Began from early 1992, Chongqing Power Supply Bureau had spent 3 and half years to build up a power load management system consisting of I master station, 6 relay stations, 1280 terminals and the distributed monitorin...Began from early 1992, Chongqing Power Supply Bureau had spent 3 and half years to build up a power load management system consisting of I master station, 6 relay stations, 1280 terminals and the distributed monitoring device. This system distributes in the hilly and mountainous areas where geographically complicated and the load widely scatters, it can supervise about 72% load and curtail more than 15% load展开更多
The majority of the population in developing countries have limited access to clean energy. <span>To increase access to clean energy, the governments and other stakeholders have been working hard to create enabl...The majority of the population in developing countries have limited access to clean energy. <span>To increase access to clean energy, the governments and other stakeholders have been working hard to create enabling environments for their adoption and utilization. For the household cooking sector, technological innovations such as improved biomass fuels, improved biomass cookstove, solar cooking, biogas and recently bottled gas service have been or are being deployed to scale up clean cooking. </span><span "=""><span>Nevertheless, a good number of the </span><span>innovations intended for upscaling clean cooking in developing countries</span><span> have failed to meet the desired goals due to limited support from the national governments or the international community. Pay-Go is among the recent innovations in the East African region intended for promoting the use of bottled </span><span>gas (liquefied petroleum gas-LPG). This study evaluates the practicality of</span> <span>Pay-Go innovation on bottled gas, popularly known as Pay-as-you-Cook.</span><span> Specifically, the article examines the evolution of Pay-as-you-Cook, its execu</span><span>tion, usefulness and challenges;and its implications on household energy</span><span> sector development. The study was conducted in Kinondoni Municipality, Dar es Salaam, Tanzania between 2018 and 2020. The study used both qualitative </span><span>and quantitative approaches. Purposive and non-random sampling tech</span><span>niques were used in selecting respondents. Purposive sampling was used to identify key informants while snowball sampling was used to find house</span><span>hold respondents. Information was gathered from KopaGas (Pay-as-you-Cook</span><span> innovator) headquarter-Kinondoni Morocco;and from Pay-as-you-Cook clients in Kinondoni Moscow, Mkwajuni and Hananasif. Methods of data collection involved semi-structured interviews and observation. Instruments of data collection included interview guides and observation checklists. Data </span><span>analysis was accomplished with Nvivo 12. Findings show that Pay-as-you-Cook</span><span> innovation was intended for promoting bottled gas adoption mainly to low-income households. The innovation was discovered to be convenient to many low-</span></span><span "=""> </span><span>income households as it enabled them to use bottled gas for cooking without necessarily climbing the economic ladder. Yet, the innovation presents several challenges which are doubtful to its practicality.</span>展开更多
Test of English for International Communication(TOEIC),as a system for English assessment,was developed by Educa⁃tional Testing Service(ETS)and it is used by government institutions and multinational enterprises to as...Test of English for International Communication(TOEIC),as a system for English assessment,was developed by Educa⁃tional Testing Service(ETS)and it is used by government institutions and multinational enterprises to assess the daily English com⁃munication ability of the people who are not native English speakers.The scores of the TOEIC test are divided into four levels,with level A B C D in descending order.This thesis fully analyzes TOEIC from the perspectives of validity,reliability and practicality so as to draw a conclusion that TOEIC is reasonably valid,reliable and practical in real application and TOEIC as an effective way to enhance whether their employees command the basic ability in commercial communication.展开更多
Human rights are not only pivotal in depicting the relationship between individuals and communities but also a focal point of political philosophical concerns oriented towards reality. The inseparability of human righ...Human rights are not only pivotal in depicting the relationship between individuals and communities but also a focal point of political philosophical concerns oriented towards reality. The inseparability of human rights from individual self-identity reveals a contradiction between practicality and historicity in understanding individuals, as highlighted in the debate between liberalism and communitarianism. In order to reconcile this contradiction, Habermas,drawing from German classical philosophy, examines practicality and historicity separately: while Fichte intertwines objectivity in self-identity, revealing the practicality of individuals but neglecting their real elements, Hegel interprets self-identity under the concept of unity,examining individuals from a historical dimension but letting rational rules dominate reality. Ultimately, Habermas reconstructs the process of modern individual self-identity from the theory of communicative action by critiquing the shackles of subjective philosophy. He not only reconciles the divergence between practicality and historicity in self-identity, but also elucidates the intersubjective core inherent in human rights.展开更多
Modern rice production faces the dual challenges of increasing grain yields while reducing inputs of chemical fertilizer.However,the disequilibrium between the nitrogen(N)supplement from the soil and the demand for N ...Modern rice production faces the dual challenges of increasing grain yields while reducing inputs of chemical fertilizer.However,the disequilibrium between the nitrogen(N)supplement from the soil and the demand for N of plants is a serious obstacle to achieving these goals.Plant-based diagnosis can help farmers make better choices regarding the timing and amount of topdressing N fertilizer.Our objective was to evaluate a non-destructive assessment of rice N demands based on the relative SPAD value(RSPAD)due to leaf positional differences.In this study,two field experiments were conducted,including a field experiment of different N rates(Exp.I)and an experiment to evaluate the new strategy of nitrogen-split application based on RSPAD(Exp.II).The results showed that higher N inputs significantly increased grain yield in modern high yielding super rice,but at the expense of lower nitrogen use efficiency(NUE).The N nutrition index(NNI)can adequately differentiate situations of excessive,optimal,and insufficient N nutrition in rice,and the optimal N rate for modern high yielding rice is higher than conventional cultivars.The RSPAD is calculated as the SPAD value of the top fully expanded leaf vs.the value of the third leaf,which takes into account the non-uniform N distribution within a canopy.The RSPAD can be used as an indicator for higher yield and NUE,and guide better management of N fertilizer application.Furthermore,we developed a new strategy of nitrogen-split application based on RSPAD,in which the N rate was reduced by 18.7%,yield was increased by 1.7%,and the agronomic N use efficiency was increased by 27.8%,when compared with standard farmers'practices.This strategy of N fertilization shows great potential for ensuring high yielding and improving NUE at lower N inputs.展开更多
Direct regeneration method has been widely concerned by researchers in the field of battery recycling because of its advantages of in situ regeneration,short process and less pollutant emission.In this review,we first...Direct regeneration method has been widely concerned by researchers in the field of battery recycling because of its advantages of in situ regeneration,short process and less pollutant emission.In this review,we firstly analyze the primary causes for the failure of three representative battery cathodes(lithium iron phosphate,layered lithium transition metal oxide and lithium cobalt oxide),targeting at illustrating their underlying regeneration mecha-nism and applicability.Efficient stripping of material from the collector to obtain pure cathode material has become a first challenge in recycling,for which we report several pretreatment methods currently available for subsequent regeneration processes.We review and discuss emphatically the research progress of five direct regeneration methods,including solid-state sintering,hydrothermal,eutectic molten salt,electrochemical and chemical lithiation methods.Finally,the application of direct regeneration technology in production practice is introduced,the problems exposed at the early stage of the industrialization of direct regeneration technol-ogy are revealed,and the prospect of future large-scale commercial production is proposed.It is hoped that this review will give readers a comprehensive and basic understanding of direct regeneration methods for used lithium-ion batteries and promote the industrial application of direct regeneration technology.展开更多
