A Complete Technique in Improving Quality and Production Efficiency of Juglans regia in Gongshan Derung and Nu Autonomous County

We applied water releasing from rootstocks technique and Juglans sigillata in Yangbi was pruned in the shape of opened-heart or round-heart shape. By bal- anced fertilization, survival rate of grafted walnuts can be improved. We reviewed technologies to enhance walnut quality and production efficiency in Gongshan Derung and Nu Autonomous County for reference.

Current Development Status of Cucumber Industry in Linyi City and Countermeasures for Improving Quality and Benefits

In order to expand and strengthen the cucumber industry in Linyi City of Shandong City and make it more effective in revitalizing the rural economy,the authors surveyed the current situation of the cucumber planting area,production management,fresh-keeping processing and marketing in Linyi City.Based on the survey,it analyzed the current problems in the development of the cucumber industry in Linyi City,including low level of facilities and equipment,the post-picking processing technology,the imperfect quality control system,the low degree of information and the weak degree of organization.Finally,it came up with recommendations including developing increasing modern technological innovation of facility structure and equipment,accelerating research on post-picking commercial processing technology of cucumber,accelerating the construction of product quality traceability system,promoting in-depth integration of informationization and cucumber industry,and improving the degree of organization and industrialization,to improve the quality and benefits of cucumber industry,so as to provide guidance for improving the overall quality,benefit and market competitiveness of cucumber industry in Linyi City.

Improving the Quality of Public Space in Old Residential Areas Based on Superposition and Intervention:A Case Study of Baihuazhou District of Nanchang City

With the development of cities,China has entered an era of stock planning.The functions of old residential areas in urban development can no longer meet the needs of residents in the new era for a better life,and new standards have been put forward for the quality of public spaces for living.This paper analyzes and sorts out the characteristics and problems of the public space in the old residential areas of Baihuazhou district.Combining superposition and intervention techniques,the spatial,historical,cultural and other characteristic elements of the residential areas are preserved to the greatest extent.The public space in the old residential areas of Baihuazhou District is updated and reconstructed in order to achieve the goal of improving the quality of its public space.

Application of PDCA in improving hand hygiene compliance and nosocomial infection quality in orthopedics

Objective:To explore the effect of the Plan-Do-Check-Action(PDCA)cycle on hand hygiene and nosocomial infection quality of or thopedic medical staff.Methods:The whole year of 2021 was selected to monitor the quality of hand hygiene and hospitalization.Follow-up monitoring and real-time recording during the period of morning shift and medical operation concentration time,and compare the compliance of hand hygiene before and after implementation,and evaluate the quality of nosocomial infection.Results:The hand hygiene compliance of doctors and nurses in stage P was 82%.The compliance of medical staff in stage D was 93%.The compliance of stage C was 94%and that of stage A was 95%.The quality score of hospital self-examination nosocomial infection was also significantly increased.Conclusions:The PDCA management cycle can effectively improve the compliance of hand hygiene and the nosocomial infection quality,which is wor thy of circulatory application in or thopedic nosocomial infection quality control,especially improving the quality of hand hygiene.

Role of clinical pathway in improving the quality of care for patients with faecal incontinence:A randomised trial

AIMTo assess the development and implementation of the Integrated Rapid Assessment and Treatment (IRAT) pathway for the management of patients with fecal incontinence and measure its impact on patients’ care. METHODSPatients referred to the colorectal unit in our hospital for the management of faecal incontinence were randomised to either the Standard Care pathway or the newly developed IRAT pathway in this feasibility study. The IRAT pathway is designed to provide a seamless multidisciplinary care to patients with faecal incontinence in a timely fashion. On the other hand, patients in the Standard Pathway were managed in the general colorectal clinic. Percentage improvements in St. Marks Incontinence Score, Cleveland Clinic Incontinence Score and Rockwood Faecal Incontinence Quality of Life Scale after completion of treatment in both groups were the primary outcome measures. Secondary endpoints were the time required to complete the management and patients’ satisfaction score. χ2, Mann-Whitney-U and Kendall tau-c correlation coefficient tests were used for comparison of outcomes of the two study groups. A P value of 0.05 or less was considered significant. RESULTSThirty-nine patients, 34 females, consented to participate. Thirty-one (79.5%) patients completed the final assessment and were included in the outcome analysis. There was no significant difference in the quality of life scales and incontinence scores. Patients in the IRAT pathway were more satisfied with the time required to complete management (P = 0.033) and had stronger agreement that all aspects of their problem were covered (P = 0.006). CONCLUSIONDespite of the lack of significant difference in outcome measures, the new pathway has positively influenced patient’s mindset, which was reflected in a higher satisfaction score.

