安心卡引导的尊严照护干预联合SHARE模式在肿瘤患者安宁疗护中的应用

目的:探讨和分析安心卡引导的尊严照护干预联合SHARE模式在肿瘤患者安宁疗护中的应用,为临床提供参考。方法:选取2022年1—12月郑州市第三人民医院收治的68例肿瘤患者作为研究对象。对照组(34例)采取传统的照护方法和告知模式,试验组(34例)采取安心卡引导的尊严照护方法和SHARE告知模式,比较两组患者的自尊水平、死亡态度、焦虑情绪、睡眠质量状况。结果:干预后,两组患者的自尊水平测定分数均增高,试验组的自尊水平测定分数显著高于对照组,差异有统计学意义(t=4.218,P<0.05);干预后,试验组的害怕、回避死亡态度得分显著低于对照组,自然接受、接近接受死亡态度得分显著高于对照组,差异有统计学意义(t=10.119、3.222、17.142、6.278,P<0.05);干预后,两组患者的焦虑情绪得分均降低,试验组焦虑情绪得分显著低于对照组,差异有统计学意义(t=18.739,P<0.05);干预后,两组患者的睡眠质量得分均降低,试验组睡眠质量得分显著低于对照组,差异有统计学意义(t=10.746,P<0.05);干预后,两组患者的疼痛程度得分均降低,干预后试验组疼痛程度得分显著低于对照组,差异有统计学意义(t=9.685,P<0.05)。结论:安心卡引导的尊严照护干预联合SHARE模式在肿瘤患者安宁疗护中,有利于肿瘤患者疾病治疗和身心健康发展,可供临床参考。

非暴力沟通联合think-pair-share模式培训在普外科护士在职培训中的应用研究

目的:探讨非暴力沟通联合think-pair-share(TPS)模式培训在普外科护士在职培训中的应用效果。方法:2020年10月至2021年10月选取本院普外科的4个护理单元,通过随机抽签法分为试验组和对照组,试验组参加非暴力沟通联合TPS模式培训,对照组参与常规非暴力沟通培训。对比两组护士临床沟通能力、患者满意度以及教学满意度的差异。结果:试验组护士临床沟通能力、患者满意度、教学满意度调查结果均优于对照组(P<0.001)。结论:非暴力沟通联合TPS模式培训在普外科护士在职培训中能提高普外科护士的护患沟通能力,提升其岗位胜任力。

长三角城市群经济韧性测度与分析——基于Shift-Share的经济韧性分解

以长三角城市群27个城市为研究对象,测度2008—2010年抵抗期和2010—2019年恢复期城市群经济韧性水平,并进一步运用Shift-Share分解方法探索长三角城市群经济韧性内在影响机制。研究显示:抵抗期和恢复期中长三角城市群经济韧性均值分别为0.309和0.301,均强于全国层面经济韧性水平;Shift-Share分解后发现竞争力分量对各城市经济韧性水平提升起到决定性作用,抵抗期阶段主要由第二、三产业共同作用影响经济韧性水平;恢复期阶段则以第二产业竞争力为主导力量,同时以第三产业竞争力作为辅助力量。通过实证探究长三角城市群经济一体化发展的规律和特点,为增强中国经济韧性提出相关建议,助力中国经济高质量发展。

A Shared Natural Neighbors Based-Hierarchical Clustering Algorithm for Discovering Arbitrary-Shaped Clusters

In clustering algorithms,the selection of neighbors significantly affects the quality of the final clustering results.While various neighbor relationships exist,such as K-nearest neighbors,natural neighbors,and shared neighbors,most neighbor relationships can only handle single structural relationships,and the identification accuracy is low for datasets with multiple structures.In life,people’s first instinct for complex things is to divide them into multiple parts to complete.Partitioning the dataset into more sub-graphs is a good idea approach to identifying complex structures.Taking inspiration from this,we propose a novel neighbor method:Shared Natural Neighbors(SNaN).To demonstrate the superiority of this neighbor method,we propose a shared natural neighbors-based hierarchical clustering algorithm for discovering arbitrary-shaped clusters(HC-SNaN).Our algorithm excels in identifying both spherical clusters and manifold clusters.Tested on synthetic datasets and real-world datasets,HC-SNaN demonstrates significant advantages over existing clustering algorithms,particularly when dealing with datasets containing arbitrary shapes.

