Acupuncture:Effective and Recommended but More Implementation Needed

Acupuncture enjoys a robust evidence base for dozens of clinical conditions and decades of research exploring its mechanisms of action. It has over 9,000 positive recommendations from official government and clinical guidelines. However, it still remains relatively inaccessible in the United States, Europe and elsewhere, especially compared to the strength of evidence-based recommendations for its use. Acupuncture would benefit from robust implementation strategies, utilizing insights and approaches from implementation science. The clinical use of Botox for migraine suffered from weaker evidence of effectiveness and greater evidence of harm, but using a streamlined and robust implementation strategy, Allergan was able to achieve widespread implementation from when it began its efforts around 2010. Such a systematic approach that identifies and overcomes barriers to implementation for acupuncture would benefit millions of people who currently are offered less effective and more invasive treatments, contrary to the recommendations of clinical guidelines.

Implementation Status and Development Strategies of Study Tour in Primary Schools in Nanchang City : A Case Study of L Primary School

In recent years,with the support and promotion of relevant policies such as the Opinions on Promoting Study Tour for Primary and Secondary School Students jointly issued by the Ministry of Education and 11 other departments,a wave of study tour has been sparked nationwide from individual pilot projects to gradual promotion.In this paper,students and teachers from grades 4 to 6 of L Primary School in Nanchang City,Jiangxi Province were selected as the survey objects.Combining the survey questionnaire,the current situation of conducting study tour in the primary school was sorted out and analyzed in depth from several aspects such as study tour cognition,study tour participation,study tour implementation,etc.Based on the survey results and relevant research,the current problems in conducting study tours in primary schools were summarized,and targeted improvement measures were proposed,in order to promote the healthy development of study tours in primary schools.

A High Efficiency Hardware Implementation of S-Boxes Based on Composite Field for Advanced Encryption Standard

The SubBytes (S-box) transformation is the most crucial operation in the AES algorithm, significantly impacting the implementation performance of AES chips. To design a high-performance S-box, a segmented optimization implementation of the S-box is proposed based on the composite field inverse operation in this paper. This proposed S-box implementation is modeled using Verilog language and synthesized using Design Complier software under the premise of ensuring the correctness of the simulation result. The synthesis results show that, compared to several current S-box implementation schemes, the proposed implementation of the S-box significantly reduces the area overhead and critical path delay, then gets higher hardware efficiency. This provides strong support for realizing efficient and compact S-box ASIC designs.

Research on the Evaluation System of Community Daycare Center Planning and Implementation from the Perspective of Subject-Object Relationships

Through literature review,we found that evaluations of urban planning implementation often focus narrowly on either the subject(stakeholders)or the object(projects),while micro-level aspects such as site selection and construction are primarily considered within the context of planning implementation.There is insufficient research on the evaluation of implementation.Community daycare centers play a crucial role in the community home care model,yet there is relatively little research on their usage efficiency,satisfaction levels,and spatial evaluation of planning implementation.Based on the theoretical understanding of the human environment,including the subject,object,and their interactions,an evaluation system for the planning and implementation of community day care centers was constructed,incorporating subjective evaluation,objective evaluation,and comparative analysis.

Research on the Evaluation of the Implementation Effect of Curriculum Examination Reform: Taking the Course of “Introduction to Language” as an Example

“Introduction to Language,”as the core course of the English major,mainly reveals the basic laws of language,enabling the students to have the ability to apply linguistic theories to explain language phenomena and solve specific language problems.This course is highly theoretical and has a certain degree of difficulty.The evaluation of student grades has always been based on examination reform,but several problems have been encountered during the implementation process.This article analyzes the current situation of the reform and implementation of the“Introduction to Language”course examination in applied universities and puts forth suggestions and specific measures to improve the assessment of the course,aiming to enhance the teaching effectiveness of the course and scientifically and comprehensively evaluate students’abilities.

Research on the Implementation Path of Labor Education in Colleges and Universities from an International Perspective

Universities shoulder the important mission of talent cultivation,scientific research,social service,cultural heritage and innovation,and international exchange and cooperation.International exchange and cooperation have become the fifth major function of universities.Based on the background of the globalization era,undergraduate colleges and universities should pay more attention to the cultivation of students’intercultural communication and understanding ability while cultivating their professional skills,and take expanding students’international vision and enhancing the international competitiveness of China’s education as important tasks.Labor education is an important content of the national education system,which has the comprehensive nurturing value of cultivating morality,increasing intelligence,strengthening physical fitness,and cultivating beauty.Higher education institutions should further optimize the system of labor education,expand students’space and field of thinking in the process of labor education,and broaden students’international perspectives.

