A more resilient livelihood is increasingly recognized as an efficient way to improve vulnerable households’food security and optimize their dietary decisions.This study quantifies rural household resilience in weste...A more resilient livelihood is increasingly recognized as an efficient way to improve vulnerable households’food security and optimize their dietary decisions.This study quantifies rural household resilience in western China,identifies the three pillars(absorptive capacity,adaptive capacity,and transformative capacity)contribution to resilience,and then establishes the estimated Resilience Capacity Index(RCI)linked with food security and dietary diversity supported by the multiple indicator multiple cause(MIMIC)model.Results show that,despite geographical heterogeneity,the RCI consistently increased from 2015 to 2021.Households with a higher RCI inheriting better capacity to deal with risk and shocks are significantly and positively correlated with increasing food expenditure and diversifying food choices.It can be because resilient households will allocate more money to food expenditure instead of saving for livelihood uncertainty.Thus,policymakers can provide more incentives for rural households to adopt more dynamic and effective risk management strategies.This,in turn,could yield positive spillover effects by preventing human capital loss associated with dietary-related chronic diseases and mortality.展开更多
Wide bandgap perovskite solar cells(PSCs)have attracted significant attention because they can be applied to the top cells of tandem solar cells.However,high open-circuit voltage(V_(OC))deficit(>0.4 V)result from p...Wide bandgap perovskite solar cells(PSCs)have attracted significant attention because they can be applied to the top cells of tandem solar cells.However,high open-circuit voltage(V_(OC))deficit(>0.4 V)result from poor crystallization and high non-radiative recombination losses become a serious limitation in the pursuit of high performance.Here,the relevance between different Pbl_(2)proportions and performance parameters are revealed through analysis of surface morphology,residual stress,and photostability.The increase of Pbl_(2)proportion promotes crystal growth and reduces the work function of the perovskite film surface and promotes the energy level alignment with the carrier transport layer,which decreased the V_(OC)deficit.However,residual PbI_(2)exacerbated the stress level of perovskite film,and the resulting lattice disorder deteriorated the photostability of the device.Ultimately,after the synergistic passivation of residual PbI_(2)and PEAI,the V_(OC)achieves 1.266 V and V_(OC)deficit is less than 0.4 V,the record value in wide bandgap PSCs.展开更多
The reliable prediction of state of charge(SOC)is one of the vital functions of advanced battery management system(BMS),which has great significance towards safe operation of electric vehicles.By far,the empirical mod...The reliable prediction of state of charge(SOC)is one of the vital functions of advanced battery management system(BMS),which has great significance towards safe operation of electric vehicles.By far,the empirical model-based and data-driven-based SOC estimation methods of lithium-ion batteries have been comprehensively discussed and reviewed in various literatures.However,few reviews involving SOC estimation focused on electrochemical mechanism,which gives physical explanations to SOC and becomes most attractive candidate for advanced BMS.For this reason,this paper comprehensively surveys on physics-based SOC algorithms applied in advanced BMS.First,the research progresses of physical SOC estimation methods for lithium-ion batteries are thoroughly discussed and corresponding evaluation criteria are carefully elaborated.Second,future perspectives of the current researches on physics-based battery SOC estimation are presented.The insights stated in this paper are expected to catalyze the development and application of the physics-based advanced BMS algorithms.展开更多
AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a tota...AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.展开更多
This editorial highlights the remarkable advancements in medical treatment strategies for pancreatic neuroendocrine tumors(pan-NETs),emphasizing tailored approaches for specific subtypes.Cytoreductive surgery and soma...This editorial highlights the remarkable advancements in medical treatment strategies for pancreatic neuroendocrine tumors(pan-NETs),emphasizing tailored approaches for specific subtypes.Cytoreductive surgery and somatostatin analogs(SSAs)play pivotal roles in managing tumors,while palliative options such as molecular targeted therapy,peptide receptor radionuclide therapy,and chemotherapy are reserved for SSA-refractory patients.Gastrinomas,insul-inomas,glucagonomas,carcinoid tumors and VIPomas necessitate distinct thera-peutic strategies.Understanding the genetic basis of pan-NETs and exploring immunotherapies could lead to promising avenues for future research.This review underscores the evolving landscape of pan-NET treatment,offering renewed hope and improved outcomes for patients facing this complex disease.展开更多
Zika virus(ZIKV)is the causative agent of a viral infection that causes neurological complications in newborns and adults worldwide.Its wide transmission route and alarming spread rates are of great concern to the sci...Zika virus(ZIKV)is the causative agent of a viral infection that causes neurological complications in newborns and adults worldwide.Its wide transmission route and alarming spread rates are of great concern to the scientific community.Numerous trials have been conducted to develop treatment options for ZIKV infection.This review highlights the latest developments in the fields of vaccinology and pharmaceuticals developments for ZIKV infection.A systematic and comprehensive approach was used to gather relevant and up-to-date data so that inferences could be made about the gaps in therapeutic development.The results indicate that several therapeutic interventions are being tested against ZIKV infection,such as DNA vaccines,subunit vaccines,live-attenuated vaccines,virus-vector-based vaccines,inactivated vaccines,virus-like particles,and mRNA-based vaccines.In addition,approved anti-ZIKV drugs that can reduce the global burden are discussed.Although many vaccine candidates for ZIKV are at different stages of development,none of them have received Food and Drug Authority approval for use up to now.The issue of side effects associated with these drugs in vulnerable newborns and pregnant women is a major obstacle in the therapeutic pathway.展开更多
Developing technologies that can be applied simultaneously in battery thermal management(BTM)and thermal runaway(TR)mitigation is significant to improving the safety of lithium-ion battery systems.Inorganic phase chan...Developing technologies that can be applied simultaneously in battery thermal management(BTM)and thermal runaway(TR)mitigation is significant to improving the safety of lithium-ion battery systems.Inorganic phase change material(PCM)with nonflammability has the potential to achieve this dual function.This study proposed an encapsulated inorganic phase change material(EPCM)with a heat transfer enhancement for battery systems,where Na_(2)HPO_(4)·12H_(2)O was used as the core PCM encapsulated by silica and the additive of carbon nanotube(CNT)was applied to enhance the thermal conductivity.The microstructure and thermal properties of the EPCM/CNT were analyzed by a series of characterization tests.Two different incorporating methods of CNT were compared and the proper CNT adding amount was also studied.After preparation,the battery thermal management performance and TR propagation mitigation effects of EPCM/CNT were further investigated on the battery modules.The experimental results of thermal management tests showed that EPCM/CNT not only slowed down the temperature rising of the module but also improved the temperature uniformity during normal operation.The peak battery temperature decreased from 76℃to 61.2℃at 2 C discharge rate and the temperature difference was controlled below 3℃.Moreover,the results of TR propagation tests demonstrated that nonflammable EPCM/CNT with good heat absorption could work as a TR barrier,which exhibited effective mitigation on TR and TR propagation.The trigger time of three cells was successfully delayed by 129,474 and 551 s,respectively and the propagation intervals were greatly extended as well.展开更多
