Continuity is the foremost defining characteristic of Chinese civilization.It ensures that the evolution of this civilization respects the fine traditions and stays on the right course throughout its creative course.M...Continuity is the foremost defining characteristic of Chinese civilization.It ensures that the evolution of this civilization respects the fine traditions and stays on the right course throughout its creative course.Meanwhile,creativity imparts ceaseless vitality to this civilization,serving as the intrinsic propulsive force that fuels its evolution.The rise of Song Studies marks one of the symbolic events in the transformation in the Chinese ideological and cultural realm.It encapsulates the dialectical unity between continuity and creativity that characterizes Chinese civilization.Song Studies adhere to the traditional classic interpretations,center the core values around“benevolence,”and pursue the way of sages,which reflect the continuity of Chinese civilization.They also embody creativity.This is manifested in the emergence of a new academic spirit that emphasizes the seeking of truth and reason,a new academic ethos that involves questioning classics in the process of their dissemination and interpreting them with one’s own insight,as well as the fusion of philosophical speculation with social practice.Conducting an integrated analysis of the defining characteristics of Chinese civilization and the rise of Song Studies helps us gain a thorough understanding of the dialectical unity between the continuity and creativity of Chinese civilization through the interactions between history and reality.It also enables us to effectively address the relationship between inheritance and transformation,as well as between maintaining core values and pursuing creativity throughout its ongoing development.展开更多
BACKGROUND Children with critical acute abdominal conditions often undergo intestinal stoma surgery.AIM To explore the impact of a visual mobile terminal-based extended care model on caregiver competence for children ...BACKGROUND Children with critical acute abdominal conditions often undergo intestinal stoma surgery.AIM To explore the impact of a visual mobile terminal-based extended care model on caregiver competence for children with enterostomies.METHODS One hundred twenty children with enterostomies and their caregivers in a children's hospital in Beijing were divided into a control group and a study group.The control group(60 cases)received traditional telephone follow-up for continuity of care,while the study group(60 cases)used a visualization mobile terminal-based care model.The incidence of stoma-related complications,caregiver burden scale,and competence scores of children with stoma were compared between the two groups.RESULTS The primary caregiver burden score in the study group(37.22±3.17)was significantly lower than that in the control group(80.00±4.47),and the difference was statistically significant(P<0.05).Additionally,the caregiving ability score of the study group(172.08±3.49)was significantly higher than that of the control group(117.55±4.28;P<0.05).The total incidence of complications in the study group(11.7%,7/60)was significantly lower compared to the control group(33.3%,20/60;χ2=8.086,P=0.004).CONCLUSION The visual mobile terminal-based care model reduces caregiver burden,improves home care ability,lowers the incidence of complications and readmission rates,and supports successful second-stage reduction surgery for children with enterostomies.展开更多
BACKGROUND Gastric cancer predominantly affects the elderly,who face significant challenges due to high postoperative complications and stress.These challenges include co-morbidities,reduced physiological reserves,and...BACKGROUND Gastric cancer predominantly affects the elderly,who face significant challenges due to high postoperative complications and stress.These challenges include co-morbidities,reduced physiological reserves,and increased risks of infections and delayed healing.Traditional postoperative care often falls short in addressing these issues effectively.Enhanced recovery after surgery(ERAS)principles have revolutionized surgical care by reducing stress and promoting recovery through a holistic approach.ERAS emphasizes preoperative optimization,intraoperative care,and postoperative rehabilitation tailored to patient needs.Despite its recog-nized benefits,the impact of continuity nursing care within the ERAS framework on elderly gastric cancer patients remains underexplored.This study examines the influence of ERAS-based continuity nursing care on postoperative satisfaction,inflammation,stress,and quality of life in elderly patients undergoing gastric cancer resection.AIM To investigate the effects of ERAS-based continuity nursing care on postoperative satisfaction,inflammation,stress,and quality of life in elderly gastric cancer pa-tients.METHODS A retrospective cohort analysis was conducted on 322 elderly patients who under-went gastric cancer resection between January 2020 and January 2022.Patients were assigned to a routine care group(n=156)or an ERAS-control(ERAS-C)group(n=166).Data collected included demographic information,inflammatory and stress markers,satisfaction scores using the patient satisfaction questionnaire-18,and quality of life measured using the European Organi-zation for Research and Treatment of Cancer 22-item quality of life questionnaire specific to gastric cancer.RESULTS The ERAS-C group exhibited significantly lower postoperative interleukin-6 levels than the routine care group(12.97±4.02 pg/mL vs 14.37±3.86 pg/mL;P=0.002).This finding indicates that the ERAS-C group experienced reduced inflammation.The ERAS-C group also had a higher cluster of differentiation(CD)4:CD8 ratio than the routine care group(2.34±0.35 vs 2.13±0.61;P<0.001),suggesting the former’s enhanced immune response.Postoperative stress markers,including norepinephrine,cortisol,and aldosterone,were significantly lower in the ERAS-C group than in the routine care group(P<0.05 for all).Compared with the routine care group,the ERAS-C group showed increased nursing satisfaction scores(80.36±7.24 vs 75.23±7.03;P<0.001)and improved quality of life indicators,such as reduced dysphagia and pain,(P<0.05).The ERAS-C group also experienced fewer complic-ations than the routine care group(5.42%vs 11.54%,P=0.048).CONCLUSION Continuity nursing care within the ERAS framework significantly enhances postoperative outcomes for elderly gastric cancer patients by reducing inflammation,stress,and complications while improving satisfaction and qua-lity of life.展开更多
