This study aimed to determine the reliability,validity and measurement invariance of scores from the Difficulties in Emotion Regulation Scale-8 in Chinese context.A total of 1114 Chinese adolescents were participants ...This study aimed to determine the reliability,validity and measurement invariance of scores from the Difficulties in Emotion Regulation Scale-8 in Chinese context.A total of 1114 Chinese adolescents were participants in three phases:N=424 for the initial DERS-8 measure completion;N=586 the DERS-8,General Anxiety Disorder Scale,Depression Scale and Emotion Regulation Scale completion,with an interval of one month.Then an additional 104 adolescents also completed DERS-8,General Anxiety Disorder Scale,Depression Scale and Emotion Regulation Scale.Both exploratory and confirmatory factor analyses confirmed the one-factor model of the scale,and the fitness indicators wereχ^(2)/df=4.05,RMSEA=0.07,CFI=0.98,and TLI=0.97.Each item of the DERS-8 had good discrimination.The internal consistency reliability coefficient,split-half reliability coefficient and test-retest reliability coefficient of the scale scores were 0.90,0.87 and 0.66,respectively.The findings suggest the Chinese version of the DERS-8 is a reliable measure of difficulty of emotion regulation in Chinese adolescents.展开更多
This study investigated the differences between children with and without learning difficulties(LD)regarding academic performance(AP)and sleep quality(SLQ).A total of 1,501 children were evaluated,including 810 with L...This study investigated the differences between children with and without learning difficulties(LD)regarding academic performance(AP)and sleep quality(SLQ).A total of 1,501 children were evaluated,including 810 with LD and 691 without LD.The results indicated that children with LD scored significantly lower in AP and had poorer sleep quality,with greater variability in SLQ patterns.Correlation analysis revealed a significant negative association between sleep quality and academic performance(r=-0.646;p<0.01),indicating that poorer sleep quality is related to lower academic performance.These findings underscore the importance of interventions focused on promoting sleep hygiene and consistent routines to mitigate the negative impacts of learning difficulties.Study limitations include the absence of mediating variables,such as screen time and mental health,suggesting the need for future research exploring longitudinal interventions and associated factors.展开更多
Monitoring adverse drug reactions(ADRs)in primary medical institutions is crucial to ensuring medication safety.Currently,this work faces difficulties such as insufficient professional ability of staff,imperfect monit...Monitoring adverse drug reactions(ADRs)in primary medical institutions is crucial to ensuring medication safety.Currently,this work faces difficulties such as insufficient professional ability of staff,imperfect monitoring systems,and low patient awareness.It is necessary to improve the level of ADR monitoring at the grassroots level and ensure the safety and effectiveness of medication through countermeasures such as strengthening personnel training,optimizing monitoring processes,and raising public awareness.展开更多
The purpose of this research is to analyze the causal mechanisms of learning difficulties of middle school students and use them to propose strategies to help them.This research is particularly valuable for its focus ...The purpose of this research is to analyze the causal mechanisms of learning difficulties of middle school students and use them to propose strategies to help them.This research is particularly valuable for its focus on middle school students.Research on this critical transition period is often lacking compared to primary and high school.Therefore,this research establishes a structured equation model and analyzes the data from the survey using the partial least squares method.The data were obtained from a 13,900 Wenzhou City,China students’questionnaire.The research found that learning strategies were the most significant influences on learning effectiveness,followed by learning motivation and learning relationships.Meanwhile,learning relationships had a significant impact on learning pressure.Therefore,this research proposes targeted support strategies.It aims to enhance learning motivation(Set achievable learning goals for each student with learning difficulties based on their actual situation),optimize learning strategies(Encourage students with learning difficulties to learn self-regulatory strategies such as goal setting,time management,and self-reflection),and improve learning relationships(Establish a good social network to promote positive interaction between students with learning difficulties and their peers).At the same time,it reduces students’learning pressure.Ultimately,the learning effectiveness of students with learning difficulties is improved.展开更多
Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is ...Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system’s anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.展开更多
