Prevention and Control Strategies of Nosocomial Infection and Effectiveness Evaluation in a Tertiary Teaching Hospital during the Epidemic of COVID-19

Objective: To evaluate the role of prevention and control strategies for nosocomial infection in a tertiary teaching hospital during the sudden outbreak of Corona Virus Disease 2019 (COVID-19). Methods: The hospital initiated an emergency plan involving multi-departmental defense and control. It adopted a series of nosocomial infection prevention and control measures, including strengthening pre-examination and triage, optimizing the consultation process, improving the hospital’s architectural composition, implementing graded risk management, enhancing personal protection, and implementing staff training and supervision. Descriptive research was used to evaluate the short-term effects of these in-hospital prevention and control strategies. The analysis compared changes in related evaluation indicators between January 24, 2020 and February 12, 2020 (Chinese Lunar New Year’s Eve 2020 to lunar January 19) and the corresponding lunar period of the previous year. Results: Compared to the same period last year, the outpatient fever rate increased by 1.85-fold (P P Conclusion: The nosocomial infection prevention and control strategies implemented during this specific period improved the detection and control abilities for the COVID-19 source of infection and enhanced the compliance with measures. This likely contributed significantly to avoiding the occurrence of nosocomial infection.

The Effectiveness of Self-regulated Learning Strategies on Chinese College Students' English Learning

The purpose of this paper is to argue the effectiveness of self-regulated learning in English education in Chinese college classroom instruction. A study is given to show whether the introduction of self-regulated learning can help improve Chinese college students' English learning, and help them perform better in the National English test-CET-4 (College English Test Level-4,).

Engineering Strategies for Suppressing the Shuttle Effect in Lithium–Sulfur Batteries

Lithium–sulfur(Li–S)batteries are supposed to be one of the most potential next-generation batteries owing to their high theoretical capacity and low cost.Nevertheless,the shuttle effect of firm multi-step two-electron reaction between sulfur and lithium in liquid electrolyte makes the capacity much smaller than the theoretical value.Many methods were proposed for inhibiting the shuttle effect of polysulfide,improving corresponding redox kinetics and enhancing the integral performance of Li–S batteries.Here,we will comprehensively and systematically summarize the strategies for inhibiting the shuttle effect from all components of Li–S batteries.First,the electrochemical principles/mechanism and origin of the shuttle effect are described in detail.Moreover,the efficient strategies,including boosting the sulfur conversion rate of sulfur,confining sulfur or lithium polysulfides(LPS)within cathode host,confining LPS in the shield layer,and preventing LPS from contacting the anode,will be discussed to suppress the shuttle effect.Then,recent advances in inhibition of shuttle effect in cathode,electrolyte,separator,and anode with the aforementioned strategies have been summarized to direct the further design of efficient materials for Li–S batteries.Finally,we present prospects for inhibition of the LPS shuttle and potential development directions in Li–S batteries.

Understanding the Relationship Between Shrinking Cities and Land Prices:Spatial Pattern,Effectiveness,and Policy Implications

Urban shrinkage has emerged as a widespread phenomenon globally and has a significant impact on land,particularly in terms of land use and price.This study focuses on 2851 county-level cities in China in 2005–2018(excluding Hong Kong,Macao,Taiwan,and‘no data’areas in Qinhai-Tibet Plateau)as the fundamental units of analysis.By employing nighttime light(NTL)data to identify shrinking cities,the propensity score matching(PSM)model was used to quantitatively examine the impact of shrinking cities on land prices,and evaluate the magnitude of this influence.The findings demonstrate the following:1)there were 613 shrinking cities in China,with moderate shrinkage being the most prevalent and severe shrinkage being the least.2)Regional disparities are evident in the spatial distribution of shrinking cities,especially in areas with diverse terrain.3)The spatial pattern of land price exhibits a significant correlated to the economic and administrative levels.4)Shrinking cities significantly negatively impact on the overall land price(ATT=–0.1241,P<0.05).However,the extent of the effect varies significantly among different spatial regions.This study contributes novel insights into the investigation of land prices and shrinking cities,ultimately serving as a foundation for government efforts to promote the sustainable development of urban areas.

