目的基于健康服务领域研究成果应用的整合性行动促进框架(integrated-promoting action on research implement action in health services framework,i-PARIHS)模式构建创伤骨科患者手术部位感染(surgical site infection,SSI)防控的...目的基于健康服务领域研究成果应用的整合性行动促进框架(integrated-promoting action on research implement action in health services framework,i-PARIHS)模式构建创伤骨科患者手术部位感染(surgical site infection,SSI)防控的审查指标,分析临床实践障碍因素并提出改进策略。方法成立循证团队、文献检索、总结最佳证据、制定审查指标,于2024年7—8月开展基线调查,调查创伤骨科医护、麻醉手术中心医护执行率及患者知晓率,从“变革、接受者、组织环境”3个要素识别障碍因素,拟定变革策略。结果根据最佳证据评估并裁剪审查指标共23项,涵盖评估与监测、内外环境优化、术中关注重点、跟踪与随访和环境因素控制5个方面,涉及创伤骨科医生的14个指标平均执行率为72.14%,涉及病房护士的14个指标平均执行率为74.11%,涉及麻醉医生的5个指标平均执行率为60.50%,涉及手术室护士的10个指标平均执行率为61.75%,涉及患者知晓的5个直接指标平均知晓率为44.54%;障碍因素分析后拟定相应促进因素8条,拟定变革策略17条。结论临床实践与循证证据存在差距,基于i-PARIHS模式构建的审查指标与障碍分析为SSI防控提供了系统化改进框架,但需进一步验证策略的临床效果。展开更多
目的基于i-PARIHS框架从变革、接受者、组织环境三个层面梳理医护人员实施临床实践指南的影响因素,为指南制订和证据转化提供参考。方法检索中国知网、万方、维普、PubMed、Web of Science数据库中的相关文献,检索时限为2014年1月1日至2...目的基于i-PARIHS框架从变革、接受者、组织环境三个层面梳理医护人员实施临床实践指南的影响因素,为指南制订和证据转化提供参考。方法检索中国知网、万方、维普、PubMed、Web of Science数据库中的相关文献,检索时限为2014年1月1日至2024年2月1日。基于i-PARIHS框架归纳影响因素。结果纳入分析的文献共23篇。变革层面影响因素包括指南的适用性、可操作性、可信度、可获得性等;接受者层面影响因素包括医护人员的态度、知识水平、技能水平、工作习惯、自我效能、工作负荷/时间缺乏等,以及团队合作程度、管理水平等;组织环境层面影响因素包括文化氛围、配套资源、监管机制、信息化建设等。结论指南、医护人员、团队及组织环境因素均会影响指南实施。应重视指南制订与传播,提升医护人员和团队指南实施能力,改善指南实施组织环境,从而促进证据顺利转化。展开更多
Under hydrothermal and solvothermal conditions,two novel cobalt-based complexes,{[Co_(2)(CIA)(OH)(1,4-dtb)]·3.2H_(2)O}n(HU23)and{[Co_(2)(CIA)(OH)(1,4-dib)]·3.5H2O·DMF}n(HU24),were successfully construct...Under hydrothermal and solvothermal conditions,two novel cobalt-based complexes,{[Co_(2)(CIA)(OH)(1,4-dtb)]·3.2H_(2)O}n(HU23)and{[Co_(2)(CIA)(OH)(1,4-dib)]·3.5H2O·DMF}n(HU24),were successfully constructed by coordinatively assembling the semi-rigid multidentate ligand 5-(1-carboxyethoxy)isophthalic acid(H₃CIA)with the Nheterocyclic ligands 1,4-di(4H-1,2,4-triazol-4-yl)benzene(1,4-dtb)and 1,4-di(1H-imidazol-1-yl)benzene(1,4-dib),respectively,around Co^(2+)ions.Single-crystal X-ray diffraction analysis revealed that in both complexes HU23 and HU24,the CIA^(3-)anions adopt aκ^(7)-coordination mode,bridging six Co^(2+)ions via their five carboxylate oxygen atoms and one ether oxygen atom.This linkage forms tetranuclear[Co4(μ3-OH)2]^(6+)units.These Co-oxo cluster units were interconnected by CIA^(3-)anions to assemble into 2D kgd-type structures featuring a 3,6-connected topology.The 2D layers were further connected by 1,4-dtb and 1,4-dib,resulting in 3D pillar-layered frameworks for HU23 and HU24.Notably,despite the similar configurations of 1,4-dtb and 1,4-dib,differences in their coordination spatial orientations lead to topological divergence in the 3D frameworks of HU23 and HU24.Topological analysis indicates that the frameworks of HU23 and HU24 can be simplified into a 3,10-connected net(point symbol:(4^(10).6^(3).8^(2))(4^(3))_(2))and a 3,8-connected tfz-d net(point symbol:(4^(3))_(2)((4^(6).6^(18).8^(4)))),respectively.This structural differentiation confirms the precise regulatory role of ligands on the topology of metal-organic frameworks.Moreover,the ultraviolet-visible absorption spectra confirmed that HU23 and HU24 have strong absorption capabilities for ultraviolet and visible light.According to the Kubelka-Munk method,their bandwidths were 2.15 and 2.08 eV,respectively,which are consistent with those of typical semiconductor materials.Variable-temperature magnetic susceptibility measurements(2-300 K)revealed significant antiferromagnetic coupling in both complexes,with their effective magnetic moments decreasing markedly as the temperature lowered.CCDC:2457554,HU23;2457553,HU24.展开更多
