The building industry has experienced a widespread transition towards green buildings and consequently a growing need for green facilities professionals to maximize green building potential in terms of energy efficien...The building industry has experienced a widespread transition towards green buildings and consequently a growing need for green facilities professionals to maximize green building potential in terms of energy efficiency,water conservation and waste reduc-tion in their operational stage.Green buildings have unique technological systems that require facility managers to have relevant knowledge and skills to conduct proper facilities management and maintenance planning to maximize the potential of green buildings.It is important,then,to investigate whether knowledge gaps for facil-ity managers exist with respect to green buildings,and if so,how these knowledge gaps could be bridged.Though several studies have investigated the operation and maintenance processes of green buildings,few studies considered facility managers’knowledge and skills regarding green facility management(GFM).Set in the context of Singapore,this study aims to holistically investigate the knowledge and skills of managing green buildings in the community of facility managers,including their per-ceived differences between green and conventional buildings,the difficulty of GFM,the knowledge gaps of GFM and the underlying reasons,as well as how the gaps could be bridged.A total of 90 survey responses were collected and eight interviews with key stakeholders were conducted,which indicate facility managers believe green build-ings do have special features that require unique knowledge and skills,and currently knowledge gaps do exist hindering the transition towards GFM.Therefore,this paper derives plausible solutions to bridge the knowledge gaps,such as establishing holistic subsidies for those facility managers participating in training programs of GFM.This study provides references for researchers and relevant governmental departments to better understand industry professionals’knowledge gaps in the transitioning process towards a green built environment,and to make better policy decisions bridging the knowledge gaps and thereby facilitating the green transition process.展开更多
Daily and weekly reporting events of climate change and impacts on populations, cultures, economies and politics at local, national, regional and international scales suggest the need to construct databases that will ...Daily and weekly reporting events of climate change and impacts on populations, cultures, economies and politics at local, national, regional and international scales suggest the need to construct databases that will be useful in future scientific inquiry and global human/environmental policies. That need is evident in constructing a geographic or locational knowledge base that examines countries, regions and cities. This study constructs a database on the impacts of climate change using Google Scholar entries for 200 countries and capital cities. A series of maps reveal the vast unevenness in the database, especially between Global North and Global South countries. The discussion explores these sharp differences and suggests future research topics for much-needed global, interdisciplinary and international research.展开更多
BACKGROUND Heart failure with preserved ejection fraction(HFpEF)following acute myocardial infarction(AMI)carries substantial morbidity and mortality,yet reliable prognostic markers beyond conventional cardiovascular ...BACKGROUND Heart failure with preserved ejection fraction(HFpEF)following acute myocardial infarction(AMI)carries substantial morbidity and mortality,yet reliable prognostic markers beyond conventional cardiovascular factors remain limited.Frailty,reflecting diminished physiological reserve,has emerged as a potential determinant of adverse outcomes in this high-risk population.Therefore,the aim of this study was to address a critical knowledge gap and to provide evidence that may guide frailty-adapted management strategies to improve prognosis and quality of life in this high-risk population.METHODS We conducted a multicenter retrospective cohort study including 4507 patients with HFpEF discharged after AMI across 82 hospitals in China(from January 2010 to March 2024).Frailty was assessed using the Hospital Frailty Risk Score(HFRS),with HFRS<5 defined as non-frail and HFRS≥5 as frail.Multivariable Cox proportional hazards models,adjusted for demographics,comorbidities,left ventricular ejection fraction,and therapies,were applied to evaluate associations between frailty and clinical outcomes.The primary endpoints were all-cause death and major adverse cardiovascular events(MACE),which defined as the composite of cardiovascular death and heart failure rehospitalization.Secondary endpoints included net adverse clinical events(NACE),which defined as the composite of all-cause death,stroke,recurrent myocardial infarction,revascularization,and major bleeding,as well as the individual components of MACE.RESULTS Frailty was independently associated with a higher risk of all-cause death[adjusted hazard ratio(aHR)=1.52,95%CI:1.31–2.03,P=0.005]and NACE(aHR=1.20,95%CI:1.02–1.41,P=0.026).At one year,frail patients had higher unadjusted rates of all-cause death(9.0%vs.2.9%)and NACE(19.8%vs.13.7%)compared with non-frail patients.For cardiovascular death,the association did not reach statistical significance(aHR=1.42,95%CI:0.99–2.03,P=0.053).No significant associations were found for MACE(aHR=1.05,95%CI:0.86–1.28,P=0.636)or heart failure rehospitalization(aHR=0.94,95%CI:0.75–1.19,P=0.616).CONCLUSIONS Frailty,as measured by the HFRS,is an independent predictor of one-year mortality and composite adverse events in post-AMI HFpEF patients.These findings support the use of HFRS at discharge to identify high-risk population who may benefit from closer follow-up,optimization of medical therapy,and targeted frailty-focused interventions.展开更多
