Colonoscopy remains the cornerstone of colorectal cancer prevention and survei-llance,but the procedure’s effectiveness is entirely dependent upon various quali-ty indicators,such as detection rates,withdrawal time,a...Colonoscopy remains the cornerstone of colorectal cancer prevention and survei-llance,but the procedure’s effectiveness is entirely dependent upon various quali-ty indicators,such as detection rates,withdrawal time,adequate bowel prepara-tion,cecal intubation rate and patient outcomes.Despite progress in endoscopic techniques,challenges persist in maintaining endoscopists’consistent perfor-mance and improving quality metrics.Artificial intelligence(AI)has emerged as a“game changer”in the gastroenterology field,offering the opportunity to signifi-cantly increase colonoscopy quality.This review highlights the role of AI-driven technologies such as deep learning,computer vision,and real-time feedback me-chanisms in optimizing key quality indicators of colonoscopy.The implementa-tion of AI in colonoscopy may reduce human error,improve endoscopist’s consis-tency in real-time decision making,ensuring higher reliability and standardiza-tion during the procedure.Furthermore,AI has the potential to reshape how en-doscopists perform and evaluate procedures,while improved lesion characte-rization may enable more precise selection for resection,reducing morbidity and the incidence of interval cancers.The review also addresses challenges and limi-tations in AI integration,including cost-effectiveness and its impact on endosco-pist training.AI holds substantial promise for advancing colonoscopy quality and elevating overall patient care,paving the way for more effective and personalized medical approaches.展开更多
Additive Manufacturing(AM)can provide customized parts that conventional techniques fail to deliver.One important parameter in AM is the quality of the parts,as a result of the material extrusion 3D printing(3D-P)proc...Additive Manufacturing(AM)can provide customized parts that conventional techniques fail to deliver.One important parameter in AM is the quality of the parts,as a result of the material extrusion 3D printing(3D-P)procedure.This can be very important in defense-related applications,where optimum performance needs to be guaranteed.The quality of the Polyetherimide 3D-P specimens was examined by considering six control parameters,namely,infill percentage,layer height,deposition angle,travel speed,nozzle,and bed temperature.The quality indicators were the root mean square(Rq)and average(Ra)roughness,porosity,and the actual to nominal dimensional deviation.The examination was performed with optical profilometry,optical microscopy,and micro-computed tomography scanning.The Taguchi design of experiments was applied,with twenty-five runs,five levels for each control parameter,on five replicas.Two additional confirmation runs were conducted,to ensure reliability.Prediction equations were constructed to express the quality indicators in terms of the control parameters.Three modeling approaches were applied to the experimental data,to compare their efficiency,i.e.,Linear Regression Model(LRM),Reduced Quadratic Regression Model,and Quadratic Regression Model(QRM).QRM was the most accurate one,still the differences were not high even considering the simpler LRM model.展开更多
Purpose:This study aimed to develop quality indicators for the care of older adults with disabilities in long-term care facilities(LTCFs)based on Maslow’s hierarchy of needs.Methods:The draft of the quality indicator...Purpose:This study aimed to develop quality indicators for the care of older adults with disabilities in long-term care facilities(LTCFs)based on Maslow’s hierarchy of needs.Methods:The draft of the quality indicators was drawn up based on a literature review and research group discussion.The quality indicators were finalized by two rounds of expert consultation(involving 15 experts)using the Delphi method.The Analytic Hierarchy Process was applied to calculate the indicators’weight.Results:The response rates of the two rounds of consultation were 100%and 93%,and the expert authority coefficients were 0.86 and 0.87.After two rounds of consultation,the expert opinion coordination coefficients of the first-,second-and third-level indicators were 0.42,0.25,and 0.96,respectively(P<0.05),and the variation coefficient was0.25.The final quality indicators for the care of older adults with disabilities in LTCFs included 7 first-level,19 second-level,and 107 third-level indicators.Conclusion:The quality indicators for the care of older adults with disabilities in LTCFs are reliable,scientific,comprehensive,and practical and specify the content of person-centered care needs.This can provide a reference for evaluating and improving care quality in LTCFs.展开更多
The quality indicators of cotton will change during storage.Taking the 5.89 million t of Xinjiang cotton from 2016 to 2021 as a sample,this paper analyzed the main fiber quality indicator data of warehouse-in and ware...The quality indicators of cotton will change during storage.Taking the 5.89 million t of Xinjiang cotton from 2016 to 2021 as a sample,this paper analyzed the main fiber quality indicator data of warehouse-in and warehouse-out cotton for storage of 1.5,3.0,4.0,5.0,6.0,and 7.0 years.It was found that the color grade of cotton decreased with the extension of storage time.The cotton with storage time of 5.0 years mainly changed from white cotton grade 2 and white cotton grade 3 to light yellow stained cotton grade 1 and yellow stained cotton grade 1.Among them,the increase of light yellow stained cotton grade 1 was the largest,and the change to yellow stained cotton grade 1 was the largest at the storage 6.0-7.0 years.In addition,there were no significant changes in moisture regain,Micronaire value,upper half mean length,length uniformity index and fiber strength.展开更多
Quality indicators in healthcare refer to measurable and quantifiable parameters used to assess and monitor the performance,effectiveness,and safety of healthcare services.These indicators provide a systematic way to ...Quality indicators in healthcare refer to measurable and quantifiable parameters used to assess and monitor the performance,effectiveness,and safety of healthcare services.These indicators provide a systematic way to evaluate the quality of care offered,and thereby to identify areas for improvement and to ensure that patient care meets established standards and best practices.Respiratory therapists play a vital role in areas of clinical administration such as infection control practices and quality improvement initiatives.Quality indicators serve as essential metrics for respiratory therapy departments to assess and enhance the overall quality of care.By systematically tracking and analyzing indicators related to infection control,treatment effectiveness,and adherence to protocols,respiratory care practitioners can identify areas to improve and implement evidence-based changes.This article reviewed how to identify,implement,and monitor quality indicators specific to the respiratory therapy departments to set benchmarks and enhance patient outcomes.展开更多
