Effect of individualized narrative nursing mode on recovery of elderly patients with fracture complicated with cerebrovascular accident.

Fractures often occur in elderly patients. Osteoporosis caused by massive loss of calcium ions in the bones of elderly patients can easily lead to femoral fractures after suffering a low- and medium-energy injury. With the gradual entry of the aging society in China, the incidence of senile fracture is also gradually increasing. However, there is no report on the application of personalized narrative nursing to the mental health, cognitive function, and limb function recovery of elderly patients with fracture complicated with cerebrovascular accident, in order to enhance the cognitive level of elderly patients with fracture complicated with cerebrovascular accident. This study was specially conducted with a positive attitude toward the disease and improving the life quality. During July 2018 to July 2021, 80 elderly patients with fracture complicated with cerebrovascular accident cured were selected in our hospital. The patients were arbitrarily classified into an assigned control group (n = 40) and a study group (n = 40). The former received routine nursing, and the latter received personalized narrative nursing mode. The nursing satisfaction, functional independence scale (FIM), self-rating anxiety scale (SAS), self-rating depression scale (SDS), cognitive function, fracture healing time, length of hospital stays, and hospitalization expenses were compared. The study group had a satisfaction rate of 100.00%, while the control group had 87.50%. The nursing satisfaction of the study group was higher (P < .05). After 3 months of nursing, the FIM scores augmented. The FIM scores of upper and lower limbs in the study group were remarkably higher (P < .05). A decrease in SAS and SDS scores was observed. The SAS and SDS scores of the study group were lower (P < .05). Three months after discharge, the cognitive function score augmented. At 3 months after discharge, the study group had a higher cognitive function score (P < .05). The fracture healing time, length of stay, and cost of hospitalization in the study group were lower (P < .05). Personalized narrative nursing model can successfully enhance the mental health and cognitive function of elderly patients with fracture complicated with cerebrovascular accident, enhance the recovery of limb function, promote patients' nursing satisfaction, and alleviate the economic burden.

Hybrid Crosslinked Solid Polymer Electrolyte via In-Situ Solidification Enables High-Performance Solid-State Lithium Metal Batteries.

Solid-state lithium-metal batteries constructed by in-situ solidification of cyclic ether are considered to be a critical strategy for the next generation of solid-state batteries with high energy density and safety. However, the poor thermal/electrochemical stability of linear polyethers and severe interfacial reactions limit its further development. Herein, in-situ ring-opening hybrid crosslinked polymerization is proposed for organic/inorganic hybrid polymer electrolyte (HCPE) with superior ionic conductivity of 2.22 × 10-3 S cm-1 at 30 °C, ultrahigh Li+ transference number of 0.88, and wide electrochemical stability window of 5.2 V. These allow highly stable lithium stripping/plating cycling for over 1000 h at 1 mA cm-2 , which also reveal a well-defined interfacial stabilization mechanism. Thus, HCPE endows assembled solid-state lithium-metal batteries with excellent long-cycle performance over 600 cycles at 2 C (25 °C) and superior capacity retention of 92.1%. More importantly, the proposed noncombustible HCPE opens up a new frontier to promote the practical application of high safety and high energy density solid-state batteries via in-situ solidification.

Tea-derived carbon dots with two ratiometric fluorescence channels for the independent detection of Hg2+ and H2O.

Ratiometric fluorescence carbon dots (CDs) that serve as probes have attracted more attention on account of their unique optical properties, low toxicity, anti-interference, and internal reference. However, the facile fabrication of CDs with the aim of detecting multiple targets through mutually independent response channels is always a challenge. Herein, multifunctional label-free N-doped ratiometric fluorescence CDs (N-CDs) are developed from tea leaves extract and o-phenylenediamine by a mild solvothermal method. The prepared N-CDs are tailored with nitrogen- and oxygen-containing functional groups on the surface and contribute to splendid hydrophilia. Two completely independent ratiometric fluorescence channels of N-CDs, respectively, respond to Hg2+ and H2O in a mutually independent manner. Based on the interactions of N-Hg and O-Hg, N-CDs achieve an excellently sensitive and selective detection for Hg2+ in the channel of I387 nm/I351 nm, giving a linear relationship in the range of 0-50 µM. Also, a wide range of Hg2+ concentration (0-100 µM) is linear to A374 nm through UV-vis assay. Otherwise, the linear determination of H2O content (0-30%) is realized in another channel (Igreen/Iblue). The good performance in the independent testing of Hg2+ and H2O, demonstrate that the proposed N-CDs have potential in multifunctional detection.

