Improving pressure ulcer care in intensive care units:Evaluating the impact of bundled care and silver nanoparticle dressings

BACKGROUND Pressure ulcer(PU)are prevalent among critically ill trauma patients,posing substantial risks.Bundled care strategies and silver nanoparticle dressings offer potential solutions,yet their combined effectiveness and impact on patient satisfaction remain insufficiently investigated.AIM To assess the impact of bundled care along with silver nanoparticle dressing on PUs management and family satisfaction in critically ill trauma patients.METHODS A total of 98 critically ill trauma patients with PUs in intensive care unit(ICU)were included in this study.Patients were randomly assigned to either the control group(conventional care with silver nanoparticle dressing,n=49)or the intervention group(bundled care with silver nanoparticle dressing,n=49).The PU Scale for Healing(PUSH)tool was used to monitor changes in status of pressure injuries over time.Assessments were conducted at various time points:Baseline(day 0)and subsequent assessments on day 3,day 6,day 9,and day 12.Family satisfaction was assessed using the Family Satisfaction ICU 24 ques-tionnaire.RESULTS No significant differences in baseline characteristics were observed between the two groups.In the intervention group,there were significant reductions in total PUSH scores over the assessment period.Specifically,surface area,exudate,and tissue type parameters all showed significant improvements compared to the control group.Family satisfaction with care and decision-making was notably higher in the intervention group.Overall family satisfaction was significantly better in the intervention group.CONCLUSION Bundled care in combination with silver nanoparticle dressings effectively alleviated PUs and enhances family satisfaction in critically ill trauma patients.This approach holds promise for improving PUs management in the ICU,benefiting both patients and their families.

Analysis of The Effect of Bundled Nursing Intervention on Lung Cancer Patients with a High Risk of PICC-Related Thrombosis

Objective: To explore the effect of bundled nursing intervention on lung cancer patients with a high risk of PICC-related thrombosis. Methods: Eighty-six PICC patients were selected and randomly divided into a control group and an observation group of 43 patients each. The control group received general nursing care and the observation group received bundled nursing intervention based on the control group. The occurrence of venous thrombosis, quality of life score, Zung self-rating depression scale (SDS) score, self-rating anxiety (SAS) score, and nursing satisfaction after treatment were compared between the two groups. Results: The incidence rate of PICC-related venous thrombosis in the observation group (2/4.652%) was lower than that of the control group (13/30.231%) after nursing intervention (P < 0.05). After the intervention, the quality-of-life scores of the observation group were higher than those of the control group (P < 0.001). After the intervention, the SDS and SAS scores of the observation group were lower than those of the control group (P < 0.001). The nursing satisfaction rate of the observation group (41/ 4.652%) was higher than that of the control group (35/18.604%) (P < 0.05). The difference is statistically significant. Conclusion: In the care of lung cancer patients with a high risk of PICC-related thrombosis, bundled nursing care achieved better results.

Bundled Hybrid Offset Riser Global Strength Analysis

Bundled hybrid offset riser (BHOR) global strength analysis, which is more complex than single line offset riser global strength analysis, was carried out in this paper. At first, the equivalent theory is used to deal with BHOR, and then its global strength in manifold cases was analyzed, along with the use of a three-dimensional nonlinear time domain finite element program. So the max bending stress, max circumferential stress, and max axial stress in the BHOR bundle main section (BMS) were obtained, and the values of these three stresses in each riser were obtained through the "stress distribution method". Finally, the Max Von Mises stress in each riser was given and a check was made whether or not they met the demand. This paper provides a reference for strength analysis of the bundled hybrid offset riser and some other bundled pipelines.

Left bundle branch pacing set to outshine biventricular pacing for cardiac resynchronization therapy?

