Imperative for long-term management and surveillance in Kawasaki disease

Kawasaki disease(KD)is a significant pediatric vasculitis known for its potential to cause severe coronary artery complications.Despite the effectiveness of initial treatments,such as intravenous immunoglobulin,KD patients can experience long-term cardiovascular issues,as evidenced by a recent case report of an adult who suffered a ST-segment elevation myocardial infarction due to previous KD in the World Journal of Clinical Cases.This editorial emphasizes the critical need for long-term management and regular surveillance to prevent such complications.By drawing on recent research and case studies,we advocate for a structured approach to follow-up care that includes routine cardiac evaluations and preventive measures.

Development of ToSPACE for Pipe Wall Thinning Management in Nuclear Power Plants

A number of piping components in the secondary system of nuclear power plants are exposed to aging mechanisms such as FAC (Flow-Accelerated Corrosion), cavitation, flashing, SPE (Solid Particle Erosion), LDIE (Liquid Droplet Impingement Erosion), etc. Those mechanisms may lead to thinning, leak, or rupture of the components. Due to the pipe ruptures caused by wall thinning in Surry unit 2 of USA in 1986 and in Mihama unit 3 of Japan in 1994, the pipe wall thinning management has emerged as one of the most important issues in nuclear power plants. To manage the pipe wall thinning in the secondary system, Korea has used a foreign program since 1996. As using the foreign country’s program for long term, it was necessary to improve from the perspective of the users. Accordingly, KEPCO-E & C has started to develop the 3D-based pipe wall thinning management program (ToSPACE, Total Solution for Piping And Component Engineering management) from eight years ago, and the development was successful. This paper describes the major functions included in ToSPACE program, such as 3D-based DB (Database) buildup, development of FAC and erosion evaluation theories, UT (Ultra-sonic Test) data reliability analysis, field connection with 3D, automatic establishment of long-term inspection plan, etc. ToSPACE program was developed to allow site engineers performing the selection of inspection quantity at each refueling outage, UT data reliability analysis, UT evaluation, determination of next inspection timing, identification of the inspecting and replacing components in 3D drawings, etc., to access easily.

Discussion on Management Model of Medical Equipment Maintenance in Hospital

With the development of technology, medical equipment plays a more important role in the modern hospital. Medical equipment provides images, physiological results or other schematics of the patients to help doctors deal with the routines. It is also the major tool to the lab assistant in the clinical teaching and studies. It becomes one of a symbol of the technological level in modern hospital. The director of the hospital should establish an effi cacious management pattern to manage the medical equipment, so that it will be operated in good condition to insure the safety of the patients. Since the maintenance is an important part of medical equipment management, it is significant that the hospital should establish a system to fit for itself. The study reviews the issues in hospital medical equipment maintenance management, the development of the maintenance management model and the characteristics, as well as the status at home and abroad. The research has been fi nished by using literature research method, questionnaire survey method and data analysis method. Then we analyze the current status of hospital medical equipment maintenance management model to fi nd the problems. Based on the authentic and effective data from the survey, we can deduce the overview about the maintenance model in Beijing. The paper discusses the advantages and the disadvantages between the different model, and it makes suggestions on the follow aspects, such as system management, quality management, personnel management, cost management, information management perspective.

Effect of dienogest treatment on uterine fibroid volume in patients with endometriosis or adenomyosis complicated by uterine fibroids

BACKGROUND Currently,the use of dienogest in clinical practice has increased significantly,and many studies have focused on its effectiveness and safety in the treatment of endometriosis and adenomyosis;however,the effects of treatment with dienogest on uterine fibroid size in patients with endometriosis or adenomyosis have not been investigated.AIM To explore changes in fibroid size in patients with concomitant uterine fibroids undergoing dienogest treatment for endometriosis or adenomyosis and to evaluate the effectiveness and safety of the drug.METHODS The clinical data of patients with uterine fibroids treated with dienogest for endometriosis or adenomyosis at Peking University First Hospital from January 2021 to January 2023 were retrospectively analyzed.RESULTS The maximum uterine fibroid diameter and volume increased after 3 months,6 months and 1 year of dienogest treatment compared with those before treatment(P<0.01).The maximum diameter and volume of the uterine adenomyoma increased after 3 months of dienogest treatment but decreased after 6 months and 1 year of treatment compared with those before treatment,but the difference was not significant(P>0.05).Endometrial thickness and antigen 125 levels were significantly thinner and decreased,respectively,after dienogest treatment(P<0.01).Pearson's correlation analysis revealed that the increase in uterine fibroid volume after 3 months of dienogest treatment was positively correlated with the basic uterine fibroid volume(r=0.792,P<0.01).Among 64 patients with dysmenorrhea,63 experienced significant relief of dysmenorrhea after 6 months of treatment with dienogest,and all patients experienced significant relief of dysmenorrhea after 12 months.Patients were able to tolerate the drugs,with an average drug tolerance score of 8.73.CONCLUSION The use of dienogest in patients with endometriosis or adenomyosis combined with uterine fibroids can effectively relieve the patient's pain symptoms and significantly reduce the sizes of ovarian endometriotic cysts,but it cannot inhibit uterine fibroid growth.

