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Alarm-Based Root Cause Analysis Based on Weighted Fault Propagation Topology for Distributed Information Network
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作者 LYU Xiaomeng CHEN Hao +2 位作者 WU Zhenyu HAN Junhua GUO Huifeng 《ZTE Communications》 2022年第3期77-84,共8页
A distributed information network with complex network structure always has a challenge of locating fault root causes.In this paper,we propose a novel root cause analysis(RCA)method by random walk on the weighted faul... A distributed information network with complex network structure always has a challenge of locating fault root causes.In this paper,we propose a novel root cause analysis(RCA)method by random walk on the weighted fault propagation graph.Different from other RCA methods,it mines effective features information related to root causes from offline alarms.Combined with the information,online alarms and graph relationship of network structure are used to construct a weighted graph.Thus,this approach does not require operational experience and can be widely applied in different distributed networks.The proposed method can be used in multiple fault location cases.The experiment results show the proposed approach achieves much better performance with 6%higher precision at least for root fault location,compared with three baseline methods.Besides,we explain how the optimal parameter’s value in the random walk algorithm influences RCA results. 展开更多
关键词 distributed information network ALARM GRAPH root cause analysis random walk
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Transmission line fault-cause identification method for large-scale new energy grid connection scenarios 被引量:3
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作者 Hanqing Liang Xiaonan Han +3 位作者 Haoyang Yu Fan Li Zhongjian Liu Kexin Zhang 《Global Energy Interconnection》 EI CAS CSCD 2022年第4期362-374,共13页
The accurate fault-cause identification for overhead transmission lines supports the operation and maintenance personnel in formulating targeted maintenance strategies and shortening the time of inspecting faulty line... The accurate fault-cause identification for overhead transmission lines supports the operation and maintenance personnel in formulating targeted maintenance strategies and shortening the time of inspecting faulty lines.With the goal of achieving“carbon peak and carbon neutrality”,the schemes for clean energy generation have rapidly developed.Moreover,new energy-consuming equipment has been widely connected to the power grid,and the operating characteristics of the power system have significantly changed.Consequently,these have impacted traditional fault identification methods.Based on the time-frequency characteristics of the fault waveform,new energy-related parameters,and deep learning model,this study proposes a fault identification method suitable for scenarios where a high proportion of new energy is connected to the power grid.Ten parameters related to the causes of transmission line fault and new energy connection scenarios are selected as model characteristic parameters.Further,a fault identification model based on adaptive deep belief networks was constructed,and its effect was verified by field data. 展开更多
关键词 fault-cause identification Transmission lines fault waveform Large-scale new energy fault cause
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A case's root cause analysis of osteofascial compartment syndrome induced by radial artery puncture and its defensive strategy 被引量:3
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作者 Feng-Ying Kang Yang Yang +2 位作者 Yu-Ping Tong Ya-Li Hu Ning-Ning Xue 《Chinese Nursing Research》 CAS 2016年第2期66-70,共5页
Objective: The objective of this study was to reduce or avoid the occurrence of the cases of osteofascial compartment syndrome induced by a radial artery puncture for arterial blood gas analysis.Methods: We analyzed a... Objective: The objective of this study was to reduce or avoid the occurrence of the cases of osteofascial compartment syndrome induced by a radial artery puncture for arterial blood gas analysis.Methods: We analyzed an adverse event using cheese model analysis, "fish bone M analysis, root cause analysis, and other methods.Results: There are three root causes leading to an adverse event: operation technique, assessment of the disease, and informing patient families. However, there are many reasons to promote the occurrence and development of the event.O>ndusions: We should analyze and manage the adverse events in patients from the point of view of a system. Developing the measures of a system defense can enhance patient safety and create a good safety culture. 展开更多
关键词 Radial artery ARTERIOPUNCTURE Osteofascial compartment syndrome root cause analysis System defense
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A Causal Fusion Inference Method for Industrial Alarm Root Cause Analysis Based on Process Topology and Alarm Event Data
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作者 Pan Zhang Wenkai Hu +1 位作者 Xiangxiang Zhang Jianqi An 《Journal of Beijing Institute of Technology》 EI CAS 2022年第4期371-381,共11页
Modern industrial systems are usually in large scale,consisting of massive components and variables that form a complex system topology.Owing to the interconnections among devices,a fault may occur and propagate to ex... Modern industrial systems are usually in large scale,consisting of massive components and variables that form a complex system topology.Owing to the interconnections among devices,a fault may occur and propagate to exert widespread influences and lead to a variety of alarms.Obtaining the root causes of alarms is beneficial to the decision supports in making corrective alarm responses.Existing data-driven methods for alarm root cause analysis detect causal relations among alarms mainly based on historical alarm event data.To improve the accuracy,this paper proposes a causal fusion inference method for industrial alarm root cause analysis based on process topology and alarm events.A Granger causality inference method considering process topology is exploited to find out the causal relations among alarms.The topological nodes are used as the inputs of the model,and the alarm causal adjacency matrix between alarm variables is obtained by calculating the likelihood of the topological Hawkes process.The root cause is then obtained from the directed acyclic graph(DAG)among alarm variables.The effectiveness of the proposed method is verified by simulations based on both a numerical example and the Tennessee Eastman process(TEP)model. 展开更多
