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The post-construction improvement technology of bored pile tips has been widely used in the construction of gravel pebble layers, but the diffusion law of the grouting slurry remains to be revealed. To study the diffusion law of the grouting slurry at the tip of bored piles in gravel pebble layers, an equivalent relationship between the seepage continuity equation and the mass diffusion continuity equation was established based on an in-depth comparative analysis; further relying on the Diluted Species Transport Module in Porous Media of Comsol Multiphysics, a three-dimensional numerical model of slurry diffusion was established to systematically study the impact of key factors such as different porosities, grouting times, grouting pressures, slurry diffusion coefficients, and the ratio of vertical to horizontal slurry diffusion coefficients on the diffusion radius of the slurry. The calculation results show that with the continuation of grouting, the increase in porosity, grouting pressure, and slurry diffusion coefficient, or the decrease in the ratio of vertical to horizontal slurry diffusion coefficients, the diffusion range of the slurry increases accordingly. Furthermore, comparatively speaking, the impact of porosity is the smallest, while the impact of the slurry diffusion coefficient is the greatest. The research findings reflect the diffusion trend of the slurry in the gravel pebble layer, which has guiding significance for the quality control of the actual design and construction of grouting. [ABSTRACT FROM AUTHOR]

Objective: There is a lack of studies on the quality of life (QoL) after posterior laminectomy in patients with thoracic ossification of the ligamentum flavum (TOLF), and risk factors associated with poor prognosis remain controversial. Therefore, the present study was conducted to illustrate the QoL for TOLF patients after surgery and determine its relationship with their demographic, surgery‐related, clinical characteristics and imaging data. Methods: One hundred and eighteen patients diagnosed with thoracic myelopathy because of TOLF were enrolled in this retrospective study. They all underwent posterior decompressive laminectomy from August 2010 to January 2022. The QoL was evaluated based on the EQ‐5D‐5L. Collecting gender, age, number of operations, compressed segments, Frankel grade, complications, body mass index (BMI), symptoms and duration, modified Japanese Orthopaedic Association (mJOA) score (preoperative), follow‐up time and type of ossification, increased signal on Sagittal T2‐weighted Images (ISST2I), occupancy rate and analyzing by Mann–Whitney U‐test, Kruskal–Wallis test, the χ2‐test, and logistic regression tests. Results: Average follow‐up 70.8 months (18–149), the mean age was 59.74 ± 9.81 years and the mean score for the QoL based on the EQ‐5D‐5 L and visual analogue scale (VAS) score were 0.71 ± 0.28 and 78.88 ± 10.21 at the final follow‐up. Moderate and severe problems were found in the pain/discomfort in 22.0% of the patients. These mobility and usual activities numbers were slightly higher (24.6% and 30.4%, respectively). The mean scores for QoL and VAS were significantly higher in patients with mild and moderate neurological impairment, normal BMI, <60 years of age, no dural tears, symptom relief at hospital discharge, unilateral and bilateral ossification on axial CT scan, ≤ 50% spinal canal occupancy on CT and MRI, and none or fuzzy on ISST2I. Conclusion: QoL after posterior laminectomy in TOLF patients is generally satisfactory compared to preoperative levels. Preoperative mJOA score, Age, comorbid diabetes, the major symptom is activity limitation, BMI, ISST2I, Intraoperative dural tears and spinal canal occupancy rate correlate significantly with the corresponding dimensions and are predictive. Age, spinal canal occupancy rate, ISST2I, preoperative mJOA score, BMI are significantly associated with and have predictive value for overall postoperative QoL. [ABSTRACT FROM AUTHOR]

Disasters and pandemics pose unique challenges to health care delivery. As health care resources continue to be stretched due to the increasing burden of the coronavirus disease (COVID-19) pandemic, telemedicine, including tele-education, may be an effective way to rationally allocate medical resources. During the COVID-19 pandemic, a multimodal telemedicine network in Sichuan Province in Western China was activated immediately after the first outbreak in January 2020. The network synergizes a newly established 5G service, a smartphone app, and an existing telemedicine system. Telemedicine was demonstrated to be feasible, acceptable, and effective in Western China, and allowed for significant improvements in health care outcomes. The success of telemedicine here may be a useful reference for other parts of the world.

BackgroundeHealth is an application of information and communication technologies across the whole range of functions that affect health. The benefits of eHealth (eg, improvement of health care operational efficiency and quality of patient care) have previously been documented in the literature. Health care providers (eg, medical doctors) are the key driving force in pushing eHealth initiatives. Without their acceptance and actual use, those eHealth benefits would be unlikely to be reaped. ObjectiveTo identify and synthesize influential factors to health care providers’ acceptance of various eHealth systems. MethodsThis systematic literature review was conducted in four steps. The first two steps facilitated the location and identification of relevant articles. The third step extracted key information from those articles including the studies’ characteristics and results. In the last step, identified factors were analyzed and grouped in accordance with the Unified Theory of Acceptance and Use of Technology (UTAUT). ResultsThis study included 93 papers that have studied health care providers’ acceptance of eHealth. From these papers, 40 factors were identified and grouped into 7 clusters: (1) health care provider characteristics, (2) medical practice characteristics, (3) voluntariness of use, (4) performance expectancy, (5) effort expectancy, (6) social influence, and (7) facilitating or inhibiting conditions. ConclusionsThe grouping results demonstrated that the UTAUT model is useful for organizing the literature but has its limitations. Due to the complex contextual dynamics of health care settings, our work suggested that there would be potential to extend theories on information technology adoption, which is of great benefit to readers interested in learning more on the topic. Practically, these findings may help health care decision makers proactively introduce interventions to encourage acceptance of eHealth and may also assist health policy makers refine relevant policies to promote the eHealth innovation.

