The advent of Industry 4.0 has compelled businesses to adopt digital approaches that combine software toenhance production efficiency. In this rapidly evolving market, software development is an ongoing process thatmu...The advent of Industry 4.0 has compelled businesses to adopt digital approaches that combine software toenhance production efficiency. In this rapidly evolving market, software development is an ongoing process thatmust be tailored to meet the dynamic needs of enterprises. However, internal research and development can beprohibitively expensive, driving many enterprises to outsource software development and upgrades to externalservice providers. This paper presents a software upgrade outsourcing model for enterprises and service providersthat accounts for the impact of market fluctuations on software adaptability. To mitigate the risk of adverseselection due to asymmetric information about the service provider’s cost and asymmetric information aboutthe enterprise’s revenues, we propose pay-per-time and revenue-sharing contracts in two distinct informationasymmetry scenarios. These two contracts specify the time and transfer payments for software upgrades. Througha comparative analysis of the optimal solutions under the two contracts and centralized decision-making withfull-information, we examine the characteristics of the solutions under two information asymmetry scenarios andanalyze the incentive effects of the two contracts on the various stakeholders. Overall, our study offers valuableinsights for firms seeking to optimize their outsourcing strategies and maximize their returns on investment insoftware upgrades.展开更多
Background:This study aimed to review treatments and evaluate the aesthetic outcomes,complications,and reoperation rates regarding surgical correction for a postoperative contracted nose.Methods:PubMed,MEDLINE,and Emb...Background:This study aimed to review treatments and evaluate the aesthetic outcomes,complications,and reoperation rates regarding surgical correction for a postoperative contracted nose.Methods:PubMed,MEDLINE,and Embase databases were searched for studies detailing aesthetic outcomes and complications of surgical correction of a contracted nose.Surgical procedures,adjuvant treatment,outcomes,and complications were synthesized and analyzed.Results:Nine articles encompassing 376 patients were included in the systematic review,and six articles(198 participants)were included in the meta-analysis.The most frequently used graft material was the autologous rib cartilage(61.1%).Surgical procedures were heterogeneous in these studies.The nasolabial angle reduced by 9.52°(95%confidence interval(CI):(-11.95,-7.09),P<0.0001),and the nasal length increased significantly(standardized mean difference(SMD)=2.25,95%CI:(1.26,2.23),P<0.00001).However,the evidence was insufficient to determine a significant change in the columellar-labial angle(SMD=-0.95,95%CI:(-2.19,0.29),P=0.13)and columellar-lobular angle(SMD=2.39,95%CI:(-1.20,5.97),P=0.19).Aesthetic dissatisfaction(12.5%)and infection(4.5%)were the most commonly reported complications.Reoperation was performed in 5.3%of patients.Conclusion:Surgical correction can increase the nasal length,reduce the nasolabial angle,and have a low reoperation rate.No significant improvement in the columellar-labial or columellar-lobular angle was observed.展开更多
Objectives: To examine the best practice evidence of the effectiveness of the flipped classroom（FC） as a burgeoning teaching model on the development of self-directed learning in nursing education.Data sources: The ...Objectives: To examine the best practice evidence of the effectiveness of the flipped classroom（FC） as a burgeoning teaching model on the development of self-directed learning in nursing education.Data sources: The relevant randomized controlled trial（RCT） and non-RCT comparative studies were searched from multiple electronic databases including PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature（CINAHL）, Cochrane Central Register of Controlled Trials（CENTRAL）, Wanfang Data, China National Knowledge Infrastructure（CNKI）, and Chinese Science and Technology Periodical Database（VIP） from inception to June 2017.Review methods: The data were independently assessed and extracted for eligibility by two reviewers. The quality of included studies was assessed by another two reviewers using a standardized form and evaluated by using the Cochrane Collaboration’s risk of bias tool. The self-directed learning scores（continuous outcomes） were analyzed by using the 95% confidence intervals（Cls） with the standard deviation average（SMD） or weighted mean difference（WMD）. The heterogeneity was assessed using Cochran’s I;statistic.Results: A total of 12 studies, which encompassed 1440 nursing students（intervention group = 685, control group = 755）, were eligible for inclusion in this review. Of 12 included studies, the quality level of one included study was A and of the others was B. The pooled effect size showed that compared with traditional teaching models, the FC could improve nursing students’ selfdirected learning skill, as measured by the Self-Directed Learning Readiness Scale（SDLRS）, Self-Directed Learning Readiness Scale for Nursing Education（SDLRSNE）, Self-Regulated Learning Scale（SRL）, Autonomous Learning Competencies scale（ALC）, and Competencies of Autonomous Learning of Nursing Students（CALNS）. Overall scores and subgroup analyses with the SRL were all in favor of the FC.Conclusions: The result of this meta-analysis indicated that FCs could improve the effect of self-directed learning in nursing education.Future studies with more RCTs using the same measurement tools are needed to draw more authoritative conclusions.展开更多
