Aiming at the intervention decision-making problem in manned/unmanned aerial vehicle（MAV/UAV） cooperative engagement, this paper carries out a research on allocation strategy of emergency discretion based on human f...Aiming at the intervention decision-making problem in manned/unmanned aerial vehicle（MAV/UAV） cooperative engagement, this paper carries out a research on allocation strategy of emergency discretion based on human factors engineering（HFE）.Firstly, based on the brief review of research status of HFE, it gives structural description to emergency in the process of cooperative engagement and analyzes intervention of commanders. After that,constraint conditions of intervention decision-making of commanders based on HFE（IDMCBHFE） are given, and the mathematical model, which takes the overall efficiency value of handling emergencies as the objective function, is established. Then, through combining K-best and variable neighborhood search（VNS） algorithm, a K-best optimization variable neighborhood search mixed algorithm（KBOVNSMA） is designed to solve the model. Finally,through three groups of simulation experiments, effectiveness and superiority of the proposed algorithm are verified.展开更多
The southwest coastal region of Bangladesh, being under tidal influence and dependent on sweet water supplies from upstream, has a unique brackish water ecosystem. The region, having vast low-lying areas enclosed by m...The southwest coastal region of Bangladesh, being under tidal influence and dependent on sweet water supplies from upstream, has a unique brackish water ecosystem. The region, having vast low-lying areas enclosed by man-made polders, is considered to be highly vulnerable to climate change induced hazards. In this study, linear trends in hydro-climatic variables, such as temperature, rainfall, sunshine, humidity, sweet water inflow and tidal water level in the region are assessed using secondary data and following both parametric and nonparametric statistical techniques. Correlation between the sweet water flow from the Gorai River, a major distributary of the Ganges River, and the salinity level in the Rupsa-Pasur River near Khulna, a southern metropolis, is also investigated. The results reveal that the temperature in the Khulna region is increasing at a significant rate, particularly in recent years. The number of extremely cold nights is decreasing and the heat index is increasing. The sunshine duration has a decreasing trend and the humidity has an increasing trend. Rainfall is increasing in terms of both magnitude and number of rainy days. However, the annual maximum rainfall and the number of days with high intensity rainfall have remained almost static. The annual maximum tidal high water level is increasing and the annual minimum low water level is decreasing at a rate of 7 - 18 mm and 4 - 8 mm per year, respectively. There is a negative correlation between the Gorai flow and the river water salinity around Khulna. Dredging of the Gorai during 1998-2001 resulted in an improvement of the salinity situation in the Khulna region. The variation in water salinity, tidal water level and sweet water flows in different time periods indicates that the human interventions through upstream diversion and coastal polders have contributed more in hydro-morphological changes in the southwest than the climate change. However, there are some evidences of climate change in the meteorological variables at Khulna.展开更多
<p align="justify"> <span style="font-family:Verdana;"></span><span style="font-family:Verdana;"></span>Clinician Burnout is a personal and public health iss...<p align="justify"> <span style="font-family:Verdana;"></span><span style="font-family:Verdana;"></span>Clinician Burnout is a personal and public health issue. Most occupational stressors contributing to clinician burnout are systemic. The combination of organizational interventions along with individual interventions is necessary to make significant lasting difference in reducing burnout, improving clinician and patient satisfaction and reducing latent error in healthcare delivery. Application of Human Factors/Ergonomics (HFE) science in healthcare leadership and management is a gap in current training for leaders. HFE uses concepts from organizational, educational and cognitive science, systems science and industrial engineering. HFE application is especially necessary in a fast changing highly stressful healthcare environment which impacts the wellbeing of clinicians and the