Reductions in non-point source pollution through different management practices for an agricultural watershed in the Three Gorges Reservoir Area

Non-point source water pollution generated by agricultural production is considered a major environmental issue in the Three Gorges Reservoir Area （TGRA） of China. The Annualised Agricultural Non-Point Source Pollution （AnnAGNPS） model was selected to assess the impact of the application of various management treats, including seven crops, five fertilizer levels and three-group management practice scenarios, on water quality from Heigou River Watershed in TGRA. The scenario subsets include conservation tillage practice （CTP）, conservation reserve program （CRP） and conversion of cropland into forestland program （CCFP）. Results indicated that tea can not be replaced by other crops because comparatively tea resulted in a higher sediment yield. CTP with no-tillage was more effective to reduce sediment yield, but could increased nutrient loss. CRP reduced sediment yield significantly, but slightly benefited on nutrient loss. CCFP reduced not only sediment yield but also the nutrient loss significantly. The conversion of cropland with a slope greater than 10° into forestland was found to be the best scenario as the sediment yield export is less than 5 tons/ha and nutrient loss is within the permissible limit.

Sustainable Management of Rice Insect Pests by Non-Chemical-Insecticide Technologies in China

Chemical pesticides play crucial roles in the management of crop diseases and pests. However, excessive and irrational use of pesticides has become a major concern and obstacle to sustainable agriculture. As a result, the quality and security of agricultural products are reduced, and the ecological and environmental integrities are threatened. Recently, environment-friendly pest management measures have been introduced and adopted to manage rice insect pests and reduce the use of insecticides. This paper reviewed the advancements in development and application of non-chemical technologies for insect pest management during rice production in China.

Non-operative management of isolated liver trauma

Liver trauma is the most common abdominal emergency with high morbidity and mortality. Now, nonoperative management（NOM） is a selective method for liver trauma. The aim of this study was to determine the success rate, mortality and morbidity of NOM for isolated liver trauma.Medical records of 81 patients with isolated liver trauma in our unit were analyzed retrospectively. The success rate, mortality and morbidity of NOM were evaluated. In this series, 9 patients with grade IV-V liver injuries underwent emergent operation due to hemodynamic instability; 72 patients, 6 with grade V, 18 grade IV, 29 grade III, 15 grade II and 4 grade I, with hemodynamic stability received NOM. The overall success rate of NOM was 97.2%（70/72）. The success rates of NOM in the patients with grade I-III, IV and V liver trauma were100%, 94.4% and 83.3%. The complication rates were 10.0%and 45.5% in the patients who underwent NOM and surgical treatment, respectively. No patient with grade I-II liver trauma had complications. All patients who underwent NOM survived.NOM is the first option for the treatment of liver trauma if the patient is hemodynamically stable. The grade of liver injury and the volume of hemoperitoneum are not suitable criteria for selecting NOM. Hepatic angioembolization associated with the correction of hypothermia, coagulopathy and acidosis is important in the conservative treatment for liver trauma.

Population distribution and threats to sustainable management of selected non-timber forest products in tropical lowland rainforests of south western Nigeria