关键词 roots cause analysis causality inference process topology alarm events
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Ensemble Based Temporal Weighting and Pareto Ranking (ETP) Model for Effective Root Cause Analysis
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作者 Naveen Kumar Seerangan S.Vijayaragavan Shanmugam 《Computers, Materials & Continua》 SCIE EI 2021年第10期819-830,共12页
Root-cause identification plays a vital role in business decision making by providing effective future directions for the organizations.Aspect extraction and sentiment extraction plays a vital role in identifying the ... Root-cause identification plays a vital role in business decision making by providing effective future directions for the organizations.Aspect extraction and sentiment extraction plays a vital role in identifying the rootcauses.This paper proposes the Ensemble based temporal weighting and pareto ranking(ETP)model for Root-cause identification.Aspect extraction is performed based on rules and is followed by opinion identification using the proposed boosted ensemble model.The obtained aspects are validated and ranked using the proposed aspect weighing scheme.Pareto-rule based aspect selection is performed as the final selection mechanism and the results are presented for business decision making.Experiments were performed with the standard five product benchmark dataset.Performances on all five product reviews indicate the effective performance of the proposed model.Comparisons are performed using three standard state-of-the-art models and effectiveness is measured in terms of F-Measure and Detection rates.The results indicate improved performances exhibited by the proposed model with an increase in F-Measure levels at 1%–15%and detection rates at 4%–24%compared to the state-of-the-art models. 展开更多
关键词 root cause analysis sentiment analysis aspect extraction ensemble modelling temporal weighting pareto ranking
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Prediction of the Behavior of a Power System Using Root Cause Failure Analysis
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作者 Seyed Mohammad Seyed Hosseini Kamran Shahanaghi Safar Shasfand 《Fluid Dynamics & Materials Processing》 EI 2022年第3期815-833,共19页
The thermo-economic performance of a gas turbine is simulated using a fish bone technique to characterize the major equipment failure causes.Moreover a fault tree analysis and a Pareto technique are implemented to ide... The thermo-economic performance of a gas turbine is simulated using a fish bone technique to characterize the major equipment failure causes.Moreover a fault tree analysis and a Pareto technique are implemented to identify the related failure modes,and the percentage and frequency of failures,respectively.A pump 101 and drier 301 belonging to the Tabriz Petrochemical Company are considered for such analysis,which is complemented with a regression method to determine a behavioral model of this equipment over a twenty-year period.Research findings indicate that 81%of major failure factors in production equipment are related to the executive procedures(24%),human error(22%),poor quality of materials and parts(20%),and lack of personnel training(15%). 展开更多
关键词 Combined heat and power root analysis thermoeconomic performance fault tree PARETO behavioral model
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A Framework for Modern Risk-Informed Root Cause Analysis Process
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作者 Dorian Conger Ivan Vrbanic +1 位作者 Ivica Basic Kenneth J.Elsea 《Journal of Energy and Power Engineering》 2020年第7期211-224,共14页
The paper discusses the framework for a risk-informed root cause analysis process.Such process enables scaling of the analysis performed based on the risk associated with the undesired event or condition,thereby creat... The paper discusses the framework for a risk-informed root cause analysis process.Such process enables scaling of the analysis performed based on the risk associated with the undesired event or condition,thereby creating tiers of analysis where the greater the risk,the more sophisticated the analysis.In a risk-informed root cause analysis process,a situation is normally not analyzed at a level less than what actually occurred.However,a situation may be investigated as though the consequence were greater than actually happened,especially if only slight differences in circumstances could result in a significantly higher consequence.While operational events or safety issues are normally expected to result only with negligible or marginal actual consequences,many of those would actually have certain potential to develop or propagate into catastrophic events.This potential can be expressed qualitatively or quantitatively.Risk-informing of root cause analysis relies on mapping the event or safety issue into a risk matrix which,traditionally,is a two-dimensional probability-consequence matrix.A new concept employed in the risk matrix for root cause analysis is that,while the probability reflects the observed or expected range of values(retaining,thus,its“traditional”meaning),the consequence reflects not only the observed or materialized impact(such as failure of equipment)but,also,its potential to propagate or develop into highly undesirable final state.The paper presents main elements of risk-informed root cause analysis process and discusses qualitative and quantitative aspects and approaches to determination of risk significance of operational events or safety issues. 展开更多
关键词 root cause risk-inform RISK PROBABILITY cause analysis safety precedence significance determination risk matrix probabalistic margin conditional probability conditional risk ANALYST training methods
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A Study of Borrowing,Imitation and Creation in English-Chinese Translation:A Case Study of Translating“The Root Cause of Poverty”
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作者 FAN Lian-yi ZHANG Shun-sheng 《Journal of Literature and Art Studies》 2022年第9期939-943,共5页
