Spatiotemporal Evaluation and Future Projection of Diurnal Temperature Range over the Tibetan Plateau in CMIP6 Models

The diurnal temperature range(DTR) serves as a vital indicator reflecting both natural climate variability and anthropogenic climate change. This study investigates the historical and projected multitemporal DTR variations over the Tibetan Plateau. It assesses 23 climate models from phase 6 of the Coupled Model Intercomparison Project(CMIP6) using CN05.1 observational data as validation, evaluating their ability to simulate DTR over the Tibetan Plateau. Then, the evolution of DTR over the Tibetan Plateau under different shared socioeconomic pathway(SSP) scenarios for the near,middle, and long term of future projection are analyzed using 11 selected robustly performing models. Key findings reveal:(1) Among the models examined, BCC-CSM2-MR, EC-Earth3, EC-Earth3-CC, EC-Earth3-Veg, EC-Earth3-Veg-LR,FGOALS-g3, FIO-ESM-2-0, GFDL-ESM4, MPI-ESM1-2-HR, MPI-ESM1-2-LR, and INM-CM5-0 exhibit superior integrated simulation capability for capturing the spatiotemporal variability of DTR over the Tibetan Plateau.(2) Projection indicates a slightly increasing trend in DTR on the Tibetan Plateau in the SSP1-2.6 scenario, and decreasing trends in the SSP2-4.5, SSP3-7.0, and SPP5-8.5 scenarios. In certain areas, such as the southeastern edge of the Tibetan Plateau, western hinterland of the Tibetan Plateau, southern Kunlun, and the Qaidam basins, the changes in DTR are relatively large.(3) Notably, the warming rate of maximum temperature under SSP2-4.5, SSP3-7.0, and SPP5-8.5 is slower compared to that of minimum temperature, and it emerges as the primary contributor to the projected decrease in DTR over the Tibetan Plateau in the future.

Mitigating the Prevalence of Diabetic Retinopathy in the United States: Utilization of the Chronic Care Model as a Public Health Framework

As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for urgent and innovative strategies in the United States. The model integrates community resources, healthcare organizations, self-management support, delivery system design, decision support, and clinical information systems. Addressing challenges and solutions, the model emphasizes proactive and preventive measures, collaborative multidisciplinary care, technological integration, and overcoming resistance to change. This paper proposes the utilization of the Chronic Care Model (CCM) as a possible public health framework for comprehensive management of diabetic retinopathy in the United States. Implementing the CCM offers a comprehensive approach to diabetic retinopathy care, addressing both individual and systemic factors, essential for improving public health outcomes.

The construction and practice of humanistic care teaching model based on 5C care theory

Objective:To construct a scientific and feasible teaching mode based on 5C caring theory and evaluate it,so as to provide a reference basis for future study about nursing humanistic quality education.Methods:Based on the 5C caring theory,the teaching design and teaching content were revising and implementing in the intervention group.Before and after the implementation of the course,a questionnaire survey was conducted using the Caring Ability Inventory(CAI).The results of the surveys were collected,and the data were statistically analysis using SPSS.Results:After the implementation of the course,the cognitive dimension,patience dimension,and humanistic caring ability scores of the nursing students in the intervention group improved compared with those before the implementation of the course(P<0.05).There were no significant difference in the control group(P>0.05).Conclusion:The humanistic caring teaching model based on 5C caring theory has a positive effect on improving nursing students'humanistic caring ability.In the future nursing teaching,the modules with the characteristics of humanistic caring ability can be increased,and carry out the educational reform throughout the humanistic caring ability.Actively guiding nursing students to establish the awareness of humanistic caring,so as to lay a solid foundation for high-quality clinical nursing work.

Analysis of the Application Effect of Family Collaborative Care Model on Elderly Patients with Type 2 Diabetes Mellitus and the Situation of Self-Care Ability

Objective: To study the application effect of the family collaborative care model on elderly patients with type 2 diabetes mellitus and its influence on self-care ability. Methods: The elderly type 2 diabetes mellitus patients (400 cases) treated in our hospital between March 2020 and July 2023 were divided into two groups by randomized grouping method;the control group received the conventional nursing program, while the observation group received the family collaborative nursing model. Blood glucose level, self-care ability, and quality of life were compared between the groups. Results: The blood glucose level of the observation group was lower than that of the control group (P < 0.05). The self- care ability and quality of life scores of the observation group were higher than those of the control group (P < 0.05). Conclusion: The family collaborative care model for elderly patients with type 2 diabetes mellitus can promote their self- care ability, improve the effect of glycemic control, and improve their quality of life, and is suitable for further promotion and application.

