Predicting the precise impacts of climate change on extreme winds remains challenging,yet strong storms are widely expected to occur more frequently in a warming climate.Wind barriers are commonly used on bridges to r...Predicting the precise impacts of climate change on extreme winds remains challenging,yet strong storms are widely expected to occur more frequently in a warming climate.Wind barriers are commonly used on bridges to reduce aerodynamic loads on trains through blocking effects.This study develops a novel wind barrier based on Tesla valves,which not only blocks incoming flow but also dissipates mechanical energy through fluid collision.To demonstrate this energy-dissipation capability,a Tesla plate is placed in a circular duct to examine its influence on pressure drop.Experimental tests and numerical simulations comparing a Tesla channel and a straight channel of equal porosity show that the Tesla configuration produces a substantially higher pressure drop.Validated simulations are then used to conduct a parametric study to optimize the design.By varying the channel ratio,diversion angle,number of dissipation units,and porosity,velocity–pressure-drop relationships for different Tesla plates are obtained.The results show that larger channel ratios,larger diversion angles,and more dissipation units,combined with lower porosity,all increase pressure drop and thus enhance energy dissipation.Finally,the aerodynamic coefficients of a high-speed train on a bridge deck equipped with a Tesla-type barrier are evaluated and compared with those for a traditional straight-channel barrier.The Tesla-type barrier reduces the train’s lateral force coefficient to only 15%–25%of that produced by the traditional barrier,and it generates an additional stabilizing force that further improves running safety.展开更多
Objective:To systematically review the current implementation status of nurses’non-pharmacological prescription authority and analyze the barriers encountered during its implementation in China,providing countermeasu...Objective:To systematically review the current implementation status of nurses’non-pharmacological prescription authority and analyze the barriers encountered during its implementation in China,providing countermeasures and references for promoting the standardized implementation of nurses’non-pharmacological prescription authority.Methods:A secondary analysis of literature was conducted to systematically search for domestic and international literature related to nurses’non-pharmacological prescription authority.Meta-analysis was performed on eligible literature to evaluate the implementation effects.Simultaneously,semi-structured in-depth interviews were conducted with healthcare workers,patients,and policymakers.Content analysis was used to organize the interview data and extract core issues and barriers.Results:A total of 46 international articles were included in the Meta-analysis,which revealed that the implementation of nurses’non-pharmacological prescription authority significantly improved patients’health management outcomes,enhanced healthcare service efficiency,and increased patient satisfaction.Conclusion:The implementation of nurses’non-pharmacological prescription authority has demonstrated significant positive effects.However,China faces multiple barriers in its advancement,necessitating efforts in optimizing policy systems,constructing collaborative models,strengthening professional skills training,and improving social awareness to guide the scientific and rational implementation of nurses’non-pharmacological prescription authority.展开更多
Railway noise barriers are an essential piece of infrastructure for reducing noise propagation.However,these barriers experience aerodynamic loads generated by high-speed trains,leading to dynamic effects that may com...Railway noise barriers are an essential piece of infrastructure for reducing noise propagation.However,these barriers experience aerodynamic loads generated by high-speed trains,leading to dynamic effects that may compromise their fatigue capacity.The most common structural design for railway noise barriers consists of vertical configurations of posts and panels.However,there have been few dynamic analyses of steel post/wood panel noise barriers under train-induced aerodynamic loads.This study used dynamic finite element analysis to assess the dynamic behavior of such noise barriers.Analysis of a 40-m-long noise barrier model and a triangular simplified load model,the latter of which effectively represented the detailed aerodynamic load,were first used to establish the model and input of the moving load during dynamic simulation.Then,the effects of different parameters on the dynamic response of the noise barrier were evaluated,including the damping ratio,the profile of the steel post,the span length of the panel,the barrier height,and the train speed.Gray relational analysis indicated that barrier height exhibited the highest correlations with the dynamic responses,followed by train speed,post profile,span length,and damping ratio.A reduction in the natural frequency and an increase in the train speed result in a higher peak response and more pronounced fluctuations between the nose and tail waves.The dynamic amplification factor(DAF)was found to be related to both the natural frequency and train speed.A model was proposed showing that the DAF significantly increases as the square of the natural frequency decreases and the cube of the train speed rises.展开更多
Insect-derived traditional Chinese medicine(TCM)constitutes an essential component of TCM,with the earliest records found in“52 Bingfang”(Prescriptions of fifty-two diseases,which is one of the earliest Chinese medi...Insect-derived traditional Chinese medicine(TCM)constitutes an essential component of TCM,with the earliest records found in“52 Bingfang”(Prescriptions of fifty-two diseases,which is one of the earliest Chinese medical prescriptions).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