The Yellow River Basin(YRB)has experienced severe floods and continuous riverbed elevation throughout history.Global climate change has been suggested to be driving a worldwide increase in flooding risk.However,owing ...The Yellow River Basin(YRB)has experienced severe floods and continuous riverbed elevation throughout history.Global climate change has been suggested to be driving a worldwide increase in flooding risk.However,owing to insufficient evidence,the quantitative correlation between flooding and climate change remains illdefined.We present a long time series of maximum flood discharge in the YRB dating back to 1843 compiled from historical documents and instrument measurements.Variations in yearly maximum flood discharge show distinct periods:a dramatic decreasing period from 1843 to 1950,and an oscillating gentle decreasing from 1950 to 2021,with the latter period also showing increasing more extreme floods.A Mann-Kendall test analysis suggests that the latter period can be further split into two distinct sub-periods:an oscillating gentle decreasing period from 1950 to 2000,and a clear recent increasing period from 2000 to 2021.We further predict that climate change will cause an ongoing remarkable increase in future flooding risk and an∼44.4 billion US dollars loss of floods in the YRB in 2100.展开更多
Anticipating the imminent surge of retired lithium-ion batteries(R-LIBs)from electric vehicles,the need for safe,cost-effective and environmentally friendly disposal technologies has escalated.This paper seeks to offe...Anticipating the imminent surge of retired lithium-ion batteries(R-LIBs)from electric vehicles,the need for safe,cost-effective and environmentally friendly disposal technologies has escalated.This paper seeks to offer a comprehensive overview of the entire disposal framework for R-LIBs,encompassing a broad spectrum of activities,including screening,repurposing and recycling.Firstly,we delve deeply into a thorough examination of current screening technologies,shifting the focus from a mere enumeration of screening methods to the exploration of the strategies for enhancing screening efficiency.Secondly,we outline battery repurposing with associated key factors,summarizing stationary applications and sizing methods for R-LIBs in their second life.A particular light is shed on available reconditioning solutions,demonstrating their great potential in facilitating battery safety and lifetime in repurposing scenarios and identifying their techno-economic issues.In the realm of battery recycling,we present an extensive survey of pre-treatment options and subsequent material recovery technologies.Particularly,we introduce several global leading recyclers to illustrate their industrial processes and technical intricacies.Furthermore,relevant challenges and evolving trends are investigated in pursuit of a sustainable end-of-life management and disposal framework.We hope that this study can serve as a valuable resource for researchers,industry professionals and policymakers in this field,ultimately facilitating the adoption of proper disposal practices.展开更多
Hepatitis B virus(HBV)reactivation is a clinically significant challenge in disease management.This review explores the immunological mechanisms underlying HBV reactivation,emphasizing disease progression and manageme...Hepatitis B virus(HBV)reactivation is a clinically significant challenge in disease management.This review explores the immunological mechanisms underlying HBV reactivation,emphasizing disease progression and management.It delves into host immune responses and reactivation’s delicate balance,spanning innate and adaptive immunity.Viral factors’disruption of this balance,as are interac-tions between viral antigens,immune cells,cytokine networks,and immune checkpoint pathways,are examined.Notably,the roles of T cells,natural killer cells,and antigen-presenting cells are discussed,highlighting their influence on disease progression.HBV reactivation’s impact on disease severity,hepatic flares,liver fibrosis progression,and hepatocellular carcinoma is detailed.Management strategies,including anti-viral and immunomodulatory approaches,are critically analyzed.The role of prophylactic anti-viral therapy during immunosuppressive treatments is explored alongside novel immunotherapeutic interventions to restore immune control and prevent reactivation.In conclusion,this compre-hensive review furnishes a holistic view of the immunological mechanisms that propel HBV reactivation.With a dedicated focus on understanding its implic-ations for disease progression and the prospects of efficient management stra-tegies,this article contributes significantly to the knowledge base.The more profound insights into the intricate interactions between viral elements and the immune system will inform evidence-based approaches,ultimately enhancing disease management and elevating patient outcomes.The dynamic landscape of management strategies is critically scrutinized,spanning anti-viral and immunomodulatory approaches.The role of prophylactic anti-viral therapy in preventing reactivation during immunosuppressive treatments and the potential of innovative immunotherapeutic interventions to restore immune control and proactively deter reactivation.展开更多
BACKGROUND Colorectal signet-ring cell carcinoma(CSRCC)is a rare clinical entity which accounts for approximately 1%of all colorectal cancers.Although multiple studies concerning this specific topic have been publishe...BACKGROUND Colorectal signet-ring cell carcinoma(CSRCC)is a rare clinical entity which accounts for approximately 1%of all colorectal cancers.Although multiple studies concerning this specific topic have been published in the past decades,the pathogenesis,associated risk factors,and potential implications on treatment are still poorly understood.Besides the low incidence,historically confusing histological criteria have resulted in confusing data.Nevertheless,the rising incidence of CSRCC along with relatively young age at presentation and associated dismal prognosis,highlight the actual interest to synthesize the known literature regarding CSRCC.AIM To provide an updated overview of risk factors,prognosis,and management of CSRCC.METHODS A literature search in the MEDLINE/PubMed database was conducted with the following search terms used:‘Signet ring cell carcinoma’and‘colorectal’.Studies in English language,published after January 1980,were included.Studies included in the qualitative synthesis were evaluated for content concerning epidemiology,risk factors,and clinical,diagnostic,histological,and molecular features,as well as metastatic pattern and therapeutic management.If possible,presented data was extracted in order to present a more detailed overview of the literature.RESULTS In total,67 articles were included for qualitative analysis,of which 54 were eligible for detailed data extraction.CSRCC has a reported incidence between 0.1%-2.4%and frequently presents with advanced disease stage at the time of diagnosis.CSRCC is associated with an impaired overall survival(5-year OS:0%-46%)and a worse stagecorrected outcome compared to mucinous and not otherwise specified adenocarcinoma.The systematic use of exploratory laparoscopy to determine the presence of peritoneal metastases has been advised.Surgery is the mainstay of treatment,although the rates of curative resection in CSRCC(21%-82%)are lower compared to those in other histological types.In case of peritoneal metastasis,cytoreductive surgery with hyperthermic intraperitoneal chemotherapy should only be proposed in selected patients.CONCLUSION CSRCC is a rare clinical entity most often characterized by young age and advanced disease at presentation.As such,diagnostic modalities and therapeutic approach should be tailored accordingly.展开更多
