In recent years,research on nursing interruptions has been conducted at various levels in emergency departments,intensive care units,hemodialysis centers,operating rooms,and sterilization and supply centers.Nursing in...In recent years,research on nursing interruptions has been conducted at various levels in emergency departments,intensive care units,hemodialysis centers,operating rooms,and sterilization and supply centers.Nursing interruptions are closely related to adverse nursing events,and interruptions in operating room nursing can significantly impact the success of a patient’s surgery.However,there is a lack of in-depth theoretical research on safety risk assessment and response decision-making by operating room nurses when faced with nursing interruptions.This article reviews the concept,current status,and impact of nursing interruptions in the operating room,analyzes the cognitive level,coping strategies,and negative emotions of operating room nurses,and elaborates on management strategies to provide references for research and management of nursing interruptions in the operating room.展开更多
Objectives:To explore the knowledge,attitude and practice of Chinese nurses regarding nursing interruptions and related factors.Methods:A total of 6,400 nurses from 31 hospitals in China were investigated by using the...Objectives:To explore the knowledge,attitude and practice of Chinese nurses regarding nursing interruptions and related factors.Methods:A total of 6,400 nurses from 31 hospitals in China were investigated by using the Knowledge,Attitude and Practice(KAP)Questionnaire of Nursing Interruptions.The questionnaire consists of three dimensions,knowledge,attitude and practice,containing 10,9 and 7 items,with full score of 50,45 and 28,respectively.Results:The mean overall KAP score regarding nursing interruptions of Chinese nurses was 74.05±16.65(range:26-123),with scores for the knowledge,attitude,and practice component being 21.74±9.80,34.83±6.98,and 17.49±4.97,respectively.Among the nurses,70.8%of them experienced an average level of KAP toward nursing interruptions while 15.5%were at a poor level.The knowledge,attitude,and practice of nursing interruptions were better in chief nurses,managers,nurses with a master degree or above,nurses ever received training,and nurses with a strong agreement to leadership compared to nurses in other groups(P<0.05).In addition,employment type,professional title,position,standardized training and leaders'attention were predictors of KAP in nurses.Conclusion:Chinese nurses have a moderate level of KAP regarding nursing interruptions.Leaders'attention,standardized training,position,professional title and employment type could predict nurses'KAP state of nursing interruptions.Thus,a targeted training program should be implemented for clinical nurses by nursing leaders,with a particular focus on feasibility and professionalism.展开更多
Highly Active Antiretroviral Therapy (HAART) has changed the course of human immunodeficiency virus (HIV) treatments since its introduction. However, for many patients, long term continuous HAART is expensive and can ...Highly Active Antiretroviral Therapy (HAART) has changed the course of human immunodeficiency virus (HIV) treatments since its introduction. However, for many patients, long term continuous HAART is expensive and can include problems with drug toxicity and side effects, as well as increased drug resistance. Because of these reasons, some HIV infected patients will voluntarily terminate HAART. Some of these patients will also interrupt the continuous prescribed therapies for short or long periods. After discontinuing HAART, patients will usually experience a rapid increase in viral load coupled with an immediate decline in CD4+ counts. The canonical example of a patient undergoing unsupervised breaks in HAART is that of the “Berlin patient”. In this case, the patient was able to control viral load in the absence of treatment by cycling HAART on and off due to non-related infections. Due to this patient, interest in the use of structured treatment interruptions (STI) as a mechanism to regulate an HIV infection piqued. This paper describes an optimal control approach to determine STI regimen for HIV patients. The optimal STI was implemented in the context of the receding horizon control (RHC) using a mathematical model for the in-vivo dynamics of an HIV type 1 infection. Using available clinical data, we calibrate the model by estimating on a patient specific basis, a best estimable set of parameters using sensitivity analysis and subset selection. We demonstrate how customized STI protocols can be designed through the variation of control parameters on a patient specific basis.展开更多
This study investigates and analyzes the electric energy interruptions impact upon the residential sector in Riyadh city, the capital of the Kingdom of Saudi Arabia (KSA) resulting from severe power outages. The study...This study investigates and analyzes the electric energy interruptions impact upon the residential sector in Riyadh city, the capital of the Kingdom of Saudi Arabia (KSA) resulting from severe power outages. The study results show that this sector which constitutes about 54% of the Saudi Electric Company in the Central Operating Area (SEC-COA) will suffer enormous tangible and intangible losses should occur in specific times, seasons and last for longer durations. The results obtained for the costs of these energy interruptions reveal a time-dependent non-linear outage cost variation. In order to reduce these energy interruptions and hence mitigate their adverse effects and consequences, the study proposes proper practical measures and solutions without compromising the consumers’ needs and convenience.展开更多
Background: Sufficient coronary perfusion pressure (CPP) to provide myocardial reperfusion is required for defibrillation success after prolonged ventricular fibrillation (VF) cardiac arrest. Chest compression interru...Background: Sufficient coronary perfusion pressure (CPP) to provide myocardial reperfusion is required for defibrillation success after prolonged ventricular fibrillation (VF) cardiac arrest. Chest compression interruptions cause a precipitous drop in CPP. Objective: To quantify the ex- tent to which CPP recovers to pre-pause levels following chest compression interruptions. Me- thods: This was a secondary analysis of data from two similar IACUC approved protocols. A total of 105 Yorkshire swine were included and VF was electrically induced. After 10 minutes of untreated VF in the first study (n = 52) and 12 minutes of untreated VF in the second (n = 53), CPR began and epinephrine was administered approximately 2 minutes prior to a planned 10-second pause to record an artifact-free ECG waveform segment. Following this pause, CPR was resumed for 20- seconds prior to defibrillation. CPP data were extracted from three time points: 2 minutes after epinephrine delivery (CPP1);following the chest compression pause (CPP2);and immediately before defibrillation (CPP3). Our primary outcome was defined as the ratio of CPP recovery (CPP3- CPP2) to the drop in CPP (CPP1-CPP2). Results: Interrupting compressions resulted in a significant drop in CPP (29.8 mmHg [95%CI: 26.2, 33.4] to 6.8 mmHg [95%CI: 5.4, 8.2]). Resuming CPR for restored 83% (95%CI: 78%, 86%) of the CPP lost. Conclusion: This study demonstrates that 83% of the decline in CPP values during a planned 10-second interruption in CPR can be restored with a short period of precordial compressions prior to defibrillation.展开更多
The functional analysis of interruption is of great necessity in carrying out a smooth conversation.By exemplifying interruptions in specific conversational situations identified in Friends,the paper has explored the ...The functional analysis of interruption is of great necessity in carrying out a smooth conversation.By exemplifying interruptions in specific conversational situations identified in Friends,the paper has explored the relative,interactive,pluralistic and situational characteristics of functions of interruptions.展开更多
