基于AGREEⅡ和RIGHT对医患沟通指南的质量评价研究

目的对医患沟通的临床实践指南进行方法学和报告质量评价,以期确定高质量指南,提供临床参考。方法通过检索MEDLINE(PubMed)、Web of Science、中国知网(CNKI)、万方数据知识服务平台、维普(VIP),补充医脉通、用药助手、丁香园网站的相关临床实践指南(CPG),使用AGREEⅡ和RIGHT工具进行指南质量评价,采用组内相关系数(ICC)用于评估评审者对每个项目理解的一致性。结果共纳入2份临床实践指南,每个领域的评审人员的总体一致性是可以接受的。AGREEⅡ评价结果显示,2篇指南推荐级别均为B级,CPG所有7个领域的平均报告率为50.64%,其中领域1最高(88.89%),领域3最低(30.95%)。RIGHT评价结果显示,指南平均报告率为29.22%。结论医患沟通相关指南质量与数量仍有待提高,指南制订者应严格按照AGREEⅡ和RIGHT的要求规范撰写,以期提出高水平、高标准的循证指南,来指导医护人员的临床实践。

Addressing Japan’s disposal of nuclear-contaminated water from the perspective of international human rights law

The discharge of nuclear-contaminated water containing radionuclides into the ocean by Japan will lead to its integration into the entire ecosystem through processes of circulation and biomagnification,eventually entering the human body via the food chain.This poses a substantial risk of irreversible damage to both the ecosystem and human health,a situation that will worsen with the ongoing discharge of such water.The respect and protection of human rights represent an international consensus,and safeguarding fundamental human rights is a substantial obligation that states must undertake in accordance with both international and domestic law.Since the Fukushima nuclear disaster,Japan has continuously violated its international legal obligations to protect human rights in several areas,including the resettlement of disaster victims,the reduction of nuclear radiation levels,and the handling of contaminated water.Such actions have compromised and will continue to compromise the basic human rights of not only its citizens but also those of people worldwide,including environmental rights,the right to life,development rights,and food rights.In the aftermath of the Fukushima meltdown,the public and workers involved in handling nuclear contaminants have been continually exposed to high radiation levels,endangering their rights to life,development,and health.Japan’s inadequate efforts in victim resettlement and environmental restoration have jeopardized the environmental and food rights of its citizens to live healthily and access food in an environment unaffected by nuclear radiation.The release of nuclear-contaminated water poses a risk of Japan’s nuclear pollution to the people of neighboring countries and the global population at large.The principle of human rights underpins the theory of a community with a shared future for humanity,and human rights are a crucial area of China’s active participation in United Nations affairs and global governance.By voicing concerns over Japan’s potential human rights violations globally,China demonstrates its role as a responsible major country.In response to Japan’s breach of legal obligations and human rights violations,China can adopt a reasoned and beneficial approach,including calling on the international community to hold Japan criminally accountable for crimes against humanity under the Rome Statute and advancing scholarly discussions on ecocide and crimes against the marine environment.Furthermore,China should persist in seeking advisory opinions from the International Court of Justice and strive for substantive accountability,utilizing the mechanisms of international human rights organizations to make its voice heard.

Venopulmonary ECMO Improved Hypoxemia and Supported the Right Ventricle in a Patient with Decompensated Eisenmenger Syndrome

Mechanical circulatory and/or respiratory assistance with extracorporeal membrane oxygenation (ECMO) has become a standard of care for patients with circulatory (venoarterial) and/or respiratory (venovenous) failure refractory to standard therapies. Adult patients with congenital heart disease are an increasingly recognized and growing population and include various groups, such as undiagnosed cases in childhood and palliated and/or corrected cases, which require subsequent care because of residual lesions, cardiac arrest/insufficiency, and arrhythmias, among other conditions. In addition, these patients are prone to developing pathologies that are typical of adulthood with a generally increased risk of morbidity and mortality because of their low reserves and organic damage associated with the underlying heart disease, which makes them candidates for ECMO. These patients represent an additional challenge in this therapy because malformations and the presence of a shunt can generally affect the usual cannulation methods and hemodynamic and oximetry monitoring. Thus, the configuration decision must be made on a case-by-case basis. Here, we present a cannulation method, venopulmonary artery ECMO, which provides hemodynamic and respiratory support, and may be ideal for patients with shunts and/or right ventricular dysfunction. To our knowledge, this is the first report of this configuration in patients with congenital heart diseases.

