Paths to Enhance Teacher Digital Literacy Under Educational Digital Transformation in China

In the context of the digital transformation of education in the new era,digital literacy for teachers is a new requirement for professional development.Teacher digital literacy encompasses four main aspects:attitudinal literacy,knowledge and skills literacy,instructional application literacy,and innovation and development literacy.Currently,there are several issues with teacher digital literacy,such as a lack of digital responsibility,insufficient digital knowledge and skills,weak digital application skills,and low digital innovation capability.Enhancing teachers’digital literacy is a complex and critical task.Based on the current state of teachers’digital literacy,this paper proposes the following approaches:(1)adherence to digital norms;(2)development of a robust training mechanism;(3)improvement of the evaluation system;(4)strengthening of digital innovation.

Postoperative ileus: Impact of pharmacological treatment,laparoscopic surgery and enhanced recovery pathways

Almost all patients develop postoperative ileus (POI) after abdominal surgery.POI represents the single largest factor influencing length of stay (LOS) after bowel resection,and has great implications for patients and resource utilization in health care.New methods to treat and decrease the length of POI are therefore of great importance.During the past decade,a substantial amount of research has been performed evaluating POI,and great progress has been made in our understanding and treatment of POI.Laparoscopic procedures,enhanced recovery pathways and pharmacologic treatment have been introduced.Each factor has substantially contributed to decreasing the length of POI and thus LOS after bowel resection.This editorial outlines resource utilization of POI,normal physiology of gut motility and pathogenesis of POI.Pharmacological treatment,fast track protocols and laparoscopic surgery can each have significant impact on pathways causing POI.The optimal integration of these treatment options continues to be assessed in prospective studies.

Impact of enhanced recovery pathways on safety and efficacy of hip and knee arthroplasty:A systematic review and meta-analysis

BACKGROUND Over the past decades,clinical pathways(CPs)for hip and knee arthroplasty have been strongly and continuously evolved based on scientific evidence and innovation.AIM The present systematic review,including meta-analysis,aimed to compare the safety and efficacy of enhanced recovery pathways(ERP)with regular pathways for patients with hip and/or knee arthroplasty.METHODS A literature search in healthcare databases(Embase,PubMed,Cochrane Library,CINAHL,and Web of Science)was conducted from inception up to June 2018.Relevant randomized controlled trials as well as observational studies comparing ERP,based on novel evidence,with regular or standard pathways,prescribing care as usual for hip and/or knee arthroplasty,were included.The effect of both CPs was assessed for(serious)adverse events[(S)AEs],readmission rate,length of hospital stay(LoS),clinician-derived clinical outcomes,patient reported outcome measures(PROMs),and financial benefits.If possible,a meta-analysis was performed.In case of considerable heterogeneity among studies,a qualitative analysis was performed.RESULTS Forty studies were eligible for data extraction,34 in meta-analysis and 40 in qualitative analysis.The total sample size consisted of more than 2 million patients undergoing hip or knee arthroplasty,with a mean age of 66 years and with 60%of females.The methodological quality of the included studies ranged from average to good.The ERP had lower(S)AEs[relative risk(RR):0.9,95%confidence interval(CI):0.8-1]and readmission rates(RR:0.8,95%CI:0.7-1),and reduced LoS[median days 6.5(0.3-9.5)],and showed similar or improved outcomes for functional recovery and PROMs compared to regular pathways.The analyses for readmission presented a statistically significant difference in the enhanced recovery pathway in favor of knee arthroplasties(P=0.01).ERP were reported to be cost effective,and the cost reduction varied largely between studies(€109 and$20573).The overall outcomes of all studies reported using Grading of Recommendation,Assessment,Development and Evaluation,presented moderate or high quality of evidence.CONCLUSION This study showed that implementation of ERP resulted in improved clinical and patient related outcomes compared to regular pathways in hip and knee arthroplasty,with a potential reduction of costs.

Developing an enhanced recovery after surgery program for oncology patients who undergo hip or knee reconstruction surgery

Enhanced recovery after surgery(ERAS)protocols are applied in orthopedic surgery and are intended to reduce perioperative stress by implementing combined evidence-based practices with the cooperation of various health professionals as an interdisciplinary team.ERAS pathways include pre-operative patient counselling,regional anesthesia and analgesia techniques,post-operative pain management,early mobilization and early feeding.Studies have shown improvement in the recovery of patients who followed an ERAS program after hip or knee arthroplasty,compared with those who followed a traditional care approach.ERAS protocols reduce post-operative stress,contribute to rapid recovery,shorten length of stay(LOS)without increasing the complications or readmissions,improve patient satisfaction and decrease the hospital costs.We suggest that the ERAS pathway could reduce the LOS in hospital for patients undergoing total hip replacement or total knee replacement.These programs require good organization and handling by the multidisciplinary team.ERAS programs increase patient's satisfaction due to their active participation which they experience as personalized treatment.The aim of the study was to develop an ERAS protocol for oncology patients who undergo bone reconstruction surgeries using massive endoprosthesis,with a view to improving the surgical outcomes.

Management of acute kidney injury in gastrointestinal tumor:An overview

Gastrointestinal tumors remain a global health problem.Acute kidney injury(AKI)is a common complication during the treatment of gastrointestinal tumors.AKI can cause a decrease in the remission rate and an increase in mortality.In this review,we analyzed the causes and risk factors for AKI in gastrointestinal tumor patients.The possible mechanisms of AKI were divided into three groups:pretreatment,intrafraction and post-treatment causes.Treatment and prevention measures were proposed according to various factors to provide guidance to clinicians and oncologists that can reduce the incidence of AKI and improve the quality of life and survival rate of gastrointestinal tumor patients.

Efficient production of 2′-fucosyllactose in unconventional yeast Yarrowia lipolytica

2′-Fucosyllactose(2′-FL)has great application value as a nutritional component and the whole cell biosynthesis of 2′-FL has become the focus of current research.Yarrowia lipolytica has great potential in oligosaccharide synthesis and large-scale fermentation.In this study,systematic engineering of Y.lipolytica for efficient 2′-FL production was performed.By fusing different protein tags,the synthesis of 2′-FL was optimized and the ubiquitin tag was demonstrated to be the best choice to increase the 2′-FL production.By iterative integration of the related genes,increasing the precursor supply,and promoting NADPH regeneration,the 2′-FL synthesis was further improved.The final 2′-FL titer,41.10 g/L,was obtained in the strain F5-1.Our work reports the highest 2′-FL production in Y.lipolytica,and demonstrates that Y.lipolytica is an efficient microbial chassis for the synthesis of oligosaccharides.