Traditional Hospital Research Articles

Percutaneous plasma disc decompression through a lower surgical approach for the treatment of cervicogenic headache in patients with cervical spondylotic radiculopathy: A retrospective cohort study.

Cervical spondylotic radiculopathy (CSR) is the most common type of cervical spondylosis, frequently accompanied by cervicogenic headache (CEH). Percutaneous plasma disc decompression (PPDD) and pulsed radiofrequency (PRF) are minimally invasive techniques targeting cervical intervertebral discs or cervical nerves, and have been proven to be effective methods for treatment of CSR and CEH. The present study aimed to evaluate clinical efficacy and practicality of percutaneous plasma disc decompression (PPDD) via a lower surgical approach for the treatment of cervicogenic headache (CEH) and upper extremity radicular pain by analyzing clinical outcomes of patients with cervical spondylotic radiculopathy (CSR) undergoing PPDD and pulsed radiofrequency (PRF). Clinical data of patients with CSR who received PPDD (n=79) or PRF (n=92) at Shanghai Traditional Chinese Medicine Hospital (Shanghai, China) and Jiashan County People's Hospital (Jiaxing, China) from January 2022 to December 2022 were retrospectively collected and analyzed. The surgical site and procedure, bleeding volume, preoperative analgesic use and upper extremity symptoms, history of nerve block treatment and duration of disease were recorded, as well as relevant postoperative complications (infection, hematoma, nerve injury). The therapeutic effects [NRS (numeric rating scale) and NDI (neck disability index) score, and CEH remission rate at 1, 3 and 6 months after treatment] of both surgical methods were investigated using the telephone follow-up. CEH remission rates at 1, 3 and 6 months after surgery in the PPDD group were significantly higher than in the PRF group (78.8 vs. 43.5, P=0.016; 84.8 vs. 34.8, P=0.003 and 75.8 vs. 26.1%, P=0.005, respectively). The PPDD group showed higher NRS scores than the PRF group at 1 month after surgery (3 vs. 2, P<0.0001) and lower NRS scores than the PRF group at 6 months after surgery (2 vs. 3, P<0.0001). NDI scores in the PPDD group were significantly lower than those in the PRF group at 1, 3 and 6 months after surgery (15.49 vs. 20.05, P=0.002; 16.06 vs. 20.10, P=0.003 and 9.90 vs. 13.80, P=0.001, respectively). There was no significant difference in postoperative complication rate between the two groups (P>0.999). PPDD could significantly relieve CEH symptoms and upper extremity radicular pain in patients with CSR treated via a lower surgical approach and PPDD was more effective than PRF for long-term CEH remission and pain alleviation.

Factors Influencing Facial Paralysis Recovery: A Retrospective Cohort Study Using Electronic Medical Records.

This study aims to report on treatment outcomes and related factors in Bell's palsy patients by analyzing Electronic Medical Records (EMR) data. To assess the impact on the duration until improvement in House-Brackmann grading post-onset, we conducted an analysis of inpatient records for Bell's palsy patients admitted to a traditional Korean medicine hospital from 2018 to 2022. A total of 1049 subjects were included in the analysis. Contributing factors to a duration of more than 14 days until improvement in HB Grade included age 40 or above, male gender, an initial period of more than 7 days from onset to admission, a history of past recurrence, and the indication for adjunctive therapy. To generalize the adaptation of adjunctive traditional Korean medicine treatment indications to treatment outcomes, larger-scale studies encompassing a broader patient population will be necessary.

