社区居家老年人跌倒经历的体验:质性研究的meta整合

目的系统评价和整合社区居家老年人跌倒经历的看法与体验,为后续发展跌倒预防及管理的干预提供信息,为健康照护实践提供建议。方法依据乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)质性系统评价方法论进行质性研究meta整合,在PubMed、CINAHL、PsycInfo、Embase、Web of science等数据库进行检索,发表时间限定为2010年1月至2023年5月,仅纳入经同行评审的英文文献。使用JBI质性研究质量评价标准评价纳入文献的方法学质量,按照ConQual评分准则检验整合结果的信度。本综述方案已在PROSPERO注册(CRD 42023421789)。结果共纳入10项研究,方法学质量评价得分为60%至90%。提炼59个完好明确的结果,将相似结果归纳组合形成7个类别,并综合成3个整合结果,在ConQual评分上,综合结果2评为中等,综合结果1和3评为低等。整合结果1:跌倒后老年人经历了身体的损伤和疼痛、日常活动受限、社交受限、独立性降低或丧失、并有恐惧和无助感。整合结果2:经历跌倒后,老年人反思跌倒的原因,并识别、解释风险因素。整合结果3:老年人对跌倒原因和后果有正面和负面的看法,其采取的应对跌倒的措施包括使用辅助器具、纠正风险因素、寻求医疗帮助、关注身体和心理状况等。结论医疗卫生提供者应重视老年人跌倒后的感受、经历,以及对跌倒原因和影响的反思,进行特定的干预。今后还需要进行纵向研究,以检测跌倒对老年人的长期影响,深入了解他们的反思、感知、态度和预防行为随时间的改变情况。

Train post‑derailment behaviours and containment methods:a review

Railway accidents,particularly serious derailments,can lead to catastrophic consequences.Therefore,it is essential to prevent derailment escalation to reduce the likelihood of severe derailments.Train post-derailment behaviours and containment methods play a critical role in preventing derailment escalation and providing passive safety protection and accident prevention in the event of a derailment.However,despite the increasing attention on this field from academia and industry in recent years,there is a lack of systematic exploration and summarization of emerging applications and containment methods in train post-derailment research.For this reason,this paper presents a comprehensive review of existing studies on train post-derailment behaviours,encompassing various topics such as post-derailment contact-impact models,dynamic modelling and simulation techniques,and the primary factors influencing post-derailment behaviours.Significantly,this review introduces and elucidates substitute guidance mechanisms(SGMs),which serve as railway-specific passive safety protection and accident prevention measures.The various types of SGMs are depicted,and their ongoing developments and applications are explored in depth.The review additionally points out several unresolved challenges including the adverse effects of SGMs,and proposes future research directions to advance the theoretical understanding and practical application of train post-derailment behaviours and containment methods.This review seeks to be a valuable reference for railway industry professionals in preventing catastrophic derailment consequences through post-derailment containment methods.

Mutual Self‑Regulation of d‑Electrons of Single Atoms and Adjacent Nanoparticles for Bifunctional Oxygen Electrocatalysis and Rechargeable Zinc‑Air Batteries

Rechargeable zinc-air batteries(ZABs)are a promising energy conversion device,which rely critically on electrocatalysts to accelerate their rate-determining reactions such as oxygen reduction(ORR)and oxygen evolution reactions(OER).Herein,we fabricate a range of bifunctional M-N-C(metal-nitrogen-carbon)catalysts containing M-Nx coordination sites and M/MxC nanoparticles(M=Co,Fe,and Cu)using a new class ofγ-cyclodextrin(CD)based metal-organic framework as the precursor.With the two types of active sites interacting with each other in the catalysts,the obtained Fe@C-FeNC and Co@C-CoNC display superior alkaline ORR activity in terms of low half-wave(E1/2)potential(~0.917 and 0.906 V,respectively),which are higher than Cu@C-CuNC(~0.829 V)and the commercial Pt/C(~0.861 V).As a bifunctional electrocatalyst,the Co@C-CoNC exhibits the best performance,showing a bifunctional ORR/OER overpotential(ΔE)of~0.732 V,which is much lower than that of Fe@C-FeNC(~0.831 V)and Cu@C-CuNC(~1.411 V),as well as most of the robust bifunctional electrocatalysts reported to date.Synchrotron X-ray absorption spectroscopy and density functional theory simulations reveal that the strong electronic correlation between metallic Co nanoparticles and the atomic Co-N4 sites in the Co@C-CoNC catalyst can increase the d-electron density near the Fermi level and thus effectively optimize the adsorption/desorption of intermediates in ORR/OER,resulting in an enhanced bifunctional electrocatalytic performance.The Co@C-CoNC-based rechargeable ZAB exhibited a maximum power density of 162.80 mW cm^(−2) at 270.30 mA cm^(−2),higher than the combination of commercial Pt/C+RuO2(~158.90 mW cm^(−2) at 265.80 mA cm^(−2))catalysts.During the galvanostatic discharge at 10 mA cm^(−2),the ZAB delivered an almost stable discharge voltage of 1.2 V for~140 h,signifying the virtue of excellent bifunctional ORR/OER electrocatalytic activity.