Improving the Quality of Conforming Triangular Meshes by Topological Clean up and DSI

A new method as a post-processing step is presented to improve the shape quality of triangular meshes, which uses a topological clean up procedure and discrete smoothing interpolate (DSI) algorithm together. This method can improve the angle distribution of mesh element. while keeping the resulting meshes conform to the predefined constraints which are inputted as a PSLG.

Improving testicular examinations on paediatric patients in the emergency department:A quality improvement study to improve early diagnosis of testicular torsion

Objective:Male paediatric patients presenting with abdominal and/or testicular pain are common in the emergency department.As a time-sensitive diagnosis,the importance of early recognition,referral,and definitive management is critical.Missed or delayed diagnoses and management of testicular torsion can result in significant long-term sequelae including impaired fertility and psychological burden.In this quality improvement study,we utilised educational posters aiming to improve awareness of testicular torsion as a differential for abdominal pain and therefore,improve the quality of testicular examinations performed in the emergency department.Methods:Observational pre-and post-intervention study was conducted at a tertiary hospital emergency department.A pre-interventional retrospective review of the electronic medical records was conducted.All male patients under 16-years-old presenting with“abdominal pain”or“testicular problem”were included.We assessed the rate of testicular examination and the quality of the examination based on four domains:Cremasteric reflex,lie,swelling,and hardness.Educational posters targeting both patients and clinicians were placed around the emergency department.Subsequent review of the electronic medical records post-intervention was performed assessing the same domains.Results:A total of 235 presentations were analysed with 124 in the pre-intervention group and 111 in the post-intervention group.Overall rate of documented testicular examinations increased by 14%(p=0.032).The quality of testicular examinations also improved from an average of 0.85 domains documented to 2.29 post-intervention(p<0.001).Subgroup analysis found doctors in training had a greater improvement in both rate and quality of documented testicular examination.Conclusion:Our study demonstrated the value of continuing education in promoting awareness of testicular torsion in the emergency department.We found a clear improvement in the quality of clinical documentation of a time-sensitive condition which may infer a decreased risk of missed and delayed diagnosis of testicular torsion.

Improving Clinical Laboratory Quality through Reduction of Tests’ Turnaround Time in Democratic Republic of the Congo: Key Strategies

In Democratic Republic of the Congo (DRC), the laboratory TAT is significantly very long and do not comply with either international standards or the suggestions of customers. However, there is neither a national nor a local strategy to improve the laboratory TAT. The aim of the present study is to develop practical management strategies to shorten clinical laboratory tests’ TAT. This was a qualitative study conducted in Kinshasa. Focus groups and Lean tools were used respectively to generate a wide range of views from a variety of laboratory staff and to eliminate several form of waste in the laboratory flow process. Based on the identified root causes of delay, focus groups participants reported that there is a lot of scope for the improvement of TAT in DRC. Consistent attendance and punctuality are essential. The hospital management should implement the Laboratory Information Systems (LIS) and install Middleware. Total laboratory automation, inventory system for all reagents and supplies used in the laboratory, expansion of the sampling area, sufficient number of high-power machine and a clear job description are indispensable. LIS, 3.5 mL BD vacutainer BarricorTM tube and point-of-care testing (POCT) are necessary for workflow improvement. A reduction of 312 minutes was achieved by eliminating or decreasing non-value-added activities. Applying the suggested key strategies, and particularly the new workflow process, is a basis for improving the laboratory tests’ TAT. The algorithm presented can be easily implemented in other laboratories that face this type of problem.

The Work of JTCA in Standardizing and Improving the Quality of Operating Information in Japan

Main Activities of JTCA JTCA activities cover the following five areas: ……

Stroke nurse-led intravenous thrombolytic therapy strategy for ischemic stroke based on timeline process:A quality improvement program from China

