New Asymptotic Results on Fermat-Wiles Theorem

We analyse the Diophantine equation of Fermat xp yp = zp with p > 2 a prime, x, y, z positive nonzero integers. We consider the hypothetical solution (a, b, c) of previous equation. We use Fermat main divisors, Diophantine remainders of (a, b, c), an asymptotic approach based on Balzano Weierstrass Analysis Theorem as tools. We construct convergent infinite sequences and establish asymptotic results including the following surprising one. If z y = 1 then there exists a tight bound N such that, for all prime exponents p > N , we have xp yp zp.

An Adapted Convolutional Neural Network for Brain Tumor Detection

In medical imaging, particularly for analyzing brain tumor MRIs, the expertise of skilled neurosurgeons or radiologists is often essential. However, many developing countries face a significant shortage of these specialists, which impedes the accurate identification and analysis of tumors. This shortage exacerbates the challenge of delivering precise and timely diagnoses and delays the production of comprehensive MRI reports. Such delays can critically affect treatment outcomes, especially for conditions requiring immediate intervention, potentially leading to higher mortality rates. In this study, we introduced an adapted convolutional neural network designed to automate brain tumor diagnosis. Our model features fewer layers, each optimized with carefully selected hyperparameters. As a result, it significantly reduced both execution time and memory usage compared to other models. Specifically, its execution time was 10 times shorter than that of the referenced models, and its memory consumption was 3 times lower than that of ResNet. In terms of accuracy, our model outperformed all other architectures presented in the study, except for ResNet, which showed similar performance with an accuracy of around 90%.

慢性阻塞性肺疾病患者血清内脂素与TNF-α及营养参数的相关性

目的探讨慢性阻塞性肺疾病(COPD)患者血清内脂素与炎性反应因子TNF-α、营养状况的关系。方法稳定期COPD患者45例作为病例组,另选择健康体检者20例作为健康对照组。酶联免疫吸附法检测血清内脂素、TNF-α水平,测定多个营养参数,比较2组间血清内脂素、TNF-α水平及各营养参数间的差异,Pearson相关法分析内脂素与TNF-α以及各营养参数的相关性,并以多参数指数评分系统(MNI)评价2组的营养状态。结果 COPD组患者血清内脂素、TNF-α水平显著高于健康对照组(P<0.05),%IBW、MAMC低于健康对照组(P<0.05)。COPD患者血清内脂素水平与TNF-α水平呈显著正相关(r=0.73,P<0.05),与%IBW、TSF、MAMC、CHI、Alb、Palb无明显相关性(r依次=0.27,0.14,0.22,0.24,0.28,0.17,P均>0.05)。据MNI评价营养状况,COPD组46.7%(21例)发生了营养不良,健康对照组无营养不良发生。COPD营养不良亚组与COPD营养正常亚组间内脂素水平差异无统计学意义(P>0.05),但均显著高于健康对照组(P<0.05)。结论 COPD患者血清内脂素水平增高,并且与TNF-α呈正相关,与各营养参数无明显相关性。在COPD中内脂素可能是一种促炎脂肪细胞因子。

慢性阻塞性肺疾病患者营养状况与血清瘦素及TNF-α的相关性研究

目的探讨慢性阻塞性肺疾病(COPD)患者营养状况与全身系统炎症的相关性。方法稳定期COPD男性患者31例,综合评价例患者营养状况。酶联免疫吸附法测血清瘦素、TNF-α水平,方差分析比较各营养参数、瘦素、肿瘤坏死因子-α(TNF-α)浓度的差异,分析瘦素与TNF-α以及各营养参数的相关性。结果 15例(48.39%)发生营养不良,COPD营养正常组瘦素浓度高于营养不良组和正常对照组,营养正常组及营养不良组TNF-α浓度均高于对照组(P<0.05)。患者血清瘦素与体重、理想体重百分比(%IBW)、肱三头肌皮褶厚度(TSF)、上臂肌围(MAMC)、Alb、TNF-α浓度呈正相关(P<0.05)。结论 COPD患者常合并营养不良,炎性细胞因子-瘦素作用可能是慢性阻塞性肺疾病患者营养不良的原因。

Comment of Walker and Avant’s method of concept analysis

In order to promote the nursing discipline to developindependently and scientifically, nursing practice shouldbe guided by nursing theory instead of intuition andexperience of nurses [1]. Nursing theory can assist nursesto deliver individual patient’s care and help to improveobservation and recognition of specific patient need, be itbiological, psychological or social [2]. Nursing theory hasdeveloped quickly and successfully in recent decadesinternationally; however, it is still in the early stage ofdevelopment in China.