Objective:To determine the global level of knowledge,attitudes,and practices towards dengue fever among the general population.Methods:To complete this systematic review and meta-analysis,a thorough search for pertine...Objective:To determine the global level of knowledge,attitudes,and practices towards dengue fever among the general population.Methods:To complete this systematic review and meta-analysis,a thorough search for pertinent English-language literature was undertaken during the study's extension until October 2023.The search used Google Scholar,Scopus,PubMed/MEDLINE,Science Direct,Web of Science,EMBASE,Springer,and ProQuest.A quality assessment checklist developed using a modified Newcastle-Ottawa Scale for the cross-sectional study was used to evaluate the risk of bias in the included papers.Inverse variance and Cochran Q statistics were employed in the STATA software version 14 to assess study heterogeneity.When there was heterogeneity,the Dersimonian and Liard random-effects models were used.Results:59 Studies totaling 87353 participants were included in this meta-analysis.These investigations included 86278 participants in 55 studies on knowledge,20196 in 33 studies on attitudes,and 74881 in 29 studies on practices.The pooled estimates for sufficient knowledge,positive attitudes,and dengue fever preventive behaviors among the general population were determined as 40.1%(95%CI 33.8%-46.5%),46.8%(95%CI 35.8%-58.9%),and 38.3%(95%CI 28.4%-48.2%),respectively.Europe exhibits the highest knowledge level at 63.5%,and Africa shows the lowest at 20.3%.Positive attitudes are most prevalent in the Eastern Mediterranean(54.1%)and Southeast Asia(53.6%),contrasting sharply with the Americas,where attitudes are notably lower at 9.05%.Regarding preventive behaviors,the Americas demonstrate a prevalence of 12.1%,Southeast Asia at 28.1%,Western Pacific at 49.6%,Eastern Mediterranean at 44.8%,and Africa at 47.4%.Conclusions:Regional disparities about the knowledge,attitude and preventive bahaviors are evident with Europe exhibiting the highest knowledge level while Africa has the lowest.These findings emphasize the importance of targeted public health interventions tailored to regional contexts,highlighting the need for region-specific strategies to enhance dengue-related knowledge and encourage positive attitudes and preventive behaviors.展开更多
Objective:To assess pregnant women's knowledge,attitude,and practice regarding nutrition and medication usage,analyse the prescribing pattern,and categorize them based on the Food and Drug Administration(FDA)guide...Objective:To assess pregnant women's knowledge,attitude,and practice regarding nutrition and medication usage,analyse the prescribing pattern,and categorize them based on the Food and Drug Administration(FDA)guidelines.Methods:A cross-sectional study was conducted with 264 pregnant women in the obstetrics and gynaecology department of a tertiary care hospital from October 2022 to August 2023.A knowledge,attitude,and practice(KAP)questionnaire was prepared in English language by the researchers and validated by an expert panel consisting of 12 members.The validated questionnaire was then translated into regional languages,Kannada and Malayalam.The reliability of the questionnaire was assessed with test-retest method with a representative sample population of 30 subjects(10 subjects for each language).The subjects'knowledge,attitude,and practice were evaluated using the validated KAP questionnaire.The safety of the medication was assessed using the FDA drug safety classification for pregnancy.Results:The mean scores for nutritional and medication usage knowledge,attitude,and practice were 4.14±1.15,4.50±1.09,and 3.00±1.47,respectively.Among 30 prescribed medications,3 belong to category A(no risk in human studies),8 belong to category B(no risk in animal studies),18 belong to category C(risk cannot be ruled out)and 1 drug is not classified.A significant association was observed between medication knowledge and practice(r=0.159,P=0.010).Conclusions:Most of the study population knows the need to maintain good dietary and medication practices during pregnancy.Counselling pregnant women regarding diet and medication usage is crucial in maternal care.展开更多
Polymer solid-state lithium batteries(SSLB)are regarded as a promising energy storage technology to meet growing demand due to their high energy density and safety.Ion conductivity,interface stability and battery asse...Polymer solid-state lithium batteries(SSLB)are regarded as a promising energy storage technology to meet growing demand due to their high energy density and safety.Ion conductivity,interface stability and battery assembly process are still the main challenges to hurdle the commercialization of SSLB.As the main component of SSLB,poly(1,3-dioxolane)(PDOL)-based solid polymer electrolytes polymerized in-situ are becoming a promising candidate solid elec-trolyte,for their high ion conductivity at room temperature,good battery elec-trochemical performances,and simple assembly process.This review analyzes opportunities and challenges of PDOL electrolytes toward practical application for polymer SSLB.The focuses include exploring the polymerization mechanism of DOL,the performance of PDOL composite electrolytes,and the application of PDOL.Furthermore,we provide a perspective on future research directions that need to be emphasized for commercialization of PDOL-based electrolytes in SSLB.The exploration of these schemes facilitates a comprehensive and profound understanding of PDOL-based polymer electrolyte and provides new research ideas to boost them toward practical application in solid-state batteries.展开更多
Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM a...Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM and WM has a long history in China,and has made important achievements in the process of clinical diagnosis and treatment.However,the methodological defects in currently published clinical practice guidelines(CPGs)limit its development.The organic integration of TCM and WM is a deeper integration of TCM and WM.To realize the progression of"integration"to"organic integration",a targeted and standardized guideline development methodology is needed.Therefore,the purpose of this study is to establish a standardized development procedure for clinical practice guidelines for the organic integration of TCM and WM to promote the systematic integration of TCM and WM research results into clinical practice guidelines in order to achieve optimal results as the whole is greater than the sum of the parts.展开更多
