The functional and structural integrity of the blood-brain barrier is crucial in maintaining homeostasis in the brain microenvironment;however,the molecular mechanisms underlying the formation and function of the bloo...The functional and structural integrity of the blood-brain barrier is crucial in maintaining homeostasis in the brain microenvironment;however,the molecular mechanisms underlying the formation and function of the blood-brain barrier remain poorly understood.The major facilitator superfamily domain containing 2A has been identified as a key regulator of blood-brain barrier function.It plays a critical role in promoting and maintaining the formation and functional stability of the blood-brain barrier,in addition to the transport of lipids,such as docosahexaenoic acid,across the blood-brain barrier.Furthermore,an increasing number of studies have suggested that major facilitator superfamily domain containing 2A is involved in the molecular mechanisms of blood-brain barrier dysfunction in a variety of neurological diseases;however,little is known regarding the mechanisms by which major facilitator superfamily domain containing 2A affects the blood-brain barrier.This paper provides a comprehensive and systematic review of the close relationship between major facilitator superfamily domain containing 2A proteins and the blood-brain barrier,including their basic structures and functions,cross-linking between major facilitator superfamily domain containing 2A and the blood-brain barrier,and the in-depth studies on lipid transport and the regulation of blood-brain barrier permeability.This comprehensive systematic review contributes to an in-depth understanding of the important role of major facilitator superfamily domain containing 2A proteins in maintaining the structure and function of the blood-brain barrier and the research progress to date.This will not only help to elucidate the pathogenesis of neurological diseases,improve the accuracy of laboratory diagnosis,and optimize clinical treatment strategies,but it may also play an important role in prognostic monitoring.In addition,the effects of major facilitator superfamily domain containing 2A on blood-brain barrier leakage in various diseases and the research progress on cross-blood-brain barrier drug delivery are summarized.This review may contribute to the development of new approaches for the treatment of neurological diseases.展开更多
Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for...Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for Implementation Research(CFIR).Methods The sample consisted of 17 nurses from three urology wards at a tertiary hospital in Beijing,China,who had participated in the EBP.Guided by the CFIR,we identified constructs influencing the sustainability of implementation by conducting a directed content analysis of the 17 individual in-depth interviews.By rating,the valence and magnitude of each construct were determined.Results This study identified 19 factors across the five domains of the CFIR.Among these determinants,16 were identified as barriers,while three were recognized as facilitators.Common barriers across different contexts were identified,such as delayed evidence updating,the complexity of intervention components and steps,and incompatibility between the implementation process and clinical practices.In contrast,facilitators of intervention implementation were regular communication and feedback,support and drive from principals and a positive cultural atmosphere.In addition,we identified“regular evidence updating”as an independent construct outside of the CFIR,a finding that will provide key information for updating the CFIR framework.Conclusions Regular evidence updating is crucial for the sustainability of EBP implementation.Researchers should receive consistent feedback from practitioners and adjust or modify the EBP as necessary.Additionally,researchers must consider the compatibility or adaptability of the EBP’s content with clinical practice in formulating it rather than adding additional complexity to the original workflow.展开更多
Major facilitator superfamily(MFS)transporters are secondary active membrane transporters that play an important role in solute interchange and energy metabolism.Peronophythora litchii causes the most destructive dise...Major facilitator superfamily(MFS)transporters are secondary active membrane transporters that play an important role in solute interchange and energy metabolism.Peronophythora litchii causes the most destructive disease on lichi,litchi downy blight.PlM90 was reported as a key oosporogenesis regulator.Here,we identified an MFS transporter gene PlMFS1,which is up-regulated during oospore formation at the late infection stage,while down-regulated in the PlM90 mutant.To investigate PlMFS1 function,we generated PlMFS1knockout mutants using CRISPR/Cas9-mediated genome editing technology.Compared with the wild-type strain SHS3,PlMFS1 deletion impaired mycelium growth,zoospore release,oospore production and pathogenicity.Furthermore,PlMFS1 deletion significantly affected P.litchii utilization of fructose,lactose and maltose,and may be the PlMFS1 mechanism involved in mycelial growth.PlMFS1 gene deletion also led to deceased laccase activity,laccase-encoding gene downregulation and impaired P.litchii pathogenicity.To our knowledge,this is the first report of an MFS transporter involved in sugar utilization,sexual reproduction,asexual reproduction and pathogenesis in oomycetes.展开更多
Objective:To understand the facilitators and barriers for frail kidney transplant recipients(KTRs)practicing Baduanjin,and to provide a theoretical basis for developing intervention strategies.Subjects and Methods:Sem...Objective:To understand the facilitators and barriers for frail kidney transplant recipients(KTRs)practicing Baduanjin,and to provide a theoretical basis for developing intervention strategies.Subjects and Methods:Semi-structured interviews were conducted with 10 frail KTRs who participated in a 3-month Baduanjin practice.The Colaizzi seven-step analysis method was used to analyze,summarize,and extract themes from the interview data.Results:Two themes were extracted:facilitators and barriers.Facilitators included intrinsic motivation and perceived benefits,while barriers included conflicts with practice time,worsening physical condition,lack of immediate benefits,and difficulty integrating into daily life.Conclusion:The practice of Baduanjin by frail KTRs is influenced by various factors.Healthcare professionals should develop personalized intervention plans that take into account these factors and the needs of the patients.展开更多
Background:Community-based first responders face high levels of workplace stressors that can pro-foundly impact their physical and mental health.Mindfulness-based interventions have shown promise in decreasing stress ...Background:Community-based first responders face high levels of workplace stressors that can pro-foundly impact their physical and mental health.Mindfulness-based interventions have shown promise in decreasing stress and increasing psychological resilience;however,implementation is difficult due to unpredictability of the job,department culture,and generational preferences.The objective of this qualitative study was to identify and enhance understanding of the specific needs and potential barriers and facilitators for the implementation of mindfulness-based programming for community-based first responders.Methods:A phenomenological qualitative study design was used to gain insights into the lived experiences of first responders and elicit perceptions regarding barriers and facilitators for engaging in mindfulness activities.During virtual semi-structured interviews,eleven career firefighters and emergency medical service(EMS)providers offered feedback relative to worksite mindfulness practices,and the use of a stress reduction smartphone application.The Consolidated Framework for Implementation Research was used to guide the analysis relative to barriers and facilitators of implementation success and sustainability.Results:First responders expressed openness to mindfulness-based interventions and a smartphone app that would provide stress reduction content,however,they were adamant that programming needed to be accessible and easily integrated into their workday.They also reinforced that organizational culture and leadership support for their health and well-being were overarching factors essential for implementation success.Conclusions:First responders were supportive of evidence-based mindfulness practices,optimally developed and/or facilitated by someone with intimate knowledge of their unique work environments and challenges.Organizational culture and leadership support were essential for implementation success and sustainability.展开更多
