Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenv...Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenvatinib and everolimus represents a viable option,and the present review aimed to summarize its activity,effectiveness,and safety.Methods:A systematic review of the literature was conducted using PubMed,targeting studies published between 2018 and 2025.Eligible studies included English-language prospective and retrospective trials reporting survival outcomes in mRCC patients treated with lenvatinib and everolimus after at least one ICI-containing regimen.Results:Nine studies met the inclusion criteria,encompassing a total of 441 patients.The lenvatinib and everolimus combination was primarily used in the third and subsequent lines of therapy.Median overall survival ranged from 7.5 to 24.5 months,while median progression-free survival was more consistent,between 6.1 and 6.7 months,except for one study reporting 12.9 months.Objective response rates varied widely(14.0%–55.7%).Adverse events of grade≥3 did not exceed the expected rate,with diarrhoea and proteinuria as the most reported events.Dose reductions and treatment discontinuations due to toxicity occurred but were generally lower than in prior pivotal trials.Conclusions:Real-world evidence suggests that lenvatinib and everolimus represent an effective and safe option after ICI failure in mRCC patients.Nevertheless,the lack of randomized phase III trials and the heterogeneity of existing studies highlight the need for more robust prospective research to guide post-ICI therapeutic strategies.展开更多
Stroke,which is the second leading cause of mortality worldwide and the third leading cause of death and disability combined,[1]necessitates cost-effective rehabilitation interventions.Acupuncture is a traditional Chi...Stroke,which is the second leading cause of mortality worldwide and the third leading cause of death and disability combined,[1]necessitates cost-effective rehabilitation interventions.Acupuncture is a traditional Chinese medicine therapy that is increasingly recognized as a complementary stroke therapy.展开更多
The emergence of laser technology has led to the gradual integration of laser weapon system(LaWS)into military scene,particularly in the field of anti-unmanned aerial vehicle(UAV),showcasing significant potential.Howe...The emergence of laser technology has led to the gradual integration of laser weapon system(LaWS)into military scene,particularly in the field of anti-unmanned aerial vehicle(UAV),showcasing significant potential.However,A current limitation lies in the absence of a comprehensive quantitative approach to assess the capabilities of LaWS.To address this issue,a damage effectiveness characterization model for LaWS is established,taking into account the properties of laser transmission through the atmosphere and the thermal damage effects.By employing this model,key parameters pertaining to the effectiveness of laser damage are determined.The impact of various spatial positions and atmospheric conditions on the damage effectiveness of LaWS have been examined,employing simulation experiments with diverse parameters.The conclusions indicate that the damage effectiveness of LaWS is contingent upon the spatial position of the target,resulting in a diminished effectiveness to damage on distant,low-altitude targets.Additionally,the damage effectiveness of LaWS is heavily reliant on the atmospheric condition,particularly in complex settings such as midday and low visibility conditions,where the damage effectiveness is substantially reduced.This paper provides an accurate and effective calculation method for the rapid decisionmaking of the operators.展开更多
To evaluate the effectiveness of weapon systems, the advantages and disadvantages of grey relational analysis and TOPSIS for multiattribute decision-making is pointed out, and an effectiveness evaluation model of weap...To evaluate the effectiveness of weapon systems, the advantages and disadvantages of grey relational analysis and TOPSIS for multiattribute decision-making is pointed out, and an effectiveness evaluation model of weapon systems by combining grey relational analysis and TOPSIS is proposed. The model aggregates the grey relational grade and the distance to a new integrated closeness and reflects not only the trend but also the situation of the alternative. The example illuminates that the model is effective for the effectiveness evaluation of weapon systems.展开更多
Background: Some depressed patients receive acupuncture as an adjunct to their conventional medications.Objective: This review aims to provide evidence on whether acupuncture can enhance the therapeutic effectiveness ...Background: Some depressed patients receive acupuncture as an adjunct to their conventional medications.Objective: This review aims to provide evidence on whether acupuncture can enhance the therapeutic effectiveness of antidepressants for treating depression, and explore whether acupuncture can reduce the adverse reactions associated with antidepressants.Search strategy: English and Chinese databases were searched for randomized controlled trials(RCTs)published until December 1, 2021.Inclusion criteria: RCTs with a modified Jadad scale score ≥ 4 were included if they compared a group of participants with depression that received acupuncture combined with antidepressants with a control group that received antidepressants alone.Data extraction and analysis: Meta-analysis was performed, and statistical heterogeneity was assessed based on Cochran’s Q statistic and its related P-value. Primary outcomes were the reduction in the severity of depression and adverse reactions associated with antidepressants, while secondary outcomes included remission rate, treatment response, social functioning, and change in antidepressant dose.The Grading of Recommendations Assessment, Development and Evaluation(GRADE) framework was used to evaluate the overall quality of evidence in the included studies.Results: This review included 16 studies(with a total of 1958 participants). Most studies were at high risk of performance bias and at low or unclear risk of selection bias, detection bias, attrition bias, reporting bias, and other bias. Analysis of the 16 RCTs showed that, compared with antidepressants alone, acupuncture along with antidepressants reduced the Hamilton Depression Rating Scale-17(HAMD-17) scores(standard mean difference [SMD]-0.44, 95% confidence interval [CI]-0.55 to-0.33, P < 0.01;I^(2)= 14%), Self-rating Depression Scale(SDS) scores(SMD-0.53, 95% CI-0.84 to-0.23, P < 0.01;I^(2)= 79%), and the Side Effect Rating Scale(SERS) scores(SMD-1.11, 95% CI-1.56 to-0.66, P < 0.01;I^(2)= 89%). Compared with antidepressants alone, acupuncture along with antidepressants improved World Health Organization Quality of Life-BREF scores(SMD 0.31, 95% CI 0.18 to 0.44, P < 0.01;I^(2)= 15%), decreased the number of participants who increased their antidepressant dosages(relative risk[RR] 0.32, 95% CI 0.22 to 0.48, P < 0.01;I^(2)= 0%), and resulted in significantly higher remission rates(RR1.52, 95% CI 1.26 to 1.83, P < 0.01;I^(2)= 0%) and treatment responses(RR 1.35, 95% CI 1.24 to 1.47, P < 0.01;I^(2)= 19%) in terms of HAMD-17 scores. The HAMD-17, SDS and SERS scores were assessed as low quality by GRADE and the other indices as being of moderate quality.Conclusion: Acupuncture as an adjunct to antidepressants may enhance the therapeutic effectiveness and reduce the adverse drug reactions in patients receiving antidepressants. These findings must be interpreted with caution, as the evidence was of low or moderate quality and there was a lack of comparative data with a placebo control.Systematic review registration: INPLASY202150008.展开更多