Uncontrolled harvesting of non-timber forest products （NTFPs） poses a serious risk of extermination to several of these species in Nigeria. Yet, there is a paucity of information on the distribution, population status and sustainable management of NTFPs in most of the tropical lowland rainforests. We, therefore, assessed the population, distribution and threats to sustainable management of NTFPs within the tropical lowland rainforests of Omo and Shasha Forest Reserves, south western Nigeria. Data were obtained through inventory surveys on five top priority species including： bush mango （Irvingia gabonensis （Aubry-Lecomte ex O’Rorke） Baill）, African walnut （Tetracarpidium conophorum （Mull. Arg.） Hutch. ＆ Dalziel syn. Plukenetia conophora）, chew-stick （Massularia acuminata （G. Don） Bullock）, fever bark （Annickia chlorantha Setten ＆ P.J.Maas syn. Enantia chloranta） and bush pepper （Piper guineense Schumach. ＆ Thonn.）. Purposive and stratified random sampling techniques were used for the inventory. Each forest reserve was stratified into three, viz： less disturbed natural forest （for areas that have been rested for at least ten years）, recently disturbed natural forest （for areas that have suffered one form of human perturbation or the other in the last five years）, and plantation forest （for areas carrying forest plantation）. Data were collected from eighteen 10 m × 500 m belt transects located in the above strata. The species were generally fewer in both plantation and recently disturbed natural forest than the less disturbed natural forest, suggesting that forest disturbances （habitat modification） for other uses may have an effect on the occurrence and densities of the NTFPs. Exceptions to this trend were found for P. guineense and T. conophorum, which were fairly common in both plantation and recently disturbed natural forest. Among three tree NTFP species （i.e. I. gabonensis, M. acuminata and A. chlorantha）, only I. gabonensis showed a significant difference in overall DBH size classes for both reserves （t=？2.404; df =21; p=0.026）. Three tree NTFP species in both reserves further showed differences from the regular patterns of distribution of trees. The fairly regular reverse J-shaped size class distribution observed for M. acuminata in the study sites, however, suggests a recuperating population. In general, destructive harvesting of species, logging operations, low population size, narrow distribution ranges and habitat degradation are the major threats to the population of NTFPs in the study area. The implications of our findings for sustainable management of NTFPs in the study area are discussed and recommendations are made for a feasible approach towards enhancing the status of the species.

The Effectiveness of Non-Surgical Weight Management Interventions for Obesity in the UK: A Review and Meta-Regression Analysis

Background: Obesity is regarded as one of the most serious challenges public health faces in the 21st century for adults and children alike. Accordingly weight management interventions remain a public health priority aiming to reduce the burden of obesity and co-morbidities. Therefore this review aims to assess the effectiveness of non-surgical weight management interventions for obesity in the UK. Method: Thirty one databases were searched that identified 20 articles for inclusion. Articles were screened and quality scored using the “Effective Public Health Practice Project Quality Assessment Tool”. Meta-regression analysis (MRA) was undertaken on seven studies that allowed for effect size calculations. Results: In adult populations, lifestyle interventions that targeted both diet and physical activity, delivered in the private sector were most effective in reducing weight and/or BMI, and were more cost-effective. In children the most successful interventions mirrored adult interventions, but were family-orientated. MRA supported these findings. Most frequent intervention duration was 12 weeks. Discussion: The results provide evidence to support policy makers for the effective delivery of weight management interventions. Findings suggest that weight management interventions in the UK are effective in reducing weight and/or BMI for both children and adults. Interventions delivered in the private sector (e.g. Weight Watchers), targeting diet and physical activity levels, demonstrated the highest levels of effectiveness. However, compared to these models, NHS programmes are less well defined in the research literature and may not have been optimised. For children, effectiveness is improved by family-level programmes incorporating children and their parents.

A Study on Compensation for Management and Protection Expenses of Non-commercial Forests

This paper analyzes the compensation nature of non-commercial forests under different ownership from two aspects, namely, whether the property right is limited and whether the management and protection expense has been incurred: there are no economic loss compensation problems caused by changes and limitation of property rights for the state-owned non-commercial forests with only the compensation on management and protection expense; but for the non-commercial forests owned by collectives or individuals, double compensation for both the economic loss and management expense exists because of limitation on the property right. In addition, an inframarginal economic analysis framework has been built for the management and protection compensation problems faced by non-commercial forests under different ownership in the perspective of the division of labor. Research results show that: the compensation standard for the management and protection expenses of non-commercial forests shall fall in between the "completely self-sufficient forestry economic structure U(Ayz)" and the "completely specialized productive structure of non-commercial forests U(B1)".