Geoscience education is crucial globally,yet its delivery in Malaysian schools remains inadequate despite increasing demand for geological services.This study examines perceptions of 157 newly enrolled students in geo...Geoscience education is crucial globally,yet its delivery in Malaysian schools remains inadequate despite increasing demand for geological services.This study examines perceptions of 157 newly enrolled students in geoscience,geology,and other science-based programs regarding the challenges in bridging the geoscience education gap from primary to pre-university levels in Malaysia.Findings indicate a moderately significant improvement in students'geoscience knowledge,with moderate perspectives on geoscience education before and after entering university.展开更多
International collaboration on the prediabetes and cardiovascular complications study started in 2013.In 2017,a reflection was reported.Incompleteness of documentation and screening of antenatal cases for gestational ...International collaboration on the prediabetes and cardiovascular complications study started in 2013.In 2017,a reflection was reported.Incompleteness of documentation and screening of antenatal cases for gestational diabetes mellitus(GDM)was concerning.Hence,further observations have been made that warrant an update.The objective of this review is to highlight gaps between clinical knowledge and practice in GDM,diabetes self-management and primary health care(PHC)for rural dwellers.We followed a descriptive field notes method.Antenatal records of patients screened for GDM with incomplete documentation were examined to determine incompleteness of data in those that also met the criteria for GDM risk assessment.Experiences on development of a diabetes register and education and notes on behavioural change wheel were also reviewed.Other data included cross-sectional evaluation of activities of daily living at two private hospitals.Up to 29%had high GDM risk factors,which fulfilled selection criteria for laboratory screening.Demographic data was complete in all women;however,incomplete documentation was observed with as much as 98%of basic data.High levels of physical activity were found in the population,and health lectures proved effective in food choices.The workforce need for diabetes care seems underestimated,but this may be better understood with reactivation of PHC services.The observations highlight behavioural change wheel issues on GDM and PHC services that need concerted focus.Two proposals are to advance the use of a‘risk assessment and screening sheet’for GDM screening and enlightenment of stakeholders on the central hub role of PHC in diabetes management.展开更多
Introduction:In 2019,the Chinese State Council launched the“Healthy China Initiative(2019-2030)”,establishing explicit targets for residents’environmental and health literacy(EHL):reaching to 15%by 2022,to 25%,and ...Introduction:In 2019,the Chinese State Council launched the“Healthy China Initiative(2019-2030)”,establishing explicit targets for residents’environmental and health literacy(EHL):reaching to 15%by 2022,to 25%,and over 2030.To identify knowledge gaps and guide targeted interventions,Shanghai implemented five consecutive EHL surveys between 2020 and 2024.Methods:We employed a multi-stage random sampling design across five cross-sectional surveys.Associations with EHL levels were examined usingχ^(2) tests,one-way analysis of variance,generalized linear models,and multivariate logistic regression analyses.Results:Among 11,220 residents aged 15-69 years assessed using the Core Questionnaire for Assessing the EHL of Chinese Residents,mean EHL scores demonstrated steady improvement.Scores increased from 55.28±15.64 points in 2020 to 61.77±15.92 points(2021),62.13±17.14 points(2022),62.03±16.97 points(2023),and 63.14±18.21 points(2024)(P<0.001).The proportion achieving adequate EHL(≥70 points)increased correspondingly,with ageadjusted rates rising from 18.78%in 2020 to 30.18%(2021),33.22%(2022),33.84%(2023),and 42.88%(2024).Among the three primary dimensions,knowledge showed the greatest improvement,increasing from 7.12%to 39.93%.Participants surveyed in 2024 had 3.50-fold higher odds of achieving adequate EHL compared with those in 2020(odds ratio=3.50;95%confidence interval:3.07,4.00).Conclusions:Although educational attainment remained the primary determinant of EHL,targeted public health education campaigns significantly improved EHL among Shanghai residents between 2020 and 2024.展开更多