Background: Evidence-based practice (EBP) is vital for high-quality patient care, yet its implementation among physiotherapists in sub-Saharan Africa (SSA) faces significant challenges. This scoping review explores th...Background: Evidence-based practice (EBP) is vital for high-quality patient care, yet its implementation among physiotherapists in sub-Saharan Africa (SSA) faces significant challenges. This scoping review explores the barriers and facilitators of EBP in this region. Objectives: To identify barriers and facilitators of EBP at individual, organisational, and extra organisational levels among physiotherapists in SSA. Methods: A comprehensive literature search was conducted across PubMed, Sabinet, BioMed Central, and Google Scholar. Seven studies from Ghana, Nigeria, Cameroon, Benin, Kenya, Zimbabwe and South Africa met the inclusion criteria. Results: Key barriers at the practitioner level included lack of time, insufficient knowledge of EBP, limited access to information resources, and inadequate research skills. Facilitators comprised positive attitudes toward EBP and a desire for further knowledge. At the organisational level, resource unavailability emerged as a major barrier. Notably, no studies addressed extra organisational factors. Conclusion: This review highlights critical barriers and facilitators of EBP among SSA physiotherapists and emphasises the need for further research on extra organisational influences. Addressing systemic challenges is essential for enhancing physiotherapist engagement in EBP, ultimately improving patient care and outcomes in sub-Saharan Africa.展开更多
Objective: The objective of the study was to identify facilitators and barriers to emergency medical service use among acute ischemic stroke patients in Korea.Methods: This paper presents a secondary analysis of a ret...Objective: The objective of the study was to identify facilitators and barriers to emergency medical service use among acute ischemic stroke patients in Korea.Methods: This paper presents a secondary analysis of a retrospective survey that collected data from questionnaires and medical records.Among 233 acute ischemic stroke patients enrolled in a large-scale study,160 patients who had arrived at a hospital within 72 h after symptom onset were included in the data analysis.Results: Users of emergency medical services needed a shorter time than non-users to arrive at hospital (140 min vs.625 min.,p =0.001) and were more likely to arrive at hospital within 3 h of symptom onset (51.9% vs.31.5%,p =0.013).For those who first contacted emergency medical service,the facilitators of emergency medical service use were the presence of hemiparesis (p =0.003),bilateral paralysis (p =0.040),and loss of balance (p =0.021).The predominant barrier was the failure to recognize the urgency of symptoms (p 0.006).Conclusions: The use of emergency medical services reduced prehospital delay and increased the likelihood of patient arrival at hospital within 3 h.Given that experiencing typical stroke symptoms was a facilitator of emergency medical service use yet failure to recognize the urgency of symptoms was a barrier,public awareness should be raised as regards stroke symptoms and the benefits of using emergency medical services.展开更多
The concepts of patient and public involvement (PPI) have been recognized and linked with quality in health services internationally and in Europe. In England, for more than a decade, NHS policies have increasingly qu...The concepts of patient and public involvement (PPI) have been recognized and linked with quality in health services internationally and in Europe. In England, for more than a decade, NHS policies have increasingly quoted patient-centred services. Limited evidence exists about the implementation of PPI policies and strategies within organisations;three studies only have explored health professionals’ perceptions of PPI. Although nurses’ positive support for patient and public involvement has been noted, comparatively little is known about senior nurses’ experiences of embedding PPI. A national consultation utilising three focus groups aimed to explore senior nurses’ perceptions of challenges and facilitators for PPI implementation. Four Strategic Health Authorities (SHAs) and eleven Primary Care Trusts (PCTs) in England, with fifteen senior nurses with leadership roles and direct PPI experience, participated. Nurses’ perceptions on patient and public involvement, challenges and facilitators for its implementation were discussed. Focus groups were digitally recorded and transcribed verbatim;anonymised transcripts were validated by participants and analysed with thematic analysis. Limited resources, patient representation and recruitment, complexities of implementing PPI and national policy changes were challenging. Commissioning limitations, lack of feedback on patient experience, limited staff awareness, negative attitudes, management of patients and public expectations constituted further challenges. Nursing role characteristics and informal involvement activities, PPI policy and cultural change, commissioning PPI competencies, related service frameworks, providing feedback on patient experiences to staff and recognition of involvement benefits were recognised as facilitators. Findings provided new insights into senior nurses’ experiences and evidence that progress towards meaningful, effective PPI remains slow. However, recognition of existing nursing role characteristics and potential delivery problems created by expanded nursing roles, informal PPI practice and internal organisational sharing of patient feedback may bring an “emerging productive partnership” with nurses enabling and contributing to effective PPI.展开更多
BACKGROUND Cardiovascular diseases(CVD)have been shown to be the greatest cause of death worldwide and rates continue to increase.It is recommended that CVD patients attend cardiac rehabilitation(CR)following a cardia...BACKGROUND Cardiovascular diseases(CVD)have been shown to be the greatest cause of death worldwide and rates continue to increase.It is recommended that CVD patients attend cardiac rehabilitation(CR)following a cardiac event to reduce mortality,improve recovery and positively influence behaviour around CVD risk factors.Despite the recognised benefits and international recommendations for exercisebased CR,uptake and attendance remain suboptimal.A greater understanding of CR barriers and facilitators is required,not least to inform service development.Through understanding current cardiac patients’attitudes and opinions around CR and physical activity(PA)could inform patient-led improvements.Moreover,through understanding aspects of CR and PA that participants like/dislike could provide healthcare providers and policy makers with information around what elements to target in the future.AIM To investigate participants’attitudes and opinions around CR and PA.METHODS This study employed a cross-sectional survey design on 567 cardiac patients.Cardiac patients who were referred for standard CR classes at a hospital in the Scottish Highlands,from May 2016 to May 2017 were sampled.As part of a larger survey,the current study analysed the free-text responses to 5 open-ended questions included within the wider survey.Questions were related to the participants’experience of CR,reasons for non-attendance,ideas to increase attendance and their opinions on PA.Qualitative data were analysed using a 6-step,reflexive thematic analysis.RESULTS Two main topic areas were explored:“Cardiac rehabilitation experience”and“physical activity”.Self-efficacy was increased as a result of attending CR due to exercising with similar individuals and the safe environment offered.Barriers ranged from age and health to distance and starting times of the classes which increased travel time and costs.Moreover,responses demonstrated a lack of information and communication around the classes.Respondents highlighted that the provision of more classes and classes being held out with working hours,in addition to a greater variety would increase attendance.In terms of PA,respondents viewed this as different to the CR experience.Responses demonstrated increased freedom when conducting PA with regards to the location,time and type of exercise conducted.CONCLUSION Changes to the structure of CR may prove important in creating long term behaviour change after completing the rehabilitation programme.展开更多
