基于Delphi法构建手术室围术期低体温预防管理评价指标体系

目的 构建手术室围术期低体温预防管理评价指标体系。方法 2022年2月,以结构-过程-结果三维质量评价模式为理论框架,参考相关文献拟定手术室围术期低体温预防管理评价指标体系,采用德尔菲法对来自手术室护理管理、院内感染、麻醉领域的23名专家进行2轮专家函询,采用优序图法确定指标权重系数。结果 2轮专家函询的积极系数分别为100.0%和95.7%,专家权威系数分别为0.946和0.934,各项指标变异系数(CV)均<0.25,Kendall’s W值分别为0.419和0.359(均P<0.001),最终构建了包含3项一级指标、9项二级指标、53项三级指标的手术室围术期低体温预防管理评价指标体系。结论基于Delphi法构建手术室围术期低体温预防管理评价指标体系有较好的科学性和可靠性,可为手术室护理管理者提供参考,有利于临床开展科学、规范、统一的质量评价。

基于Delphi-AHP法的高职专业课教师课程思政能力评价指标体系建构

专业课教师的课程思政能力是高职院校全面推进课程思政工作的关键。针对高职专业课教师课程思政能力结构尚不明晰,评价体系粗放等问题,采用Delphi-AHP法构建高职专业课教师课程思政能力评价指标体系。通过文献三级编码、专家咨询和研究小组讨论,拟定高职专业课教师课程思政能力评价指标体系草案,然后经过两轮德尔菲(Delphi)专家咨询,确定了包含5个一级指标、17个二级指标和58个三级指标的评价指标体系,再采用层次分析法(AHP),构建各级指标判断矩阵,计算各指标权重并检验判断矩阵的一致性,确定各指标的合理权重。研究结果在理论上为探究高职专业课教师课程思政能力内涵拓展了新的认知视角,在实践上为高职院校教师课程思政能力测评提供了可操作的依据和方向。

基于Delphi法构建全科住院医师规范化培训教学查房细化评分量表

目的探索构建标准化全科住院医师规范化培训教学查房细化评分量表。方法采用焦点小组法组织从事全科医学工作10年以上的专家进行讨论,初步构建《全科住院医师规范化培训教学查房细化评分表》。然后,由10名全科教学查房指导专家,根据指标的重要性、可行性及专家的积极性、协调性等进行两轮Delphi问卷咨询。最后,运用层次分析法计算各级指标的权重,确定评价指标体系。结果共进行2轮焦点小组讨论,5名成员对各级指标进行讨论修改分类,初步建立教学查房评估指标体系。10名咨询专家共进行2轮问卷咨询,问卷回收率均为100%。第一轮、第二轮专家咨询的权威系数分别为0.93,0.97,协调系数Kendall’s W分别为0.522,0.421,P<0.001。根据两轮专家咨询结果构建7项一级指标、20项二级指标、119项三级指标,其中一级指标的权重分别为0.0327、0.0464、0.1599、0.2815、0.1599、0.1599、0.1599,所有指标判断矩阵的一致性比率CR均小于0.1。结论本研究构建的全科教学查房细化评分体系合理、完整、可操作性好,多维度反映查房教师及住院医师表现,可作为全科教学查房评价的参考依据。

基于Delphi+BSC导向的基层医疗机构医疗质量控制指标体系构建研究

目的:构建一套与基层医疗机构发展导向相适应、科学合理且能有效应用的医疗质量控制指标体系。方法:通过文献研究及政策文件分析筛选初始指标,借鉴平衡计分卡理论并运用德尔菲法构建质控指标体系及指标权重。结果:通过两轮专家咨询构建了基层医疗机构质量控制指标体系并得出了指标权重,包括4个一级指标、39个二级指标,专家积极系数、权威程度和意见协调程度均较好。结论:该指标体系对基层医疗机构医疗质量控制管理具有较高的科学性和可行性。如果辅以智慧医疗信息化平台的支撑,将能开展常态化推广运用,形成同质化质控管理模式。

基于Delphi-AHP的轻武器训练安全风险因素分析

轻武器是军队数量最多、使用频率最高,也是训练中出现安全事故较多的一类装备。为解决轻武器训练安全风险因素缺乏量化分析的问题,采用“Delphi构建指标-AHP确定权重-事故分析对比验证”的方法,首次构建了轻武器训练安全评价指标体系,系统分析风险因素。结果表明:基于Delphi-AHP确定的指标权重与事故分析结果较为一致,研究方法科学合理;轻武器训练风险性高、影响因素多,需重点考虑人员和管理因素,关注受训者技能水平、受训者安全意识、组织指挥、风险评估及隐患排查等因素,组训时需考虑不同种类轻武器风险因素差异。