Human mucosal immunization is expected to afford protection against infection and reduce transmission by generating anti-infective immunity at the mucosal entry site of viruses and bacteria.Nasal or oral administratio...Human mucosal immunization is expected to afford protection against infection and reduce transmission by generating anti-infective immunity at the mucosal entry site of viruses and bacteria.Nasal or oral administration has the advantage of being needle free and self-administered,thereby improving compliance and coverage of large populations.In China,the experience of COVID-19 has promoted substantial efforts in the development of nasal vaccinations in the general health protection strategy.The hurdles we are facing in the development of mucosal vaccines,however,come from the still limited knowledge of the mechanisms controlling mucosal immunity in different anatomical locations and in response to different pathogens/vaccines.Identifying and filling the knowledge gaps in order to develop effective and safe mucosal immunization strategies requires global collaboration,not only at the scientific level but,most importantly,by engaging public and private health organizations,governments,and regulatory authorities.We have highlighted here some of the crucial issues in mucosal immunization and provided suggestions for the way forward toward a global preparedness effort to prevent infectious diseases and ensure vaccine equity.展开更多
Open Science(OS)and Research has reached mixed maturity levels in Finland.The meaning of the national project in the ecosystem of Finnish universities of applied sciences(UAS)is to enhance and elaborate OS and Open Ed...Open Science(OS)and Research has reached mixed maturity levels in Finland.The meaning of the national project in the ecosystem of Finnish universities of applied sciences(UAS)is to enhance and elaborate OS and Open Education(OE)activities.Future actions were defined based on a survey and interviews carried out in the Finnish UAS sector during 2018 and 2019.The aim of both data collections was to evaluate the current status and attitudes towards open Research,Development,and Innovation(RDI)among staff members.Another purpose was to define the need for internal support services concerning open RDI and OE and to identify knowledge gaps.The results revealed several gaps in understanding OS and OE initiatives.Real-life actions were mostly vague,and the respondents experienced the need for support.On the other hand,the attitudes towards open RDI were positive,and the issue aroused questions and reflections.This study revealed gaps in knowledge and actions in Finnish UAS sectors.These results have been the basis of development actions such as joint workshops,educational webinars,and common instructions.The future plan includes the establishment of an experts’network for supporting open RDI and Education.展开更多
基金funded by the Singapore Ministry of Education Tier 1 Research Grant that is administered by the National University of Singapore(R-296-000-151-133).
文摘The building industry has experienced a widespread transition towards green buildings and consequently a growing need for green facilities professionals to maximize green building potential in terms of energy efficiency,water conservation and waste reduc-tion in their operational stage.Green buildings have unique technological systems that require facility managers to have relevant knowledge and skills to conduct proper facilities management and maintenance planning to maximize the potential of green buildings.It is important,then,to investigate whether knowledge gaps for facil-ity managers exist with respect to green buildings,and if so,how these knowledge gaps could be bridged.Though several studies have investigated the operation and maintenance processes of green buildings,few studies considered facility managers’knowledge and skills regarding green facility management(GFM).Set in the context of Singapore,this study aims to holistically investigate the knowledge and skills of managing green buildings in the community of facility managers,including their per-ceived differences between green and conventional buildings,the difficulty of GFM,the knowledge gaps of GFM and the underlying reasons,as well as how the gaps could be bridged.A total of 90 survey responses were collected and eight interviews with key stakeholders were conducted,which indicate facility managers believe green build-ings do have special features that require unique knowledge and skills,and currently knowledge gaps do exist hindering the transition towards GFM.Therefore,this paper derives plausible solutions to bridge the knowledge gaps,such as establishing holistic subsidies for those facility managers participating in training programs of GFM.This study provides references for researchers and relevant governmental departments to better understand industry professionals’knowledge gaps in the transitioning process towards a green built environment,and to make better policy decisions bridging the knowledge gaps and thereby facilitating the green transition process.
文摘Daily and weekly reporting events of climate change and impacts on populations, cultures, economies and politics at local, national, regional and international scales suggest the need to construct databases that will be useful in future scientific inquiry and global human/environmental policies. That need is evident in constructing a geographic or locational knowledge base that examines countries, regions and cities. This study constructs a database on the impacts of climate change using Google Scholar entries for 200 countries and capital cities. A series of maps reveal the vast unevenness in the database, especially between Global North and Global South countries. The discussion explores these sharp differences and suggests future research topics for much-needed global, interdisciplinary and international research.
