Effect of internet multiple linkage mode-based extended care combined with in-hospital comfort care on colorectal cancer patients undergoing colostomy

BACKGROUND Patients with colorectal cancer may need postoperative nursing to improve prognosis,and conventional nursing is not effective.Clinical research is needed to explore nursing methods that can more effectively improve postoperative conditions on colorectal cancer patients undergoing colostomy.AIM To explore the effect of internet multiple linkage mode-based extended care combined with in-hospital comfort care on colorectal cancer patients undergoing colostomy.METHODS Data from 187 patients with colostomy treated in our hospital from May 2019 to March 2022 were collected and divided into three groups,A(n=62),B(n=62)and C(n=63),according to different intervention methods.Group A received internet multiple linkage mode-based extended care combined with in-hospital comfort care.Group B received internet multiple linkage mode-based extended care.Group C received usual care intervention.Complications were compared among the three groups.The stoma self-efficacy scale,Hamilton Anxiety Scale,RESULTS The complication rate of group A,B and C(16.13%,20.97%and 60.32%,respectively)was significantly different(all P<0.05).The incidence of complications in groups A and B was lower than that in group C,and there was no significant difference between groups A and B(P>0.05).After intervention,the scores of ostomy care,social contact,diet choice,confidence in maintaining vitality,confidence in self-care of ostomy,confidence in sexual life,confidence in sexual satisfaction and confidence in physical labor in the three groups were all higher than before intervention,and the scores of groups A and B were higher than those of group C,with statistical significance(P<0.05).The Hamilton Anxiety Scale and Hamilton Depression Scale scores of the three groups after intervention were lower than those before intervention.The scores of groups A and B were lower than those of group C,and the score of group A was lower than that of group B,all with statistical significance(all P<0.05).There was a statist-ically significant difference in cancer-induced fatigue among the three groups(P<0.05).After intervention,the scores of physical health,psychological health,social health and mental health of the three groups were lower than before the intervention.The scores of group A and B were lower than that of group C;and the score of group A was lower than that of group B,all with statistical significance(all P<0.05).CONCLUSION Internet multiple linkage mode-based extended care combined with in-hospital comfort care can effectively improve self-efficacy,bad mood,cancer-related fatigue and life quality of colorectal cancer patients undergoing colostomy.

Effects of Driving Mode on the Performance of Multiple-Chamber Piezoelectric Pumps with Multiple Actuators

Due to the limited output capability of piezoelectric diaphragm pumps, the driving voltage is frequently increased to obtain the desired output. However, the excessive voltage application may lead to a large deformation in the piezoelectric ceramics, which could cause it to breakdown or become damaged. Therefore, increasing the number of chambers to obtain the desired output is proposed. Using a check-valve quintuple-chamber pump with quintuple piezoelectric actuators, the characteristics of the pump under different driving modes are investigated through experiments. By changing the number and connection mode of working actuators, pump performances in terms of flow rate and backpressure are tested at a voltage of 150 V with a frequency range of 60 Hz -400 Hz. Experiment results indicate that the properties of the multiple-chamber pump change significantly with distinct working chambers even though the number of pumping chambers is the same. Pump performance declines as the distance between the working actuators increases. Moreover, pump performance declines dramatically when the working piezoelectric actuator closest to the outlet is involved. The maximum backpressures of the pump with triple, quadruple, and quintuple actuators are increased by 39%, 83%, and 128%, respectively, compared with the pump with double working actuators; the corresponding maximum flow rates of the pumps are simply increased by 25.9%, 49.2%, and 67.8%, respectively. The proposed research offers practical guidance for the effective utilization of the multiple-chamber pumps under different driving modes.

Reliability analysis of retaining walls with multiple failure modes

In order to reduce the errors of the reliability of the retaining wall structure in the establishment of function, in the estimation of parameter and algorithm, firstly, two new reliability and stability models of anti-slipping and anti-overturning based on the upper-bound theory of limit analysis were established, and two kinds of failure modes were regarded as a series of systems with multiple correlated failure modes. Then, statistical characteristics of parameters of the retaining wall structure were inferred by maximal entropy principle. At last, the structural reliabilities of single failure mode and multiple failure modes were calculated by Monte Carlo method in MATLAB and the results were compared and analyzed on the sensitivity. It indicates that this method, with a high precision, is not only easy to program and quick in calculation, but also without the limit of nonlinear functions and non-normal random variables. And the results calculated by this method which applies both the limit analysis theory, maximal entropy principle and Monte Carlo method into analyzing the reliability of the retaining wall structures is more scientific, accurate and reliable, in comparison with those calculated by traditional method.

