目的总结CDK4/6抑制剂治疗乳腺癌所致不良反应的相关护理证据,为临床实践提供循证依据。方法采用PIPOST问题开发工具构建循证问题,按照“6S”证据金字塔模型,遵循自上而下的原则,系统检索BMJ Best Practice、Up To Date、澳大利亚乔安...目的总结CDK4/6抑制剂治疗乳腺癌所致不良反应的相关护理证据,为临床实践提供循证依据。方法采用PIPOST问题开发工具构建循证问题,按照“6S”证据金字塔模型,遵循自上而下的原则,系统检索BMJ Best Practice、Up To Date、澳大利亚乔安娜布里格斯研究所循证卫生保健数据库、美国国立指南数据库、美国国立综合癌症网络、加拿大医学会临床实践指南网、苏格兰校际指南网、国际指南协作网、英国国家卫生与临床优化研究所、新西兰指南协作组网站、加拿大安大护理学会、Pub Med、Web of Science、Cochrane Library、Embase、中国期刊全文数据库、万方学术期刊全文数据库、医脉通等,检索时限为建库起至2023年12月31日。由2~4名研究者进行文献筛选、质量评价、证据提取及整合。结果最终纳入17篇文献,其中包含1篇临床决策、1篇指南、2篇专家共识、4篇meta分析、1篇随机对照试验、2篇系统评价、6篇原始研究。从用药前评估、用药观察、皮肤护理、胃肠道反应管理、多学科协作管理、心理干预6个方面总结出17条证据。结论本研究总结了CDK4/6抑制剂治疗乳腺癌所致不良反应的相关护理证据,可为临床护理实践提供参考,护理人员可结合患者的临床症状与实际需求,实施规范化、个体化的护理干预。展开更多
随着第六代移动通信系统(6th generation mobile communication system, 6G)通信技术的发展,空天地一体化网络(Spaceair-ground integrated network, SAGIN)作为6G的重要组成部分,旨在实现卫星、空中平台与地面系统的无缝互联,在应急通...随着第六代移动通信系统(6th generation mobile communication system, 6G)通信技术的发展,空天地一体化网络(Spaceair-ground integrated network, SAGIN)作为6G的重要组成部分,旨在实现卫星、空中平台与地面系统的无缝互联,在应急通信、环境监测、智能交通等领域展现出巨大的潜力.然而,SAGIN具有异构结构、链路动态性高、资源分布广泛等特征,给网络的高效管理与优化带来巨大的挑战.近年来,人工智能(Artificial intelligence, AI)技术凭借强大的感知、学习与自主决策能力应用于通信网络,为SAGIN的智能演进提供了新契机.本文首先系统介绍SAGIN网络架构的基本组成与关键特征,并梳理当前主流AI技术在网络优化中的主要技术体系与适配优势,包括机器学习、图神经网络以及强化学习.其次,本文深入探讨了AI技术在SAGIN中智能资源管理、移动性管理与路由优化、空中平台路径规划、任务卸载与计算协同等典型场景中的应用与最新进展.最后,本文总结了AI技术应用在SAGIN网络中面临的挑战并展望了AI与SAGIN融合发展的未来方向.本文概述了AI技术在SAGIN网络中应用的优势与进展,旨在为AI赋能的SAGIN研究与应用发展提供技术参考.展开更多
Climate models are essential for understanding past,present,and future changes in atmospheric circulation,with circulation modes providing key sources of seasonal predictability and prediction uncertainties for both g...Climate models are essential for understanding past,present,and future changes in atmospheric circulation,with circulation modes providing key sources of seasonal predictability and prediction uncertainties for both global and regional climates.This study assesses the performance of models participating in phase 6 of the Coupled Model Intercomparison Project in simulating interannual variability modes of Northern Hemisphere 500-hPa geopotential height during winter and summer,distinguishing predictable(potentially predictable on seasonal or longer timescales)and unpredictable(intraseasonal and essentially unpredictable at long range)components,using reanalysis data and a variance decomposition method.Although most models effectively capture unpredictable modes in reanalysis,their ability to reproduce dominant predictable modes-specifically the Pacific-North American pattern,Arctic Oscillation,and Western Pacific Oscillation in winter,and the East Atlantic and North Atlantic Oscillations in summer-varies notably.An optimal ensemble is identified to distinguish(a)predictable-external modes,dominated by external forcing,and(b)predictable-internal modes,associated with slow internal variability,during the historical period(1950-2014)and the SSP5-8.5 scenario(2036-2100).Under increased radiative forcing,the leading winter/summer predictable-external mode exhibits a more uniform spatial distribution,remarkably larger trend and annual variance,and enhanced height-sea surface temperature(SST)covariance under SSP5-8.5 compared to historical conditions.The dominant winter/summer predictable-internal modes also exhibit increased variance and height-SST covariance under SSP5-8.5,along with localized changes in spatial configuration.Minimal changes are observed in spatial distribution or variance for dominant winter/summer unpredictable modes under SSP5-8.5.This study,from a predictive perspective,deepens our understanding of model uncertainties and projected changes in circulations.展开更多