基金supported by the Tianjin Key Medical Discipline(Specialty)Construction Project(TJYXZDXK-029A)the Key Project of Tianjin Natural Science Foundation(21JCZDJC01080)the Tianjin Fourth Central Hospital Outstanding Young Talent Fund(tjdszxyy20230008).
文摘BACKGROUND Heart failure with preserved ejection fraction(HFpEF)following acute myocardial infarction(AMI)carries substantial morbidity and mortality,yet reliable prognostic markers beyond conventional cardiovascular factors remain limited.Frailty,reflecting diminished physiological reserve,has emerged as a potential determinant of adverse outcomes in this high-risk population.Therefore,the aim of this study was to address a critical knowledge gap and to provide evidence that may guide frailty-adapted management strategies to improve prognosis and quality of life in this high-risk population.METHODS We conducted a multicenter retrospective cohort study including 4507 patients with HFpEF discharged after AMI across 82 hospitals in China(from January 2010 to March 2024).Frailty was assessed using the Hospital Frailty Risk Score(HFRS),with HFRS<5 defined as non-frail and HFRS≥5 as frail.Multivariable Cox proportional hazards models,adjusted for demographics,comorbidities,left ventricular ejection fraction,and therapies,were applied to evaluate associations between frailty and clinical outcomes.The primary endpoints were all-cause death and major adverse cardiovascular events(MACE),which defined as the composite of cardiovascular death and heart failure rehospitalization.Secondary endpoints included net adverse clinical events(NACE),which defined as the composite of all-cause death,stroke,recurrent myocardial infarction,revascularization,and major bleeding,as well as the individual components of MACE.RESULTS Frailty was independently associated with a higher risk of all-cause death[adjusted hazard ratio(aHR)=1.52,95%CI:1.31–2.03,P=0.005]and NACE(aHR=1.20,95%CI:1.02–1.41,P=0.026).At one year,frail patients had higher unadjusted rates of all-cause death(9.0%vs.2.9%)and NACE(19.8%vs.13.7%)compared with non-frail patients.For cardiovascular death,the association did not reach statistical significance(aHR=1.42,95%CI:0.99–2.03,P=0.053).No significant associations were found for MACE(aHR=1.05,95%CI:0.86–1.28,P=0.636)or heart failure rehospitalization(aHR=0.94,95%CI:0.75–1.19,P=0.616).CONCLUSIONS Frailty,as measured by the HFRS,is an independent predictor of one-year mortality and composite adverse events in post-AMI HFpEF patients.These findings support the use of HFRS at discharge to identify high-risk population who may benefit from closer follow-up,optimization of medical therapy,and targeted frailty-focused interventions.
文摘Geoscience education is crucial globally,yet its delivery in Malaysian schools remains inadequate despite increasing demand for geological services.This study examines perceptions of 157 newly enrolled students in geoscience,geology,and other science-based programs regarding the challenges in bridging the geoscience education gap from primary to pre-university levels in Malaysia.Findings indicate a moderately significant improvement in students'geoscience knowledge,with moderate perspectives on geoscience education before and after entering university.
文摘International collaboration on the prediabetes and cardiovascular complications study started in 2013.In 2017,a reflection was reported.Incompleteness of documentation and screening of antenatal cases for gestational diabetes mellitus(GDM)was concerning.Hence,further observations have been made that warrant an update.The objective of this review is to highlight gaps between clinical knowledge and practice in GDM,diabetes self-management and primary health care(PHC)for rural dwellers.We followed a descriptive field notes method.Antenatal records of patients screened for GDM with incomplete documentation were examined to determine incompleteness of data in those that also met the criteria for GDM risk assessment.Experiences on development of a diabetes register and education and notes on behavioural change wheel were also reviewed.Other data included cross-sectional evaluation of activities of daily living at two private hospitals.Up to 29%had high GDM risk factors,which fulfilled selection criteria for laboratory screening.Demographic data was complete in all women;however,incomplete documentation was observed with as much as 98%of basic data.High levels of physical activity were found in the population,and health lectures proved effective in food choices.The workforce need for diabetes care seems underestimated,but this may be better understood with reactivation of PHC services.The observations highlight behavioural change wheel issues on GDM and PHC services that need concerted focus.Two proposals are to advance the use of a‘risk assessment and screening sheet’for GDM screening and enlightenment of stakeholders on the central hub role of PHC in diabetes management.
