Analysis of the disease entities and typical characteristics of day surgery based on three Public Tertiary A hospitals in China

Background:In recent years,day surgery has gained widespread attention in the medical industry.This thesis focuses on three tertiary general hospitals in different regions in China where day surgery has been carried out earlier,is more developed,has a more comprehensive range of day surgery procedures,and has an annual volume of 10,000 or more day surgery cases.The study will provide hands-on experience for other medical institutions to carry out day surgery.Methods:67,337 valid items of data were retrieved from the Hospital Information Systems of the three hospitals.In this thesis,descriptive analysis was carried out on basic information about day surgery patients,including composition of patients’major diseases,hospitalization costs.Non-parametric tests were used to compare the data in each group,the median and interquartile range were used to show the trend in the concentration of the relevant indicators.The difference was considered statistically significant at P<0.05.Results:The largest proportion of day surgery patients were between the ages of 51 and 70.About 57.30%of day surgery patients paid for their medical care with the basic medical insurance of urban employees.Senile cataract,benign breast tumor,and endometrial polyp were the top three major diagnoses of day surgery patients.The average inpatient expenditure for day surgery patients was 8982.10 yuan,with consumables cost representing the highest proportion at approximately 46.01%of the total hospitalization cost,followed by treatment cost at around 31.01%of the total cost.Conclusions:Day surgery is more suitable for middle-aged patients and may not be the best choice for children and elderly patients over 80 years old.Most day surgery cases are elective surgeries for non-emergency situations.The distribution of day surgery patients is primarily concentrated in ophthalmic,breast,and reproductive system diseases,although each hospital has its own unique characteristics.The development of day surgery presents both economic and social benefits.

Seasonal Prediction of Extreme High-Temperature Days in Southwestern China Based on the Physical Precursors

Extreme high temperatures frequently occur in southwestern China,significantly impacting the local ecological system and economic development.However,accurate prediction of extreme high-temperature days(EHDs)in this region is still an unresolved challenge.Based on the spatiotemporal characteristics of EHDs over China,a domain-averaged EHD index over southwestern China(SWC-EHDs)during April-May is defined.The simultaneous dynamic and thermodynamic fields associated with the increased SWC-EHDs are a local upper-level anticyclonic(high-pressure)anomaly and wavy geopotential height anomaly patterns over Eurasia.In tracing the origins of the lower boundary anomalies,two physically meaningful precursors are detected for SWC-EHDs.They are the tripolar SST change tendency from December-January to February-March in the northern Atlantic and the February-March mean snow depth in central Asia.Using these two selected predictors,a physics-based empirical model prediction was applied to the training period of 1961–2005 to obtain a skillful prediction of the EHDs index,attaining a correlation coefficient of 0.76 in the independent prediction period(2006–19),suggesting that 58%of the total SWC-EHDs variability is predictable.This study provides an estimate for the lower bound of the seasonal predictability of EHDs as well as for the hydrological drought over southwestern China.

Pregnancy Outcomes for Day 5 Versus Day 6 Single Frozen-thawed Blastocyst Transfer with Different Qualities of Embryos: A Large Matched-cohort Study

