinanet相比,mAP分别提高了4.99、2.49、3.94、2.25和4.12个百分点。该研究方法利用旋转框准确定位麦穗位置,使得框内背景区域面积大幅度减少,为实际观察麦穗生长状况和统计数量提供了一种有效的方法。

Three-dimensionally oriented organization of hexagonal MIL-96 microplates toward superior film microstructure

Preferential orientation control of metal—organic framework(MOF)films is advantageous for maximizing pore uniformity and minimizing grain-boundary defects.Nonetheless,the preparation of MOF films with both in-plane and out-of-plane orientations remains a grand challenge.In this study,we reported the preparation of three-dimensionally oriented MIL-96 layers through combining morphology control of MIL-96 seeds with addition of polyvinylpyrrolidone surfactants and arachidonic acids.The three-dimensionally oriented MIL-96 film was readily obtained through in-plane epitaxial growth.It is anticipated that the aforementioned protocol can be effective for obtaining diverse MOF films with a three-dimensionally oriented organization.

Oriented Bounding Box Object Detection Model Based on Improved YOLOv8

In the study of oriented bounding boxes(OBB)object detection in high-resolution remote sensing images,the problem of missed and wrong detection of small targets occurs because the targets are too small and have different orientations.Existing OBB object detection for remote sensing images,although making good progress,mainly focuses on directional modeling,while less consideration is given to the size of the object as well as the problem of missed detection.In this study,a method based on improved YOLOv8 was proposed for detecting oriented objects in remote sensing images,which can improve the detection precision of oriented objects in remote sensing images.Firstly,the ResCBAMG module was innovatively designed,which could better extract channel and spatial correlation information.Secondly,the innovative top-down feature fusion layer network structure was proposed in conjunction with the Efficient Channel Attention(ECA)attention module,which helped to capture inter-local cross-channel interaction information appropriately.Finally,we introduced an innovative ResCBAMG module between the different C2f modules and detection heads of the bottom-up feature fusion layer.This innovative structure helped the model to better focus on the target area.The precision and robustness of oriented target detection were also improved.Experimental results on the DOTA-v1.5 dataset showed that the detection Precision,mAP@0.5,and mAP@0.5:0.95 metrics of the improved model are better compared to the original model.This improvement is effective in detecting small targets and complex scenes.

Estimation of cancer cell migration in biomimetic random/oriented collagen fiber microenvironments

Increasing data indicate that cancer cell migration is regulated by extracellular matrixes and their surrounding biochemical microenvironment,playing a crucial role in pathological processes such as tumor invasion and metastasis.However,conventional two-dimensional cell culture and animal models have limitations in studying the influence of tumor microenvironment on cancer cell migration.Fortunately,the further development of microfluidic technology has provided solutions for the study of such questions.We utilize microfluidic chip to build a random collagen fiber microenvironment(RFM)model and an oriented collagen fiber microenvironment(OFM)model that resemble early stage and late stage breast cancer microenvironments,respectively.By combining cell culture,biochemical concentration gradient construction,and microscopic imaging techniques,we investigate the impact of different collagen fiber biochemical microenvironments on the migration of breast cancer MDA-MB-231-RFP cells.The results show that MDA-MB-231-RFP cells migrate further in the OFM model compared to the RFM model,with significant differences observed.Furthermore,we establish concentration gradients of the anticancer drug paclitaxel in both the RFM and OFM models and find that paclitaxel significantly inhibits the migration of MDA-MB-231-RFP cells in the RFM model,with stronger inhibition on the high concentration side compared to the low concentration side.However,the inhibitory effect of paclitaxel on the migration of MDA-MB-231-RFP cells in the OFM model is weak.These findings suggest that the oriented collagen fiber microenvironment resembling the late-stage tumor microenvironment is more favorable for cancer cell migration and that the effectiveness of anticancer drugs is diminished.The RFM and OFM models constructed in this study not only provide a platform for studying the mechanism of cancer development,but also serve as a tool for the initial measurement of drug screening.

An Approach to Detect Structural Development Defects in Object-Oriented Programs

Structural development defects essentially refer to code structure that violates object-oriented design principles. They make program maintenance challenging and deteriorate software quality over time. Various detection approaches, ranging from traditional heuristic algorithms to machine learning methods, are used to identify these defects. Ensemble learning methods have strengthened the detection of these defects. However, existing approaches do not simultaneously exploit the capabilities of extracting relevant features from pre-trained models and the performance of neural networks for the classification task. Therefore, our goal has been to design a model that combines a pre-trained model to extract relevant features from code excerpts through transfer learning and a bagging method with a base estimator, a dense neural network, for defect classification. To achieve this, we composed multiple samples of the same size with replacements from the imbalanced dataset MLCQ1. For all the samples, we used the CodeT5-small variant to extract features and trained a bagging method with the neural network Roberta Classification Head to classify defects based on these features. We then compared this model to RandomForest, one of the ensemble methods that yields good results. Our experiments showed that the number of base estimators to use for bagging depends on the defect to be detected. Next, we observed that it was not necessary to use a data balancing technique with our model when the imbalance rate was 23%. Finally, for blob detection, RandomForest had a median MCC value of 0.36 compared to 0.12 for our method. However, our method was predominant in Long Method detection with a median MCC value of 0.53 compared to 0.42 for RandomForest. These results suggest that the performance of ensemble methods in detecting structural development defects is dependent on specific defects.