BackgroundeHealth is a tool that may be used to facilitate responses to influenza pandemics. Prior to implementation of eHealth in the hospital setting, assessment of the organizational preparedness is an important step in the planning process. Including this step may increase the chance of implementation success. ObjectiveTo identify the preparedness issues in relation to implementation of eHealth for future influenza pandemics. MethodsOne hospital was selected in Australia for this study. We conducted 12 individual interviews to gather a rich data set in relation to eHealth preparedness in the context of the 2009 influenza A (H1N1) pandemic at this major teaching hospital. These participants’ views were analyzed according to five main themes: (1) challenges in present practices or circumstances for pandemic responses, which indicates a need for change, (2) healthcare providers’ exposure to eHealth, (3) organizational technological capacity to support an IT innovation for medical practices, (4) resource preparedness, and (5) socio-cultural issues in association with eHealth implementation in response to a pandemic. ResultsThis article reports a subset of the issues identified during the case study. These issues include, for example, poor sharing of patient health records, poor protection of patient privacy, clinicians’ concerns about IT reliability and dissatisfaction with the software in use, clinicians’ concerns about IT’s impact on professional autonomy versus having inefficient IT support, and inefficient communication across departments in the form of consultation. ConclusionsBased on discussions with the participants and interpretation of their responses, we assessed the hospital’s preparedness status and also identified areas of deficiency. Accordingly, we suggest possible solutions for the areas in need of improvement to facilitate eHealth implementation’s success. The study results will also provide policymakers at national, state and local levels with insights to refine relevant public health policies for the planning and management of pandemics from the eHealth perspective.

Based on the rigid-flexible coupled multi-body dynamics theory,with software of three-dimensional solid design,on the basis of finite element software and multi-body dynamics software,the coupled dynamics simulation model of double cross universal joints is created. The flexible characteristic of intermediate shaft hollow section is taken into consideration in this model. The mode analysis of intermediate shaft is carried out and modal neutral file is obtained. To study the influence of angle size that formed among input shaft with intermediate shaft and output shaft with intermediate shaft on transmission uniformity,the dynamics simulation analysis in three kinds of misalignment angle are carried out. The research results show that the less difference in angle size of input shaft between intermediate shaft and output shaft between intermediate shaft,the smaller inhomogeneity in the rotation,it is consistent with the universal joint transmission theory. The modeling and analysis method provides a reference way to design and optimize the cross universal joints.

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Objective: To analyze the research status, research hotspots and frontier trends of traditional Chinese medicine (TCM) in the treatment of influenza in the past 20 years through the knowledge graph, so as to provide reference basis for further research., Methods: The related literatures of TCM in the treatment of influenza were collected in China National Knowledge Infrastructure (CNKI) from 2000 to 2019. The relevant graphs of authors, research institutions and key words were drawn by CiteSpace 5.6, the distribution and cooperation of main research forces in this field were analyzed, and the research frontiers and hot spot information in this field were discussed., Results: A total of 3 048 related literatures were obtained, involving 949 authors and 242 research institutions. The analysis of the number of articles showed that the volume of articles related to the treatment of influenza with TCM fluctuated greatly in the past 20 years, which was obviously affected by the sudden hot spots around 2010, but showed an overall upward trend, with an average annual volume of about 152 articles. The analysis of the author's cooperation map showed that a total of 77 core authors had published more than 5 articles, accounting for only 8.1% of all authors, and 5 authors had published more than 30 articles. Five major teams had been formed with Gu Ligang, Liu Qingquan, Lu Fangguo, Cui Xiaolan and Zhang Fengxue as the core. The analysis of the cooperation map of research institutions showed that the cooperation among institutions was not good, and only the scientific research institutes in Beijing and Guangzhou had formed a closely related cooperation network. The keyword co-occurrence map showed that 8 keywords appeared more than 100 times, especially ultra-high-frequency keywords, influenza virus ranked first (n = 518). There were 14 key nodes, such as influenza virus, TCM treatment, viral pneumonia and so on, which supported the current research field of TCM in the treatment of influenza. Fourteen clusters were formed to classify the current research hotspots, including the nomenclature of influenza, virus type, TCM treatment, western medicine knowledge, etc., and the map showed that the clustering was reasonable and the structure was significant. Timeline graph showed that parainfluenza virus, virus disease, pharmacodynamics, heat-clearing and detoxifying drugs, bacteriostasis and experimental research had all been studied for more than 8 years, revealing the research hotspots and trends of TCM in the treatment of influenza., Conclusions: The overall research related to the treatment of influenza with TCM is relatively perfect. In the future, the close cooperation among authors and institutions should be strengthened. The molecular mechanism research, clinical and animal trials of TCM should be further studied, so as to improve the research system of TCM treatment of influenza.