Objective This study aimed to determine whether the day of blastocyst expansion affects pregnancy outcomes in frozen-thawed blastocyst transfer(FBT)cycles.Methods A retrospective match-cohort study was conducted.Patients who underwent blastocyst transfer in frozen-thawed cycles at day 5 or 6 were matched for potential confounding factors.A total of 2207 matched pairs of FBT cycles were included from January 2016 to December 2019 in our Reproductive Medicine Center.Results The clinical pregnancy rate(CPR)and live birth rate(LBR)were significantly increased in day 5 blastocyst transfers when compared to day 6 blastocyst transfers,in terms of the same embryo quality.For FBT cycles with good-quality embryo,the CPR at day 5 and 6 was 61.30%and 57.56%,respectively(P=0.045),and the LBR was 44.79%and 36.16%,respectively(P<0.001).For FBT cycles with poor-quality embryo,the CPR at day 5 and 6 was 48.61%and 40.89%,respectively(P=0.006),and the LBR was 31.71%and 25.74%,respectively(P=0.019).The CPR for FBT cycles with good-quality embryo was statistically higher at day 6 than that at day 5 with poor-quality embryo transferred(57.56%vs.48.61%,P=0.001).Maternal age,anti-Müllerian hormone(AMH),endometrial thickness,embryo quality,and the day of blastocyst expansion were independently correlated with the CPR and LBR.The FBT cycles at day 5 had significantly higher CPR(adjusted odds ratio[OR]=1.246,95%confidence intervals[CI]:1.097–1.415,P=0.001)and LBR(adjusted OR=1.435,95%CI:1.258–1.637,P<0.001)than those at day 6.Conclusion The embryo quality is the primary indicator for FBT cycles.Day 5 blastocysts should be preferred when the quality of embryo at day 5 is the same as that at day 6.

Hybrid model based on K-means++ algorithm, optimal similar day approach, and long short-term memory neural network for short-term photovoltaic power prediction

Photovoltaic(PV) power generation is characterized by randomness and intermittency due to weather changes.Consequently, large-scale PV power connections to the grid can threaten the stable operation of the power system. An effective method to resolve this problem is to accurately predict PV power. In this study, an innovative short-term hybrid prediction model(i.e., HKSL) of PV power is established. The model combines K-means++, optimal similar day approach,and long short-term memory(LSTM) network. Historical power data and meteorological factors are utilized. This model searches for the best similar day based on the results of classifying weather types. Then, the data of similar day are inputted into the LSTM network to predict PV power. The validity of the hybrid model is verified based on the datasets from a PV power station in Shandong Province, China. Four evaluation indices, mean absolute error, root mean square error(RMSE),normalized RMSE, and mean absolute deviation, are employed to assess the performance of the HKSL model. The RMSE of the proposed model compared with those of Elman, LSTM, HSE(hybrid model combining similar day approach and Elman), HSL(hybrid model combining similar day approach and LSTM), and HKSE(hybrid model combining K-means++,similar day approach, and LSTM) decreases by 66.73%, 70.22%, 65.59%, 70.51%, and 18.40%, respectively. This proves the reliability and excellent performance of the proposed hybrid model in predicting power.

Load-forecasting method for IES based on LSTM and dynamic similar days with multi-features

To fully exploit the rich characteristic variation laws of an integrated energy system(IES)and further improve the short-term load-forecasting accuracy,a load-forecasting method is proposed for an IES based on LSTM and dynamic similar days with multi-features.Feature expansion was performed to construct a comprehensive load day covering the load and meteorological information with coarse and fine time granularity,far and near time periods.The Gaussian mixture model(GMM)was used to divide the scene of the comprehensive load day,and gray correlation analysis was used to match the scene with the coarse time granularity characteristics of the day to be forecasted.Five typical days with the highest correlation with the day to be predicted in the scene were selected to construct a“dynamic similar day”by weighting.The key features of adjacent days and dynamic similar days were used to forecast multi-loads with fine time granularity using LSTM.Comparing the static features as input and the selection method of similar days based on non-extended single features,the effectiveness of the proposed prediction method was verified.