Analysis of the Effect of Integrated Extended Care Model in Improving the Quality of Life of Elderly Patients with Type 2 Diabetes Mellitus

Objective: To analyze the impact of an integrated extended care model on improving the quality of life of elderly patients with Type 2 Diabetes Mellitus (T2DM). Methods: A total of 176 patients admitted to the hospital from March 2015 to February 2018 were selected and randomly assigned to an observation group and a control group, with 88 patients each. The control group implemented conventional nursing interventions, and the observation group carried out an integrated extended-care model. The level of glycemic control, quality of life, and daily medication adherence between both groups were compared. Results: The observation group showed significant improvement in the level of glycemic control, and their fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels were significantly lower as compared with those in the study group (P < 0.05). The quality of life of the patients in the observation group was higher than that of the control group (P < 0.05). The observation group had a higher compliance score (95.48 ± 7.45) than the control group (81.31 ± 8.72) (t = 8.909, P < 0.05). Conclusion: The integrated extended care model allows patients to receive comprehensive and individualized nursing services after discharge, which improves the effect of drug therapy and the quality of life of patients.

个性化护理联合CICARE沟通模式在耳鼻喉门诊患者中的应用

目的:探讨个性化护理联合CICARE沟通模式在耳鼻喉门诊患者中的应用效果。方法:采用便利取样法将2022年6月1日~2023年12月31日就诊于耳鼻喉门诊的256例患者作为研究对象,将2022年6月1日~2023年1月31日就诊的128例作为对照组,将2023年2月1日~12月31日就诊的128例作为实验组;对照组给予常规耳鼻喉门诊护理,实验组给予个性化护理联合CICARE沟通模式;比较两组护理前后护理质量、护理满意度。结果:护理后,实验组有形性感知、可靠性感知、响应性感知、保证性感知评分均高于对照组(P<0.05,P<0.01),两组移情性感知比较差异无统计学意义(P>0.05);护理后,实验组服务态度、沟通能力、就诊秩序、专业素质、护理安全、护理满意度总分均高于对照组(P<0.05,P<0.01)。结论:将个性化护理联合CICARE沟通模式应用于耳鼻喉门诊患者中,能够提高护理质量和护理满意度。

Projected changes in extreme snowfall events over the Tibetan Plateau based on a set of RCM simulations

Extreme snowfall events over the Tibetan Plateau(TP)cause considerable damage to local society and natural ecosystems.In this study,the authors investigate the projected changes in such events over the TP and its surrounding areas based on an ensemble of a set of 21st century climate change projections using a regional climate model,RegCM4.The model is driven by five CMIP5 global climate models at a grid spacing of 25 km,under the RCP4.5 and RCP8.5 pathways.Four modified ETCCDI extreme indices-namely,SNOWTOT,S1mm,S10mm,and Sx5day-are employed to characterize the extreme snowfall events.RegCM4 generally reproduces the spatial distribution of the indices over the region,although with a tendency of overestimation.For the projected changes,a general decrease in SNOWTOT is found over most of the TP,with greater magnitude and better cross-simulation agreement over the eastern part.All the simulations project an overall decrease in S1mm,ranging from a 25%decrease in the west and to a 50%decrease in the east of the TP.Both S10mm and Sx5day are projected to decrease over the eastern part and increase over the central and western parts of the TP.Notably,S10mm shows a marked increase(more than double)with high cross-simulation agreement over the central TP.Significant increases in all four indices are found over the Tarim and Qaidam basins,and northwestern China north of the TP.The projected changes show topographic dependence over the TP in the latitudinal direction,and tend to decrease/increase in low-/high-altitude areas.

Surface Processes Driving Intracontinental Basin Subsidence in the Context of India–Eurasia Collision:Evidence from Flexural Subsidence Modeling of the Cenozoic Southern Tarim Basin along the West Kunlun Foreland,NW Tibetan Plateau

The India–Eurasia collision has produced a number of Cenozoic deep intracontinental basins,which bear important information for revealing the far-afield responses to the remote collision.Despite their significance,their subsiding mechanism remains the subject of debate,with end-member models attributing it to either orogenic or sedimentary load.In this study,we conduct flexural subsidence modeling with a two-dimensional finite elastic plate model on the Hotan-Mazatagh section along the southern Tarim Basin,which defines a key region in the foreland of the West Kunlun Orogen,along the NW margin of the Tibetan Plateau.The modeling results indicate that the orogenic load of West Kunlun triggers the southern Tarim Basin to subside by up to less than ~6 km,with its impact weakening towards the basin interiors until ~230 km north from the Karakax fault.The sedimentary load,consisting of Cenozoic strata,forces the basin to subside by ~2 to~7 km.In combination with the retreat of the proto-Paratethys Sea and the paleogeographic reorganization of the Tarim Basin,we propose that surface processes,in particular a shift from an exorheic to an endorheic drainage system associated with the consequent thick sedimentary load,played a decisive role in forming deep intracontinental basins in the context of the India-Eurasia collision.