基于Delphi法的口服抗凝药物治疗患者知信行问卷研究

目的编制一套用于评价口服抗凝药物治疗患者知识、信念、行为的调查问卷。方法以知信行理论为指导,采用文献分析和访谈法设计口服抗凝药物治疗患者知信行初始问卷;采用Delphi法就初始问卷进行专家函询,并围绕专家建议修改问卷,形成最终问卷。结果向18名专家进行两轮函询,每轮函询均发放和回收18份问卷,专家积极系数为100%,专家权威系数为0.94。两轮函询中问卷所有维度、因子、条目的重要性均分均≥4分,变异系数均≤0.25,问卷整体及知识、信念、行为3个维度的肯德尔和谐系数为0.09~0.34(P均<0.05)。第一轮专家函询后修改4个条目,删除2个条目,新增5个条目;第二轮专家函询后修改10个条目。最终形成的问卷包含知识、信念、行为3个维度,17个问卷因子,40个条目。结论所编制的口服抗凝药物治疗患者知信行问卷的可靠性和科学性均较高,专家意见较一致,可用于评估口服抗凝药物治疗患者的知识、信念、行为现状。

基于Delphi法的社区人群轻度认知障碍疾病认知问卷编制研究

背景人口老龄化背景下,维护脑健康已成为健康中国建设的必然要求,开展社区人群认知障碍疾病认知研究具有重要意义,然而目前尚缺乏针对社区人群轻度认知障碍(MCI)疾病认知水平的调查工具。目的编制社区人群MCI疾病认知调查问卷,并检验其信效度,为促进认知障碍疾病管理提供依据。方法在文献研究、专题小组讨论基础上提出问卷设计的理论框架并初步编制问卷条目,于2021年4—5月采用Delphi法邀请13名相关领域专家进行2轮函询以对问卷条目进行评价,通过预调查对条目描述进行修订,于2021年10—12月通过问卷调查对条目进行难度指数分析、辨别度分析、相关性分析及信效度评价,进一步完善问卷。结果(1)专家函询:两轮函询专家积极程度分别为100.0%、84.6%,专家权威系数分别为0.858、0.845,两轮函询专家对各条目“重要性”评分均值分别为3.77~4.92、3.91~4.91,两轮评分变异系数分别为0.056~0.246、0.061~0.213,两轮函询肯德尔和谐系数分别为0.197、0.252(均P<0.001),两轮咨询分别收到29条、12条专家修改意见及建议。(2)问卷调查:共发放809份问卷,回收有效问卷797份,有效回收率98.52%。各条目难度指数为10%~90%,各条目辨别度指数大多高于20%,各条目得分及各维度得分均与问卷总得分呈正相关(P<0.05)。问卷Cronbach’sα系数为0.712,折半信度系数为0.764。模型检验结果KMO值=0.800(>0.6),Bartlett球形检验χ^(2)=3049.278(P<0.05),提示适合进行因子分析。探索性因子分析结果提示,因子累积方差贡献率为54.930%。最终问卷包括“对MCI基本知识的认识与理解”“个人就诊经历”“MCI诊疗期望”“就医决定与行为”4个维度,共20个条目。结论本研究基于Delphi法编制的社区人群MCI疾病认知调查问卷信效度较好,可作为调查社区人群MCI疾病认识水平的工具。

基于Delphi法构建垂体腺瘤个案管理护理方案

目的:基于德尔菲法构建以个案管理模式为中心的垂体腺瘤病人照护方案,提供临床实践依据。方法:通过查阅国内外文献、临床调研,结合个案管理临床干预模式初步构建垂体腺瘤个案管理照护方案,对我国6个地区22名护理管理和个案管理等相关领域专家进行两轮德尔菲专家函询,确定各级指标。结果:最终形成的垂体腺瘤个案管理方案包括4个一级指标、13个二级指标、62个三级指标;两轮德尔菲专家函询积极系数分别为96.5%和100.0%,专家权威系数分别为0.909和0.916,一级指标的肯德尔和谐系数分别为0.186和0.136,均有统计学意义(P<0.05)。结论:基于Delphi法构建的垂体腺瘤个案管理临床护理方案符合垂体腺瘤多学科团队诊疗需求,内容全面、可靠,具有较高的科学性、实用性,可为垂体腺瘤等临床疾病的单病种管理提供参考依据。