[Intervention effect of injury control orthopedic strategy on fat embolism syndrome associated with long shaft fracture of lower limb].

OBJECTIVE: To observe the intervention effect of damage control orthopaedic(DCO) strategy on fat embolism syndrome(FES) associated with long shaft fracture of lower limbs. METHODS: Retrospective analysis was made on the clinical data of 163 patients with FES associated with lower limb long shaft fractures admitted from January 2015 to May 2021. They were divided into two groups based on the time point of implementing DCO strategy in January 2018. Total of 92 patients were admitted from January 2015 to December 2017 as the control group, and other 71 patients were admitted from January 2018 to May 2021 as the intervention group. The hospital mortality, arterial oxygen saturation (SaO2), arterial partial pressure of oxygen (PaO2) and oxygenation index (OI), hemoglobin (Hb), platelet count(PLT), Harris score of hip joint, HSS score of knee joint, AOFAS score of ankle joint, clinical efficacy and complications were observed and compared between two groups. RESULTS: Total of 163 patients were followed up for 12 to 18 months with an average of (16.91±1.22) months. The in-hospital mortality rate in the intervention group was 2.82% (2/71), and that in the control group was 16.30% (15/92), the difference between two groups was statistically significant(χ2=6.455, P<0.05). After the intervention, SaO2, PaO2 and OI in two groups were higher than those before the intervention(P<0.05), and after the intervention, SaO2, PaO2 and OI in two groups were statistically significant(P<0.05). Hb and PLT in two groups after intervention were higher than those before intervention (P<0.001), and there was statistically significant difference in Hb and PLT between two groups after intervention (P<0.05). The Harris score of hip joint, HSS score of knee joint and AOFAS score of ankle joint in both groups after 3 months of treatment were better than those before treatment (P<0.05). The total clinical effective rate of the intervention group was higher than that of the control group(χ2=4.194, P<0.05). The total incidence of complications in the intervention group was lower than that in the control group(χ2=4.747, P<0.05). CONCLUSION: DCO strategy is helpful to reduce the in-hospital mortality of patients with FES associated with long shaft fracture of lower extremities, eliminate FES symptoms and stabilize vital signs, gain time advantage for phase Ⅱ definitive surgery, and has significant clinical intervention effect, which is worth popularizing.

Contrasting impacts of dry versus humid heat on US corn and soybean yields.

The impact of extreme heat on crop yields is an increasingly pressing issue given anthropogenic climate warming. However, some of the physical mechanisms involved in these impacts remain unclear, impeding adaptation-relevant insight and reliable projections of future climate impacts on crops. Here, using a multiple regression model based on observational data, we show that while extreme dry heat steeply reduced U.S. corn and soy yields, humid heat extremes had insignificant impacts and even boosted yields in some areas, despite having comparably high dry-bulb temperatures as their dry heat counterparts. This result suggests that conflating dry and humid heat extremes may lead to underestimated crop yield sensitivities to extreme dry heat. Rainfall tends to precede humid but not dry heat extremes, suggesting that multivariate weather sequences play a role in these crop responses. Our results provide evidence that extreme heat in recent years primarily affected yields by inducing moisture stress, and that the conflation of humid and dry heat extremes may lead to inaccuracy in projecting crop yield responses to warming and changing humidity.

The Current status of steroid-refractory immune-checkpoint-inhibitor-related hepatotoxicity.

ICI-related hepatotoxicity (IRH) is becoming more and more common as immune checkpoint inhibitors (ICIs) have begun to be increasingly approved and used in combination with other anti-tumor drugs worldwide. Steroids are the first choice for the treatment of IRH, but the subsequent optimal treatment algorithm remains unclear if the disease progresses to steroid-refractory IRH. Therefore, in this paper we reviewed all the pertinent literature on steroid-refractory IRH to the greatest extent possible in an attempt to provide information on which to base an update of the treatment algorithm for steroid-refractory IRH.