Study on Path Selection and Implementation Effect of Counselors in College Students’Career Planning Education

Under the background of a severe job market and fierce talent competition,the career planning education of college students is of great importance.In this study,a combination of quantitative and qualitative research methods was used;500 students in Shenzhen Polytechnic of Information Technology were surveyed by questionnaire,and 40 counselors were interviewed in depth to comprehensively analyze the role and practical effect of counselors in career planning education.The research showed that the role positioning of counselors includes the guide of students’career development,emotional support,and job-hunting strategy,and the specific path selection involves the strengthening of professional knowledge,the construction of interpersonal relationship networks,and personalized counseling.Based on the survey and interview data,this paper constructed a model for enhancing the role of counselors in career planning education and put forward a set of targeted work paths.

FPGA Implementation of Extended Kalman Filter for Parameters Estimation of Railway Wheelset

It is necessary to know the status of adhesion conditions between wheel and rail for efficient accelerating and decelerating of railroad vehicle.The proper estimation of adhesion conditions and their real-time implementation is considered a challenge for scholars.In this paper,the development of simulation model of extended Kalman filter(EKF)in MATLAB/Simulink is presented to estimate various railway wheelset parameters in different contact conditions of track.Due to concurrent in nature,the Xilinx®System-on-Chip Zynq Field Programmable Gate Array(FPGA)device is chosen to check the onboard estimation ofwheel-rail interaction parameters by using the National Instruments(NI)myRIO®development board.The NImyRIO®development board is flexible to deal with nonlinearities,uncertain changes,and fastchanging dynamics in real-time occurring in wheel-rail contact conditions during vehicle operation.The simulated dataset of the railway nonlinear wheelsetmodel is tested on FPGA-based EKF with different track conditions and with accelerating and decelerating operations of the vehicle.The proposed model-based estimation of railway wheelset parameters is synthesized on FPGA and its simulation is carried out for functional verification on FPGA.The obtained simulation results are aligned with the simulation results obtained through MATLAB.To the best of our knowledge,this is the first time study that presents the implementation of a model-based estimation of railway wheelset parameters on FPGA and its functional verification.The functional behavior of the FPGA-based estimator shows that these results are the addition of current knowledge in the field of the railway.

Impact of Multidisciplinary Collaborative Intervention on Isolation Implementation in Prevention and Control of Multi-drug Resistance Infection

Objective Contact precautions,especially the initiation of isolation,are important measures to prevent and control multidrug-resistant organisms(MDROs).However,the implementation in clinical practice remains weak.This study aimed to analyze the impact of multidisciplinary collaborative intervention on isolation implementation in multidrug-resistant infection,and determine the factors that affect the implementation of isolation measures.Methods A multidisciplinary collaborative intervention related to isolation was conducted at a teaching tertiary hospital in central China on November 1,2018.The information of 1338 patients with MDRO infection and colonization at 10 months before and after the intervention was collected.Then,the issuance of isolation orders was retrospectively analyzed.Univariate analysis and multivariate logistic regression analysis were performed to analyze the factors that affected the isolation implementation.Results The overall issuance rate of isolation orders was 61.21%,which increased from 33.12%to 75.88%(P<0.001)after the implementation of the multidisciplinary collaborative intervention.The intervention(P<0.001,OR=0.166)was a promoting factor for the issuance of isolation orders,in addition to the length of stay(P=0.004,OR=0.991),department(P=0.004),and microorganism(P=0.038).Conclusion The isolation implementation remains far lower than policy standards.Multidisciplinary collaborative interventions can effectively improve the compliance to isolation measures implemented by doctors,thereby promoting the standardized management of MDROs,and providing reference for further improving the quality of hospital infection management.

Implementation Research on the Effects and Results of a National Health Promotion Project

The purpose of this study was to describe the implementation of the Finnish government’s 2017-2018 key project titled “Effective lifestyle counselling for social and health care cross-functionally” (VESOTE) in primary health care organizations in Southwest Finland. The study also aimed to illustrate the project’s impacts on nursing practices in primary health care organizations in terms of lifestyle counselling. Data were collected from all of the primary health care organizations in Southwest Finland by using a questionnaire. The data were analyzed qualitatively and by using descriptive statistics. The participants considered the VESOTE project important in terms of its contents. However, only individual measures of the project were adopted into practice. Organizations require tools to monitor the implementation of a new operating model. This should be taken into account when launching national projects.

