Factors influencing the continuity of evidence-based practice in perioperative airway management for elderly patients with fractures:A qualitative study

BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we took the evidence-based practice of perioperative airway management in elderly fracture patients as an example and adopted a descriptive phenomenological approach to understand the influencing factors of its sustainability to provide a reference basis for promoting the continuity of evidence-based practice in the clinic.AIM To explore factors influencing the persistence of evidence-based practice in perioperative airway management in elderly patients with fractures.METHODS This study was qualitative research.Nine nurses who implemented evidencebased practice in the orthopedic ward of a tertiary comprehensive hospital in Shanghai from September 2023 to October 2023 were selected using purposive sampling as research subjects.Semi-structured interviews were conducted with them,and the data were analyzed using the Colaizzi phenomenological analysis method based on the three dimensions and ten factors of the NHS sustainability model.RESULTS Three main themes and ten subthemes were identified:Process aspects(benefits to patients,benefits to nurses,lack of follow-up,complex processes);staff aspects(insufficient human resources,inadequate training and education,lack of leadership support);and organizational environment aspects(inadequate infrastructure,poor patient compliance,poor doctor cooperation).CONCLUSION Human resources,training and education,leadership support,infrastructure,and patient-physician collaboration are important factors influencing the sustainability of evidence-based practice for perioperative airway management in older patients with fractures.

Research on Risk Identification and Industrial Governance of Digital Education Products Based on Data Annotation Technology

The social transformation brought aboutby digital technology is deeply impacting various industries.Digital education products, with core technologiessuch as 5G, AI, IoT (Internet of Things),etc., are continuously penetrating areas such as teaching,management, and evaluation. Apps, miniprograms,and emerging large-scale models are providingexcellent knowledge performance and flexiblecross-media output. However, they also exposerisks such as content discrimination and algorithmcommercialization. This paper conducts anevidence-based analysis of digital education productrisks from four dimensions: “digital resourcesinformationdissemination-algorithm design-cognitiveassessment”. It breaks through corresponding identificationtechnologies and, relying on the diverse characteristicsof governance systems, explores governancestrategies for digital education products from the threedomains of “regulators-developers-users”.

Evidence-based orthobiologic practice:Current evidence review and future directions

The field of orthopedic and regenerative medicine is rapidly evolving with the increasing utilization of orthobiologic.These biologically derived therapies,inc-luding platelet-rich plasma,mesenchymal stem cells,bone marrow aspirate con-centrate,stromal vascular fraction(SVF),and autologous chondrocyte implanta-tion,are gaining traction for their potential to enhance the body's natural healing processes.They offer a promising alternative to traditional surgical interventions for musculoskeletal injuries and degenerative conditions.Current evidence su-ggests significant benefits of orthobiologics in treating conditions like osteoarth-ritis,tendon injuries,and spinal disorders,yet inconsistencies in treatment pro-tocols and outcomes persist.The global market for orthobiologics is projected to grow substantially,driven by advancements in biologic therapies such as adipose-derived stem cells and SVF,and the demand for minimally invasive treatments.Despite their promise,regulatory and ethical challenges,as well as the need for high-quality,standardized research,remain significant obstacles.Future dire-ctions in the field include advancements in delivery systems,personalized medi-cine approaches,and the exploration of novel sources like induced pluripotent stem cells,aiming for more targeted and effective treatments.Collaborative efforts are crucial to overcoming these challenges and ensuring the safe and effective application of orthobiologics in clinical practice.

Effect of cetuximab plus FOLFOX4 regimen on clinical outcomes in advanced gastric carcinoma patients receiving evidence-based care