Lattice Network for Lightweight Image Restoration.

Deep learning has made unprecedented progress in image restoration (IR), where residual block (RB) is popularly used and has a significant effect on promising performance. However, the massive stacked RBs bring about burdensome memory and computation cost. To tackle this issue, we aim to design an economical structure for adaptively connecting pair-wise RBs, thereby enhancing the model representation. Inspired by the topological structure of lattice filter in signal processing theory, we elaborately propose the lattice block (LB), where couple butterfly-style topological structures are utilized to bridge pair-wise RBs. Specifically, each candidate structure of LB relies on the combination coefficients learned through adaptive channel reweighting. As a basic mapping block, LB can be plugged into various IR models, such as image super-resolution, image denoising, image deraining, etc. It can avail the construction of lightweight IR models accompanying half parameter amount reduced, while keeping the considerable reconstruction accuracy compared with RBs. Moreover, a novel contrastive loss is exploited as a regularization constraint, which can further enhance the model representation without increasing the inference expenses. Experiments on several IR tasks illustrate that our method can achieve more favorable performance than other state-of-the-art models with lower storage and computation.

Artificial intelligence in brachytherapy for cervical cancer.

Brachytherapy (BT) consists in the insertion of radioactive implants directly into the tissue through an applicator, in order to kill tumor cells. This is for the tumor tissue to receive a higher dose, whereas the surrounding normal tissues receive a lower dose of radiation because of the rapid fall of the dose. Because of the special anatomical position of the cervix, smaller organ mobility, and higher tolerable doses of radiotherapy in the vagina and uterus, BT has been most widely used to treat cervical cancer and is an important part of radical radiotherapy for this type of cancer. Furthermore, it is closely related to the prognosis of patients. However, the treatment process, including target area delineation, applicator reconstruction, plan design, and optimization, is time-consuming, which may lead to changes in patient's bladder filling or gastrointestinal peristalsis. Therefore, this not only yields a poor patient experience, but may also affect the accuracy of the treatment and prognosis. With the development of computer hardware, deep learning has been gradually applied in different fields and different networks have been developed to solve various problems. By combining deep learning technology with three-dimensional BT technology, the automation of BT planning can be realized, which, in turn, can significantly shorten the treatment time, alleviate the pain of the patient, and improve treatment efficacy. This article summarizes and gives the prospects of the application of artificial intelligence in the context of BT for cervical cancer.

Study on Transmission Channel and Pollution Sources Region of O3 in Qingyuan City.

Based on the Lagrange mixed single-particle trajectory model and NCEP global reanalysis meteorological data, the 72 h backward airflow trajectory in Qingyuan City in different seasons from 2018 to 2020 was analyzed by cluster analysis. Combined with the hourly average concentration data of O3, the potential source contribution factor (PSCF) analysis and concentration weighted trajectory (CWT) analysis were used to study the regional transport and possible source area of O3 in Qingyuan City and analyzed the relationship among O3 and wind speed, wind direction, NO2, and CO. The results showed that from 2018 to 2020, the most significant proportion of primary pollutants in Qingyuan City was ozone. The annual average concentration reached the highest value since monitoring in 2019. In 2020, the impact of epidemic prevention and control decreased. The daily average concentration change characteristics showed a single peak, with the highest concentration in the afternoon, the highest peak concentration in summer, followed by spring, and the lowest concentration in winter. There are differences in the concentration of O3 between different sources of airflow in Qingyuan City. The potential source contribution factor shows that the high-value covered areas are mainly in Guangzhou, Foshan, and Zhongshan, which can be considered the main potential source areas. These areas can be regarded as the main potential source areas. The concentration weight trajectory showed that external and local sources affected the O3 pollution in Qingyuan during the four seasons. The high ozone concentration in Qingyuan mainly appeared in the south wind direction, indicating that the high ozone concentration in Qingyuan was greatly affected by the external transmission of the southern Pearl River Delta. The correlation between ozone concentration and CO concentration is poor, and the effect on ozone concentration is less than that of NO2.

Learning All-In Collaborative Multiview Binary Representation for Clustering.

