The spatial optimization of best management practices(BMPs) plays a critical role in precise watershed pollution control. However, the effectiveness of BMPs exhibits a complex nonlinear dependence on both configuratio...The spatial optimization of best management practices(BMPs) plays a critical role in precise watershed pollution control. However, the effectiveness of BMPs exhibits a complex nonlinear dependence on both configuration unit scale and rainfall intensity, often leading to widespread spatiotemporal mismatches during implementation. To fill this gap, this study proposes a new framework:(a) delineating configuration units based on the implementation scale differences between structural and nonstructural BMPs;(b) incorporating BMP reduction thresholds to enable dynamic adjustment of design scales according to inflow loads;and(c) developing a staged allocation strategy tailored to varying rainfall scenarios. The framework is exemplified by an agricultural catchment in the southeastern Liaohe watershed, China. The results showed that the framework could improve the assessment accuracy and cost-effectiveness of pollution control. Specifically, neglecting BMP reduction thresholds resulted in a 51.35% underestimation of treatment costs. Incorporating these thresholds and dynamically adjusting BMP design scales reduced treatment costs by 62.70%. Furthermore, the framework facilitated more precise localization of structural BMPs(1 km^(2)) and improved optimization efficiency by 95.91%. The proposed staged allocation strategy ensured water quality compliance under varying rainfall intensities. Structural BMPs primarily addressed pollution from light to moderate rainfall in the initial stage, while nonstructural BMPs targeted heavy rainfall pollution in the subsequent stage. The proposed framework may enhance the spatiotemporal adaptability of BMP configuration to respond to the threats posed by climate change and human activities. It can also be extended to other agriculture-dominated watersheds.展开更多
Objective:To explore the application of the Registered Nurses'Association of Ontario(RNAO)Best Practice Guideline(BPG)for Developing and Sustaining Nursing Leadership through the lens of nursing students transitio...Objective:To explore the application of the Registered Nurses'Association of Ontario(RNAO)Best Practice Guideline(BPG)for Developing and Sustaining Nursing Leadership through the lens of nursing students transitioning from classroom learning to clinical practice.Through this reflection,the authors hope to inspire and empower future nursing leaders to champion innovation,resilience,and excellence in healthcare.Methods:By integrating evidence-based leadership principles,the authors reflect on their personal experiences,challenges,and successes in implementing these guidelines in real-world settings.Results:The paper highlights the significance of leadership in fostering healthy work environments and improving patient outcomes,emphasizing the role of nursing students as emerging leaders.Practical strategies for applying BPG,the RNAO BPG suggests leadership skills on professional development,and recommendations for embedding leadership principles into nursing education and practice are discussed.Conclusions:Implementing nursing leadership from the beginning of a nursing student's journey is vital for shaping the next generation of healthcare leaders.By integrating leadership principles early in nursing education,students can develop the skills needed to navigate clinical challenges,collaborate effectively with healthcare teams,and advocate for positive change.Starting with leadership guidelines in nursing school ensures that future nurses are equipped to foster supportive work environments,improve patient outcomes,and drive innovation from the very start of their careers,making leadership an inherent part of their professional identity.展开更多
Objectives This study aimed to compare the effectiveness of the semi-virtual simulation and traditional simulation teaching models based on the Standards of Best Practice(SOBP)according to the International Nursing As...Objectives This study aimed to compare the effectiveness of the semi-virtual simulation and traditional simulation teaching models based on the Standards of Best Practice(SOBP)according to the International Nursing Association for Clinical Simulation and Learning(INACSL)in the Adult Nursing course.Methods This study used a quasi-experimental design.A total of 94 third-year nursing students from a university in Beijing between November and December 2022 were recruited as participants.An innovative semi-virtual simulation teaching model was designed based on the SOBP established by the INACSL.In the Adult Nursing course,both the semi-virtual and traditional simulation teaching models were implemented.At the end of the simulation sessions,participants completed the Chinese version of the Simulation Effectiveness Tool-Modified(SET-M)to assess the effectiveness of the two teaching models.Results All nursing students completed the simulation sessions.There was no difference(t=−0.93,P=0.353)in the total scores between the semi-virtual simulation teaching model(50.87±5.30)and the traditional simulation teaching model(50.37±5.16).However,there was a statistically significant difference(t=−2.65,P=0.010)in the prebriefing section(semi-virtual simulation:5.60±0.71;traditional simulation:5.33±0.78).In contrast,no statistically significant differences were found for the scenario and debriefing sections(P>0.05).At the individual item level,statistical differences(P<0.05)between the two models were identified for items 1 and 9,but not for the remaining items(P>0.05).By analyzing the open-ended question,it was found that both simulation models were effective,and students’comments were similar.Conclusions The study demonstrated equivalent effectiveness between the semi-virtual and traditional simulation teaching models.Semi-virtual simulation teaching model could offer a more flexible and feasible approach to simulation teaching.展开更多