Understanding organizational context and heart failure management in long term care homes in Ontario, Canada

Objective: To assess current heart failure (HF) care processes and organizational context in long-term care (LTC) homes as a prelude to adapting the Canadian Cardiovascular Society (CCS) HF guidelines for use in these settings. Methods: This research reports on the results of thirteen focus groups (N = 83 participants;average of 60 minutes duration) conducted in three Ontario LTC homes to better understand how HF was managed and how organizational context impacted care. Participants included physicians, nurse practitioners, registered nurses, registered practical nurses, and personal support workers. Results: Focus group findings revealed that the complexity of the LTC environment presents challenges for managing HF. Most residents have multiple advanced chronic conditions that must be managed simultaneously. Culturally, LTC is first and foremost a resident’s home where residents may choose not to comply with care recommendations. Staff routines, scopes of practice, professional hierarchies, available resources and government regulations limit flexibility in providing care. Staff lacked knowledge, skills and resources for managing HF. Nevertheless, all staff viewed LTC as the preferred place for managing HF, avoiding residents’ hospitalizations wherever possible. These data suggest that strategies for improving LTC staff communication and education, strengthening existing relationships between staff, family, residents and community resources, and acquiring additional resources in LTC homes have the potential to improve HF management in this setting. Conclusion: LTC is a complex and dynamic environment that presents many challenges for providing care for residents. This research provides the foundation for subsequent work to develop and test implementation strategies to manage HF in LTC, which are consistent with the CCS HF guidelines and are feasible within LTC staff’s work routines, capacities and resources.

A Descriptive Longitudinal Study of Chronic Pain Outcomes and Gender Differences in a Multidisciplinary Pain Management Centre

Background: The long-term outcomes of patients with chronic pain treated in a multidisciplinary pain management center remain variable. Objective: This study aims to evaluate the changes in outcomes of patient’s self-reported pain, psychosocial status, health related quality of life and gender differences following treatment in amultidisciplinary pain management centre. Design: A prospective longitudinal cross-sectional study uses questionnaires. Treatment Setting: A pragmatic and individualized patient centered approach in a tertiary level multidisciplinary pain management center. Subjects: Patients with chronic pain referred to the centre from 2004-2010. Outcome Measures: Pain Numerical Rating Scale (NRS), Pain Temporal Description (1 - 6), Pain Self- Efficacy Questionnaire (PSEQ), Depression Anxiety Stress Scales (DASS-21) and Short Form-36 (SF- 36). Follow-up questionnaires were sent at 6 and 12 months after initial assessment. Results: Mean duration of baseline chronic pain was 8.1 years and 61% of chronic pains were involving the musculoskeletal system. At 6 and 12 month follow-ups, 273 and 180 participants had been surveyed respectively. At 6-month follow-up, there were significant improvements on pain intensity (Cohen’s d = 0.8), pain self-efficacy (Cohen’s d = 0.47), depression and stress scores (Cohen’s d = 0.16) and six out of eight domains of SF-36 (Cohen’s d = 0.2 - 0.4). At 12-month follow-up, improvements were maintained on pain intensity, self-efficacy and three out of eight domains of SF-36. There were distinctive pre- and post-treatment gender differences in these outcomes and overall females showed better short- and long-term outcomes than males. Conclusion: Multidisciplinary pain management using an individualized patient centered approach remains an effective treatment for chronic pain in both the short- (6 month) and long-term (12 month). The distinctive pre- and post-treatment gender differences particularly in the psychological outcomes, suggest that it may be beneficial to further delineate and better manage vulnerable patient subgroups.

Successful Strategic Management for Growth-Oriented Timber Haulage Entrepreneurs

The aim of this study was to investigate the growth of a timber haulage company and the entrepreneur behind the growth. The purpose of the study was to find out what kind of impact strategic management has on the growth of profitability. Entrepreneurs＇ financial and strategic objectives were studied, as well as growth strategies and their implications. Studied companies were all located in Finland. The research material was collected by personal interviews in 2008 from 23 entrepreneurs. Their financial statements from 2001 to 2007 were also taken into account. The study found that the role of management seems to be crucial in profitable growth and much more meaningful than, for example, the financial situation. Strategic objectives and chosen growth strategy seem especially to be key elements for successful growth. Particularly in low profit sectors, management should not focus growth purely on current conditions, but also on seeking other ways to exploit the company＇s resources.