BACKGROUND Colorectal surgeons are well aware that performing surgery for rectal cancer becomes more challenging in obese patients with narrow and deep pelvic cavities.Therefore,it is essential for colorectal surgeons...BACKGROUND Colorectal surgeons are well aware that performing surgery for rectal cancer becomes more challenging in obese patients with narrow and deep pelvic cavities.Therefore,it is essential for colorectal surgeons to have a comprehensive understanding of pelvic structure prior to surgery and anticipate potential surgical difficulties.AIM To evaluate predictive parameters for technical challenges encountered during laparoscopic radical sphincter-preserving surgery for rectal cancer.METHODS We retrospectively gathered data from 162 consecutive patients who underwent laparoscopic radical sphincterpreserving surgery for rectal cancer.Three-dimensional reconstruction of pelvic bone and soft tissue parameters was conducted using computed tomography(CT)scans.Operative difficulty was categorized as either high or low,and multivariate logistic regression analysis was employed to identify predictors of operative difficulty,ultimately creating a nomogram.RESULTS Out of 162 patients,21(13.0%)were classified in the high surgical difficulty group,while 141(87.0%)were in the low surgical difficulty group.Multivariate logistic regression analysis showed that the surgical approach using laparoscopic intersphincteric dissection,intraoperative preventive ostomy,and the sacrococcygeal distance were independent risk factors for highly difficult laparoscopic radical sphincter-sparing surgery for rectal cancer(P<0.05).Conversely,the anterior-posterior diameter of pelvic inlet/sacrococcygeal distance was identified as a protective factor(P<0.05).A nomogram was subsequently constructed,demonstrating good predictive accuracy(C-index=0.834).CONCLUSION The surgical approach,intraoperative preventive ostomy,the sacrococcygeal distance,and the anterior-posterior diameter of pelvic inlet/sacrococcygeal distance could help to predict the difficulty of laparoscopic radical sphincter-preserving surgery.展开更多
The posttreatment period is a key part of the management of pediatric cancer.During this time,school and psychological difficulties have been described in childhood cancer survivors(CCS)and can be prognostic for the s...The posttreatment period is a key part of the management of pediatric cancer.During this time,school and psychological difficulties have been described in childhood cancer survivors(CCS)and can be prognostic for the success of social reintegration.This study estimated the influence of the household’s socioeconomic status(SES)on these psychosocial difficulties.This study is based on a prospective multicentric database and focused on children who received a psychosocial evaluation during their follow-up from 2013 to 2020.We retrieved data on school and psychological difficulties.Household SES was estimated by a social deprivation score.Data from1003 patients were analyzed.School difficulties were noted in 22%of CCS.A greater social deprivation was significantly associated with school difficulty.Tumor relapse,treatment with hematopoietic stem cell transplantation,and central nervous system(CNS)tumors remained significant risk factors.In the subgroup of CNS tumors,school difficulties were increased and associated with greater social deprivation.Psychological difficulties were not associated with the deprivation score.There is a link between SES and school difficulties in CCS.Further investigations should be carried out for children with CNS tumors,which is the population of the greatest concern.展开更多
Background:Given the heightened risk of developmental challenges associated with preterm birth,it is crucial to explore interventions that may ameliorate potential adverse outcomes.This study aimed to examine whether ...Background:Given the heightened risk of developmental challenges associated with preterm birth,it is crucial to explore interventions that may ameliorate potential adverse outcomes.This study aimed to examine whether meeting the 24-h movement behavior(24-HMB)guidelines,which include recommendations on physical activity(PA),screen time(ST),and sleep(SL),is related to indicators of cognitive difficulties,internalizing problems(e.g.,depression and anxiety),and externalizing problems(e.g.,difficulties in making friends and arguing)in a sample of preterm youth(children and adolescents born preterm).Methods:In this cross-sectional study,data from 3410 preterm youth(aged 6 to 17 years)were included for data analyses.Multivariable logistic regression was used to investigate associations between meeting the 24-HMB guidelines and the above-mentioned health outcomes,while controlling for sociodemographic and health-related factors.Results:The prevalence of meeting 24-HMB guidelines varied across independent and integrated components of the 24-HMB guidelines.Meeting the ST guideline alone(p<0.05)and integrated guidelines(i.e.,ST+SL and ST+SL+PA)were associated with fewer cognitive difficulties and reduced internalizing and externalizing problems(p<0.05).Specifically,meeting the SL guideline alone and integrated guidelines(i.e.,SL+ST)were associated with lower odds of depression and anxiety(p<0.01).Additionally,meeting independent,and integrated(PA and/or ST)guidelines were associated with less pronounced difficulties in making friends and arguing(p<0.05).Meeting 24-HMB guidelines in an isolated and integrated manner are linked to better cognitive performance and fewer internalizing and externalizing problems in preterm youth.Conclusion:Results suggest that advocating for the implementation of the 24-HMB guidelines may reduce cognitive challenges and behavioral issues,which is of high relevance for improving public health.Future longitudinal studies in preterm youth should investigate how modifying specific 24-HMB behaviors,especially ST,influence cognitive difficulties,internalizing and externalizing problems in this vulnerable population.展开更多
