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Background Cardiotoxicity is a leading cause of mortality among breast cancer patients treated with chemotherapy. Therefore, an early risk assessment is vital for the clinical prevention and treatment of cardiotoxicity in breast cancer patients treated with chemotherapy, although a recognized tool is scant in our country. Objective To develop a cardiotoxic risk assessment scale for breast cancer patients undergoing chemotherapy and to test its reliability and validity. Methods Through reviewing relevant domestic and international literatures, a pool involving items to assess the risk of cardiotoxicity in breast cancer patients treated with chemotherapy was created. Semi-structured interviews with healthcare providers at Jiangsu Cancer Hospital from September to October 2022 were performed by purposive sampling, thus primarily forming a tool of items for the cardiotoxic risk assessment scale. In addition, breast cancer patients treated with chemotherapy in Jiangsu Cancer Hospital were randomly selected for a pre-survey and validation of the reliability and validity of the scale. Ranked by the score of the cardiotoxic risk assessment scale, the top 27% of participants were assigned into the high-score group, and the remaining were in the low-score group. Cronbach's α coefficient was used to evaluate the internal consistency of the scale. Validity of the scale was verified by measuring the item-level content validity index (I-CVI) and scale-level content validity index (S-CVI). Exploratory factor analysis was performed to assess the structural validity. Receiver operating characteristic (ROC) curves were plotted, and the area under tcurve (AUC) was calculated to determine the predictive validity. Results Twenty healthcare providers were included in the semi-structured interviews. After two rounds of expert consultations, a 19-item cardiotoxic risk assessment scale in breast cancer patients treated with chemotherapy was developed. In this study, there were 79 patients in the low-score group and 83 in the high-score group. No significant differences in the history of smoking, endocrine treatment and immunotherapy were detected between the two groups (P>0.05). Correlation analysis showed that the history of smoking and immunotherapy was not significantly correlated with the total scores (P>0.05). Eventually, three items of smoking history, history of endocrine treatment and history of immunotherapy were removed, forming a 16-item scale. The Cronbach's α coefficient, test-retest reliability and inter-rater reliability were 0.739, 0.983 and 0.984, respectively. Content validity results showed that I-CVI ranged from 0.83 to 1.00, and S-CVI was 0.98. Predictive validity results showed the AUC of 0.887 (95%CI=0.827-0.947, P

Objective To analyze the clinical distribution of Klebsiella pneumoniae isolates, screen for the multidrug resistance of Klebsiella pneumoniae strains to commonly used antimicrobial drugs, and provide reference for the prevention and control of hospital-acquired infections and rational clinical use of antimicrobial drugs. Methods Various clinical specimens collected from January 2018 to December 2022 at the Zhongda Hospital Affiliated to Southeast University were cultured to isolate bacteria. The VITEK automated microbial analyzer was used to identify the bacterial species. A total of 3 342 non-repetitive Klebsiella pneumoniae isolates were obtained during this period. Each Klebsiella pneumoniae strain was subjected to drug susceptibility testing using automated antimicrobial systems, disk diffusion methods, or standard broth microdilution methods to determine the antibiotic resistance profiles of Klebsiella pneumoniae. The detection rate of Klebsiella pneumoniae in clinical specimens and its association with specimen sources or department categories were analyzed. Results Klebsiella pneumoniae isolates were obtained from sputum (42.07%), urine (14.81%), and blood (10.29%). The departments with higher detection rates of Klebsiella pneumoniae were Intensive Care Unit (ICU) (35.19%), Neurosurgery (6.28%), and Respiratory and Critical Care Medicine (5.42%). The resistance identification results showed the highest resistance rate to ampicillin (100.00%) and the lowest resistance rate to amikacin (4.22%). Annual analysis of resistance rates to carbapenems in Klebsiella pneumoniae isolates from 2018 to 2021 revealed an increasing trend: 2.94%, 4.66%, 7.90%, and 15.35%, respectively. However, in 2022, the resistance rate started to decrease (5.38%). Carbapenem-resistant Klebsiella pneumoniae strains were predominantly of the KPC type, and there was a statistically significant difference in the resistance rates to commonly used antimicrobial drugs between carbapenem-resistant Klebsiella pneumoniae and carbapenem-sensitive Klebsiella pneumoniae(P＜0.01). Conclusion Klebsiella pneumoniae maintains a high level of clinical isolation rate, along with high resistance rates. Therefore, it is necessary to strengthen the prevention and control of hospital-acquired bacterial infections and surveillance of drug resistance. Rational selection of antimicrobial drugs should be employed for the treatment of Klebsiella pneumoniae infections.

