Study on the Application of Refined Nursing Care in The Care for Elderly Patients with Reflux Esophagitis

Objective: To investigate the application effect of refined nursing care in the care for elderly patients with reflux esophagitis. Methods: Following the difference in nursing style, 84 cases of elderly patients with reflux esophagitis admitted to our hospital from May 2022 to May 2023 were randomly grouped into a control group and a research group, with 42 cases each. The control group was given conventional nursing care and the research group was given refined nursing care. The psychological state and treatment adherence of the two groups of patients after the nursing intervention were compared. Results: After the nursing intervention, the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores of the research group were lower than those of the control group (P < 0.05). The treatment compliance of the research group was better than the control group (P < 0.05). Conclusion: The implementation of refined nursing care for elderly patients with reflux esophagitis exhibited a significant effect on improving the patient’s psychological state, treatment compliance, and rehabilitation.

Refined Anam-Net:Lightweight Deep Learning Model for Improved Segmentation Performance of Optic Cup and Disc for Glaucoma Diagnosis

In this work,we aim to introduce some modifications to the Anam-Net deep neural network(DNN)model for segmenting optic cup(OC)and optic disc(OD)in retinal fundus images to estimate the cup-to-disc ratio(CDR).The CDR is a reliable measure for the early diagnosis of Glaucoma.In this study,we developed a lightweight DNN model for OC and OD segmentation in retinal fundus images.Our DNN model is based on modifications to Anam-Net,incorporating an anamorphic depth embedding block.To reduce computational complexity,we employ a fixed filter size for all convolution layers in the encoder and decoder stages as the network deepens.This modification significantly reduces the number of trainable parameters,making the model lightweight and suitable for resource-constrained applications.We evaluate the performance of the developed model using two publicly available retinal image databases,namely RIM-ONE and Drishti-GS.The results demonstrate promising OC segmentation performance across most standard evaluation metrics while achieving analogous results for OD segmentation.We used two retinal fundus image databases named RIM-ONE and Drishti-GS that contained 159 images and 101 retinal images,respectively.For OD segmentation using the RIM-ONE we obtain an f1-score(F1),Jaccard coefficient(JC),and overlapping error(OE)of 0.950,0.9219,and 0.0781,respectively.Similarly,for OC segmentation using the same databases,we achieve scores of 0.8481(F1),0.7428(JC),and 0.2572(OE).Based on these experimental results and the significantly lower number of trainable parameters,we conclude that the developed model is highly suitable for the early diagnosis of glaucoma by accurately estimating the CDR.

Impact of early refined nursing program on prognosis of middleaged and elderly patients with cognitive dysfunction combined with cerebral infarction

BACKGROUND Cerebral infarction is a local or extensive necrosis of brain tissue.Subsequently,the corresponding neurological deficits appear.The incidence of cerebrovascular diseases in China is increasing gradually.After the onset of cerebrovascular disease,the most common sequelae include movement disorders,language disorders,and cognitive dysfunction.AIM To investigate the effect of early refined nursing program on the prognosis of middle-aged and elderly patients with cerebral infarction combined with cognitive dysfunction.METHODS A retrospective study was conducted to divide 60 patients with cerebral infarction and cognitive impairment into an experimental group(n=32)and a control group(n=28).The experimental group received early intensive care every day,and the control group received daily routine care.The scores of the Mini-Mental State Examination(MMSE)and the Trail Making Test(TMT),as well as the latency and amplitude of the event-related potential P300,were used as main indicators to evaluate changes in cognitive function,and changes in BDNF,TGF-β,and GDNF expression were used as secondary indicators.RESULTS Both groups experienced notable enhancements in MMSE scores,with the experi-mental group demonstrating higher scores than the control group(experimental:28.75±2.31;control:25.84±2.87).Moreover,reductions in TMT-A and TMT-B scores were observed in both groups(experimental:TMT-A 52.36±6.18,TMT-B 98.47±10.23;control:TMT-A 61.48±7.92,TMT-B 112.63±12.55),with the experimental group displaying lower scores.P300 Latency decreased(experimental:270.63 ms±14.28 ms;control:285.72 ms±16.45 ms),while amplitude increased(experimental:7.82μV±1.05μV;control:6.35μV±0.98μV)significantly in both groups,with superior outcomes in the experimental cohort.Additionally,the levels of the growth factors BDNF,TGF-β1,and GDNF surged(experimental:BDNF 48.37 ng/mL±5.62 ng/mL,TGF-β152.14 pg/mL±4.28 pg/mL,GDNF 34.76 ng/mL±3.89 ng/mL;control:BDNF 42.58 ng/mL±4.73 ng/mL,TGF-β146.23 pg/mL±3.94 pg/mL,GDNF 30.25 ng/mL±2.98 ng/mL)in both groups,with higher levels in the experimental group.CONCLUSION For middle-aged and elderly patients with cerebral infarction and cognitive dysfunction,early refined nursing can significantly improve their cognitive function and prognosis.