Objective:Early thrombolytic therapy for ischemic stroke within the therapeutic window is associated with improved clinical outcomes.This study investigated whether optimizing intravenous thrombolytic(IVT)therapy strategies for stroke could reduce treatment delays.Methods:To reduce delays in IVT therapy for ischemic stroke,a series of quality improvement measures were implemented at a tertiary hospital in Hangzhou,Zhejiang Province,from June 2021 to August 2023,which included developing a timeline process management system,forming a nurse-led stroke process management team,providing homogeneous training,standardizing the IVT therapy process for ischemic stroke,and introducing an incentive policy.During the pre-(from June 2021 to February 2022,group A)and post-(from March to November 2022,group B1;from December 2022 to August 2023,group B2[implementation of an additional incentive policy])of the implementation the strategy,the door-tocomputed tomographic angiography(CTA)time(DCT),CTA time,neurology consultation to consent for IVT,CTA-to-needle time(CNT),and door-to-needle time(DNT),the percentage of people who underwent CTA within 20 min,15 min,and 10 min and DNT within 60 min,45 min,and 30 min were collected and compared.Results:Following the implementation of the standardized IVT process management strategy for stroke,the DNT for group B1 and group B2 were 30(24,44)min and 31(24,41)min,respectively,both significantly lower than the 46(38,58)min in group A(P<0.001);the median DCT were both 13 min in group B1 and B2 lower than 17min in group A(P<0.001);the median CTA were 12 min in Group B1 and 9 min in Group B2 lower than 14 min in group A(P<0.001);similar results were observed during the neurology consultation to obtain consent for IVT and CNT.Compared with group A,the proportion of DCT20 min,15 min,and 10 min was higher in groups B1 and B2(P<0.05),and the same result was observed at DNT60 min,45 min,and 30 min(P<0.05).However,the additional incentive policy did not significantly differ between Group B2 and Group B1.Conclusions:Optimizing IVT therapy for ischemic stroke is a feasible approach to limit the DNT to 30 min in ischemic stroke,significantly reducing delays within the therapeutic window and increasing the number of patients meeting target time segments.Additionally,generating a timeline for the IVT therapy process by scanning positioning quick response codes was a significant breakthrough in achieving the informatization of IVT quality management for stroke.

An Empirical Study on Improving the Quality of Agricultural Undergraduate Thesis from the Perspective of Professional Certification

Professional certification is an important way to promote professional construction and the quality of personnel training.Undergraduate thesis is an important part of comprehensive training for agricultural students,and it is also one of the"prescribed actions"of professional certification examination.Based on the perspective of professional certification,taking the graduation thesis of Agronomy Major of Southwest University in recent five years as an example,this paper analyzes the reasons for the gap between the quality of graduation thesis and professional certification standards,and puts forward six paths to improve the quality of graduation thesis of agricultural undergraduates,such as more independent topic selection,more diversified forms,multilink submission materials online,relaxed time,and adding graduation thesis index We should guide the project,link up the construction of professional core courses,build a"learning community between teachers and students".

Strategies for Improving the Teaching Quality in Middle Schools Under the Double Reduction Policy

The meaning of the term“reduction”in Double Reduction Policy implores teachers to reflect on their teaching process and improve teaching efficiency.Not only should the quantity be reduced,but so should the behavior.Having a comprehensive understanding of the students’learning process is actually a form of science.Therefore,we need to study and enhance its development[1].In order to reduce the learning burden and increase the efficiency of classroom teaching,we must clearly identify the inefficient and ineffective behaviors in classroom teaching,so as to avoid the following situations:a lack of deep thinking,a lack of ability in lesson preparation,fragmentation of questions and answers,a lack of questions that highlight the key points,anticlimax teaching process,and the habit of running over time in class[2,3].On this basis,this paper elaborates the current education state and clarifies the basic requirements of effective classroom teaching.Meanwhile,to reduce students’workload and increase the efficiency in carrying out assignments,much attention should be paid to optimizing assignment design and refining homework review and feedback.The purpose is to assign homework with an appropriate amount(achievable),precision(targeted),and suitability(personalized).Putting an end to the repetitious and unified training is not enough to improve the effect.

Discussion on the Status Quo of Non-Destructive Testing Technology in Highway Engineering and Strategies of Improving the Quality of Testing

Highway test and detection technology play a very important role in controlling the quality of road and bridge engineering and improving the maintenance of roads and bridges.The study of highway bridge test detection technology is both theoretically and practically useful.Road and bridge test and detection is a complicated task.With the development of science and technology,highway and bridge engineering test and detection technology has also made great progress.The continuous improvement of test and detection technology has brought good social benefits to road and bridge construction.This article discusses the problems in test and detection technology of highway bridges and how to improve the quality of test and detection.

