Background:The study aimed to assess the efficacy and safety of dinoprostone vaginal insert in labor induction following optimization of standard operating procedure(SOP)and to discover independent predictors of vagin...Background:The study aimed to assess the efficacy and safety of dinoprostone vaginal insert in labor induction following optimization of standard operating procedure(SOP)and to discover independent predictors of vaginal delivery.Methods:This study comprised 551 pregnant women who required cervical ripening with dinoprostone before induction of labor.Using univariate and multivariate analyses,independent predictors of vaginal delivery were identified.Results:443 of the 551 women(80.4%)gave birth vaginally.Vaginal delivery was predicted by maternal age(24-30 vs.<24,P<0.001;30-35 vs.<24,P=0.03),gestational age(P=0.005),birth weight(P<0.001),parity(P=0.001),pre-pregnancy BMI(P<0.001),premature rupture of membranes(P=0.001),meconium-stained amniotic fluid(P<0.001),fundal height(P<0.001)and the Bishop score(P<0.001).None of the women exhibited severe postpartum hemorrhage.Conclusions:The maternal age,gestational age,birth weight,parity,body mass index,premature membrane rupture,amniotic fluid contamination,fundal height,and the Bishop score were independent predictors of vaginal delivery.These may guide the clinical use of dinoprostone for induction of labor.展开更多
Laterally reversed(mirrored)fingerprints are difficult to detect by applying routine search procedures.One suggestion to avoid errors when dealing with probable reversals is to perform comparisons with both direct and...Laterally reversed(mirrored)fingerprints are difficult to detect by applying routine search procedures.One suggestion to avoid errors when dealing with probable reversals is to perform comparisons with both direct and reversed fingerprints.This simple procedure has been applied and led to the detection of two more cases of reversed fingerprint usage in fake documents.In one of the reported cases,experts found on the web the same fingerprints used by criminals in fake documents.This finding is important because it indicates that matched fingerprints do not necessarily link different criminal cases.展开更多
Objective The purpose of the present study is to provide scientific evidence for the implementation of standardized management of the loaner instruments by examining the process of receiving through issuing steps and ...Objective The purpose of the present study is to provide scientific evidence for the implementation of standardized management of the loaner instruments by examining the process of receiving through issuing steps and analyzing challenges encountered by the CSSD of our hospital. Methods The loaner instruments were collected and categorized into the control group( 2 639 pieces during the period of January 2013 to December 2014) and the observation group( 2 418 pieces during the period of January 2015 to December 2016). The possible causes of the challenges were carefully investigated and analyzed. Results After the implementation of standardized management procedures,the efficiency and qualified care of the loaner instruments was significantly improved by measuring qualified rate. The difference in the qualified rate between control and observation groups was statistically significant( P < 0. 01). Conclusion The implementation of the standardized management procedures is important for central sterilization supply departments in guarantee of safe supplies of the loaner instruments,reducing operation risks,and ultimately ensuring patient safety.展开更多
This paper explores the integration of Standard Operating Procedures (SOPs) using virtual reality and smart glasses technology in food manufacturing. The study employs a thorough methodology, combining observational i...This paper explores the integration of Standard Operating Procedures (SOPs) using virtual reality and smart glasses technology in food manufacturing. The study employs a thorough methodology, combining observational insights to develop a comprehensive SOP. Implementation at different firms resulted in significant improvements, reducing product waste and enhancing overall efficiency. The use of virtual reality further augments SOP adoption. The findings underscore SOPs’ transformative influence, offering a tangible solution to challenges in the food production sector. Recommendations include regular SOP reviews and ongoing training for sustained success. Different firms exemplify SOPs as indispensable tools for operational excellence.展开更多
Optimization procedures are required to minimize the amount of fuel consumption and exhaust emissions from marine engines.This study discusses the procedures to optimize the performance of any marine engine implemente...Optimization procedures are required to minimize the amount of fuel consumption and exhaust emissions from marine engines.This study discusses the procedures to optimize the performance of any marine engine implemented in a 0D/1D numerical model in order to achieve lower values of exhaust emissions.From that point,an extension of previous simulation researches is presented to calculate the amount of SOx emissions from two marine diesel engines along their load diagrams based on the percentage of sulfur in the marine fuel used.The variations of SOx emissions are computed in g/k W·h and in parts per million(ppm)as functions of the optimized parameters:brake specific fuel consumption and the amount of air-fuel ratio respectively.Then,a surrogate model-based response surface methodology is used to generate polynomial equations to estimate the amount of SOx emissions as functions of engine speed and load.These developed non-dimensional equations can be further used directly to assess the value of SOx emissions for different percentages of sulfur of the selected or similar engines to be used in different marine applications.展开更多