BACKGROUND For intrahepatic duct(IHD)stones,laparoscopic liver resection(LLR)is currently a reliable treatment.However,the current LLR difficulty scoring system(DSS)is only available for patients with hepatocellular c...BACKGROUND For intrahepatic duct(IHD)stones,laparoscopic liver resection(LLR)is currently a reliable treatment.However,the current LLR difficulty scoring system(DSS)is only available for patients with hepatocellular carcinoma.AIM To explore the development of a DSS for IHD stone patients with LLR and the validation of its reliability.METHODS We used clinical data from 80 patients who received LLR for IHD stones.Forty-six of these patients were used in multiple linear regression to construct a scoring system.Another 34 patients from different centers were used as external validation.The completeness of our DSS was then evaluated in patients with varying degrees of surgical difficulty based on documented surgical outcomes in the study group of patients.RESULTS The following five predictors were ultimately included and scored by calculating the weighted contribution of each factor to the prediction of operative time in the training cohort:Location of stones,number of stones≥3,stones located in the bile ducts of several grades,previous biliary surgery less than twice,distal bile duct atrophy.Subsequently,the data set was validated using a DSS developed from the variables.The following variables were identified as statistically significant in external validation:Operative time,blood loss,intraoperative transfusion,postoperative alanine aminotransferase,and Clavien-Dindo grading≥3.These variables demonstrated statistically significant differences in patients with three or more grades.CONCLUSION Patients with IHD stones have varying degrees of surgical difficulty,and the newly developed DSS can be validated with external data to effectively predict risks and complications after LLR surgery.展开更多
Objective: To study the application effect of mouth-opening training sticks combined with oral massage on patients with mouth-opening difficulty after treatment for head and neck cancer. Methods: Using convenient samp...Objective: To study the application effect of mouth-opening training sticks combined with oral massage on patients with mouth-opening difficulty after treatment for head and neck cancer. Methods: Using convenient sampling, 60 patients with mouth-opening difficulty after treatment for head and neck cancer admitted to the Oncology Department from February 2022 to October 2023 were selected for a 2-week exercise and nursing program. The patients were divided into a control group (February 1, 2022 to November 30, 2022) and an observation group (December 1, 2022 to October 31, 2023), with 30 patients in each group. The control group underwent routine mouth-opening functional exercises combined with cork for oral support training, while the observation group underwent routine mouth-opening functional exercises combined with oral massage and mouth-opening training sticks for oral support training. The mouth-opening degree, mouth-opening difficulty level, comfort level, compliance, and quality of life were observed in both groups. Results: Before the intervention, there were no statistically significant differences in mouth-opening degree and mouth-opening difficulty level between the two groups (P > 0.05). After the intervention, the mouth-opening degree, mouth-opening difficulty level, oral comfort level, compliance, and QLICP-HN scores in the observation group were all better than those in the control group, with statistically significant differences (P < 0.05). Conclusion: The combination of mouth-opening training sticks and oral massage with mouth-opening functional exercises can effectively improve the degree of mouth-opening difficulty, enhance oral comfort, increase compliance with mouth-opening exercises, and improve quality of life.展开更多
According to the physics of tokamak start-up,this study constructs a zero-dimensional(0D)model applicable to electron cyclotron(EC)wave assisted start-up in NCST spherical torus(spherical tokamak)and CN-H1 stellarator...According to the physics of tokamak start-up,this study constructs a zero-dimensional(0D)model applicable to electron cyclotron(EC)wave assisted start-up in NCST spherical torus(spherical tokamak)and CN-H1 stellarators.Using the constructed 0D model,the results obtained in this study under the same conditions are compared and validated against reference results for pure hydrogen plasma start-up in tokamak.The results are in good agreement,especially regarding electron temperature,ion temperature and plasma current.In the presence of finite Ohmic electric field in the spherical tokamak,a study on the EC wave assisted start-up of the NCST plasma at frequency of 28 GHz is conducted.The impact of the vertical magnetic field B_(v)on EC wave assisted start-up,the relationship between EC wave injection power P_(inj),Ohmic electric field E,and initial hydrogen atom density n_(H0)are explored separately.It is found that under conditions of Ohmic electric field lower than ITER(~0.3 V m^(-1)),EC wave can expand the operational space to achieve better plasma parameters.Simulating the process of28 GHz EC wave start-up in the CN-H1 stellarator plasma,the plasma current in the zerodimensional model is replaced with the current in the poloidal coil of the stellarator.Plasma startup can be successfully achieved at injection powers in the hundreds of kilowatts range,resulting in electron densities on the order of 10^(17)-10^(18)m^(-3).展开更多
Solid rocket motors have important applications in the propulsion of trans-media vehicles and underwater launched rockets.In this paper,the ignition start-up process of an underwater solid rocket motor across a wide d...Solid rocket motors have important applications in the propulsion of trans-media vehicles and underwater launched rockets.In this paper,the ignition start-up process of an underwater solid rocket motor across a wide depth range has been numerically studied.A novel multi-domain integrated model has been developed by combining the solid propellant ignition and combustion model with the volume of fluid multiphase model.This integrated model enables the coupled simulation of the propellant combustion and gas flow inside the motor,along with the gas jet evolution in the external water environment.The detailed flow field developments in the combustion chamber,nozzle,and wake field are carefully analyzed.The variation rules of the internal ballistics and thrust performance are also obtained.The effects of environmental medium and operating depth on the ignition start-up process are systematically discussed.The results show that the influence of the operating environment on the internal ballistic characteristics is primarily reflected in the initial period after the nozzle closure opens.The development of the gas jet in water lags significantly compared with that in air.As the water depth increases,the ignition delay time of the motor is shortened,and the morphology evolution of the gas jet is significantly compressed and accelerated.Furthermore,the necking and bulging of the jet boundary near the nozzle outlet and the consequent shock oscillations are intensified,resulting in stronger fluctuations in the wake pressure field and motor thrust.展开更多