A study on the influencing factors of rural tourism promoting households'shared prosperity in Yinan County of Shandong Province

This study examines the influencing factors of rural tourism in promoting shared prosperity among households,using the case study of Yinan County in Shandong province,China.The research aims to provide insights into the economic benefits experienced by low-income households in the context of rural tourism development.Based on field research conducted from April 8,2023,to May 17,2023,including interviews and site visits,the study constructs an evaluation index system to assess the influencing factors.Through expert scoring and the application of a weighted set-valued mathematical statistical model,the importance and quantification of each factor are determined.The results indicate that the current stage of promoting shared prosperity through rural tourism in Yinan County is primarily influenced by the scale of tourist consumption of external visitors.This factor outweighs others such as the participation capacity and willingness of low-income households,the capacity of investment enterprises,and the policies and financial allocation of the local government.The findings emphasize the significance of external visitor spending and highlight the need to address the obstacles faced by low-income households in accessing economic benefits.The evaluation index system and measurement model presented in this study offer a scientific basis for assessing and improving the income situation of low-income households in rural tourism development initiatives.However,it is crucial to note that the importance of these influencing factors may evolve with the lifecycle of the tourism destination.Future research should include long-term tracking and consider a broader range of indicators to deepen our understanding of their mechanisms and significance.Furthermore,alternative approaches and theories may provide valuable perspectives for further exploration in this field.

Youth Exchange“Harmony for Shared Prosperity”

Contemporary World Magazine,which is affiliated to the International Department of the CPC Central Committee(IDCPC),held an exchange act ivi ty themed on“Harmony for Shared Prosperity”in Beijing on May 7,2024.

Joint Management of Shared Resources, Issues and Conflicts of the Nso and Oku Tribes in the Ngongbaa Montane Forest Area, NWR of Cameroon

Wherever people live together in or near homelands that harbour joint natural resources such as forest, water, minerals, oil etc., they must collaborate, co-exist and share these resources irrespective of their genetic, social, cultural, and political peculiarities. This is not always the case when self-interest, ethnic divisions, elitist politics, economic interest and power tussle set in. The Nso and Oku people who reside in the Ngongbaa Forest area constitute an example of joint management of resources where at one period, their relationship over the management of the Oku Mountain Forest was cordial and at another, the relationship became conflictive. This study was designed to study the influence of the KIFP forest management policies on the Nso indigenous forest Management system in Ngongbaa Forest, and its implications. The data collected for the study was secured through the administration of a questionnaire to residents of 10 villages adjacent to the Ngongbaa Forest, and forest users who carried out livelihood activities there between 1963 and 2015. These forest user groups include beekeepers, rat trappers, grazers, mushroom gatherers, ground honey/tree honey harvesters, carvers, etc. The investigation also extended to the traditional leaders of Nso and Oku who are in charge of the land tenure systems. The findings show that the Oku Mountain Forest is jointly owned by the Nso and Oku people. The Nso own the eastern half of the forest known as Ngongbaa Forest while the Oku own the western half, known as the Kilum Forest. The cordial relationship that existed between these people ensured the conservation of the forest. But the conflicts that later set in, especially due to the creation of the Kilum Mountain Forest Project in 1987 later changed to the Kilum Ijim Forest Project (KIFP) in 1992 sidelined the local communities which was contrary to the dispositions of the new Cameroon forest law enacted in 1994. Thus, the indigenous conservation practices became ignored which the local population never digested well. This seriously jeopardized the wellbeing of the forest in general.

An Exploration of the Three Dimensions and Epochal Strengths of Building a Human Community With a Shared Future

The idea of a human community with a shared future was proposed by the Communist Party of China(CPC)Central Committee with Comrade Xi Jinping at its core for the future development of human beings to face up to the most important question in today's world:“What is happening to the world and what should we do?”It profoundly answers the question of the world,history,and the times.The theory of a human community with a shared future is an innovative theory with a multidimensional formation logic that guides humanity toward continually seeking common interests and values.This paper dives into the profound motivations behind building a human community with a shared future from historical,cultural,and practical dimensions and analyzes its epochal value from both domestic and international perspectives.This not only helps exert China's role in the international community,contributing Chinese strength to the construction of a peaceful,stable,and prosperous human society,but also enhances the influence of the idea of a human community with a shared future in the international community,accelerating the building of a human community with a shared future that considers the legitimate concerns of all countries,and aiding in solving the crises facing the world.

