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-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。

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+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。

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.

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.

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.

Robustness Study and Superior Method Development and Validation for Analytical Assay Method of Atropine Sulfate in Pharmaceutical Ophthalmic Solution

Background: The robustness is a measurement of an analytical chemical method and its ability to contain unaffected by little with deliberate variation of analytical chemical method parameters. The analytical chemical method variation parameters are based on pH variability of buffer solution of mobile phase, organic ratio composition changes, stationary phase (column) manufacture, brand name and lot number variation;flow rate variation and temperature variation of chromatographic system. The analytical chemical method for assay of Atropine Sulfate conducted for robustness evaluation. The typical variation considered for mobile phase organic ratio change, change of pH, change of temperature, change of flow rate, change of column etc. Purpose: The aim of this study is to develop a cost effective, short run time and robust analytical chemical method for the assay quantification of Atropine in Pharmaceutical Ophthalmic Solution. This will help to make analytical decisions quickly for research and development scientists as well as will help with quality control product release for patient consumption. This analytical method will help to meet the market demand through quick quality control test of Atropine Ophthalmic Solution and it is very easy for maintaining (GDP) good documentation practices within the shortest period of time. Method: HPLC method has been selected for developing superior method to Compendial method. Both the compendial HPLC method and developed HPLC method was run into the same HPLC system to prove the superiority of developed method. Sensitivity, precision, reproducibility, accuracy parameters were considered for superiority of method. Mobile phase ratio change, pH of buffer solution, change of stationary phase temperature, change of flow rate and change of column were taken into consideration for robustness study of the developed method. Results: The limit of quantitation (LOQ) of developed method was much low than the compendial method. The % RSD for the six sample assay of developed method was 0.4% where the % RSD of the compendial method was 1.2%. The reproducibility between two analysts was 100.4% for developed method on the contrary the compendial method was 98.4%.

Hybrid Strategy of Partitioned and Monolithic Methods for Solving Strongly Coupled Analysis of Inverse and Direct Piezoelectric and Circuit Coupling

The inverse and direct piezoelectric and circuit coupling are widely observed in advanced electro-mechanical systems such as piezoelectric energy harvesters.Existing strongly coupled analysis methods based on direct numerical modeling for this phenomenon can be classified into partitioned or monolithic formulations.Each formulation has its advantages and disadvantages,and the choice depends on the characteristics of each coupled problem.This study proposes a new option:a coupled analysis strategy that combines the best features of the existing formulations,namely,the hybrid partitioned-monolithic method.The analysis of inverse piezoelectricity and the monolithic analysis of direct piezoelectric and circuit interaction are strongly coupled using a partitioned iterative hierarchical algorithm.In a typical benchmark problem of a piezoelectric energy harvester,this research compares the results from the proposed method to those from the conventional strongly coupled partitioned iterative method,discussing the accuracy,stability,and computational cost.The proposed hybrid concept is effective for coupled multi-physics problems,including various coupling conditions.

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。

Stability Analysis and Performance Evaluation of Additive Mixed-Precision Runge-Kutta Methods

Additive Runge-Kutta methods designed for preserving highly accurate solutions in mixed-precision computation were previously proposed and analyzed.These specially designed methods use reduced precision for the implicit computations and full precision for the explicit computations.In this work,we analyze the stability properties of these methods and their sensitivity to the low-precision rounding errors,and demonstrate their performance in terms of accuracy and efficiency.We develop codes in FORTRAN and Julia to solve nonlinear systems of ODEs and PDEs using the mixed-precision additive Runge-Kutta(MP-ARK)methods.The convergence,accuracy,and runtime of these methods are explored.We show that for a given level of accuracy,suitably chosen MP-ARK methods may provide significant reductions in runtime.

