OBJECTIVES To establish a scoring system combining the ACEF score and the quantitative blood flow ratio(QFR) to improve the long-term risk prediction of patients undergoing percutaneous coronary intervention(PCI).METH...OBJECTIVES To establish a scoring system combining the ACEF score and the quantitative blood flow ratio(QFR) to improve the long-term risk prediction of patients undergoing percutaneous coronary intervention(PCI).METHODS In this population-based cohort study, a total of 46 features, including patient clinical and coronary lesion characteristics, were assessed for analysis through machine learning models. The ACEF-QFR scoring system was developed using 1263consecutive cases of CAD patients after PCI in PANDA Ⅲ trial database. The newly developed score was then validated on the other remaining 542 patients in the cohort.RESULTS In both the Random Forest Model and the Deep Surv Model, age, renal function(creatinine), cardiac function(LVEF)and post-PCI coronary physiological index(QFR) were identified and confirmed to be significant predictive factors for 2-year adverse cardiac events. The ACEF-QFR score was constructed based on the developmental dataset and computed as age(years)/EF(%) + 1(if creatinine ≥ 2.0 mg/d L) + 1(if post-PCI QFR ≤ 0.92). The performance of the ACEF-QFR scoring system was preliminarily evaluated in the developmental dataset, and then further explored in the validation dataset. The ACEF-QFR score showed superior discrimination(C-statistic = 0.651;95% CI: 0.611-0.691, P < 0.05 versus post-PCI physiological index and other commonly used risk scores) and excellent calibration(Hosmer–Lemeshow χ^(2)= 7.070;P = 0.529) for predicting 2-year patient-oriented composite endpoint(POCE). The good prognostic value of the ACEF-QFR score was further validated by multivariable Cox regression and Kaplan–Meier analysis(adjusted HR = 1.89;95% CI: 1.18–3.04;log-rank P < 0.01) after stratified the patients into high-risk group and low-risk group.CONCLUSIONS An improved scoring system combining clinical and coronary lesion-based functional variables(ACEF-QFR)was developed, and its ability for prognostic prediction in patients with PCI was further validated to be significantly better than the post-PCI physiological index and other commonly used risk scores.展开更多
目的系统评价护理专业本科生参与虚拟现实技术教学的真实体验。方法计算机检索PubMed、Web of Science、PsycINFO、CINAHL、Cochrane Library、Scopus、中国生物医学数据库、中国知网、万方数据库和维普数据库,检索关于护理专业本科生...目的系统评价护理专业本科生参与虚拟现实技术教学的真实体验。方法计算机检索PubMed、Web of Science、PsycINFO、CINAHL、Cochrane Library、Scopus、中国生物医学数据库、中国知网、万方数据库和维普数据库,检索关于护理专业本科生参与虚拟现实技术教学体验的质性研究,检索时限从建库至2022年2月28日。采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准对文献进行质量评价,采用汇集性整合方法对结果进行归纳和整合。结果共纳入10篇研究,提炼出48个研究结果,归纳形成8个新的类别,综合成3个整合结果:虚拟现实教学的独特与积极体验;情境和角色的转换体验;虚拟现实教学中内容设计和技术的体验缺陷。结论护理专业学生对参与虚拟现实教学呈现积极的态度和体验,且创新性的教学方式和不同的学习体验有利于摆脱固有的学生思维,促进临床经验的生成和同理心的发展,但还需进一步丰富教学内容设计细节,优化虚拟现实的技术体验。展开更多
目的:系统评价新入职护士(新护士)工作压力体验的质性研究,以期为新护士的工作压力管理与应对提供参考依据。方法:检索PubMed、Web of Science、中国知网等数据库中关于新护士工作压力的质性研究,采用澳大利亚乔安娜布里格斯研究所(JBI...目的:系统评价新入职护士(新护士)工作压力体验的质性研究,以期为新护士的工作压力管理与应对提供参考依据。方法:检索PubMed、Web of Science、中国知网等数据库中关于新护士工作压力的质性研究,采用澳大利亚乔安娜布里格斯研究所(JBI)循证卫生保健中心质性研究质量评价工具评价文献质量,采取Meta整合方法进行整合。结果:共纳入27项研究,提炼37个主要结果,归纳成11个类别,综合成3个整合结果,即多重因素使新护士工作压力倍增,工作压力使新护士产生躯体和情绪反应,新护士的压力应对资源和应对方式。结论:管理者应重视压力对新护士身心健康及工作的影响,采用多种干预措施积极应对,稳定护理队伍和促进护理专业的可持续发展。展开更多
基金sponsored by Sino Medical,Tianjin,Chinasupported by the Beijing Municipal Science and Technology Project[Z191100006619107 to B.X.]Capital Health Development Research Project[20201–4032 to K.D.].
