Effects of Doctor-Nurse Integrated Care Combined with Health Education on Hip Function, Incidence of Deep Vein Thrombosis and Nursing Satisfaction in Patients with Hip Arthroplasty.

Objective: The aim of our study was to investigate the effect of implementing doctor-nurse integrated care combined with health education on joint function recovery, incidence of deep vein thrombosis, coping style, self-efficacy and nursing care satisfaction in patients undergoing hip arthroplasty. Methods: This is a clinical prospective randomized study with 83 patients who underwent total hip arthroplasty in the orthopedic department of our hospital between May 2019 and May 2022 selected by a random number table. They were divided into 2 groups: the observation group (n = 42) and the control group (n = 41). Both groups used the integrated care model during the perioperative period. Patients in the observation group were also given health education and the differences in the incidence of lower limb deep vein thrombosis, hip function score, coping style, self-efficacy and nursing satisfaction in the 2 groups were compared. Results: Preoperatively, there was no statistically significant difference between the Harris Hip Score (HHS) in the observation group and the control group (P > .05); the HHS in the observation group was higher than in the control group at 2 weeks and 1 month after surgery, and the difference was statistically significant (P < .05); there was no statistically significant difference between the confrontation, avoidance and submission scores of the 2 groups the first day after surgery (P > .05); while the confrontation and avoidance scores in the observation group were higher than in the control group at 2 weeks after surgery, with statistical significance. There was no statistically significant difference between role function, emotional control, symptom management and nurse-patient communication scores in the 2 groups the first day after surgery (P > .05); while the emotional control, symptom management and nurse-patient communication scores in the observation group were higher than in the control group at 2 weeks after surgery, and the differences were statistically significant (P < .05). Overall patient satisfaction in the observation group was better than in the control group, and the difference was statistically significant (P < .05). There was no statistically significant difference in the incidence of lower limb deep vein thrombosis in the 2 groups (P > .05). Conclusion: The implementation of an integrated care model combined with health education in patients with hip arthroplasty is beneficial to improving self-efficacy, patient trauma coping style, promoting early hip function recovery and improving nursing care satisfaction.

A novel chromosome 2q24.3-q32.1 microdeletion in a fetus with multiple malformations.

BACKGROUND: Terminal or interstitial deletion of chromosome 2q is rarely reported but clinically significant, which can result in developmental malformations and psychomotor retardation in humans. In the present study, we analyzed this deletion to comprehensively clarify the relationship between phenotype and microdeletion region. METHODS: We collected clinical records of the fetus and summarized patient symptoms. Subsequently, genomic DNA was extracted from fetal tissue or peripheral blood collected from parents. In addition, whole-exome sequencing (WES) and copy number variation sequencing (CNV-seq) were performed. RESULTS: The fetus presented a previously unreported interstitial deletion of 2q24.3-q32.1. WES and CNV-seq revealed a de novo 18.46 Mb deletion at 2q24.3-q32.1, a region involving 94 protein-coding genes, including HOXD13, MAP3K20, DLX1, DLX2, SCN2A, and SCN1A. The fetus had upper and lower limb malformations, including camptodactyly and syndactyly, along with congenital cardiac defects. CONCLUSION: Herein, we report a fetus with a novel microdeletion of chromosome 2q24.3-q32.1, likely a heterozygous pathogenic variant. Haploinsufficiency of HOXD13 might be related to limb deformity in the fetus.

Compact hybrid plasmonic slot waveguide sensor with a giant enhancement factor for surface-enhanced Raman scattering application.

In this paper, a surface-enhanced Raman scattering (SERS) sensor with a giant field enhancement factor based on the coupling of surface plasmon polaritons (SPPs) is designed and studied theoretically. The proposed sensor adopts a metal-dielectric layered hybrid slot waveguide structure, combining thin metal (gold) layers and silicon nitride strip waveguides. Unlike other similar sensors, the silicon nitride waveguide structure does not serve as an excitation signal channel, conventionally loaded with the guided modes, but as an auxiliary layer, making it easier to concentrate the light field in the slot. Therefore, the sensor has a higher enhancement factor compared to the pure metal or dielectric slot structure. The results exhibit that we can obtain a maximum enhancement factor exceeding 10^6 under the compact configuration of 510 × 300 × 225nm^3 at the wavelength of 785 nm. By analyzing the dependence of the sensor performance on the structural parameters, we show that the structure of such sensor can directly be applied to SERS spectroscopic analysis as well as integrated with micro-and nano-photonic platform to perform on-chip detection system.