基于Delphi法的《中医妇科临床诊疗指南·妊娠恶阻》评价与修订

目的:修订妊娠恶阻中医临床诊疗指南。方法:检索2010年1月至2015年2月发表的关于中医药治疗妊娠恶阻的文献,结合文献研究,运用Delphi法进行3轮专家问卷调查,收集专家意见,统计专家积极系数和专家共识度,采用SPSS 19.0对专家熟悉程度、专家意见集中程度和专家意见协调程度进行计算,最后根据统计结果和专家咨询结果确定纳入条目。结果:共检出文献141篇,符合要求的高质量目标文献44篇。通过3轮问卷调查和专家论证会,对妊娠恶阻的术语和定义、诊断、辨证、治疗、预防和调护达成专家共识,最终形成妊娠恶阻中医诊疗指南修订征求意见稿。结论:本次妊娠恶阻修订稿较2012版相比修改了症状、辅助检查、治疗原则、针灸疗法部分,增加了预防与调摄,并对原指南的治法方药及中成药添加了文献依据及证据级别。

A comparison study on structure-function relationship of polysaccharides obtained from sea buckthorn berries using different methods:antioxidant and bile acid-binding capacity

In this study,the structural characters,antioxidant activities and bile acid-binding ability of sea buckthorn polysaccharides(HRPs)obtained by the commonly used hot water(HRP-W),pressurized hot water(HRP-H),ultrasonic(HRP-U),acid(HRP-C)and alkali(HRP-A)assisted extraction methods were investigated.The results demonstrated that extraction methods had significant effects on extraction yield,monosaccharide composition,molecular weight,particle size,triple-helical structure,and surface morphology of HRPs except for the major linkage bands.Thermogravimetric analysis showed that HRP-U with filamentous reticular microstructure exhibited better thermal stability.The HRP-A with the lowest molecular weight and highest arabinose content possessed the best antioxidant activities.Moreover,the rheological analysis indicated that HRPs with higher galacturonic acid content and molecular weight showed higher viscosity and stronger crosslinking network(HRP-C,HRP-W and HRP-U),which exhibited stronger bile acid binding capacity.The present findings provide scientific evidence in the preparation technology of sea buckthorn polysaccharides with good antioxidant and bile acid binding capacity which are related to the structure affected by the extraction methods.

Drilling-based measuring method for the c-φ parameter of rock and its field application

The technology of drilling tests makes it possible to obtain the strength parameter of rock accurately in situ. In this paper, a new rock cutting analysis model that considers the influence of the rock crushing zone(RCZ) is built. The formula for an ultimate cutting force is established based on the limit equilibrium principle. The relationship between digital drilling parameters(DDP) and the c-φ parameter(DDP-cφ formula, where c refers to the cohesion and φ refers to the internal friction angle) is derived, and the response of drilling parameters and cutting ratio to the strength parameters is analyzed. The drillingbased measuring method for the c-φ parameter of rock is constructed. The laboratory verification test is then completed, and the difference in results between the drilling test and the compression test is less than 6%. On this basis, in-situ rock drilling tests in a traffic tunnel and a coal mine roadway are carried out, and the strength parameters of the surrounding rock are effectively tested. The average difference ratio of the results is less than 11%, which verifies the effectiveness of the proposed method for obtaining the strength parameters based on digital drilling. This study provides methodological support for field testing of rock strength parameters.

Volumetric lattice Boltzmann method for pore-scale mass diffusionadvection process in geopolymer porous structures