safety of patients under care. Practical suggestions for working with various healthcare leadership styles and organizational dynamics, while aligning wellness efforts with institutional mission are discussed. Concrete examples of decreasing extraneous mental load on clinicians to preserve their brainpower to achieve quality patient care are illustrated. Organizational interventions in combination with individual interventions to reduce and manage burnout have enormous potential to improve clinician wellbeing and satisfaction in taking care of patients, reduce costs, risk of error and create the safe working environment needed to sustainably give high quality care to patients. </p>展开更多
BACKGROUND Enhancing awareness and use of pre-exposure prophylaxis(PrEP)and postexposure prophylaxis(PEP)is vital to curb human immunodeficiency virus(HIV)spread.High-risk behaviors prevalent among sexually transmitte...BACKGROUND Enhancing awareness and use of pre-exposure prophylaxis(PrEP)and postexposure prophylaxis(PEP)is vital to curb human immunodeficiency virus(HIV)spread.High-risk behaviors prevalent among sexually transmitted infection clinic outpatients underscore the need for increased PrEP/PEP education in this group.AIM To investigate the effects of both onsite and online health education on the knowledge of,and willingness to use,PrEP and PEP among individuals receiving PEP services.METHODS Participants were drawn from a cohort study on PEP service intervention at an STD/AIDS outpatient clinic in designated HIV/AIDS hospitals in Beijing,conducted from January 1 to June 30,2022.Health education was provided both onsite and online during follow-up.Surveys assessing knowledge of,and willingness to use,PrEP/PEP were administered at baseline and again at 24 wk post-intervention.RESULTS A total of 112 participants were enrolled in the study;105 completed the follow-up at week 24.The percentage of participants with adequate knowledge of,and willingness to use,PrEP significantly increased from 65.2%and 69.6%at baseline to 83.8%and 82.9%at the end of the intervention(both P<0.05).Similarly,those with adequate knowledge of,and willingness to use,PEP increased from 74.1%and 77.7%at baseline to 92.4%and 89.5%at week 24(P<0.05).Being between 31 years and 40 years of age,having a postgraduate degree or higher,and reporting a monthly expenditure of RMB 5000 or more were found to be significantly associated with knowledge of PrEP and PEP(both P<0.05).CONCLUSION The findings show that both onsite and online health education significantly improved the knowledge of,and increased willingness to use,PrEP and PEP in individuals utilizing PEP services.展开更多
Although a large number of trials in the SCI field have been conducted,few proven gains have been realized for patients.In the present study,we determined the efficacy of a novel combination treatment involving surgic...Although a large number of trials in the SCI field have been conducted,few proven gains have been realized for patients.In the present study,we determined the efficacy of a novel combination treatment involving surgical intervention and long-term weight-bearing walking training in spinal cord injury(SCI)subjects clinically diagnosed as complete or American Spinal Injury Association Impairment Scale(AIS)Class A(AIS-A).A total of 320 clinically complete SCI subjects(271 male and 49 female),aged 16–60 years,received early(≤7 days,n=201)or delayed(8–30 days,n=119)surgical interventions to reduce intraspinal or intramedullary pressure.Fifteen days post-surgery,all subjects received a weight-bearing walking training with the“Kunming Locomotion Training Program(KLTP)”for a duration of 6 months.The neurological deficit and recovery were assessed using the AIS scale and a 10-point Kunming Locomotor Scale(KLS).We found that surgical intervention significantly improved AIS scores measured at 15 days post-surgery as compared to the pre-surgery baseline scores.Significant improvement of AIS scores was detected at 3 and 6 months and the KLS further showed significant improvements between all pair-wise comparisons of time points of 15 days,3 or 6 months indicating continued improvement in walking scores during the 6-month period.In conclusion,combining surgical intervention within 1 month post-injury and weight-bearing locomotor training promoted continued and statistically significant neurological recoveries in subjects with clinically complete SCI,which generally shows little clinical recovery within the first year after injury and most are permanently disabled.This study was approved by the Science and Research Committee of Kunming General Hospital of PLA and Kunming Tongren Hospital,China and registered at ClinicalTrials.gov(Identifier:NCT04034108)on July 26,2019.展开更多