The role of marital status in gallbladder cancer: a real-world competing risk analysis

BackgroundThe association between marital status and gallbladder cancer (GBC) remains uncertain. This study aimed to verify the relationship between marital status and GBC and construct a prognostic nomogram to predict the impact of marital status on GBC patients.MethodGBC patients were divided into married and unmarried groups using data from the Surveillance, Epidemiology, and End Results (SEER) database. We employed competing risk analyses, propensity score matching (PSM), and Kaplan-Meier survival analyses. The relationship between marital status and GBC was then verified, and the predicted nomogram was constructed.ResultsA total of 3913 GBC patients were obtained from the SEER database, and an additional 76 GBC patients from Hangzhou Traditional Chinese Medicine Hospital were selected as the external validation group. The competing risk analysis revealed a significant disparity in the 5-year cumulative incidence of cancer-specific death (CSD) between the two cohorts (59.1% vs. 65.2%, p = 0.003). Furthermore, the multivariate competing hazards regression analysis identified a significant association (HR, 1.17; 95% CI, 1.04–1.31; p = 0.007) between marital status and CSD. To assess the 1-, 3-, and 5-year risks of CSD, a comprehensive competing event nomogram was constructed using factors derived from the multivariate analysis. The area under the receiver operating characteristic curve (AUC) values for the 1-, 3-, and 5-year training cohorts were 0.806, 0.785, and 0.776, respectively. In the internal validation cohort, these values were 0.798, 0.790, and 0.790, while the external validation cohort exhibited AUC values of 0.748, 0.835, and 0.883 for the corresponding time intervals. Furthermore, calibration curves demonstrated a commendable level of concordance between the observed and predicted probabilities of CSD.ConclusionMarriage was a protective factor for GBC patients after taking competing risk into consideration. The proposed nomogram demonstrated exceptional predictive power.

Selected donor CD34(+) cell boosts for salvage treatment of poor graft function following allogeneic hematopoietic stem cell transplantation in primary myelofibrosis: 3 cases report

A retrospective analysis was conducted on three patients with primary myelofibrosis who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) at Shanghai Zhaxin Traditional Chinese and Western Medicine Hospital from 2020 to 2023. They subsequently developed poor graft function. The patients received selected donor CD34(+) cell boosts as salvage therapy. There were two male patients and one female patient, with a median age of 68 (39-69) years. The median time from allo-HSCT to the selected donor CD34(+) cell boost was 83 (56-154) days. The median infusion of selected donor CD34(+) cells was 7.67 (7.61-9.06) ×10(6)/kg, with a CD34(+) cell purity of 97.76% (96.50%-97.91%) and a recovery rate of 70% (42%-75%) . Hematological recovery was achieved in two cases. No acute GVHD was observed in any of the three patients. One case of moderate oral chronic GVHD was noted. Selected donor CD34(+) cell boosts for the treatment of poor graft function after allo-HSCT in primary myelofibrosis was effective and no severe acute or chronic GVHD was observed.

Sodium hyaluronate and pranoprofen improve visual function and reduce inflammation in patients with dry eye

Objective The aim of this study was to investigate the clinical use of sodium hyaluronate (SH) combined with pranoprofen in treating patients with dry eye. Methods A total of 117 patients with dry eye who were treated in the Traditional Chinese Medicine Hospital of Kunshan from March 2020 and May 2022 were included. According to the therapy approaches, they were treated with SH (SH group), pranoprofen (pranoprofen group), and SH combined with pranoprofen (joint group) (n = 39). Results The effective rates of dry eye were 79.49%, 74.36% and 94.87% in the SH group, the pranoprofen group and the joint group, respectively (p < 0.05). After treatment, the tear BUT and SIT in the joint group were all prominently increased than those in the other two groups (p < 0.05). The corneal fluorescein staining and dry eye symptom scores in the joint group after treatment were dramatically lower than those in the other two groups (p < 0.001). After treatment, the visual contrast sensitivity (12 c/d, 18 c/d and 24 c/d) in the joint group was markedly higher than those in the other two groups (p < 0.001). The CPR, TNF-α, IFN-γ and IL-1β levels in the joint group were notably decreased than those in other two groups (p < 0.001). After treatment, the VRQOL quality-of-life scores in the joint group were significantly higher than those in the other two groups (p < 0.05). Conclusion SH combined with pranoprofen showed clear therapeutic benefit in treating dry eye, and the curative effect was more favorable than with either medication alone.