Objective To observe the practice of standard management of outpatient complaints and improve the quality of outpatient medical care. Methods Total of 72 cases of outpatient complaints received from July 2020 to august 2020 were included as the control group, and another 72 cases of outpatient complaints received from September 2020 to October 2020 were included as the observation group. Cases of outpatient complaints in the control group were addressed by using a conventional method, and those in the observation group were addressed by using a standard management procedure. The incidence of medical dispute and patient satisfaction were compared between two groups. Results There were 6 cases of medical dispute reported in the control group. T he satisfaction rate was 98. 61%(71/72) in the observation group, which was higher than 84. 72%(61/72) in the control group. Conclusion Standardized treatment of outpatient complaints not only mediate doctor-patient disputes, but also protect the rights and interests of both sides. The practice of standardized treatment may improve the overall service quality of the hospital and the satisfaction of patients. (目的 探讨门诊投诉规范化处理的实践效果。方法 将2020年7月—8月接收的72份投诉案例设为对照组, 将2020年9月—10月接收的72份投诉案例设为观察组。对照组采取常规方法接待和处理, 观察组严格执行门诊投诉规范处置。统计2组医疗纠纷发生情况, 比较2组当事患者对处置过程的满意度。结果 观察组未发生医疗纠纷, 对照组发生医疗纠纷6(8. 33%)起。观察组当事患者对处置流程的满意度为98. 61%(71/72), 对照组为84. 72%(61/72)。结论 规范处置门诊投诉, 能够有效控制医患纠纷, 保障医患双方的权益, 有助于提高医院整体服务质量, 提升患者满意度。)

Dragon fruit stem disease significantly affects both the quality and yield of dragon fruit. Therefore, there is an urgent need for an efficient, high-precision intelligent detection method to address the challenge of disease detection. To address the limitations of traditional methods, including slow detection and weak micro-integration capability, this paper proposes an improved YOLOv8-G algorithm. The algorithm reduces computational redundancy by introducing the C2f-Faster module. The loss function was modified to the structured intersection over union (SIoU), and the coordinate attention (CA) and content-aware reorganization feature extraction (CARAFE) modules were incorporated. These enhancements increased the model's stability and improved its accuracy in recognizing small targets. Experimental results showed that the YOLOv8-G algorithm achieved a mean average precision (mAP) of 83.1% and mAP50:95 of 48.3%, representing improvements of 3.3% and 2.3%, respectively, compared to the original model. The model size and floating point operations per second (FLOPS) were reduced to 4.9 MB and 6.9 G, respectively, indicating reductions of 20% and 14.8%. The improved model achieves higher accuracy in disease detection while maintaining a lighter weight, serving as a valuable reference for researchers in the field of dragon fruit stem disease detection. [ABSTRACT FROM AUTHOR]

To achieve an accurate measurement of tread size after fixed-length cutting, this paper proposes a point-cloud-based tread size measurement method. Firstly, a mathematical model of corner points and a reprojection error is established, and the optimal solution of the number of corner points is determined by the non-dominated sorting genetic algorithm II (NSGA-II), which reduces the reprojection error of the RGB-D camera. Secondly, to address the problem of the low accuracy of the traditional pixel metric ratio measurement method, the random sampling consensus point cloud segmentation algorithm (RANSAC) and the oriented bounding box (OBB) collision detection algorithm are introduced to complete the accurate detection of the tread size. By comparing the absolute error and relative error data of several groups of experiments, the accuracy of the detection method in this paper reaches 1 mm, and the measurement deviation is between 0.14% and 2.67%, which is in line with the highest accuracy standard of the national standard. In summary, the RGB-D visual inspection method constructed in this paper has the characteristics of low cost and high inspection accuracy, which is a potential solution to enhance the pickup guidance of tread size measurement. [ABSTRACT FROM AUTHOR]