Introduction:Surveys from the China-Tanzania Malaria Control Project demonstrated that the 1,7-malaria Reactive Community-Based Testing and Response(1,7-mRCTR)approach significantly reduced malaria incidence rates.How...Introduction:Surveys from the China-Tanzania Malaria Control Project demonstrated that the 1,7-malaria Reactive Community-Based Testing and Response(1,7-mRCTR)approach significantly reduced malaria incidence rates.However,implementation was disrupted by security concerns,infectious disease outbreaks,and supply shortages.This study evaluates how these interruptions affected intervention effectiveness to inform future malaria control strategies.Methods:The study employed a two-phased design:Phase I(2016–2018)and Phase II(2019–2021).Weekly malaria incidence rates per 100 people were calculated from cases reported by local health facilities in the intervention areas during both phases.Seasonal and trend decomposition using loess(STL)and interrupted time series modeling with piecewise linear regression were used to evaluate the impact of disruptions on 1,7-mRCTR implementation effectiveness.Results:In Tanzania’s 1,7-mRCTR areas,malaria incidence peaked during November-December and June-July.Phase I’s 8-month interruption reversed the weekly trend from a 0.17%decline to a 0.58%increase(P=0.001).After resumption,incidence dropped 8.96%(P=0.039)and maintained a 0.39%long-term decline(P=0.003).Even with seasonal adjustment,the interruption slowed the weekly decline from 0.08%to 0.07%(P=0.003).Phase II showed a similar pattern:a one-week interruption caused a 0.70%drop(P=0.007)but shifted the trend from a 0.02%decline to a 0.08%increase(P=0.001).After resumption,interventions stabilized the decline at 0.11%weekly(P=0.001).Conclusions:This research demonstrates that Tanzania’s malaria incidence is closely linked to seasonal patterns and consistent intervention efforts.Phase I’s 8-month security-related interruption reduced 1,7-mRCTR effectiveness by 12.5%,while Phase II’s 3-month pandemic-induced interruption caused only short-term fluctuations with minimal long-term impact.Rapid resumption of interventions after disruptions allowed for prompt recovery,highlighting the importance of adaptive strategies to maintain progress toward malaria control goals.展开更多
The performance of an integrated packet voice/data multiplexer using a stop-and-wait(SW)automatic repeat request(ARQ)protocol is discussed.We assume that the input for the data traffic is exponentially distributed in ...The performance of an integrated packet voice/data multiplexer using a stop-and-wait(SW)automatic repeat request(ARQ)protocol is discussed.We assume that the input for the data traffic is exponentially distributed in increments via the Poisson process,with each data packet transmitted within an individual slot time.Another assumption is that there is only a single voice signal,which has a higher priority over the data packet,and whose traffic is given via an on-off Markov process.Whenever the voice signal is active,the output link is used and will be blocked for the data packet.We introduce the concept of buffer occupancy to simplify the analysis,and discover that data multiplexers using the SW ARQ protocol exhibit a behavior of queueing delay and buffering when the interruption signal is given via a Markov process.Simulation results verify the validity of the analytical results.展开更多
Spinal cord injury(SCI)interrupts the flow of information between the brain and the spinal cord,thus leading to a loss of sensory information and motor paralysis of the body below the lesion.Surprisingly,most SCIs are...Spinal cord injury(SCI)interrupts the flow of information between the brain and the spinal cord,thus leading to a loss of sensory information and motor paralysis of the body below the lesion.Surprisingly,most SCIs are incomplete and spare supraspinal pathways,especially those located within the peripheral white matter of the spinal cord,which includes reticulospinal pathways originating from the medullary reticular formation.Whereas there is abundant literature about the motor cortex,its corticospinal pathway,and its capacity to modulate functional recovery after SCI,less is known about the medullary reticular formation and its reticulospinal pathway.展开更多
In this paper, we study the M/M/1 queue with working vacations and vacation interruptions. The working vacation is introduced recently, during which the server can still provide service on the original ongoing work at...In this paper, we study the M/M/1 queue with working vacations and vacation interruptions. The working vacation is introduced recently, during which the server can still provide service on the original ongoing work at a lower rate. Meanwhile, we introduce a new policy：, the server can come back from the vacation to the normal working level once some indices of the system, such as the number of customers, achieve a certain value in the vacation period. The server may come back from the vacation without completing the vacation. Such policy is called vacation interruption. We connect the above mentioned two policies and assume that if there are customers in the system after a service completion during the vacation period, the server will come back to the normal working level. In terms of the quasi birth and death process and matrix-geometric solution method, we obtain the distributions and the stochastic decomposition structures for the number of customers and the waiting time and provide some indices of systems.展开更多
This paper studies the time-dependent analysis of an M/M/1 queueing model with single,multiple working vacation,balking and vacation interruptions.Whenever the system becomes empty,the server commences working vacatio...This paper studies the time-dependent analysis of an M/M/1 queueing model with single,multiple working vacation,balking and vacation interruptions.Whenever the system becomes empty,the server commences working vacation.During the working vacation period,if the queue length reaches a positive threshold value‘k’,the working vacation of the server is interrupted and it immediately starts the service in an exhaustive manner.During working vacations,the customers become discouraged due to the slow service and possess balking behavior.The transient system size probabilities of the proposed model are derived explicitly using the method of generating function and continued fraction.The performance indices such as average and variance of system size are also obtained.Further,numerical simulations are presented to analyze the impact of system parameters.展开更多
Background:To investigate SCL/TAL 1 interrupting locus(STIL)’s role and prognostic significance in lung adenocarcinoma(LUAD)progression,we examined STIL and E2 promoter binding factor 1(E2F1)expression and their impa...Background:To investigate SCL/TAL 1 interrupting locus(STIL)’s role and prognostic significance in lung adenocarcinoma(LUAD)progression,we examined STIL and E2 promoter binding factor 1(E2F1)expression and their impacts on LUAD prognosis using Gene Expression Profiling Interactive Analysis(GEPIA).Methods:Functional assays including CCK-8,wound-healing,5-ethynyl-2-deoxyuridine(EdU),Transwell assays,and flow cytometry,elucidated STIL and E2F1’s effects on cell viability,proliferation,apoptosis,and migration.Gene set enrichment analysis(GSEA)identified potential pathways,while metabolic assays assessed glucose metabolism.Results:Our findings reveal that STIL and E2F1 are overexpressed in LUAD,correlating with adverse outcomes.It enhances cell proliferation,migration,and invasion,and suppresses apoptosis,activating downstream of E2F1.Silencing E2F1 reversed the promotion effect of the STIL overexpression on cell viability and invasiveness.Importantly,STIL modulates glycolysis,influencing glucose consumption,lactate production,and energy balance in LUAD cells.Conclusion:Our model,incorporating STIL,age,and disease stage,robustly predicts patient prognosis,underscored STIL’s pivotal role in LUAD pathogenesis through metabolic reprogramming.This comprehensive approach not only confirms STIL’s prognostic value but also highlights its potential as a therapeutic target in LUAD.展开更多
