基于SLP对A配送中心平面布置优化研究

本文分析配送中心A各单元区布局现状及存在的问题,通过系统布置设计方法对配送中心A各单元区之间的物流相关性与非物流相关性之间的综合关系进行分析,在此基础上对其平面布局进行了重新规划,再结合综合模糊评价法,得出了适合实际情况的最优布局。

SLEEP-MAD模式护理策略在结直肠癌病人术后护理中的应用

目的:探讨SLEEP-MAD模式护理策略在结直肠癌病人术后护理中的应用价值。方法:2022年5月—2023年5月选取医院收治的86例结直肠癌病人为研究对象,按照随机数字表法将病人分为观察组、对照组各43例,对照组行常规护理,观察组实施SLEEP-MAD模式护理策略,干预前后采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、视觉模拟疼痛评分表(VAS)、匹兹堡睡眠质量指数量表(PSQI)、癌因性疲乏评分及欧洲癌症研究与治疗组织生命质量量表(EORTC QLQ-C30)评价病人的不良情绪、疼痛感、癌因性疲乏、睡眠质量及生活质量。结果:干预后观察组病人HAMA、HAMD、VAS、PSQI及癌因性疲乏评分低于对照组(P<0.05);干预后观察组病人EORTC QLQ-C30评分高于对照组(P<0.05)。结论:SLEEP-MAD模式护理策略可有效减轻结直肠癌病人焦虑及抑郁情绪,减轻病人术后疼痛感及癌因性疲乏,改善病人睡眠质量及生活质量。

基于SLP法的福州F医院门诊部诊疗单元布局优化研究

在患者就诊需求与医院就诊模式不断变化的背景下,综合医院门诊部诊疗单元布局,已不能满足患者的就诊需求。该文以福州F医院门诊部诊疗单元为研究对象,以优化医院门诊部诊疗单元布局为目的,通过实地调研、行为观察等方法,首先对福州F医院门诊部诊疗单元布局存在的问题进行分析,进而采用SLP法对F医院门诊部诊疗单元进行优化分析。最后,从平面功能、平面流线和候诊区三个层面,针对优化分析结果提出优化策略,为综合医院门诊部诊疗单元布局优化提出新的理论方法以供参考与借鉴。

Non-alcoholic fatty liver disease and sleep disorders

Studies have shown that non-alcoholic fatty liver disease(NAFLD)may be associated with sleep disorders.In order to explore the explicit relationship between the two,we systematically reviewed the effects of sleep disorders,especially obstructive sleep apnea(OSA),on the incidence of NAFLD,and analyzed the possible mechanisms after adjusting for confounding factors.NAFLD is independently associated with sleep disorders.Different sleep disorders may be the cause of the onset and aggravation of NAFLD.An excessive or insufficient sleep duration,poor sleep quality,insomnia,sleep-wake disorders,and OSA may increase the incidence of NAFLD.Despite that some research suggests a unidirectional causal link between the two,specifically,the onset of NAFLD is identified as a result of changes in sleep characteristics,and the reverse relationship does not hold true.Nevertheless,there is still a lack of specific research elucidating the reasons behind the higher risk of developing sleep disorders in individuals with NAFLD.Further research is needed to establish a clear relationship between NAFLD and sleep disorders.This will lay the groundwork for earlier identification of potential patients,which is crucial for earlier monitoring,diagnosis,effective prevention,and treatment of NAFLD.

Sleep quality and characteristics of older adults with acute cardiovascular disease

Sleep plays a vital role in restoring the physical and mental health of people with cardiovascular disease.However,the hospital setting is not a conducive environment for sleep.Sleep interruptions by members of the care team,including vital sign checks,medication delivery,and blood draws for laboratory investigations,are routinely done in many hospitals.Frequent interruptions by staff and noise by other patients have been cited as barriers to restorative sleep in the hospital.