From“Car Priority”to“People Priority”: Exploring New Ideas for Refined Road Space Design

Roads are crucial public spaces in cities and serve as a window to showcase the city’s characteristics.They serve not only as a means of urban transportation but also as a crucial spatial carrier for urban communication activities and a significant location for meeting the increasing demands of people for a better quality of life.The current road infrastructure prioritizes the right of way for cars,neglecting the design of sidewalks and green belts within the road’s boundaries,and extension spaces between buildings and boundary lines of roads.There is a pressing need to improve street space in response to the demand for development transformation and the creation of a warmer city.This paper summarizes common problems in current road spaces,draws on the experience of excellent urban road spaces in foreign countries,discusses new ideas for the refined design of road spaces based on the transformation of road planning concepts,and suggests a reference standard for guiding detailed design.Simultaneously,the review of road construction will incorporate the detailed design of road space to enhance the role of planning in guiding and controlling the construction of road works.

Evaluation of the Impact of Refined Quality Control Management Model on the Qualified Rate of Disinfection and Sterilization of Surgical Instruments in the Sterilization Supply Center

Objective:To evaluate the application value of a refined quality control management model for a sterilization supply center.Methods:A retrospective analysis was conducted on the work situation of the sterilization supply center from January 2021 to January 2023.The work situation before January 31,2022,was classified as the control group;a routine quality control management model was implemented,and the work situation after January 31,2022,was classified as the observation group.The quality of medical device management and department satisfaction between the two groups were compared.Results:The timely recovery and supply rate,classification and cleaning pass rate,disinfection pass rate,packaging pass rate,sterilization pass rate,and department satisfaction score in the observation group were all higher than those of the control group(P<0.05).Conclusion:Implementing a refined quality control management model in the sterilization supply center can improve the quality management level of medical devices and department satisfaction and is worthy of promotion.

Inhibition of Propionibacterium acnes by refined bamboo vinegar and preparation of the slow-release system with bamboo charcoal as the carrier

Background:Acne vulgaris is one of the most common skin diseases that can significantly impact a considerable proportion of individuals over their lifetime.Objective:This study focuses on the exploration of the application potential of bamboo vinegar in cosmetics.Materials and Methods:The stock solution of bamboo vinegar is subjected to reduced-pressure distillation at different temperatures to obtain refined bamboo vinegar.Then,inhibition of Propionibacterium acnes(P.acnes)by refined bamboo vinegar is observed.Moreover,the refined bamboo vinegar is adsorbed and released with activated bamboo charcoal as the carrier.In all,this study aims to probe into the mechanism of the controlledrelease system of bamboo vinegar.Results:The results shows that the harmful substances(tar)in bamboo vinegar distilled at 70℃decreased by 94.44%,which is a more notable decrease compared with that in the stock solution.The total organic acid content in bamboo vinegar after reduced-pressure distillation is 11.840%,reaching the national standard for refined bamboo vinegar(GB/T 31734–2015).Additionally,the minimum inhibitory concentration of refined bamboo vinegar against P.acnes using the punch method is 7.90 mg/mL.This indicates that refined bamboo vinegar has the potential as a prospective raw material for formulations in anti-acne cosmetic products.Furthermore,the release rate of bamboo charcoal/bamboo vinegar in water for 15 min reaches 70.57%,which then slows down to a plateau.The slow-release behavior is agreed with the Ritger-Peppas model and is beneficial to relieve the irritation of bamboo vinegar to the skin and lengthen its bacteriostatic duration.Conclusion:The foregoing conclusions can serve as the theoretical foundation for the application of bamboo vinegar in anti-acne cosmetics.