Background:Spinocerebellar ataxia type 2(SCA2)is a neurodegenerative disease marked by significant clinical and genetic heterogeneity,primarily caused by expanded CAG mutations in the ATXN2 gene.The unstable expansion...Background:Spinocerebellar ataxia type 2(SCA2)is a neurodegenerative disease marked by significant clinical and genetic heterogeneity,primarily caused by expanded CAG mutations in the ATXN2 gene.The unstable expansion of CAG repeats disrupts the genetic stability of animal models,which is detrimental to disease research.Methods:In this study,we established a mouse model in which CAG repeats do not undergo microsatellite instability(MSI)across generations.A humanized ATXN2 cDNA with four CAA interruptions within 73 CAG expansions was inserted into the Rosa26 locus of C57BL/6J mice.A 23 CAG control mouse model was also generated to verify ATXN2 integration and expression.Results:In our model,the number of CAG repeats remained stable during transmission,with no CAG repeat expansion observed in 64 parent-to-offspring transmissions.Compared with SCA2-Q23 mice,SCA2-Q73 mice exhibited progressive motor impairment,reduced Purkinje cell count and volume(indicative of cell atrophy),and muscle atrophy.These observations in the mice suggest that the behavioral and neuropathological phenotypes may reflect the features of SCA2 patients.RNA-seq analysis of the gastrocnemius muscle in SCA2-Q73 mice showed significant changes in muscle differentiation and development gene expression at 56 weeks,with no significant differences at 16 weeks compared to SCA2-Q23 mice.The expression level of the Myf6 gene significantly changed in the muscles of aged mice.Conclusion:In summary,the establishment of this model not only provides a stable animal model for studying CAG transmission in SCA2 but also indicates that the lack of long-term neural stimulation leads to muscle atrophy.展开更多
In rice systems under continuous flooding(CF)irrigation,rice grains with high arsenic(As)concentration can be produced.In Argentina,these areas are located in the south of Corrientes Province and the north of Entre R&...In rice systems under continuous flooding(CF)irrigation,rice grains with high arsenic(As)concentration can be produced.In Argentina,these areas are located in the south of Corrientes Province and the north of Entre Ríos Province.The combination of agronomic management,genetic variability of rice varieties,and the characteristics of soil and irrigation water determines the concentration and proportion of grain As species.In this study,we evaluated two factors affecting grain As accumulation:irrigation management,CF and interrupted flooding(IF),and rice variety,rice with medium,long,and double long/wide grains.The experiments were conducted during four cropping cycles(2015–2016,2016–2017,2017–2018,and 2020–2021)on a farm in the north of Entre Ríos Province.Total As concentration in husked grains showed a wide range and was mostly above 0.30 mg kg^(-1),even after the polishing process.Fortunately,organic As was the predominant species.In polished rice,inorganic As concentration ranged between 0.02 and 0.28 mg kg^(-1).Significant differences were observed in grain As concentration between four rice varieties,with the highest inorganic and total As concentrations in grains of the medium-grain variety.The interaction of rice variety by irrigation management did not affect grain yield,but significantly reduced total As concentration in grains.Soil drainage under IF explained 43%–46%of the reduction of total As concentration in grains.The management practices of irrigation and rice variety had slight effects on inorganic As concentration in grains.In conclusion,a single soil drying period combined with proper rice varieties can be an effective management practice for mitigating As accumulation in rice grains.展开更多
Catalytic syntheses of silaoxycarbocyclics from an interrupted Catellani reaction of 3-iodochromones with bridged olefins and octamethyl-1,4-dioxacyclohexasilane is described.This protocol involves the oxidative addit...Catalytic syntheses of silaoxycarbocyclics from an interrupted Catellani reaction of 3-iodochromones with bridged olefins and octamethyl-1,4-dioxacyclohexasilane is described.This protocol involves the oxidative addition of chromonyl-norbornyl-palladacycle generated through successive oxidative addition of Pd(0)to 3-iodochromones,migratory insertion of NBE and intramolecular ortho-C(sp^(2))-H activation to the tetrasilane,thus motivating a(4+6)annulation and ring expansion.The synthetic practicality of current strategy is further proved by the late-stage modification of pharmaceuticals and natural products,gram-scale experiments,as well as the transformations of functional groups of silaoxycarbocyclics.展开更多
Digital avatars have become a standard feature on e-commerce platforms.As virtual hosts,they emulate human behavior,broadcast live programs without interruption,and present“Made in China”products to foreign consumer...Digital avatars have become a standard feature on e-commerce platforms.As virtual hosts,they emulate human behavior,broadcast live programs without interruption,and present“Made in China”products to foreign consumers,thanks to their proficiency in multiple languages.The impressive efficiency of these digital avatars is made possible by the colossal computing power that enables them to perform their functions.“This year,the storage requirements of the digital avatars have increased significantly,by approximately 500 times compared to last year.The current local storage capacity is no longer sufficient.”展开更多
BACKGROUND At present,prophylactic ileostomy is commonly used to protect distal intestinal anastomoses,particularly during the recovery period following colorectal surgery.However,after the ileum is returned to the ab...BACKGROUND At present,prophylactic ileostomy is commonly used to protect distal intestinal anastomoses,particularly during the recovery period following colorectal surgery.However,after the ileum is returned to the abdominal cavity,abdominal closure using traditional vertical interrupted suturing is associated with a higher incidence of wound infections.For patients undergoing ileostomy closure,selecting an appropriate suturing method for the skin incision at the stoma site is crucial for improving patient prognosis.AIM To investigate the impact of three different skin suturing methods at the ileostomy closure site on patient prognosis.METHODS Thirty patients who underwent ileostomy closure at the Affiliated Hospital of Qinghai University between January 2024 and October 2024 were selected based on inclusion and exclusion criteria.The patients were divided into three groups:The purse-string suture group,the cross-suture group,and the vertical interrupted suture group,with 10 cases in each group.The purse-string suture group,cross-suture group,and vertical interrupted suture group used purse-string,cross,and vertical interrupted suturing methods,respectively,for the skin incision at the ileostomy closure site.RESULTS There were no statistically significant differences among the three groups in terms of operative time,intraoperative blood loss,time to resume liquid diet,time to first bowel movement,postoperative hospital stay,hospitalization costs,or levels of white blood cell count,hemoglobin,and albumin on the third postoperative day(P>0.05).Nevertheless,significant differences(P<0.05)were observed in incision suture removal time,wound healing time,C-reactive protein levels on the third postoperative day,visual analog scale pain scores during the first three postoperative days,and the incidence of surgical site infection.Overall,the therapeutic outcomes of the pursestring suture group and the cross-suture group were superior to the vertical interrupted suture group.CONCLUSION Using purse-string or cross-suturing methods for skin incision at the ileostomy closure site can shorten wound healing and suture removal times,reduce surgical site infection incidence and postoperative inflammatory response,alleviate incision pain,and promote rapid postoperative recovery.展开更多