AIM: To describe the clinical features of congenital double elevator palsy(CDEP) and to evaluate various surgical outcomes between the standard Knapp and augmented Knapp procedures, based on improvements in primary...AIM: To describe the clinical features of congenital double elevator palsy(CDEP) and to evaluate various surgical outcomes between the standard Knapp and augmented Knapp procedures, based on improvements in primary eye position and ocular motility.METHODS: Twenty-two patients with CDEP at Shanghai Children's Hospital were enrolled from July 2014 to January 2018. The forced duction test(FDT) was negative in 21 patients, aged 8 mo to 12 y(mean 5.4 y). Patients were divided into two treatment groups: 16 patients underwent the standard Knapp procedure(group A), with or without horizontal squint procedure; and 5 patients underwent the augmented Knapp procedure(Foster procedure; group B). One patient underwent inferior rectus recession in the affected eye and superior rectus recession in the sound eye because of a positive FDT. The pre-and postoperative vertical deviations in the primary position and ocular motility were compared in the two groups.RESULTS: Twenty-one eyes of the 22 patients(95%) were aligned within 10 prism diopters(PD), and all patients(100%) reached ≥25% elevation improvement after surgery. The average corrected vertical deviation in group B was statistically better than that of group A. For group A, the vertical deviation in the primary position decreased from 24.75Δ±8.35Δ to 4.56Δ±8.07Δ after surgery, for an improvement of 23.06Δ±6.51Δ(P〈0.05). In group B, the decrease was from 35.00Δ±5.00Δ(range 30Δ-40Δ) to 1.00Δ±2.24Δ, for an improvement of 34.00Δ±4.18Δ(P〈0.05). There were significant differences between the pre-and postoperative elevation in each group(group A, P〈0.05; group B, P〈0.05). The average scale of improved elevation in group B(1.80±0.45) was not significantly better than that of group A(1.69±0.87; Z=-0.732, P=0.548). The average follow-up periods lasted 21 mo in group A and 18 mo in group B.CONCLUSION: For vertical deviations 〈30Δ, the standard Knapp procedure can be chosen. For deviations greater than 30Δ-40Δ, the Foster procedure should be chosen. Because of our early interference, the inferior rectus(IR) muscle did not show mechanical restriction. Monocular elevation deficiency(MED) should be diagnosed early so that complications will be reduced and the procedure will be easier for the surgeon.展开更多
Background:Snakebites can lead to lifelong consequences and is one of the main causes of death among military troops worldwide.However,few Chinese military medics know the proper first aid procedures for snakebites.Th...Background:Snakebites can lead to lifelong consequences and is one of the main causes of death among military troops worldwide.However,few Chinese military medics know the proper first aid procedures for snakebites.Therefore,this study aimed to explore the impact of the Standard Operation Procedure(SOP)and checklist on Chinese military medics’ability to manage snakebite first aid.Methods:This study was a prospective single-blind randomized controlled trial conducted in a military medical university of China from May to June 2017.A questionnaire-based survey was performed to collect the participants’socio-demographic profiles before the baseline measurement.During the baseline measurement,participants were requested to provide corresponding first aid that was responsive to the simulative situation portrayed by the standardized patients(SPs)and the evaluators then scored their performances according to a checklist for snakebite first aid scoring table.After the baseline measurement,they were randomly assigned to one of three intervention groups after stratification according to their baseline performance scores:group A received a self-learning course with textbooks(n=27),group B received a self-learning training on the SOP and checklist(n=27)and group C was engaged in an interactive discussion panel regarding the SOP and checklist(n=26).After the interventions,participants received outcome measurements about snakebite first aid key points capability from the same evaluator and SP for each group to avoid observational error.The reviewers were blinded about the grouping in the trial.Results:The baseline measurement yielded no significant difference(H=1.647,P=0.439)among the three groups.The post-intervention scores were higher than the pre-intervention scores for all three(A,B and C)groups(P=0.008,P<0.001 and P<0.001,respectively).There was significant difference of the post-intervention scores among the three groups(F=8.841,P<0.001).Both post-intervention scores of group B and group C were higher than that of group A(P<0.001 and P=0.001,respectively),but no difference was found between group B and C(P=0.695).The acceptance questionnaire score of SOP and checklist was mostly very satisfied,as the final scores of group B and group C were 4.62±0.61 and 4.82±0.45,respectively.Conclusions:In this study,the implementation of an SOP and checklist for snakebite first aid was shown to update and improve first aid treatment concepts in military medics.These intervention methods played an important role in improving the medics’cognition and understanding of snakebite first aid.Therefore,this finding suggests that SOP and checklist training should be further implemented in Chinese troops for snakebite care.展开更多