Awareness and Practice on Household Solid Waste Management among the Community People

Household solid waste management is a major public health concern in the community people and closely related to daily human life. Community people can play a pivotal role in managing household solid waste. Objectives: This study was aimed to assess the awareness and practice of household solid waste management among the people living in the Mugda community in Dhaka. Methods: A descriptive co-relational study design was used. A total of 112 participants were selected with the convenience sampling technique. The data collection period was from July 2019 to June 2020. The data were collected from the participants by face-to-face interview through the door-to-door survey by using a structured questionnaire. Data were analyzed by using descriptive, Pearson correlation, t-test, and one-way ANOVA statistics. Results: Finding of the study shows that the mean awareness regarding household solid waste management was 7.96 (SD = 1.64) and the mean practice was 2.94 (SD = 1.35) respectively. It indicates that the awareness and practice of community people were at a moderate level. In bivariate analysis, it has been shown that training on household solid waste management (“P < 0.001”), and recyclable waste (p = 0.019) were statistically significantly correlated with household solid waste management practice. Conclusion: Overall awareness and practice level of household solid waste management were at a moderate level among the community people. Training on household solid waste management and recyclable waste management were statistically significantly correlated with household solid waste management. Policymakers can use this baseline data to make a strategy for increasing awareness among the community people.

小甜甜:审美审丑都是天后

Kenny:小甜甜又开始工作了,客串了《老爸老妈浪漫史》,据说口碑很好呢。迷宝:她一工作就显得很靠谱,其实之前的专辑也真的好听,不过可惜都被八卦盖过了。

Training of Laic Blind Subjects to Basic Life Support Manoeuvres

Heart attack is an extremely urgent medical condition which may occur at any time and can affect anybody and means the failure of the pump function of the heart and it represents the condition which brings to death. The aim of this study is the training, which is the acquisition of knowledge, abilities and skills as a result of education and practice in a certain discipline and this project has been created to make as accessible to all as possible the information about the identification and treatment of heart attack. However, the key objective has been involving only laic blind subjects in the trial and theoretical-practical course to support vital functions （BLS （basic life support））, to demonstrate that in a state of emergency, like a heart attack, even a subject affected by visual impairment, if properly trained, can be very helpful and can contribute to save a life. Fifteen partially sighted and sightless executors have participated in this study. In order to evaluate learning objectives of the course, participants have completed a pre-course test to examine these areas： cognitive and emotional, motivational, theoretical-practical; while, at the end of the course, participants have completed a comment card about the course. At the end of this study it can be seen that blind subjects do not present any type of limitation in the learning and in the execution of BLS manoeuvres after an appropriate training.

Quality of life in head and neck cancer survivors： A concept analysis

Objective： To identify and clarify the existing definitions of quality of life in head and neck cancer survivors. Thisconcept analysis will inform healthcare professionals of promoting nursing care for head and neck cancer survivors andeventually improve their quality of life. Method： Concept analysis based on Walker and Avant’s framework. Results：Quality of life is a subjective and personally derived cognitive evaluation of global well-being by perceiving a feeling ofoverall life satisfaction in his/her own value, happiness, and the independence to manage daily activities and lifeexperience. Three defining attributes for quality of life were identified： a feeling of overall life satisfaction in his/hervalue, global personal well-being, and independence. An improvement of quality of life means an improvement ofclinical outcome. However, the variety of instruments for measuring life quality makes it difficult for healthcareprofessionals to select a standard one for head and neck cancer survivors. Conclusion： By proposing a comprehensivedefinition of the concept, this analysis contributes to the advancement of knowledge about quality of life in the context ofhead and neck cancer survivorship. Through a sound understanding of the phenomenon, healthcare professions willrecognize or measure head and neck cancer survivors’ life conditions in a more accurate way and to implementintervention where necessary, eventually, improve patients’ life quality in survivorship.

ICU Delirium： A concept analysis

Objective： To explore and analyze the concept of intensive care unit （ICU） delirium. Method： Walker and Avant’sstrategy of analysis was adopted to this research. Results： ICU delirium is defined as the presence of an acute cognitiveimpairment, accompanied by a disturbance of consciousness with fluctuating inattention, and the array of dysfunctionsonly developed for a short period of time in ICU. The antecedents of ICU delirium include （1） the high severity of illness,（2） pain, （3） sedative use, （4） immobilization, （5） sleep deprivation and （6） unpleasant awareness. The consequencesinvolve （1） promoting the risks of self-extubation and unplanned removal of catheters, （2） prolonging the length of ICUstay, （3） increasing the mortality of critical patients and （4） Some different ICU delirium assessment instruments aregathered. Confusion Assessment Method for Intensive Care Unit assessment tool （CAM-ICU） was the most populardiagnostic tool used by nurses. Conclusion： Concept analysis as an extension and development of nursing theory cancreate a linkage between practice and theory. It will create a knowledge foundation of ICU delirium and provide atheoretical basis to construct nursing theory. This study can help ICU nurses to understand and recognize ICU delirium.ICU nurses will be enlightened to develop effective interventions of ICU delirium to improve critical patients’ clinicaloutcomes.