The deleterious effects of long-term right ventricular pacing necessitated the search for alternative pacing sites which could prevent or alleviate pacinginduced cardiomyopathy.Until recently,biventricular pacing(BiVP)was the only modality which could mitigate or prevent pacing induced dysfunction.Further,BiVP could resynchronize the baseline electromechanical dssynchrony in heart failure and improve outcomes.However,the high non-response rate of around 20%-30%remains a major limitation.This non-response has been largely attributable to the direct non-physiological stimulation of the left ventricular myocardium bypassing the conduction system.To overcome this limitation,the concept of conduction system pacing(CSP)came up.Despite initial success of the first CSP via His bundle pacing(HBP),certain drawbacks including lead instability and dislodgements,steep learning curve and rapid battery depletion on many occasions prevented its widespread use for cardiac resynchronization therapy(CRT).Subsequently,CSP via left bundle branch-area pacing(LBBP)was developed in 2018,which over the last few years has shown efficacy comparable to BiVP-CRT in small observational studies.Further,its safety has also been well established and is largely free of the pitfalls of the HBP-CRT.In the recent metanalysis by Yasmin et al,comprising of 6 studies with 389 participants,LBBPCRT was superior to BiVP-CRT in terms of QRS duration,left ventricular ejection fraction,cardiac chamber dimensions,lead thresholds,and functional status amongst heart failure patients with left bundle branch block.However,there are important limitations of the study including the small overall numbers,inclusion of only a single small randomized controlled trial(RCT)and a small follow-up duration.Further,the entire study population analyzed was from China which makes generalizability a concern.Despite the concerns,the meta-analysis adds to the growing body of evidence demonstrating the efficacy of LBBP-CRT.At this stage,one must acknowledge that the fact that still our opinions on this technique are largely based on observational data and there is a dire need for larger RCTs to ascertain the position of LBBPCRT in management of heart failure patients with left bundle branch block.

Left bundle branch pacing vs biventricular pacing in heart failure patients with left bundle branch block:A systematic review and meta-analysis

BACKGROUND Left bundle branch pacing(LBBP)is a novel pacing modality of cardiac resynchronization therapy(CRT)that achieves more physiologic native ventricular activation than biventricular pacing(BiVP).AIM To explore the validity of electromechanical resynchronization,clinical and echocardiographic response of LBBP-CRT.METHODS Systematic review and Meta-analysis were conducted in accordance with the standard guidelines as mentioned in detail in the methodology section.RESULTS In our analysis,the success rate of LBBP-CRT was determined to be 91.1%.LBBP CRT significantly shortened QRS duration,with significant improvement in echocardiographic parameters,including left ventricular ejection fraction,left ventricular end-diastolic diameter and left ventricular end-systolic diameter in comparison with BiVP-CRT.CONCLUSION A significant reduction in New York Heart Association class and B-type natriuretic peptide levels was also observed in the LBBP-CRT group vs BiVP-CRT group.Lastly,the LBBP-CRT cohort had a reduced pacing threshold at follow-up as compared to BiVP-CRT.

Simulation studies of tungsten impurity behaviors during neon impurity seeding with tungsten bundled charge state model using SOLPS-ITER on EAST

An investigation into tungsten(W)impurity behaviors with the update of the EAST lower W divertor for H-mode has been carried out using SOLPS-ITER.This work aims to study the effect of external neon(Ne)impurity seeding on W impurity sputtering with the bundled charge state model.As the Ne seeding rate increases,plasma parameters,W concentration(C_(W)),and eroded W flux(Γ_(W)^(Ero))at both targets are compared and analyzed between the highly resolved bundled model‘jett’and the full W charge state model.The results indicate that‘jett’can produce divertor behaviors essentially in agreement with the full W charge state model.The bundled scheme with high resolution in low W charge states(<W^(20+))has no obvious effect on the Ne impurity distribution and thus little effect on W sputtering by Ne.Meanwhile,parametric scans of radial particle and thermal transport diffusivities(D_(⊥)andχ_(e,i))in the SOL are simulated using the‘jett’bundled model.The results indicate that the transport diffusivity variations have significant influences on the divertor parameters,especially for W impurity sputtering.

Crosstalk Effect in Bundled SWCNT, DWCNT and MWCNT Carbon Nanotubes

In this paper, different models of parallel Carbon nanotube Bundles are carried out and simulated. In the first place, a model of three parallel SWCNT （singe walled carbon nanotube） Bundles and DWCNT （double walled carbon nanotube） Bundles was established and simulated. It has been noticed that the variation on the number of Carbon nanotubes in the bundle has an impact on the crosstalk amplitude. In the second place, a model of three parallel MWCNT （multi walled carbon nanotube） Bundles was established and simulated and the crosstalk effect has been noticed and compared with SWCNT/DWCNT Bundles. Finally a model of mixed Bundles （Single-Double-Single） and （Double-Single-Double） was carried out and simulated. All simulations were established using Pspice.