A New Model for Home Inotropes as a Bridge to Heart Transplantation: A Study Comparing Outcomes in Patients Managing Inotropes Independently at Home vs Traditional Hospital in the Home Programme

A New Model for Home Inotropes as a Bridge to Heart Transplantation: A Study Comparing Outcomes in Patients Managing Inotropes Independently at Home vs Traditional Hospital in the Home Programme

Experience design of lifestyle communities: the future of hospitality and tourism

PurposeThis paper aims to provide a critical reflection on the experience design of the lifestyle communities in the hospitality and tourism industry. Specifically, this paper proposes a conceptual model that governs experience design in creating unique and memorable experiences for lifestyle communities.Design/methodology/approachThis paper is based on a critical analysis of emerging phenomena, related literature and researchers’ experiences and insights.FindingsThe lifestyle community is conceptualized as a group of people who share a specific interest, value or activity and the type of its existence can be classified as physical, virtual or hybrid. As the importance of experience design has been highlighted in the hospitality and tourism industry, the study provides the guest experience design framework of lifestyle communities that suggests an operationalization of experience design that touches shared values of customers within lifestyle communities.Research limitations/implicationsThis study introduces a framework that highlights the role of experience design in the development of lifestyle communities, thereby enriching the emerging body of knowledge. Additionally, the research illustrates how lifestyle communities diverge from traditional hospitality business models by using distinctive positioning strategies.Practical implicationsThis study provides practical implications on how to capture the growing number of customers represented by lifestyle communities in the future. A deep understanding of frameworks may be crucial to establishing the experience design of lifestyle communities to correspond to the future of the hospitality and tourism industry.Originality/valueThis study remarks an initial attempt to provide a critical reflection of a rising contemporary issue: experience design and lifestyle communities. Conceptualization through a profound reflection of the issue offers insights to define existing phenomena and suggestions to capture future opportunities and actual management. Furthermore, future research directions in hospitality and tourism are elucidated by the provided conceptual frameworks.

Advancements in Interventional Pulmonology: Harnessing Ultrasound Techniques for Precision Diagnosis and Treatment.

Medical ultrasound has emerged as an indispensable tool within interventional pulmonology, revolutionizing diagnostic and procedural practices through its non-invasive nature and real-time visualization capabilities. By harnessing the principles of sound waves and employing a variety of transducer types, ultrasound facilitates enhanced accuracy and safety in procedures such as transthoracic needle aspiration and pleural effusion drainage, consequently leading to improved patient outcomes. Understanding the fundamentals of ultrasound physics is paramount for clinicians, as it forms the basis for interpreting imaging results and optimizing interventions. Thoracic ultrasound plays a pivotal role in diagnosing conditions like pleural effusions and pneumothorax, while also optimizing procedures such as thoracentesis and biopsy by providing precise guidance. Advanced ultrasound techniques, including endobronchial ultrasound, has transformed the evaluation and biopsy of lymph nodes, bolstered by innovative features like elastography, which contribute to increased procedural efficacy and patient safety. Peripheral ultrasound techniques, notably radial endobronchial ultrasound (rEBUS), have become essential for assessing pulmonary nodules and evaluating airway structures, offering clinicians valuable insights into disease localization and severity. Neck ultrasound serves as a crucial tool in guiding supraclavicular lymph node biopsy and percutaneous dilatational tracheostomy procedures, ensuring safe placement and minimizing associated complications. Ultrasound technology is suited for further advancement through the integration of artificial intelligence, miniaturization, and the development of portable devices. These advancements hold the promise of not only improving diagnostic accuracy but also enhancing the accessibility of ultrasound imaging in diverse healthcare settings, ultimately expanding its utility and impact on patient care. Additionally, the integration of enhanced techniques such as contrast-enhanced ultrasound and 3D imaging is anticipated to revolutionize personalized medicine by providing clinicians with a more comprehensive understanding of anatomical structures and pathological processes. The transformative potential of medical ultrasound in interventional pulmonology extends beyond mere technological advancements; it represents a paradigm shift in healthcare delivery, empowering clinicians with unprecedented capabilities to diagnose and treat pulmonary conditions with precision and efficacy. By leveraging the latest innovations in ultrasound technology, clinicians can navigate complex anatomical structures with confidence, leading to more informed decision-making and ultimately improving patient outcomes. Moreover, the portability and versatility of modern ultrasound devices enable their deployment in various clinical settings, from traditional hospital environments to remote or resource-limited areas, thereby bridging gaps in healthcare access and equity.