Refined mathematical model for the breaching of concrete-face sand-gravel dams due to overtopping failure

Overtopping is one of the main reasons for the breaching of concrete-face sand-gravel dams(CFSGDs).In this study,a refined mathematical model was established based on the characteristics of the overtopping breaching of CFSGDs.The model characteristics were as follows:(1)Based on the Renormailzation Group(RNG)k-εturbulence theory and volume of fluid(VOF)method,the turbulent characteristics of the dam-break flow were simulated,and the erosion surface of the water and soil was tracked;(2)In consideration of the influence of the change in the sediment content on the dam-break flow,the dam material transport equation,which could reflect the characteristics of particle settlement and entrainment motion,was used to simulate the erosion process of the sand gravels;(3)Based on the bending moment balance method,a failure equation of the concrete face slab under dead weight and water load was established.The proposed model was verified through a case study on the failure of the Gouhou CFSGD.The results showed that the proposed model could well simulate the erosion mode of the special vortex flow of the CFSGD scouring the support body of the concrete face slab inward and reflect the mutual coupling relationship between the dam-break flow,sand gravels,and concrete face slabs.Compared with the measured values,the relative errors of the peak discharge,final breach average width,dam breaching duration,and maximum failure length of the face slab calculated using the proposed model were all less than 12%,thus verifying the rationality of the model.The proposed model was demonstrated to perform better and provide more detailed results than three selected parametric models and three simplified mathematical models.The study results can aid in establishing the risk level and devising early warning strategies for CFSGDs.

Refined disturbance observer based prescribed performance fixed-time control of high-speed EMS trains with track irregularities

High-speed Electromagnetic Suspension(EMS)train is continuously impacted by the irregularity of the track,which worsens the levitation performance of the train.In this paper,a composite control scheme for the EMS is proposed to suppress track irregularities by integrating a Refined Disturbance Observer(RDO)and a Prescribed Performance Fixed-Time Controller(PPFTC).The RDO is designed to estimate precisely the track irregularities and lumped disturbances with uncertainties and exogenous disturbances in the suspension system,and reduce input chattering by applying to the disturbance compensation channel.PPFTC is designed to converge the suspension air gap error to equilibrium point with prescribed performance by completing error conversion,and solve the fast dynamic issue of EMS.And the boundary of overshoot and steady-state is limited in the ranged prescribed.A theoretical analysis is conducted on the stability of the proposed control method.Finally,the effectiveness and reasonability of the proposed composite anti-disturbance control scheme is verified by simulation results.

Differential distribution of authenticity results of different varieties of refined honey based on stable isotope ratio method

Objective Using the stable isotope ratio method for the authenticity identification and variety identification of refined honey.Methods In this paper,a total of 17 samples of different varieties of refined honey were used to obtain refined honey proteins by precipitation with sodium tungstate solution and sulphuric acid solution.The isotope mass spectrometer was used to simultaneously detect theδ^(13)C values of refined honey proteins and refined honey as well as theδ^(18)O andδ^(2)H values of refined honey,processed of the results obtained,analysed the authenticity of the samples and conduct a variety identification study.Results Tested of the resulting honey samples,the results showed that four batches of refined honey did not up to standard,two batches of C-4 vegetable syrup were detected as adulterated,and two batches of protein were not detected.Theδ^(18)O andδ^(2)H values of refined honey were also found to be effective in distinguishing the varietal origin of refined honey to a certain extent.Conclusions The stable isotope ratio method is useful in the authenticity identification of refined honey,and provides new ideas to further promote the authenticity of refined honey and variety identification research.