Fiber-reinforced composites are an ideal material for the lightweight design of aerospace structures. Especially in recent years, with the rapid development of composite additive manufacturing technology, the design o...Fiber-reinforced composites are an ideal material for the lightweight design of aerospace structures. Especially in recent years, with the rapid development of composite additive manufacturing technology, the design optimization of variable stiffness of fiber-reinforced composite laminates has attracted widespread attention from scholars and industry. In these aerospace composite structures, numerous cutout panels and shells serve as access points for maintaining electrical, fuel, and hydraulic systems. The traditional fiber-reinforced composite laminate subtractive drilling manufacturing inevitably faces the problems of interlayer delamination, fiber fracture, and burr of the laminate. Continuous fiber additive manufacturing technology offers the potential for integrated design optimization and manufacturing with high structural performance. Considering the integration of design and manufacturability in continuous fiber additive manufacturing, the paper proposes linear and nonlinear filtering strategies based on the Normal Distribution Fiber Optimization (NDFO) material interpolation scheme to overcome the challenge of discrete fiber optimization results, which are difficult to apply directly to continuous fiber additive manufacturing. With minimizing structural compliance as the objective function, the proposed approach provides a strategy to achieve continuity of discrete fiber paths in the variable stiffness design optimization of composite laminates with regular and irregular holes. In the variable stiffness design optimization model, the number of candidate fiber laying angles in the NDFO material interpolation scheme is considered as design variable. The sensitivity information of structural compliance with respect to the number of candidate fiber laying angles is obtained using the analytical sensitivity analysis method. Based on the proposed variable stiffness design optimization method for complex perforated composite laminates, the numerical examples consider the variable stiffness design optimization of typical non-perforated and perforated composite laminates with circular, square, and irregular holes, and systematically discuss the number of candidate discrete fiber laying angles, discrete fiber continuous filtering strategies, and filter radius on structural compliance, continuity, and manufacturability. The optimized discrete fiber angles of variable stiffness laminates are converted into continuous fiber laying paths using a streamlined process for continuous fiber additive manufacturing. Meanwhile, the optimized non-perforated and perforated MBB beams after discrete fiber continuous treatment, are manufactured using continuous fiber co-extrusion additive manufacturing technology to verify the effectiveness of the variable stiffness fiber optimization framework proposed in this paper.展开更多
Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly p...Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly patients with CHD with UAP admitted to our hospital from March 2022 to March 2023 were selected and grouped into an observation group and a control group of 50 cases each according to the randomized number table method.The nursing effect and quality of life of the observation group(continuity nursing)and the control group(routine nursing)were compared.Results:The total effective rate of nursing care was 96.00%observation group and 80.00%for the control group,and the differences were significant(χ2=6.061,P<0.05).Patients in the observation group had fewer episodes(1.42±0.21)times/week and a shorter duration(5.46±0.39)min,which were better than the control group(t=3.465,2.973;P<0.05).The depression self-rating depression scale(SDS)score(42.16±6.64)and anxiety self-rating scale(SAS)score(32.26±7.35)in the observation group were lower and the quality of life was higher as compared to that of the control group(P<0.05).Conclusion:Continuous nursing care improved the nursing effect of elderly CHD with UAP patients,promoted the alleviation of UAP symptoms,improved patient mentality,and improved their quality of life.Hence,continuous nursing care possesses significant clinical application value.展开更多
A cautious projection BFGS method is proposed for solving nonconvex unconstrained optimization problems.The global convergence of this method as well as a stronger general convergence result can be proven without a gr...A cautious projection BFGS method is proposed for solving nonconvex unconstrained optimization problems.The global convergence of this method as well as a stronger general convergence result can be proven without a gradient Lipschitz continuity assumption,which is more in line with the actual problems than the existing modified BFGS methods and the traditional BFGS method.Under some additional conditions,the method presented has a superlinear convergence rate,which can be regarded as an extension and supplement of BFGS-type methods with the projection technique.Finally,the effectiveness and application prospects of the proposed method are verified by numerical experiments.展开更多
In this paper,I consider the Hölder continuity of the Lyapunov exponent for a quasi-periodic Szegö cocycle with weak Liouville frequency.I extend the existing results about the regularity of the Lyapunov exp...In this paper,I consider the Hölder continuity of the Lyapunov exponent for a quasi-periodic Szegö cocycle with weak Liouville frequency.I extend the existing results about the regularity of the Lyapunov exponent from the Schrödinger cocycle in[24]to a Szegö cocycle.展开更多
Regarding laminated structures,an electromechanically coupled Finite Element(FE)model based on Layerwise Third-Order Shear Deformation(LW-TOSD)theory is proposed for sta-tic and dynamic analysis.LW-TOSD ensures the co...Regarding laminated structures,an electromechanically coupled Finite Element(FE)model based on Layerwise Third-Order Shear Deformation(LW-TOSD)theory is proposed for sta-tic and dynamic analysis.LW-TOSD ensures the continuity of in-plane displacements and trans-verse shear stresses.The current LW-TOSD can be applied to arbitrary multi-layer laminated structures with only seven Degrees of Freedom(DOFs)for each element node and eliminates the use of the shear correction factors.Moreover,a shear penalty stiffness matrix is constructed to sat-isfy artificial constraints to optimize the structural shear strain.A dynamic finite element model is obtained based on LW-TOSD using the Hamilton's principle.First,the accuracy of the current model is validated by comparing with literature and ABAQUS results.Then,this study carries out numerical investigations of piezolaminated structures for different width-to-thickness ratios,length-to-width ratios,penalty stiffness matrix,boundary conditions,electric fields and dynamics.展开更多