Regarding the complexity and inconsistency of results in existing evaluation methods of mine cooling system, this paper clarifies the advantages, disadvantages and application of various mine cooling sys- tems through...Regarding the complexity and inconsistency of results in existing evaluation methods of mine cooling system, this paper clarifies the advantages, disadvantages and application of various mine cooling sys- tems through principle analysis, and divides all the cooling systems into air-cooling, ice-cooling and water-cooling according to the transportation of cold energy. On this basis, the paper proposes a simple and efficient evaluation method for mine cooling system. The first index of this method is the air temper- ature at point C which is 15 m away from the return wind corner at working face. A cooling system will be judged ineligible if the air temperature at point C is above 30 ℃ during operation, because in this case, the combustible gases in coal will sharply overflow, inducing gas incidents. Based on the preliminary judg- ment of the first index, another two evaluation indexes are proposed based on the cooling ability and dehumidification of an airflow volume of 1000 m3/min at point C to evaluate the investment and opera- tion cost of mine cooling system. This evaluation method has already been successfully applied in the cooling system design of Zhangshuanglou coal mine.展开更多
Equipment systems-of-systems （SOS） effectiveness evaluation can provide important reference for construction and optimization of the equipment SoS. After discussing the basic theory and methods of parallel experimen...Equipment systems-of-systems （SOS） effectiveness evaluation can provide important reference for construction and optimization of the equipment SoS. After discussing the basic theory and methods of parallel experiments, we depict an SoS effectiveness analysis and evaluation method using parallel expe- riments theory in detail. A case study is carried out which takes the missile defense system as an example. An artificial system of the missile defense system is constructed with the multi-agent modeling method. Then, single factor, multiple factors and defense position deployment computational experiments are carried out and evaluated with the statistical analysis method. Experiment re- sults show that the altitude of the secondary interception missile is not the key factor which affects SoS effectiveness and putting the defense position ahead will increase defense effectiveness. The case study demonstrates the feasibility of the proposed method.展开更多
The laser weapons will play a special role in the future high-tech war.To study the impact of airborne laser weapon on the System-of-System(SoS)effectiveness in cooperative com-bat,this paper proposes an indicator con...The laser weapons will play a special role in the future high-tech war.To study the impact of airborne laser weapon on the System-of-System(SoS)effectiveness in cooperative com-bat,this paper proposes an indicator construction method based on the combination of the weapon capability indicator system and the combat simulation.The indicator system of capability is divided into 4 layers by the bottom-to-up generation mechanism of indicators.It can describe the logical relationship between the indicator layers from a qualitative perspective.Together with the 4 layers capability indicator system,a hierarchical framework of airborne laser weapon is established by the agent-based modeling and simulation.Impact analyses show that the SoS effectiveness improves with the increase of the laser weapon output power,the laser launcher diameter,and the photoelectric sensor pixel.But the SoS effectiveness promotion brought by the photoelectric sensor pixel is limited.The results can be used for the development of tactical airborne laser weapon.展开更多
Coal mine safety supervision system plays an important role in the coal mine safety management in China.However,the current supervision system is established on the basis of learning the advanced experience from other...Coal mine safety supervision system plays an important role in the coal mine safety management in China.However,the current supervision system is established on the basis of learning the advanced experience from other developed countries.It needs to be further improved according to national conditions.Therefore,the effectiveness of coal mine safety supervision system reform on three types of collieries are assessed by using time series analysis method based on comparative analysis of the supervision system before and after the reform in this paper.The regression results show that the structural reform is not conductive to the improvement of coal mine safety situation in the short term,but conductive significantly in the long term.Specifically,the effects in township coal mines are more significant than stateowned key coal mines in the long run,but negative effects also exist in the short term.The negative effects in state-owned key coal mines are non-significant compared with township coal mines.Moreover,the regression results are analyzed from the aspects of the closure policy of illegal small township coal mines at the end of 1998 and shortage of the new supervision system.Finally,the suggestions on improving the new supervision system are put forward based on the above analysis.展开更多
To reduce complexity, the combat effectiveness simulation system(CESS) is often decomposed into static structure,physical behavior, and cognitive behavior, and model abstraction is layered onto domain invariant knowle...To reduce complexity, the combat effectiveness simulation system(CESS) is often decomposed into static structure,physical behavior, and cognitive behavior, and model abstraction is layered onto domain invariant knowledge(DIK) and application variant knowledge(AVK) levels. This study concentrates on the specification of CESS’s physical behaviors at the DIK level of abstraction, and proposes a model driven framework for efficiently developing simulation models within model-driven engineering(MDE). Technically, this framework integrates the four-layer metamodeling architecture and a set of model transformation techniques with the objective of reducing model heterogeneity and enhancing model continuity. As a proof of concept, a torpedo example is illustrated to explain how physical models are developed following the proposed framework. Finally, a combat scenario is constructed to demonstrate the availability, and a further verification is shown by a reasonable agreement between simulation results and field observations.展开更多
Effectiveness evaluation of the joint operation system is an important basis for the demonstration and development of weapon equipment.With the consideration that existing models of system effectiveness evaluation sel...Effectiveness evaluation of the joint operation system is an important basis for the demonstration and development of weapon equipment.With the consideration that existing models of system effectiveness evaluation seldom describe the structural relationship among equipment clearly as well as reflect the dynamic,the analog-to-digital converter-graphical evaluation and review technique(ADC-GERT)network parameter estimation model is proposed based on the ADC model and the joint operation system structure.Firstly,analysis of the joint operation system structure and operation process is conducted to build the GERT network,where equipment subsystems are nodes and activities are directed arches.Then the mission effectiveness of equipment subsystems is calculated by the ADC model.The probability transfer parameters are modified by the mission effectiveness of equipment subsystems based on the Bayesian theorem,with the ADC-GERT network parameter estimation model constructed.Finally,a case study is used to validate the efficiency and dynamic of the ADC-GERT network parameter estimation model.展开更多