A cluster-randomized trial comparing two SWITCH implementation support strategies for school wellness intervention effectiveness

Background:The School Wellness Integration Targeting Child Health(SWITCH)intervention has demonstrated feasibility as an implementation approach to help schools facilitate changes in students’physical activity(PA),sedentary screen time(SST),and dietary intake(DI).This study evaluated the comparative effectiveness of enhanced(individualized)implementation and standard(group-based)implementation.Methods:Twenty-two Iowa elementary schools participated,with each receiving standardized training(wellness conference and webinars).Schools were matched within region and randomized to receive either individualized or group implementation support.The PA,SST,and DI outcomes of 1097 students were assessed at pre-and post-intervention periods using the Youth Activity Profile.Linear mixed models evaluated differential change in outcomes by condition,for comparative effectiveness,and by gender.Results:Both implementation conditions led to significant improvements in PA and SST over time(p<0.01),but DI did not improve commensurately(p value range:0.02‒0.05).There were no differential changes between the group and individualized conditions for PA(p=0.51),SST(p=0.19),or DI(p=0.73).There were no differential effects by gender(i.e.,non-significant condition-by-gender interactions)for PA(p_(for interaction)=0.86),SST(p_(for interaction)=0.46),or DI(p_(for interaction)=0.15).Effect sizes for both conditions equated to approximately 6 min more PA per day and approximately 3 min less sedentary time.Conclusion:The observed lack of difference in outcomes suggests that group implementation of SWITCH is equally effective as individualized implementation for building capacity in school wellness programming.Similarly,the lack of interaction by gender suggests that SWITCH can be beneficial for both boys and girls.Additional research is needed to understand the school-level factors that influence implementation(and outcomes)of SWITCH.

Effective implementation and improvement of fast labeled multi-Bernoulli filter

Effective implementation of the fast labeled multi-Bernoulli(FLMB)filter is addressed for target tracking with interval measurements.Firstly,a sequential Monte Carlo(SMC)implementation of the FLMB filter,SMC-FLMB filter,is derived based on generalized likelihood function weighting.Then,a box particle(BP)implementation of the FLMB filter,BP-FLMB filter,is developed,with a computational complexity reduction of the SMC-FLMB filter.Finally,an improved version of the BP-FLMB filter,improved BP-FLMB(IBP-FLMB)filter,is proposed,improving its estimation accuracy and real-time performance under the conditions of low detection probability and high clutter.Simulation results show that the BP-FLMB filter has a great improvement of the real-time performance than the SMC-FLMB filter,with similar tracking performance.Compared with the BP-FLMB filter,the IBP-FLMB filter has better estimation performance and real-time performance under the conditions of low detection probability and high clutter.

Level of Implementation of Seasonal Malaria Chemoprevention in Children Aged between 3 to 59 Months in Koza, Far North Region of Cameroon

Background: Seasonal Malaria Chemoprevention (SMC) is a strategy put in place by World Health Organisation (WHO) to fight against malaria in zones of high seasonal malaria transmission since the year 2012. This strategy has been implemented in the Far North and North regions of Cameroon since the year 2016. Despite the implementation of this program the number of cases and deaths from seasonal malaria among the under 5 seems to be rising in Koza health area. Objective: To determine the level of implementation of the SMC Program and its impact on the mortality of children aged 03 to 59 months during the season of high transmission. Methods: This was a community-based cross-sectional and 7-years retrospective study. Data was surveyed for 3 months in 3 health areas of Koza health area. Data were collected and typed in Kobo collect, cleaned in MS Excel and analyzed in SPSS version 25 to come out with descriptive statistics. Results: Among the 172 households, female children were mostly represented 99 (57%) The age group mostly represented was 2 years. The population knowledge on SMC’s overall score was above average. The overall coverage rate (4 cycles) was 84% from interviewed parents and 67.5% from SMC cards. More than 23% of children experienced at least one side effect with the most common being vomiting (72%). The population’s overall impression of the program was good at 85%. The trends SMC coverage showed a sinusoidal fluctuation from 2015 to 2021, 2016 to 2019 and 2020 to 2021. Conclusion: The coverage rate of SMC was high thus the program is well implemented.

Research on Identification Method of Apple Diseases in Southern Xinjiang Based on Deep Learning and Its System Implementation

Apple disease samples were collected from the southern Xinjiang and annotated to design a convolutional neural network model based on deep learning.The accuracy and robustness of the model was improved through training and optimization algorithms,and a complete apple disease identification system was developed with the model as the core,and evaluated for its performance in terms of accuracy,recall rate and speed.This study provides a reliable AI-based apple disease diagnosis solution for the apple planting industry in the southern Xinjiang,hoping to help farmers better manage and protect crop health.