Observation of Multiple Broadband Alfvénic Chirping Modes in HL-2A NBI Plasmas

Multiple broadband Alfvenic chirping modes(CMs),with frequencies in the wide range of f-35-150 kHz and chirping down rapidly,are found in HL-2A neutral beam injection plasmas,and the CMs can even coexist.The frequency chirping down process can be completed within-1 ms,and the frequency shift can reach 30-50 kHz.The CMs propagate in ion diamagnetic drift directions poloidally.The toroidal mode number is confirmed to be n=1,2,3 and 4 for the f-35-65,55-90,70-120 and 100-150 kHz CMs,respectively.The CMs are more like to be energetic-particle continuum modes(EPMs),since the modes almost locate on the Alfven continuum.

Prediction of mode I fracture toughness of rock using linear multiple regression and gene expression programming

Prediction of mode I fracture toughness(KIC) of rock is of significant importance in rock engineering analyses. In this study, linear multiple regression(LMR) and gene expression programming(GEP)methods were used to provide a reliable relationship to determine mode I fracture toughness of rock. The presented model was developed based on 60 datasets taken from the previous literature. To predict fracture parameters, three mechanical parameters of rock mass including uniaxial compressive strength(UCS), Brazilian tensile strength(BTS), and elastic modulus(E) have been selected as the input parameters. A cluster of data was collected and divided into two random groups of training and testing datasets.Then, different statistical linear and artificial intelligence based nonlinear analyses were conducted on the training data to provide a reliable prediction model of KIC. These two predictive methods were then evaluated based on the testing data. To evaluate the efficiency of the proposed models for predicting the mode I fracture toughness of rock, various statistical indices including coefficient of determination(R2),root mean square error(RMSE), and mean absolute error(MAE) were utilized herein. In the case of testing datasets, the values of R2, RMSE, and MAE for the GEP model were 0.87, 0.188, and 0.156,respectively, while they were 0.74, 0.473, and 0.223, respectively, for the LMR model. The results indicated that the selected GEP model delivered superior performance with a higher R2value and lower errors.

Behavior of multiple modes before and during minor disruption with the external resonant magnetic perturbations on J-TEXT tokamak

The behavior of multiple modes before and during minor disruption with the external resonant magnetic perturbations(RMPs)has been studied on a J-TEXT tokamak.The main component of RMPs is m/n=2/1,where m and n are the numbers of the poloidal and toroidal modes,respectively.During the mode-locking caused by RMPs,it is found that before a minor or a major disruption(if there is no minor disruption),strong oscillations in both electron temperature and density occur if the edge safety factor q_(a)>3.The analysis shows that the oscillations are caused by the m/n=3/1 mode.In addition,using the ECE,Mirnov coils and 2D electron cyclotron emission imaging diagnostic systems,it is found that a thermal collapse occurs on the inner side of the 2/1magnetic island during the minor disruption,and before the collapse,a 3/2 island increases,after the collapse,the 3/2 island may disappear.Moreover,the study also shows that these 3/1,2/1 and 3/2modes play roles in the thermal collapse of disruptions.

Sensitivity of the Multiple Equilibria to Gorverning System, Mode Chosen and Parameter

Multiple equilibria of a forced, dissipative atmosphere system studied by Charney andothers have provided a new insight into the dynamics of the atmospheric circulation. But thetheoretical results remain some uncertainty for different approaches. Charney and Devore (1979) obtained two stable equilibria for certain range of externalforcing in the barotropic model, one of which is a high--index circulation, and the other alow--index for a blocking state. However Charney and Straus (1980) found that only thelow--index (blocking) state is stable and there do not exist multiple equilibria in the baroclinicmodel.