THE SPILLOVER MANAGEMENT IN THE DYNAMIC OUTPUT FEEDBACK CONTROL OF FLEXIBLE SPACECRAFT

ＴＨＥＳＰＩＬＬＯＶＥＲＭＡＮＡＧＥＭＥＮＴＩＮＴＨＥＤＹＮＡＭＩＣＯＵＴＰＵＴＦＥＥＤＢＡＣＫＣＯＮＴＲＯＬＯＦＦＬＥＸＩＢＬＥＳＰＡＣＥＣＲＡＦＴＴＨＥＳＰＩＬＬＯＶＥＲＭＡＮＡＧＥＭＥＮＴＩＮＴＨＥＤＹＮＡＭＩＣＯＵＴＰＵＴＦＥＥＤＢＡＣＫＣＯ...

Research on Supplier Relationship Management of the Main Manufacturer of Large Aircraft Project:A Psychological Contract Perspective

The main manufacturer and its suppliers＇ relationship management is very important for success of the large aircraft project. The study concentrates on analysis of the relationship management on a psychological con- tract perspective, shows that constructing good psychological contract is useful to promote mutual trust, reduce the transaction cost caused by incompleteness of formal contract, avoid the risk of supplier management between the main manufacturer and suppliers of the large aircraft project. And with further understanding of the dynamic contracting process as well as formation framework of psychological contract between the main manufacturer and suppliers, we can better understand the relationship black-box and provide a new perspective for the study of the relationship management, then given some constructive suggestions to supplier relationship management.

Rapidly separating dissolving microneedles with sustained-release colchicine and stabilized uricase for simplified long-term gout management

Despite growing prevalence and incidence,the management of gout remains suboptimal.The intermittent nature of the gout makes the long-term urate-lowering therapy(ULT)particularly important for gout management.However,patients are reluctant to take medication day after day to manage incurable occasional gout flares,and suffer from possible long-term toxicity.Therefore,a safe and easy-tooperate drug delivery system with simple preparation for the long-term management of gout is very necessary.Here,a chitosan-containing sustained-release microneedle system co-loaded with colchicine and uricase liposomes were fabricated to achieve this goal.This microneedle system was confirmed to successfully deliver the drug to the skin and maintain a one-week drug retention.Furthermore,its powerful therapeutic potency to manage gout was investigated in both acute gouty and chronic gouty models.Besides,the drug co-delivery system could help avoid long-term daily oral colchicine,a drug with a narrow therapeutic index.This system also avoids mass injection of uricase by improving its stability,enhancing the clinical application value of uricase.In general,this two-drug system reduces the dosage of uricase and colchicine and improves the patient’s compliance,which has a strong clinical translation.

基于1553B总线的大规模信息系统设计问题研究

某大型航天器GNC系统应用1553B总线构建了其规模庞大的信息系统,在信息系统设计过程中产生了3个问题:超长总线下的稳定通信、应用层协议的设计、多条总线的管理等。对这3个问题开展研究,描述了3个问题的由来,给出了问题的解决方法,并验证了方法的实际效果。结果表明:总线中继的方法,有效解决了1553B总线在240 m长度下的稳定可靠通信问题;广播帧计数回传的应用层协议,节省了总线数据通讯开销、并提供了丰富的故障诊断信息;遍历寻优的总线管理策略,最大程度上发挥了多机多总线系统的容错能力。

