Objectives This study aimed to explore and clarify the concept of reflective supervision as a professional self-care strategy to create a positive Intensive Care Unit(ICU)practice environment.Methods Walker and Avant...Objectives This study aimed to explore and clarify the concept of reflective supervision as a professional self-care strategy to create a positive Intensive Care Unit(ICU)practice environment.Methods Walker and Avant’s eight-step concept analysis approach was utilized to identify and define the attributes,antecedents,and consequences of reflective supervision in the ICU.An extensive literature search was conducted across various databases,including Google Scholar,CINAHL,PubMed.Articles published from 2005 to 2025 were identified.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020 statement to indicate the included articles and extract related data based on relevance.Results Forty articles were included in the analysis.The identified attributes included the supervisor-supervisee relationship,effective communication,teamwork,collaborations,reflection,competencies,feedback,continuous support,and autonomous choice.The identified antecedents included participation,supportive supervision,flexibility,open-door policy,training,and motivation.Consequences impacting the success of reflective supervision were identified as promotion of resiliency,autonomy,work-life balance,self-awareness,increased self-esteem,professional development,critical thinking,increased job satisfaction,and enhanced commitment.Conclusions Reflective supervision is a complex professional self-care strategy that enhances ICU practice,by promoting nurses’well-being,self-awareness,therapeutic skills,and professional development.展开更多
Let M be a compact n-manifold of positive sectional curvature.We will review classical results on the fundamental group of M,a motivation on the c(n)-cyclic conjecture that the fundamental group of M contains a cyclic...Let M be a compact n-manifold of positive sectional curvature.We will review classical results on the fundamental group of M,a motivation on the c(n)-cyclic conjecture that the fundamental group of M contains a cyclic subgroup of index bounded above by c(n),a constant depending only on n,and we will survey partial results(up to date)on the c(n)-cyclic conjecture.展开更多
Hepatocellular carcinoma(HCC)is a highly heterogenous dis-ease in histology,genetic aberrations,and protein expression.Over the past decade,the development of new omics techniques has fa-cilitated significant advances...Hepatocellular carcinoma(HCC)is a highly heterogenous dis-ease in histology,genetic aberrations,and protein expression.Over the past decade,the development of new omics techniques has fa-cilitated significant advances in the field of molecular typing stud-ies of HCC.In the era of precision medicine,it is of great signif-icance to improve the efficacy of HCC treatment based on tumor molecular subtyping.Cytokeratin(CK)19-positive HCC has gained increasing atten-tion.Although CK19 is a marker of biliary epithelial cells,10%−30%of HCCs are observed to be CK19 positive[1].Differing from com-bined hepatocellular and cholangiocarcinoma,CK19-positive HCC displays typical HCC morphological features,exhibiting strong co-express of both hepatocyte and cholangiocyte markers within the same tumor cells.Consequently,CK19-positive HCC is also referred to as dual-phenotype HCC,with displaying cholangiolar differenti-ation.展开更多
Higher education is transitioning from mass expansion to high-quality development.In this process,mental health issues among college students have become increasingly prominent,encompassing not only academic stress-in...Higher education is transitioning from mass expansion to high-quality development.In this process,mental health issues among college students have become increasingly prominent,encompassing not only academic stress-induced anxiety but also complex challenges such as interpersonal adaptation difficulties and career planning confusion.Traditional“problem-oriented”intervention models have shown limitations in responsiveness and adaptability,often only passively addressing existing psychological crises rather than preventing them in advance.This study aims to explore an AI-powered“positive psychology”proactive intervention model through developing an intelligent system.The system automatically collects,filters,and personalizes recommendations for positive activities on campus.Using a randomized controlled trial design,we conducted an 8-week intervention study involving 126 college students at a university.The study found that AI-based“campus positive activity”recommendations effectively boost students’positive emotions and promote psychological capital development through cumulative micro-interventions.This provides universities with empirical evidence and innovative methods to implement low-cost,efficient,and scalable mental health promotion programs through smart technology.展开更多
Objective:This study aimed to evaluate the diagnostic accuracy of MRI in the detection of nodal metastasis in urothelial bladder cancer(UBC)and to assess the long-term oncological outcomes of upfront radical cystectom...Objective:This study aimed to evaluate the diagnostic accuracy of MRI in the detection of nodal metastasis in urothelial bladder cancer(UBC)and to assess the long-term oncological outcomes of upfront radical cystectomy(RC)in patients with clinical lymph node-positive(cN^(+))muscle-invasive UBC.Methods:A retrospective analysis of 1053 consecutive UBC patients treated with RC between January 1,2004 and January 31,2014 was performed.Radiological,clinical,pathological data and survival outcomes of cN^(+) patients were collected.Cox regression analyses were used to assess the impact of the radiological,clinical,and pathological variables on survival.Results:A total of 233(22%)patients were diagnosed with cN^(+) UBC with a mean age of 57.3(standard deviation 8.1)years,of whom 144(62%)were found to have pathologically positive lymph