Working for Global Progress in Human Rights

It should be ensured that all peoples enjoy human rights as equals by allowing them to follow their respective paths of modernization.DECEMBER 2023 marked the 75th anniversary of the Universal Declaration of Human Rights(UDHR).On December 10,1948,the United Nations General Assembly adopted the UDHR(General Assembly resolution 217 A),the first international document on this issue.Chang Peng Chun(P.C.Chang,1892-1957),vice chairman of the original UN Commission on Human Rights at the time.

Promoting Human Rights Through Development

China’s human rights practice focuses on the rights of subsistence and development,China always regards rights to subsistence and development as primary and basic human rights.As a goal humanity has pursued for a long time,the Chinese people have worked tirelessly to protect human rights for all.Consistent with its rising global stature,the nation has moved from its traditionally more defensive posture to a more activist role in the field of global human rights protection,especially in the United Nations Human Rights Council.

Problems and Countermeasures to Improve Clinical Trial Participants’Compensation Rights in China

Objective To discuss the problems existing in the compensation of Chinese clinical trial participants and propose some suggestions for improving their rights.Methods The literature related to the participants’right to compensation at home and abroad was searched to study the inadequacy of the compensation right for clinical trial participants in China from four aspects:insurance system,principle of attribution,legal relationship and compensation regulations.Then,some suggestions to improve the participants’right to compensation were proposed.Results and Conclusion China lacks clear legal norms for participants’right to compensation.There are problems such as unclear insurance rules and compensation rules,unclear contractual relationships between parties to clinical trials,and no laws and regulations to rely on for attribution and compensation.China should issue regulatory guidelines related to the right to compensation of participants in clinical trials,so that all parties in clinical trials can have rules to follow if there is the occurrence of injury,which can better protect the rights and interests of the participants.

Development of Human Rights-Based Practices in Psychiatry from People Living with Mental Health Problems During Involuntary Hospitalization or Treatment - A Secondary Publication

This article presents the research protocol of an interpretative phenomenological study that aims to understand the lived experiences of coercion and human rights-based practices in psychiatry from the perspectives of people living with mental health problems during involuntary hospitalization or treatment.This qualitative study used an interpretative phenomenological analysis design.In-depth,one-on-one interviews along with a socio-demographic questionnaire were conducted with approximately 10 participants.Data analysis was followed by an iterative and hermeneutic emergence coding process.By centering human rights-based practices on the lived experiences of people living with mental health problems who encountered coercion,this study highlighted the contributing and limiting factors to the recognition of human rights in nursing practices.This study also promoted the development of nursing knowledge and practices that can significantly contribute to an individual’s recovery process.

Farmers' Self-decision Right in New Countryside Construction——An interview with Lu Xueyi,a specialist on rural issues

Lu Xueyi graduated from the Philosophy Department of Beijing University in 1962. He pursued graduate studies at the Philosophy Institute of the Chinese Academy of Social Sciences during 1962-1965. He has long been engaged in the study of sociology, social structure and rural development. He worked once as director of the Sociology Institute of CASS. After 1998 he.. has served as member of the Academic Committee of CASS. In 1996 he became president of China Sociology Society. He was a deputy to the Eighth and Ninth National People＇s Congresses. He is author of The Chinese Countryside and Chinese Farmers amid Reforms, Chinese Society in a Transitional Period, Evolution of China＇s Social Structure and On Agriculture, the Countryside and Peasantry.

瑞波西利联合内分泌治疗用于绝经前侵袭性HR+/HER2-晚期乳腺癌患者:随机Ⅱ期RIGHT Choice试验

1文献来源Lu Y-S, Mahidin EIBM, Azim H, et al.Abstract GS1-10:Primary results from the randomized phaseⅡRIGHT Choice trial of premenopausal patients with aggressive HR+/HER2-advanced breast cancer treated with ribociclib+endocrine therapy vs physician’s choice combination chemotherapy[J].Cancer Res,2023,83(5S):GS1-10.