TRACK与C-ACT评分在儿童哮喘管理中的价值评估

目的:通过研究儿童呼吸和哮喘控制测试(test for respiratory and asthma control in kids,TRACK)和儿童哮喘控制测试(childhood asthma control test,C-ACT)与全球哮喘防治创议(global initiative for asthma,GINA)标准哮喘控制水平评估的一致性、与哮喘儿童肺功能指标的相关性,探讨2种评分方法在儿童哮喘管理中的价值。方法:选择2020年8月至2022年3月重庆市妇幼保健院儿科门诊就诊的哮喘患儿135例为研究对象,用TRACK评分表和C-ACT评分表对相应年龄的患儿及其家长进行问卷调查,分析2种评分方法与GINA标准哮喘控制水平评估分级的一致性、与肺功能指标的相关性,并比较不同评分结果组肺功能指标差异。结果:TRACK评分、C-ACT评分与GINA哮喘控制水平分级一致性检验Kappa值分别为0.517和0.531,均显示一致性一般;TRACK评分与TPF%TE和VPF%VE存在显著的正相关,但TRACK评分、C-ACT评分与FEV1%均没有显著性相关;不同TRACK评分组哮喘患儿的FEV1%差异无统计学意义(F=2.054,P=0.134),但多重比较发现≥80分组与<60分组FEV1%的差异有统计学意义(P=0.048);不同TRACK评分组哮喘患儿的TPTEF/TE(%)(F=3.171,P=0.044)和VPEF/VE(%)(F=3.919,P=0.022)差异有统计学意义,进一步多重比较发现其差异主要来自于≥80分组与60~80分组,其中VPEF/VE(%)(P=0.017)的组间差异较TPTEF/TE(%)(P=0.030)更为明显;比较不同C-ACT评分组哮喘患儿的FEV1%差异无统计学意义(F=1.756,P=0.182)。结论:TRACK评分能更好反映儿童肺功能的差异,可作为5岁以下儿童哮喘管理的一个有效评估工具。

领导-成员交换组合对追随力的影响--传统性和感知人力资源管理强度的调节作用

随着员工地位提升,员工追随力的激发成为组织关心的议题.从员工和领导对彼此关系质量(LMX)感知存在不对等的现象入手,基于角色理论,本研究构建了员工和领导的LMX组合对追随力影响的理论模型并考察了传统性和感知人力资源管理强度的边界作用.通过收集75位领导和350位员工的配对样本数据,并进行潜在剖面分析、多项式回归和响应面分析,研究发现:员工和领导之间存在四种LMX组合.具体来说,“高-高”组合比“低-低”组合更容易激发追随力;“高-低”组合比“低-高”组合更容易激发追随力.同时,LMX不同组合与追随力之间的关系也受到传统性和感知人力资源管理强度的调节.具体来说,高传统性下,“高-高”组合和追随力之间的关系与“低-低”组合相比得到了增强,“低-高”组合和追随力之间的关系与“高-低”组合相比得到了增强;高感知人力资源管理强度下,“低-低”组合和追随力之间的关系与“高-高”组合相比得到了增强,“高-低”组合和追随力之间的关系与“低-高”组合相比得到了增强.研究深化了LMX组合对追随力产生的差异影响及其边界作用,为解决员工和领导关系不对等问题提供了理论依据和实证支持.

JCI标准下管理模式对医院环境卫生管理的价值分析

目的于国际医院联合委员会评审标准(Joint Commission International,JCI)标准下管理模式对医院环境卫生管理的应用价值进行分析。方法选取2021年1月—2023年1月钦州市第二人民医院住院病区的97名医务人员作为研究对象。2021年1月—2022年1月采用常规管理方式,记作干预前;2022年2月—2023年1月期间采用JCI标准下管理模式,记作干预后。对比干预前后的环境质量考核情况、物体表面卫生合格情况、医务人员手卫生依从性情况以及医务人员满意率。结果干预后,环境质量考核分数显著高于干预前,差异有统计学意义(P<0.05);干预后,物体表面卫生合格率(97.95%)高于干预前(95.36%),差异有统计学意义(P<0.05);干预后的医务人员手卫生依从性率(96.27%)高于干预前(91.18%),差异有统计学意义(P<0.05)。干预后医务人员的满意率(96.91%)高于干预前(89.69%),差异有统计学意义(P<0.05)。结论在医院环境卫生管理中实施JCI标准下管理模式能够改善院内环境清洁度、物体表面清洁度,提高医务人员手卫生依从性,进而提高医疗安全性、降低院内感染发生情况,医务人员满意度较高。

《黑图档·道光朝》所见盛京官地之军务用地管理

盛京官地之军务用地在《黑图档·道光朝》中主要是指盛京围场,盛京围场设置于顺治帝时期,直至清朝灭亡,其一直承担的向朝廷纳贡的使命才彻底完结。在《黑图档·道光朝》中记载着围场管理的诸多事宜,论文通过对《黑图档·道光朝》与其他相关史料的梳理,从人员管理、日常事务管理及纠纷处理三个方面探讨清朝统治者对盛京围场的管理。

e-Science环境下科研活动与科学数据一站式管理平台研究

在信息化、数据密集化(e-Science)科学研究新形势下,规范高效地管理科研活动和科学数据,对科研创新突破、资源集成共享具有十分重要的意义。文章在调研多个研究团队科研数据管理现状的基础上,基于科研—数据双生命周期模型,构建了科研活动与科学数据的一站式管理平台。初步探讨了平台的系统架构与功能实现,详细阐述了平台的用户角色管理及权限分配策略,以期这个新型平台能为科研数据管理服务工作提供一些新的思路和方法。