Objective:This review examined the co-morbidity of malaria and hypertension in Nigerian adults,with a focus on epidemiological trends,genetic and environmental risk factors,pathophysiological mechanisms,and systemic h...Objective:This review examined the co-morbidity of malaria and hypertension in Nigerian adults,with a focus on epidemiological trends,genetic and environmental risk factors,pathophysiological mechanisms,and systemic healthcare barriers.Methods:A qualitative synthesis of peer-reviewed literature,national health surveys,and institutional reports published between 2000 and 2025 was conducted using thematic analysis.While centered on Nigeria,the review incorporated comparative insights from global studies on renin angiotensin aldosterone system polymorphisms,co-infection dynamics,and health service inequalities.Results:The findings indicate overlapping risk factors including renin angiotensin aldosterone system gene polymorphisms,urbanization,and poverty.Angiotensin Ⅱ demonstrates dual functions,contributing both to malaria suppression and to hypertension pathogenesis.Clinical challenges include diagnostic overlap,adverse drug interactions,and disparities in service delivery between rural and urban populations.These challenges particularly affect older adults and highlight systemic gaps in access,workforce distribution,and policy alignment.Conclusion:The dual burden of malaria and hypertension in Nigeria requires integrated disease management strategies that address both communicable and non-communicable disease risks.Urgent priorities include multisectoral policy reforms,expanded rural health investments,and the adoption of precision medicine approaches guided by genetic profiling.The implications extend to clinical practice through co-screening and tailored treatment protocols and to public health policy,where integrated frameworks are essential to reducing inequities and improving long-term outcomes.展开更多
Liver transplantation is a vital intervention for patients with end-stage liver disease;however,the Arab world faces significant barriers that hinder access to this life-saving procedure in terms of both practice and ...Liver transplantation is a vital intervention for patients with end-stage liver disease;however,the Arab world faces significant barriers that hinder access to this life-saving procedure in terms of both practice and research.This narrative review explores the multifaceted challenges,including financial constraints,limited healthcare infrastructure,cultural factors,and the prevalence of infectious diseases.In the Arab countries,both culture and religion were found to play major roles in the acceptability of liver transplantation.High rates of misconceptions and financial strain on patients and healthcare systems necessitate more transplantation programs and improved financial coverage and insurance policies.Enhancing healthcare facilities and improving access to innovative technologies through research is essential for optimizing transplantation outcomes,considering that common diseases in the region decrease the donor pool and increase complication risks.Public health initiatives to prevent and control prevalent liver diseases,particularly hepatitis,and to manage infection risk are also critical.Stricter regulations should be enforced in less developed countries in the region along with early screening practices to address inherited blood disorders and infectious diseases.Additionally,targeted research on liver diseases specific to the Arab context is crucial,along with fostering dialogue about cultural,religious,economic,and health-related factors affecting donor and recipient eligibility.By tackling these complex barriers through targeted comprehensive strategies,the Arab world can advance to a more equitable and effective liver transplantation system,ultimately improving patient outcomes and quality of life.展开更多
BACKGROUNDLimited research exists on attitudes and barriers to organ donation in the UnitedArab Emirates, highlighting the need for a deeper understanding of public perceptionsand challenges.AIMTo assess the attitudes...BACKGROUNDLimited research exists on attitudes and barriers to organ donation in the UnitedArab Emirates, highlighting the need for a deeper understanding of public perceptionsand challenges.AIMTo assess the attitudes and barriers toward organ donation.METHODSA cross-sectional study was adopted and included 607 samples consisting ofstudents, faculty, and staff who were selected from three universities in Ajmanand who had signed consent forms. A validated self-administered questionnairethat included 13 attitudes and 14 barrier items was used as a tool. The reliabilityof the tool was 0.89 (Cronbach's alpha). In the analysis of attitude scores, responseswere rated on a scale from 0 to 4, with 0 representing 'strongly disagree'and 4 representing 'strongly agree' for supportive attitudes towards organdonation. Participants with a total attitude score of 39 or higher indicated agreementor strong agreement with all items, reflecting a generally supportiveattitude toward organ donation. Lower scores suggested that the respondent wasneutral or disagreed with one or more items, indicating a less supportive attitudetoward organ donation. Knowledge about organ donation was assessed by selfadministeredquestionnaire that included 13 items. Analysis was done using SPSSversion 29. χ2 was used to assess associations between variables.RESULTSMost participants were young (≤ 30 years old, 83.7%), female (79.2%), from World Health Organization Eastern Mediterranean Region countries (69.5%), Muslim (82.4%), students (80.6%), single(83.9%), and from a nursing college (33.1%). The majority had no personal or family history of organ donation(93.2% and 93.9%, respectively). Supportive attitudes toward organ donation were significantly associated withreligion (P = 0.003), working status (P = 0.009), university (P = 0.019), and knowledge (P < 0.001). Additionally,those with a personal or family history of organ donation were significantly more supportive (56.8% vs 33.3%, P =0.004). Lack of awareness was the most reported barrier for organ donation (64.1%) followed by being afraid oforgan donation due to medical procedures required (51.9%).CONCLUSIONThe findings suggest that supportive attitudes toward organ donation are influenced by demographic factors,personal experiences, and knowledge levels. Lack of awareness and fear of medical procedures were the mostreported barriers to organ donation. These results highlight the need for targeted educational programs to increaseawareness and promote positive attitudes toward organ donation.展开更多
