基于AGREEⅡ和RIGHT对医患沟通指南的质量评价研究

目的对医患沟通的临床实践指南进行方法学和报告质量评价,以期确定高质量指南,提供临床参考。方法通过检索MEDLINE(PubMed)、Web of Science、中国知网(CNKI)、万方数据知识服务平台、维普(VIP),补充医脉通、用药助手、丁香园网站的相关临床实践指南(CPG),使用AGREEⅡ和RIGHT工具进行指南质量评价,采用组内相关系数(ICC)用于评估评审者对每个项目理解的一致性。结果共纳入2份临床实践指南,每个领域的评审人员的总体一致性是可以接受的。AGREEⅡ评价结果显示,2篇指南推荐级别均为B级,CPG所有7个领域的平均报告率为50.64%,其中领域1最高(88.89%),领域3最低(30.95%)。RIGHT评价结果显示,指南平均报告率为29.22%。结论医患沟通相关指南质量与数量仍有待提高,指南制订者应严格按照AGREEⅡ和RIGHT的要求规范撰写,以期提出高水平、高标准的循证指南,来指导医护人员的临床实践。

Addressing Japan’s disposal of nuclear-contaminated water from the perspective of international human rights law

The discharge of nuclear-contaminated water containing radionuclides into the ocean by Japan will lead to its integration into the entire ecosystem through processes of circulation and biomagnification,eventually entering the human body via the food chain.This poses a substantial risk of irreversible damage to both the ecosystem and human health,a situation that will worsen with the ongoing discharge of such water.The respect and protection of human rights represent an international consensus,and safeguarding fundamental human rights is a substantial obligation that states must undertake in accordance with both international and domestic law.Since the Fukushima nuclear disaster,Japan has continuously violated its international legal obligations to protect human rights in several areas,including the resettlement of disaster victims,the reduction of nuclear radiation levels,and the handling of contaminated water.Such actions have compromised and will continue to compromise the basic human rights of not only its citizens but also those of people worldwide,including environmental rights,the right to life,development rights,and food rights.In the aftermath of the Fukushima meltdown,the public and workers involved in handling nuclear contaminants have been continually exposed to high radiation levels,endangering their rights to life,development,and health.Japan’s inadequate efforts in victim resettlement and environmental restoration have jeopardized the environmental and food rights of its citizens to live healthily and access food in an environment unaffected by nuclear radiation.The release of nuclear-contaminated water poses a risk of Japan’s nuclear pollution to the people of neighboring countries and the global population at large.The principle of human rights underpins the theory of a community with a shared future for humanity,and human rights are a crucial area of China’s active participation in United Nations affairs and global governance.By voicing concerns over Japan’s potential human rights violations globally,China demonstrates its role as a responsible major country.In response to Japan’s breach of legal obligations and human rights violations,China can adopt a reasoned and beneficial approach,including calling on the international community to hold Japan criminally accountable for crimes against humanity under the Rome Statute and advancing scholarly discussions on ecocide and crimes against the marine environment.Furthermore,China should persist in seeking advisory opinions from the International Court of Justice and strive for substantive accountability,utilizing the mechanisms of international human rights organizations to make its voice heard.

双碳目标下减压渣油高值利用的RIGHT技术研发

炼油低碳转型发展的关键是高含碳重组分的高效高值利用。通过溶剂脱沥青技术把质量较差的常规焦化原料(即减压渣油)分为脱油沥青(DOA)和脱沥青油(DAO),然后利用相似相溶原理,把两种低价值的以芳烃结构为主的DOA和催化裂化轻循环油(LCO)混合进行加氢(组分炼油),同时DAO单独加氢,形成了中石化石油化工科学研究院有限公司一体化加氢RIGHT(RIPP InteGrated HydroTreating)技术。加氢后DOA进焦化装置可以生产低金属(V、Ni质量分数均小于150μg/g)或低金属低硫(硫质量分数不大于3.0%)的石油焦,为高端炭材料提供高质量前躯体。与常规焦化相比,RIGHT技术可把低档次的高金属和高硫含量的石油焦产率降低约70%。加氢后的LCO满足LTAG进料要求,可以生产轻芳烃(BTX)和高辛烷值汽油调合组分;DAO在比常规渣油加氢质量空速高1倍的情况下进行加氢,加氢后DAO的氢质量分数为12.25%~12.32%,残炭小于2.0%,金属(Ni+V)质量分数小于0.1μg/g,是优质催化裂化/催化裂解原料,可以多产低碳烯烃和高辛烷值汽油调合组分并大幅度降低过程剂耗。基于DOA和LCO混合油中高金属含量特点,研发了脱金属和容金属能力更强的RRC系列资源再造催化剂,运转后催化剂金属V和Ni沉积量高,是获取高价值V和Ni,尤其是V的宝贵资源。DAO加氢装置运转周期可以提高至4年,从根本上解决渣油加氢装置运转周期短的问题,同时后部渣油加氢脱硫催化剂可以再生,能够提高催化剂资源利用率。RIGHT技术能把减压渣油通过组分炼油技术更多地用于生产高价值低硫低金属含量石油焦和化工料,从而实现炼油领域高碳含量组分的低碳化和高值化利用。