Based on the translated version of“The Root Cause of Poverty”by Rutger Bregman on the Ted speech online platform,this research analyzes the application of direct borrowing,imitative translation and creative translat... Based on the translated version of“The Root Cause of Poverty”by Rutger Bregman on the Ted speech online platform,this research analyzes the application of direct borrowing,imitative translation and creative translation in English-Chinese translation.First,we believe the direct borrowing of a ready-made version is most ideal as it reveals the common ground both languages share when translating a source text.Next,it is preferable to imitate an already existing expression as similarity is reader-friendly.However,it is sometimes necessary to adopt creative translation to preserve differences to ensure that the meaning of the original language is accurately transmitted. 展开更多
关键词 The root cause of Poverty direct borrowing imitative translation creative translation
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Interpretation on Cultural Conflicts between America and China and the Conflict Root Cause Reflected in The Joy Luck Club
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作者 杨波秀 《海外英语》 2016年第20期165-167,共3页
This paper is mainly written to explore how cultural differences and clashes between America and China give rise to mother-daughter discords and conflicts. The paper was conducted based on the definition of culture in... This paper is mainly written to explore how cultural differences and clashes between America and China give rise to mother-daughter discords and conflicts. The paper was conducted based on the definition of culture in order to make clear of cultural conflicts. It is written to analyze the two groups of women immigrants unavoidably encountering the clash between their ancestral culture—Chinese culture and the dominant culture--American culture. Furthermore, the paper demonstrates that the mothers' Chinese roots are the root cause of misunderstandings and conflicts between their American-born daughters and themselves.Besides, the writer analyzes that different standpoints towards education value between mothers and American- born daughters cause their misunderstanding and conflicts. The conclusion is that the diversities between Chinese culture and American culture are the root cause for the mother-daughter discords and conflicts. 展开更多
关键词 cultural differences cultural conflicts mother-daughter conflicts the root cause The Joy Luck Club
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Analysis of Poverty Performance and Its Rooted Causes of the Aid-Poverty- Development Counties in Sichuan
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作者 Shen Mao-yingInstitute of Mountain Hazards and Environment, Chinese Academy of Sciences, Chengdu 610041, Sichuan, China Sichuan Academy of Social Sciences, Chengdu 610072, Sichuan, China 《Wuhan University Journal of Natural Sciences》 CAS 2003年第03B期911-918,共8页
There are 36 counties affirmed to be aid-poverty-development county in the early 21st century, which distribute around the circumferential mountain of Sichuan Basin.According to the topographic features and the distri... There are 36 counties affirmed to be aid-poverty-development county in the early 21st century, which distribute around the circumferential mountain of Sichuan Basin.According to the topographic features and the distribution of nationality, these aid-poverty-development counties can be classified into 4 depressed-regions. Study shows that regional poverty performance of 4 depressed-regions not only has many commons in the field of regional economic structure and industry structure, which is far behind the average development performance of Sichuan in the field of economic sum per capita such as GDP, farmer net income per capita as well as retail scale consumer goods, it is also quite different related to infrastructure and social development within 4 depressed-regions. Regional Poverty is chronically resulted in interaction of the multi-factors. Natural condition constraint is the basic factor contributed to regional poverty, policy influences play key role, the poor culture is inherent factor to regional poverty and the marginal locations play important role. 展开更多
关键词 四川盆地 贫困地区 扶贫工程 农村
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The Cause and Prevention of Major Earthquakes in the World
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作者 Cuixiang Zhong 《Journal of Environmental Science and Engineering(B)》 2023年第2期92-95,共4页
On February 6, 2023, a series of severe earthquakes occurred in eastern Turkey and neighboring areas of Syria. It was the largest earthquake in the world in more than a year, and the largest earthquake in the history ... On February 6, 2023, a series of severe earthquakes occurred in eastern Turkey and neighboring areas of Syria. It was the largest earthquake in the world in more than a year, and the largest earthquake in the history of Turkey. Living under the fear of earthquakes, the people in Turkey and other earthquake zones have hoped again and again to change their fate, but they have to resign themselves to fate. Thus, the author analyzed the causes of large earthquakes such as Turkey earthquake, and found that some of the world’s potential seismic zones have been eroded by sea water or river water for a long time to create a series of surface faults. When the moon gets close to these faults, it will have a huge gravitational pull on them, and even cause the fault to move, resulting in strong earthquakes. Especially in some seismic zones, earthquakes are occurring more and more frequently and their intensity is getting bigger and bigger. The main reason is that the opening of the Arctic shipping route and the exploration and exploitation of oil and gas have caused the melting of the Arctic ice sheet and the loss of glaciers, which has led to the weakening of the Arctic vortex and the reduction of the compression ability of the polar vortices to the clouds, thus slowing down the rotation of the Earth and thus the revolution of the moon. So the moon gradually moves in a spiral toward the Earth;as the moon orbit close to the Earth, the moon’s gravity on the surface faults will gradually strengthen, so it is easy to cause the surface fault dislocations, resulting in frequent earthquakes or strong earthquakes. So the author puts forward some measures to prevent frequent and strong earthquakes. 展开更多
关键词 Major earthquakes cause PREVENTION fault the moon.
