Expert Consensus on Clinical Management of T2DM Combined with Obesity Reversal Treatment in China(2023 Edition)

With lifestyle changes,the incidence of type 2 diabetes(T2DM)and obesity has significantly increased,becoming major chronic diseases that seriously threaten the health of China’s residents.Both domestic and international guidelines and consensus exist regarding the diagnosis and management of this disease.In recent years,T2DM treatment has focused more on new tactics that lean towards a patient-centered comprehensive management approach,replacing the traditional glucose-centered approach.Additionally,an increasing amount of evidence in medicine suggests that the reversal of diabetes is possible.However,there is currently no expert consensus on the clinical management of T2DM combined with obesity reversal treatment.Therefore,experts and scholars in China with extensive experience in T2DM combined with obesity reversal treatment have been invited to develop this consensus.The content includes early identification and diagnosis of T2DM combined with obesity,definition and mechanisms of diabetes reversal,disease assessment and grading,staging of diabetes and goals of reversal,the 2+N reversal strategy,inpatient system treatment combined with comprehensive outpatient management(including weight control,precise nutrition,scientific exercise,glucose-lowering medication,psychological intervention,rehabilitation therapy,and remote follow-up through online platforms),and evaluation of post-reversal efficacy.The aim is to further improve the level of T2DM combined with obesity reversal diagnosis,treatment,and management in China,and to implement the Healthy China strategy.

Establishment of the Agricultural Knowledge Management System in the Knowledge-oriented Government

In order to optimizing the process of the government agricultural decision-making, based on the theories and technologies of the knowledge management, the meaning of the knowledge-based government is firstly analyzed. Combining with the detailed requirements of government for agricultural knowledge management, an agricultural knowledge management system including the agricultural knowledge sharing system, the agricultural Web data-mining system and the agricultural expert decision system is established in the paper.

Expert consensus on early childhood caries management

Early childhood caries(ECC)is a significant chronic disease of childhood and a rising public health burden worldwide.ECC may cause a higher risk of new caries lesions in both primary and permanent dentition,affecting lifelong oral health.The occurrence of ECC has been closely related to the core microbiome change in the oral cavity,which may be influenced by diet habits,oral health management,fluoride use,and dental manipulations.So,it is essential to improve parental oral health and awareness of health care,to establish a dental home at the early stage of childhood,and make an individualized caries management plan.Dental interventions according to the minimally invasive concept should be carried out to treat dental caries.This expert consensus mainly discusses the etiology of ECC,caries-risk assessment of children,prevention and treatment plan of ECC,aiming to achieve lifelong oral health.

Practical seismic resilience evaluation and crisis management planning through GIS-based vulnerability assessment of buildings

The objective of this paper is to demonstrate how assessment of seismic vulnerability can be effective in protection against earthquakes.Findings are reported from a case study in a densely populated urban area near an active fault,utilizing practical methods and exact engineering data.Vulnerability factors were determined due to technical considerations,and a field campaign was performed to collect the required data.Multi-criteria decision making was carried out by means of an analytical hierarchy process including a fuzzy standardization.Earthquake scenarios were applied through an implicit vulnerability model.GIS was utilized and the results were analyzed by classifying the state of vulnerability in levels as very low,low,moderate,high,and very high.Seismic resilience was evaluated as vulnerabilities below the moderate state,being about 40% in an intensity of 6 Mercalli and less than 10% in 10 Mercalli.It is concluded that seismic resilience in the area studied is not acceptable,the area is vulnerable in the expected scenarios,and due to the high seismicity of the region,proper crisis management planning is required in parallel with attempts toward retrofitting.In this regard,an emergency map was developed with reference to the assessed vulnerabilities.

An Interactive Expert System Based Decision Making Model for the Management of Transit System Alternate Fuel Vehicle Assets

Traditionally, the process used by public transportation entities to determine the acquisition strategy for new vehicle asset is based upon a broad range of criteria. Vehicle cost has been cited as one of the more critical factors which decision makers consider. It is currently a common practice to consider other factors (life-cycle cost, fuel efficiency, vehicle reliability, environmental effects, etc.) that contribute to a more comprehensive approach. This study investigates the next generation of advancements in decision making tools in the area of the application of methods to quantify and manage uncertainty. In particular, the uncertainty comes from the public policy arena where future policy and regulations are not always based upon logical and predictable processes. The fleet decision making process in most governmental agencies is a very complex and interdependent activity. There are always competing forces and agendas within the view of the decision maker. Rarely is the decision maker a single person although, within the transit environment, there is often one person charged with the responsibility of fleet management. The focus of this research examines the decision making of the general transit agency community via the development of an expert systems prototype tool. A computer-based prototype system is developed which provide an expert knowledge-based recommendation, based upon variable user inputs. The results shown in this study show that a decision making tool for the management of transit system alternate fuel vehicle assets can be modeled and tested. The direct users of this research are the transit agency administrations. The results can be used by the management teams as a reliable input to inform their urban transit buses expansion decision making process.