BACKGROUND Gastric subepithelial lesions(SELs)are elevated lesions originating from the muscularis mucosa,submucosa,or muscularis propria,and may also include extraluminal lesions.For small SELs(less than 5 cm),comple...BACKGROUND Gastric subepithelial lesions(SELs)are elevated lesions originating from the muscularis mucosa,submucosa,or muscularis propria,and may also include extraluminal lesions.For small SELs(less than 5 cm),complete endoscopic excision is the preferred treatment.Endoscopic full-thickness resection(EFTR)has proven to be an effective approach.AIM To evaluate the efficacy of the interrupted closure technique compared to the traditional closure technique in EFTR for gastric SELs.METHODS This single-center,prospective,randomized controlled trial was conducted at a tertiary hospital from September 2023 to September 2024.A total of 90 patients who underwent EFTR for gastric SELs were randomly allocated to either the interrupted closure group(n=44)or the traditional closure group(n=46).RESULTS All patients had complete resection and wound closure without any severe postoperative complications.The incidence of intraoperative gas-related complications was significantly lower in the interrupted closure group than in the traditional closure group(2.27%vs 26.09%,P=0.001),demonstrating interrupted closure technique can reduce the incidence of gas-related issues.Statistical analysis revealed that the incidence of postoperative infection was significantly lower in the experimental group than in the control group(15.91%vs 41.30%,P=0.008).Additionally,the median duration of antibiotic use was lower in the experimental group(3.5 days vs 5 days,P=0.013).Abdominal pain levels on postoperative days 1 and 4 were also lower in the experimental group compared to the control group(P<0.001).CONCLUSION The interrupted closure technique in EFTR for treating gastric SELs is safe and effective,reducing the incidence of intraoperative gas complications and postoperative infections.展开更多
The incremental capacity analysis(ICA)technique is notably limited by its sensitivity to variations in charging conditions,which constrains its practical applicability in real-world scenarios.This paper introduces an ...The incremental capacity analysis(ICA)technique is notably limited by its sensitivity to variations in charging conditions,which constrains its practical applicability in real-world scenarios.This paper introduces an ICA-compensation technique to address this limitation and propose a generalized framework for assessing the state of health(SOH)of batteries based on ICA that is applicable under differing charging conditions.This novel approach calculates the voltage profile under quasi-static conditions by subtracting the voltage increase attributable to the additional polarization effects at high currents from the measured voltage profile.This approach's efficacy is contingent upon precisely acquiring the equivalent impedance.To obtain the equivalent impedance throughout the batteries'lifespan while minimizing testing costs,this study employs a current interrupt technique in conjunction with a long short-term memory(LSTM)network to develop a predictive model for equivalent impedance.Following the derivation of ICA curves using voltage profiles under quasi-static conditions,the research explores two scenarios for SOH estimation:one utilizing only incremental capacity(IC)features and the other incorporating both IC features and IC sampling.A genetic algorithm-optimized backpropagation neural network(GABPNN)is employed for the SOH estimation.The proposed generalized framework is validated using independent training and test datasets.Variable test conditions are applied for the test set to rigorously evaluate the methodology under challenging conditions.These evaluation results demonstrate that the proposed framework achieves an estimation accuracy of 1.04%for RMSE and 0.90%for MAPE across a spectrum of charging rates ranging from 0.1 C to 1 C and starting SOCs between 0%and 70%,which constitutes a major advancement compared to established ICA methods.It also significantly enhances the applicability of conventional ICA techniques in varying charging conditions and negates the necessity for separate testing protocols for each charging scenario.展开更多
In the context of the Diagnosis Related Groups(DRGs)system,the orthopedic hospital implemented refined drug control to provide a pharmacological reference for promoting rational clinical drug use.A statistical analysi...In the context of the Diagnosis Related Groups(DRGs)system,the orthopedic hospital implemented refined drug control to provide a pharmacological reference for promoting rational clinical drug use.A statistical analysis was conducted on the hospital’s data from January to December 2021(prior to the implementation of control),focusing on the types of unreasonable prescriptions.A multi-dimensional analysis was also conducted to identify the underlying causes of inappropriate medication practices.Following this,refined drug control measures were introduced,and data from January to December 2022(post-control)were compared,examining factors such as the average drug cost,drug expenses for the IC29 diagnosis group,and the drug cost ratio.An interrupted time-series analysis was employed to evaluate the effects of these interventions.The results showed that after the implementation of refined drug control in the orthopedic department,significant reductions were observed in the average cost per patient,average drug cost per patient,drug cost ratio,cost consumption index,average length of hospital stay,and allocation ratio(P<0.05).In particular,the first month of control(January 2022)saw a marked decrease in average drug costs per patient by 1272.90 yuan(P<0.01),a reduction in the drug cost ratio by 0.98%,and a decline in drug costs for the IC29 diagnosis group by 616.79 yuan(P>0.05).Moreover,the rate of unreasonable inappropriate prescribing dropped dramatically from 40.48%in 2021 to 3.57%by December 2022.The refined control of drug use within the orthopedic hospital significantly improved the rationality of clinical prescribing practices,reduced the occurrence of adverse drug reactions,and enhanced patient adherence to prescribed treatments.These findings demonstrated considerable clinical value in promoting efficient and safe drug use.展开更多
基金Analysis of Lung Compliance Measurement and its Guided Therapeutic Effects in Patients with ARDS Secondary to Severe Multiple Trauma(Project No.:XSD-2023-002)。
文摘In recent years,research on nursing interruptions has been conducted at various levels in emergency departments,intensive care units,hemodialysis centers,operating rooms,and sterilization and supply centers.Nursing interruptions are closely related to adverse nursing events,and interruptions in operating room nursing can significantly impact the success of a patient’s surgery.However,there is a lack of in-depth theoretical research on safety risk assessment and response decision-making by operating room nurses when faced with nursing interruptions.This article reviews the concept,current status,and impact of nursing interruptions in the operating room,analyzes the cognitive level,coping strategies,and negative emotions of operating room nurses,and elaborates on management strategies to provide references for research and management of nursing interruptions in the operating room.
