Objective:The institutionalization of care for patients with dementia is becoming a trend. Understanding the burden on employed caregivers and exploring associated factors are of great importance in practice. Therefore, this study aimed to examine the relationship between basic attributes, caring ability, and caregiver burden in employed caregivers practicing in nursing homes. Methods:This cross-sectional study included 541 employed caregivers in 11 four-star nursing homes in Zhejiang Province from April to December 2022. Caregiver burden was assessed using the Zarit Burden Interview (ZBI). Demographic characteristics of participants, characteristics of the older patients with dementia, caring characteristics, training in dementia care, and caring abilities were collected for analysis of influencing factors. A hierarchical multiple regression analysis was conducted to explore the factors influencing the burden on employed caregivers in nursing homes. Results:The ZBI score of employed caregivers in nursing homes was 40.42 ± 10.18, representing a moderate caregiver burden. Factors such as age (U = 27.82, P < 0.001), residence (U = 7.89, P < 0.001), educational level (H = 55.81, P < 0.001), self-care of older patients with dementia (H = 85.21, P < 0.001), daily care hours (H = 73.25, P < 0.001), number of older people with dementia cared for (H = 14.56, P = 0.012) and training in dementia care (U = -9.43, P < 0.001) were significantly associated with caregiver burden.Caring ability was negatively associated with caregiver burden (r = -0.22, P < 0.01). Furthermore, after controlling for demographic characteristics, the characteristics of older people with dementia, caring characteristics, training in dementia care, and caring ability explained 8.5%, 5.8%, and 4.8% of the caregiver burden, respectively. Conclusion:The burden of employed caregivers on patients with dementia in nursing homes can be attributed to various factors. We recommend tailored interventions, such as dementia care training and reviewing the number and duration of hours worked to reduce the burden experienced by caregivers.

Objective:To construct a scientific and practical group activity program for senile dementia.Methods:A systematic search was conducted to identify the literature on group activities of senile dementia in the Registered Nurses Association of Ontario, guidelines from National Institute for Health and Care Excellence, JBI EBP database, Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure, WanFang Data until January 1, 2022. Two researchers independently evaluated the methodological quality of the included literature. According to the retrieved literature, the first draft of group activity program was made. Two rounds of Delphi expert correspondence were conducted with experts from medical, nursing, rehabilitation and community care fields, and evaluated by expert authority coefficient and coordination coefficient, finally, the content index system of group activity program for senile dementia was established.Results:The recovery rates of the two rounds of expert consultation questionnaires were 94.44% and 94.74%, the degree of authority were 0.79 and 0.82, the coordination coefficients of importance were 0.149 and 0.184, and the coordination coefficients of feasibility were 0.130 and 0.366, all P < 0.01. Finally, the group activities program for senile dementia consists of 4 first-class indicators, 15 second-class indicators and 38 third-class indicators.Conclusion:The group activity program for senile dementia is scientific and feasible, and can be promoted and implemented within institutions with qualification and professional capabilitie at different levels.

In surface defect dark-field inspection of the curved optical element, the camera field of view (FOV) is much smaller than the aperture of the element, so the images of different positions on the element surface, which are also called sub-aperture images, need to be collected and stitched to obtain the whole surface image of the element. It is usually achieved by controlling multi-axis motion guide rails to make relative motion between camera and optical element. During sub-aperture images collection, there is not only relative translation between camera and optical element, but also optical element spin and swing with its optical axis for curved optical element. The motion errors of each motion axis will make sub-aperture scanning path deviate its predetermined path. Hence, it will lead to the dislocation of the stitching image, and will cause defects break and dislocation in stitching image, which will largely affect the optical element surface quality quantitative evaluation. Since multi-axis kinematics (MAK) is a mathematical model which is often used to describe the motion of objects located in multi-axis system, such as numerical control machine and mechanical arm. The multi-axis kinematics error analysis (MAKEA) model is put forward in this paper and applied in the optical element surface defects dark-field imaging inspection system. The effect of all axis motion errors including optical axis motion errors to sub-aperture scanning path has been specifically simulated and analyzed. The simulation result indicates that the optical axis swing error caused by assembly is the main error of dark-field imaging system, whereupon a swing angle assembly error measurement (SAAEM) method by measuring the optical axis positions of different thickness spherical optical elements is proposed. By adjusting the motor of the element optical axis swing, the optical axis swing error can be compensated. The sub-aperture images stitching experiment is carried out to verify the validity of optical axis swing error compensation. Results show the situation of sub-aperture images stitching dislocation is improved. The root-mean-square-error (RMSE) of sub-aperture images scanning path after error compensation is nearly 1/20 of the RMSE before compensation.

