目的:了解重症监护病房(Intensive Care Unit,ICU)护士面对患者死亡的情感体验,探究存在替代性创伤反应的ICU护士面对患者死亡的情感体验。方法:本研究采用描述性现象学的研究设计,选取ICU存在替代性创伤反应(灾难救助者替代性创伤问卷...目的:了解重症监护病房(Intensive Care Unit,ICU)护士面对患者死亡的情感体验,探究存在替代性创伤反应的ICU护士面对患者死亡的情感体验。方法:本研究采用描述性现象学的研究设计,选取ICU存在替代性创伤反应(灾难救助者替代性创伤问卷各因子及总分超过理论中值)的责任护士16例,对其个体生活的参考框架、自我能力、自我资源、心理需求与认知图式和意象进行深入访谈,运用Colaizzi7步分析法进行资料分析。结果:ICU护士面对患者死亡的情感体验归纳为应激刺激下的自我防御和持续浸润后的情感内耗2个主题,其中应激刺激下的自我防御包括无意识的短暂封闭和个人化的情绪反应;持续浸润后的情绪内耗包括镜像复制患方情绪、尸体料理触发终结感、安慰家属束手无策、难以避免承担责任、消磨职业的归属感以及家庭成员关系严峻。结论:本研究总结了ICU护士面对患者死亡的双重情感体验,即应激刺激下的自我防御和持续浸润后的情感内耗。展开更多
Hafnium zirconium oxides(HZO),which exhibit ferroelectric properties,are promising materials for nanoscale device fabrication due to their high complementary metal-oxide-semiconductor(CMOS) compatibility.In addition t...Hafnium zirconium oxides(HZO),which exhibit ferroelectric properties,are promising materials for nanoscale device fabrication due to their high complementary metal-oxide-semiconductor(CMOS) compatibility.In addition to piezoelectricity,ferroelectricity,and flexoelectricity,this study reports the observation of ferroelasticity using piezoelectric force microscopy(PFM) and scanning transmission electron microscopy(STEM).The dynamics of 90° ferroelastic domains in HZO thin films are investigated under the influence of an electric field.Switching of the retentive domains is observed through repeated wake-up measurements.This study presents a possibility of enhancing polarization in HZO thin films during wake-up processes.展开更多
OBJECTIVES To evaluate the effectiveness of a large-scale,web-based,in-service hypertension management training project among lay health workers(LHWs) at primary care health(PHC) settings in China,and to examine the f...OBJECTIVES To evaluate the effectiveness of a large-scale,web-based,in-service hypertension management training project among lay health workers(LHWs) at primary care health(PHC) settings in China,and to examine the factors contributing to the variations of effectiveness.METHODS We used data from a web-based national hypertension management training project implemented in 2018,it was designed to facilitate LHWs to learn,understand,and apply the relevant knowledge and skills in hypertension management through providing training courses by use of the web-based platform with unified standards.All LHWs were required to participate in the exams before and after training to acquire scores for the use of evaluating their performance of hypertension management knowledge.We first used descriptive analysis to present the variations of effectiveness in hypertension management knowledge among LHWs by important subgroups.Afterwards,we used multilevel logistic regression to examine the individual and regional factors contributing to the variations and quantify the magnitude of how these factors affected training effectiveness.RESULTS There were 1,208,610 LHWs who completed training and were certificated.Nationally,the scores of LHWs increased significantly from 62.87 ± 21.14 out of 100 in the pre-test to 88.30 ± 11.31 in the post-test by 25.43(95% confidence interval[CI]:25.40-25.47).Training contents involved in antihypertensive medication showed the lowest score(54.36) in the pre-test and soared the most after training,up to 84.22 by 54.94%.Individual factors associated with disparities in the knowledge of hypertension management decreased substantially after training,which included sex,age,education,practice type,professional level,and hierarchy of working institutions.Geographical variations were shown at the provincial level,with the majority of them being explained by factors at the regional level.CONCLUSIONS Accessible web-based training modality,government efforts,accompanied with experiences derived from the training,could be generalized to other low-and middle-income countries in facilitating the hypertension management capacity of LHWs.Localization and evaluation is warranted on the way to its further application.展开更多