BACKGROUND Although chemotherapy is effective for treating advanced gastric carcinoma(aGC),it may lead to an adverse prognosis.Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for improving efficacy and outcomes in aGC patients.AIM To determine the efficacy and safety of cetuximab(CET)combined with the FOLFOX4 regimen(infusional fluorouracil,folinic acid,and oxaliplatin)as firstline therapy for patients with aGC,who received evidence-based care(EBC).METHODS A total of 117 aGC patients who received EBC from March 2019 to March 2022 were enrolled.Of these,60 in the research group(RG)received CET+FOLFOX4 as first-line therapy,whereas 57 in the control group(CG)received FOLFOX4.The efficacy[clinical response rate(RR)and disease control rate(DCR)],safety(liver and kidney dysfunction,leukopenia,thrombocytopenia,rash,and diarrhea),serum tumor marker expression[STMs;carbohydrate antigen(CA)19-9,CA72-4,and carcinoembryonic antigen(CEA)],inflammatory indicators[interleukin(IL)-2 and IL-10],and quality of life(QOL)of the two groups were compared.RESULTS A markedly higher RR and DCR were observed in the RG compared with the CG,with an equivalent safety profile between the two groups.RG exhibited notably reduced CA19-9,CA72-4,CEA,and IL-2 levels following treatment,which were lower than the pre-treatment levels and those in the CG.Post-treatment IL-10 was statistically increased in RG,higher than the pre-treatment level and the CG.Moreover,a significantly improved QOL was evident in the RG.CONCLUSION The CET+FOLFOX4 regimen is highly effective as first-line treatment for aGC patients receiving EBC.It facilitates the suppression of STMs,ameliorates the serum inflammatory microenvironment,and enhances QOL,without increased adverse drug effects.

China's Maritime Governance:Practical Evolution and Theoretical Construction

Increasingly engaged in maritime governance,China has developed its distinct vision and gradually established a complete theoretical system surrounding it.In terms of discourse,China has proposed a collection of concepts and ideas including a maritime community with a shared future,the 2lst Century Maritime Silk Road,Blue Partnerships,and marine ecological civilization.In terms of connotations,China champions such values as lasting peace,common prosperity,openness and inclusiveness,and cleanness and beautifulness.Exteriorly and interiorly,we can observe the unique character of China's vision concerning maritime governance,which will continue to upgrade and bear fruit in future practices,boosting the development of Chinese maritime governance theories,multilateral maritime cooperation,and ocean-related international legislation.Guided by its vision,China is expected to contribute more to global maritime security and marine ecological civilization.

Goals and Challenges of Global AI Governance and Chinese Solutions

In July 2023,United Nations(UN)Secretary-General Antonio Guterres called for the establishment of an entity agency responsible for artificial intelligence(AI)security governance,and organized an“AI High-level Advisory Committee”to explore pertinent issues,opening the prelude to global AI governance.In October 2023,Chinese President Xi Jinping put forward the Global AI Governance Initiative in his keynote address at the opening ceremony of the Third Belt and Road Forum for International Cooperation,elaborating China’s policy positions on AI governance to the international community.

Research on the Collaborative Governance of Social Responsibility in Online Audiovisual Enterprises

This paper aims to analyze the present conditions of the social responsibility ecosystem in online audiovisual enterprises in the digital age. It focuses on the governance of social responsibility in these enterprises and conducts an in-depth analysis of the problems and influencing factors related to the social responsibility aberrations of online audiovisual enterprises. Drawing upon social responsibility theory and collaborative governance theory, this research constructs a social responsibility guidance and governance system guided by the public, supported by the voluntary fulfillment of responsibilities by online audiovisual enterprises, and based on the collaborative participation of diverse stakeholders. It explores and optimizes the implementation pathways of this system, providing theoretical support and practical guidance for promoting the sustainable development of online audiovisual enterprises. Furthermore, it aims to contribute to the creation of a harmonious Internet ecosystem.

Do companies influenced by smart cities pay more attention to green governance?Mechanism and optimal spatial correlation

Smart cities are a way for China to construct an innovative and environmentally conscious nation.The paper examines the impact of smart cities on corporate green governance and provides a theoretical foundation for formulating and executing smart city policy in China.Based on panel data from Chinese A-share listed companies in Shanghai and Shenzhen from 2008 to 2020,this study constructs a multiperiod double-difference model to examine the influence of smart cities on corporate green governance.Additionally,it uses a spatial double-difference model to investigate the spatial spillover effect of smart cities on neighboring areas.The findings indicate that smart cities effectively enhance corporate green governance.Analyzing the influencing mechanisms reveals that resource allocation efficiency,technological innovation,management environmental awareness,and regional environmental enforcement efforts act as mediators.Furthermore,the study reveals that the impact of smart cities on promoting corporate green governance is more pronounced in regions with lower levels of marketization and resource-based cities.Moreover,the research explores the spatial spillover effects of smart cities,with an effective radius of approximately 350 km.The optimal spatial correlation zone for green governance of businesses in neighboring areas in relation to smart cities is within a range of 250-350 km.This is manifested by the significant promotion of green governance in neighboring area businesses facilitated by smart cities.

