Periconceptional Folic Acid Use and Its Effects on Neural Tube Defects—Five Counties,Shanxi Province,China,2010–2016

Summary What is already known about this topic?Robust evidence indicates that supplementing with folic acid periconceptionally may decrease the risk of neural tube defects(NTDs)in fetuses.What is added by this report?Over half of the mothers in both the NTD case group and the control group utilized folic acid supplements during the periconceptional period,showing no notable variations between the two groups.

Periconceptional Folic Acid Only Versus Multiple Micronutrients Containing Folic Acid and Association with Gestational Diabetes Mellitus-Beijing Municipality,China,2017-2021

Summary What is already known about this topic?Inconsistent results have been reported on the association between periconceptional folic acid only(FAO)or multiple micronutrients containing folic acid(MMFA)supplementation and the risk of gestational diabetes mellitus(GDM)in previous research.What is added by this report?In a prospective cohort study conducted among pregnant women in Haidian District,Beijing Municipality,it was observed that those who took MMFA demonstrated a higher likelihood of developing GDM in comparison to those who consumed FAO periconceptionally.Interestingly,the increased risk for GDM in pregnant women supplemented with MMFA compared to FAO was primarily due to changes in fasting plasma glucose.What are the implications for public health practice?It is highly recommended that women prioritize the use of FAO in order to yield potential benefits in the prevention of GDM.

Reform of Hospitality English Teaching Based on the Educational Concept of Outcome-Based Education(OBE)

The Outcome-Based Education(OBE)educational concept,proposed by renowned American educator Spady,aims to guide students in mastering learning laws and ultimately achieving expected learning outcomes.The application of OBE educational concept in Hospitality English curriculum not only can effectively enhance the learning effect but also promote the reform of the Hospitality English curriculum,thus improving students’learning enthusiasm.Therefore,taking the Hospitality English curriculum as an example,this paper points out the existing problems in the teaching of this course and suggests the reform measures based on the OBE teaching concept,hoping to provide guidelines for related educational work.

A concept analysis of vicarious resilience in mental health nursing

Objective:The introduction of the vicarious resilience concept in psychology and mental health nursing literature is a highly promising advancement.By utilizing this novel concept,experts in various domains can enhance their comprehension of how to foster resilience in individuals by observing and learning from the resilience of others.This concept analysis aims to elucidate the concept of vicarious resilience in mental health nursing by defining its related attributes,antecedents,and consequences.Methods:Walker and Avant’s strategy for concept analysis method was used.This review specifically examined mental health nurse providers.A comprehensive literature search was performed in the PubMed,Medline,the Cochrane Library,and CINAHL databases.The inclusion criterion was Englishlanguage documents on vicarious resilience within mental health nursing.Results:A total of 24 articles were included.The concept’s attributes were empathy,hope,resourcefulness,awareness,and spirituality.Antecedents were associated with listening to patients’trauma narratives,self-care,self-awareness,and support from colleagues.Consequences were enhanced well-being,changes in life goals,adaptation,personal growth,and increased personal resilience.Currently,there is only one tool in the empirical reference.Conclusion:Interpreting the concept of vicarious resilience in mental health nursing and determining its characteristics can be utilized to design nursing interventions to develop vicarious resilience and enhance the quality of care in mental health facilities.

Rule acquisition of three-way semi-concept lattices in formal decision context

Three-way concept analysis is an important tool for information processing,and rule acquisition is one of the research hotspots of three-way concept analysis.However,compared with three-way concept lattices,three-way semi-concept lattices have three-way operators with weaker constraints,which can generate more concepts.In this article,the problem of rule acquisition for three-way semi-concept lattices is discussed in general.The authors construct the finer relation of three-way semi-concept lattices,and propose a method of rule acquisition for three-way semi-concept lattices.The authors also discuss the set of decision rules and the relationships of decision rules among object-induced three-way semi-concept lattices,object-induced three-way concept lattices,classical concept lattices and semi-concept lattices.Finally,examples are provided to illustrate the validity of our conclusions.