Objective:To assess the factors associated with knowledge,attitude and behavior of contraception use among urban slum population in Chennai.Methods:A cross-sectional study was conducted in the urban slum of Anakaputhu...Objective:To assess the factors associated with knowledge,attitude and behavior of contraception use among urban slum population in Chennai.Methods:A cross-sectional study was conducted in the urban slum of Anakaputhur,Chennai.Married couples between ages of 19-49 years and living in slum areas were taken up for the study by simple random sampling.Pregnant women,postnatal and postmenopausal women were excluded from the study.Data collection was done using a pretested structured questionnaire focusing on details regarding contraception knowledge,attitude,and practices.Data analysis was done using IBM SPSS version 22.Analytical test like Chi square and odds ratio(OR)were used to identify association between knowledge,attitude,and behavior of contraception with the associated variables and enter method of logistic regression analysis was done.Results:Out of the 360 respondents,228 were females,with a mean age of(34±5)years.Approximately 43%demonstrated adequate knowledge of contraception use,and 91%were aware of at least one contraceptive method.Notably,72%exhibited a positive attitude towards contraceptive use.Nevertheless,43%(155 individuals)did not utilize any contraceptive method.Among contraceptive users,intrauterine devices were the most commonly adopted,followed by barrier methods and female sterilization.There was significant association between knowledge of contraception and education(aOR 7.29,95%CI 2.93-18.10,P<0.05),age(aOR 2.04,95%CI 1.19-3.50,P<0.05)and socioeconomic class(aOR 3.66,95%CI 1.71-7.85,P<0.05;aOR 3.97,95%CI 2.12-7.49,P<0.05).Regarding attitude towards contraception use,education(aOR 8.54,95%CI 2.35-31.03,P<0.05),sex(aOR 0.15,95%CI 0.06-0.37,P<0.05),age(aOR 0.53,95%CI 0.28-0.99,P<0.05),socio-economic class(aOR 4.42,95%CI 1.97-9.92,P<0.05;aOR 9.83,95%CI 3.63-26.58,P<0.05)and number of children(aOR 10.04,95%CI 4.26-23.66,P<0.05)were the variables that had a significant association.Conclusions:These findings underscore the imperative for enhanced dissemination of health education pertaining to contraception use within the slum population.The health sectors of the area and other stakeholders need to make sure to extend penetration of family planning related services to the urban slum population.展开更多
Objective:To elucidate the relationship among knowledge,attitudes,and practices regarding Covid-19 and their relationship with booster vaccination status among women with infertility.Methods:This questionnaire-based c...Objective:To elucidate the relationship among knowledge,attitudes,and practices regarding Covid-19 and their relationship with booster vaccination status among women with infertility.Methods:This questionnaire-based cross-sectional study was performed online and offline among women with infertility who visited an infertility clinic in Jakarta,Indonesia.We assessed the patient’s knowledge,attitudes,and practices regarding Covid-19 and their relationship with booster vaccination status and sociodemographic profile.Results:A total of 178 subjects participated in this study,and most participants(92.6%)had received booster Covid-19 vaccines.From the questionnaire,74.2%had good knowledge,and 99.4%had good attitudes regarding Covid-19;however,only 57.9%of patients had good practices.A weak positive correlation existed between knowledge and attitudes(r=0.11,P=0.13)and a moderate negative correlation between attitudes and practices(r=-0.44,P=0.56).Participants’knowledge about vaccines and infertility was correlated with booster vaccination status(P=0.04).Academic background(P=0.01)and attitudes(P=0.01)were also correlated with booster vaccination status.The significant determinants of hesitance of receiving Covid-19 booster vaccines were high school education or below(OR=0.08,95%CI 0.02-0.36)and poor practices(OR=0.21,95%CI 0.05-0.95).Conclusions:The majority of the participants had received the Covid-19 booster vaccine and had good knowledge and attitudes but poor practices regarding Covid-19.Most participants had poor knowledge about the relationship between infertility and the Covid-19 vaccine.The general population should be more informed and reminded about practices to prevent Covid-19 and the relationship between vaccination and fertility to increase the number of people who receive Covid-19 booster vaccines.展开更多
The footprints of water and nitrogen(WF and NF)provide a comprehensive overview of the type and quantity of water consumption and reactive nitrogen(Nr)loss in crop production.In this study,a field experiment over two ...The footprints of water and nitrogen(WF and NF)provide a comprehensive overview of the type and quantity of water consumption and reactive nitrogen(Nr)loss in crop production.In this study,a field experiment over two years(2019 and 2020)compared three integrated agronomic practice management(IAPM)systems:An improved management system(T2),a high-yield production system(T3),and an integrated soil-crop management system(ISCM)using a local smallholder farmer’s practice system(T1)as control,to investigate the responses of WF,Nr losses,water use efficiency(WUE),and nitrogen use efficiency(NUE)to IAPM.The results showed that IAPM optimized water distribution and promoted water use by summer maize.The evapotranspiration over the whole maize growth period of IAPM increased,but yield increased more,leading to a significant increase in WUE.The WUE of the T2,T3,and ISCM treatments was significantly greater than in the T1 treatment,in 2019 and 2020respectively,by 19.8-21.5,31.8-40.6,and 34.4-44.6%.The lowest WF was found in the ISCM treatment,which was 31.0%lower than that of the T1 treatment.In addition,the ISCM treatment optimized soil total nitrogen(TN)distribution and significantly increased TN in the cultivated layer.Excessive nitrogen fertilizer was applied in treatment T3,producing the highest maize yield,and resulting in the highest Nr losses.In contrast,the ISCM treatment used a reduced nitrogen fertilizer rate,sacrificing grain yield partly,which reduced Nr losses and eventually led to a significant increase in nitrogen use efficiency and nitrogen recovery.The Nr level in the ISCM treatment was34.8%lower than in the T1 treatment while NUE was significantly higher than in the T1 treatment by 56.8-63.1%in2019 and 2020,respectively.Considering yield,WUE,NUE,WF,and NF together,ISCM should be used as a more sustainable and clean system for sustainable production of summer maize.展开更多
Integrative cultivation practices(ICPs)are essential for enhancing cereal yield and resource use efficiency.However,the effects of ICP on the rhizosphere environment and roots of paddy rice are still poorly understood...Integrative cultivation practices(ICPs)are essential for enhancing cereal yield and resource use efficiency.However,the effects of ICP on the rhizosphere environment and roots of paddy rice are still poorly understood.In this study,four rice varieties were produced in the field.Each variety was treated with six different cultivation techniques,including zero nitrogen application(0 N),local farmers’practice(LFP),nitrogen reduction(NR),and three progressive ICP techniques comprised of enhanced fertilizer N practice and increased plant density(ICP1),a treatment similar to ICP1 but with alternate wetting and moderate drying instead of continuous flooding(ICP2),and the same practices as ICP2 with the application of organic fertilizer(ICP3).The ICPs had greater grain production and nitrogen use efficiency than the other three methods.Root length,dry weight,root diameter,activity of root oxidation,root bleeding rate,zeatin and zeatin riboside compositions,and total organic acids in root exudates were elevated with the introduction of the successive cultivation practices.ICPs enhanced nitrate nitrogen,the activities of urease and invertase,and the diversity of microbes(bacteria)in rhizosphere and non-rhizosphere soil,while reducing the ammonium nitrogen content.The nutrient contents(ammonium nitrogen,total nitrogen,total potassium,total phosphorus,nitrate,and available phosphorus)and urease activity in rhizosphere soil were reduced in all treatments in comparison with the non-rhizosphere soil,but the invertase activity and bacterial diversity were greater.The main root morphology and physiology,and the ammonium nitrogen contents in rhizosphere soil at the primary stages were closely correlated with grain yield and internal nitrogen use efficiency.These findings suggest that the coordinated enhancement of the root system and the environment of the rhizosphere under integrative cultivation approaches may lead to higher rice production.展开更多