Background:Heat stroke(HS)is a serious,life-threatening disease.However,there is no scoring system for HS so far.This research is to establish a scoring system that can quantitatively assess the severity of exertional...Background:Heat stroke(HS)is a serious,life-threatening disease.However,there is no scoring system for HS so far.This research is to establish a scoring system that can quantitatively assess the severity of exertional heat stroke(EHS).Methods:Data were collected from a total of 170 exertional heat stroke(EHS)patients between 2005 and 2016 from 52 hospitals in China.Univariate statistical methods and comparison of the area under the receiver operating characteristic(ROC)curve(AUC)were used to screen exertional heat stroke score(EHSS)parameters,including but not limited body temperature(T),Glasgow Coma Scale(GCS)and others.By comparing the sizes of the AUCs of the APACHE II,SOFA and EHSS assessments,the effectiveness of EHSS in evaluating the prognosis of EHS patients was verified.Results:Through screening with a series of methods,as described above,the present study determined 12 parameters–body temperature(T),GCS,p H,lactate(Lac),platelet count(PLT),prothrombin time(PT),fibrinogen(Fib),troponin I(Tn I),aspartate aminotransferase(AST),total bilirubin(TBIL),creatinine(Cr)and acute gastrointestinal injury(AGI)classification–as EHSS parameters.It is a 0–47 point system designed to reflect increasing severity of heat stroke.Low(EHSS<20)and high scores(EHSS>35)showed 100%survival and 100%mortality,respectively.We found that AUCEHSS>AUCSOFA>AUCAPACHE II.Conclusions:A total of 12 parameters–T,GCS,p H,Lac,PLT,PT,Fib,Tn I,AST,TBIL,Cr and gastrointestinal AGI classification–are the EHSS parameters with the best effectiveness in evaluating the prognosis of EHS patients.As EHSS score increases,the mortality rate of EHS patients gradually increases.展开更多
Combat system effectiveness simulation (CSES) is a special type of complex system simulation. Three non-functional requirements (NFRs), i.e. model composability, domain specific modeling, and model evolvability, are g...Combat system effectiveness simulation (CSES) is a special type of complex system simulation. Three non-functional requirements (NFRs), i.e. model composability, domain specific modeling, and model evolvability, are gaining higher priority from CSES users when evaluating different modeling methodologies for CSES. Traditional CSES modeling methodologies are either domain-neutral (lack of domain characteristics consideration and limited support for model composability) or domain-oriented (lack of openness and evolvability) and fall short of the three NFRs. Inspired by the concept of architecture in systems engineering and software engineering fields, we extend it into a concept of model architecture for complex simulation systems, and propose a model architecture-oriented modeling methodology in which the model architecture plays a central role in achieving the three NFRs. Various model-driven engineering (MDE) approaches and technologies, including simulation modeling platform (SMP), unified modeling language (UML), domain specific modeling (DSM), eclipse modeling framework (EMF), graphical modeling framework (GMF), and so forth, are applied where possible in representing the CSES model architecture and its components' behaviors from physical and cognitive domain aspects. A prototype CSES system, called weapon effectiveness simulation system (WESS), and a non-trivial air-combat simulation example are presented to demonstrate the methodology.展开更多
As one of the most important part of weapon system of systems(WSoS),quantitative evaluation of reconnaissance satellite system(RSS)is indispensable during its construction and application.Aiming at the problem of nonl...As one of the most important part of weapon system of systems(WSoS),quantitative evaluation of reconnaissance satellite system(RSS)is indispensable during its construction and application.Aiming at the problem of nonlinear effectiveness evaluation under small sample conditions,we propose an evaluation method based on support vector regression(SVR)to effectively address the defects of traditional methods.Considering the performance of SVR is influenced by the penalty factor,kernel type,and other parameters deeply,the improved grey wolf optimizer(IGWO)is employed for parameter optimization.In the proposed IGWO algorithm,the opposition-based learning strategy is adopted to increase the probability of avoiding the local optima,the mutation operator is used to escape from premature convergence and differential convergence factors are applied to increase the rate of convergence.Numerical experiments of 14 test functions validate the applicability of IGWO algorithm dealing with global optimization.The index system and evaluation method are constructed based on the characteristics of RSS.To validate the proposed IGWO-SVR evaluation method,eight benchmark data sets and combat simulation are employed to estimate the evaluation accuracy,convergence performance and computational complexity.According to the experimental results,the proposed method outperforms several prediction based evaluation methods,verifies the superiority and effectiveness in RSS operational effectiveness evaluation.展开更多
Objective:To evaluate the effectiveness and safety of seven oral Chinese patent medicines(CPMs)as adjuvant therapy for cancer-related anemia(CRA)by network meta-analysis(NMA).Methods:A literature search to obtain rand...Objective:To evaluate the effectiveness and safety of seven oral Chinese patent medicines(CPMs)as adjuvant therapy for cancer-related anemia(CRA)by network meta-analysis(NMA).Methods:A literature search to obtain randomized controlled trials(RCTs)of seven oral CPMs in the adjuvant treatment of CRA was conducted in multiple databases from the inception to April 2022.The RevMan5.3 and R 4.1.1 software were used for NMA.Results:We ultimately included 29 RCTs with 2140 patients.Traditional meta-analysis showed that Fufang E'jiao syrup(FFEJS),Shengxuebao mixture(SXBM),Shengxuening tablets(SXNT),Jianpi Shengxue granules(JPSXG),and Yixuesheng capsule(YXSC)combined with basic Western treatment(BWT)could improve the hemoglobin(HGB)level.JPSXG combined with BWT could improve the red blood cell(RBC).FFEJS combined with BWT improved the Karnofsky performance status(KPS).NMA showed that FFEJS,JPSXG,SXBM,and SXNT plus BWT improved HGB better than Shengxue tablets(SXT)plus BWT,with top three ranking results being JPSXG plus BWT>SXNT plus BWT>FFEJS plus BWT.FFEJS plus BWT,JPSXG plus BWT,SXBM plus BWT,SXNT plus BWT,and SXT plus BWT improved RBC better than BWT,with top three ranking results being SXNT plus BWT>JPSXG plus BWT>FFEJS plus BWT.In terms of the KPS score,compared with SXT plus BWT,FFEJS,JPSXG,SXBM,SXNT,and Yizhong Shengxue capsule(YZSXC)plus BWT had higher KPS,with top three ranking results being SXBM plus BWT>JPSXG plus BWT>FFEJS plus BWT.Conclusions:Our NMA demonstrated that seven oral CPMs used as adjuvant treatment of CRA had a definite clinical effect.JPSXG not only increases the levels of HGB and RBC to enhance the clinical effect but also improves patients'quality of life.More accurate conclusions need to be verified by more high-quality RCTs.展开更多
BACKGROUND Diabetic retinopathy(DR)is currently recognized as one of the most serious diabetic microangiopathies and a major cause of adult blindness.Commonly used clinical approaches include etiological control,micro...BACKGROUND Diabetic retinopathy(DR)is currently recognized as one of the most serious diabetic microangiopathies and a major cause of adult blindness.Commonly used clinical approaches include etiological control,microvascular improvement,and surgical intervention,but they are ineffective and have many side effects.Oral Chinese medicine(OCM)has been used for thousands of years to treat DR and is still widely used today,but it is unclear which OCM is more effective for DR.AIM To estimate relative effectiveness and safety profiles for different classes of OCMs for DR,and provide rankings of the available OCMs.METHODS The search time frame was from the creation of the database to January 2023.RevMan 5.3 and Stata 14.0 software were used to perform the systematic review and Network meta-analyses(NMA).RESULTS A total of 107 studies and 9710 patients were included,including 4767 cases in the test group and 4973 cases in the control group.Based on previous studies and clinical reports,and combined with the recommendations of Chinese guidelines for the prevention and treatment of DR,9 OCMs were finally included in this study,namely Compound Xueshuantong Capsules,Qiming