Alcohol,total sugar,total acid,and total phenol contents are the main indicators of wine quality detection.This study aims to establish simultaneous analysis models for the four indicators through near-infrared(NIR)sp...Alcohol,total sugar,total acid,and total phenol contents are the main indicators of wine quality detection.This study aims to establish simultaneous analysis models for the four indicators through near-infrared(NIR)spectroscopy with wavelength optimization.A Norris derivative filter(NDF)platform with multiparameter optimization was established for spectral pretreatment.The optimal parameters(i.e.,derivative order,number of smoothing points,and number of differential gaps)were(2,9,3)for alcohol,(1,19,5)for total sugar,(1,17,11)for total acid,and(1,1,1)for total phenol.The equidistant combinationpartial least squares(EC-PLS)was used for large-scale wavelength screening.The wavelength step-by-step phaseout PLS(WSP-PLS)and exhaustive methods were used for secondary optimization.The final optimization models for the four indicators included 7,10,15,and 13 wavelengths located in the overtone or combination regions,respectively.In an independent validation,the root mean square errors,correlation coefficient for prediction(i.e.,SEP and RP),and ratio of performance-to-deviation(RPD)were 0.41 v/v,0.947,and 3.2 for alcohol;1.48 g/L,0.992,and 6.8 for total sugar;0.68 g/L,0.981,and5.1 for total acid;and 0.181 g/L,0.948,and 2.9 for total phenol.The results indicate high correlation,low error,and good overall prediction performance.Consequently,the established reagent-free NIR analytical models are important in the rapid and real-time quality detection of the wine fermentation process and finished products.The proposed wavelength models provide a valuable reference for designing small dedicated instruments.展开更多
Background and aim:Adequate bowel preparation is important for safe and effective colonoscopy.Quality indicators(QI)for colonoscopy include achieving at least 95%completion rate and an adenoma detection rate(ADR)of at...Background and aim:Adequate bowel preparation is important for safe and effective colonoscopy.Quality indicators(QI)for colonoscopy include achieving at least 95%completion rate and an adenoma detection rate(ADR)of at least 25%in average-risk men and 15%in average-risk women aged over 50.Our aim was to investigate the impact of bowel preparation on ADR and colonoscopy completion rates.Methods:This retrospective cohort study included patients who underwent colonoscopy between January 2008 and December 2009.The main outcome measurements were ADR and colonoscopy completion rates to the cecum.Results:A total of 2519 patients was included;1030(41.0%)had excellent preparation,1145(45.5%)good-,240(9.5%)fair-,and 104(4.1%)poor preparation.Colonoscopy completion rates were significantly lower in patients with poor or fair preparation(72.1%and 75.4%,respectively)than in those with good and excellent preparation(99.7%and 99.9%,respectively;P<0.001),and significantly lower than the QI of 95%(P<0.001).ADR in men and women combined was similar in all four grades of preparation(excellent,good,fair and poor)at 24.2%vs.26.8%vs.32.1%vs.22.1%,respectively;P¼0.06.All the groups had ADR above the QI(25%for men and 15%for women)with evidence of significantly higher ADR in the women with excellent or good preparation and in men with excellent,good or fair preparation.On multivariate analysis,male gender was significantly associated with increased ADR(P<0.001),while the quality of bowel preparation did not influence ADR.Conclusions:Patients with fair and poor standards of preparation have significantly lower colonoscopy completion rates than those with excellent and good preparation.However,there was no difference in ADR between the different grades of preparation.展开更多
In this study, emphasis has focused on assessing the potential hydro-environmental impacts of a barrage across the Severn Estuary, with a numerical model being developed and applied to the estuary to assess the impact...In this study, emphasis has focused on assessing the potential hydro-environmental impacts of a barrage across the Severn Estuary, with a numerical model being developed and applied to the estuary to assess the impacts of proposed Severn Barrage on the hydrodynamic, sediment transport and faecal indicator organism distribu- tion within the estuary. The results show that the Severn Barrage has the potential to reduce the tidal currents in a highly dynamic estuary. This leads to the reduction of suspended sediment concentrations, which in turn affects the bacterial transport processes which is highly related to the sediment transport processes.展开更多
Quality of Maternal, Neonatal and Child (MNCH) care is an important aspect in ensuring healthy outcomes and survival of mothers and children. To maintain quality in health services provided, organizations and other st...Quality of Maternal, Neonatal and Child (MNCH) care is an important aspect in ensuring healthy outcomes and survival of mothers and children. To maintain quality in health services provided, organizations and other stakeholders in maternal and child health recommend regular quality measurement. Quality indicators are the key components in the quality measurement process. However, the literature shows neither an indicator selection process nor a set of quality indicators for quality measurement that is universally accepted. The lack of a universally accepted quality indicator selection process and set of quality indicators results in the establishment of a variety of quality indicator selection processes and several sets of quality indicators whenever the need for quality measurement arises. This adds extra processes that render quality measurement process. This study, therefore, aims to establish a set of quality indicators from a broad set of quality indicators recommended by the World Health Organization (WHO). The study deployed a machine learning technique, specifically a random forest classifier to select important indicators for quality measurement. Twenty-nine indicators were identified as important features and among those, eight indicators namely maternal mortality ratio, still-birth rate, delivery at a health facility, deliveries assisted by skilled attendants, proportional breach delivery, normal delivery rate, born before arrival rate and antenatal care visit coverage were identified to be the most important indicators for quality measurement.展开更多
Objectives:This study aimed to evaluate the measurement properties and methodological quality of instruments developed to evaluate the quality of online health information.Methods:In this study,a systematic search was...Objectives:This study aimed to evaluate the measurement properties and methodological quality of instruments developed to evaluate the quality of online health information.Methods:In this study,a systematic search was conducted across a range of databases,including the China National Knowledge Infrastructure(CNKI),Wanfang,China Science and Technology Journal(VIP),SinoMed,PubMed,Web of Science,CINAHL,Embase,the Cochrane Library,PsycINFO,and Scopus.The search period spanned from the inception of the databases to October 2023.Two researchers independently conducted the literature screening and data extraction.The methodological quality of the included studies was assessed using the Consensus-based Standards for the Selection of Health Measurement Instruments(COSMIN)Risk of Bias checklist.The measurement properties were evaluated using the coSMIN criteria.The modified Grading,Recommendations,Assessment,Development,and Evaluation(GRADE)system was used to determine the quality grade.Results:A total of 18 studies were included,and the measurement properties of 17 scales were assessed.Fifteen scales had content validity,three had structural validity,six had internal consistency,two had test-retest reliability,nine had interater reliability,one had measurement error,six instruments had criterion validity,and three scales had hypotheses testing for construct validity;however,the evaluation of their methodological quality and measurement properties revealed deficiencies.Of these 17 scales,15 were assigned a Level B recommendation,and two received a Level C recommendation.Conclusions:The Health Information Website Evaluation Tool(HIWET)can be temporarily used to evaluate the quality of health information on websites.The Patient Education Materials Assessment Tool(PEMAT)can temporarily assess the quality of video-based health information.However,the effectiveness of both tools needs to be further verified.展开更多