Prediction of hypertension risk based on multiple feature fusion

ObjectiveIn the application of machine learning to the prediction of hypertension, many factors have seriously affected the classification accuracy and generalization performance. We propose a pulse wave classification model based on multi-feature fusion for accuracy prediction of hypertension. Methods and MaterialsWe propose an ensemble under-sampling model with dynamic weights to decrease the influence of class imbalance on classification, further to automatically classify of hypertension on inquiry diagnosis. We also build a deep learning model based on hybrid attention mechanism, which transforms pulse waves to feature maps for extraction of in-depth features, so as to automatically classify hypertension on pulse diagnosis. We build the multi-feature fusion model based on dynamic Dempster/Shafer (DS) theory combining inquiry diagnosis and pulse diagnosis to enhance fault tolerance of prediction for multiple classifiers. In addition, this study calculates feature importance ranking of scale features on inquiry diagnosis and temporal and frequency-domain features on pulse diagnosis. ResultsThe accuracy, sensitivity, specificity, F1-score and G-mean after 5-fold cross-validation were 94.08%, 93.43%, 96.86%, 93.45% and 95.12%, respectively, based on the hypertensive samples of 409 cases from Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine and Hospital of Integrated Traditional Chinese and Western Medicine. We find the key factors influencing hypertensive classification accuracy, so as to assist in the prevention and clinical diagnosis of hypertension. ConclusionCompared with the state-of-the-art models, the multi-feature fusion model effectively utilizes the patients’ correlated multimodal features, and has higher classification accuracy and generalization performance.

Deployment and validation of a smart bed architecture for untethered patients with wireless biomonitoring stickers.

Conventional patient monitoring in healthcare has limitations such as delayed identification of deteriorating conditions, disruptions to patient routines, and discomfort due to extensive wiring for bed-bound patients. To address these, we have recently developed an innovative IoT-based healthcare system for real-time wireless patient monitoring. This system includes a flexible epidermal patch that collects vital signs using low power electronics and transmits the data to IoT nodes in hospital beds. The nodes connect to a smart gateway that aggregates the information and interfaces with the hospital information system (HIS), facilitating the exchange of electronic health records (EHR) and enhancing access to patient vital signs for healthcare professionals. Our study validates the proposed smart bed architecture in a clinical setting, assessing its ability to meet healthcare personnel needs, patient comfort, and data transmission reliability. Technical performance assessment involves analyzing key performance indicators for communication across various interfaces, including the wearable device and the smart box, and the link between the gateway and the HIS. Also, a comparative analysis is conducted on data from our architecture and traditional hospital equipment. Usability evaluation involves questionnaires completed by patients and healthcare professionals. Results demonstrate the robustness of the architecture proposed, exhibiting reliable and efficient information flow, while offering significant improvements in patient monitoring over conventional wired methods, including unrestricted mobility and improved comfort to enhance healthcare delivery.

The primary nursing model of remote monitoring in patients with implantable cardiac devices (CIED)