Threshold conditions of electric field enhancement and energy confinement in the low-index core of nanoscale waveguides.

Threshold conditions to realize electric field enhancement and energy confinement in the low-refractive-index core of nanoscale waveguides are studied by solving the field function. When the incident lightwave meets the relation of special thresholds, we observe the enhanced electric field and a concentrated light energy in the core. The electric field enhancement and the confined light power are highly dependent on the light wavelength. When the core width is 30 nm, for a wavelength of 1.55 µm, we achieve a power confinement factor above 40%. As the basis for a growing number of potential applications, the threshold conditions discovered in this work will find significant applications in many fields, such as optical sensors and optical communication components.

Selective adsorption of PHC and regeneration of washing effluents by modified diatomite.

Selective removal of petroleum hydrocarbons (PHCs) from soil washing effluents is the key to the surfactant-enhanced soil washing technology. In this study, the diatomite was modified by nonionic surfactant TX-100 and applied in the selective adsorption of PHCs in the soil washing effluents. The modified diatomites were characterized by scanning electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction, N2 adsorption/desorption and X-ray photoelectron spectroscopy respectively. The adsorption process followed the pseudo-second-order model and the adsorption isotherms indicated that the interaction between PHCs and modified diatomite was monolayer adsorption. The important operating factors such as TX-100 dosage, adsorbent dosage, time and temperature were optimized. With the participation of the low-cost adsorbent TX3-Db with high adsorption capacity, the recovery efficiency of the washing effluents was still up to 78.9% after three cycles. A selective adsorption mechanism, based on steric hindrance and electrostatic repulsion, was proposed to explain the removal of PHCs from washing effluents.

Specific Synthesis of 3H-Indole Derivatives via Rh(III)-Catalyzed Cascade Annulation between N-Phenylbenzimidamides and Pyridotriazoles.

An efficient synthetic method to construct 3H-indole derivatives has been successfully developed involving rhodium-catalyzed highly selective C-H bond activation of N-phenylbenzimidamides and subsequent couplings with pyridotriazoles. This cascade approach features excellent chemoselectivity and unique of products containing quaternary carbon center with the pyridyl moiety.

In silico simulation of liver crack detection using ultrasonic shear wave imaging.

BACKGROUND: Liver trauma is an important source of morbidity and mortality worldwide. A timely detection and precise evaluation of traumatic liver injury and the bleeding site is necessary. There is a need to develop better imaging modalities of hepatic injuries to increase the sensitivity of ultrasonic imaging techniques for sites of hemorrhage caused by cracks. In this study, we conduct an in silico simulation of liver crack detection and delineation using an ultrasonic shear wave imaging (USWI) based method. METHODS: We simulate the generation and propagation of the shear wave in a liver tissue medium having a crack using COMSOL. Ultrasound radio frequency (RF) signal synthesis and the two-dimensional speckle tracking algorithm are applied to simulate USWI in a medium with randomly distributed scatterers. Crack detection is performed using the directional filter and the edge detection algorithm rather than the conventional inversion algorithm. Cracks with varied sizes and locations are studied with our method and the crack localization results are compared with the given crack. RESULTS: Our pilot simulation study shows that, by using USWI combined with a directional filter cum edge detection technique, the near-end edge of the crack can be detected in all the three cracks that we studied. The detection errors are within 5%. For a crack of 1.6 mm thickness, little shear wave can pass through it and the far-end edge of the crack cannot be detected. The detected crack lengths using USWI are all slightly shorter than the actual crack length. The robustness of our method in detecting a straight crack, a curved crack and a subtle crack of 0.5 mm thickness is demonstrated. CONCLUSIONS: In this paper, we simulate the use of a USWI based method for the detection and delineation of the crack in liver. The in silico simulation helps to improve understanding and interpretation of USWI measurements in a physical scattered liver medium with a crack. This pilot study provides a basis for improved insights in future crack detection studies in a tissue phantom or liver.