文摘目的总结CDK4/6抑制剂治疗乳腺癌所致不良反应的相关护理证据,为临床实践提供循证依据。方法采用PIPOST问题开发工具构建循证问题,按照“6S”证据金字塔模型,遵循自上而下的原则,系统检索BMJ Best Practice、Up To Date、澳大利亚乔安娜布里格斯研究所循证卫生保健数据库、美国国立指南数据库、美国国立综合癌症网络、加拿大医学会临床实践指南网、苏格兰校际指南网、国际指南协作网、英国国家卫生与临床优化研究所、新西兰指南协作组网站、加拿大安大护理学会、Pub Med、Web of Science、Cochrane Library、Embase、中国期刊全文数据库、万方学术期刊全文数据库、医脉通等,检索时限为建库起至2023年12月31日。由2~4名研究者进行文献筛选、质量评价、证据提取及整合。结果最终纳入17篇文献,其中包含1篇临床决策、1篇指南、2篇专家共识、4篇meta分析、1篇随机对照试验、2篇系统评价、6篇原始研究。从用药前评估、用药观察、皮肤护理、胃肠道反应管理、多学科协作管理、心理干预6个方面总结出17条证据。结论本研究总结了CDK4/6抑制剂治疗乳腺癌所致不良反应的相关护理证据,可为临床护理实践提供参考,护理人员可结合患者的临床症状与实际需求,实施规范化、个体化的护理干预。
基金supported by the National Natural Science Foundation of China(Grant Nos.U2342210 and 42275043)the National Institute of Natural Hazards,Ministry of Emergency Management of China(Grant Nos.J2223806,ZDJ2024-25 and ZDJ2025-34)。
文摘Climate models are essential for understanding past,present,and future changes in atmospheric circulation,with circulation modes providing key sources of seasonal predictability and prediction uncertainties for both global and regional climates.This study assesses the performance of models participating in phase 6 of the Coupled Model Intercomparison Project in simulating interannual variability modes of Northern Hemisphere 500-hPa geopotential height during winter and summer,distinguishing predictable(potentially predictable on seasonal or longer timescales)and unpredictable(intraseasonal and essentially unpredictable at long range)components,using reanalysis data and a variance decomposition method.Although most models effectively capture unpredictable modes in reanalysis,their ability to reproduce dominant predictable modes-specifically the Pacific-North American pattern,Arctic Oscillation,and Western Pacific Oscillation in winter,and the East Atlantic and North Atlantic Oscillations in summer-varies notably.An optimal ensemble is identified to distinguish(a)predictable-external modes,dominated by external forcing,and(b)predictable-internal modes,associated with slow internal variability,during the historical period(1950-2014)and the SSP5-8.5 scenario(2036-2100).Under increased radiative forcing,the leading winter/summer predictable-external mode exhibits a more uniform spatial distribution,remarkably larger trend and annual variance,and enhanced height-sea surface temperature(SST)covariance under SSP5-8.5 compared to historical conditions.The dominant winter/summer predictable-internal modes also exhibit increased variance and height-SST covariance under SSP5-8.5,along with localized changes in spatial configuration.Minimal changes are observed in spatial distribution or variance for dominant winter/summer unpredictable modes under SSP5-8.5.This study,from a predictive perspective,deepens our understanding of model uncertainties and projected changes in circulations.