This paper focuses on the continuity of the truncated Hardy-Littlewood maximal function.We first show that the truncated Hardy-Littlewood maximal function is lower semi-continuous.Then by investigating the behavior of...This paper focuses on the continuity of the truncated Hardy-Littlewood maximal function.We first show that the truncated Hardy-Littlewood maximal function is lower semi-continuous.Then by investigating the behavior of the truncated Hardy-Littlewood maximal function when the truncated parameterγchanges,we obtain an equivalent condition of the continuity of the truncated Hardy-Littlewood maximal function.展开更多
Background: Continuity of care is a distinguishing feature of primary care. Better continuity of care program showed a significant effect in controlling diabetes and it is complications. This study explores the effect...Background: Continuity of care is a distinguishing feature of primary care. Better continuity of care program showed a significant effect in controlling diabetes and it is complications. This study explores the effect of continuity of care on control of diabetes mellites in primary health care centres. Objectives: 1) To assess the effect of Continuity of care on controlling haemoglobin (Hb A1C) and fasting blood Sugar (FBS);2) To compare the control of Diabetes by using (Hb A1C and FBS) indices on same patient before and after application of chronic illness clinic;3) To identify the relation between age and gender affecting continuity of care in diabetic patient. Methods: It is a Prospective cohort study design. Included both gender and diabetic patient age above 24 years old. The data extracted from health care specialty center (HCSC) clinics in National guard hospital at Riyadh, through HCSC data base on three phases: 1) Phase 1: the data extracted of diabetic patients from October to November 2022 including MRN, diabetic patient, age, Hb A1C, Fasting blood glucose. 2) Phase 2: the same MRN extracted from phase 1 was extracted again retrospectively for six months from April to September 2022, to compare the indices before implanting the chronic illness clinic including Hb A1C, Fasting blood glucose. 3) Phase 3: prospectively from December 2022 to September 2023. Results: Among diabetic patients aged 60 years old and above showed better control of HbA1C and FBS comparing to these patients below age of 60 years old, with significant improvement of HbA1C after implanting chronic illness clinic. Conclusion: The significant improvement in the control of diabetic patients followed in primary health care centers reinforce the evidence of the importance of continuity of care.展开更多
Objective: To explore the impact of the WeChat platform continuity of care model based on the KAP (knowledge, attitudes, and practices) theory on the self-management of stroke patients with hypertension after discharg...Objective: To explore the impact of the WeChat platform continuity of care model based on the KAP (knowledge, attitudes, and practices) theory on the self-management of stroke patients with hypertension after discharge from the hospital. Methods: 62 stroke patients with hypertension discharged from the rehabilitation department of a tertiary A hospital in Nanning City, Guangxi Zhuang Autonomous Region, from October 2022 to April 2023 were sampled by convenience sampling method. Patients discharged from Rehabilitation I were included in the control group, and conventional nursing care was used;while patients discharged from Rehabilitation II were included in the observation group, and WeChat platform continuity of nursing care model based on the KAP theory was implemented. The intervention effect of the two groups was compared. Results: After 4 and 12 weeks of intervention, the diastolic and systolic blood pressure of the patients in the observation group were lower than those in the control group (P < 0.05);after 12 weeks of intervention, the rate of medication adherence and the score of adherence to hypertension treatment in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion: The application of the WeChat platform continuity of care model based on KAP theory to stroke patients with hypertension can improve blood pressure, medication adherence rate, hypertension treatment adherence, and overall enhance the self-management level of these patients.展开更多
Objective:To explore the impact of a continuity of care model on negative emotions and self-efficacy in patients undergoing digestive endoscopic tumor resection.Methods:A retrospective analysis was conducted on 80 pat...Objective:To explore the impact of a continuity of care model on negative emotions and self-efficacy in patients undergoing digestive endoscopic tumor resection.Methods:A retrospective analysis was conducted on 80 patients who underwent digestive endoscopic tumor resection in the Gastroenterology Department of Baoying County People’s Hospital between October 2022 and October 2024.Patients were randomly divided into a control group(n=40)and an observation group(n=40)using a random number table.The control group received routine nursing care,while the observation group was additionally provided with continuity of care interventions.After two months of intervention,the negative emotions and self-efficacy of the two groups were compared and statistically analyzed.Results:There was no statistically significant difference in baseline data between the two groups(P>0.05).After two months of intervention,the observation group demonstrated significantly lower HAMD and HAMA scores compared to the control group(both P=0.000),and significantly higher GSES scores(P=0.000).Conclusion:Applying a continuity of care model to patients undergoing digestive endoscopic tumor resection can alleviate negative emotions,enhance self-efficacy,and improve self-care abilities.展开更多