Laparoscopic right radical hemicolectomy: Central vascular ligation and complete mesocolon excision vs D3 lymphadenectomy - How I do it?

In colon cancer surgery,ensuring the complete removal of the primary tumor and draining lymph nodes is crucial.Lymphatic drainage in the colon follows the vascular supply,typically progressing from pericolic to paraaortic lymph nodes.While NCCN guidelines recommend the removal of 10-12 lymph nodes for ade-quate oncological resection,achieving complete oncological resection involves more than just meeting these numerical targets.Various techniques have been developed and studied over time to attain optimal oncological outcomes.A key technique central to this goal is identifying the ileocolic vessels at their origin from the superior mesenteric vessels.Complete excision of the visceral and parietal mesocolon ensures the intact removal of the specimen,while D3 lymphade-nectomy targets all draining regional lymph nodes.Although these principles emphasize different aspects,they ultimately converge to achieve the same goal of complete oncological resection.This article aims to simplify the surgical steps that align with the principle of central vascular ligation and mesocolon mobilization while ensuring adequate D3 dissection.

MKEAH:Multimodal knowledge extraction and accumulation based on hyperplane embedding for knowledge-based visual question answering

Background External knowledge representations play an essential role in knowledge-based visual question and answering to better understand complex scenarios in the open world.Recent entity-relationship embedding approaches are deficient in representing some complex relations,resulting in a lack of topic-related knowledge and redundancy in topic-irrelevant information.Methods To this end,we propose MKEAH:Multimodal Knowledge Extraction and Accumulation on Hyperplanes.To ensure that the lengths of the feature vectors projected onto the hyperplane compare equally and to filter out sufficient topic-irrelevant information,two losses are proposed to learn the triplet representations from the complementary views:range loss and orthogonal loss.To interpret the capability of extracting topic-related knowledge,we present the Topic Similarity(TS)between topic and entity-relations.Results Experimental results demonstrate the effectiveness of hyperplane embedding for knowledge representation in knowledge-based visual question answering.Our model outperformed state-of-the-art methods by 2.12%and 3.24%on two challenging knowledge-request datasets:OK-VQA and KRVQA,respectively.Conclusions The obvious advantages of our model in TS show that using hyperplane embedding to represent multimodal knowledge can improve its ability to extract topic-related knowledge.

PAL-BERT:An Improved Question Answering Model

In the field of natural language processing(NLP),there have been various pre-training language models in recent years,with question answering systems gaining significant attention.However,as algorithms,data,and computing power advance,the issue of increasingly larger models and a growing number of parameters has surfaced.Consequently,model training has become more costly and less efficient.To enhance the efficiency and accuracy of the training process while reducing themodel volume,this paper proposes a first-order pruningmodel PAL-BERT based on the ALBERT model according to the characteristics of question-answering(QA)system and language model.Firstly,a first-order network pruning method based on the ALBERT model is designed,and the PAL-BERT model is formed.Then,the parameter optimization strategy of the PAL-BERT model is formulated,and the Mish function was used as an activation function instead of ReLU to improve the performance.Finally,after comparison experiments with traditional deep learning models TextCNN and BiLSTM,it is confirmed that PALBERT is a pruning model compression method that can significantly reduce training time and optimize training efficiency.Compared with traditional models,PAL-BERT significantly improves the NLP task’s performance.