Machine Learning Driven Latency Optimization for Internet of Things Applications in Edge Computing

Emerging Internet of Things(IoT)applications require faster execution time and response time to achieve optimal performance.However,most IoT devices have limited or no computing capability to achieve such stringent application requirements.To this end,computation offloading in edge computing has been used for IoT systems to achieve the desired performance.Nevertheless,randomly offloading applications to any available edge without considering their resource demands,inter-application dependencies and edge resource availability may eventually result in execution delay and performance degradation.We introduce Edge-IoT,a machine learning-enabled orchestration framework in this paper,which utilizes the states of edge resources and application resource requirements to facilitate a resource-aware offloading scheme for minimizing the average latency.We further propose a variant bin-packing optimization model that co-locates applications firmly on edge resources to fully utilize available resources.Extensive experiments show the effectiveness and resource efficiency of the proposed approach.

自然旅游地居民自然保护态度的影响因素——中国九寨沟和英国新森林国家公园的比较

居民的自然保护态度对自然旅游地的自然保护与旅游可持续发展至关重要,自然旅游地居民自然保护态度的影响因子及影响方式,已经成为自然旅游地管理的重要内容,但相关研究薄弱。以中国九寨沟和英国新森林国家公园(New Forest National Park,NF)为例,根据实地问卷调查数据,从两地居民的人口属性、旅游环保期望、旅游环境影响感知及旅游环境伦理观与其自然保护态度关系的角度,进行定量比较研究。研究发现:(1)两地居民的自然保护态度受不同因子的影响,存在明显的中外差异;(2)人口属性特征如性别、年龄、居住年限、教育水平及旅游业参与情况对新森林国家公园社区居民的自然保护态度没有影响;但性别、旅游业参与情况却影响九寨沟居民的自然保护态度,女性及旅游业参与者更支持对九寨沟进行自然保护;(3)新森林国家公园居民的自然保护态度受其旅游环保期望及旅游环境伦理观的影响:旅游环保期望较高、持保护主义环境伦理观的新森林国家公园居民,更有可能支持对新森林国家公园进行自然保护;(4)九寨沟居民的自然保护态度不受其旅游环保期望及旅游环境伦理的影响,但受其旅游环境影响感知的影响;居民的旅游环境影响感知越消极,越支持对九寨沟进行自然保护。

点到隐式曲面的正交投影计算

针对点到隐式曲面的正交投影问题,提出一种稳定的几何迭代算法.首先构造初始点处的一条特殊的法截线,并给出沿着该法截线追踪投影点的二阶泰勒迭代方法;然后将给定点向初始点处的法截线的曲率圆作投影,提出基于曲率的步长控制策略,在此基础上给出了基于梯度的迭代误差矫正方法.仿真结果表明,该算法具有良好的收敛性、鲁棒性以及精确性.

澳门护理专业本科生逆境商的调查研究

目的调查澳门特别行政区护理专业本科生的逆境商,并分析其影响因素。方法采用便利抽样方法从澳门某高等院校中选取护理专业本科生158名。调查问卷包括基本人口社会学问卷、逆境商量表、情绪智力量表、简化应对方式问卷及父母教养方式量表。结果本组护理专业本科生的逆境商得分为(116.72±11.39)分。他们的逆境商得分与消极应对方式和母亲管教风格(过度干预、过度保护)呈负相关(r=-0.332,P<0.001;r=-0.167,P=0.036)。多元回归分析结果,仅消极应对方式进入回归方程(F=19.154,P<0.001)。女生的逆境商得分高于男生(31.98±3.26比29.21±3.08,t=-4.442,P<0.001)。结论澳门护理专业本科生平均逆境商得分处于中等水平,女生更有可能将逆境归因于自己,这可能与其社会心理和文化背景有关。澳门护理专业本科生有必要提高自身克服挫折的能力。教育者应恃別注意培养学生积极的应对方式。