nodes at final pathology.Adjuvant chemotherapy was administered to 58(25%)patients.The sensitivity,specificity,positive predictive value,and negative predictive value of MRI to detect pathological lymph node-positive disease were 51%,88%,62%,and 83%,respectively.The overall accuracy was 79% with a calculated area under the curve of 70%.The median follow-up period was 17.0(interquartile range 8.2e58.7)months.During this period,54(23%)patients developed local recurrence while 56(24%)experienced distant metastasis and the estimated 1-,3-,5-,and 10-year recurrence-free survival for cN^(+) patients were 78%,56%,51%,and 48%,respectively.On multivariate analysis,advanced pT stage(pT3e4 vs.pT2)was the only independent predictor of recurrence-free survival.Conclusion:Despite its potential in preoperative assessment of muscle-invasive UBC,MRI showed limited sensitivity for detecting node-positive disease.Notably,in patients with MRIdetected cN^(+) UBC,those who underwent upfront RC demonstrated long-term survival outcomes comparable to those treated with neoadjuvant chemotherapy followed by consolidative cystectomy in previously published studies.展开更多
Fine particulatematter(PM_(2.5))samples were collected in two neighboring cities,Beijing and Baoding,China.High-concentration events of PM_(2.5) in which the average mass concentration exceeded 75μg/m^(3) were freque...Fine particulatematter(PM_(2.5))samples were collected in two neighboring cities,Beijing and Baoding,China.High-concentration events of PM_(2.5) in which the average mass concentration exceeded 75μg/m^(3) were frequently observed during the heating season.Dispersion Normalized Positive Matrix Factorization was applied for the source apportionment of PM_(2.5) as minimize the dilution effects of meteorology and better reflect the source strengths in these two cities.Secondary nitrate had the highest contribution for Beijing(37.3%),and residential heating/biomass burning was the largest for Baoding(27.1%).Secondary nitrate,mobile,biomass burning,district heating,oil combustion,aged sea salt sources showed significant differences between the heating and non-heating seasons in Beijing for same period(2019.01.10–2019.08.22)(Mann-Whitney Rank Sum Test P<0.05).In case of Baoding,soil,residential heating/biomass burning,incinerator,coal combustion,oil combustion sources showed significant differences.The results of Pearson correlation analysis for the common sources between the two cities showed that long-range transported sources and some sources with seasonal patterns such as oil combustion and soil had high correlation coefficients.Conditional Bivariate Probability Function(CBPF)was used to identify the inflow directions for the sources,and joint-PSCF(Potential Source Contribution Function)was performed to determine the common potential source areas for sources affecting both cities.These models facilitated a more precise verification of city-specific influences on PM_(2.5) sources.The results of this study will aid in prioritizing air pollution mitigation strategies during the heating season and strengthening air quality management to reduce the impact of downwind neighboring cities.展开更多
Despite advancements in neuroimaging,false positive diagnoses of intracranial aneurysms remain a significant concern.This article examines the causes,prevalence,and implications of such false-positive diagnoses.We dis...Despite advancements in neuroimaging,false positive diagnoses of intracranial aneurysms remain a significant concern.This article examines the causes,prevalence,and implications of such false-positive diagnoses.We discuss how conditions like arterial occlusion with vascular stump formation and infundibular widening can mimic aneurysms,particularly in the anterior circulation.The article compares various imaging modalities,including computer tomography angiogram,magnetic resonance imaging/angiography,and digital subtraction angiogram,highlighting their strengths and limitations.We emphasize the im-portance of accurate differentiation to avoid unnecessary surgical interventions.The potential of emerging technologies,such as high-resolution vessel wall ima-ging and deep neural networks for automated detection,is explored as promising avenues for improving diagnostic accuracy.This manuscript underscores the need for continued research and clinical vigilance in the diagnosis of intracranial aneurysms.展开更多
In this paper,we study the Bowen entropy of stable sets in positive entropy G-system of amenable group actions.The lower bound of the Bowen entropy of these sets are estimated.
This article studies a class of nonlinear Kirchhoff equations with exponential critical growth,trapping potential,and perturbation.Under appropriate assumptions about f and h,the article obtained the existence of norm...This article studies a class of nonlinear Kirchhoff equations with exponential critical growth,trapping potential,and perturbation.Under appropriate assumptions about f and h,the article obtained the existence of normalized positive solutions for this equation via the Trudinger-Moser inequality and variational methods.Moreover,these solutions are also ground state solutions.Additionally,the article also characterized the asymptotic behavior of solutions.The results of this article expand the research of relevant literature.展开更多
In this paper,we introduce the real pairwise completely positive(RPCP)matrices with one of them is necessarily positive semidefinite while the other one is necessarily entrywise nonnegative,which has a real pairwise c...In this paper,we introduce the real pairwise completely positive(RPCP)matrices with one of them is necessarily positive semidefinite while the other one is necessarily entrywise nonnegative,which has a real pairwise completely positive(RPCP)decomposition.We study the properties of RPCP matrices and give some necessary and sufficient conditions for a matrix pair to be RPCP.First,we give an equivalent decomposition for the RPCP matrices,which is different from the RPCP-decomposition and show that the matrix pair(X,X)is RPCP if and only if X is completely positive.Besides,we also prove that the RPCP matrices checking problem is equivalent to the separable completion problem.A semidefinite algorithm is also proposed for detecting whether or not a matrix pair is RPCP.The asymptotic and finite convergence of the algorithm are also discussed.If it is RPCP,we can further give a RPCP-decomposition for it;if it is not,we can obtain a certificate for this.展开更多
