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.

Analysis of the interaction between bolt-reinforced rock and surface support in tunnels based on convergence-confinement method

To investigate the interaction of the bolt-reinforced rock and the surface support,an analytical model of the convergence-confinement type is proposed,considering the sequential installation of the fully grouted rockbolts and the surface support.The rock mass is assumed to be elastic-brittle-plastic material,obeying the linear Mohr-Coulomb criterion or the non-linear Hoek-Brown criterion.According to the strain states of the tunnel wall at bolt and surface support installation and the relative magnitude between the bolt length and the plastic depth during the whole process,six cases are categorized upon solving the problem.Each case is divided into three stages due to the different effects of the active rockbolts and the passive surface support.The fictitious pressure is introduced to quantify the threedimensional(3D)effect of the tunnel face,and thus,the actual physical location along the tunnel axis of the analytical section can be considered.By using the bolt-rock strain compatibility and the rocksurface support displacement compatibility conditions,the solutions of longitudinal tunnel displacement and the reaction pressure of surface support along the tunnel axis are obtained.The proposed analytical solutions are validated by a series of 3D numerical simulations.Extensive parametric studies are conducted to examine the effect of the typical parameters of rockbolts and surface support on the tunnel displacement and the reaction pressure of the surface support under different rock conditions.The results show that the rockbolts are more effective in controlling the tunnel displacement than the surface support,which should be installed as soon as possible with a suitable length.For tunnels excavated in weak rocks or with restricted displacement control requirements,the surface support should also be installed or closed timely with a certain stiffness.The proposed method provides a convenient alternative approach for the optimization of rockbolts and surface support at the preliminary stage of tunnel design.

Stability analysis of longwall top-coal caving face in extra-thick coal seams based on an innovative numerical hydraulic support model

The relationship between support and surrounding rock is of great significance to the control of surrounding rock in mining process.In view of the fact that most of the existing numerical simulation methods construct virtual elements and stress servo control to approximately replace the hydraulic support problem,this paper establishes a new numerical model of hydraulic support with the same working characteristics as the actual hydraulic support by integrating numerical simulation software Rhino,Griddle and FLAC3D,which can realize the simulation of different working conditions.Based on this model,the influence mechanism of the supporting strength of hydraulic support on surrounding rock stress regulation and coal stability in front of the top coal caving face in extra thick coal seam were researched.Firstly,under different support intensity,the abutment pressure of the bearing coal and the coal in front of it presents the “three-stage”evolution characteristics.The influence range of support intensity is 15%–30%.Secondly,1.5 MPa is the upper limit of impact that the support strength can have on the front coal failure area.Thirdly,within a displacement range of 2.76 m from the coal wall,a support strength of1.5 MPa provides optimal control of the horizontal displacement of the coal.

Loss to Specialized Cardiology Follow-Up in Adults Living with Congenital Heart Disease

Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a successful transition.This is critical too,as patients lost to specialised care are more likely to experience mor-bidity and premature mortality.Aims:To understand the prevalence and reasons for loss to follow-up(LTF)at a large Australian Adult Congenital Heart Disease(ACHD)centre.Methods:Patients with moderate or highly complex CHD and gaps in care of>3 years(defined as LTF)were identified from a comprehensive ACHD data-base.Structured telephone interviews examined current care and barriers to clinic attendance.Results:Overall,407(22%)of ACHD patients(n=1842)were LTF.The mean age at LTF was 31(SD 11.5)years and 54%were male;311(76%)were uncontactable.Compared to adults seen regularly,lost patients were younger,with a greater socio-economic disadvantage,and had less complex CHD(p<0.05 for all).We interviewed 59 patients(14%).The top 3 responses for care absences were“feeling well”(61%),losing track of time(36%),and not needing fol-low-up care(25%).Conclusions:A large proportion of the ACHD population becomes lost to specialised cardiac care,even after a successful transition.This Australian study reports younger age,moderate complexity defects,and socio-economic disadvantage as predictive of loss to follow-up.This study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.

