Smoking of Carica papaya in Nigeria:The rationale,the public health effects and policies for intervention

Psychoactive substance use is characterized by the habitual use of substances that have significant effects in altering the activities of neurotransmitters in certain regions of the brain.Consequently,these alterations manifest as cognitive,emotional,perceptual and behavioural changes in affected individuals[1].

Erratum regarding Declaration of Competing Interest statements in previously published articles

Declaration of Competing Interest statements were incorrectly included in the published version of the following articles that appeared in previous issues of Materials Reports:Energy.The appropriate Declaration of Competing Interest statements,provided by the authors,are included below.

Rational Engineering of Secondary Metabolic Pathways in a Heterologous Host to Enable the Biosynthesis of Hibarimicin Derivatives with Enhanced Anti-Melanomic Activity

A 61-kb biosynthetic gene cluster(BGC),which is accountable for the biosynthesis of hibarimicin(HBM)B from Microbispora rosea subsp.hibaria TP-A0121,was heterologously expressed in Streptomyces coelicolor M1154,which generated a trace of the target products but accumulated a large amount of shunt products.Based on rational analysis of the relevant secondary metabolism,directed engineering of the biosynthetic pathways resulted in the high production of HBM B,as well as new HBM derivates with improved antitumor activity.These results not only establish a biosynthetic system to effectively synthesize HBMs-a class of the largest and most complex Type-Ⅱpolyketides,with a unique pseudo-dimeric structure-but also set the stage for further engineering and deep investigation of this complex biosynthetic pathway toward potent anticancer drugs.

Blockchain-Based Key Management Scheme Using Rational Secret Sharing

Traditional blockchain key management schemes store private keys in the same location,which can easily lead to security issues such as a single point of failure.Therefore,decentralized threshold key management schemes have become a research focus for blockchain private key protection.The security of private keys for blockchain user wallet is highly related to user identity authentication and digital asset security.The threshold blockchain private key management schemes based on verifiable secret sharing have made some progress,but these schemes do not consider participants’self-interested behavior,and require trusted nodes to keep private key fragments,resulting in a narrow application scope and low deployment efficiency,which cannot meet the needs of personal wallet private key escrow and recovery in public blockchains.We design a private key management scheme based on rational secret sharing that considers the self-interest of participants in secret sharing protocols,and constrains the behavior of rational participants through reasonable mechanism design,making it more suitable in distributed scenarios such as the public blockchain.The proposed scheme achieves the escrow and recovery of personal wallet private keys without the participation of trusted nodes,and simulate its implementation on smart contracts.Compared to other existing threshold wallet solutions and keymanagement schemes based on password-protected secret sharing(PPSS),the proposed scheme has a wide range of applications,verifiable private key recovery,low communication overhead,higher computational efficiency when users perform one-time multi-key escrow,no need for trusted nodes,and personal rational constraints and anti-collusion attack capabilities.

Approximate solution of Volterra-Fredholm integral equations using generalized barycentric rational interpolant

It is well-known that interpolation by rational functions results in a more accurate approximation than the polynomials interpolation.However,classical rational interpolation has some deficiencies such as uncontrollable poles and low convergence order.In contrast with the classical rational interpolants,the generalized barycentric rational interpolants which depend linearly on the interpolated values,yield infinite smooth approximation with no poles in real numbers.In this paper,a numerical collocation approach,based on the generalized barycentric rational interpolation and Gaussian quadrature formula,was introduced to approximate the solution of Volterra-Fredholm integral equations.Three types of points in the solution domain are used as interpolation nodes.The obtained numerical results confirm that the barycentric rational interpolants are efficient tools for solving Volterra-Fredholm integral equations.Moreover,integral equations with Runge’s function as an exact solution,no oscillation occurrs in the obtained approximate solutions so that the Runge’s phenomenon is avoided.