Dual Mode-Multiple Output SEPIC Converter Integrated with Passive Ripple Cancelling Circuit for Standalone PV Energy Harvesting System

This document addresses an exhaustive standalone Photovoltaic (PV) energy harvesting system considering two crucial issues: system efficiency and cost effectiveness. It contributes a compact resolution with a combined feature of Dual Mode-Multiple Output (DMMO) associated with input ripple reduction technique. Control strategy incorporates with aspect of Maximum Power Point Tracking (MPPT) and output voltage levels regulation. A theoretical analysis is conducted to evaluate the effect of ripple current on PV power. Proposed dual mode converter achieves efficiency of 98.36% and 97.76% respectively for mode-1 and mode-2 operation. However, simulation is performed applying MATLAB/SIMULINK tools to analyze the feasibility of the recommended system.

Multiple mode cooperation based software engineering talents training

The main problems of the traditional software talent training are that the knowledge learned is out of touch of the industry,weak ability to solve complex engineering problems and the comprehensive quality cannot meet the requirements of enterprises.Taking the course of digital image processing as an example,this paper analyzes the key steps in the training process in details,and proposes a multiple mode collaborative based software engineering talent training mechanism,which brings the key subjects of teaching materials,teachers,students,enterprises,subjects into a unified training mechanism,so as to provide a new ideas for software talent teaching.

Suppression of multiple modal resonances of a cantilever beam by an impact damper

Impact dampers are usually used to suppress single mode resonance. The goal of this paper is to clarify the difference when the impact damper suppresses the resonances of different modes. A cantilever beam equipped with the impact damper is modeled. The elastic contact of the ball and the cantilever beam is described by using the Hertz contact model. The viscous damper between the ball and the cantilever beam is modeled to consume the vibrational energy of the cantilever beam. A piecewise ordinary differential-partial differential equation of the cantilever beam is established, including equations with and without the impact damper. The vibration responses of the cantilever beam with and without the impact damper are numerically calculated. The effects of the impact absorber parameters on the vibration reduction are examined. The results show that multiple resonance peaks of the cantilever beam can be effectively suppressed by the impact damper. Specifically, all resonance amplitudes can be reduced by a larger weight ball. Moreover, the impacting gap is very effective in suppressing the vibration of the cantilever beam. More importantly, there is an optimal impacting gap for each resonance mode of the cantilever beam, but the optimal gap for each mode is different.

Integrated guidance and control of guided projectile with multiple constraints based on fuzzy adaptive and dynamic surface

Based on fuzzy adaptive and dynamic surface(FADS),an integrated guidance and control(IGC)approach was proposed for large caliber naval gun guided projectile,which was robust to target maneuver,canard dynamic characteristics,and multiple constraints,such as impact angle,limited measurement of line of sight(LOS)angle rate and nonlinear saturation of canard deflection.Initially,a strict feedback cascade model of IGC in longitudinal plane was established,and extended state observer(ESO)was designed to estimate LOS angle rate and uncertain disturbances with unknown boundary inside and outside of system,including aerodynamic parameters perturbation,target maneuver and model errors.Secondly,aiming at zeroing LOS angle tracking error and LOS angle rate in finite time,a nonsingular terminal sliding mode(NTSM)was designed with adaptive exponential reaching law.Furthermore,combining with dynamic surface,which prevented the complex differential of virtual control laws,the fuzzy adaptive systems were designed to approximate observation errors of uncertain disturbances and to reduce chatter of control law.Finally,the adaptive Nussbaum gain function was introduced to compensate nonlinear saturation of canard deflection.The LOS angle tracking error and LOS angle rate were convergent in finite time and whole system states were uniform ultimately bounded,rigorously proven by Lyapunov stability theory.Hardware-in-the-loop simulation(HILS)and digital simulation experiments both showed FADS provided guided projectile with good guidance performance while striking targets with different maneuvering forms.

Reliability analysis for aeroengine turbine disc fatigue life with multiple random variables based on distributed collaborative response surface method

The fatigue life of aeroengine turbine disc presents great dispersion due to the randomness of the basic variables,such as applied load,working temperature,geometrical dimensions and material properties.In order to ameliorate reliability analysis efficiency without loss of reliability,the distributed collaborative response surface method(DCRSM) was proposed,and its basic theories were established in this work.Considering the failure dependency among the failure modes,the distributed response surface was constructed to establish the relationship between the failure mode and the relevant random variables.Then,the failure modes were considered as the random variables of system response to obtain the distributed collaborative response surface model based on structure failure criterion.Finally,the given turbine disc structure was employed to illustrate the feasibility and validity of the presented method.Through the comparison of DCRSM,Monte Carlo method(MCM) and the traditional response surface method(RSM),the results show that the computational precision for DCRSM is more consistent with MCM than RSM,while DCRSM needs far less computing time than MCM and RSM under the same simulation conditions.Thus,DCRSM is demonstrated to be a feasible and valid approach for improving the computational efficiency of reliability analysis for aeroengine turbine disc fatigue life with multiple random variables,and has great potential value for the complicated mechanical structure with multi-component and multi-failure mode.