COMPLETE KAHLER METRICS WITH POSITIVE HOLOMORPHIC SECTIONAL CURVATURES ON CERTAIN LINE BUNDLES(RELATED TO A COHOMOGENEITY ONE POINT OF VIEW ON A YAU CONJECTURE)

In this article,we study Kahler metrics on a certain line bundle over some compact Kahler manifolds to find complete Kahler metrics with positive holomorphic sectional(or bisectional)curvatures.Thus,we apply a strategy to a famous Yau conjecture with a co-homogeneity one geometry.

Selective his bundle pacing eliminates crochetage sign:A case report

BACKGROUND Crochetage sign is a specific electrocardiographic manifestation of ostium secundum atrial septal defects(ASDs),which is associated with the severity of the left-to-right shunt.Herein,we reported a case of selective his bundle pacing(SHBP)that eliminated crochetage sign in a patient with ostium secundum ASD.CASE SUMMARY A 77-year-old man was admitted with a 2-year history of chest tightness and shortness of breath.Transthoracic echocardiography revealed an ostium secundum ASD.Twelve-lead electrocardiogram revealed atrial fibrillation with a prolonged relative risk interval,incomplete right bundle branch block,and crochetage sign.The patient was diagnosed with an ostium secundum ASD,atrial fibrillation with a second-degree atrioventricular block,and heart failure.The patient was treated with selective his bundle pacemaker implantation.After the procedure,crochetage sign disappeared during his bundle pacing on the electrocardiogram.CONCLUSION S-HBP eliminated crochetage sign on electrocardiogram.Crochetage sign may be a manifestation of a conduction system disorder.

Left bundle branch area pacing combined with implantable cardioverter-defibrillator treatment for heart failure after myocardial infarction

Left bundle branch area pacing(LBBAP)has emerged as a new physiological pacing mode.Previous studies have confirmed the feasibility and efficacy of LBBAP for cardiac resynchronization therapy(CRT)in heart failure(HF)patients with left bundle branch block(LBBB)and a narrower QRS duration(QRSd)to have a higher percentage of super responders,and lower pacing thresholds than biventricular pacing(BiVP).

A new interacting capillary bundle model on the multiphase flow in micropores of tight rocks

Surfactants are widely used in the fracturing fluid to enhance the imbibition and thus the oil recovery rate. However, current numerical models cannot capture the physics behind capillary imbibition during the wettability alteration by surfactants. Although the interacting capillary bundle(ICB) model shows potential in characterizing imbibition rates in different pores during wettability alteration, the existing ICB models neglect the influence of wettability and viscosity ratio on the imbibition behavior, making it difficult to accurately describe the oil-water imbibition behavior within the porous media. In this work,a new ICB mathematical model is established by introducing pressure balance without assuming the position of the leading front to comprehensively describe the imbibition behavior in a porous medium under different conditions, including gas-liquid spontaneous imbibition and oil-water imbibition.When the pore size distribution of a tight rock is known, this new model can predict the changes of water saturation during the displacement process in the tight rock, and also determine the imbibition rate in pores of different sizes. The water saturation profiles obtained from the new model are validated against the waterflooding simulation results from the CMG, while the imbibition rates calculated by the model are validated against the experimental observations of gas-liquid spontaneous imbibition. The good match above indicates the newly proposed model can show the water saturation profile at a macroscopic scale while capture the underlying physics of the multiphase flow in a porous medium at a microscopic scale. Simulation results obtained from this model indicate that both wettability and viscosity ratio can affect the sequence of fluid imbibition into pores of different sizes during the multiphase flow, where less-viscous wetting fluid is preferentially imbibed into larger pores while more-viscous wetting fluid tends to be imbibed into smaller pores. Furthermore, this model provides an avenue to calculate the imbibition rate in pores of different sizes during wettability alteration and capture the non-Darcy effect in micro-and nano-scale pores.

Fiber Bundle Topology Optimization for Surface Flows

This paper presents a topology optimization approach for the surface flows on variable design domains.Via this approach,the matching between the pattern of a surface flow and the 2-manifold used to define the pattern can be optimized,where the 2-manifold is implicitly defined on another fixed 2-manifold named as the base manifold.The fiber bundle topology optimization approach is developed based on the description of the topological structure of the surface flow by using the differential geometry concept of the fiber bundle.The material distribution method is used to achieve the evolution of the pattern of the surface flow.The evolution of the implicit 2-manifold is realized via a homeomorphous map.The design variable of the pattern of the surface flow and that of the implicit 2-manifold are regularized by two sequentially implemented surface-PDE filters.The two surface-PDE filters are coupled,because they are defined on the implicit 2-manifold and base manifold,respectively.The surface Navier-Stokes equations,defined on the implicit 2-manifold,are used to describe the surface flow.The fiber bundle topology optimization problem is analyzed using the continuous adjoint method implemented on the first-order Sobolev space.Several numerical examples have been provided to demonstrate this approach,where the combination of the viscous dissipation and pressure drop is used as the design objective.