Evidence is not homogeneous on indicators able to monitor and assess qualityperformance for organ donation. This may be related to differences in healthcareorganizations among countries but also to the scarcity of dat...Evidence is not homogeneous on indicators able to monitor and assess qualityperformance for organ donation. This may be related to differences in healthcareorganizations among countries but also to the scarcity of data on this topic so far.In the present review, we assessed available evidence on quality metrics in solidorgan procurement in the United States and in Europe by means of a PubMedsearch. Evidence was summarized according to countries, considering that thedonation and transplantation systems differ from country to country. In UnitedStates, the assessment of these indicators is periodically performed by the nationalnetwork for organ sharing to evaluate the performance of each Organ ProcurementOrganization (OPO). Quality metrics consider several factors, in primispopulation characteristics (i.e. race/ethnicity, age, socio-economic status). That iswhy the assessment of each OPO performance relies on several quality metrics,not only one single indicator. In Europe, quality improvement programs representa structural element of organ and transplant system in several countries, but fewpapers have to date addressed the results obtained by a quality improvementprogram based on indicators. In Poland, the use of quality indicators and improvementprocedures were associated with better results in those hospitals whichimplemented these programs in respect to hospitals who did not. In TuscanyRegion (Italy) the implementation of a monitoring and reporting approach basedon indicators by the Regional Transplant Center was associated with an increasedin transplant and donation activity (especially in cDCD donors). According toavailable evidence, the development of a method for quality assessment andquality improvement has been recognized as pivotal for donation and transplantauthorities to identify key interventions either at national and/or hospital levels.展开更多
BACKGROUND Although transarterial chemoembolization(TACE)is an effective treatment for liver cancer,clinical practice has shown that many patients experience significant psychological distress following the procedure,...BACKGROUND Although transarterial chemoembolization(TACE)is an effective treatment for liver cancer,clinical practice has shown that many patients experience significant psychological distress following the procedure,which can hinder postoperative recovery and prognosis.Therefore,effective and evidence-based interventions are urgently needed to address this issue.AIM To evaluate the impact of nursing quality-sensitive indicators combined with mindfulness-based stress reduction(MBSR)interventions in patients undergoing TACE.METHODS A total of 84 patients who underwent TACE from June 2022 to March 2024 were enrolled in the study.They were randomly assigned to either the observation group(n=42),which received nursing quality-sensitive indicator-based care combined with MBSR intervention,or the control group(n=42),which received routine care combined with MBSR intervention.Psychological stress response levels[assessed using the Trait Meta-Mood Scale(TMMS)],coping strategies[measured with the Jalowiec Coping Scale(JCS)],quality of care[evaluated using the Perceived Nursing Service Quality(PNSQ)scale],and overall patient satisfaction were compared between the two groups.RESULTS After 4 weeks,the observation group demonstrated significantly higher TMMS scores,as well as increased optimism,support-seeking,bravery,PNSQ scores,and satisfaction(P<0.05).In contrast,scores for selfdependence,conservatism,resignation,and avoidance in the JCS were significantly lower in the observation group than in the control group(P<0.05).CONCLUSION The combination of nursing quality-sensitive indicators and MBSR intervention in TACE patients not only reduces psychological stress and encourages a more positive attitude toward illness but also enhances nursing quality and improves the overall patient experience.展开更多
In this paper, some indices of sulfide, organic carbon, oil and heavy metals （copper, lead, zinc, cadmium, mercury, arsenic and chromium） in the sediments from Dagu Dainage Canal at the Bohai Bay during four seasons...In this paper, some indices of sulfide, organic carbon, oil and heavy metals （copper, lead, zinc, cadmium, mercury, arsenic and chromium） in the sediments from Dagu Dainage Canal at the Bohai Bay during four seasons in 2012 - 2013 are selected, and Water Quality Pollution Index （API） is applied to evaluate water quality indices, aiming for the systematic evaluation of the water quality of Dagu Dainage Canal. The results showed that four stations of D3, D6, D7and D9 for S2 had the type Ⅱand Ⅲ of water; others had the type Ⅰ ; the total level of TOC, TPH, Cu, Pb, Zn, Cd, Hg, As and Cr were type Ⅰ, Ⅳ, Ⅱ, Ⅴ, Ⅱ, Ⅴ, Ⅲ, Vand Ⅴ. Water Quality Pollution Index （API） was 3.28, which illustrated Dagu Dainage Canal was in the state of contamination and the degree of pollution exceeded the standard functional areas.展开更多
Endoscopic resection,particularly endoscopic submucosal dissection(ESD),is widely used as a standard treatment modality for early gastric cancer(EGC)when the risk of lymph node metastasis is negligible.Compared with s...Endoscopic resection,particularly endoscopic submucosal dissection(ESD),is widely used as a standard treatment modality for early gastric cancer(EGC)when the risk of lymph node metastasis is negligible.Compared with surgical gastrectomy,ESD is a minimally invasive procedure with additional advantages,such as preservation of the entire stomach and maintenance of the patient’s quality of life.However,not all patients achieve curative resection after ESD of EGC.Several patients require surgical gastrectomy after ESD to achieve a curative treatment.Additional surgery after ESD,owing to non-curative resection,places considerable emotional and financial burdens on patients.Recently,as the number of endoscopists performing ESD has increased,the rate of non-curative resection after ESD has increased correspondingly.In order to decrease the non-curative resection rate,as well as determine the ideal rate of non-curative resection after ESD,it is time to consider quality indicators for the outcomes of ESD for EGC.展开更多
