Determinants of the behavioral intention to use a mobile nursing application by nurses in China.

BACKGROUND: Although a mobile nursing application has began to adopt in nursing, few studies have focused on nurses' behavioral intention of it. The objective of this study is to gain insight into the behavioral intention of nurses, i.e. chinese nurses of the future, to use a mobile nursing application. This study adopted an extension of the Unified Theory of Acceptance and Use of Technology to examine Chinese nurses' acceptance of a mobile nursing application. METHODS: A total of 1207 nurses participated in the cross-sectional survey. The majority of nurses were female (96.2%). The mean age of the participants was 34.18 (SD 7.39). The hypothesized relationships were tested using AMOS structural equation model. RESULTS: All constructs exhibited an acceptable level of reliability and validity with Cα and CR > 0.7 and AVE > 0.5. An extension of the Unified Theory of Acceptance and Use of Technology Model had good explanatory power for nurses' behavioral intention of a mobile nursing application. Although effort expectancy and perceived risks had a surprisingly insignificant effect on nurses' behavioral intention to use a mobile nursing application, performance expectancy, social influence, facilitating conditions, self-efficacy, and perceived incentives demonstrated significant influence with ß = .259, p < .001, ß = .296, p < .001, ß = .063, p = .037, ß = .344, p < .001, ß = .091, p = .001, respectively. CONCLUSION: With 70.2% of the variance in behavioral intention to use a mobile nursing app explained by this model, it could be helpful for potential adopters, and further investigation should test the actual usage behavior for a mobile nursing app and investigate the related factors.

Sparse Representation Based Frequency Detection and Uncertainty Reduction in Blade Tip Timing Measurement for Multi-Mode Blade Vibration Monitoring.

The accurate monitoring of blade vibration under operating conditions is essential in turbo-machinery testing. Blade tip timing (BTT) is a promising non-contact technique for the measurement of blade vibrations. However, the BTT sampling data are inherently under-sampled and contaminated with several measurement uncertainties. How to recover frequency spectra of blade vibrations though processing these under-sampled biased signals is a bottleneck problem. A novel method of BTT signal processing for alleviating measurement uncertainties in recovery of multi-mode blade vibration frequency spectrum is proposed in this paper. The method can be divided into four phases. First, a single measurement vector model is built by exploiting that the blade vibration signals are sparse in frequency spectra. Secondly, the uniqueness of the nonnegative sparse solution is studied to achieve the vibration frequency spectrum. Thirdly, typical sources of BTT measurement uncertainties are quantitatively analyzed. Finally, an improved vibration frequency spectra recovery method is proposed to get a guaranteed level of sparse solution when measurement results are biased. Simulations and experiments are performed to prove the feasibility of the proposed method. The most outstanding advantage is that this method can prevent the recovered multi-mode vibration spectra from being affected by BTT measurement uncertainties without increasing the probe number.

Serial multiple mediators in the relationship between symptom burden and sleep quality among patients with heart failure.

BACKGROUND: Sleep disturbance is common in patients with heart failure. The aims of this study were to assess the prevalence of sleep disturbance in patients with heart failure, and to examine the serial multiple mediation effects of psychological distress and sleep hygiene practices on the relationship between symptom burden and sleep quality. METHODS: We recruited eligible heart failure patients in a large, university-affiliated hospital in Shandong Province, China, from November 2018 to June 2019. The Pittsburgh Sleep Quality Index, Heart Failure Somatic Perception Scale, Hospital Anxiety and Depression Scale, and Sleep Hygiene Practice Scale were used to assess patients' sleep quality, symptom burden, psychological distress, and sleep hygiene practices. The mediation effects were analyzed using the PROCESS tool in SPSS. RESULTS: Two hundred and thirty seven heart failure patients were included in the final analyses. Among these patients, 189 patients (67.1%) had a sleep disturbance (Pittsburgh Sleep Quality Index score of >5). Higher symptom burden, higher level of psychological distress, and poorer sleep hygiene practices were associated with patients' poorer sleep quality. The psychological distress and sleep hygiene practices had mediation effects on the relationship between symptom burden and sleep quality in patients with heart failure. CONCLUSIONS: Patients' symptom burden could affect their sleep quality through psychological distress and sleep hygiene practices besides a direct effect. Thus, psychological distress and sleep hygiene practices should be fully considered in the development of interventions to improve patients' sleep quality, apart from alleviating patients' symptom burden.

Association between nut consumption and mortality among Chinese older people: A national cohort study based on CLHLS from 2008 to 2018.