Kinematics and Dynamics Analysis of a Quadruped Walking Robot with Parallel Leg Mechanism

It is desired to require a walking robot for the elderly and the disabled to have large capacity,high stiffness,stability,etc.However,the existing walking robots cannot achieve these requirements because of the weight-payload ratio and simple function.Therefore,Improvement of enhancing capacity and functions of the walking robot is an important research issue.According to walking requirements and combining modularization and reconfigurable ideas,a quadruped/biped reconfigurable walking robot with parallel leg mechanism is proposed.The proposed robot can be used for both a biped and a quadruped walking robot.The kinematics and performance analysis of a 3-UPU parallel mechanism which is the basic leg mechanism of a quadruped walking robot are conducted and the structural parameters are optimized.The results show that performance of the walking robot is optimal when the circumradius R,r of the upper and lower platform of leg mechanism are 161.7 mm,57.7 mm,respectively.Based on the optimal results,the kinematics and dynamics of the quadruped walking robot in the static walking mode are derived with the application of parallel mechanism and influence coefficient theory,and the optimal coordination distribution of the dynamic load for the quadruped walking robot with over-determinate inputs is analyzed,which solves dynamic load coupling caused by the branches’ constraint of the robot in the walk process.Besides laying a theoretical foundation for development of the prototype,the kinematics and dynamics studies on the quadruped walking robot also boost the theoretical research of the quadruped walking and the practical applications of parallel mechanism.

公共健康、养生条件与旅游发展:旅游目的地品牌化的机会

1引言随着世界各地旅游目的地竞争的加剧,不论其地理位置和类型（如城市、农村、海滨）,旅游目的地面临的探寻新的变化形式以使其在拥挤的市场中仍然保持脱颖而出的压力一直在增加①。正如摩根（Morgan）、普里查德（Pritchard）和普莱德（Pride）指出的那样,＂在一个重信息。

Influence of Tourists′ Environmental Tropisms on Their Attitudes to Tourism and Nature Conservation in Natural Tourist Destinations: A Case Study of Jiuzhaigou National Park in China

People′s environmental tropism has an effect on their understanding of tourism-nature relationship,and also influences their attitudes to natural resources utilization and environmental protection.Taking Jiuzhaigou National Park of China as a study case,the authors conducted some quantitative analyses with the tools of SPSS 16.0 and LISREL 8.7,to explore the influence of tourists′ environmental tropism on their attitudes to tourism and nature conservation in the natural tourist destination.Three hypotheses and the theoretic model of influences of tourists′ environmental tropism on their attitudes to tourism and nature conservation have been tested and accepted based on the Structural Equation Model analysis on survey data collected in Jiuzhaigou National Park of China.Some conclusions were drawn as follows: 1) tourists′ human-prioritized concept influences their cognition to tourism-nature relationship.This concept has a positive influence on their supportive attitudes to tourism,but a negative influence on their attitudes to nature conservation;2) tourists′ human-nature coordination concept has a positive influence on their supportive attitudes to both tourism and nature conservation,especially to the latter.This paper generally proves that human′s environmental tropism does have an influence on their attitudes to tourism and nature conservation in natural tourist destinations.

颗粒激发形核在热挤压Al6061/SiC_p复合材料再结晶过程中的作用(英文)

采用电子背散射衍射技术,研究SiCp增强热挤压Al6061铝合金复合材料的织构和微观组织演变。Al6061铝合金及其Ni包覆SiCp增强的复合材料织构中都存在强的β纤维,其轴平行于挤压方向。在未用SiCp增强的热挤压Al6061铝合金中,除了主要的立方织构001)100,在完全再结晶晶粒中也存在部分等轴结构。这种再结晶织构的出现归因于粒径小于5μm的SiCp粒子的形成而产生的粒子激发形核。在这些条件下,低Z(～1012s1)值证实了粒子激发形核是再结晶的主导机制之一,且受变形区的形成而非储能的控制。

An iterative approach to enhance the clinical learning experience in Macao nursing education

Objective: The aim of this study was to reduce or eliminate the stressors to enhance nursing students' clinical learning experience through implementation of an iterative approach that developed a personalised response to student stress.Methods: A prospective cohort research design was applied to collect data from a sample of undergraduate nursing students across the four study years.An iterative approach was employed to improve students' learning experience and the Stressors in Nursing Students Scale-Chinese Version (SINS-CN) was used to measure student stress.Key problems encountered by students were identified,refined and the responding solutions were worked out and implemented among this group of students through their first year to fourth year.Results: The overall SINS-CN mean score (2.17-2.82) of students was declined to a moderate level.Conclusions: Having implemented iterative approach to address factors that led to stressful environments encountered by the nursing students,the overall stress score and each sub-dimension score decreased significantly.Therefore,it is recommended that this approach could be adopted by other colleagues in the nursing arena around the world.