Dysphagia is a common functional impairment after stroke, resulting in aspiration of liquids, ingested foods, or oral secretions and influencing the quality of life. Noninvasive repetitive transcranial magnetic stimulation has been widely used for rehabilitation of dysphagia. The purpose of this meta-analysis was to investigate the efficacy of repetitive transcranial magnetic stimulation on poststroke swallowing impairment. Four databases were systematically searched for eligible studies from their inception to 31 September 2021. Review Manager 5.4 software was used for this meta-analysis. The bias of included randomized controlled trials was assessed using the version 2 of the Cochrane risk-of-bias tool for randomized trials. Nine randomized controlled trials involving 393 patients were included according to the selection criteria. The results revealed significant benefit of repetitive transcranial magnetic stimulation as a treatment of dysphagia following the onset of stroke, when compared with intervention without repetitive transcranial magnetic stimulation. Applying repetitive transcranial magnetic stimulation on different stimulation sites effectively improved the dysphagia of poststroke patients, and no significant difference was observed among the different stimulation sites subgroups. Our findings support repetitive transcranial magnetic stimulation as an effectively treatment of the poststroke dysphagia, especially in unilateral hemispheric stroke patients.

Objective. Based on a retrospective case-control study, logistic multivariate analysis was employed to explore the effects of nursing and psychological factors on the rehabilitation of motor and cognitive function in patients with stroke. Methods. A total of 200 stroke patients treated from February 2019 to April 2020 were enrolled in our hospital. According to the results of exercise and cognitive rehabilitation, the patients with good rehabilitation were divided into the control group (n = 140) and the research group (n = 60). The effects of nursing and psychological factors on the rehabilitation of motor and cognitive function in patients with stroke were analyzed. Results. First of all, we compared the general data. There were significant differences in terms of age, years of education, occupational status, payment methods of medical expenses, family income and the course of the disease, and the difference was statistically significant ( P < 0.05 ). There was no significant difference in general data ( P > 0.05 ). Secondly, we compared the nursing effective rates. The nursing effective rates of the study group were 10 cases, 15 cases, 12 cases, and 23 cases, and the nursing effective rate was 61.67%. In the control group, 78 cases were markedly effective, 33 cases were effective, 25 cases were general and 14 cases were ineffective, and the nursing effective rate was 90.00%. The effective rate of nursing in the study group was higher than that in the control group, and the difference was statistically significant ( P < 0.05 ). There was no significant difference in anxiety and depression scores before nursing ( P > 0.05 ), but they decreased after nursing. In addition, the scores of anxiety and depression in the study group were higher than those in the control group, and the difference was statistically significant ( P < 0.05 ). There was no significant difference in motor function and cognitive function between prenursing and prenursing ( P > 0.05 ); after nursing, the motor function increased and the score of cognitive function decreased. Furthermore, the motor function of the study group was lower compared to the control group, and the score of cognitive function of the study group was higher compared to the control group, and the difference was statistically significant ( P < 0.05 ). The results of the Person correlation analysis showed that there was a significant correlation between nursing anxiety depression and the rehabilitation effect of motor cognitive function in stroke patients. The results of logistic regression analysis showed that age, family income, nursing efficiency, anxiety, and depression were the factors affecting the rehabilitation of motor and cognitive function in stroke patients. Conclusion. Age and family income may be the risk factors affecting the psychological mood of patients. Medical staff should pay attention to the negative emotion of patients and strengthen the nursing intervention of patients.