Refined Aerodynamic Test of Wide-Bodied Aircraft and Its Application

The large dual-channel wide-bodied aircraft has a long range and a high cruise Mach number.Therefore,its aerodynamic design requires a high level ofwind tunnel test refinement.Based on the requirements of aerodynamic design for the future wide-bodied aircraft and the characteristics of high-speed wind tunnel tests,the error theory is introduced to analyze the factors affecting the accuracy of the test data.This study carries out a series of research on the improvement of refined aerodynamic test technology in an FL-26 wind tunnel,including design and optimization of the support system of wide-bodied aircraft,model attitude angle measurement,Mach number control accuracy,measurement and control system stability,test data correction and perfection,high-precision force balance and standard model development.In addition,the effect of the standard specification of the refined aerodynamic test is investigated to improve the data quality.The research findings have been applied in the standard model test and subsequent models of wide-bodied aircraft.The results show that whenMach numbers are less than 0.9,the control accuracy of Mach numbers in the FL-26 wind tunnel is smaller than 0.001 and the measurement error of attack angle is smaller than 0.01°.Therefore,it has the ability to correct the data influenced by factors,such as support/wall interference,model deformation,floating resistance and airflow deflection angle.The repeatability accuracy of the standard model’s comparison test shows that the lift coefficient is less than or equal to 0.0012,the drag coefficient is less than or equal to 0.00004,pitching moment coefficient is less than or equal to 0.0004.The bending resolution of the model’s deformation measurement is less than 0.2 mm,and the tensional deformation is smaller than 0.04°.The revised aerodynamic data and model deformation measurement results have good agreement with that of the ETW wind tunnel.The results demonstrate that the improved technology presented in this paper can significantly enhance the refined aerodynamic test of wide-bodied aircraft.

Performance characterization, of rigid polyurethane foam with refined alkali lignin and modified alkali lignin

The two kinds of rigid polyurethane （PU） foams were prepared with respectively adding the refined alkali lignin and alkali lignin modified by 3-chloro-1,2-epoxypropane to be instead of 15% of the polyether glycol in weight. The indexes of mechanical performance, apparent density, thermal stability and aging resistance were separately tested for the prepared PU foams. The results show that the mechanical property, thermal insulation and thermal stability for PU foam with modified alkali lignin are excellent among two kinds of PU foams and control samples. The additions of the refined alkali lignin and modified alkali lignin to PU foam have little effect on the natural aging or heat aging resistance except for decreasing hot alkali resistance apparently. Additionally, the thermal conductivity of modified alkali lignin PU foam is lowest among two kinds of PU foams and control samples. The alkali lignin PU foam modified by 3-chloro-1,2-epoxypropane could be applied in the heat preservation field.

Boxcar滤波器和极化Refined Lee滤波器对极化SAR分类精度影响的评估

本文阐述了Boxcar滤波器和极化Refined Lee滤波器的滤波原理,比较了两种滤波器的滤波效果。通过滤波后的极化图像分类精度的比较发现,滤波能显著提高监督分类的精度,滤波是提高分类精度必不可少的技术环节,Boxcar滤波在提高分类精度方面要优于Refined Lee滤波,此外滤波窗口的大小对分类精度也有重要的影响。

REFINED HYBRID MINDLIN PLATE ELEMENT FOR GEOMETRICALLY NON LINEAR ANALYSIS

Based upon a generalized variational principle, which relaxed the inter element continuity requirements, a novel refined hybrid Mindlin plate element is developed, its non linear element stiffness matrices are decomposed into a series of matrices with respect to the assumed strain modes. The formulation presented in this paper is different from any other non linear mixed/hybrid element formulation all successful experience of linear hybrid formulation is absorbed into the formulation(adding non conforming modes and realizing orthogonalization) Numerical results show that the present approach is more effective than any other non linear hybrid element formulation over the accuracy and computational efficiency. In addition, non conforming modes can also overcome the shear locking effect.

Long-Term Animal Feeding Trial of the Refined Konjac Meal Ⅱ. Effects of the Refined Konjac Meal on the Aging of the Brain, Liver, and Cardiovascular Tissue Cells in Rats

Rats of both sexes were fed on a basal feed containing 1% refined konjac meal (RKM) for 18 months and the effects of RKM on the cell aging were observed. A comparable group fed on the basic feed was used as the control. Results obtained demonstrate that the long-term feeding of RKM to rats can delay the course of cell aging of the gliocyte, cadiomyocyte, and the endothelial cell of the large and medium arteriases, hence it is likely to delay the occurrence of arteriosclerosis and improve the functions of the brain, heart and vascular system.