电子目的地:旅游技术和应用的全球最佳实践

为进一步提高本刊的学术水平和国际影响力,本栏目2013年起进行了全新改版,特邀请相关领域的专家学者担任本栏目的特邀责任编辑,由这些特邀责任编辑约请各自领域国内外有一定影响力的专家学者参与讨论。

Digital Relief Generation from 3D Models

It is difficult to extend image-based relief generation to high-relief generation, as the images contain insufficient height information. To generate reliefs from three-dimensional （3D） models, it is necessary to extract the height fields from the model, but this can only generate bas-reliefs. To overcome this problem, an efficient method is proposed to generate bas-reliefs and high-reliefs directly from 3D meshes. To produce relief features that are visually appropriate, the 3D meshes are first scaled. 3D unsharp masking is used to enhance the visual features in the 3D mesh, and average smoothing and Laplacian smoothing are implemented to achieve better smoothing results. A nonlinear variable scaling scheme is then employed to generate the final bas-reliefs and high-reliefs. Using the proposed method, relief models can be generated from arbitrary viewing positions with different gestures and combinations of multiple 3D models. The generated relief models can be printed by 3D printers. The proposed method provides a means of generating both high-reliefs and bas-reliefs in an efficient and effective way under the appropriate scaling factors.

Operation and Force Analysis of the Guide Wire in a Minimally Invasive Vascular Interventional Surgery Robot System

To develop a robot system for minimally invasive surgery is significant,however the existing minimally invasive surgery robots are not applicable in practical operations,due to their limited functioning and weaker perception.A novel wire feeder is proposed for minimally invasive vascular interventional surgery.It is used for assisting surgeons in delivering a guide wire,balloon and stenting into a specific lesion location.By contrasting those existing wire feeders,the motion methods for delivering and rotating the guide wire in blood vessel are described,and their mechanical realization is presented.A new resistant force detecting method is given in details.The change of the resistance force can help the operator feel the block or embolism existing in front of the guide wire.The driving torque for rotating the guide wire is developed at different positions.Using the CT reconstruction image and extracted vessel paths,the path equation of the blood vessel is obtained.Combining the shapes of the guide wire outside the blood vessel,the whole bending equation of the guide wire is obtained.That is a risk criterion in the delivering process.This process can make operations safer and man-machine interaction more reliable.A novel surgery robot for feeding guide wire is designed,and a risk criterion for the system is given.

Fabrication and characterization of groove-gate MOSFETs based on a self-aligned CMOS process

N and P-channel groove-gate MOSFETs based on a self-aligned CMOS process have been fabricated and characterized. For the devices with channel length of 140nm, the measured drain induced barrier lowering （DIBL） was 66mV/V for n-MOSFETs and 82mV/V for p-MOSFETs. The substrate current of a groove-gate n-MOSFET was 150 times less than that of a conventional planar n-MOSFET, These results demonstrate that groove-gate MOSFETs have excellent capabilities in suppressing short-channel effects. It is worth emphasizing that our groove-gate MOSFET devices are fabricated by using a simple process flow, with the potential of fabricating devices in the sub-100nm range.

Robotic rectal cancer surgery:Results from a European multicentre case series of 240 resections and comparative analysis between cases performed with the da Vinci Si and Xi systems