Granules,Compound Danshen Dripping Pills,Hexue Mingmu Tablets(HXMM),Qiju Dihuang Pills(QJDH),Shuangdan Mingmu Capsules(SDMM),Danggui Buxue Decoction(DGBX),Xuefu Zhuyu Decoction and Buyang Huanwu Decoction.When these nine OCMs were analyzed in combination with conventional western medicine treatment(CT)compared with CT alone,the NMA results showed that HXMM+CT has better intervention effect on the overall efficacy of DR patients,HXMM+CT has better effect on improving patients'visual acuity,SDMM+CT has better effect on inhibiting vascular endothelial growth factor,DGBX+CT has better effect on reducing fundus hemorrhage area,HXMM+CT has better effect on reducing fasting blood glucose,and QJDH+CT has better effect on reducing glycated hemoglobin.When there are not enough clinical indicators for reference,SDMM+CT or HXMM+CT treatments can be chosen because they are effective for more indicators and demonstrate multidimensional efficacy.CONCLUSION This study provides evidence that combining OCMs with CT leads to better outcomes in all aspects of DR compared to using CT alone.Based on the findings,we highly recommend the use of SDMM or HXMM for the treatment of DR.These two OCMs have demonstrated outstanding efficacy across multiple indicators.展开更多
To improve the effect of destroying time-sensitive target （TST）, a method of operational effectiveness evaluation is presented and some influential factors are analyzed based on the combat flow of system for destroy...To improve the effect of destroying time-sensitive target （TST）, a method of operational effectiveness evaluation is presented and some influential factors are analyzed based on the combat flow of system for destroying TST. Considering the possible operation modes of the system, a waved operation mode and a continuous operation mode are put forward at first. At the same time, some relative formulas are modified. In examples, the influential factors and operation modes are analyzed based on the system effectiveness. From simulation results, some design and operation strategies of the system for destroying time sensitive targets are concluded, which benefit to the improvement of the system effectiveness.展开更多
Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects p...Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects people＇s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective.Methods： A narrative analysis of the data was performed for the eligible studies. Four databases were chosen： CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration＇s risk of bias tool. Results： A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS]s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality ot life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD.Conclusions： The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.展开更多
AIM:To assess the effectiveness,safety,and costeffectiveness of the Argus II in treatment of the retinitis pigmentosa(RP)patients.METHODS:The Pro Quest,Web of Science,EMBASE,MEDLINE(via Pub Med)were searched using com...AIM:To assess the effectiveness,safety,and costeffectiveness of the Argus II in treatment of the retinitis pigmentosa(RP)patients.METHODS:The Pro Quest,Web of Science,EMBASE,MEDLINE(via Pub Med)were searched using combinations of the keywords of Argus,safety,effectiveness,bionic eye,retinal prosthesis,and RP through March 2018.The retrieved records were screened and then assessed for eligibility.RESULTS:Totally 926 records were retrieved from the searched databases and finally 12 studies included.The RP patients showed improvements in visual function after receiving the prosthesis,compared to the time before the prosthesis or the time it was off.This was measured by square localization,direction of motion,and grating visual acuity tests.No major adverse effect was reported for the Argus II prosthesis itself and/or the surgery to implement it,but the most frequently reported items were hypotony,and conjunctival dehiscence.The incremental cost-effectiveness ratio(ICER)was calculated to be€14603 per qualityadjusted life year(QALY)in UK and$207616 per QALY in Canada.CONCLUSION:The available evidence shows that the Argus II prosthesis in RP patients is effective in improvement of their visual function.Some minor adverse effects are reported for the prosthesis.The cost-effectiveness studies show that the technology is cost-effective only at high levels of willingness-to-pay.展开更多
Ecosystem services have become one of the core elements of ecosystem management and evaluation. As a key area of ecosystem services and for maintaining national ecological security, ecosystem changes and implementatio...Ecosystem services have become one of the core elements of ecosystem management and evaluation. As a key area of ecosystem services and for maintaining national ecological security, ecosystem changes and implementation effect evaluation are important in national key ecological function zones, for promoting the main function zone strategy and for improving the construction of an ecological civilization. This article studies the ecological zone of a tropical rainforest region in the central mountain area of Hainan Island, China. Multi-source satellite data and ground observation statistics are analyzed with geo-statistics method and ecological assessment model. The core analysis of this paper includes ecosystem patterns, quality and services. By means of spatial and temporal scale expansion and multidimensional space-time correlation analysis, the trends and stability characteristics of ecosystem changes are analyzed, and implementation effect evaluation is discussed. The analysis shows a variety of results. The proportion of forest area inside the ecological zone was significantly higher than the average level in Hainan Island. During 1990–2013, settlement gradually increased inside the ecological zone. After implementation of the zone in 2010, human activity intensity increased, with the main land use being urban construction and land reclamation. Water conservation in the ecological function zone was higher than that outside the zone. In general, it increased slightly, but had obvious fluctuations. Soil conservation inside the zone was also better than that outside. However, it demonstrated dramatic fluctuations and relatively poor stability during 1990–2013. The human disturbance index inside the zone was significantly lower than that outside, and had a lower biodiversity threat level. Especially in 2010–2013, the increased range of the human disturbance index inside the zone was significantly less than that outside.展开更多
文摘Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenvatinib and everolimus represents a viable option,and the present review aimed to summarize its activity,effectiveness,and safety.Methods:A systematic review of the literature was conducted using PubMed,targeting studies published between 2018 and 2025.Eligible studies included English-language prospective and retrospective trials reporting survival outcomes in mRCC patients treated with lenvatinib and everolimus after at least one ICI-containing regimen.Results:Nine studies met the inclusion criteria,encompassing a total of 441 patients.The lenvatinib and everolimus combination was primarily used in the third and subsequent lines of therapy.Median overall survival ranged from 7.5 to 24.5 months,while median progression-free survival was more consistent,between 6.1 and 6.7 months,except for one study reporting 12.9 months.Objective response rates varied widely(14.0%–55.7%).Adverse events of grade≥3 did not exceed the expected rate,with diarrhoea and proteinuria as the most reported events.Dose reductions and treatment discontinuations due to toxicity occurred but were generally lower than in prior pivotal trials.Conclusions:Real-world evidence suggests that lenvatinib and everolimus represent an effective and safe option after ICI failure in mRCC patients.Nevertheless,the lack of randomized phase III trials and the heterogeneity of existing studies highlight the need for more robust prospective research to guide post-ICI therapeutic strategies.