Objective:To analyze the effect of continuity of care in the cardiac intensive care unit(CICU)on improving cognitive function and psychological state in patients with heart failure(HF).Methods:A total of 112 chronic H...Objective:To analyze the effect of continuity of care in the cardiac intensive care unit(CICU)on improving cognitive function and psychological state in patients with heart failure(HF).Methods:A total of 112 chronic HF patients admitted to the CICU of Xuzhou Traditional Chinese Medicine Hospital from July 2022 to August 2024 were selected and randomly divided into two groups using the red and blue ball method:a control group(n=56)and a study group(n=56).The control group received routine CICU nursing management,while the study group received routine CICU nursing combined with continuity of care management.Cognitive function(using the Montreal Cognitive Assessment,MoCA),psychological state(using the Self-Rating Depression Scale,SDS,and Self-Rating Anxiety Scale,SAS),and quality of life(using the Minnesota Living with Heart Failure Questionnaire,MLHFQ)were compared between the two groups.Results:After the intervention,the cognitive function scores of the study group were significantly higher than those of the control group(P<0.05).The SDS and SAS scores of the study group were significantly lower than those of the control group after the intervention(P<0.05).The quality of life in the study group was also significantly better than in the control group(P<0.05).Conclusion:CICU continuity of care can effectively improve cognitive function and psychological state in patients with HF,while also enhancing their quality of life.展开更多
We obtain the H?lder continuity and joint H?lder continuity in space and time for the random field solution to the parabolic Anderson equation ■ in d-dimensional space, where ■ is a mean zero Gaussian noise with tem...We obtain the H?lder continuity and joint H?lder continuity in space and time for the random field solution to the parabolic Anderson equation ■ in d-dimensional space, where ■ is a mean zero Gaussian noise with temporal covariance γ0 and spatial covariance given by a spectral density μ(ξ). We assume that ■ and ■ , where αi, i = 1, · · ·, d(or α) can take negative value.展开更多
An example is presented to introduce the concept of implicit continuity proposed as contrasted with the explicit continuity.A sufficient and necessary condition of the implicit continuity is given and proved in forms ...An example is presented to introduce the concept of implicit continuity proposed as contrasted with the explicit continuity.A sufficient and necessary condition of the implicit continuity is given and proved in forms of implicit system.This condition also offers the solution of initial values at the points where the dynamic system is discontinuous.Some discussions are contributed to the physical significance of implicit continuity.展开更多
It is shown that an arbitrary function from D Rn to Rm will become C0,a-continuous in almost every x∈ D after restriction to a certain subset with limit pointx. For n 〉 m differentiability can be obtained. Example...It is shown that an arbitrary function from D Rn to Rm will become C0,a-continuous in almost every x∈ D after restriction to a certain subset with limit pointx. For n 〉 m differentiability can be obtained. Examples show the Ho1der exponent a=min{1,n/m}is optimal.展开更多
The aim of this work is to introduce some weak forms of continuity in bitopological spaces. Then we use these new forms of weak continuity to give many decompositions of?i-continuity and pairwise continuity.
Planning and implementation as well as increased control over the Business Continuity Management （BCM） is a complex task in the company requiring adequate resources. BCM aims to reduce risks and develops plans for r...Planning and implementation as well as increased control over the Business Continuity Management （BCM） is a complex task in the company requiring adequate resources. BCM aims to reduce risks and develops plans for restoring business activities if they are interrupted by a disaster. The purpose of the paper is to analyze and describe two standards, Information Technology Infrastructure Library （ITIL） and Control Objectives for Information and Related Technology （COBIT）, especially their mapping for the improved planning and implementation of the BCM as well as the increased control over the BCM activities. COBIT is used more as a management framework, providing management tools, such as control objectives, metrics and maturity models in order to complement the control framework. ITIL includes process steps and tasks because it is more oriented towards IT processes （process framework）, defining the best practice for IT service management. Within this mapping, ITIL processes may be used to achieve and demonstrate compliance with COBIT control objectives for BCM process.展开更多
The Lt-norm method is one of the widely used matching filters for adaptive multiple subtraction. When the primaries and multiples are mixed together, the L1-norm method might damage the primaries, leading to poor late...The Lt-norm method is one of the widely used matching filters for adaptive multiple subtraction. When the primaries and multiples are mixed together, the L1-norm method might damage the primaries, leading to poor lateral continuity. In this paper, we propose a constrained L1-norm method for adaptive multiple subtraction by introducing the lateral continuity constraint for the estimated primaries. We measure the lateral continuity using prediction-error filters （PEF）. We illustrate our method with the synthetic Pluto dataset. The results show that the constrained L1-norm method can simultaneously attenuate the multiples and preserve the primaries.展开更多
In order to ensure machining stability,curvature continuity and smooth cutting force are very important so as to meet the constraints of both cutting force and kinematics of machine tools.For five-axis flank milling,i...In order to ensure machining stability,curvature continuity and smooth cutting force are very important so as to meet the constraints of both cutting force and kinematics of machine tools.For five-axis flank milling,it is difficult to meet both of the constraints because tool path points and tool axis vectors interact with each other.In this paper,multiple relationships between tool path points and tool axis vectors with cutting force and kinematics of machine tools are established,and the strategies of corner-looping milling and clothoidal spirals are combined so as to find feasible solutions under both of the constraints.Tool path parameters are iterated by considering the maximum cutting force and the feasible range of the tool axis vector,and eventually a curvature continuity five-axis flank milling tool path with smooth cutting force is generated.Machining experimental results show that the conditions of cutting force are satisfied,vibration during the process of machining is reduced,and the machining quality of the surface is improved.展开更多
基金a phased achievement of the“Research on Chinese Confucian Orthodoxy”(Project No.:17ZDA010),a major project of the National Social Science Fund of China.