Forensic science plays a significant role in crime scene analysis and other evidence collection(such as clothes,cigarette butts,blood,semen,hair,etc.,)to scientifically establish the accused’s guilt.In rape and murde...Forensic science plays a significant role in crime scene analysis and other evidence collection(such as clothes,cigarette butts,blood,semen,hair,etc.,)to scientifically establish the accused’s guilt.In rape and murder cases,DNA tests confirm the victim’s identity.It provides certain evidence that is helpful in the speedy investigation and conclusion of a trial.However,it is not a foolproof science and it has certain limitations.Hence,the first responders,such as the Crime Laboratory Ultimate Evidence System team and the forensic experts,must keep these limitations in mind during sample collection and examination,otherwise,it may lead to incorrect results.Such incorrect results may be obtained due to insufficient sample quantity,improper collection methods,or delay in an examination.It is highly recommended to implement standard operating procedure guidelines,failing which the admissibility of such forensic evidence to prove beyond all reasonable doubts is at stake.Accordingly,the court shall acquit the accused giving him the benefit of doubt.This article focuses on the applicability and limitations of forensic science in the Indian Criminal Justice System and the need to adopt due protocols to yield viable results.展开更多
Countries in Asia and the Pacific are more prone to natural disasters than those in other parts of the world.Because of this,there is an urgent need to continue developing effective,end-to-end early warning systems th...Countries in Asia and the Pacific are more prone to natural disasters than those in other parts of the world.Because of this,there is an urgent need to continue developing effective,end-to-end early warning systems that lead to an effective response by emergency managers and people at risk.ESCAP/WMO Typhoon Committee(TC),in cooperation with WMO/ESCAP Panel on Tropical Cyclones(PTC),conducted a regional cooperation project on Synergized Standard Operating Procedures for Coastal Multi-Hazards Early Warning System(SSOP)with fund support from ESCAP Multi-Donor Trust Fund for Tsunami,Disaster and Climate Preparedness in Indian Ocean and South East Asia.SSOP project was conducted successfully and achieved its proposed goals.Its results and achievements greatly benefit the Members not only in the region but also in all other regions of WMO.The paper reviewed its implementation process,strategy and activities;briefed its main achievements including SSOP Manual,capacity building and cooperation mechanism between TC and PTC;summarized the experiences and lessons from project implementation;and highlighted its sustainability.The paper also suggested the approaches to enhance the sustainability of SSOP results and the cooperation between two regional bodies TC and PTC.展开更多
Introduction:The cyclical process of hazard identification,risk assessment,risk mitigation,and review is a key step in developing a biorisk management(BRM)system.This paper describes how this process was initiated in ...Introduction:The cyclical process of hazard identification,risk assessment,risk mitigation,and review is a key step in developing a biorisk management(BRM)system.This paper describes how this process was initiated in two laboratories in Pakistan using a unique model of blended learning.Methods:A training needs analysis showed that the staff had very little knowledge of BRM systems.A workshop using a unique blended model was conducted in which virtual and in-presence learning occurred simultaneously.This workshop aimed to train the participants by applying two key concepts from the World Health Organization Laboratory Biosafety Manual 4th edition:1)the cyclical process of risk assessment and 2)mapping the core biorisk and establishing heightened control measures in the laboratories of the participants based on the risk assessment.All scenarios and examples used in the training were from the participants’laboratory work processes.Results:Prior to this project,no risk assessment was conducted in these laboratories.After the workshop,a risk assessment was performed for six work processes.In addition,seven core requirements and three heightened control measures were mapped,a biorisk officer was appointed,and a biosafety committee was convened.Furthermore,a biorisk manual,a biological waste management plan,an occupational health center,and a system for audits and inspections are being developed.Discussion and conclusion:BRM training is not a one-time effort;it has to be strengthened to ensure the development and implementation of a comprehensive and sustainable BRM system.Training must be applicable to local settings and incremental,in a way that participants are not overloaded with information.展开更多