Right ventricle dysfunction does not predict mortality in patients with SARS-CoV-2-related acute respiratory distress syndrome on extracorporeal membrane oxygenation support

BACKGROUND The prognostic role of right ventricle dilatation and dysfunction(RVDD)has not been elucidated in patients with coronavirus disease(COVID)-related respiratory failure refractory to standard treatment needing extracorporeal membrane oxygenation(ECMO)support.AIM To assess whether pre veno-venous(VV)ECMO RVDD were related to inintensive care unit(ICU)mortality.METHODS We enrolled 61 patients with COVID-related acute respiratory distress syndrome refractory to conventional treatment submitted to VV ECMO and consecutively admitted to our ICU(an ECMO referral center)from 31th March 2020 to 31th August 2021.An echocardiographic exam was performed immediately before VV ECMO implantation.RESULTS Males were prevalent(73.8%)and patients with a body mass index>30 kg/m^(2) were the majority(46/61,75%).The overall in-ICU mortality rate was 54.1%(33/61).RVDD was detectable in more than half of the population(34/61,55.7%)and associated with higher simplified organ functional assessment(SOFA)values(P=0.029)and a longer mechanical ventilation duration prior to ECMO support(P=0.046).Renal replacement therapy was more frequently needed in RVDD patients(P=0.002).A higher in-ICU mortality(P=0.024)was observed in RVDD patients.No echo variables were independent predictors of in-ICU death.CONCLUSION In patients with COVID-related respiratory failure on ECMO support,RVDD(dilatation and dysfunction)is a common finding and identifies a subset of patients characterized by a more severe disease(as indicated by higher SOFA values and need of renal replacement therapy)and by a higher in-ICU mortality.RVDD(also when considered separately)did not result independently associated with in-ICU mortality in these patients.

A Sandwich Technique Employing Right Ventricular Incision to Repair Posterior Ventricular Septal Rupture with Right Ventricular Wall Dissection: A Case Report

Background: Ventricular septal rupture (VSR) leading to right ventricular (RV) wall dissection is an extremely rare and life-threatening complication of inferior myocardial infarction (MI) with posterior VSR. Its rare incidence and complex pathology make it difficult to select the appropriate surgical procedures to prevent fatalities. Case Presentation: A 68-year-old woman was transferred to our hospital because of a post-infarction VSR 12 days after symptom onset. Short-axis image obtained using transthoracic echocardiography demonstrated a large posterior VSR. Moreover, the VSR was continuous, with a large echo-free space in the posterior wall of the right ventricle. Color echocardiography showed blood flowing into the echo-free space through the septal defect and blood flowing out into the RV lumen. Coronary angiography revealed complete occlusion of the second segment of the right coronary artery. Thus, dissection of the posterior wall of the right ventricle that continued into the RV lumen was considered to have been caused by the posterior VSR caused by an inferior MI. The patient underwent urgent surgery to repair the VSR using the sandwich double-patch technique by making a posterior RV incision that was repaired using a third patch. No additional procedure was required to block the flow from the cavity of the RV wall dissection into the RV lumen. Postoperative echocardiography and contrast-enhanced computed tomography demonstrated that the VSR was closed securely and the RV wall dissection was almost completely thrombosed. Conclusion: In this case, a patient with a posterior VSR and RV wall dissection was successfully treated using the sandwich double-patch technique with a posterior RV incision. No additional procedure may be needed for RV wall dissection when a secure VSR repair is complete;however, close follow-up is essential to improve the long-term prognosis.

Impacts of Changes in Structure of Rural Land Property Rights on Agricultural Performance

In the reform process of the rural land property rights system,the incentive mechanism of the rural land property rights system has a crucial impact on the production activities of rural economic entities.Due to the different rights structures of the property rights system in different social and economic development stages,the land rights and interests enjoyed by rural economic subjects are different,and the degree of incentives for farmers is also different.This difference in incentives affects farmers investment in agricultural production factors,which in turn affects agricultural performance.This paper analyzes the incentive impacts of the structure of rural land property rights on the changes of farmers land rights and agricultural performance since the founding of the People s Republic of China,in order to further deepen the reform of the land system,protect the rights and interests of farmers,promote the modernization of agriculture and rural areas,and explore the realization form and operation mechanism of the rural collective land system in the new era.