This experimental study investigated how text difficulty and different working memory capacity(WMC)affected Chinese EFL learners’reading comprehension and their tendency to engage in task-unrelated thoughts,that is,m...This experimental study investigated how text difficulty and different working memory capacity(WMC)affected Chinese EFL learners’reading comprehension and their tendency to engage in task-unrelated thoughts,that is,mind wandering(MW),in the course of reading.Sixty first-year university non-English majors participated in the study.A two-factor mixed experimental design of 2(text difficulty:difficult and simple)×2(WMC:high/large and low/small)was employed.Results revealed that 1)the main and interaction effects of WMC and text difficulty on voluntary MW were significant,whereas those on involuntary MW were not;2)while reading the easy texts,the involuntary MW of high-WMC individuals was less frequent than that of low-WMC ones,whereas while reading the difficult ones,the direct relationship between WMC and involuntary MW was not found;and that 3)high-WMC individuals had a lower overall rate of MW and better reading performance than low-WMC individuals did,but with increasing text difficulty,their rates of overall MW and voluntary MW were getting higher and higher,and the reading performance was getting lower and lower.These results lend support to WM theory and have pedagogical implications for the instruction of L2 reading.展开更多
The school placement processes of students from immigrant backgrounds considered to be in“difficulty”is an international concern at the intersection of works relating to special education and those concerning the sc...The school placement processes of students from immigrant backgrounds considered to be in“difficulty”is an international concern at the intersection of works relating to special education and those concerning the school experiences of students from immigrant backgrounds or racialized groups.The research problem of this article concerns the identification of these students as disabled or as having adjustment or learning difficulties.From a perspective anchored in Disability Critical Race Studies,this ethnographic study documents different interpretations of perceived difficulties made by school actors with regard to seven primary school students from immigrant backgrounds.Five interpretation types are presented:(1)medicalization by dismissal of cultural markers,(2)medicalization by professional constraint,(3)medicalization by cultural deficit,(4)precautionary wait,and(5)cultural differentialism.Our results help to shed light on the special education overrepresentation phenomenon regarding these students and to understand how ableism and(neo)racism contribute to it.展开更多
The purpose of this study is to determine the teacher’s perceptions of the challenges and strategies in supporting students with reading difficulties.This study used qualitative method of research and descriptive app...The purpose of this study is to determine the teacher’s perceptions of the challenges and strategies in supporting students with reading difficulties.This study used qualitative method of research and descriptive approach as its research design,in addition to a set of structured interview questions administered through Google Forms to gather data from elementary teachers of Taal Central School,located at Taal Batangas.These structured interview questions were carefully designed to cover various dimensions of the study,including the types of challenges perceived by teachers,strategies employed,and possible solutions for addressing the problems encountered in the process of supporting students with reading difficulties.The results revealed that teachers faced several challenges when teaching students with reading difficulties such as emotional and motivational issues/factors,lack of resources or teaching aids,deficits in knowledge and skills,and problems with student engagement and participation.This study also showed common approaches utilized by the teachers in supporting students with reading difficulties,which were fostering a positive and supportive environment,adopting individualized and multifaceted approaches,and utilizing effective teaching tools and strategies.Lastly,teachers also concluded varied solutions in addressing the challenges perceived in teaching students with reading difficulties towards fostering reading proficiency.These include developing peer support,use of positive reinforcement,and parental involvement.Moreover,specialized resources,professional development for teachers,and specific teaching strategies are also highlighted as crucial components.By integrating these approaches,teachers concluded that it can create a supportive and effective learning environment tailored to the needs of students with reading difficulties.展开更多
基金funded by Science Research Project of Hebei Education Department(BJ2025238)Humanities and Social Science Research Project of Hebei Normal University(S24YX002)Humanities and Social Science Research Foundation of Hebei Normal University(S22B019).