Analyzing of mixing performance determination factors for the structure of radial multiple jets-in-crossflow

The radial multiple jets-in-crossflow mixing structure(RMJCMS) is extensively used in industrial manufacture. In this research, the effects of thickness of injection ring on mixing performance and factors influencing the mixing performance of RMJCMS were discussed based on the results of computational fluid dynamics. The simulation results showed that the dimensionless mixing distance, with the increase of the thickness of injection ring, drops from 1.1 to 0.18 first and then increases to 0.27 while the uniformity of flux monotonously improves, manifesting that the consistency of flux is not the single element determining the mixing performance. Analyzing the simulation results, a conclusion was drawn that the consistency of flux, penetration mode and interaction among injection flows which can be altered by adjusting the thickness of injection ring, determine the mixing performance of RMJCMS jointly. That is to say, in RMJCMS an injection ring with a suitable thickness can realize the function of injection and rectification simultaneously, which not only improves the mixing performance but also reduces the complexity of RMJCMS as well.

Raman spectrum study of δ-doped GaAs/AlAs multiple-quantum wells

Three samples of GaAs/A1As multiple-quantum wells with different quantum well widths and tS-doped with Be ac- ceptors at the well center were grown on （100） GaAs substrates by molecular beam epitaxy. Polarized Raman spectra were recorded on the three samples at temperatures in a range of 4-50 K in a backscattering configuration. The two branches of coupled modes due to the interaction of the hole intersubband transitions and the quantum-well longitudinal optical （LO） phonon were observed clearly. The evaluation formalism of the Green function was employed and each lineshape of the Raman spectrum of the coupled modes was simulated. The dependence of the peak position of Raman shifts of the two coupled modes as well as the quantum-well LO phonon on the quantum-well size and measured temperature were given, and the coupling interaction mechanism between the hole subband transitions and the quantum-well LO phonon was researched.

System Reliability Analysis for Truss Structures Based on Automatic Updated Model

Multiple failure modes tend to be identified in the reliability analysis of a redundant truss structure.This identification process involves updating the model for identifying the next potential failure members.Herein we intend to update the finite element model automatically in the identification process of failure modes and further perform the system reliability analysis efficiently.This study presents a framework that is implemented through the joint simulation of MATLAB and APDL and consists of three parts:reliability index of a single member,identification of dominant failure modes,and system-level reliability analysis for system reliability analysis of truss structures.Firstly,RSM(response surface method)combines with a constrained optimization model to calculate the reliability indices ofmembers.Then theβ-unzipping method is adopted to identify the dominant failuremodes,and the system function in MATLAB,as well as the EKILL command in APDL,is used to facilitate the automatic update of the finite element model and realize load-redistribution.Besides,the differential equivalence recursion algorithmis performed to approximate the reliability indices of failuremodes efficiently and accurately.Eventually,the PNET(probabilistic network evaluation technique)is used to calculate the joint failure probability as well as the system reliability index.Two illustrative examples demonstrate the accuracy and efficiency of the proposed system reliability analysis framework through comparison with corresponding references.

Robust stability analysis for Markovian jumping stochastic neural networks with mode-dependent time-varying interval delay and multiplicative noise

This paper is concerned with the problem of robust stability for a class of Markovian jumping stochastic neural networks （MJSNNs） subject to mode-dependent time-varying interval delay and state-multiplicative noise. Based on the Lyapunov-Krasovskii functional and a stochastic analysis approach, some new delay-dependent sufficient conditions are obtained in the linear matrix inequality （LMI） format such that delayed MJSNNs are globally asymptotically stable in the mean-square sense for all admissible uncertainties. An important feature of the results is that the stability criteria are dependent on not only the lower bound and upper bound of delay for all modes but also the covariance matrix consisting of the correlation coefficient. Numerical examples are given to illustrate the effectiveness.