Objective:To evaluate the predictive value of the neutrophil⁃to⁃lymphocyte ratio(NLR)and the systemic immune⁃inflammation index(SII)in predicting patients with anti⁃melanoma differentiation⁃associated gene 5⁃positive(...Objective:To evaluate the predictive value of the neutrophil⁃to⁃lymphocyte ratio(NLR)and the systemic immune⁃inflammation index(SII)in predicting patients with anti⁃melanoma differentiation⁃associated gene 5⁃positive(anti⁃MDA5+)dermatomyositis(DM)develop into the rapidly progressive interstitial lung disease(RPILD).Methods:We retrospectively analyzed the clinical and laboratory data of 124 anti⁃MDA5+DM patients from the First Affiliated Hospital of Nanjing Medical University between March 2019 and September 2023.We identified independent risk factors associated with the development and mortality of RPILD with the Cox regression analysis,and determined the optimal cut⁃off values for predicting adverse outcomes with the receiver operating characteristic(ROC)curve analysis.Results:Among the 124 patients,36 patients(29.03%)developed RPILD,and 39 patients(31.45%)died during the follow⁃up period.The results of multivariate Cox regression analysis showed that the elevated NLR was an independent risk factor for RPILD development,while the elevated SII expression was independently associated with the increased mortality of RPILD.Based on the ROC curve analysis,NLR>6.12 was a predictor for RPILD,and SII>875.79 was associated with increased mortality risk of RPILD.Conclusion:Both NLR and SII are accessible,cost⁃effective,and reliable prognostic indicators for the prognosis of patients with anti⁃MDA5^(+)DM,providing a valuable guidance for clinical management and risk stratification of the disease.展开更多
In life,we are bound to encounter various difficulties and setbacks.However,it is of great significance to maintain a positive attitude when were facing these challenges.For me,this lesson was deeply impressed upon me...In life,we are bound to encounter various difficulties and setbacks.However,it is of great significance to maintain a positive attitude when were facing these challenges.For me,this lesson was deeply impressed upon me during a particularly tough period.展开更多
Adolescence is a crucial period marked by significant developmental changes,during which risk-taking behaviors can be both a normative part of development and a potential source of concern.However,prior research has f...Adolescence is a crucial period marked by significant developmental changes,during which risk-taking behaviors can be both a normative part of development and a potential source of concern.However,prior research has focused predominantly on the adverse aspects of risk-taking(i.e.,negative risk-taking),overlooked the positive counterpart(i.e.,positive risk-taking),and lacked a detailed examination of both.This study aims to elucidate the distinct characteristics and interrelationships of positive and negative risk-taking behaviors among adoles-cents and to identify the key factors that influence these behaviors.Through a comprehensive synthesis of theoretical and empirical literature,we explore the multifaceted nature of risk-taking,highlighting its complex influencing factors,including individual traits,family dynamics,peer influence,school environment,and broader community contexts.By identifying the shared and unique factors contributing to positive and negative risk-taking behaviors,we can enable adolescents to navigate this complex stage of life and design targeted interventions.Future research directions include the application of person-centered approaches,the implementation of longitudinal tracking and the interactive effects of influencing factors,among other aspects.展开更多
BACKGROUND Lung ultrasonography is being increasingly used in mechanically ventilated patients to evaluate the lung aeration during incremental positive end expiratory pressure(PEEP)adjustments and to evaluate the wea...BACKGROUND Lung ultrasonography is being increasingly used in mechanically ventilated patients to evaluate the lung aeration during incremental positive end expiratory pressure(PEEP)adjustments and to evaluate the weaning process from mechanical ventilation.The effects of PEEP may vary across different lung pathologies and may not consistently correlate with changes in lung aeration as assessed by lung ultrasound scores(LUSs).AIM To assess the role of lung ultrasonography in evaluating lung aeration during the application of PEEP in mechanically ventilated patients with various lung pathologies.METHODS An observational study was conducted over 18 months in a tertiary care hospital.Patients of both genders,aged between 18-75 years,who had been admitted to the intensive care unit,and required mechanical ventilation,were studied.A standard ventilatory strategy was used and incremental levels of PEEP[5,10,and 15 cm water(H_(2)O)]were applied.Baseline characteristics,including oxygen saturation(SpO2),LUS,mean arterial pressure(MAP),heart rate(HR),and their changes with incremental PEEP levels,were recorded and analyzed.RESULTS In this study,45.9%of patients required a PEEP of 5 cm H_(2)O to achieve the endpoint of lung aeration(LUS of 0).In addition,86.5% and 13.5% of patients reached the endpoint of lung aeration at PEEP levels of 10 and 15 cm H_(2)O,respectively.The proportion of patients with higher lung scores decreased significantly with increasing PEEP levels(P<0.001 for 5 and 10 cm H_(2)O and P=0.032 for 15 cm H_(2)O).SpO2 increased significantly with higher PEEP levels(P<0.001),confirming the effectiveness of PEEP in improving oxygenation.The results also revealed a significant increase in HR and a decrease in MAP following the application of higher PEEP levels.CONCLUSION Increasing PEEP levels in mechanically ventilated patients improves lung aeration,which can be effectively assessed using bedside lung ultrasonography.展开更多