The Egyptian government introduced wheat-flour fortification with iron and folic acid to reduce the incidence of neural tube defects, but suspended it for technical reasons. We previously developed novel legume foods ...The Egyptian government introduced wheat-flour fortification with iron and folic acid to reduce the incidence of neural tube defects, but suspended it for technical reasons. We previously developed novel legume foods with enhanced folate content. In this study, we investigated the efficacy of 12-week intervention with folate-enhanced foods versus folic acid supplement in improving folate status in Egyptian women. A randomized, parallel intervention trial with two active groups (n = 19, n = 18) and one blinded control group (n = 20) was executed over 12 weeks. Volunteers received either germinated legume foods and orange juice (≈250 μg/d folate) or folic acid supplement (500 μg/d) or apple juice (0 μg/d folate). Folate status was assessed by erythrocyte and plasma folate and total homocysteine (tHcy) at day 0, and after 8 and 12 weeks of intervention. After 12 weeks, mean plasma folate increased by 14 (P < 0.0001) and 12 (P < 0.0001) nmoL in the folic acid and food group, respectively. Erythrocyte folate concentration increased in the folic acid group from 614 to 912 (P < 0.0001) and in the food group from 631 to 914 nmoL (P < 0.0001). After 12 weeks, 90% of subjects in the folic acid group and 70% in the food group had erythrocyte folate concentrations exceeding 906 nmol/L. tHcy concentration was decreased by 20% (P = 0.007) and 18% (P = 0.006) in the folic acid and food group, respectively, but remained unchanged in the control group during intervention. Folate-enhanced foods effectively improve folate status in women of reproductive age. These foods could be used as a complement to folic acid fortification.展开更多
Despite the existence of many interventions to mitigate or adapt to the health effects of climate change,their effectiveness remains unclear.Here,we introduce the Comprehensive Evaluation Framework for Intervention on...Despite the existence of many interventions to mitigate or adapt to the health effects of climate change,their effectiveness remains unclear.Here,we introduce the Comprehensive Evaluation Framework for Intervention on Health Effects of Ambient Temperature to evaluate study designs and effects of intervention studies.The framework comprises three types of interventions:proactive,indirect,and direct,and four categories of indicators:classification,methods,scope,and effects.We trialed the framework by an evaluation of existing intervention studies.The evaluation revealed that each intervention has its own applicable characteristics in terms of effectiveness,feasibility,and generalizability scores.We expanded the framework's potential by offering a list of intervention recommendations in different scenarios.Future applications are then explored to establish models of the relationship between study designs and intervention effects,facilitating effective interventions to address the health effects of ambient temperature under climate change.展开更多
基金supported by the National Natural Science Foundation of China(61573017)the Doctoral Foundation of Air Force Engineering University(KGD08101604)
文摘Aiming at the intervention decision-making problem in manned/unmanned aerial vehicle（MAV/UAV） cooperative engagement, this paper carries out a research on allocation strategy of emergency discretion based on human factors engineering（HFE）.Firstly, based on the brief review of research status of HFE, it gives structural description to emergency in the process of cooperative engagement and analyzes intervention of commanders. After that,constraint conditions of intervention decision-making of commanders based on HFE（IDMCBHFE） are given, and the mathematical model, which takes the overall efficiency value of handling emergencies as the objective function, is established. Then, through combining K-best and variable neighborhood search（VNS） algorithm, a K-best optimization variable neighborhood search mixed algorithm（KBOVNSMA） is designed to solve the model. Finally,through three groups of simulation experiments, effectiveness and superiority of the proposed algorithm are verified.