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基于健康社会决定因素的宁夏中老年人慢性病共病的影响因素研究 被引量:1
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作者 马春芳 汤榕 +1 位作者 杨晓花 李月 《中国全科医学》 北大核心 2024年第4期447-453,共7页
背景人口老龄化进程日益加快,中老年人健康问题突出。慢性病共病严重威胁中老年人的健康和生活质量,阻碍健康中国行动的进展,探讨其与健康社会决定因素的关系具有积极意义。目的了解宁夏中老年人慢性病共病情况及健康社会决定因素情况,... 背景人口老龄化进程日益加快,中老年人健康问题突出。慢性病共病严重威胁中老年人的健康和生活质量,阻碍健康中国行动的进展,探讨其与健康社会决定因素的关系具有积极意义。目的了解宁夏中老年人慢性病共病情况及健康社会决定因素情况,分析中老年人健康社会决定因素与慢性病共病的关联,为中老年慢性病共病患者的健康管理和干预策略制定提供参考。方法采用多阶段分层随机抽样方法于2022-06-27—08-27调查宁夏石嘴山市、银川市、固原市的10个区/县1997名中老年人的健康相关数据,应用Apriori算法分析宁夏地区中老年人的共病模式,采用非条件Logistic回归分析探讨宁夏中老年人慢性病共病与健康社会决定因素的关联性。结果宁夏地区中老年人慢性病共病人数418例,慢性病共病率20.9%;关联规则结果显示有14条共病模式,其中11条与冠心病有关,9条与高血压有关,9条与糖尿病有关;非条件Logistic回归分析结果显示,年龄≥60岁、子女数量为2~3个、已建立健康档案、工作状况为离退休和无业、养老保险为城乡居民基本养老保险的中老年人慢性病共病率较高(P<0.05),夜间睡眠时长为7~8 h和>8 h、大专及以上文化水平的中老年人慢性病共病率较低(P<0.05)。结论中老年慢性病共病的影响因素涉及个体、社区、社会各个方面,建议从多维度对慢性病共病患者进行干预,以期提高其健康水平。 展开更多
关键词 慢性病共病 中老年人 健康社会决定因素 关联规则 影响因素分析
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长期维持性透析患者的衰弱现况及其影响因素
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作者 李娜 白彝华 +3 位作者 蒋红樱 张凤 李萌 杨娇 《实用医学杂志》 CAS 北大核心 2024年第3期330-335,共6页
目的分析长期维持性透析(简称:透析)患者的衰弱现况及其影响因素,探讨不同的透析方式和新型冠状病毒感染(COVID-19)复阳与衰弱综合征的相关性。方法选取2023年2-6月在肾内科规律透析的患者为研究对象。采用横断面的方法进行调查,收集患... 目的分析长期维持性透析(简称:透析)患者的衰弱现况及其影响因素,探讨不同的透析方式和新型冠状病毒感染(COVID-19)复阳与衰弱综合征的相关性。方法选取2023年2-6月在肾内科规律透析的患者为研究对象。采用横断面的方法进行调查,收集患者的临床资料,了解患者的透析方式,明确患者是否为COVID-19复阳。使用Fried衰弱表型评估标准将患者分为3组:无衰弱组、衰弱前期组和衰弱综合征组。比较3组患者衰弱表型的临床特征,分析各组患者的临床资料、透析方式及COVID-19复阳与衰弱的相关性,采用多因素logistic回归分析患者发生衰弱综合征的影响因素。结果本研究共纳入透析患者246例,其中无衰弱组77例(31.3%),衰弱前期组83例(33.7%),衰弱综合征组86例(35.0%)。衰弱综合征组呈现出高龄、高透析前血肌酐水平、低血清白蛋白水平及合并胸腔积液的特征(均P<0.05)。血透组和腹透组的衰弱情况比较差异无统计学意义(P=0.960)。COVID-19复阳患者的衰弱评分较未复阳者高(P<0.001)。多因素logistic回归显示,年龄、COVID-19复阳、血清白蛋白、透析前血肌酐及胸腔积液与患者发生衰弱综合征独立相关(均P<0.05)。结论透析患者衰弱综合征呈现出较高的发生率,其发生与透析方式无关;高血清白蛋白水平是患者发生衰弱综合征的保护性因素,而COVID-19复阳、高龄、透析前高血肌酐水平及胸腔积液是其发生衰弱综合征的危险因素。 展开更多
关键词 肾透析 衰弱 新型冠状病毒感染 复阳 影响因素分析
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我国高中生静坐时长与健康素养现状及其影响因素调查
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作者 沈鹤军 侍崇艳 +2 位作者 郑清 黄玉 景涛 《北京大学学报(医学版)》 CAS CSCD 北大核心 2024年第2期239-246,共8页