文摘Continuity is the foremost defining characteristic of Chinese civilization.It ensures that the evolution of this civilization respects the fine traditions and stays on the right course throughout its creative course.Meanwhile,creativity imparts ceaseless vitality to this civilization,serving as the intrinsic propulsive force that fuels its evolution.The rise of Song Studies marks one of the symbolic events in the transformation in the Chinese ideological and cultural realm.It encapsulates the dialectical unity between continuity and creativity that characterizes Chinese civilization.Song Studies adhere to the traditional classic interpretations,center the core values around“benevolence,”and pursue the way of sages,which reflect the continuity of Chinese civilization.They also embody creativity.This is manifested in the emergence of a new academic spirit that emphasizes the seeking of truth and reason,a new academic ethos that involves questioning classics in the process of their dissemination and interpreting them with one’s own insight,as well as the fusion of philosophical speculation with social practice.Conducting an integrated analysis of the defining characteristics of Chinese civilization and the rise of Song Studies helps us gain a thorough understanding of the dialectical unity between the continuity and creativity of Chinese civilization through the interactions between history and reality.It also enables us to effectively address the relationship between inheritance and transformation,as well as between maintaining core values and pursuing creativity throughout its ongoing development.
基金Supported by Project of the Health Bureau of the Logistics and Security Department of the Central Military Commission,No.145BHQ090003076XMilitary Family Planning Special Fund,No.21JSZ18.
文摘BACKGROUND Children with critical acute abdominal conditions often undergo intestinal stoma surgery.AIM To explore the impact of a visual mobile terminal-based extended care model on caregiver competence for children with enterostomies.METHODS One hundred twenty children with enterostomies and their caregivers in a children's hospital in Beijing were divided into a control group and a study group.The control group(60 cases)received traditional telephone follow-up for continuity of care,while the study group(60 cases)used a visualization mobile terminal-based care model.The incidence of stoma-related complications,caregiver burden scale,and competence scores of children with stoma were compared between the two groups.RESULTS The primary caregiver burden score in the study group(37.22±3.17)was significantly lower than that in the control group(80.00±4.47),and the difference was statistically significant(P<0.05).Additionally,the caregiving ability score of the study group(172.08±3.49)was significantly higher than that of the control group(117.55±4.28;P<0.05).The total incidence of complications in the study group(11.7%,7/60)was significantly lower compared to the control group(33.3%,20/60;χ2=8.086,P=0.004).CONCLUSION The visual mobile terminal-based care model reduces caregiver burden,improves home care ability,lowers the incidence of complications and readmission rates,and supports successful second-stage reduction surgery for children with enterostomies.
文摘BACKGROUND Gastric cancer predominantly affects the elderly,who face significant challenges due to high postoperative complications and stress.These challenges include co-morbidities,reduced physiological reserves,and increased risks of infections and delayed healing.Traditional postoperative care often falls short in addressing these issues effectively.Enhanced recovery after surgery(ERAS)principles have revolutionized surgical care by reducing stress and promoting recovery through a holistic approach.ERAS emphasizes preoperative optimization,intraoperative care,and postoperative rehabilitation tailored to patient needs.Despite its recog-nized benefits,the impact of continuity nursing care within the ERAS framework on elderly gastric cancer patients remains underexplored.This study examines the influence of ERAS-based continuity nursing care on postoperative satisfaction,inflammation,stress,and quality of life in elderly patients undergoing gastric cancer resection.AIM To investigate the effects of ERAS-based continuity nursing care on postoperative satisfaction,inflammation,stress,and quality of life in elderly gastric cancer pa-tients.METHODS A retrospective cohort analysis was conducted on 322 elderly patients who under-went gastric cancer resection between January 2020 and January 2022.Patients were assigned to a routine care group(n=156)or an ERAS-control(ERAS-C)group(n=166).Data collected included demographic information,inflammatory and stress markers,satisfaction scores using the patient satisfaction questionnaire-18,and quality of life measured using the European Organi-zation for Research and Treatment of Cancer 22-item quality of life questionnaire specific to gastric cancer.RESULTS The ERAS-C group exhibited significantly lower postoperative interleukin-6 levels than the routine care group(12.97±4.02 pg/mL vs 14.37±3.86 pg/mL;P=0.002).This finding indicates that the ERAS-C group experienced reduced inflammation.The ERAS-C group also had a higher cluster of differentiation(CD)4:CD8 ratio than the routine care group(2.34±0.35 vs 2.13±0.61;P<0.001),suggesting the former’s enhanced immune response.Postoperative stress markers,including norepinephrine,cortisol,and aldosterone,were significantly lower in the ERAS-C group than in the routine care group(P<0.05 for all).Compared with the routine care group,the ERAS-C group showed increased nursing satisfaction scores(80.36±7.24 vs 75.23±7.03;P<0.001)and improved quality of life indicators,such as reduced dysphagia and pain,(P<0.05).The ERAS-C group also experienced fewer complic-ations than the routine care group(5.42%vs 11.54%,P=0.048).CONCLUSION Continuity nursing care within the ERAS framework significantly enhances postoperative outcomes for elderly gastric cancer patients by reducing inflammation,stress,and complications while improving satisfaction and qua-lity of life.