Spatial Differentiation and Convergence Trend of High-quality Development Level of China’s Tourism Economy

This paper aims to interpret the connotation of high-quality development of tourism economy(HQTE)from the perspective of the new development concepts of innovation,coordination,green,openness and sharing,and then to evaluate the spatial differenti-ation of China’s HQTE based on provincial panel data from 2009 to 2018.Specifically,we employ the spatial convergence model to ex-plore the absolute and conditionalβconvergence trends of HQTE in the whole country and the eastern,central and western regions of China.Our empirical results reveal that:1)within the decade,from 2009 to 2018,regions of China with the highest HQTE index is its eastern region followed by the central region and then the western region,but the fastest growing one is the western region of China fol-lowed by the central region and then the eastern region.2)Whether or not the spatial effect is included,there are absolute and condition-alβconvergence in HQTE in the whole country and aforementioned three regions.3)The degree of government attention as well as the level of economic development and location accessibility are the positive driving factors for the convergence of HQTE in the whole country and the three regions.The degree of marketization and human capital have not passed the significance test either in the whole country or in the three regions.The above conclusions could deepen the understanding of the regional imbalance and spatial conver-gence characteristics of HQTE,clarify the primary development objects,and accomplish the goal of China’s HQTE.

Repeated pregnancy losses with multiple aneuploidies and major genomic imbalance:A case report

Rationale:If one of the partners is having balanced autosomal translocation,it is usually observed that the offspring inherit either normal chromosomes,balanced translocation identical to one of the parent or unbalanced chromosomal rearrangements of the same parental chromosome having translocation.Concern:A unique case presented with history of 8 miscarriages for genetic counseling.The last abortus material evaluation showed monosomy of chromosome X(Turner syndrome)in all the analyzed cells.There was a history of infertility and also repeated second trimester abortions on the paternal side.On the maternal side,there was a history of intellectual disability.Diagnose:History of repeated abnormal pregnancy outcomes.Wife’s karyotype is normal;however,husband shows translocation between chromosome 4 and 22.Intervention:Peripheral blood sample around 3 mL was collected for karyotype.Embryo biopsy was done and DNA was extracted and processed for whole exome sequencing.Outcomes:Wife’s karyotype is normal and husband has translocation between chromosome 4 and 22.Surprisingly,the entire pregnancy outcome including embryo screening has different,complete or partial aneuploidies of chromosomes other than chromosome 4 and 22.Main lesson:Though the translocation in one of the parent is balanced,we have to think beyond traditional ways for evaluating a couple with repeated pregnancy loss as we cannot predict the errors at cell division.Option of in vitro fertilization and preimplantation genetic diagnosis in couples having balanced translocations should be discussed so that early intervention can prevent the agony of pregnancy loss.

Recent advances in managing obstructive sleep apnea

Obstructive sleep apnea(OSA)is a rapidly increasing global concern.If it remains untreated,it can lead to cardiovascular,metabolic,and psychiatric complications and may result in premature death.The efficient and effective management of OSA can have a beneficial effect and help reduce the financial burden on the health sector.There has been constant development in OSA management,and numerous options are available.The mainstay of therapy is still the conventional measures and behavioral modifications.However,in cases of failure of these modalities,surgical therapy is the only option.Numerous studies have shown that proper management of OSA has beneficial effects with good long-term outcomes.

Impact of fast-track surgery on perioperative care in patients undergoing hepatobiliary surgery

BACKGROUND Fast-track surgery(FTS)is a modern nursing approach that has gained popularity in the perioperative phase of surgery.AIM To investigate the impact of FTS on perioperative care for hepatobiliary surgery.METHODS A retrospective analysis was performed on 98 patients who underwent hepato-biliary surgery and were admitted to our hospital from August 2021 to October 2023.They were divided into an observation group and a control group with 49 patients in each group according to different nursing directions.The control group was treated with standard nursing and the observation group was treated with FTS concept nursing.The length of hospital stay,visual analog scale(VAS)score,wound complications,nursing satisfaction,self-rating scale(SAS)score,and SF-36 quality of life(QoL)score were compared between the two groups before and after care.RESULTS The duration of hospitalization,hospitalization cost,operation time,first im-plantation time,exhaust time,and first defecation time were shorter than the observation group(P<0.05).Additionally,the observation group showed a sig-nificant difference between the VAS and SAS scores on days 1,3,and 7(P<0.05).The complication rate in the observation group was 4.05%was significantly lower than the 18.36%in the control group,and the comparison groups were statistically significant(χ2=5.018,P=0.025).The observation group had a significantly higher level of nurse satisfaction(94.92%)than the control group(79.59%;χ2=6.078,P=0.014).Both groups showed higher QoL scores after nursing care,with higher scores in the observation group than in the control group(P=0.032).CONCLUSION FTS in patients undergoing hepatobiliary surgery can effectively improve negative mood,QoL,and nursing sa-tisfaction;reduce wound complications;and accelerate patient rehabilitation.