基金supported by the social development project of the National Social Science Fund Project(No.17BTQ063)National Natural Science Foundation of China(72174094).
文摘Stroke,which is the second leading cause of mortality worldwide and the third leading cause of death and disability combined,[1]necessitates cost-effective rehabilitation interventions.Acupuncture is a traditional Chinese medicine therapy that is increasingly recognized as a complementary stroke therapy.
基金supported by the National Social Science Foundation of China(2022-SKJJ-C-037)the National Natural Science Foundation of China General Program(72071209).
文摘The emergence of laser technology has led to the gradual integration of laser weapon system(LaWS)into military scene,particularly in the field of anti-unmanned aerial vehicle(UAV),showcasing significant potential.However,A current limitation lies in the absence of a comprehensive quantitative approach to assess the capabilities of LaWS.To address this issue,a damage effectiveness characterization model for LaWS is established,taking into account the properties of laser transmission through the atmosphere and the thermal damage effects.By employing this model,key parameters pertaining to the effectiveness of laser damage are determined.The impact of various spatial positions and atmospheric conditions on the damage effectiveness of LaWS have been examined,employing simulation experiments with diverse parameters.The conclusions indicate that the damage effectiveness of LaWS is contingent upon the spatial position of the target,resulting in a diminished effectiveness to damage on distant,low-altitude targets.Additionally,the damage effectiveness of LaWS is heavily reliant on the atmospheric condition,particularly in complex settings such as midday and low visibility conditions,where the damage effectiveness is substantially reduced.This paper provides an accurate and effective calculation method for the rapid decisionmaking of the operators.
文摘To evaluate the effectiveness of weapon systems, the advantages and disadvantages of grey relational analysis and TOPSIS for multiattribute decision-making is pointed out, and an effectiveness evaluation model of weapon systems by combining grey relational analysis and TOPSIS is proposed. The model aggregates the grey relational grade and the distance to a new integrated closeness and reflects not only the trend but also the situation of the alternative. The example illuminates that the model is effective for the effectiveness evaluation of weapon systems.
基金supported by a grant from National Natural Science Foundation of China (grant number 82104983)Scientific Research Program by Traditional Chinese Medicine Bureau of Guangdong Province,China (grant number 20201103)Fundamental Research Funds for the Central Universities,China (grant number 21620362)。
文摘Background: Some depressed patients receive acupuncture as an adjunct to their conventional medications.Objective: This review aims to provide evidence on whether acupuncture can enhance the therapeutic effectiveness of antidepressants for treating depression, and explore whether acupuncture can reduce the adverse reactions associated with antidepressants.Search strategy: English and Chinese databases were searched for randomized controlled trials(RCTs)published until December 1, 2021.Inclusion criteria: RCTs with a modified Jadad scale score ≥ 4 were included if they compared a group of participants with depression that received acupuncture combined with antidepressants with a control group that received antidepressants alone.Data extraction and analysis: Meta-analysis was performed, and statistical heterogeneity was assessed based on Cochran’s Q statistic and its related P-value. Primary outcomes were the reduction in the severity of depression and adverse reactions associated with antidepressants, while secondary outcomes included remission rate, treatment response, social functioning, and change in antidepressant dose.The Grading of Recommendations Assessment, Development and Evaluation(GRADE) framework was used to evaluate the overall quality of evidence in the included studies.Results: This review included 16 studies(with a total of 1958 participants). Most studies were at high risk of performance bias and at low or unclear risk of selection bias, detection bias, attrition bias, reporting bias, and other bias. Analysis of the 16 RCTs showed that, compared with antidepressants alone, acupuncture along with antidepressants reduced the Hamilton Depression Rating Scale-17(HAMD-17) scores(standard mean difference [SMD]-0.44, 95% confidence interval [CI]-0.55 to-0.33, P < 0.01;I^(2)= 14%), Self-rating Depression Scale(SDS) scores(SMD-0.53, 95% CI-0.84 to-0.23, P < 0.01;I^(2)= 79%), and the Side Effect Rating Scale(SERS) scores(SMD-1.11, 95% CI-1.56 to-0.66, P < 0.01;I^(2)= 89%). Compared with antidepressants alone, acupuncture along with antidepressants improved World Health Organization Quality of Life-BREF scores(SMD 0.31, 95% CI 0.18 to 0.44, P < 0.01;I^(2)= 15%), decreased the number of participants who increased their antidepressant dosages(relative risk[RR] 0.32, 95% CI 0.22 to 0.48, P < 0.01;I^(2)= 0%), and resulted in significantly higher remission rates(RR1.52, 95% CI 1.26 to 1.83, P < 0.01;I^(2)= 0%) and treatment responses(RR 1.35, 95% CI 1.24 to 1.47, P < 0.01;I^(2)= 19%) in terms of HAMD-17 scores. The HAMD-17, SDS and SERS scores were assessed as low quality by GRADE and the other indices as being of moderate quality.Conclusion: Acupuncture as an adjunct to antidepressants may enhance the therapeutic effectiveness and reduce the adverse drug reactions in patients receiving antidepressants. These findings must be interpreted with caution, as the evidence was of low or moderate quality and there was a lack of comparative data with a placebo control.Systematic review registration: INPLASY202150008.
