In this paper,we obtain a vector bundle valued mixed hard Lefschetz theorem.The argument is mainly based on the works of Tien-Cuong Dinh and Viet-Anh Nguyen.
In this paper,we prove that for certain fiber bundles there is a k-Futaki-Ono conformally Kahler metric related to a metric in any given Kahler class for any k≥2.
Porous liquid-conducting micro-heat exchangers have garnered considerable attention for their role in efficient heat dissipation in small electronic devices.This demand highlights the need for advanced mathematical mo...Porous liquid-conducting micro-heat exchangers have garnered considerable attention for their role in efficient heat dissipation in small electronic devices.This demand highlights the need for advanced mathematical models to optimize the selection of mixed heat exchange media and equipment design.A capillary bundle evaporation model for porous liquid-conducting media was developed based on the conjugate mass transfer evaporation rate prediction model of a single capillary tube,supplemented by mercury injection experimental data.Theoretical and experimental comparisons were conducted using 1,2-propanediol-glycerol(PG-VG)mixtures at molar ratios of 1:9,3:7,5:5,and 7:3 at 120,150,and 180℃.The Jouyban-Acree model was implemented to enhance the evaporation rate predictions.For the 7:3 PG-VG mixture at 180℃under the experimental conditions of the thermal medium,the model's error reduced from 16.75%to 10.84%post-correction.Overall,the mean relative error decreased from 11.76%to 5.98%after correction.展开更多
Objective:To explore the application effect of bundle management in the safe nursing of patients with autoimmune encephalitis.Methods:Seventy-five patients with autoimmune encephalitis who met the inclusion criteria i...Objective:To explore the application effect of bundle management in the safe nursing of patients with autoimmune encephalitis.Methods:Seventy-five patients with autoimmune encephalitis who met the inclusion criteria in our hospital from January 2024 to June 2024 were randomly divided into two groups:an observation group of 39 patients and a control group of 36 patients.The control group received routine nursing care,while the observation group implemented a bundle management strategy based on routine nursing care.Safety nursing outcomes,clinical symptom improvement time,hospital stay,and neurologic function recovery were observed in both groups.Results:The incidence of adverse events in the observation group was 12.82%,significantly lower than the 33.33%in the control group,with a statistically significant difference(P<0.05).There was no statistically significant difference in restraint usage and ICU transfer rates between the two groups(P>0.05).The clinical symptom improvement time,hospital stay,and neurologic function recovery in the observation group were significantly better than those in the control group,with a statistically significant difference(P<0.05).Conclusion:Through the bundle management model,effective connections can be ensured in various aspects of treatment and rehabilitation for patients with autoimmune encephalitis,providing patients with comprehensive and multi-level nursing services and improving their overall satisfaction and treatment effectiveness.展开更多
Objective:To study the application effect of bundle nursing strategy in the maintenance of difficult blood vessels for long-term hemodialysis patients.Methods:A prospective study was conducted on 40 long-term hemodial...Objective:To study the application effect of bundle nursing strategy in the maintenance of difficult blood vessels for long-term hemodialysis patients.Methods:A prospective study was conducted on 40 long-term hemodialysis patients admitted from January 2024 to January 2025.The patients were randomly divided into a control group(20 cases)and an observation group(20 cases)using computer random sampling.The control group received routine nursing for difficult blood vessels,while the observation group received a bundle nursing strategy for difficult blood vessels.The self-care ability,complication rate,and nursing satisfaction were compared between the two groups.Results:After nursing,the self-care ability score of the observation group was higher than that of the control group(P<0.05).The complication rate in the observation group was lower than that in the control group(P<0.05).The nursing satisfaction in the observation group was higher than that in the control group(P<0.05).Conclusion:The application of the bundle nursing strategy in the maintenance of difficult blood vessels for long-term hemodialysis patients is beneficial for improving self-care ability,reducing complications,and increasing patient satisfaction with nursing services.展开更多
