Intensive care unit (ICU) nurses are at high risk for work-related musculoskeletal disorders (WRMDs). Data on occupational injuries indicate the significance of WRMDs among ICU nurses. Intervention ...programs have previously been developed to reduce WRMDs, but different intervention methods need to be adopted for different groups of people. This study aimed to evaluate the effectiveness of a multidimensional intervention program to prevent and reduce WRMDs in ICU nurses.
This study was designed as a two-armed cluster-controlled trial with an intervention group and a control group. The clusters were independent hospital ICUs, and the participants consisted of registered nurses in China. By cluster random sampling, 89 nurses from two ICUs were assigned to the intervention group, and 101 nurses from two other ICUs were assigned to the control group. A multidimensional intervention program based on previous studies was designed. This program combined improving risk perception, health behavior training, and promoting a safe working environment. The multidimensional intervention program was implemented in the intervention group, whereas routine specialist training was implemented in the control group. Baseline and follow-up (3 and 6 months) data were collected using self-reported online questionnaires. The primary outcome was the report rate of WRMDs in the past 7 days. Secondary outcomes were risk perception, application of health behavior, and perception of a safe working environment. The data were statistically analyzed using SPSS 19.0.
A total of 190 nurses provided three recorded outcome measurements (intervention group, N = 89 (94.68%); control group, N = 101 (94.39%)). After 6 months, the intervention group experienced significant improvement relative to the control group in the report rate of WRMDs in the past 7 days (OR = 1.953, p = 0.037), risk perception (OR = 0.517, p < 0.001), application of health behavior (OR = 0.025, p < 0.001), and perception of a safe working environment (OR = 1.637, p = 0.024).
The multidimensional intervention program was superior to routine specialist training in preventing the occurrence of WRMDs in ICU nurses. WRMD training should include multifaceted approaches and pay increased attention to specific department functions.
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IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UL, UM, UPUK, VSZLJ
Background
This study aimed to investigate the clinical relevance of the immune microenvironment in patients with combined hepatocellular carcinoma and cholangiocarcinoma (cHCC‐ICC).
Patients and ...Methods
The density of tumor‐infiltrating CD3+, CD8+, CD163+, and Foxp3+ immune cells, as well as Programmed cell death 1, Programmed cell death‐ligand 1, and Tumor necrosis factor receptor superfamily member 4, was measured in the peritumor liver, tumor invasive margin, and intratumor subregions of 56 cHCC‐ICC by immunohistochemistry. The immune index was established to stratify patients. Prognostic significance of immune cell subsets and immune indices was evaluated.
Results
The distribution of immune cells was highly heterogeneous among different subregions of cHCC‐ICC. As compared with the hepatocellular carcinoma (HCC) component, the lower density of CD8+ T cells and higher intensity of Foxp3+ Tregs and immune checkpoints in the intrahepatic cholangiocarcinoma (ICC) component may indicate a stronger immune evasive ability of ICC. Based on clustering classification or a combination of random forest and lasso‐cox, two models of immune indices were established and both were identified as independent prognostic factors for cHCC‐ICC patients. The selected immune variables in the immune prognostic models derived from both HCC and ICC subregions, indicating that the prognosis of cHCC‐ICC patients was a complex interaction of both components.
Conclusions
The immune contexture was heterogeneous among different subregions of cHCC‐ICC patients and contributed differently to patient prognosis. Immune score based on the densities of immune cells might serve as a promising prognostic predictor for cHCC‐ICC patients.
Highlights
The prognosis of cHCC‐ICC patients was a complex interaction of both cancer components.
The immune evasive ability of ICC components is stronger than that of HCC components.
Heterogeneous immunological features could serve as a promising prognostic index for cHCC‐ICC patients.
Immunotherapy strategies could be a potential treatment for cHCC‐ICC patients.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Platinum (Pt)‐based catalysts are considered as the most active catalysts for the oxygen reduction reaction (ORR). However, their applications have remained limited because of the high cost of Pt, ...and developing catalysts with low Pt contents is a challenge. Herein, a highly active catalyst (Pt–COF800) is constructed for the ORR by immobilizing hierarchical Pt subnano‐ and nanoparticles on covalent organic framework (COF)‐derived carbon. The catalyst shows excellent activity in alkaline conditions. The physical characterization demonstrates low nuclear Pt atoms and nanoparticles and confirms the role of heterogeneous active sites. This work paves the way for the construction of functional porous carbon materials with dual‐scale Pt clusters and may be applied to industrial catalytic reactions.