Background: Few quantitative studies have explored the associations between nut consumption and better health outcomes among a national cohort of community-dwelling older Chinese people. Given the need for more evidence to support the health benefits of nuts among Chinese people, we investigated whether nut consumption was associated with subsequent 10-year mortality. Methods: We analyzed data from the Chinese Longitudinal Healthy Longevity Survey. The data on nut consumption at baseline were collected using a questionnaire through face-to-face interviews. The vital status and date of death were ascertained by a close family member or village doctor of the deceased participant during the follow-up survey. Cox analyses were performed to explore the association between nut consumption and mortality. Subgroup analyses by age group (<80 or ≥80 years), sex (male/female), activities of daily living (impaired or normal), and physical exercise (yes or no) were performed to assess whether the association between nut consumption and mortality differed across different populations. Results: The median survival time was 1,302 days for the 11,915 participants with complete information of survival time and nut consumption. The association between nut consumption and mortality was significant after the adjusting for significant factors in the univariate Cox analyses. The hazard ratios were lower in male participants, those who were <80 years old, and those who did not engage in physical exercise at baseline. The association between nut consumption and mortality was not significant among participants with normal activities of daily living. Conclusion: The association between nut consumption and mortality was not significant among participants who had normal activities of daily living but was significant among participants who had impaired activities of daily living. Including nuts in the diets cloud help to extend the lifespan in older Chinese people, especially those with impaired activities of daily living.

Microwave-induced steam distillation (MISD) remediation in petroleum hydrocarbon-contaminated sites: From process improvement to pilot application.

The process improvement, a pilot remediation test and the decontamination mechanism of microwave-induced steam distillation (MISD) for petroleum hydrocarbons (PHs) removal were conducted. Processes of multistage steam distillation and carbon reinforcement were compared to determine the best remediation process. Pilot project was then carried out to explore the applicability of MISD in site-scale remediation. The remediation efficiency, procedures and influencing factors of site-scale MISD project were studied by monitoring variations of soil moisture, temperature and PHs concentrations. Furthermore, the decontamination mechanisms of PHs were clarified based on kinetic analysis. The results showed that the multistage steam distillation could improve 10%∼15% remediation efficiency, and the carbon reinforcement could shorten remediation duration of each steam distillation stage by 50%. Pilot MISD project adopted multistage steam distillation process and went through four (initial, rapid heating-up, gentle heating-up and quasi-equilibrium) remediation stages (overall temperature ≤100 °C). The final PHs removal rate was about 60%, which would get better with greater proportion of low boiling points components and stronger vapor extraction. Kinetic studies showed that PHs was removed by steam stripping and limited by intraparticle diffusion in the "steam distillation zone", while local high temperature (＞100 °C) greatly improved PHs volatilization and provided activation energy for PHs desorbed and degraded in the "selective heating zone".

Analysis of the LNAPL Migration Process in the Vadose Zone under Two Different Media Conditions.

This study focused on the processes of free infiltration, precipitation displacement, and natural attenuation of the LNAPL under the condition of near-surface leakage. Sandbox experiments were performed to explore the migration characteristics of LNAPL in the vadose zone with two media structures and the influences of the soil interface on the migration of LNAPL. The results indicate that the vertical migration velocity of the LNAPL infiltration front in medium and coarse sand was 1 order of magnitude higher than that in fine sand and that the LNAPL accumulated at the coarse-fine interface, which acted as the capillary barrier. Displacement of precipitation for LNAPL had little relationship with rainfall intensity and was obviously affected by medium particle size, where coarse sand (40.78%) > medium sand (20.5%) > fine sand (10%). The natural attenuation rate of the LNAPL in the vadose zone was related to the water content of the media; the natural attenuation rate of fine sand was higher. This study simulated the process of the LNAPL leakage from the near surface into the layered heterogeneous stratum, improved the understanding of the migration of the LNAPL under different stratum conditions, and can provide support for the treatment of LNAPL leakage events in the actual site.

Scalable Characterization of 2D Gallium-Intercalated Epitaxial Graphene.

Scalable synthesis of two-dimensional gallium (2D-Ga) covered by graphene layers was recently realized through confinement heteroepitaxy using silicon carbide substrates. However, the thickness, uniformity, and area coverage of the 2D-Ga heterostructures have not previously been studied with high-spatial resolution techniques. In this work, we resolve and measure the 2D-Ga heterostructure thicknesses using scanning electron microscopy (SEM). Utilizing multiple correlative methods, we find that SEM image contrast is directly related to the presence of uniform bilayer Ga at the interface and a variation of the number of graphene layers. We also investigate the origin of SEM contrast using both experimental measurements and theoretical calculations of the surface potentials. We find that a carbon buffer layer is detached due to the gallium intercalation, which increases the surface potential as an indication of the 2D-Ga presence. We then scale up the heterostructure characterization over a few-square millimeter area by segmenting SEM images, each acquired with nanometer-scale in-plane resolution. This work leverages the spectroscopic imaging capabilities of SEM that allows high-spatial resolution imaging for tracking intercalants, identifying relative surface potentials, determining the number of 2D layers, and further characterizing scalability and uniformity of low-dimensional materials.