目的:分析增强现实(AR)体感运动联合穴位按摩对乳腺癌患者症状群的应用效果.方法:便利选取180例乳腺癌术后患者,根据随机数字表法按1:1:1的比例分为AR体感运动联合穴位按摩(AR-AM)组、穴位按摩(AM)组和假穴位按摩(FAM)组,3组患者分别接受AR体感运动联合穴位按摩、穴位按摩和假穴位按摩治疗,每周均为5次.分别在基线期(干预前)、干预第4周、第8周(干预治疗结束)和第12周(洗脱期结束)后采用简易疲乏量表(BFI)、简明疼痛调查表(BPI)、匹兹堡睡眠质量指数(PSQI)量表、焦虑自评量表(SAS)和抑郁自评量表(SDS)进行评分,并使用广义线性混合效应模型评估3组患者疲乏、疼痛、睡眠障碍及焦虑、抑郁程度.结果:170例参与者完成了自主康复干预研究,其中AR-AM组58例、AM组56例、FAM组56例.疲乏、疼痛、睡眠障碍和抑郁均值得分进行组间比较,AR-AM vs AM、AR-AM vs FAM和AM vs FAM之间第4、8、12周后各时点的下降水平均有统计学差异(P<0.001),AR-AM组患者疲乏、疼痛、睡眠障碍和抑郁得分下降最多,AM组患者次之,FAM组几乎无变化.焦虑得分组间比较,AR-AM vs AM和AR-AM vs FAM之间各时点的下降水平有统计学差异(P<0.001),AM vs FAM之间各时点的下降水平在第4周后无统计学差异(P=0.164),在第8周后有统计学差异(P<0.05),在第12周后无统计学差异(P=0.053).疲乏、疼痛、睡眠障碍、焦虑和抑郁变量在干预4周、8周和12周时的两两组间对比差异均具有统计学意义,且各组干预方式与时间交互作用显著(P<0.001).结论:AR体感运动穴位按摩能有效改善乳腺癌患者疲乏、疼痛、睡眠障碍、焦虑和抑郁症状,提高其生活质量.

目的 研究离床护理对重度脑卒中患者日常活动能力及生存质量影响.方法 收集浙江医院康复医学科2017年11月至2019年9月收治的符合重度脑卒中标准的患者78例,通过随机分组法分成对照组及观察组各39例,对照组采用脑卒中常规护理,观察组在此基础上进行离床护理流程,在出院前对患者进行日常生活活动能力评定(改良Bartherl指数)、出院后3个月随访对患者进行SF-36生命质量量表问卷调查. 结果 观察组在卧床时间(t=6.271,P<0.05)、住院时间(t=4.107,P<0.05)、并发症发生率(χ2=13.053,P<0.05)三个方面均低于对照组,差异有统计学意义.观察组出院前改良Barthel指数得分明显高于对照组(t=4.933,P<0.05).出院后3个月,观察组SF-36测评所有维度的得分和总分明显高于对照组(P<0.05). 结论 离床护理可明显提高重度脑卒中老人出院后日常生活活动能力和生存质量.

Quantitative defects detection has always been the one of the difficulties in optical element surface quality evaluation. In order to solve this problem, the optical element surface defects detection based on dark-field imaging system, which has been researched by our group team for nearly twenty years, has been summarized The plane and sphere optical element surface defects detection details are introduced. Specifically, it involves plane optical element surface leveling, sphere optical element spherical center alignment, low magnification image acquisition, low magnification image stitching, feature extraction, high magnification defects detection and report output based on the form of specific standard (Such as America Military Standard MIL-PRF-13830B or China National Standard GB/T 1185-2006). Besides, a China National Standard about digitized quantitative measurement of the defect, which is proposed by our group (now is in the stage of request for public advice), is also introduced.

Background: This study aims to evaluate the potential effect and the underlying mechanism of C-C motif chemokine ligand 2 (CCL2) in ischemic stroke. Methods: An integrated bioinformatics analysis was performed to identify the differentially expressed (DE) genes and their related pathways in ischemic stroke. In vivo study of a rat model of middle cerebral artery occlusion (MCAO) was further established to assess the effect of CCL2 on severity of neurologic impairments. The expression levels of proinflammatory cytokines were also evaluated using the ELISA assay, and Western blot was also used to determine the expression of CCL2 and other DE proteins in the related pathways. Results: A total of 88 DE genes were identified from the microarray dataset of ischemic stroke. The bioinformatics analysis revealed that CCL2 was highly expressed in ischemic stroke tissue and promoted the ischemic stroke progression via activation of the chemokine signaling pathway and cytokine-cytokine receptor interaction pathway. The in vivo study of the ischemic stroke rat model also showed that the CCL2 expression was elevated in the MCAO/R rats, with significant neurological impairments and ischemic infarct area in the brain tissue being observed. The administration of CCL2 inhibitors significantly inhibited the inflammatory response, attenuated the neurological impairments, and decreased the ischemic infarct area in the MCAO/R rats. Furthermore, the downregulation of CCL2 also inhibited the expression of the pathway-related proteins including CCL7, CCR2, CXCL16, and TNF-alpha. Conclusions: These results indicate that the CCL2/chemokine signaling pathway is responsible for ischemic stroke progression and might represent a potential therapeutic target for ischemic stroke treatment.