Background:Communication barriers are a critical yet underexplored determinant of psychological well-being in oncology care,particularly among rural Chinese patients treated in urban hospitals.This study examined how ...Background:Communication barriers are a critical yet underexplored determinant of psychological well-being in oncology care,particularly among rural Chinese patients treated in urban hospitals.This study examined how Mandarin proficiency influences emotional distress and identified implications for mental health promotion.Methods:A sequential mixed-methods design was adopted.Quantitative data were collected from 180 rural cancer patients using the Putonghua Proficiency Test(PSC),the Hospital Anxiety and Depression Scale(HADS),and the Distress Thermometer(DT).Multiple linear regressions estimated covariate-adjusted associations between Mandarin proficiency and distress outcomes,controlling for demographic and clinical factors.Semi-structured interviews with 20 patients explored communication experiences and psychosocial impacts.Quantitative and qualitative findings were integrated for triangulated interpretation.Results:Lower Mandarin proficiency was significantly associated with higher anxiety(β=−0.30,p=0.001),depression(β=−0.25,p=0.01),and distress(β=−0.28,p=0.003),with an adjusted R^(2)=0.18(F=7.4,p<0.001).Each 10-point increase in PSC corresponded to a 0.5-point reduction in DT score(B=−0.05,p=0.003).Qualitative themes revealed confusion,stigma,isolation,and reliance on family interpreters,confirming that linguistic inequity functions as an independent psychosocial stressor in oncology care.Conclusion:Language barriers significantly heighten distress among rural Chinese cancer patients.Addressing these barriers through interpreter services,culturally responsive staff training,and inclusive educational materials should be recognized as a core strategy for mental health promotion and equitable cancer care.展开更多
This paper aims to explore the influence of different noise barrier heights on the sound source generation mechanisms of higher-speed trains(400 km/h)using a combination of delayed detached eddy simulation(DDES)and Ff...This paper aims to explore the influence of different noise barrier heights on the sound source generation mechanisms of higher-speed trains(400 km/h)using a combination of delayed detached eddy simulation(DDES)and Ffowcs Williams-Hawkings(FW-H)equations.Four cases are investigated and compared,i.e.1)no barrier,2)2.3 m,3)3.3 m,and 4)4.3 m single-side barriers on a bridge.Numerical results show that the presence of noise barriers causes an increase in sound source intensity ranging from 2.1 to 2.8 dB(A).However,the relationship between the barrier height and the increase in sound source intensity varies across different parts of the train.Compared with the head and front middle cars,the boundary layer is thicker around the rear-middle and tail car areas.A thick boundary layer introduces the influence of the crash wall,causing asymmetry and increases in sound source intensity.This is due to the deceleration region formed between the crash wall and the rail surface,as well as the acceleration region formed by the contraction of the flow channel in the noise barrier,both of which influence the sound source's characteristics.In addition,higher barriers exacerbate asymmetry and increases in sound source intensity.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
Born and raised in Japan,Tatsuya Amano started learning English in the 7th grade.But after finishing his doctorate at the University of Tokyo in 2006,he began traveling to international scientific conferences.To his d...Born and raised in Japan,Tatsuya Amano started learning English in the 7th grade.But after finishing his doctorate at the University of Tokyo in 2006,he began traveling to international scientific conferences.To his dismay,he discovered his English was not good enough to allow him to converse with many of the other participants.“I found so many barriers to communicating with other people in English,”recalled Amano,now an associate professor in the School of the Environment at the University of Queensland in Brisbane,Australia.展开更多
This review examines the critical risks,barriers,and success factors in achieving sustainable affordable housing(SAH)by addressing environmental,economic,social and technical dimensions of sustainability.The aim of th...This review examines the critical risks,barriers,and success factors in achieving sustainable affordable housing(SAH)by addressing environmental,economic,social and technical dimensions of sustainability.The aim of this study is to identify different critical risks and barriers to the development of the Sustainable Affordable Housing(SAH)CSF framework.The objectives of this research are to define SAH(Sustainable Affordable Housing)and important factors for achieving SAH and to develop SAH Critical Success Factors(CSFs)frameworks.To achieve these objectives,there are two methods for reviewing and analyzing documents,i.e.,systematic review and bibliographic review.The years of publication are limited to 2014 to 2023 in the English language and restricted to open access.A total of 63 articles were retrieved and screened for relevance identified as directly relevant to our topic using the PRISMA systematic review process.The growth pattern aligns strongly with an exponential growth model,as evidenced by a high R^(2) value of 0.9133 indicating a robust correlation and demonstrating the accelerating interest in the field over the past decade.This comprehensive analysis led to the development of the sustainable affordable housing(SAH)critical success framework,providing a structured approach to understanding and implementing critical factors for sustainable and affordable housing initiatives.The findings emphasize the need for integrated policy reforms,innovative construction technologies,and collaborative stakeholder engagement to advance the SAH agenda.Future research directions include conducting longitudinal studies to assess the long-term impacts of SAH policies,comparative analyses of international best practices,and explorations into emerging construction technologies.展开更多