Expert consensus on the perioperative management of patients with sepsis

INTRODUCTION Sepsis is defined as an infection associated with systemic manifestations of inflammation, which has become the most common complication in the perioperative period caused by severe burn/trauma and major surgical operation.[1,2] The incidence of sepsis in adults is estimated to be 149–240/100 000 per year, and that of severe sepsis and septic shock is 56–91/100 000 per year. In the last decade, the short-term mortality of sepsis has declined to around 20% in developed countries partly due to the international Surviving Sepsis Campaign （SSC）, while the mortality remains very high （50%–80%） in 1–5 years after discharge from hospitals.[3–7] Thus, sepsis and its subsequent severe sepsis and septic shock are currently major issues in the field of medical and health care.

Dynamic Management of Digital Rights for Long-term Preservation：the Expert System Approach

This presentation focuses on the complex issue of managing digital rights for long-term preservation. It describes the strategy and the methodology adopted within the SPAR project (French National Library), which rely on a special kind of knowledge-based system.

Knowledge-Based Systems for the Assessment and Management of Bridge Structures: A Review

It is becoming an important social problem to make maintenance and rehabilitation of existing infrastructures such as bridges, buildings, etc. in the world. The kernel of such structure management is to develop a method of safety assessment on items which include remaining life and load carrying capacity. The purpose of this paper is to summarize the finding of up-to-date research articles concerning the application of knowledge-based systems to assessment and management of structures and to illustrate the potential of such systems in the structural engineering. In here, knowledge-based systems include knowledge-based expert systems incorporation with artificial neural networks, fuzzy reasoning and genetic or immune algorithms. Specifically, two modern bridge management systems (BMS’s) are presented in the paper. The first is a BMS to assess the performance and derive optimal strategies for inspection and maintenance of concrete bridge structures using reliability based and knowledge-based systems. The second is the concrete bridge rating expert system (J-BMS BREX) to evaluate the performance of existing bridges by incorporating with artificial neural networks and fuzzy reasoning.

Artificial Intelligence Technique and Wireless Sensor Networks in En­ergy Management System for Secure Power Optimization

The modern basic building blocks of a control system consist of data acquisition,dispensation of data by the system operators and the remote control of system devices.However,the physical controls,technical ex­aminations and deductions were originally implemented to aid the process and control of power system design.The complexity of the power system keeps increasing due the technical improvements,diversity and dynamic requirements.Artificial intelligence is the science of automating intelligent activities presently attainable by individuals.Intelligent system techniques may be of excessive benefit in the application of area power system con­trols.Whereas smart grid can be measured as a modern electric power grid structure for better productivity and dependability via automatic control,excessive power converters,modern communications setup,sensing and metering equipment,and modern energy management techniques estab­lished on the optimization of demand,energy and network accessibility,and so on.The enormous depiction of the entire transmission grid,in the perspective of smart grids,is quite unclear;and in Nigeria no studies have been put on ground in order for the existing network to be turn into a smart grid.In this research work emphasis is placed on generation and transmis­sion stations;power optimization using artificial intelligent techniques and wireless sensor networks for power control management system.

Application and Innovation of Equipment Reliability Management at Nuclear Power Stations

To achieve excellent production capability and maintain high security for nuclear power stations, equipment reliability is studied as a key issue. As the main branch, equipment reliability management is considered as an effective approach to make plant management strategy and organize routine work. Some achievements on research and application of equipment reliability management at Daya Bay Nuclear Power Station are introduced in this paper. By studying and implementing 1NPO （Institute of Nuclear Power Operations） AP-913 equipment reliability process, reliability-centered maintenance （RCM）, critical component management （CCM）, and many other similar methods, equipment reliability management system has been established at Daya Bay. And by continuous effort on improving application effect of these technologies, some innovation has also been made. Some innovative products, such as iSOM Intelligent Expert System, reliability and technique centered maintenance （RtCM）, predictive maintenance system （PdM）, and so on, have been developed. Based on these achievements, Daya Bay Nuclear Power Station has achieved excellent operation performance and won several prizes in WANO （World Association of Nuclear Operators） competition every year.