Depicting the battle between nectarine and Monilinia laxa:the fruit developmental stage dictates the effectiveness of the host defenses and the pathogen’s infection strategies

Infections by the fungus Monilinia laxa,the main cause of brown rot in Europe,result in considerable losses of stone fruit.Herein,we present a comprehensive transcriptomic approach to unravel strategies deployed by nectarine fruit and M.laxa during their interaction.We used M.laxa-inoculated immature and mature fruit,which was resistant and susceptible to brown rot,respectively,to perform a dual RNA-Seq analysis.In immature fruit,host responses,pathogen biomass,and pathogen transcriptional activity peaked at 14–24 h post inoculation(hpi),at which point M.laxa appeared to switch its transcriptional response to either quiescence or death.Mature fruit experienced an exponential increase in host and pathogen activity beginning at 6 hpi.Functional analyses in both host and pathogen highlighted differences in stage-dependent strategies.For example,in immature fruit,M.laxa unsuccessfully employed carbohydrate-active enzymes(CAZymes)for penetration,which the fruit was able to combat with tightly regulated hormone responses and an oxidative burst that challenged the pathogen’s survival at later time points.In contrast,in mature fruit,M.laxa was more dependent on proteolytic effectors than CAZymes,and was able to invest in filamentous growth early during the interaction.Hormone analyses of mature fruit infected with M.laxa indicated that,while jasmonic acid activity was likely useful for defense,high ethylene activity may have promoted susceptibility through the induction of ripening processes.Lastly,we identified M.laxa genes that were highly induced in both quiescent and active infections and may serve as targets for control of brown rot.

Review on Hydroxyurea Usage in Young Children with Sickle Cell Disease: Examining Hemoglobin Induction, Potential Benefits, Responses, Safety, and Effectiveness

Sickle cell disease (SCD) is a prevalent condition, particularly in the countries of sub-Saharan Africa, where the presence of specific genes associated with Malaria contributes to its high prevalence. Patients with sickle cell disease frequently experience painful episodes necessitating hospitalization, and their hemoglobin levels are typically lower than those of the general population. There are different treatment options available to manage complications, such as transfusing blood, hydroxyurea, and strong anti-pains. However, with all these treatments, patients still commonly experience pain crises and suffer from organ damage. Hydroxyurea, the sole approved medication for sickle cell anemia in developed and developing countries, is widely used in children despite being primarily indicated for adults. Multiple studies have demonstrated the efficacy of hydroxyurea in inducing HbF production in young children with SCD. Elevated HbF levels have been associated with improved clinical outcomes, including a reduction in vaso-occlusive crises, acute chest syndrome, and the need for blood transfusions. Furthermore, increased HbF levels have been shown to ameliorate disease-related organ damage, such as pulmonary hypertension and sickle cell retinopathy. The response to hydroxyurea treatment in young children with SCD is variable. Some patients achieve substantial increases in HbF levels and experience significant clinical benefits, while others may have a more modest response. Factors influencing the response include baseline HbF levels, genetic modifiers, treatment adherence, and dose optimization. Safety is a crucial consideration when using hydroxyurea in young children. Studies have shown that hydroxyurea is generally well-tolerated, with the most common adverse effects being myelosuppression, gastrointestinal symptoms, and dermatological manifestations. However,long-term effects and potential risks, such as renal dysfunction and reproductive impacts, require further investigation. The effectiveness of hydroxyurea in young children with SCD has been demonstrated in various clinical trials and observational studies. These studies have shown a significant reduction in disease-related complications and improved quality of life. However, optimal dosing, treatment duration, and long-term outcomes are still areas of ongoing research. This review focuses on recent studies investigating the benefits, effectiveness, responses, and safety of hydroxyurea in pediatric individuals diagnosed with sickle cell disease.

Design and operation strategies of the system for destroying time-sensitive target based on system effectiveness

To improve the effect of destroying time-sensitive target （TST）, a method of operational effectiveness evaluation is presented and some influential factors are analyzed based on the combat flow of system for destroying TST. Considering the possible operation modes of the system, a waved operation mode and a continuous operation mode are put forward at first. At the same time, some relative formulas are modified. In examples, the influential factors and operation modes are analyzed based on the system effectiveness. From simulation results, some design and operation strategies of the system for destroying time sensitive targets are concluded, which benefit to the improvement of the system effectiveness.