A Project Management and Decision Support System for Non-standard Equipment's Eexecuting Work

Based on the features of the non-standard equipment executing work, a project management and decision support system oriented to the non-standard equipment is developed, and the information model, function model as well as the structure framework of the system are also introduced in this paper.

线上线下同伴导师协同式健康管理方案在农村糖尿病不规范治疗患者中的应用研究

背景农村糖尿病患者不规范治疗现象尤为严重,预防和控制糖尿病并发症,降低其致残率和死亡率是当前我国农村糖尿病健康管理的首要问题。目的探讨线上线下(O2O)同伴导师协同式健康管理对农村糖尿病不规范治疗患者的风险感知及糖尿病管理自我效能的影响。方法采用便利抽样法,选取2023年4—11月在大庆市让胡路区喇嘛甸镇的农村糖尿病不规范治疗患者90例作为研究对象,采用随机数字表法分为试验组45例和对照组45例。试验组采用O2O同伴导师协同式健康管理方案,干预时间为6个月,对照组采用常规慢性病健康管理。比较两组患者在风险感知及糖尿病管理自我效能方面的差异。结果试验组42例,对照组41例完成该研究。干预后试验组糖尿病风险感知量表得分为(43.86±7.00)分,高于对照组的(32.56±4.24)分(t=8.864,P<0.001);干预后试验组糖尿病管理自我效能量表得分为(100.45±16.74)分,高于对照组的(75.54±13.82)分(t=7.384,P<0.001)。结论O2O同伴导师协同式健康管理方案能有效提高农村糖尿病不规范治疗患者的风险感知及糖尿病管理自我效能,提高其健康管理水平。

MDT联合绩效考评管理模式对提高择期手术首台开台准时率的应用研究

目的探讨MDT联合绩效考评管理模式对非公立医院提高择期手术首台开台准时率的影响。方法按月统计2023年10月至2024年6月佛山复星禅诚医院住院择期手术首台开台例数、准时率、延时原因,使用FOCUS PDCA管理工具立项并制定MDT联合绩效考评管理方案,观察管理方案实施后和改进后择期手术首台开台准时率的变化。结果MDT联合绩效考评管理方案实施后(2024年1月—3月)和改进后(2024年4月—6月)的择期手术首台开台准时率均提高,且方案实施后(2024年1月—3月)首台开台准时率明显高于方案实施前(2023年10月—12月),差异有统计学意义(P<0.01)。结论MDT联合绩效考评管理模式有助于非公立医院提高择期手术首台开台准时率,可提高手术室的运营管理质量。

Sedimentation retention basin utilization for best management practice

Approaches to the artificial impoundment and theoretical design of sedimentation retention basin are reviewed with particular attention to best management practice(BMP) to control agriculture and surface runoff. Sediments retention basins are the small version of farm pond used where a criteria of farm pond is not met. Such basin traps the pollutants and suspended solids prior to entry into streams and lakes. The study is focused with special reference to the assessment and control of non point source pollution(NPSP) from the sub basin area of Tai Lake in the Xishan County of Wuxi City of China. The author suggested two different approaches to conduct this study including theoretical design for sedimentation retention basin and computation of flow, sediment transport and deposition during the artificial impoundment of retention basin for BMP's utilization. Theoretical design will provide a useful function as a first line defense against the movement of sediments and transport of pollutants into the Tai Lake while the assessment of sediments deposition will help to make its proper use and periodic cleanup.

