Management Measures for Preventing Postoperative Incision Infections in General Surgery at Primary Hospitals

Objective:To analyze the management measures and effects of preventing postoperative incision infections in the general surgery department of primary hospitals.Methods:Forty-nine surgical patients with 11 healthcare workers who were admitted to the general surgery department of the primary hospital between August 2021 and August 2022 were selected as the routine group for routine incision infection management.Forty-nine surgical patients with 11 healthcare workers admitted to the same department between September 2022 and September 2023 were selected as the prevention group for prophylactic management of postoperative incision infections.The incision infection rate,knowledge,attitude,and practice(KAP)scores,and management satisfaction of the patients as well as the management skill scores of healthcare workers were compared between the two groups.Results:The rate of postoperative incision infection in the prevention group was lower than that in the routine group;after implementing management measures,patients in the prevention group had higher KAP scores than those in the routine group;patients in the prevention group were more satisfied with the management than those in the routine group;and healthcare workers in the prevention group had higher scores than those in the routine group,with P<0.05 for the comparison between the groups.Conclusion:The implementation of preventive management for general surgery patients in primary hospitals can reduce the incidence of postoperative incision infection and improve the KAP of patients,with higher management satisfaction.It can also enhance the management skills of healthcare workers,thus improving their overall management level.

A Preliminary Study on the Management Strategy of University Personnel Files based on Artificial Intelligence Technology

In order to improve the management strategy for personnel files in colleges and universities,simplify the complex process of file management,and improve file management security and content preservation of the files.This paper elaborates on the application of Artificial Intelligence(AI)technology in university personnel file management through theoretical analysis based on the understanding of Al technology.

Thoughts on the Management of Personnel Files in Higher Vocational Colleges in the Context of“Double High Plan”

Starting from the background of the"Double High Plan"in conjunction with the role of personnel file management in advancing the"Double High Plan",this paper analyzes the current status of personnel file management in higher vocational colleges and the necessity of personnel management in higher vocational colleges,and explores the effective measures to strengthen the informatization of personnel files management to make it more reasonable,standardized and informatized.

Delta River Swampy Areas Earth Fill Embankments Primary Consolidation Management Issues

It is well known that soft silty clayey and even peaty soils especially existing in Great River Deltas Swampy Areas,under important Earth Fill Embankment Construction experience huge and hardly bearable primary consolidations settlements along with the minor but not negligible consequent secondary consolidation effects.In order to properly manage these particular huge settlements environments,it is very important to follow up the settlements monitoring data,by a macroscopic soil volume interpretation along with some amendments namely some mathematical added variabilities of the classic Terzaghi Primary Consolidation Equation,which are examined in a companion paper recently published in this Journal.In this paper some indications are given about how to face the macroscopic soil volume primary consolidation settlements,and especially it is suggested how to interpret the misleading laboratory consolidation test values of the coefficient of consolidation.Moreover,some design alternative solutions are examined to grasp both the potential technical and economic benefits along with their consequent disadvantages.Finally,this paper underlined the primary role of the supervision engineer to get a good estimate in the settlements forecasting and his related ability to understand the meaning of anomalous monitoring data and to timely make and match the primary consolidation settlements forecasting calculation adjustments.

Analysis of Blockchain Architecture in File Sharing Management for Tertiary Institution

The aim of this paper is to analyze the sharing and management of files in a tertiary institution using blockchain architecture. It is expected to enable an online system that could provide a decentralized architecture for multiple transfers and sharing of files amongst participants, to design a system that can provide data integrity and security of files using IBM Blockchain technology, to provide a system that can allow multiple user and multiple transactions at once. The research was motivated because of the security challenges associated with existing system which include: delay in transfer and sharing of files, much authority and task given to a single user in a centralized system, high risk of attack and loss of files, reduced speed of file transfer and file access/retrieval, limited number of users per time. Methodology adopted was Object Oriented Analysis Design Methodology (OOADM) in conjunction with Unified Modeling Language (UML) and IBM Blockchain Technology while the programming language used was HTML, CSS, Java and Node Js. The result after design was a decentralized cloud based file sharing and management system that enables multi-shared, replicated and permissioned transactions amongst participants in a network.