基于改进Theil指数和Shift-Share模型的2012—2021年中国产业偏离分析

文章首先通过对现有文献的梳理和分析,发现针对产业偏离的测算,传统的产业偏离度E系数、Theil指数及Shift-Share模型均存在一定的缺陷,E系数和Theil指数的缺陷主要体现在计算原理方面,而Shift-Share模型的缺陷主要表现在参照系选择的合理性和数据采集的可行性方面。然后,基于现有模型的基本原理,提出了更为合理和更具可操作性的产业偏离测算方法,再采用实证研究的方法,根据2012—2021年的数据,对中国的产业偏离情况进行具体分析,得出尽管中国存在产业偏离,但产业偏离度在逐渐减小。最后,基于修正模型的计算结果,并结合当前的国际国内环境,提出如下政策建议:1)第一产业要依靠创新和科技引领,促进农村劳动力在城乡间有序转移,实现农业生产的规模化和现代化;2)第二产业要加快产业的升级换代,建立和保持独立、自主、完整的工业体系,加大在基础研究方面的投入,尽早突破美西方的技术封锁;3)第三产业的发展重点应该在金融和科教两个方面,要进一步提升香港地区、上海和北京等城市的世界金融中心地位,依靠金融创新来规避现行国际金融体系的不利约束和影响,同时要将科教兴国战略落到实处,努力探索适合中国国情的从小学到大学各阶段的教育模式。

基于改进的think-pair-share混合式教学在药学专业英语教学中的应用研究

该研究以2018级药学专业本科2个班为研究对象,试验组采取改进的think-pair-share混合式教学,对照组采用传统教学模式。通过对两组学生考试成绩、单元测验成绩、SRSSDL评分,探索改进的think-pair-share混合式教学在医学相关专业教学中的应用效果。结果显示,试验组学生期末考试成绩、单元测验成绩、SRSSDL量表评分均明显高于对照组(P<0.05,P<0.01)。改进的think-pair-share混合式教学能显著提升学生的主动学习和自我效能,有望在医药相关专业教学中推广应用。

SHARE交接班模型在术后患者转运中的应用及临床获益分析

目的建立术后患者SHARE转运交接班模型,并评价其临床应用效果。方法选取2022年10月—2023年3月于我院住院的手术患者200例。随机分为观察组和对照组,每组100例。观察组采用SHARE转运交接班模型,对照组采用传统术后转运交接模型。比较两组患者采取不同的转运交接模型的不良事件发生率、转运时间、转运规范性和满意率。符合正态分布的计量资料以xˉ±s表示,组间比较采用t检验;计数资料以例数(%)表示,采用χ^(2)检验或Fisher确切概率法。结果观察组患者的引流管打折固定不规范、导尿管受压、留置针拔脱的发生率较对照组均明显下降,差异均有统计学意义(χ^(2)分别为4.613、6.157、5.158,P均<0.05)。观察组患者的手术室至复苏室所用时间为(3.48±0.38)min,从复苏室至病房所用时间为(5.94±0.24)min,均显著小于对照组的(3.85±0.39)min、(7.46±0.39)min,差异均有统计学意义(t值分别为-3.29、-16.77,P均<0.05)。观察组转运患者的规范性明显提高(χ^(2)=10.317,P<0.01)。观察组患者、医师及护士对于医疗过程的满意率均明显高于对照组,差异均有统计学意义(χ^(2)分别为12.374、4.500、7.791,P均<0.05)。结论SHARE转运交接班模型有利于降低术后患者不良事件发生率、节约转运时间、提高转运规范性及满意率。

SHARE数据库介绍与数据提取方法

人口老龄化是人类社会成功的标志之一,同时全球医疗服务体系也面临着老龄化带来的巨大冲击和挑战。SHARE数据库是研究欧洲公民生命历程中健康、社会、经济和环境等因素对老龄化的影响的基础研究数据库,同时也是最大的欧洲社会科学小组研究,该数据库提供了国际可比的纵向微观数据,使人们能够了解欧洲个人的公共卫生和社会经济生活条件。本文将对SHARE数据库架构进行介绍,指引用户在官网上如何下载提取数据,旨在为医学科研者提供一个高质量的医学公共数据资源平台。

Artificial intelligence promotes shared decision-making through recommending tests to febrile pediatric outpatients

BACKGROUND:To promote the shared decision-making(SDM)between patients and doctors in pediatric outpatient departments,this study was designed to validate artificial intelligence(AI)-initiated medical tests for children with fever.METHODS:We designed an AI model,named Xiaoyi,to suggest necessary tests for a febrile child before visiting a pediatric outpatient clinic.We calculated the sensitivity,specificity,and F1 score to evaluate the efficacy of Xiaoyi’s recommendations.The patients were divided into the rejection and acceptance groups.Then we analyzed the rejected examination items in order to obtain the corresponding reasons.RESULTS:We recruited a total of 11,867 children with fever who had used Xiaoyi in outpatient clinics.The recommended examinations given by Xiaoyi for 10,636(89.6%)patients were qualified.The average F1 score reached 0.94.A total of 58.4%of the patients accepted Xiaoyi’s suggestions(acceptance group),and 41.6%refused(rejection group).Imaging examinations were rejected by most patients(46.7%).The tests being time-consuming were rejected by 2,133 patients(43.2%),including rejecting pathogen studies in 1,347 patients(68.5%)and image studies in 732 patients(31.8%).The difficulty of sampling was the main reason for rejecting routine tests(41.9%).CONCLUSION:Our model has high accuracy and acceptability in recommending medical tests to febrile pediatric patients,and is worth promoting in facilitating SDM.