Effect of transcranial direct current stimulation on postoperative sleep disturbance in older patients undergoing lower limb major arthroplasty:a prospective,double-blind,pilot,randomised controlled trial

Background Postoperative sleep disturbance(PSD)is a common and serious postoperative complication and is associated with poor postoperative outcomes.Aims This study aimed to investigate the effect of transcranial direct current stimulation(tDCS)on PSD in older patients undergoing lower limb major arthroplasty.Methods In this prospective,double-blind,pilot,randomised,sham-controlled trial,patients 65 years and over undergoing lower limb major arthroplasty were randomly assigned to receive active tDCS(a-tDCS)or sham tDCS(s-tDCS).The primary outcomes were the objective sleep measures on postoperative nights(N)1 and N2.Results 116 inpatients were assessed for eligibility,and a total of 92 patients were enrolled;47 received a-tDCS and 45 received s-tDCS.tDCS improved PSD by altering the following sleep measures in the a-tDCS and s-tDCS groups;the respective comparisons were as follows:the promotion of rapid eye movement(REM)sleep time on N1(64.5(33.5-105.5)vs 19.0(0.0,45.0)min,F=20.10,p<0.001)and N2(75.0(36.0-120.8)vs 30.0(1.3-59.3)min,F=12.55,p<0.001);the total sleep time on N1(506.0(408.0-561.0)vs 392.0(243.0-483.5)min,F=14.13,p<0.001)and N2(488.5(455.5-548.5)vs 346.0(286.5-517.5)min,F=7.36,p=0.007);the deep sleep time on N1(130.0(103.3-177.0)vs 42.5(9.8-100.8)min,F=24.4,p<0.001)and N2(103.5(46.0-154.8)vs 57.5(23.3-106.5)min,F=8.4,p=0.004);and the percentages of light sleep and REM sleep on N1 and N2(p<0.05 for each).The postoperative depression and anxiety scores did not differ significantly between the two groups.No significant adverse events were reported.Conclusion In older patients undergoing lower limb major arthroplasty,a single session of anodal tDCS over the left dorsolateral prefrontal cortex showed a potentially prophylactic effect in improving postoperative short-term objective sleep measures.However,this benefit was temporary and was not maintained over time.

Association between abnormal default mode network homogeneity and sleep disturbances in major depressive disorder

Background Sleep disturbance is a common comorbidity of major depressive disorder(MDD).However,network homogeneity(NH)changes of the default mode network(DMN)in MDD with sleep disturbances are unclear.Aims The purpose of this study was to probe the abnormal NH in the DMN in MDD with sleep disturbances and to reveal the differences between MDD with or without sleep disturbances.Methods Twenty-four patients with MDD and sleep disturbances(Pa_s),33 patients with MDD without sleep disturbances(Pa_ns)and 32 healthy controls(HCs)were recruited in this study.Resting-state functional imaging data were analysed using NH.Results Compared with Pa_ns and HCs,Pa_s showed decreased NH in the left superior medial prefrontal cortex and increased NH in the right precuneus.There was a negative correlation between NH in the left superior medial prefrontal cortex and sleep disturbances(r=−0.42,p=0.001)as well as a positive correlation between NH in the right precuneus and sleep disturbances(r=0.41,p=0.002)in patients with MDD.Conclusions MDD with sleep disturbances is associated with abnormal NH in the DMN,which could differentiate pa_s from pa_ns.The DMN may play a crucial role in the neurobiological mechanisms of MDD with sleep disturbances.

Dual roles of the amygdala-hippocampus circuit in the regulation of rapid eye movement sleep and depression symptoms by repetitive transcranial magnetic stimulation in patients with insomnia

To the editor:It is commonly reported that people with insomnia often experience comorbid emotional disorders,such as mood and anxiety disorders.12 A study found that fragmented rapid eye movement(REM)sleep in individuals with insomnia is associated with higher Beck Depression Inventory(BDI)scores.3 REM sleep architecture disruption is a typical symptom of insomnia.