The present analysis provided the quality assessment of 65 Continuous Operating Reference Stations(CORS) situated in and around Mexico using the data of about ten years(January 2010 to January 2020).To accomplish the ...The present analysis provided the quality assessment of 65 Continuous Operating Reference Stations(CORS) situated in and around Mexico using the data of about ten years(January 2010 to January 2020).To accomplish the assessment,we considered 4 quality indexes for performing the quality check,incluing the multipath effect on L1 and L2 bands,signal-to-noise ratio in both bands,cycle slips,and integrity.Meanwhile,a new reference parameter named regio nal values for Mexico(RVM) was calculated for the stations situated in Mexico.Additionally,an exhaustive analysis of the quality indicators in the worst and best cases was performed.The signal degradation was proved by a long-term time series and cru stal defo rmation analysis in GAMIT/GLOBK platform.The results showed a stro ng correlation between integrity,cycle slips and daily observations time,and the multipath effect is strong in the case of outdated systems.The study indicates that the estimated quality indexes and values could be the basis for establishing new CORS in Mexico,and the errors corrections which cannot be mitigated in the postprocessing stage would greatly help utilize the data for different scientific applications.The results were supported by deformation analysis in part of Baja California Peninsula in Mexico indicating northern and eastern velocity vector of -3.08±0.02 mm/yr,-7.85±0.02 mm/yr and-0.07±0.03 mm/yr,-9.33±0.02 mm/yr respectively at MPR1 and INEG stations.展开更多
Obesity and global warming are two major challengesthat affect communities’health and quality of life.Providing good walking environments,with appropriate pedestrian infrastructure,green areas and access to commercia...Obesity and global warming are two major challengesthat affect communities’health and quality of life.Providing good walking environments,with appropriate pedestrian infrastructure,green areas and access to commercial retail and transport hubs favour liveable,healthy,and sustainable cities.The Lisbon City Hall has implemented an intervention program in the public space as a strategy to improve environmental quality and mitigate the effects of climate change.The program“A square in each neighbourhood”intends not only to reinforce the economic base of Lisbon,namely tourism,restaurants,commerce,and creative activities but also to promote physical activity and improve the quality of living of all citizens.For studying the impact of the public space quality on the walking environment,Campolide,a typical Lisbon neighbourhood,Portugal,which includes one of the requalified squares,was selected.A two-step methodology based on spatial modelling is proposed.In the first step,the public space quality was evaluated based on a set of 13 urban quality attributes.Attributes,intended for the street level,were collected from open data platforms and complemented with a field survey.Then,through spatial analysis,these attributes were used to build the Pedestrian Environment Quality Indicator and the Priority Intervention Indicator.Using these indicators,walking-friendly streets were mapped and the most critical sites that require priority intervention were identified to prepare for the requalification planning process.The street with the highest quality in the study area according to the dimensions evaluated-connectivity,convenience,comfort,cleanliness,and conviviality-has a great offer of trees,bus stops,commercial establishments,commercial diversity,crossings,paper bins/eco points and esplanades.On the opposite side of the rank,the street with the lowest quality has no trees or green areas,transport stops,benches and tables,or commercial activity.The urban quality indicators constitute a helpful tool for city planners and policymakers when planning sustainable living neighbourhoods.展开更多
Field experiments were conducted to examine the influence factors of cultivar, nitrogen application and irrigation on grain protein content, gluten content and grain hardness in three winter wheat cultivars under fo...Field experiments were conducted to examine the influence factors of cultivar, nitrogen application and irrigation on grain protein content, gluten content and grain hardness in three winter wheat cultivars under four levels of nitrogen and irrigation treatments. Firstly, the influence of cultivars and environment factors on grain quality were studied, the effective factors were cultivars, irrigation, fertilization, etc. Secondly, total nitrogen content around winter wheat anthesis stage was proved to be significantly correlative with grain protein content, and spectral vegetation index significantly correlated to total nitrogen content around anthesis stage were the potential indicators for grain protein content. Accumulation of total nitrogen content and its transfer to grain is the physical link to produce the final grain protein, and total nitrogen content at anthesis stage was proved to be an indicator of final grain protein content. The selected normalized photochemical reflectance index (NPRI) was proved to be able to predict grain protein content on the close correlation between the ratio of total carotenoid to chlorophyll a and total nitrogen content. The method contributes towards developing optimal procedures for predicting wheat grain quality through analysis of their canopy reflected spectrum at anthesis stage. Regression equations were established to forecast grain protein and dry gluten content by total nitrogen content at anthesis stage, so it is feasible for forecasting grain quality by establishing correlation equations between biochemical constitutes and canopy reflected spectrum.展开更多
This study analyzes the role of financial development(FD)on the impact of technologi-cal innovation(TI)on six environmental quality indicators for the 25 economies that are part of the Organization for Economic Cooper...This study analyzes the role of financial development(FD)on the impact of technologi-cal innovation(TI)on six environmental quality indicators for the 25 economies that are part of the Organization for Economic Cooperation and Development for the period from 2000 to 2019.We use a two-step dynamic generalized method of moments approach to understand this relationship.The results show that FD augments the posi-tive effects of TI on four of the six environmental indicators,namely ecological foot-print,adjusted net savings,pressure on nature,and environmental performance.However,no significant effects on environmental sustainability and environmental vulnerability indices were found.When considering all of the environmental quality indicators,TI appears to enhance environmental quality.We find evidence to support the existence of the environmental Kuznets curve in the context of each environmen-tal indicator and economic growth.Moreover,FD and energy consumption appear to accelerate environmental degradation.Based on these results,FD should be viewed as an important parameter in designing policies for innovation to achieve the goal of net-zero carbon emissions.Highlights.Technological innovation and environmental quality nexus is studied.The moderating role of financial development is analyzed.Six different environmental quality indicators are used for OECD countries.Financial development intensifies the environmental benefits of innovation.•The EKC hypothesis is confirmed for all six environmental indicators.展开更多