目的:调查我国高中生静坐时长与健康素养现状及其影响因素,为提升高中生的身心健康水平提供依据。方法:采用分层随机整群抽样法,调查我国31个省、市和自治区(不包括香港地区、澳门特别行政区和中国台湾省数据)的高一和高二年级学生的静... 目的:调查我国高中生静坐时长与健康素养现状及其影响因素,为提升高中生的身心健康水平提供依据。方法:采用分层随机整群抽样法,调查我国31个省、市和自治区(不包括香港地区、澳门特别行政区和中国台湾省数据)的高一和高二年级学生的静坐时长和健康素养。采用Kruskal-Wallis H法、独立样本Mann-Whitney U检验,并运用多元线性回归模型分析静坐时长与健康素养总分的影响因素。结果:健康素养总评分在不同地区、城乡分布、家庭年收入、父母亲学历、年龄、性别的多组间比较,差异均有统计学意义(P<0.01);静坐时长在不同地区、家庭年收入、父母亲学历、性别的多组间比较,差异均有统计学意义(P<0.01),但在不同年龄、城乡分布的组间比较,差异均无统计学意义(P>0.05);多元线性回归模型分析提示,健康素养总评分与家庭年收入、母亲学历呈正相关,与父亲学历、静坐时长呈负相关,标准化回归系数β比较显示,父亲学历(-0.32)>家庭年收入(0.15)>母亲学历(0.09)>平均每天静坐时长(-0.02),即父亲学历的影响最大,家庭年收入次之;静坐时长与家庭年收入、母亲学历呈正相关,与健康素养总评分呈负相关,标准化回归系数β比较显示,家庭年收入(0.14)>母亲学历(0.13)>健康素养总评分(-0.02),即家庭年收入的影响最大,母亲学历次之。结论:我国高一和高二年级学生每天静坐时间总体较长,健康素养水平总体较低,健康素养水平和静坐时长互为负相关,且受高中生父母学历和家庭经济水平的影响较大。 展开更多
关键词 青少年 静坐时长 健康素养 影响因素分析
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尿毒症腹膜透析相关胃肠功能紊乱的临床特征及影响因素研究
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作者 李静 马雷雷 +3 位作者 王冠然 姜晨 邢海涛 杨洪涛 《中国全科医学》 CAS 北大核心 2024年第18期2198-2204,共7页
背景胃肠功能紊乱是腹膜透析患者常见的并发症,严重影响患者食欲和情绪,致使患者营养不良、脱水、电解质紊乱或诱发全身炎症反应等,还会导致腹膜透析效能下降,增加医疗难度,降低患者的生活水平。目的观察尿毒症患者腹膜透析相关胃肠功... 背景胃肠功能紊乱是腹膜透析患者常见的并发症,严重影响患者食欲和情绪,致使患者营养不良、脱水、电解质紊乱或诱发全身炎症反应等,还会导致腹膜透析效能下降,增加医疗难度,降低患者的生活水平。目的观察尿毒症患者腹膜透析相关胃肠功能紊乱的临床特征并分析其影响因素,为防治腹膜透析相关胃肠道功能紊乱的临床诊治提供参考。方法本研究为回顾性研究,选取2019-09-01—2021-09-01在天津中医药大学第一附属医院肾病科进行维持性腹膜透析的304例尿毒症患者为研究对象。根据是否合并胃肠功能紊乱将患者分为胃肠功能紊乱组和无胃肠功能紊乱组。收集两组患者的一般资料、合并症、实验室检查指标、透析充分性相关指标等并进行比较。运用SPSS 23.0软件对临床资料进行统计,总结分析腹膜透析相关胃肠功能紊乱的临床特征,采用多因素Logistic回归分析探讨尿毒症患者发生腹膜透析相关胃肠道功能紊乱的影响因素。结果304例尿毒症腹膜透析患者中合并胃肠道功能紊乱189例(62.2%),胃肠功能紊乱组患者中位年龄为62(52,67)岁。两组患者年龄、糖尿病肾病原发病比例、合并高血压比例、合并冠心病比例比较,差异有统计学意义(P<0.05);两组患者血钙、胆固醇、肌酸激酶、C反应蛋白、总胆红素、血糖、糖化血红蛋白、降钙素原、三酰甘油水平比较,差异均有统计学意义(P<0.05);两组患者血尿素氮、残肾尿素清除指数(Kt/V)、腹膜Kt/V、总肌酐清除率(Ccr)、残肾Ccr、总Ccr标准化比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,糖尿病肾病原发病(OR=7.471,95%CI=1.161~48.061,P=0.034)、糖化血红蛋白升高(OR=1.367,95%CI=1.080~1.731,P=0.009)是尿毒症患者发生腹膜透析相关胃肠功能紊乱的独立危险因素,残肾Ccr升高(OR=0.952,95%CI=0.908~0.997,P=0.038)是尿毒症患者发生腹膜透析相关胃肠功能紊乱的独立保护因素。结论尿毒症患者腹膜透析相关胃肠道功能紊乱发生率较高,多发于老年患者;糖尿病肾病原发病、糖化血红蛋白升高可能是尿毒症患者发生腹膜透析相关胃肠功能紊乱的独立危险因素,残肾Ccr升高可能是尿毒症患者发生腹膜透析相关胃肠功能紊乱的独立保护因素。 展开更多
