Impact of Remote Working on the Employees During COVID-19 Pandemic-Conclusions From Creative Specialists and Software Developers in the Perspective of the Age of Industry 4.0

The objective of the article is identification of similarities in behavior and work attitude toward remote working in times of COVID-19 pandemic.Evaluation is concerned on employees of creative employees from different countries and business sectors.The author conducted research on Polish and American creative specialists,including software developers.Research conducted for this article in the first stage was qualitative,and in the second stage is based on quantitative methodology and secondary data from American research.The qualitative research conducted in Poland and was based on unstructured interviews with open-ended questions in the form of self-report concerning workflows during remote working.The first stage can be used as the starting point to next research of creative specialists from other countries.The quantitative research is based on secondary data from a study conducted among American employees of Microsoft Corporation.It was research made in the form of survey during COVID-19 pandemic(March-May 2020).The conclusions from each of the stages of research were used to create universal conclusions in the form of gathered key similarities and differences in behavior and wellbeing of creative specialist from different countries during remote working.The analysis included Industry 4.0 perspective-like market needs(e.g.building innovation which require a combination of creativity and technical skills)or condition of constant change.The research and analysis also reveals the potential for future research in the other countries and business sectors.

An Approach to Evaluate the Implementation Effects of Advanced Manufacturing Technology Based on the Specialists' Opinion Selection

Since domestic corporations firstly introduced into and implemented the Advanced Manufacturing Technology (AMT),how to scientifically evaluate the implementation effects of AMT has been an urgent problem.Through the review of for- eign relative studies,this paper constructs an indicator system used to evaluate the implementation effects of AMT.Operational performance,Organizational or managerial performance,Satisfactory performance,and Competitive performance are indicators of first level in the system,and 19 indicators of second level have been selected to estimate the implementation effects of AMT.In this study,a model based on Minkowski distance discriminance to select the specialists’ opinion was designed to evaluate the indica- tor system,and the measure’s validity and practicability was proved by a case study to a diesel engine factory.

Understanding practice patterns of glaucoma sub-specialists in India

AIM：To obtain information on the prevailing practice patterns of glaucoma specialists in India.METHODS：Glaucoma specialists attending the Annual Conference of the Glaucoma Society of India（GSI）were surveyed.This survey,conducted in 2013,was based on an interactive audience response system.RESULTS：The information was obtained from 146 glaucoma specialists.Approximately half（n=83;57%）had≥10y of experience in managing glaucoma and were in institutional practice（n=74,51%）.Goldmann applanation tonometry was preferred by 103（72%）specialists whilst n=25（17.4%）used non-contact tonometer.Indentation gonioscopy was favoured by two-thirds（n=90,66%）whereas stereoscopic optic disc examination and visual fields using Humphrey perimeter was performed by a majority of the specialists surveyed（n=115,86%and n=114;83%respectively）.Nearly three quarter specialists（n=96;72%）preferred optical coherence tomography for imaging.The primary choice for treatment of angle closure disease and primary open angle glaucoma was laser（iridotomy,n=117;93%）and medical management（prostaglandin analogue,n=104;78%）,respectively.Approximately only a third of the specialists surveyed（n=37;28%）were performing both trabeculectomy and implantation of a glaucoma drainage device and about half（n=64;47%）were not operating on congenital glaucoma at all.CONCLUSION：This survey has found conformance with preferred practice patterns in several areas of diagnosisand management of glaucoma,but there was diversity in a few areas.The information is a significant step towards improvement of glaucoma care in India,including planning for future strategies.

Diagnosis and Treatment of Cholangiocarcinoma: A Consensus from Surgical Specialists of China

Cholangiocarcinoma refers to malignant tumors that develop in epithelial lining of biliary system, and it is divided into two categories according to tumor location, intrahepatic cholangiocarcinoma （ICC） and extrahepatic cholangiocarcinoma （ECC）. ICC occurs from the epithelial cells of the intrahepatic bile duct, its branches and interlobular biliary tree; and ECC is divided into hilar cholangiocarcinoma and distal cholangiocarcinoma by the circumscription at the confluence of cystic duct and the common hepatic duct.