Porous materials present significant advantages for absorbing radioactive isotopes in nuclear waste streams.To improve absorption efficiency in nuclear waste treatment,a thorough understanding of the diffusion-advection process within porous structures is essential for material design.In this study,we present advancements in the volumetric lattice Boltzmann method(VLBM)for modeling and simulating pore-scale diffusion-advection of radioactive isotopes within geopolymer porous structures.These structures are created using the phase field method(PFM)to precisely control pore architectures.In our VLBM approach,we introduce a concentration field of an isotope seamlessly coupled with the velocity field and solve it by the time evolution of its particle population function.To address the computational intensity inherent in the coupled lattice Boltzmann equations for velocity and concentration fields,we implement graphics processing unit(GPU)parallelization.Validation of the developed model involves examining the flow and diffusion fields in porous structures.Remarkably,good agreement is observed for both the velocity field from VLBM and multiphysics object-oriented simulation environment(MOOSE),and the concentration field from VLBM and the finite difference method(FDM).Furthermore,we investigate the effects of background flow,species diffusivity,and porosity on the diffusion-advection behavior by varying the background flow velocity,diffusion coefficient,and pore volume fraction,respectively.Notably,all three parameters exert an influence on the diffusion-advection process.Increased background flow and diffusivity markedly accelerate the process due to increased advection intensity and enhanced diffusion capability,respectively.Conversely,increasing the porosity has a less significant effect,causing a slight slowdown of the diffusion-advection process due to the expanded pore volume.This comprehensive parametric study provides valuable insights into the kinetics of isotope uptake in porous structures,facilitating the development of porous materials for nuclear waste treatment applications.

基于AHP-Delphi法的黄河山西段水土流失治理生态效益评价研究

针对黄河山西段水土流失问题,对山西采取的水土流失治理措施进行梳理。基于AHP法与Delphi法构建起包含三个评价层次、十二个指标层的水土流失治理生态效益综合评价体系,详细分析各指标含义及计算方法,并对该体系的一致性进行检验,计算各指标的权重,对无量纲化处理过后的各指标进行分值量化,结合评价等级标准,最终得出结论:治理后总体评分为81.61分,评价等级为Ⅳ级。说明山西多年来对省内水土流失问题的整治取得了良好效益,有效缓解了水土流失问题。

Material point method simulation of hydro-mechanical behaviour in twophase porous geomaterials: A state-of-the-art review

The material point method(MPM)has been gaining increasing popularity as an appropriate approach to the solution of coupled hydro-mechanical problems involving large deformation.In this paper,we survey the current state-of-the-art in the MPM simulation of hydro-mechanical behaviour in two-phase porous geomaterials.The review covers the recent advances and developments in the MPM and their extensions to capture the coupled hydro-mechanical problems involving large deformations.The focus of this review is aiming at providing a clear picture of what has or has not been developed or implemented for simulating two-phase coupled large deformation problems,which will provide some direct reference for both practitioners and researchers.

基于Delphi法构建尘肺病患者健康教育评估工具

目的通过德尔菲(Delphi)法构建尘肺病患者健康教育的评估工具,用于评估健康教育的有效性。方法基于相关专家共识和临床研究,通过问卷星制定尘肺病患者健康教育评估问卷初稿,遴选行业相关专家14名,于2023年4-5月期间,通过微信等方式邀请专家对问卷条目重要性进行判断,并最终确定尘肺病患者健康教育评估问卷。结果2轮函询问卷有效回收率均为100%。第1轮专家函询中,熟悉程度(Cs)为0.880,判断依据(Ca)为0.930,权威系数(Cr)为0.905;第2轮专家函询中,Cs为0.900,Ca为0.960,Cr为0.930。第2轮函询中各级条目的Kendall′s W值均高于第1轮,差异有统计学意义(P<0.001)。最终筛选出包含10个一级项目和60个二级条目的尘肺病患者健康教育评估问卷。结论采用Delphi法构建的尘肺病患者健康教育评估问卷较为可靠,可用于评估尘肺病患者健康教育的有效性。

Dermatology nurse prescribing in China:a Delphi method

Objectives:To identify the dermatological system drugs that may be prescribed by Chinese dermatological nurses through expert consensus.Methods:A 2-round study,consisting of 32 medical and nursing exper ts,was conducted using the Delphi method from September 2019 to June 2020.Microsoft Excel 2019 and IBM SPSS Ver.22 were used to analyze the results of the consultations.Results:A total of 63 drugs across 13 categories were identified as relevant to Chinese nurses working in dermatological departments.Among these drugs,1 drug was generally prescribed independently,17 drugs tended to be prescribed collaboratively,and 45 were prescribed either independently or in collaboration with others.Conclusions:This exper t consensus determines the prescription drugs that may be prescribed by dermatology nurses in China,which can be used as the key content of prescription drug training for dermatology nurses in future.The results of the study could provide a basis for the implementation of nurses'prescription rights in China in future and provide a reference for the formulation of relevant legislation on nurses'prescription rights.