Defect detection based on machine vision and machine learning techniques has drawn much attention in recent years. Deep learning is very suitable for such segmentation and detection tasks and has become a promising research area. Surface quality inspection is essentially important in the manufacturing of mobile phone back glass (MPBG). Different types of defects are produced because of the imperfection of the manufacturing technique. Unlike general transparent glass, screen printing glass has totally different reflection and scattering characteristics, which means the traditional dark-field imaging system is not suitable for this task. Meanwhile, the imaging system requires high resolution since the minimum defect size can be 0.005 mm2. According to the imaging characteristics of screen printing glass, this paper proposes a coaxial bright-field (CBF) imaging system and low-angle bright-field (LABF) imaging system, and 8K line-scan complementary metal oxide semiconductor(CMOS) cameras are utilized to capture images with the resolution size of 16,000*8092. The CBF system is applied for the weak-scratch and discoloration defects while the LABF system is applied for the dent defect. A symmetric convolutional neural network composed of encoder and decoder structures is proposed based on U-net, which produces a semantic segmentation with the same size as the original input image. More than 10,000 original images were captured, and more than 30,000 defective and non-defective images were manually annotated in the glass surface defect dataset (GSDD). Verified by the experiments, the results showed that the average precision reaches more than 91% and the average recall rate reaches more than 95%. The method is very suitable for the surface defect inspection of screen printing mobile phone back glass.

目的 观察间歇置管对脑卒中后吞咽障碍患者血清营养学指标的影响.方法 按随机数字表将32例患者分为观察组和对照组,各16例.对照组采取长期留置鼻饲管给予肠内营养,观察组采用经口间歇置管给予肠内营养.观察干预前、干预2周及干预4周后血清白蛋白、转铁蛋白、前白蛋白等指标.结果 观察组白蛋白值随着干预时间延长呈上升趋势,与对照组比较,F时间×组间=3.549,P=0.035;观察组转铁蛋白值随着干预时间延长呈上升趋势,与对照组比较,F时间×组间=5.666,P=0.006;观察组前白蛋白值随着干预时间延长呈上升趋势,与对照组比较,F时间×组间=5.338,P=0.007.结论 经口间歇置管肠内营养干预能改善脑卒中后吞咽障碍患者营养状况.

An electromagnetic simulation model of microscopic scattering dark-field imaging was built based on the finite difference time domain (FDTD) method. The scattered light distribution of different defect’s size was obtained. Results show the span of distribution curve and the distribution peak are relative to the defect’s width and depth respectively. In the width range of 0.5 μm to 1 μm, there is a linear relationship between the distribution span and the defect’s width. Its goodness of linear fit reaches 0.9. Within the depth range of 0.1μm, the distribution peak linearly changes with the depth. But with the depth becomes deeper, the linear relationship between distribution peak and defect’s depth disappears. The results in this paper can provide instructive reference for the defect’s size inversion.

Defect size recognition is significant to the evaluation of optical element surface quality. Currently, it’s mainly achieved by the conventional image process, such as threshold segmentation. However, as the defect size gradually approaches the diffraction limit of the imaging system, the defect gray distribution changes from bimodal to unimodal, which makes it difficult to be accurately recognized. In this paper, an electromagnetic simulation model of the microscopic scattering dark-field imaging (MSDI) system is built based on the finite-difference time-domain (FDTD) method to research the defect imaging mechanism. The point spread function (PSF) of our MSDI system is measured to revise the far-field simulation light intensity distribution, and the mean value of the distance between three groups of feature points, whose intensity is 0.75, 0.5, and 0.25 of the light intensity distribution peak value, is taken as the feature parameter of the light intensity distribution. To obtain the defect size, the decision regression tree (DRT) is proposed to get the relationship between the feature parameter and the defect size. Besides, some scratches samples are made to verify the validity of the DRT. The results show the relative error of DRT is within 10%, which is better than the threshold segmentation.