Covalent organic frameworks(COFs)are crystalline and porous materials formed from periodically organized organic molecules bonded covalently to create highly stable architectures.Their mechanical properties can be pre...Covalent organic frameworks(COFs)are crystalline and porous materials formed from periodically organized organic molecules bonded covalently to create highly stable architectures.Their mechanical properties can be precisely adjusted through structural modifications,making COFs exceptionally suitable for applications in cancer treatment and drug delivery.This review summarizes strategies for controlling the mechanical properties of COFs,including adjustments in structural dimensions,pore sizes and host-vip interactions.The remarkable advancements in drug delivery,cancer therapy,photodynamic therapy and photothermal therapy achieved through COFs with tunable mechanical properties are then discussed.By providing deeper insights into the biomedical applications of COF systems,this reviewaims to foster interdisciplinary research combining nanomedicine and COF materials.Additionally,the review explores recent studies and discoveries on COFs’potential as innovative drug carriers capable of biological overcoming barriers such as the blood-brain barrier,nasal mucosa,cutaneous layers and oral mucosa.Greater insight into both the limitations and potential of COFs could pave the way for developing more effective and targeted strategies within this challenging field.展开更多
1|Introduction The Federal Republic of Somalia,often perceived as linguistically homogeneous,is home to a rich tapestry of dialects and minority languages that reflect its diverse cultural heritage.While Somali is the...1|Introduction The Federal Republic of Somalia,often perceived as linguistically homogeneous,is home to a rich tapestry of dialects and minority languages that reflect its diverse cultural heritage.While Somali is the official medium of communication,it is divided into two major dialects:Maxaa Tiri(spoken by approximately 60%of the population)and Maay(spoken by approximately 20%of the population)[1].Minority languages such as Bravanese(also known as Chimwiini or Chimbalazi),Mushunguli,Benadiri Somali,and Kibajuni are spoken by smaller communities,particularly in the southern and coastal regions[1].展开更多
Dear Editor,Reproductive healthcare and autonomy are integral to overall health,well-being,and human fundamental rights[1].However,for individuals with disabilities,access to reproductive healthcare and their autonomy...Dear Editor,Reproductive healthcare and autonomy are integral to overall health,well-being,and human fundamental rights[1].However,for individuals with disabilities,access to reproductive healthcare and their autonomy is significantly jeopardized due to a combination of parameters[1].Disabled people have to deal with a wide range of social barriers while they decide to access healthcare facilities for reproductive health[2,3].展开更多
After 20 years of rapid development,China's photovoltaic industry has become a leading industry in the international market.In recent years,photovoltaic power,a renewable and clean energy,has attracted global atte...After 20 years of rapid development,China's photovoltaic industry has become a leading industry in the international market.In recent years,photovoltaic power,a renewable and clean energy,has attracted global attention.This paper sorts out the technical barriers to trade related to the photovoltaic industry in Europe and the United States,analyzes the short-term and long-term impact on China,and finally puts forward countermeasures.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
With the increasing use of technology in language education,understanding the benefits and barriers of mobile-assisted language learning(MALL)is crucial for effective integration.Qualitative data were collected throug...With the increasing use of technology in language education,understanding the benefits and barriers of mobile-assisted language learning(MALL)is crucial for effective integration.Qualitative data were collected through interviews among Chinese English teachers in universities.Thematic analysis was employed to identify themes.The findings reveal that Chinese English teachers perceive MALL to offer benefits like convenience,effectiveness,efficiency,engagement,personalization,and resource richness.However,several barriers were identified,including low teacher ability,student device misuse,lack of institutional support,technical limitations,health concerns,and time constraints.These findings contribute to a deeper understanding of the factors influencing the adoption of MALL in Chinese universities and have implications for language teaching practice.展开更多
Traffic-induced ground vibrations cause significant problems for residents and nearby structures.Reducing the effect of these vibrations on the neighboring environment is a key challenge,particularly in urban areas.Th...Traffic-induced ground vibrations cause significant problems for residents and nearby structures.Reducing the effect of these vibrations on the neighboring environment is a key challenge,particularly in urban areas.This study presents both numerical and experimental investigations of the performance of mass scatters for screening ground vibrations.A three-dimensional numerical model is validated and extended to conduct a comparative study on the efficiency of three geotechnical methods of isolation.These methods include trench barriers,waveimpeding blocks(WIBs),and mass scatters.The results showed that mass scatters represent an efficient way of scattering ground vibrations,and their efficiency is mainly related to the weights of mass scatters and their natural frequency,which control the dynamic soil response in the frequency domain.Rigid trench barriers are less effective than soft ones,and their efficiency is more pronounced regarding the WIB.Soft barriers with a depth of an order of half of the wavelength can decrease the vibration levels by up to 50%,which is comparable to the performance of enormous mass scatters.The dimensions of WIBs must be chosen according to the wavelength of incident waves and the cutoff frequency of the topsoil layer.Considering the significant wavelength of traffic-induced vibration,the use of trench barriers or WIBs becomes impractical and expensive;therefore,mass scatters appear to be an efficient and practical solution.展开更多
基金supported by the National Natural Science Foundation of China(52475105)Special Fund for Science and Technology Innovation of Jiangsu Province(BE2022610)National Natural Science Foundation of China(U23A20661).