Dear Editor,General anesthetics play a pivotal role in inducing a safe and reversible loss of consciousness in patients,the importance of which cannot be overstated[1].Among the intravenous anesthetics,propofol stands...Dear Editor,General anesthetics play a pivotal role in inducing a safe and reversible loss of consciousness in patients,the importance of which cannot be overstated[1].Among the intravenous anesthetics,propofol stands out for its rapid onset and swift systemic clearance,effectively eliminating the prolonged sedation associated with earlier agents[2].展开更多
BACKGROUND Patients undergoing rectal cancer surgery frequently encounter challenges in their self-care abilities,disease knowledge,and emotional well-being postoperatively.Effective nursing interventions are critical...BACKGROUND Patients undergoing rectal cancer surgery frequently encounter challenges in their self-care abilities,disease knowledge,and emotional well-being postoperatively.Effective nursing interventions are critical for improving the quality of life and minimizing complications.This study explored the clinical implications of integrating health education guided by problem management with positive incentive nursing to address these challenges.AIM To evaluate the effect of this combined nursing model on postoperative self-care ability,disease knowledge,mood state,and complication rates in patients undergoing rectal cancer surgery.METHODS Eighty patients who underwent rectal cancer surgery between October 2021 and August 2024 were allocated into reference(routine care)and experimental(problem management-guided health education combined with positive incentive nursing)groups.The outcomes included exercise of self-care agency scale,disease knowledge(hospital-specific questionnaire),mood state(profile of mood states),and complication rates.RESULTS The experimental group demonstrated significant improvements in self-care ability(P<0.05),with higher scores for health knowledge,self-concept,self-care skills,and self-care responsibility than the reference group.Disease knowledge scores also improved markedly in the experimental group(P<0.05).Mood state scores showed a significant decrease in the negative dimensions(e.g.,anxiety and depression)and an increase in energy vitality(P<0.05).Additionally,the experimental group exhibited a lower complication rate than the reference group(7.5%vs 27.5%,P<0.05).CONCLUSION The integration of problem management-guided health education with positive incentive nursing significantly enhanced postoperative self-care abilities,disease knowledge,and emotional well-being while reducing complication rates.This model demonstrated potential for widespread adoption in clinical practice by offering a structured approach to improve patient outcomes and quality of life.展开更多
In this paper,we study the following Schrödinger-Poisson system{-ε^(p)Δ_(p)u+V(x)|u|^(p-2)u+ϕ|u|^(p-2)u=f(u)+|u|^(p*-2)u in R^(3),-ε^(2)Δϕ=|u|^(p)in R^(3),whereε>0 is a parameter,3/2<p<3,Δ_(p)u=div...In this paper,we study the following Schrödinger-Poisson system{-ε^(p)Δ_(p)u+V(x)|u|^(p-2)u+ϕ|u|^(p-2)u=f(u)+|u|^(p*-2)u in R^(3),-ε^(2)Δϕ=|u|^(p)in R^(3),whereε>0 is a parameter,3/2<p<3,Δ_(p)u=div(|∇u|^(p-2)∇u),p^(*)=3p/3-p,V:R^(3)→R is a potential function with a local minimum and f is subcritical growth.Based on the penalization method,Nehari manifold techniques and Ljusternik-Schnirelmann category theory,we obtain the multiplicity and concentration of positive solutions to the above system.展开更多
The purpose of this study is to analyze the galloping characteristics of the catenary positive feeder in fluctuating wind areas considering dynamic-wind angle of attack and aerodynamic damping.Firstly,the flow field m...The purpose of this study is to analyze the galloping characteristics of the catenary positive feeder in fluctuating wind areas considering dynamic-wind angle of attack and aerodynamic damping.Firstly,the flow field model of the catenary positive feeder was established,the fluctuating wind field was simulated by Davenport wind power spectrum and linear filtering method,and the wind speed at inlet in calculation domain was controlled by editing the profile file to simulate and calculate the aerodynamic characteristics of the positive feeder in the fluctuating wind area.Then,taking the positive feeder as the research object,the mathematical model of actual structure and the corresponding finite element model were established.By applying the wind load to the finite element model,the influence of aerodynamic damping caused by the self-movement of the positive feeder on the galloping response was analyzed,and the frequency domain characteristics of galloping displacement of the positive feeder considering aerodynamic damping were studied.Finally,the calculation method of aerodynamic damping by the Guidelines for Electrical Transmission Line Structural Loading(ASCE No.74)was used for the galloping response of the positive feeder and compared with the proposed method.The results show that when considering aerodynamic damping,the galloping amplitude of the positive feeder decreases significantly,and the first-order resonance effect on the vertical displacement and horizontal displacement decreases significantly.The galloping trajectories calculated by the two methods are consistent.Therefore,this study is of great significance to further clarify the ice-free galloping mechanism of the catenary positive feeder in violent wind areas.展开更多