Non‑fungible tokens:a bubble or the end of an era of intellectual property rights

The viability of exponentially growing non-fungible token(NFT)market is evaluated by identifying potential value-generating mechanisms that can be rationalized.After identifying the value-generating mechanisms underlying the positive values of NFTs,this study establishes a pricing model for NFTs that follows a continuous-time financial framework.As NFTs are claimed to securitize“ownership rights short of use”,and as such they may potentially serve as a substitute for the need to rely replace the reliance on the legal protection provided by intellectual property rights(IPRs).Considering this issue,this study evaluates the likelihood that NFTs will replace existing mechanisms that protect producers’rightful claim to use their assets or the need to apply the legal code that governs IPRs.The financial condition for this potential shift is derived for a category of assets whose use or consumption does not reduce supply as the notion of scarcity does not apply.

Federation Boosting Tree for Originator Rights Protection

The problem of data island hinders the application of big data in artificial intelligence model training,so researchers propose a federated learning framework.It enables model training without having to centralize all data in a central storage point.In the current horizontal federated learning scheme,each participant gets the final jointly trained model.No solution is proposed for scenarios where participants only provide training data in exchange for benefits,but do not care about the final jointly trained model.Therefore,this paper proposes a newboosted tree algorithm,calledRPBT(the originator Rights Protected federated Boosted Tree algorithm).Compared with the current horizontal federal learning algorithm,each participant will obtain the final jointly trained model.RPBT can guarantee that the local data of the participants will not be leaked,while the final jointly trained model cannot be obtained.It is worth mentioning that,from the perspective of the participants,the scheme uses the batch idea to make the participants participate in the training in random batches.Therefore,this scheme is more suitable for scenarios where a large number of participants are jointly modeling.Furthermore,a small number of participants will not actually participate in the joint training process.Therefore,the proposed scheme is more secure.Theoretical analysis and experimental evaluations show that RPBT is secure,accurate and efficient.

Evolutionary game-based optimization of green certificate-carbon emission right-electricity joint market for thermal-wind-photovoltaic power system

With the increasing proportion of renewable energy in the power market,the demands on government financial subsidies are gradually increasing.Thus,a joint green certificate-carbon emission right-electricity multi-market trading process is proposed to study the market-based strategy for renewable energy.Considering the commodity characteristics of green certificates and carbon emission rights,the dynamic cost models of green certificates and carbon rights are constructed based on the Rubinstein game and ladder pricing models.Furthermore,considering the irrational bidding behavior of energy suppliers in the actual electricity market,an evolutionary game based multi-market bidding optimization model is presented.Subsequently,it is solved using a composite differential evolutionary algorithm.Finally,the case study results reveal that the proposed model can increase profits and the consumption rate of renewable energy and reduce carbon emission.

Abdominal Mass Revealing a Right Ovarian Cyst in a 2-Year-Old Infant: A Case Report

Introduction: Ovarian cysts are rare pathologies in infants. They represent 1% to 2% of all abdominal tumors in children. Abdominal pain is the most frequent initial sign. Sometimes the discovery is fortuitous, revealed by an abdominal ultrasound. We report here the case of an ovarian cyst in an infant in order to clarify the diagnostic and therapeutic particularities. Patient and observation: 2-year-old infant, female, weighing 12 kg and with no particular pathological history, was admitted to our department for pain plus abdominal mass evolving for 2 months. The clinical examination had noted: a mass ranging from FID to hypogastrium, painless, of firm consistency, with regular contour, with a smooth and mobile surface in relation to the deep plane. The abdominal ultrasound performed had concluded to a mesenteric cyst. The treatment consisted of a monobloc total cystectomy with preservation of the healthy ovarian tissue by a transverse laparotomy under the umbilical. The postoperative course was simple;the histological study of the surgical specimen had concluded to a serous cystadenoma. Conclusion: Ovarian cysts are benign tumors in most cases. Abdominal pain is the most common initial symptom at any age. Sometimes they can be incidentally discovered by ultrasound. The preservation of healthy ovarian tissue in the rules of oncological surgery allows the preservation of subsequent fertility.