文摘Predicting the precise impacts of climate change on extreme winds remains challenging,yet strong storms are widely expected to occur more frequently in a warming climate.Wind barriers are commonly used on bridges to reduce aerodynamic loads on trains through blocking effects.This study develops a novel wind barrier based on Tesla valves,which not only blocks incoming flow but also dissipates mechanical energy through fluid collision.To demonstrate this energy-dissipation capability,a Tesla plate is placed in a circular duct to examine its influence on pressure drop.Experimental tests and numerical simulations comparing a Tesla channel and a straight channel of equal porosity show that the Tesla configuration produces a substantially higher pressure drop.Validated simulations are then used to conduct a parametric study to optimize the design.By varying the channel ratio,diversion angle,number of dissipation units,and porosity,velocity–pressure-drop relationships for different Tesla plates are obtained.The results show that larger channel ratios,larger diversion angles,and more dissipation units,combined with lower porosity,all increase pressure drop and thus enhance energy dissipation.Finally,the aerodynamic coefficients of a high-speed train on a bridge deck equipped with a Tesla-type barrier are evaluated and compared with those for a traditional straight-channel barrier.The Tesla-type barrier reduces the train’s lateral force coefficient to only 15%–25%of that produced by the traditional barrier,and it generates an additional stabilizing force that further improves running safety.
基金Scientific Research Fund Project of Yunnan Provincial Department of Education(Project No.:2024J2130)。
文摘Objective:To systematically review the current implementation status of nurses’non-pharmacological prescription authority and analyze the barriers encountered during its implementation in China,providing countermeasures and references for promoting the standardized implementation of nurses’non-pharmacological prescription authority.Methods:A secondary analysis of literature was conducted to systematically search for domestic and international literature related to nurses’non-pharmacological prescription authority.Meta-analysis was performed on eligible literature to evaluate the implementation effects.Simultaneously,semi-structured in-depth interviews were conducted with healthcare workers,patients,and policymakers.Content analysis was used to organize the interview data and extract core issues and barriers.Results:A total of 46 international articles were included in the Meta-analysis,which revealed that the implementation of nurses’non-pharmacological prescription authority significantly improved patients’health management outcomes,enhanced healthcare service efficiency,and increased patient satisfaction.Conclusion:The implementation of nurses’non-pharmacological prescription authority has demonstrated significant positive effects.However,China faces multiple barriers in its advancement,necessitating efforts in optimizing policy systems,constructing collaborative models,strengthening professional skills training,and improving social awareness to guide the scientific and rational implementation of nurses’non-pharmacological prescription authority.
基金financially supported by the Swedish Transport Administration(Trafikverket)through the“Excellence Area 4”and FOI-BBT program(Grant Nos.BBT-2019-022 and BBT-TRV 2024/132497).
文摘Railway noise barriers are an essential piece of infrastructure for reducing noise propagation.However,these barriers experience aerodynamic loads generated by high-speed trains,leading to dynamic effects that may compromise their fatigue capacity.The most common structural design for railway noise barriers consists of vertical configurations of posts and panels.However,there have been few dynamic analyses of steel post/wood panel noise barriers under train-induced aerodynamic loads.This study used dynamic finite element analysis to assess the dynamic behavior of such noise barriers.Analysis of a 40-m-long noise barrier model and a triangular simplified load model,the latter of which effectively represented the detailed aerodynamic load,were first used to establish the model and input of the moving load during dynamic simulation.Then,the effects of different parameters on the dynamic response of the noise barrier were evaluated,including the damping ratio,the profile of the steel post,the span length of the panel,the barrier height,and the train speed.Gray relational analysis indicated that barrier height exhibited the highest correlations with the dynamic responses,followed by train speed,post profile,span length,and damping ratio.A reduction in the natural frequency and an increase in the train speed result in a higher peak response and more pronounced fluctuations between the nose and tail waves.The dynamic amplification factor(DAF)was found to be related to both the natural frequency and train speed.A model was proposed showing that the DAF significantly increases as the square of the natural frequency decreases and the cube of the train speed rises.