Post-operative morbidity after neoadjuvant chemotherapy and resection for gallbladder cancer: A national surgical quality improvement program analysis

BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for neoadjuvant therapy in gallbladder cancer.As investigations continue to analyze the regimen and benefit of NACT for ongoing care of gallbladder cancer patients,we examined American College of Surgeons National Surgical Quality Improvement Program(NSQIP)database to determine if there was higher morbidity among the neo-adjuvant group within the 30-day post-operative period.We hypothesized patients who underwent NACT were more likely to have higher post-operative morbidity.AIM To investigate the 30-day post-operative morbidity outcomes between patients who received NACT and underwent surgery and patients who only had surgery.METHODS A retrospective analysis of the targeted hepatectomy NSQIP data between 2015 and 2019 was performed to determine if NACT in gallbladder cancer increased the risk for post-operative morbidity(bile leak,infection rate,rate of converting to open surgery,etc.)compared to the group who only had surgery.To calculate the odds ratio for the primary and secondary outcomes,a crude logistic regression was performed.RESULTS Of the 452 patients,52 patients received NACT prior to surgery.There were no statistically significant differences in the odds of morbidity between the two groups,including bile leak[odds ratio(OR),0.69;95%confidence interval(95%CI):0.16-2.10;P=0.55],superficial wound infection(OR,0.58;95%CI:0.03-3.02;P=0.61),and organ space wound infection(OR,0.63;95%CI:0.18-1.63;P=0.61).CONCLUSION There was no significant difference in the risk of 30-day post-operative morbidity between the NACT and surgery group and the surgery only group.

Enhancing Private Healthcare Effectiveness in Lagos State, Nigeria: An Overview of the Effect of Quality Improvement Initiatives and Implications for Sustainable Healthcare Delivery

Background: Nigeria, a nation grappling with rapid population growth, economic intricacies, and complex healthcare challenges, particularly in Lagos State, the economic hub and most populous state, faces the challenge of ensuring quality healthcare access. The overview of the effect of quality improvement initiatives in this paper focuses on private healthcare providers in Lagos State, Nigeria. The study assesses the impact of donor-funded quality improvement projects on these private healthcare facilities. It explores the level of participation, perceived support, and tangible effects of the initiatives on healthcare delivery within private healthcare facilities. It also examines how these initiatives influence patient inflow and facility ratings, and bring about additional benefits and improvements, provides insights into the challenges faced by private healthcare providers in implementing quality improvement projects and elicits recommendations for improving the effectiveness of such initiatives. Methods: Qualitative research design was employed for in-depth exploration, utilizing semi-structured interviews. Private healthcare providers in Lagos involved in the SP4FP Quality Improvement Project were purposively sampled for diversity. Face-to-face interviews elicited insights into participation, perceived support, and project effects. Questions covered participation levels, support perception, changes observed, challenges faced, and recommendations. Thematic analysis identified recurring themes from interview transcripts. Adherence to ethical guidelines ensured participant confidentiality and informed consent. Results: Respondents affirmed active involvement in the SP4FP Quality Improvement Project, echoing literature emphasizing private-sector collaboration with the public sector. While acknowledging positive influences on facility ratings, respondents highlighted challenges within the broader Nigerian healthcare landscape affecting patient numbers. Respondents cited tangible improvements, particularly in staff management and patient care processes, validating the positive influence of quality improvement projects. Financial constraints emerged as a significant challenge, aligning with existing literature emphasizing the pragmatic difficulties faced by private healthcare providers. Conclusions: This study illuminates the complex landscape of private healthcare provision in Lagos State, emphasizing the positive impact of donor-funded quality improvement projects. The findings provide nuanced insights, guiding policymakers, healthcare managers, and practitioners toward collaborative, sustainable improvements. As Nigeria progresses, these lessons will be crucial in shaping healthcare policies prioritizing population well-being.

Quieting the neonatal intensive care unit:A quality improvement initiative

BACKGROUND The neonatal intensive care unit(NICU)is vital for preterm infants but is often plagued by harmful noise levels.Excessive noise,ranging from medical equipment to conversations,poses significant health risks,including hearing impairment and neurodevelopmental issues.The American Academy of Pediatrics recommends strict sound limits to safeguard neonatal well-being.Strategies such as education,environmental modifications,and quiet hours have shown to reduce noise levels.However,up to 60%of the noises remain avoidable.High noise exposure exacerbates physiological disturbances,impacting vital functions and long-term neurological outcomes.Effective noise reduction in the NICU is crucial for promoting optimal neonatal development.AIM To measure the sound levels in a NICU and reduce ambient sound levels by at least 10%from baseline.METHODS A quasi-experimental quality improvement project was conducted over 4 mo in a 20-bed level 3 NICU in a tertiary care medical college.Baseline noise levels were recorded continuously using a sound level meter.The interventions included targeted education,environmental modifications,and organizational changes,and were implemented through three rapid Plan-Do-Study-Act(PDSA)cycles.Weekly feedback and monitoring were conducted,and statistical process control charts were used for analysis.The mean noise values were compared using the paired t-test.RESULTS The baseline mean ambient noise level in the NICU was 67.8 dB,which decreased to 50.5 dB after the first cycle,and further decreased to 47.4 dB and 51.2 dB after subsequent cycles.The reduction in noise levels was 21%during the day and 28%PDSA cycle(mean difference of−17.3 dB,P<0.01).Peak noise levels decreased from 110 dB to 88.24 dB after the intervention.CONCLUSION A multifaceted intervention strategy reduced noise in the NICU by 25%over 4 months.The success of this initiative emphasizes the significance of comprehensive interventions for noise reduction.