A Glimpse of the Initial Conditions for the Development of Science and Technology and Soviet Specialists in the PRC:1949–1955

This article aims to analyze the so-called“starting point”when modern scientific and technological successes in China were in their infancy,and to provide the reader with insight on how various challenges were overcome in their development.The period under review is 1949–1955.The information about this period was obtained from Soviet archives and special literature.The first part of the article describes the state of affairs in the People’s Republic of China(PRC)in the early years of its formation,focusing on education,science,industry(including military),communications,and rail transport.The second part turns to the Soviet specialists working in the PRC during these years,focusing on their profession,number,cities of residence and living conditions.Issues regarding Chinese specialists’internship in the Union of Soviet Socialist Republics(USSR)are also touched upon.The article selects several lesserknown areas in which professional competencies were established in this very weak post-war country to discover the origins of the most important science and technology in the contemporary PRC,thereby contributing to readers’understanding of the initial conditions for the development of science and technology in China.

How Specialists Become Primary Care Physicians in Japan

Background: Most countries have a shortage of Primary Care (PC) physicians. Japan has mitigated this problem by specialists making a mid-career change to PC when they go into private practice. This study examines the circumstances under which specialists shift to PC. Methods: Since the division between specialists and PC physicians is blurred in Japan, we focus on Physicians Providing Home Visits (PPHV). The list of PPHV was obtained from the local medical associations in two neighboring medical planning areas in Japan. The methods used were a questionnaire and in-depth interviews. Results: Of the 46 listed as PPHV, 38 responded to the questionnaires. Physicians mainly acquired their knowledge and skills in primary care from post-graduate clinical training and on the job training after becoming PPHV. The specialists who had moved to PC were equally knowledgeable regarding PC as those had taken the PC accreditation exam. The in-depth interviews revealed that the higher income earned in clinics and being able to retain their identity as a specialist were also important factors. Conclusions: The factors that contributed to physicians making a mid-career change from specialists to PC were their experiences after being certified, the higher income in clinics and the ability to retain their professional identity as specialists. These enabling factors might also be applicable for increasing the ratio of PC physicians at the global level although further studies are required.

Current status of clinical nursing specialists and the demands of osteoporosis specialized nurses in China's Mainland

The clinical nursing specialist(CNS)is an expert who applies an expanded range of practical,theoretical,and research-based competencies to the care of patients within in a specialty clinical area within the larger discipline of nursing.A large number of studies consistently conclude that the CNS is a valuable healthcare resource that provides highquality clinical and evidence-based nursing practice and improves patient outcome.The CNS has been involved in healthcare practices for many years,with an increasingly diverse role.However,the training for the CNS in China is only in a preliminary developmental stage.The aim of this article is to review the history and development of the CNS role.Furthermore,the epidemiologic status of osteoporosis,as well as the feasibility and necessity of developing training programs in China for the osteoporosis CNS,will be discussed.

Training indicators and quantitative criteria for emergency nurse specialists

Objective： By constructing a training system of quality evaluation standards for emergency nurse specialist（ENS）, we can ensure smooth operations and quality training for ENS.Methods： First, the frame structure of indicators was designed on the basis of system theory and the balanced scorecard method. Meanwhile, corresponding quantitative standard indicators were compiled through literature analysis and a review of training characteristics. Next, screening indicators were collected through consultation with experts and statistical calculations. The indicators weight coefficient was calculated using the analytic hierarchy process（AHP）. Finally, indicators were validated in two groups of nurses in two different training courses.Results：（1） We created a three-level indicator system： level-Ⅰ dimensions have 4 indicators, while level-Ⅱ dimensions and level-Ⅲ dimensions have 13 and 34 indicators, respectively;（2） The coefficient of expert＇s judgment is 0.840, familiarity is 0.914 and authority is 0.877, and the three rounds of coordination coefficient are 0.456, 0.553 and 0.715, respectively;（3） There are at least 56 indicators in alternative quantitative standards; and（4） The alpha reliability value of the indicator system in the two training course had no significant difference（P 〉 0.05）. The same result was observed when examining two groups of nurses in one training course（P 〉 0.05）.Conclusions： This study established a training system of quality evaluation standards for emergency nurse specialists that is objective, reliable, easy to operate and representative according to scientific selection and verification. This system can therefore provide a basis for quality evaluation and targeted improvement for ENS training in addition to promoting health.