In Democratic Republic of the Congo (DRC), the laboratory TAT is significantly very long and do not comply with either international standards or the suggestions of customers. However, there is neither a national nor ...In Democratic Republic of the Congo (DRC), the laboratory TAT is significantly very long and do not comply with either international standards or the suggestions of customers. However, there is neither a national nor a local strategy to improve the laboratory TAT. The aim of the present study is to develop practical management strategies to shorten clinical laboratory tests’ TAT. This was a qualitative study conducted in Kinshasa. Focus groups and Lean tools were used respectively to generate a wide range of views from a variety of laboratory staff and to eliminate several form of waste in the laboratory flow process. Based on the identified root causes of delay, focus groups participants reported that there is a lot of scope for the improvement of TAT in DRC. Consistent attendance and punctuality are essential. The hospital management should implement the Laboratory Information Systems (LIS) and install Middleware. Total laboratory automation, inventory system for all reagents and supplies used in the laboratory, expansion of the sampling area, sufficient number of high-power machine and a clear job description are indispensable. LIS, 3.5 mL BD vacutainer Barricor<sup>TM</sup> tube and point-of-care testing (POCT) are necessary for workflow improvement. A reduction of 312 minutes was achieved by eliminating or decreasing non-value-added activities. Applying the suggested key strategies, and particularly the new workflow process, is a basis for improving the laboratory tests’ TAT. The algorithm presented can be easily implemented in other laboratories that face this type of problem.展开更多
文摘Colonoscopy remains the cornerstone of colorectal cancer prevention and survei-llance,but the procedure’s effectiveness is entirely dependent upon various quali-ty indicators,such as detection rates,withdrawal time,adequate bowel prepara-tion,cecal intubation rate and patient outcomes.Despite progress in endoscopic techniques,challenges persist in maintaining endoscopists’consistent perfor-mance and improving quality metrics.Artificial intelligence(AI)has emerged as a“game changer”in the gastroenterology field,offering the opportunity to signifi-cantly increase colonoscopy quality.This review highlights the role of AI-driven technologies such as deep learning,computer vision,and real-time feedback me-chanisms in optimizing key quality indicators of colonoscopy.The implementa-tion of AI in colonoscopy may reduce human error,improve endoscopist’s consis-tency in real-time decision making,ensuring higher reliability and standardiza-tion during the procedure.Furthermore,AI has the potential to reshape how en-doscopists perform and evaluate procedures,while improved lesion characte-rization may enable more precise selection for resection,reducing morbidity and the incidence of interval cancers.The review also addresses challenges and limi-tations in AI integration,including cost-effectiveness and its impact on endosco-pist training.AI holds substantial promise for advancing colonoscopy quality and elevating overall patient care,paving the way for more effective and personalized medical approaches.
文摘Additive Manufacturing(AM)can provide customized parts that conventional techniques fail to deliver.One important parameter in AM is the quality of the parts,as a result of the material extrusion 3D printing(3D-P)procedure.This can be very important in defense-related applications,where optimum performance needs to be guaranteed.The quality of the Polyetherimide 3D-P specimens was examined by considering six control parameters,namely,infill percentage,layer height,deposition angle,travel speed,nozzle,and bed temperature.The quality indicators were the root mean square(Rq)and average(Ra)roughness,porosity,and the actual to nominal dimensional deviation.The examination was performed with optical profilometry,optical microscopy,and micro-computed tomography scanning.The Taguchi design of experiments was applied,with twenty-five runs,five levels for each control parameter,on five replicas.Two additional confirmation runs were conducted,to ensure reliability.Prediction equations were constructed to express the quality indicators in terms of the control parameters.Three modeling approaches were applied to the experimental data,to compare their efficiency,i.e.,Linear Regression Model(LRM),Reduced Quadratic Regression Model,and Quadratic Regression Model(QRM).QRM was the most accurate one,still the differences were not high even considering the simpler LRM model.
基金This study was funded by the National Natural Science Foundation of China (Grant No. 72074164)Chinese Academy of Medical Sciences(Grant No. 2020-JKCS-024).
文摘Purpose:This study aimed to develop quality indicators for the care of older adults with disabilities in long-term care facilities(LTCFs)based on Maslow’s hierarchy of needs.Methods:The draft of the quality indicators was drawn up based on a literature review and research group discussion.The quality indicators were finalized by two rounds of expert consultation(involving 15 experts)using the Delphi method.The Analytic Hierarchy Process was applied to calculate the indicators’weight.Results:The response rates of the two rounds of consultation were 100%and 93%,and the expert authority coefficients were 0.86 and 0.87.After two rounds of consultation,the expert opinion coordination coefficients of the first-,second-and third-level indicators were 0.42,0.25,and 0.96,respectively(P<0.05),and the variation coefficient was0.25.The final quality indicators for the care of older adults with disabilities in LTCFs included 7 first-level,19 second-level,and 107 third-level indicators.Conclusion:The quality indicators for the care of older adults with disabilities in LTCFs are reliable,scientific,comprehensive,and practical and specify the content of person-centered care needs.This can provide a reference for evaluating and improving care quality in LTCFs.
基金Supported by 2021 Science and Technology Project of China Grain Reserves Group Limited Company(Sinograin)"Research on Natural Variation Law of Reserve Cotton Quality"(2021-11).
文摘The quality indicators of cotton will change during storage.Taking the 5.89 million t of Xinjiang cotton from 2016 to 2021 as a sample,this paper analyzed the main fiber quality indicator data of warehouse-in and warehouse-out cotton for storage of 1.5,3.0,4.0,5.0,6.0,and 7.0 years.It was found that the color grade of cotton decreased with the extension of storage time.The cotton with storage time of 5.0 years mainly changed from white cotton grade 2 and white cotton grade 3 to light yellow stained cotton grade 1 and yellow stained cotton grade 1.Among them,the increase of light yellow stained cotton grade 1 was the largest,and the change to yellow stained cotton grade 1 was the largest at the storage 6.0-7.0 years.In addition,there were no significant changes in moisture regain,Micronaire value,upper half mean length,length uniformity index and fiber strength.
文摘Quality indicators in healthcare refer to measurable and quantifiable parameters used to assess and monitor the performance,effectiveness,and safety of healthcare services.These indicators provide a systematic way to evaluate the quality of care offered,and thereby to identify areas for improvement and to ensure that patient care meets established standards and best practices.Respiratory therapists play a vital role in areas of clinical administration such as infection control practices and quality improvement initiatives.Quality indicators serve as essential metrics for respiratory therapy departments to assess and enhance the overall quality of care.By systematically tracking and analyzing indicators related to infection control,treatment effectiveness,and adherence to protocols,respiratory care practitioners can identify areas to improve and implement evidence-based changes.This article reviewed how to identify,implement,and monitor quality indicators specific to the respiratory therapy departments to set benchmarks and enhance patient outcomes.