Abstract Introduction The treatment of cardiac pathologies with devices has led to an exponential increase in patients with CIED, who need more frequent, more careful check-ups, with a consequent increase in the number and clinical complexity of patients who refer to cardiac stimulation centers. Aim The use of remote monitoring makes it possible to have a continuous flow of information relating not only to the performance of the device but also to clinical events such as arrhythmias and heart failure without the need for direct contact, drastically reducing hospital accesses and at the same time promptly detecting any critical issues that require intervention in a more or less short time. The benefits of remote monitoring, as we have seen over the years, intervene at multiple levels, economic, social and clinical. Materials and methods Numerous studies have shown how remote monitoring can replace outpatient check-ups without compromising patient safety, reducing resource consumption, while scheduling at least one outpatient follow-up per year as recommended by international guidelines. With the introduction of telecardiology and remote monitoring in clinical practice, new organizational models have been implemented, which harmonize and codify the activity of the various professionals involved in the diagnostic and therapeutic process. This model must guarantee a precise definition of roles and responsibilities, traceability of actions, continuity of care, low consumption of resources, patient satisfaction and acceptance, integration with traditional hospital and out-of-hospital diagnosis and treatment pathways. A model that encompasses all these peculiar features is the PRIMARY NURSE MODEL. Primary nursing is a relationship based and resource driven system of care delivery, the building blocks are: attribution and acceptance by each individual of personal responsibility in making decisions; assignment of day to day care according to the case method; direct person to person communication; a person operationally responsible for the quality of care provided to patients. The decentralised decision making approach is based on three basic concepts: the nurse's decision making authority, responsibility and accountability. Results and conclusions The real CORE of this model is represented by the responsibility for the decisions made by a single nurse. Then each patient is assigned to a nurse responsible for continuity of care, whose duties include patient and caregiver education and training, website data entry, review of critical case transmissions and assessments, and submission of critical cases to the physician.

Unlocking the potential of digital twins: Transforming hospital practices for better care

Digital twins are virtual replicas of physical assets or processes and have emerged as a promising technology in various industries, including healthcare. This paper explores the application of digital twins in hospital operations and talks about their role in enhancing patient care and improving workflow efficiency. Through a comprehensive review of the literature and analysis of case studies, we examine how digital twins are revolutionizing traditional hospital practices and improving the delivery of healthcare services. The paper begins with an introduction to digital twins in healthcare, which provides an idea of the technology and its underlying principles. We then explore the many ways in which digital twins are being implemented across different areas of hospital operations, from patient monitoring in the Intensive Care Unit (ICU) to medication management in the pharmacy. Throughout this paper, we have included flowcharts that will help the reader better understand the idea we pitch. Furthermore, the paper discusses the challenges and considerations associated with adopting digital twins in hospital settings, including data privacy concerns, interoperability issues, and the need for better infrastructure. We also explore emerging trends and future directions in digital twin technology. We try to predict how this technology may continue to evolve and shape the future of patient care. In conclusion, this paper underscores the potential of digital twins to transform hospital practices and revolutionize the delivery of healthcare services. By using the power of digital twins, hospitals can improve operational efficiency, personalize patient care, and ultimately improve the overall quality of healthcare delivery.

Effect of DU meridian long snake moxibustion on intestinal flora of people with yang deficiency

BackgroundThe changes of intestinal flora are closely related to the occurrence and development of many diseases. Long snake moxibustion has the functions of strengthening the body resistance, eliminating pathogenic factors and balancing yin and yang, and has been widely used in clinic. This study aimed to explore the effect of long snake moxibustion on intestinal flora in people with yang deficiency constitution. MethodsThe 60 subjects with yang deficiency constitution recruited in a tertiary A-level-integrated traditional Chinese medicine hospital were randomly divided into Du meridian group and non-Du meridian group between May 1, 2021, and July 31, 2021, which were treated once a week for 12 consecutive times. The scores of symptoms of yang deficiency were recorded before and after treatment, fresh stool samples were collected, and the distribution of intestinalflora was detected by 16 S rDNA sequencing technology. ResultsCompared with before treatment, the scores of symptoms of yang deficiency in both groups had a distinct decrease after treatment (P<0.05), and the effect of Du meridian group was better than that of non-Du meridian group. After treatment, the Du meridian group was superior to the non-Du meridian treatment group in the diversity of intestinal flora, the relative abundance of phylum and genus, and the dominant intestinal flora. ConclusionsLong snake moxibustion on Du meridian can improve the diversity of intestinal flora, promote the balance between beneficial bacteria and harmful bacteria, enhance the integrity of intestinal epithelial barrier and regulate intestinal immunity, thus improving Yang deficiency constitution.