The application of technology in health care, in the form of electronic health records (EHR), is the most important and necessary issue in order to improve the quality of health care, and studies have shown that, not ...The application of technology in health care, in the form of electronic health records (EHR), is the most important and necessary issue in order to improve the quality of health care, and studies have shown that, not only is it a way to integrate information and represent the condition of patients, and a dynamic source for health care, however it leads to gain access to clinical information and records, electronic communications, comprehensive training and management, and ultimately enhancing the public health;the aim of this study is to investigate the factors influencing the implementation of EHR, which are known as barriers and facilitators. The research is conducted in the form of a review research, and with the help of the Keywords of EHR;barriers and facilitators, articles, from 2008 to 2013, were searched and studied in the Internet-databases. The results of the studies show that the most effective factors include: efficiency, motivation, management, and the participation of end users. Factors such as technical aspects ease of use, available resources, and human resources, have limited effects. And security and privacy, the expected output, lack of time, and workload have relative effects, and also the relation between the patient and clinical staff, has no effects in the process of implementing EHR.展开更多
Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is important to promote uptake of family planning services because it is one of the four pillars of...Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is important to promote uptake of family planning services because it is one of the four pillars of the Safe Motherhood Initiative to reduce maternal death in developing countries. It is also enshrined in health related Sustainable Development Goals. Post Partum Intra Uterine Contraceptive Device (PPIUCD) is the oldest methods of family planning. During the ancient times, foreign bodies like stones were introduced into the woman’s uterus for prevention of pregnancy. Post partum method of contraception is highly recommended because it is long acting, convenient, safe and highly effective with minimal side effects compared to the hormonal methods. Despite these advantages, the method is the lowest in use globally, regionally and locally. According to the Meru Hospital records for the year 2017, the immediate PPIUCD uptake was very low at 3.4%. The broad objective of this study was to assess the factors that facilitate uptake of PPIUCD at Meru Hospital. The study site was post natal ward maternity department of Meru Hospital for a period of two months that is September and October in the year 2018. A descriptive research design was used and the study population was the mothers who were admitted in the ward during the study period. A sample size of 74 respondents was used as the representative to the target population of 289 mothers. Simple random sampling was used to get the sample for the facilitators. Data were collected using structured questionnaires and interview schedules. The data collection instruments were pretested at Embu Level five Hospital and split half reliability test technique used. Validity was ensured through review of literature from similar studies and by consulting supervisors in the department. Permission to conduct the study was sought from National Commission for Science, Technology and Innovation through Chuka University Ethics and Research Committee. Descriptive analysis was done to get percentages using Statistical Package for Social Science (SPSS) for windows version 23.0. Qualitative data were analyzed by grouping data into themes according to the study objectives. The analyzed data were presented in tables, charts and narratives. The findings of the study revealed that;the main client related facilitators to PPIUCD uptake were older age above 30 years, employment, tertiary level of education and knowledge on the method as a result of the providers’ effort to share information. That is 70% of older aged mothers, 60% of the employed and 40% with tertiary education had the insertion. The main provider facilitator to PPIUCD uptake was timely counseling and insertion services. 20% of those who had the insertion said that timely counseling was done during antenatal period. The main method related facilitator to PPIUCD uptake was past experience and preference to alternative methods of contraception. 50% of those who accepted the insertion had previous bad experience and side effects of other alternative methods. Some 30% of users perceived that the method was effective and convenient because once inserted no need for frequent visits to the clinic. The study concluded that clients, providers and method factors facilitated uptake of immediate PPIUCD. The study recommends putting in place strategies to improve the uptake of the method by considering the client, provider and method related facilitators.展开更多
It is well known that the incorporation of research findings into practice leads to less costs of health care, more personal productivity, longer and healthier lives for patients, and also will decrease pain and suffe...It is well known that the incorporation of research findings into practice leads to less costs of health care, more personal productivity, longer and healthier lives for patients, and also will decrease pain and suffering of patients. Thus, the aim of this integrative review was to identify the barriers and facilitators of research utilization among the world and the best strategies used to overcome the barriers. A literature search was conducted by viewing relevant studies via computerized searching through EBSCO, Medline, Science Direct, Pub Med, Ovid, and Arabic Journals research databases. The number of reviewed studies was 192 and all of them in English, no studies in Arabic. Only 26 of them were selected based on inclusion criteria. Twenty six studies were included, with most using a cross-sectional survey design. The most identified barriers are lack of time, inadequate facilities and resources to implement new ideas, no enough authority to implement new ideas, lack of administrative support and others, while the most identified suggested that facilitators are improving the scientific knowledge of nurses and support from unit managers. The majority of these studies used Barriers scale which is not a standardized tool. However, there is a big gap between real situation and the identified evidences resulted from researches.展开更多
There is a higher Human Papilloma Virus peak prevalence in younger women (18 - 25 years) of university age. The undergraduate university students are more at a risk of acquiring cervical cancer because they are at the...There is a higher Human Papilloma Virus peak prevalence in younger women (18 - 25 years) of university age. The undergraduate university students are more at a risk of acquiring cervical cancer because they are at the stage of exploring which predisposes them to risky behavior like early sexual intercourse and multiple sexual partners among others. This creates a need for cervical cancer screening in the population. The facilitators and barriers to cervical cancer screening have been studied in the Ugandan general population but little is known among University students which this study is taking interest. <strong>Objective: </strong>This study is aimed at determining the facilitators, barriers and background factors associated to cervical cancer screening among female undergraduate students in Makerere University. <strong>Methods: </strong>Four hundred twenty-two (422) female undergraduate students of Makerere University who fit the eligibility criteria were recruited in this descriptive cross-sectional quantitative study. A self-administered semi structured questionnaire was administered to these participants chosen by convenient sampling. Data collected was analyzed using SPSS version 23 software and logistic regression models was used. <strong>Results:</strong> Less than a half of (21.1%) of the participants had ever screened for cervical cancer. At multivariate analysis, only year of study and married status were associated to cervical cancer screening with a P-values were of (0.015) and (0.001) with a (1.173 - 4.261) and (1.594 - 6.130) 95% CI respectively. The facilitators agreed upon by participants included: Access to free cervical cancer screening services, adequate knowledge about cervical cancer screening and advice from a friend, family or physician among others. The reported barriers to screening were fear of bad result, low risk perception and fear of embarrassment among others. <strong>Conclusions and Recommendations: </strong>Among the female undergraduate students of Makerere University, only 21.1% had screened for cervical cancer. Therefore, there is a critical need for university based cancer education campaign on cervical cancer and the benefits of screening. Screening services should be integrated into the existing university medical services.展开更多