Effect of information-motivation-behavioral skills model based perioperative nursing on pain in patients with gallstones

BACKGROUND The incidence of cholecystolithiasis is on the rise.Use of information,motivation,and behavioral skills can play a positive role in promoting changes in individual health behaviors.However,reports on the effects of information-motivationbehavioral(IMB)skills model based high-quality nursing as a perioperative nursing intervention for patients with gallstones are nonexistent.AIM To explore the application of IMB skills model based high-quality nursing in patients with gallstones.METHODS Two hundred and sixteen patients with cholecystolithiasis treated at our hospital from January 2022 to January 2023 were enrolled and divided into a control,highquality,and combined nursing groups,with 72 patients in each group.The control,high-quality,and combination groups received conventional,high-quality,and IMB skills model based perioperative nursing services,respectively.Differences in clinical indicators,stress levels,degree of pain,emotional state,and quality of life were observed,and complications and nursing satisfaction among the three groups were evaluated.RESULTS After nursing,the time to recovery of gastrointestinal function in the high-quality and combined nursing groups was significantly shorter than that of the control group,with the recovery of gastrointestinal function being the fastest in the combined nursing group(P<0.05).After nursing intervention,cortisol and norepinephrine levels in the high-quality and combined nursing groups were closer to normal than those of the control group 24 h after surgery,with the combined nursing group having the closest to normal levels(P<0.05).After 3 and 7 d of intervention,the patients’pain significantly improved,which was more prominent in the highquality and combination groups.Meanwhile,the pain score in the combination group was significantly lower than those of the control and high-quality nursing groups(P<0.05).After nursing intervention,the emotional states of all patients improved,and the scores of patients in the combination group were significantly lower than those of the control and high-quality nursing groups.The quality of life of patients in the high-quality and combined nursing groups significantly improved after nursing intervention compared to that of the control group,with the combined nursing group having the highest quality of life score.After intervention,the incidence of complications in the high-quality and combination groups was significantly lower than that of the control group(P<0.05),but the difference between the combination and high-quality nursing groups was not significant.Nursing satisfaction of patients in the high-quality and combination groups was significantly higher than that of the control group,with the nursing satisfaction being the highest in the combination group(P<0.05).CONCLUSION IMB skills model based nursing can improve surgical stress levels,degrees of pain,emotional state,quality of life,and nursing satisfaction of patients with gallstones and reduce the incidence of complications.

Construction of Industrialization Development Model for"1+4+X"Community-Based Elderly Care in Gannan Old Revolutionary Base Area in the Context of Population Aging

In the context of controlling population development in a planned way,China entered an aging society in the early 21 st century.In this context,how to meet the needs of the elderly care and form an effective elderly care model has become a key problem to be solved urgently by local government departments.With the continuous advancement of the elderly care policy,the community-based elderly care has gradually become the mainstream and is in the stage of vigorous promotion.Taking the Gannan old revolutionary base area in Jiangxi Province as an example,this study puts forward"1+4+X"community-based elderly care model based on the policy system of community-based elderly care,the physical and mental health of the elderly,the material space and the construction of evaluation system,and explores how to promote the application of this community model efficiently in the form of industrialization,so as to drive the economic growth of the Gannan old revolutionary base area,promote the employment development and improve the community-based elderly care service.

Effects of health concept model-based detailed behavioral care on mood and quality of life in elderly patients with chronic heart failure

BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion of the elderly.AIM To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.METHODS This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received.The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group(SG;n=62),and those who underwent routine detailed behavioral nursing intervention were included as a control group(CG;n=54).Patients’negative emotions(NEs),quality of life(QoL),and nutritional status were assessed using the self-rating anxiety/depression scale(SAS/SDS),the Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the Modified Quantitative Subjective Global Assessment(MQSGA)of nutrition,respectively.Differences in rehabilitation efficiency,NEs,cardiac function(CF)indexes,nutritional status,QoL,and nursing satisfaction were comparatively analyzed.RESULTS A higher response rate was recorded in the SG vs the CG after intervention(P<0.05).After care,the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG(P<0.05).The post-intervention SAS and SDS scores,as well as MQSGA and MLHFQ scores,were also lower in the SG(P<0.05).The SG was also superior to the CG in the overall nursing satisfaction rate(P<0.05).CONCLUSION Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients,and it can not only effectively enhance rehabilitation efficiency,but also mitigate patients’NEs and improve their CF and QoL.