文摘This study aimed to determine the reliability,validity and measurement invariance of scores from the Difficulties in Emotion Regulation Scale-8 in Chinese context.A total of 1114 Chinese adolescents were participants in three phases:N=424 for the initial DERS-8 measure completion;N=586 the DERS-8,General Anxiety Disorder Scale,Depression Scale and Emotion Regulation Scale completion,with an interval of one month.Then an additional 104 adolescents also completed DERS-8,General Anxiety Disorder Scale,Depression Scale and Emotion Regulation Scale.Both exploratory and confirmatory factor analyses confirmed the one-factor model of the scale,and the fitness indicators wereχ^(2)/df=4.05,RMSEA=0.07,CFI=0.98,and TLI=0.97.Each item of the DERS-8 had good discrimination.The internal consistency reliability coefficient,split-half reliability coefficient and test-retest reliability coefficient of the scale scores were 0.90,0.87 and 0.66,respectively.The findings suggest the Chinese version of the DERS-8 is a reliable measure of difficulty of emotion regulation in Chinese adolescents.
文摘This study investigated the differences between children with and without learning difficulties(LD)regarding academic performance(AP)and sleep quality(SLQ).A total of 1,501 children were evaluated,including 810 with LD and 691 without LD.The results indicated that children with LD scored significantly lower in AP and had poorer sleep quality,with greater variability in SLQ patterns.Correlation analysis revealed a significant negative association between sleep quality and academic performance(r=-0.646;p<0.01),indicating that poorer sleep quality is related to lower academic performance.These findings underscore the importance of interventions focused on promoting sleep hygiene and consistent routines to mitigate the negative impacts of learning difficulties.Study limitations include the absence of mediating variables,such as screen time and mental health,suggesting the need for future research exploring longitudinal interventions and associated factors.
文摘Monitoring adverse drug reactions(ADRs)in primary medical institutions is crucial to ensuring medication safety.Currently,this work faces difficulties such as insufficient professional ability of staff,imperfect monitoring systems,and low patient awareness.It is necessary to improve the level of ADR monitoring at the grassroots level and ensure the safety and effectiveness of medication through countermeasures such as strengthening personnel training,optimizing monitoring processes,and raising public awareness.
基金2025 Wenzhou Key Research Base of Philosophy and Social Science(Wenzhou University Learning Science and Technology Research Centre)Research Project:Investigation and Strategy Research on the Causes of Middle School Students’Learning Difficulties in the Context of the Leading Country in Education.
文摘The purpose of this research is to analyze the causal mechanisms of learning difficulties of middle school students and use them to propose strategies to help them.This research is particularly valuable for its focus on middle school students.Research on this critical transition period is often lacking compared to primary and high school.Therefore,this research establishes a structured equation model and analyzes the data from the survey using the partial least squares method.The data were obtained from a 13,900 Wenzhou City,China students’questionnaire.The research found that learning strategies were the most significant influences on learning effectiveness,followed by learning motivation and learning relationships.Meanwhile,learning relationships had a significant impact on learning pressure.Therefore,this research proposes targeted support strategies.It aims to enhance learning motivation(Set achievable learning goals for each student with learning difficulties based on their actual situation),optimize learning strategies(Encourage students with learning difficulties to learn self-regulatory strategies such as goal setting,time management,and self-reflection),and improve learning relationships(Establish a good social network to promote positive interaction between students with learning difficulties and their peers).At the same time,it reduces students’learning pressure.Ultimately,the learning effectiveness of students with learning difficulties is improved.
文摘Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system’s anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.
基金Institutional review board statement:The study was reviewed and approved by the Wenzhou Central Hospital Institutional Review Board(Approval No.K2018-01-003).