Objective:This study aimed to investigate the nurses’perspectives on open family visitation and its barriers and facilitators in neonatal intensive care units(NICUs).Methods:This is a descriptive,cross-sectional stud...Objective:This study aimed to investigate the nurses’perspectives on open family visitation and its barriers and facilitators in neonatal intensive care units(NICUs).Methods:This is a descriptive,cross-sectional study.A total of 113 nurses employed in 3 main NICUs of Tabriz participated in the study through the census sampling method.Nurses’perspectives on open visitation and its facilitators and barriers were assessed and analyzed using the Beliefs and Attitudes toward Visitation in NICU Questionnaire(BAVNIQ)and descriptive and analytical statistics,respectively.Results:Approximately 74%of the nurses who participating in the study had a moderate perspective on open visitation.From the nurses’viewpoint,“Parents’low awareness of sensitivity and hygienic principles of the NICU”was the first(90.3%)barrier,and the 2 factors,namely,“physical structure of the ward/lack of sufficient space”and“far distance between family’s residence and the hospital/having another child,”were the second(86.8%)barrier with an equal percentage.Among the facilitating factors,“Supporting employed parents during the neonate’s hospitalization”and“providing facilities for family accommodation in the hospital”were the first(82.3%)and the second(79.6%)facilitators,respectively,for open visitation.Conclusions:The majority of NICU nurses had a moderate perspective on the family open visitation.This reluctance seems to be originated mainly from the factors inhibiting open visitation,making its implementation challenging for nurses.The perspective of the frontline staff in caring for vulnerable infants on facilitators and barriers to open visitation may help policymakers,managers,and relevant officials in decision-making and implementing new visiting policies in the NICUs.展开更多
Background: The purpose of this study was to clarify the effects of a facilitator training course focused on teaching beginners facilitator intervention skills. Intervention Method: One-and-a-half-day program combinin...Background: The purpose of this study was to clarify the effects of a facilitator training course focused on teaching beginners facilitator intervention skills. Intervention Method: One-and-a-half-day program combining education, role plays and relaxation. Methods: Participants were 11 participants, and of these 8 gave valid responses to our questionnaire. The scores of the participants on a facilitator intervention skills scale and on a scale of facilitator skills to cope with difficult situations were compared before and after the course, using SPSS16 for windows. In addition, the participants’ impressions before and after the course were analyzed qualitatively and inductively. Results: Seven of the 16 items on the facilitator intervention skills scale and 7 of the 12 items on the facilitator skills to cope with difficult situations improved the participants after the facilitator training. All participants indicated that they could understand the lectures. Their impressions changed from anxiety and enthusiasm to pleasure of learning and discovery of specific problems. Conclusion: The results suggested that the educational method created in this study, with emphasis on role-playing, is useful.展开更多
In this paper, the author provides a representation of Italian public hospital facilitators （HFs） （clinics, regional or local community hospitals, and medical centers） by means of different types of networks. Movi...In this paper, the author provides a representation of Italian public hospital facilitators （HFs） （clinics, regional or local community hospitals, and medical centers） by means of different types of networks. Moving from the balance scorecards of HFs, the author has analyzed the representation of those data through the use of the minimum spanning tree （MST） and the planar maximally-filtered graph （PMFG）. This paper firstly examined the amount of information provided by the two networks and then run a sensitivity analysis of the networks by varying the elements of the balance scorecards to be considered. In this way, the author obtained a quite unusual representation of the overall economic situation of Italian HFs. Moreover, the author observed the emergence of patterns which in the author＇s opinion might help policy makers to realize a more efficient allocation of financial resources among the existing HFs.展开更多
This paper introduces a dynamic facilitating mechan is m for the integration of process planning and scheduling in a batch-manufacturi ng environment. This integration is essential for the optimum use of production re...This paper introduces a dynamic facilitating mechan is m for the integration of process planning and scheduling in a batch-manufacturi ng environment. This integration is essential for the optimum use of production resources and generation of realistic process plans that can be readily executed with little or no modification. In this paper, integration is modeled in two le vels, viz., process planning and scheduling, which are linked by an intelligent facilitator. The process planning module employs an optimization approach in whi ch the entire plan solution space is first generated and a search algorithm is t hen used to find the optimal plan. Based on the result of scheduling module an u nsatisfactory performance parameter is fed back to the facilitator, which then i dentifies a particular job and issues a change to its process plan solution spac e to obtain a satisfactory schedule.展开更多
Background Verticillium dahliae,a soil-borne fungi,can cause Verticillium wilt,and seriously diminish the yield and quality of cotton.However,the pathogenic mechanism of V.dahliae is complex and not clearly understood...Background Verticillium dahliae,a soil-borne fungi,can cause Verticillium wilt,and seriously diminish the yield and quality of cotton.However,the pathogenic mechanism of V.dahliae is complex and not clearly understood at the moment.This study aimed to identify the high-affinity nicotinic acid transporter genes in V.dahliae.The gene expression profiles in V.dahliae following sensing of root exudates from susceptible and resistant cotton varieties were analyzed.The function of VdNAT1 in the pathogenic process of V.dahliae was studied using the tobacco rattle virus(TRV)-based host-induced gene silencing(HIGS)technique.Results Eight high-affinity nicotinic acid transporter genes were identified from V.dahliae through the bioinformatics method.Each protein contains a conserved major facilitator superfamily(MFS)domain,which belongs to the MFS superfamily.Evolutionary relationship analysis revealed that all 8 genes belong to the anion:cation symporter(ACS)subfamily.All proteins have transmembrane domains,ranging from 7 to 12.The expression levels of most VdNAT genes were significantly increased after induction by root exudates from susceptible cotton varieties.Silencing VdNAT1 gene by HIGS significantly inhibited the accumulation of fungal biomass in cotton plants,and alleviated the disease symptoms of cotton.Conclusions Eight VdNAT genes were identified from V.dahliae,and most VdNAT genes was up-regulated after induced by root exudates from susceptible cotton variety.In addition,VdNAT1 is required for the pathogenicity of V.dahliae.Overall,these findings will facilitate the pathogenic molecular mechanism of V.dahliae and provide candidate genes.展开更多