CD5-positive(CD5+)diffuse large B-cell lymphoma(DLBCL)represents a special subgroup of DLBCL with a more aggressive disease course and is more likely to develop into relapsed/refractory(r/r)DLBCL in response to immuno...CD5-positive(CD5+)diffuse large B-cell lymphoma(DLBCL)represents a special subgroup of DLBCL with a more aggressive disease course and is more likely to develop into relapsed/refractory(r/r)DLBCL in response to immunochemotherapy.The incidence of CD5+DLBCL is 5%–10%among DLBCL patients1.展开更多
In order to support the physical research on the EAST tokamak,a new positive ion source with designed beam energy of 120 keV was proposed to be developed.Accelerator structure is one of the key components of the ion s...In order to support the physical research on the EAST tokamak,a new positive ion source with designed beam energy of 120 keV was proposed to be developed.Accelerator structure is one of the key components of the ion source.Through the finite element analysis method,the electrostatic analyses of insulators and grid plates were carried out,the material and structure parameters of insulators were determined.The maximum electric field around each insulator is about 4 kV/mm,and the maximum electric field between grids is about 14 kV/mm,which can meet the 120 keV withstand voltage holding.The insulation system for the positive ion source accelerator with 120 keV is designed,and the connection and basic parameters of insulators and support flanges are analyzed and determined.展开更多
文摘Objectives This study aimed to explore and clarify the concept of reflective supervision as a professional self-care strategy to create a positive Intensive Care Unit(ICU)practice environment.Methods Walker and Avant’s eight-step concept analysis approach was utilized to identify and define the attributes,antecedents,and consequences of reflective supervision in the ICU.An extensive literature search was conducted across various databases,including Google Scholar,CINAHL,PubMed.Articles published from 2005 to 2025 were identified.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020 statement to indicate the included articles and extract related data based on relevance.Results Forty articles were included in the analysis.The identified attributes included the supervisor-supervisee relationship,effective communication,teamwork,collaborations,reflection,competencies,feedback,continuous support,and autonomous choice.The identified antecedents included participation,supportive supervision,flexibility,open-door policy,training,and motivation.Consequences impacting the success of reflective supervision were identified as promotion of resiliency,autonomy,work-life balance,self-awareness,increased self-esteem,professional development,critical thinking,increased job satisfaction,and enhanced commitment.Conclusions Reflective supervision is a complex professional self-care strategy that enhances ICU practice,by promoting nurses’well-being,self-awareness,therapeutic skills,and professional development.
文摘Let M be a compact n-manifold of positive sectional curvature.We will review classical results on the fundamental group of M,a motivation on the c(n)-cyclic conjecture that the fundamental group of M contains a cyclic subgroup of index bounded above by c(n),a constant depending only on n,and we will survey partial results(up to date)on the c(n)-cyclic conjecture.
基金supported by grants from the Major Re-search Plan of the National Natural Science Foundation of China(92159202)the National Key Research and Development Pro-gram of China(2021YFA1100500)+5 种基金the Key Research&Develop-ment Plan of Zhejiang Province(2024C03051)the Innovation Team of Hangzhou Medical College(CXLJ202401)Joint TCM Science&Technology Projects of National Demonstration Zones for Compre-hensive TCM Reform(GZY-KJS-ZJ-2025-002)the National Natural Science Foundation of China(82303387)the Natural Science Foun-dation of Zhejiang Province(LQ23H160048)the Construction Fund of Key Medical Disciplines of Hangzhou(2025HZGF05).
文摘Hepatocellular carcinoma(HCC)is a highly heterogenous dis-ease in histology,genetic aberrations,and protein expression.Over the past decade,the development of new omics techniques has fa-cilitated significant advances in the field of molecular typing stud-ies of HCC.In the era of precision medicine,it is of great signif-icance to improve the efficacy of HCC treatment based on tumor molecular subtyping.Cytokeratin(CK)19-positive HCC has gained increasing atten-tion.Although CK19 is a marker of biliary epithelial cells,10%−30%of HCCs are observed to be CK19 positive[1].Differing from com-bined hepatocellular and cholangiocarcinoma,CK19-positive HCC displays typical HCC morphological features,exhibiting strong co-express of both hepatocyte and cholangiocyte markers within the same tumor cells.Consequently,CK19-positive HCC is also referred to as dual-phenotype HCC,with displaying cholangiolar differenti-ation.
文摘Higher education is transitioning from mass expansion to high-quality development.In this process,mental health issues among college students have become increasingly prominent,encompassing not only academic stress-induced anxiety but also complex challenges such as interpersonal adaptation difficulties and career planning confusion.Traditional“problem-oriented”intervention models have shown limitations in responsiveness and adaptability,often only passively addressing existing psychological crises rather than preventing them in advance.This study aims to explore an AI-powered“positive psychology”proactive intervention model through developing an intelligent system.The system automatically collects,filters,and personalizes recommendations for positive activities on campus.Using a randomized controlled trial design,we conducted an 8-week intervention study involving 126 college students at a university.The study found that AI-based“campus positive activity”recommendations effectively boost students’positive emotions and promote psychological capital development through cumulative micro-interventions.This provides universities with empirical evidence and innovative methods to implement low-cost,efficient,and scalable mental health promotion programs through smart technology.