The Experiences of Palliative Care Specialists in Implementing Palliative Care into Their Work Settings in Lusaka, Zambia

There is a significant unmet need for palliative care globally: of the 58 million people dying annually, it was estimated that at least 60% will have the prolonged advanced illness and dying and would benefit from palliative care. Zambia has a total population of 15,066,266 people. About 1,150,400 people are living with HIV and 18,900 people were reported to have died of HIV in 2014 alone. The most recent palliative care situational analysis in Zambia highlighted that palliative care remained “an essential absent factor” and revealed that there were gaps in the type of care given in various home based care (HBC) programs. Therefore, this study aimed at exploring the experiences of trained palliative care specialists in implementing palliative care in Lusaka, Zambia. This study was an exploratory qualitative research. The population comprised of the trained palliative care specialists in either degree or diploma in palliative care, working in Lusaka. Purposive sampling was used and the sample totaled 6 (n-6). The data collection was done using a semi-structured interview guide, through face-to-face in-depth interviews. The interviews lasted for an average of 20 minutes. Prompts and probes were used to increase detailed analysis explorations. Eleven themes broadly classified as facilitators or challenges emerged from the study. Among the facilitators: training influence;higher level support;effective team work and delivery models;and personal development and motivation to serve. challenges included: lack of PC knowledge;lack of essential medication for PC;work burden;lack of financial resources;lack of acceptance of PC;lack of PC guidelines;and legal restrictions on the use of opioids. The study provided evidence of the challenges and facilitators that influence palliative care that specialists experience while implementing PC. It is therefore, recommended that more research, education, effective teamwork is promoted as the study revealed that participants needed support for effective implementation of palliative care.

Disparity in clinical care for patients with inflammatory bowel disease between specialists and non-specialists

Background: Although inflammatory bowel disease (IBD) patients have been increasing and new thera-peutic options for IBD have been developed, there are relatively few clinicians who specialize in IBD. Patients treated by a non-specialist of IBD may not receive appropriate treatment. This study aimed to compare disease and medication status between IBD patients treated by a specialist and those treated by a non-specialist. Methods: Medical charts of ambulating IBD patients in two hospitals were examined. All patients in one hospital were treated by one of the IBD specialists, while in the other hospital, patients were treated by one of the gastroenterologists who was a non-specialist of IBD. Results: The numbers of IBD patients were 255 (hospital with specialists) and 74 (hospital without specialists), respectively. Disease activity of the patients was not well-controlled in the hospital without specialists compared to in the hospi- tal with specialists (ulcerative colitis (UC): p = 0.0006 and Crohn’s disease: p = 0.012, respectively). The proportion of UC patients who received an insufficient dose of mesalazine (Pentasa < 3 g/day or Asacol < 3.6 g/day) was higher in the hospital without specialists (47% vs. 15%, p < 0.0001). In the hospital without specialists, more patients received long-term corticosteroids (UC: 23% vs. 5%, p < 0.0001), while fewer patients received immunomodulators (UC: 8% vs. 46%, p < 0.0001). Conclusions: IBD patients of the hospital without specialists were not well-controlled and were not prescribed appropriately with thera-peutic drugs. Fostering and placement of the specialist of IBD is an urgent problem.

An Assessment of Awareness of Specialists in Adequate Diagnostics of Chronic Pancreatitis in Kazakhstan

Our national center of gastroenterology provides highly specialized care, including chronic pancreatitis. Another area of our activities is educational programs, including postgraduate and fellows’ courses. Thereby, we have noted significant gaps in the knowledge of the specialists that involved in the chronic pancreatitis management. The most critical downsides are related to insufficient attention to etiology and risk factors, using outdated classifications, the lack of knowledge in arsenal of diagnostic techniques, polypharmacy or application of low level of evidence treatment methods. Finally, we have made amendments in the National Clinical Protocol in Chronic Pancreatitis [1], updated the State Educational Standard for residents of the gastroenterological profile [2]. The aim of the study was the analysis of the basic knowledge among different specialists in the management of chronic pancreatitis (CP) around the country. This qualitative study consists of two parts, including focus group interviews followed by interviews with the specialists across the country, which was conducted during the period 2015-2018. In this paper, we present results of diagnostic approaches at the different levels of medical care. The general practitioners have noted the absence of modern methods of laboratory and visual diagnostics in their routine practice, therefore explaining the plenty of the complicated forms. Another issue is the low specialist’s adherence to clinical guidelines, poor knowledge of the risk factors and overestimation of the clinical presentation value except malnutrition symptoms. On the other hand, surgeons and other specialists are not ready to implement modern diagnostic tools and methods in their practice. Obviously, in accordance with the results of our study, our educational center should conduct a number of training activities, as well as develop new algorithms for medical care specialists.