文摘BACKGROUND Colorectal surgeons are well aware that performing surgery for rectal cancer becomes more challenging in obese patients with narrow and deep pelvic cavities.Therefore,it is essential for colorectal surgeons to have a comprehensive understanding of pelvic structure prior to surgery and anticipate potential surgical difficulties.AIM To evaluate predictive parameters for technical challenges encountered during laparoscopic radical sphincter-preserving surgery for rectal cancer.METHODS We retrospectively gathered data from 162 consecutive patients who underwent laparoscopic radical sphincterpreserving surgery for rectal cancer.Three-dimensional reconstruction of pelvic bone and soft tissue parameters was conducted using computed tomography(CT)scans.Operative difficulty was categorized as either high or low,and multivariate logistic regression analysis was employed to identify predictors of operative difficulty,ultimately creating a nomogram.RESULTS Out of 162 patients,21(13.0%)were classified in the high surgical difficulty group,while 141(87.0%)were in the low surgical difficulty group.Multivariate logistic regression analysis showed that the surgical approach using laparoscopic intersphincteric dissection,intraoperative preventive ostomy,and the sacrococcygeal distance were independent risk factors for highly difficult laparoscopic radical sphincter-sparing surgery for rectal cancer(P<0.05).Conversely,the anterior-posterior diameter of pelvic inlet/sacrococcygeal distance was identified as a protective factor(P<0.05).A nomogram was subsequently constructed,demonstrating good predictive accuracy(C-index=0.834).CONCLUSION The surgical approach,intraoperative preventive ostomy,the sacrococcygeal distance,and the anterior-posterior diameter of pelvic inlet/sacrococcygeal distance could help to predict the difficulty of laparoscopic radical sphincter-preserving surgery.
基金supported by a grant from SFCE INCa (Institut National du Cancer)GOCE (Grand Ouest Cancer de l’Enfant).
文摘The posttreatment period is a key part of the management of pediatric cancer.During this time,school and psychological difficulties have been described in childhood cancer survivors(CCS)and can be prognostic for the success of social reintegration.This study estimated the influence of the household’s socioeconomic status(SES)on these psychosocial difficulties.This study is based on a prospective multicentric database and focused on children who received a psychosocial evaluation during their follow-up from 2013 to 2020.We retrieved data on school and psychological difficulties.Household SES was estimated by a social deprivation score.Data from1003 patients were analyzed.School difficulties were noted in 22%of CCS.A greater social deprivation was significantly associated with school difficulty.Tumor relapse,treatment with hematopoietic stem cell transplantation,and central nervous system(CNS)tumors remained significant risk factors.In the subgroup of CNS tumors,school difficulties were increased and associated with greater social deprivation.Psychological difficulties were not associated with the deprivation score.There is a link between SES and school difficulties in CCS.Further investigations should be carried out for children with CNS tumors,which is the population of the greatest concern.
基金supported by the Shenzhen Educational Research Funding(Grant No.zdzb2014)the Shenzhen Science and Technology Innovation Commission(Grant No.202307313000096)+3 种基金the Social Science Foundation from China’s Ministry of Education(Grant No.23YJA880093)a Post-Doctoral Fellowship(Grant No.2022M711174)the National Center for Mental Health(Grant No.Z014)a Research Excellence Scholarship of Shenzhen University(Grant No.ZYZD2305).
文摘Background:Given the heightened risk of developmental challenges associated with preterm birth,it is crucial to explore interventions that may ameliorate potential adverse outcomes.This study aimed to examine whether meeting the 24-h movement behavior(24-HMB)guidelines,which include recommendations on physical activity(PA),screen time(ST),and sleep(SL),is related to indicators of cognitive difficulties,internalizing problems(e.g.,depression and anxiety),and externalizing problems(e.g.,difficulties in making friends and arguing)in a sample of preterm youth(children and adolescents born preterm).Methods:In this cross-sectional study,data from 3410 preterm youth(aged 6 to 17 years)were included for data analyses.Multivariable logistic regression was used to investigate associations between meeting the 24-HMB guidelines and the above-mentioned health outcomes,while controlling for sociodemographic and health-related factors.Results:The prevalence of meeting 24-HMB guidelines varied across independent and integrated components of the 24-HMB guidelines.Meeting the ST guideline alone(p<0.05)and integrated guidelines(i.e.,ST+SL and ST+SL+PA)were associated with fewer cognitive difficulties and reduced internalizing and externalizing problems(p<0.05).Specifically,meeting the SL guideline alone and integrated guidelines(i.e.,SL+ST)were associated with lower odds of depression and anxiety(p<0.01).Additionally,meeting independent,and integrated(PA and/or ST)guidelines were associated with less pronounced difficulties in making friends and arguing(p<0.05).Meeting 24-HMB guidelines in an isolated and integrated manner are linked to better cognitive performance and fewer internalizing and externalizing problems in preterm youth.Conclusion:Results suggest that advocating for the implementation of the 24-HMB guidelines may reduce cognitive challenges and behavioral issues,which is of high relevance for improving public health.Future longitudinal studies in preterm youth should investigate how modifying specific 24-HMB behaviors,especially ST,influence cognitive difficulties,internalizing and externalizing problems in this vulnerable population.