Didactic Sequences as an Educational Product to Facilitate Teaching-Learning Processes in Lato Sensu Graduate Courses in the Area of Health Management in Primary Care

Teaching strategies can be considered as techniques that are constructed to be used with the objective of promoting teaching and learning in the classroom, so that the teacher is considered a mentor, as he is the one who selects, analyzes, studies, organizes, builds and proposes the most classic tools to facilitate the learning process [1]. This study is an experience report related to the construction of an educational product that consists of the elaboration of pedagogical strategies, characterized by five didactic sequences in the perspective of collaborating with teaching-learning processes in lato sensu graduate courses. The themes that are part of the didactic sequences were built based on the results obtained in scientific research carried out during the development of the strict sensu postgraduate course in Teaching in Health and Technology, which involved: the work of coordinators who work in the field of health management in Primary Care, situations that challenge the management of Primary Care and the potentialities of work in the management of Primary Care. The didactic sequences have fun teaching strategies that provide meaningful learning for a future qualified professional performance. These sequences involve the use of active methodologies and the use of digital tools. The educational product developed seeks to promote benefits that can collaborate with the improvement of Primary Care Management and teaching-learning processes in the training of health professionals. Therefore, the pedagogical strategies, as well as its entire construction process, were developed through the collaboration of professors of the Health and Society discipline at the State University of Health Sciences of Alagoas (UNCISAL), seeking to make it qualify for effective construction of knowledge and that promote its wide use in the academic environment.

Factors Affecting the Knowledge and Practice of Drug Management among Healthcare Workers in Primary Health Centers in South-East, Nigeria

The knowledge of health workers regarding their management of drugs is very important in ensuring good health. One of the major indices of the performance of primary health care (PHC) remains improved access to essential drugs as they are the link between patients and health services. Consequently, their availability or absence will contribute to a positive or negative impact on health. This was a quasi-experimental study, carried out in Anambra state, which compared the intervention and control groups following the training and provision of drug management tools to PHC workers in the intervention group. A multi-stage sampling technique was used to select 264 health workers from 132 health centers from two senatorial zones in the State, one acting as a control group and the other as an intervention group. Data was collected using a pre-tested in-depth interview guide and semi-structured interviewer administered questionnaire. Statistical analysis was conducted using SPSS at a statistical significance level of p value less than 0.05, while qualitative data was analyzed using N-Vivo. Several factors such as age, sex, educational qualification, cadre of staff, years of practice and PHC workers’ previous training were identified as affecting the knowledge and practice of drug management. The majority (72.0% and 71.2%) in intervention and control groups respectively said inadequate information or lack of knowledge was the main reason for poor practices while the proportion with low interest of health workers for drug management was (38.5%) for intervention and (59.8%) for the control group and the difference between the groups was statistically significant (p = 0.034). In conclusion, this study has shown that age, sex, educational qualification, cadre of staff, years of practice and PHC workers’ previous training were factors associated with health workers’ knowledge and practice of drug management. The study recommends the development of Aide Memoire and conduct of training and retraining on drug management to improve both knowledge and practice of drug management in PHCs in Nigeria.

Primary Healthcare System of Pakistan: Challenges to Self-Management of Type 2 Diabetes

This review article is aimed at describing the primary healthcare system of Pakistan and its challenges in the face of epidemic of type 2 diabetes, focusing particularly on the middle-aged population of rural area of Pakistan. The main concern in Pakistan is that its middle-aged population is facing the onslaught of obesity and overweight due to lack of physical activity. In addition unhealthy eating habits making it more difficult for this population to control their weight. All these factors are contributing to a high risk of type 2 diabetes for the population of Pakistan. This article provides insight into the primary health care system of Pakistan and highlights its deficiencies by identifying that its primary healthcare system has a poor utilization of health care services, the poor accessibility to health system and poor management of diabetes by the healthcare system, gender disparity and inequity in the health care system. The primary objective of this study is to provide an overview of self-management of diabetes among the middle-aged population of Pakistan and to identify the overall deficiencies in the primary healthcare system, its delivery and access to the system, barriers to self-management of diabetes and quality of life in that region.