AIM:To describe the practice patterns of intravitreal injections(IVIs)among ophthalmologists in China.METHODS:This was a cross-sectional online survey.Ophthalmologists who had performed accumulated more than 100 injec...AIM:To describe the practice patterns of intravitreal injections(IVIs)among ophthalmologists in China.METHODS:This was a cross-sectional online survey.Ophthalmologists who had performed accumulated more than 100 injections were contacted by the Brightness Center,a hospital-based national network,to complete an anonymous,24-question,internet-based survey.They were surveyed on practices in injection techniques,pre-,and post-injections procedures.RESULTS:A total of 333 ophthalmologists from 28 provinces/municipalities/autonomous regions responded to the survey(50.68%response rate).The 91.29%of the respondents evaluated systemic risk factors by medical history,electrocardiogram(ECG)and blood test.All the respondents used pre-injection prophylactic antibiotics.Most checked intraocular pressure(IOP,99.1%)and blood pressure(96.1%)before injections.A majority of the respondents performed injections in the operating room(98.8%),wore masks(99.7%),gloves(99.4%)and sterile surgical clothing(96.1%),performed topical anesthetics(97.9%),and applied povidone-iodine(95.8%)pre-injection.The 61.26%of the respondents dilated pupil.About half of the respondents(51.05%)performed bilateral injections in the same setting.Superior temporal quadrant(40.54%)was the most frequent site of injection.Around three quarters used 30-gauge needles.Most respondents(97.9%)measured the site of injection from limbus.More than half(53.45%)performed conjunctiva displacement prior to injection.The 32.43%of the respondents checked IOP post-injection and 87.99%physicians checked hand motion(HM)or counting fingers(CF)after injection,while 36.94%observed optic nerve perfusion.All participants used topical antibiotics post-injections.Most physicians(91.89%)reviewed patients on the following day.CONCLUSION:This study provides a description of the real-world practice patterns in IVIs in China and offers critical information regarding education and training of ophthalmologists and amendment of local society guidelines.展开更多
The Sun et al's training program for clinical research nurses(CRNs)in the World Journal of Clinical Cases is a comprehensive and scientific approach.It includes structured frameworks for CRN training,aiming to imp...The Sun et al's training program for clinical research nurses(CRNs)in the World Journal of Clinical Cases is a comprehensive and scientific approach.It includes structured frameworks for CRN training,aiming to improve CRN competency.This program emphasizes practical abilities,updates training content,and improves evaluation methods.The cultivation of CRN talents focuses on enhancing the training system,establishing a multifaceted evaluation framework,and continuously refining the training programs.Regular feedback and evalua-tion are essential to improve CRNs'competency in practical settings.展开更多
Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)globally.However,the level of scientific evidence supporting ESMO...Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)globally.However,the level of scientific evidence supporting ESMO CPG recommendations has not been systematically investigated.This study assessed ESMO CPG levels of evidence(LOE)and grades of recommendations(GOR),as well as their trends over time across various cancer settings.Methods:We manually extracted every recommendation with the Infectious Diseases Society of America(IDSA)classification from each CPG.We examined the distribution of LOE and GOR in all available ESMO CPG guidelines across different topics and cancer types.Results:Among the 1,823 recommendations in the current CPG,30%were classified as LOEⅠ,and 43%were classified as GOR A.Overall,there was a slight decrease in LOEⅠ(−2%)and an increase in the proportion of GOR A(+1%)in the current CPG compared to previous versions.The proportion of GOR A recommendations based on higher levels of evidence such as randomized trials(LOEⅠ–Ⅱ)shows a decrease(71%vs.63%,p=0.009)while recommendations based on lower levels of evidence(LOEⅢ–Ⅴ)show an increase(29%vs.37%,p=0.01)between previous and current version.In the current versions,the highest proportion of LOEⅠ(42%)was found in recommendations related to pharmacotherapy,while the highest proportion of GOR A recommendations was found in the areas of pathology(50%)and diagnostic(50%)recommendations.Significant variability in LOEⅠand GOR A recommendations and their changes over time was observed across different cancer types.Conclusion:One-third of the current ESMO CPG recommendations are supported by the highest level of evidence.More well-designed randomized clinical trials are needed to increase the proportion of LOEⅠand GOR A recommendations,ultimately leading to improved outcomes for cancer patients.展开更多
BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we...BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we took the evidence-based practice of perioperative airway management in elderly fracture patients as an example and adopted a descriptive phenomenological approach to understand the influencing factors of its sustainability to provide a reference basis for promoting the continuity of evidence-based practice in the clinic.AIM To explore factors influencing the persistence of evidence-based practice in perioperative airway management in elderly patients with fractures.METHODS This study was qualitative research.Nine nurses who implemented evidencebased practice in the orthopedic ward of a tertiary comprehensive hospital in Shanghai from September 2023 to October 2023 were selected using purposive sampling as research subjects.Semi-structured interviews were conducted with them,and the data were analyzed using the Colaizzi phenomenological analysis method based on the three dimensions and ten factors of the NHS sustainability model.RESULTS Three main themes and ten subthemes were identified:Process aspects(benefits to patients,benefits to nurses,lack of follow-up,complex processes);staff aspects(insufficient human resources,inadequate training and education,lack of leadership support);and organizational environment aspects(inadequate infrastructure,poor patient compliance,poor doctor cooperation).CONCLUSION Human resources,training and education,leadership support,infrastructure,and patient-physician collaboration are important factors influencing the sustainability of evidence-based practice for perioperative airway management in older patients with fractures.展开更多
BACKGROUND The emergency department(ED)plays a critical role in establishing artificial airways and implementing mechanical ventilation.Managing airbags in the ED presents a prime opportunity to mitigate the risk of v...BACKGROUND The emergency department(ED)plays a critical role in establishing artificial airways and implementing mechanical ventilation.Managing airbags in the ED presents a prime opportunity to mitigate the risk of ventilator-associated pneumonia.Nonetheless,existing research has largely overlooked the understanding,beliefs,and practical dimensions of airway airbag management among ED nurses,with a predominant focus on intensive care unit nurses.AIM To investigate the current status of ED nurses'knowledge,beliefs,and practical behaviors in airway airbag management and their influencing factors.METHODS A survey was conducted from July 10th to August 10th,2023,using convenience sampling on 520 ED nurses from 15 tertiary hospitals and 5 sary hospitals in Shanghai.Pathway analysis was utilized to analyze the influencing factors.RESULTS The scores for ED nurses'airway airbag management knowledge were 60.26±23.00,belief was 88.65±13.36,and behavior was 75.10±19.84.The main influencing factors of airbag management knowledge included participation in specialized nurse or mechanical ventilation training,department,and work experience in the department.Influencing factors of airbag management belief comprised knowledge,department,and participation in specialized nurse or mechanical ventilation training.Primary influencing factors of airbag management behavior included knowledge,belief,department,participation in specialized nurse or mechanical ventilation training,and professional title.The belief in airbag management among ED nurses acted as a partial mediator between knowledge and behavior,with a total effect value of 0.513,and an indirect effect of 0.085,constituting 16.6%of the total effect.CONCLUSION ED nurses exhibit a positive attitude toward airbag management with relatively standardized practices,yet there remains room for improvement in their knowledge levels.Nursing managers should implement interventions tailored to the characteristics of ED nurses'airbag management knowledge,beliefs,and practices to enhance their airbag management proficiency.展开更多
文摘Began from early 1992, Chongqing Power Supply Bureau had spent 3 and half years to build up a power load management system consisting of I master station, 6 relay stations, 1280 terminals and the distributed monitoring device. This system distributes in the hilly and mountainous areas where geographically complicated and the load widely scatters, it can supervise about 72% load and curtail more than 15% load
