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
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
Objective:To explore the value of bundled nursing interventions based on empowerment theory in the care of patients with indwelling urinary catheters.Methods:Forty-two patients with indwelling urinary catheters,admitt...Objective:To explore the value of bundled nursing interventions based on empowerment theory in the care of patients with indwelling urinary catheters.Methods:Forty-two patients with indwelling urinary catheters,admitted from June 2022 to June 2023,were sampled and randomly divided using a random number table.Group A received bundled nursing care based on empowerment theory,while Group B received standard care.The differences in catheterization duration,unplanned extubation rate,emotional scores,quality of life scores,and adverse events were compared.Results:Group A had a shorter catheterization duration and a lower rate of unplanned extubation than Group B,with P<0.05.Anxiety(SAS)and depression(SDS)scores were lower in Group A than in Group B,with P<0.05,and the quality of life(SF-36)scores were higher in Group A than in Group B,with P<0.05.The adverse event rate for Group A was also lower than that for Group B,with P<0.05.Conclusion:Patients with indwelling urinary catheters who received bundled nursing care based on empowerment theory experienced improved emotional stability,optimized quality of life,fewer unplanned extubation events,and the intervention was highly effective and feasible.展开更多
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...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.展开更多
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 effective...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.展开更多
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 ve...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.展开更多
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 ...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.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
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...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.展开更多
Healthcare downstream referral programs,where patients are transferred to a community hospital after surgical treatment in a tertiary hospital for rehabilitation treatment,have been widely advocated.However,no appropr...Healthcare downstream referral programs,where patients are transferred to a community hospital after surgical treatment in a tertiary hospital for rehabilitation treatment,have been widely advocated.However,no appropriate payment scheme aligns incentives to promote the program.This paper mainly compares two payment schemes:bundled and unbundled,which refer to packaged versus separate payments for surgery and rehabilitation treatment.By establishing a three-stage Stackelberg game within a M/Cox-2/1 queuing framework,our paper considers a payer maximizing social welfare in the base model and a payer maximizing the system's long-term surplus in the extension.The base model finds that:(i)the payer pays less under the bundled payment scheme when the potential arrival rate is low and the delay cost is high;otherwise,in most cases,the payer pays more under the bundled payment scheme.(ii)The bundled payment scheme yields greater referral volume and a higher level of effort.(iii)The bundled payment scheme is a weak Pareto improvement(PI hereafter)when both the potential arrival rate and the delay cost are high;the unbundled payment scheme is a PI when the delay cost is moderate and the potential arrival rate is relatively low;otherwise,there is no PI.However,when the payer aims to maximize the system's long-term surplus with a limited budget,several different results are obtained.These results can provide practical insights for policymakers to coordinate downstream referral programs.展开更多
Background:In recent years,the prevalence of type 2 diabetes among Chinese population has been increasing by years,directly leading to an average annual growth rate of 19.90%of medical expenditure.Therefore,it is urge...Background:In recent years,the prevalence of type 2 diabetes among Chinese population has been increasing by years,directly leading to an average annual growth rate of 19.90%of medical expenditure.Therefore,it is urgent to work on strategies to control the growth of medical expenditure on type 2 diabetes on the basis of the reality of China.Therefore,in this study,we explored the feasibility of implementing bundled payment in China through analyzing bundled payment standards of type 2 diabetes outpatient services.Methods:This study analyzed the outpatient expenditure on type 2 diabetes with Beijing Urban Employee's Basic Medical Insurance from 2010 to 2012.Based on the analysis of outpatient expenditure and its influential factors,we adopted decision tree approach to conduct a case-mix analysis.In the end,we built a case-mix model to calculate the standard expenditure and the upper limit of each combination.Results:We found that age,job status,and whether with complication were significant factors that influence outpatient expenditure for type 2 diabetes.Through the analysis of the decision tree,we used six variables(complication,age,diabetic foot,diabetic nephropathy,cardiac-cerebrovascular disease,and neuropathy)to group the cases,and obtained 11 case-mix groups.Conclusions:We argued that it is feasible to implement bundled payment on type 2 diabetes outpatient services.Bundled payment is effective to control the increase of outpatient expenditure.Further improvements are needed for the implementation of bundled payment reimbursement standards,together with relevant policies and measures.展开更多