Impacts of Sea Surface Temperature on the Interannual Variability of Winter Haze Days in Guangdong Province

The impact of sea surface temperature(SST)on winter haze in Guangdong province(WHDGD)was analyzed on the interannual scale.It was pointed out that the northern Indian Ocean and the northwest Pacific SST play a leading role in the variation of WHDGD.Cold(warm)SST anomalies over the northern Indian Ocean and the Northwest Pacific stimulate the eastward propagation of cold(warm)Kelvin waves through the Gill forced response,causing Ekman convergence(divergence)in the western Pacific,inducing abnormal cyclonic(anticyclonic)circulation.It excites the positive(negative)Western Pacific teleconnection pattern(WP),which results in the temperature and the precipitation decrease(increase)in Guangdong and forms the meteorological variables conditions that are conducive(not conducive)to the formation of haze.ENSO has an asymmetric influence on WHDGD.In El Niño(La Niña)winters,there are strong(weak)coordinated variations between the northern Indian Ocean,the northwest Pacific,and the eastern Pacific,which stimulate the negative(positive)phase of WP teleconnection.In El Niño winters,the enhanced moisture is attributed to the joint effects of the horizontal advection from the surrounding ocean,vertical advection from the moisture convergence,and the increased atmospheric apparent moisture sink(Q2)from soil evaporation.The weakening of the atmospheric apparent heat source(Q1)in the upper layer is not conducive to the formation of inversion stratification.In contrast,in La Niña winters,the reduced moisture is attributed to the reduced upward water vapor transport and Q2 loss.Due to the Q1 increase in the upper layer,the temperature inversion forms and suppresses the diffusion of haze.

Interannual Variation and Statistical Prediction of Summer Dry and Hot Days in South China from 1970 to 2018

The frequent occurrence of dry and hot(DH)days in South China in summer has a negative impact on social development and human health.This study explored the variation characteristics of DH days and the possible reasons for this knotty problem.The findings revealed a notable increase in the number of DH days across most stations,indicating a significant upward trend.Additionally,DH events were observed to occur frequently.The number of DH days increased during 1970-1990,decreased from 1991 to 1997,and stayed stable after 1997.The key climate factors affecting the interannual variability of the number of DH days were the Indian Ocean Basin warming(IOBW)in spring and the East Asian Summer Monsoon(EASM).Compared with the negative phase of IOBW,in the positive phase of IOBW,500 hPa and 850 hPa geopotential height enhanced,the West Pacific subtropical high strengthened and extended abnormally to the west,more solar radiation reached the surface,surface outgoing longwave radiation increased,and there was an anomalous anticyclone in eastern South China.The atmospheric circulation characteristics of the positive and negative phases of ESAM were opposite to those of IOBW,and the abnormal circulation of the positive(negative)phases of ESAM was unfavorable(favorable)for the increase in the number of DH days.A long-term prediction model for the number of summer DH days was established using multiple linear regression,incorporating the key climate factors.The correlation coefficient between the observed and predicted number of DH days was 0.65,and the root-mean-square error was 2.8.In addition,independent forecasts for 2019 showed a deviation of just 1 day.The results of the independent recovery test confirmed the stability of the model,providing evidence that climatic factors did have an impact on DH days in South China.

Explore the clinical nursing path of daytime laparoscopic cholecystectomy under the guidance of enhanced recovery after surgery

Objective:To explore the safety and effectiveness nursing of 12 h discharged daytime laparoscopic cholecystectomy guided by enhanced recovery after surgery(ERAS)concept.Methods:Included 180 cases from the 12 h discharged daytime laparoscopic cholecystectomy patients which assessmended and guided by ERAS,with the 180 case of routine cholecystectomy patients as control group at the same time.To quantitatively analyze the related indexes of perioperative period and ERAS concept,and evaluate the clinical safety,and effectiveness.Results:It displayed no significant differences in average age,gender distribution,duration of gallbladder related disease and distribution of clinical symptoms between the two groups(P>0.05).There were also no significant differences in preoperative smoking history,hypertension history,cardio-cerebrovascular history,abdominal operation history and disease composition ratio between the two groups(P>0.05).None of the patients had conversion to laparotomy.Compared with the conventional surgery group,there were no significant differences in the average amount of intraoperative blood loss,operation time and muscle strength before returning to the ward in patients with ERAS guided day surgery(P>0.05).When compared with the conventional surgery group,ERAS guided day surgery group had no significant difference in muscle strength between the two groups when going under the ground(t=1.64,P=0.082).Also,the level of peripheral white blood cells in patients with ERAS guided day surgery group was not significantly increased at 6 h after surgery.Meanwhile,liver function related indexes,transaminase,total bilirubin,indirect bilirubin were not significantly abnormal(P>0.05).Conclusion:12 h daytime laparoscopic cholecystectomy guided by ERAS concept can improve the clinical efficacy of patients with cholecystolithiasis,which is safe and feasible.