Adaptation and validation of moral distress thermometer in Chinese nurses

BackgroundMoral distress seriously affects professional nurses, and a number of instruments have been developed to measure the level of moral distress. The moral distress thermometer (MDT) is one of the commonly used instruments that can rapidly measure real-time moral distress; however, it remains unclear whether it is still useful in the Chinese cultural context.AimThis study aimed to adapt and validate the MDT among Chinese registered nurses.Research designAn online, cross-sectional, survey study of adapting and validating Chinese version of MDT.Participants and research contextA total of 182 registered nurses effectively finished this survey. The correlation between MDT score and the score of the moral distress scale-revised version (MDS-R) was used for evaluating convergent validity, and MDT scores of registered nurses who working in different departments and who made different actions to the final question of the MDS-R were compared by using one-way ANOVA to evaluate construct validity.Ethical considerationsThe Ethics Committee of Chongqing Traditional Chinese Medicine Hospital approved this study.ResultsThe Chinese version of MDT was described as relevant to measure moral distress, with a reported item-level content validity index (I-CVI) and scale-level CVI (S-CVI) of 1. The mean MDT score and mean MDS-R score were 2.54 and 38.66, respectively, and the correlation between these two scores was significantly moderate (r = 0.41). Nurses working different departments reported different levels of moral distress, and those working in intensive care unit reported the highest level of moral distress than those working in other departments (p = 0.04). The MDT scores between nurses who presented different actions to their position were also significantly different, and those who had ever left and those who had considered leaving but did not leave reported significantly higher moral distress.ConclusionThe MDT is a reliable, valid, and easy-to-use instrument to rapidly measure the real-time moral distress of registered nurses in China.

A mixed integer linear programming model for quarantine-based home healthcare scheduling under uncertainty

Home healthcare companies (HHC) have emerged as vital alternatives to traditional hospitals, particularly in meeting the healthcare needs of individuals within the comfort of their homes. The COVID-19 pandemic has amplified the significance of HHC services, offering a crucial alternative for patients and the elderly to follow quarantine protocols while receiving essential healthcare at home. Consequently, HHC companies must align their planning strategies with the World Health Organization (WHO) health guidelines. This research introduces a Mixed Integer Linear Programming (MILP) model tailored for home healthcare services during COVID-19, aiming to ensure strict adherence to quarantine protocols while enhancing service efficiency and quality. The proposed vehicle routing problem with pickup/delivery and time window formulation incorporates critical elements such as patient and caregiver classification, work and break regulations adherence, workload balancing, and multi-depot capabilities. The model addresses uncertain demand and service times through a stochastic programming approach to enhance practicality. K-means clustering is applied to streamline scenarios, with a sensitivity analysis determining the optimal number of clusters. Additionally, measures intrinsic to stochastic programming, such as the Expected Value of Perfect Information (EVPI) and Value of Stochastic Solution (VSS), are computed for comprehensive analysis.

Multidisciplinary Collaboration in Hospitals via Patient- and Process-Oriented Units: A Longitudinal Study.

The complexity of healthcare is increasing, mainly due to the prevalence of multimorbidity in an ageing population. Complex care for patients with multimorbidity requires a multidisciplinary approach. Traditional physician-centered hospital structures do not facilitate the necessary multidisciplinary collaboration. European hospitals are implementing process-based hospital designs with patient- and process-oriented units to stimulate multidisciplinary collaboration. Patient-oriented units are formed based on shared patient groups and focus on care trajectories, while process-oriented units are formed based on having similar processes and focus on efficiency. This study has two aims. First, to study the effect of introduction of these units on multidisciplinary collaboration and perceived impact (efficiency, innovation, and effectiveness). Second, to study whether there are differences between patient- and process-oriented units. A survey-based longitudinal evaluation study was conducted in 2020 and 2022 among physicians in a Dutch hospital to measure multidisciplinary collaboration (relational coordination) and perceived impact (efficiency, innovation, and effectiveness). In addition, open questions were used to enrich the data. Quantitative and qualitative data together suggest that physicians in patient-oriented units notice benefits from the redesign to multidisciplinary units, they perceive higher impact over time. Physicians in process-oriented units achieve a better relationship with the physicians in their unit over time, but they do not perceive impact as high as physicians in patient-oriented units. A process-based design with patient- and process-oriented units is supportive of multidisciplinary collaboration and perceived impact, especially for physicians in patient-oriented units. Physicians in patient-oriented units are positive about the introduction of these units as they feel it contributes to better multidisciplinary patient care. As the results for physicians in process-oriented units may be less directly visible in terms of quality of care, they are less likely to see positive effects, even though their relationships are improving.