A highly active catalyst (Pt–COF800) is demonstrated for the oxygen reduction reaction (ORR) by immobilizing hierarchical platinum (Pt) subnano‐ and nanoparticles on covalent organic framework (COF)‐derived carbon. The catalyst shows excellent activity in alkaline conditions. The physical characterization verifies the low nuclear Pt atoms and nanoparticles and heterogeneous active sites.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
This paper proposes a novel variable-length beam element that takes into account the effect of beam spinning. This is the first such beam element of variable length based on the absolute nodal ...coordinate formulation. In addition to the position and slope vectors, the angles of rotation around the element axis of cross sections that contain two nodes are introduced into the element coordinates to describe the spinning of an assumed Euler-Bernoulli beam with circular cross section. The material coordinates of the two nodes are also included in the arbitrary Lagrangian-Eulerian description used for previous element to describe the varying element length caused by mass transportation at the boundaries. The proposed element facilitates convenient and effective numerical modeling of the dynamics of a circular-cross-section beam with transportation boundaries and that is spinning. Numerical examples demonstrate that the proposed element can describe the dynamic behavior of a circular-cross-section beam effectively. In the field of engineering, this novel element could be used in the dynamic analysis of drill stems, the slender workpiece of a cylindrical shaft during the turning process, and the lead screw in a ball screw mechanism.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The stable operation of sewage treatment is of great significance to controlling regional water environment pollution. It is also important to forecast the inlet water quality accurately, which may ...ensure the purification efficiency of sewage treatment at a low cost. In this paper, a combined kernel principal component analysis (KPCA) and extreme learning machine (ELM) model is established to forecast the inlet water quality of sewage treatment. Specifically, KPCA is employed for feature extraction and dimensionality reduction of the inlet wastewater quality and ELM is utilized for the future inlet water quality forecasting. The experimental results indicated that the KPCA-ELM model has a higher accuracy than the other comparison PCA-ELM model, ELM model, and back propagation neural network (BPNN) model for forecasting COD and BOD concentration of the inlet wastewater, with mean absolute error (MAE) values of 2.322 mg/L and 1.125 mg/L, mean absolute percentage error (MAPE) values of 1.223% and 1.321%, and root mean square error (RMSE) values of 3.108 and 1.340, respectively. It is recommended from this research that the method may provide a reliable and effective reference for forecasting the water quality of sewage treatment.
Developing a highly efficient water-splitting photocatalyst for hydrogen production under visible light is urgent. In this study, β-SiC nanowire photocatalysts loaded with 0.01–0.1 wt. % nickel were ...prepared. Their microstructure and hydrogen production activity were studied. The catalyst with 0.05 wt. % nickel and a sacrificial agent Na2S–Na2SO3 shows the highest hydrogen production rate of 375.4 µmol g−1 h−1 since the loaded nickel prohibits the recombination of photogenerated electron–hole pairs in the system, which enhances the photocatalytic activity.
Background
Previous studies suggested that unhealthy sleep patterns were closely associated with gastrointestinal diseases, but the impact of unhealthy sleep duration on chronic constipation has not ...been well studied until now. In this study, we aim to explore the association between sleep duration and constipation among males and females.
Methods
We utilized the US National Health and Nutrition Examination Surveys data from 2005 to 2010, and adults (≥20 years old) who completed the sleep and bowel health questionnaires were enrolled in this observational study. Sleep duration was categorized into four groups: very short sleep (<5 h/night), short sleep (5–6 h/night), normal sleep (7–8 h/night), and long sleep (≥9 h/night). Chronic constipation was defined as Bristol Stool Scale Type 1(separate hard lumps, like nuts) or Type 2(sausage-like but lumpy). Controlling demographic, lifestyle, and dietary factors, the logistic regression model in Generalized Linear Model (GLM) function was used to estimate the correlation of sleep duration with constipation among men and women.
Results
Of the 11,785 individuals (51.2% males and 48.8% females), 4.3% of men and 10.2% of women had constipation, respectively. More than half of patients with constipation did not adopt the recommended sleep duration. Compared with normal individuals, male participants with constipation had a higher proportion of shorter sleep duration (41.0 vs. 32.3% in the short sleep group and 6.3 vs. 4.7% in the very short sleep group), and female individuals with constipation had a higher proportion of long sleep duration (12.7 vs. 8.2%). After covariates adjustment, men with short sleep duration (5–6 h/night) correlated with increased odds for constipation (OR:1.54, 95%CI:1.05–2.25), and women with long sleep duration (≥9 h/night) linked to the higher constipation risk (OR:1.58, 95%CI:1.10–2.29). Excessive sleep duration in males or insufficient sleep duration in females was neither linked to increased nor decreased constipation risk.