Cardiac resynchronization therapy(CRT)reduces heart failure(HF)hospitaliz-ations and all-cause mortality in patients with HF with reduced ejection fraction with left bundle branch(LBB)block.Biventricular pacing(BVP)is...Cardiac resynchronization therapy(CRT)reduces heart failure(HF)hospitaliz-ations and all-cause mortality in patients with HF with reduced ejection fraction with left bundle branch(LBB)block.Biventricular pacing(BVP)is considered the gold standard for achieving CRT;however,approximately 30%–40%of patients do not respond to BVP-CRT.Recent studies have demonstrated that LBB pacing(LBBP)produces remarkable results in CRT.In this meta-analysis,LBBP-CRT showed better outcomes than conventional BVP-CRT,including greater QRS duration reduction and left ventricular ejection fraction improvement,along with consistently lower pacing thresholds on follow-up.Additionally,there was a grea-ter reduction in New York Heart Association class and brain natriuretic peptide levels.This study contributes to the growing body of encouraging data on LBBP-CRT from recent years.With ongoing technological advancements and increasing operator expertise,the day may not be far when LBBP-CRT becomes the standard of care rather than the exception.展开更多
Objective:To investigate the clinical application value of bundled nursing care in postoperative recovery of lung cancer patients.Methods:Eighty lung cancer patients who underwent surgical treatment from October 2022 ...Objective:To investigate the clinical application value of bundled nursing care in postoperative recovery of lung cancer patients.Methods:Eighty lung cancer patients who underwent surgical treatment from October 2022 to May 2024 were selected as the study subjects.Their clinical data were retrospectively analyzed and grouped by nursing methods.The bundled nursing care group(n=40)received bundled nursing care,while the conventional nursing care group(n=40)received routine nursing care.Lung function,immune function,complication rate,pain level,exercise tolerance,and quality of life were compared between the two groups.Results:Before nursing,there were no statistically significant differences in lung function,immune function,pain level,exercise tolerance,and quality of life between the bundled nursing care group and the conventional nursing care group(P>0.05).After nursing,both groups showed improvement in lung function,immune function,pain level,exercise tolerance,and quality of life,but the bundled nursing care group had better results and a lower complication rate,with statistical significance(P<0.05).Conclusion:The bundled nursing care has a higher clinical application value in postoperative recovery of lung cancer patients and is worthy of widespread clinical use.展开更多
BACKGROUND Peripherally inserted central catheters(PICCs)are crucial for patients requiring long-term intravenous therapy,especially within digestive surgery under bundled care protocols.AIM To evaluate and compare th...BACKGROUND Peripherally inserted central catheters(PICCs)are crucial for patients requiring long-term intravenous therapy,especially within digestive surgery under bundled care protocols.AIM To evaluate and compare the efficacy,safety,and patient-reported outcomes of single-lumen vs double-lumen PICCs among patients undergoing digestive surgery within a structured bundled care framework.METHODS This retrospective cohort study analyzed data from 249 patients who underwent digestive surgery and utilized either single-lumen(n=117)or double-lumen(n=132)PICCs between January 2021 and June 2024.Clinical outcomes,patient satisfaction,catheterization duration,and complication rates were compared using statistical analysis via SPSS(version 29.0).The bundled care protocol was consistently applied,focusing on standardized procedures,staff training,and patient support.RESULTS Single-lumen PICCs were associated with a significantly lower thrombosis rate(0.85%)than double-lumen PICCs(6.82%,P=0.039).The single-lumen group experienced shorter catheterization durations(12.5±3.14 days vs 13.6±4.50 days,P=0.025)and higher successful infusion rates(92.7%±5.32%vs 90.4%±6.60%,P=0.003).This group also reported higher comfort scores(8.40±1.20 vs 7.90±1.50,P=0.004)and lower pain levels(2.90±0.70 vs 3.20±0.80,P=0.002).Aside from thrombosis,complication rates showed no significant difference between the groups.CONCLUSION Within bundled care context,single-lumen PICCs demonstrated advantages in reducing thrombosis risk,procedural efficiency,patient comfort,and satisfaction compared with double-lumen PICCs.The findings underscore the importance of considering patient-specific needs and clinical scenarios in catheter choice.展开更多