In this study,we examine the problem of sliced inverse regression(SIR),a widely used method for sufficient dimension reduction(SDR).It was designed to find reduced-dimensional versions of multivariate predictors by re...In this study,we examine the problem of sliced inverse regression(SIR),a widely used method for sufficient dimension reduction(SDR).It was designed to find reduced-dimensional versions of multivariate predictors by replacing them with a minimally adequate collection of their linear combinations without loss of information.Recently,regularization methods have been proposed in SIR to incorporate a sparse structure of predictors for better interpretability.However,existing methods consider convex relaxation to bypass the sparsity constraint,which may not lead to the best subset,and particularly tends to include irrelevant variables when predictors are correlated.In this study,we approach sparse SIR as a nonconvex optimization problem and directly tackle the sparsity constraint by establishing the optimal conditions and iteratively solving them by means of the splicing technique.Without employing convex relaxation on the sparsity constraint and the orthogonal constraint,our algorithm exhibits superior empirical merits,as evidenced by extensive numerical studies.Computationally,our algorithm is much faster than the relaxed approach for the natural sparse SIR estimator.Statistically,our algorithm surpasses existing methods in terms of accuracy for central subspace estimation and best subset selection and sustains high performance even with correlated predictors.展开更多
Jiang Shaohong is my best friend.He is 14years old and he is in Class 1,Grade 8.He is clever and can learn things quickly.He works hard at all his subjects.He has many hobbies,such as reading,singing,dancing,and playi...Jiang Shaohong is my best friend.He is 14years old and he is in Class 1,Grade 8.He is clever and can learn things quickly.He works hard at all his subjects.He has many hobbies,such as reading,singing,dancing,and playing sports.He loves animals,so he keeps a small dog as a pet and takes good care of it at home.He is kind and helpful.He often helps his classmates with their studies.展开更多
I have a best friend・His name is Li Xuan・We live in the same neighborhood and go to the same school.Li Xuan is a kind and clever boy.He always smiles and is ready to help others.One day,I had a problem with my math ho...I have a best friend・His name is Li Xuan・We live in the same neighborhood and go to the same school.Li Xuan is a kind and clever boy.He always smiles and is ready to help others.One day,I had a problem with my math homework and I was very worried.展开更多
BACKGROUND Sub-Saharan Africa(SSA)and Southeast Asia account for 80%of hepatocellular carcinoma(HCC)cases globally.Public healthcare systems in low-and middleincome countries often face significant economic constraint...BACKGROUND Sub-Saharan Africa(SSA)and Southeast Asia account for 80%of hepatocellular carcinoma(HCC)cases globally.Public healthcare systems in low-and middleincome countries often face significant economic constraints,resulting in limited treatment options.The objectives of this study were to identify factors associated with poor outcomes in patients with Barcelona Clinic Liver Cancer(BCLC)stage C and D undergoing transarterial chemoembolization(TACE)and to compare their outcomes to patients treated tyrosine kinase inhibitors(TKIs)or best supportive care(BSC)only.AIM To assess clinical outcomes and identify predictive factors that may facilitate the broader implementation of TACE in patients with advanced HCC within resource-constrained settings such as SSA.METHODS A single-center,retrospective cohort study was conducted to investigate the risk factors associated with the outcome of TACE in patients with BCLC stage C and D using univariate and multivariate regression analysis.Frequency matching was used to ensure comparable distributions of confounding factors across patients treated with TACE,TKIs,or BSC.Survival analysis was performed to compare outcomes among the matched groups.RESULTS Patients with BCLC stage C and D presenting with elevated gamma-glutamyl transferase levels or elevated aspartate aminotransferase levels or portal vein infiltration were identified as high-risk and demonstrated poor response to TACE treatment.In contrast,patients with BCLC stage C disease who lacked these highrisk features showed significantly longer overall survival when treated with TACE compared to those who received BSC or TKIs.CONCLUSION Gamma-glutamyl transferase levels,aspartate aminotransferase levels,and portal vein infiltration are critical risk factors to consider when determining treatment strategies for HCC patients in SSA.Patients without these factors can derive significant benefits from TACE as an alternative to BSC or TKIs.展开更多
目的:调查BEST(better&systematic team training)培训法在护士PDA静脉输液查对培训中的效果。方法:采用BEST培训法,包括理论授课+讨论+操作练习+反馈性汇报+录像回放+分析总结流程等对护士进行查对培训,并调查培训的效果。结果:护...目的:调查BEST(better&systematic team training)培训法在护士PDA静脉输液查对培训中的效果。方法:采用BEST培训法,包括理论授课+讨论+操作练习+反馈性汇报+录像回放+分析总结流程等对护士进行查对培训,并调查培训的效果。结果:护士长及骨干和科室普通护士在培训后视频纠错的得分均高于培训前(P<0.001);科室护士查对培训前后得分差异与学历(r=-0.167,P=0.007)、年龄(r=-0.136,P=0.030)、工作年限(r=-0.154,P=0.014)呈负相关,即学历越低,年龄越小,工作年限越短,培训前后得分差异越大,效果越好。结论:BEST训练法能有效提高护士,尤其是低年资护士的查对意识,强化操作流程,是一种理想、科学的在职操作培训方法。展开更多