Experimental study of core MHD behavior and a novel algorithm for rational surface detection based on profile reflectometry in EAST

Microwave reflectometry is a powerful diagnostic that can measure the density profile and localized turbulence with high spatial and temporal resolution and will be used in ITER,so understanding the influence of plasma perturbations on the reflect signal is important.The characteristics of the reflect signal from profile reflectometry,the time-of-flight(TOF)signal associated with the MHD instabilities,are investigated in EAST.Using a 1D full-wave simulation code by the Finite-DifferenceTime-Domain(FDTD)method,it is well validated that the local density flattening could induce the discontinuity of the simulated TOF signal and an obvious change of reflect amplitude.Experimental TOF signals under different types of MHD instabilities(sawtooth,sawtooth precursors and tearing mode)are studied in detail and show agreement with the simulation.Two new improved algorithms for detecting and localizing the radial positions of the low-order rational surface,the cross-correlation and gradient threshold(CGT)method and the 2D convolutional neural network approach(CNN)are presented for the first time.It is concluded that TOF signal analysis from profile reflectometry can provide a straightforward and localized measurement of the plasma perturbation from the edge to the core simultaneously and may be a complement or correction to the q-profile control,which will be beneficial for the advanced tokamak operation.

The Global Security Initiative: Its Relevance, Rationale and Delivery

Today,our world is undergoing profound changes unseen in a century.Global security landscape is becoming ever more unstable and uncertain.In the face of growing deficits in security,Chinese President Xi Jinping put forward the Global Security Initiative(GSI),offering a clear answer to the question of the times:what kind of security concept does the world need,and how can we achieve common security?It is of great significance to fully grasp the relevance of and the rationale for the GSI,and push for its strategic delivery,so as to contribute to the long-term peace and stability of the world.

Practice of Perioperative Rational Use of Antibacterial Drugs Based on Drug Pathway

[Objectives]To establish a new management model for rational use of perioperative antibacterial drugs in surgical departments.[Methods]Based on evidence-based medicine,the department s drug pathway was formulated,and the new mode of rational drug use control was established by using fine pharmaceutical technology intervention,and the intervention effect was evaluated by the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs.[Results]After adopting drug pathway in departments,the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs decreased significantly,and the effect of rational drug use control was remarkable.[Conclusions]The drug pathway provides a new management and control mode for the rational use of perioperative antibacterial drugs in surgical departments of hospitals.Thus,it is worthy of popularization and application.

Exact controllability of rational expectations model with multiplicative noise and input delay

This paper considers the rational expectations model with multiplicative noise and input delay,where the system dynamics rely on the conditional expectations of future states.The main contribution is to obtain a sufficient condition for the exact controllability of the rational expectations model.In particular,we derive a sufficient Gramian matrix condition and a rank condition for the delay-free case.The key is the solvability of the backward stochastic difference equations with input delay which is derived from the forward and backward stochastic system.

The Frontiers and Future Landscape of Research and Education on Value Rationality in Contemporary China

The importance of conducting in-depth research and education on value rationality in the new era is increasingly recognized.Therefore,it is essential to systematically grasp the themes,frontiers,and trends of research in this field,organizing the knowledge system to provide references for future studies.This necessitates clarifying the research achievements of scholars from different disciplines and institutions.Using the CiteSpace visualization analysis method,we can analyze,summarize,and synthesize research networks,hotspots,and knowledge structures,thereby forming a direction for advancing research.Through literature review methods and knowledge graph software analysis,it is believed that value rationality and instrumental rationality represent the rational attitudes individuals adopt when contemplating issues and putting them into practice.They are merely methods and should not be subjected to excessive value judgments.The relationship between value rationality and instrumental rationality is a focal point of societal concern,involving complex interdisciplinary issues with significant theoretical value and practical implications.In the future,the academic community needs to strengthen research collaboration,enhance the expansion of value rationality in various social practice fields,and conduct empirical studies to build consensus for the construction of Chinese society.

Evaluation of the Effectiveness of Community Pharmacy Services on Rational Medication Use in Elderly Patients with Hypertension and Diabetes

Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.