文摘The majority of the population in developing countries have limited access to clean energy. <span>To increase access to clean energy, the governments and other stakeholders have been working hard to create enabling environments for their adoption and utilization. For the household cooking sector, technological innovations such as improved biomass fuels, improved biomass cookstove, solar cooking, biogas and recently bottled gas service have been or are being deployed to scale up clean cooking. </span><span "=""><span>Nevertheless, a good number of the </span><span>innovations intended for upscaling clean cooking in developing countries</span><span> have failed to meet the desired goals due to limited support from the national governments or the international community. Pay-Go is among the recent innovations in the East African region intended for promoting the use of bottled </span><span>gas (liquefied petroleum gas-LPG). This study evaluates the practicality of</span> <span>Pay-Go innovation on bottled gas, popularly known as Pay-as-you-Cook.</span><span> Specifically, the article examines the evolution of Pay-as-you-Cook, its execu</span><span>tion, usefulness and challenges;and its implications on household energy</span><span> sector development. The study was conducted in Kinondoni Municipality, Dar es Salaam, Tanzania between 2018 and 2020. The study used both qualitative </span><span>and quantitative approaches. Purposive and non-random sampling tech</span><span>niques were used in selecting respondents. Purposive sampling was used to identify key informants while snowball sampling was used to find house</span><span>hold respondents. Information was gathered from KopaGas (Pay-as-you-Cook</span><span> innovator) headquarter-Kinondoni Morocco;and from Pay-as-you-Cook clients in Kinondoni Moscow, Mkwajuni and Hananasif. Methods of data collection involved semi-structured interviews and observation. Instruments of data collection included interview guides and observation checklists. Data </span><span>analysis was accomplished with Nvivo 12. Findings show that Pay-as-you-Cook</span><span> innovation was intended for promoting bottled gas adoption mainly to low-income households. The innovation was discovered to be convenient to many low-</span></span><span "=""> </span><span>income households as it enabled them to use bottled gas for cooking without necessarily climbing the economic ladder. Yet, the innovation presents several challenges which are doubtful to its practicality.</span>
文摘Test of English for International Communication(TOEIC),as a system for English assessment,was developed by Educa⁃tional Testing Service(ETS)and it is used by government institutions and multinational enterprises to assess the daily English com⁃munication ability of the people who are not native English speakers.The scores of the TOEIC test are divided into four levels,with level A B C D in descending order.This thesis fully analyzes TOEIC from the perspectives of validity,reliability and practicality so as to draw a conclusion that TOEIC is reasonably valid,reliable and practical in real application and TOEIC as an effective way to enhance whether their employees command the basic ability in commercial communication.
基金This article is a phased outcome of the research project“Research on Contemporary Chinese Human Rights Theory and Discourse”funded by the Scientific Research Fund of Renmin University of China (Special Funds for Basic Scientific Research of Central Universities)(Project Approval Number 22XNA006)。
文摘Human rights are not only pivotal in depicting the relationship between individuals and communities but also a focal point of political philosophical concerns oriented towards reality. The inseparability of human rights from individual self-identity reveals a contradiction between practicality and historicity in understanding individuals, as highlighted in the debate between liberalism and communitarianism. In order to reconcile this contradiction, Habermas,drawing from German classical philosophy, examines practicality and historicity separately: while Fichte intertwines objectivity in self-identity, revealing the practicality of individuals but neglecting their real elements, Hegel interprets self-identity under the concept of unity,examining individuals from a historical dimension but letting rational rules dominate reality. Ultimately, Habermas reconstructs the process of modern individual self-identity from the theory of communicative action by critiquing the shackles of subjective philosophy. He not only reconciles the divergence between practicality and historicity in self-identity, but also elucidates the intersubjective core inherent in human rights.
基金finically supported by the National Key Research and Development Program of China(2022YFD2300304)the R&D Foundation of Jiangsu Province,China(BE2022425)the Priority Academic Program Development of Jiangsu Higher-Education Institutions,China(PAPD)。
文摘Modern rice production faces the dual challenges of increasing grain yields while reducing inputs of chemical fertilizer.However,the disequilibrium between the nitrogen(N)supplement from the soil and the demand for N of plants is a serious obstacle to achieving these goals.Plant-based diagnosis can help farmers make better choices regarding the timing and amount of topdressing N fertilizer.Our objective was to evaluate a non-destructive assessment of rice N demands based on the relative SPAD value(RSPAD)due to leaf positional differences.In this study,two field experiments were conducted,including a field experiment of different N rates(Exp.I)and an experiment to evaluate the new strategy of nitrogen-split application based on RSPAD(Exp.II).The results showed that higher N inputs significantly increased grain yield in modern high yielding super rice,but at the expense of lower nitrogen use efficiency(NUE).The N nutrition index(NNI)can adequately differentiate situations of excessive,optimal,and insufficient N nutrition in rice,and the optimal N rate for modern high yielding rice is higher than conventional cultivars.The RSPAD is calculated as the SPAD value of the top fully expanded leaf vs.the value of the third leaf,which takes into account the non-uniform N distribution within a canopy.The RSPAD can be used as an indicator for higher yield and NUE,and guide better management of N fertilizer application.Furthermore,we developed a new strategy of nitrogen-split application based on RSPAD,in which the N rate was reduced by 18.7%,yield was increased by 1.7%,and the agronomic N use efficiency was increased by 27.8%,when compared with standard farmers'practices.This strategy of N fertilization shows great potential for ensuring high yielding and improving NUE at lower N inputs.
基金supported by the National Key Research and Development Program of China(No.2023YFC3904800)the Key Project of Jiangxi Provincial Research and Development Program(No.20223BBG74006)+5 种基金the Key Project of Ganzhou City Research and Development Program(No.2023PGX17350)“Thousand Talents Program”of Jiangxi Province(No.001043232090)Science&Technology Talents Lifting Project of Hunan Province(No.2022TJ-N16)Natural Science Foundation of Hunan Province(Nos.2024JJ4022 and 2023JJ30277)China Postdoctoral Fellowship Program(No.GZC20233205)the Open-End Fund for National-Local Joint Engineering Research Center of Heavy Metals Pollutants Control and Resource Utilization(ES202480184).
文摘Direct regeneration method has been widely concerned by researchers in the field of battery recycling because of its advantages of in situ regeneration,short process and less pollutant emission.In this review,we firstly analyze the primary causes for the failure of three representative battery cathodes(lithium iron phosphate,layered lithium transition metal oxide and lithium cobalt oxide),targeting at illustrating their underlying regeneration mecha-nism and applicability.Efficient stripping of material from the collector to obtain pure cathode material has become a first challenge in recycling,for which we report several pretreatment methods currently available for subsequent regeneration processes.We review and discuss emphatically the research progress of five direct regeneration methods,including solid-state sintering,hydrothermal,eutectic molten salt,electrochemical and chemical lithiation methods.Finally,the application of direct regeneration technology in production practice is introduced,the problems exposed at the early stage of the industrialization of direct regeneration technol-ogy are revealed,and the prospect of future large-scale commercial production is proposed.It is hoped that this review will give readers a comprehensive and basic understanding of direct regeneration methods for used lithium-ion batteries and promote the industrial application of direct regeneration technology.