目的 分析脑卒中后吞咽障碍患者抑郁和焦虑情绪发生的影响因素.方法 选取2017年5月-2018年6月在浙江医院康复医学科住院治疗的脑卒中后吞咽障碍并需管饲进食的患者,收集身高、体重、文化程度、血清营养学指标和管饲方式等资料,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估其焦虑和抑郁情绪发生情况,并采用Logistic回归模型分析抑郁和焦虑情绪发生的影响因素.结果 共纳入96例脑卒中后吞咽障碍患者,发生焦虑情绪34例,发生率为35.42％;发生抑郁情绪29例,发生率为30.21％.Logistic回归分析结果显示,白蛋白正常(OR=0.208,95％(CI:0.054～0.800)是脑卒中后吞咽障碍患者发生焦虑情绪的保护因素,而留置胃管(OR=5.789,95％ CI:1.654～20.260)是危险因素.转铁蛋白正常(OR =0.189,95％CI:0.042～0.860)是脑卒中后吞咽障碍患者发生抑郁情绪的保护因素,而留置胃管(OR=13.977,95％CI:1.472～132.667)是危险因素.结论 脑卒中后吞咽障碍患者抑郁和焦虑情绪发生率较高,白蛋白正常是患者发生焦虑情绪的保护因素,转铁蛋白正常是患者发生抑郁情绪的保护因素,留置胃管是患者发生焦虑或抑郁情绪的危险因素.

提出了一种基于细芯光纤结合Mach-Zehnder干涉仪的高灵敏度曲率传感器,传感头由一段细芯光纤嵌入在两段的单模光纤中错位熔接而成.当干涉仪受到弯曲作用时,由于细芯光纤和单模光纤的错位熔接,使得纤芯和包层模光强度产生损耗,在一定曲率范围内使得纤芯和包层模光强度更加接近而导致干涉增强,通过研究特定干涉峰的干涉强度相对于曲率的变化关系,可以实现光纤曲率传感.为了增加曲率的校准精度,提出了一种基于悬链线法的光纤弯曲的曲率修正模型.实验结果表明:利用曲率修正模型修正后,在9.15 m-1到11.02 m-1的范围内的曲率测量灵敏度达到142.28 dB/m-1.这种基于强度变化的低成本、高灵敏曲率传感器,具有广阔的应用前景.

A polarization-dependent twist sensor based on an in-fiber Mach-Zehnder interferometer is proposed.The sensor is constructed by core-offset fusion splicing of a 15-mm-long polarization maintaining fiber (PMF) between two single mode fibers.With the increasing of the twist applied on the sensor,the intensity of the output light transmitting along the two orthogonal polarization states has changed,which leads to the intensity changes of the resonance peaks in the transmission spectrum.By measuring the slow axis resonance peak intensity changes in clockwise and counterclockwise directions with the distorted angle within 0-180°,the maximum sensitivity can reach 0.624 dB/° · m-1,which is almost 2 times of that of the existing similar strain sensor.Due to the intensity demodulation method,the proposed sensor has an application advantage in marked contrast compared with other twist optic fiber sensors which usually employ high-cost wavelength-shift means.

A ferromagnetic material equipment internal defect detection system based on low-frequency (20-50 Hz) electromagnetic technique was proposed. Direct current magnetization was used to make the ferromagnetic material sample (20# steel for instance) be in a saturation magnetization state to decrease its permeability, which is beneficial for increasing the skin depth of the sample and strengthening the signal of the magnetic flux leakage. A low-frequency alternating current source was used to excite the spatial alternating electromagnetic field and a Hall sensor was used to collect the signal of the spatial magnetic field. Experimental results showed that the 6-mm buried depth internal defect with the sensitivity of 0.05 mm can be detected in the 12-mm thick 20# steel plate or pipeline, which is almost 1.5 times higher than that of the current similar sensors.

A transverse load fiber sensor based on Mach-Zehnder interferometer constructed by a Bowknot-type taper between a single mode fiber (SMF) and a polarization maintaining fiber (PMF) was proposed. Due to the polarization maintaining fiber's birefringence, intensities of the two peaks which are corresponding to the fast and slow axis modes changed with the transverse load applied on the PMF. The experimental results showed that the structure with a 2 cm-long PMF has the sensitivities of 104.52 and - 102.94 dB/(N/mm) for the fast and slow axis spectral dip wavelengths of 1485 and 1545 nm in the interference pattern, respectively, which are almost 7 times higher than that of the current similar existing transverse load sensor.

目的 观察康复护理对社区半失能老人吞咽障碍误吸的影响.方法 63例有吞咽障碍的社区半失能老人,随机分为观察组32例与对照组31例.对照组予吞咽筛查及常规吞咽障碍宣教及简单指导,观察组加用康复护理,3个月后观察两组洼田饮水试验评分变化及误吸率.结果 干预后,两组洼田饮水试验评分及误吸率均有所降低,观察组明显低于对照组,两组洼田饮水试验评分差异有统计学意义,两组误吸率比较差异无统计学意义.结论 常规宣教基础上加用康复护理对半失能老人吞咽障碍的康复作用更明显,患者吞咽功能得到改善,误吸率减少.