白鲜不同生育时期营养元素积累规律及分配特征

以3年生白鲜(Dictamnus dasycarpus)为研究对象,通过测定白鲜不同生育时期根、茎、叶的干质量及营养元素含量,分析白鲜不同生育时期营养元素积累规律及分配特征,为白鲜科学精准施肥提供理论依据。结果表明:白鲜在生长过程中,不同营养元素的积累量由大到小的顺序为氮(N)、钙(Ca)、磷(P)、钾(K)、镁(Mg)、铁(Fe)、锰(Mn)、锌(Zn)、铜(Cu);在生长初期,N、P、K质量分数相对较高,植物对N、P、K元素的需求较大;出苗期至花蕾期,白鲜根中N、P、K的积累量分配比例明显降低,茎叶中积累量分配比例明显增加;从果前期开始,白鲜茎叶中Ca、Mg质量分数和积累量显著增加,在茎叶中分配比例相对较高;果前期和果中期茎叶中Fe、Mn质量分数显著增加,Fe、Mn元素积累量在果中期相对较高,茎叶中分配比例有所增加;根中Zn质量分数从果前期至果中期显著增加,整株积累量显著增大,果中期在根中分配比例达到最大,白鲜茎叶中Cu、Zn质量分数在花蕾期相对较高,在茎叶中的分配比例达到最大。因此,白鲜出苗期至花蕾期需要补充大量元素(N、P、K)及微量元素(Cu、Zn),果前期至果熟期需要补充中量元素(Ca、Mg)和微量元素(Fe、Mn、Zn)。

替雷利珠单抗药物利用评价标准的建立与应用

目的针对替雷利珠单抗建立药物利用评价(drug use evaluation,DUE)标准,对南京医科大学附属南京医院替雷利珠单抗使用情况进行评价,为临床合理用药提供参考依据。方法根据替雷利单抗药品说明书、临床相关指导原则、诊疗指南和专家共识等,建立替雷利珠单抗DUE标准,依据标准回顾性分析评价2023年1—9月南京医科大学附属南京医院使用替雷利珠单抗的住院病人用药情况。结果替雷利珠单抗DUE标准包含14个指标。纳入96例病人,共使用替雷利珠单抗687次。体力评分、器官功能和实验室指标、给药剂量、给药途径、输注时间、给药频次和疗效评估合理率100%;禁忌证、溶媒种类和用量合理率98.96%;联合用药合理率97.92%;药物相互作用合理率96.88%;给药顺序和时间合理率84.38%;适应证合理率80.21%;不良反应监测与处理合理率39.58%。结论建立并应用替雷利珠单抗DUE标准可发现用药过程中的不合理现象,为临床安全用药提供参考依据。

CHS-DRG支付方式下药物合理使用循证与应用策略研究

在CHS-DRG支付下,医院成本控制的能力决定着医院运营管理的效果。药品是医疗成本和临床治疗中不可或缺的一部分,如何能够平衡好药品成本与医疗质量是需要深入探讨的问题。本研究通过循证导向构建医院合理用药体系,以CHS-DRG病组和合理用药为切入点,充分发挥临床药师的专业特点,通过CHS-DRG付费下费用异常点监测路径以及CHS-DRG付费下合理用药事前、事中、事后管理探索,制定综合应用与管理策略路径,在促进住院用药规范化、同质化和保证医疗质量的基础上使药品成本稳定可控制,推动医院内涵式发展。

立法学基本问题的范围及其界定

立法由于其“创新”的基本属性,确定了其内容一定意义上的不可预测,与法律的确定性要求有所冲突。因此,立法长期被排除在法学研究之外。作为法学学科的立法学,需要从依法治国、依法执政的高度,探索立法权及其行使的法律化,尝试把立法问题转化为法律问题,从而形成一个立法学独立的研究领域。围绕立法与理性关系这一核心问题,将立法现象背后的普遍性、一般性、规律性问题纳入一个严肃的、理性的学术讨论之中,可以构建起以立法的正当性、合法性、科学性为基础问题,延伸到包括立法法律关系、立法与立法权的性质、立法权的构成、立法权的运行、立法论证与正当化、立法权力与责任等为延展问题的立法学基本问题体系。