Validation of short version of evidence-based practice instruments among nurses in clinical practice:Evidence-based practice beliefs,implementation,and organizational culture

Objective:The objective of the study is to validate the short version of evidence-based practice(EBP)instruments among nurses in clinical practice.Methods:An institutional-based cross-sectional research design was used and a stratified sampling technique to select 285 nurse clinicians.The study utilized a structured questionnaire comprising of demographic data from the participants and three validated scales:the shortened versions of the EBP Beliefs Scale,the EBP Implementation Scale,and the Organizational Culture and Readiness for System-Wide Integration of Evidence-Based Practice(OCRSIEP)survey.With the use of descriptive statistics,the data were analyzed and presented in frequencies and percentages,while inter-item correlation coefficient(ICC)and the Kaiser-Meyer-Olkin measure of sampling adequacy were used to confirm the validity of using factor analysis.Results:Findings revealed the mean scores of the EBP Beliefs Scale ranged from 1.50 to 1.61,EBP Implementation Scale ranged from 1.84 to 1.94,and the OCRSIEP Scale ranged from 1.93 to 2.19.All the three shortened scales accordingly had good internal reliability,29.30±9.93 out of 80 for the EBP Beliefs Scale,19.56±7.37 out of 72 for the EBP Implementation Scale,and 66.32±20.35 out of 125 for the OCRSIEP Scale.Conclusion:This study has generated a valid Short Version of EBP reliable instrument that is psychometrically robust that can be used by nurses and clinicians to evaluate EBP in clinical settings since the results presented as a whole confirmed the high reliability and factorial validity.

Current Implementation and Experience of Natural Farming in Japan

The natural farming in Japan mainly includes Mokich Okadas natural farming theory and Masanobu Fukuokas natural farming theory in terms of genre.Natural farming was proposed and implemented to deal with the anabatic soil degradation and food safety problems.Among themꎬMokich Okadas natural farming theory advocates the restoration of the agricultural tradition of the past and combination with modern agricultural science and technologyꎻMasanobu Fukuokas natural farming theory advocates a complete return to natural and traditional farming and puts forward a set of green agricultural cultivation methods focusing on injurious insect control with beneficial insectꎬweed control with green herbaceous plantsꎬsoil reclamation with grassꎬnontoxic and cost￣reducing method based on the Japanese ancient agricultural books.Their natural farming theories have been widely popularized and applied in Japanꎬand its successful experience is worthy of study and reference for China.

Implementation Strategy of“Eight in One”of Integrated Medical and Care Service System in China:A Case Study of Anshan City of Liaoning

With the gradual intensification of aging in China,the issue of elderly care has become the primary issue that needs to be urgently solved in society.The construction of a reasonable and scientific integrated medical and care service system can not only efficiently allocate medical resources and services,but also better meet the needs of the elderly.Due to the involvement of multiple disciplines such as architecture,sociology,psychology,and behavioral science in the construction of the system,as well as the restriction of various objective factors such as medical capacity,spatial scale,and operating costs,the government and elderly care institutions have always been unable to find the best solution for how to scientifically and reasonably construct an integrated medical and care service system.This paper is based on Anshan City,Liaoning Province,which has prominent aging issues and distinct characteristics of the elderly population.Through extensive field research in elderly care institutions,and face-to-face communication with personnel from relevant government departments such as the Municipal Commission on Aging,the Civil Affairs Bureau,the Health Commission,the Medical Insurance Bureau,and the Human Resources and Social Security Bureau,it truly understands the problems that arise in the construction of the urban integrated medical and care service system.From three aspects:urban situation,institutional situation and the needs of the elderly,it is proposed to establish a clear departmental linkage mechanism with clear rights and responsibilities,a policy guarantee mechanism tailored to local conditions,a multi-measure operation mechanism,a technology first intelligent response mechanism,a warm and efficient service mechanism for the people,an overall layout mechanism,an evaluation and supervision mechanism for full process control,and a talent supply mechanism of external introduction and internal training.It aims to provide reference for the construction of an integrated medical and care service system in similar cities.