肿瘤整合康复管理专家共识(2024)

肿瘤慢病化趋势对肿瘤康复提出了新的要求,但目前肿瘤康复领域系统性、整合式的构建和论证仍然较少,建立肿瘤整合康复管理规范势在必行。为此,上海市抗癌协会康复管理专业委员会开展真实世界康复需求调研,牵头国内多名肿瘤学、康复医学、护理学、健康管理等相关领域专家召开多轮专家论证会征集意见,共同制定《肿瘤整合康复管理专家共识(2024)》。该共识提出肿瘤整合康复的定义与目标,阐述了肿瘤整合康复的分期、体系与模式、评估与干预,明确了基层医疗卫生机构在肿瘤整合康复领域的具体实践,以期为肿瘤康复学科发展和肿瘤患者整合康复管理策略的制订提供依据。

我国司法鉴定管理体制的完善路径镜鉴——以英国专家证人管理改革为例

我国司法鉴定体制改革的目标是建立和健全统一的司法鉴定管理体制。近年来,英国在统一专家证人的资格审查与选任程序、统一和重塑专家证人的职责、统一专家证据的披露要求以及统一专家证人的管理体制等方面进行了改革,为我们提供了在面对现代专家证人管理类似挑战时尝试应对的例证。对我国而言,应确保司法鉴定活动各方主体的权益,为案件事实认定提供技术支持。首先,在对鉴定主体资格的管理上,应当明确司法鉴定管理和法院监督的界限,注意两者之间的衔接;其次,在责任追究的管理上,应当在充分尊重鉴定人独立的诉讼地位的前提下,明确鉴定人的真实义务和责任,完善法院和当事人对鉴定人的责任追究机制;最后,在技术标准的管理上,应当加大行业管理的力度,实现司法鉴定行业协会向纵深发展,推动其在行业标准制定上发挥更大作用。

长三角地区寻常型银屑病中医临床诊疗专家共识

银屑病是一种免疫介导的慢性、易复发的炎症性皮肤病,其典型皮损为皮肤鳞屑样红斑。临床上将银屑病分为寻常型、红皮病型、脓疱型和关节病型4种类型。其中寻常型银屑病最为常见,根据病程分为进行期、静止期和退行期[1]。中医对寻常型银屑病有独特理解,将其归于“白疕”“干癣”“蛇虱”等范畴。中医药治疗寻常型银屑病疗效确切,能有效改善其临床症状,减少复发率。长三角地区在银屑病诊疗中具有独特的地域性和流行病学特征,但对其遣方用药尚无统一标准,因此有必要制定适用于该地区的中医药诊疗寻常型银屑病专家共识,以更科学地指导临床实践,发挥中医药诊疗的特色与优势。

《成人肥厚型心肌病康复和运动管理中国专家共识》要点解读

肥厚型心肌病是临床上常见的一种常染色体显性遗传相关的心肌病,其以心肌肥厚为主要特征,可导致恶性心律失常、心力衰竭等并发症,是运动性猝死的首要病因。为规范成人肥厚型心肌病的康复和运动管理,国内多学科权威专家联合发布《成人肥厚型心肌病康复和运动管理中国专家共识》。本文结合肥厚型心肌病运动康复的最新研究进展和临床实践,从疾病的分型、药物治疗、手术治疗、综合康复、家族成员管理和生活方式管理等方面对该共识的要点进行解读。

PDCA循环管理在危重患者保护性约束中的应用效果

目的 探讨PDCA循环管理在危重患者保护性约束中的应用效果。方法 选取本院2022年11月27日至2023年6月23日收治的252例急诊重症监护室患者,随机分为对照组和研究组,每组126例,对照组予以常规保护性约束护理,研究组在常规的保护性约束护理基础上采用PDCA循环管理模式下的保护性约束护理。将两组患者的约束松紧适宜率、约束肢体位置正确率、约束部位皮肤正常率、约束肢体末梢血运良好率进行对比。结果 研究组的约束松紧适宜率、约束肢体位置正确率、约束部位皮肤正常率、约束肢体末梢血运良好率均高于对照组,差异均有统计学意义(P<0.05)。结论 在危重患者保护性约束护理中,PDCA循环管理模式能够有效提高约束松紧适宜率、约束肢体位置正确率、约束部位皮肤正常率、约束肢体末梢血运良好率。