Non-alcoholic fatty liver disease and liver transplantation:Outcomes and advances

Non-alcoholic fatty liver disease(NAFLD)is one of the most prevalent causes of chronic liver disease worldwide.In the last decade it has become the third most common indication for liver transplantation in the United States.Increasing prevalence of NAFLD in the general population also poses a risk to organ donation,as allograft steatosis can be associated with non-function of the graft.Post-transplant survival is comparable between NAFLD and non-NAFLD causes of liver disease,although long term outcomes beyond 10 year are lacking.NAFLD can recur in the allograft frequently although thus far post transplant survival has not been impacted.De novo NAFLD can also occur in the allograft of patients transplanted for non-NAFLD liver disease.Predictors for NAFLD post-transplant recurrence include obesity,hyperlipidemia and diabetes as well as steroid dose after liver transplantation.A polymorphism in PNPLA3 that mediates triglyceride hydrolysis and is linked to pre-transplant risk of obesity and NAFLD has also been linked to post transplant NAFLD risk.Although immunosuppression side effects potentiate obesity and the metabolic syndrome,studies of immunosuppression modulation and trials of specific immunosuppression regimens post-transplant are lacking in this patient population.Based on pre-transplant data,sustained weight loss through diet and exercise is the most effective therapy for NAFLD.Other agents occasionally utilized in NAFLD prior to transplantation include vitamin E and insulin-sensitizing agents.Studies of these therapies are lacking in the post-transplant population.A multimodality and multidisciplinary approach to treatment should be utilized in management of post-transplant NAFLD.

Myocardial infarction with non-obstructive coronary arteries: A comprehensive review and future research directions

Acute coronary syndromes constitute a variety of myocardial injury presentations that include a subset of patients presenting with myocardial infarction with non-obstructive coronary arteries(MINOCA).This acute coronary syndrome differs from type 1 myocardial infarction(MI)regarding patient characteristics,presentation,physiopathology,management,treatment,and prognosis.Two-thirds of MINOCA subjects present ST-segment elevation;MINOCA patients are younger,are more often female and tend to have fewer cardiovascular risk factors.Moreover,MINOCA is a working diagnosis,and defining the aetiologic mechanism is relevant because it affects patient care and prognosis.In the absence of relevant coronary artery disease,myocardial ischaemia might be triggered by an acute event in epicardial coronary arteries,coronary microcirculation,or both.Epicardial causes of MINOCA include coronary plaque disruption,coronary dissection,and coronary spasm.Microvascular MINOCA mechanisms involve microvascular coronary spasm,takotsubo syndrome(TTS),myocarditis,and coronary thromboembolism.Coronary angiography with non-significant coronary stenosis and left ventriculography are first-line tests in the differential study of MINOCA patients.The diagnostic arsenal includes invasive and non-invasive techniques.Medical history and echocardiography can help indicate vasospasm or thrombosis,if one finite coronary territory is affected,or specify TTS if apical ballooning is present.Intravascular ultrasound,optical coherence tomography,and provocative testing are encouraged.Cardiac magnetic resonance is a cornerstone in myocarditis diagnosis.MINOCA is not a benign diagnosis,and its polymorphic forms differ in prognosis.MINOCA care varies across centres,and future multi-centre clinical trials with standardized criteria may have a positive impact on defining optimal cardiovascular care for MINOCA patients.

Liver trauma: What current management?

Background: The liver is the most commonly damaged organ in abdominal trauma. The management of liver trauma has experienced many changes over the last two decades. Currently there is a trend toward a non-operative treatment warranted by the successful pediatric experience and better results recorded in many trauma centers worldwide. This study aimed to evaluate outcomes of operative and non-operative management of liver trauma in our institution over the last five years.Methods: The patients with a diagnosis of blunt or penetrating liver injuries, admitted and managed in our hospital from January 2012 to December 2016 were retrospectively studied. The patients were divided into 2 groups, operated and non-operated groups, according to the initial management considered appropriate at the time of patient admission. Clinical features and outcomes were analyzed.Results: The study involved 83 patients, with a mean age of 33 years and a marked male predominance(85.5%). The most common type of lesions was blunt trauma and the main cause was road traffic accidents. Sixty-eight liver injuries(81.9%) were of low severity(grades Ⅰ,Ⅱ,Ⅲ), while 15(18.1%) were of high severity(grade Ⅳ or greater). Fifty-six patients(67.5%) had multiple injuries. Surgical treatment was performed in 26(31.3%) patients. Non-operative management was undertaken in 57 cases(68.7%). The morbidity and mortality rates were clearly lower in non-operative patients compared to those in the operated group.Conclusions: Careful non-operative management is an adequate therapeutic strategy for the patients suffering from liver trauma with stable hemodynamics. Patients with complex hepatic trauma and especially those with other organ injuries continue to have significantly higher mortality.