Space Elastic Modal Modeling and Control of A New Generation Solid Bundled Rocket

In this paper,based upon the characteristics of elastic modal combination of large solid bundled launch vehicles,the finite element theory is used to describe the complex elastic vibration of a solid bundled launch vehicle,and a new three-channel unified elastic vibration equation was established.The elastic vibration equation can reflect the coupling between channels and between boosters and core stage.Some issues need consideration in the theoretical derivation,an engineering application was proposed,and the elastic vibration model was verified.The results of the theoretical derivation and simulation show that the elastic vibration equation of a solid bundled launch vehicle established in the paper is correct and can meet the needs for the engineering application.

Study on the Effect of Solid Particles on Jet Flow and Base Thermal Environment for Solid-Liquid Bundled Rocket

Compared with using liquid rocket engines,there are a lot of high-temperature solid particles in the solid-liquid bundled rocket,which make the rocket base thermal environment worse.In order to study the influence of high-temperature solid particles on the base thermal environment,firstly,the effect of particle diameter on the jet distribution and the thermal environment in a single solid motor jet was analyzed using a numerical simulation method,and the results were compared with those of a ground test.Further,the effects of high-temperature solid particles on the jet and the thermal environment of the solid-liquid bundled rocket were analyzed and compared with flight data.The results show that high-temperature solid particles can increase the jet temperature and reduce the jet velocity.The larger the particle diameter,the greater the impact on the jet core temperature.The role of high-temperature solid particles cannot be ignored in the study of the base thermal environment.

专业Bundles策略护理在骨折合并脾脏损伤护理中的应用价值

目的:探讨与分析专业Bundles策略护理在骨折合并脾脏损伤护理中的应用价值.方法:选择2021年2月—2023年2月我院收治的76例骨折合并脾脏损伤患者为研究对象,根据随机信封抽签1∶1原则将其分为Bundles组与对照组,各38例.对照组在围手术期实施常规护理,Bundles组在对照组基础上给予围手术期专业Bundles策略护理,2组护理观察时间均为14 d.记录2组患者的预后恢复、心理变化、并发症与护理满意度情况.结果:Bundles组术中出血量少于对照组,手术时间、术后肛门排气时间、术后肛门排便时间、术后下床活动时间、术后住院时间均短于对照组,组间差异有统计学意义(P<0.05);护理14 d后,2组SDS、SAS评分均低于护理前,且Bundles组低于对照组,差异有统计学意义(P<0.05);Bundles组并发症发生率低于对照组,差异有统计学意义(P<0.05);Bundles组护理满意度高于对照组,差异有统计学意义(P<0.05).结论:专业Bundles策略护理在骨折合并脾脏损伤护理中的应用能促进患者康复,可减少创伤,缓解患者的焦虑与抑郁情绪,并且还能提高安全性,减少不良事件的发生,患者更加满意.

Optimized CUDA Implementation to Improve the Performance of Bundle Adjustment Algorithm on GPUs

The 3D reconstruction pipeline uses the Bundle Adjustment algorithm to refine the camera and point parameters. The Bundle Adjustment algorithm is a compute-intensive algorithm, and many researchers have improved its performance by implementing the algorithm on GPUs. In the previous research work, “Improving Accuracy and Computational Burden of Bundle Adjustment Algorithm using GPUs,” the authors demonstrated first the Bundle Adjustment algorithmic performance improvement by reducing the mean square error using an additional radial distorting parameter and explicitly computed analytical derivatives and reducing the computational burden of the Bundle Adjustment algorithm using GPUs. The naïve implementation of the CUDA code, a speedup of 10× for the largest dataset of 13,678 cameras, 4,455,747 points, and 28,975,571 projections was achieved. In this paper, we present the optimization of the Bundle Adjustment algorithm CUDA code on GPUs to achieve higher speedup. We propose a new data memory layout for the parameters in the Bundle Adjustment algorithm, resulting in contiguous memory access. We demonstrate that it improves the memory throughput on the GPUs, thereby improving the overall performance. We also demonstrate an increase in the computational throughput of the algorithm by optimizing the CUDA kernels to utilize the GPU resources effectively. A comparative performance study of explicitly computing an algorithm parameter versus using the Jacobians instead is presented. In the previous work, the Bundle Adjustment algorithm failed to converge for certain datasets due to several block matrices of the cameras in the augmented normal equation, resulting in rank-deficient matrices. In this work, we identify the cameras that cause rank-deficient matrices and preprocess the datasets to ensure the convergence of the BA algorithm. Our optimized CUDA implementation achieves convergence of the Bundle Adjustment algorithm in around 22 seconds for the largest dataset compared to 654 seconds for the sequential implementation, resulting in a speedup of 30×. Our optimized CUDA implementation presented in this paper has achieved a 3× speedup for the largest dataset compared to the previous naïve CUDA implementation.