A Problem Not to Be Ignored: The Influencing Factors of Mobile Phone Addiction and Its Influence on Sleep Quality

Background and Objective: With the popularity and widespread use of mobile phones, the effects of mobile phone dependence and addiction on individuals’ physical and mental health have attracted more and more attention. The present study aims to analyze the current state of mobile phone addiction and its impact on sleep quality within the population, while also exploring the influence of related factors on sleep quality. Ultimately, this research will provide a scientific foundation for targeted intervention measures and strategies. Methods: A total of 253 permanent residents in Nanjing were randomly selected as study subjects. The Mobile Phone Addiction Index (MPAI) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the degree of smartphone addiction and sleep quality of the study subjects. Body mass index (BMI) was measured according to standardized procedures. Independent sample t-test, Chi-square test, rank sum test and multiple linear regression were used to analyze the correlation between mobile phone addiction and sleep quality, and P Results: 117 people (46.2%) were addicted to mobile phones. Chi-square test showed that the rate of mobile phone addiction in drinking group was significantly higher than that in non-drinking group (P P P P P P P P P P Conclusion: Mobile phone addiction may lead to shorter sleep duration and reduce sleep efficiency. The withdrawal of mobile phone addiction may have a negative impact on sleep quality. According to the characteristics of the population, appropriate comprehensive intervention measures should be taken to build an effective evaluation system, so as to reduce the impact of mobile phone addiction and withdrawal problems on sleep and improve sleep quality.

Clinical efficacy and mechanism study of mid-frequency anti-snoring device in treating moderate obstructive sleep apnea-hypopnea syndrome

BACKGROUND Obstructive sleep apnea-hypopnea syndrome(OSAHS)is primarily caused by airway obstruction due to narrowing and blockage in the nasal and nasopha-ryngeal,oropharyngeal,soft palate,and tongue base areas.The mid-frequency anti-snoring device is a new technology based on sublingual nerve stimulation.Its principle is to improve the degree of oropharyngeal airway stenosis in OSAHS patients under mid-frequency wave stimulation.Nevertheless,there is a lack of clinical application and imaging evidence.METHODS We selected 50 patients diagnosed with moderate OSAHS in our hospital between July 2022 and August 2023.They underwent a 4-wk treatment regimen involving the mid-frequency anti-snoring device during nighttime sleep.Following the treatment,we monitored and assessed the sleep apnea quality of life index and Epworth Sleepiness Scale scores.Additionally,we performed computed tomo-graphy scans of the oropharynx in the awake state,during snoring,and while using the mid-frequency anti-snoring device.Cross-sectional area measurements in different states were taken at the narrowest airway point in the soft palate posterior and retrolingual areas.RESULTS Compared to pretreatment measurements,patients exhibited a significant reduction in the apnea-hypopnea index,the percentage of time with oxygen saturation below 90%,snoring frequency,and the duration of the most prolonged apnea event.The lowest oxygen saturation showed a notable increase,and both sleep apnea quality of life index and Epworth Sleepiness Scale scores improved.Oropharyngeal computed tomography scans revealed that in OSAHS patients cross-sectional areas of the oropharyngeal airway in the soft palate posterior area and retrolingual area decreased during snoring compared to the awake state.Conversely,during mid-frequency anti-snoring device treatment,these areas increased compared to snoring.CONCLUSION The mid-frequency anti-snoring device demonstrates the potential to enhance various sleep parameters in patients with moderate OSAHS,thereby improving their quality of life and reducing daytime sleepiness.These therapeutic effects are attributed to the device’s ability to ameliorate the narrowing of the oropharynx in OSAHS patients.

Probiotics administration alleviates cognitive impairment and circadian rhythm disturbance induced by sleep deprivation

Gut microbiome is indispensable for maintaining normal brain function.Specifically,gut microbiota plays a causal role in sleep deprivation(SD)-induced cognitive impairment.In this study,neurobehavioral effects of the Bifidobacterium breve strain(CCFM1025)were assessed in sleep-deprived mice.CCFM1025 improved the body weight and food and water intake of the mice.It also alleviated SD-induced cognitive behavioural abnormalities(in the novel object recognition test),but did not show beneficial effects on mood-and spatial memory-related behaviours.CCFM1025 significantly altered the gut microbial composition and genome function.Key microbial metabolites that may regulate sleep function were also identified,such as isovaleric acid andγ-aminobutyric acid in the gut and purine metabolites in the serum.Those metabolites may participate in gutbrain communication by acting on the striatal melatonin system,for example to increase melatonin levels,and by regulating the expression of circadian clock genes such as those encoding the adenosine A2A receptor and period circadian regulator 1.Collectively,administration of probiotics alleviated cognitive impairment and circadian rhythm disturbance induced by SD via modulation of gut microbiome and its metabolites.These findings may help guide the treatment of insomnia or other sleep disorders via dietary strategies.