基金supports for this research were provided by the National Natural Science Foundation of China(No.12272301,12002278,U1906233)the Guangdong Basic and Applied Basic Research Foundation,China(Nos.2023A1515011970,2024A1515010256)+1 种基金the Dalian City Supports Innovation and Entrepreneurship Projects for High-Level Talents,China(2021RD16)the Key R&D Project of CSCEC,China(No.CSCEC-2020-Z-4).
文摘Fiber-reinforced composites are an ideal material for the lightweight design of aerospace structures. Especially in recent years, with the rapid development of composite additive manufacturing technology, the design optimization of variable stiffness of fiber-reinforced composite laminates has attracted widespread attention from scholars and industry. In these aerospace composite structures, numerous cutout panels and shells serve as access points for maintaining electrical, fuel, and hydraulic systems. The traditional fiber-reinforced composite laminate subtractive drilling manufacturing inevitably faces the problems of interlayer delamination, fiber fracture, and burr of the laminate. Continuous fiber additive manufacturing technology offers the potential for integrated design optimization and manufacturing with high structural performance. Considering the integration of design and manufacturability in continuous fiber additive manufacturing, the paper proposes linear and nonlinear filtering strategies based on the Normal Distribution Fiber Optimization (NDFO) material interpolation scheme to overcome the challenge of discrete fiber optimization results, which are difficult to apply directly to continuous fiber additive manufacturing. With minimizing structural compliance as the objective function, the proposed approach provides a strategy to achieve continuity of discrete fiber paths in the variable stiffness design optimization of composite laminates with regular and irregular holes. In the variable stiffness design optimization model, the number of candidate fiber laying angles in the NDFO material interpolation scheme is considered as design variable. The sensitivity information of structural compliance with respect to the number of candidate fiber laying angles is obtained using the analytical sensitivity analysis method. Based on the proposed variable stiffness design optimization method for complex perforated composite laminates, the numerical examples consider the variable stiffness design optimization of typical non-perforated and perforated composite laminates with circular, square, and irregular holes, and systematically discuss the number of candidate discrete fiber laying angles, discrete fiber continuous filtering strategies, and filter radius on structural compliance, continuity, and manufacturability. The optimized discrete fiber angles of variable stiffness laminates are converted into continuous fiber laying paths using a streamlined process for continuous fiber additive manufacturing. Meanwhile, the optimized non-perforated and perforated MBB beams after discrete fiber continuous treatment, are manufactured using continuous fiber co-extrusion additive manufacturing technology to verify the effectiveness of the variable stiffness fiber optimization framework proposed in this paper.
文摘Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly patients with CHD with UAP admitted to our hospital from March 2022 to March 2023 were selected and grouped into an observation group and a control group of 50 cases each according to the randomized number table method.The nursing effect and quality of life of the observation group(continuity nursing)and the control group(routine nursing)were compared.Results:The total effective rate of nursing care was 96.00%observation group and 80.00%for the control group,and the differences were significant(χ2=6.061,P<0.05).Patients in the observation group had fewer episodes(1.42±0.21)times/week and a shorter duration(5.46±0.39)min,which were better than the control group(t=3.465,2.973;P<0.05).The depression self-rating depression scale(SDS)score(42.16±6.64)and anxiety self-rating scale(SAS)score(32.26±7.35)in the observation group were lower and the quality of life was higher as compared to that of the control group(P<0.05).Conclusion:Continuous nursing care improved the nursing effect of elderly CHD with UAP patients,promoted the alleviation of UAP symptoms,improved patient mentality,and improved their quality of life.Hence,continuous nursing care possesses significant clinical application value.
基金supported by the Guangxi Science and Technology base and Talent Project(AD22080047)the National Natural Science Foundation of Guangxi Province(2023GXNFSBA 026063)+1 种基金the Innovation Funds of Chinese University(2021BCF03001)the special foundation for Guangxi Ba Gui Scholars.
文摘A cautious projection BFGS method is proposed for solving nonconvex unconstrained optimization problems.The global convergence of this method as well as a stronger general convergence result can be proven without a gradient Lipschitz continuity assumption,which is more in line with the actual problems than the existing modified BFGS methods and the traditional BFGS method.Under some additional conditions,the method presented has a superlinear convergence rate,which can be regarded as an extension and supplement of BFGS-type methods with the projection technique.Finally,the effectiveness and application prospects of the proposed method are verified by numerical experiments.