CICARE沟通模式联合细节护理及呼吸训练在心脏磁共振检查患者中的应用

目的探讨CICARE沟通模式联合细节护理及呼吸训练在心脏磁共振检查患者中的应用效果。方法选取2022年1月—2022年12月在医院行心脏磁共振检查患者180例,按照组间基线资料可比的原则分为对照组和观察组,各90例,对照组给予常规护理,观察组在对照组基础上给予CICARE沟通模式联合细节护理及呼吸训练,比较两组患者护理前后的Zung焦虑自评量表(SAS)和汉密尔顿焦虑自评量表(HAMA)评分、检查相关情况、图像质量、患者满意度。结果护理干预后,观察组患者SAS、HAMA评分低于对照组,差异有统计学意义(P<0.05)。观察组患者检查时间短于对照组,差异有统计学意义(P<0.05),两组扫描成功率比较,差异无统计学意义(P>0.05)。观察组患者图像质量优于对照组,图像伪影发生率为18.89%,低于对照组的50.00%,差异有统计学意义(P<0.05)。观察组患者物理环境、护理、护理技术、安全、指导沟通满意度评分高于对照组,差异有统计学意义(P<0.05)。结论CICARE沟通模式联合细节护理及呼吸训练应用于心脏磁共振检查患者中,可有效缓解焦虑情况,提高图像质量、扫描成功率和患者满意度,提高检查效率。

Investigating the effect of the Tibetan Plateau on the ITCZ using a coupled Earth system model

本文利用耦合地球气候系统模式研究了青藏高原对热带辐合带(ITCZ)的影响.我们研究发现热带大西洋ITCZ的位置对青藏高原存在与否有明显的敏感性.与目前真实情况相比,移除青藏高原会导致北半球海面降温,南半球海面升温.这种海面温度变化在大西洋表现得尤为明显,导致热带大西洋最大海温中心向南移动,从而迫使大气对流中心向南移动,即表现为ITCZ的南移.相应地,夏季热带大气Hadley环流的上升支也发生明显南移.北(南)半球海洋变冷(变暖)这种态势要求增强跨赤道向北的大气经向热量输送,从而维持各个半球的能量平衡,而这需要ITCZ位置的南移才能实现.本文研究表明,青藏高原的存在在现今ITCZ气候态的形成中可能扮演了重要角色.

Quantifying Contribution of Recycled Moisture to Precipitation in Temperate Glacier Region,Southeastern Tibetan Plateau,China

Recycled moisture is an important indicator of the renewal capacity of regional water resources.Due to the existence of Yulong Snow Mountain,Lijiang in Yunnan Province,southeast of the Qinghai-Tibet Plateau,China,is the closest ocean glacier area to the equator in Eurasia.Daily precipitation samples were collected from 2017 to 2018 in Lijiang to quantify the effect of sub-cloud evaporation and recycled moisture on precipitation combined with the d-excess model during monsoon and non-monsoon periods.The results indicated that the d-excess values of precipitation fluctuated between–35.6‰and 16.0‰,with an arithmetic mean of 3.5‰.The local meteoric water line(LMWL)wasδD=7.91δ^(18)O+2.50,with a slope slightly lower than the global meteoric water line(GMWL).Subcloud evaporation was higher during the non-monsoon season than during the monsoon season.It tended to peak in March and was primarily influenced by the relative humidity.The source of the water vapour affected the proportion of recycled moisture.According to the results of the Hybrid Single-Particle Lagrangian Integrated Trajectory(HYSPLIT)model,the main sources of water vapour in Lijiang area during the monsoon period were the southwest and southeast monsoons.During the non-monsoon period,water vapour was transported by a southwesterly flow.The recycled moisture in Lijiang area between March and October 2017 was 10.62%.Large variations were observed between the monsoon and non-monsoon seasons,with values of 5.48%and 25.65%,respectively.These differences were primarily attributed to variations in the advection of water vapour.The recycled moisture has played a supplementary role in the precipitation of Lijiang area.