BACKGROUND Regarding the incidence of malignant tumors in China,the incidence of liver cancer ranks fourth,second only to lung,gastric,and esophageal cancers.The case fatality rate ranks third after lung and cervical ...BACKGROUND Regarding the incidence of malignant tumors in China,the incidence of liver cancer ranks fourth,second only to lung,gastric,and esophageal cancers.The case fatality rate ranks third after lung and cervical cancer.In a previous study,the whole-process management model was applied to patients with breast cancer,which effectively reduced their negative emotions and improved treatment adherence and nursing satisfaction.METHODS In this single-center,randomized,controlled study,60 randomly selected patients with liver cancer who had been admitted to our hospital from January 2021 to January 2022 were randomly divided into an observation group(n=30),who received whole-process case management on the basis of routine nursing mea-sures,and a control group(n=30),who were given routine nursing measures.We compared differences between the two groups in terms of anxiety,depression,the level of hope,self-care ability,symptom distress,sleep quality,and quality of life.RESULTS Post-intervention,Hamilton anxiety scale,Hamilton depression scale,memory symptom assessment scale,and Pittsburgh sleep quality index scores in both groups were lower than those pre-intervention,and the observation group had lower scores than the control group(P<0.05).Herth hope index,self-care ability assessment scale-revision in Chinese,and quality of life measurement scale for patients with liver cancer scores in both groups were higher than those pre-intervention,with higher scores in the observation group compared with the control group(P<0.05).CONCLUSION Whole-process case management can effectively reduce anxiety and depression in patients with liver cancer,alleviate symptoms and problems,and improve the level of hope,self-care ability,sleep quality,and quality of life,as well as provide feasible nursing alternatives for patients with liver cancer.展开更多
BACKGROUND A new nomenclature consensus has emerged for liver diseases that were previously known as non-alcoholic fatty liver disease(NAFLD)and metabolic dysfunction-associated fatty liver disease(MAFLD).They are now...BACKGROUND A new nomenclature consensus has emerged for liver diseases that were previously known as non-alcoholic fatty liver disease(NAFLD)and metabolic dysfunction-associated fatty liver disease(MAFLD).They are now defined as metabolic dysfunction-associated steatotic liver disease(MASLD),which includes cardiometabolic criteria in adults.This condition,extensively studied in obese or overweight patients,constitutes around 30%of the population,with a steady increase worldwide.Lean patients account for approximately 10%-15%of the MASLD population.However,the pathogenesis is complex and is not well understood.AIM To systematically review the literature on the diagnosis,pathogenesis,characteristics,and prognosis in lean MASLD patients and provide an interpretation of these new criteria.METHODS We conducted a comprehensive database search on PubMed and Google Scholar between January 2012 and September 2023,specifically focusing on lean NAFLD,MAFLD,or MASLD patients.We include original articles with patients aged 18 years or older,with a lean body mass index categorized according to the World Health Organization criteria,using a cutoff of 25 kg/m2 for the general population and 23 kg/m2 for the Asian population.RESULTS We include 85 studies in our analysis.Our findings revealed that,for lean NAFLD patients,the prevalence rate varied widely,ranging from 3.8%to 34.1%.The precise pathogenesis mechanism remained elusive,with associations found in genetic variants,epigenetic modifications,and adaptative metabolic response.Common risk factors included metabolic syndrome,hypertension,and type 2 diabetes mellitus,but their prevalence varied based on the comparison group involving lean patients.Regarding non-invasive tools,Fibrosis-4 index outperformed the NAFLD fibrosis score in lean patients.Lifestyle modifications aided in reducing hepatic steatosis and improving cardiometabolic profiles,with some medications showing efficacy to a lesser extent.However,lean NAFLD patients exhibited a worse prognosis compared to the obese or overweight counterpart.CONCLUSION MASLD is a complex disease comprising epigenetic,genetic,and metabolic factors in its pathogenesis.Results vary across populations,gender,and age.Limited data exists on clinical practice guidelines for lean patients.Future studies employing this new nomenclature can contribute to standardizing and generalizing results among lean patients with steatotic liver disease.展开更多
Rice‒rape,rice‒wheat and rice‒garlic rotations are common cropping systems in Southwest China,and they have played a significant role in ensuring ecological and economic benefits(EB)and addressing the challenges of Ch...Rice‒rape,rice‒wheat and rice‒garlic rotations are common cropping systems in Southwest China,and they have played a significant role in ensuring ecological and economic benefits(EB)and addressing the challenges of China’s food security in the region.However,the crop yields in these rotation systems are 1.25‒14.73%lower in this region than the national averages.Intelligent decision-making with machine learning can analyze the key factors for obtaining better benefits,but it has rarely been used to enhance the probability of obtaining such benefits from rotations in Southwest China.Thus,we used a data-intensive approach to construct an intelligent decision‒making system with machine learning to provide strategies for improving the benefits of rice-rape,rice-wheat,and rice-garlic rotations in Southwest China.The results show that raising the yield and partial fertilizer productivity(PFP)by increasing seed input under high fertilizer application provided the optimal benefits with a 10%probability in the rice-garlic system.Obtaining high yields and greenhouse gas(GHG)emissions by increasing the N application and reducing the K application provided suboptimal benefits with an 8%probability in the rice-rape system.Reducing N and P to enhance PFP and yield provided optimal benefits with the lowest probability(8%)in the rice‒wheat system.Based on the predictive analysis of a random forest model,the optimal benefits were obtained with fertilization regimes by reducing N by 25%and increasing P and K by 8 and 74%,respectively,in the rice-garlic system,reducing N and K by 54 and by 36%,respectively,and increasing P by 38%in rice-rape system,and reducing N by 4%and increasing P and K by 65 and 23%in rice-wheat system.These strategies could be further optimized by 17‒34%for different benefits,and all of these measures can improve the effectiveness of the crop rotation systems to varying degrees.Overall,these findings provide insights into optimal agricultural inputs for higher benefits through an intelligent decision-making system with machine learning analysis in the rice-rape,rice‒wheat,and rice-garlic systems.展开更多