Consensus of Chinese Specialists on Diagnosis and Treatment of Resistant Hypertension

INTRODUCTION Resistant hypertension has become a challenge in the treatment of hypertension.As the population continues to age and obesity,sleep apnea hypopnea syndrome,and chronic kidney disease increase in incidence,resistant hypertension has become an increasingly common issue in clinical practice.Failure to control blood pressure can impair target organs such as the heart,brain,and kidney,facilitating the occurrence of clinical cardiovascular events.

Knock-in of exogenous sequences based on CRISPR/Cas9 targeting autosomal genes and sex chromosomes in the diamondback moth,Plutella xylostella

Genetic pest control strategies based on precise sex separation and only releasing sterile males can be accomplished by site-specific genome editing.In the current study,we showed that the mutation of single-allele Pxfl(2)d can significantly impair the normal mating behavior and testis development in male adults of the notorious cruciferous insect pest Plutella xylostella,in addition to its known functions in the ovarian development in female adults and egg hatching.Subsequent CRISPR/Cas9-based knock-in experiments revealed that site-specific integration of an exogenous green fluorescent protein(GFP)gene into autosomal Pxfl(2)d for labelling mutants could be achieved.However,this gene is not a suitable target for GFP insertion to establish a genetically stable knock-in strain because of the severe decline in reproductive capacity.We further screened for the W-chromosome-linked and Z-chromosome-linked regions to test the knock-in efficiency mediated by CRISPR/Cas9.The results verified that both types of chromosomes can be targeted for the site-specific insertion of exogenous sequences.We ultimately obtained a homozygous knock-in strain with the integration of both Cas9 and cyan fluorescent protein(CFP)expression cassettes on a Z-linked region in P.xylostella,which can also be used for early sex detection.By injecting the sgRNA targeting Pxfl(2)d alone into the eggs laid by female adults of the Z-Cas9-CFP strain,the gene editing efficiency reached 29.73%,confirming the success of expressing a functional Cas9 gene.Taken together,we demonstrated the feasibility of the knock-in of an exogenous gene to different genomic regions in P.xylostella,while the establishment of a heritable strain required the positioning of appropriate sites.This study provides an important working basis and technical support for further developing genetic strategies for insect pest control.

Pancreatic surgery and tertiary pancreatitis services warrant provision for support from a specialist diabetes team

Pancreatic surgery units undertake several complex operations,albeit with consi-derable morbidity and mortality,as is the case for the management of complicated acute pancreatitis or chronic pancreatitis.The centralisation of pancreatic surgery services,with the development of designated large-volume centres,has contribu-ted to significantly improved outcomes.In this editorial,we discuss the complex associations between diabetes mellitus(DM)and pancreatic/periampullary disease in the context of pancreatic surgery and overall management of complex pancreatitis,highlighting the consequential needs and the indispensable role of specialist diabetes teams in support of tertiary pancreatic services.Type 3c pan-creatogenic DM,refers to DM developing in the setting of exocrine pancreatic disease,and its identification and management can be challenging,while the glycaemic control of such patients may affect their course of treatment and outcome.Adequate preoperative diabetes assessment is warranted to aid identification of patients who are likely to need commencement or escalation of glucose lowering therapy in the postoperative period.The incidence of new onset diabetes after pancreatic resection is widely variable in the literature,and depends on the type and extent of pancreatic resection,as is the case with pancreatic parenchymal loss in the context of severe pancreatitis.Early involvement of a specialist diabetes team is essential to ensure a holistic management.In the current era,large volume pancreatic surgery services commonly abide by the principles of enhanced recovery after surgery,with inclusion of provisions for optimisation of the perioperative glycaemic control,to improve outcomes.While various guidelines are available to aid perioperative management of DM,auditing and quality improvement platforms have highlighted deficiencies in the perioperative management of diabetic patients and areas of required improvement.The need for perioperative support of diabetic patients by specialist diabetes teams is uniformly underlined,a fact that becomes clearly more prominent at all different stages in the setting of pancreatic surgery and the management of complex pancreatitis.Therefore,pancreatic surgery and tertiary pancreatitis services must be designed with a provision for support from specialist diabetes teams.With the ongoing accumulation of evidence,it would be reasonable to consider the design of specific guidelines for the glycaemic management of these patients.