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...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.展开更多
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 tra...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.展开更多
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...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.展开更多
Objective:Surgical procedures manifest immense risks to patients.One of the adverse events that healthcare professionals see as a threat to the patient’s health is the development of complications known as surgical s...Objective:Surgical procedures manifest immense risks to patients.One of the adverse events that healthcare professionals see as a threat to the patient’s health is the development of complications known as surgical site infection(SSI).Although several effor ts are being under taken to determine the proper means to reduce such complications,there is still a high incidence of SSI worldwide.Surgery requires knowledge in infection control and high precision in maintaining a clean surgical site.This study tested the effectiveness of an operating room(OR)bundle of care in preventing SSI in patients undergoing elective exploratory laparotomy cholecystectomy surgery.Methods:A quasi-experimental pretest and posttest design was utilized to determine its effectiveness.The study was composed of 60 par ticipants divided into two groups:30 subjects were selected to receive the OR bundle of care,while the other 30 subjects received the usual care.The groupings were determined through a systematic random sampling technique.The OR bundle of care had three interventions,namely:(1)maintaining perioperative normothermia,(2)no pre-operative surgical site hair removal,and(3)changing gloves before abdominal wall closure.These patients were evaluated using the standard instrument,Bates–Jensen Wound Assessment Tool(BWAT)in the post-intervention phases of the wound healing process,which are as follows:hemostasis,inflammatory,and proliferative phases.To describe the difference in the patients’wound status after implementation of the OR bundle of care in each post-intervention phase,Friedman’s test was used.To describe the difference in the patients’wound status in both groups after implementation of the OR bundle of care,the Mann–Whitney U test was used.Results:The patient’s wound status was lower,indicating a more healing process.Differences between the wound status of the control and the experimental group were observed on the third postoperative day.This indicates that the experimental group’s wound status healed much faster and more effectively than the control group based on the BWAT scoring severity scoring.A significant difference in the patient’s wound status from the hemostasis phase compared with the proliferative phase was observed.Conclusions:The OR bundle of care has been shown to be effective in preventing SSI in patients who had undergone exploratory laparotomy cholecystectomy surgery in the selected hospital,if there is uniform and consistent implementation of the said intervention.展开更多
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...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.展开更多
基金supported by the National key R and D Program of China 2020YFA0713100the NSFC(12141104,12371062 and 12431004).
文摘In this paper,we obtain a vector bundle valued mixed hard Lefschetz theorem.The argument is mainly based on the works of Tien-Cuong Dinh and Viet-Anh Nguyen.
基金supported by the Nature Science Foundation of China(12171140).
文摘In this paper,we prove that for certain fiber bundles there is a k-Futaki-Ono conformally Kahler metric related to a metric in any given Kahler class for any k≥2.
基金the funding support of National Natural Science Foundation of China(21978204)。
文摘Porous liquid-conducting micro-heat exchangers have garnered considerable attention for their role in efficient heat dissipation in small electronic devices.This demand highlights the need for advanced mathematical models to optimize the selection of mixed heat exchange media and equipment design.A capillary bundle evaporation model for porous liquid-conducting media was developed based on the conjugate mass transfer evaporation rate prediction model of a single capillary tube,supplemented by mercury injection experimental data.Theoretical and experimental comparisons were conducted using 1,2-propanediol-glycerol(PG-VG)mixtures at molar ratios of 1:9,3:7,5:5,and 7:3 at 120,150,and 180℃.The Jouyban-Acree model was implemented to enhance the evaporation rate predictions.For the 7:3 PG-VG mixture at 180℃under the experimental conditions of the thermal medium,the model's error reduced from 16.75%to 10.84%post-correction.Overall,the mean relative error decreased from 11.76%to 5.98%after correction.