Constructing an ion‐oriented channel on a zinc electrode through surface engineering

The inherent shortcomings of a zinc anode in aqueous zinc‐ion batteries(ZIBs)such as zinc dendrites and side reactions severely limit their practical application.Herein,to address these issues,an ion‐oriented transport channel constructed by graphdiyne(GDY)nanowalls is designed and grown in situ on the surface of a zinc electrode.The vertically stacked GDY nanowalls with a unique hierarchical porous structure and mechanical properties form a nanomesh‐like interface on the zinc electrode,acting as an ion‐oriented channel,which can efficiently confine the segmented growth of zinc metal in microscopic regions of hundreds of nanometers.In those microscopic regions,the uniform domain current density is effortlessly maintained compared with a large surface area,thereby inhibiting zinc dendrites effectively.Besides,due to the presence of the ion‐oriented channel,the modified zinc anode demonstrates long‐term stable zinc plating/stripping performance for more than 600 h at 1 mAh cm^(−2)in an aqueous electrolyte.In addition,full‐cells coupled with MnO2 show high specific capacity and power density,as well as excellent cycling stability with a capacity retention of 82%after 5000 cycles at 1 A g^(−1).This work provides a feasible and accessible surface engineering approach to modify the electrode interface for confined and dendrite‐free zinc deposition in aqueous ZIBs.

厄瓜多尔Oriente盆地白垩系Napo组LU亚段沉积模式

厄瓜多尔Oriente盆地北部白垩系Napo组LU亚段地层油气资源极其丰富,具有较大的油气勘探潜力,由于目前对LU亚段地层沉积模式认识不清晰,极大程度上限制了研究区进一步勘探开发。依据LU亚段岩芯观察、测井、成熟度分析以及镜下薄片等资料,通过岩芯岩性、结构等岩石学特征,沉积构造、生物遗迹化石、沉积韵律等沉积学特征,以及测井相标志认为,研究区LU亚段地层发育于潮汐作用为主的海陆过渡环境,并在前人研究基础上提出潮控河口湾与陆棚之间存在过渡带沉积,形成了潮控河口湾-过渡带-陆棚沉积体系,识别出潮汐水道、潮汐砂坝、砂坪、海绿石砂席、混合坪、陆棚泥和灰质滩共7种沉积微相,其中,优势储层相带为潮汐水道和潮汐砂坝,砂坪次之。建立研究区潮控河口湾-过渡带-陆棚沉积模式,以期对Oriente盆地白垩系Napo组油气勘探提供有利的科学依据。

Construction of Oriented Structure in Inner Surface of Small-Diameter Artificial Blood Vessels:A Review

There is an urgent need for small-diameter artificial blood vessels in clinic.Physical,chemical and biological factors should be integrated to avoid thrombosis and intimal hyperplasia after implantation and to promote successful fabrication of small-diameter artificial blood vessels.From a physical perspective,the internal oriented structures of natural blood vessels plays an important role in guiding the directional growth of cells,improving the blood flow environment,and promoting the regeneration of vascular tissue.In this review,the effects of the oriented structures on cells,including endothelial cells(ECs),smooth muscle cells(SMCs)and stem cells,as well as the effect of the oriented structures on hemodynamics and vascular tissue remodeling and regeneration are introduced.Various forms of oriented structures(fibers,grooves,channels,etc.)and their construction methods are also reviewed.Conclusions and future perspectives are given.It is expected to give some references to relevant researches.

Expert consensus on endodontic therapy for patients withsystemic conditions

The overall health condition of patients significantly affects the diagnosis, treatment, and prognosis of endodontic diseases. Asystemic consideration of the patient’s overall health along with oral conditions holds the utmost importance in determining thenecessity and feasibility of endodontic therapy, as well as selecting appropriate therapeutic approaches. This expert consensus is acollaborative effort by specialists from endodontics and clinical physicians across the nation based on the current clinical evidence,aiming to provide general guidance on clinical procedures, improve patient safety and enhance clinical outcomes of endodontictherapy in patients with compromised overall health.