文摘Objective:This study aimed to evaluate the diagnostic accuracy of MRI in the detection of nodal metastasis in urothelial bladder cancer(UBC)and to assess the long-term oncological outcomes of upfront radical cystectomy(RC)in patients with clinical lymph node-positive(cN^(+))muscle-invasive UBC.Methods:A retrospective analysis of 1053 consecutive UBC patients treated with RC between January 1,2004 and January 31,2014 was performed.Radiological,clinical,pathological data and survival outcomes of cN^(+) patients were collected.Cox regression analyses were used to assess the impact of the radiological,clinical,and pathological variables on survival.Results:A total of 233(22%)patients were diagnosed with cN^(+) UBC with a mean age of 57.3(standard deviation 8.1)years,of whom 144(62%)were found to have pathologically positive lymph nodes at final pathology.Adjuvant chemotherapy was administered to 58(25%)patients.The sensitivity,specificity,positive predictive value,and negative predictive value of MRI to detect pathological lymph node-positive disease were 51%,88%,62%,and 83%,respectively.The overall accuracy was 79% with a calculated area under the curve of 70%.The median follow-up period was 17.0(interquartile range 8.2e58.7)months.During this period,54(23%)patients developed local recurrence while 56(24%)experienced distant metastasis and the estimated 1-,3-,5-,and 10-year recurrence-free survival for cN^(+) patients were 78%,56%,51%,and 48%,respectively.On multivariate analysis,advanced pT stage(pT3e4 vs.pT2)was the only independent predictor of recurrence-free survival.Conclusion:Despite its potential in preoperative assessment of muscle-invasive UBC,MRI showed limited sensitivity for detecting node-positive disease.Notably,in patients with MRIdetected cN^(+) UBC,those who underwent upfront RC demonstrated long-term survival outcomes comparable to those treated with neoadjuvant chemotherapy followed by consolidative cystectomy in previously published studies.
基金supported by the National Institute of Environmental Research(NIER)funded by the Ministry of Environment(No.NIER-2019-04-02-039)supported by Particulate Matter Management Specialized Graduate Program through the Korea Environmental Industry&Technology Institute(KEITI)funded by the Ministry of Environment(MOE).
文摘Fine particulatematter(PM_(2.5))samples were collected in two neighboring cities,Beijing and Baoding,China.High-concentration events of PM_(2.5) in which the average mass concentration exceeded 75μg/m^(3) were frequently observed during the heating season.Dispersion Normalized Positive Matrix Factorization was applied for the source apportionment of PM_(2.5) as minimize the dilution effects of meteorology and better reflect the source strengths in these two cities.Secondary nitrate had the highest contribution for Beijing(37.3%),and residential heating/biomass burning was the largest for Baoding(27.1%).Secondary nitrate,mobile,biomass burning,district heating,oil combustion,aged sea salt sources showed significant differences between the heating and non-heating seasons in Beijing for same period(2019.01.10–2019.08.22)(Mann-Whitney Rank Sum Test P<0.05).In case of Baoding,soil,residential heating/biomass burning,incinerator,coal combustion,oil combustion sources showed significant differences.The results of Pearson correlation analysis for the common sources between the two cities showed that long-range transported sources and some sources with seasonal patterns such as oil combustion and soil had high correlation coefficients.Conditional Bivariate Probability Function(CBPF)was used to identify the inflow directions for the sources,and joint-PSCF(Potential Source Contribution Function)was performed to determine the common potential source areas for sources affecting both cities.These models facilitated a more precise verification of city-specific influences on PM_(2.5) sources.The results of this study will aid in prioritizing air pollution mitigation strategies during the heating season and strengthening air quality management to reduce the impact of downwind neighboring cities.
文摘Despite advancements in neuroimaging,false positive diagnoses of intracranial aneurysms remain a significant concern.This article examines the causes,prevalence,and implications of such false-positive diagnoses.We discuss how conditions like arterial occlusion with vascular stump formation and infundibular widening can mimic aneurysms,particularly in the anterior circulation.The article compares various imaging modalities,including computer tomography angiogram,magnetic resonance imaging/angiography,and digital subtraction angiogram,highlighting their strengths and limitations.We emphasize the im-portance of accurate differentiation to avoid unnecessary surgical interventions.The potential of emerging technologies,such as high-resolution vessel wall ima-ging and deep neural networks for automated detection,is explored as promising avenues for improving diagnostic accuracy.This manuscript underscores the need for continued research and clinical vigilance in the diagnosis of intracranial aneurysms.
基金Supported by NSFC(No.11861010),also supported by NSFC(No.12171175),also supported by NSFC(No.12261006)NSF of Guangxi Province(No.2018GXNSFFA281008)Project of Guangxi First Class Disciplines of Statistics(No.GJKY-2022-01)。
文摘In this paper,we study the Bowen entropy of stable sets in positive entropy G-system of amenable group actions.The lower bound of the Bowen entropy of these sets are estimated.
基金Supported by National Natural Science Foundation of China(11671403,11671236)Henan Provincial General Natural Science Foundation Project(232300420113)。
文摘This article studies a class of nonlinear Kirchhoff equations with exponential critical growth,trapping potential,and perturbation.Under appropriate assumptions about f and h,the article obtained the existence of normalized positive solutions for this equation via the Trudinger-Moser inequality and variational methods.Moreover,these solutions are also ground state solutions.Additionally,the article also characterized the asymptotic behavior of solutions.The results of this article expand the research of relevant literature.
文摘In this paper,we introduce the real pairwise completely positive(RPCP)matrices with one of them is necessarily positive semidefinite while the other one is necessarily entrywise nonnegative,which has a real pairwise completely positive(RPCP)decomposition.We study the properties of RPCP matrices and give some necessary and sufficient conditions for a matrix pair to be RPCP.First,we give an equivalent decomposition for the RPCP matrices,which is different from the RPCP-decomposition and show that the matrix pair(X,X)is RPCP if and only if X is completely positive.Besides,we also prove that the RPCP matrices checking problem is equivalent to the separable completion problem.A semidefinite algorithm is also proposed for detecting whether or not a matrix pair is RPCP.The asymptotic and finite convergence of the algorithm are also discussed.If it is RPCP,we can further give a RPCP-decomposition for it;if it is not,we can obtain a certificate for this.