Objective:This study aims to explore the facilitating and hindering factors faced by rehabilitation professionals in providing cognitive rehabilitation services for patients with Post-Stroke Cognitive Impairment(PSCI)...Objective:This study aims to explore the facilitating and hindering factors faced by rehabilitation professionals in providing cognitive rehabilitation services for patients with Post-Stroke Cognitive Impairment(PSCI)in China,offering empirical evidence for optimizing service models.Methods:Using purposive sampling,semi-structured interviews were conducted with 15 rehabilitation professionals from three tertiary hospitals and two community health service centers in Hubei Province from September to November 2023.Audio recordings were transcribed to obtain textual data,which were analyzed using Nvivo 12 software for coding.An inductive thematic analysis approach was employed to distill key themes.Results:The study identified multiple facilitating and hindering factors related to cognitive rehabilitation,summarizing them into four core themes and eight sub-themes:(1)Cognitive Screening:Presence of practical barriers and inadequate professional knowledge,which limited early detection and effective intervention for cognitive impairments;(2)Individualized Rehabilitation:Lack of patient-directed personalized interventions and multidisciplinary team collaboration,affecting patient engagement and rehabilitation outcomes;(3)Lack of Psychological Rehabilitation:The necessity of psychological interventions was emphasized,yet there is a significant scarcity of neuropsychological resources,limiting the implementation of psychological support;(4)Challenges of Community Continuity in Rehabilitation:Severe service discontinuity,with community healthcare institutions facing shortages of professional knowledge and equipment,resulting in patients being unable to receive continuous and effective rehabilitation support after discharge.Conclusion:Current PSCI rehabilitation services face issues such as insufficient staffing,ineffective multidisciplinary team collaboration,and a lack of community resources.Enhancing neuropsychological resources,establishing standardized MDT collaboration processes,and creating a referral system linking hospitals,communities,and families are essential to improve primary care capacity and enhance rehabilitation outcomes for patients.展开更多
基金supported by the National Natural Science Foundation of China,No.82104412(to TD)Shaanxi Provincial Key R&D Program,No.2023-YBSF-165(to TD)+1 种基金the Natural Science Foundation of Shaanxi Department of Science and Technology,No.2018JM7022(to FM)Shaanxi Provincial Key Industry Chain Project,No.2021ZDLSF04-11(to PW)。
文摘The functional and structural integrity of the blood-brain barrier is crucial in maintaining homeostasis in the brain microenvironment;however,the molecular mechanisms underlying the formation and function of the blood-brain barrier remain poorly understood.The major facilitator superfamily domain containing 2A has been identified as a key regulator of blood-brain barrier function.It plays a critical role in promoting and maintaining the formation and functional stability of the blood-brain barrier,in addition to the transport of lipids,such as docosahexaenoic acid,across the blood-brain barrier.Furthermore,an increasing number of studies have suggested that major facilitator superfamily domain containing 2A is involved in the molecular mechanisms of blood-brain barrier dysfunction in a variety of neurological diseases;however,little is known regarding the mechanisms by which major facilitator superfamily domain containing 2A affects the blood-brain barrier.This paper provides a comprehensive and systematic review of the close relationship between major facilitator superfamily domain containing 2A proteins and the blood-brain barrier,including their basic structures and functions,cross-linking between major facilitator superfamily domain containing 2A and the blood-brain barrier,and the in-depth studies on lipid transport and the regulation of blood-brain barrier permeability.This comprehensive systematic review contributes to an in-depth understanding of the important role of major facilitator superfamily domain containing 2A proteins in maintaining the structure and function of the blood-brain barrier and the research progress to date.This will not only help to elucidate the pathogenesis of neurological diseases,improve the accuracy of laboratory diagnosis,and optimize clinical treatment strategies,but it may also play an important role in prognostic monitoring.In addition,the effects of major facilitator superfamily domain containing 2A on blood-brain barrier leakage in various diseases and the research progress on cross-blood-brain barrier drug delivery are summarized.This review may contribute to the development of new approaches for the treatment of neurological diseases.
基金supported by the Peking University Nursing Discipline Research Development Fund(No.TYZH2023001)。
文摘Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for Implementation Research(CFIR).Methods The sample consisted of 17 nurses from three urology wards at a tertiary hospital in Beijing,China,who had participated in the EBP.Guided by the CFIR,we identified constructs influencing the sustainability of implementation by conducting a directed content analysis of the 17 individual in-depth interviews.By rating,the valence and magnitude of each construct were determined.Results This study identified 19 factors across the five domains of the CFIR.Among these determinants,16 were identified as barriers,while three were recognized as facilitators.Common barriers across different contexts were identified,such as delayed evidence updating,the complexity of intervention components and steps,and incompatibility between the implementation process and clinical practices.In contrast,facilitators of intervention implementation were regular communication and feedback,support and drive from principals and a positive cultural atmosphere.In addition,we identified“regular evidence updating”as an independent construct outside of the CFIR,a finding that will provide key information for updating the CFIR framework.Conclusions Regular evidence updating is crucial for the sustainability of EBP implementation.Researchers should receive consistent feedback from practitioners and adjust or modify the EBP as necessary.Additionally,researchers must consider the compatibility or adaptability of the EBP’s content with clinical practice in formulating it rather than adding additional complexity to the original workflow.
基金funded by the Natural Science Foundation of Guangdong Province,China(Grant Nos.2023A1515012617,2022A1515010458 and 2023A1515030267)Guangzhou Science&Technology Program(Grant No.202201010410)the earmarked fund for CARS-32。
文摘Major facilitator superfamily(MFS)transporters are secondary active membrane transporters that play an important role in solute interchange and energy metabolism.Peronophythora litchii causes the most destructive disease on lichi,litchi downy blight.PlM90 was reported as a key oosporogenesis regulator.Here,we identified an MFS transporter gene PlMFS1,which is up-regulated during oospore formation at the late infection stage,while down-regulated in the PlM90 mutant.To investigate PlMFS1 function,we generated PlMFS1knockout mutants using CRISPR/Cas9-mediated genome editing technology.Compared with the wild-type strain SHS3,PlMFS1 deletion impaired mycelium growth,zoospore release,oospore production and pathogenicity.Furthermore,PlMFS1 deletion significantly affected P.litchii utilization of fructose,lactose and maltose,and may be the PlMFS1 mechanism involved in mycelial growth.PlMFS1 gene deletion also led to deceased laccase activity,laccase-encoding gene downregulation and impaired P.litchii pathogenicity.To our knowledge,this is the first report of an MFS transporter involved in sugar utilization,sexual reproduction,asexual reproduction and pathogenesis in oomycetes.
基金funded by the General Program of the National Natural Science Foundation of China(82072553)the Fundamental Research Funds for the Central Universities(2022-JYB-JBZR-026).
文摘Objective:To understand the facilitators and barriers for frail kidney transplant recipients(KTRs)practicing Baduanjin,and to provide a theoretical basis for developing intervention strategies.Subjects and Methods:Semi-structured interviews were conducted with 10 frail KTRs who participated in a 3-month Baduanjin practice.The Colaizzi seven-step analysis method was used to analyze,summarize,and extract themes from the interview data.Results:Two themes were extracted:facilitators and barriers.Facilitators included intrinsic motivation and perceived benefits,while barriers included conflicts with practice time,worsening physical condition,lack of immediate benefits,and difficulty integrating into daily life.Conclusion:The practice of Baduanjin by frail KTRs is influenced by various factors.Healthcare professionals should develop personalized intervention plans that take into account these factors and the needs of the patients.