Application and Promotion of Whole-Process Capacity Management Model for CHF Patients Led by Specialist Nurses in “Heart Failure Center Alliance Unit”

Objective: To implement the whole-process capacity management model led by specialist nurses, improve the capacity management behavior of medical staff, and build a standardized, standardized and operable CHF capacity management system. Methods: According to the evidence pyramid principle and search strategy, 2 evidence-based nursing backbone completed literature search in both Chinese and English, and finally included 7 literatures. Results: Around the three key links of capacity assessment, monitoring and management, stakeholders were invited to evaluate each evidence according to the FAME principle, that is, the feasibility, suitability, effectiveness and clinical significance of evidence. Finally, 11 best evidences were obtained and 5 clinical review indicators of the cost project were transformed. This study formulated the competence management plan for CHF patients based on the current situation, established competence load evaluation criteria for CHF patients, and determined the target “dry weight” value for CHF patients. Conclusion: The whole-course volume management model of CHF patients guided by specialist nurses should be established and applied and promoted in the “heart failure Center Alliance unit”, so as to improve the capacity management ability of medical staff for CHF patients, enhance the self-management ability of CHF patients, improve the capacity management behavior and health outcomes, and effectively reduce the hospitalization rate and mortality rate of CHF patients in the region.

Beijing Specialists Give Free Medical Treatment in Yunnan Province

To help improve the physical conditions of the people in the Hui ethnic minority areas of Yunnan Province, from December 6 to 11,2005, a 10-member medical team of specialists from the Capital went to the Weishan Yi and Hui Ethnic Minority Autonomous County of Dali Prefecture and Xundian Hui and Yi Ethnic Minority Autonomous County of Kunming City to give free medical treatment for 6 days. This activity

Specialists in“advertising printing”at MAN Roland:

New opportunities ahead for print media in advertis-ing-talks among experts promote cooperation a-mong partners:agencies,printers and suppliers"Print media in advertising have a promising fu-ture;accuracy of reaching target groups and specificadvertising effectiveness are important advantageswhich will remain assets in the competition betweenprinting and electronic media."This opinion

Senior Agroforestry Specialists Forum Held in Beijing

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Experience inheritance from famous specialists based on real- world clinical research paradigm of traditional Chinese medicine

The current modes of experience inheritance from famous specialists in traditional Chinese medicine （TCM） include master and disciple, literature review, clinical-epidemiology-based clinical research observation, and analysis and data mining via computer and database technologies. Each mode has its advantages and disadvantages. However, a scientific and instructive experience inheritance mode has not been developed. The advent of the big data era as well as the formation and practice accumulation of the TCM clinical research paradigm in the real world have provided new perspectives, techniques, and methods for inheriting experience from famous TCM specialists. Through continuous exploration and practice, the research group proposes the innovation research mode based on the real-world TCM clinical research paradigm, which involves the inheritance and innovation of the existing modes. This mode is formulated in line with its own development regularity of TCM and is expected to become the main mode of experience inheritance in the clinical field.

某三级甲等专科医院推进互联网分级诊疗的思考

复旦大学附属眼耳鼻喉科医院在发展互联网医院的基础上,积极探索建立互联网分级诊疗。与全国6省(市)11个地区的16家医院达成互联网分级诊疗战略合作,利用专科医院优势,通过远程会诊、远程教学、科普直播等多项举措共同推进互联网分级诊疗。在推进互联网分级诊疗的过程中遇到了远程需求较少、药品配送困难、精准转诊率低、费用结算不明、利益分配不均等难点。应积极尝试从加强医疗联合体合作关系、增加医疗联合体药品目录、加强基层培训、完善医疗联合体利益分配和构建当地眼健康档案等方面进一步完善互联网分级诊疗。