A 365-Day Record of Maternal Admissions in Intensive Care Unit at the University of Port Harcourt Teaching Hospital in Nigeria

BACKGROUND. The intensive care unit provides critically ill patients with the necessary monitoring, care and supports to optimize their organ/system functions. Parturients are often at risk of sudden deteriorations or exacerbation of chronic illnesses from direct or indirect causes and would often require admissions into the intensive care or high dependency unit. This study is aimed at looking at the trends of maternal admissions in 365 days at the intensive care unit of a tertiary teaching hospital in Southern part of Nigeria, a country that contributes significantly to the global proportion of maternal morbidity and mortality. METHODS. The study adopted a retrospective approach. All critically ill parturients admitted and requiring organ support or close monitoring in the ICU had their files and ICU documents reviewed. The review was held from January-December 2018. RESULTS. Thirty-nine (39) parturients with a mean age (years) of 33 ± 1.3 were admitted, representing 2.9% of annual deliveries. All admissions were postnatal and came predominantly from the unbooked labour ward (51%) and the time lag from maternal deteriorations to presentation to the ICU was 72 ± 10 hours. The main indications for admissions were due to postpartum haemorrhage (33.3%), complications of hypertensive disorders of pregnancy (30.9%) and sepsis (25.6%). Nineteen (48.7%) patients died from obstetric haemorrhage, complications of hypertensive disorders of pregnancy, sepsis and pulmonary embolism. CONCLUSION. The trend of maternal admissions at this specific time frame reflects the burden of maternal critical care in our environment. It highlights the need to holistically tackle the known scourge with improved care.

Causes and Effects of Stillbirths on Days Open and Cow Herd Survival in Holstein Friesian Cows

The aim of this retrospective study was to investigate the causes and the effects of stillbirth on the number of days open and cow herd survival in subsequent lactation of Holstein Friesian cows. A total of 1371 calvings from research dairy farm were used. Stillbirth in calves was defined as the death of a fetus before or during calving at full term (≥270 days of gestation) or within 24 hours after calving. During the period from January 2006 to December 2017 a percent of 95.04% of the calvings were with live calves, and 4.96% of the calvings were stillbirths. The major causes of stillbirth identified were: calving difficulty, parity of the cows, and sex of the calves at calving. A five point scale was used to assess calving difficulties, and numbers 1, 2 and 3 were considered unassisted calvings and number 4 and 5 as assisted. The twin calvings were not taken into account. Days open were measured as days from first calving to conception, and cow herd survival from first calving to culling or death. Trend test and multivariate data analysis were used. The findings revealed that primiparous cows were at higher risk of having stillbirths compared with multiparous cows. Cows that were at calving male calves were at higher risk of having stillbirths compared with cows that had female calves at calving. Also, cows with assisted calving were at higher risk of having stillbirths compared with cows with unassisted calvings. Cows with stillbirths had a increase mean of days open with 32 days. Cow herd survival was better in the cows with live calves at calving compared with the cows that had stillbirth at calvings.

International Children's Day Activity for Chinese and Lao Students Launched at Xishuangbanna

Jointly sponsored by the China Charity Federation and the Ministry of Education and Sports of Laos,the sixth"Belt and Road,People-to-People Bonds"Student's Hand-inHand Activity and the International Children's Day Activity for Chinese and Lao Students was launched in Xishuangbanna on May 24.