基金Paper extracted from The New Xiangya Talent Projects of the Third Xiangya Hospital of Central South University(NO:JY201720).
文摘Objectives:To explore the knowledge,attitude and practice of Chinese nurses regarding nursing interruptions and related factors.Methods:A total of 6,400 nurses from 31 hospitals in China were investigated by using the Knowledge,Attitude and Practice(KAP)Questionnaire of Nursing Interruptions.The questionnaire consists of three dimensions,knowledge,attitude and practice,containing 10,9 and 7 items,with full score of 50,45 and 28,respectively.Results:The mean overall KAP score regarding nursing interruptions of Chinese nurses was 74.05±16.65(range:26-123),with scores for the knowledge,attitude,and practice component being 21.74±9.80,34.83±6.98,and 17.49±4.97,respectively.Among the nurses,70.8%of them experienced an average level of KAP toward nursing interruptions while 15.5%were at a poor level.The knowledge,attitude,and practice of nursing interruptions were better in chief nurses,managers,nurses with a master degree or above,nurses ever received training,and nurses with a strong agreement to leadership compared to nurses in other groups(P<0.05).In addition,employment type,professional title,position,standardized training and leaders'attention were predictors of KAP in nurses.Conclusion:Chinese nurses have a moderate level of KAP regarding nursing interruptions.Leaders'attention,standardized training,position,professional title and employment type could predict nurses'KAP state of nursing interruptions.Thus,a targeted training program should be implemented for clinical nurses by nursing leaders,with a particular focus on feasibility and professionalism.
文摘Highly Active Antiretroviral Therapy (HAART) has changed the course of human immunodeficiency virus (HIV) treatments since its introduction. However, for many patients, long term continuous HAART is expensive and can include problems with drug toxicity and side effects, as well as increased drug resistance. Because of these reasons, some HIV infected patients will voluntarily terminate HAART. Some of these patients will also interrupt the continuous prescribed therapies for short or long periods. After discontinuing HAART, patients will usually experience a rapid increase in viral load coupled with an immediate decline in CD4+ counts. The canonical example of a patient undergoing unsupervised breaks in HAART is that of the “Berlin patient”. In this case, the patient was able to control viral load in the absence of treatment by cycling HAART on and off due to non-related infections. Due to this patient, interest in the use of structured treatment interruptions (STI) as a mechanism to regulate an HIV infection piqued. This paper describes an optimal control approach to determine STI regimen for HIV patients. The optimal STI was implemented in the context of the receding horizon control (RHC) using a mathematical model for the in-vivo dynamics of an HIV type 1 infection. Using available clinical data, we calibrate the model by estimating on a patient specific basis, a best estimable set of parameters using sensitivity analysis and subset selection. We demonstrate how customized STI protocols can be designed through the variation of control parameters on a patient specific basis.
文摘This study investigates and analyzes the electric energy interruptions impact upon the residential sector in Riyadh city, the capital of the Kingdom of Saudi Arabia (KSA) resulting from severe power outages. The study results show that this sector which constitutes about 54% of the Saudi Electric Company in the Central Operating Area (SEC-COA) will suffer enormous tangible and intangible losses should occur in specific times, seasons and last for longer durations. The results obtained for the costs of these energy interruptions reveal a time-dependent non-linear outage cost variation. In order to reduce these energy interruptions and hence mitigate their adverse effects and consequences, the study proposes proper practical measures and solutions without compromising the consumers’ needs and convenience.
文摘Background: Sufficient coronary perfusion pressure (CPP) to provide myocardial reperfusion is required for defibrillation success after prolonged ventricular fibrillation (VF) cardiac arrest. Chest compression interruptions cause a precipitous drop in CPP. Objective: To quantify the ex- tent to which CPP recovers to pre-pause levels following chest compression interruptions. Me- thods: This was a secondary analysis of data from two similar IACUC approved protocols. A total of 105 Yorkshire swine were included and VF was electrically induced. After 10 minutes of untreated VF in the first study (n = 52) and 12 minutes of untreated VF in the second (n = 53), CPR began and epinephrine was administered approximately 2 minutes prior to a planned 10-second pause to record an artifact-free ECG waveform segment. Following this pause, CPR was resumed for 20- seconds prior to defibrillation. CPP data were extracted from three time points: 2 minutes after epinephrine delivery (CPP1);following the chest compression pause (CPP2);and immediately before defibrillation (CPP3). Our primary outcome was defined as the ratio of CPP recovery (CPP3- CPP2) to the drop in CPP (CPP1-CPP2). Results: Interrupting compressions resulted in a significant drop in CPP (29.8 mmHg [95%CI: 26.2, 33.4] to 6.8 mmHg [95%CI: 5.4, 8.2]). Resuming CPR for restored 83% (95%CI: 78%, 86%) of the CPP lost. Conclusion: This study demonstrates that 83% of the decline in CPP values during a planned 10-second interruption in CPR can be restored with a short period of precordial compressions prior to defibrillation.