Essential role of postoperative follow-up in the management of clear cell sarcoma

Clear cell sarcoma(CCS)is a rare melanocytic soft tissue sarcoma known for itspropensity to metastasize to the lymph nodes and typically has an unfavorableprognosis.Currently,surgical resection is the primary treatment for localizedCCS,while radiotherapy and chemotherapy are preferred for metastatic cases.The roles of adjuvant chemotherapy,radiotherapy,and lymph node dissection arecontroversial.Although immunotherapy has emerged as a promising avenue inCCS treatment research,there are no established clinical standards for postoperativefollow-up.This editorial discusses a recent article by Liu et al,with afocus on current diagnostic modalities,treatment approaches,and the challengingprognosis associated with CCS.Our aim is to underscore the importance of longtermpatient follow-up in CCS management.

Long-term assessment of collagenase treatment for Dupuytren’s contracture:A 10-year follow-up study

BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.AIM To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with DC.METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic reevaluation.The study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years post-surgery.RESULTS Thirty-seven patients completed the 10-year follow-up.At 10 years,patients treated at the PIP joint exhibited a 100%recurrence.However,patients treated at the MCP joint only showed a 50%recurrence.Patient satisfaction varied,with a lower satisfaction reported in PIP joint cases.Recurrence exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained efficacy.Significant differences were noted between outcomes at the 7-year and 10-year intervals.CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint.However,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction.Re-intervention is needed within a decade of treatment.

Aqueous-phase reforming of hydroxyacetone solution to bio-based H_(2)over supported Pt catalysts

Aqueous-phase reforming(APR)is an attractive process to produce bio-based hydrogen from waste biomass streams,during which the catalyst stability is often challenged due to the harsh reaction conditions.In this work,three Pt-based catalysts supported on C,AlO(OH),and ZrO_(2)were investigated for the APR of hydroxyacetone solution in afixed bed reactor at 225℃and 35 bar.Among them,the Pt/C catalyst showed the highest turnover frequency for H_(2)production(TOF of 8.9 molH_(2)molPt^(-1)min^(-1))and the longest catalyst stability.Over the AlO(OH)and ZrO_(2)supported Pt catalysts,the side reactions consuming H_(2),formation of coke,and Pt sintering result in a low H_(2)production and the fast catalyst deactivation.The proposed reaction pathways suggest that a promising APR catalyst should reform all oxygenates in the aqueous phase,minimize the hydrogenation of the oxygenates,maximize the WGS reaction,and inhibit the condensation and coking reactions for maximizing the hydrogen yield and a stable catalytic performance.

Critical role of carbon support in metal nanoaggregate facilitating Fe-N-C catalyst for PEM fuel cell application

Metal nanoaggregates can simultaneously enhance the activity and stability of Fe-N-C catalysts in proton-exchange-membrane fuel cells(PEMFC).Previous studies on the relevant mechanism have focused on the direct interaction between FeN_(4)active sites and metal nanoaggregates.However,the role of carbon support that hosts metal nanoaggregates and active sites has been overlooked.Here,a Fe-N-C catalyst encapsulating inactive gold nanoparticles is prepared as a model catalyst to investigate the electronic tuning of Au nanoparticles(NPs)towards the carbon support.Au NPs donate electrons to carbon support,making it rich inπelectrons,which reduces the work function and regulates the electronic configuration of the FeN_(4)sites for an enhanced ORR activity.Meanwhile,the electron-rich carbon support can mitigate the electron depletion of FeN_(4)sites caused by carbon support oxidation,thereby preserving its high activity.The yield and accumulation of H_(2)O_(2)are thus alleviated,which delays the oxidation of the catalyst and benefits the stability.Due to the electron-rich carbon support,the composite catalyst achieves a top-level peak power density of 0.74 W/cm^(2) in a 1.5 bar H_(2)-air PEMFC,as well as the improved stability.This work elucidates the key role of carbon support in the performance enhancement of the FeN-C/metal nanoaggregate composite catalysts for fuel cell application.

Mechanism of high-preload support based on the NPR anchor cable in layered soft rock tunnels

The control of large deformation problems in layered soft rock tunnels needs to solve urgently.The roof problem is particularly severe among the deformation issues in tunnels.This study first analyzes the asymmetric deformation modes in layered soft rock tunnels with large deformations.Subsequently,we construct a mechanical model under ideal conditions for controlling the roof of layered soft rock tunnels through high preload with the support of NPR anchor cables.The prominent roles of long and short NPR anchor cables in the support system are also analyzed.The results indicate the significance of high preload in controlling the roof of layered soft rock tunnels.The short NPR anchor cables effectively improve the integrity of the stratified soft rock layers,while the long NPR anchor cables effectively mobilize the self-bearing capacity of deep-stable rock layers.Finally,the high-preload support method with NPR anchor cables is validated to have a good effect on controlling large deformations in layered soft rock tunnels through field monitoring data.