Population aging has become an inevitable trend and exerted profound influences on socio-economic development in China.In this study,we utilized data from national population census and statistical yearbooks in 2010 a...Population aging has become an inevitable trend and exerted profound influences on socio-economic development in China.In this study,we utilized data from national population census and statistical yearbooks in 2010 and 2020 to explore spatio-temporal patterns of aging population and its coupling correlations with socio-economic factors from both global and local perspectives.The results from Local Indicators of Spatial Association(LISA)uncover notable spatial disparities in aging population rates,with higher rates concentrated in the eastern regions and lower rates in the western areas of the Chinese mainland.The results from the global correlation analysis with the changes in aging population rates show significant positive correlations with government interventions and industrial structures,but negatively correlated with economic development,social consumption,and medical facilities.From a local perspective,a Geographically Weighted(GW)correlation analysis is employed to uncover local correlations between aging trends and socio-economic factors.The insights gained from this technique not only underscore the complexity and diversity of economic implications stemming from population aging,but also provide invaluable guidance for crafting region-specific economic policies tailored to various stages of population aging.展开更多
目的探讨在诊断为急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后,在心脏磁共振(Cardiac Magnetic Resonance,CMR)图像上的细胞外容积(Extracellular Volume,ECV)与微循环障碍(MVO)的关系。方法回顾性连续选择于2022...目的探讨在诊断为急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后,在心脏磁共振(Cardiac Magnetic Resonance,CMR)图像上的细胞外容积(Extracellular Volume,ECV)与微循环障碍(MVO)的关系。方法回顾性连续选择于2022年1月至2023年10月因STEMI就诊并行CMR检查及PCI的患者308例,根据患者磁共振图像是否存在明显MVO分为MVO组及对照组,比较两组的临床基线资料。采用单因素及多因素Logistic回归分析研究STEMI患者PCI术后MVO发生的影响因素,并绘制相关ROC曲线以研究ECV、超敏肌钙蛋白T(hs-TnT)峰值、TIMI血流分级以及左室射血分数(LVEF)对PCI后是否发生MVO的预测价值。结果TIMI血流分级、N末端脑钠肽前体(NT-proBNP)峰值、hs-TnT峰值、LVEF及心肌梗死部位ECV提示是MVO独立危险因素(P<0.01)。ECV预测MVO的ROC曲线下面积(AUC)为0.687(95%CI:0.628~0.746,P<0.001),敏感度为84.9%,特异性为49.4%。且与低ECV组相比,高ECV组患者的hs-TnT更高,LVEF更低(P<0.01)。结论梗死部位的ECV是MVO的独立危险因素。展开更多
文摘目的:了解重症监护病房(Intensive Care Unit,ICU)护士面对患者死亡的情感体验,探究存在替代性创伤反应的ICU护士面对患者死亡的情感体验。方法:本研究采用描述性现象学的研究设计,选取ICU存在替代性创伤反应(灾难救助者替代性创伤问卷各因子及总分超过理论中值)的责任护士16例,对其个体生活的参考框架、自我能力、自我资源、心理需求与认知图式和意象进行深入访谈,运用Colaizzi7步分析法进行资料分析。结果:ICU护士面对患者死亡的情感体验归纳为应激刺激下的自我防御和持续浸润后的情感内耗2个主题,其中应激刺激下的自我防御包括无意识的短暂封闭和个人化的情绪反应;持续浸润后的情绪内耗包括镜像复制患方情绪、尸体料理触发终结感、安慰家属束手无策、难以避免承担责任、消磨职业的归属感以及家庭成员关系严峻。结论:本研究总结了ICU护士面对患者死亡的双重情感体验,即应激刺激下的自我防御和持续浸润后的情感内耗。
基金Project supported by the the National Key Research and Development Program of China (Grant No. 2022YFA1402902)the National Natural Science Foundation of China (Grant Nos. 12074119, 12204171, 12134003, and 12374145)+1 种基金the Chenguang Program Foundation of Shanghai Education Development Foundation and Shanghai Municipal Education Commission, ECNU (East China Normal University) Multifunctional Platform for Innovation (006)the Fundamental Research Funds for the Central Universities。
文摘Hafnium zirconium oxides(HZO),which exhibit ferroelectric properties,are promising materials for nanoscale device fabrication due to their high complementary metal-oxide-semiconductor(CMOS) compatibility.In addition to piezoelectricity,ferroelectricity,and flexoelectricity,this study reports the observation of ferroelasticity using piezoelectric force microscopy(PFM) and scanning transmission electron microscopy(STEM).The dynamics of 90° ferroelastic domains in HZO thin films are investigated under the influence of an electric field.Switching of the retentive domains is observed through repeated wake-up measurements.This study presents a possibility of enhancing polarization in HZO thin films during wake-up processes.