文摘Objective:To evaluate the predictive value of the neutrophil⁃to⁃lymphocyte ratio(NLR)and the systemic immune⁃inflammation index(SII)in predicting patients with anti⁃melanoma differentiation⁃associated gene 5⁃positive(anti⁃MDA5+)dermatomyositis(DM)develop into the rapidly progressive interstitial lung disease(RPILD).Methods:We retrospectively analyzed the clinical and laboratory data of 124 anti⁃MDA5+DM patients from the First Affiliated Hospital of Nanjing Medical University between March 2019 and September 2023.We identified independent risk factors associated with the development and mortality of RPILD with the Cox regression analysis,and determined the optimal cut⁃off values for predicting adverse outcomes with the receiver operating characteristic(ROC)curve analysis.Results:Among the 124 patients,36 patients(29.03%)developed RPILD,and 39 patients(31.45%)died during the follow⁃up period.The results of multivariate Cox regression analysis showed that the elevated NLR was an independent risk factor for RPILD development,while the elevated SII expression was independently associated with the increased mortality of RPILD.Based on the ROC curve analysis,NLR>6.12 was a predictor for RPILD,and SII>875.79 was associated with increased mortality risk of RPILD.Conclusion:Both NLR and SII are accessible,cost⁃effective,and reliable prognostic indicators for the prognosis of patients with anti⁃MDA5^(+)DM,providing a valuable guidance for clinical management and risk stratification of the disease.
文摘In life,we are bound to encounter various difficulties and setbacks.However,it is of great significance to maintain a positive attitude when were facing these challenges.For me,this lesson was deeply impressed upon me during a particularly tough period.
基金Soft Science Special Project of Gansu Basic Research Plan,No.25JRZA072Youth Project of Philosophy and Social Science Foundation of Gansu Province,No.2024QN015+1 种基金General Project of Philosophy and Social Science Foundation of Gansu Province,No.2024YB049Lanzhou Philosophy and Social Science Planning Project,No.24-B13.
文摘Adolescence is a crucial period marked by significant developmental changes,during which risk-taking behaviors can be both a normative part of development and a potential source of concern.However,prior research has focused predominantly on the adverse aspects of risk-taking(i.e.,negative risk-taking),overlooked the positive counterpart(i.e.,positive risk-taking),and lacked a detailed examination of both.This study aims to elucidate the distinct characteristics and interrelationships of positive and negative risk-taking behaviors among adoles-cents and to identify the key factors that influence these behaviors.Through a comprehensive synthesis of theoretical and empirical literature,we explore the multifaceted nature of risk-taking,highlighting its complex influencing factors,including individual traits,family dynamics,peer influence,school environment,and broader community contexts.By identifying the shared and unique factors contributing to positive and negative risk-taking behaviors,we can enable adolescents to navigate this complex stage of life and design targeted interventions.Future research directions include the application of person-centered approaches,the implementation of longitudinal tracking and the interactive effects of influencing factors,among other aspects.
文摘BACKGROUND Lung ultrasonography is being increasingly used in mechanically ventilated patients to evaluate the lung aeration during incremental positive end expiratory pressure(PEEP)adjustments and to evaluate the weaning process from mechanical ventilation.The effects of PEEP may vary across different lung pathologies and may not consistently correlate with changes in lung aeration as assessed by lung ultrasound scores(LUSs).AIM To assess the role of lung ultrasonography in evaluating lung aeration during the application of PEEP in mechanically ventilated patients with various lung pathologies.METHODS An observational study was conducted over 18 months in a tertiary care hospital.Patients of both genders,aged between 18-75 years,who had been admitted to the intensive care unit,and required mechanical ventilation,were studied.A standard ventilatory strategy was used and incremental levels of PEEP[5,10,and 15 cm water(H_(2)O)]were applied.Baseline characteristics,including oxygen saturation(SpO2),LUS,mean arterial pressure(MAP),heart rate(HR),and their changes with incremental PEEP levels,were recorded and analyzed.RESULTS In this study,45.9%of patients required a PEEP of 5 cm H_(2)O to achieve the endpoint of lung aeration(LUS of 0).In addition,86.5% and 13.5% of patients reached the endpoint of lung aeration at PEEP levels of 10 and 15 cm H_(2)O,respectively.The proportion of patients with higher lung scores decreased significantly with increasing PEEP levels(P<0.001 for 5 and 10 cm H_(2)O and P=0.032 for 15 cm H_(2)O).SpO2 increased significantly with higher PEEP levels(P<0.001),confirming the effectiveness of PEEP in improving oxygenation.The results also revealed a significant increase in HR and a decrease in MAP following the application of higher PEEP levels.CONCLUSION Increasing PEEP levels in mechanically ventilated patients improves lung aeration,which can be effectively assessed using bedside lung ultrasonography.
基金supported by grants from the National Natural Science Foundation of China(82101273)the Second Affiliated Hospital of the Army Medical University Incubation Program for Young Doctoral Talents(2023YQB007).