CONSPECTUS:Superstrong materials can be utilized in many fields such as bulletproof vests,airframes,suspension bridges,flywheel energy storage,etc.As one of the strongest materials,carbon nanotubes(CNTs)can potentiall...CONSPECTUS:Superstrong materials can be utilized in many fields such as bulletproof vests,airframes,suspension bridges,flywheel energy storage,etc.As one of the strongest materials,carbon nanotubes(CNTs)can potentially be used to fabricate superstrong fibers.However,the tensile strength of CNTs is impaired a lot by defects,and the CNT fibers prepared so far have strengths much lower than that of a single CNT,showing a“size effect”.The conventional study of solid mechanics is usually based on the assumption that materials contain defects.Defect-free ultralong CNTs can hopefully help us avoid the“size effect”of nanomaterials and produce superstrong CNT fibers.They would also provide a system for the study of the mechanical behavior of ideal solids with a nonlocalized“quantum stress singularity”.In this Account,we discuss our recent studies on the mechanical behavior of defect-free single CNTs and CNT bundles.First,we introduce the defect-free structure of ultralong CNTs,which is one type of ideal solid.Second,we review the investigation of the static tensile properties and dynamic fatigue resistance and their temperature-dependence of single centimeters long defect-free CNTs.The results showed that defect-free CNTs have superior comprehensive mechanical properties,including superstrength,-toughness,and-durability.Different from traditional materials,the fatigue lifetime and fracture of CNTs are dominated by the first single-bond-sized defect(quantum stress singularity),showing“superbrittleness”.Third,by using a gas flow focusing in situ synthesis method as well as a synchronous tightening and relaxing strengthening strategy,we successfully fabricated CNT bundles with tensile strengths approaching that of single CNTs and showed that the“size effect”can be avoided.In addition,the advantages and promising future of using CNTs in flywheel energy storage are discussed.Finally,we provide our perspectives on the challenges and future directions in this field.展开更多
This work demonstrates the application of electrospun single and bundled carbon nanofibers(CNFs)as piezoresistive sensing elements in flexible and ultralightweight sensors.Material,electrical,and nanomechanical charac...This work demonstrates the application of electrospun single and bundled carbon nanofibers(CNFs)as piezoresistive sensing elements in flexible and ultralightweight sensors.Material,electrical,and nanomechanical characterizations were conducted on the CNFs to understand the effect of the critical synthesis parameter—the pyrolyzation temperature on the morphological,structural,and electrical properties.The mechanism of conductive path change under the influence of external stress was hypothesized to explain the piezoresistive behavior observed in the CNF bundles.Quasi-static tensile strain characterization of the CNF bundle-based flexible strain sensor showed a linear response with an average gauge factor of 11.14(for tensile strains up to 50%).Furthermore,conductive graphitic domain discontinuity model was invoked to explain the piezoresistivity originating in a single isolated electrospun CNF.Finally,a single piezoresistive CNF was utilized as a sensing element in an NEMS flow sensor to demonstrate air flow sensing in the range of 5-35 m/s.展开更多
1 Introduction and main contributions Various power-aware solutions have been proposed to address the alarming energy waste and consequent serious environmental issues since Gupta and Singh initiated the seminal study...1 Introduction and main contributions Various power-aware solutions have been proposed to address the alarming energy waste and consequent serious environmental issues since Gupta and Singh initiated the seminal study on green networking problem in 2003.Most of the researches concentrated their efforts on power-aware networking under the non-bundled link scenarios by leveraging the dynamic power management based Low Power Idle(LPI)policy which was defined and standardized in the IEEE 802.3az standard.However,in modern backbone networks,pairs of routers are typically connected,for each traffic direction,by multiple physical links that form one logical bundled link,which is the link aggregation technique defined and standardized in IEEE 802.1AX.展开更多