Influence of perinatal factors on full-term low-birth-weight infants and construction of a predictive model

BACKGROUND Being too light at birth can increase the risk of various diseases during infancy.AIM To explore the effect of perinatal factors on term low-birth-weight(LBW)infants and build a predictive model.This model aims to guide the clinical management of pregnant women’s healthcare during pregnancy and support the healthy growth of newborns.METHODS A retrospective analysis was conducted on data from 1794 single full-term pregnant women who gave birth.Newborns were grouped based on birth weight:Those with birth weight<2.5 kg were classified as the low-weight group,and those with birth weight between 2.5 kg and 4 kg were included in the normal group.Multiple logistic regression analysis was used to identify the factors influencing the occurrence of full-term LBW.A risk prediction model was established based on the analysis results.The effectiveness of the model was analyzed using the Hosmer–Leme show test and receiver operating characteristic(ROC)curve to verify the accuracy of the predictions.RESULTS Among the 1794 pregnant women,there were 62 cases of neonatal weight<2.5 kg,resulting in an LBW incidence rate of 3.46%.The factors influencing full-term LBW included low maternal education level[odds ratio(OR)=1.416],fewer prenatal examinations(OR=2.907),insufficient weight gain during pregnancy(OR=3.695),irregular calcium supplementation during pregnancy(OR=1.756),and pregnancy hypertension syndrome(OR=2.192).The prediction model equation was obtained as follows:Logit(P)=0.348×maternal education level+1.067×number of prenatal examinations+1.307×insufficient weight gain during pregnancy+0.563×irregular calcium supplementation during pregnancy+0.785×pregnancy hypertension syndrome−29.164.The area under the ROC curve for this model was 0.853,with a sensitivity of 0.852 and a specificity of 0.821.The Hosmer–Leme show test yieldedχ^(2)=2.185,P=0.449,indicating a good fit.The overall accuracy of the clinical validation model was 81.67%.CONCLUSION The occurrence of full-term LBW is related to maternal education,the number of prenatal examinations,weight gain during pregnancy,calcium supplementation during pregnancy,and pregnancy-induced hypertension.The constructed predictive model can effectively predict the risk of full-term LBW.

Development and validation of a nomogram for predicting in-hospital mortality of intensive care unit patients with liver cirrhosis

BACKGROUND Liver cirrhosis patients admitted to intensive care unit(ICU)have a high mortality rate.AIM To establish and validate a nomogram for predicting in-hospital mortality of ICU patients with liver cirrhosis.METHODS We extracted demographic,etiological,vital sign,laboratory test,comorbidity,complication,treatment,and severity score data of liver cirrhosis patients from the Medical Information Mart for Intensive Care IV(MIMIC-IV)and electronic ICU(eICU)collaborative research database(eICU-CRD).Predictor selection and model building were based on the MIMIC-IV dataset.The variables selected through least absolute shrinkage and selection operator analysis were further screened through multivariate regression analysis to obtain final predictors.The final predictors were included in the multivariate logistic regression model,which was used to construct a nomogram.Finally,we conducted external validation using the eICU-CRD.The area under the receiver operating characteristic curve(AUC),decision curve,and calibration curve were used to assess the efficacy of the models.RESULTS Risk factors,including the mean respiratory rate,mean systolic blood pressure,mean heart rate,white blood cells,international normalized ratio,total bilirubin,age,invasive ventilation,vasopressor use,maximum stage of acute kidney injury,and sequential organ failure assessment score,were included in the multivariate logistic regression.The model achieved AUCs of 0.864 and 0.808 in the MIMIC-IV and eICU-CRD databases,respectively.The calibration curve also confirmed the predictive ability of the model,while the decision curve confirmed its clinical value.CONCLUSION The nomogram has high accuracy in predicting in-hospital mortality.Improving the included predictors may help improve the prognosis of patients.

Advancing critical care recovery:The pivotal role of machine learning in early detection of intensive care unit-acquired weakness

This editorial explores the significant challenge of intensive care unit-acquiredweakness(ICU-AW),a prevalent condition affecting critically ill patients,characterizedby profound muscle weakness and complicating patient recovery.Highlightingthe paradox of modern medical advances,it emphasizes the urgent needfor early identification and intervention to mitigate ICU-AW's impact.Innovatively,the study by Wang et al is showcased for employing a multilayer perceptronneural network model,achieving high accuracy in predicting ICU-AWrisk.This advancement underscores the potential of neural network models inenhancing patient care but also calls for continued research to address limitationsand improve model applicability.The editorial advocates for the developmentand validation of sophisticated predictive tools,aiming for personalized carestrategies to reduce ICU-AW incidence and severity,ultimately improving patientoutcomes in critical care settings.