Multiview clustering via binary representation has attracted intensive attention due to its effectiveness in handling large-scale multiple view data. However, these kind of clustering approaches usually ignore a very important potential high-order correlation in discrete representation learning. In this article, we propose a novel all-in collaborative multiview binary representation for clustering (AC-MVBC) framework, where multiview collaborative binary representation and clustering structure are learned in a joint manner. Specifically, using a new type of tensor low-rank constraint, the high-order collaborations, i.e., cross-view and inner view collaborations, can be effectively captured in our model. Moreover, by incorporating the Bregman discrepancy, the projective consistency among different views can be guaranteed to achieve a more powerful binary representation. An efficient optimization algorithm is also proposed to solve the objective function with fast convergence empirically. Experimental results on several challenge datasets demonstrate that the proposed method has achieved highly competent performance compared with the state-of-the-art multiview clustering (MVC) methods while maintaining low computational and memory requirements.

Adaptive response of Dongzhaigang mangrove in China to future sea level rise.

Mangrove forests are valuable intertidal ecosystems that provide coastline protection, biodiversity maintenance, and carbon sequestration. However, their survival is under severe threat from rapidly rising sea levels. In this study, we aimed to investigate the changes in the area of the Dongzhaigang mangrove in China since the 1950s and causes of these changes using literature and remote sensing data. The impact of historical and future sea level rise (SLR) on the mangroves was analyzed using remote sensing data and climate model data under the low, intermediate, and very high greenhouse gas emission scenarios (Representative Concentration Pathways (RCPs) 2.6, 4.5, and 8.5). The area of the mangrove forests decreased from 3416 to 1711 hm2 during 1956-1988 and remained constant at 1711 hm2 after the 1990s, owing to anthropogenic disturbances such as reclamation and aquaculture before the 1980s and the protection of nature reserve establishment after the 1990s, respectively. Under RCPs 4.5 and 8.5, SLR is expected to cause > 26% of the mangroves to disappear by 2100, whereas under RCP 2.6, only 17% of the mangroves will likely be lost. Biological measures such as reestablishment of ponds as mangrove forests, afforestation, and biological embankment for sediment trapping in coastal wetlands are recommended to enhance the resilience of mangroves to SLR.

Proteomic Profiling of Cerebrum Mitochondria, Myelin Sheath, and Synaptosome Revealed Mitochondrial Damage and Synaptic Impairments in Association with 3 × Tg-AD Mice Model.

Alzheimer's disease (AD) is the most common age-associated dementia with complex pathological hallmarks. Mitochondrion, synaptosome, and myelin sheath appear to be vulnerable and play a key role in the pathogenesis of AD. To clarify the early mechanism associated with AD, followed by subcellular components separation, we performed iTRAQ (isobaric tags for relative and absolute quantification)-based proteomics analysis to simultaneously investigate the differentially expressed proteins (DEPs) within the mitochondria, synaptosome, and myelin sheath in the cerebrum of the 6-month-old triple transgenic AD (3 × Tg-AD) and 6-month-old wild-type (WT) mice. A large number of DEPs between the AD and WT mice were identified. Most of them are related to mitochondria and synaptic dysfunction and cytoskeletal protein change. Differential expressions of Lrpprc, Nefl, and Sirpa were verified by Western blot analysis. The results suggest that decreased energy metabolism, impaired amino acid metabolism and neurotransmitter synthesis, increase compensatory fatty acid metabolism, up-regulated cytoskeletal protein expression, and oxidative stress are the early events of AD. Among these, mitochondrial damage, synaptic dysfunction, decreased energy metabolism, and abnormal amino acid metabolism are the most significant events. The results indicate that it is feasible to separate and simultaneously perform proteomics analysis on the three subcellular components.

A Flexible Semi-Interpenetrating Network-Enhanced Ionogel Polymer Electrolyte for Highly Stable and Safe Lithium Metal Batteries.