基金supported by the Fund for Innovative Research Group of the National Natural Science Foundation of China (Grant No.52221003)。
文摘The spatial optimization of best management practices(BMPs) plays a critical role in precise watershed pollution control. However, the effectiveness of BMPs exhibits a complex nonlinear dependence on both configuration unit scale and rainfall intensity, often leading to widespread spatiotemporal mismatches during implementation. To fill this gap, this study proposes a new framework:(a) delineating configuration units based on the implementation scale differences between structural and nonstructural BMPs;(b) incorporating BMP reduction thresholds to enable dynamic adjustment of design scales according to inflow loads;and(c) developing a staged allocation strategy tailored to varying rainfall scenarios. The framework is exemplified by an agricultural catchment in the southeastern Liaohe watershed, China. The results showed that the framework could improve the assessment accuracy and cost-effectiveness of pollution control. Specifically, neglecting BMP reduction thresholds resulted in a 51.35% underestimation of treatment costs. Incorporating these thresholds and dynamically adjusting BMP design scales reduced treatment costs by 62.70%. Furthermore, the framework facilitated more precise localization of structural BMPs(1 km^(2)) and improved optimization efficiency by 95.91%. The proposed staged allocation strategy ensured water quality compliance under varying rainfall intensities. Structural BMPs primarily addressed pollution from light to moderate rainfall in the initial stage, while nonstructural BMPs targeted heavy rainfall pollution in the subsequent stage. The proposed framework may enhance the spatiotemporal adaptability of BMP configuration to respond to the threats posed by climate change and human activities. It can also be extended to other agriculture-dominated watersheds.
文摘Objective:To explore the application of the Registered Nurses'Association of Ontario(RNAO)Best Practice Guideline(BPG)for Developing and Sustaining Nursing Leadership through the lens of nursing students transitioning from classroom learning to clinical practice.Through this reflection,the authors hope to inspire and empower future nursing leaders to champion innovation,resilience,and excellence in healthcare.Methods:By integrating evidence-based leadership principles,the authors reflect on their personal experiences,challenges,and successes in implementing these guidelines in real-world settings.Results:The paper highlights the significance of leadership in fostering healthy work environments and improving patient outcomes,emphasizing the role of nursing students as emerging leaders.Practical strategies for applying BPG,the RNAO BPG suggests leadership skills on professional development,and recommendations for embedding leadership principles into nursing education and practice are discussed.Conclusions:Implementing nursing leadership from the beginning of a nursing student's journey is vital for shaping the next generation of healthcare leaders.By integrating leadership principles early in nursing education,students can develop the skills needed to navigate clinical challenges,collaborate effectively with healthcare teams,and advocate for positive change.Starting with leadership guidelines in nursing school ensures that future nurses are equipped to foster supportive work environments,improve patient outcomes,and drive innovation from the very start of their careers,making leadership an inherent part of their professional identity.
文摘Objectives This study aimed to compare the effectiveness of the semi-virtual simulation and traditional simulation teaching models based on the Standards of Best Practice(SOBP)according to the International Nursing Association for Clinical Simulation and Learning(INACSL)in the Adult Nursing course.Methods This study used a quasi-experimental design.A total of 94 third-year nursing students from a university in Beijing between November and December 2022 were recruited as participants.An innovative semi-virtual simulation teaching model was designed based on the SOBP established by the INACSL.In the Adult Nursing course,both the semi-virtual and traditional simulation teaching models were implemented.At the end of the simulation sessions,participants completed the Chinese version of the Simulation Effectiveness Tool-Modified(SET-M)to assess the effectiveness of the two teaching models.Results All nursing students completed the simulation sessions.There was no difference(t=−0.93,P=0.353)in the total scores between the semi-virtual simulation teaching model(50.87±5.30)and the traditional simulation teaching model(50.37±5.16).However,there was a statistically significant difference(t=−2.65,P=0.010)in the prebriefing section(semi-virtual simulation:5.60±0.71;traditional simulation:5.33±0.78).In contrast,no statistically significant differences were found for the scenario and debriefing sections(P>0.05).At the individual item level,statistical differences(P<0.05)between the two models were identified for items 1 and 9,but not for the remaining items(P>0.05).By analyzing the open-ended question,it was found that both simulation models were effective,and students’comments were similar.Conclusions The study demonstrated equivalent effectiveness between the semi-virtual and traditional simulation teaching models.Semi-virtual simulation teaching model could offer a more flexible and feasible approach to simulation teaching.