Coping： a concept analysis in the cancer context

Objectives： The aim of this paper is to analyse the concept of coping in the cancer context. This concept analysis willprovide a theoretical framework for oncology nurses to help patients cope with the influences of cancer and adapt to theirnew situations. Methods： The concept analysis of coping was conducted according to Walker and Avant＇s method.Results： Coping is defined as a process of dealing with stressful events by means of cognitive appraisal, purposefulefforts, and use of available supports and resources in order to achieve physiological and psychological adjustment.Antecedents to coping involve stressful events, individual personality, individual experience, and available supports andresources. Different coping strategies based on patients’ responses to suffering from cancer bring about positive ornegative results. Effective coping means being well-adapted, which is conducive to patients’ health and optimum qualityof life. Roy’s middle range theory of coping and adaptation processing provides a theoretical framework for the study ofcoping. The Mental Adjustment to Cancer scale and the 15-item Coping and Adaptation Processing Scale are consideredpractical and effectual instruments to measure coping in the cancer context. Conclusions： This concept analysiscontributes to understanding the process of coping with cancer. Oncology nurses should identify cancer patients’ copingpatterns, provide timely and proper professional support and educate effective coping strategies in order to help patientsadapt to their new situations both physiologically and psychologically.

中国网民善于规划网络生活

尽管互联网蕴涵着庞大的内容及无穷的可能性，但是人们更愿意高效地、有计划地。

A Concept Analysis of Continuity of Care in Nursing

Purpose： This paper is a report about the concept analysis of continuity of care, to get further understanding of continuity of care. Methods： The Walker and Avant concept analysis approach was applied in this paper. Results： The three attributes include： seamless transfer, flexible reaction and effective interaction. The antecedents were changed needs and patient centred care. In addition, the continuity of care had a significant effect on patients’ outcome, satisfaction and costs. Conclusions： This analysis provides nurses an understanding about continuity of care in both patient’s and care provider’s perspective. Continuity of care is a tailored services provided by care givers, which is an essential element of healthcare system.

美国：在线学位教育真的可行吗？

Every day, students around the world are booting up, logging on, and signing in to their virtual classrooms.

我的强人哲学

"我不相信一只老虎或一只狮子可以强过一万只绵羊,也不需要一万只兔子或绵羊组成的队伍,我需要的是一万只老虎,一万只狮子。"

一种新型机械瓣静脉输入接口的使用致导管相关的血液感染率上升

静脉导管输入接口技术从带可移动盖帽的开口模式转变成了更加复杂的机械瓣封闭模式。在我们的研究所，我们观察到由一种新型无针正压机械瓣静脉输入接口的使用，而导致的导管相关血液感染率明显上升。

Elucidation of the sodiation/desodiation mechanism in Ca_(0.5)Ti_(2)(PO_(4))_(3)/C as promising electrode for sodium batteries: New insights into the phase transitions

The structure evolution and electrochemical performance of Na SICON-type Ca_(0.5)Ti_(2)(PO_(4))_(3) for sodium batteries are presented.This phosphate was synthesized by a solid-state method,and the obtained particles were coated with carbon using sucrose.This compound crystallizes in the rhombohedral system with space group R-3.The presence of carbon in the Ca_(0.5)Ti_(2)(PO_(4))_(3)/C composite was confirmed by Raman and Thermogravimetric analysis.The electrochemical performance of Ca_(0.5)Ti_(2)(PO_(4))_(3)/C was investigated in the potential window 1.5–3.0 V vs.sodium metal at different scan rates.The compound is able to initially intercalate/deintercalate 1.6/1.15 Na per formula unit,respectively.In operando synchrotron diffraction was done in the potential window 0.02–3.0 V vs.Na|Na+and revealed the occurrence of several reaction regions upon first discharge.Up to 4 Na+ion per formula unit can be inserted during the first discharge.An intensive refinement of the synchrotron X-ray diffraction(SXRD)patterns of discharged Ca_(0.5)Ti_(2)(PO_(4))_(3) evidenced the existence of five regions depending on the sodium content while the crystal structures of new phases were elucidated for the first time where sodium insertion occurs in the unusual M3 and M’3 sites of the Na SICON structure.