Research on the Design of Rural Cultural Tourism Space under the Background of Rural Revitalization: A Case Study of Dujiazhuang Village, Mentougou, Beijing

From the perspective of endogenous development concept,Dujiazhuang Village,Mentougou was taken as an example to explore the development of rural cultural tourism space.The rural tourism resources in the west of Beijing are rich in type and numerous,but the development of cultural tourism is unbalanced and inadequate.Guided by the endogenousconcept and driven by the design of cultural tourism space,rural public space should be as the entry point to integrate the elements of rural resources and create a design that stimulates the endogenous ability of villagers.Culture can promote tourism,and industry can drive the economy to increase income and enhance the villagers'cultural identity.

Value and Measures of Integrating Local Red Culture into the Ideological and Political Course of Environmental Disciplines under the OBE Concept

Based on output-oriented education,the OBE(Outcome-Based Education)concept integrates local red culture into the ideological and political course of environmental disciplines,and is an important part of training applied talents of environmental disciplines in the new era.This educational model makes an innovation on the traditional educational and teaching concepts and centers on students.This paper analyzes the value of integrating local red culture into the ideological and political course under the OBE concept,and puts forward an effective implementation path.

The Tenth Anniversary of Free Trade Pilot Zones in China:Fundamental Experiences and Enhancement Strategies

Since the 18th National Congress of the Communist Party of China,the country has established 21 Free Trade Pilot Zones(FTZs),achieving significant pioneering results in reform and opening up and creating a strong demonstrative effect nationwide.The basic experience from a decade of FTZs includes:adhering to the centralized and unified leadership of the CPC Central Committee;combining top-level design with encouragement of grassroots innovation;leveraging the distinct characteristics and strengths of FTZs to form a differentiated development pattern;maintaining the integration of opening up with domestic reforms;using openness to drive reforms;and organically combining openness with national security assurance.Under the current and future new circumstances,China’s FTZs face new challenges and tasks.In accordance with the directives of the 20th National Congress of the Communist Party of China,an enhancement strategy for the FTZs needs to be implemented.This involves the following:First,accurately understanding and responding to the changing situation to create strategic opportunities.Second,shifting paradigms to implement innovation-driven strategies,using the new development pattern concept to guide the reform experiments and construction of the FTZs.Third,granting more autonomy to FTZs for reforms,pursuing progress while maintaining stability,and solidly advancing the reform experiments in the FTZs.Fourth,orderly expanding the opening up of the service sector and cautiously advancing the internationalization of the renminbi.Fifth,promoting innovative development in trade to build a strong trade nation.Sixth,establishing synergy with bilateral FTZs,Belt and Road cooperation,and national diplomatic strategies to enhance the linkage effect.

International Healthcare Terminologies for Morbidity New Era: SNOMED and ICD11

The Information Technology (IT) developments have changed the use of Healthcare terminologies from paper-based mortality statistics with the WHO international classifications of diseases (ICD) to the IT-based morbidity implementations for instance for Casemix-based healthcare funding and managing systems. This higher level of granularity is worldwide spread under the umbrella of several national modifications named ICD10 XM. These developments have met the increased use of the International Clinical Reference Terminology named SNOMED. When the updating of WHO ICD10 to WHO ICD11 was decided a merging was envisaged and a WHO SNOMED CT common work proposed a methodology to create a common formal ontology between the 11th version of the WHO International Classification of Diseases and Health Problems (ICD) and the most used in the world clinical terminology named Systematized Nomenclature of Human and Veterinary Medicine - Clinical Terms (SCT). The present work follows this unachieved work and aims to develop a SNOMED-based formal ontology for ICD11 chapter 1 using the textual definitions of ICD11 codes which is a completely new character of ICD and the ontology tools provided by SCT in the publicly available SNOMED Browser. There are two key results: the lexical alignment is complete and the ontology alignment is incomplete with the validated SNOMED concept model can be completed with not yet validated attributes and values of the SNOMED Compositional Grammar. The work opens a new era for the seamless use of both international terminologies for morbidity for instance for DRG/Casemix and clinical management use. The main limitation is that it is restricted to 1 out of 26 chapters of ICD11.