Predictors and optimal management of tumor necrosis factor antagonist nonresponse in inflammatory bowel disease:A literature review

Tumor necrosis factor-α(TNF-α)antagonists,the first biologics approved for treating patients with inflammatory bowel disease(IBD),are effective for the induction and maintenance of remission and significantly improving prognosis.However,up to one-third of treated patients show primary nonresponse(PNR)to anti-TNF-αtherapies,and 23%-50%of IBD patients experience loss of response(LOR)to these biologics during subsequent treatment.There is still no recognized predictor for evaluating the efficacy of anti-TNF drugs.This review summarizes the existing predictors of PNR and LOR to anti-TNF in IBD patients.Most predictors remain controversial,and only previous surgical history,disease manifestations,drug concentrations,antidrug antibodies,serum albumin,some biologic markers,and some genetic markers may be potentially predictive.In addition,we also discuss the next steps of treatment for patients with PNR or LOR to TNF antagonists.Therapeutic drug monitoring plays an important role in treatment selection.Dose escalation,combination therapy,switching to a different anti-TNF drug,or switching to a biologic with a different mechanism of action can be selected based on the concentration of the drug and/or antidrug antibodies.

Discussion on the Information Collection Methods of Public Health Emergency Files

In public health emergencies, the collection of archival information in the area of public health emergencies is very important, which can provide a reference for the early warning and processing mechanism. At the present stage, the unlimited demand of archival users for resources and the convenience of obtaining resources have become the two driving forces to promote the “transformation” and “growth” of archives. Public health emergencies, the transformation of archives collection and service mode, social media has become an indispensable platform for user information exchange, sharing and transmission, which requires archives to change the mode of archives acquisition and storage. Archival users require more interactive, targeted and cutting-edge forms of access and archival services are also developing toward diversified functions and connotations. Archival information resource sharing is also an important link in this development trend. This paper attempts to analyze the collection methods of archives departments in public health emergencies, and then puts forward the corresponding measures for archives departments to play their functions, such as flexibly solving the needs of archives access, strengthening the development of information resources, doing a good job in the collection of relevant archives, and publicizing archives work in combination with hot spots. This paper discusses the completeness of archival data collection, the means of archival management, the scientific classification of archival data, the ways of archival data collection and so on.

Research on Electronic Document Management System Based on Cloud Computing

With the development of information technology,cloud computing technology has brought many conveniences to all aspects of work and life.With the continuous promotion,popularization and vigorous development of e-government and e-commerce,the number of documents in electronic form is getting larger and larger.Electronic document is an indispensable main tool and real record of e-government and business activities.How to scientifically and effectively manage electronic documents?This is an important issue faced by governments and enterprises in improving management efficiency,protecting state secrets or business secrets,and reducing management costs.This paper discusses the application of cloud computing technology in the construction of electronic file management system,proposes an architecture of electronic file management system based on cloud computing,and makes a more detailed discussion on key technologies and implementation.The electronic file management system is built on the cloud architecture to enable users to upload,download,share,set security roles,audit,and retrieve files based on multiple modes.An electronic file management system based on cloud computing can make full use of cloud storage,cloud security,and cloud computing technologies to achieve unified,reliable,and secure management of electronic files.

Management of missile injuries to the maxillofacial region: A case series

AIM: To assess our management of patients suffering from missile injuries to the maxillofacial region.METHODS: From December 2009 to September 2012, 40 patients with missile injuries(high velocity gunshot and bullet wounds, explosive injuries and shrapnel etc.) affecting the maxillofacial region were treated. All except for 2 patients were males. All had soft tissue injuries with or without bone injuries. These patients were referred to the plastic and maxillofacial surgery ward of our hospital. The patients were 19 to 65 years of age(mean 45 years). In 19 cases, there were missile injuries to other parts of the body, especially the lower extremities. All of the patients were managed by early soft tissue debridement, comprehensive reconstruction and antibiotics. This retrospective study was approved by the IRB and ethical committees.RESULTS: The majority of injuries were caused by high velocity projectiles(88%) and the remaining by car explosions or dynamite blasts(12%). 40 patients were treated surgically. Thirty patients had soft tissue loss(75%) and 20 patients(50%) had bone loss; there was combined soft tissue and bone loss in 10(25%) patients. Facial fractures were in the orbital bones in 10 cases, maxillary in 7, nasal in 5 and the mandible in 3 cases. We used primary repair in the majority of soft tissue defects(25 of 40 cases). Bone repair was done primarily at the same stage using miniplates, titanium screws or wires. In some cases with a bone defect, iliac bone grafts were used simultaneously or in the later stages(mandibular defects). There was no failure of bone reconstruction in our cases. Infections occurred in two cases and were treated with systemic antibiotics and dressing changes, without any long term sequelae.CONCLUSION: Our principles for soft tissue reconstructions were according to the reconstructive ladder and included primary repair, local flaps, skin grafts and regional flaps depending on the extent of damage. Primary repair in facial missile defects was not associated with increased morbidity or complications in this series. We recommend this approach when feasible.