文摘In this paper,I consider the Hölder continuity of the Lyapunov exponent for a quasi-periodic Szegö cocycle with weak Liouville frequency.I extend the existing results about the regularity of the Lyapunov exponent from the Schrödinger cocycle in[24]to a Szegö cocycle.
基金support from the National Natural Science Foundation of China (No.11972020)the Natural Science Foundation of Shanghai,China (No.21ZR1424100).
文摘Regarding laminated structures,an electromechanically coupled Finite Element(FE)model based on Layerwise Third-Order Shear Deformation(LW-TOSD)theory is proposed for sta-tic and dynamic analysis.LW-TOSD ensures the continuity of in-plane displacements and trans-verse shear stresses.The current LW-TOSD can be applied to arbitrary multi-layer laminated structures with only seven Degrees of Freedom(DOFs)for each element node and eliminates the use of the shear correction factors.Moreover,a shear penalty stiffness matrix is constructed to sat-isfy artificial constraints to optimize the structural shear strain.A dynamic finite element model is obtained based on LW-TOSD using the Hamilton's principle.First,the accuracy of the current model is validated by comparing with literature and ABAQUS results.Then,this study carries out numerical investigations of piezolaminated structures for different width-to-thickness ratios,length-to-width ratios,penalty stiffness matrix,boundary conditions,electric fields and dynamics.
基金Supported by NSF of Zhejiang Province of China(LQ18A010002,LQ17A010002)。
文摘This paper focuses on the continuity of the truncated Hardy-Littlewood maximal function.We first show that the truncated Hardy-Littlewood maximal function is lower semi-continuous.Then by investigating the behavior of the truncated Hardy-Littlewood maximal function when the truncated parameterγchanges,we obtain an equivalent condition of the continuity of the truncated Hardy-Littlewood maximal function.
文摘Background: Continuity of care is a distinguishing feature of primary care. Better continuity of care program showed a significant effect in controlling diabetes and it is complications. This study explores the effect of continuity of care on control of diabetes mellites in primary health care centres. Objectives: 1) To assess the effect of Continuity of care on controlling haemoglobin (Hb A1C) and fasting blood Sugar (FBS);2) To compare the control of Diabetes by using (Hb A1C and FBS) indices on same patient before and after application of chronic illness clinic;3) To identify the relation between age and gender affecting continuity of care in diabetic patient. Methods: It is a Prospective cohort study design. Included both gender and diabetic patient age above 24 years old. The data extracted from health care specialty center (HCSC) clinics in National guard hospital at Riyadh, through HCSC data base on three phases: 1) Phase 1: the data extracted of diabetic patients from October to November 2022 including MRN, diabetic patient, age, Hb A1C, Fasting blood glucose. 2) Phase 2: the same MRN extracted from phase 1 was extracted again retrospectively for six months from April to September 2022, to compare the indices before implanting the chronic illness clinic including Hb A1C, Fasting blood glucose. 3) Phase 3: prospectively from December 2022 to September 2023. Results: Among diabetic patients aged 60 years old and above showed better control of HbA1C and FBS comparing to these patients below age of 60 years old, with significant improvement of HbA1C after implanting chronic illness clinic. Conclusion: The significant improvement in the control of diabetic patients followed in primary health care centers reinforce the evidence of the importance of continuity of care.
文摘Objective: To explore the impact of the WeChat platform continuity of care model based on the KAP (knowledge, attitudes, and practices) theory on the self-management of stroke patients with hypertension after discharge from the hospital. Methods: 62 stroke patients with hypertension discharged from the rehabilitation department of a tertiary A hospital in Nanning City, Guangxi Zhuang Autonomous Region, from October 2022 to April 2023 were sampled by convenience sampling method. Patients discharged from Rehabilitation I were included in the control group, and conventional nursing care was used;while patients discharged from Rehabilitation II were included in the observation group, and WeChat platform continuity of nursing care model based on the KAP theory was implemented. The intervention effect of the two groups was compared. Results: After 4 and 12 weeks of intervention, the diastolic and systolic blood pressure of the patients in the observation group were lower than those in the control group (P < 0.05);after 12 weeks of intervention, the rate of medication adherence and the score of adherence to hypertension treatment in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion: The application of the WeChat platform continuity of care model based on KAP theory to stroke patients with hypertension can improve blood pressure, medication adherence rate, hypertension treatment adherence, and overall enhance the self-management level of these patients.
文摘Objective:To explore the impact of a continuity of care model on negative emotions and self-efficacy in patients undergoing digestive endoscopic tumor resection.Methods:A retrospective analysis was conducted on 80 patients who underwent digestive endoscopic tumor resection in the Gastroenterology Department of Baoying County People’s Hospital between October 2022 and October 2024.Patients were randomly divided into a control group(n=40)and an observation group(n=40)using a random number table.The control group received routine nursing care,while the observation group was additionally provided with continuity of care interventions.After two months of intervention,the negative emotions and self-efficacy of the two groups were compared and statistically analyzed.Results:There was no statistically significant difference in baseline data between the two groups(P>0.05).After two months of intervention,the observation group demonstrated significantly lower HAMD and HAMA scores compared to the control group(both P=0.000),and significantly higher GSES scores(P=0.000).Conclusion:Applying a continuity of care model to patients undergoing digestive endoscopic tumor resection can alleviate negative emotions,enhance self-efficacy,and improve self-care abilities.