文摘Background:The study aimed to assess the efficacy and safety of dinoprostone vaginal insert in labor induction following optimization of standard operating procedure(SOP)and to discover independent predictors of vaginal delivery.Methods:This study comprised 551 pregnant women who required cervical ripening with dinoprostone before induction of labor.Using univariate and multivariate analyses,independent predictors of vaginal delivery were identified.Results:443 of the 551 women(80.4%)gave birth vaginally.Vaginal delivery was predicted by maternal age(24-30 vs.<24,P<0.001;30-35 vs.<24,P=0.03),gestational age(P=0.005),birth weight(P<0.001),parity(P=0.001),pre-pregnancy BMI(P<0.001),premature rupture of membranes(P=0.001),meconium-stained amniotic fluid(P<0.001),fundal height(P<0.001)and the Bishop score(P<0.001).None of the women exhibited severe postpartum hemorrhage.Conclusions:The maternal age,gestational age,birth weight,parity,body mass index,premature membrane rupture,amniotic fluid contamination,fundal height,and the Bishop score were independent predictors of vaginal delivery.These may guide the clinical use of dinoprostone for induction of labor.
文摘Laterally reversed(mirrored)fingerprints are difficult to detect by applying routine search procedures.One suggestion to avoid errors when dealing with probable reversals is to perform comparisons with both direct and reversed fingerprints.This simple procedure has been applied and led to the detection of two more cases of reversed fingerprint usage in fake documents.In one of the reported cases,experts found on the web the same fingerprints used by criminals in fake documents.This finding is important because it indicates that matched fingerprints do not necessarily link different criminal cases.
基金Special Fund of Academic Competence Improvement Project in Nursing of Integrated Traditional Chinese and Western M edicine(TG20180002g)
文摘Objective The purpose of the present study is to provide scientific evidence for the implementation of standardized management of the loaner instruments by examining the process of receiving through issuing steps and analyzing challenges encountered by the CSSD of our hospital. Methods The loaner instruments were collected and categorized into the control group( 2 639 pieces during the period of January 2013 to December 2014) and the observation group( 2 418 pieces during the period of January 2015 to December 2016). The possible causes of the challenges were carefully investigated and analyzed. Results After the implementation of standardized management procedures,the efficiency and qualified care of the loaner instruments was significantly improved by measuring qualified rate. The difference in the qualified rate between control and observation groups was statistically significant( P < 0. 01). Conclusion The implementation of the standardized management procedures is important for central sterilization supply departments in guarantee of safe supplies of the loaner instruments,reducing operation risks,and ultimately ensuring patient safety.
文摘This paper explores the integration of Standard Operating Procedures (SOPs) using virtual reality and smart glasses technology in food manufacturing. The study employs a thorough methodology, combining observational insights to develop a comprehensive SOP. Implementation at different firms resulted in significant improvements, reducing product waste and enhancing overall efficiency. The use of virtual reality further augments SOP adoption. The findings underscore SOPs’ transformative influence, offering a tangible solution to challenges in the food production sector. Recommendations include regular SOP reviews and ongoing training for sustained success. Different firms exemplify SOPs as indispensable tools for operational excellence.
基金performed within the Strategic Research Plan of the Centre for Marine Technology and Ocean Engineering(CENTEC)financed by Portuguese Foundation for Science and Technology(Fundacao para a Ciência e Tecnologia(FCT)),under contract UID/Multi/00134/2013-LISBOA-01-0145-FEDER-007629。
文摘Optimization procedures are required to minimize the amount of fuel consumption and exhaust emissions from marine engines.This study discusses the procedures to optimize the performance of any marine engine implemented in a 0D/1D numerical model in order to achieve lower values of exhaust emissions.From that point,an extension of previous simulation researches is presented to calculate the amount of SOx emissions from two marine diesel engines along their load diagrams based on the percentage of sulfur in the marine fuel used.The variations of SOx emissions are computed in g/k W·h and in parts per million(ppm)as functions of the optimized parameters:brake specific fuel consumption and the amount of air-fuel ratio respectively.Then,a surrogate model-based response surface methodology is used to generate polynomial equations to estimate the amount of SOx emissions as functions of engine speed and load.These developed non-dimensional equations can be further used directly to assess the value of SOx emissions for different percentages of sulfur of the selected or similar engines to be used in different marine applications.