The equivalent electrical circuit model of a bundled single-walled carbon nanotube based distributed RLC interconnects is employed for the crosstalk analysis. The accurate time domain analysis and crosstalk effect in ...The equivalent electrical circuit model of a bundled single-walled carbon nanotube based distributed RLC interconnects is employed for the crosstalk analysis. The accurate time domain analysis and crosstalk effect in the VLSI interconnect has emerged as an essential design criteria. This paper presents a brief description of the numerical method based finite difference time domain （FDTD） technique that is intended for estimation of voltages and currents on coupled transmission lines. For the FDTD implementation, the stability of the proposed model is strictly restricted by the Courant condition. This method is used for the estimation of crosstalk induced propagation delay and peak voltage in lossy RLC interconnects. Both functional and dynamic crosstalk effects are analyzed in the coupled transmission line. The effect of line resistance on crosstalk induced delay, and peak voltage under dynamic and functional crosstalk is also evaluated. The FDTD analysis and the SPICE simulations are carried out at 32 nm technology node for the global interconnects. It is observed that the analytical results obtained using the FDTD technique are in good agreement with the SPICE simulation results. The crosstalk induced delay, propagation delay, and peak voltage obtained using the FDTD technique shows average errors of 4.9%, 3.4% and 0.46%, respectively, in comparison to SPICE.展开更多
The influence of the squeeze film between the tube and the support structure on flow-induced vibrations is a critical factor in tube bundles subjected to two-phase cross-flow.This aspect can significantly alter the th...The influence of the squeeze film between the tube and the support structure on flow-induced vibrations is a critical factor in tube bundles subjected to two-phase cross-flow.This aspect can significantly alter the threshold for fluidelastic instability and affect heat transfer efficiency.This paper presents a mathematical model incorporating the squeeze film force between the tube and the support structure.We aim to clarify the mechanisms underlying fluidelastic instability in tube bundle systems exposed to two-phase flow.Using a self-developed computer program,we performed numerical calculations to examine the influence of the squeeze film on the threshold of fluidelastic instability in the tube bundle system.Furthermore,we analyzed how the thickness and length of the squeeze film affect both the underlying mechanisms and the critical velocity of fluidelastic instability.展开更多
The Qinghai-Xizang Plateau of China faces challenges like thaw slumping,threatening slope stability and infrastructure.Understanding the mechanical properties of the roots of the dominant herbaceous plant species in t...The Qinghai-Xizang Plateau of China faces challenges like thaw slumping,threatening slope stability and infrastructure.Understanding the mechanical properties of the roots of the dominant herbaceous plant species in the alpine meadow layer of the permafrost regions on the Qinghai-Xizang Plateau is essential for evaluating their role in enhancing soil shear strength and mitigating slope deformation in these fragile environments.In this study,the roots of four dominant herbaceous plant species—Kobresia pygmaea,Kobresia humilis,Carex moorcroftii,and Leontopodium pusillum—that are widely distributed in the permafrost regions of the Qinghai-Xizang Plateau were explored to determine their mechanical properties and effects in enhancing soil shear strength.Through indoor single root tensile and root group tensile tests,we determined the root diameter,tensile force,tensile strength,tensile ratio,and strength frequency distributions.We also evaluated their contributions to inhibiting slope deformation and failure during the formation and development of thermal thaw slumps in the alpine meadow.The results showed that the distribution of the root diameter of the dominant plant species is mostly normal,while the tensile strength tends to be logarithmically normally distributed.The relationship between the root diameter and root tensile strength conforms to a power function.The theoretical tensile strength of the root group was calculated using the Wu-Waldron Model(WWM)and the Fiber Bundle Model(FBM)under the assumption that the cumulative single tensile strength of the root bundle is identical to the tensile strength of the root group in the WWM.The FBM considers three fracture modes:FBM-D(the tensile force on each single root is proportional to its diameter relative to the total sum of all the root diameters),FBM-S(the cross-sectional stress in the root bundle is uniform),and FBM-N(each tensile strength test of individual roots experiences an equal load).It was found that the model-calculated tensile strength of the root group was 162.60%higher than the test value.The model-derived tensile force of the root group from the FBM-D,FBM-S,and FBM-N was 73.10%,28.91%,and 13.47%higher than the test values,respectively.The additional cohesion of the soil provided by the roots was calculated to be 25.90-45.06 kPa using the modified WWM,67.05-38.15 kPa using the FBM-S,and 57.24-32.74 kPa using the FBM-N.These results not only provide a theoretical basis for further quantitative evaluation of the mechanical effects of the root systems of herbaceous plant species in reinforcing the surface soil but also have practical significance for the effective prevention and control of thermal thaw slumping disasters in the permafrost regions containing native alpine meadows on the Qinghai-Xizang Plateau using flexible plant protection measures.展开更多
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.
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.