Background:Return to play(RTP)in elite rugby is managed using a 6-stage graduated RTP protocol,which can result in clearance to play within 1 week of injury.We aimed to explore how symptom,cognitive,and balance presen...Background:Return to play(RTP)in elite rugby is managed using a 6-stage graduated RTP protocol,which can result in clearance to play within 1 week of injury.We aimed to explore how symptom,cognitive,and balance presentation and evolution during concussion screens 2 h(head injury assessment(HIA2)and 48 h(HIA3)after injury were associated with time to RTP)to identify whether a more conservative graduated RTP may be appropriate.Methods:A retrospective cohort study was conducted in 380 concussed rugby players from elite men’s rugby over 3 consecutive seasons.Players were classified as shorter or longer returns,depending on whether RTP occurred within 7 days(allowing them to be considered to play the match 1 week after injury)or longer than 8 days,respectively.Symptom,cognitive,and balance performance during screens was assessed relative to baseline(normal or abnormal)and to the preceding screen(improving or worsening).Associations between sub-test abnormalities and RTP time were explored using odds ratios(OR,longer vs.shorter).Median day absence was compared between players with abnormal or worsening results and those whose results were normal or improving.Results:Abnormal symptom results during screens 2 h and 48 h after concussion were associated with longer return time(HIA2:OR=2.21,95%confidence interval(95%CI):1.39-3.50;HIA3:OR=3.30,95%CI:1.89-5.75).Worsening symptom number or severity from the time of injury to 2 h and 48 h post-injury was associated with longer return(HIA2:OR=2.49,95%CI:1.36-4.58;HIA3:OR=3.34,95%CI:1.10-10.15).Median days absence was greater in players with abnormal symptom results at both HIA2 and HIA3.Cognitive and balance performance were not associated with longer return and did not affect median days absence.Conclusion:Symptom presentation and evolution within 48 h of concussion were associated with longer RTP times.This may guide a more conservative approach to RTP,while still adhering to individualized concussion management principles.展开更多
Coastal zones are dynamic,rich environments,now densely populated,and increasingly challenged by human and climatechange pressures.Effective long-term integrated coastal zone planning is needed to ensure sustainable e...Coastal zones are dynamic,rich environments,now densely populated,and increasingly challenged by human and climatechange pressures.Effective long-term integrated coastal zone planning is needed to ensure sustainable environmental protection and economic development.In this study,we reviewed the history of coastal zone planning since its birth in the 1950s based on the literature retrieved from the Web of Science(Core Collection)from 2000–2023,then summarized the tools and spatial allocation methods commonly used in the planning process,and finally proposed potential solutions to the challenges faced.The results show that after decades of development,coastal zone planning has changed from a decentralized activity to a targeted and integrated one,with an increasing emphasis on the ecosystem approach and the use of multiple planning tools.Spatial analysis techniques and environmental modelling software have become increasingly popular.Linear programming and overlay analysis are common approaches when performing spatial optimization,but land-sea interactions and planning in the marine parts still lack in-depth analysis and practical experience.We are also aware that the challenges posed by the integration of administrative hierarchies,scoping and conservation objectives,stakeholder participation,consideration of social dimensions,and climate change are pervasive throughout the planning process.There is an urgent need to develop more flexible and accurate spatial modelling tools,as well as more efficient participatory methods,and to focus on the holistic nature of the land-sea system to create more resilient and sustainable coastal zones.展开更多
Objective:To explore the role of specialized group management in the quality control of perioperative nursing.Methods:45 surgical nurses from our hospital were selected as the research subjects.Traditional operating r...Objective:To explore the role of specialized group management in the quality control of perioperative nursing.Methods:45 surgical nurses from our hospital were selected as the research subjects.Traditional operating room management was adopted from July 2019 to June 2020,and specialized group management was adopted from July 2020 to June 2021.The surgeon’s satisfaction,surgical nurses’core professional competence,and surgical patients’satisfaction were obtained through surveys and the results were analyzed.Results:Surgeon satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Besides,surgical nurses’core professional competency scores before the implementation of specialized group management were significantly lower than after its implementation(P<0.05).Lastly,surgical patients’satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Conclusion:Specialized group management helps to improve the quality of perioperative care and should be applied in clinical practice.展开更多
In 2009,the World Health Organization included snakebite on the list of neglected tropical diseases,acknowledging it as a common occupational hazard for farmers,plantation workers,and others,causing tens of thousands ...In 2009,the World Health Organization included snakebite on the list of neglected tropical diseases,acknowledging it as a common occupational hazard for farmers,plantation workers,and others,causing tens of thousands of deaths and chronic physical disabilities every year.This guideline aims to provide practical information to help clinical professionals evaluate and treat snakebite victims.These recommendations are based on clinical experience and clinical research evidence.This guideline focuses on the following topics:snake venom,clinical manifestations,auxiliary examination,diagnosis,treatments,and prevention.展开更多
Globally,sub-optimal use of nitrogen (N) fertiliser and elevated N irrigation groundwater have led to high leached nitrate (NO_(3)^(–)) losses from protected vegetable field systems.Optimising fertiliser and irrigati...Globally,sub-optimal use of nitrogen (N) fertiliser and elevated N irrigation groundwater have led to high leached nitrate (NO_(3)^(–)) losses from protected vegetable field systems.Optimising fertiliser and irrigation management in different soil types is crucial to reduce future N loads from such systems.The present 4-year study examined leached N loads from lysimeter monitoring arrays set up across 18 protected vegetable system sites encompassing the dominant soil types of northern China.The treatments applied at each field site were:1) a high N and high irrigation input treatment (HNHI);2) a low N but high irrigation input treatment (LNHI) and 3) a low N with low irrigation input treatment (LNLI).Results showed that the mean annual leached total nitrogen loads from the HNHI,LNHI and LNLI treatments were 325,294 and 257 kg N ha^(–1) in the fluvo-aquic soil,114,100 and 78 kg N ha^(–1) in the cinnamon soil and 79,68 and 57 kg N ha^(–1) in the black soil,respectively.The N dissolved in irrigation water in the fluvo-aquic soil areas was 8.26-fold higher than in the cinnamon areas.A structural equation model showed that N fertiliser inputs and leaching water amounts explained 14.7 and 81.8%of the variation of leached N loads,respectively.Correspondingly,reducing irrigation water by 21.5%decreased leached N loads by 20.9%,while reducing manure N and chemical N inputs by 22 and 25%decreased leached N loads by only 9.5%. This study highlights that protected vegetable fields dominated by fluvo-aquic soil need management to curtail leached N losses in northern China.展开更多
基金This paper was supported by the National Natural Science Foundation of China(NSFC)(71973138 and 72061137002)the Ministry of Science and Technology of China(2023YFE0105009).