文摘BACKGROUND For intrahepatic duct(IHD)stones,laparoscopic liver resection(LLR)is currently a reliable treatment.However,the current LLR difficulty scoring system(DSS)is only available for patients with hepatocellular carcinoma.AIM To explore the development of a DSS for IHD stone patients with LLR and the validation of its reliability.METHODS We used clinical data from 80 patients who received LLR for IHD stones.Forty-six of these patients were used in multiple linear regression to construct a scoring system.Another 34 patients from different centers were used as external validation.The completeness of our DSS was then evaluated in patients with varying degrees of surgical difficulty based on documented surgical outcomes in the study group of patients.RESULTS The following five predictors were ultimately included and scored by calculating the weighted contribution of each factor to the prediction of operative time in the training cohort:Location of stones,number of stones≥3,stones located in the bile ducts of several grades,previous biliary surgery less than twice,distal bile duct atrophy.Subsequently,the data set was validated using a DSS developed from the variables.The following variables were identified as statistically significant in external validation:Operative time,blood loss,intraoperative transfusion,postoperative alanine aminotransferase,and Clavien-Dindo grading≥3.These variables demonstrated statistically significant differences in patients with three or more grades.CONCLUSION Patients with IHD stones have varying degrees of surgical difficulty,and the newly developed DSS can be validated with external data to effectively predict risks and complications after LLR surgery.
文摘Objective: To study the application effect of mouth-opening training sticks combined with oral massage on patients with mouth-opening difficulty after treatment for head and neck cancer. Methods: Using convenient sampling, 60 patients with mouth-opening difficulty after treatment for head and neck cancer admitted to the Oncology Department from February 2022 to October 2023 were selected for a 2-week exercise and nursing program. The patients were divided into a control group (February 1, 2022 to November 30, 2022) and an observation group (December 1, 2022 to October 31, 2023), with 30 patients in each group. The control group underwent routine mouth-opening functional exercises combined with cork for oral support training, while the observation group underwent routine mouth-opening functional exercises combined with oral massage and mouth-opening training sticks for oral support training. The mouth-opening degree, mouth-opening difficulty level, comfort level, compliance, and quality of life were observed in both groups. Results: Before the intervention, there were no statistically significant differences in mouth-opening degree and mouth-opening difficulty level between the two groups (P > 0.05). After the intervention, the mouth-opening degree, mouth-opening difficulty level, oral comfort level, compliance, and QLICP-HN scores in the observation group were all better than those in the control group, with statistically significant differences (P < 0.05). Conclusion: The combination of mouth-opening training sticks and oral massage with mouth-opening functional exercises can effectively improve the degree of mouth-opening difficulty, enhance oral comfort, increase compliance with mouth-opening exercises, and improve quality of life.
基金supported by the National Key Research and Development Program of China(Nos.2022YFE03070000 and 2022YFE03070003)National Natural Science Foundation of China(Nos.12375220 and 12075114)。
文摘According to the physics of tokamak start-up,this study constructs a zero-dimensional(0D)model applicable to electron cyclotron(EC)wave assisted start-up in NCST spherical torus(spherical tokamak)and CN-H1 stellarators.Using the constructed 0D model,the results obtained in this study under the same conditions are compared and validated against reference results for pure hydrogen plasma start-up in tokamak.The results are in good agreement,especially regarding electron temperature,ion temperature and plasma current.In the presence of finite Ohmic electric field in the spherical tokamak,a study on the EC wave assisted start-up of the NCST plasma at frequency of 28 GHz is conducted.The impact of the vertical magnetic field B_(v)on EC wave assisted start-up,the relationship between EC wave injection power P_(inj),Ohmic electric field E,and initial hydrogen atom density n_(H0)are explored separately.It is found that under conditions of Ohmic electric field lower than ITER(~0.3 V m^(-1)),EC wave can expand the operational space to achieve better plasma parameters.Simulating the process of28 GHz EC wave start-up in the CN-H1 stellarator plasma,the plasma current in the zerodimensional model is replaced with the current in the poloidal coil of the stellarator.Plasma startup can be successfully achieved at injection powers in the hundreds of kilowatts range,resulting in electron densities on the order of 10^(17)-10^(18)m^(-3).