Introduction:Robotic systems are designed to address the limitations of laparoscopic surgery,leading to a growing interest in robotic rectal surgery.However,certain technical limitations associated with the previous systems(da Vinci S&Si)have arguably slowed down its wholesale adoption.The latest robotic platform,the da Vinci Xi,addresses these limitations.This study aims to examine the short-term surgical outcomes of 240 single-docking fully-robotic rectal cancer resections and compare the outcomes of cases performed with the da Vinci Xi vs Si systems.Materials and methods:All consecutive patients receiving robotic rectal cancer resections from three centres between 2013 and 2018 were identified from prospectively collated databases.The baseline characteristics and short-term surgical outcomes are presented and the da Vinci Xi vs Si system outcomes are analysed.Results:A total of 240 patients were identified(124 Si,116 Xi).Median operation-time and length-of-stay were 260 minutes and 6 days respectively.Conversion and 30-day mortality rates were 0.The da Vinci Si vs Xi system analysis shows that operation-time was lower in the Si group(230 vs 300 min,p=0.000)but length-of-stay,lymph node yield and circumferential resection margin favoured the Xi group(7 vs 5 days,p=0.010;17 vs 21,p=0.000;92.7%vs 99.1%,p=0.020).Conclusion:Single-docking fully-robotic rectal cancer surgery is safe,feasible and can lead to good shortterm outcomes,making it a good alternative to laparoscopic rectal cancer surgery.The new systems technological advances may result in better short-term outcomes but further larger scale observational studies are required if we are to reach such a conclusion.

Quasi-Solid-State Ion-Conducting Arrays Composite Electrolytes with Fast Ion Transport Vertical-Aligned Interfaces for All-Weather Practical Lithium-Metal Batteries

The rapid improvement in the gel polymer electrolytes(GPEs)with high ionic conductivity brought it closer to practical applications in solid-state Li-metal batteries.The combination of solvent and polymer enables quasi-liquid fast ion transport in the GPEs.However,different ion transport capacity between solvent and polymer will cause local nonuniform Li+distribution,leading to severe dendrite growth.In addition,the poor thermal stability of the solvent also limits the operating-temperature window of the electrolytes.Optimizing the ion transport environment and enhancing the thermal stability are two major challenges that hinder the application of GPEs.Here,a strategy by introducing ion-conducting arrays(ICA)is created by vertical-aligned montmorillonite into GPE.Rapid ion transport on the ICA was demonstrated by 6Li solid-state nuclear magnetic resonance and synchrotron X-ray diffraction,combined with computer simulations to visualize the transport process.Compared with conventional randomly dispersed fillers,ICA provides continuous interfaces to regulate the ion transport environment and enhances the tolerance of GPEs to extreme temperatures.Therefore,GPE/ICA exhibits high room-temperature ionic conductivity(1.08 mS cm^(−1))and long-term stable Li deposition/stripping cycles(>1000 h).As a final proof,Li||GPE/ICA||LiFePO_(4) cells exhibit excellent cycle performance at wide temperature range(from 0 to 60°C),which shows a promising path toward all-weather practical solid-state batteries.

Modelling the ZR Relationship of Precipitation Nowcasting Based on Deep Learning

Sudden precipitations may bring troubles or even huge harm to people’s daily lives.Hence a timely and accurate precipitation nowcasting is expected to be an indispensable part of our modern life.Traditionally,the rainfall intensity estimation from weather radar is based on the relationship between radar reflectivity factor(Z)and rainfall rate(R),which is typically estimated by location-dependent experiential formula and arguably uncertain.Therefore,in this paper,we propose a deep learning-based method to model the ZR relation.To evaluate,we conducted our experiment with the Shenzhen precipitation dataset.We proposed a combined method of deep learning and the ZR relationship,and compared it with a traditional ZR equation,a ZR equation with its parameters estimated by the least square method,and a pure deep learning model.The experimental results show that our combined model performsmuch better than the equation-based ZRformula and has the similar performance with a pure deep learning nowcasting model,both for all level precipitation and heavy ones only.

Gemcitabine-induced haemolytic uremic syndrome,although infrequent,can it be prevented:A case report and review of literature

Gemcitabine is an antineoplastic used to treat several malignancies including pancreatic cancer. Its toxicity profile is well known with myelotoxicity, increased vascular permeability and peripheral oedema as most frequent adverse events. However, several cases of acute renal failure have been reported and haemolytic uremic syndrome(HUS) seems to be the underlying process. The cause of HUS remains unknown but its consequences can be lethal. Therefore, a high grade of suspicion is crucial to diagnose it and promptly treat it. This hopefully will reduce its morbidity. HUS is characterized by progressive renal failure associated with microangiopathic haemolytic anaemia and thrombocytopenia. The primary event is damage to endothelial cells and thrombotic microangiopathy(TMA) is the histopathological lesion. TMA affects mainly renal microvasculature. However, some cases evolve with central nervous or cardiovascular systems involvement. We present here a case of gemcitabine-induced HUS, with renal and cardiovascular system affected at the time of diagnosis which to our knowledge this is the first time of such case to be reported.