Advancing smart tourism destinations: A case study using bidirectional encoder representations from transformers‐based occupancy predictions in torrevieja (Spain)

AbstractTourism represents a crucial socio‐economic pillar globally, yet the multifaceted challenges it poses necessitate innovative management approaches. The paradigm of smart tourism harnesses advanced data analytics tools to promote both profitability and sustainability in tourist destinations, leading to new levels of destination smartness. Accurate tourist occupancy prediction, particularly in areas dominated by second‐home accommodations where traditional hospitality data may be insufficient, plays a key role in optimising tourism management. To address this data gap, our prior research employed ARIMA modelling on Airbnb booking time series and analysed tourism‐related Twitter conversations to forecast occupancy levels in Torrevieja (Alicante); a prominent second‐home tourism destination in Southeastern Spain. In this extended study, we delve deeper into the realm of social sensing by utilising bidirectional encoder representations from transformers (BERT) for topic modelling. Our methodology involves the processing and analysis of Twitter data to identify prominent themes related to Torrevieja. The findings not only reveal nuanced perceptions and discussions about the destination but also underscore the effectiveness of BERT in capturing intricate topic dynamics. Importantly, this work highlights how the alignment of specific topics with booking patterns can further enhance predictive accuracy for tourist occupancy, presenting a robust toolkit for stakeholders in the tourism sector.

Application of Time-Driven Activity-Based Costing for Head and Neck Microvascular Free Flap Reconstruction.

Traditional hospital accounting fails to provide an accurate cost of complex surgical care. Here we describe the application of time-driven activity-based costing (TDABC) to characterize costs of head and neck oncologic procedures involving free tissue transfer. Retrospective cohort study. Single tertiary academic medical center. An analysis of head and neck oncologic procedures involving microvascular free flap reconstruction from 2018 to 2020 (n = 485) was performed using TDABC methodology to measure cost across operative case and postoperative admission, using quantity of time and cost per unit of each resource to characterize resource utilization. Univariate and generalized linear mixed models were used to examine associations between patient and hospital characteristics and cost of care delivery. The total cost of care delivery was $41,905.77 ± 21,870.27 with operating room (OR) supplies accounting for only 10% of the total cost. Multivariable analyses identified significant cost drivers including operative time, postoperative length of stay, number of return trips to the OR, postoperative complication, number of free flaps performed, and patient transfer from another hospital or via emergency department admission (P < .05). Operative time and postoperative length of stay, but not operative supplies, were primary drivers of cost of care for head and neck oncology cases involving free tissue transfer. TDABC offers granular cost characterization to inform cost optimization through unused capacity identification and postoperative admission efficiencies.

Observation of therapeutic effect of lamp irradiation combined with purple gromwell oil gauze on alleviating intestinal colic in patients.