Research on the flow stability and noise reduction characteristics of quasi-periodic elastic support skin

To enhance flow stability and reduce hydrodynamic noise caused by fluctuating pressure,a quasiperiodic elastic support skin composed of flexible walls and elastic support elements is proposed for fluid noise reduction.The arrangement of the elastic support element is determined by the equivalent periodic distance and quasi-periodic coefficient.In this paper,a dynamic model of skin in a fluid environment is established.The influence of equivalent periodic distance and quasi-periodic coefficient on flow stability is investigated.The results suggest that arranging the elastic support elements in accordance with the quasi-periodic law can effectively enhance flow stability.Meanwhile,the hydrodynamic noise calculation results demonstrate that the skin exhibits excellent noise reduction performance,with reductions of 10 dB in the streamwise direction,11 dB in the spanwise direction,and 10 dB in the normal direction.The results also demonstrate that the stability analysis method can serve as a diagnostic tool for flow fields and guide the design of noise reduction structures.

The Support Systems and Coping Strategies of Infertile Women Attending the Out-Patient Consultation Unit of CHRACERH Yaoundé, Cameroon: A Cross-Sectional Study

Background: Infertility is a complex disorder with significant psycho-social and economic consequences. It globally affects 10% - 15% of couples. In Cameroon, little is known about what women do to overcome the psychosocial aspects of the disease. Objectives: This study aimed to identify the support systems and coping strategies of infertile women attending the outpatient consultation unit of the Gynaecological Endoscopic Surgery and Reproductive Teaching Hospital (CHRACERH), Yaoundé, Cameroon. Methods: A hospital-based cross-sectional study was conducted from the 14th of March to the 6th of April 2023 at CHRACERH Yaoundé. A total of 190 participants were recruited using a convenience sampling method. Data regarding socio-demographic characteristics, support systems and coping strategies were collected using a pretested questionnaire. Descriptive and analytic statistics were conducted using SPSS version 25. Results: The mean age of participants was 39.52 ± 7.64 years. The majority 78.9% of participants were workers (public, private sector, or traders) and were Christians 95.8%. The most common source of psychological support was from family 76.8 and husbands 72.63%. Most of the participants 89.5% resorted to prayer and getting busy 48.4% as a coping strategy. There was no statistically significant relationship between coping strategies and psychological disorders p > 0.05. Conclusion: The main support system of participants was family, husband, and friends. Prayer, getting busy and adoption were the most common coping strategies. There is a need for the Ministry of Public Health and other stakeholders to put in place other support systems and coping strategies (FELICIA) used elsewhere and provide adequate health education and infection control to prevent infertility in Cameroon.

Improved Twin Support Vector Machine Algorithm and Applications in Classification Problems

The distribution of data has a significant impact on the results of classification.When the distribution of one class is insignificant compared to the distribution of another class,data imbalance occurs.This will result in rising outlier values and noise.Therefore,the speed and performance of classification could be greatly affected.Given the above problems,this paper starts with the motivation and mathematical representing of classification,puts forward a new classification method based on the relationship between different classification formulations.Combined with the vector characteristics of the actual problem and the choice of matrix characteristics,we firstly analyze the orderly regression to introduce slack variables to solve the constraint problem of the lone point.Then we introduce the fuzzy factors to solve the problem of the gap between the isolated points on the basis of the support vector machine.We introduce the cost control to solve the problem of sample skew.Finally,based on the bi-boundary support vector machine,a twostep weight setting twin classifier is constructed.This can help to identify multitasks with feature-selected patterns without the need for additional optimizers,which solves the problem of large-scale classification that can’t deal effectively with the very low category distribution gap.

