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.

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.

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.

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.

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.

Refinement Mechanism of Microstructure of Undercooled Nickel Based Alloys

Through the use of purification and recirculation superheating techniques on molten glass,the Ni65Cu33Co2 alloy was successfully undercooled to a maximum temperature of 292 K.High-speed photography was employed to capture the process of interface migration of the alloy liquid,allowing for an analysis of the relationship between the morphological characteristics of the alloy liquid solidification front and the degree of undercooling.Additionally,the microstructure of the alloy was examined using metallographic microscopy,leading to a systematic study of the microscopic morphological characteristics and evolution laws of the refined structure during rapid solidification.The research reveals that the grain refining mechanism of the Ni-Cu-Co ternary alloy is consistent with that of the binary alloy(Ni-Cu).Specifically,under low undercooling conditions,intense dendritic remelting was found to cause grain refinement,while under high undercooling conditions,recrystallization driven by accumulated stress and plastic strain resulting from the interaction between the liquid flow and the primary dendrites caused by rapid solidification was identified as the main factor contributing to grain refinement.Furthermore,the study highlights the significant role of the Co element in influencing the solidification rate and reheat effect of the alloy.The addition of Co was also found to facilitate the formation of non-segregated solidification structure,indicating its importance in the overall solidification process.

Grain refinement of Mg-Ca alloys by native MgO particles

In Mg-Ca alloys the grain refining mechanism,in particular regarding the role of nucleant substrates,remains the object of debates.Although native MgO is being recognised as a nucleating substrate accounting for grain refinement of Mg alloys,the possible interactions of MgO with alloying elements that may alter the nucleation potency have not been elucidated yet.Herein,we design casting experiments of Mg-xCa alloys varied qualitatively in number density of native MgO,which are then comprehensively studied by advanced electron microscopy.The results show that grain refinement is enhanced as the particle number density of MgO increases.The native MgO particles are modified by interfacial layers due to the co-segregation of Ca and N solute atoms at the MgO/Mg interface.Using aberration-corrected scanning transmission electron microscopy and electron energy loss spectroscopy,we reveal the nature of these Ca/N interfacial layers at the atomic scale.Irrespective of the crystallographic termination of MgO,Ca and N co-segregate at the MgO/Mg interface and occupy Mg and O sites,respectively,forming an interfacial structure of a few atomic layers.The interfacial structure is slightly expanded,less ordered and defective compared to the MgO matrix due to compositional deviations,whereby the MgO substrate is altered as a poorer template to nucleate Mg solid.Upon solidification in a TP-1 mould,the impotent MgO particles account for the grain refining mechanism,where they are suggested to participate into nucleation and grain initiation processes in an explosive manner.This work not only reveals the atomic engineering of a substrate through interfacial segregation but also demonstrates the effectiveness of a strategy whereby native MgO particles can be harnessed for grain refinement in Mg-Ca alloys.

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.

Integrated multi-scale approach combining global homogenization and local refinement for multi-field analysis of high-temperature superconducting composite magnets

Second-generation high-temperature superconducting(HTS)conductors,specifically rare earth-barium-copper-oxide(REBCO)coated conductor(CC)tapes,are promising candidates for high-energy and high-field superconducting applications.With respect to epoxy-impregnated REBCO composite magnets that comprise multilayer components,the thermomechanical characteristics of each component differ considerably under extremely low temperatures and strong electromagnetic fields.Traditional numerical models include homogenized orthotropic models,which simplify overall field calculation but miss detailed multi-physics aspects,and full refinement(FR)ones that are thorough but computationally demanding.Herein,we propose an extended multi-scale approach for analyzing the multi-field characteristics of an epoxy-impregnated composite magnet assembled by HTS pancake coils.This approach combines a global homogenization(GH)scheme based on the homogenized electromagnetic T-A model,a method for solving Maxwell's equations for superconducting materials based on the current vector potential T and the magnetic field vector potential A,and a homogenized orthotropic thermoelastic model to assess the electromagnetic and thermoelastic properties at the macroscopic scale.We then identify“dangerous regions”at the macroscopic scale and obtain finer details using a local refinement(LR)scheme to capture the responses of each component material in the HTS composite tapes at the mesoscopic scale.The results of the present GH-LR multi-scale approach agree well with those of the FR scheme and the experimental data in the literature,indicating that the present approach is accurate and efficient.The proposed GH-LR multi-scale approach can serve as a valuable tool for evaluating the risk of failure in large-scale HTS composite magnets.