文摘AIM: To describe the clinical features of congenital double elevator palsy(CDEP) and to evaluate various surgical outcomes between the standard Knapp and augmented Knapp procedures, based on improvements in primary eye position and ocular motility.METHODS: Twenty-two patients with CDEP at Shanghai Children's Hospital were enrolled from July 2014 to January 2018. The forced duction test(FDT) was negative in 21 patients, aged 8 mo to 12 y(mean 5.4 y). Patients were divided into two treatment groups: 16 patients underwent the standard Knapp procedure(group A), with or without horizontal squint procedure; and 5 patients underwent the augmented Knapp procedure(Foster procedure; group B). One patient underwent inferior rectus recession in the affected eye and superior rectus recession in the sound eye because of a positive FDT. The pre-and postoperative vertical deviations in the primary position and ocular motility were compared in the two groups.RESULTS: Twenty-one eyes of the 22 patients(95%) were aligned within 10 prism diopters(PD), and all patients(100%) reached ≥25% elevation improvement after surgery. The average corrected vertical deviation in group B was statistically better than that of group A. For group A, the vertical deviation in the primary position decreased from 24.75Δ±8.35Δ to 4.56Δ±8.07Δ after surgery, for an improvement of 23.06Δ±6.51Δ(P〈0.05). In group B, the decrease was from 35.00Δ±5.00Δ(range 30Δ-40Δ) to 1.00Δ±2.24Δ, for an improvement of 34.00Δ±4.18Δ(P〈0.05). There were significant differences between the pre-and postoperative elevation in each group(group A, P〈0.05; group B, P〈0.05). The average scale of improved elevation in group B(1.80±0.45) was not significantly better than that of group A(1.69±0.87; Z=-0.732, P=0.548). The average follow-up periods lasted 21 mo in group A and 18 mo in group B.CONCLUSION: For vertical deviations 〈30Δ, the standard Knapp procedure can be chosen. For deviations greater than 30Δ-40Δ, the Foster procedure should be chosen. Because of our early interference, the inferior rectus(IR) muscle did not show mechanical restriction. Monocular elevation deficiency(MED) should be diagnosed early so that complications will be reduced and the procedure will be easier for the surgeon.
基金supported by the Clinical Support program of General Hospital of PLA(No.2018FC-WJFWZX-2-19)Military Medical Innovation Program(18CXZ009)。
文摘Background:Snakebites can lead to lifelong consequences and is one of the main causes of death among military troops worldwide.However,few Chinese military medics know the proper first aid procedures for snakebites.Therefore,this study aimed to explore the impact of the Standard Operation Procedure(SOP)and checklist on Chinese military medics’ability to manage snakebite first aid.Methods:This study was a prospective single-blind randomized controlled trial conducted in a military medical university of China from May to June 2017.A questionnaire-based survey was performed to collect the participants’socio-demographic profiles before the baseline measurement.During the baseline measurement,participants were requested to provide corresponding first aid that was responsive to the simulative situation portrayed by the standardized patients(SPs)and the evaluators then scored their performances according to a checklist for snakebite first aid scoring table.After the baseline measurement,they were randomly assigned to one of three intervention groups after stratification according to their baseline performance scores:group A received a self-learning course with textbooks(n=27),group B received a self-learning training on the SOP and checklist(n=27)and group C was engaged in an interactive discussion panel regarding the SOP and checklist(n=26).After the interventions,participants received outcome measurements about snakebite first aid key points capability from the same evaluator and SP for each group to avoid observational error.The reviewers were blinded about the grouping in the trial.Results:The baseline measurement yielded no significant difference(H=1.647,P=0.439)among the three groups.The post-intervention scores were higher than the pre-intervention scores for all three(A,B and C)groups(P=0.008,P<0.001 and P<0.001,respectively).There was significant difference of the post-intervention scores among the three groups(F=8.841,P<0.001).Both post-intervention scores of group B and group C were higher than that of group A(P<0.001 and P=0.001,respectively),but no difference was found between group B and C(P=0.695).The acceptance questionnaire score of SOP and checklist was mostly very satisfied,as the final scores of group B and group C were 4.62±0.61 and 4.82±0.45,respectively.Conclusions:In this study,the implementation of an SOP and checklist for snakebite first aid was shown to update and improve first aid treatment concepts in military medics.These intervention methods played an important role in improving the medics’cognition and understanding of snakebite first aid.Therefore,this finding suggests that SOP and checklist training should be further implemented in Chinese troops for snakebite care.