文摘Dear Editor,General anesthetics play a pivotal role in inducing a safe and reversible loss of consciousness in patients,the importance of which cannot be overstated[1].Among the intravenous anesthetics,propofol stands out for its rapid onset and swift systemic clearance,effectively eliminating the prolonged sedation associated with earlier agents[2].
文摘BACKGROUND Patients undergoing rectal cancer surgery frequently encounter challenges in their self-care abilities,disease knowledge,and emotional well-being postoperatively.Effective nursing interventions are critical for improving the quality of life and minimizing complications.This study explored the clinical implications of integrating health education guided by problem management with positive incentive nursing to address these challenges.AIM To evaluate the effect of this combined nursing model on postoperative self-care ability,disease knowledge,mood state,and complication rates in patients undergoing rectal cancer surgery.METHODS Eighty patients who underwent rectal cancer surgery between October 2021 and August 2024 were allocated into reference(routine care)and experimental(problem management-guided health education combined with positive incentive nursing)groups.The outcomes included exercise of self-care agency scale,disease knowledge(hospital-specific questionnaire),mood state(profile of mood states),and complication rates.RESULTS The experimental group demonstrated significant improvements in self-care ability(P<0.05),with higher scores for health knowledge,self-concept,self-care skills,and self-care responsibility than the reference group.Disease knowledge scores also improved markedly in the experimental group(P<0.05).Mood state scores showed a significant decrease in the negative dimensions(e.g.,anxiety and depression)and an increase in energy vitality(P<0.05).Additionally,the experimental group exhibited a lower complication rate than the reference group(7.5%vs 27.5%,P<0.05).CONCLUSION The integration of problem management-guided health education with positive incentive nursing significantly enhanced postoperative self-care abilities,disease knowledge,and emotional well-being while reducing complication rates.This model demonstrated potential for widespread adoption in clinical practice by offering a structured approach to improve patient outcomes and quality of life.
基金supported by the Natural Science Foundation of Gansu Province(No.24JRRP001)。
文摘In this paper,we study the following Schrödinger-Poisson system{-ε^(p)Δ_(p)u+V(x)|u|^(p-2)u+ϕ|u|^(p-2)u=f(u)+|u|^(p*-2)u in R^(3),-ε^(2)Δϕ=|u|^(p)in R^(3),whereε>0 is a parameter,3/2<p<3,Δ_(p)u=div(|∇u|^(p-2)∇u),p^(*)=3p/3-p,V:R^(3)→R is a potential function with a local minimum and f is subcritical growth.Based on the penalization method,Nehari manifold techniques and Ljusternik-Schnirelmann category theory,we obtain the multiplicity and concentration of positive solutions to the above system.
基金supported by National Natural Science Foundation of China (No.51867013)Natural Science Foundation of Gansu Province (No.20JR5RA414)。
文摘The purpose of this study is to analyze the galloping characteristics of the catenary positive feeder in fluctuating wind areas considering dynamic-wind angle of attack and aerodynamic damping.Firstly,the flow field model of the catenary positive feeder was established,the fluctuating wind field was simulated by Davenport wind power spectrum and linear filtering method,and the wind speed at inlet in calculation domain was controlled by editing the profile file to simulate and calculate the aerodynamic characteristics of the positive feeder in the fluctuating wind area.Then,taking the positive feeder as the research object,the mathematical model of actual structure and the corresponding finite element model were established.By applying the wind load to the finite element model,the influence of aerodynamic damping caused by the self-movement of the positive feeder on the galloping response was analyzed,and the frequency domain characteristics of galloping displacement of the positive feeder considering aerodynamic damping were studied.Finally,the calculation method of aerodynamic damping by the Guidelines for Electrical Transmission Line Structural Loading(ASCE No.74)was used for the galloping response of the positive feeder and compared with the proposed method.The results show that when considering aerodynamic damping,the galloping amplitude of the positive feeder decreases significantly,and the first-order resonance effect on the vertical displacement and horizontal displacement decreases significantly.The galloping trajectories calculated by the two methods are consistent.Therefore,this study is of great significance to further clarify the ice-free galloping mechanism of the catenary positive feeder in violent wind areas.
基金supported by funding from the National Natural Science Foundation of China(Grant No.82170167 to Xiaoxi Zhou and Grant No.82300226 to Hui Luo)。
文摘CD5-positive(CD5+)diffuse large B-cell lymphoma(DLBCL)represents a special subgroup of DLBCL with a more aggressive disease course and is more likely to develop into relapsed/refractory(r/r)DLBCL in response to immunochemotherapy.The incidence of CD5+DLBCL is 5%–10%among DLBCL patients1.
基金supported by National Natural Science Foundation of China(No.11975261)。
文摘In order to support the physical research on the EAST tokamak,a new positive ion source with designed beam energy of 120 keV was proposed to be developed.Accelerator structure is one of the key components of the ion source.Through the finite element analysis method,the electrostatic analyses of insulators and grid plates were carried out,the material and structure parameters of insulators were determined.The maximum electric field around each insulator is about 4 kV/mm,and the maximum electric field between grids is about 14 kV/mm,which can meet the 120 keV withstand voltage holding.The insulation system for the positive ion source accelerator with 120 keV is designed,and the connection and basic parameters of insulators and support flanges are analyzed and determined.