Association of cardiometabolic multimorbidity with all-cause and cardiovascular disease mortality among Chinese hypertensive patients

BACKGROUND Hypertension usually clusters with multiple comorbidities.However,the association between cardiometabolic multimorbidity(CMM)and mortality in hypertensive patients is unclear.This study aimed to investigate the association between CMM and all-cause and cardiovascular disease(CVD)mortality in Chinese patients with hypertension.METHODS The data used in this study were from the China National Survey for Determinants of Detection and Treatment Status of Hypertensive Patients with Multiple Risk Factors(CONSIDER),which comprised 5006 participants aged 19–91 years.CMM was defined as the presence of one or more of the following morbidities:diabetes mellitus,dyslipidemia,chronic kidney disease,coronary heart disease,and stroke.Cox proportional hazard models were used to calculate the hazard ratios(HR)with 95%CI to determine the association between the number of CMMs and both all-cause and CVD mortality.RESULTS Among 5006 participants[mean age:58.6±10.4 years,50%women(2509 participants)],76.4%of participants had at least one comorbidity.The mortality rate was 4.57,4.76,8.48,and 16.04 deaths per 1000 person-years in hypertensive patients without any comorbidity and with one,two,and three or more morbidities,respectively.In the fully adjusted model,hypertensive participants with two cardiometabolic diseases(HR=1.52,95%CI:1.09–2.13)and those with three or more cardiometabolic diseases(HR=2.44,95%CI:1.71–3.48)had a significantly elevated risk of all-cause mortality.The findings were similar for CVD mortality but with a greater increase in risk magnitude.CONCLUSIONS In this study,three-fourths of hypertensive patients had CMM.Clustering with two or more comorbidities was associated with a significant increase in the risk of all-cause and cardiovascular mortality among hypertensive patients,suggesting more intensive treatment and control in this high-risk patient group.

The association between C-reactive protein to albumin ratio and 6-month neurological outcome in patients with in-hospital cardiac arrest

The global incidence rates of in-hospital cardiac arrest(IHCA)range from1.2 to 9.0 per1,000 hospitalized patients,as per the National Cardiac Arrest Database.[1] While IHCAs tend to exhibit superior 30-day survival rates relative to out-of-hospital cardiac arrests (OHCA) due to situational advantages,such as immediate access to medical personnel and treatments.

Multimorbidity and mortality among older patients with coronary heart disease in Shenzhen,China

BACKGROUND The current understanding of the magnitude and consequences of multimorbidity in Chinese older adults with coronary heart disease(CHD)is insufficient.We aimed to assess the association and population-attributable fractions(PAFs)between multimorbidity and mortality among hospitalized older patients who were diagnosed with CHD in Shenzhen,China.METHODS We conducted a retrospective cohort study of older Chinese patients(aged≥65 years)who were diagnosed with CHD.Cox proportional hazards models were used to estimate the associations between multimorbidity and all-cause and cardiovascular disease(CVD)mortality.We also calculated the PAFs.RESULTS The study comprised 76,455 older hospitalized patients who were diagnosed with CHD between January 1,2016,and August 31,2022.Among them,70,217(91.9%)had multimorbidity,defined as the presence of at least one of the predefined 14 chronic conditions.Those with cancer,hemorrhagic stroke and chronic liver disease had the worst overall death risk,with adjusted HRs(95%CIs)of 4.05(3.77,4.38),2.22(1.94,2.53),and 1.85(1.63,2.11),respectively.For CVD mortality,the highest risk was observed for hemorrhagic stroke,ischemic stroke,and chronic kidney disease;the corresponding adjusted HRs(95%CIs)were 3.24(2.77,3.79),1.91(1.79,2.04),and 1.81(1.64,1.99),respectively.All-cause mortality was mostly attributable to cancer,heart failure and ischemic stroke,with PAFs of 11.8,10.2,and 9.1,respectively.As for CVD mortality,the leading PAFs were heart failure,ischemic stroke and diabetes;the corresponding PAFs were 18.0,15.7,and 6.1,respectively.CONCLUSIONS Multimorbidity was common and had a significant impact on mortality among older patients with CHD in Shenzhen,China.Cancer,heart failure,ischemic stroke and diabetes are the primary contributors to PAFs.Therefore,prioritizing improved treatment and management of these comorbidities is essential for the survival prognosis of CHD patients from a holistic public health perspective.

Refining safety considerations for intradialytic blood flow restriction exercise. Commentary on “Concerns on the application of blood-flow restriction resistance exercise and thrombosis risk in hemodialysis patients”

I read with great interest the article“Concerns on the application of blood flow restriction resistance exercise and thrombosis risk in hemodialysis patients”by Correa et al.1 The study presents complementary data from a previous randomized controlled trial,2 exploring the application of intradialytic blood flow restriction exercise for hemodialysis patients.