Cellulose frameworks have emerged as promising materials for light management due to their exceptional light-scattering capabilities and sustainable nature.Conventional biomass-derived cellulose frameworks face a fund...Cellulose frameworks have emerged as promising materials for light management due to their exceptional light-scattering capabilities and sustainable nature.Conventional biomass-derived cellulose frameworks face a fundamental trade-off between haze and transparency,coupled with impractical thicknesses(≥1 mm).Inspired by squid’s skin-peeling mechanism,this work develops a peroxyformic acid(HCOOOH)-enabled precision peeling strategy to isolate intact 10-μm-thick bamboo green(BG)frameworks—100×thinner than wood-based counterparts while achieving an unprecedented optical performance(88%haze with 80%transparency).This performance surpasses delignified biomass(transparency<40%at 1 mm)and matches engineered cellulose composites,yet requires no energy-intensive nanofibrillation.The preserved native cellulose I crystalline structure(64.76%crystallinity)and wax-coated uniaxial fibril alignment(Hermans factor:0.23)contribute to high mechanical strength(903 MPa modulus)and broadband light scattering.As a light-management layer in polycrystalline silicon solar cells,the BG framework boosts photoelectric conversion efficiency by 0.41%absolute(18.74%→19.15%),outperforming synthetic anti-reflective coatings.The work establishes a scalable,waste-to-wealth route for optical-grade cellulose materials in next-generation optoelectronics.展开更多
The intrinsic pressure framework,which treats self-propelling force as an external force,provides a convenient and consistent description of mechanical equilibrium in active matter.However,direct experimental evidence...The intrinsic pressure framework,which treats self-propelling force as an external force,provides a convenient and consistent description of mechanical equilibrium in active matter.However,direct experimental evidence is still lacking.To validate this framework,here we employ a programmable robotic platform,where a single light-controlled wheeled robot travels in an activity landscape.Our experiments quantitatively demonstrate that the intrinsic pressure difference across the activity interface is balanced by the emerged polarization force.This result unambiguously confirms the theoretical predictions,thus validating the intrinsic pressure framework and laying the experimental foundation for the intrinsic pressure-based mechanical description of dry active matter.展开更多