文摘Objective:To explore the value of bundled nursing interventions based on empowerment theory in the care of patients with indwelling urinary catheters.Methods:Forty-two patients with indwelling urinary catheters,admitted from June 2022 to June 2023,were sampled and randomly divided using a random number table.Group A received bundled nursing care based on empowerment theory,while Group B received standard care.The differences in catheterization duration,unplanned extubation rate,emotional scores,quality of life scores,and adverse events were compared.Results:Group A had a shorter catheterization duration and a lower rate of unplanned extubation than Group B,with P<0.05.Anxiety(SAS)and depression(SDS)scores were lower in Group A than in Group B,with P<0.05,and the quality of life(SF-36)scores were higher in Group A than in Group B,with P<0.05.The adverse event rate for Group A was also lower than that for Group B,with P<0.05.Conclusion:Patients with indwelling urinary catheters who received bundled nursing care based on empowerment theory experienced improved emotional stability,optimized quality of life,fewer unplanned extubation events,and the intervention was highly effective and feasible.
基金supported by National Natural Science Foundation of China(Nos.12075283 and 11975271)。
文摘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.
文摘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.
文摘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.
文摘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.
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.
基金the following financial support for the research,authorship,and/or publication of this article:Wenhui Zhou and Yanhong Gan was supported by the National Science Foundation of China,Grant/Award Numbers:71925002the Foundation for Innovative Research Groups of the National Natural Science Foundation of China,Grant/Award Numbers:72321001+3 种基金Yuanyuan Dang was supported by the National Natural Science Foundation of China,Grant/Award Numbers:72471095 and 72101090the Special Fund Project for Scientific and Technological Innovation(Soft Science)of Guangdong Province,Grant/Award Numbers:2022A1515011620 and 2024A1515011518Guangdong Philosophy and Social Sciences,Grant/Award Numbers:GD21YGL09 and 2023GZYB22Innovative Research Team of Shanghai International Studies University,Grant/Award Numbers:2023KFKT003.
文摘Healthcare downstream referral programs,where patients are transferred to a community hospital after surgical treatment in a tertiary hospital for rehabilitation treatment,have been widely advocated.However,no appropriate payment scheme aligns incentives to promote the program.This paper mainly compares two payment schemes:bundled and unbundled,which refer to packaged versus separate payments for surgery and rehabilitation treatment.By establishing a three-stage Stackelberg game within a M/Cox-2/1 queuing framework,our paper considers a payer maximizing social welfare in the base model and a payer maximizing the system's long-term surplus in the extension.The base model finds that:(i)the payer pays less under the bundled payment scheme when the potential arrival rate is low and the delay cost is high;otherwise,in most cases,the payer pays more under the bundled payment scheme.(ii)The bundled payment scheme yields greater referral volume and a higher level of effort.(iii)The bundled payment scheme is a weak Pareto improvement(PI hereafter)when both the potential arrival rate and the delay cost are high;the unbundled payment scheme is a PI when the delay cost is moderate and the potential arrival rate is relatively low;otherwise,there is no PI.However,when the payer aims to maximize the system's long-term surplus with a limited budget,several different results are obtained.These results can provide practical insights for policymakers to coordinate downstream referral programs.
文摘Background:In recent years,the prevalence of type 2 diabetes among Chinese population has been increasing by years,directly leading to an average annual growth rate of 19.90%of medical expenditure.Therefore,it is urgent to work on strategies to control the growth of medical expenditure on type 2 diabetes on the basis of the reality of China.Therefore,in this study,we explored the feasibility of implementing bundled payment in China through analyzing bundled payment standards of type 2 diabetes outpatient services.Methods:This study analyzed the outpatient expenditure on type 2 diabetes with Beijing Urban Employee's Basic Medical Insurance from 2010 to 2012.Based on the analysis of outpatient expenditure and its influential factors,we adopted decision tree approach to conduct a case-mix analysis.In the end,we built a case-mix model to calculate the standard expenditure and the upper limit of each combination.Results:We found that age,job status,and whether with complication were significant factors that influence outpatient expenditure for type 2 diabetes.Through the analysis of the decision tree,we used six variables(complication,age,diabetic foot,diabetic nephropathy,cardiac-cerebrovascular disease,and neuropathy)to group the cases,and obtained 11 case-mix groups.Conclusions:We argued that it is feasible to implement bundled payment on type 2 diabetes outpatient services.Bundled payment is effective to control the increase of outpatient expenditure.Further improvements are needed for the implementation of bundled payment reimbursement standards,together with relevant policies and measures.