Enhancing transboundary natural tourism resources governance:unveiling the spatial pattern and its influencing factors

Tourism resources that span provincial boundaries in China play a pivotal role in regional development,yet effective governance poses persistent challenges.This study addresses this issue by constructing a comprehensive database of transboundary natural tourism resources(TNTR)through amalgamation of diverse data sources.Utilizing the Getis-Ord Gi^(*),kernel density estimation,and geographical detectors,we scrutinize the spatial patterns of TNTR,focusing on both named and unnamed entities,while exploring the influencing factors.Our findings reveal 7883 identified TNTR in China,with mountain tourism resources emerging as the predominant type.Among provinces,Hunan boasts the highest count,while Shanghai exhibits the lowest.Southern China demonstrates a pronounced clustering trend in TNTR distribution,with the spatial arrangement of biological landscapes appearing more random compared to geological and water landscapes.Western China,characterized by intricate terrain,exhibits fewer TNTR,concurrently unveiling a significant presence of unnamed natural tourism resources.Crucially,administrative segmentation influences TNTR development,generating disparities in regional goals,developmental stages and intensities,and management approaches.In response to these variations,we advocate for strengthening the naming of the unnamed transboundary tourism resources,constructing a geographic database of TNTR for government and establishing a collaborative management mechanism based on TNTR database.Our research contributes to elucidating the intricate landscape of TNTR,offering insights for tailored governance strategies in the realm of cross-provincial tourism resource management.

Transformation of French Governance Model for Oceanian Overseas Territories

The governance of France's overseas territories in Oceania has undergone a significant model transformation since the end of World War Ⅱ. In recent years, it has further highlighted its determination to pursue strategic autonomy. Through strict governance and legal mechanisms, France has promoted local autonomy and economic transformation, and has shifted the governance of these territories from colonial control to political cooperation and from predatory development to localized sustainable development. France's overseas territories in Oceania have increasingly become the fulcrum of its foreign strategy, serving the overall interests of its country and its overseas security. In recent years, France's governance policies in the region have become increasingly diversified, such as promoting economic diversification, strengthening regional security cooperation, weakening its independence tendencies, and promoting changes in the regional situation and relevant national policies.

Researching the Impact of the Quality of Village Governance on Farmers’Well-Being:From the Perspectives of Income and Occupational Differentiation

The goal of village governance is to improve the well-being of farmers,so this study aims to measure the impact the quality of village governance on the well-being of farmers.It also examines the heterogeneity of this impact across different farmer groups from the perspectives of income levels and occupational differentiation.To this end,this study developed an indicator system based on survey data collected from 1,442 farmers in the Sichuan,Shaanxi,and Gansu provinces,as well as the Ningxia Hui autonomous region.Multiple linear regression models were then used to analyze this data,and the findings revealed that improvements in the quality of village governance significantly increased the well-being of farmers.Specifically,primary-level empowerment and capacity building were shown to contribute the most to the enhancement of the farmers’well-being,followed by social inclusion,and social cohesion was found to have only a minimal effect.In terms of income levels,improving the quality of village governance benefited middle-income farmers the most,followed by low-income farmers,and it had the least effect on high-income farmers.In terms of occupations,full-time farmers gained the most from improvements in the quality of village governance,followed by off-farm farmers,with part-time farmers benefiting the least.Based on these findings,this study suggests that policymakers should improve the quality of village governance to enhance the well-being of farmers,focusing on the impact that level of income and occupational differentiation have on village governance.

Evidence-Based Nursing Practice of Reducing Immune-Related Skin Toxicity of Tumor Patients Guided by Sensitive Indicators

Purpose research on nursing sensitive indicators in tumor Patients application effect in immune-related skin toxicity management. Method select our hospital April to June, 202360 cases patients with immune therapy settings as the control group. August-October, 2023 60 cases the patients treated with immune therapy were the experimental group. The control group adopted regular nursing methods, while the experimental group sensitive Indicators, evidence-based give preventive care. The social situation, psychological state, physical function, quality of life score, incidence of skin toxicity caused by immune checkpoint inhibitors, moderate and above of the two groups of patients were compared. Incidence of skin toxicity. Result: experience group SAS score, SDS score higher than the control group, the difference was statistically significant (P < 0.05);The incidence of skin toxic reactions caused by immune checkpoint inhibitors and the incidence of moderate and above skin toxic reactions in the experimental group are lower than those in the control group, and the difference is statistically significant (P < 0.05). Conclusion: sensitive indicator guidance evidence-based preventive care can reduce the degree of immune-related skin toxicity, improve the psychological state and quality of life of tumor patients treated with immune therapy and reduce the incidence of adverse reactions, improve nursing quality and patient satisfaction.