Fate of Right Coronary Artery Occlusion after a Surgically Repaired Aorto- Ventricular Tunnel in a Neonate

The aorto-ventricular tunnel is a rare congenital cardiac anomaly.We present a case of aorto-ventricular tunnel diagnosed via fetal echocardiography.Emergency surgery was performed on the 2nd day of life to close the tun-nel,located just in front of the right coronary ostium,due to the patient’s unstable health condition.The post-operative period revealed complete occlusion of the right coronary artery.Due to the patient’s stability,we opted not to reintervene on the right coronary artery.The patient fully recovered without the need for further coronary intervention.In cases of patients with an aorto-ventricular tunnel(AVT)and associated coronary lesions,it is crucial to exercise caution when intervening in the coronary arteries.

Pragmatist View of Human Rights:Theoretical Explanations of China’s Human Rights Practice

The pragmatist view of human rights represents a the-oretical condensation of the Chinese practice in human rights devel-opment.In view of the problem of circular idling between rights and claims caused by the traditional view of human rights of focusing on contents and not valuing implementation,social segmentation caused by empty talks on interests and claims while ignoring social develop-ment,and the phenomenon of the issue of human rights completely becoming empty and useless political rhetoric,the pragmatic view of human rights,based on the fact that there is a gap between the claims and realization of human rights,emphasizes that instead of blindly ex-panding the types of rights in term of text,it is better to base on prac-tice and promote the maximum realization of existing rights through development.The pragmatist view of human rights attaches impor-tance to relevant economic,social and cultural basis to promote the realization of human rights,rather than only focusing on the claims themselves;it pays greater attention to enhancing the realization of rights,rather than the distribution of rights under the total limit;it ad-vocates more for cooperativism in the realization of rights,rather than confrontation.The pragmatic concept of human rights takes Marxism as its theoretical basis and the gene of practice and the dimension of development as its theoretical characteristics,and promotes the devel-opment of human rights through the realization of rights.

Venopulmonary ECMO Improved Hypoxemia and Supported the Right Ventricle in a Patient with Decompensated Eisenmenger Syndrome

Mechanical circulatory and/or respiratory assistance with extracorporeal membrane oxygenation (ECMO) has become a standard of care for patients with circulatory (venoarterial) and/or respiratory (venovenous) failure refractory to standard therapies. Adult patients with congenital heart disease are an increasingly recognized and growing population and include various groups, such as undiagnosed cases in childhood and palliated and/or corrected cases, which require subsequent care because of residual lesions, cardiac arrest/insufficiency, and arrhythmias, among other conditions. In addition, these patients are prone to developing pathologies that are typical of adulthood with a generally increased risk of morbidity and mortality because of their low reserves and organic damage associated with the underlying heart disease, which makes them candidates for ECMO. These patients represent an additional challenge in this therapy because malformations and the presence of a shunt can generally affect the usual cannulation methods and hemodynamic and oximetry monitoring. Thus, the configuration decision must be made on a case-by-case basis. Here, we present a cannulation method, venopulmonary artery ECMO, which provides hemodynamic and respiratory support, and may be ideal for patients with shunts and/or right ventricular dysfunction. To our knowledge, this is the first report of this configuration in patients with congenital heart diseases.

Twenty Years of the Implementation of the Human Rights Clause in the Constitution:Achievements,Implications,and Research Topics

On March 14,2004,the Second Session of the 10th National People’s Congress of China adopted the fourth amendment to the Chinese Constitution,the most noticeable highlight of which is the addition of the paragraph“the state respects and protects human rights”as the third clause in Article 33 of Chapter II“Basic Rights and Obligations of Citizens”in the Constitution.The inclusion of the clause of human rights in the Constitution is considered an important milestone in the history of human rights development in the People’s Republic of China.The implementation of the human rights clause not only showcases the values of the Party and the state in respecting and protecting human rights,but also promotes the development of human rights,shapes the culture of human rights,and endows the rule of law with a rich humanistic spirit.Over the past 20 years,the publicity,research and practice of the human rights clause have made the Chi-nese people realize that human rights are not only a“great term”,but also a common value shared by mankind.Amid the once-in-a-century changes of the world,although the development of human rights is facing various challenges,the humanistic spirit contained in the hu-man rights clause has become the internal driving force for building consensus in the whole of society.Reinterpreting the significance and value of the human rights clause can help us conscientiously draw on the experience in the implementation of the clause over the past 20 years and contribute Chinese wisdom and experience to global human rights governance with a more open mind and inclusive attitude.