Long-Term Animal Feeding Trial of the Refined Konjac Meal Ⅰ. Effects of the Refined Konjac Meal on the Calcium and Phosphorus Metabolism and the Bone in Rat

Effects of refined konjac meal (RKM) on the calcium and phosphorus metabolism and bone parameters were observed in rats of both sexes fed with food containing 1% of RKM for 18 months. A comparable group of rats fed on basic diet only was used as a control.Results obtained indicate that all the measured parameters (serum calcium and phosphorus level, femur weight and its calcium and phesphorus content, and the osteometry of the tibia) showed no significant difference between the experimental and the control groups.Thus there is no adverse effect either on the calcium and phosphorus metabolism or on the bone after a long-term intake at a moderate dosage.

A method combining refined composite multiscale fuzzy entropy with PSO-SVM for roller bearing fault diagnosis

Combining refined composite multiscale fuzzy entropy(RCMFE)and support vector machine(SVM)with particle swarm optimization(PSO)for diagnosing roller bearing faults is proposed in this paper.Compared with refined composite multiscale sample entropy(RCMSE)and multiscale fuzzy entropy(MFE),the smoothness of RCMFE is superior to that of those models.The corresponding comparison of smoothness and analysis of validity through decomposition accuracy are considered in the numerical experiments by considering the white and 1/f noise signals.Then RCMFE,RCMSE and MFE are developed to affect extraction by using different roller bearing vibration signals.Then the extracted RCMFE,RCMSE and MFE eigenvectors are regarded as the input of the PSO-SVM to diagnose the roller bearing fault.Finally,the results show that the smoothness of RCMFE is superior to that of RCMSE and MFE.Meanwhile,the fault classification accuracy is higher than that of RCMSE and MFE.

Modelling of an hydraulic excavator using simplifiedrefined instrumental variable(SRIV)algorithm

Instead of establishing mathematical hydraulic system models from physical laws usually done with the problems of complex modelling processes, low reliability and practicality caused by large uncertainties, a novel modelling method for a highly nonlinear system of a hydraulic excavator is presented. Based on the data collected in the excavator＇s arms driving experiments, a data-based excavator dynamic model using Simplified Refined Instrumental Variable （SRIV） identification and estimation algorithms is established. The validity of the proposed data-based model is indirectly demonstrated by the performance of computer simulation and the.real machine motion control exoeriments.

Can regional economy influence China's water use intensity?:based on refined LMDI method

China experienced a decline of water use intensity in the 11th Five Year Plan,but the water use intensity actually increased in 2009.To the best of our knowledge,the index decomposition analysis method was rarely used to analyze changes in water use,and no decomposition analysis has investigated the role of regional economy in the decline of water use intensity.In this paper,we use logarithmic mean Divisia index(LMDI)techniques to decompose the change of water use intensity in the period 2006-2010.We find that the change of industrial water use intensity is confirmed as the dominant contributor to the decline in the overall water use intensity;the regional structure effect and the industrial structure effect is positive to the decline of overall water use intensity;the decline of China's water use intensity is mainly attributed to the effect of developed eastern provinces;meanwhile,the effect of central and undeveloped western is also positive to the decline of overall water use intensity;at least one out of three effects is positive to the decline of water use intensity in the different provinces;the intensity effect is positive and the industrial structure effect is positive to the declines of China's water use intensity based on chaining approach except the period 2008-2009,individually;and the deviation of regional structure effect and industrial structure effect between with regional economy and without regional economy in LMDI is 0.9 and2.3 m^3/10~4 RMB,respectively.