文摘The southwest coastal region of Bangladesh, being under tidal influence and dependent on sweet water supplies from upstream, has a unique brackish water ecosystem. The region, having vast low-lying areas enclosed by man-made polders, is considered to be highly vulnerable to climate change induced hazards. In this study, linear trends in hydro-climatic variables, such as temperature, rainfall, sunshine, humidity, sweet water inflow and tidal water level in the region are assessed using secondary data and following both parametric and nonparametric statistical techniques. Correlation between the sweet water flow from the Gorai River, a major distributary of the Ganges River, and the salinity level in the Rupsa-Pasur River near Khulna, a southern metropolis, is also investigated. The results reveal that the temperature in the Khulna region is increasing at a significant rate, particularly in recent years. The number of extremely cold nights is decreasing and the heat index is increasing. The sunshine duration has a decreasing trend and the humidity has an increasing trend. Rainfall is increasing in terms of both magnitude and number of rainy days. However, the annual maximum rainfall and the number of days with high intensity rainfall have remained almost static. The annual maximum tidal high water level is increasing and the annual minimum low water level is decreasing at a rate of 7 - 18 mm and 4 - 8 mm per year, respectively. There is a negative correlation between the Gorai flow and the river water salinity around Khulna. Dredging of the Gorai during 1998-2001 resulted in an improvement of the salinity situation in the Khulna region. The variation in water salinity, tidal water level and sweet water flows in different time periods indicates that the human interventions through upstream diversion and coastal polders have contributed more in hydro-morphological changes in the southwest than the climate change. However, there are some evidences of climate change in the meteorological variables at Khulna.
文摘<p align="justify"> <span style="font-family:Verdana;"></span><span style="font-family:Verdana;"></span>Clinician Burnout is a personal and public health issue. Most occupational stressors contributing to clinician burnout are systemic. The combination of organizational interventions along with individual interventions is necessary to make significant lasting difference in reducing burnout, improving clinician and patient satisfaction and reducing latent error in healthcare delivery. Application of Human Factors/Ergonomics (HFE) science in healthcare leadership and management is a gap in current training for leaders. HFE uses concepts from organizational, educational and cognitive science, systems science and industrial engineering. HFE application is especially necessary in a fast changing highly stressful healthcare environment which impacts the wellbeing of clinicians and the safety of patients under care. Practical suggestions for working with various healthcare leadership styles and organizational dynamics, while aligning wellness efforts with institutional mission are discussed. Concrete examples of decreasing extraneous mental load on clinicians to preserve their brainpower to achieve quality patient care are illustrated. Organizational interventions in combination with individual interventions to reduce and manage burnout have enormous potential to improve clinician wellbeing and satisfaction in taking care of patients, reduce costs, risk of error and create the safe working environment needed to sustainably give high quality care to patients. </p>
基金This study received ethical approval from the ethics committee of Beijing Youan Hospital,Capital Medical University[No.(2021)078]the research was implemented in strict conformity with the guidelines outlined in the Declaration of Helsinki.
文摘BACKGROUND Enhancing awareness and use of pre-exposure prophylaxis(PrEP)and postexposure prophylaxis(PEP)is vital to curb human immunodeficiency virus(HIV)spread.High-risk behaviors prevalent among sexually transmitted infection clinic outpatients underscore the need for increased PrEP/PEP education in this group.AIM To investigate the effects of both onsite and online health education on the knowledge of,and willingness to use,PrEP and PEP among individuals receiving PEP services.METHODS Participants were drawn from a cohort study on PEP service intervention at an STD/AIDS outpatient clinic in designated HIV/AIDS hospitals in Beijing,conducted from January 1 to June 30,2022.Health education was provided both onsite and online during follow-up.Surveys assessing knowledge of,and willingness to use,PrEP/PEP were administered at baseline and again at 24 wk post-intervention.RESULTS A total of 112 participants were enrolled in the study;105 completed the follow-up at week 24.The percentage of participants with adequate knowledge of,and willingness to use,PrEP significantly increased from 65.2%and 69.6%at baseline to 83.8%and 82.9%at the end of the intervention(both P<0.05).Similarly,those with adequate knowledge of,and willingness to use,PEP increased from 74.1%and 77.7%at baseline to 92.4%and 89.5%at week 24(P<0.05).Being between 31 years and 40 years of age,having a postgraduate degree or higher,and reporting a monthly expenditure of RMB 5000 or more were found to be significantly associated with knowledge of PrEP and PEP(both P<0.05).CONCLUSION The findings show that both onsite and online health education significantly improved the knowledge of,and increased willingness to use,PrEP and PEP in individuals utilizing PEP services.
基金This work was supported in part by the Hong Kong Spinal Cord Injury Fund.