文摘Background:Community-based first responders face high levels of workplace stressors that can pro-foundly impact their physical and mental health.Mindfulness-based interventions have shown promise in decreasing stress and increasing psychological resilience;however,implementation is difficult due to unpredictability of the job,department culture,and generational preferences.The objective of this qualitative study was to identify and enhance understanding of the specific needs and potential barriers and facilitators for the implementation of mindfulness-based programming for community-based first responders.Methods:A phenomenological qualitative study design was used to gain insights into the lived experiences of first responders and elicit perceptions regarding barriers and facilitators for engaging in mindfulness activities.During virtual semi-structured interviews,eleven career firefighters and emergency medical service(EMS)providers offered feedback relative to worksite mindfulness practices,and the use of a stress reduction smartphone application.The Consolidated Framework for Implementation Research was used to guide the analysis relative to barriers and facilitators of implementation success and sustainability.Results:First responders expressed openness to mindfulness-based interventions and a smartphone app that would provide stress reduction content,however,they were adamant that programming needed to be accessible and easily integrated into their workday.They also reinforced that organizational culture and leadership support for their health and well-being were overarching factors essential for implementation success.Conclusions:First responders were supportive of evidence-based mindfulness practices,optimally developed and/or facilitated by someone with intimate knowledge of their unique work environments and challenges.Organizational culture and leadership support were essential for implementation success and sustainability.
文摘Background: Evidence-based practice (EBP) is vital for high-quality patient care, yet its implementation among physiotherapists in sub-Saharan Africa (SSA) faces significant challenges. This scoping review explores the barriers and facilitators of EBP in this region. Objectives: To identify barriers and facilitators of EBP at individual, organisational, and extra organisational levels among physiotherapists in SSA. Methods: A comprehensive literature search was conducted across PubMed, Sabinet, BioMed Central, and Google Scholar. Seven studies from Ghana, Nigeria, Cameroon, Benin, Kenya, Zimbabwe and South Africa met the inclusion criteria. Results: Key barriers at the practitioner level included lack of time, insufficient knowledge of EBP, limited access to information resources, and inadequate research skills. Facilitators comprised positive attitudes toward EBP and a desire for further knowledge. At the organisational level, resource unavailability emerged as a major barrier. Notably, no studies addressed extra organisational factors. Conclusion: This review highlights critical barriers and facilitators of EBP among SSA physiotherapists and emphasises the need for further research on extra organisational influences. Addressing systemic challenges is essential for enhancing physiotherapist engagement in EBP, ultimately improving patient care and outcomes in sub-Saharan Africa.
文摘Objective: The objective of the study was to identify facilitators and barriers to emergency medical service use among acute ischemic stroke patients in Korea.Methods: This paper presents a secondary analysis of a retrospective survey that collected data from questionnaires and medical records.Among 233 acute ischemic stroke patients enrolled in a large-scale study,160 patients who had arrived at a hospital within 72 h after symptom onset were included in the data analysis.Results: Users of emergency medical services needed a shorter time than non-users to arrive at hospital (140 min vs.625 min.,p =0.001) and were more likely to arrive at hospital within 3 h of symptom onset (51.9% vs.31.5%,p =0.013).For those who first contacted emergency medical service,the facilitators of emergency medical service use were the presence of hemiparesis (p =0.003),bilateral paralysis (p =0.040),and loss of balance (p =0.021).The predominant barrier was the failure to recognize the urgency of symptoms (p 0.006).Conclusions: The use of emergency medical services reduced prehospital delay and increased the likelihood of patient arrival at hospital within 3 h.Given that experiencing typical stroke symptoms was a facilitator of emergency medical service use yet failure to recognize the urgency of symptoms was a barrier,public awareness should be raised as regards stroke symptoms and the benefits of using emergency medical services.
文摘The concepts of patient and public involvement (PPI) have been recognized and linked with quality in health services internationally and in Europe. In England, for more than a decade, NHS policies have increasingly quoted patient-centred services. Limited evidence exists about the implementation of PPI policies and strategies within organisations;three studies only have explored health professionals’ perceptions of PPI. Although nurses’ positive support for patient and public involvement has been noted, comparatively little is known about senior nurses’ experiences of embedding PPI. A national consultation utilising three focus groups aimed to explore senior nurses’ perceptions of challenges and facilitators for PPI implementation. Four Strategic Health Authorities (SHAs) and eleven Primary Care Trusts (PCTs) in England, with fifteen senior nurses with leadership roles and direct PPI experience, participated. Nurses’ perceptions on patient and public involvement, challenges and facilitators for its implementation were discussed. Focus groups were digitally recorded and transcribed verbatim;anonymised transcripts were validated by participants and analysed with thematic analysis. Limited resources, patient representation and recruitment, complexities of implementing PPI and national policy changes were challenging. Commissioning limitations, lack of feedback on patient experience, limited staff awareness, negative attitudes, management of patients and public expectations constituted further challenges. Nursing role characteristics and informal involvement activities, PPI policy and cultural change, commissioning PPI competencies, related service frameworks, providing feedback on patient experiences to staff and recognition of involvement benefits were recognised as facilitators. Findings provided new insights into senior nurses’ experiences and evidence that progress towards meaningful, effective PPI remains slow. However, recognition of existing nursing role characteristics and potential delivery problems created by expanded nursing roles, informal PPI practice and internal organisational sharing of patient feedback may bring an “emerging productive partnership” with nurses enabling and contributing to effective PPI.
文摘BACKGROUND Cardiovascular diseases(CVD)have been shown to be the greatest cause of death worldwide and rates continue to increase.It is recommended that CVD patients attend cardiac rehabilitation(CR)following a cardiac event to reduce mortality,improve recovery and positively influence behaviour around CVD risk factors.Despite the recognised benefits and international recommendations for exercisebased CR,uptake and attendance remain suboptimal.A greater understanding of CR barriers and facilitators is required,not least to inform service development.Through understanding current cardiac patients’attitudes and opinions around CR and physical activity(PA)could inform patient-led improvements.Moreover,through understanding aspects of CR and PA that participants like/dislike could provide healthcare providers and policy makers with information around what elements to target in the future.AIM To investigate participants’attitudes and opinions around CR and PA.METHODS This study employed a cross-sectional survey design on 567 cardiac patients.Cardiac patients who were referred for standard CR classes at a hospital in the Scottish Highlands,from May 2016 to May 2017 were sampled.As part of a larger survey,the current study analysed the free-text responses to 5 open-ended questions included within the wider survey.Questions were related to the participants’experience of CR,reasons for non-attendance,ideas to increase attendance and their opinions on PA.Qualitative data were analysed using a 6-step,reflexive thematic analysis.RESULTS Two main topic areas were explored:“Cardiac rehabilitation experience”and“physical activity”.Self-efficacy was increased as a result of attending CR due to exercising with similar individuals and the safe environment offered.Barriers ranged from age and health to distance and starting times of the classes which increased travel time and costs.Moreover,responses demonstrated a lack of information and communication around the classes.Respondents highlighted that the provision of more classes and classes being held out with working hours,in addition to a greater variety would increase attendance.In terms of PA,respondents viewed this as different to the CR experience.Responses demonstrated increased freedom when conducting PA with regards to the location,time and type of exercise conducted.CONCLUSION Changes to the structure of CR may prove important in creating long term behaviour change after completing the rehabilitation programme.