Guided Care护理模式对老年骨质疏松症患者自我管理能力和生活质量的影响

目的探讨分析Guided Care护理模式对老年骨质疏松症患者自我管理能力和生活质量的影响。方法简单随机选取2022年1月—2023年9月山东省泰安荣军医院收治的60例老年骨质疏松症患者为研究对象,按随机数表法将其分为常规组(实施常规护理干预),模式组(在常规组的基础上给予Guided Care护理模式干预),每组30例,两组均持续干预2个月,比较两组患者干预前后的健康认知水平、跌倒风险、自我管理能力、生活质量、护理满意度。结果干预2个月后,模式组的健康认知水平评分高于常规组,差异有统计学意义(P<0.05)。干预2个月后,模式组的跌倒风险评分低于常规组,差异有统计学意义(P<0.05)。干预2个月后,模式组的自我管理能力评分高于常规组,生活质量评分低于常规组,差异有统计学意义(P均<0.05)。干预2个月后,模式组的护理满意度为93.33%,高于常规组的护理满意度73.33%,差异有统计学意义(χ^(2)=4.320,P<0.05)。结论在老年骨质疏松症患者中,应用Guided Care护理模式,可以有效地提升患者的健康认知水平及自我管理能力,提高患者的生活质量,降低患者跌倒的风险。

Modeling black carbon and its potential radiative effects over the Tibetan Plateau

A regional climate model(RegCM4.3.4) coupled with an aerosol-snow/ice feedback module was used to simulate the deposition of anthropogenic light-absorbing impurities in snow/ice and the potential radiative feedback of black carbon(BC) on temperature and snow cover over the Tibetan Plateau(TP) in 1990-2009. Two experiments driven by ERA-interim reanalysis were performed, i.e., with and without aerosol-snow/ice feedback. Results indicated that the total deposition BC and organic matter(OM) in snow/ice in the monsoon season(MayeS eptember) were much more than non-monsoon season(the remainder of the year). The great BC and OM deposition were simulated along the margin of the TP in the non-monsoon season, and the higher deposition values also occurred in the western TP than the other regions during the monsoon period. BC-in-snow/ice decreased surface albedo and caused positive surface radiative forcing(SRF)(3.0-4.5 W m^(-2)) over the western TP in the monsoon season. The maximum SRF(5-6 W m^(-2)) simulated in the Himalayas and southeastern TP in the non-monsoon season. The surface temperature increased by 0.1-1.5℃ and snow water equivalent decreased by 5-25 mm over the TP, which showed similar spatial distributions with the variations of SRF in each season. This study provided a useful tool to investigate the mechanisms involved in the effect of aerosols on climate change and the water cycle in the cryospheric environment of the TP.

Development of the Transitional Care Model for nursing care in China's Mainland:A literature review

Background:The Transitional Care Model(TCM)for nursing care has yet to be implemented in China despite its success in Western countries.However,rapid social changes have demanded an upgrade in the quality of nursing care;in 2010,the Chinese government has acknowledged the need to implement the TCM in China.Objective:This study has the following objectives:(1)perform a thorough review of the literature regarding the development and implementation of the TCM in China's Mainland within the past 5 years;(2)provide a comprehensive discussion of the current status,problems,and strategies related to the implementation of the TCM in China's Mainland;and(3)suggest strategies pertaining to the future of the TCM in China.Design:The current pertinent literature is systematically reviewed.Data sources:Systematic and manual searches in computerized databases for relevant studies regarding the TCM led to the inclusion of 26 papers in this review.Review methods:Abstracts that satisfied the inclusion criteria were reviewed independently by the two authors of this manuscript,and discrepancies were resolved through discussion.The same reviewers independently assessed the paper in its entirety for selected abstracts.Results:The present English literature reviewrevealed a paucity of updated information about the development and implementation of the TCM in China's Mainland.Nevertheless,the dramatic growth of the TCM in the past 5 years has had a vital impact within the society and in nursing development.This review also revealed numerous issues regarding the focus of the TCM.Overall implications for practiceandrecommendations for future researchare discussed.Conclusion:Despite the potential of this nursing model to have a successful and beneficial impact in China's Mainland,it remains an under-researched topic.Further research on education and training as well as premium policies for nurses under the TCM are needed.