From the Subjectivity of Human Rights to the Universality of Human Rights——A Preliminary Interpretation of the Theory on the Subjectivity of Human Rights

Universality is one of the essential characteristics of human rights, but there is a substantive difference between idealism and realism in understanding the concept of universality of human rights. The concepts of radical universality and strong universality based on the concept of natural human rights are too idealistic and thus have a high risk of being alienated into a tool of international re-pression in practice. On the contrary, the theory on the subjectivity of human rights can effectively defuse this risk brought about by radical universality and strong universality. Advocating a transition from the universality of human rights to the subjectivity of human rights not only keeps in line with the actual construction process of international human rights, but can also effectively interpret the practical difficul-ties in the realization process of international human rights. Therefore, it can be used as another alternative theory on human rights beyond the theory of natural human rights.

Clinical Study of Accelerated Rehabilitation Concept Combined with Tianji Robot-Assisted Surgery in Lumbar Degenerative Diseases

Objective: To compare the effectiveness and safety of two surgical methods for lumbar degenerative diseases;the combination of the concept of accelerated rehabilitation with the assistance of Tianji Robotics and the concept of accelerated rehabilitation combined with manual pedicle screw placement assisted by conventional C-arm fluoroscopy. Methods: A retrospective analysis was performed on 70 patients who received the concept of accelerated rehabilitation combined with spinal surgery for lumbar degenerative diseases in Baise People’s Hospital from January 2022 to January 2024. Among them, 35 patients in the robot group received accelerated rehabilitation concept combined with robot-assisted surgery;In the conventional C-arm group, 35 patients received the accelerated rehabilitation concept combined with manual pedicle screw placement assisted by conventional C-arm fluoroscopy. VAS score (preoperative/postoperative), ODI score (preoperative/postoperative), intraoperative bleeding volume, postoperative hospital stay, postoperative complications and the accuracy rate of screw placement were compared between the two groups. Result: There was no statistically significant difference in preoperative VAS scores between the robot group and the conventional C-arm group (6.45 ± 0.82 VS 6.63 ± 0.81, P = 0.6600). The postoperative VAS score of the robot group was better than that of the conventional C-arm group (1.69 ± 0.80 VS 2.45 ± 0.85, P = 0.0000*). There was no statistically significant difference in preoperative ODI scores between the robot group and the conventional C-arm group (32.11 ± 3.18 VS 31.66 ± 2.25, P = 0.4900). The postoperative ODI score of the robot group was better than that of the conventional C-arm group (22.68 ± 1.94 VS 24.57 ± 2.25, P = 0.0000*). The postoperative complications in the robot group were less than those in the conventional C-arm group (2.7778% VS 28.5724%, P = 0.0030*). The intraoperative bleeding in the robot group was lower than that in the conventional C-arm group (320.85 ± 276.28 VS 490.00 ± 395.34, P = 0.0420*). The postoperative hospital stay of the robot group was shorter than that of the conventional C-arm group (10.00 ± 9.32 VS 14.49 ± 7.55, P = 0.0300*). The screw placement inaccuracy score of the robot group was lower than that of the conventional C-arm group (0.17 ± 0.51 VS 1.45 ± 1.46, P = 0.0000*). Conclusion: The combination of the concept of accelerated rehabilitation and Tianji Orthopedic robot-assisted surgery is more effective and safer in posterior lumbar decompression and internal fixation surgery with a screw rod system, and is worthy of promotion and application.