Bioorganic Municipal Waste Management to Deploy a Sustainable Solid Waste Disposal Practice in China

The utilization of bioorganic municipal waste (BMW) is considered essentially for the further development of integrated waste management practice in China. Awareness and knowledge about the importance of BMW management and source separation of waste on household level, as a precondition for the implementation of an economically feasible integrated waste management infrastructure, were developed in Europe during the last decade. The Sino–German RRUBMW Project is facilitating applied research investigations in 4 pilot areas in Shenyang to assess the population’s behavior to develop the design criteria for appropriate process technologies and to provide the basis to adopt BMW management policy in China.

Amelanotic primary cervical malignant melanoma:A case report and review of literature

BACKGROUND Primary malignant melanoma of the cervix(PMMC)is an extremely rare disease that originates from primary cervical malignant melanoma and frequently re-presents a challenge in disease diagnosis due to unclarified clinical and histo-logical presentations,particularly those without melanin.CASE SUMMARY Here,we report a case of amelanotic PMMC,with a history of breast cancer and thyroid carcinoma.The patient was finally diagnosed by immunohistochemical staining and staged as IB2 based on the International Federation of Gynecology and Obstetrics with reference to National Comprehensive Cancer Network guide-lines and was treated with radical hysterectomy,bilateral salpingo-oophorectomy and pelvic lymphadenectomy.She then received combination therapy consisting of immunotherapy with tislelizumab and radiofrequency hyperthermia.She has remained free of disease for more than 1 year.CONCLUSION The differential diagnosis process reenforced the notion that immunohisto-chemical staining is the most reliable approach for amelanotic PMMC diagnosis.Due to the lack of established therapeutic guidelines,empirical information from limited available studies does not provide the rationale for treatment-decision making.By integrating'omics'technologies and patient-derived xenografts or mini-patient-derived xenograft models this will help to identify selective thera-peutic window(s)and screen the appropriate therapeutics for targeted therapies,immune checkpoint blockade or combination therapy strategies effectively and precisely that will ultimately improve patient survival.

Estimated cost for cardiovascular disease risk-based management at a primary healthcare center in Nepal

Background:Low-and middle-income countries are facing an increasing burden of disability and death due to cardiovascular diseases.Policy makers and healthcare providers alike need resource estimation tools to improve healthcare delivery and to strengthen healthcare systems to address this burden.We estimated the direct medical costs of primary prevention,screening,and management for cardiovascular diseases in a primary healthcare center in Nepal based on the Global Hearts evidence based treatment protocols for risk-based management.Methods:We adapted the World Health Organization’s non-communicable disease costing tool and built a model to predict the annual cost of primary CVD prevention,screening,and management at a primary healthcare center level.We used a one-year time horizon and estimated the cost from the Nepal government’s perspective.We used Nepal health insurance board’s price for medicines and laboratory tests,and used Nepal government’s salary for human resource cost.With the model,we estimated annual incremental cost per case,cost for the entire population,and cost per capita.We also estimated the amount of medicines for one-year,annual number of laboratory tests,and the monthly incremental work load of physicians and nurses who deliver these services.Results:For a primary healthcare center with a catchment population of 10,000,the estimated cost to screen and treat 50%of eligible patients is USD21.53 per case and averages USD1.86 per capita across the catchment population.The cost of screening and risk profiling only was estimated to be USD2.49 per case.At same coverage level,we estimated that an average physician’s workload will increase annually by 190 h and by 111 h for nurses,i.e.,additional 28.5 workdays for physicians and 16.7 workdays for nurses.The total annual cost could amount up to USD18,621 for such a primary healthcare center.Conclusion:This is a novel study for a PHC-based,primary CVD risk-based management program in Nepal,which can provide insights for programmatic and policy planners at the Nepalese municipal,provincial and central levels in implementing the WHO Global Hearts Initiative.The costing model can serve as a tool for financial resource planning for primary prevention,screening,and management for cardiovascular diseases in other low-and middleincome country settings globally.