文摘Objective:To explore the application effect of bundle management in the safe nursing of patients with autoimmune encephalitis.Methods:Seventy-five patients with autoimmune encephalitis who met the inclusion criteria in our hospital from January 2024 to June 2024 were randomly divided into two groups:an observation group of 39 patients and a control group of 36 patients.The control group received routine nursing care,while the observation group implemented a bundle management strategy based on routine nursing care.Safety nursing outcomes,clinical symptom improvement time,hospital stay,and neurologic function recovery were observed in both groups.Results:The incidence of adverse events in the observation group was 12.82%,significantly lower than the 33.33%in the control group,with a statistically significant difference(P<0.05).There was no statistically significant difference in restraint usage and ICU transfer rates between the two groups(P>0.05).The clinical symptom improvement time,hospital stay,and neurologic function recovery in the observation group were significantly better than those in the control group,with a statistically significant difference(P<0.05).Conclusion:Through the bundle management model,effective connections can be ensured in various aspects of treatment and rehabilitation for patients with autoimmune encephalitis,providing patients with comprehensive and multi-level nursing services and improving their overall satisfaction and treatment effectiveness.
文摘Objective:To study the application effect of bundle nursing strategy in the maintenance of difficult blood vessels for long-term hemodialysis patients.Methods:A prospective study was conducted on 40 long-term hemodialysis patients admitted from January 2024 to January 2025.The patients were randomly divided into a control group(20 cases)and an observation group(20 cases)using computer random sampling.The control group received routine nursing for difficult blood vessels,while the observation group received a bundle nursing strategy for difficult blood vessels.The self-care ability,complication rate,and nursing satisfaction were compared between the two groups.Results:After nursing,the self-care ability score of the observation group was higher than that of the control group(P<0.05).The complication rate in the observation group was lower than that in the control group(P<0.05).The nursing satisfaction in the observation group was higher than that in the control group(P<0.05).Conclusion:The application of the bundle nursing strategy in the maintenance of difficult blood vessels for long-term hemodialysis patients is beneficial for improving self-care ability,reducing complications,and increasing patient satisfaction with nursing services.
文摘Cardiac resynchronization therapy(CRT)reduces heart failure(HF)hospitaliz-ations and all-cause mortality in patients with HF with reduced ejection fraction with left bundle branch(LBB)block.Biventricular pacing(BVP)is considered the gold standard for achieving CRT;however,approximately 30%–40%of patients do not respond to BVP-CRT.Recent studies have demonstrated that LBB pacing(LBBP)produces remarkable results in CRT.In this meta-analysis,LBBP-CRT showed better outcomes than conventional BVP-CRT,including greater QRS duration reduction and left ventricular ejection fraction improvement,along with consistently lower pacing thresholds on follow-up.Additionally,there was a grea-ter reduction in New York Heart Association class and brain natriuretic peptide levels.This study contributes to the growing body of encouraging data on LBBP-CRT from recent years.With ongoing technological advancements and increasing operator expertise,the day may not be far when LBBP-CRT becomes the standard of care rather than the exception.
基金Science and Technology Support Program of Baoding City,Hebei Province(Project No.:2241ZF326)。
文摘Objective:To investigate the clinical application value of bundled nursing care in postoperative recovery of lung cancer patients.Methods:Eighty lung cancer patients who underwent surgical treatment from October 2022 to May 2024 were selected as the study subjects.Their clinical data were retrospectively analyzed and grouped by nursing methods.The bundled nursing care group(n=40)received bundled nursing care,while the conventional nursing care group(n=40)received routine nursing care.Lung function,immune function,complication rate,pain level,exercise tolerance,and quality of life were compared between the two groups.Results:Before nursing,there were no statistically significant differences in lung function,immune function,pain level,exercise tolerance,and quality of life between the bundled nursing care group and the conventional nursing care group(P>0.05).After nursing,both groups showed improvement in lung function,immune function,pain level,exercise tolerance,and quality of life,but the bundled nursing care group had better results and a lower complication rate,with statistical significance(P<0.05).Conclusion:The bundled nursing care has a higher clinical application value in postoperative recovery of lung cancer patients and is worthy of widespread clinical use.