文摘The functional analysis of interruption is of great necessity in carrying out a smooth conversation.By exemplifying interruptions in specific conversational situations identified in Friends,the paper has explored the relative,interactive,pluralistic and situational characteristics of functions of interruptions.
基金Supported by the UK Department for International Development(DFID)through the China-UK Global Health Support Programme(GHSP-CS-OP4-D02)the Bill&Melinda Gates Foundation(OPP1198779,OPP1213975).
文摘Introduction:Surveys from the China-Tanzania Malaria Control Project demonstrated that the 1,7-malaria Reactive Community-Based Testing and Response(1,7-mRCTR)approach significantly reduced malaria incidence rates.However,implementation was disrupted by security concerns,infectious disease outbreaks,and supply shortages.This study evaluates how these interruptions affected intervention effectiveness to inform future malaria control strategies.Methods:The study employed a two-phased design:Phase I(2016–2018)and Phase II(2019–2021).Weekly malaria incidence rates per 100 people were calculated from cases reported by local health facilities in the intervention areas during both phases.Seasonal and trend decomposition using loess(STL)and interrupted time series modeling with piecewise linear regression were used to evaluate the impact of disruptions on 1,7-mRCTR implementation effectiveness.Results:In Tanzania’s 1,7-mRCTR areas,malaria incidence peaked during November-December and June-July.Phase I’s 8-month interruption reversed the weekly trend from a 0.17%decline to a 0.58%increase(P=0.001).After resumption,incidence dropped 8.96%(P=0.039)and maintained a 0.39%long-term decline(P=0.003).Even with seasonal adjustment,the interruption slowed the weekly decline from 0.08%to 0.07%(P=0.003).Phase II showed a similar pattern:a one-week interruption caused a 0.70%drop(P=0.007)but shifted the trend from a 0.02%decline to a 0.08%increase(P=0.001).After resumption,interventions stabilized the decline at 0.11%weekly(P=0.001).Conclusions:This research demonstrates that Tanzania’s malaria incidence is closely linked to seasonal patterns and consistent intervention efforts.Phase I’s 8-month security-related interruption reduced 1,7-mRCTR effectiveness by 12.5%,while Phase II’s 3-month pandemic-induced interruption caused only short-term fluctuations with minimal long-term impact.Rapid resumption of interventions after disruptions allowed for prompt recovery,highlighting the importance of adaptive strategies to maintain progress toward malaria control goals.
文摘The performance of an integrated packet voice/data multiplexer using a stop-and-wait(SW)automatic repeat request(ARQ)protocol is discussed.We assume that the input for the data traffic is exponentially distributed in increments via the Poisson process,with each data packet transmitted within an individual slot time.Another assumption is that there is only a single voice signal,which has a higher priority over the data packet,and whose traffic is given via an on-off Markov process.Whenever the voice signal is active,the output link is used and will be blocked for the data packet.We introduce the concept of buffer occupancy to simplify the analysis,and discover that data multiplexers using the SW ARQ protocol exhibit a behavior of queueing delay and buffering when the interruption signal is given via a Markov process.Simulation results verify the validity of the analytical results.
基金supported by Craig H.Neilsen Foundation,Wings for Life Foundation,Canadian Institutes of Health Research,and Fonds de Recherche Québec-Santé(to FB).
文摘Spinal cord injury(SCI)interrupts the flow of information between the brain and the spinal cord,thus leading to a loss of sensory information and motor paralysis of the body below the lesion.Surprisingly,most SCIs are incomplete and spare supraspinal pathways,especially those located within the peripheral white matter of the spinal cord,which includes reticulospinal pathways originating from the medullary reticular formation.Whereas there is abundant literature about the motor cortex,its corticospinal pathway,and its capacity to modulate functional recovery after SCI,less is known about the medullary reticular formation and its reticulospinal pathway.
基金This work was supported in part by National Natural Science Foundation of China under Grant No. 10671170.5. Acknowledgment The authors thank to the anonymous referees for their insightful comments and suggestions, which are very helpful to improve the presentations of the paper.
文摘In this paper, we study the M/M/1 queue with working vacations and vacation interruptions. The working vacation is introduced recently, during which the server can still provide service on the original ongoing work at a lower rate. Meanwhile, we introduce a new policy：, the server can come back from the vacation to the normal working level once some indices of the system, such as the number of customers, achieve a certain value in the vacation period. The server may come back from the vacation without completing the vacation. Such policy is called vacation interruption. We connect the above mentioned two policies and assume that if there are customers in the system after a service completion during the vacation period, the server will come back to the normal working level. In terms of the quasi birth and death process and matrix-geometric solution method, we obtain the distributions and the stochastic decomposition structures for the number of customers and the waiting time and provide some indices of systems.
文摘This paper studies the time-dependent analysis of an M/M/1 queueing model with single,multiple working vacation,balking and vacation interruptions.Whenever the system becomes empty,the server commences working vacation.During the working vacation period,if the queue length reaches a positive threshold value‘k’,the working vacation of the server is interrupted and it immediately starts the service in an exhaustive manner.During working vacations,the customers become discouraged due to the slow service and possess balking behavior.The transient system size probabilities of the proposed model are derived explicitly using the method of generating function and continued fraction.The performance indices such as average and variance of system size are also obtained.Further,numerical simulations are presented to analyze the impact of system parameters.
文摘Background:To investigate SCL/TAL 1 interrupting locus(STIL)’s role and prognostic significance in lung adenocarcinoma(LUAD)progression,we examined STIL and E2 promoter binding factor 1(E2F1)expression and their impacts on LUAD prognosis using Gene Expression Profiling Interactive Analysis(GEPIA).Methods:Functional assays including CCK-8,wound-healing,5-ethynyl-2-deoxyuridine(EdU),Transwell assays,and flow cytometry,elucidated STIL and E2F1’s effects on cell viability,proliferation,apoptosis,and migration.Gene set enrichment analysis(GSEA)identified potential pathways,while metabolic assays assessed glucose metabolism.Results:Our findings reveal that STIL and E2F1 are overexpressed in LUAD,correlating with adverse outcomes.It enhances cell proliferation,migration,and invasion,and suppresses apoptosis,activating downstream of E2F1.Silencing E2F1 reversed the promotion effect of the STIL overexpression on cell viability and invasiveness.Importantly,STIL modulates glycolysis,influencing glucose consumption,lactate production,and energy balance in LUAD cells.Conclusion:Our model,incorporating STIL,age,and disease stage,robustly predicts patient prognosis,underscored STIL’s pivotal role in LUAD pathogenesis through metabolic reprogramming.This comprehensive approach not only confirms STIL’s prognostic value but also highlights its potential as a therapeutic target in LUAD.