基金supported by the key project of National Natural Science Foundation ‘‘Deep Heat Governance and Utilization’’ (Nos.51134005 and 41402273)the Doctoral Fund of Ministry of Education (No. 20130023110021)
文摘Regarding the complexity and inconsistency of results in existing evaluation methods of mine cooling system, this paper clarifies the advantages, disadvantages and application of various mine cooling sys- tems through principle analysis, and divides all the cooling systems into air-cooling, ice-cooling and water-cooling according to the transportation of cold energy. On this basis, the paper proposes a simple and efficient evaluation method for mine cooling system. The first index of this method is the air temper- ature at point C which is 15 m away from the return wind corner at working face. A cooling system will be judged ineligible if the air temperature at point C is above 30 ℃ during operation, because in this case, the combustible gases in coal will sharply overflow, inducing gas incidents. Based on the preliminary judg- ment of the first index, another two evaluation indexes are proposed based on the cooling ability and dehumidification of an airflow volume of 1000 m3/min at point C to evaluate the investment and opera- tion cost of mine cooling system. This evaluation method has already been successfully applied in the cooling system design of Zhangshuanglou coal mine.
文摘Equipment systems-of-systems （SOS） effectiveness evaluation can provide important reference for construction and optimization of the equipment SoS. After discussing the basic theory and methods of parallel experiments, we depict an SoS effectiveness analysis and evaluation method using parallel expe- riments theory in detail. A case study is carried out which takes the missile defense system as an example. An artificial system of the missile defense system is constructed with the multi-agent modeling method. Then, single factor, multiple factors and defense position deployment computational experiments are carried out and evaluated with the statistical analysis method. Experiment re- sults show that the altitude of the secondary interception missile is not the key factor which affects SoS effectiveness and putting the defense position ahead will increase defense effectiveness. The case study demonstrates the feasibility of the proposed method.
文摘The laser weapons will play a special role in the future high-tech war.To study the impact of airborne laser weapon on the System-of-System(SoS)effectiveness in cooperative com-bat,this paper proposes an indicator construction method based on the combination of the weapon capability indicator system and the combat simulation.The indicator system of capability is divided into 4 layers by the bottom-to-up generation mechanism of indicators.It can describe the logical relationship between the indicator layers from a qualitative perspective.Together with the 4 layers capability indicator system,a hierarchical framework of airborne laser weapon is established by the agent-based modeling and simulation.Impact analyses show that the SoS effectiveness improves with the increase of the laser weapon output power,the laser launcher diameter,and the photoelectric sensor pixel.But the SoS effectiveness promotion brought by the photoelectric sensor pixel is limited.The results can be used for the development of tactical airborne laser weapon.
基金supported by the National Nat-ural Science Foundation Projects of China under Grant 71271206Innovation Project of Graduate Education for Jiangsu Province under Grant KYZZ_0377.
文摘Coal mine safety supervision system plays an important role in the coal mine safety management in China.However,the current supervision system is established on the basis of learning the advanced experience from other developed countries.It needs to be further improved according to national conditions.Therefore,the effectiveness of coal mine safety supervision system reform on three types of collieries are assessed by using time series analysis method based on comparative analysis of the supervision system before and after the reform in this paper.The regression results show that the structural reform is not conductive to the improvement of coal mine safety situation in the short term,but conductive significantly in the long term.Specifically,the effects in township coal mines are more significant than stateowned key coal mines in the long run,but negative effects also exist in the short term.The negative effects in state-owned key coal mines are non-significant compared with township coal mines.Moreover,the regression results are analyzed from the aspects of the closure policy of illegal small township coal mines at the end of 1998 and shortage of the new supervision system.Finally,the suggestions on improving the new supervision system are put forward based on the above analysis.
基金supported by the National Natural Science Foundation of China(61273198)
文摘To reduce complexity, the combat effectiveness simulation system(CESS) is often decomposed into static structure,physical behavior, and cognitive behavior, and model abstraction is layered onto domain invariant knowledge(DIK) and application variant knowledge(AVK) levels. This study concentrates on the specification of CESS’s physical behaviors at the DIK level of abstraction, and proposes a model driven framework for efficiently developing simulation models within model-driven engineering(MDE). Technically, this framework integrates the four-layer metamodeling architecture and a set of model transformation techniques with the objective of reducing model heterogeneity and enhancing model continuity. As a proof of concept, a torpedo example is illustrated to explain how physical models are developed following the proposed framework. Finally, a combat scenario is constructed to demonstrate the availability, and a further verification is shown by a reasonable agreement between simulation results and field observations.
基金supported by the National Natural Science Foundation of China(72071111,71801127,71671091)the NSFC and the UK Royal Society joint project(71811530338)+2 种基金the Special Postdoctoral Fund of China(2019TQ0150)the Fundamental Research Funds for the Central Universities of China(NC2019003)the Intelligence Introduction Base of the Ministry of Science and Technology(G20190010178)。
文摘Effectiveness evaluation of the joint operation system is an important basis for the demonstration and development of weapon equipment.With the consideration that existing models of system effectiveness evaluation seldom describe the structural relationship among equipment clearly as well as reflect the dynamic,the analog-to-digital converter-graphical evaluation and review technique(ADC-GERT)network parameter estimation model is proposed based on the ADC model and the joint operation system structure.Firstly,analysis of the joint operation system structure and operation process is conducted to build the GERT network,where equipment subsystems are nodes and activities are directed arches.Then the mission effectiveness of equipment subsystems is calculated by the ADC model.The probability transfer parameters are modified by the mission effectiveness of equipment subsystems based on the Bayesian theorem,with the ADC-GERT network parameter estimation model constructed.Finally,a case study is used to validate the efficiency and dynamic of the ADC-GERT network parameter estimation model.