Clinical guidelines of non-alcoholic fatty liver disease: A systematic review

AIM To perform a systematic review to grade guidelines and present recommendations for clinical management of non-alcoholic fatty liver disease(NAFLD).METHODS A database search was conducted on Pub Med for guidelines published before May 2016, supplemented by reviewing relevant websites. The Appraisal of Guidelines for Research and Evaluation(ARGEE) instrument Ⅱ was a tool designed to appraise the methodological rigor and transparency in which a clinical guideline is developed and it is used internationally. it was used to appraise the quality of guidelines in this study. The inclusion criteria include: clinical NAFLD guidelines for adults, published in English, and released by governmental agencies or key organizations.RESULTS Eleven guidelines were included in this study. Since 2007, guidelines have been released in Asia(3 in China, 1 in South Korea, and 1 in Japan), Europe(1 in italy),America(1 in United States and 1 in Chile) and three international agencies [European associations joint, Asia-Pacific Working Party and World Gastroenterology Organization(WGO)]. Using the ARGEE Ⅱ instrument, we found US 2012 and Europe 2016 had the highest scores, especially in the areas of rigor of development and applicability. Additionally, italy 2010 and Korea 2013 also presented comprehensive content, rigorous procedures and good applicability. And WGO 2014 offered various algorithms for clinical practice. Lastly, a practical algorithm for the clinical management was developed, based on the recommended guidelines.CONCLUSION This is the first systematic review of NAFLD guidelines. it may yield insights for physicians and policy-makers in the development and application of guidelines.

Management of proximal humerus fractures in adults

The majority of proximal humerus fractures are lowenergy osteoporotic injuries in the elderly and their incidence is increasing in the light of an ageing population. The diversity of fracture patterns encountered renders objective classification of prognostic value challenging. Non-operative management has been associated with good functional outcomes in stable, minimally displaced and certain types of displaced fractures.Absolute indications for surgery are infrequent and comprise compound, pathological, multi-fragmentary head-splitting fractures and fracture dislocations, as well as those associated with neurovascular injury. A constantly expanding range of reconstructive and replacement options however has been extending the indications for surgical management of complex proximal humerus fractures. As a result, management decisions are becoming increasingly complicated, in an attempt to provide the best possible treatment for each indi-vidual patient, that will successfully address their specific fracture configuration, comorbidities and functional expectations. Our aim was to review the management options available for the full range of proximal humerus fractures in adults, along with their specific advantages, disadvantages and outcomes.

Options for Healthcare Waste Management and Treatment in China

Healthcare waste management and treatment is one of the national priority tasks of China’s Tenth Five-Year Plan. Numerous installations disposing medical waste have already operated the project or under construction to the operation in 2006. This paper focuses on the assessment of existing and future options to handle medical waste (MW). Internationally available and so far in China applied technologies and management practice are analysed, including the problems how to segregate medical waste streams at the source and to reduce the ‘critical waste’ to mainly infectious and aesthetically sensible materials. Non-hazardous MW can be managed and treated in analogue to municipal solid waste (MSW). In most of the European countries decentralised hospital incinerators have been, because of high operation costs and pollution problems, widely banned and replaced by pre-treatment technologies at the source and centralised incineration plants for hazardous MW. Information for adapting and further developing MW management solutions and treatment technologies in China and applying the most appropriate MWM practice is provided.