基金We thank Prof.Dezheng Wang for English editing.This work was supported by Foundation for the National Basic Research P rogram of Ch ina grant s 2016YFA0200102,2020YFC22011002020YFA0210700 National Natural Science Foundation of China grants 21636005,22075163,and 51872156.
文摘CONSPECTUS:Superstrong materials can be utilized in many fields such as bulletproof vests,airframes,suspension bridges,flywheel energy storage,etc.As one of the strongest materials,carbon nanotubes(CNTs)can potentially be used to fabricate superstrong fibers.However,the tensile strength of CNTs is impaired a lot by defects,and the CNT fibers prepared so far have strengths much lower than that of a single CNT,showing a“size effect”.The conventional study of solid mechanics is usually based on the assumption that materials contain defects.Defect-free ultralong CNTs can hopefully help us avoid the“size effect”of nanomaterials and produce superstrong CNT fibers.They would also provide a system for the study of the mechanical behavior of ideal solids with a nonlocalized“quantum stress singularity”.In this Account,we discuss our recent studies on the mechanical behavior of defect-free single CNTs and CNT bundles.First,we introduce the defect-free structure of ultralong CNTs,which is one type of ideal solid.Second,we review the investigation of the static tensile properties and dynamic fatigue resistance and their temperature-dependence of single centimeters long defect-free CNTs.The results showed that defect-free CNTs have superior comprehensive mechanical properties,including superstrength,-toughness,and-durability.Different from traditional materials,the fatigue lifetime and fracture of CNTs are dominated by the first single-bond-sized defect(quantum stress singularity),showing“superbrittleness”.Third,by using a gas flow focusing in situ synthesis method as well as a synchronous tightening and relaxing strengthening strategy,we successfully fabricated CNT bundles with tensile strengths approaching that of single CNTs and showed that the“size effect”can be avoided.In addition,the advantages and promising future of using CNTs in flywheel energy storage are discussed.Finally,we provide our perspectives on the challenges and future directions in this field.
文摘This work demonstrates the application of electrospun single and bundled carbon nanofibers(CNFs)as piezoresistive sensing elements in flexible and ultralightweight sensors.Material,electrical,and nanomechanical characterizations were conducted on the CNFs to understand the effect of the critical synthesis parameter—the pyrolyzation temperature on the morphological,structural,and electrical properties.The mechanism of conductive path change under the influence of external stress was hypothesized to explain the piezoresistive behavior observed in the CNF bundles.Quasi-static tensile strain characterization of the CNF bundle-based flexible strain sensor showed a linear response with an average gauge factor of 11.14(for tensile strains up to 50%).Furthermore,conductive graphitic domain discontinuity model was invoked to explain the piezoresistivity originating in a single isolated electrospun CNF.Finally,a single piezoresistive CNF was utilized as a sensing element in an NEMS flow sensor to demonstrate air flow sensing in the range of 5-35 m/s.
基金supported by the 2021 High-Level Talents Scientific Research Start-Up Funding Project of West Anhui University(No.WGKQ2021054)the Natural Science Research Key Project of Anhui Educational Committee(No.2022AH051667)the National Natural Science Foundation of China(Grant Nos.62032013 and 92267206).
文摘1 Introduction and main contributions Various power-aware solutions have been proposed to address the alarming energy waste and consequent serious environmental issues since Gupta and Singh initiated the seminal study on green networking problem in 2003.Most of the researches concentrated their efforts on power-aware networking under the non-bundled link scenarios by leveraging the dynamic power management based Low Power Idle(LPI)policy which was defined and standardized in the IEEE 802.3az standard.However,in modern backbone networks,pairs of routers are typically connected,for each traffic direction,by multiple physical links that form one logical bundled link,which is the link aggregation technique defined and standardized in IEEE 802.1AX.