Analysis of the Ideological and Political Concepts and Teaching Strategies for Quality Improvement in Physical Education Courses in Colleges and Universities

In today’s higher education system,the physical education program is not only for teaching sports skills and exercising physical fitness but also an important position for cultivating students’character,emotions,and values.With the in-depth development of the concept of ideological education,the ideology of college physical education courses has become an important direction of educational reform.In this paper,we will discuss the connotation of the concept of ideology and politics in college physical education courses,analyze the methods to effectively integrate the ideology and politics elements while guaranteeing the quality of teaching,and put forward the corresponding strategies to improve the quality,with a view to providing new ideas and methods for the construction of ideology and politics in college physical education courses.

Quality Management Research on the Purchasing of Food Processing Enterprises

In order to improve the purchased goods quality management level of food processing enterprises, the causes of quality management problems were ana- lyzed, which were classified into four categories, namely, natural toxins in raw ma- terials, quality problems in planting and breeding, quality problems in transportation, quality problems in delivery acceptance. Then, based on the causes, eight measures to improve goods purchasing management were put forward, and graphs were used to illustrate the corresponding countermeasure to each cause. This study is of theo- retical significance for the food processing enterprises to improve the quality man- agement of purchased goods through formulating improvement measures based on their operating states.

Phytosynthetic bacteria (PSB) as a water quality improvement mechanism in saline-alkali wetland ponds

The efficiency of phytosynthetic bacteria (PSB) to improve the water quality in saline alkali ponds was studied, the result showed that (1) PSB application could increase the content of DO, NO\+-\-3\|N and effective phosphorus (EP) in ponds; (2) the changes of COD were not evident, just effective in later period after PSB application; (3) PSB application could decrease the contents of NH\+-\-4\|N (NH\-3\|N), NO\+-\-2\|N ; (4) PSB application could improve the structure of the effective nitrogen (EN) and EP, stimulate the growth of phytoplankton, and increase primary productivity, and finally increase the commercial profits of ponds because of the increase of EP and the decrease of EN contents; (5) the effect exerting speed of PSB was slower, but the effect sustaining time was longer; (6) the appropriate concentration of PSB application in saline alkali wetland ponds was 10×10 -6 mg/L, one time effective period was more than 15 days. So PSB was an efficient water quality improver in saline alkali ponds.

Discussion on strategy of grain quality improvement for super high yielding japonica rice in Northeast China

japonica rice is mainly distributed in Northeast China and accounts for 44.6% of the total cultivated area of japonica rice in China. The comprehensive using of inter-subspecies heterosis is the main breeding mode of super japonica rice varieties in this region. Improving rice quality at relative high yielding level is the current research focus. Performing crosses between indica and japonica lines allows for the recombination of regulatory genes and genetic backgrounds, leading to complicated genetic rice quality characteristics, which can be used to explore patterns of quality improvement. In the present study, we utilize recombinant inbred lines （RILs） derived from indica-japonica hybridization to analyze the effect factors of rice quality derived from genetic factors, which contain both regulatory genes concerning rice quality and genetic backgrounds＇ random introduction frequency coming from indica （Di value）, and the improvement strategy was further discussed. The regulatory genes involved in amylase content （Wx） and nitrogen utilization efficiency （NRT1.1B） were the major factors affecting the amylose content （AC） and protein content （PC） in RILs, respectively. Both the Di value and the major grain width gene （GS5） had regulatory effects on milled rice width （MRW） in RILs, and their interaction explained the major variance of MRW in the RILs. With the mediation of MRW and chalkiness degree （C）, Di value had a further impact on head rice rate （HR）, which was relatively poor when the Di value was over 40%. In Northeast China, the Di value should be lowered by backcrossing or multiple crosses during the breeding of indica-japonica hybridization to maintain the whole better HR and further to emphasize the use of favorable genes in individual selection.