基金supported by the National Natural Science Foundation of China(81671966)the Beijing Natural Science Foundation(7182155)+2 种基金the Application Research and Achievement Extension of Clinical Characteristics in Chinese Capital Foundation(Z171100001017160)the Cultivation Program for Military Medical Science and Technology Youth-Growth Project(16QNP139)the Clinical Research Support Foundation of Chinese PLA General Hospital(2015FC-ZHCG-1002)。
文摘Background:Heat stroke(HS)is a serious,life-threatening disease.However,there is no scoring system for HS so far.This research is to establish a scoring system that can quantitatively assess the severity of exertional heat stroke(EHS).Methods:Data were collected from a total of 170 exertional heat stroke(EHS)patients between 2005 and 2016 from 52 hospitals in China.Univariate statistical methods and comparison of the area under the receiver operating characteristic(ROC)curve(AUC)were used to screen exertional heat stroke score(EHSS)parameters,including but not limited body temperature(T),Glasgow Coma Scale(GCS)and others.By comparing the sizes of the AUCs of the APACHE II,SOFA and EHSS assessments,the effectiveness of EHSS in evaluating the prognosis of EHS patients was verified.Results:Through screening with a series of methods,as described above,the present study determined 12 parameters–body temperature(T),GCS,p H,lactate(Lac),platelet count(PLT),prothrombin time(PT),fibrinogen(Fib),troponin I(Tn I),aspartate aminotransferase(AST),total bilirubin(TBIL),creatinine(Cr)and acute gastrointestinal injury(AGI)classification–as EHSS parameters.It is a 0–47 point system designed to reflect increasing severity of heat stroke.Low(EHSS<20)and high scores(EHSS>35)showed 100%survival and 100%mortality,respectively.We found that AUCEHSS>AUCSOFA>AUCAPACHE II.Conclusions:A total of 12 parameters–T,GCS,p H,Lac,PLT,PT,Fib,Tn I,AST,TBIL,Cr and gastrointestinal AGI classification–are the EHSS parameters with the best effectiveness in evaluating the prognosis of EHS patients.As EHSS score increases,the mortality rate of EHS patients gradually increases.
基金supported by the National Natural Science Foundation of China(61273198)
文摘Combat system effectiveness simulation (CSES) is a special type of complex system simulation. Three non-functional requirements (NFRs), i.e. model composability, domain specific modeling, and model evolvability, are gaining higher priority from CSES users when evaluating different modeling methodologies for CSES. Traditional CSES modeling methodologies are either domain-neutral (lack of domain characteristics consideration and limited support for model composability) or domain-oriented (lack of openness and evolvability) and fall short of the three NFRs. Inspired by the concept of architecture in systems engineering and software engineering fields, we extend it into a concept of model architecture for complex simulation systems, and propose a model architecture-oriented modeling methodology in which the model architecture plays a central role in achieving the three NFRs. Various model-driven engineering (MDE) approaches and technologies, including simulation modeling platform (SMP), unified modeling language (UML), domain specific modeling (DSM), eclipse modeling framework (EMF), graphical modeling framework (GMF), and so forth, are applied where possible in representing the CSES model architecture and its components' behaviors from physical and cognitive domain aspects. A prototype CSES system, called weapon effectiveness simulation system (WESS), and a non-trivial air-combat simulation example are presented to demonstrate the methodology.
基金the National Defense Science and Technology Key Laboratory Fund of China(XM2020XT1023).
文摘As one of the most important part of weapon system of systems(WSoS),quantitative evaluation of reconnaissance satellite system(RSS)is indispensable during its construction and application.Aiming at the problem of nonlinear effectiveness evaluation under small sample conditions,we propose an evaluation method based on support vector regression(SVR)to effectively address the defects of traditional methods.Considering the performance of SVR is influenced by the penalty factor,kernel type,and other parameters deeply,the improved grey wolf optimizer(IGWO)is employed for parameter optimization.In the proposed IGWO algorithm,the opposition-based learning strategy is adopted to increase the probability of avoiding the local optima,the mutation operator is used to escape from premature convergence and differential convergence factors are applied to increase the rate of convergence.Numerical experiments of 14 test functions validate the applicability of IGWO algorithm dealing with global optimization.The index system and evaluation method are constructed based on the characteristics of RSS.To validate the proposed IGWO-SVR evaluation method,eight benchmark data sets and combat simulation are employed to estimate the evaluation accuracy,convergence performance and computational complexity.According to the experimental results,the proposed method outperforms several prediction based evaluation methods,verifies the superiority and effectiveness in RSS operational effectiveness evaluation.
基金This work was supported by the National Natural Science Foundation of China(82074240)the Capital Health Research and Development of Special(2020-2-4193).
文摘Objective:To evaluate the effectiveness and safety of seven oral Chinese patent medicines(CPMs)as adjuvant therapy for cancer-related anemia(CRA)by network meta-analysis(NMA).Methods:A literature search to obtain randomized controlled trials(RCTs)of seven oral CPMs in the adjuvant treatment of CRA was conducted in multiple databases from the inception to April 2022.The RevMan5.3 and R 4.1.1 software were used for NMA.Results:We ultimately included 29 RCTs with 2140 patients.Traditional meta-analysis showed that Fufang E'jiao syrup(FFEJS),Shengxuebao mixture(SXBM),Shengxuening tablets(SXNT),Jianpi Shengxue granules(JPSXG),and Yixuesheng capsule(YXSC)combined with basic Western treatment(BWT)could improve the hemoglobin(HGB)level.JPSXG combined with BWT could improve the red blood cell(RBC).FFEJS combined with BWT improved the Karnofsky performance status(KPS).NMA showed that FFEJS,JPSXG,SXBM,and SXNT plus BWT improved HGB better than Shengxue tablets(SXT)plus BWT,with top three ranking results being JPSXG plus BWT>SXNT plus BWT>FFEJS plus BWT.FFEJS plus BWT,JPSXG plus BWT,SXBM plus BWT,SXNT plus BWT,and SXT plus BWT improved RBC better than BWT,with top three ranking results being SXNT plus BWT>JPSXG plus BWT>FFEJS plus BWT.In terms of the KPS score,compared with SXT plus BWT,FFEJS,JPSXG,SXBM,SXNT,and Yizhong Shengxue capsule(YZSXC)plus BWT had higher KPS,with top three ranking results being SXBM plus BWT>JPSXG plus BWT>FFEJS plus BWT.Conclusions:Our NMA demonstrated that seven oral CPMs used as adjuvant treatment of CRA had a definite clinical effect.JPSXG not only increases the levels of HGB and RBC to enhance the clinical effect but also improves patients'quality of life.More accurate conclusions need to be verified by more high-quality RCTs.