文摘Although a large number of trials in the SCI field have been conducted,few proven gains have been realized for patients.In the present study,we determined the efficacy of a novel combination treatment involving surgical intervention and long-term weight-bearing walking training in spinal cord injury(SCI)subjects clinically diagnosed as complete or American Spinal Injury Association Impairment Scale(AIS)Class A(AIS-A).A total of 320 clinically complete SCI subjects(271 male and 49 female),aged 16–60 years,received early(≤7 days,n=201)or delayed(8–30 days,n=119)surgical interventions to reduce intraspinal or intramedullary pressure.Fifteen days post-surgery,all subjects received a weight-bearing walking training with the“Kunming Locomotion Training Program(KLTP)”for a duration of 6 months.The neurological deficit and recovery were assessed using the AIS scale and a 10-point Kunming Locomotor Scale(KLS).We found that surgical intervention significantly improved AIS scores measured at 15 days post-surgery as compared to the pre-surgery baseline scores.Significant improvement of AIS scores was detected at 3 and 6 months and the KLS further showed significant improvements between all pair-wise comparisons of time points of 15 days,3 or 6 months indicating continued improvement in walking scores during the 6-month period.In conclusion,combining surgical intervention within 1 month post-injury and weight-bearing locomotor training promoted continued and statistically significant neurological recoveries in subjects with clinically complete SCI,which generally shows little clinical recovery within the first year after injury and most are permanently disabled.This study was approved by the Science and Research Committee of Kunming General Hospital of PLA and Kunming Tongren Hospital,China and registered at ClinicalTrials.gov(Identifier:NCT04034108)on July 26,2019.
文摘The Egyptian government introduced wheat-flour fortification with iron and folic acid to reduce the incidence of neural tube defects, but suspended it for technical reasons. We previously developed novel legume foods with enhanced folate content. In this study, we investigated the efficacy of 12-week intervention with folate-enhanced foods versus folic acid supplement in improving folate status in Egyptian women. A randomized, parallel intervention trial with two active groups (n = 19, n = 18) and one blinded control group (n = 20) was executed over 12 weeks. Volunteers received either germinated legume foods and orange juice (≈250 μg/d folate) or folic acid supplement (500 μg/d) or apple juice (0 μg/d folate). Folate status was assessed by erythrocyte and plasma folate and total homocysteine (tHcy) at day 0, and after 8 and 12 weeks of intervention. After 12 weeks, mean plasma folate increased by 14 (P < 0.0001) and 12 (P < 0.0001) nmoL in the folic acid and food group, respectively. Erythrocyte folate concentration increased in the folic acid group from 614 to 912 (P < 0.0001) and in the food group from 631 to 914 nmoL (P < 0.0001). After 12 weeks, 90% of subjects in the folic acid group and 70% in the food group had erythrocyte folate concentrations exceeding 906 nmol/L. tHcy concentration was decreased by 20% (P = 0.007) and 18% (P = 0.006) in the folic acid and food group, respectively, but remained unchanged in the control group during intervention. Folate-enhanced foods effectively improve folate status in women of reproductive age. These foods could be used as a complement to folic acid fortification.
基金support provided by Natural Science Foundation of Jiangsu Province(BK20231327)General Program of National Natural Science Foundation of China(42377420)+1 种基金the Chinese Natural Science Foundation(71921003)Jiangsu Provincial Natural Science Foundation(BE2022841).
文摘Despite the existence of many interventions to mitigate or adapt to the health effects of climate change,their effectiveness remains unclear.Here,we introduce the Comprehensive Evaluation Framework for Intervention on Health Effects of Ambient Temperature to evaluate study designs and effects of intervention studies.The framework comprises three types of interventions:proactive,indirect,and direct,and four categories of indicators:classification,methods,scope,and effects.We trialed the framework by an evaluation of existing intervention studies.The evaluation revealed that each intervention has its own applicable characteristics in terms of effectiveness,feasibility,and generalizability scores.We expanded the framework's potential by offering a list of intervention recommendations in different scenarios.Future applications are then explored to establish models of the relationship between study designs and intervention effects,facilitating effective interventions to address the health effects of ambient temperature under climate change.