SHARE模式在我国癌症患者不幸消息告知中的应用

不幸消息告知(breaking bad news,BBN)是医务工作者必备且极具挑战的重要医患沟通技能,应用恰当的沟通模式进行BBN操作,可以有效提高癌症患者对病情的正确认知、治疗依从性和满意度,同时缓解不幸消息对患者情绪的不良影响等。国内外近年来开展了大量BBN相关研究及实践,并形成了多种沟通模式,其中SHARE模式被认为相对更适用于我国医疗环境繁忙及家属参与决策的文化背景。为了更好地适应当前我国知情权和决定权逐渐回归患者自身的趋势,提高我国医务工作者的医患沟通能力,本研究概述了SHARE模式在我国癌症患者BBN中的应用,重点阐述了其在我国的沟通对象,以及BBN对癌症患者心理状态等方面的影响。

基于互联网的Think-Pair-Share教学模式在放射科住院医师规范化培训中的应用研究

目的探讨基于互联网的Think-Pair-Share教学模式在放射科住院医师规范化培训中的应用效果及价值。方法选取2020年9月—2021年9月在浙江大学医学院附属第二医院放射科轮转的规培住院医师44人,随机分为试验组和对照组,每组22人,试验组采用基于互联网的Think-Pair-Share教学模式,对照组采用传统线上教学方法,以脑小血管病影像评估为教学内容,观察两组学员的学习成效,通过考核成绩和教学满意度调查问卷进行教学效果的分析比较。结果试验组学员考核成绩显著高于对照组(P<0.05),对于疑难病例诊断的学习效果尤为显著(P<0.01)。试验组学员对教学的满意度高于对照组(P<0.05)。结论在基于互联网的放射科住院医师规范化培训中,Think-Pair-Share教学模式效果优于传统线上教学模式,有助于培养学员独立思考的习惯,提高学员的专业知识和临床综合素质。

Key elements and checklist of shared decisionmaking conversation on life-sustaining treatment in emergency:a multispecialty study from China

BACKGROUND:Shared decision-making(SDM)has broad application in emergencies.Most published studies have focused on SDM for a certain disease or expert opinions on future research gaps without revealing the full picture or detailed guidance for clinical practice.This study is to investigate the optimal application of SDM to guide life-sustaining treatment(LST)in emergencies.METHODS:This study was a prospective two-round Delphi consensus-seeking survey among multiple stakeholders at the China Consortium of Elite Teaching Hospitals for Residency Education.Participants were identified based on their expertise in medicine,law,administration,medical education,or patient advocacy.All individual items and questions in the questionnaire were scored using a 5-point Likert scale,with responses ranging from"very unimportant"(a score of 1)to"extremely important"(a score of 5).The percentages of the responses that had scores of 4-5on the 5-point Likert scale were calculated.A Kendall’s W coefficient was calculated to evaluate the consensus of experts.RESULTS:A two-level framework consisting of 4 domains and 22 items as well as a ready-touse checklist for the informed consent process for LST was established.An acceptable Kendall’s W coefficient was achieved.CONCLUSION:A consensus-based framework supporting SDM during LST in an emergency department can inform the implementation of guidelines for clinical interventions,research studies,medical education,and policy initiatives.

BC-PC-Share:Blockchain-Based Patient-Centric Data Sharing Scheme for PHRs in Cloud Computing