Relevance of sleep for wellness:New trends in using artificial intelligence and machine learning

Sleep and well-being have been intricately linked,and sleep hygiene is paramount for developing mental well-being and resilience.Although widespread,sleep disorders require elaborate polysomnography laboratory and patient-stay with sleep in unfamiliar environments.Current technologies have allowed various devices to diagnose sleep disorders at home.However,these devices are in various validation stages,with many already receiving approvals from competent authorities.This has captured vast patient-related physiologic data for advanced analytics using artificial intelligence through machine and deep learning applications.This is expected to be integrated with patients’Electronic Health Records and provide individualized prescriptive therapy for sleep disorders in the future.

Astrocytic calcium waves:unveiling their roles in sleep and arousal modulation

Neuron-astrocyte interactions are vital for the brain’s connectome.Understanding astrocyte activities is crucial for comprehending the complex neural network,particularly the population-level functions of neurons in different cortical states and associated behaviors in mammals.Studies on animal sleep and wakefulness have revealed distinct cortical synchrony patterns between neurons.Astrocytes,outnumbering neurons by nearly fivefold,support and regulate neuronal and synaptic function.Recent research on astrocyte activation during cortical state transitions has emphasized the influence of norepinephrine as a neurotransmitter and calcium waves as key components of ion channel signaling.This summary focuses on a few recent studies investigating astrocyte-neuron interactions in mouse models during sleep,wakefulness,and arousal levels,exploring the involvement of noradrenaline signaling,ion channels,and glutamatergic signaling in different cortical states.These findings highlight the significant impact of astrocytes on large-scale neuronal networks,influencing brain activity and responsiveness.Targeting astrocytic signaling pathways shows promise for treating sleep disorders and arousal dysregulation.More research is needed to understand astrocytic calcium signaling in different brain regions and its implications for dysregulated brain states,requiring future human studies to comprehensively investigate neuron-astrocyte interactions and pave the way for therapeutic interventions in sleep-and arousal-related disorders.

Interaction between adolescent sleep rhythms and gender in an obese population

BACKGROUND The obesity rate of adolescents is gradually increasing,which seriously affects their mental health,and sleep plays an important role in adolescent obesity.AIM To investigate the relationship between sleep rhythm and obesity among adolescents and further explores the interactive effect of sleep rhythm and gender on adolescent obesity,providing a theoretical basis for developing interventions for adolescent obesity.METHODS Research data source Tianjin Mental Health Promotion Program for Students.From April to June 2022,this study selected 14201 students from 13 middle schools in a certain district of Tianjin as the research subject using the convenient cluster sampling method.Among these students,13374 accepted and completed the survey,with an effective rate of 94.2%.The demographic data and basic information of adolescents,such as height and weight,were collected through a general situation questionnaire.The sleep rhythm of adolescents was evaluated using the reduced version of the morningness-eveningness questionnaire.RESULTS A total of 13374 participants(6629 females,accounting for 49.56%;the average age is 15.21±1.433 years)were analyzed.Among them,the survey showed that 2942 adolescent were obesity,accounting for 22%and 2104 adolescent were overweight,accounting for 15.7%.Among them,1692 male adolescents are obese,with an obesity rate of 25.1%,higher than 18.9%of female adolescents.There is a statistically significant difference between the three groups(χ2=231.522,P<0.000).The obesity group has the smallest age(14.94±1.442 years),and there is a statistical difference in age among the three groups(F=69.996,P<0.000).Obesity rates are higher among individuals who are not-only-child,have residential experience within six months,have family economic poverty,and have evening-type sleep(P<0.05).Logistic regression analysis shows a correlation between sleep rhythm and adolescent obesity.Evening-type sleep rhythm can increase the risk of obesity in male adolescents[1.250(1.067-1.468)],but the effect on female obesity is not remarkable.Further logistic regression analysis in the overall population demonstrates that the interaction between evening-type sleep rhythm and the male gender poses a risk of adolescent obesity[1.122(1.043-1.208)].CONCLUSION Among adolescents,the incidence of obesity in males is higher than in females.Evening-type sleep rhythm plays an important role in male obesity but has no significant effect on female obesity.Progressive analysis suggests an interactive effect of sleep rhythm and gender on adolescent obesity,and the combination of evening-type sleep and the male gender promotes the development of adolescent obesity.In formulating precautions against adolescent obesity,obesity in male adolescents with evening-type sleep should be a critical concern.