A Review on Sources,Extractions and Analysis Methods of a Sustainable Biomaterial:Tannins

Condensed and hydrolysable tannins are non-toxic natural polyphenols that are a commercial commodity industrialized for tanning hides to obtain leather and for a growing number of other industrial applications mainly to substitute petroleum-based products.They are a definite class of sustainable materials of the forestry industry.They have been in operation for hundreds of years to manufacture leather and now for a growing number of applications in a variety of other industries,such as wood adhesives,metal coating,pharmaceutical/medical applications and several others.This review presents the main sources,either already or potentially commercial of this forestry by-materials,their industrial and laboratory extraction systems,their systems of analysis with their advantages and drawbacks,be these methods so simple to even appear primitive but nonetheless of proven effectiveness,or very modern and instrumental.It constitutes a basic but essential summary of what is necessary to know of these sustainable materials.In doing so,the review highlights some of the main challenges that remain to be addressed to deliver the quality and economics of tannin supply necessary to fulfill the industrial production requirements for some materials-based uses.

High-Order Decoupled and Bound Preserving Local Discontinuous Galerkin Methods for a Class of Chemotaxis Models

In this paper,we explore bound preserving and high-order accurate local discontinuous Galerkin(LDG)schemes to solve a class of chemotaxis models,including the classical Keller-Segel(KS)model and two other density-dependent problems.We use the convex splitting method,the variant energy quadratization method,and the scalar auxiliary variable method coupled with the LDG method to construct first-order temporal accurate schemes based on the gradient flow structure of the models.These semi-implicit schemes are decoupled,energy stable,and can be extended to high accuracy schemes using the semi-implicit spectral deferred correction method.Many bound preserving DG discretizations are only worked on explicit time integration methods and are difficult to get high-order accuracy.To overcome these difficulties,we use the Lagrange multipliers to enforce the implicit or semi-implicit LDG schemes to satisfy the bound constraints at each time step.This bound preserving limiter results in the Karush-Kuhn-Tucker condition,which can be solved by an efficient active set semi-smooth Newton method.Various numerical experiments illustrate the high-order accuracy and the effect of bound preserving.

Review of Collocation Methods and Applications in Solving Science and Engineering Problems

The collocation method is a widely used numerical method for science and engineering problems governed by partial differential equations.This paper provides a comprehensive review of collocation methods and their applications,focused on elasticity,heat conduction,electromagnetic field analysis,and fluid dynamics.The merits of the collocation method can be attributed to the need for element mesh,simple implementation,high computational efficiency,and ease in handling irregular domain problems since the collocation method is a type of node-based numerical method.Beginning with the fundamental principles of the collocation method,the discretization process in the continuous domain is elucidated,and how the collocation method approximation solutions for solving differential equations are explained.Delving into the historical development of the collocation methods,their earliest applications and key milestones are traced,thereby demonstrating their evolution within the realm of numerical computation.The mathematical foundations of collocation methods,encompassing the selection of interpolation functions,definition of weighting functions,and derivation of integration rules,are examined in detail,emphasizing their significance in comprehending the method’s effectiveness and stability.At last,the practical application of the collocation methods in engineering contexts is emphasized,including heat conduction simulations,electromagnetic coupled field analysis,and fluid dynamics simulations.These specific case studies can underscore collocation method’s broad applicability and effectiveness in addressing complex engineering challenges.In conclusion,this paper puts forward the future development trend of the collocation method through rigorous analysis and discussion,thereby facilitating further advancements in research and practical applications within these fields.

Generalized nth-Order Perturbation Method Based on Loop Subdivision Surface Boundary Element Method for Three-Dimensional Broadband Structural Acoustic Uncertainty Analysis

In this paper,a generalized nth-order perturbation method based on the isogeometric boundary element method is proposed for the uncertainty analysis of broadband structural acoustic scattering problems.The Burton-Miller method is employed to solve the problem of non-unique solutions that may be encountered in the external acoustic field,and the nth-order discretization formulation of the boundary integral equation is derived.In addition,the computation of loop subdivision surfaces and the subdivision rules are introduced.In order to confirm the effectiveness of the algorithm,the computed results are contrasted and analyzed with the results under Monte Carlo simulations(MCs)through several numerical examples.