文摘Objective:To determine the global level of knowledge,attitudes,and practices towards dengue fever among the general population.Methods:To complete this systematic review and meta-analysis,a thorough search for pertinent English-language literature was undertaken during the study's extension until October 2023.The search used Google Scholar,Scopus,PubMed/MEDLINE,Science Direct,Web of Science,EMBASE,Springer,and ProQuest.A quality assessment checklist developed using a modified Newcastle-Ottawa Scale for the cross-sectional study was used to evaluate the risk of bias in the included papers.Inverse variance and Cochran Q statistics were employed in the STATA software version 14 to assess study heterogeneity.When there was heterogeneity,the Dersimonian and Liard random-effects models were used.Results:59 Studies totaling 87353 participants were included in this meta-analysis.These investigations included 86278 participants in 55 studies on knowledge,20196 in 33 studies on attitudes,and 74881 in 29 studies on practices.The pooled estimates for sufficient knowledge,positive attitudes,and dengue fever preventive behaviors among the general population were determined as 40.1%(95%CI 33.8%-46.5%),46.8%(95%CI 35.8%-58.9%),and 38.3%(95%CI 28.4%-48.2%),respectively.Europe exhibits the highest knowledge level at 63.5%,and Africa shows the lowest at 20.3%.Positive attitudes are most prevalent in the Eastern Mediterranean(54.1%)and Southeast Asia(53.6%),contrasting sharply with the Americas,where attitudes are notably lower at 9.05%.Regarding preventive behaviors,the Americas demonstrate a prevalence of 12.1%,Southeast Asia at 28.1%,Western Pacific at 49.6%,Eastern Mediterranean at 44.8%,and Africa at 47.4%.Conclusions:Regional disparities about the knowledge,attitude and preventive bahaviors are evident with Europe exhibiting the highest knowledge level while Africa has the lowest.These findings emphasize the importance of targeted public health interventions tailored to regional contexts,highlighting the need for region-specific strategies to enhance dengue-related knowledge and encourage positive attitudes and preventive behaviors.
文摘Objective:To assess pregnant women's knowledge,attitude,and practice regarding nutrition and medication usage,analyse the prescribing pattern,and categorize them based on the Food and Drug Administration(FDA)guidelines.Methods:A cross-sectional study was conducted with 264 pregnant women in the obstetrics and gynaecology department of a tertiary care hospital from October 2022 to August 2023.A knowledge,attitude,and practice(KAP)questionnaire was prepared in English language by the researchers and validated by an expert panel consisting of 12 members.The validated questionnaire was then translated into regional languages,Kannada and Malayalam.The reliability of the questionnaire was assessed with test-retest method with a representative sample population of 30 subjects(10 subjects for each language).The subjects'knowledge,attitude,and practice were evaluated using the validated KAP questionnaire.The safety of the medication was assessed using the FDA drug safety classification for pregnancy.Results:The mean scores for nutritional and medication usage knowledge,attitude,and practice were 4.14±1.15,4.50±1.09,and 3.00±1.47,respectively.Among 30 prescribed medications,3 belong to category A(no risk in human studies),8 belong to category B(no risk in animal studies),18 belong to category C(risk cannot be ruled out)and 1 drug is not classified.A significant association was observed between medication knowledge and practice(r=0.159,P=0.010).Conclusions:Most of the study population knows the need to maintain good dietary and medication practices during pregnancy.Counselling pregnant women regarding diet and medication usage is crucial in maternal care.
基金We express our sincere appreciation to the National Natural Science Foundation of China(No.51474113(M.Jing),22279070[L.Wang]and U21A20170[X.He])the Ministry of Science and Technology of China(No.2019YFA0705703[L.Wang]).And we would like to thank the“Explorer 100”cluster system of Tsinghua National Laboratory for Information Science and Technology for facility support.
文摘Polymer solid-state lithium batteries(SSLB)are regarded as a promising energy storage technology to meet growing demand due to their high energy density and safety.Ion conductivity,interface stability and battery assembly process are still the main challenges to hurdle the commercialization of SSLB.As the main component of SSLB,poly(1,3-dioxolane)(PDOL)-based solid polymer electrolytes polymerized in-situ are becoming a promising candidate solid elec-trolyte,for their high ion conductivity at room temperature,good battery elec-trochemical performances,and simple assembly process.This review analyzes opportunities and challenges of PDOL electrolytes toward practical application for polymer SSLB.The focuses include exploring the polymerization mechanism of DOL,the performance of PDOL composite electrolytes,and the application of PDOL.Furthermore,we provide a perspective on future research directions that need to be emphasized for commercialization of PDOL-based electrolytes in SSLB.The exploration of these schemes facilitates a comprehensive and profound understanding of PDOL-based polymer electrolyte and provides new research ideas to boost them toward practical application in solid-state batteries.
基金supported by the National Natural Science Foundation of China(82174230)the Fundamental Research Funds for the Central Universities(2042022kf1213)。
文摘Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM and WM has a long history in China,and has made important achievements in the process of clinical diagnosis and treatment.However,the methodological defects in currently published clinical practice guidelines(CPGs)limit its development.The organic integration of TCM and WM is a deeper integration of TCM and WM.To realize the progression of"integration"to"organic integration",a targeted and standardized guideline development methodology is needed.Therefore,the purpose of this study is to establish a standardized development procedure for clinical practice guidelines for the organic integration of TCM and WM to promote the systematic integration of TCM and WM research results into clinical practice guidelines in order to achieve optimal results as the whole is greater than the sum of the parts.
