Abrupt near-surface temperature changes in mountainous areas are a special component of the mountain climate system.Fast and accurate measurements of the locations,intensity,and width of the near-surface changes are n...Abrupt near-surface temperature changes in mountainous areas are a special component of the mountain climate system.Fast and accurate measurements of the locations,intensity,and width of the near-surface changes are necessary but highly difficult due to the complicated environmental conditions and instrumental issues.This paper develops a spatial pattern recognition method to measure the near-surface high temperature increase(NSHTI),one of the lesser-attended changes.First,raster window measurement was proposed to calculate the temperature lapse rate using MODIS land surface temperature and SRTM DEM data.It fully considers the terrain heights of two neighboring cells on opposite or adjacent slopes with a moving window of 3×3 cell size.Second,a threshold selection was performed to identify the NSHTI cells using a threshold of-0.65℃/100 m.Then,the NSHTI strips were parameterized through raster vectorization and spatial analysis.Taking Yunnan,a mountainous province in southwestern China,as the study area,the results indicate that the NSHTI cells concentrate in a strip-like pattern along the mountains and valleys,and the strips are almost parallel to the altitude contours with a slight northward uplift.Also,they are located mostly at a 3/5 height of high mountains or within 400 m from the valley floors,where the controlling topographic index is the altitude of the terrain trend surface but not the absolute elevation and the topographic uplift height and cutting depth.Additionally,the NSHTI intensity varies with the geographic locations and the proportions increase with an exponential trend,and the horizontal width has a mean of about 1000 m and a maximum of over 5000 m.The result demonstrates that the proposed method can effectively recognize NSHTI boundaries over mountains,providing support for the modeling of weather and climate systems and the development of mountain resources.展开更多
Several notable issues arise from overcrowding in an emergency department (ED) for both patients and staff. Longer wait times, higher ambulance diversion rates, longer stays, higher incidence of medical errors, higher...Several notable issues arise from overcrowding in an emergency department (ED) for both patients and staff. Longer wait times, higher ambulance diversion rates, longer stays, higher incidence of medical errors, higher rates of patient mortality, and greater harm to hospitals due to financial losses are some of these problems. Collaboration is crucial in the healthcare industry since it determines the team’s hourly performance in managing patient care. By using Walker and Avant’s (2011) concept analysis method, the author reviewed the literature to better understand ED crowding, to ensure that patients receive safe treatment in a timely manner, and to highlight best practices that can be identified through concept analysis and practice evaluations. In conducting this concept analysis, Walker and Avant’s framework was applied to examine the nature of the findings selected for the advancement of the concept. Everyone working in the ED, from those who determine policy to those on the front lines continually encounter new obstacles, but has little or no time to formulate fresh concepts or reconsider how ED treatment is provided. Overcrowding occurs when the number of patients requiring attention, awaiting transfer, or undergoing diagnosis and treatment exceeds the physical capacity of ED staff. If a clear plan is not in place to increase and improve services in proportion to a growing population, this situation will persist.展开更多
Background: In recent years, we have established an entry-level Forward Surgical Team (FST) training program in a Chinese military medical university for the 5th grade undergraduates, who would be deployed to differen...Background: In recent years, we have established an entry-level Forward Surgical Team (FST) training program in a Chinese military medical university for the 5th grade undergraduates, who would be deployed to different military medical services as primary combat surgeons. This study aimed to assess the role of this pre-service training in improving their confidence with combat medical skills, after several years since they received the training. Methods: We conducted a nationwide survey of 239 primary combat surgeons who have ever participated in an entry-level FST training program before deployment between June 2016 and June 2020, which was for evaluating on a 5-point Likert scale the benefits of entry-level FST training and conventional surgery training in improving their confidence with combat medical skills. The difference in scores was compared using the student t-test. Significance was considered as P Results: The total score was significantly higher for entry-level FST training than that for conventional surgery training (30.76 ± 4.33 vs. 28.95 ± 4.80, P There was no significant difference between the training for surgical skills confidence scores (18.03 ± 8.04 vs. 17.51 ± 8.30, P = 0.098), but for non-technical skills, the score of entry-level FST training was significantly higher than that of conventional surgery training (12.73 ± 5.39 vs. 11.44 ± 5.62, P The distributions of confidence scores were different under various subgroups by demographics. There were no significant differences in scores between the two training in all specific surgical skill sets except “life-saving surgery” (P = 0.011). Scores of all 4 non-technical skill sets were significantly higher for entry-level FST than those for conventional surgery training (P Conclusions: The training should be considered as an essential strategy to improve confidence in combat medical skills, especially life-saving surgery and non-technical skills, for primary combat surgeons.展开更多