文摘The application of technology in health care, in the form of electronic health records (EHR), is the most important and necessary issue in order to improve the quality of health care, and studies have shown that, not only is it a way to integrate information and represent the condition of patients, and a dynamic source for health care, however it leads to gain access to clinical information and records, electronic communications, comprehensive training and management, and ultimately enhancing the public health;the aim of this study is to investigate the factors influencing the implementation of EHR, which are known as barriers and facilitators. The research is conducted in the form of a review research, and with the help of the Keywords of EHR;barriers and facilitators, articles, from 2008 to 2013, were searched and studied in the Internet-databases. The results of the studies show that the most effective factors include: efficiency, motivation, management, and the participation of end users. Factors such as technical aspects ease of use, available resources, and human resources, have limited effects. And security and privacy, the expected output, lack of time, and workload have relative effects, and also the relation between the patient and clinical staff, has no effects in the process of implementing EHR.
文摘Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is important to promote uptake of family planning services because it is one of the four pillars of the Safe Motherhood Initiative to reduce maternal death in developing countries. It is also enshrined in health related Sustainable Development Goals. Post Partum Intra Uterine Contraceptive Device (PPIUCD) is the oldest methods of family planning. During the ancient times, foreign bodies like stones were introduced into the woman’s uterus for prevention of pregnancy. Post partum method of contraception is highly recommended because it is long acting, convenient, safe and highly effective with minimal side effects compared to the hormonal methods. Despite these advantages, the method is the lowest in use globally, regionally and locally. According to the Meru Hospital records for the year 2017, the immediate PPIUCD uptake was very low at 3.4%. The broad objective of this study was to assess the factors that facilitate uptake of PPIUCD at Meru Hospital. The study site was post natal ward maternity department of Meru Hospital for a period of two months that is September and October in the year 2018. A descriptive research design was used and the study population was the mothers who were admitted in the ward during the study period. A sample size of 74 respondents was used as the representative to the target population of 289 mothers. Simple random sampling was used to get the sample for the facilitators. Data were collected using structured questionnaires and interview schedules. The data collection instruments were pretested at Embu Level five Hospital and split half reliability test technique used. Validity was ensured through review of literature from similar studies and by consulting supervisors in the department. Permission to conduct the study was sought from National Commission for Science, Technology and Innovation through Chuka University Ethics and Research Committee. Descriptive analysis was done to get percentages using Statistical Package for Social Science (SPSS) for windows version 23.0. Qualitative data were analyzed by grouping data into themes according to the study objectives. The analyzed data were presented in tables, charts and narratives. The findings of the study revealed that;the main client related facilitators to PPIUCD uptake were older age above 30 years, employment, tertiary level of education and knowledge on the method as a result of the providers’ effort to share information. That is 70% of older aged mothers, 60% of the employed and 40% with tertiary education had the insertion. The main provider facilitator to PPIUCD uptake was timely counseling and insertion services. 20% of those who had the insertion said that timely counseling was done during antenatal period. The main method related facilitator to PPIUCD uptake was past experience and preference to alternative methods of contraception. 50% of those who accepted the insertion had previous bad experience and side effects of other alternative methods. Some 30% of users perceived that the method was effective and convenient because once inserted no need for frequent visits to the clinic. The study concluded that clients, providers and method factors facilitated uptake of immediate PPIUCD. The study recommends putting in place strategies to improve the uptake of the method by considering the client, provider and method related facilitators.
文摘It is well known that the incorporation of research findings into practice leads to less costs of health care, more personal productivity, longer and healthier lives for patients, and also will decrease pain and suffering of patients. Thus, the aim of this integrative review was to identify the barriers and facilitators of research utilization among the world and the best strategies used to overcome the barriers. A literature search was conducted by viewing relevant studies via computerized searching through EBSCO, Medline, Science Direct, Pub Med, Ovid, and Arabic Journals research databases. The number of reviewed studies was 192 and all of them in English, no studies in Arabic. Only 26 of them were selected based on inclusion criteria. Twenty six studies were included, with most using a cross-sectional survey design. The most identified barriers are lack of time, inadequate facilities and resources to implement new ideas, no enough authority to implement new ideas, lack of administrative support and others, while the most identified suggested that facilitators are improving the scientific knowledge of nurses and support from unit managers. The majority of these studies used Barriers scale which is not a standardized tool. However, there is a big gap between real situation and the identified evidences resulted from researches.
文摘There is a higher Human Papilloma Virus peak prevalence in younger women (18 - 25 years) of university age. The undergraduate university students are more at a risk of acquiring cervical cancer because they are at the stage of exploring which predisposes them to risky behavior like early sexual intercourse and multiple sexual partners among others. This creates a need for cervical cancer screening in the population. The facilitators and barriers to cervical cancer screening have been studied in the Ugandan general population but little is known among University students which this study is taking interest. <strong>Objective: </strong>This study is aimed at determining the facilitators, barriers and background factors associated to cervical cancer screening among female undergraduate students in Makerere University. <strong>Methods: </strong>Four hundred twenty-two (422) female undergraduate students of Makerere University who fit the eligibility criteria were recruited in this descriptive cross-sectional quantitative study. A self-administered semi structured questionnaire was administered to these participants chosen by convenient sampling. Data collected was analyzed using SPSS version 23 software and logistic regression models was used. <strong>Results:</strong> Less than a half of (21.1%) of the participants had ever screened for cervical cancer. At multivariate analysis, only year of study and married status were associated to cervical cancer screening with a P-values were of (0.015) and (0.001) with a (1.173 - 4.261) and (1.594 - 6.130) 95% CI respectively. The facilitators agreed upon by participants included: Access to free cervical cancer screening services, adequate knowledge about cervical cancer screening and advice from a friend, family or physician among others. The reported barriers to screening were fear of bad result, low risk perception and fear of embarrassment among others. <strong>Conclusions and Recommendations: </strong>Among the female undergraduate students of Makerere University, only 21.1% had screened for cervical cancer. Therefore, there is a critical need for university based cancer education campaign on cervical cancer and the benefits of screening. Screening services should be integrated into the existing university medical services.
基金supported by Pediatric Health Research Center,Tabriz University of Medical Sciences(Grant number:IR.TBZMED.REC.1398.585).