The prevalence and specific characteristics of hospitalised pressure ulcer patients: A multicentre cross-sectional study.

OBJECTIVE: To ascertain the pressure ulcer prevalence in secondary and tertiary general hospitals in different areas of Guangdong Province in China and explore the possible risk factors that are related to pressure ulcers. BACKGROUND: Few multicentre studies have been conducted on pressure ulcer prevalence in Chinese hospitals. DESIGN: A cross-sectional study design was used. METHODS: Data from a total of 25,264 patients were included in the analysis at 25 hospitals in China. The investigators were divided into two groups. The investigators in group 1 examined the patients' skin. When a pressure ulcer was found, a pressure ulcer assessment form was completed. The investigators in group 2 provided guidance to the nurses, who assessed all patients and completed another questionnaire. A multivariate logistic regression analysis was used to analyse the relationship between the possible risk factors and pressure ulcer. RESULTS: The overall prevalence rate of pressure ulcers in the 25 hospitals ranged from 0%-3.49%, with a mean of 1.26%. The most common stage of the pressure ulcers was stage II (41.4%); most common anatomical locations were sacrum (39.5%) and the feet (16.4%). Braden score (p < .001), expected length of stay (p < .001), incontinence (p < .001), care group (p = .011), hospital location (p < .001), type of hospitals (p = .004), ages of patients (p < .001) were associations of pressure ulcers from the multivariate logistic regression analysis. CONCLUSIONS: The overall prevalence rate of pressure ulcers in Chinese hospitals was lower than that reported in previous investigations. Specific characteristics of pressure ulcer patients were as follows: low Braden score, longer expected length of stay, double incontinence, an ICU and a medical ward, hospital location in the Pearl River Delta, a university hospital and an older patient. RELEVANCE TO CLINICAL PRACTICE: The survey could make managers know their prevalence level of pressure ulcers and provide priorities for clinical nurses.

Domain Motions and Functionally-Key Residues of L-Alanine Dehydrogenase Revealed by an Elastic Network Model.

Mycobacterium tuberculosis L-alanine dehydrogenase (L-MtAlaDH) plays an important role in catalyzing L-alanine to ammonia and pyruvate, which has been considered to be a potential target for tuberculosis treatment. In the present work, the functional domain motions encoded in the structure of L-MtAlaDH were investigated by using the Gaussian network model (GNM) and the anisotropy network model (ANM). The slowest modes for the open-apo and closed-holo structures of the enzyme show that the domain motions have a common hinge axis centered in residues Met133 and Met301. Accompanying the conformational transition, both the 1,4-dihydronicotinamide adenine dinucleotide (NAD)-binding domain (NBD) and the substrate-binding domain (SBD) move in a highly coupled way. The first three slowest modes of ANM exhibit the open-closed, rotation and twist motions of L-MtAlaDH, respectively. The calculation of the fast modes reveals the residues responsible for the stability of the protein, and some of them are involved in the interaction with the ligand. Then, the functionally-important residues relevant to the binding of the ligand were identified by using a thermodynamic method. Our computational results are consistent with the experimental data, which will help us to understand the physical mechanism for the function of L-MtAlaDH.

Ultra-Wideband High-Efficiency Solar Absorber and Thermal Emitter Based on Semiconductor InAs Microstructures.