基金supported by the National Natural Science Foundation of China (Grant No. 42061004)the Joint Special Project of Agricultural Basic Research of Yunnan Province (Grant No. 202101BD070001093)the Youth Special Project of Xingdian Talent Support Program of Yunnan Province
文摘Abrupt near-surface temperature changes in mountainous areas are a special component of the mountain climate system.Fast and accurate measurements of the locations,intensity,and width of the near-surface changes are necessary but highly difficult due to the complicated environmental conditions and instrumental issues.This paper develops a spatial pattern recognition method to measure the near-surface high temperature increase(NSHTI),one of the lesser-attended changes.First,raster window measurement was proposed to calculate the temperature lapse rate using MODIS land surface temperature and SRTM DEM data.It fully considers the terrain heights of two neighboring cells on opposite or adjacent slopes with a moving window of 3×3 cell size.Second,a threshold selection was performed to identify the NSHTI cells using a threshold of-0.65℃/100 m.Then,the NSHTI strips were parameterized through raster vectorization and spatial analysis.Taking Yunnan,a mountainous province in southwestern China,as the study area,the results indicate that the NSHTI cells concentrate in a strip-like pattern along the mountains and valleys,and the strips are almost parallel to the altitude contours with a slight northward uplift.Also,they are located mostly at a 3/5 height of high mountains or within 400 m from the valley floors,where the controlling topographic index is the altitude of the terrain trend surface but not the absolute elevation and the topographic uplift height and cutting depth.Additionally,the NSHTI intensity varies with the geographic locations and the proportions increase with an exponential trend,and the horizontal width has a mean of about 1000 m and a maximum of over 5000 m.The result demonstrates that the proposed method can effectively recognize NSHTI boundaries over mountains,providing support for the modeling of weather and climate systems and the development of mountain resources.
文摘Several notable issues arise from overcrowding in an emergency department (ED) for both patients and staff. Longer wait times, higher ambulance diversion rates, longer stays, higher incidence of medical errors, higher rates of patient mortality, and greater harm to hospitals due to financial losses are some of these problems. Collaboration is crucial in the healthcare industry since it determines the team’s hourly performance in managing patient care. By using Walker and Avant’s (2011) concept analysis method, the author reviewed the literature to better understand ED crowding, to ensure that patients receive safe treatment in a timely manner, and to highlight best practices that can be identified through concept analysis and practice evaluations. In conducting this concept analysis, Walker and Avant’s framework was applied to examine the nature of the findings selected for the advancement of the concept. Everyone working in the ED, from those who determine policy to those on the front lines continually encounter new obstacles, but has little or no time to formulate fresh concepts or reconsider how ED treatment is provided. Overcrowding occurs when the number of patients requiring attention, awaiting transfer, or undergoing diagnosis and treatment exceeds the physical capacity of ED staff. If a clear plan is not in place to increase and improve services in proportion to a growing population, this situation will persist.
文摘Background: In recent years, we have established an entry-level Forward Surgical Team (FST) training program in a Chinese military medical university for the 5th grade undergraduates, who would be deployed to different military medical services as primary combat surgeons. This study aimed to assess the role of this pre-service training in improving their confidence with combat medical skills, after several years since they received the training. Methods: We conducted a nationwide survey of 239 primary combat surgeons who have ever participated in an entry-level FST training program before deployment between June 2016 and June 2020, which was for evaluating on a 5-point Likert scale the benefits of entry-level FST training and conventional surgery training in improving their confidence with combat medical skills. The difference in scores was compared using the student t-test. Significance was considered as P Results: The total score was significantly higher for entry-level FST training than that for conventional surgery training (30.76 ± 4.33 vs. 28.95 ± 4.80, P There was no significant difference between the training for surgical skills confidence scores (18.03 ± 8.04 vs. 17.51 ± 8.30, P = 0.098), but for non-technical skills, the score of entry-level FST training was significantly higher than that of conventional surgery training (12.73 ± 5.39 vs. 11.44 ± 5.62, P The distributions of confidence scores were different under various subgroups by demographics. There were no significant differences in scores between the two training in all specific surgical skill sets except “life-saving surgery” (P = 0.011). Scores of all 4 non-technical skill sets were significantly higher for entry-level FST than those for conventional surgery training (P Conclusions: The training should be considered as an essential strategy to improve confidence in combat medical skills, especially life-saving surgery and non-technical skills, for primary combat surgeons.