Influence of arm position change from adduction to abduction on intracavitary electrocardiogram.

PURPOSE: The aim of this study is to evaluate the influence of arm movements from adduction to abduction on intracavitary electrocardiogram and the position of a catheter tip. METHODS: Overall, 192 peripherally inserted central catheter lines were placed under intracavitary electrocardiogram guidance and 188 of them were enrolled in the study. The catheter was first placed at a time point corresponding to the peak P wave with the arm in adduction. The arm was then abducted to 90° without changing catheter insertion length. During the procedure, basal electrocardiogram, intracavitary electrocardiogram, and radiographs with the arm in adduction and abduction were recorded. Amplitude wave changes and catheter movements were measured on electrocardiogram records and radiographs, respectively. RESULTS: In 188 cases, the P wave displayed typical changes, and 97.8% (184/188) catheters were successfully placed correctly. At the peak P wave, the amplitude of the peak P wave was 8.64 times greater than that of the basal P wave, and the P/R ratio was 0.61. When the arm was abducted to 90°, the amplitude of the P wave dropped to 57% of its peak, P/R decreased from 0.61 to 0.34, and the catheter tip moved cephalad 1.00 and 0.77 vertebral body units in male and female patients, respectively. CONCLUSION: Peripherally inserted central catheter moves toward the heart when the arm position changes from abduction to adduction. Peripherally inserted central catheter tip placement at the peak P wave with patient's arm in adduction is accurate and can prevent the catheter from advancing too low. R wave can function as a reference for observing P wave changes during peripherally inserted central catheter placement.

Diagnostic accuracy of machine-learning-assisted detection for anterior cruciate ligament injury based on magnetic resonance imaging: Protocol for a systematic review and meta-analysis.

BACKGROUND: Although many machine learning algorithms have been developed to detect anterior cruciate ligament (ACL) injury based on magnetic resonance imaging (MRI), the performance of different algorithms required further investigation. The objectives of this current systematic review are to evaluate the diagnostic accuracy of machine-learning-assisted detection for ACL injury based on MRI and find the current best algorithm. METHOD: We will conduct a comprehensive database search for clinical diagnostic tests in PubMed, EMBASE, Cochrane Library, and Web of science without restrictions on publication status and language. The reference lists of the included articles will also be checked to identify additional studies for potential inclusion. Two reviewers will independently review all literature for inclusion and assess their methodological quality using Quality Assessment of Diagnostic Accuracy Studies version 2. Clinical diagnostic tests exploring the efficacy of machine-learning-assisted system for detecting ACL injury based on MRI will be considered for inclusion. Another 2 reviewers will independently extract data from eligible studies based on a pre-designed standardized form. Any disagreements will be resolved by consensus. RevMan 5.3 and Stata SE 12.0 software will be used for data synthesis. If appropriate, we will calculate the summary sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of machine-learning-assisted diagnosis system for ACL injury detection. A hierarchical summary receiver operating characteristic (HSROC) curve will also be plotted, and the area under the ROC curve (AUC) is going to calculated using the bivariate model. If the pooling of results is considered inappropriate, we will present and describe our findings in diagrams and tables and describe them narratively. RESULT: This is the first systematic assessment of machine learning system for the detection of ACL injury based on MRI. We predict it will provide highquality synthesis of existing evidence for the diagnostic accuracy of machine-learning-assisted detection for ACL injury and a relatively comprehensive reference for clinical practice and development of interdisciplinary field of artificial intelligence and medicine. CONCLUSION: This protocol outlined the significance and methodologically details of a systematic review of machine-learning-assisted detection for ACL injury based on MRI. The ongoing systematic review will provide high-quality synthesis of current evidence of machine learning system for detecting ACL injury. REGISTRATION: The meta-analysis has been prospectively registered in PROSPERO (CRD42019136581).

Analytic double product integrals for all-frequency relighting.

This paper presents a new technique for real-time relighting of static scenes with all-frequency shadows from complex lighting and highly specular reflections from spatially varying BRDFs. The key idea is to depict the boundaries of visible regions using piecewise linear functions, and convert the shading computation into double product integrals­the integral of the product of lighting and BRDF on visible regions. By representing lighting and BRDF with spherical Gaussians and approximating their product using Legendre polynomials locally in visible regions, we show that such double product integrals can be evaluated in an analytic form. Given the precomputed visibility, our technique computes the visibility boundaries on the fly at each shading point, and performs the analytic integral to evaluate the shading color. The result is a real-time all-frequency relighting technique for static scenes with dynamic, spatially varying BRDFs, which can generate more accurate shadows than the state-of-the-art real-time PRT methods.