关键词 尿毒症 腹膜透析 胃肠道功能紊乱 临床特征 影响因素分析
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心房颤动患者射频消融术后居家运动康复强度-时间依从性轨迹及预测因素的纵向研究
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作者 王洁 孙国珍 +6 位作者 鲍志鹏 王琳 高敏 刘沈馨雨 于甜栖 王琴 高蓉蓉 《中国全科医学》 北大核心 2024年第2期168-176,183,共10页
背景我国心房颤动(以下简称房颤)患病率逐年升高,患者的预后及生活质量亟需关注。现有研究证实运动康复是改善房颤射频消融术后患者预后及生活质量不佳的有效方式。依从性是衡量运动康复益处是否持续存在的关键指标,但其变化轨迹未知。... 背景我国心房颤动(以下简称房颤)患病率逐年升高,患者的预后及生活质量亟需关注。现有研究证实运动康复是改善房颤射频消融术后患者预后及生活质量不佳的有效方式。依从性是衡量运动康复益处是否持续存在的关键指标,但其变化轨迹未知。目的基于前瞻性纵向观察的心房颤动患者射频消融术后居家运动康复强度-时间依从性5期追踪数据,考察发展轨迹及预测因素。方法采用便利抽样法,选取2020年5—11月就诊于南京医科大学第一附属医院心血管内科行射频消融术的246例房颤患者为研究对象进行随访。其中入组1周为基线调查,入组后3、6、9个月和12个月为追踪调查。收集患者的一般资料;本研究使用智能设备或运动日志对依从性进行监督和记录,从强度-时间依从性评估运动依从性;采用运动自我效能量表(SEE)、运动恐惧量表(Fact-CHF)、领悟社会支持量表(PSSS)、患者积极度量表(PAM13)分别评估患者的运动自我效能、运动恐惧水平、社会支持情况、积极度水平。利用Mplus工具构建潜类别增长模型(LCGM),取最优的拟合模型确定房颤患者射频消融术后居家运动康复强度-时间依从性的发展轨迹,采用Logistic回归分析识别轨迹类别的预测因素。结果44例患者失访,最终共202例纳入分析。基线、运动3个月、运动6个月、运动9个月、运动12个月患者例数分别为202、201、185、174例和159例,患者强度-时间依从性分别为(0.83±0.55)、(1.07±0.54)、(0.99±0.57)、(0.91±0.55)、(0.89±0.60)。LCGM结果显示,患者的运动康复强度-时间依从性变化过程具有群体异质性,分为3个潜类别轨迹组:缓慢下降-低水平组(n=69,34.2%)、快速上升-高水平组(n=14,6.9%)、持续依从组(n=119,58.9%)。无序多分类Logistic回归分析结果显示,以缓慢下降-低水平组为参照组,快速上升-高水平组和持续依从组男性患者的强度-时间依从性水平更高(P<0.001);快速上升-高水平组和持续依从组患者的年龄更大,运动自我效能水平更高(P<0.05);快速上升-高水平组患者的运动恐惧水平更低(P<0.05);持续依从组患者的积极度水平更高(P<0.05)。结论房颤患者射频消融术后居家运动康复强度-时间依从性呈多类别曲线增长的发展轨迹;未来可依据依从性的时变特点和因素定期进行强化干预,进而提高患者居家运动康复依从性水平且保持稳定。 展开更多
关键词 心房颤动 射频消融术 居家运动康复 依从性 影响因素研究 纵向研究
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基层老年慢性病患者心血管疾病综合发生风险的影响因素研究
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作者 余新艳 苏鹏 +5 位作者 袁晓静 姜清茹 杨建云 赵旭东 王一凡 张海澄 《中国全科医学》 北大核心 2024年第10期1186-1193,1200,共9页
背景心血管疾病是造成我国居民死亡和疾病负担的首要病因,防控形势严峻。心血管疾病风险影响因素管理是预防心血管疾病的重要基础。但目前国内外应用单导联可穿戴心电设备针对基层老年慢性病患者心血管疾病发生风险的影响因素调查研究较... 背景心血管疾病是造成我国居民死亡和疾病负担的首要病因,防控形势严峻。心血管疾病风险影响因素管理是预防心血管疾病的重要基础。但目前国内外应用单导联可穿戴心电设备针对基层老年慢性病患者心血管疾病发生风险的影响因素调查研究较少,且在既往研究中也未以整体观对患者包含不同数量风险的变量重要性进行排序。目的分析基层管理的65岁以上老年慢性病患者心血管疾病综合发生风险的影响因素,为基层心血管疾病综合防控提供客观依据及帮助。方法选取2021年12月—2022年9月宁夏回族自治区26家基层医疗卫生机构的3039例65岁以上+高血压、糖尿病、冠心病其中至少1种慢性病的患者为研究对象。