From the Subjectivity of Human Rights to the Universality of Human Rights——A Preliminary Interpretation of the Theory on the Subjectivity of Human Rights

Universality is one of the essential characteristics of human rights, but there is a substantive difference between idealism and realism in understanding the concept of universality of human rights. The concepts of radical universality and strong universality based on the concept of natural human rights are too idealistic and thus have a high risk of being alienated into a tool of international re-pression in practice. On the contrary, the theory on the subjectivity of human rights can effectively defuse this risk brought about by radical universality and strong universality. Advocating a transition from the universality of human rights to the subjectivity of human rights not only keeps in line with the actual construction process of international human rights, but can also effectively interpret the practical difficul-ties in the realization process of international human rights. Therefore, it can be used as another alternative theory on human rights beyond the theory of natural human rights.

The Historical Position and Value Dimensions of Human Rights Civilization

Human beings are the mainstay and the ultimate goal of civilization.The history of human civilization is a continuous struggle to realize the respect,liberation,protection,and development of humanity.Human rights are an achievement of humanity and a symbol of progress,and the human rights civilization is an important component of human civilization.Understanding and interpreting human rights from the perspective of human rights civilization means that human rights are not only a concept or an idea but also a grand historical and long-term social practice.Up to now,the development of human rights civilization has roughly experienced four awakening eras:initialization,revolution,popularization,and globalization.In terms of its value dimensions,it has the characteristics of progressiveness,diversity,commonality,inclusiveness,indivisibility,openness,and so on.The historical position of human rights civilization and the development of its value dimensions have shown to the world that human rights are the common wealth of humanity,and human rights belong to all mankind;human rights are historical,concrete,and developmental;the concept of human rights is constantly evolving,and its connotations and categories are constantly expanding;achieving the free and well-rounded development of every person is the highest value realm of human rights civilization.The Chinese modernization endows Chinese civilization with modern strength and opens up new horizons for human rights civilization.The new pattern of human rights civilization to be created by Chinese modernization not only possesses the common characteristics of human rights civilization but also enjoys Chinese characteristics based on its own national conditions,enriching and developing the diversity of human rights civilization for all mankind.

On the Cooperation Between China and the Non-Aligned Movement in the Field of the Right to Development and its Prospects

China and the Non-Aligned Movement share the same goals,a common code of conduct,and similar ideas in protecting the right to development,and the two have a solid foundation for cooper-ation.Both emphasize that the right to development is a basic human right,strive to elevate the right to development to a mainstream hu-man right,and jointly advocate placing the right to development at the center of the agenda.They work together to enhance the strategic sta-tus of the right to development.Both of them have participated in the formulation of the Declaration on the Right to Development,and col-laborated to improve the Declaration.They have also jointly proposed the resolution on the right to development,and supported the drafting of the Convention on the Right to Development to advance the codifi-cation of the right to development.Both of them uphold South-South cooperation and promote North-South dialogue and cooperation.They have established a support mechanism to promote international cooperation on the right to development in a coordinated manner.The cooperation between China and the Non-Aligned Movement in pro-tecting the right to development has broken the past Western-centered paradigm of human rights development,broadened the international perspective of the human rights cause,and played a crucial role in the formation of international human rights norms.In the future,oppor-tunities and challenges coexist for cooperation between the two sides,with promising prospects.China’s cooperation with the Non-Aligned Movement in the protection of the right to development has accumulat-ed valuable and inspirational experiences for the human rights cause of developing countries and the building of the international human rights system.。

Operational requirements analysis method based on question answering of WEKG

The weapon and equipment operational requirement analysis(WEORA) is a necessary condition to win a future war,among which the acquisition of knowledge about weapons and equipment is a great challenge. The main challenge is that the existing weapons and equipment data fails to carry out structured knowledge representation, and knowledge navigation based on natural language cannot efficiently support the WEORA. To solve above problem, this research proposes a method based on question answering(QA) of weapons and equipment knowledge graph(WEKG) to construct and navigate the knowledge related to weapons and equipment in the WEORA. This method firstly constructs the WEKG, and builds a neutral network-based QA system over the WEKG by means of semantic parsing for knowledge navigation. Finally, the method is evaluated and a chatbot on the QA system is developed for the WEORA. Our proposed method has good performance in the accuracy and efficiency of searching target knowledge, and can well assist the WEORA.