Background: The flipped classroom has generated considerable interest in nursing education in the last few years, especially in higher education in China. However, research to date has been insufficient to confirm the...Background: The flipped classroom has generated considerable interest in nursing education in the last few years, especially in higher education in China. However, research to date has been insufficient to confirm the effectiveness of the flipped classroom approach. Since most of the Chinese studies are published in Chinese journals, they may not be easily accessible to international researchers. Therefore,this meta-analysis aimed to review the effectiveness of a flipped classroom in nursing education both in English and Chinese databases.Objective: The aim of the present study was to identify the robust available evidence about the effectiveness of flipped classrooms in nursing education through a systematic review and meta-analysis.Methods: A systematic search of English databases, including PubMed, EMBASE, Science Director,CINAHL and Google Scholar, and Chinese databases, including Chinese National Knowledge Infrastructure(CNKI), WanFang Data, VIP Information and Chinese Biomedical Literature(CMB), were conducted to identify peer-reviewed studies that met the inclusion criteria. Two reviewers independently performed study identification with Endnote X7 software and used Excel to extract data. The risk of bias in the included studies was assessed with Cochrane Collaboration's risk of bias tool, and a meta-analysis was conducted using RevMan 5.3 software following the guidelines proposed by PRISMA reporting standards with the protocol register No. CRD42016041826.Results: A total of 29 studies were included in systematic review. There was a significant postintervention improvement in academic performance both in knowledge with a pooled random-effects standardized mean difference of 1.13 and skills with a pooled random-effects standardized mean difference(SMD) of 1.68. Students' self-learning abilities were also improved with a pooled random-effects SMD of 1.51 compared with traditional lecture. In the subgroup analysis, we found that the effect sizes had high fidelity in terms of nursing degrees and research settings. There was a high rating of flipped classroom pedagogy from teaching evaluations, study satisfaction, study attitude and improvement in critical thinking and problem-solving skills.Conclusions: These results indicated that a flipped classroom might help nursing students improve in knowledge, skills, attitudes, self-learning, study satisfaction, critical thinking and problem-solving skills.We recommend adopting this approach for nursing education reform. There is a call for robust empirical research and unification of appraisal standards for further support of the effectiveness of the flipped classroom. Furthermore, a meta-regression analysis is also recommended to explore the sources of heterogeneity in included studies.展开更多
文摘The advent of Industry 4.0 has compelled businesses to adopt digital approaches that combine software toenhance production efficiency. In this rapidly evolving market, software development is an ongoing process thatmust be tailored to meet the dynamic needs of enterprises. However, internal research and development can beprohibitively expensive, driving many enterprises to outsource software development and upgrades to externalservice providers. This paper presents a software upgrade outsourcing model for enterprises and service providersthat accounts for the impact of market fluctuations on software adaptability. To mitigate the risk of adverseselection due to asymmetric information about the service provider’s cost and asymmetric information aboutthe enterprise’s revenues, we propose pay-per-time and revenue-sharing contracts in two distinct informationasymmetry scenarios. These two contracts specify the time and transfer payments for software upgrades. Througha comparative analysis of the optimal solutions under the two contracts and centralized decision-making withfull-information, we examine the characteristics of the solutions under two information asymmetry scenarios andanalyze the incentive effects of the two contracts on the various stakeholders. Overall, our study offers valuableinsights for firms seeking to optimize their outsourcing strategies and maximize their returns on investment insoftware upgrades.
基金supported by the Key Clinical Projects of Peking University Third Hospital(grant no.BYSYZD2019013)。
文摘Background:This study aimed to review treatments and evaluate the aesthetic outcomes,complications,and reoperation rates regarding surgical correction for a postoperative contracted nose.Methods:PubMed,MEDLINE,and Embase databases were searched for studies detailing aesthetic outcomes and complications of surgical correction of a contracted nose.Surgical procedures,adjuvant treatment,outcomes,and complications were synthesized and analyzed.Results:Nine articles encompassing 376 patients were included in the systematic review,and six articles(198 participants)were included in the meta-analysis.The most frequently used graft material was the autologous rib cartilage(61.1%).Surgical procedures were heterogeneous in these studies.The nasolabial angle reduced by 9.52°(95%confidence interval(CI):(-11.95,-7.09),P<0.0001),and the nasal length increased significantly(standardized mean difference(SMD)=2.25,95%CI:(1.26,2.23),P<0.00001).However,the evidence was insufficient to determine a significant change in the columellar-labial angle(SMD=-0.95,95%CI:(-2.19,0.29),P=0.13)and columellar-lobular angle(SMD=2.39,95%CI:(-1.20,5.97),P=0.19).Aesthetic dissatisfaction(12.5%)and infection(4.5%)were the most commonly reported complications.Reoperation was performed in 5.3%of patients.Conclusion:Surgical correction can increase the nasal length,reduce the nasolabial angle,and have a low reoperation rate.No significant improvement in the columellar-labial or columellar-lobular angle was observed.