Comparison of vergence mechanisms between university students with good and poor sleep quality

AIM:To compare the vergence mechanisms between good and poor sleepers in university students.METHODS:A total of 64 university students were recruited in this study.The validated Malay version of Pittsburgh Sleep Quality Index questionnaire(PSQI-M)was used to measure the participants’sleep quality over the past month.Participants were categorized as good sleepers(n=32)and poor sleepers(n=32)based on the PSQI-M scores.Heterophoria and fusional vergences were measured at distance and near.Mann-Whitney U test was used to compare heterophoria,negative fusional vergence(NFV),and positive fusional vergence(PFV)at distance and near between good and poor sleepers.Spearman correlation analysis was used to study the relationship between PSQI-M score and PFV at distance.RESULTS:Both distance and near heterophorias were not significantly different between good and poor sleepers(P>0.05).There was a difference in distance PFV(P<0.05)between good and poor sleepers,but not in distance NFV,near NFV,and near PFV(P>0.05).Distance PFV was negatively correlated with PSQI-M score(rs=-0.33,P<0.05).CONCLUSION:University students with poor sleep quality demonstrates a reduced ability to maintain fusion with increasing convergence demand at distance.Sleep quality assessment during binocular vision examination in university students is recommended.

Stubborn Hypoxia in Neonates with D-Transposition of the Great Arteries afterArterial Switch Operation: Central Sleep Apnea as the Cause and PotentialIndicator of Brain Immaturity

D-transposition of the great arteries(d-TGA)is surgically repaired with the arterial switch operation(ASO)with excellent results,however short and long-term morbidities still develop including neurocognitive delay.Clinically significant central sleep apnea is uncommon in non-premature infants,but when present indicates immature autonomic control of respiration likely due to a neurologic disorder.We report the unanticipatedfinding of central sleep apnea in four-term neonates with d-TGA after uncomplicated ASO,with the short-term complication of delayed hospital discharge and long-term concerns regarding this early marker of brain immaturity and its hindrance to normal development.Within this report,we will review each patient’s clinical course and then examine the literature on pediatric central sleep apnea,neurodevelopmental outcomes after ASO,and the important overlap of these entities in the care of patients going forward.

Associations of daily sedentary behavior,physical activity,and sleep with irritable bowel syndrome:A prospective analysis of 362,193 participants

Background:Irritable bowel syndrome(IBS)substantially affects quality of life and requires early prevention.This study aimed to elucidate the relationships between IBS and daily behaviors,including sedentary behavior(SB),physical activity(PA),and sleep.In particular,it seeks to identify healthy behaviors to reduce IBS risk,which previous studies have rarely addressed.Methods:Daily behaviors were retrieved from self-reported data of 362,193 eligible UK Biobank participants.Incident cases were determined by self-report or health care data according to RomeⅣcriteria.Results:A total of 345,388 participants were IBS-free at baseline,during a median follow-up of 8.45 years,19,885 incident IBS cases were recorded.When examined individually,SB and shorter(≤7 h/day)or longer(>7 h/day)sleep duration were each positively associated with increased IBS risk,and PA was associated with lower IBS risk.The isotemporal substitution model suggested that replacing SB with other activities could provide further protective effects against IBS risk.Among people sleeping≤7 h/day,replacing 1 h of SB with equivalent light PA,vigorous PA,or sleep was associated with 8.1%(95%confidence interval(95%CI):0.901-0.937),5.8%(95%CI:0.896-0.991),and 9.2%(95%CI:0.885-0.932)reduced IBS risk,respectively.For people sleeping>7 h/day,light and vigorous PA were associated with a 4.8%(95%CI:0.926-0.978)and a 12.0%(95%CI:0.815-0.949)lower IBS risk,respectively.These benefits were mostly independent of genetic risk for IBS.Conclusion:SB and unhealthy sleep duration are risk factors for IBS.A promising way to mitigate IBS risk for individuals sleeping≤7 h/day and for those sleeping>7 h/day appears to be by replacing SB with adequate sleep or vigorous PA,respectively,regardless of the genetic predisposition of IBS.