Factors influencing willingness to participate in ophthalmic clinical trials and strategies for effective recruitment

AIM:To explore the factors influencing individuals’willingness to participate in ophthalmic clinical trials.METHODS:A questionnaire survey was conducted from January to April 2021 among patients and their family members at Zhongshan Ophthalmic Center,Sun Yat-sen University,in Guangzhou,China.The survey gathered data on respondents’willingness,demographic and socioeconomic profiles,as well as their reasons and concerns regarding engagement in clinical trials.RESULTS:Of the 1078 residents surveyed(mean age 31.2±13.1y;65.8%females)in Guangzhou,749(69.5%)expressed a willingness to participate in future ophthalmic clinical trials.Specific characteristics associated with greater willingness included a younger age,lower annual income,higher education,prior participation experience,previous ophthalmic treatment,and a better understanding of clinical trials.With the exception of age,these characteristics were significantly linked to a higher willingness.The primary barrier to participation,expressed by 64.8%of those willing and 54.4%of those unwilling,was“Uncertain efficacy”.In terms of motivations,the willing group ranked“Better therapeutic benefits”(35.0%),“Professional monitoring”(34.3%),and“Trust in healthcare professionals”(33.1%)as their top three reasons,whereas the unwilling participants indicated“Full comprehension of the protocol”(46.2%)as the key facilitator.CONCLUSION:This study reveals a substantial willingness to participate in ophthalmic clinical trials and demonstrates the predictive role of demographic and socioeconomic factors.Variations in motivators and concerns between willing and unwilling participants highlight the significance of tailored recruitment strategies.Importantly,the need for and trust in healthcare professionals stand out as powerful motivations,underscoring the importance of enhancing physician-patient relationships,adopting patient-centered communication approaches,and addressing individualized needs to improve accrual rates.

Farmers’ Knowledge and Perceptions of the Effects of Climate Variability and Pollution on Crop Production and Their Varying Adaptation Strategies in The Gambia

Crop and livestock production is critical to food security in The Gambia. Over the years, the country has experienced a reduced yield due to perceived climate change events with limited studies on how climate change and pollution affect crop production. This study assesses farmers’ knowledge and perceptions of the effects of climate variability and pollution on crop production and their varying adaptation strategies in The Gambia. Both quantitative and qualitative methods were used in this study. The sample size for quantitative data collection was calculated as 432 while the qualitative data involves both the focus group discussions and key informant interviews. The focus group discussions comprised two districts in each of the six agricultural regions and two farming communities engaged in crop production were chosen from each district. Furthermore, eight key informant interviews from relevant institutions were conducted. The study shows that The Gambia is highly vulnerable to extreme climatic events. Although most farmers opined that agricultural land contamination emanates from farm runoff and indiscriminate waste dumping, they had little knowledge of heavy metal pollution and bioremediation. The results showed that farmers experienced constraints such as inadequate access to credit, water, and irrigation facilities, insufficient access to efficient inputs, salt intrusion, etc. which threatened food security. The study concludes that crop farmers acknowledged the existence and impacts of climate change, and therefore recommend the availability and affordability of climate change resilient crops and promote variability awareness campaigns to address climate change impacts in The Gambia.

Evaluation of the effectiveness of preventive nursing measures for pressure injuries in patients in the neurology intensive care unit

BACKGROUND Patients in neurology intensive care units(ICU)are prone to pressure injuries(PU)due to factors such as severe illness,long-term bed rest,and physiological dysfunction.PU not only causes pain and complications to patients,but also increases medical burden,prolongs hospitalization time,and affects the recovery process.AIM To evaluate and optimize the effectiveness of pressure injury prevention nursing measures in neurology ICU patients.METHODS A retrospective study was conducted,and 60 patients who were admitted to the ICU of the Department of Neurology were selected and divided into an observation group and a control group according to the order of admission,with 30 people in each group.The observation group implemented pressure injury prevention and nursing measures,while the control group adopted routine care.RESULTS Comparison between observation and control groups following pressure injury prevention nursing intervention revealed significantly lower incidence rates in the observation group compared to the control group at 48 h(8.3%vs 26.7%),7 d(16.7%vs 43.3%),and 14 d(20.0%vs 50.0%).This suggests a substantial reduction in pressure injury incidence in the observation group,with the gap widening over time.Additionally,patients in the observation group exhibited quicker recovery,with a shorter average time to get out of bed(48 h vs 72 h)and a shorter average length of stay(12 d vs 15 d)compared to the control group.Furthermore,post-intervention,patients in the observation group reported significantly improved quality of life scores,including higher scores in body satisfaction,feeling and function,and comfort(both psychological and physiological),indicating enhanced overall well-being and comfort following the implementation of pressure injury prevention nursing measures.CONCLUSION Implementing pressure injury preventive care measures for neurology ICU patients will have better results.