依据72 h心电图分析结果划分为正常组632例、风险组2407例。分析两组患者基本资料,确定最佳λ值,绘制模型,采用LASSO回归和多因素Logistic回归分析探讨老年慢性病患者心血管疾病综合风险影响因素;并对影响心血管疾病综合风险及包含不同数量风险的变量排序。结果两组患者年龄、性别、BMI、教育程度、职业、城乡分布、吸烟、运动、冠心病+糖尿病、高血压+冠心病及糖尿病比较,差异均有统计学意义(P<0.05);最佳λ值为0.01568531。LASSO回归和多因素Logistic回归模型分析显示年龄、BMI、城乡分布、吸烟、高血压+冠心病+糖尿病是心血管疾病综合风险的影响因素(P<0.05)。受试者工作特征曲线下面积(AUC)=0.650(95%CI=0.627~0.673,P<0.001)。影响综合风险及不同数量风险种类变量排序前五位的分别为:年龄、BMI、城乡分布、饮茶、运动;年龄、高血压+冠心病、性别、城乡分布、吸烟;年龄、高血压+冠心病、性别、BMI、城乡分布;糖尿病+冠心病、年龄、高血压+冠心病、高血压+冠心病+糖尿病、高血压+糖尿病。结论年龄、BMI、城乡分布、吸烟、高血压合并冠心病及糖尿病是65岁以上+慢性病患者发生心血管疾病风险的影响因素。除年龄外,BMI及生活习惯对心血管疾病综合风险的发生影响较为重要,随着+风险种类数量的增多,慢性病尤其慢性病共病的影响增强。基层医护团队应以单导联可穿戴设备为载体定期对老年慢性病患者进行心血管疾病综合发生风险管理,其不但可高效、低成本的实现心血管疾病发生风险的一级、二级预防及健康管理,并可加速基层医疗服务应加快从不连贯的诊疗服务向全程健康管理的转变。 展开更多
关键词 慢性病 基层医疗卫生机构 老年人 心血管疾病 影响因素分析 变量排序
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达格列净对2型糖尿病患者经皮冠状动脉介入治疗术后对比剂肾病发病的影响
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作者 刘晓罡 杨世诚 +2 位作者 付乃宽 邵独婧 张鹏 《中国全科医学》 CAS 北大核心 2024年第24期2994-2999,共6页
背景达格列净是治疗2型糖尿病(T2DM)的有效药物,还具有降低T2DM肾病进展风险、减少尿蛋白以及心脏保护等作用,然而,达格列净能否降低T2DM患者经皮冠状动脉介入治疗(PCI)术后对比剂肾病(CIN)发生率,目前尚不完全清楚。目的探讨达格列净对... 背景达格列净是治疗2型糖尿病(T2DM)的有效药物,还具有降低T2DM肾病进展风险、减少尿蛋白以及心脏保护等作用,然而,达格列净能否降低T2DM患者经皮冠状动脉介入治疗(PCI)术后对比剂肾病(CIN)发生率,目前尚不完全清楚。目的探讨达格列净对T2DM患者PCI术后CIN发病的影响。方法根据达格列净使用情况以1∶1倾向性匹配原则,回顾性连续纳入2021—2023年于天津市胸科医院心内科行PCI治疗的T2DM患者共484例为研究对象,其中达格列净组242例、对照组242例。收集2组患者PCI术前的临床资料并进行比较,同时记录2组患者PCI术前、PCI术后48 h及PCI术后1周的肾功能,包括血尿素氮(BUN)、血清肌酐(Scr)、肌酐清除率(Ccr)、胱抑素C(Cys-C)、β2微球蛋白(β2-MG)、中性粒细胞明胶酶相关载脂蛋白(NGAL)的变化。主要终点事件为CIN发病率,次要终点事件为PCI围术期肾功能的变化。采用多因素Logistic回归分析达格列净对T2DM患者PCI术后CIN发病的影响。结果达格列净组患者CIN发病率为6.2%,低于对照组患者的CIN发病率(12.0%),差异有统计学意义(χ2=4.900,P=0.039);达格列净组患者CIN危险评分及B型钠尿肽高于对照组(P<0.05)。PCI术前、术后1周,2组患者BUN、Scr、Ccr、Cys-C、β2-MG、NGAL水平比较,差异均无统计学意义(P>0.05)。PCI术后48 h,达格列净组患者Cys-C、β2-MG、NGAL水平低于对照组(P<0.05)。多因素Logistic回归分析结果显示,CIN危险评分高(OR=1.213,95%CI=1.085~1.358,P=0.001)、B型钠尿肽水平升高(OR=3.940,95%CI=1.479~10.494,P=0.006)是T2DM患者PCI术后CIN发病的独立危险因素,使用达格列净(OR=0.338,95%CI=0.159~0.717,P=0.005)是T2DM患者PCI术后CIN发病的独立保护因素。结论使用达格列净是T2DM患者PCI术后CIN发病的独立保护因素,达格列净并不增加T2DM患者PCI术后急性肾损伤的发病风险,并可能降低CIN的发生率。 展开更多
关键词 糖尿病 2型 急性肾损伤 达格列净 对比剂 经皮冠状动脉介入治疗 影响因素分析