Clinical Practice of Evidence-Based PDCA Cycle Management Model in Accelerated Recovery of Lung Cancer Patients

Objective: To explore the nursing effect of evidence-based PDCA cycle management mode in accelerated rehabilitation of patients undergoing thoracoscopic lung cancer radical surgery. Methods: 104 patients who underwent thoracoscopic lung cancer radical surgery in our hospital from June 2022 to February 2023 were randomly divided into control group and intervention group, with 52 cases in each group. The control group implemented evidence-based ERAS clinical pathway management, while the intervention group implemented evidence-based PDCA cycle quality management. The postoperative recovery of the two groups of patients was compared. Results: The postoperative recovery of the intervention group was significantly better than that of the control group. The first time to get out of bed, the first time to eat, the duration of chest drainage tube placement, and the length of hospital stay were significantly shorter than those of the control group. The incidence of postoperative chest complications and hospitalization costs were significantly lower than those of the control group, and patient satisfaction was significantly higher than that of the control group (P Conclusion: Evidence-based PDCA cycle quality management mode can effectively improve the implementation quality of accelerated rehabilitation nursing for patients undergoing thoracoscopic lung cancer radical surgery, and it is worthy of clinical promotion.

Evidence-based Clinical Chinese Medicine:What Has Changed Over the Past 20 Years

Chinese medicine has been used for centuries to treat a range of health conditions.This history has produced a wealth of classical literature,case studies and clinical research data detailing its use and effectiveness.However,high-quality and conclusive evidence that meets modern requirements for clinical decision support is lacking.This evidence gap limits the integration of Chinese medicine with contemporary medicine,which in turn limits global access and acceptance of Chinese medicine as a form of safe and effective health care.Over the past 20 years,researchers and organisations around the world,including the World Health Organization(WHO)and United Nations,have worked to support the integration of traditional medicines,such as Chinese medicine,with conventional medicines to improve global health care.This paper provides an overview of Chinese medicine studies published in the top four general medical journals(BMJ,JAMA,Lancet and New England Journal of Medicine)from February 2005 to February 2024 in the past 20 years to highlight the progress in the development of this evidence base.It also highlights key actions taken to promote evidence-based clinical Chinese medicine,including product and practitioner regulation,formalising education standards,and international collaborations.Research conducted at the China-Australia International Research Centre for Chinese Medicine demonstrates the benefits of such a collaboration.Through development of its unique and inclusive‘whole-evidence’approach,plus clinical studies and systematic reviews,the Centre has significantly contributed to the evidence base for clinical Chinese medicine.In addition,its high-impact papers and groundbreaking monographs have been cited in international conventional medicine guidelines.While progress has certainly been made during the past 20 years to build a stronger evidence base for clinical Chinese medicine,there is still a considerable gap that limits its integration with conventional medicine.Future funding and research are needed to continue this work and achieve to safe,effective and accessible traditional medicine as part of the WHO’s Universal Health Coverage strategy.

Regarding the Regulatory Sandbox Route and Mechanism for Governance of Artificial Intelligence

The main challenge in AI governance today is striking a balance between controlling AI dangers and fostering AI innovation.Regulators in a number of nations have progressively extended the regulatory sandbox,which was first implemented in the banking sector,to AI governance in an effort to reduce the conflict between regulation and innovation.The AI regulatory sandbox is a new and feasible route for AI governance in China that not only helps to manage the risks of technology application but also prevents inhibiting AI innovation.It keeps inventors'trial-and-error tolerance space inside the regulatory purview while offering a controlled setting for the development and testing of novel AI that hasn't yet been put on the market.By providing full-cycle governance of AI with the principles of agility and inclusive prudence,the regulatory sandbox offers an alternative to the conventional top-down hard regulation,expost regulation,and tight regulation.However,the current system also has inherent limitations and practical obstacles that need to be overcome by a more rational and effective approach.To achieve its positive impact on AI governance,the AI regulatory sandbox system should build and improve the access and exit mechanism,the coordination mechanism between the sandbox and personal information protection,and the mechanisms of exemption,disclosure,and communication.