基金supported by the National Natural Science Foundation of China(Grant No.61078040)the Science and Technology Project of Guangdong Province of China(No.2014A020212445).
文摘Alcohol,total sugar,total acid,and total phenol contents are the main indicators of wine quality detection.This study aims to establish simultaneous analysis models for the four indicators through near-infrared(NIR)spectroscopy with wavelength optimization.A Norris derivative filter(NDF)platform with multiparameter optimization was established for spectral pretreatment.The optimal parameters(i.e.,derivative order,number of smoothing points,and number of differential gaps)were(2,9,3)for alcohol,(1,19,5)for total sugar,(1,17,11)for total acid,and(1,1,1)for total phenol.The equidistant combinationpartial least squares(EC-PLS)was used for large-scale wavelength screening.The wavelength step-by-step phaseout PLS(WSP-PLS)and exhaustive methods were used for secondary optimization.The final optimization models for the four indicators included 7,10,15,and 13 wavelengths located in the overtone or combination regions,respectively.In an independent validation,the root mean square errors,correlation coefficient for prediction(i.e.,SEP and RP),and ratio of performance-to-deviation(RPD)were 0.41 v/v,0.947,and 3.2 for alcohol;1.48 g/L,0.992,and 6.8 for total sugar;0.68 g/L,0.981,and5.1 for total acid;and 0.181 g/L,0.948,and 2.9 for total phenol.The results indicate high correlation,low error,and good overall prediction performance.Consequently,the established reagent-free NIR analytical models are important in the rapid and real-time quality detection of the wine fermentation process and finished products.The proposed wavelength models provide a valuable reference for designing small dedicated instruments.
文摘Background and aim:Adequate bowel preparation is important for safe and effective colonoscopy.Quality indicators(QI)for colonoscopy include achieving at least 95%completion rate and an adenoma detection rate(ADR)of at least 25%in average-risk men and 15%in average-risk women aged over 50.Our aim was to investigate the impact of bowel preparation on ADR and colonoscopy completion rates.Methods:This retrospective cohort study included patients who underwent colonoscopy between January 2008 and December 2009.The main outcome measurements were ADR and colonoscopy completion rates to the cecum.Results:A total of 2519 patients was included;1030(41.0%)had excellent preparation,1145(45.5%)good-,240(9.5%)fair-,and 104(4.1%)poor preparation.Colonoscopy completion rates were significantly lower in patients with poor or fair preparation(72.1%and 75.4%,respectively)than in those with good and excellent preparation(99.7%and 99.9%,respectively;P<0.001),and significantly lower than the QI of 95%(P<0.001).ADR in men and women combined was similar in all four grades of preparation(excellent,good,fair and poor)at 24.2%vs.26.8%vs.32.1%vs.22.1%,respectively;P¼0.06.All the groups had ADR above the QI(25%for men and 15%for women)with evidence of significantly higher ADR in the women with excellent or good preparation and in men with excellent,good or fair preparation.On multivariate analysis,male gender was significantly associated with increased ADR(P<0.001),while the quality of bowel preparation did not influence ADR.Conclusions:Patients with fair and poor standards of preparation have significantly lower colonoscopy completion rates than those with excellent and good preparation.However,there was no difference in ADR between the different grades of preparation.
文摘In this study, emphasis has focused on assessing the potential hydro-environmental impacts of a barrage across the Severn Estuary, with a numerical model being developed and applied to the estuary to assess the impacts of proposed Severn Barrage on the hydrodynamic, sediment transport and faecal indicator organism distribu- tion within the estuary. The results show that the Severn Barrage has the potential to reduce the tidal currents in a highly dynamic estuary. This leads to the reduction of suspended sediment concentrations, which in turn affects the bacterial transport processes which is highly related to the sediment transport processes.
文摘Quality of Maternal, Neonatal and Child (MNCH) care is an important aspect in ensuring healthy outcomes and survival of mothers and children. To maintain quality in health services provided, organizations and other stakeholders in maternal and child health recommend regular quality measurement. Quality indicators are the key components in the quality measurement process. However, the literature shows neither an indicator selection process nor a set of quality indicators for quality measurement that is universally accepted. The lack of a universally accepted quality indicator selection process and set of quality indicators results in the establishment of a variety of quality indicator selection processes and several sets of quality indicators whenever the need for quality measurement arises. This adds extra processes that render quality measurement process. This study, therefore, aims to establish a set of quality indicators from a broad set of quality indicators recommended by the World Health Organization (WHO). The study deployed a machine learning technique, specifically a random forest classifier to select important indicators for quality measurement. Twenty-nine indicators were identified as important features and among those, eight indicators namely maternal mortality ratio, still-birth rate, delivery at a health facility, deliveries assisted by skilled attendants, proportional breach delivery, normal delivery rate, born before arrival rate and antenatal care visit coverage were identified to be the most important indicators for quality measurement.
基金supported by President Foundation of the Third Affiliated Hospital of Southern Medical University(YH202207)。
文摘Objectives:This study aimed to evaluate the measurement properties and methodological quality of instruments developed to evaluate the quality of online health information.Methods:In this study,a systematic search was conducted across a range of databases,including the China National Knowledge Infrastructure(CNKI),Wanfang,China Science and Technology Journal(VIP),SinoMed,PubMed,Web of Science,CINAHL,Embase,the Cochrane Library,PsycINFO,and Scopus.The search period spanned from the inception of the databases to October 2023.Two researchers independently conducted the literature screening and data extraction.The methodological quality of the included studies was assessed using the Consensus-based Standards for the Selection of Health Measurement Instruments(COSMIN)Risk of Bias checklist.The measurement properties were evaluated using the coSMIN criteria.The modified Grading,Recommendations,Assessment,Development,and Evaluation(GRADE)system was used to determine the quality grade.Results:A total of 18 studies were included,and the measurement properties of 17 scales were assessed.Fifteen scales had content validity,three had structural validity,six had internal consistency,two had test-retest reliability,nine had interater reliability,one had measurement error,six instruments had criterion validity,and three scales had hypotheses testing for construct validity;however,the evaluation of their methodological quality and measurement properties revealed deficiencies.Of these 17 scales,15 were assigned a Level B recommendation,and two received a Level C recommendation.Conclusions:The Health Information Website Evaluation Tool(HIWET)can be temporarily used to evaluate the quality of health information on websites.The Patient Education Materials Assessment Tool(PEMAT)can temporarily assess the quality of video-based health information.However,the effectiveness of both tools needs to be further verified.