文摘A more resilient livelihood is increasingly recognized as an efficient way to improve vulnerable households’food security and optimize their dietary decisions.This study quantifies rural household resilience in western China,identifies the three pillars(absorptive capacity,adaptive capacity,and transformative capacity)contribution to resilience,and then establishes the estimated Resilience Capacity Index(RCI)linked with food security and dietary diversity supported by the multiple indicator multiple cause(MIMIC)model.Results show that,despite geographical heterogeneity,the RCI consistently increased from 2015 to 2021.Households with a higher RCI inheriting better capacity to deal with risk and shocks are significantly and positively correlated with increasing food expenditure and diversifying food choices.It can be because resilient households will allocate more money to food expenditure instead of saving for livelihood uncertainty.Thus,policymakers can provide more incentives for rural households to adopt more dynamic and effective risk management strategies.This,in turn,could yield positive spillover effects by preventing human capital loss associated with dietary-related chronic diseases and mortality.
基金the supports from the National Natural Science Foundation of China(Nos.62264012,62164009)Inner Mongolia Higher Education Research Project(No.NJZZ22343)+1 种基金Inner Mongolia University Research Foundation for Advanced Talents in 2021(No.10000-21311201/005)the Inner Mongolia Autonomous Region for Advanced Talents in 2020(No.12000-12102628)。
文摘Wide bandgap perovskite solar cells(PSCs)have attracted significant attention because they can be applied to the top cells of tandem solar cells.However,high open-circuit voltage(V_(OC))deficit(>0.4 V)result from poor crystallization and high non-radiative recombination losses become a serious limitation in the pursuit of high performance.Here,the relevance between different Pbl_(2)proportions and performance parameters are revealed through analysis of surface morphology,residual stress,and photostability.The increase of Pbl_(2)proportion promotes crystal growth and reduces the work function of the perovskite film surface and promotes the energy level alignment with the carrier transport layer,which decreased the V_(OC)deficit.However,residual PbI_(2)exacerbated the stress level of perovskite film,and the resulting lattice disorder deteriorated the photostability of the device.Ultimately,after the synergistic passivation of residual PbI_(2)and PEAI,the V_(OC)achieves 1.266 V and V_(OC)deficit is less than 0.4 V,the record value in wide bandgap PSCs.
基金supported by the Open Project of Hubei Key Laboratory of Power System Design and Test for Electrical Vehicle(No.ZDSYS202304)the National Natural Science Foundation of China(No.62303007)the Anhui Provincial Natural Science Foundation(No.2308085ME142)。
文摘The reliable prediction of state of charge(SOC)is one of the vital functions of advanced battery management system(BMS),which has great significance towards safe operation of electric vehicles.By far,the empirical model-based and data-driven-based SOC estimation methods of lithium-ion batteries have been comprehensively discussed and reviewed in various literatures.However,few reviews involving SOC estimation focused on electrochemical mechanism,which gives physical explanations to SOC and becomes most attractive candidate for advanced BMS.For this reason,this paper comprehensively surveys on physics-based SOC algorithms applied in advanced BMS.First,the research progresses of physical SOC estimation methods for lithium-ion batteries are thoroughly discussed and corresponding evaluation criteria are carefully elaborated.Second,future perspectives of the current researches on physics-based battery SOC estimation are presented.The insights stated in this paper are expected to catalyze the development and application of the physics-based advanced BMS algorithms.
基金Supported by the Key Innovation and Guidance Program of the Eye Hospital,School of Ophthalmology&Optometry,Wenzhou Medical University(No.YNZD2201903)the Scientific Research Foundation of the Eye Hospital,School of Ophthalmology&Optometry,Wenzhou Medical University(No.KYQD20180306)the Nursing Project of the Eye Hospital of Wenzhou Medical University(No.YNHL2201908).
文摘AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.
文摘This editorial highlights the remarkable advancements in medical treatment strategies for pancreatic neuroendocrine tumors(pan-NETs),emphasizing tailored approaches for specific subtypes.Cytoreductive surgery and somatostatin analogs(SSAs)play pivotal roles in managing tumors,while palliative options such as molecular targeted therapy,peptide receptor radionuclide therapy,and chemotherapy are reserved for SSA-refractory patients.Gastrinomas,insul-inomas,glucagonomas,carcinoid tumors and VIPomas necessitate distinct thera-peutic strategies.Understanding the genetic basis of pan-NETs and exploring immunotherapies could lead to promising avenues for future research.This review underscores the evolving landscape of pan-NET treatment,offering renewed hope and improved outcomes for patients facing this complex disease.
基金This work is supported by the United Arab Emirates University UPAR(Grant No.G3458).
文摘Zika virus(ZIKV)is the causative agent of a viral infection that causes neurological complications in newborns and adults worldwide.Its wide transmission route and alarming spread rates are of great concern to the scientific community.Numerous trials have been conducted to develop treatment options for ZIKV infection.This review highlights the latest developments in the fields of vaccinology and pharmaceuticals developments for ZIKV infection.A systematic and comprehensive approach was used to gather relevant and up-to-date data so that inferences could be made about the gaps in therapeutic development.The results indicate that several therapeutic interventions are being tested against ZIKV infection,such as DNA vaccines,subunit vaccines,live-attenuated vaccines,virus-vector-based vaccines,inactivated vaccines,virus-like particles,and mRNA-based vaccines.In addition,approved anti-ZIKV drugs that can reduce the global burden are discussed.Although many vaccine candidates for ZIKV are at different stages of development,none of them have received Food and Drug Authority approval for use up to now.The issue of side effects associated with these drugs in vulnerable newborns and pregnant women is a major obstacle in the therapeutic pathway.