基于加速康复外科理念的围手术期营养管理在先天性巨结肠患儿中的应用

目的探讨基于加速康复外科理念的围手术期营养管理在先天性巨结肠患儿中的应用效果。方法选取2020年8月至2023年4月右江民族医学院附属医院小儿外科收治的66例先天性巨结肠患儿为研究对象,其中2020年8月至2021年12月入院的患儿纳入对照组(33例),2022年1月至2023年4月入院的患儿纳入干预组(33例)。对照组给予常规护理,干预组给予基于加速康复外科理念的围手术期营养管理。比较两组的营养学指标、生活质量。结果干预组出院3个月后的儿科营养不良筛查表评分低于对照组,术后第7天、出院3个月后的总蛋白及血红蛋白水平高于对照组(P<0.05);干预组出院3个月后的儿童生活质量普适性核心量表评分高于对照组(P<0.05)。结论基于加速康复外科理念的围手术期营养管理能够改善先天性巨结肠患儿的营养状态,提高生活质量,值得推广应用。

基于气凝胶与相变材料夹层结构的电池热失控-热管理综合布置决策

为提高电池模组热失控抑制与热管理散热综合效果,本文设计了一种电池间添加相变材料(PCM)-气凝胶夹层结构的热管理系统并优化夹层的布置结构。结果表明,针对抑制热失控传播,纯气凝胶的布置效果最佳,相较于自然空冷,可使模组中最后一个电池触发热失控的时间延长,但电池热管理散热效果显著恶化;针对强化热管理散热,纯相变材料的布置效果最佳,相较于自然空冷,可使电池一个放电循环下的最高温度降低20℃以上,但其抑制热失控传播的效果明显弱于纯气凝胶;针对热失控-热管理综合效益,PCM-气凝胶-PCM布置形式具有更广泛的适用性,在保证电池热失控抑制效果的同时强化了电池正常工作时的散热,可实现整体效益的最大化。

降低社会物流成本研究

物流是实体经济的“筋络”,连接生产与消费、内贸与外贸。有效降低社会物流成本是增强产业核心竞争力、提升经济运行效率的重要举措。当前我国社会物流成本较高,这是我国经济结构、物流业水平、供应链水平、市场效率等因素综合作用的结果:一方面,我国服务业占比低,工业占比高,且多数产品附加值较低,不利于物流费用的降低和产品所对应GDP的增加,影响社会物流总费用与GDP比率的降低;另一方面,我国综合运输体系尚未完全建立,社会库存量大周转慢,物流基础设施不完善且投入不足,物流服务运作主体仍有缺陷,税费高且不统一,产学研一体化体系尚未形成,行业协会合作欠缺,不利于科技赋能和物流业水平、供应链水平、市场效率提升,导致保管和管理费用居高不下,影响社会物流总费用与GDP比率的降低。社会物流成本是国家经济社会发展成本重要的组成部分,通常包括运输成本、保管成本、管理成本三个部分。降低社会物流成本是一项系统工程,切忌单纯从物流看物流,要着眼国民经济全局,通过发展新质生产力、改造物流供应链、推动物流业数智化转型、提升产业链供应链现代化水平、深化市场化改革,着力降低经济结构性物流成本、组织模式性物流成本、运行性物流成本、管理制度性物流成本,四者缺一不可。其中,发展新质生产力、推动物流业进行供应链改造和数智化升级,是降低社会物流成本的必由之路;打造创新力更强、附加值更高、更安全可靠的产业链供应链,是降低物流成本的根本之策;促进物流与供应链制度型开放、深化供给侧结构性改革、构建物流统一大市场,是降低物流成本的制度性保障。此外,还要加强物流与供应链绩效考核,增强物流成本核算意识。

我国数据出境安全风险要素体系研究

[目的/意义]构建数据出境风险要素体系,对识别数据出境安全风险,把握数据出境安全整体态势,提升国家安全风险管理水平具有重要意义。[方法/过程]以我国数据出境流动的现实场景和典型事件为依据,挖掘数据出境安全风险的主要来源维度;结合数据跨境服务主体调查,提出数据出境安全风险要素集,并构建数据出境安全风险框架;基于专家知识对风险要素进行权重排序和评估。[结果/结论]研究结果表明:内容维度的风险要素受到专家关注程度最高,内容的分级分类以及个人隐私保障是其中的重点;黑客、合作方等境外主体造成的风险具有极强的破坏力;出境环境变化与出境数据内部管理虽然同样容易产生风险,但负面影响相对较低。基于此,从法制保障、多元协同与关键技术角度提出数据跨境流动风险应对建议。