中华优秀传统文化核心思想理念视角下预算绩效管理的优化研究

预算绩效管理是财政管理中的重要环节,也是当前我国财政管理改革的主要着力点。它对于完善财政管理体制和财政资金管理具有重要作用。但预算绩效管理制度舶来品的属性明显,本土化任务繁重。本文详尽分析中华优秀传统文化核心思想理念,发掘其蕴含的预算绩效管理价值,应用中华优秀传统文化核心思想理念重新诠释预算绩效管理,寻求优化路径。本文建议以“讲仁爱、重民本”为前提与出发点,推演人民至上观;以“守诚信、崇正义”为过程与手段,追求道德约束观;以“尚和合、求大同”为目标与方向,提炼长远全局观,从而实现预算绩效管理与中华优秀传统文化的融合发展,促进预算绩效管理有效实施。

糖尿病足个案管理师岗位胜任力评价指标的构建

目的构建糖尿病足个案管理师岗位胜任力评价指标,为糖尿病足个案管理师选拔、培训和考核提供客观、科学的理论依据。方法以岗位胜任力冰山模型为理论基础,通过文献回顾和采用整群抽样法选取该院不同科室的10名专科护士进行半结构式深入访谈、咨询,制订糖尿病足个案管理师岗位胜任力评价初级指标,并通过采用德尔菲专家函询法对19名专家进行3轮函询,结合该院实际和专家意见构建糖尿病足个案管理师岗位胜任力评价指标体系。结果3轮咨询后问卷回收率为100%,肯德尔和谐系数分别为0.136~0.270、0.182~0.235、0.184~0.341,专家权威系数分别为0.926、0.955、0.961。最终形成了5个一级指标(护理决策能力、人际沟通能力、质量监督能力、教育指导能力、科研创新能力)、13个二级指标、69个三级指标的糖尿病足个案管理师岗位胜任力评价指标体系。结论本研究构建的糖尿病足个案管理师岗位胜任力评价指标体系科学、实用、可靠,可为糖尿病足个案管理师的选拔、培训、考核、评价等提供可量化的指标参考依据。

不同性质园所园长任期结束综合督导省级评估指标设置研究

地方政府应通过了解管理区域内政策需求,积极推进制度创新,提高政策执行效能。分析发现,我国地方政府对园长以及幼儿园的督导指标具有较大的一致性。本文以行政管理自由裁量权理论为指导,基于福建省幼儿园办园行为督导评估数据分析,并借鉴其他相关政策文件内容,探讨不同性质园所园长任期结束综合督导评估指标优化设置问题。研究发现,办园行为督导数据分析可以为分类评估指标优化设置提供政策需求线索;公办园和普惠性民办园在园舍规划、设备设施、玩具图书与课程材料、专业成长、薪资待遇这5项指标方面差异显著,显示出分类评估指标优化设置的潜在需求,因此提出针对公、民办园园长评估分类指标的5项建议,并建言对已有评估资料进行深入分析,循证支持对不同性质园所的分类管理。

园校合作:学前教育专业组织管理类课程改革的新型模式探究

组织管理类课程是学前教育专业课程体系的重要组成部分,一直以来在课程目标、课程内容、课程实施、课程考核评价方面存在着一定的问题,特别是偏狭性明显、“知识本位”突出、模式僵化、实践取向缺乏,这些问题给学前教育专业组织管理类课程的顺利运行带来一定的困难,为了妥善地解决这样的问题,文章以园校合作为立足点,从树立实践取向的课程改革意识、建立园校合作的课程管理制度、设计园校合作的课程运行方案等方面着手构建学前教育专业组织管理类课程改革的新型模式。

OBE理念下高校与幼儿园协同育人模式创新——以新疆高校幼儿园组织与管理课程为例

在“学生中心、产出导向、持续改进”的师范类专业认证OBE理念指引下,文本通过问卷法、访谈法及观察法,对10个班级的374名学生开展为期4学期的教学改革研究,以推进学前教育专业本科核心课程幼儿园组织与管理的教学改革,探索线上与线下混合、高校与幼儿园协同育人的教学模式。文本对培养适应学前教育行业发展需要和国家幼有所育战略目标的学前教育高素质专业人才,具有一定的实践创新意义和应用推广价值。