文摘Forensic science plays a significant role in crime scene analysis and other evidence collection(such as clothes,cigarette butts,blood,semen,hair,etc.,)to scientifically establish the accused’s guilt.In rape and murder cases,DNA tests confirm the victim’s identity.It provides certain evidence that is helpful in the speedy investigation and conclusion of a trial.However,it is not a foolproof science and it has certain limitations.Hence,the first responders,such as the Crime Laboratory Ultimate Evidence System team and the forensic experts,must keep these limitations in mind during sample collection and examination,otherwise,it may lead to incorrect results.Such incorrect results may be obtained due to insufficient sample quantity,improper collection methods,or delay in an examination.It is highly recommended to implement standard operating procedure guidelines,failing which the admissibility of such forensic evidence to prove beyond all reasonable doubts is at stake.Accordingly,the court shall acquit the accused giving him the benefit of doubt.This article focuses on the applicability and limitations of forensic science in the Indian Criminal Justice System and the need to adopt due protocols to yield viable results.
文摘Countries in Asia and the Pacific are more prone to natural disasters than those in other parts of the world.Because of this,there is an urgent need to continue developing effective,end-to-end early warning systems that lead to an effective response by emergency managers and people at risk.ESCAP/WMO Typhoon Committee(TC),in cooperation with WMO/ESCAP Panel on Tropical Cyclones(PTC),conducted a regional cooperation project on Synergized Standard Operating Procedures for Coastal Multi-Hazards Early Warning System(SSOP)with fund support from ESCAP Multi-Donor Trust Fund for Tsunami,Disaster and Climate Preparedness in Indian Ocean and South East Asia.SSOP project was conducted successfully and achieved its proposed goals.Its results and achievements greatly benefit the Members not only in the region but also in all other regions of WMO.The paper reviewed its implementation process,strategy and activities;briefed its main achievements including SSOP Manual,capacity building and cooperation mechanism between TC and PTC;summarized the experiences and lessons from project implementation;and highlighted its sustainability.The paper also suggested the approaches to enhance the sustainability of SSOP results and the cooperation between two regional bodies TC and PTC.
基金funded by UK aid from the UK government through the Fleming Fund Project.
文摘Introduction:The cyclical process of hazard identification,risk assessment,risk mitigation,and review is a key step in developing a biorisk management(BRM)system.This paper describes how this process was initiated in two laboratories in Pakistan using a unique model of blended learning.Methods:A training needs analysis showed that the staff had very little knowledge of BRM systems.A workshop using a unique blended model was conducted in which virtual and in-presence learning occurred simultaneously.This workshop aimed to train the participants by applying two key concepts from the World Health Organization Laboratory Biosafety Manual 4th edition:1)the cyclical process of risk assessment and 2)mapping the core biorisk and establishing heightened control measures in the laboratories of the participants based on the risk assessment.All scenarios and examples used in the training were from the participants’laboratory work processes.Results:Prior to this project,no risk assessment was conducted in these laboratories.After the workshop,a risk assessment was performed for six work processes.In addition,seven core requirements and three heightened control measures were mapped,a biorisk officer was appointed,and a biosafety committee was convened.Furthermore,a biorisk manual,a biological waste management plan,an occupational health center,and a system for audits and inspections are being developed.Discussion and conclusion:BRM training is not a one-time effort;it has to be strengthened to ensure the development and implementation of a comprehensive and sustainable BRM system.Training must be applicable to local settings and incremental,in a way that participants are not overloaded with information.