基金CAMS Innovation Fund for Medical Sciences,Grant/Award Number:CIFMS,2021-I2M-1-024The Joint Fund for the Department of Science and Technology of Yunnan Province-Kunming Medical University,Grant/Award Number:202201AY070001-007+1 种基金Open Research Fund Project of Yunnan Provincial Key Laboratory of Pharmacology of Natural Medicines,Grant/Award Number:YKLPNP-G2403The Science and Technology Leading Talent Program of Yunnan Province,Grant/Award Number:202405AB350002。
文摘Background:Spinocerebellar ataxia type 2(SCA2)is a neurodegenerative disease marked by significant clinical and genetic heterogeneity,primarily caused by expanded CAG mutations in the ATXN2 gene.The unstable expansion of CAG repeats disrupts the genetic stability of animal models,which is detrimental to disease research.Methods:In this study,we established a mouse model in which CAG repeats do not undergo microsatellite instability(MSI)across generations.A humanized ATXN2 cDNA with four CAA interruptions within 73 CAG expansions was inserted into the Rosa26 locus of C57BL/6J mice.A 23 CAG control mouse model was also generated to verify ATXN2 integration and expression.Results:In our model,the number of CAG repeats remained stable during transmission,with no CAG repeat expansion observed in 64 parent-to-offspring transmissions.Compared with SCA2-Q23 mice,SCA2-Q73 mice exhibited progressive motor impairment,reduced Purkinje cell count and volume(indicative of cell atrophy),and muscle atrophy.These observations in the mice suggest that the behavioral and neuropathological phenotypes may reflect the features of SCA2 patients.RNA-seq analysis of the gastrocnemius muscle in SCA2-Q73 mice showed significant changes in muscle differentiation and development gene expression at 56 weeks,with no significant differences at 16 weeks compared to SCA2-Q23 mice.The expression level of the Myf6 gene significantly changed in the muscles of aged mice.Conclusion:In summary,the establishment of this model not only provides a stable animal model for studying CAG transmission in SCA2 but also indicates that the lack of long-term neural stimulation leads to muscle atrophy.
基金the National Agency for the Promotion of Research,Technological Development and Innovation(Argentina)the National University of Entre Ríos(Argentina)+1 种基金the PROARROZ Foundation(Argentina)the company EBRO(Argentina)for the financial support of this research。
文摘In rice systems under continuous flooding(CF)irrigation,rice grains with high arsenic(As)concentration can be produced.In Argentina,these areas are located in the south of Corrientes Province and the north of Entre Ríos Province.The combination of agronomic management,genetic variability of rice varieties,and the characteristics of soil and irrigation water determines the concentration and proportion of grain As species.In this study,we evaluated two factors affecting grain As accumulation:irrigation management,CF and interrupted flooding(IF),and rice variety,rice with medium,long,and double long/wide grains.The experiments were conducted during four cropping cycles(2015–2016,2016–2017,2017–2018,and 2020–2021)on a farm in the north of Entre Ríos Province.Total As concentration in husked grains showed a wide range and was mostly above 0.30 mg kg^(-1),even after the polishing process.Fortunately,organic As was the predominant species.In polished rice,inorganic As concentration ranged between 0.02 and 0.28 mg kg^(-1).Significant differences were observed in grain As concentration between four rice varieties,with the highest inorganic and total As concentrations in grains of the medium-grain variety.The interaction of rice variety by irrigation management did not affect grain yield,but significantly reduced total As concentration in grains.Soil drainage under IF explained 43%–46%of the reduction of total As concentration in grains.The management practices of irrigation and rice variety had slight effects on inorganic As concentration in grains.In conclusion,a single soil drying period combined with proper rice varieties can be an effective management practice for mitigating As accumulation in rice grains.
基金financial support from the National Natural Science Foundation of China(Nos.22261057 and 21901265)Guizhou Provincial Natural Science Foundation(No.QKHJC-2020-1Z072)+3 种基金the Science and Technology Department of Guizhou Province(Nos.QKHPTRC-CXTD[2022]012 and QKHPTRCGCC[2023]003)Zunyi Medical University(No.18ZY-002)Science and Technology Department of Zunyi(Nos.ZSKH-2018-3,ZSKHHZZ[2020]70,ZSKRPT-2020-5 and ZSKRPT-2021-5)Fifth Batch of Talent Base in Guizhou Province(No.S-030-1).
文摘Catalytic syntheses of silaoxycarbocyclics from an interrupted Catellani reaction of 3-iodochromones with bridged olefins and octamethyl-1,4-dioxacyclohexasilane is described.This protocol involves the oxidative addition of chromonyl-norbornyl-palladacycle generated through successive oxidative addition of Pd(0)to 3-iodochromones,migratory insertion of NBE and intramolecular ortho-C(sp^(2))-H activation to the tetrasilane,thus motivating a(4+6)annulation and ring expansion.The synthetic practicality of current strategy is further proved by the late-stage modification of pharmaceuticals and natural products,gram-scale experiments,as well as the transformations of functional groups of silaoxycarbocyclics.
文摘Digital avatars have become a standard feature on e-commerce platforms.As virtual hosts,they emulate human behavior,broadcast live programs without interruption,and present“Made in China”products to foreign consumers,thanks to their proficiency in multiple languages.The impressive efficiency of these digital avatars is made possible by the colossal computing power that enables them to perform their functions.“This year,the storage requirements of the digital avatars have increased significantly,by approximately 500 times compared to last year.The current local storage capacity is no longer sufficient.”