文摘In this study,we examine the problem of sliced inverse regression(SIR),a widely used method for sufficient dimension reduction(SDR).It was designed to find reduced-dimensional versions of multivariate predictors by replacing them with a minimally adequate collection of their linear combinations without loss of information.Recently,regularization methods have been proposed in SIR to incorporate a sparse structure of predictors for better interpretability.However,existing methods consider convex relaxation to bypass the sparsity constraint,which may not lead to the best subset,and particularly tends to include irrelevant variables when predictors are correlated.In this study,we approach sparse SIR as a nonconvex optimization problem and directly tackle the sparsity constraint by establishing the optimal conditions and iteratively solving them by means of the splicing technique.Without employing convex relaxation on the sparsity constraint and the orthogonal constraint,our algorithm exhibits superior empirical merits,as evidenced by extensive numerical studies.Computationally,our algorithm is much faster than the relaxed approach for the natural sparse SIR estimator.Statistically,our algorithm surpasses existing methods in terms of accuracy for central subspace estimation and best subset selection and sustains high performance even with correlated predictors.
文摘Jiang Shaohong is my best friend.He is 14years old and he is in Class 1,Grade 8.He is clever and can learn things quickly.He works hard at all his subjects.He has many hobbies,such as reading,singing,dancing,and playing sports.He loves animals,so he keeps a small dog as a pet and takes good care of it at home.He is kind and helpful.He often helps his classmates with their studies.
文摘I have a best friend・His name is Li Xuan・We live in the same neighborhood and go to the same school.Li Xuan is a kind and clever boy.He always smiles and is ready to help others.One day,I had a problem with my math homework and I was very worried.
基金Supported by International Centre for Genetic Engineering and BiotechnologyHarry Crossley Foundation at the University of Cape Town.
文摘BACKGROUND Sub-Saharan Africa(SSA)and Southeast Asia account for 80%of hepatocellular carcinoma(HCC)cases globally.Public healthcare systems in low-and middleincome countries often face significant economic constraints,resulting in limited treatment options.The objectives of this study were to identify factors associated with poor outcomes in patients with Barcelona Clinic Liver Cancer(BCLC)stage C and D undergoing transarterial chemoembolization(TACE)and to compare their outcomes to patients treated tyrosine kinase inhibitors(TKIs)or best supportive care(BSC)only.AIM To assess clinical outcomes and identify predictive factors that may facilitate the broader implementation of TACE in patients with advanced HCC within resource-constrained settings such as SSA.METHODS A single-center,retrospective cohort study was conducted to investigate the risk factors associated with the outcome of TACE in patients with BCLC stage C and D using univariate and multivariate regression analysis.Frequency matching was used to ensure comparable distributions of confounding factors across patients treated with TACE,TKIs,or BSC.Survival analysis was performed to compare outcomes among the matched groups.RESULTS Patients with BCLC stage C and D presenting with elevated gamma-glutamyl transferase levels or elevated aspartate aminotransferase levels or portal vein infiltration were identified as high-risk and demonstrated poor response to TACE treatment.In contrast,patients with BCLC stage C disease who lacked these highrisk features showed significantly longer overall survival when treated with TACE compared to those who received BSC or TKIs.CONCLUSION Gamma-glutamyl transferase levels,aspartate aminotransferase levels,and portal vein infiltration are critical risk factors to consider when determining treatment strategies for HCC patients in SSA.Patients without these factors can derive significant benefits from TACE as an alternative to BSC or TKIs.
文摘目的:调查BEST(better&systematic team training)培训法在护士PDA静脉输液查对培训中的效果。方法:采用BEST培训法,包括理论授课+讨论+操作练习+反馈性汇报+录像回放+分析总结流程等对护士进行查对培训,并调查培训的效果。结果:护士长及骨干和科室普通护士在培训后视频纠错的得分均高于培训前(P<0.001);科室护士查对培训前后得分差异与学历(r=-0.167,P=0.007)、年龄(r=-0.136,P=0.030)、工作年限(r=-0.154,P=0.014)呈负相关,即学历越低,年龄越小,工作年限越短,培训前后得分差异越大,效果越好。结论:BEST训练法能有效提高护士,尤其是低年资护士的查对意识,强化操作流程,是一种理想、科学的在职操作培训方法。