基金funded by the National Natural Science Foundation of China(Grant Nos.:82222068,82070423,82270348,and 82173779)the Innovation Team and Talents Cultivation Pro-gram of National Administration of Traditional Chinese Medicine,China(Grant No:ZYYCXTD-D-202206)+1 种基金Fujian Province Science and Technology Project,China(Grant Nos.:2021J01420479,2021J02058,2022J011374,and 2022J02057)Fundamental Research Funds for the Chinese Central Universities,China(Grant No.:20720230070).
文摘Insect-derived traditional Chinese medicine(TCM)constitutes an essential component of TCM,with the earliest records found in“52 Bingfang”(Prescriptions of fifty-two diseases,which is one of the earliest Chinese medical prescriptions).
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Objective:This review examined the co-morbidity of malaria and hypertension in Nigerian adults,with a focus on epidemiological trends,genetic and environmental risk factors,pathophysiological mechanisms,and systemic healthcare barriers.Methods:A qualitative synthesis of peer-reviewed literature,national health surveys,and institutional reports published between 2000 and 2025 was conducted using thematic analysis.While centered on Nigeria,the review incorporated comparative insights from global studies on renin angiotensin aldosterone system polymorphisms,co-infection dynamics,and health service inequalities.Results:The findings indicate overlapping risk factors including renin angiotensin aldosterone system gene polymorphisms,urbanization,and poverty.Angiotensin Ⅱ demonstrates dual functions,contributing both to malaria suppression and to hypertension pathogenesis.Clinical challenges include diagnostic overlap,adverse drug interactions,and disparities in service delivery between rural and urban populations.These challenges particularly affect older adults and highlight systemic gaps in access,workforce distribution,and policy alignment.Conclusion:The dual burden of malaria and hypertension in Nigeria requires integrated disease management strategies that address both communicable and non-communicable disease risks.Urgent priorities include multisectoral policy reforms,expanded rural health investments,and the adoption of precision medicine approaches guided by genetic profiling.The implications extend to clinical practice through co-screening and tailored treatment protocols and to public health policy,where integrated frameworks are essential to reducing inequities and improving long-term outcomes.
文摘Liver transplantation is a vital intervention for patients with end-stage liver disease;however,the Arab world faces significant barriers that hinder access to this life-saving procedure in terms of both practice and research.This narrative review explores the multifaceted challenges,including financial constraints,limited healthcare infrastructure,cultural factors,and the prevalence of infectious diseases.In the Arab countries,both culture and religion were found to play major roles in the acceptability of liver transplantation.High rates of misconceptions and financial strain on patients and healthcare systems necessitate more transplantation programs and improved financial coverage and insurance policies.Enhancing healthcare facilities and improving access to innovative technologies through research is essential for optimizing transplantation outcomes,considering that common diseases in the region decrease the donor pool and increase complication risks.Public health initiatives to prevent and control prevalent liver diseases,particularly hepatitis,and to manage infection risk are also critical.Stricter regulations should be enforced in less developed countries in the region along with early screening practices to address inherited blood disorders and infectious diseases.Additionally,targeted research on liver diseases specific to the Arab context is crucial,along with fostering dialogue about cultural,religious,economic,and health-related factors affecting donor and recipient eligibility.By tackling these complex barriers through targeted comprehensive strategies,the Arab world can advance to a more equitable and effective liver transplantation system,ultimately improving patient outcomes and quality of life.