文摘BACKGROUND At present,prophylactic ileostomy is commonly used to protect distal intestinal anastomoses,particularly during the recovery period following colorectal surgery.However,after the ileum is returned to the abdominal cavity,abdominal closure using traditional vertical interrupted suturing is associated with a higher incidence of wound infections.For patients undergoing ileostomy closure,selecting an appropriate suturing method for the skin incision at the stoma site is crucial for improving patient prognosis.AIM To investigate the impact of three different skin suturing methods at the ileostomy closure site on patient prognosis.METHODS Thirty patients who underwent ileostomy closure at the Affiliated Hospital of Qinghai University between January 2024 and October 2024 were selected based on inclusion and exclusion criteria.The patients were divided into three groups:The purse-string suture group,the cross-suture group,and the vertical interrupted suture group,with 10 cases in each group.The purse-string suture group,cross-suture group,and vertical interrupted suture group used purse-string,cross,and vertical interrupted suturing methods,respectively,for the skin incision at the ileostomy closure site.RESULTS There were no statistically significant differences among the three groups in terms of operative time,intraoperative blood loss,time to resume liquid diet,time to first bowel movement,postoperative hospital stay,hospitalization costs,or levels of white blood cell count,hemoglobin,and albumin on the third postoperative day(P>0.05).Nevertheless,significant differences(P<0.05)were observed in incision suture removal time,wound healing time,C-reactive protein levels on the third postoperative day,visual analog scale pain scores during the first three postoperative days,and the incidence of surgical site infection.Overall,the therapeutic outcomes of the pursestring suture group and the cross-suture group were superior to the vertical interrupted suture group.CONCLUSION Using purse-string or cross-suturing methods for skin incision at the ileostomy closure site can shorten wound healing and suture removal times,reduce surgical site infection incidence and postoperative inflammatory response,alleviate incision pain,and promote rapid postoperative recovery.
基金Supported by the Shenyang Science and Technology,No.22-321-32-15Department of Science and Technology of Liaoning Province,No.2023JH2/101600015.
文摘BACKGROUND Gastric subepithelial lesions(SELs)are elevated lesions originating from the muscularis mucosa,submucosa,or muscularis propria,and may also include extraluminal lesions.For small SELs(less than 5 cm),complete endoscopic excision is the preferred treatment.Endoscopic full-thickness resection(EFTR)has proven to be an effective approach.AIM To evaluate the efficacy of the interrupted closure technique compared to the traditional closure technique in EFTR for gastric SELs.METHODS This single-center,prospective,randomized controlled trial was conducted at a tertiary hospital from September 2023 to September 2024.A total of 90 patients who underwent EFTR for gastric SELs were randomly allocated to either the interrupted closure group(n=44)or the traditional closure group(n=46).RESULTS All patients had complete resection and wound closure without any severe postoperative complications.The incidence of intraoperative gas-related complications was significantly lower in the interrupted closure group than in the traditional closure group(2.27%vs 26.09%,P=0.001),demonstrating interrupted closure technique can reduce the incidence of gas-related issues.Statistical analysis revealed that the incidence of postoperative infection was significantly lower in the experimental group than in the control group(15.91%vs 41.30%,P=0.008).Additionally,the median duration of antibiotic use was lower in the experimental group(3.5 days vs 5 days,P=0.013).Abdominal pain levels on postoperative days 1 and 4 were also lower in the experimental group compared to the control group(P<0.001).CONCLUSION The interrupted closure technique in EFTR for treating gastric SELs is safe and effective,reducing the incidence of intraoperative gas complications and postoperative infections.
基金funded by the Bavarian State Ministry of ScienceResearch and Art(Grant number:H.2-F1116.WE/52/2)。
文摘The incremental capacity analysis(ICA)technique is notably limited by its sensitivity to variations in charging conditions,which constrains its practical applicability in real-world scenarios.This paper introduces an ICA-compensation technique to address this limitation and propose a generalized framework for assessing the state of health(SOH)of batteries based on ICA that is applicable under differing charging conditions.This novel approach calculates the voltage profile under quasi-static conditions by subtracting the voltage increase attributable to the additional polarization effects at high currents from the measured voltage profile.This approach's efficacy is contingent upon precisely acquiring the equivalent impedance.To obtain the equivalent impedance throughout the batteries'lifespan while minimizing testing costs,this study employs a current interrupt technique in conjunction with a long short-term memory(LSTM)network to develop a predictive model for equivalent impedance.Following the derivation of ICA curves using voltage profiles under quasi-static conditions,the research explores two scenarios for SOH estimation:one utilizing only incremental capacity(IC)features and the other incorporating both IC features and IC sampling.A genetic algorithm-optimized backpropagation neural network(GABPNN)is employed for the SOH estimation.The proposed generalized framework is validated using independent training and test datasets.Variable test conditions are applied for the test set to rigorously evaluate the methodology under challenging conditions.These evaluation results demonstrate that the proposed framework achieves an estimation accuracy of 1.04%for RMSE and 0.90%for MAPE across a spectrum of charging rates ranging from 0.1 C to 1 C and starting SOCs between 0%and 70%,which constitutes a major advancement compared to established ICA methods.It also significantly enhances the applicability of conventional ICA techniques in varying charging conditions and negates the necessity for separate testing protocols for each charging scenario.
基金Jiangxi Provincial Hospital Pharmacy Special Research Fund Project(Grant No.2024-ZXYJ02).
文摘In the context of the Diagnosis Related Groups(DRGs)system,the orthopedic hospital implemented refined drug control to provide a pharmacological reference for promoting rational clinical drug use.A statistical analysis was conducted on the hospital’s data from January to December 2021(prior to the implementation of control),focusing on the types of unreasonable prescriptions.A multi-dimensional analysis was also conducted to identify the underlying causes of inappropriate medication practices.Following this,refined drug control measures were introduced,and data from January to December 2022(post-control)were compared,examining factors such as the average drug cost,drug expenses for the IC29 diagnosis group,and the drug cost ratio.An interrupted time-series analysis was employed to evaluate the effects of these interventions.The results showed that after the implementation of refined drug control in the orthopedic department,significant reductions were observed in the average cost per patient,average drug cost per patient,drug cost ratio,cost consumption index,average length of hospital stay,and allocation ratio(P<0.05).In particular,the first month of control(January 2022)saw a marked decrease in average drug costs per patient by 1272.90 yuan(P<0.01),a reduction in the drug cost ratio by 0.98%,and a decline in drug costs for the IC29 diagnosis group by 616.79 yuan(P>0.05).Moreover,the rate of unreasonable inappropriate prescribing dropped dramatically from 40.48%in 2021 to 3.57%by December 2022.The refined control of drug use within the orthopedic hospital significantly improved the rationality of clinical prescribing practices,reduced the occurrence of adverse drug reactions,and enhanced patient adherence to prescribed treatments.These findings demonstrated considerable clinical value in promoting efficient and safe drug use.