Long-term thinning decreases the contribution of heterotrophic respiration to soil respiration in subalpine plantations

Interest in the dynamics of soil respiration(R_(S))in subalpine forest ecosystems is increasing due to their high soil carbon density and potential sensitivity to environmental changes.However,as a principal silvicultural practice,the long-term impacts of thinning on R_(S) and its heterotrophic and autotrophic respiration components(R_(h) and Ra,respectively)in subalpine plantations are poorly understood,espe-cially in winter.A 3-year field observation was carried out with consideration of winter CO_(2) efflux in middle-aged sub-alpine spruce plantations in northwestern China.A trench-ing method was used to explore the long-term impacts of thinning on Rs,Rn and R_(a).Seventeen years after thinning,mean annual Rs,Rn and R_(a) increased,while the contribu-tion of R_(h) to R_(s) decreased with thinning intensity.Thinning significantly decreased winter R,because of the reduction in R_(n) but had no significant effect on Ra.The temperature sensitivity(Q_(10))of R_(h) and R_(a) also increased with thinning intensity,with lower Q_(10) values for R_(h)(2.1-2.6)than for Ra(2.4-2.8).The results revealed the explanatory variables and pathways related to R_(n) and R_(a) dynamics.Thinning increased soil moisture and nitrate nitrogen(NO_(3)^(-)-N),and the enhanced nitrogen and water availability promoted R_(h) and R_(a) by improving fine root biomass and microbial activity.Our results highlight the positive roles of NO_(3)^(-)-N in stimulating R_(s) components following long-term thinning.Therefore,applications of nitrogen fertilizer are not recommended while thinning subalpine spruce plantations from the perspective of reducing soil CO_(2) emissions.The increased Q_(10) values of R_(s) components indicate that a large increase in soil CO_(2) emissions would be expected following thinning because of more pronounced climate warming in alpineregions.

Long-Term Performance and Microstructural Characterization of Dam Concrete in the Three Gorges Project

This study investigates the long-term performance of laboratory dam concrete in different curing environments over ten years and the microstructure of 17-year-old laboratory concrete and actual concrete cores drilled from the Three Gorges Dam.The mechanical properties of the laboratory dam concrete,whether cured in natural or standard environments,continued to improve over time.Furthermore,the laboratory dam concrete exhibited good resistance to diffusion and a refined microstructure after 17 years.However,curing and long-term exposure to the local natural environment reduced the frost resistance.Microstructural analyses of the laboratory concrete samples demonstrated that moderate-heat cement and fine fly ash(FA)particles were almost fully hydrated to form compact micro structures consisting of large quantities of homogeneous calcium(alumino)silicate hydrate(C-(A)-S-H)gels and a few crystals.No obvious interfacial transition zones were observed in the microstructure owing to the longterm pozzolanic reaction.This dense and homogenous microstructure was the crucial reason for the excellent long-term performance of the dam concrete.A high FA volume also played a significant role in the microstructural densification and performance growth of dam concrete at a later age.The concrete drilled from the dam surface exhibited a loose microstructure with higher microporosity,indicating that concrete directly exposed to the actual service environment suffered degradation caused by water and wind attacks.In this study,both macro-performance and microstructural analyses revealed that the application of moderate-heat cement and FA resulted in a dense and homogenous microstructure,which ensured the excellent long-term performance of concrete from the Three Gorges Dam after 17 years.Long-term exposure to an actual service environment may lead to microstructural degradation of the concrete surface.Therefore,the retained long-term dam concrete samples need to be further researched to better understand its microstructural evolution and development of its properties.

Soil bacterial and fungal communities resilience to long-term nitrogen addition in subtropical forests in China

Atmospheric nitrogen(N)deposition is predicted to increase,especially in the subtropics.However,the responses of soil microorganisms to long-term N addition at the molecular level in N-rich subtropical forests have not been clarified.A long-term nutrient addition experiment was conducted in a subtropical evergreen old-growth forest in China.The four treatments were:control,low N(50 kg N ha^(-1)a^(-1)),high N(100 kg N ha^(-1)a^(-1)),and combined N and phosphorus(P)(100 kg N ha^(-1)a^(-1)+50 kg P ha^(-1)a^(-1)).Metagenomic sequencing characterized diversity and composition of soil microbial communities and used to construct bacterial/fungal co-occurrence networks.Nutrient-treated soils were more acidic and had higher levels of dissolved organic carbon than controls.There were no significant differences in microbial diversity and community composition across treatments.The addition of nutrients increased the abundance of copiotrophic bacteria and potentially beneficial microorganisms(e.g.,Gemmatimonadetes,Chaetomium,and Aureobasidium).Low N addition increased microbiome network connectivity.Three rare fungi were identified as module hubs under nutrient addition,indicating that low abundance fungi were more sensitive to increased nutrients.The results indicate that the overall composition of microbial communities was stable but not static to long-term N addition.Our findings provide new insights that can aid predictions of the response of soil microbial communities to long-term N addition.