The Way to Optimize the Right to Personal Data Portability in Chinese Practice——Based on Empirical Analysis of the Privacy Policies of 66 Mobile Apps

Although the existing legal norms and judicial practic-es can provide basic guidance for the right to personal data portabili-ty, it can be concluded that there are obstacles to the realization of this right through empirical research of the privacy policies of 66 mobile apps, such as whether they have stipulations on the right to personal data portability, whether they are able to derive copies of personal in-formation automatically, whether there are textual examples, whether ID verification is required, whether the copied documents are encrypt-ed, and whether the scope of personal information involved is consis-tent. This gap in practice, on the one hand, reflects the misunderstand-ing of the right to personal data portability, and on the other hand, is a result of the negative externalities, practical costs and technical lim-itations of the right to personal data portability. Based on rethinking the right to data portability, we can somehow solve practical problems concerning the right to personal data portability through multiple measures such as promoting the fulfillment of this right by legislation, optimizing technology-oriented operations, refining response process mechanisms, and enhancing system interoperability.

Working for Global Progress in Human Rights

It should be ensured that all peoples enjoy human rights as equals by allowing them to follow their respective paths of modernization.DECEMBER 2023 marked the 75th anniversary of the Universal Declaration of Human Rights(UDHR).On December 10,1948,the United Nations General Assembly adopted the UDHR(General Assembly resolution 217 A),the first international document on this issue.Chang Peng Chun(P.C.Chang,1892-1957),vice chairman of the original UN Commission on Human Rights at the time.

Research on the Constitutional,Historical and Practical Logic of the Chinese Path of Human Rights Development——From the Perspective of the Inclusion of Human Rights Clause in the Constitution

The inclusion of the human rights clause in the Chi-nese Constitution is a concern and expression of the spirit of the Con-stitution,which has laid the institutional regulations of the fundamen-tal law for the development of human rights in China,provided the principles and value norms of the highest level of effectiveness for the legal protection of human rights,and built a profound constitutional basis for the formation and improvement of the Chinese path of human rights development.The human rights clause is not only a summariza-tion and affirmation of the historical practice of Chinese human rights development under the leadership of the Communist Party of China,but also a new starting point for the development of human rights in China under the leadership of the Communist Party of China.It marks that the development of human rights in China has entered a new era.The Party and the state have finally embarked on a path of human rights development with Chinese characteristics by formulating and implementing the Human Rights Action Plan of China,eliminating ab-solute poverty through the national poverty alleviation campaign,and promoting human rights protection through the rule of law.

Understanding the Human Rights of Modern Individuals—Revisiting Habermas’s Dual Critique and the Reconstruction of Intersubjectivity

Human rights are not only pivotal in depicting the relationship between individuals and communities but also a focal point of political philosophical concerns oriented towards reality. The inseparability of human rights from individual self-identity reveals a contradiction between practicality and historicity in understanding individuals, as highlighted in the debate between liberalism and communitarianism. In order to reconcile this contradiction, Habermas,drawing from German classical philosophy, examines practicality and historicity separately: while Fichte intertwines objectivity in self-identity, revealing the practicality of individuals but neglecting their real elements, Hegel interprets self-identity under the concept of unity,examining individuals from a historical dimension but letting rational rules dominate reality. Ultimately, Habermas reconstructs the process of modern individual self-identity from the theory of communicative action by critiquing the shackles of subjective philosophy. He not only reconciles the divergence between practicality and historicity in self-identity, but also elucidates the intersubjective core inherent in human rights.

Side Event"Human Rights Protection for the Next Generation:the Rights of Children and Youth"Held in Geneva

On January 23,as the UN Human Rights Council's Universal Periodic Review Working Group conducted its fourth review of China's human rights record,the side event"Human Rights Protection for the Next Generation:the Rights of Children and Youth",co-sponsored by the New Sunshine Charity Foundation and China NGO Network for International Exchanges,was held in Geneva.Experts and scholars representing dozens of civil society organisations from different countries exchanged their views around the topic.

Reaffirming the Significance of the Universal Declaration of Human Rights and Upholding the Highest Values of Human Rights in the New Era

It is of particular significance to commemorate the 75th anniversary of the Universal Declaration of Human Rights on the special occasion of the 10th National Constitution Day.In reviewing the Universal Declaration of Human Rights,I’ll share my insights and reflections in three aspects.