Differentially Private Support Vector Machines with Knowledge Aggregation

With the widespread data collection and processing,privacy-preserving machine learning has become increasingly important in addressing privacy risks related to individuals.Support vector machine(SVM)is one of the most elementary learning models of machine learning.Privacy issues surrounding SVM classifier training have attracted increasing attention.In this paper,we investigate Differential Privacy-compliant Federated Machine Learning with Dimensionality Reduction,called FedDPDR-DPML,which greatly improves data utility while providing strong privacy guarantees.Considering in distributed learning scenarios,multiple participants usually hold unbalanced or small amounts of data.Therefore,FedDPDR-DPML enables multiple participants to collaboratively learn a global model based on weighted model averaging and knowledge aggregation and then the server distributes the global model to each participant to improve local data utility.Aiming at high-dimensional data,we adopt differential privacy in both the principal component analysis(PCA)-based dimensionality reduction phase and SVM classifiers training phase,which improves model accuracy while achieving strict differential privacy protection.Besides,we train Differential privacy(DP)-compliant SVM classifiers by adding noise to the objective function itself,thus leading to better data utility.Extensive experiments on three high-dimensional datasets demonstrate that FedDPDR-DPML can achieve high accuracy while ensuring strong privacy protection.

A Support Data-Based Core-Set Selection Method for Signal Recognition

In recent years,deep learning-based signal recognition technology has gained attention and emerged as an important approach for safeguarding the electromagnetic environment.However,training deep learning-based classifiers on large signal datasets with redundant samples requires significant memory and high costs.This paper proposes a support databased core-set selection method(SD)for signal recognition,aiming to screen a representative subset that approximates the large signal dataset.Specifically,this subset can be identified by employing the labeled information during the early stages of model training,as some training samples are labeled as supporting data frequently.This support data is crucial for model training and can be found using a border sample selector.Simulation results demonstrate that the SD method minimizes the impact on model recognition performance while reducing the dataset size,and outperforms five other state-of-the-art core-set selection methods when the fraction of training sample kept is less than or equal to 0.3 on the RML2016.04C dataset or 0.5 on the RML22 dataset.The SD method is particularly helpful for signal recognition tasks with limited memory and computing resources.

Enhanced stability of nitrogen-doped carbon-supported palladium catalyst for oxidative carbonylation of phenol

Enhancing the stability of supported noble metal catalysts emerges is a major challenge in both science and industry.Herein,a heterogeneous Pd catalyst(Pd/NCF)was prepared by supporting Pd ultrafine metal nanoparticles(NPs)on nitrogen-doped carbon;synthesized by using F127 as a stabilizer,as well as chitosan as a carbon and nitrogen source.The Pd/NCF catalyst was efficient and recyclable for oxidative carbonylation of phenol to diphenyl carbonate,exhibiting higher stability than Pd/NC prepared without F127 addition.The hydrogen bond between chitosan(CTS)and F127 was enhanced by F127,which anchored the N in the free amino group,increasing the N content of the carbon material and ensuring that the support could provide sufficient N sites for the deposition of Pd NPs.This process helped to improve metal dispersion.The increased metal-support interaction,which limits the leaching and coarsening of Pd NPs,improves the stability of the Pd/NCF catalyst.Furthermore,density functional theory calculations indicated that pyridine N stabilized the Pd^(2+)species,significantly inhibiting the loss of Pd^(2+)in Pd/NCF during the reaction process.This work provides a promising avenue towards enhancing the stability of nitrogen-doped carbon-supported metal catalysts.

Environmental Impact Assessment Follow-Up of Seismic Survey Offshore Activities in Brazil

Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest from scientists and practitioners, though it is recognized as one of the weakest points of EIA systems globally. Also, EIA follow-up is influenced by the context, mainly in terms of the types of projects or activities and their related impacts on the environment. Therefore, the present paper is focused on the investigation of the follow-up stage applied to the activity of seismic survey coupled with offshore oil & gas exploitation in Brazil. Research was based on a qualitative approach that included document analysis and semi-structured interviews with analysts involved in EIA processes, and sought to generate evidence of effectiveness of the EIA follow-up as conducted by the Federal Environment Agency (Ibama) in order to situate the practice of follow-up in the broader context of international best practice principles. Based on the findings, it was concluded that, due to the peculiarities of offshore seismic survey, it is necessary to promote adaptations in the procedures for monitoring impacts in order to ensure proper alignment with the principles and conceptual foundations that guide EIA practice. Specifically, the timing of the execution of the activity imposes challenges for its integration into the “conventional” cycle that has guided the monitoring of the impacts in the EIA of projects.