文摘The equivalent electrical circuit model of a bundled single-walled carbon nanotube based distributed RLC interconnects is employed for the crosstalk analysis. The accurate time domain analysis and crosstalk effect in the VLSI interconnect has emerged as an essential design criteria. This paper presents a brief description of the numerical method based finite difference time domain （FDTD） technique that is intended for estimation of voltages and currents on coupled transmission lines. For the FDTD implementation, the stability of the proposed model is strictly restricted by the Courant condition. This method is used for the estimation of crosstalk induced propagation delay and peak voltage in lossy RLC interconnects. Both functional and dynamic crosstalk effects are analyzed in the coupled transmission line. The effect of line resistance on crosstalk induced delay, and peak voltage under dynamic and functional crosstalk is also evaluated. The FDTD analysis and the SPICE simulations are carried out at 32 nm technology node for the global interconnects. It is observed that the analytical results obtained using the FDTD technique are in good agreement with the SPICE simulation results. The crosstalk induced delay, propagation delay, and peak voltage obtained using the FDTD technique shows average errors of 4.9%, 3.4% and 0.46%, respectively, in comparison to SPICE.
基金financially supported by the National Natural Science Foundation of China(Grant No.12072336).
文摘The influence of the squeeze film between the tube and the support structure on flow-induced vibrations is a critical factor in tube bundles subjected to two-phase cross-flow.This aspect can significantly alter the threshold for fluidelastic instability and affect heat transfer efficiency.This paper presents a mathematical model incorporating the squeeze film force between the tube and the support structure.We aim to clarify the mechanisms underlying fluidelastic instability in tube bundle systems exposed to two-phase flow.Using a self-developed computer program,we performed numerical calculations to examine the influence of the squeeze film on the threshold of fluidelastic instability in the tube bundle system.Furthermore,we analyzed how the thickness and length of the squeeze film affect both the underlying mechanisms and the critical velocity of fluidelastic instability.
基金supported by the Qinghai Science and Technology Department Project(2025-QY-225)the National Natural Science Foundation of China(42267024)the Second Comprehensive Scientific Investigation and Research Project of the Qinghai-Xizang Plateau(2019QZKK0905).
文摘The Qinghai-Xizang Plateau of China faces challenges like thaw slumping,threatening slope stability and infrastructure.Understanding the mechanical properties of the roots of the dominant herbaceous plant species in the alpine meadow layer of the permafrost regions on the Qinghai-Xizang Plateau is essential for evaluating their role in enhancing soil shear strength and mitigating slope deformation in these fragile environments.In this study,the roots of four dominant herbaceous plant species—Kobresia pygmaea,Kobresia humilis,Carex moorcroftii,and Leontopodium pusillum—that are widely distributed in the permafrost regions of the Qinghai-Xizang Plateau were explored to determine their mechanical properties and effects in enhancing soil shear strength.Through indoor single root tensile and root group tensile tests,we determined the root diameter,tensile force,tensile strength,tensile ratio,and strength frequency distributions.We also evaluated their contributions to inhibiting slope deformation and failure during the formation and development of thermal thaw slumps in the alpine meadow.The results showed that the distribution of the root diameter of the dominant plant species is mostly normal,while the tensile strength tends to be logarithmically normally distributed.The relationship between the root diameter and root tensile strength conforms to a power function.The theoretical tensile strength of the root group was calculated using the Wu-Waldron Model(WWM)and the Fiber Bundle Model(FBM)under the assumption that the cumulative single tensile strength of the root bundle is identical to the tensile strength of the root group in the WWM.The FBM considers three fracture modes:FBM-D(the tensile force on each single root is proportional to its diameter relative to the total sum of all the root diameters),FBM-S(the cross-sectional stress in the root bundle is uniform),and FBM-N(each tensile strength test of individual roots experiences an equal load).It was found that the model-calculated tensile strength of the root group was 162.60%higher than the test value.The model-derived tensile force of the root group from the FBM-D,FBM-S,and FBM-N was 73.10%,28.91%,and 13.47%higher than the test values,respectively.The additional cohesion of the soil provided by the roots was calculated to be 25.90-45.06 kPa using the modified WWM,67.05-38.15 kPa using the FBM-S,and 57.24-32.74 kPa using the FBM-N.These results not only provide a theoretical basis for further quantitative evaluation of the mechanical effects of the root systems of herbaceous plant species in reinforcing the surface soil but also have practical significance for the effective prevention and control of thermal thaw slumping disasters in the permafrost regions containing native alpine meadows on the Qinghai-Xizang Plateau using flexible plant protection measures.