Sharing of personal health records(PHR)in cloud computing is an essential functionality in the healthcare system.However,how to securely,efficiently and flexibly share PHRs data of the patient in a multi-receiver setting has not been well addressed.For instance,since the trust domain of the cloud server is not identical to the data owner or data user,the semi-trust cloud service provider may intentionally destroy or tamper shared PHRs data of user or only transform partial ciphertext of the shared PHRs or even return wrong computation results to save its storage and computation resource,to pursue maximum economic interest or other malicious purposes.Thus,the PHRs data storing or sharing via the cloud server should be performed with consistency and integrity verification.Fortunately,the emergence of blockchain technology provides new ideas and prospects for ensuring the consistency and integrity of shared PHRs data.To this end,in this work,we leverage the consortiumblockchain technology to enhance the trustworthiness of each participant and propose a blockchain-based patient-centric data sharing scheme for PHRs in cloud computing(BC-PC-Share).Different from the state-of-art schemes,our proposal can achieve the following desired properties:(1)Realizing patient-centric PHRs sharing with a public verification function,i.e.,which can ensure that the returned shared data is consistent with the requested shared data and the integrity of the shared data is not compromised.(2)Supporting scalable and fine-grained access control and sharing of PHRs data with multiple domain users,such as hospitals,medical research institutes,and medical insurance companies.(3)Achieving efficient user decryption by leveraging the transformation key technique and efficient user revocation by introducing time-controlled access.The security analysis and simulation experiment demonstrate that the proposed BC-PC-Share scheme is a feasible and promising solution for PHRs data sharing via consortium blockchain.

Non-Cooperative Game of Coordinated Scheduling of Parallel Machine Production and Transportation in Shared Manufacturing

Given the challenges of manufacturing resource sharing and competition in the modern manufacturing industry,the coordinated scheduling problem of parallel machine production and transportation is investigated.The problem takes into account the coordination of production and transportation before production as well as the disparities in machine spatial position and performance.A non-cooperative game model is established,considering the competition and self-interest behavior of jobs from different customers for machine resources.The job from different customers is mapped to the players in the game model,the corresponding optional processing machine and location are mapped to the strategy set,and the makespan of the job is mapped to the payoff.Then the solution of the scheduling model is transformed into the Nash equilibrium of the non-cooperative game model.A Nash equilibrium solution algorithm based on the genetic algorithm(NEGA)is designed,and the effective solution of approximate Nash equilibrium for the game model is realized.The fitness function,single-point crossover operator,and mutation operator are derived from the non-cooperative game model’s characteristics and the definition of Nash equilibrium.Rules are also designed to avoid the generation of invalid offspring chromosomes.The effectiveness of the proposed algorithm is demonstrated through numerical experiments of various sizes.Compared with other algorithms such as heuristic algorithms(FCFS,SPT,and LPT),the simulated annealing algorithm(SA),and the particle swarm optimization algorithm(PSO),experimental results show that the proposed NE-GA algorithm has obvious performance advantages.

Adaptive Consistent Management to Prevent System Collapse on Shared Object Manipulation in Mixed Reality

A concurrency control mechanism for collaborative work is akey element in a mixed reality environment. However, conventional lockingmechanisms restrict potential tasks or the support of non-owners, thusincreasing the working time because of waiting to avoid conflicts. Herein, wepropose an adaptive concurrency control approach that can reduce conflictsand work time. We classify shared object manipulation in mixed reality intodetailed goals and tasks. Then, we model the relationships among goal,task, and ownership. As the collaborative work progresses, the proposedsystem adapts the different concurrency control mechanisms of shared objectmanipulation according to the modeling of goal–task–ownership. With theproposed concurrency control scheme, users can hold shared objects andmove and rotate together in a mixed reality environment similar to realindustrial sites. Additionally, this system provides MS Hololens and Myosensors to recognize inputs from a user and provides results in a mixed realityenvironment. The proposed method is applied to install an air conditioneras a case study. Experimental results and user studies show that, comparedwith the conventional approach, the proposed method reduced the number ofconflicts, waiting time, and total working time.

Shared Cache Based on Content Addressable Memory in a Multi-Core Architecture

Modern shared-memory multi-core processors typically have shared Level 2(L2)or Level 3(L3)caches.Cache bottlenecks and replacement strategies are the main problems of such architectures,where multiple cores try to access the shared cache simultaneously.The main problem in improving memory performance is the shared cache architecture and cache replacement.This paper documents the implementation of a Dual-Port Content Addressable Memory(DPCAM)and a modified Near-Far Access Replacement Algorithm(NFRA),which was previously proposed as a shared L2 cache layer in a multi-core processor.Standard Performance Evaluation Corporation(SPEC)Central Processing Unit(CPU)2006 benchmark workloads are used to evaluate the benefit of the shared L2 cache layer.Results show improved performance of the multicore processor’s DPCAM and NFRA algorithms,corresponding to a higher number of concurrent accesses to shared memory.The new architecture significantly increases system throughput and records performance improvements of up to 8.7%on various types of SPEC 2006 benchmarks.The miss rate is also improved by about 13%,with some exceptions in the sphinx3 and bzip2 benchmarks.These results could open a new window for solving the long-standing problems with shared cache in multi-core processors.