基金supported by the National Level Project of China.
文摘Solid rocket motors have important applications in the propulsion of trans-media vehicles and underwater launched rockets.In this paper,the ignition start-up process of an underwater solid rocket motor across a wide depth range has been numerically studied.A novel multi-domain integrated model has been developed by combining the solid propellant ignition and combustion model with the volume of fluid multiphase model.This integrated model enables the coupled simulation of the propellant combustion and gas flow inside the motor,along with the gas jet evolution in the external water environment.The detailed flow field developments in the combustion chamber,nozzle,and wake field are carefully analyzed.The variation rules of the internal ballistics and thrust performance are also obtained.The effects of environmental medium and operating depth on the ignition start-up process are systematically discussed.The results show that the influence of the operating environment on the internal ballistic characteristics is primarily reflected in the initial period after the nozzle closure opens.The development of the gas jet in water lags significantly compared with that in air.As the water depth increases,the ignition delay time of the motor is shortened,and the morphology evolution of the gas jet is significantly compressed and accelerated.Furthermore,the necking and bulging of the jet boundary near the nozzle outlet and the consequent shock oscillations are intensified,resulting in stronger fluctuations in the wake pressure field and motor thrust.
文摘This experimental study investigated how text difficulty and different working memory capacity(WMC)affected Chinese EFL learners’reading comprehension and their tendency to engage in task-unrelated thoughts,that is,mind wandering(MW),in the course of reading.Sixty first-year university non-English majors participated in the study.A two-factor mixed experimental design of 2(text difficulty:difficult and simple)×2(WMC:high/large and low/small)was employed.Results revealed that 1)the main and interaction effects of WMC and text difficulty on voluntary MW were significant,whereas those on involuntary MW were not;2)while reading the easy texts,the involuntary MW of high-WMC individuals was less frequent than that of low-WMC ones,whereas while reading the difficult ones,the direct relationship between WMC and involuntary MW was not found;and that 3)high-WMC individuals had a lower overall rate of MW and better reading performance than low-WMC individuals did,but with increasing text difficulty,their rates of overall MW and voluntary MW were getting higher and higher,and the reading performance was getting lower and lower.These results lend support to WM theory and have pedagogical implications for the instruction of L2 reading.
文摘The school placement processes of students from immigrant backgrounds considered to be in“difficulty”is an international concern at the intersection of works relating to special education and those concerning the school experiences of students from immigrant backgrounds or racialized groups.The research problem of this article concerns the identification of these students as disabled or as having adjustment or learning difficulties.From a perspective anchored in Disability Critical Race Studies,this ethnographic study documents different interpretations of perceived difficulties made by school actors with regard to seven primary school students from immigrant backgrounds.Five interpretation types are presented:(1)medicalization by dismissal of cultural markers,(2)medicalization by professional constraint,(3)medicalization by cultural deficit,(4)precautionary wait,and(5)cultural differentialism.Our results help to shed light on the special education overrepresentation phenomenon regarding these students and to understand how ableism and(neo)racism contribute to it.
文摘The purpose of this study is to determine the teacher’s perceptions of the challenges and strategies in supporting students with reading difficulties.This study used qualitative method of research and descriptive approach as its research design,in addition to a set of structured interview questions administered through Google Forms to gather data from elementary teachers of Taal Central School,located at Taal Batangas.These structured interview questions were carefully designed to cover various dimensions of the study,including the types of challenges perceived by teachers,strategies employed,and possible solutions for addressing the problems encountered in the process of supporting students with reading difficulties.The results revealed that teachers faced several challenges when teaching students with reading difficulties such as emotional and motivational issues/factors,lack of resources or teaching aids,deficits in knowledge and skills,and problems with student engagement and participation.This study also showed common approaches utilized by the teachers in supporting students with reading difficulties,which were fostering a positive and supportive environment,adopting individualized and multifaceted approaches,and utilizing effective teaching tools and strategies.Lastly,teachers also concluded varied solutions in addressing the challenges perceived in teaching students with reading difficulties towards fostering reading proficiency.These include developing peer support,use of positive reinforcement,and parental involvement.Moreover,specialized resources,professional development for teachers,and specific teaching strategies are also highlighted as crucial components.By integrating these approaches,teachers concluded that it can create a supportive and effective learning environment tailored to the needs of students with reading difficulties.
