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
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
Hematopoietic cell transplantation(HCT)is the curative cornerstone for a wide spectrum of high-risk hematological malignancies and selected non-malignant disorders(1).As indications expand and survival improves,HCT su...Hematopoietic cell transplantation(HCT)is the curative cornerstone for a wide spectrum of high-risk hematological malignancies and selected non-malignant disorders(1).As indications expand and survival improves,HCT survivors increasingly face chronic complications,psychosocial distress,and long-term quality-of-life impairments that demand continuous,multidisciplinary management(2,3).However,the rapid evolution of transplantation contrasts sharply with the lag in specialized nursing capacity,credentialing,and governance systems in China.This commentary integrates national policy directives,recent workforce data,and clinical experience to examine current deficits,highlights the clinical value of nurse-led continuity-of-care,and proposes a sustainable framework for hematology specialist nurse-driven HCT care.展开更多
The snapshot Fault Detection(FD)algorithm of Advanced Receiver Autonomous Integrity Monitoring(ARAIM)necessitates the allocation of continuity and integrity risk requirements from the operational exposure time level t...The snapshot Fault Detection(FD)algorithm of Advanced Receiver Autonomous Integrity Monitoring(ARAIM)necessitates the allocation of continuity and integrity risk requirements from the operational exposure time level to the single epoch level.Current studies primarily focus on finding a conservative Number of Effective Samples(NES)as a risk mapping factor.However,considering that the NES varies with the observation environment and the type of the fault mode,applying a fixed NES can constrain the performance of the algorithm.To address this issue,the continuity and integrity risks over the operational exposure time are analyzed and bounded based on all epochs within the exposure time.A more adaptable method for continuity and integrity budget allocation over the operational exposure time is presented,capable of monitoring the continuity and integrity risks over the recent operational exposure time in real time,and dynamically adjusting the allocation values based on the current observation environment.Simulation results demonstrate that,compared with the allocation method based on a fixed NES,ARAIM based on the proposed allocation method exhibits superior performance in terms of the availability.At an FD execution frequency equal to the required Time-To-Alert(TTA),the dual-constellation H-ARAIM provides 100%of the global coverage with 99.5%availability of the RNP 0.1 service,and the dual-constellation V-ARAIM provides 86.38%of the global coverage with 99.5%availability of the LPV-200 service.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
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.
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Hematopoietic cell transplantation(HCT)is the curative cornerstone for a wide spectrum of high-risk hematological malignancies and selected non-malignant disorders(1).As indications expand and survival improves,HCT survivors increasingly face chronic complications,psychosocial distress,and long-term quality-of-life impairments that demand continuous,multidisciplinary management(2,3).However,the rapid evolution of transplantation contrasts sharply with the lag in specialized nursing capacity,credentialing,and governance systems in China.This commentary integrates national policy directives,recent workforce data,and clinical experience to examine current deficits,highlights the clinical value of nurse-led continuity-of-care,and proposes a sustainable framework for hematology specialist nurse-driven HCT care.
基金supported by the National Key Research and Development Program of China(No.2023YFB4302804)the National Natural Science Foundation of China(Nos.U2233217,62371029,62471023,62301016,and 62101015)。
文摘The snapshot Fault Detection(FD)algorithm of Advanced Receiver Autonomous Integrity Monitoring(ARAIM)necessitates the allocation of continuity and integrity risk requirements from the operational exposure time level to the single epoch level.Current studies primarily focus on finding a conservative Number of Effective Samples(NES)as a risk mapping factor.However,considering that the NES varies with the observation environment and the type of the fault mode,applying a fixed NES can constrain the performance of the algorithm.To address this issue,the continuity and integrity risks over the operational exposure time are analyzed and bounded based on all epochs within the exposure time.A more adaptable method for continuity and integrity budget allocation over the operational exposure time is presented,capable of monitoring the continuity and integrity risks over the recent operational exposure time in real time,and dynamically adjusting the allocation values based on the current observation environment.Simulation results demonstrate that,compared with the allocation method based on a fixed NES,ARAIM based on the proposed allocation method exhibits superior performance in terms of the availability.At an FD execution frequency equal to the required Time-To-Alert(TTA),the dual-constellation H-ARAIM provides 100%of the global coverage with 99.5%availability of the RNP 0.1 service,and the dual-constellation V-ARAIM provides 86.38%of the global coverage with 99.5%availability of the LPV-200 service.
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.