基金financially supported by the National Key Research and Development Program(Grant No.2022YFE0207400)the National Natural Science Foundation of China(Grant No.U22A20168 and 52174225)。
文摘Developing technologies that can be applied simultaneously in battery thermal management(BTM)and thermal runaway(TR)mitigation is significant to improving the safety of lithium-ion battery systems.Inorganic phase change material(PCM)with nonflammability has the potential to achieve this dual function.This study proposed an encapsulated inorganic phase change material(EPCM)with a heat transfer enhancement for battery systems,where Na_(2)HPO_(4)·12H_(2)O was used as the core PCM encapsulated by silica and the additive of carbon nanotube(CNT)was applied to enhance the thermal conductivity.The microstructure and thermal properties of the EPCM/CNT were analyzed by a series of characterization tests.Two different incorporating methods of CNT were compared and the proper CNT adding amount was also studied.After preparation,the battery thermal management performance and TR propagation mitigation effects of EPCM/CNT were further investigated on the battery modules.The experimental results of thermal management tests showed that EPCM/CNT not only slowed down the temperature rising of the module but also improved the temperature uniformity during normal operation.The peak battery temperature decreased from 76℃to 61.2℃at 2 C discharge rate and the temperature difference was controlled below 3℃.Moreover,the results of TR propagation tests demonstrated that nonflammable EPCM/CNT with good heat absorption could work as a TR barrier,which exhibited effective mitigation on TR and TR propagation.The trigger time of three cells was successfully delayed by 129,474 and 551 s,respectively and the propagation intervals were greatly extended as well.
基金the National Natural Science Foundation of China(Grants No.42041006,41790443 and 41927806).
文摘The Yellow River Basin(YRB)has experienced severe floods and continuous riverbed elevation throughout history.Global climate change has been suggested to be driving a worldwide increase in flooding risk.However,owing to insufficient evidence,the quantitative correlation between flooding and climate change remains illdefined.We present a long time series of maximum flood discharge in the YRB dating back to 1843 compiled from historical documents and instrument measurements.Variations in yearly maximum flood discharge show distinct periods:a dramatic decreasing period from 1843 to 1950,and an oscillating gentle decreasing from 1950 to 2021,with the latter period also showing increasing more extreme floods.A Mann-Kendall test analysis suggests that the latter period can be further split into two distinct sub-periods:an oscillating gentle decreasing period from 1950 to 2000,and a clear recent increasing period from 2000 to 2021.We further predict that climate change will cause an ongoing remarkable increase in future flooding risk and an∼44.4 billion US dollars loss of floods in the YRB in 2100.
基金supported by an Australian Government Research Training Program Scholarship offered to the first author of this study。
文摘Anticipating the imminent surge of retired lithium-ion batteries(R-LIBs)from electric vehicles,the need for safe,cost-effective and environmentally friendly disposal technologies has escalated.This paper seeks to offer a comprehensive overview of the entire disposal framework for R-LIBs,encompassing a broad spectrum of activities,including screening,repurposing and recycling.Firstly,we delve deeply into a thorough examination of current screening technologies,shifting the focus from a mere enumeration of screening methods to the exploration of the strategies for enhancing screening efficiency.Secondly,we outline battery repurposing with associated key factors,summarizing stationary applications and sizing methods for R-LIBs in their second life.A particular light is shed on available reconditioning solutions,demonstrating their great potential in facilitating battery safety and lifetime in repurposing scenarios and identifying their techno-economic issues.In the realm of battery recycling,we present an extensive survey of pre-treatment options and subsequent material recovery technologies.Particularly,we introduce several global leading recyclers to illustrate their industrial processes and technical intricacies.Furthermore,relevant challenges and evolving trends are investigated in pursuit of a sustainable end-of-life management and disposal framework.We hope that this study can serve as a valuable resource for researchers,industry professionals and policymakers in this field,ultimately facilitating the adoption of proper disposal practices.
文摘Hepatitis B virus(HBV)reactivation is a clinically significant challenge in disease management.This review explores the immunological mechanisms underlying HBV reactivation,emphasizing disease progression and management.It delves into host immune responses and reactivation’s delicate balance,spanning innate and adaptive immunity.Viral factors’disruption of this balance,as are interac-tions between viral antigens,immune cells,cytokine networks,and immune checkpoint pathways,are examined.Notably,the roles of T cells,natural killer cells,and antigen-presenting cells are discussed,highlighting their influence on disease progression.HBV reactivation’s impact on disease severity,hepatic flares,liver fibrosis progression,and hepatocellular carcinoma is detailed.Management strategies,including anti-viral and immunomodulatory approaches,are critically analyzed.The role of prophylactic anti-viral therapy during immunosuppressive treatments is explored alongside novel immunotherapeutic interventions to restore immune control and prevent reactivation.In conclusion,this compre-hensive review furnishes a holistic view of the immunological mechanisms that propel HBV reactivation.With a dedicated focus on understanding its implic-ations for disease progression and the prospects of efficient management stra-tegies,this article contributes significantly to the knowledge base.The more profound insights into the intricate interactions between viral elements and the immune system will inform evidence-based approaches,ultimately enhancing disease management and elevating patient outcomes.The dynamic landscape of management strategies is critically scrutinized,spanning anti-viral and immunomodulatory approaches.The role of prophylactic anti-viral therapy in preventing reactivation during immunosuppressive treatments and the potential of innovative immunotherapeutic interventions to restore immune control and proactively deter reactivation.
文摘BACKGROUND Colorectal signet-ring cell carcinoma(CSRCC)is a rare clinical entity which accounts for approximately 1%of all colorectal cancers.Although multiple studies concerning this specific topic have been published in the past decades,the pathogenesis,associated risk factors,and potential implications on treatment are still poorly understood.Besides the low incidence,historically confusing histological criteria have resulted in confusing data.Nevertheless,the rising incidence of CSRCC along with relatively young age at presentation and associated dismal prognosis,highlight the actual interest to synthesize the known literature regarding CSRCC.AIM To provide an updated overview of risk factors,prognosis,and management of CSRCC.METHODS A literature search in the MEDLINE/PubMed database was conducted with the following search terms used:‘Signet ring cell carcinoma’and‘colorectal’.Studies in English language,published after January 1980,were included.Studies included in the qualitative synthesis were evaluated for content concerning epidemiology,risk factors,and clinical,diagnostic,histological,and molecular features,as well as metastatic pattern and therapeutic management.If possible,presented data was extracted in order to present a more detailed overview of the literature.RESULTS In total,67 articles were included for qualitative analysis,of which 54 were eligible for detailed data extraction.CSRCC has a reported incidence between 0.1%-2.4%and frequently presents with advanced disease stage at the time of diagnosis.CSRCC is associated with an impaired overall survival(5-year OS:0%-46%)and a worse stagecorrected outcome compared to mucinous and not otherwise specified adenocarcinoma.The systematic use of exploratory laparoscopy to determine the presence of peritoneal metastases has been advised.Surgery is the mainstay of treatment,although the rates of curative resection in CSRCC(21%-82%)are lower compared to those in other histological types.In case of peritoneal metastasis,cytoreductive surgery with hyperthermic intraperitoneal chemotherapy should only be proposed in selected patients.CONCLUSION CSRCC is a rare clinical entity most often characterized by young age and advanced disease at presentation.As such,diagnostic modalities and therapeutic approach should be tailored accordingly.