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社区规范管理稳定性冠心病患者运动耐量情况及其影响因素分析
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作者 杨玲 杜雪平 +1 位作者 董建琴 董玉明 《中国全科医学》 北大核心 2024年第1期51-58,共8页
背景稳定性冠心病(SCAD)患者冠状动脉硬化狭窄、斑块破裂形成血栓的风险高,再发心血管事件概率高,是反复住院的重要原因。发达国家通过运动康复为主的心脏康复使得本国心血管疾病的发生率、死亡率、再入院率明显下降,医疗费用降低。目... 背景稳定性冠心病(SCAD)患者冠状动脉硬化狭窄、斑块破裂形成血栓的风险高,再发心血管事件概率高,是反复住院的重要原因。发达国家通过运动康复为主的心脏康复使得本国心血管疾病的发生率、死亡率、再入院率明显下降,医疗费用降低。目的调查首都医科大学附属复兴医院月坛社区卫生服务中心规范管理SCAD患者运动耐量及其影响因素,为后期社区心脏康复提供科学依据。方法2020年1月,通过整群抽样在首都医科大学附属复兴医院月坛社区卫生服务中心卫生信息系统(CHIS)(医生工作站)选取规范管理、75岁以下SCAD患者980例,采用自行设计问卷[包括一般资料调查表、退伍军人特定活动问卷(VSAQ)等]对其进行调查。依据VSAQ测得的代谢当量(METs)值者分为运动耐量≤7.0 METs组和运动耐量>7.0 METs组,比较不同运动耐量SCAD患者临床资料的差异,采用Logistic回归分析探讨SCAD患者运动耐量的影响因素。结果980例SCAD患者中,运动耐量>7.0 METs者108例(11.0%),5.0~7.0 METs者619例(63.2%),<5.0 METs者253例(25.8%);运动耐量≤7.0METs组SCAD患者的性别、年龄、PCI术接受情况、糖尿病患病情况、血压达标情况、规律运动情况、运动强度水平、每次运动时间与运动耐量>7.0 METs组比较,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,性别、年龄、是否患有糖尿病、血压控制是否达标、是否规律运动、运动强度是SCAD患者运动耐量的影响因素(P<0.05)。结论SCAD患者有运动意识,但运动耐量整体水平较低(≤7.0 METs),缺乏运动指导,建议通过运动康复,提高运动耐量,从而改善其生活质量。 展开更多
关键词 稳定性冠心病 二级预防 运动耐量 运动康复 影响因素分析
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腹腔镜直肠癌手术后发生腹直肌萎缩的影响因素分析及预测模型构建
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作者 吕进 吕成余 +3 位作者 徐牧 徐晓军 王志 王和明 《腹腔镜外科杂志》 2024年第2期103-107,共5页
目的:探讨腹腔镜直肠癌手术后发生腹直肌萎缩的影响因素,并构建预测模型。方法:回顾性选择2020年3月至2023年3月收治的行腹腔镜根治手术的229例直肠癌患者,收集临床相关资料,根据术后是否发生腹直肌萎缩将患者分为萎缩组(n=47)与对照组(... 目的:探讨腹腔镜直肠癌手术后发生腹直肌萎缩的影响因素,并构建预测模型。方法:回顾性选择2020年3月至2023年3月收治的行腹腔镜根治手术的229例直肠癌患者,收集临床相关资料,根据术后是否发生腹直肌萎缩将患者分为萎缩组(n=47)与对照组(n=182)。Logistic回归分析直肠癌腹腔镜手术后发生腹直肌萎缩的因素,受试者工作特征曲线构建直肠癌腹腔镜术后发生腹直肌萎缩的预测模型,Hosmer-Lemeshow检验预测模型的校准度。结果:多因素Logistic回归分析显示,年龄较大、术后长期卧床、预防性造口、术后化疗、术后并发手术部位感染是直肠癌腹腔镜手术后发生腹直肌萎缩的危险因素(P<0.05),高白蛋白水平是保护因素(P<0.05)。受试者工作特征曲线分析显示,预测模型预测直肠癌腹腔镜手术后发生腹直肌萎缩的曲线下面积为0.868(95%CI:0.817~0.909),灵敏度、特异度分别为85.11%与87.91%。Hosmer-Lemeshow检验显示预测模型具有较好的符合度(χ^(2)=3.251,P>0.05)。结论:年龄较大、术后长期卧床、预防性造口、术后化疗、手术部位感染、低白蛋白是直肠癌腹腔镜手术后腹直肌萎缩的相关因素,据此建立预测模型可较好地预测腹直肌萎缩风险。 展开更多
关键词 直肠肿瘤 腹腔镜检查 预防性造口 腹直肌萎缩 影响因素分析 预测模型
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