To address the current steel surface defect detection algorithms in practical applications involving low detection accuracy, an efficient and highly accurate strip steel surface defect detection algorithm, DEW-YOLO, is proposed in this paper. Firstly, by combining the advantages of deformable convolutional networks (DCNs), this paper innovates the C2F module in YOLOv8 and proposes a C2f_DCN module that can flexibly sample features to enhance the abilities of learning and expressing defect features of different sizes and shapes. Secondly, the explicit visual center (EVC) is introduced into the backbone network, which enhances feature extraction capabilities and adaptability and enables the model to better adjust features at different levels and scales. Finally, the original loss function is replaced with the Wise-IoU (WIoU) loss function to accurately measure the similarity between the target frames and improve the defect detection performance of the model. The experimental results on the NEU-DET dataset demonstrate that the algorithms proposed in this paper achieved a mean average precision (mAP) of 80.3% in steel surface defect detection tasks, which was a 3.9% improvement over the original YOLOv8 model. The model's inference speed reached 91 frames per second (FPS). DEW-YOLO effectively enhances the accuracy of steel defect detection and better satisfies industrial inspection requirements. [ABSTRACT FROM AUTHOR]

Single‐molecular organic photovoltaics (SMOPVs), which are based on monadic systems containing donor (D) and acceptor (A) molecule blocks that facilitate exciton dissociation, offer obvious advantages over binary or multicomponent bulk‐heterojunction (BHJ) systems, including simplified cell fabrication, stabilized morphology of the D/A interface, and extended device operation lifetime. However, limited by the development of A blocks, the power conversion efficiency (PCE, ≈5%) of SMOPVs based on molecular D–A dyads still lags conventional BHJ OPVs (over 19%). Herein, by introducing a narrow‐bandgap A–DA'D–A conjugated backbone as the A‐block, combined with the linear D‐block BDT‐3T‐R and flexible alkyl chain linker, two molecular dyads, SM‐1Y (one D‐block and one A‐block) and SM‐2Y (one D‐block and two A‐blocks), are designed and developed. Due to superior absorption spectra and better molecular stacking compared to SY‐1Y, SM‐2Y‐based SMOPV delivers a PCE of 8.13%, which is the highest value in the SMOPV reported thus far. Note that both SM‐1Y and SM‐2Y devices show much better storage and photostability stability as compared to the control BDT‐3T‐C6:Y18‐C3 binary system. [ABSTRACT FROM AUTHOR]

The fine-tuning of molecular aggregation and optimization of blend microstructures through effective molecular design strategies to simultaneously achieve high device efficiency and stability in all-polymer solar cells (all-PSCs) remain a significant challenge. This study presents a new design of random terpolymerization polymer acceptors (PAs) achieved by copolymerizing polymeric Y-series acceptors with congeneric molecules (TYTz-4F) that function as pendant structures. These PAs, PY-TYTz-x (x = 2.5, 5, and 10), exhibit similar absorption and energy levels but possess reduced electron mobilities and inferior molecular aggregation compared to PY-TYTz-0 (named PY-V-γ). Among these PA-based devices, power conversion efficiencies (PCEs) of 18.14% and 16.17% were achieved in rigid and flexible devices, respectively, by pairing PY-TYTz-5 with PM6 as the donor. Furthermore, the analysis of morphological characteristics and physical mechanisms confirmed the abovementioned performance results and also highlighted the advantage of this design strategy in improving the mechanical robustness of the devices. Impressively, in comparison to the control PA PY-TYTz-0, PY-TYTz-5 also exhibited much better compatibility with other classical polymer donors, including PBDB-T, PM7, D18-Cl, and PTQ10, thereby resulting in significantly improved performance in corresponding devices. This work underscores the potential of constructing random terpolymerization PAs with Y-derivative acceptor pendants in improving the donor/acceptor compatibility and facilitating the performance and commercial applications of all-PSCs. [ABSTRACT FROM AUTHOR]