Evolution and Governance of the Structure of Marine Economic Networks in China’s Coastal Areas: Based on Sea-related A-share Listed Companies

Data on discrete,isolated attributes of the marine economy are often used in traditional marine economic research.However,as the focus of urban research shifts from internal static attributes to external dynamic linkages,the importance of marine economic net-work research is beginning to emerge.The construction of the marine economic network in China’s coastal areas is necessary to change the flow of land and sea resources and optimize regional marine economic development.Employing data from headquarters and branches of sea-related A-share listed enterprises to construct the marine economic network in China,we use social network analysis(SNA)to discuss the characteristics of its evolution as of 2010,2015,and 2020 and its governance.The following results were obtained.1)In terms of topological characteristics,the scale of the marine economic network in China’s coastal areas has accelerated and expan-ded,and the connections have become increasingly close;thus,this development has complex network characteristics.2)In terms of spatial structure,the intensity of the connection fluctuates and does not form stable development support;the group structure gradually becomes clear,but the overall pattern is fragmented;there are spatial differences in marine economic agglomeration radiation;the radi-ation effect of the eastern marine economic circle is obvious;and the polarization effect of northern and southern marine economic circles is significant.On this basis,we construct a framework for the governance of a marine economic network with the market,the government,and industry as the three governing bodies.By clarifying the driving factors and building objectives of marine economic network construction,this study aims to foster the high-quality development of China’s marine economy.

Rights Risks of Using Affective Computing Technology in Public Governance and Their Regulation

As the frontier of intelligent computing technology,affective computing has been used in border inspection,case investigation,crime assessment,public opinion management,traffic management and other scenarios of public governance.However,there are still public risks associated with its failure to meet the basic requirements of modern public governance,and these risks are rooted in its technical characteristics.The technical characteristics of turning emotions into signals can give rise to such problems as degrading the right to informed consent,de-governance,and undermining human dignity when applied in public governance,and consequently can lead to social rights anxiety.Additionally,the affective modeling characteristics of affective computing tend to incur the rights risks of insufficient algorithm accuracy,algorithmic discrimination,and algorithmic black boxes.To avoid these risks,it is necessary to adopt the dynamic consent model as the premise for applying affective computing in public governance,and to regulate the auxiliary application of affective computing in public governance in a hierarchical manner,to achieve a balance between the application of affective computing technology and the protection of citizens'rights and the maintenance of public ethics.

The Criminal Governance Model of Domestic Violence and Its Legislative Improvement

Domestic violence is a serious threat to the basic human rights of family members,especially victimized women.In order to effectively prevent domestic violence,the criminal law needs to respond in an appropriate and timely manner.However,the traditional criminal governance model suffers from the problem of the lagging involvement of public power.At the same time,the public-private partnership governance model,based on the personal safety protection order system stipulated in the Anti-domestic Violence Law of the People's Republic of China,is also flawed in its institutional design and specific implementation.The criminal governance model for domestic violence should be guided by the view of positive criminal law,and the governance path should be furtheroptimized from two aspects:strengthening the foundation of the public-private cooperation governance model and deepeningthe criminal-civil interface.This will help to fully protect the legitimate rights and interests of victims of domestic violence.

Evidence-Based Design Application of Water Landscaping for Rehabilitation Gardens for Patients with Mental Disorders

The aim of the article is to explore the influence of the water landscape design of a rehabilitation garden for patients with mental disorders on the recovery effect of patients,intending to provide a better rehabilitation environment for patients with mental disorders.Based on literature research,this article reviews three aspects of evidence-based design theory,the concept of water landscape in rehabilitation gardens,and the types of water features in rehabilitation gardens.The results show that well-designed water features can significantly improve patients’psychological state and reduce anxiety and stress,and that water landscape design in rehabilitation gardens is an effective rehabilitation tool that can facilitate the recovery process of patients with mental disorders.Future designs should take into full consideration patients’needs and preferences,as well as best practices in waterscape design,to maximize its positive impact on patients’recovery.

Improving the Selection Model of Essential Medicines in China by Evidence-based Thinking

Objective To sort out the problems in the selection model of essential medicines in China,and to put forward some suggestions to optimize the selection model to ensure the rationality of the medicines in the essential medicines list.Methods The domestic and foreign literature on the selection of essential medicines was reviewed.Then,the opinions on the selection methods and results of essential medicines from foreign literature were investigated to make a comparison with the selection of essential medicines in China.Finally,the general and special laws of the selection process of the essential medicines were explored.Results and Conclusion It is recommended that the selection model of essential medicines in China should be further optimized,and the evidence-based thinking and methods should be utilized to enhance the scientific nature of the selection process.