Differential Game Based Link Resource Management for Next Generation Optical Network

In this paper, we investigate the link resource management problem for optical networks, to achieve the resource cost during the information transmission. We use the differential game to formulate the cost control problem for the link resource management, to minimize the resource allocation cost functions, which dynamic behaviours are described by differential equations. Each link controls its transmission bandwidth based on the Nash equilibriums of the differential game. The effectiveness of the proposed model is given through numerical simulations.

Acute pain management in symptomatic cholelithiasis

AIM To review the evidence for the use of different nonsteroidal anti-inflammatory drugs(NSAIDs) in the treatment of biliary colic.METHODS The strategies employed included an extensive literature review for articles and studies related to biliary colic from electronic databases including Pub Med,Science Direct,Wiley Inter Science,Medline and Cochrane from last 15 years.Keywords: "Biliary colic","management of biliary colic","non-steroidal anti-inflammatory drugs","cholelithiasis" and "biliary colic management".Six randomized control trials,1 non-randomized trial and 1 meta-analysis were included in this review.The outcomes of these studies and their significance have been reviewed in this paper.RESULTS Current evidence suggests there are no set protocols for biliary colic pain management.NSAIDs are potent in the management of biliary colic,not only in terms of symptom control but in disease progression as well.Apart from the studies on diclofenac and ketorolac,there are studies which have shown that intravenous tenoxicam and injectable flurbiprofen are equally effective in managing biliary colic.The efficacy of NSAIDs is superior in terms of lower number of doses and longer duration of action in comparison to other analgesic agents.CONCLUSION This literature review has found that NSAIDs are safe and effective for pain control in biliary colic,and reduce the likelihood of further complications.

基于Non-MPPT算法的区域光伏消纳控制策略

基于两级式光伏发电系统环境自适应算法以及光伏阵列分布式结构,提出一种适用于区域光伏消纳控制的Non-MPPT(maximum power point tracking)算法,力主解决光伏发电系统出力过剩问题。该算法基于光伏模块分布式前级优化器,实现不同环境下光伏模块分散控制,并通过光伏模块输出电压、电流随机变量,导出光伏电池环境修正参数,进而实时修正区域光伏模块最大功率电压,使其最大功率电压实时跟随外部环境变化,并结合电导增量法,实现不同环境下光伏阵列全局最大功率跟踪。而后,若区域性电网光伏发电系统出力过剩,则将区域光伏按其实际出力情况进行分区管理,以区域电网对其出力分配额度为控制目标,推导出光伏阵列对应输出电压,并将其引入至光伏发电系统前级Boost电路,通过修正Boost电路占空比,使光伏发电系统输出功率快速跟随主网需求指令,解决了区域内光伏过剩出力的消纳问题。最后,通过Matlab/Simulink仿真软件搭建两级式三相光伏并网系统,验证该算法在电力系统应用中的有效性。

Decentralized Control for Residential Energy Management of a Smart Users' Microgrid with Renewable Energy Exchange

This paper presents a decentralized control strategy for the scheduling of electrical energy activities of a microgrid composed of smart homes connected to a distributor and exchanging renewable energy produced by individually owned distributed energy resources. The scheduling problem is stated and solved with the aim of reducing the overall energy supply from the grid, by allowing users to exchange the surplus renewable energy and by optimally planning users' controllable loads. We assume that each smart home can both buy/sell energy from/to the grid taking into account time-varying non-linear pricing signals. Simultaneously, smart homes cooperate and may buy/sell locally harvested renewable energy from/to other smart homes. The resulting optimization problem is formulated as a non-convex non-linear programming problem with a coupling of decision variables in the constraints. The proposed solution is based on a novel heuristic iterative decentralized scheme algorithm that suitably extends the Alternating Direction Method of Multipliers to a non-convex and decentralized setting. We discuss the conditions that guarantee the convergence of the presented algorithm. Finally, the application of the proposed technique to a case study under several scenarios shows its effectiveness.