基金Supported by the Key Projects in the Three-Year Plan of Shanghai Municipal Public Health System(2023-2025)(No.GWV1-11.1-39)the National Disease Control and Prevention Administration Talent Project of Field Epidemiological Investigation(No.Y2023-28B)the Shanghai Municipal Health Commission Science and Youth Research Fund(No.20234Y0297).
文摘Introduction:In 2019,the Chinese State Council launched the“Healthy China Initiative(2019-2030)”,establishing explicit targets for residents’environmental and health literacy(EHL):reaching to 15%by 2022,to 25%,and over 2030.To identify knowledge gaps and guide targeted interventions,Shanghai implemented five consecutive EHL surveys between 2020 and 2024.Methods:We employed a multi-stage random sampling design across five cross-sectional surveys.Associations with EHL levels were examined usingχ^(2) tests,one-way analysis of variance,generalized linear models,and multivariate logistic regression analyses.Results:Among 11,220 residents aged 15-69 years assessed using the Core Questionnaire for Assessing the EHL of Chinese Residents,mean EHL scores demonstrated steady improvement.Scores increased from 55.28±15.64 points in 2020 to 61.77±15.92 points(2021),62.13±17.14 points(2022),62.03±16.97 points(2023),and 63.14±18.21 points(2024)(P<0.001).The proportion achieving adequate EHL(≥70 points)increased correspondingly,with ageadjusted rates rising from 18.78%in 2020 to 30.18%(2021),33.22%(2022),33.84%(2023),and 42.88%(2024).Among the three primary dimensions,knowledge showed the greatest improvement,increasing from 7.12%to 39.93%.Participants surveyed in 2024 had 3.50-fold higher odds of achieving adequate EHL compared with those in 2020(odds ratio=3.50;95%confidence interval:3.07,4.00).Conclusions:Although educational attainment remained the primary determinant of EHL,targeted public health education campaigns significantly improved EHL among Shanghai residents between 2020 and 2024.
基金supported by the Gates Foundation(INV-059115)the Alliance of International Science Organizations(ANSO-CR-KP-2022-01)partly supported by the National Natural Science Foundation of China(92469301).
文摘Human mucosal immunization is expected to afford protection against infection and reduce transmission by generating anti-infective immunity at the mucosal entry site of viruses and bacteria.Nasal or oral administration has the advantage of being needle free and self-administered,thereby improving compliance and coverage of large populations.In China,the experience of COVID-19 has promoted substantial efforts in the development of nasal vaccinations in the general health protection strategy.The hurdles we are facing in the development of mucosal vaccines,however,come from the still limited knowledge of the mechanisms controlling mucosal immunity in different anatomical locations and in response to different pathogens/vaccines.Identifying and filling the knowledge gaps in order to develop effective and safe mucosal immunization strategies requires global collaboration,not only at the scientific level but,most importantly,by engaging public and private health organizations,governments,and regulatory authorities.We have highlighted here some of the crucial issues in mucosal immunization and provided suggestions for the way forward toward a global preparedness effort to prevent infectious diseases and ensure vaccine equity.
基金based on the work done in the “open RDI, learning, and the innovation ecosystem of Finnish UAS” projectco-funded by the Ministry of Education and Culture of Finland
文摘Open Science(OS)and Research has reached mixed maturity levels in Finland.The meaning of the national project in the ecosystem of Finnish universities of applied sciences(UAS)is to enhance and elaborate OS and Open Education(OE)activities.Future actions were defined based on a survey and interviews carried out in the Finnish UAS sector during 2018 and 2019.The aim of both data collections was to evaluate the current status and attitudes towards open Research,Development,and Innovation(RDI)among staff members.Another purpose was to define the need for internal support services concerning open RDI and OE and to identify knowledge gaps.The results revealed several gaps in understanding OS and OE initiatives.Real-life actions were mostly vague,and the respondents experienced the need for support.On the other hand,the attitudes towards open RDI were positive,and the issue aroused questions and reflections.This study revealed gaps in knowledge and actions in Finnish UAS sectors.These results have been the basis of development actions such as joint workshops,educational webinars,and common instructions.The future plan includes the establishment of an experts’network for supporting open RDI and Education.