Intestinal colic is a common complication in patients who have undergone radical surgery for colorectal cancer. Traditional Chinese medicine has advantages, including safety and stability, for the treatment of intestinal colic. Lamp irradiation for abdominal ironing has been applied in the treatment of many gastrointestinal diseases. Purple gromwell oil has the effects of clearing heat, cooling blood, reducing swelling, and relieving pain. To investigate the impact of lamp irradiation combined with purple gromwell oil gauze on ameliorating intestinal colic in patients after radical surgery for colorectal cancer. A total of 120 patients who experienced postoperative intestinal colic complications after radical surgery for colorectal cancer and who were admitted to Foshan Traditional Chinese Medicine Hospital between June 2019 and March 2023 were enrolled as study subjects. The patients were divided into a control group (60 patients) and an observation group (60 patients) based on treatment method. The control group was treated with lamp irradiation, while the observation group was treated with lamp irradiation and external application of purple gromwell oil gauze. The clinical efficacy, Numeric Rating Scale (NRS) score, duration of symptoms, and rate of adverse reaction occurrence were further compared between the two groups. The general effective rate in the observation group was 95.00%, which was significantly higher than that in the control group (86.67%, P < 0.05). Before treatment, there was no significant difference in the duration of symptoms between the groups (P > 0.05). After 1, 2, 3, and 4 d of treatment, the duration of symptoms in both groups were decreased, and the duration in the observation group was significantly lower than that in the control group (96.54 ± 9.57 vs 110.45 ± 11.23, 87.26 ± 12.07 vs 104.44 ± 11.68, 80.45 ± 16.21 vs 99.44 ± 14.95, 73.18 ± 15.58 vs 92.17 ± 14.20; P < 0.05). After 1, 3, 5, and 7 d of treatment, the NRS scores in both groups were decreased, and the NRS scores in the observation group were significantly lower than those in the control group (3.56 ± 0.41 vs 4.04 ± 0.58, 3.07 ± 0.67 vs 3.74 ± 1.02, 2.52 ± 0.76 vs 3.43 ± 0.85, 2.03 ± 0.58 vs 3.03 ± 0.82; P < 0.05). There was no significant difference in the rate of adverse reaction occurrence between the groups (P > 0.05). The use of lamp irradiation combined with purple gromwell oil gauze in patients with intestinal colic after radical surgery for colorectal cancer can reduce symptom duration, alleviate intestinal colic, and improve treatment efficacy, and this approach is safe. It is worth promoting the use of this treatment in clinical practice.

A comparative study of acupuncture combined with rehabilitation gymnastics on postoperative anal function of lower rectal cancer

BACKGROUND From the anal function, inflammatory response and other indicators, acupuncture combined with rehabilitation gymnastics was applied to patients with cancer undergoing low resection, aiming to improve the prognosis of patients. AIM To explore the effects of acupuncture combined with rehabilitation gymnastics on anal function after lower rectal cancer surgery. METHODS From January 2020 to December 2022, 128 patients who underwent rectal cancer surgery in the Department of Oncology of Hebei Provincial Hospital of Traditional Chinese Medicine Hospital were selected and divided into two groups using the random number table method, with 64 patients in each group. Patients in the control group were not treated with acupuncture or rehabilitation gymnastics and served as blank controls. Patients in the study group were treated with acupuncture and rehabilitation gymnastics from the 7th postoperative day. The anal incontinence scores, changes in serum interleukin-4, interleukin-6, and interleukin-10 Levels, and serum motilin, 5-hydroxytryptamine, and vasoactive intestinal peptide levels were compared. RESULTS There were no significant differences in serum interleukin-4, interleukin-6, and interleukin-10 Levels between the groups before treatment (P &gt; 0.05). After treatment, these levels were better than those of the control group (P &lt; 0.05). There was no significant difference in the anal incontinence scores between the groups before and 7 d after surgery (P &gt; 0.05). Anal incontinence scores in the study group were lower than those in the control group at 14 d, 21 d, and 28 d postoperatively (P &lt; 0.05). There were no significant differences in serum motilin, 5-hydroxytryptamine, or vasoactive intestinal peptide levels between the groups before treatment (P &gt; 0.05). After treatment, these levels were higher in the study group than in the control group, and vasoactive intestinal peptide level was lower in the study group than in the control group (P &lt; 0.05). CONCLUSION Acupuncture combined with rehabilitation gymnastics can promote the recovery of anal function and reduce the inflammatory response in patients with lower rectal cancer after surgery.