文摘Objective:This study aimed to investigate the nurses’perspectives on open family visitation and its barriers and facilitators in neonatal intensive care units(NICUs).Methods:This is a descriptive,cross-sectional study.A total of 113 nurses employed in 3 main NICUs of Tabriz participated in the study through the census sampling method.Nurses’perspectives on open visitation and its facilitators and barriers were assessed and analyzed using the Beliefs and Attitudes toward Visitation in NICU Questionnaire(BAVNIQ)and descriptive and analytical statistics,respectively.Results:Approximately 74%of the nurses who participating in the study had a moderate perspective on open visitation.From the nurses’viewpoint,“Parents’low awareness of sensitivity and hygienic principles of the NICU”was the first(90.3%)barrier,and the 2 factors,namely,“physical structure of the ward/lack of sufficient space”and“far distance between family’s residence and the hospital/having another child,”were the second(86.8%)barrier with an equal percentage.Among the facilitating factors,“Supporting employed parents during the neonate’s hospitalization”and“providing facilities for family accommodation in the hospital”were the first(82.3%)and the second(79.6%)facilitators,respectively,for open visitation.Conclusions:The majority of NICU nurses had a moderate perspective on the family open visitation.This reluctance seems to be originated mainly from the factors inhibiting open visitation,making its implementation challenging for nurses.The perspective of the frontline staff in caring for vulnerable infants on facilitators and barriers to open visitation may help policymakers,managers,and relevant officials in decision-making and implementing new visiting policies in the NICUs.
文摘Background: The purpose of this study was to clarify the effects of a facilitator training course focused on teaching beginners facilitator intervention skills. Intervention Method: One-and-a-half-day program combining education, role plays and relaxation. Methods: Participants were 11 participants, and of these 8 gave valid responses to our questionnaire. The scores of the participants on a facilitator intervention skills scale and on a scale of facilitator skills to cope with difficult situations were compared before and after the course, using SPSS16 for windows. In addition, the participants’ impressions before and after the course were analyzed qualitatively and inductively. Results: Seven of the 16 items on the facilitator intervention skills scale and 7 of the 12 items on the facilitator skills to cope with difficult situations improved the participants after the facilitator training. All participants indicated that they could understand the lectures. Their impressions changed from anxiety and enthusiasm to pleasure of learning and discovery of specific problems. Conclusion: The results suggested that the educational method created in this study, with emphasis on role-playing, is useful.
文摘In this paper, the author provides a representation of Italian public hospital facilitators （HFs） （clinics, regional or local community hospitals, and medical centers） by means of different types of networks. Moving from the balance scorecards of HFs, the author has analyzed the representation of those data through the use of the minimum spanning tree （MST） and the planar maximally-filtered graph （PMFG）. This paper firstly examined the amount of information provided by the two networks and then run a sensitivity analysis of the networks by varying the elements of the balance scorecards to be considered. In this way, the author obtained a quite unusual representation of the overall economic situation of Italian HFs. Moreover, the author observed the emergence of patterns which in the author＇s opinion might help policy makers to realize a more efficient allocation of financial resources among the existing HFs.
文摘This paper introduces a dynamic facilitating mechan is m for the integration of process planning and scheduling in a batch-manufacturi ng environment. This integration is essential for the optimum use of production resources and generation of realistic process plans that can be readily executed with little or no modification. In this paper, integration is modeled in two le vels, viz., process planning and scheduling, which are linked by an intelligent facilitator. The process planning module employs an optimization approach in whi ch the entire plan solution space is first generated and a search algorithm is t hen used to find the optimal plan. Based on the result of scheduling module an u nsatisfactory performance parameter is fed back to the facilitator, which then i dentifies a particular job and issues a change to its process plan solution spac e to obtain a satisfactory schedule.
基金supported by National Natural Science Foundation of China(No.32160615).
文摘Background Verticillium dahliae,a soil-borne fungi,can cause Verticillium wilt,and seriously diminish the yield and quality of cotton.However,the pathogenic mechanism of V.dahliae is complex and not clearly understood at the moment.This study aimed to identify the high-affinity nicotinic acid transporter genes in V.dahliae.The gene expression profiles in V.dahliae following sensing of root exudates from susceptible and resistant cotton varieties were analyzed.The function of VdNAT1 in the pathogenic process of V.dahliae was studied using the tobacco rattle virus(TRV)-based host-induced gene silencing(HIGS)technique.Results Eight high-affinity nicotinic acid transporter genes were identified from V.dahliae through the bioinformatics method.Each protein contains a conserved major facilitator superfamily(MFS)domain,which belongs to the MFS superfamily.Evolutionary relationship analysis revealed that all 8 genes belong to the anion:cation symporter(ACS)subfamily.All proteins have transmembrane domains,ranging from 7 to 12.The expression levels of most VdNAT genes were significantly increased after induction by root exudates from susceptible cotton varieties.Silencing VdNAT1 gene by HIGS significantly inhibited the accumulation of fungal biomass in cotton plants,and alleviated the disease symptoms of cotton.Conclusions Eight VdNAT genes were identified from V.dahliae,and most VdNAT genes was up-regulated after induced by root exudates from susceptible cotton variety.In addition,VdNAT1 is required for the pathogenicity of V.dahliae.Overall,these findings will facilitate the pathogenic molecular mechanism of V.dahliae and provide candidate genes.
基金Ethics Committee of Taihe Hospital in Shiyan City(Project No.:2023XM008)。
文摘Objective:This study aims to explore the facilitating and hindering factors faced by rehabilitation professionals in providing cognitive rehabilitation services for patients with Post-Stroke Cognitive Impairment(PSCI)in China,offering empirical evidence for optimizing service models.Methods:Using purposive sampling,semi-structured interviews were conducted with 15 rehabilitation professionals from three tertiary hospitals and two community health service centers in Hubei Province from September to November 2023.Audio recordings were transcribed to obtain textual data,which were analyzed using Nvivo 12 software for coding.An inductive thematic analysis approach was employed to distill key themes.Results:The study identified multiple facilitating and hindering factors related to cognitive rehabilitation,summarizing them into four core themes and eight sub-themes:(1)Cognitive Screening:Presence of practical barriers and inadequate professional knowledge,which limited early detection and effective intervention for cognitive impairments;(2)Individualized Rehabilitation:Lack of patient-directed personalized interventions and multidisciplinary team collaboration,affecting patient engagement and rehabilitation outcomes;(3)Lack of Psychological Rehabilitation:The necessity of psychological interventions was emphasized,yet there is a significant scarcity of neuropsychological resources,limiting the implementation of psychological support;(4)Challenges of Community Continuity in Rehabilitation:Severe service discontinuity,with community healthcare institutions facing shortages of professional knowledge and equipment,resulting in patients being unable to receive continuous and effective rehabilitation support after discharge.Conclusion:Current PSCI rehabilitation services face issues such as insufficient staffing,ineffective multidisciplinary team collaboration,and a lack of community resources.Enhancing neuropsychological resources,establishing standardized MDT collaboration processes,and creating a referral system linking hospitals,communities,and families are essential to improve primary care capacity and enhance rehabilitation outcomes for patients.