文摘Evidence is not homogeneous on indicators able to monitor and assess qualityperformance for organ donation. This may be related to differences in healthcareorganizations among countries but also to the scarcity of data on this topic so far.In the present review, we assessed available evidence on quality metrics in solidorgan procurement in the United States and in Europe by means of a PubMedsearch. Evidence was summarized according to countries, considering that thedonation and transplantation systems differ from country to country. In UnitedStates, the assessment of these indicators is periodically performed by the nationalnetwork for organ sharing to evaluate the performance of each Organ ProcurementOrganization (OPO). Quality metrics consider several factors, in primispopulation characteristics (i.e. race/ethnicity, age, socio-economic status). That iswhy the assessment of each OPO performance relies on several quality metrics,not only one single indicator. In Europe, quality improvement programs representa structural element of organ and transplant system in several countries, but fewpapers have to date addressed the results obtained by a quality improvementprogram based on indicators. In Poland, the use of quality indicators and improvementprocedures were associated with better results in those hospitals whichimplemented these programs in respect to hospitals who did not. In TuscanyRegion (Italy) the implementation of a monitoring and reporting approach basedon indicators by the Regional Transplant Center was associated with an increasedin transplant and donation activity (especially in cDCD donors). According toavailable evidence, the development of a method for quality assessment andquality improvement has been recognized as pivotal for donation and transplantauthorities to identify key interventions either at national and/or hospital levels.
文摘BACKGROUND Although transarterial chemoembolization(TACE)is an effective treatment for liver cancer,clinical practice has shown that many patients experience significant psychological distress following the procedure,which can hinder postoperative recovery and prognosis.Therefore,effective and evidence-based interventions are urgently needed to address this issue.AIM To evaluate the impact of nursing quality-sensitive indicators combined with mindfulness-based stress reduction(MBSR)interventions in patients undergoing TACE.METHODS A total of 84 patients who underwent TACE from June 2022 to March 2024 were enrolled in the study.They were randomly assigned to either the observation group(n=42),which received nursing quality-sensitive indicator-based care combined with MBSR intervention,or the control group(n=42),which received routine care combined with MBSR intervention.Psychological stress response levels[assessed using the Trait Meta-Mood Scale(TMMS)],coping strategies[measured with the Jalowiec Coping Scale(JCS)],quality of care[evaluated using the Perceived Nursing Service Quality(PNSQ)scale],and overall patient satisfaction were compared between the two groups.RESULTS After 4 weeks,the observation group demonstrated significantly higher TMMS scores,as well as increased optimism,support-seeking,bravery,PNSQ scores,and satisfaction(P<0.05).In contrast,scores for selfdependence,conservatism,resignation,and avoidance in the JCS were significantly lower in the observation group than in the control group(P<0.05).CONCLUSION The combination of nursing quality-sensitive indicators and MBSR intervention in TACE patients not only reduces psychological stress and encourages a more positive attitude toward illness but also enhances nursing quality and improves the overall patient experience.
基金financially supported by Key Laboratory of Marine Oil Spill Identification and Damage Assessment Technology, State Oceanic Administration (201214)Key Laboratory of Pollution Processes and Environmental Criteria (Nankai University),Ministry of Education (KL-PPEC-2013-09)
文摘In this paper, some indices of sulfide, organic carbon, oil and heavy metals （copper, lead, zinc, cadmium, mercury, arsenic and chromium） in the sediments from Dagu Dainage Canal at the Bohai Bay during four seasons in 2012 - 2013 are selected, and Water Quality Pollution Index （API） is applied to evaluate water quality indices, aiming for the systematic evaluation of the water quality of Dagu Dainage Canal. The results showed that four stations of D3, D6, D7and D9 for S2 had the type Ⅱand Ⅲ of water; others had the type Ⅰ ; the total level of TOC, TPH, Cu, Pb, Zn, Cd, Hg, As and Cr were type Ⅰ, Ⅳ, Ⅱ, Ⅴ, Ⅱ, Ⅴ, Ⅲ, Vand Ⅴ. Water Quality Pollution Index （API） was 3.28, which illustrated Dagu Dainage Canal was in the state of contamination and the degree of pollution exceeded the standard functional areas.
文摘Endoscopic resection,particularly endoscopic submucosal dissection(ESD),is widely used as a standard treatment modality for early gastric cancer(EGC)when the risk of lymph node metastasis is negligible.Compared with surgical gastrectomy,ESD is a minimally invasive procedure with additional advantages,such as preservation of the entire stomach and maintenance of the patient’s quality of life.However,not all patients achieve curative resection after ESD of EGC.Several patients require surgical gastrectomy after ESD to achieve a curative treatment.Additional surgery after ESD,owing to non-curative resection,places considerable emotional and financial burdens on patients.Recently,as the number of endoscopists performing ESD has increased,the rate of non-curative resection after ESD has increased correspondingly.In order to decrease the non-curative resection rate,as well as determine the ideal rate of non-curative resection after ESD,it is time to consider quality indicators for the outcomes of ESD for EGC.
基金data provided by the GAGE Facility, operated by UNAVCO, Inc., with support from the National Science Foundation and the National Aeronautics and Space Administration under NSF Cooperative Agreement EAR-1724794。
文摘The present analysis provided the quality assessment of 65 Continuous Operating Reference Stations(CORS) situated in and around Mexico using the data of about ten years(January 2010 to January 2020).To accomplish the assessment,we considered 4 quality indexes for performing the quality check,incluing the multipath effect on L1 and L2 bands,signal-to-noise ratio in both bands,cycle slips,and integrity.Meanwhile,a new reference parameter named regio nal values for Mexico(RVM) was calculated for the stations situated in Mexico.Additionally,an exhaustive analysis of the quality indicators in the worst and best cases was performed.The signal degradation was proved by a long-term time series and cru stal defo rmation analysis in GAMIT/GLOBK platform.The results showed a stro ng correlation between integrity,cycle slips and daily observations time,and the multipath effect is strong in the case of outdated systems.The study indicates that the estimated quality indexes and values could be the basis for establishing new CORS in Mexico,and the errors corrections which cannot be mitigated in the postprocessing stage would greatly help utilize the data for different scientific applications.The results were supported by deformation analysis in part of Baja California Peninsula in Mexico indicating northern and eastern velocity vector of -3.08±0.02 mm/yr,-7.85±0.02 mm/yr and-0.07±0.03 mm/yr,-9.33±0.02 mm/yr respectively at MPR1 and INEG stations.