Since the use of chemical fuels is permanently damaging the environment, the need for new energy sources is urgent for mankind. Given that solar energy is a clean and sustainable energy source, this study investigates and proposes a six-layer composite ultra-wideband high-efficiency solar absorber with an annular microstructure. It achieves this by using a combination of the properties of metamaterials and the quantum confinement effects of semiconductor materials. The substrate is W-Ti-Al2O3, and the microstructure is an annular InAs-square InAs film-Ti film combination. We used Lumerical Solutions' FDTD solution program to simulate the absorber and calculate the model's absorption, field distribution, and thermal radiation efficiency (when it is used as a thermal emitter), and further explored the physical mechanism of the model's ultra-broadband absorption. Our model has an average absorption of 95.80% in the 283-3615 nm band, 95.66% in the 280-4000 nm band, and a weighted average absorption efficiency of 95.78% under AM1.5 illumination. Meanwhile, the reflectance of the model in the 5586-20,000 nm band is all higher than 80%, with an average reflectance of 94.52%, which has a good thermal infrared suppression performance. It is 95.42% under thermal radiation at 1000 K. It has outstanding performance when employed as a thermal emitter as well. Additionally, simulation results show that the absorber has good polarization and incidence angle insensitivity. The model may be applied to photodetection, thermophotovoltaics, bio-detection, imaging, thermal ion emission, and solar water evaporation for water purification.

Hemodynamic signal changes and functional connectivity in acute stroke patients with dysphagia during volitional swallowing: a pilot study.

BACKGROUND: Dysphagia is one of the major post-stroke complications, understanding post-stroke changes in cortical excitability and promoting early remodeling of swallowing-related cortical areas to enable accurate treatment is essential for recovery of patients. OBJECTIVES: We aimed to investigate hemodynamic signal changes and functional connectivity in acute stroke patients with dysphagia compared to age-matched healthy participants in response to volitional swallowing using functional near-infrared spectroscopy (fNIRS) in this pilot study. METHODS: Patients with first-ever post-stroke dysphagia having an onset of 1-4 weeks and age-matched right-handed healthy subjects were recruited in our study. fNIRS with 47 channels was utilized to detect the oxyhemoglobin (HbO2 ) and reduced hemoglobin (HbR) concentration changes when volitional swallowing. Cohort analysis was performed by a one-sample t-test. Two-sample t-test was utilized to compare the difference in cortical activation between patients with post-stroke dysphagia and healthy subjects. Furthermore, the relative changes in the concentration of the HbO2 throughout the experimental procedure were extracted for the functional connectivity analysis. The Pearson correlation coefficients of the HbO2 concentration of each channel were analyzed on a time series, and then a Fisher Z transformation was then performed, and the transformed values were defined as the functional connection strengths between the channels. RESULTS: In this present study, a total of nine patients with acute post-stroke dysphagia were enrolled in the patient group and nine age-matched healthy participants in the healthy control group. Our study observed that the extensive regions of the cerebral cortex were activated in the healthy control group, while the activation area of patient group's cortical regions was quite limited. The mean functional connectivity strength of participants was 0.485 ± 0.105 in the healthy control group, and 0.252 ± 0.146 in the patient group, with a significant difference between the two groups (p = 0.001). CONCLUSION: Compared to the healthy individuals, cerebral cortex regions of acute stroke patients were only marginally activated during volitional swallowing task, and the average functional connectivity strength of cortical network in patients was relatively weaker.

[Analysis of the 4th generation outer space bred Angelica dahurica by FTIR spectroscopy].

The major components of the 4th generation outer space bred angelica and the ground group were determined and analyzed by Fourier transform infrared spectroscopy (FTIR) and second derivative spectrum, considering the large mutation of the plants with space mutagenesis. The results show that the content of the coumarin (1741 cm(-1)), which is the main active components of the space angelica dahurica increased, and the content of the protein (1 459, 1 419 cm(-1)) and the fat (930 cm(-1)) increased slightly, whereas the content of the starch and the dietary fiber reduced drastically. There are obvious differences between the peak values of the second derivative spectra of the plants, revealing that the outer space angelica dahurica contained amine component at 1 279 cm(-1). Space mutation breeding is favor of breeding angelica with better idiosyncrasy.

[Analysis of atractylodes macrocephala koidz of spaceflight breeding with XRF and PXRD].