Sparse Modal Decomposition Method Addressing Underdetermined Vortex-Induced Vibration Reconstruction Problem for Marine Risers

When investigating the vortex-induced vibration(VIV)of marine risers,extrapolating the dynamic response on the entire length based on limited sensor measurements is a crucial step in both laboratory experiments and fatigue monitoring of real risers.The problem is conventionally solved using the modal decomposition method,based on the principle that the response can be approximated by a weighted sum of limited vibration modes.However,the method is not valid when the problem is underdetermined,i.e.,the number of unknown mode weights is more than the number of known measurements.This study proposed a sparse modal decomposition method based on the compressed sensing theory and the Compressive Sampling Matching Pursuit(Co Sa MP)algorithm,exploiting the sparsity of VIV in the modal space.In the validation study based on high-order VIV experiment data,the proposed method successfully reconstructed the response using only seven acceleration measurements when the conventional methods failed.A primary advantage of the proposed method is that it offers a completely data-driven approach for the underdetermined VIV reconstruction problem,which is more favorable than existing model-dependent solutions for many practical applications such as riser structural health monitoring.

Numerical manifold method for thermo-mechanical coupling simulation of fractured rock mass

As a calculation method based on the Galerkin variation,the numerical manifold method(NMM)adopts a double covering system,which can easily deal with discontinuous deformation problems and has a high calculation accuracy.Aiming at the thermo-mechanical(TM)coupling problem of fractured rock masses,this study uses the NMM to simulate the processes of crack initiation and propagation in a rock mass under the influence of temperature field,deduces related system equations,and proposes a penalty function method to deal with boundary conditions.Numerical examples are employed to confirm the effectiveness and high accuracy of this method.By the thermal stress analysis of a thick-walled cylinder(TWC),the simulation of cracking in the TWC under heating and cooling conditions,and the simulation of thermal cracking of the SwedishÄspöPillar Stability Experiment(APSE)rock column,the thermal stress,and TM coupling are obtained.The numerical simulation results are in good agreement with the test data and other numerical results,thus verifying the effectiveness of the NMM in dealing with thermal stress and crack propagation problems of fractured rock masses.

A stable implicit nodal integration-based particle finite element method(N-PFEM)for modelling saturated soil dynamics

In this study,we present a novel nodal integration-based particle finite element method(N-PFEM)designed for the dynamic analysis of saturated soils.Our approach incorporates the nodal integration technique into a generalised Hellinger-Reissner(HR)variational principle,creating an implicit PFEM formulation.To mitigate the volumetric locking issue in low-order elements,we employ a node-based strain smoothing technique.By discretising field variables at the centre of smoothing cells,we achieve nodal integration over cells,eliminating the need for sophisticated mapping operations after re-meshing in the PFEM.We express the discretised governing equations as a min-max optimisation problem,which is further reformulated as a standard second-order cone programming(SOCP)problem.Stresses,pore water pressure,and displacements are simultaneously determined using the advanced primal-dual interior point method.Consequently,our numerical model offers improved accuracy for stresses and pore water pressure compared to the displacement-based PFEM formulation.Numerical experiments demonstrate that the N-PFEM efficiently captures both transient and long-term hydro-mechanical behaviour of saturated soils with high accuracy,obviating the need for stabilisation or regularisation techniques commonly employed in other nodal integration-based PFEM approaches.This work holds significant implications for the development of robust and accurate numerical tools for studying saturated soil dynamics.

An inverse analysis of fluid flow through granular media using differentiable lattice Boltzmann method

This study presents a method for the inverse analysis of fluid flow problems.The focus is put on accurately determining boundary conditions and characterizing the physical properties of granular media,such as permeability,and fluid components,like viscosity.The primary aim is to deduce either constant pressure head or pressure profiles,given the known velocity field at a steady-state flow through a conduit containing obstacles,including walls,spheres,and grains.The lattice Boltzmann method(LBM)combined with automatic differentiation(AD)(AD-LBM)is employed,with the help of the GPU-capable Taichi programming language.A lightweight tape is used to generate gradients for the entire LBM simulation,enabling end-to-end backpropagation.Our AD-LBM approach accurately estimates the boundary conditions for complex flow paths in porous media,leading to observed steady-state velocity fields and deriving macro-scale permeability and fluid viscosity.The method demonstrates significant advantages in terms of prediction accuracy and computational efficiency,making it a powerful tool for solving inverse fluid flow problems in various applications.