An ionogel polymer electrolyte (IGPE), which combines the merits of high ionic conductivity and excellent safety property of a liquid electrolyte and a solid electrolyte, respectively, has shown great prospects in the application of a new generation of lithium secondary batteries. However, the increase in the ionic conductivity of IGPE will inevitably be at the expense of reduced mechanical strength, and this dilemma limits its application and market promotion. Here, an IGPE with a semi-interpenetrating cross-linked network structure was synthesized by UV-cross-linking to tackle this plight. The optimal sample ME82 shows an excellent ionic conductivity of 1.19 mS cm-1 at room temperature and robust mechanical strength (breaking strength: 1.55 MPa, elongation at break: 259%). Therefore, the assembled LiFePO4/ME82/Li cion cell displays an outstanding initial specific discharge capacity of 160.9 mAh g-1 at 55 °C 0.5 C, with a capacity retention of 94.00% after 200 cycles. In addition, ME82-based flexible batteries can withstand bending, folding, and even shearing abuse, which indicates that ME82 has application potentials in flexible electronic devices.

The main mechanisms of trimethyltin chloride-induced neurotoxicity: Energy metabolism disorder and peroxidation damage.

Trimethyltin chloride (TMT) is a by-product in the synthesis of organotin, a plastic stabilizer. With the rapid development of industry, the occupational hazards caused by TMT cannot be ignored. TMT is a typical neurotoxicant, which mainly damages the limbic system and brainstem of the nervous system. Previous studies have demonstrated that the neurotoxicity induced by TMT is linked to the inhibition of energy metabolism, but the underlying mechanism remains elusive. In order to investigate the mechanism of TMT-induced inhibition of energy metabolism, C57BL/6 male mice were administered by IP injection in different TMT doses (0 mg/kg, 1.00 mg/kg, 2.15 mg/kg and 4.64 mg/kg) and times (1d, 3d and 6d), and then the changes of superoxide dismutase (SOD) activity, malondialdehyde (MDA) level and Na+-K+-ATPase activity in cerebral cortex, cerebellum, hippocampus, pons, medulla oblongata of mice, the expressions of Na+-K+-ATPase protein, AMP-activated protein kinase (AMPK), phosphorylated AMP-activated protein kinase(p-AMPK)and peroxisome proliferator-activated receptor γ coactivator-1 α (PGC-1α) in hippocampus and medulla oblongata were measured; the effects of TMT on the viability, the activity of SOD, glutathione (GSH) and Na+-K+-ATPase, MDA level, and the expression of PGC-1α and Na+-K+-ATPase protein in N2a cells were measured by different TMT doses and times, in order to verify the experiments in vivo. Our results found that most of the mice showed depression, tremor, epilepsy, spasm and other symptoms after TMT exposure. Moreover, with the increase of TMT dose, the activity of Na+-K+-ATPase and the expressions of AMPK protein in the hippocampus and medulla oblongata of mice decreased, and the expressions of p-AMPK protein increased. Peroxidative damage was evident in hippocampus, medulla oblongata of mice and N2a cells, and the expression of PGC-1α and Na+-K+-ATPase protein was significantly down-regulated. Therefore, it is reasonable to believe that TMT-induced neurotoxic symptoms and inhibition of energy metabolism may be related to p-AMPK and down-regulation of PGC-1α in the hippocampus and medulla oblongata.

Removal of N,N-dimethylformamide by dielectric barrier discharge plasma combine with manganese activated carbon.

Manganese activated carbon (Mn-AC) was successfully prepared by the incipient wetness method and characterized by SEM, XRD, and FTIR. This study chose N,N-dimethylformamide (DMF) as the target pollutant, and the removal rate of DMF and removal mechanism were systematically studied by dielectric barrier discharge (DBD) plasma combined with Mn-AC. This study indicated that DBD plasma combined with Mn-AC could effectively remove DMF. With the addition of Mn-AC, the removal rate and mineralization rate of DMF within 40 min increased from 51.5% and 36.0% to 82.2% and 58.2%, respectively. The discharge power, initial concentration of DMF, initial pH of the solution, and dosage of Mn-AC affect the removal of DMF. The optimal discharge power is 16.19 W, and energy efficiency is 20.79 mg·kJ-1; low concentration DMF could be removed more effectively. Neutral and alkaline conditions showed better removal effect of DMF than acid conditions; Mn-AC optimal dosage is 1.0 g L-1. The concentration variations of O3, H2O2, and ·OH manifested that Mn-AC could effectively convert O3 and H2O2 to ·OH, thereby increasing the DMF removal rate. Quenching experiments showed that ·OH is the main active species in the reaction. Based on reaction products of DMF such as N-methylformamide, methanol, formaldehyde, and formic acid, possible degradation pathways were proposed. Prospect analysis demonstrated combining plasma systems with catalysts is promising.