The contents of various elements in the fourth generation atractylodes macrocephala koidz cultivated by spaceflight breeding were analyzed and compared with those of the ground group on the whole jointly by XRF and PXRD. The results showed that the element Na and Ti could not be detected in the space group, and the levels of K and Mn were enhanced by 1.16 and 1.15 times as these elements were measured in ground group, but other elements' contents declined to different degrees, and the most notable elements are Si and P, decreasing by 82.1% and 71.2% accordingly; there is some whewellite in the ground group, whereas much less is found in the space group. The ground group contains inulin, however none in the space group. Spaceflight breeding can harvest significantly mutated specific Chinese herbal medicines varieties. The combination of two testing techniques has a positive role in space breeding applied in cultivation of medicinal plants.

[Study of Dioscorea opposita Thunb from different producing areas with XRF and PXRD].

The contents of various elements in rhizoma dioscoreae were analyzed and compared with those of shishou D. opposita Thunb on the whole jointly by XRF and PXRD. The results showed that the element Cu, Al and Mn could not be detected in rhizoma dioscoreae, but the element Mg, Zn and Cr were found, and other elements contents changed to different degrees; there are starch and whewellite in both groups, the crystal type of starches separated from rhizoma dioscoreae cultivars was a typical B-type pattern, but as C-type and V-type in shishou D. opposita Thunb, which is a mixture of A-type, B-type and V-type. The combination of two testing techniques could be applied to the mensuration and analysis of the elements and micro-structural of Dioscorea opposita Thunb which could be from different producing areas.

[Application of XRF to the analysis of Scutellaria baicalensis with space mutagenesis].

X-ray fluorescence spectrum (XRF) analytic method was applied to the determination of the contents and varieties of mineral elements in the space flight mutagenesis breeding scutellaria baicalensis Georgi, and compared with the ground group which were planted and collected together under the same conditions, in an attempt to search for the influence of space environment upon mutation on scutellaria baicalensis Georgi. The result indicates that the varieties of the main mineral elements in the two samples are samely basically, therefore, the two samples have same absorption and enrichment capability of specific element, but the contents of elements Ca, Na, Zn and S increase by 0.3, 0.3, 0.04 and 0.7 times, respectively, in the space group. This modern testing method played an important role in the study. It is recommended that the testing method should be used in the selection of space bred herbal seeds for its advantages, such as quick, simple, highly sensitive, and of wide measure range. To conclude, New breeds can be selected by space breeding, it is significant for the selection and growing of space herbal medicine seeds, and it also has broad application in space breeding of medical plants.

The performance of surface enhanced Raman scattering and spatial resolution with triangular plate dimer from ultra-ultraviolet to near-infrared range.

The theoretical research on surface enhanced Raman spectroscopy (SERS) of triangular plate dimer (TPD) is of great significance for the design of experimental substrates. In this paper, the SERS properties of the TPD with Au, Ag, Al and Cu have been theoretical investigated in the ultra-ultraviolet, visible and near-infrared region. The influence of the TPD configuration, including the tip radian, the dimer distance and the aspect ratio on the electric field, Raman enhancement and spatial resolution are studied by the finite element method. The results show that there are dipole resonance band and quadruple dipole resonance band in the surface plasmon resonance band of TPD. The tip radian and dimer distance play the dominant role in the electric field enhancement, and the aspect ratio can be mainly used to tune the peak position of the electric field. The smaller tip radian and dimer distance will produce a stronger localized electric field and a small red shift of the peak position. Adjusting the aspect ratio can tune the position of electric field peak from ultraviolet (UV) to near-infrared without changing the peak value of the electric field significantly, especially for Al TPD. The maximum Raman enhancement factor of Au, Ag and Cu all reach 11 orders of magnitude, and 9 orders of magnitude for Al. The spatial resolution changes linearly with the gap distance, and the maximum spatial distributions of Au, Ag, Al and Cu achieve 0.65 nm, 0.67 nm, 0.69 nm and 0.70 nm with the dimer distance of 1 nm. Our results not only provide a better theoretical guidance for the optimization of TPD substrates in the SERS experiment, but also extend its application scope from ultra-UV to near-infrared range.

Study on surface enhanced Raman scattering of Au and Au@Al2O3 spherical dimers based on 3D finite element method.