文摘BACKGROUND Peripherally inserted central catheters(PICCs)are crucial for patients requiring long-term intravenous therapy,especially within digestive surgery under bundled care protocols.AIM To evaluate and compare the efficacy,safety,and patient-reported outcomes of single-lumen vs double-lumen PICCs among patients undergoing digestive surgery within a structured bundled care framework.METHODS This retrospective cohort study analyzed data from 249 patients who underwent digestive surgery and utilized either single-lumen(n=117)or double-lumen(n=132)PICCs between January 2021 and June 2024.Clinical outcomes,patient satisfaction,catheterization duration,and complication rates were compared using statistical analysis via SPSS(version 29.0).The bundled care protocol was consistently applied,focusing on standardized procedures,staff training,and patient support.RESULTS Single-lumen PICCs were associated with a significantly lower thrombosis rate(0.85%)than double-lumen PICCs(6.82%,P=0.039).The single-lumen group experienced shorter catheterization durations(12.5±3.14 days vs 13.6±4.50 days,P=0.025)and higher successful infusion rates(92.7%±5.32%vs 90.4%±6.60%,P=0.003).This group also reported higher comfort scores(8.40±1.20 vs 7.90±1.50,P=0.004)and lower pain levels(2.90±0.70 vs 3.20±0.80,P=0.002).Aside from thrombosis,complication rates showed no significant difference between the groups.CONCLUSION Within bundled care context,single-lumen PICCs demonstrated advantages in reducing thrombosis risk,procedural efficiency,patient comfort,and satisfaction compared with double-lumen PICCs.The findings underscore the importance of considering patient-specific needs and clinical scenarios in catheter choice.
文摘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.
文摘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.
文摘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.
文摘Objective:Surgical procedures manifest immense risks to patients.One of the adverse events that healthcare professionals see as a threat to the patient’s health is the development of complications known as surgical site infection(SSI).Although several effor ts are being under taken to determine the proper means to reduce such complications,there is still a high incidence of SSI worldwide.Surgery requires knowledge in infection control and high precision in maintaining a clean surgical site.This study tested the effectiveness of an operating room(OR)bundle of care in preventing SSI in patients undergoing elective exploratory laparotomy cholecystectomy surgery.Methods:A quasi-experimental pretest and posttest design was utilized to determine its effectiveness.The study was composed of 60 par ticipants divided into two groups:30 subjects were selected to receive the OR bundle of care,while the other 30 subjects received the usual care.The groupings were determined through a systematic random sampling technique.The OR bundle of care had three interventions,namely:(1)maintaining perioperative normothermia,(2)no pre-operative surgical site hair removal,and(3)changing gloves before abdominal wall closure.These patients were evaluated using the standard instrument,Bates–Jensen Wound Assessment Tool(BWAT)in the post-intervention phases of the wound healing process,which are as follows:hemostasis,inflammatory,and proliferative phases.To describe the difference in the patients’wound status after implementation of the OR bundle of care in each post-intervention phase,Friedman’s test was used.To describe the difference in the patients’wound status in both groups after implementation of the OR bundle of care,the Mann–Whitney U test was used.Results:The patient’s wound status was lower,indicating a more healing process.Differences between the wound status of the control and the experimental group were observed on the third postoperative day.This indicates that the experimental group’s wound status healed much faster and more effectively than the control group based on the BWAT scoring severity scoring.A significant difference in the patient’s wound status from the hemostasis phase compared with the proliferative phase was observed.Conclusions:The OR bundle of care has been shown to be effective in preventing SSI in patients who had undergone exploratory laparotomy cholecystectomy surgery in the selected hospital,if there is uniform and consistent implementation of the said intervention.
基金Supported by the National Natural Science Foundation of China (Grant No.51009033)
文摘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.