文摘Objective:To assess the factors associated with knowledge,attitude and behavior of contraception use among urban slum population in Chennai.Methods:A cross-sectional study was conducted in the urban slum of Anakaputhur,Chennai.Married couples between ages of 19-49 years and living in slum areas were taken up for the study by simple random sampling.Pregnant women,postnatal and postmenopausal women were excluded from the study.Data collection was done using a pretested structured questionnaire focusing on details regarding contraception knowledge,attitude,and practices.Data analysis was done using IBM SPSS version 22.Analytical test like Chi square and odds ratio(OR)were used to identify association between knowledge,attitude,and behavior of contraception with the associated variables and enter method of logistic regression analysis was done.Results:Out of the 360 respondents,228 were females,with a mean age of(34±5)years.Approximately 43%demonstrated adequate knowledge of contraception use,and 91%were aware of at least one contraceptive method.Notably,72%exhibited a positive attitude towards contraceptive use.Nevertheless,43%(155 individuals)did not utilize any contraceptive method.Among contraceptive users,intrauterine devices were the most commonly adopted,followed by barrier methods and female sterilization.There was significant association between knowledge of contraception and education(aOR 7.29,95%CI 2.93-18.10,P<0.05),age(aOR 2.04,95%CI 1.19-3.50,P<0.05)and socioeconomic class(aOR 3.66,95%CI 1.71-7.85,P<0.05;aOR 3.97,95%CI 2.12-7.49,P<0.05).Regarding attitude towards contraception use,education(aOR 8.54,95%CI 2.35-31.03,P<0.05),sex(aOR 0.15,95%CI 0.06-0.37,P<0.05),age(aOR 0.53,95%CI 0.28-0.99,P<0.05),socio-economic class(aOR 4.42,95%CI 1.97-9.92,P<0.05;aOR 9.83,95%CI 3.63-26.58,P<0.05)and number of children(aOR 10.04,95%CI 4.26-23.66,P<0.05)were the variables that had a significant association.Conclusions:These findings underscore the imperative for enhanced dissemination of health education pertaining to contraception use within the slum population.The health sectors of the area and other stakeholders need to make sure to extend penetration of family planning related services to the urban slum population.
文摘Objective:To elucidate the relationship among knowledge,attitudes,and practices regarding Covid-19 and their relationship with booster vaccination status among women with infertility.Methods:This questionnaire-based cross-sectional study was performed online and offline among women with infertility who visited an infertility clinic in Jakarta,Indonesia.We assessed the patient’s knowledge,attitudes,and practices regarding Covid-19 and their relationship with booster vaccination status and sociodemographic profile.Results:A total of 178 subjects participated in this study,and most participants(92.6%)had received booster Covid-19 vaccines.From the questionnaire,74.2%had good knowledge,and 99.4%had good attitudes regarding Covid-19;however,only 57.9%of patients had good practices.A weak positive correlation existed between knowledge and attitudes(r=0.11,P=0.13)and a moderate negative correlation between attitudes and practices(r=-0.44,P=0.56).Participants’knowledge about vaccines and infertility was correlated with booster vaccination status(P=0.04).Academic background(P=0.01)and attitudes(P=0.01)were also correlated with booster vaccination status.The significant determinants of hesitance of receiving Covid-19 booster vaccines were high school education or below(OR=0.08,95%CI 0.02-0.36)and poor practices(OR=0.21,95%CI 0.05-0.95).Conclusions:The majority of the participants had received the Covid-19 booster vaccine and had good knowledge and attitudes but poor practices regarding Covid-19.Most participants had poor knowledge about the relationship between infertility and the Covid-19 vaccine.The general population should be more informed and reminded about practices to prevent Covid-19 and the relationship between vaccination and fertility to increase the number of people who receive Covid-19 booster vaccines.
基金support of the National Key R&D Program of China(2023YFD2301500)the China Agriculture System of MOF and MARA(CARS-02)the Shandong Central Guiding the Local Science and Technology Development,China(YDZX20203700002548)。
文摘The footprints of water and nitrogen(WF and NF)provide a comprehensive overview of the type and quantity of water consumption and reactive nitrogen(Nr)loss in crop production.In this study,a field experiment over two years(2019 and 2020)compared three integrated agronomic practice management(IAPM)systems:An improved management system(T2),a high-yield production system(T3),and an integrated soil-crop management system(ISCM)using a local smallholder farmer’s practice system(T1)as control,to investigate the responses of WF,Nr losses,water use efficiency(WUE),and nitrogen use efficiency(NUE)to IAPM.The results showed that IAPM optimized water distribution and promoted water use by summer maize.The evapotranspiration over the whole maize growth period of IAPM increased,but yield increased more,leading to a significant increase in WUE.The WUE of the T2,T3,and ISCM treatments was significantly greater than in the T1 treatment,in 2019 and 2020respectively,by 19.8-21.5,31.8-40.6,and 34.4-44.6%.The lowest WF was found in the ISCM treatment,which was 31.0%lower than that of the T1 treatment.In addition,the ISCM treatment optimized soil total nitrogen(TN)distribution and significantly increased TN in the cultivated layer.Excessive nitrogen fertilizer was applied in treatment T3,producing the highest maize yield,and resulting in the highest Nr losses.In contrast,the ISCM treatment used a reduced nitrogen fertilizer rate,sacrificing grain yield partly,which reduced Nr losses and eventually led to a significant increase in nitrogen use efficiency and nitrogen recovery.The Nr level in the ISCM treatment was34.8%lower than in the T1 treatment while NUE was significantly higher than in the T1 treatment by 56.8-63.1%in2019 and 2020,respectively.Considering yield,WUE,NUE,WF,and NF together,ISCM should be used as a more sustainable and clean system for sustainable production of summer maize.
基金supported by the National Key Research and Development Program of China (2022YFD2300304)the National Natural Science Foundation of China (32071944 and 32272197)+2 种基金the Hong Kong Research Grants Council, China (GRF 14177617, 12103219, 12103220, and AoE/M-403/16)the State Key Laboratory of Agrobiotechnology (Strategic Collaborative Projects) in The Chinese University of Hong Kong, China, the Six Talent Peaks Project in Jiangsu Province, China (SWYY151)the Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions, China (PAPD).
文摘Integrative cultivation practices(ICPs)are essential for enhancing cereal yield and resource use efficiency.However,the effects of ICP on the rhizosphere environment and roots of paddy rice are still poorly understood.In this study,four rice varieties were produced in the field.Each variety was treated with six different cultivation techniques,including zero nitrogen application(0 N),local farmers’practice(LFP),nitrogen reduction(NR),and three progressive ICP techniques comprised of enhanced fertilizer N practice and increased plant density(ICP1),a treatment similar to ICP1 but with alternate wetting and moderate drying instead of continuous flooding(ICP2),and the same practices as ICP2 with the application of organic fertilizer(ICP3).The ICPs had greater grain production and nitrogen use efficiency than the other three methods.Root length,dry weight,root diameter,activity of root oxidation,root bleeding rate,zeatin and zeatin riboside compositions,and total organic acids in root exudates were elevated with the introduction of the successive cultivation practices.ICPs enhanced nitrate nitrogen,the activities of urease and invertase,and the diversity of microbes(bacteria)in rhizosphere and non-rhizosphere soil,while reducing the ammonium nitrogen content.The nutrient contents(ammonium nitrogen,total nitrogen,total potassium,total phosphorus,nitrate,and available phosphorus)and urease activity in rhizosphere soil were reduced in all treatments in comparison with the non-rhizosphere soil,but the invertase activity and bacterial diversity were greater.The main root morphology and physiology,and the ammonium nitrogen contents in rhizosphere soil at the primary stages were closely correlated with grain yield and internal nitrogen use efficiency.These findings suggest that the coordinated enhancement of the root system and the environment of the rhizosphere under integrative cultivation approaches may lead to higher rice production.
基金Supported by Shanghai Pujiang Program(No.2020PJD047)Program of Shanghai Academic/Technology Research Leader(No.21XD1402700)+1 种基金Bethune•Lumitin Young and Middle-Aged Ophthalmic Research Fund(No.BJ-LM2021010J)Science and Technology Research Project of Songjiang District(No.2020SJ307).