Evolution of United States Technology Alliance Strategy and Reshaping of International Strategic Landscape

Building a technology alliance is the main strategy for the United States to maintain its scientific and technological hegemony under its technopolitical strategic framework.After Joe Biden took office,the United States implemented“small yard with high fences”strategy for scientific and technological competition,as the first step toward building a technology alliance.The main goal is to restrict the flow of strategic emerging technologies and factors of innovation to rival countries.

Collaborative Optimization of a Matrix Manufacturing System Based on Overall Equipment Effectiveness

When several traditional flow-shop lines operate in parallel,the operation mode with no communication between production lines will no longer be the optimal production paradigm.This paper describes matrix manufacturing systems(MMS)in a general manner from the perspective of related works,comparing different manufacturing organizational forms and their characteristics.Subsequently,MMS are extracted during the parallel production of multiple surface mount technology(SMT)lines.An overall equipment effectiveness(OEE)online calculation model and a collaborative optimization method are proposed based on the OEE of the MMS.The innovative idea of this study is to divide existing multiple parallel SMT lines into MMS.The efficiency of each matrix unit(MU)was calculated,and a collaborative optimization method was proposed based on an indicator(OEE).In this paper,an example of eight SMT lines is presented.The partitioning of MUs,OEE calculation of each MU,and the low OEE unit collaborative optimization method are described in detail.Through a case study,the architecture of the collaborative optimization model for the MMS was constructed and discussed.Finally,the improvement in the OEE proved the effectiveness and usability of the proposed architecture.

Training Low-Achiever EFL Learners with Metacognitive Strategy Training for Effective Vocabulary Retention

There is ample research on the vocabulary learning strategies used by EFL and ESL learners.Moreover,many researchers have attempted to discern the effectiveness of teaching vocabulary learning strategies instruction.However,the impact of using metacognitive strategies along with vocabulary learning strategies on weak language learners has not been researched.The aim of this paper is to report on the effects of training low-achiever English as a foreign language learners with vocabulary learning strategies along with metacognitive strategies on vocabulary acquisition.Two B1 level groups of students were assigned as treatment and control groups at a university in Istanbul,Turkey.A Vocabulary Strategy Use Survey was given to identify the vocabulary strategy use of the subjects at the outset of the study.The treatment group was trained on vocabulary learning strategies combined with metacognitive strategy training.The control group studied the same words without any training.A vocabulary test was administered to both groups as a post-test and the results were compared.The findings of the Post-Test demonstrated that training weak language learners with vocabulary learning strategies along with metacognitive strategies has a positive impact on helping these learners increase their lexical knowledge,as the experimental group scored higher on the post-test compared to the control group.

Double-Blind, Parallel Group Study to Compare the Clinical Effectiveness of Calcium Dobesilate 500 mg BID vs. Calcium Dobesilate LP 1 g OD, in Patients with Chronic Venous Insufficiency of the Lower Limbs

Background: Chronic venous insufficiency (CVI) describes a condition that affects the venous system of the lower extremities due to venous hypertension (VH. The prevalence is between 5% - 30%. CVI is associated with older age, smoking, lower extremity trauma, presence of an arteriovenous shunt, and elevated estrogen levels. All patients should be initially treated with conservative management. Venoactive drugs like calcium dobesilate are useful. Objectives: The primary objective compared the clinical improvement in patients with CVI, grades 0 - 3 of the CEAP classification of chronic venous disease, produced by two formulations of calcium dobesilate: calcium dobesilate LP 1 g OD vs calcium dobesilate 500 mg BID, immediate release. The secondary objective assessed the side effects of both formulations. Method: All patients took one tablet and one capsule at 7 am, and one capsule at 7 pm, for 8 weeks. One group received dobesilate 1 g OD and the other group received dobesilate 500 md BID. They were evaluated after 15, 30 and 60 days of treatment, using the symptom evaluation scale. Results: In both groups, there was a significant decrease in the symptom score after 15 days. Four patients in the Dobesilate OD group: had adverse effects, which did not require suspension of treatment. In the BID dobesilate group, there was one therapeutic failure, and one case of gastric discomfort. Conclusions: Prolonged-release Calcium dobesilate 1 g OD is as effective as calcium dobesilate 500 mg BID for the treatment of patients with chronic venous insufficiency.