Virtual reality for preoperative patient education: Impact on satisfaction, usability, and burnout from the perspective of new nurses

BACKGROUND Traditional paper-based preoperative patient education is a struggle for new nurses and requires extensive training.In this situation,virtual reality technology can help the new nurses.Despite its potential benefits,there are studies on patient satisfaction but there is limited information on the usability of virtual reality(VR)technology for new nurses in giving preoperative education to patients.AIM To investigate the impact on satisfaction,usability,and burnout of a system using VR technology in preoperative patient education.METHODS The study involved 20 nurses from the plastic surgery ward and 80 patients admitted between April and May 2019.Each nurse taught four patients:Two using traditional verbal education and two using virtual reality.The System Usability Scale,After-Scenario Questionnaire,and Maslach Burnout Inventory(MBI)were employed to evaluate the impact of these education methods.RESULTS The VR education groups showed a statistically higher satisfaction than the traditional verbal education groups.Among the three subscales of the MBI,emotional exhaustion and personal accomplishment improved statistically significantly.VR was also better in terms of usability.CONCLUSION This study suggests VR enhances usability and reduces burnout in nurses,but further research is needed to assess its impact on depersonalization and objective measures like stress and heart rate.

Predictive modeling for postoperative delirium in elderly patients with abdominal malignancies using synthetic minority oversampling technique

BACKGROUND Postoperative delirium,particularly prevalent in elderly patients after abdominal cancer surgery,presents significant challenges in clinical management.AIM To develop a synthetic minority oversampling technique(SMOTE)-based model for predicting postoperative delirium in elderly abdominal cancer patients.METHODS In this retrospective cohort study,we analyzed data from 611 elderly patients who underwent abdominal malignant tumor surgery at our hospital between September 2020 and October 2022.The incidence of postoperative delirium was recorded for 7 d post-surgery.Patients were divided into delirium and non-delirium groups based on the occurrence of postoperative delirium or not.A multivariate logistic regression model was used to identify risk factors and develop a predictive model for postoperative delirium.The SMOTE technique was applied to enhance the model by oversampling the delirium cases.The model’s predictive accuracy was then validated.RESULTS In our study involving 611 elderly patients with abdominal malignant tumors,multivariate logistic regression analysis identified significant risk factors for postoperative delirium.These included the Charlson comorbidity index,American Society of Anesthesiologists classification,history of cerebrovascular disease,surgical duration,perioperative blood transfusion,and postoperative pain score.The incidence rate of postoperative delirium in our study was 22.91%.The original predictive model(P1)exhibited an area under the receiver operating characteristic curve of 0.862.In comparison,the SMOTE-based logistic early warning model(P2),which utilized the SMOTE oversampling algorithm,showed a slightly lower but comparable area under the curve of 0.856,suggesting no significant difference in performance between the two predictive approaches.CONCLUSION This study confirms that the SMOTE-enhanced predictive model for postoperative delirium in elderly abdominal tumor patients shows performance equivalent to that of traditional methods,effectively addressing data imbalance.

Patient satisfaction and follow-up adherence to glaucoma case management clinic in China

AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.

Depression and anxiety among cancer patients visiting a tertiary care cancer hospital

BACKGROUND Cancer patients frequently experience psychological problems related to reactions to cancer diagnosis,cancer type and stage,treatment effects,recurrence,fear of end-of-life,survivorship,and financial burden.Depression and anxiety are both psychological and physiological disturbances among cancer patients.AIM To assess the prevalence of depression and anxiety among cancer patients attending a tertiary care cancer hospital.METHODS A cross-sectional study was conducted at Bhaktapur Cancer Hospital in Kathmandu Valley among 220 cancer patients aged from 18 years to 70 years.Ethical approval was taken from the Institutional Review Committee of CiST College.Convenient sampling was used to interview patients with the standardized Patient-Health Questionnaire(PHQ-9)for Depression and Hospital Anxiety and Depression sub-scale(HADS-A)for anxiety.Epi-Data was used for data entry and transferred to SPSS Version 25 for analysis.RESULTS The study revealed that of 220 patients,most of the respondents belonged to the age group 51-60 years.More than half 131(59.6%)of the respondents were female,most of them had depression,and one-third had anxiety.Among the respondents,124(56.4%)had mild depression,70(31.8%)had moderate depression,and 3(1.3%)had severe depression;79(35.9%)had mild anxiety,64(29.1%)had moderate anxiety,and 4(1.8%)had severe anxiety.CONCLUSION Most respondents were depressed and one-third had anxiety.More than half and nearly one-third had mild and moderate depression,respectively,and nearly one-third had mild and moderate anxiety,which is higher than other studies.