文摘OBJECTIVES To evaluate the effectiveness of a large-scale,web-based,in-service hypertension management training project among lay health workers(LHWs) at primary care health(PHC) settings in China,and to examine the factors contributing to the variations of effectiveness.METHODS We used data from a web-based national hypertension management training project implemented in 2018,it was designed to facilitate LHWs to learn,understand,and apply the relevant knowledge and skills in hypertension management through providing training courses by use of the web-based platform with unified standards.All LHWs were required to participate in the exams before and after training to acquire scores for the use of evaluating their performance of hypertension management knowledge.We first used descriptive analysis to present the variations of effectiveness in hypertension management knowledge among LHWs by important subgroups.Afterwards,we used multilevel logistic regression to examine the individual and regional factors contributing to the variations and quantify the magnitude of how these factors affected training effectiveness.RESULTS There were 1,208,610 LHWs who completed training and were certificated.Nationally,the scores of LHWs increased significantly from 62.87 ± 21.14 out of 100 in the pre-test to 88.30 ± 11.31 in the post-test by 25.43(95% confidence interval[CI]:25.40-25.47).Training contents involved in antihypertensive medication showed the lowest score(54.36) in the pre-test and soared the most after training,up to 84.22 by 54.94%.Individual factors associated with disparities in the knowledge of hypertension management decreased substantially after training,which included sex,age,education,practice type,professional level,and hierarchy of working institutions.Geographical variations were shown at the provincial level,with the majority of them being explained by factors at the regional level.CONCLUSIONS Accessible web-based training modality,government efforts,accompanied with experiences derived from the training,could be generalized to other low-and middle-income countries in facilitating the hypertension management capacity of LHWs.Localization and evaluation is warranted on the way to its further application.
基金National Natural Science Foundation of China(No.42071368)Fundamental Research Funds for the Central Universities(Nos.2042022dx0001,2042024kf0005).
文摘Population aging has become an inevitable trend and exerted profound influences on socio-economic development in China.In this study,we utilized data from national population census and statistical yearbooks in 2010 and 2020 to explore spatio-temporal patterns of aging population and its coupling correlations with socio-economic factors from both global and local perspectives.The results from Local Indicators of Spatial Association(LISA)uncover notable spatial disparities in aging population rates,with higher rates concentrated in the eastern regions and lower rates in the western areas of the Chinese mainland.The results from the global correlation analysis with the changes in aging population rates show significant positive correlations with government interventions and industrial structures,but negatively correlated with economic development,social consumption,and medical facilities.From a local perspective,a Geographically Weighted(GW)correlation analysis is employed to uncover local correlations between aging trends and socio-economic factors.The insights gained from this technique not only underscore the complexity and diversity of economic implications stemming from population aging,but also provide invaluable guidance for crafting region-specific economic policies tailored to various stages of population aging.
文摘目的探讨在诊断为急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后,在心脏磁共振(Cardiac Magnetic Resonance,CMR)图像上的细胞外容积(Extracellular Volume,ECV)与微循环障碍(MVO)的关系。方法回顾性连续选择于2022年1月至2023年10月因STEMI就诊并行CMR检查及PCI的患者308例,根据患者磁共振图像是否存在明显MVO分为MVO组及对照组,比较两组的临床基线资料。采用单因素及多因素Logistic回归分析研究STEMI患者PCI术后MVO发生的影响因素,并绘制相关ROC曲线以研究ECV、超敏肌钙蛋白T(hs-TnT)峰值、TIMI血流分级以及左室射血分数(LVEF)对PCI后是否发生MVO的预测价值。结果TIMI血流分级、N末端脑钠肽前体(NT-proBNP)峰值、hs-TnT峰值、LVEF及心肌梗死部位ECV提示是MVO独立危险因素(P<0.01)。ECV预测MVO的ROC曲线下面积(AUC)为0.687(95%CI:0.628~0.746,P<0.001),敏感度为84.9%,特异性为49.4%。且与低ECV组相比,高ECV组患者的hs-TnT更高,LVEF更低(P<0.01)。结论梗死部位的ECV是MVO的独立危险因素。