Learning of Concepts: A Review of Relevant Advances Since 2010 and Its Inspirations for Teaching

This article reviews the psychological and neuroscience achievements in concept learning since 2010 from the perspectives of individual learning and social learning,and discusses several issues related to concept learning,including the assistance of machine learning about concept learning.In terms of individual learning,current evidence shows that the brain tends to process concrete concepts through typical features(shared features);and for abstract concepts,semantic processing is the most important cognitive way.In terms of social learning,interpersonal neural synchrony(INS)is considered the main indicator of efficient knowledge transfer(such as teaching activities between teachers and students),but this phenomenon only broadens the channels for concept sources and does not change the basic mode of individual concept learning.Ultimately,this article argues that the way the human brain processes concepts depends on the concept’s own characteristics,so there are no“better”strategies in teaching,only more“suitable”strategies.

Conceptual Analysis of Self-Management in Patients with Hypertension

Objective:To clarify the concept of self-management in hypertensive patients by analyzing the definition,attributes,and measurement tools through a literature review.Methods:An Internet-based search of the databases was conducted using Academic Search Complete,Medical Line,CINAHL,Health Source:Nursing/Scholarly Edition,and Google Scholar.In the search process,keywords or free text were combined by using Boolean operators,with the search terms“self of management”or“self-management,”“concept*analysis”or“concept*definition,”and Walker and Avant’s concept analysis method was used.Results:Analysis of relevant literature summarized the conceptual attributes of self-management in hypertensive patients as the active participation of patients in the treatment process;the presence of interaction provided by patients and health care providers;the use of certain health management tools;and the aim of maintaining and improving the health status and living capacity of hypertensive patients.Conclusion:The concept of self-management for hypertensive patients was clarified,which helps to promote the application of hypertensive self-management in clinical work and improve outcomes and quality of life for patients with hypertension.

Self-management in patients with diabetic foot ulcer:a concept analysis

Objective:This paper presents an analysis of the concept of patient outcomes.Methods:The present study conducted searches on various databases,including Wanfang,Sinomed,CNKI,Pub Med,Cochrane Library,Embase,Web of Science,and Ovid.The paper followed the Walker and Avant concept-analysis approach.Results:Initially,899 pieces of literature were identified through the search process,and after screening,41 of them were ultimately included in the analysis.The identified attributes of the concept included(1)capability,(2)decision making,and(3)action.These antecedents were shaped by factors such as illness perception,self-efficacy,and family and social.The consequences included(1)physiological effects,(2)psychological effects,and(3)social influence.Conclusions:The concept analysis of self-management in patients with diabetic foot ulcers(DFUs)not only aids in clinical practice and suppor ts interventions,but also contributes to the development of self-management theory.The common goal of clinical medical staff is to assist DFU patients in improving cognitive ability,making correct self-management decisions,and enhancing self-management behavior.

Analyzing the Adaptation of Rebecca from the Novel to the Film in Light of the Black-and-White

Classical Chinese aesthetics is based on Chinese philosophy.The characteristic of classical Chinese aesthetics regards“artistic conception”as one of the basic aesthetic categories.Chinese art speaks highly of the charm of the black-and-white.During the adaptation,there is the same beauty in the black-and-white photography and the“color without color”of Chinese paintings.The“artistic conception”is similar between them from the aesthetic perspective.Therefore,the unique“artistic conception”of the novel should be mastered,if the adapter aims to retain the“soul”of it.In other words,film adaptation not only considers“similarity in form”,but also draws much attention to“similarity in spirit”.The latter is the essence of film adaptation.

Design Concept and Innovation of Jakarta-Bandung HSR

This paper analyzes the geographical,climatic,cultural and religious factors that influence station building design,and discusses the characteristics and design concepts of traditional Indonesian building.Additionally,the following innovative concepts are proposed for station building design:innovation in the building form that organically integrates high speed railway characteristics with regional features;innovation in spatial layout that adapts to the local climate and culture;innovation in flexible flow lines and diverse commercial spaces;innovation in interior design that fully incorporates the local culture.The station buildings of Jakarta-Bandung HSR not only fulfill the function of passenger riding but also serve as prominent landmark structures that spread regional culture and represent the city's image so as to offer valuable insights for the design of high speed railway station buildings in future overseas projects.