Conclusions
In this observational study of a nationally representative sample of adults, we demonstrate a differential impact of unhealthy sleep duration on constipation among men and women. Short sleep duration poses a higher risk of constipation in men, and excessive sleep duration correlates with higher constipation risk in women.
BackgroundTransition metal nitrogen doped carbon materials are promising to replace precious metal platinum-based materials as an important electrocatalyst for oxygen reduction, and have attracted ...extensive attention in the research fields of energy storage materials and energy conversion devices.PurposeThis study aims to develop new vanadium doped transition metal carbon materials with excellent catalytic performance, and clarify the role of the introduced of vanadium.MethodsThe vanadium doped cobalt-nitrogen-carbon catalyst was designed by two-step pyrolysis method and impregnation method. The catalytic performance of the oxygen reduction reaction (ORR) was evaluated by a three electrode system using rotating disk electrode. The morphology and microstructure of catalysts were characterized by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). X-ray diffraction (XRD) was employed to examine crystal orientation structure of catalyst whilst the element types and distribution of mate
We report the results of a combined study of detrital zircon U–Pb geochronology and bulk‐rock elemental geochemistry on late Neoproterozoic to Cambrian clastic sedimentary rocks from South Jiangxi ...within Cathaysia. These clastic rocks are characterized by moderate chemical index of alteration (CIA) values of 73 and high Th/U ratios (>3.8), indicating moderate weathering of the source area. The relatively high index of compositional variability (ICV = 0.62–1.30) values indicates a source compositionally dominated by immature material that lacks alumina‐rich minerals. Bulk‐rock major and trace element systematics on discrimination diagrams are consistent with the source provenance being felsic‐intermediate igneous rocks of ancient continental crust origin. The geochemistry is also consistent with the clastic sedimentary rocks being deposited in a setting at or in the vicinity of passive continental margins. Detrital zircon U–Pb ages of the clastic rocks record five major age populations: 2,614–2,376 Ma (peak at ca. 2,482 Ma), 1,953–1,353 Ma, 1,000–900 Ma (peak at ca. 958 Ma), 850–730 Ma (peaks at ca. 845 and 763 Ma), and 685–571 Ma (peak at ca. 635 Ma). The age data provide a record of igneous activity in the source provenance: the 2,482 Ma peak is consistent with the global Neoarchean continental crust growth; the 1,953–1,353 Ma population correlates with the period of assembly and breakup of the Columbia supercontinent; the prominent peak at ca. 958 Ma corresponds to a common thermal–tectonic event associated with the assembly of Rodinia, and the 850–730 Ma population is consistent with the breakup of the Rodinia supercontinent. The ca. 850 Ma age is indicative of initial stage of Rodinia breakup in South China. Our data also reveal a 670–530 Ma population that correlates well with the Pan‐African event associated with the formation of the Gondwana supercontinent, although no direct geological evidence for this event has been found within the SCB. Moreover, complex zircon morphology and comparisons of detrital zircon U–Pb age spectra in a global context suggest the late Neoproterozoic–Cambrian sedimentary rocks in the Cathaysia Block must have sourced from an exotic source with magmatic activities of late Archean, Grenvillian, and Pan‐African ages, which do not outcrop in the Cathaysia Block or adjacent regions and need to be further explored.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Currently, the sedimentation process concerning the formation of the morphological changes of deltas under the action of waves has received little attention. Two numerical simulations were carried ...out in this study to explore the sedimentary morphological changes of deltas under wave action. In the first experiment, the morphological characteristics of river-dominated deltas and wave-dominated deltas were compared. Results showed that a wave-dominated delta was more likely to produce slender and stable rivers relative to a river-dominated delta. In the second experiment, the morphologies of wave-dominated deltas with sediments of different grain sizes were compared. Results indicated that delta morphology was not significantly correlated with the median grain size (
) of the sediment, and the average grain size of the coarser sediments (
) was an important factor affecting delta morphology. Moreover, a delta with a larger
value of the input sediment, a smaller topset gradient, and a smaller number of active river channels had a more arcuate shape. The results showed that the hydrodynamic numerical simulation method has the ability to reveal the evolution of deltas under the action of waves. The final simulation results were consistent with the actual delta data.
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