In this paper, the surface enhanced Raman scattering (SERS) characteristics of Au and Au@Al2O3 nanoparticle dimers were calculated and analyzed by using finite element method (3D-FEM). Firstly, the electric field enhancement factors of Au nanoparticles at the dimer gap were optimized from three aspects: the incident angle of the incident light, the radius of nanoparticle and the distance of the dimer. Then, aluminum oxide is wrapped on the Au dimer. What is different from the previous simulation is that Al2O3 shell and Au core are regarded as a whole and the total radius of Au@Al2O3 dimer is controlled to remain unchanged. By comparing the distance of Au nucleus between Au and Au@Al2O3 dimer, it is found that the electric field enhancement factor of Au@Al2O3 dimer is much greater than that of Au dimer with the increase of Al2O3 thickness. The peak of electric field of Au@Al2O3 dimer moves towards the middle of the resonance peak of the two materials, and it is more concentrated than that of the Au dimer. The maximum electric field enhancement factor 583 is reached at the shell thickness of 1 nm. Our results provide a theoretical reference for the design of SERS substrate and the extension of the research scope.

[Study of the fourth generation of Salvia miltiorrhiza Bge by XRF].

X-ray fluorescence spectrum (XRF) analytic method was used to analyze and compare the contents and varieties of mineral elements in the ground group Salvia miltiorrhiza Bge, and the fourth generation Salvia miltiorrhiza Bge with space flight mutagenesis breeding in order to provide important basic data for selecting high quality breed and further research. The result indicates that the varieties of the main mineral elements in the two samples are the same basically, but Cu/Zn ratio is enhanced to 1.0, the contents of microelements Cr, Mn and Fe increase by 0.6, 0.5, and 0.3 times respectively compared with the ground group. To conclude, in the space group the contents and proportions of the mineral elements are improved and optimized. Xray fluorescence spectrum analytic method has many advantages, such as quickness, simplicity, high sensitivity, wide measure range, etc. The method can be used for quantitative element analysis and study of Chinese herbal medicines.

[Research on the fourth generation of radix isatidis by FTIR].

FTIR spectra of fourth-generation space bred radix isatidis and FTIR spectra of radix isatidis in a ground group were determined on the whole. Comparative analysis was conducted on main constituents (components) to accumulate data for comprehensively understanding and thoroughly studying the inherent property, and to explore a method of evaluating the quality of space bred radix isatidis. The results showed that slight difference existed in the positions and shapes of the absorption peaks in FTIR spectra of samples between the two groups. The intensities of main absorption peaks of radix isatidis in the space group were strengthened to various degrees compared with those in the ground group. The absorption peaks were markedly enhanced at wave numbers of 1 047, 1 630 and 1 412 cm(-1), indicating that the contents of polysaccharides, sterides, triterpenes and flavanoids, particularly polysaccharides with anti-viral efficacy, increased to different extents. The absorption peak intensity of space radix isatidis at the wave number of 1 745 cm(-1) was weakened compared with that of radix isatidis in the ground group, suggesting the reduction of glycosides and organic acids. It is concluded that the contents of a plurality of active components of radix isatidis in the space group are elevated. New radix isatidis varieties with high contents of diverse active components can be harvested by spaceflight mutation breeding.

[Comprehensive characterization of main components and microstructures in five different species of Salvia miltiorrhiza bge].

Studied with X-ray fluorescence spectrum analytic (XRF), powder X-ray diffraction (PXRD) and Fourier transform infrared spectroscopy (FTIR) for five different species of Salvia miltiorrhiza bge grew in Anguo, the intrinsic components and microstructures were determined and comprehensive characterization was carried out. The figure of comprehensive characterization can describe characteristics of intrinsic components from elements, crystal and amorphous active component, it can give an intuitive description for the same components and subtle differences in the intrinsic components of Salvia miltiorrhiza bge, which are different idioplasmatic and same species. It is the ideal method because of the simple preparation of sample, rapid and fine accurate measurement with reproducibility and objectivity, so that it can be used for breeding of fine varieties of Chinese medicinal materials, Chinese medicinal materials GAP guidance of growing conditions, medicinal origin characteristics, the intrinsic composition and microstructure characterization, quality control and authenticity of the identification.