Value of refined care in patients with acute exacerbation of chronic obstructive pulmonary disease

BACKGROUND Under physiological conditions,sputum produced during acute exacerbation of chronic obstructive pulmonary disease(AECOPD)can move passively with the cilia in the airway;the sputum is gradually excreted from the depth of the airways through the stimulation of the coughing reflex on the sensory nerve on the surface of the airway.However,when the sputum is thick,the cough is weak,or the tracheal cilia are abnormal,sputum accumulation may occur and affect the exchange of oxygen and carbon dioxide in the lung.Furthermore,the presence of pathogenic microorganisms in sputum may cause or aggravate the symptoms of pulmonary infection in patients,which is the main factor leading to AECOPD.Therefore,promoting effective drainage of sputum and maintaining airway opening are key points requiring clinical attention.AIM To explore the effect of refined nursing strategies in patients with AECOPD and dysphagia.METHODS We selected 126 patients with AECOPD and difficulty of expectoration at our hospital,and divided them into a refined care group and a routine care group,with 63 cases each,using a random number table.The two groups of patients were treated with expectorant,anti-infection,oxygen inhalation,and other basic treatment measures;patients in the refined care group were given refined nursing intervention during hospitalization,and the routine care group received conventional nursing intervention.The differences in sputum expectoration,negative pressure suction rate,blood gas parameters,dyspnea score measured through the tool developed by the Medical Research Council(MRC),and quality of life were compared between the two groups.RESULTS After 7 d of intervention,the sputum expectoration effect of the refined care group was 62.30%,the effective rate was 31.15%,and the inefficiency rate was 6.56%.The sputum expectoration effect of the routine care group was 44.07%,the effective rate was 42.37%,and the inefficiency rate was 13.56%.The refined care group had better sputum expectoration than the routine care group(P<0.05).The negative pressure suction rate in the refined care group was significantly lower than that of the routine care group during the treatment(22.95%vs 44.07%,P<0.05).Before the intervention,the arterial oxygen saturation(PaO2)and arterial carbon dioxide saturation(PaCO2)values were not significantly different between the two groups(P>0.05);the PaO2 and PaCO2 values in the refined care group were comparable to those in the routine care group after 7 d of intervention(P>0.05).Before the intervention,there was no significant difference in the MRC score between the two groups(P>0.05);the MRC score of the refined care group was lower than that of the routine care group after 7 d of intervention,but the difference was not statistically significant(P>0.05).Before intervention,there was no significant difference in the symptoms,activities,disease impact,or St.George’s Respiratory questionnaire(SGRQ)total scores between the two groups(P>0.05).After 7 days of intervention,the symptoms,activities,and total score of SGRQ of the refined care group were higher than those of the routine care group,but the difference was not statistically significant(P>0.05).CONCLUSION AECOPD with thick sputum,weak coughing reflex,and abnormal tracheal cilia function will lead to sputum accumulation and affect the exchange of oxygen and carbon dioxide in the lung.Patients with AECOPD who have difficulty expectorating sputum may undergo refined nursing strategies that will promote expectoration,alleviate clinical symptoms,and improve the quality of life.

Comparison of Hypolipidemic Effect of Refined Konjac Meal With Several Common Dietary Fibers and Their Mechanisms of Action

The effects of RKM in comparison with pectin, algin and agar on lipid levels in serum and liver and on liver histopathology in rats were studied. In addition, the effects of all the tested materials on the composition and output of fecal bile acid were observed. All four kinds of dietary fiber were given at a level of 5% of diet to young male rats of Wistar strain fed on a lipid-rich diet contalning 5 % lard, 1% cholesteral and 0. 25 % cholate. All the dietary fibers tested have similar effects on serum lipid composition. In all groups, these substances prevent ed increases in total cholesterol in fasting serum, but the level of triglyceride was tmchangd.The concentrations of totaI cholesterol and triglyceride in the liver were lower in the RKM group than in the control group and the other three groups. Hepatic histopathological exami nation also showed the most significant lipotropic effect in the RKM group. The daily output of fecal bile acids (CDCA+GDCA) was significantly increased in the four experimental groups than in the normal group and the control group. The increase of CDCA was more significant than GDCA, suggesting that the increase of fecal bile acids, especially CDCA, may be one of the mechanisms by which RKM and the other three dietary fibers exerts a hypocholesterolemic effect