BACKGROUND Data regarding the agreement among multiple operators for measurement of quadriceps muscle thickness by bedside ultrasonography(USG)are sparse.AIM To statistically assess the agreement among 5 operators for...BACKGROUND Data regarding the agreement among multiple operators for measurement of quadriceps muscle thickness by bedside ultrasonography(USG)are sparse.AIM To statistically assess the agreement among 5 operators for measurement of quadriceps muscle thickness on bedside USG.METHODS This was a cross-sectional observational study.The 5 operators of varied experience(comprised of 1 critical care consultant,2 fellows,and 2 nurses)independently measured quadriceps muscle thickness in triplicate for 45 critically ill patients each,using USG.Intra-and interrater agreement rates among the 5 operators were assessed using intraclass correlation coefficient(ICC)and expressed with 95%confidence interval(CI).RESULTS The 5 operators produced a total of 135 readings and 675 observations for ICC calculations to determine the intraoperator and interoperator variations respectively.For intraoperator agreement,the overall ICC(95%CI)was 0.998(0.997,0.999)for operator 1,0.998(0.997,0.999)for operator 2,0.997(0.995,0.999)for operator 3,0.999(0.998,0.999)for operator 4,and 0.998(0.997,0.999)for operator 5.For interoperator agreement,the overall ICC(95%CI)was 0.977(0.965,0.986;P<0.001)for reading 1,0.974(0.960,0.984;P<0.001)for reading 2,and 0.975(0.961,0.985;P<0.001)for reading 3.CONCLUSION USG measurement of quadriceps muscle thickness was not dependent on clinical experience,supporting training for nurses in it.展开更多
The measurement,reporting,and verification(MRV) of climate finance was originated from discussions under the United Nations Framework Convention on Climate Change(UNFCCC).It has been one of the key issues of global cl...The measurement,reporting,and verification(MRV) of climate finance was originated from discussions under the United Nations Framework Convention on Climate Change(UNFCCC).It has been one of the key issues of global climate negotiations since 2009 and will continue to be of significant importance in addressing climate change and strengthening international trust.This paper analyses the concept,the objective,and the progress of the MRV of climate finance based on reviews of the latest literature and think-tank reports regarding climate finance regime and MRV.Following the analysis,challenges faced with the MRV of climate finance are illustrated.This paper presents that the comparability of climate finance data needs to be improved due to the variety of methodologies used for disaggregating climate finance.In addition,the integrality of the MRV system of climate finance has been impaired by the lack of feedback mechanism from the recipients to the contributors in reporting system.Furthermore,although accounting system of climate finance has been developing and improving,it remains incapacity in providing accurate data on disbursed climate finance.Responding to the above challenges,this paper proposes the key tasks in establishing a comprehensive MRV system for climate finance at international level.The tasks involve developing a measurement system with consistent data basis and accounting basis,a reporting system with more detailed guidance and standardized formats,as well as a verification mechanism balancing top-down and bottom-up review processes.In the last section,this paper concludes that the establishment of an improved MRV of climate finance requires concerted cooperation and negotiations between developed and developing country Parties under the UNFCCC.As one of the few developing country donors to the Global Environmental Facility(GEF),China is suggested to clarify its propositions as a developing country in aspects such as concept,coverage,and architecture of climate finance and MRV system,and gain bargaining power in improving operating and technical rules of international climate finance regime.展开更多
文摘BACKGROUND Data regarding the agreement among multiple operators for measurement of quadriceps muscle thickness by bedside ultrasonography(USG)are sparse.AIM To statistically assess the agreement among 5 operators for measurement of quadriceps muscle thickness on bedside USG.METHODS This was a cross-sectional observational study.The 5 operators of varied experience(comprised of 1 critical care consultant,2 fellows,and 2 nurses)independently measured quadriceps muscle thickness in triplicate for 45 critically ill patients each,using USG.Intra-and interrater agreement rates among the 5 operators were assessed using intraclass correlation coefficient(ICC)and expressed with 95%confidence interval(CI).RESULTS The 5 operators produced a total of 135 readings and 675 observations for ICC calculations to determine the intraoperator and interoperator variations respectively.For intraoperator agreement,the overall ICC(95%CI)was 0.998(0.997,0.999)for operator 1,0.998(0.997,0.999)for operator 2,0.997(0.995,0.999)for operator 3,0.999(0.998,0.999)for operator 4,and 0.998(0.997,0.999)for operator 5.For interoperator agreement,the overall ICC(95%CI)was 0.977(0.965,0.986;P<0.001)for reading 1,0.974(0.960,0.984;P<0.001)for reading 2,and 0.975(0.961,0.985;P<0.001)for reading 3.CONCLUSION USG measurement of quadriceps muscle thickness was not dependent on clinical experience,supporting training for nurses in it.
基金supported by the National Natural Science Foundation of China project "The joint mechanism and macro-regulation mechanism for national emission trading market of China"[Grant Number:71503288]the Research Base Project of Beijing Philosophy and Social Science Foundation "Payments for Ecosystem Services Mechanism that Supports The Synergetic Development of Ecological Protection in Beijing-Tianjin-Hebei Region"[Grant Number:16JDYJC039]the project "Environmental Risk Management for Corporate Lending in China's Commercial Banks" sponsored by the Scientific Research Foundation for the returned overseas Chinese scholars,State Education Ministry
文摘The measurement,reporting,and verification(MRV) of climate finance was originated from discussions under the United Nations Framework Convention on Climate Change(UNFCCC).It has been one of the key issues of global climate negotiations since 2009 and will continue to be of significant importance in addressing climate change and strengthening international trust.This paper analyses the concept,the objective,and the progress of the MRV of climate finance based on reviews of the latest literature and think-tank reports regarding climate finance regime and MRV.Following the analysis,challenges faced with the MRV of climate finance are illustrated.This paper presents that the comparability of climate finance data needs to be improved due to the variety of methodologies used for disaggregating climate finance.In addition,the integrality of the MRV system of climate finance has been impaired by the lack of feedback mechanism from the recipients to the contributors in reporting system.Furthermore,although accounting system of climate finance has been developing and improving,it remains incapacity in providing accurate data on disbursed climate finance.Responding to the above challenges,this paper proposes the key tasks in establishing a comprehensive MRV system for climate finance at international level.The tasks involve developing a measurement system with consistent data basis and accounting basis,a reporting system with more detailed guidance and standardized formats,as well as a verification mechanism balancing top-down and bottom-up review processes.In the last section,this paper concludes that the establishment of an improved MRV of climate finance requires concerted cooperation and negotiations between developed and developing country Parties under the UNFCCC.As one of the few developing country donors to the Global Environmental Facility(GEF),China is suggested to clarify its propositions as a developing country in aspects such as concept,coverage,and architecture of climate finance and MRV system,and gain bargaining power in improving operating and technical rules of international climate finance regime.