Effect of Temperature on Frost-Free Days and Length of Crop Growing Season across Southern Ontario

Climate change has an impact on various climatic variables. In this study our focus is mainly on temperature characteristics of climate parameter. In temperate and humid regions like southern Ontario, the effect of climate change on Frost-free days in winter is distinctive. The average annual temperature is going upward but the extreme increase is in the winter temperature. Winter average temperature is going up by about 2˚C. However, extreme daily minimum temperature is going up by more than 3˚C. This climate effect has a great impact on the nature of precipitation and length of frost-free days. The snowfall over winter months is decreasing and the rainfall is increasing. However, the number of frost-free days during late fall months, early winter months, late winter months and early spring months are increasing. This result reveals an increase in length of the growing season. This research focuses on the effect of change in climatic variables on Frost-free days in Southern Ontario. Therefore, special attention should be given to the effect of change in climate Frost-free conditions on length of crop growing in winter season for potential investigation.

Stevens’s Ethical Identity Dilemma in The Remains of the Day

Based on ethical literary criticism,this paper aims to analyze the factors contributing to Stevens’loss of ethical identity.It contends that distorted ethical relationships are the primary driver behind Stevens’s ethical identity dilemma,which includes the abnormal father-son relationship,Stevens’s blind admiration for his master,and his avoidance of Miss Kenton’s feelings.

April Fools’ Day

When I was at school,April Fools’Day was always good fun.We played tricks on each other and sometimes on the teacher.

Tomorrow Is Another Day

Several days ago,I had a fever.I had a headache.And I also had a cough.I thought I would die.What’s wrong with me’?I was suffering from COVID-19.I thought COVID-19 was far away from me before.But when I had it,I felt so anxious.I didn’t know what I should do.I didn’t want to study.I didn’t want to speak.

Happy Mother's Day!

The month of May starts with the letter M.There's another word that also starts with the letter M,and there is a special day for her in the month of May.Do you know what this special day is?It's Mother's Day!

Application of Whole-Process Management in Day Surgery for Endometrial Polyp

Objective:To explore the effect of whole-process management model in nursing management of endometrial polyp day surgery.Methods:266 patients that underwent endometrial polyp day surgery from January to December 2022 were selected for this study,and they were separated into an observation group(131 patients)and a control group(135 patients);the clinical data of the two groups were compared.Results:After intervention,the scores of Hamilton Anxiety Scale(HAM-A)of the patients in the observation group were lower than those in the control group(P<0.05).The rate of postoperative complications in the observation group was lower than that in the control group(P<0.05),and the satisfaction degree of the patients in the observation group was higher than that in the control group(P<0.05).Conclusion:The application of the whole-course management model in endometrial polyp day surgery can alleviate patients’anxiety,ensure the quality and safety of day surgery nursing,and improve patients’satisfaction.

Valentine’s Day

Every February,across the country,candy,flowers,and gifts are exchanged between loved ones,all in the name of St.Valentine.But who is thismysterious saint and why do we celebrate thisholiday?

Father’s Day

Father’s Day comes on the third Sunday in June.It is not a national holiday. On that day, Americanshonour their fathers. Many people send their fathers acard or a gift. Americans are great letter-writers. Whatever happensin a family, you congratulate all the members. Youcongratulate people at Easter, Christmas and Whit-

Boxing Day的由来

在英国的法定假日(Bank holiday或Leyal holiday)里,Boxing Day(节礼日)是一年中的最后一个假日。通常在圣诞节(12月25日)之后的一天,但不绝对是12月26日,根据英美字典解释Boxiny Day,是圣诞节之后的第一个weekday(工作日)。如1988年12月26日恰好是Monday(星期一),这天便是Boxing Day.而1993年12月26日和1999年12月26日是Sunday(星期日),因此,这两年的Boxing Day便是12月27日了。根据英国古者的习俗,在Boxing Day 这天是人们向雇员和服务人员(如:邮递员,送奶工等)