Problem Analysis and Effective Strategies of Ecological Civilization Education for Undergraduates in the New Age

The ecological civilization in the new age is one important aspect for undergraduates.We must enhance the concept of their civilization and improve the quality of civilization.Carrying out ecological civilization education in colleges and universities has a practical significance for enriching the contents of ideological and political education to realize their all-round development.Nowadays,some undergraduates lack awareness of ecological civilization and ignore its importance.For this reason,undergraduates need to pay attention to ecological civilization and improve their own ecological civilization literacy to promote the all-round development in qualities in the new age.This paper mainly analyzes the current problems in undergraduates’ecological civilization education and explores effective strategies to solve the current problems in undergraduates’ecological civilization education.The strategies include integrating ecological civilization resources,innovating methods of ecological civilization,strengthening ecological educator team construction,embodying ecological culture in campus construction and creating the atmosphere,emphasizing innovative practices for ecological civilization,strengthening publicity of social-ecological civilization,and attaching importance to family education of ecological civilization.

Opportunities to Improve the Quality of Environmental Reports and the Effectiveness of Environmental Impact Assessment: A Case of Electric Power Transmission Systems in Brazil

A good quality Environmental Impact Statement (EIS) is key for the effectiveness of Environmental Impact Assessment (EIA) processes and consequently to the acceptability of projects subject to EIA. The international literature has contributed to the understanding of the essential aspects to be verified regarding the quality of EIS, offering a wide spectrum of good practice examples related to the content of the studies. Even so, there is a need for empirical studies that allow the identification of specific aspects related to the context of application of the EIS, which could lead to the identification of opportunities to improve both the quality of the reports and also the effectiveness of EIA. Therefore, the present paper is focused on the quality review of a number of EIS submitted to the Brazilian Federal Environmental Agency (Ibama) to instruct the assessment of electric power transmission systems. Based on the application of the EIS quality review package as proposed by Lee and Colley (1992), the outcomes reveal opportunities for improving the scope of EIA, analysis of alternatives, prediction of magnitude and the assessment of impact significance. Finally, the development and/or adaptation of a similar tool for the systematic review of the quality of EIA reports is recommended.

Comparative observation of the effectiveness and safety of remimazolam besylate versus dexmedetomidine in gastrointestinal surgery in obese patients

BACKGROUND Surgery for obese patients carries a higher risk of anesthesia complications compared with surgery for nonobese patients.Thus,a safe and effective anesthesia strategy is necessary to improve the medical experience of such patients and ensure their safety.AIM To compared the effectiveness and safety of remimazolam besylate versus dexmedetomidine(DEX)in gastrointestinal surgery in obese patients.METHODS The study cohort included 60 obese patients undergoing gastrointestinal surgery between July 2021 and April 2023,comprising 30 patients who received DEX intervention(control group)and 30 patients who received remimazolam besylate intervention(research group).Heart rate(HR),respiratory rate(RR),mean arterial pressure(MAP),blood oxygen saturation(SpO_(2)),safety(nausea and vomiting,bradycardia,hypotension,and apnea),anesthesia and examination indices[induction time,anesthesia recovery time,and postanesthesia care unit(PACU)discharge time],sedation effect(Ramsay Sedation Scale),and postoperative pain visual analog scale were comparatively analyzed before anesthesia(T0),during anesthesia(T1),and after anesthesia(T2).RESULTS At T1,the research group showed significantly smaller changes in HR,RR,MAP,and SpO_(2) than the control group,with a significantly lower adverse reaction rate and shorter induction,anesthesia recovery,and PACU discharge times.Additionally,the intra-and postoperative Ramsay Sedation Scale scores were statistically higher in the research group than in the control group.CONCLUSION Remimazolam besylate was significantly more effective than DEX in gastrointestinal surgery in obese patients and had a higher safety profile and value in clinical promotion.