文摘Objective:To analyze the effect of continuity of care in the cardiac intensive care unit(CICU)on improving cognitive function and psychological state in patients with heart failure(HF).Methods:A total of 112 chronic HF patients admitted to the CICU of Xuzhou Traditional Chinese Medicine Hospital from July 2022 to August 2024 were selected and randomly divided into two groups using the red and blue ball method:a control group(n=56)and a study group(n=56).The control group received routine CICU nursing management,while the study group received routine CICU nursing combined with continuity of care management.Cognitive function(using the Montreal Cognitive Assessment,MoCA),psychological state(using the Self-Rating Depression Scale,SDS,and Self-Rating Anxiety Scale,SAS),and quality of life(using the Minnesota Living with Heart Failure Questionnaire,MLHFQ)were compared between the two groups.Results:After the intervention,the cognitive function scores of the study group were significantly higher than those of the control group(P<0.05).The SDS and SAS scores of the study group were significantly lower than those of the control group after the intervention(P<0.05).The quality of life in the study group was also significantly better than in the control group(P<0.05).Conclusion:CICU continuity of care can effectively improve cognitive function and psychological state in patients with HF,while also enhancing their quality of life.
基金supported by an NSERC granta startup fund of University of Albertasupported by Martin Hairer’s Leverhulme Trust leadership award
文摘We obtain the H?lder continuity and joint H?lder continuity in space and time for the random field solution to the parabolic Anderson equation ■ in d-dimensional space, where ■ is a mean zero Gaussian noise with temporal covariance γ0 and spatial covariance given by a spectral density μ(ξ). We assume that ■ and ■ , where αi, i = 1, · · ·, d(or α) can take negative value.
文摘An example is presented to introduce the concept of implicit continuity proposed as contrasted with the explicit continuity.A sufficient and necessary condition of the implicit continuity is given and proved in forms of implicit system.This condition also offers the solution of initial values at the points where the dynamic system is discontinuous.Some discussions are contributed to the physical significance of implicit continuity.
文摘It is shown that an arbitrary function from D Rn to Rm will become C0,a-continuous in almost every x∈ D after restriction to a certain subset with limit pointx. For n 〉 m differentiability can be obtained. Examples show the Ho1der exponent a=min{1,n/m}is optimal.
文摘The aim of this work is to introduce some weak forms of continuity in bitopological spaces. Then we use these new forms of weak continuity to give many decompositions of?i-continuity and pairwise continuity.
文摘Planning and implementation as well as increased control over the Business Continuity Management （BCM） is a complex task in the company requiring adequate resources. BCM aims to reduce risks and develops plans for restoring business activities if they are interrupted by a disaster. The purpose of the paper is to analyze and describe two standards, Information Technology Infrastructure Library （ITIL） and Control Objectives for Information and Related Technology （COBIT）, especially their mapping for the improved planning and implementation of the BCM as well as the increased control over the BCM activities. COBIT is used more as a management framework, providing management tools, such as control objectives, metrics and maturity models in order to complement the control framework. ITIL includes process steps and tasks because it is more oriented towards IT processes （process framework）, defining the best practice for IT service management. Within this mapping, ITIL processes may be used to achieve and demonstrate compliance with COBIT control objectives for BCM process.
基金This work is sponsored by National Natural Science Foundation of China （No. 40874056）, Important National Science ＆ Technology Specific Projects 2008ZX05023-005-004, and the NCET Fund.Acknowledgements The authors are grateful to Liu Yang, and Zhu Sheng-wang for their constructive remarks on this manuscript.
文摘The Lt-norm method is one of the widely used matching filters for adaptive multiple subtraction. When the primaries and multiples are mixed together, the L1-norm method might damage the primaries, leading to poor lateral continuity. In this paper, we propose a constrained L1-norm method for adaptive multiple subtraction by introducing the lateral continuity constraint for the estimated primaries. We measure the lateral continuity using prediction-error filters （PEF）. We illustrate our method with the synthetic Pluto dataset. The results show that the constrained L1-norm method can simultaneously attenuate the multiples and preserve the primaries.
基金supported by the National Natural Science Foundation of Chin-China Aerospace Science and Technology Corporation on Advance Manufacturing(No.U1537209)National Natural Science Foundation of China(No.51775278)Jiangsu Province Outstanding Youth Fund of China(No.BK20140036).
文摘In order to ensure machining stability,curvature continuity and smooth cutting force are very important so as to meet the constraints of both cutting force and kinematics of machine tools.For five-axis flank milling,it is difficult to meet both of the constraints because tool path points and tool axis vectors interact with each other.In this paper,multiple relationships between tool path points and tool axis vectors with cutting force and kinematics of machine tools are established,and the strategies of corner-looping milling and clothoidal spirals are combined so as to find feasible solutions under both of the constraints.Tool path parameters are iterated by considering the maximum cutting force and the feasible range of the tool axis vector,and eventually a curvature continuity five-axis flank milling tool path with smooth cutting force is generated.Machining experimental results show that the conditions of cutting force are satisfied,vibration during the process of machining is reduced,and the machining quality of the surface is improved.