文摘OBJECTIVES To establish a scoring system combining the ACEF score and the quantitative blood flow ratio(QFR) to improve the long-term risk prediction of patients undergoing percutaneous coronary intervention(PCI).METHODS In this population-based cohort study, a total of 46 features, including patient clinical and coronary lesion characteristics, were assessed for analysis through machine learning models. The ACEF-QFR scoring system was developed using 1263consecutive cases of CAD patients after PCI in PANDA Ⅲ trial database. The newly developed score was then validated on the other remaining 542 patients in the cohort.RESULTS In both the Random Forest Model and the Deep Surv Model, age, renal function(creatinine), cardiac function(LVEF)and post-PCI coronary physiological index(QFR) were identified and confirmed to be significant predictive factors for 2-year adverse cardiac events. The ACEF-QFR score was constructed based on the developmental dataset and computed as age(years)/EF(%) + 1(if creatinine ≥ 2.0 mg/d L) + 1(if post-PCI QFR ≤ 0.92). The performance of the ACEF-QFR scoring system was preliminarily evaluated in the developmental dataset, and then further explored in the validation dataset. The ACEF-QFR score showed superior discrimination(C-statistic = 0.651;95% CI: 0.611-0.691, P < 0.05 versus post-PCI physiological index and other commonly used risk scores) and excellent calibration(Hosmer–Lemeshow χ^(2)= 7.070;P = 0.529) for predicting 2-year patient-oriented composite endpoint(POCE). The good prognostic value of the ACEF-QFR score was further validated by multivariable Cox regression and Kaplan–Meier analysis(adjusted HR = 1.89;95% CI: 1.18–3.04;log-rank P < 0.01) after stratified the patients into high-risk group and low-risk group.CONCLUSIONS An improved scoring system combining clinical and coronary lesion-based functional variables(ACEF-QFR)was developed, and its ability for prognostic prediction in patients with PCI was further validated to be significantly better than the post-PCI physiological index and other commonly used risk scores.
文摘目的系统评价护理专业本科生参与虚拟现实技术教学的真实体验。方法计算机检索PubMed、Web of Science、PsycINFO、CINAHL、Cochrane Library、Scopus、中国生物医学数据库、中国知网、万方数据库和维普数据库,检索关于护理专业本科生参与虚拟现实技术教学体验的质性研究,检索时限从建库至2022年2月28日。采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准对文献进行质量评价,采用汇集性整合方法对结果进行归纳和整合。结果共纳入10篇研究,提炼出48个研究结果,归纳形成8个新的类别,综合成3个整合结果:虚拟现实教学的独特与积极体验;情境和角色的转换体验;虚拟现实教学中内容设计和技术的体验缺陷。结论护理专业学生对参与虚拟现实教学呈现积极的态度和体验,且创新性的教学方式和不同的学习体验有利于摆脱固有的学生思维,促进临床经验的生成和同理心的发展,但还需进一步丰富教学内容设计细节,优化虚拟现实的技术体验。
文摘目的:系统评价新入职护士(新护士)工作压力体验的质性研究,以期为新护士的工作压力管理与应对提供参考依据。方法:检索PubMed、Web of Science、中国知网等数据库中关于新护士工作压力的质性研究,采用澳大利亚乔安娜布里格斯研究所(JBI)循证卫生保健中心质性研究质量评价工具评价文献质量,采取Meta整合方法进行整合。结果:共纳入27项研究,提炼37个主要结果,归纳成11个类别,综合成3个整合结果,即多重因素使新护士工作压力倍增,工作压力使新护士产生躯体和情绪反应,新护士的压力应对资源和应对方式。结论:管理者应重视压力对新护士身心健康及工作的影响,采用多种干预措施积极应对,稳定护理队伍和促进护理专业的可持续发展。