Effect of Cellulose Microfibers from Sugar Beet Pulp By-product on the Reinforcement of HDPE Composites Prepared by Twin‐screw Extrusion and Injection Molding

The aims of this work turn towards the valorization of the underutilized Raw Sugar Beet Pulp by-product to produce white Cellulose Microfibers(CMFs),and its potential effect as a reinforcement for the development of High-Density Polyethylene(HDPE)composites.Pure CMFs were first obtained by subjecting raw SBP to alkali and bleaching treatments.Several characterization techniques were performed to confirm the successful removal of the amorphous compounds from the surface of individual fibers,including SEM,XRD,TGA,and FT-IR analysis.Various CMF loadings(5–10 wt%)were incorporated as bio-fillers into HDPE polymer to evaluate their reinforcing ability in comparison to raw and alkali-treated SBP using twin-screw extrusion followed by injection molding.Styrene–(Ethylene–Butene)–Styrene Three-Block Co-Polymer Grafted with Maleic Anhydride was used as a compatibilizer to improve the interfacial adhesion between fibers and the matrix.Thermal,mechanical,and rheological properties of the produced composite samples were investigated.It was found that the Young’s modulus were gradually increased with increasing of fibers loadings,with a maximum increase of 30%and 26%observed for composite containing 10 wt%of CMFs and raw SBP,respectively,over neat HDPE.While,the use of coupling agent enhances the ductile behavior of the composites.It was also found that all fiber improves the hardness and toughness behavior of all reinforced composites as well as the complex modulus particularly at 10 wt%.The thermal stability slightly increases with the addition of fibers.This study demonstrates a new route for the valorization of SBP by-products.These fibers can be considered as a valuable bio-fillers candidate for the development of composite materials with enhanced properties.

Effect of acupressure on procedural pain before heel lancing in neonates

OBJECTIVE:To investigate the effect of acupressure applied to UB60 and K3 acupuncture points in order to relieve the procedural pain caused by heel lancing blood sampling process in the term newborns.METHODS:The data were collected by using the Information Form and the Neonatal Infant Pain Scale.Acupressure applied for 3 min before heel lancing blood sampling in the newborns in the experimental group(n=31).No intervention was applied to newborns in the control group(n=32).RESULTS:A significant difference was found between mean scores of the newborns in the control and acupressure group in favor of the acupressure group in terms of heart rate during and after the procedure,oxygen saturation before,during and after the procedure,duration of crying during and after the procedure(P<0.05).It was found that there was a significant difference between groups in terms of Neonatal Infant Pain Scale mean scores during(P=0.001)and after the procedure(P<0.05),and the difference was found to be in favor of the acupressure group.CONCLUSION:As a result,acupressure was found to be an effective method in relieving pain caused by heel lancing blood sampling in newborns.

Multiple origin of the lichenicolous life habit in Helotiales,based on nuclear ribosomal sequences

The Helotiales are an ecologically and morphologically highly diverse group of ascomycetes that also includes lichen-inhabiting(lichenicolous)species.We generated sequence data of three rDNA regions(nuSSU,nuLSU,5.8S of ITS)from 28 lichenicolous specimens representing nine genera in order to determine their phylogenetic placement.Based on the most complete dataset of helotialean fungi to date,the analyses were performed using Maximum Likelihood(ML)and Bayesian approaches.Our results suggest that 1)the lichen-inhabiting life-style in Helotiales was subjected to gains or losses at least three times;2)Thamnogalla,previously tentatively included in Ostropales,is shown to belong to Helotiales;3)ascomata found intermixed with pycnidia of the asexual Diplolaeviopsis ranula and possessing the same pigments are tentatively considered as the sexual morph of this taxon,and are shown to belong to Helotiales;4)the lichenicolous species of cf.Diplolaeviopsis,Llimoniella,Rhymbocarpus,Skyttea,Thamnogalla and Unguiculariopsis form a well-supported clade together with non-lichenicolous encoelioid fungi from the genera Ionomidotis,Cordierites and Encoelia;5)Geltingia associata forms a highly supported clade with the fungicolous asexual fungus Eleutheromyces subulatus,whereas Pezizella epithallina clusters with an aquatic asexual fungus Tetracladium sp.;6)Phaeopyxis punctum belongs to Ostropomycetidae(Lecanoromycetes),but its deep relationships to other groups remain unresolved based on rDNA sequences.