文摘AIM:To describe the practice patterns of intravitreal injections(IVIs)among ophthalmologists in China.METHODS:This was a cross-sectional online survey.Ophthalmologists who had performed accumulated more than 100 injections were contacted by the Brightness Center,a hospital-based national network,to complete an anonymous,24-question,internet-based survey.They were surveyed on practices in injection techniques,pre-,and post-injections procedures.RESULTS:A total of 333 ophthalmologists from 28 provinces/municipalities/autonomous regions responded to the survey(50.68%response rate).The 91.29%of the respondents evaluated systemic risk factors by medical history,electrocardiogram(ECG)and blood test.All the respondents used pre-injection prophylactic antibiotics.Most checked intraocular pressure(IOP,99.1%)and blood pressure(96.1%)before injections.A majority of the respondents performed injections in the operating room(98.8%),wore masks(99.7%),gloves(99.4%)and sterile surgical clothing(96.1%),performed topical anesthetics(97.9%),and applied povidone-iodine(95.8%)pre-injection.The 61.26%of the respondents dilated pupil.About half of the respondents(51.05%)performed bilateral injections in the same setting.Superior temporal quadrant(40.54%)was the most frequent site of injection.Around three quarters used 30-gauge needles.Most respondents(97.9%)measured the site of injection from limbus.More than half(53.45%)performed conjunctiva displacement prior to injection.The 32.43%of the respondents checked IOP post-injection and 87.99%physicians checked hand motion(HM)or counting fingers(CF)after injection,while 36.94%observed optic nerve perfusion.All participants used topical antibiotics post-injections.Most physicians(91.89%)reviewed patients on the following day.CONCLUSION:This study provides a description of the real-world practice patterns in IVIs in China and offers critical information regarding education and training of ophthalmologists and amendment of local society guidelines.
文摘The Sun et al's training program for clinical research nurses(CRNs)in the World Journal of Clinical Cases is a comprehensive and scientific approach.It includes structured frameworks for CRN training,aiming to improve CRN competency.This program emphasizes practical abilities,updates training content,and improves evaluation methods.The cultivation of CRN talents focuses on enhancing the training system,establishing a multifaceted evaluation framework,and continuously refining the training programs.Regular feedback and evalua-tion are essential to improve CRNs'competency in practical settings.
文摘Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)globally.However,the level of scientific evidence supporting ESMO CPG recommendations has not been systematically investigated.This study assessed ESMO CPG levels of evidence(LOE)and grades of recommendations(GOR),as well as their trends over time across various cancer settings.Methods:We manually extracted every recommendation with the Infectious Diseases Society of America(IDSA)classification from each CPG.We examined the distribution of LOE and GOR in all available ESMO CPG guidelines across different topics and cancer types.Results:Among the 1,823 recommendations in the current CPG,30%were classified as LOEⅠ,and 43%were classified as GOR A.Overall,there was a slight decrease in LOEⅠ(−2%)and an increase in the proportion of GOR A(+1%)in the current CPG compared to previous versions.The proportion of GOR A recommendations based on higher levels of evidence such as randomized trials(LOEⅠ–Ⅱ)shows a decrease(71%vs.63%,p=0.009)while recommendations based on lower levels of evidence(LOEⅢ–Ⅴ)show an increase(29%vs.37%,p=0.01)between previous and current version.In the current versions,the highest proportion of LOEⅠ(42%)was found in recommendations related to pharmacotherapy,while the highest proportion of GOR A recommendations was found in the areas of pathology(50%)and diagnostic(50%)recommendations.Significant variability in LOEⅠand GOR A recommendations and their changes over time was observed across different cancer types.Conclusion:One-third of the current ESMO CPG recommendations are supported by the highest level of evidence.More well-designed randomized clinical trials are needed to increase the proportion of LOEⅠand GOR A recommendations,ultimately leading to improved outcomes for cancer patients.
基金The study was reviewed and approved by the Ethics Committee of Shanghai Tongren Hospital(Approval Number:Tongren Lun Audit 2022-075-01).
文摘BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we took the evidence-based practice of perioperative airway management in elderly fracture patients as an example and adopted a descriptive phenomenological approach to understand the influencing factors of its sustainability to provide a reference basis for promoting the continuity of evidence-based practice in the clinic.AIM To explore factors influencing the persistence of evidence-based practice in perioperative airway management in elderly patients with fractures.METHODS This study was qualitative research.Nine nurses who implemented evidencebased practice in the orthopedic ward of a tertiary comprehensive hospital in Shanghai from September 2023 to October 2023 were selected using purposive sampling as research subjects.Semi-structured interviews were conducted with them,and the data were analyzed using the Colaizzi phenomenological analysis method based on the three dimensions and ten factors of the NHS sustainability model.RESULTS Three main themes and ten subthemes were identified:Process aspects(benefits to patients,benefits to nurses,lack of follow-up,complex processes);staff aspects(insufficient human resources,inadequate training and education,lack of leadership support);and organizational environment aspects(inadequate infrastructure,poor patient compliance,poor doctor cooperation).CONCLUSION Human resources,training and education,leadership support,infrastructure,and patient-physician collaboration are important factors influencing the sustainability of evidence-based practice for perioperative airway management in older patients with fractures.
文摘BACKGROUND The emergency department(ED)plays a critical role in establishing artificial airways and implementing mechanical ventilation.Managing airbags in the ED presents a prime opportunity to mitigate the risk of ventilator-associated pneumonia.Nonetheless,existing research has largely overlooked the understanding,beliefs,and practical dimensions of airway airbag management among ED nurses,with a predominant focus on intensive care unit nurses.AIM To investigate the current status of ED nurses'knowledge,beliefs,and practical behaviors in airway airbag management and their influencing factors.METHODS A survey was conducted from July 10th to August 10th,2023,using convenience sampling on 520 ED nurses from 15 tertiary hospitals and 5 sary hospitals in Shanghai.Pathway analysis was utilized to analyze the influencing factors.RESULTS The scores for ED nurses'airway airbag management knowledge were 60.26±23.00,belief was 88.65±13.36,and behavior was 75.10±19.84.The main influencing factors of airbag management knowledge included participation in specialized nurse or mechanical ventilation training,department,and work experience in the department.Influencing factors of airbag management belief comprised knowledge,department,and participation in specialized nurse or mechanical ventilation training.Primary influencing factors of airbag management behavior included knowledge,belief,department,participation in specialized nurse or mechanical ventilation training,and professional title.The belief in airbag management among ED nurses acted as a partial mediator between knowledge and behavior,with a total effect value of 0.513,and an indirect effect of 0.085,constituting 16.6%of the total effect.CONCLUSION ED nurses exhibit a positive attitude toward airbag management with relatively standardized practices,yet there remains room for improvement in their knowledge levels.Nursing managers should implement interventions tailored to the characteristics of ED nurses'airbag management knowledge,beliefs,and practices to enhance their airbag management proficiency.