A cloud model target damage effectiveness assessment algorithm based on spatio-temporal sequence finite multilayer fragments dispersion

To solve the problem of target damage assessment when fragments attack target under uncertain projectile and target intersection in an air defense intercept,this paper proposes a method for calculating target damage probability leveraging spatio-temporal finite multilayer fragments distribution and the target damage assessment algorithm based on cloud model theory.Drawing on the spatial dispersion characteristics of fragments of projectile proximity explosion,we divide into a finite number of fragments distribution planes based on the time series in space,set up a fragment layer dispersion model grounded in the time series and intersection criterion for determining the effective penetration of each layer of fragments into the target.Building on the precondition that the multilayer fragments of the time series effectively assail the target,we also establish the damage criterion of the perforation and penetration damage and deduce the damage probability calculation model.Taking the damage probability of the fragment layer in the spatio-temporal sequence to the target as the input state variable,we introduce cloud model theory to research the target damage assessment method.Combining the equivalent simulation experiment,the scientific and rational nature of the proposed method were validated through quantitative calculations and comparative analysis.

Seismic effectiveness evaluation and optimized design of tie up method for securing museum collections

To quantify the seismic effectiveness of the most commonly used fishing line tie up method for securing museum collections and optimize fixed strategies for exhibitions,shaking table tests of the seismic systems used for typical museum collection replicas have been carried out.The influence of body shape and fixed measure parameters on the seismic responses of replicas and the interaction behavior between replicas and fixed measures have been explored.Based on the results,seismic effectiveness evaluation indexes of the tie up method are proposed.Reasonable suggestions for fixed strategies are given,which provide a basis for the exhibition of delicate museum collections considering the principle of minimizing seismic responses and intervention.The analysis results show that a larger ratio of height of mass center to bottom diameter led to more intense rocking responses.Increasing the initial pretension of fishing lines was conducive to reducing the seismic responses and stress variation of the lines.Through comprehensive consideration of the interaction forces and effective securement,it is recommended to apply 20%of breaking stress as the initial pretension.For specific museum collections that cannot be effectively protected by the independent tie up method,an optimized strategy of a combination of fishing lines and fasteners is recommended.

Effectiveness and economic outcomes in patients undergoing laparoscopic radical prostatectomy with a new surgical shear with an integrated energy system:A retrospective study based on a tertiary hospital database in China

ObjectiveThis study aimed to demonstrate a new surgical shear with an integrated energy system(Harmonic ACE^(®)+7)value by determining its effectiveness and economic outcomes compared with conventional ultrasonic shears(CUSs)in a real-world setting.MethodsThis was a retrospective study of adults with prostate cancer undergoing laparoscopic radical prostatectomy with the ACE^(®)+7 shear or CUSs between August 2019 and April 2021 at Shanghai Ruijin Hospital(the headquarters and Luwan Center in China).Demographic and diagnosis information,intraoperative and postoperative clinical outcomes,and total and categorical costs were collected.Propensity score matching was performed to form the study population for each clinical group.Data were compared between the two groups using t-test and Chi-squared test.ResultsThe ACE^(®)+7 was associated with a lower mean number of hemostatic clips used per surgery compared with CUSs(12.8 vs.19.8,p<0.001),a moderate but not significant difference in mean postoperative drainage duration(6.6[standard deviation,SD 2.2]days vs.7.9[SD 4.1]days,p=0.082),a reduction on mean total drainage volume(275.5[SD 374.3] mL vs.492.9[SD 1495.0]mL,p=0.321),and a lower mean rate of postoperative hemostatic drug usage(16.0%vs.52.0%,p<0.001).There was no significant difference in total costs between the ACE^(®)+7 and CUS groups.ConclusionThis study provides real-world data demonstrating that the ACE^(®)+7 shear with an integrated energy system improves clinical outcomes compared with CUSs and can offer cost savings for hospitals and health systems.Using the ACE^(®)+7 during laparoscopic radical prostatectomy allows physicians to help their patients achieve better outcomes and not spend additional money.