Establishment and management of neurosurgery emergency observation ward during the COVID‑19 epidemic period

During the COVID‑19 epidemic period,the front‑line antiepidemic departments have attracted much attention.However,to meet people’s daily needs for the diagnosis and treatment,emergency department and intensive care unit are also the focus of work to control the source of infection,cut off the transmission route,and reduce the risk of novel coronavirus transmission while treating patients.In order to further strengthen the management,our department of neurosurgery took active measures in the emergency treatment for patients and summarized the coping strategies and relevant experience from the aspects of establishment of emergency observation wards,medical staff management,patients and family management,daily environment and object surface disinfection management,material management,and nursing quality management,hoping to provide reference for the nursing management of emergency wards after the outbreak of public health emergencies.

Optimal reconfiguration of constellation using adaptive innovation driven multiobjective evolutionary algorithm

Constellation reconfiguration is a critical issue to recover from the satellite failure,maintain the regular operation,and enhance the overall performance.The constellation reconfiguration problem faces the difficulties of high dimensionality of design variables and extremely large decision space due to the great and continuously growing constellation size.To solve such real-world problems that can be hardly solved by traditional algorithms,the evolutionary operators should be promoted with available domain knowledge to guide the algorithm to explore the promising regions of the trade space.An adaptive innovationdriven multi-objective evolutionary algorithm(MOEA-AI)employing automated innovation(AI)and adaptive operator selection(AOS)is proposed to extract and apply domain knowledge.The available knowledge is extracted from the final or intermediate solution sets and integrated into an operator by the automated innovation mechanism.To prevent the overuse of knowledgedependent operators,AOS provides top-level management between the knowledge-dependent operators and conventional evolutionary operators.It evaluates and selects operators according to their actual performance,which helps to identify useful operators from the candidate set.The efficacy of the MOEAAI framework is demonstrated by the simulation of emergency missions.It was verified that the proposed algorithm can discover a non-dominant solution set with better quality,more homogeneous distribution,and better adaptation to practical situations.

A new charging scheme in an emergency department observation unit under Beijing＇s basic medical insurance

Background The new medical insurance policy （JRSYF（2010） No.255） was released by the Beijing Municipal Government and became effective on January 1,2011.Medical expenses incurred during a stay in an emergency department （ED） observation unit can be reimbursed as a hospital admission.The aim of this study was to evaluate the impact of a new charging scheme during stays in ED observation unit under Beijing＇s Basic Medical Insurance.Methods Data for those patients who had stayed in ED observation unit in 2010 （before the implementation of a new charging scheme） and 2012 （after the implementation of this policy） were retrospectively analyzed in terms of length of stay,patients who were observed （PO）,and median medical costs.Results After the implementation of a new charging scheme,compared with the year of 2010,in year of 2012,there were statistically significant longer lengths of stay at the observation unit （6 （4-9） vs.5 （4-7） days; P〈0.001）,more PO （2 257vs.1 783; P〈0.001）,and more median medical costs （RMB 6 026 vs.3 650 Yuan; P〈0.01）.The proportion of elderly patients （≥60 years of age） in 2012 was larger than that in 2010 （70.22% vs.63.71%; P〈0.01）.It was performed on those patients who were admired after the implementation of a new charging scheme.Compared with patients who were not admired had stayed in ED observation units,the patients who were admired had stayed in ED observation units that had a higher proportion for 〉15 days （36.22% vs.5.61%; P〈0.01）; they had higher median medical costs RMB （9 186 vs.5 668Yuan; P〈0.001） and they were more elderly （≥60 years of age） （86.10% vs.66.39%; P〈0.01）.Conclusions The new charging scheme under Beijing＇s Basic Medical Insurance allows patients to get access to inpatient admission more easily.It lowers patients＇ financial burden in ED observation unit.Since more people stay at ED observation unit,it increases ED payments by the insurance system.However,it slows the turnover rate of ED observation unit and causes overcrowding in ED.Hence,the advantages and disadvantages of the new policy are obvious.

Discrete Quantum Transitions, Duality: Emergence of Physical Structures and Occurrence of Observed Formations (Hidden Properties of Mathematical Physics Equations)

With the help of skew-symmetric differential forms, the hidden properties of the mathematical physics equations that describe discrete quantum transitions and emergence the physical structures are investigated. It is shown that the mathematical physics equations possess a unique property. They can describe discrete quantum transitions, emergence of physical structures and occurrence observed formations. However, such a property possesses only equations on which no additional conditions, namely, the conditions of integrability, are imposed. The intergrability conditions are realized from the equations themselves. Just under realization of integrability conditions double solutions to the mathematical physics equations, which describe discrete transitions and so on, are obtained. The peculiarity consists in the fact that the integrability conditions do not directly follow from the mathematical physics equations;they are realized under the description of evolutionary process. The hidden properties of differential equations were discovered when studying the integrability of differential equations of mathematical physics that depends on the consistence between the derivatives in differential equations along different directions and on the consistence of equations in the set of equations. The results of this work were obtained with the help of skew-symmetric differential forms that possess a nontraditional mathematical apparatus such as nonidentical relations, degenerate transformations and the transition from nonintegrable manifolds to integrable structures. Such results show that mathematical physics equations can describe quantum processes.