文摘BACKGROUNDLimited research exists on attitudes and barriers to organ donation in the UnitedArab Emirates, highlighting the need for a deeper understanding of public perceptionsand challenges.AIMTo assess the attitudes and barriers toward organ donation.METHODSA cross-sectional study was adopted and included 607 samples consisting ofstudents, faculty, and staff who were selected from three universities in Ajmanand who had signed consent forms. A validated self-administered questionnairethat included 13 attitudes and 14 barrier items was used as a tool. The reliabilityof the tool was 0.89 (Cronbach's alpha). In the analysis of attitude scores, responseswere rated on a scale from 0 to 4, with 0 representing 'strongly disagree'and 4 representing 'strongly agree' for supportive attitudes towards organdonation. Participants with a total attitude score of 39 or higher indicated agreementor strong agreement with all items, reflecting a generally supportiveattitude toward organ donation. Lower scores suggested that the respondent wasneutral or disagreed with one or more items, indicating a less supportive attitudetoward organ donation. Knowledge about organ donation was assessed by selfadministeredquestionnaire that included 13 items. Analysis was done using SPSSversion 29. χ2 was used to assess associations between variables.RESULTSMost participants were young (≤ 30 years old, 83.7%), female (79.2%), from World Health Organization Eastern Mediterranean Region countries (69.5%), Muslim (82.4%), students (80.6%), single(83.9%), and from a nursing college (33.1%). The majority had no personal or family history of organ donation(93.2% and 93.9%, respectively). Supportive attitudes toward organ donation were significantly associated withreligion (P = 0.003), working status (P = 0.009), university (P = 0.019), and knowledge (P < 0.001). Additionally,those with a personal or family history of organ donation were significantly more supportive (56.8% vs 33.3%, P =0.004). Lack of awareness was the most reported barrier for organ donation (64.1%) followed by being afraid oforgan donation due to medical procedures required (51.9%).CONCLUSIONThe findings suggest that supportive attitudes toward organ donation are influenced by demographic factors,personal experiences, and knowledge levels. Lack of awareness and fear of medical procedures were the mostreported barriers to organ donation. These results highlight the need for targeted educational programs to increaseawareness and promote positive attitudes toward organ donation.
文摘Background:Communication barriers are a critical yet underexplored determinant of psychological well-being in oncology care,particularly among rural Chinese patients treated in urban hospitals.This study examined how Mandarin proficiency influences emotional distress and identified implications for mental health promotion.Methods:A sequential mixed-methods design was adopted.Quantitative data were collected from 180 rural cancer patients using the Putonghua Proficiency Test(PSC),the Hospital Anxiety and Depression Scale(HADS),and the Distress Thermometer(DT).Multiple linear regressions estimated covariate-adjusted associations between Mandarin proficiency and distress outcomes,controlling for demographic and clinical factors.Semi-structured interviews with 20 patients explored communication experiences and psychosocial impacts.Quantitative and qualitative findings were integrated for triangulated interpretation.Results:Lower Mandarin proficiency was significantly associated with higher anxiety(β=−0.30,p=0.001),depression(β=−0.25,p=0.01),and distress(β=−0.28,p=0.003),with an adjusted R^(2)=0.18(F=7.4,p<0.001).Each 10-point increase in PSC corresponded to a 0.5-point reduction in DT score(B=−0.05,p=0.003).Qualitative themes revealed confusion,stigma,isolation,and reliance on family interpreters,confirming that linguistic inequity functions as an independent psychosocial stressor in oncology care.Conclusion:Language barriers significantly heighten distress among rural Chinese cancer patients.Addressing these barriers through interpreter services,culturally responsive staff training,and inclusive educational materials should be recognized as a core strategy for mental health promotion and equitable cancer care.
基金Project(2022YFB2603400)supported by the National Key Research and Development Program,China。
文摘This paper aims to explore the influence of different noise barrier heights on the sound source generation mechanisms of higher-speed trains(400 km/h)using a combination of delayed detached eddy simulation(DDES)and Ffowcs Williams-Hawkings(FW-H)equations.Four cases are investigated and compared,i.e.1)no barrier,2)2.3 m,3)3.3 m,and 4)4.3 m single-side barriers on a bridge.Numerical results show that the presence of noise barriers causes an increase in sound source intensity ranging from 2.1 to 2.8 dB(A).However,the relationship between the barrier height and the increase in sound source intensity varies across different parts of the train.Compared with the head and front middle cars,the boundary layer is thicker around the rear-middle and tail car areas.A thick boundary layer introduces the influence of the crash wall,causing asymmetry and increases in sound source intensity.This is due to the deceleration region formed between the crash wall and the rail surface,as well as the acceleration region formed by the contraction of the flow channel in the noise barrier,both of which influence the sound source's characteristics.In addition,higher barriers exacerbate asymmetry and increases in sound source intensity.
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Born and raised in Japan,Tatsuya Amano started learning English in the 7th grade.But after finishing his doctorate at the University of Tokyo in 2006,he began traveling to international scientific conferences.To his dismay,he discovered his English was not good enough to allow him to converse with many of the other participants.“I found so many barriers to communicating with other people in English,”recalled Amano,now an associate professor in the School of the Environment at the University of Queensland in Brisbane,Australia.