智能机器人在基层慢性病管理中的应用与挑战

全球慢性病患病率不断上升,给社会的发展和个人健康带来重大挑战。管理慢性病需要长期治疗和监测,对患者的生活方式提出了一定要求。随着人口老龄化和人们生活方式的改变,慢性病防控正变得越发重要。近年来,随着医疗卫生领域科技创新向纵深发展,借助人工智能的智能机器人在医疗领域的应用也逐渐成为国家重要战略方向之一,传统的慢性病管理方法过于依赖医生和患者之间的线下交流,导致医生无法与患者保持长期且有效的沟通和随访,患者病情出现变化时医生可能无法及时发现和监测。此外,传统的慢性病管理方法通常是一种通用化的方法,无法充分考量到每位患者的个体差异。鉴于传统慢性病管理方法的局限性,本文提倡利用智能机器人提供更便捷高效的基层服务。本文认为,通过个性化健康管理方案、辅助医疗诊断、定时提醒服药等功能,使智能机器人能够致力于改善患者生活质量、减轻医疗资源压力,从而推动全球智能化医疗管理的发展。

人工智能大语言模型在基层医疗卫生服务中的应用与挑战

基层医疗系统是实现健康公平的关键。我国面临医疗资源分布不平衡、基层医生数量短缺以及慢性病防治形势不容乐观的严峻挑战。人工智能大语言模型在医疗系统中发挥出了强大优势,本文深入探讨了大模型在基层医疗系统中的应用及其面临的挑战,提出应进一步深化大模型的应用,以辅助基层医生常见病诊疗,推动智能化健康教育和慢性病管理,托底“老少边穷”地区基层卫生服务,激发全科医学的飞跃性发展,并推进大模型在全科诊疗与基层卫生服务中的产业化,为健康中国建设提供重要支撑。

Carbon storage and net primary productivity in Canadian boreal mixedwood stands

Canadian boreal mixedwood forests are extensive,with large potential for carbon sequestration and storage;thus,knowledge of their carbon stocks at different stand ages is needed to adapt forest management practices to help meet climate-change mitigation goals.Carbon stocks were quantified at three Ontario boreal mixedwood sites.A harvested stand,a juvenile stand replanted with spruce seedlings and a mature stand had total carbon stocks(±SE)of 133±13 at age 2,130±13 at age 25,and 207±15 Mg C ha^-1 at age 81 years.At the clear-cut site,stocks were reduced by about 40%or 90 Mg C ha^-1 at harvest.Vegetation held 27,34 and 62%of stocks,while detritus held 34,29 and 13%of stocks at age 2,25 and 81,respectively.Mineral soil carbon stocks averaged 51 Mg C ha^-1,and held 38,37 and 25%of stocks.Aboveground net primary productivity(±SE)in the harvested and juvenile stand was 2.1±0.2 and 3.7±0.3 Mg C ha^-1 per annum(p.a.),compared to 2.6±2.5 Mg C ha^-1 p.a.in the mature stand.The mature canopies studied had typical boreal mixedwood composition and mean carbon densities of 208 Mg C ha^-1,which is above average for managed Canadian boreal forest ecosystems.A comparison of published results from Canadian boreal forest ecosystems showed that carbon stocks in mixedwood stands are typically higher than coniferous stands at all ages,which was also true for stocks in vegetation and detritus.Also,aboveground net primary productivity was typically found to be higher in mixedwood than in coniferous boreal forest stands over a range of ages.Measurements from this study,together with those published from the other boreal forest stands demonstrate the potential for enhanced carbon sequestration through modified forest management practices to take advantage of Canadian boreal mixedwood stand characteristics.

A brief review on the diagnostic and therapeutic principles of primary urethral cancer

Objective:Primary urethral carcinoma(PUC)is a rare malignant carcinoma but with limited therapeutic options.This review aims to provide an overview of the current strategies on this patient settings.Methods:Recent literature ranging from January 1987 and December 2021 was assessed through PubMed search to assess the diagnostic and therapeutic principles of PUC.Results:A complete of examination including cystoscopy,imaging,and biopsy should be conducted for these patients.Once diagnosed,the clinical decision of PUC should be made according to the tumor location,pathological pattern,and extent of the tumor.For patients with superficial and distal urethral lesions,organ sparing approaches or radical reconstructive procedures can be utilized.While for more advanced disease or nodal involvement,an optimal multimodal treatment strategy consisted of surgery and radiochemotherapy should be adopted.For patients with urothelial carcinoma of the prostate,the management including transurethral resection of the prostate followed by bacille Calmette-Guerin or radical cysto-prostatectomy should depend on the infiltration depth of PUC.Conclusion:A complete of examination is important for the diagnosis of PUC.The management of PUC should be determined by the location,pathological pattern,and extent of the tumor.More multi-institutional collaborations should be held to investigate better treatment modal-ities for PUC.