基金This study protocol was approved by the General Hospital of the Yangtze River Shipping,and all the families have voluntarily participated in the study and have signed informed consent forms.
文摘BACKGROUND Regarding the incidence of malignant tumors in China,the incidence of liver cancer ranks fourth,second only to lung,gastric,and esophageal cancers.The case fatality rate ranks third after lung and cervical cancer.In a previous study,the whole-process management model was applied to patients with breast cancer,which effectively reduced their negative emotions and improved treatment adherence and nursing satisfaction.METHODS In this single-center,randomized,controlled study,60 randomly selected patients with liver cancer who had been admitted to our hospital from January 2021 to January 2022 were randomly divided into an observation group(n=30),who received whole-process case management on the basis of routine nursing mea-sures,and a control group(n=30),who were given routine nursing measures.We compared differences between the two groups in terms of anxiety,depression,the level of hope,self-care ability,symptom distress,sleep quality,and quality of life.RESULTS Post-intervention,Hamilton anxiety scale,Hamilton depression scale,memory symptom assessment scale,and Pittsburgh sleep quality index scores in both groups were lower than those pre-intervention,and the observation group had lower scores than the control group(P<0.05).Herth hope index,self-care ability assessment scale-revision in Chinese,and quality of life measurement scale for patients with liver cancer scores in both groups were higher than those pre-intervention,with higher scores in the observation group compared with the control group(P<0.05).CONCLUSION Whole-process case management can effectively reduce anxiety and depression in patients with liver cancer,alleviate symptoms and problems,and improve the level of hope,self-care ability,sleep quality,and quality of life,as well as provide feasible nursing alternatives for patients with liver cancer.
文摘BACKGROUND A new nomenclature consensus has emerged for liver diseases that were previously known as non-alcoholic fatty liver disease(NAFLD)and metabolic dysfunction-associated fatty liver disease(MAFLD).They are now defined as metabolic dysfunction-associated steatotic liver disease(MASLD),which includes cardiometabolic criteria in adults.This condition,extensively studied in obese or overweight patients,constitutes around 30%of the population,with a steady increase worldwide.Lean patients account for approximately 10%-15%of the MASLD population.However,the pathogenesis is complex and is not well understood.AIM To systematically review the literature on the diagnosis,pathogenesis,characteristics,and prognosis in lean MASLD patients and provide an interpretation of these new criteria.METHODS We conducted a comprehensive database search on PubMed and Google Scholar between January 2012 and September 2023,specifically focusing on lean NAFLD,MAFLD,or MASLD patients.We include original articles with patients aged 18 years or older,with a lean body mass index categorized according to the World Health Organization criteria,using a cutoff of 25 kg/m2 for the general population and 23 kg/m2 for the Asian population.RESULTS We include 85 studies in our analysis.Our findings revealed that,for lean NAFLD patients,the prevalence rate varied widely,ranging from 3.8%to 34.1%.The precise pathogenesis mechanism remained elusive,with associations found in genetic variants,epigenetic modifications,and adaptative metabolic response.Common risk factors included metabolic syndrome,hypertension,and type 2 diabetes mellitus,but their prevalence varied based on the comparison group involving lean patients.Regarding non-invasive tools,Fibrosis-4 index outperformed the NAFLD fibrosis score in lean patients.Lifestyle modifications aided in reducing hepatic steatosis and improving cardiometabolic profiles,with some medications showing efficacy to a lesser extent.However,lean NAFLD patients exhibited a worse prognosis compared to the obese or overweight counterpart.CONCLUSION MASLD is a complex disease comprising epigenetic,genetic,and metabolic factors in its pathogenesis.Results vary across populations,gender,and age.Limited data exists on clinical practice guidelines for lean patients.Future studies employing this new nomenclature can contribute to standardizing and generalizing results among lean patients with steatotic liver disease.
基金supported by the China Postdoctoral Science Foundation(2022M722301)the Sichuan Province Innovative Talent Funding Project for Postdoctoral Fellows,China(BX202207)the Natural Science Foundation of Sichuan Province,China(2023NSFC0014 and 2024NSFSC1225).
文摘Rice‒rape,rice‒wheat and rice‒garlic rotations are common cropping systems in Southwest China,and they have played a significant role in ensuring ecological and economic benefits(EB)and addressing the challenges of China’s food security in the region.However,the crop yields in these rotation systems are 1.25‒14.73%lower in this region than the national averages.Intelligent decision-making with machine learning can analyze the key factors for obtaining better benefits,but it has rarely been used to enhance the probability of obtaining such benefits from rotations in Southwest China.Thus,we used a data-intensive approach to construct an intelligent decision‒making system with machine learning to provide strategies for improving the benefits of rice-rape,rice-wheat,and rice-garlic rotations in Southwest China.The results show that raising the yield and partial fertilizer productivity(PFP)by increasing seed input under high fertilizer application provided the optimal benefits with a 10%probability in the rice-garlic system.Obtaining high yields and greenhouse gas(GHG)emissions by increasing the N application and reducing the K application provided suboptimal benefits with an 8%probability in the rice-rape system.Reducing N and P to enhance PFP and yield provided optimal benefits with the lowest probability(8%)in the rice‒wheat system.Based on the predictive analysis of a random forest model,the optimal benefits were obtained with fertilization regimes by reducing N by 25%and increasing P and K by 8 and 74%,respectively,in the rice-garlic system,reducing N and K by 54 and by 36%,respectively,and increasing P by 38%in rice-rape system,and reducing N by 4%and increasing P and K by 65 and 23%in rice-wheat system.These strategies could be further optimized by 17‒34%for different benefits,and all of these measures can improve the effectiveness of the crop rotation systems to varying degrees.Overall,these findings provide insights into optimal agricultural inputs for higher benefits through an intelligent decision-making system with machine learning analysis in the rice-rape,rice‒wheat,and rice-garlic systems.