文摘Objectives: To examine the best practice evidence of the effectiveness of the flipped classroom（FC） as a burgeoning teaching model on the development of self-directed learning in nursing education.Data sources: The relevant randomized controlled trial（RCT） and non-RCT comparative studies were searched from multiple electronic databases including PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature（CINAHL）, Cochrane Central Register of Controlled Trials（CENTRAL）, Wanfang Data, China National Knowledge Infrastructure（CNKI）, and Chinese Science and Technology Periodical Database（VIP） from inception to June 2017.Review methods: The data were independently assessed and extracted for eligibility by two reviewers. The quality of included studies was assessed by another two reviewers using a standardized form and evaluated by using the Cochrane Collaboration’s risk of bias tool. The self-directed learning scores（continuous outcomes） were analyzed by using the 95% confidence intervals（Cls） with the standard deviation average（SMD） or weighted mean difference（WMD）. The heterogeneity was assessed using Cochran’s I;statistic.Results: A total of 12 studies, which encompassed 1440 nursing students（intervention group = 685, control group = 755）, were eligible for inclusion in this review. Of 12 included studies, the quality level of one included study was A and of the others was B. The pooled effect size showed that compared with traditional teaching models, the FC could improve nursing students’ selfdirected learning skill, as measured by the Self-Directed Learning Readiness Scale（SDLRS）, Self-Directed Learning Readiness Scale for Nursing Education（SDLRSNE）, Self-Regulated Learning Scale（SRL）, Autonomous Learning Competencies scale（ALC）, and Competencies of Autonomous Learning of Nursing Students（CALNS）. Overall scores and subgroup analyses with the SRL were all in favor of the FC.Conclusions: The result of this meta-analysis indicated that FCs could improve the effect of self-directed learning in nursing education.Future studies with more RCTs using the same measurement tools are needed to draw more authoritative conclusions.
文摘Background: The flipped classroom has generated considerable interest in nursing education in the last few years, especially in higher education in China. However, research to date has been insufficient to confirm the effectiveness of the flipped classroom approach. Since most of the Chinese studies are published in Chinese journals, they may not be easily accessible to international researchers. Therefore,this meta-analysis aimed to review the effectiveness of a flipped classroom in nursing education both in English and Chinese databases.Objective: The aim of the present study was to identify the robust available evidence about the effectiveness of flipped classrooms in nursing education through a systematic review and meta-analysis.Methods: A systematic search of English databases, including PubMed, EMBASE, Science Director,CINAHL and Google Scholar, and Chinese databases, including Chinese National Knowledge Infrastructure(CNKI), WanFang Data, VIP Information and Chinese Biomedical Literature(CMB), were conducted to identify peer-reviewed studies that met the inclusion criteria. Two reviewers independently performed study identification with Endnote X7 software and used Excel to extract data. The risk of bias in the included studies was assessed with Cochrane Collaboration's risk of bias tool, and a meta-analysis was conducted using RevMan 5.3 software following the guidelines proposed by PRISMA reporting standards with the protocol register No. CRD42016041826.Results: A total of 29 studies were included in systematic review. There was a significant postintervention improvement in academic performance both in knowledge with a pooled random-effects standardized mean difference of 1.13 and skills with a pooled random-effects standardized mean difference(SMD) of 1.68. Students' self-learning abilities were also improved with a pooled random-effects SMD of 1.51 compared with traditional lecture. In the subgroup analysis, we found that the effect sizes had high fidelity in terms of nursing degrees and research settings. There was a high rating of flipped classroom pedagogy from teaching evaluations, study satisfaction, study attitude and improvement in critical thinking and problem-solving skills.Conclusions: These results indicated that a flipped classroom might help nursing students improve in knowledge, skills, attitudes, self-learning, study satisfaction, critical thinking and problem-solving skills.We recommend adopting this approach for nursing education reform. There is a call for robust empirical research and unification of appraisal standards for further support of the effectiveness of the flipped classroom. Furthermore, a meta-regression analysis is also recommended to explore the sources of heterogeneity in included studies.