Self‐disclosure (SD) is a common psychological intervention that involves expressing the patient's feelings and thoughts. The purpose of this study was to assess the effectiveness of different themes of SD on cancer patients. We searched eight databases including PubMed, Cochrane Library Trials, Web of Science, CINAHL, Medline, EMBASE, CNKI and Wanfang from inception to July 2022. Other sources included clinical data registers. The Cochrane Collaboration's tool was used to assess the risk of bias in the included studies. RevMan Analysis software 5.3 was used for data analysis. The protocol of this meta‐analysis has been registered on PROSPERO (CRD42022339661). Twenty‐two RCTs studies were included. The pooled results demonstrated that self‐regulation self‐disclosure (SRD) had significant effects on patients' sleep quality, benefit‐finding, anxiety and quality of life (QOL), whereas emotional disclosure (ED) did not. Furthermore, enhanced self‐regulation self‐disclosure (ESRD) or cancer‐related self‐disclosure (CD) significantly improved patients' QOL, although health education self‐disclosure (HED) and positive self‐disclosure (PD) did not. Our study suggests that different themes of SD have varied effects on patients, but it remains unclear which themes to use at what point in time. Future research should investigate what themes of SD are adopted at different points in time and the duration of different periods. [ABSTRACT FROM AUTHOR]

Backgrounds & Aims: The nutritional evaluation of pancreatic cancer (PC) patients lacks a gold standard or scientific consensus, we aimed to summarize and systematically evaluate the prognostic value of nutritional screening and assessment tools used for PC patients. Methods: Relevant studies were retrieved from major databases (PubMed, Embase, Web of Science, Cochrane Library) and searched from January 2010 to December 2023. We performed meta-analyses with STATA 14.0 when three or more studies used the same tool. Results: This analysis included 27 articles involving 6,060 PC patients. According to a meta-analysis of these studies, poor nutritional status evaluated using five nutritional screening tools Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI), Controlling Nutritional Status Score (CONUT), Nutrition Risk Screening (NRS2002) and Glasgow Prognostic Score (GPS) was associated with all-cause mortality in PC patients. But Modified Glasgow Prognostic Score (mGPS) did not. Of all tools analyzed, CONUT had the maximum HR for mortality (HR = 1.978, 95%CI 1.345–2.907, P = 0.001). Conclusion: All-cause mortality in PC patients was predicted by poor nutritional status. CONUT may be the best nutritional assessment tool for PC patients. The clinical application value of Short Form Mini Nutritional Assessment (MNA-SF), Generated Subjective Global Assessment (SGA) and Patient-generated Subjective Global Assessment (PG-SGA) in PC patients need to be confirmed. In order to improve patients' nutritional status and promote their recovery, nutritional screening tools can be used. Registration: This systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) (number CRD42022376715). [ABSTRACT FROM AUTHOR]

Polygoni Multiflori Radix (PMR) is a medicinal herb commonly used in China and Eastern Asia. Recently, the discovery of hepatotoxicity in PMR has received considerable attention from scientists. Processing is a traditional Chinese medicine technique used for the effective reduction of toxicity. One uncommon technique is the braising method—also known as 'Wen‐Fa' in Chinese—which is used to prepare tonics or poisonous medications. Braised PMR (BPMR)—also known as 'Wen‐He‐Shou‐Wu'—is one of the processed products of the braising method. However, the non‐volatile components of BPMR have not been identified and examined in detail, and therefore, the hepatotoxic advantage of BPMR remains unknown. In this study, we compared the microscopic characteristics of different samples in powder form using scanning electron microscopy (SEM), investigated the non‐volatile components, assessed the effects of different processed PMR products on the liver, and compared the differences between BPMR and PMR Praeparata recorded in the Chinese Pharmacopoeia (2020 edition). We found that the hepatotoxicity of BPMR was dramatically decreased, which may be related to an increase in polysaccharide content and a decrease in toxic substances. The present study provides an important foundation for future investigations of the processing mechanisms of BPMR. [ABSTRACT FROM AUTHOR]