Association of accelerometer-measured sleep duration and different intensities of physical activity with incident type 2 diabetes in a population-based cohort study

Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a population-based prospective cohort study.Methods:Altogether,88,000 participants(mean age=62.2±7.9 years,mean±SD)were included from the UK Biobank.Sleep duration(short:<6 h/day;normal:6-8 h/day;long:>8 h/day)and PA of different intensities were measured using a wrist-won accelerometer over a 7-day period between 2013 and 2015.PA was classified according to the median or World Health Organization-recommendation:total volume of PA(high,low),moderate-to-vigorous PA(MVPA)(recommended,not recommended),and light-intensity PA(high,low).Incidence of type 2diabetes was ascertained using hospital records or death registries.Results:During a median follow-up of 7.0 years,1615 incident type 2 diabetes cases were documented.Compared with normal sleep duration,short(hazard ratio(HR)=1.21,95%confidence interval(95%CI):1.03-1.41)but not long sleep duration(HR=1.01,95%CI:0.89-1.15)was associated with excessive type 2 diabetes risk.This increased risk among short sleepers seems to be protected against by PA.Compared with normal sleepers with high or recommended PA,short sleepers with low volume of PA(HR=1.81,95%CI:1.46-2.25),not recommended(below the World Health Organization-recommended level of)MVPA(HR=1.92,95%CI:1.55-2.36),or low light-intensity PA(HR=1.49,95%CI:1.13-1.90)had a higher risk of type 2 diabetes,while short sleepers with a high volume of PA(HR=1.14,95%CI:0.88-1.49),recommended MVPA(HR=1.02,95%CI:0.71-1.48),or high light-intensity PA(HR=1.14,95%CI:0.92-1.41)did not.Conclusion:Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes.A higher level of PA,regardless of intensity,potentially ameliorates this excessive risk.

Sleep Posture Classification Using RGB and Thermal Cameras Based on Deep Learning Model

Sleep posture surveillance is crucial for patient comfort,yet current systems face difficulties in providing compre-hensive studies due to the obstruction caused by blankets.Precise posture assessment remains challenging because of the complex nature of the human body and variations in sleep patterns.Consequently,this study introduces an innovative method utilizing RGB and thermal cameras for comprehensive posture classification,thereby enhancing the analysis of body position and comfort.This method begins by capturing a dataset of sleep postures in the form of videos using RGB and thermal cameras,which depict six commonly adopted postures:supine,left log,right log,prone head,prone left,and prone right.The study involves 10 participants under two conditions:with and without blankets.Initially,the database is normalized into a video frame.The subsequent step entails training a fine-tuned,pretrained Visual Geometry Group(VGG16)and ResNet50 model.In the third phase,the extracted features are utilized for classification.The fourth step of the proposed approach employs a serial fusion technique based on the normal distribution to merge the vectors derived from both the RGB and thermal datasets.Finally,the fused vectors are passed to machine learning classifiers for final classification.The dataset,which includes human sleep postures used in this study’s experiments,achieved a 96.7%accuracy rate using the Quadratic Support Vector Machine(QSVM)without the blanket.Moreover,the Linear SVM,when utilized with a blanket,attained an accuracy of 96%.When normal distribution serial fusion was applied to the blanket features,it resulted in a remarkable average accuracy of 99%.

Observation of the Effectiveness of Rapid Recovery Nursing on Lung Cancer Surgery Patients and Its Impact on Sleep Quality

Objective: To investigate the nursing effects of rapid recovery care measures on lung cancer surgery patients. Methods: 42 cases of lung cancer surgery patients were divided into control group and study group, with 21 cases in each group. The sleep quality and postoperative recovery indicators were compared between the two groups. Results: The study group showed better results than the control group in terms of PSQI scores, venting time, extubation time, time to getting out of bed, and duration of antibiotic use, with P Conclusion: Rapid recovery nursing has a positive impact on improving sleep quality and promoting postoperative recovery in lung cancer surgery patients.