A REFINEMENT OF THE SCHWARZ-PICK ESTIMATES AND THE CARATHéODORY METRIC IN SEVERAL COMPLEX VARIABLES

In this article,we first establish an asymptotically sharp result on the higher order Fréchet derivatives for bounded holomorphic mappings f(x)=f(0)+∞∑s=1Dskf(0)(x^(sk))/(sk)!:B_(X)→B_(Y),where B_X is the unit ball of X.We next give a sharp result on the first order Fréchet derivative for bounded holomorphic mappings F(X)=F(0+)∞∑s=KD^(s)f(0)(x^(8)/s!):B_(X)→B_(Y),where B_(X)is the unit ball of X.The results that we derive include some results in several complex variables,and extend the classical result in one complex variable to several complex variables.

Exploration and Practice of Nitrogen Addition Process for LF Refining Ladle Bottom Blowing Nitrogen Steel Liquid

This article discusses and analyzes the law of nitrogen increase in liquid steel and the main factors affect-ing the nitrogen increasing of molten steel,through the way of adding nitrogen to molten steel by bottom blowing nitrogen gas in LF refining process.It is considered that the main factors affecting the nitrogen increasing instability of molten steel are the initial temperature of LF refining,nitrogen relative element,surface active elements[O]and[S]of steel liquid,and bottom blowing rate of ladle.The large-scale production practice shows that T[O]not more than 50×10-6 and[S]is not more than 0.020 in LF refining at the initial temperature of not less than 1570.The liquid steel nitrogen enrichment test is carried out by ladle bottom blowing nitrogen gas after 20 min of refining,the flow rate is set as(6.0~7.0)NL/min per ton,and it is turned to 2 NL/min at 6 min before the end of refining,the nitrogen increasing rate of liquid steel is basically stable at(5~6)×10-6 per minute.

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。

River-Net:面向河道提取的Refined-Lee Kernel深度神经网络模型

高精度提取合成孔径雷达(SAR)图像中的河流边界,对河流水势监测具有重要意义。以检测郑州7·20暴雨后黄河的健康状况为实施例,该文融合精致Lee滤波思想与卷积操作的滤波特性,提出了基于河道几何特性的优化内部权值卷积核Refined-Lee Kernel,进而提出了一种新型河道提取深度神经网络模型,即River-Net。为验证所提模型的有效性,该文获取了郑州7·20暴雨前后两景欧空局Sentinel-1卫星20 m分辨率干涉宽幅(IW)影像数据,利用暴雨前的影像对模型进行训练,用于提取暴雨后的黄河河道,分析黄河在暴雨后的涨势情况。实验结果表明,相比主流语义分割模型,所提模型能够更精确地在SAR图像中提取河道,对洪水灾害的检测与评估有重要应用价值。

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.

Study of ultrahigh-purity copper billets refined by vacuum melting and directional solidification

The purpose of this paper is to study large-sized copper billets refined with 5N ultrahigh purity after vacuum melting and directional solidifi-cation （VMDS）. The precise impurity analysis of copper billets was carried out with a glow discharge mass spectrometer （GDMS）. The re-sults demonstrate that the total concentration of twenty-two impurities is decreased by 63.1wt.%-66.5 wt.%. Ag, P, S, Na, Mg, Se, Zn, In and Bi are easy to be removed due to lgPimp - lgPCu 1.5, and they can be removed effectively under the vacuum condition of 1650-1700 K for 30 min. The electrical conductivity of 5N copper is higher than that of the raw material as the impurity concentrations decrease. The segrega-tion effect in directional solidification can be remarkable when the equilibrium distribution coefficient （k0） value is less than 0.65 due to the strong affinity of Cu for some metallic and non-metallic impurities.