Left bundle branch area pacing:A new era of cardiac resynchronization therapy?

The recent systematic review and meta-analysis provided a comprehensive focus on the current state of cardiac resynchronization therapy(CRT).The authors determined the feasibility of physiological left bundle branch area pacing(LBBAP)in patients indicated for CRT through a careful analysis of trials.They found that LBBAP was associated with significant reductions in QRS duration,New York Heart Association functional class,B-type natriuretic peptide levels,and pacing thresholds as well as improvements in echocardiographic parameters compared to biventricular pacing.

DTN网络中的基于Bundle协议的数据包发送算法

DTN传输协议引入束和分片的概念,将数据分块传输以适应经常发生链接中断的链路。研究了DTN传输层的Bundle协议和LTP(Licklider transmission protocol)协议,针对网络环境可能在短时间内剧烈变化的问题,研究了数据块的大小对传输效率的影响,提出了DTN网络中基于Bundle协议的数据包发送算法,动态选择最适合当前网络状况的发送策略以获得最佳的系统性能和传输效率。仿真结果表明:适当选取发送数据块的大小可以大幅度提高传输效率。

基于Douglas-Peucker和Quick Bundles算法的水上交通模式识别

针对船舶航迹数据量大、数据冗余、航迹特征不明显等问题,提出一种融合道格拉斯-普克(Douglas-Peucker,DP)压缩算法和基于距离的快速捆绑包(Quick Bundles,QB)聚类算法的水上交通模式识别方法。该方法根据航迹数据特征、压缩率和压缩误差等指标选择合理的压缩阈值实现大规模船舶自动识别系统(automatic identification system,AIS)数据的压缩。在此基础上,提出一种基于最小直接翻转距离的聚类指标,利用QB算法实现船舶航迹的有效聚类。实验结果表明,提出的方法既可以简化航迹聚类过程,也可准确高效地实现航迹聚类,为水上交通精细化管理与决策提供数据支撑。

QTL Analysis of Rice Peduncle Vascular Bundle System and Panicle Traits

A double haploid (DH) population of rice (Oryza sativa L.) derived from anther culture of ZYQ8/JX17, a typical indica and japonica hybrid, was used for genetic analysis of rice peduncle vascular system and panicle traits. The number of large vascular bundles (LVB), the number of small vascular bundles (SVB) in the peduncle, and the panicle traits including the number of primary rachis branches (PRB), the number of spikelets per panicle (SNP), peduncle top diameter (PTD), and panicle length (PL) were investigated in the parents and DH lines. The quantitative trait loci (QTLs) for each trait were analyzed based on the constructed molecular linkage map of this population. Three QTLs for LVB (qLVB_1, qLVB_6 and qLVB_7) were detected on chromosomes 1, 6, and 7, respectively. Two putative QTLs for SVB (qSVB_4 and qSVB_6) were mapped on chromosomes 4 and 6 respectively. Four QTLs (qPRB_4a, qPRB_4b, qPRB_6 and qPRB_7) on chromosomes 4, 6, and 7, respectively, were detected for PRB. Three QTLs (qSPN_4a, qSPN_4b and qSPN_6) were identified on chromosomes 4 and 6, respectively, which could significantly affect SPN. Five QTLs for PTD (qPTD_2, qPTD_5, qPTD_6, qPTD_8 and qPTD_12) were identified on chromosomes 2, 5, 6, 8, and 12, respectively. Three QTLs for PL (qPL_4, qPL_6 and qPL_8) were detected on chromosomes 4, 6, and 8, respectively. Clustering of QTLs, such as qLVB_6, qSVB_6, qSNP_6, qPTD_6, and qPL_6 detected in the interval G122_G1314b on chromosome 6, was found. These results suggest that some QTLs for peduncle vascular bundle system are possibly responsible for the panicle traits.