基金This work was financed by national funds through FCT-Foundation for Science and Technology,I.P.,within the scope of the project“UIDB/04647/2020”of CICS.NOVA-Interdisciplinary Centre of Social Sciences from Universidade NOVA de LisboaThe first author was financed by national funds through the FCT,under the Norma Transitória-DL 57/2016/CP1453/CT0004.
文摘Obesity and global warming are two major challengesthat affect communities’health and quality of life.Providing good walking environments,with appropriate pedestrian infrastructure,green areas and access to commercial retail and transport hubs favour liveable,healthy,and sustainable cities.The Lisbon City Hall has implemented an intervention program in the public space as a strategy to improve environmental quality and mitigate the effects of climate change.The program“A square in each neighbourhood”intends not only to reinforce the economic base of Lisbon,namely tourism,restaurants,commerce,and creative activities but also to promote physical activity and improve the quality of living of all citizens.For studying the impact of the public space quality on the walking environment,Campolide,a typical Lisbon neighbourhood,Portugal,which includes one of the requalified squares,was selected.A two-step methodology based on spatial modelling is proposed.In the first step,the public space quality was evaluated based on a set of 13 urban quality attributes.Attributes,intended for the street level,were collected from open data platforms and complemented with a field survey.Then,through spatial analysis,these attributes were used to build the Pedestrian Environment Quality Indicator and the Priority Intervention Indicator.Using these indicators,walking-friendly streets were mapped and the most critical sites that require priority intervention were identified to prepare for the requalification planning process.The street with the highest quality in the study area according to the dimensions evaluated-connectivity,convenience,comfort,cleanliness,and conviviality-has a great offer of trees,bus stops,commercial establishments,commercial diversity,crossings,paper bins/eco points and esplanades.On the opposite side of the rank,the street with the lowest quality has no trees or green areas,transport stops,benches and tables,or commercial activity.The urban quality indicators constitute a helpful tool for city planners and policymakers when planning sustainable living neighbourhoods.
基金financially supported by the Special Funds for Major State Basic Research Project,China(G20000779)the China National High Tech R&D Program(2002AA243011,2003AA209010,H020821020130).
文摘Field experiments were conducted to examine the influence factors of cultivar, nitrogen application and irrigation on grain protein content, gluten content and grain hardness in three winter wheat cultivars under four levels of nitrogen and irrigation treatments. Firstly, the influence of cultivars and environment factors on grain quality were studied, the effective factors were cultivars, irrigation, fertilization, etc. Secondly, total nitrogen content around winter wheat anthesis stage was proved to be significantly correlative with grain protein content, and spectral vegetation index significantly correlated to total nitrogen content around anthesis stage were the potential indicators for grain protein content. Accumulation of total nitrogen content and its transfer to grain is the physical link to produce the final grain protein, and total nitrogen content at anthesis stage was proved to be an indicator of final grain protein content. The selected normalized photochemical reflectance index (NPRI) was proved to be able to predict grain protein content on the close correlation between the ratio of total carotenoid to chlorophyll a and total nitrogen content. The method contributes towards developing optimal procedures for predicting wheat grain quality through analysis of their canopy reflected spectrum at anthesis stage. Regression equations were established to forecast grain protein and dry gluten content by total nitrogen content at anthesis stage, so it is feasible for forecasting grain quality by establishing correlation equations between biochemical constitutes and canopy reflected spectrum.
基金This research paper did not receive any financial aid from any source.
文摘This study analyzes the role of financial development(FD)on the impact of technologi-cal innovation(TI)on six environmental quality indicators for the 25 economies that are part of the Organization for Economic Cooperation and Development for the period from 2000 to 2019.We use a two-step dynamic generalized method of moments approach to understand this relationship.The results show that FD augments the posi-tive effects of TI on four of the six environmental indicators,namely ecological foot-print,adjusted net savings,pressure on nature,and environmental performance.However,no significant effects on environmental sustainability and environmental vulnerability indices were found.When considering all of the environmental quality indicators,TI appears to enhance environmental quality.We find evidence to support the existence of the environmental Kuznets curve in the context of each environmen-tal indicator and economic growth.Moreover,FD and energy consumption appear to accelerate environmental degradation.Based on these results,FD should be viewed as an important parameter in designing policies for innovation to achieve the goal of net-zero carbon emissions.Highlights.Technological innovation and environmental quality nexus is studied.The moderating role of financial development is analyzed.Six different environmental quality indicators are used for OECD countries.Financial development intensifies the environmental benefits of innovation.•The EKC hypothesis is confirmed for all six environmental indicators.
文摘In Democratic Republic of the Congo (DRC), the laboratory TAT is significantly very long and do not comply with either international standards or the suggestions of customers. However, there is neither a national nor a local strategy to improve the laboratory TAT. The aim of the present study is to develop practical management strategies to shorten clinical laboratory tests’ TAT. This was a qualitative study conducted in Kinshasa. Focus groups and Lean tools were used respectively to generate a wide range of views from a variety of laboratory staff and to eliminate several form of waste in the laboratory flow process. Based on the identified root causes of delay, focus groups participants reported that there is a lot of scope for the improvement of TAT in DRC. Consistent attendance and punctuality are essential. The hospital management should implement the Laboratory Information Systems (LIS) and install Middleware. Total laboratory automation, inventory system for all reagents and supplies used in the laboratory, expansion of the sampling area, sufficient number of high-power machine and a clear job description are indispensable. LIS, 3.5 mL BD vacutainer Barricor<sup>TM</sup> tube and point-of-care testing (POCT) are necessary for workflow improvement. A reduction of 312 minutes was achieved by eliminating or decreasing non-value-added activities. Applying the suggested key strategies, and particularly the new workflow process, is a basis for improving the laboratory tests’ TAT. The algorithm presented can be easily implemented in other laboratories that face this type of problem.