20世纪三四十年代马克思主义史家的新经世致用论——以马克思主义史学四大家为中心

20世纪三四十年代,中国马克思主义史学形成了一种新经世致用论。这种新经世致用论以马克思主义“科学性与革命性相统一”的原则为指导,是对传统经世致用论批判与继承的产物,具体表现为史学求真与致用的统一,体现了马克思主义的实践理性精神。马克思主义与中国传统文化都有实践理性精神,而传统经世致用思想则为马克思主义史家新经世致用论提供了历史解释的视域。马克思主义史家虽然认为革命性是以科学性为基础的,但往往为了革命性而忽视科学性。故史学要真正做到经世致用,必须以尊重史学科学性为前提。

学科实践的感性活动基础与育人价值实现

感性关涉人对外部世界的反映以及人的活动和存在方式,它既指感性认识,也指人的主观感受能力,更指实践的感性活动。人的完整性在于其实践性,形成于实践的感性活动,实践体现了感性的核心要义。学科实践是感性学习活动与理性学习活动的深度融合,它在本质上是以学科为载体、面向感性的现实世界、运用学科知识解决真实问题的实践活动。学科实践具有深刻的感性活动基础:其一,学科实践是认识性实践与改造性实践的统一;其二,作为学科实践主体的学生是具有感性意识和感性需要的感性存在;其三,学科实践是学生以外部世界和自我为对象的感性活动。深化实践育人,要求回应学科实践的感性活动基础。由感性直观到感性实践,确立学科实践的感性表达;超越知识符号,促进学生面向现实世界的学习;发展思维,实现感性认识向理性认识的转化;设计多样化的学科或跨学科的感性活动,丰富学生的主体经验。

我国中小学师德问责政策的演进逻辑与理性选择

中小学师德问责政策的日臻完善是提高中小学教师师德修养的必经之路,对促进中小学生的和谐健康发展具有深远意义。通过梳理改革开放以来有关中小学师德问责的相关政策,发现我国师德问责政策经历了初步创立时期、寻觅探索时期、发展深入时期和日渐成熟时期四个阶段。其演进呈现出以改变师德困境为目的的动力机制、以多种渠道保障政策落实、以教育公平为政策目标的价值取向和以文本形式表达政策话语的逻辑。未来我国中小学师德问责政策将朝着育人为本的动力机制、多元化的价值取向、政策工具助力过程保障、政策话语日益合理科学等方向发展。

课题达成型品管圈在治疗药物监测多学科团队合作模式构建中的实践和成效

目的基于课题达成型品管圈管理方法构建治疗药物监测(TDM)多学科团队合作模式,提升医疗服务质量。方法确定“TDM多学科团队合作模式构建和应用”为活动主题,按照课题达成型品管圈的基本步骤开展并对活动前后的成果进行评价。结果活动实施后,构建了TDM多学科团队合作模式,实施了服务技能培养和效率提升策略,并搭建了智能化信息交互平台。活动成效显著,涵盖管理指标、能力指标、信息指标和效率指标的8项目标均得到提升,目标达标率113.48%,进步率62.46%。改善后TDM全流程规范率达95%,临床满意度93%,专业药师储备人数增加3人,药师考核合格率95%,TDM服务质控合格率92%,患者满意度95%,信息交互准确性95%,信息交互及时性100%。品管圈活动后,团队成员在品管圈手法运用、团队协作、责任感、自信心等方面得到明显提升。结论在医院TDM管理中应用课题达成型品管圈成功构建了多学科团队合作模式,提升了管理指标及工作人员综合素质。

34例复方骨肽注射液致不良反应文献分析

目的分析复方骨肽注射液不良反应(ADR)的原因和规律,为临床合理用药提供参考。方法检索中国知网数据库和万方数据库关于复方骨肽注射液ADR的个案报道并进行统计与分析。结果复方骨肽注射液导致的ADR个案报道共计34例;其年龄分布以>45岁年龄段最多(24例,70.58%);多发生在用药后的1 d内(62.86%);复方骨肽注射液导致的ADR累及系统位居前3的分别为全身系统(55例次,30.90%)、心血管系统(37例次,20.79%)和消化系统(29例次,16.29%),共121例次(67.98%)。结论应用复方骨肽注射剂时应严格遵照说明书要求,对过敏体质者和老年人用药须慎重,加强用药监测,对出现的ADR给予及时处理。