文摘Background:Return to play(RTP)in elite rugby is managed using a 6-stage graduated RTP protocol,which can result in clearance to play within 1 week of injury.We aimed to explore how symptom,cognitive,and balance presentation and evolution during concussion screens 2 h(head injury assessment(HIA2)and 48 h(HIA3)after injury were associated with time to RTP)to identify whether a more conservative graduated RTP may be appropriate.Methods:A retrospective cohort study was conducted in 380 concussed rugby players from elite men’s rugby over 3 consecutive seasons.Players were classified as shorter or longer returns,depending on whether RTP occurred within 7 days(allowing them to be considered to play the match 1 week after injury)or longer than 8 days,respectively.Symptom,cognitive,and balance performance during screens was assessed relative to baseline(normal or abnormal)and to the preceding screen(improving or worsening).Associations between sub-test abnormalities and RTP time were explored using odds ratios(OR,longer vs.shorter).Median day absence was compared between players with abnormal or worsening results and those whose results were normal or improving.Results:Abnormal symptom results during screens 2 h and 48 h after concussion were associated with longer return time(HIA2:OR=2.21,95%confidence interval(95%CI):1.39-3.50;HIA3:OR=3.30,95%CI:1.89-5.75).Worsening symptom number or severity from the time of injury to 2 h and 48 h post-injury was associated with longer return(HIA2:OR=2.49,95%CI:1.36-4.58;HIA3:OR=3.34,95%CI:1.10-10.15).Median days absence was greater in players with abnormal symptom results at both HIA2 and HIA3.Cognitive and balance performance were not associated with longer return and did not affect median days absence.Conclusion:Symptom presentation and evolution within 48 h of concussion were associated with longer RTP times.This may guide a more conservative approach to RTP,while still adhering to individualized concussion management principles.
基金Under the auspices of National Key R&D Plan (No.2022YFB3903604)the Youth Innovation Promotion Association of Chinese Academy of Sciences (No.2023060)Key Project of Innovation LREIS (No.KPI001)。
文摘Coastal zones are dynamic,rich environments,now densely populated,and increasingly challenged by human and climatechange pressures.Effective long-term integrated coastal zone planning is needed to ensure sustainable environmental protection and economic development.In this study,we reviewed the history of coastal zone planning since its birth in the 1950s based on the literature retrieved from the Web of Science(Core Collection)from 2000–2023,then summarized the tools and spatial allocation methods commonly used in the planning process,and finally proposed potential solutions to the challenges faced.The results show that after decades of development,coastal zone planning has changed from a decentralized activity to a targeted and integrated one,with an increasing emphasis on the ecosystem approach and the use of multiple planning tools.Spatial analysis techniques and environmental modelling software have become increasingly popular.Linear programming and overlay analysis are common approaches when performing spatial optimization,but land-sea interactions and planning in the marine parts still lack in-depth analysis and practical experience.We are also aware that the challenges posed by the integration of administrative hierarchies,scoping and conservation objectives,stakeholder participation,consideration of social dimensions,and climate change are pervasive throughout the planning process.There is an urgent need to develop more flexible and accurate spatial modelling tools,as well as more efficient participatory methods,and to focus on the holistic nature of the land-sea system to create more resilient and sustainable coastal zones.
基金Hebei University Affiliated Hospital Youth Fund Scientific Research Project Project Number:2019Q017。
文摘Objective:To explore the role of specialized group management in the quality control of perioperative nursing.Methods:45 surgical nurses from our hospital were selected as the research subjects.Traditional operating room management was adopted from July 2019 to June 2020,and specialized group management was adopted from July 2020 to June 2021.The surgeon’s satisfaction,surgical nurses’core professional competence,and surgical patients’satisfaction were obtained through surveys and the results were analyzed.Results:Surgeon satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Besides,surgical nurses’core professional competency scores before the implementation of specialized group management were significantly lower than after its implementation(P<0.05).Lastly,surgical patients’satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Conclusion:Specialized group management helps to improve the quality of perioperative care and should be applied in clinical practice.
基金supported by the National Science Foundation of China(82160647)Hainan Clinical Medical Research Center Project(LCYX202310)+1 种基金Hainan Provincial Major Science and Technology Projects(ZDKJ202004)CAMS Innovation Fund for Medical Sciences(2019-I2M-5-023).
文摘In 2009,the World Health Organization included snakebite on the list of neglected tropical diseases,acknowledging it as a common occupational hazard for farmers,plantation workers,and others,causing tens of thousands of deaths and chronic physical disabilities every year.This guideline aims to provide practical information to help clinical professionals evaluate and treat snakebite victims.These recommendations are based on clinical experience and clinical research evidence.This guideline focuses on the following topics:snake venom,clinical manifestations,auxiliary examination,diagnosis,treatments,and prevention.
基金supported by the National Key Research and Development Program of China(2021YFD1700900)the National Natural Science Foundation of China(31972519)+1 种基金the Agricultural Science and Technology Innovation Program of the Chinese Academy of Agricultural Sciences(2060302-05-956-1)the Project for the Government’s Purchase Service,China(13210186)。
文摘Globally,sub-optimal use of nitrogen (N) fertiliser and elevated N irrigation groundwater have led to high leached nitrate (NO_(3)^(–)) losses from protected vegetable field systems.Optimising fertiliser and irrigation management in different soil types is crucial to reduce future N loads from such systems.The present 4-year study examined leached N loads from lysimeter monitoring arrays set up across 18 protected vegetable system sites encompassing the dominant soil types of northern China.The treatments applied at each field site were:1) a high N and high irrigation input treatment (HNHI);2) a low N but high irrigation input treatment (LNHI) and 3) a low N with low irrigation input treatment (LNLI).Results showed that the mean annual leached total nitrogen loads from the HNHI,LNHI and LNLI treatments were 325,294 and 257 kg N ha^(–1) in the fluvo-aquic soil,114,100 and 78 kg N ha^(–1) in the cinnamon soil and 79,68 and 57 kg N ha^(–1) in the black soil,respectively.The N dissolved in irrigation water in the fluvo-aquic soil areas was 8.26-fold higher than in the cinnamon areas.A structural equation model showed that N fertiliser inputs and leaching water amounts explained 14.7 and 81.8%of the variation of leached N loads,respectively.Correspondingly,reducing irrigation water by 21.5%decreased leached N loads by 20.9%,while reducing manure N and chemical N inputs by 22 and 25%decreased leached N loads by only 9.5%. This study highlights that protected vegetable fields dominated by fluvo-aquic soil need management to curtail leached N losses in northern China.