文摘This review examines the critical risks,barriers,and success factors in achieving sustainable affordable housing(SAH)by addressing environmental,economic,social and technical dimensions of sustainability.The aim of this study is to identify different critical risks and barriers to the development of the Sustainable Affordable Housing(SAH)CSF framework.The objectives of this research are to define SAH(Sustainable Affordable Housing)and important factors for achieving SAH and to develop SAH Critical Success Factors(CSFs)frameworks.To achieve these objectives,there are two methods for reviewing and analyzing documents,i.e.,systematic review and bibliographic review.The years of publication are limited to 2014 to 2023 in the English language and restricted to open access.A total of 63 articles were retrieved and screened for relevance identified as directly relevant to our topic using the PRISMA systematic review process.The growth pattern aligns strongly with an exponential growth model,as evidenced by a high R^(2) value of 0.9133 indicating a robust correlation and demonstrating the accelerating interest in the field over the past decade.This comprehensive analysis led to the development of the sustainable affordable housing(SAH)critical success framework,providing a structured approach to understanding and implementing critical factors for sustainable and affordable housing initiatives.The findings emphasize the need for integrated policy reforms,innovative construction technologies,and collaborative stakeholder engagement to advance the SAH agenda.Future research directions include conducting longitudinal studies to assess the long-term impacts of SAH policies,comparative analyses of international best practices,and explorations into emerging construction technologies.
文摘Covalent organic frameworks(COFs)are crystalline and porous materials formed from periodically organized organic molecules bonded covalently to create highly stable architectures.Their mechanical properties can be precisely adjusted through structural modifications,making COFs exceptionally suitable for applications in cancer treatment and drug delivery.This review summarizes strategies for controlling the mechanical properties of COFs,including adjustments in structural dimensions,pore sizes and host-vip interactions.The remarkable advancements in drug delivery,cancer therapy,photodynamic therapy and photothermal therapy achieved through COFs with tunable mechanical properties are then discussed.By providing deeper insights into the biomedical applications of COF systems,this reviewaims to foster interdisciplinary research combining nanomedicine and COF materials.Additionally,the review explores recent studies and discoveries on COFs’potential as innovative drug carriers capable of biological overcoming barriers such as the blood-brain barrier,nasal mucosa,cutaneous layers and oral mucosa.Greater insight into both the limitations and potential of COFs could pave the way for developing more effective and targeted strategies within this challenging field.
文摘1|Introduction The Federal Republic of Somalia,often perceived as linguistically homogeneous,is home to a rich tapestry of dialects and minority languages that reflect its diverse cultural heritage.While Somali is the official medium of communication,it is divided into two major dialects:Maxaa Tiri(spoken by approximately 60%of the population)and Maay(spoken by approximately 20%of the population)[1].Minority languages such as Bravanese(also known as Chimwiini or Chimbalazi),Mushunguli,Benadiri Somali,and Kibajuni are spoken by smaller communities,particularly in the southern and coastal regions[1].
文摘Dear Editor,Reproductive healthcare and autonomy are integral to overall health,well-being,and human fundamental rights[1].However,for individuals with disabilities,access to reproductive healthcare and their autonomy is significantly jeopardized due to a combination of parameters[1].Disabled people have to deal with a wide range of social barriers while they decide to access healthcare facilities for reproductive health[2,3].
文摘After 20 years of rapid development,China's photovoltaic industry has become a leading industry in the international market.In recent years,photovoltaic power,a renewable and clean energy,has attracted global attention.This paper sorts out the technical barriers to trade related to the photovoltaic industry in Europe and the United States,analyzes the short-term and long-term impact on China,and finally puts forward countermeasures.
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.
文摘With the increasing use of technology in language education,understanding the benefits and barriers of mobile-assisted language learning(MALL)is crucial for effective integration.Qualitative data were collected through interviews among Chinese English teachers in universities.Thematic analysis was employed to identify themes.The findings reveal that Chinese English teachers perceive MALL to offer benefits like convenience,effectiveness,efficiency,engagement,personalization,and resource richness.However,several barriers were identified,including low teacher ability,student device misuse,lack of institutional support,technical limitations,health concerns,and time constraints.These findings contribute to a deeper understanding of the factors influencing the adoption of MALL in Chinese universities and have implications for language teaching practice.
文摘Traffic-induced ground vibrations cause significant problems for residents and nearby structures.Reducing the effect of these vibrations on the neighboring environment is a key challenge,particularly in urban areas.This study presents both numerical and experimental investigations of the performance of mass scatters for screening ground vibrations.A three-dimensional numerical model is validated and extended to conduct a comparative study on the efficiency of three geotechnical methods of isolation.These methods include trench barriers,waveimpeding blocks(WIBs),and mass scatters.The results showed that mass scatters represent an efficient way of scattering ground vibrations,and their efficiency is mainly related to the weights of mass scatters and their natural frequency,which control the dynamic soil response in the frequency domain.Rigid trench barriers are less effective than soft ones,and their efficiency is more pronounced regarding the WIB.Soft barriers with a depth of an order of half of the wavelength can decrease the vibration levels by up to 50%,which is comparable to the performance of enormous mass scatters.The dimensions of WIBs must be chosen according to the wavelength of incident waves and the cutoff frequency of the topsoil layer.Considering the significant wavelength of traffic-induced vibration,the use of trench barriers or WIBs becomes impractical and expensive;therefore,mass scatters appear to be an efficient and practical solution.