基金The National Administration of Traditional Chinese Medicine for the Youth Qihuang Scholar Support Project.
文摘BACKGROUND Diabetic retinopathy(DR)is currently recognized as one of the most serious diabetic microangiopathies and a major cause of adult blindness.Commonly used clinical approaches include etiological control,microvascular improvement,and surgical intervention,but they are ineffective and have many side effects.Oral Chinese medicine(OCM)has been used for thousands of years to treat DR and is still widely used today,but it is unclear which OCM is more effective for DR.AIM To estimate relative effectiveness and safety profiles for different classes of OCMs for DR,and provide rankings of the available OCMs.METHODS The search time frame was from the creation of the database to January 2023.RevMan 5.3 and Stata 14.0 software were used to perform the systematic review and Network meta-analyses(NMA).RESULTS A total of 107 studies and 9710 patients were included,including 4767 cases in the test group and 4973 cases in the control group.Based on previous studies and clinical reports,and combined with the recommendations of Chinese guidelines for the prevention and treatment of DR,9 OCMs were finally included in this study,namely Compound Xueshuantong Capsules,Qiming Granules,Compound Danshen Dripping Pills,Hexue Mingmu Tablets(HXMM),Qiju Dihuang Pills(QJDH),Shuangdan Mingmu Capsules(SDMM),Danggui Buxue Decoction(DGBX),Xuefu Zhuyu Decoction and Buyang Huanwu Decoction.When these nine OCMs were analyzed in combination with conventional western medicine treatment(CT)compared with CT alone,the NMA results showed that HXMM+CT has better intervention effect on the overall efficacy of DR patients,HXMM+CT has better effect on improving patients'visual acuity,SDMM+CT has better effect on inhibiting vascular endothelial growth factor,DGBX+CT has better effect on reducing fundus hemorrhage area,HXMM+CT has better effect on reducing fasting blood glucose,and QJDH+CT has better effect on reducing glycated hemoglobin.When there are not enough clinical indicators for reference,SDMM+CT or HXMM+CT treatments can be chosen because they are effective for more indicators and demonstrate multidimensional efficacy.CONCLUSION This study provides evidence that combining OCMs with CT leads to better outcomes in all aspects of DR compared to using CT alone.Based on the findings,we highly recommend the use of SDMM or HXMM for the treatment of DR.These two OCMs have demonstrated outstanding efficacy across multiple indicators.
基金supported by the National Natural Science Foundation of China (60774064)the Aerospace Science Foundation (05D53022)the Youth for NPU Teachers Scientific and Technological Innovation Foundation (W016210)
文摘To improve the effect of destroying time-sensitive target （TST）, a method of operational effectiveness evaluation is presented and some influential factors are analyzed based on the combat flow of system for destroying TST. Considering the possible operation modes of the system, a waved operation mode and a continuous operation mode are put forward at first. At the same time, some relative formulas are modified. In examples, the influential factors and operation modes are analyzed based on the system effectiveness. From simulation results, some design and operation strategies of the system for destroying time sensitive targets are concluded, which benefit to the improvement of the system effectiveness.
文摘Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects people＇s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective.Methods： A narrative analysis of the data was performed for the eligible studies. Four databases were chosen： CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration＇s risk of bias tool. Results： A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS]s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality ot life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD.Conclusions： The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.
基金Supported by the National Institute for Health Research(NIHR)of Iran。
文摘AIM:To assess the effectiveness,safety,and costeffectiveness of the Argus II in treatment of the retinitis pigmentosa(RP)patients.METHODS:The Pro Quest,Web of Science,EMBASE,MEDLINE(via Pub Med)were searched using combinations of the keywords of Argus,safety,effectiveness,bionic eye,retinal prosthesis,and RP through March 2018.The retrieved records were screened and then assessed for eligibility.RESULTS:Totally 926 records were retrieved from the searched databases and finally 12 studies included.The RP patients showed improvements in visual function after receiving the prosthesis,compared to the time before the prosthesis or the time it was off.This was measured by square localization,direction of motion,and grating visual acuity tests.No major adverse effect was reported for the Argus II prosthesis itself and/or the surgery to implement it,but the most frequently reported items were hypotony,and conjunctival dehiscence.The incremental cost-effectiveness ratio(ICER)was calculated to be€14603 per qualityadjusted life year(QALY)in UK and$207616 per QALY in Canada.CONCLUSION:The available evidence shows that the Argus II prosthesis in RP patients is effective in improvement of their visual function.Some minor adverse effects are reported for the prosthesis.The cost-effectiveness studies show that the technology is cost-effective only at high levels of willingness-to-pay.
基金National Key R&D Program of China,No.2017YFC0506506,No.2016YFC0500206National Natural Science Foundation of China,No.41501484
文摘Ecosystem services have become one of the core elements of ecosystem management and evaluation. As a key area of ecosystem services and for maintaining national ecological security, ecosystem changes and implementation effect evaluation are important in national key ecological function zones, for promoting the main function zone strategy and for improving the construction of an ecological civilization. This article studies the ecological zone of a tropical rainforest region in the central mountain area of Hainan Island, China. Multi-source satellite data and ground observation statistics are analyzed with geo-statistics method and ecological assessment model. The core analysis of this paper includes ecosystem patterns, quality and services. By means of spatial and temporal scale expansion and multidimensional space-time correlation analysis, the trends and stability characteristics of ecosystem changes are analyzed, and implementation effect evaluation is discussed. The analysis shows a variety of results. The proportion of forest area inside the ecological zone was significantly higher than the average level in Hainan Island. During 1990–2013, settlement gradually increased inside the ecological zone. After implementation of the zone in 2010, human activity intensity increased, with the main land use being urban construction and land reclamation. Water conservation in the ecological function zone was higher than that outside the zone. In general, it increased slightly, but had obvious fluctuations. Soil conservation inside the zone was also better than that outside. However, it demonstrated dramatic fluctuations and relatively poor stability during 1990–2013. The human disturbance index inside the zone was significantly lower than that outside, and had a lower biodiversity threat level. Especially in 2010–2013, the increased range of the human disturbance index inside the zone was significantly less than that outside.