Build Asian Consensus on Human Rights,Promote-Overview of Academic Viewpoints at the Asian Forum on Human Rights 2022

The Asian Forum on Human Rights was held at the Renmin University of China(RUC)from November 26 to 27,2022.With the theme“Environment,Climate Change and Human Rights,”the event consisted of 12 sub-forums.The forum was hosted by RUC and jointly organized by the RUC Law School,RUC School of Global Governance,Human Rights Center of RUC,RUC Asia-Pacific Institute of Law,and RUC Center for Coordination and Innovation of Food Safety Governance.The forum focused on discussing topics related to climate change and the environment and responded to common concerns of the international community.It built an international exchange platform to facilitate Asian scholars to build consensus on human rights.Covering a wide range of topics,the event promoted academic exchange in various fields.Experts and scholars from both home and abroad built an extensive consensus on topics such as climate change,environmental conservation,and human rights protection through open exchanges and in-depth discussions,contributing their ideas and wisdom to improving the common well-being of Asian people.

Why The Constitution Should Protect Personal Credit Information?——An Approach of Right Argumentation

Protecting personal credit information through constitutional rights is not only essemtial for individuals to defend against infringements on their personal credit information rights and interests by public power in the social credit system,but also a requirement for unified legislation on social credit to explore the basis for constitutional norms.In the era of the credit economy,personal credit information has become a vital resource for realizing personal autonomy.Along with the increase in the state’s supervision and control of personal credit,the realization of the autonomous value in the interests related to personal credit information has also set more obligations for the state.Therefore,interests related to personal credit information should be regarded as a constitutional right.Because of its significant economic interest and value,the right to personal credit information should be classified as a constitutional property right.As a constitutional property right,the right to personal credit information can not only help protect people’s economic interests,but also achieve the goal of safeguarding their personality interests.

Isoperistaltic vs antiperistaltic anastomosis after right hemicolectomy:A comprehensive review

To optimize the efficiency of ileocolic anastomosis following right hemicolectomy,several variations of the surgical technique have been tested.These include performing the anastomosis intra-or extracorporeally or performing a stapled or hand-sewn anastomosis.Among the least studied is the configuration of the two stumps(i.e.,isoperistaltic or antiperistaltic)in the case of a side-to-side anastomosis.The purpose of the present study is to compare the isoperistaltic and antiperistaltic side-to-side anastomotic configuration after right hemicolectomy by reviewing the relevant literature.High-quality literature is scarce,with only three studies directly comparing the two alternatives,and no study has revealed any significant differences in the incidence of anastomosis-related complications such as leakage,stenosis,or bleeding.However,there may be a trend towards an earlier recovery of intestinal function following antiperistaltic anastomosis.Finally,existing data do not identify a certain anastomotic configuration(i.e.,isoperistaltic or antiperistaltic)as superior over the other.Thus,the most appropriate approach is to master both anastomotic techniques and select between the two configurations based on each individual case scenario.

The Four Categories of Chinese Discourse on Human Rights and Their Interrelationships

In China,the main discourse on human rights can be classified into four categories:political discourse,policy discourse,institutional discourse,and academic discourse.These four categories show significant differences in terms of the context,content,mode of expression,characteristics,and functions of the discourse.They cannot be simply equated or interchangeable with one another.However,they also rely on,restrict,and promote each other,and under certain conditions,they can be transformed into one another.It is needed to prevent imbalances,mismatches in context,isolation,and inadequate translation among human rights discourses.Meanwhile,it is essential to promote balanced development among different discourses,where each discourse maintains its own boundaries,refers to one another,and undergoes accurate translation,in order to construct their healthy interrelationships.Exploring appropriate methods of translation between discourses is an important and worthwhile topic for research in Chinese human rights discourse.It holds significant practical significance and academic value in constructing the Chinese human rights discourse system.