以OBE为导向的多元教学模式在实验诊断学教学改革中的应用

目的 探究以成果导向教育(outcomes-based education,OBE)为基础的多元教学模式在实验诊断学教学中的应用效果。方法 2022年2—8月,选取河北大学2019级临床专业3班、4班学生作为研究对象,共计159名学生,将3班79名学生作为对照组,4班80名为试验组。对照组学生应用传统教学模式教学,试验组学生应用以OBE为导向的多元教学模式教学,比较两组学生的总成绩、笔试成绩、课堂提问+出勤成绩,并从多维度对教学满意度进行调查,对比分析两组学生的学习效果。结果 试验组总成绩、笔试成绩高于对照组,差异有统计学意义(P <0.05);两组课堂提问+出勤成绩比较,差异无统计学意义(P> 0.05)。试验组学生对教学的课程设计、教学方法、教学内容、学习兴趣、学习效率、检验报告解读能力、临床思维培养能力的满意度均高于照组,差异有统计学意义(P <0.05)。结论OBE导向的多元教学模式在实验诊断学教改中的应用提高了学生的学习能力、学习兴趣、团结合作和沟通能力,有助于培养适应医学发展所需要的具有创新能力的实用型医学人才。

生态环境法典的罪刑条款设置

“《刑法典》是环境刑法更好的归属”的观点,只是一种主观判断,不一定符合事实;我国清末以来的刑法典都预设了多元刑事立法模式,单一刑法典模式不是由刑法典自身形成的,而是由于其他法律不设置罪刑条款形成的,生态环境法典应当直接设置环境犯罪的罪刑条款;罪刑条款应当与行为规则、行政处罚条款密切接近,故应采取分散型设置方式;行政刑法的特点是通过补强行为规则,确保行为规则的有效性,故生态环境法典中的罪刑条款通常采取行政犯的表述方式,但部分条款也可以采取刑法犯的表述方式;罪刑条款应以行政处罚条款为基础,通过增加不法要素与责任要素的方式,使环境犯罪具备应受刑罚处罚性;处理行政处罚与刑罚处罚的关系时,重在防止以刑罚处罚替代行政处罚;应当将行为人积极履行《民法典》规定的“修复生态环境责任”,规定为环境犯罪的减免处罚事由;生态环境法典中的罪刑条款设置应注重必要性、明确性、合理性、协调性,不必顾虑与现行刑法典中环境犯罪条款的重复与交叉。

考虑多失效模式的桩锚结构鲁棒性设计及经济性优化

目的 研究岩土力学参数的不确定性对桩锚支护体系的整体影响,探究经济性和鲁棒性共同作用的优化设计。方法 选取黄土地区工程案例,考虑支护桩隆起破坏、支护桩倾覆破坏、整体稳定性破坏三类破坏形式,使用蒙特卡洛及点估计法嵌套的方式求出不同设计组合下的失效概率及标准差;同时考虑优化设计的经济性,筛选出桩锚支护结构体系的鲁棒性优化设计方案。结果 随着桩长增加,主控模式由隆起破坏向整体稳定性改变,不同的几何参数对结构鲁棒性影响不同,优化后可以获得同时满足经济性、鲁棒性及可靠度要求的最佳设计方案。结论 在桩锚结构设计中考虑经济性优化及多失效模式的鲁棒性设计是必要的。

基于联合库存的公立医院多院区药品采购模式分析

目的 评价联合库存管理(JMI)方法在医院多院区药品采购与控制管理中的应用效果。方法 基于JMI模式,运用合理的数据处理方法从某集团医院筛选出4种试点药品进行研究,从库存成本、周转情况、供应情况等方面对比、分析应用后的效果。结果 某集团医院在应用中心医院主导的JMI模式后,3家分院试点药品库存量和库存金额显著降低,库存量较实施前减少31.93%,平均库存金额减少16.23%;库存周转天数显著减少,3家分院周转天数均减少1 d以上;药品缺货率显著降低,试点药品中变化最明显的多柔比星脂质体注射液,缺货率下降6.7%;各组数据的比较结果均具有统计学意义(P<0.05)。结论 医院多院区采用中心医院主导的JMI模式,可以明显改善药品采购管理和库存管理的效果,从而提升医院资金的使用效率。