An Extremely Stretchable and Self-Healable Supramolecular Polymer Network.

The construction of a single polymer network with extreme stretchability, relatively high mechanical strength, and fast and facile autonomous room-temperature self-healing capability still remains a challenge. Herein, supramolecular polymer networks are fabricated by synergistically incorporating metal-ligand and hydrogen bonds in poly(propylene glycol) (PPG). The representative specimen, PPG-Im-MDA-1.5-0.25-Cu, shows a combination of notable mechanical properties involving an extreme stretching ratio of 346 ± 14× and a Young's modulus of 2.10 ± 0.14 MPa, which are superior to the previously reported extremely stretchable polymeric materials. Notably, the destroyed specimen can fully recover mechanical performances within 1 h. The tunability of mechanical properties and self-healing capability has been actualized by merely tailoring the content of a chain extender. The application of the as-prepared supramolecular PPG network in constructing a flexible and self-healable conductor has been demonstrated. This strategy provides some insights for preparing extremely stretchable and self-healable polymeric materials.

Applications of artificial intelligence in radiophysics.

Artificial intelligence (AI) is playing an important role in radiation oncology. One of the most important applications is in radiotherapy physics. In this field, it has improved the automation of radiotherapy plan design and quality control (QC), thereby promoting and ensuring individualized precision treatment. This article reviews the applications and research on AI in the physics of radiotherapy and projects the prospects of AI in the following aspects: radiotherapy plan design, radiotherapy quality assurance, and QC, organs at risk contouring, dose prediction, etc.

Na@La-modified zeolite particles for simultaneous removal of ammonia nitrogen and phosphate from rejected water: performance and mechanism.

Rejected water from sludge processing in wastewater treatment plants (WWTPs) is very harmful due to its high concentration of ammonia nitrogen and phosphorus. It is therefore necessary to find a low-cost and convenient technique to simultaneously remove ammonia nitrogen and phosphorus from rejected water. In this study, natural granular zeolite was modified by NaCl and La(OH)3 to obtain a new material (Na@La-MZP), with several advantages compared with powdered zeolite. Na@La-MZP could remove 92.61% ammonia nitrogen (50 mg/L) and 99.01% phosphate (60 mg/L) at the optimal conditions of dosage 12.5 g/L, initial pH 6.0 and reaction time 12 hours, which enabled the effluent to satisfy the discharge standard (GB 18918-2002) for municipal WWTPs in China. The maximum adsorption capacity of Na@La-MZP was determined as 17.92 mg NH4+-N/g and 9.53 mg P/g by the Langmuir isotherm. Pseudo-second-order kinetics could well illustrate the adsorption process and show that the ammonia nitrogen and phosphate can be degraded by chemical reaction. The characterizations of Na@La-MZP confirmed the removal mechanism of ammonia nitrogen and phosphate. The Na@La-MZP still maintained more than 75% removal efficiency after five reuses. Furthermore, the estimated cost of this treatment method was 0.22 $/m3 rejected water.

Achieving enhanced biological nitrogen removal via 2450 MHz electromagnetic wave loading on returned sludge in anaerobic-anoxic-oxic process.

To evaluate the enhancing of the biological nitrogen removal effectiveness by electromagnetic wave loading on returned sludge in the A/A/O reactor, some experiments were completed with the returned sludge loaded by 2,450 MHz electromagnetic wave. The excess sludge yield and pollutant removal effect of the system were evaluated. Results showed that stronger denitrification effect and less sludge yield were achieved. When 30% of the returned sludge was loaded by electromagnetic wave, the actual denitrification efficiency increased by 7% without dosage. The dissolution of carbon, nitrogen and phosphorus from loaded returned sludge was detected, thus providing the system with a supplemental carbon source of 4.6 g/d SCOD. The specific oxygen uptake rate of the oxic activated sludge increased by 14%, and the denitrification rate of the anoxic activated sludge increased by 29%. Illumina MiSeq analysis showed that the microbial richness increased obviously, and denitrifying bacteria (i.e. Dechloromonas, Zoogloea and Azospira, etc.) were accumulated.