Development of multi-functional anchorage support dynamic-static coupling performance test system and its application

In underground engineering with complex conditions,the bolt(cable)anchorage support system is in an environment where static and dynamic stresses coexist,under the action of geological conditions such as high stresses and strong disturbances and construction conditions such as the application of high prestress.It is essential to study the support components performance under dynamic-static coupling conditions.Based on this,a multi-functional anchorage support dynamic-static coupling performance test system(MAC system)is developed,which can achieve 7 types of testing functions,including single component performance,anchored net performance,anchored rock performance and so on.The bolt and cable mechanical tests are conducted by MAC system under different prestress levels.The results showed that compared to the non-prestress condition,the impact resistance performance of prestressed bolts(cables)is significantly reduced.In the prestress range of 50–160 k N,the maximum reduction rate of impact energy resisted by different types of bolts is 53.9%–61.5%compared to non-prestress condition.In the prestress range of 150–300 k N,the impact energy resisted by high-strength cable is reduced by76.8%–84.6%compared to non-prestress condition.The MAC system achieves dynamic-static coupling performance test,which provide an effective means for the design of anchorage support system.

Nutritional Support under the Neuman Systems Model for Stroke Patients

Objective: To explore nutritional support under the Neuman systems model in treating dysphagia in stroke patients. Methods: In this retrospective study, we enrolled 97 patients with dysphagia after stroke admitted to our hospital, and randomly divided them into the Neuman group (n = 51) given nursing intervention based on Neuman systems model and a control group (n = 46) given routine nursing intervention. Both groups received nutritional support for 3 months. Nutritional indexes (serum total protein, plasma albumin, serum albumin, hemoglobin and transferrin levels) and immune indexes (immunoglobulin (Ig) A, IgG, IgM and total lymphocyte count (TLC) in both groups were recorded and compared. Pulmonary function recovery, video fluoroscopic swallowing study score, water swallowing test score, complication rate, and health knowledge mastery level were also compared between the two groups. Results: After the intervention, the Neuman group showed less decrease in the nutritional and immune index scores (serum total protein, plasma albumin, hemoglobin, serum albumin;IgA, IgG, IgM, and TLC;all P Conclusion: For patients with stroke and dysphagia, comprehensive nursing intervention (e.g., nutritional support) under theNeuman systems model can promote the recovery of immune, swallowing, and pulmonary function, reduce complication incidence and facilitate comprehensive rehabilitation, ensuring adequate nutritional intake.

Literature Review on Support for Children and Families Experiencing Parental Bereavement

Purpose: This study aimed to understand the actual nursing support in a wide perspective by reviewing overseas literature on support for children who have experienced parental bereavement and their families. The goal was to identify future challenges in nursing support in clinical practice in Japan. Method: Literature searchable as of May 2023 was retrieved using PubMed, resulting in 11 relevant articles. Result: The results revealed the following: 1) For support provided to children, 13 codes were condensed into 5 subcategories and 4 categories. 2) For support provided to families, 36 codes were condensed into 11 subcategories and 4 categories. Conclusion: Open communication was found to be essential for supporting children and their families who have experienced parental bereavement. Moreover, involvement of multiple professions facilitated the provision of specialized support to address diverse needs of children and families, playing a crucial role in overcoming grief. Additionally, the effectiveness of support systems for bereaved families highlighted the need for nursing professionals in Japan to gain knowledge through learning opportunities and to establish a multi-disciplinary approach to support, thus indicating future challenges in nursing support.

Meter-Scale Thin-Walled Structure with Lattice Infill for Fuel Tank Supporting Component of Satellite:Multiscale Design and Experimental Verification

Lightweight thin-walled structures with lattice infill are widely desired in satellite for their high stiffness-to-weight ratio and superior buckling strength resulting fromthe sandwich effect.Such structures can be fabricated bymetallic additive manufacturing technique,such as selective laser melting(SLM).However,the maximum dimensions of actual structures are usually in a sub-meter scale,which results in restrictions on their appliance in aerospace and other fields.In this work,a meter-scale thin-walled structure with lattice infill is designed for the fuel tank supporting component of the satellite by integrating a self-supporting lattice into the thickness optimization of the thin-wall.The designed structure is fabricated by SLM of AlSi10Mg and cold metal transfer welding technique.Quasi-static mechanical tests and vibration tests are both conducted to verify the mechanical strength of the designed large-scale lattice thin-walled structure.The experimental results indicate that themeter-scale thin-walled structure with lattice infill could meet the dimension and lightweight requirements of most spacecrafts.