The evolution of cities into digitally managed environments requires computational systems that can operate in real time while supporting predictive and adaptive infrastructure management.Earlier approaches have often...The evolution of cities into digitally managed environments requires computational systems that can operate in real time while supporting predictive and adaptive infrastructure management.Earlier approaches have often advanced one dimension—such as Internet of Things(IoT)-based data acquisition,Artificial Intelligence(AI)-driven analytics,or digital twin visualization—without fully integrating these strands into a single operational loop.As a result,many existing solutions encounter bottlenecks in responsiveness,interoperability,and scalability,while also leaving concerns about data privacy unresolved.This research introduces a hybrid AI–IoT–Digital Twin framework that combines continuous sensing,distributed intelligence,and simulation-based decision support.The design incorporates multi-source sensor data,lightweight edge inference through Convolutional Neural Networks(CNN)and Long ShortTerm Memory(LSTM)models,and federated learning enhanced with secure aggregation and differential privacy to maintain confidentiality.A digital twin layer extends these capabilities by simulating city assets such as traffic flows and water networks,generating what-if scenarios,and issuing actionable control signals.Complementary modules,including model compression and synchronization protocols,are embedded to ensure reliability in bandwidth-constrained and heterogeneous urban environments.The framework is validated in two urban domains:traffic management,where it adapts signal cycles based on real-time congestion patterns,and pipeline monitoring,where it anticipates leaks through pressure and vibration data.Experimental results show a 28%reduction in response time,a 35%decrease in maintenance costs,and a marked reduction in false positives relative to conventional baselines.The architecture also demonstrates stability across 50+edge devices under federated training and resilience to uneven node participation.The proposed system provides a scalable and privacy-aware foundation for predictive urban infrastructure management.By closing the loop between sensing,learning,and control,it reduces operator dependence,enhances resource efficiency,and supports transparent governance models for emerging smart cities.展开更多
目的基于i-PARIHS(Promoting action on research implementation in health services integrated framework)模式,构建临床实践指南转化和应用路径图。方法以“护士职业性腰背痛预防与护理临床实践指南转化研究”为例,以我国医疗政策...目的基于i-PARIHS(Promoting action on research implementation in health services integrated framework)模式,构建临床实践指南转化和应用路径图。方法以“护士职业性腰背痛预防与护理临床实践指南转化研究”为例,以我国医疗政策环境为背景,以证据转化与临床应用的方法学为参考,围绕i-PARIHS模式的4个阶段,构建临床实践指南临床转化和应用的路径图。结果基于i-PARIHS模式的指南转化动态路径图,包括4个阶段,12个步骤,阐释了指南转化研究的具体过程,明确了相应的步骤内容、预期目标、侧重要素和方法学参考,同时强调了“促进者”在项目实施中的联结价值和驱动作用,并指出促进者和接受者之间需要双向反馈和互动机制。结论基于i-PARIHS模式的指南转化动态路径图,优化了原模式的实施流程,适合指导国内机构开展基于指南证据的循证实践。展开更多
目的:描述国内6所综合性儿童医院儿科重症监护室(Pediatric Intensive Care Unit,PICU)在中心静脉导管维护证据应用过程中评估及识别障碍因素的现状。方法:以“PICU中心静脉维护证据应用的多中心研究项目”的6个证据应用场所(PICU)障碍...目的:描述国内6所综合性儿童医院儿科重症监护室(Pediatric Intensive Care Unit,PICU)在中心静脉导管维护证据应用过程中评估及识别障碍因素的现状。方法:以“PICU中心静脉维护证据应用的多中心研究项目”的6个证据应用场所(PICU)障碍因素分析报告为研究对象,采用i-PARIHS理论框架中“变革”层面7个条目、“变革接受者”层面17个条目以及“组织环境”9个条目的3个评估清单,以单个证据应用场所评估内容完成率、单个条目评估完成率进行评价。结果:6个PICU对“变革”层面评估内容完成率、单个条目评估完成率均为100%,“变革接受者”层面的评估内容完成率为41.2%~82.4%,“组织环境”为11.1%~66.7%。所有的证据应用场所在“变革接受者”层面有3个条目、“组织环境”层面有2个条目均未作评估。结论:PICU中心静脉导管维护证据应用的障碍因素评估缺乏全面性和系统性,应采取有效的策略克服障碍因素以促进证据在临床的成功应用。展开更多
目的开展提高婴幼儿尿标本留取成功率的循证实践,制订护理质量审查指标,分析实践过程中的障碍因素,以期为临床实施提供参考。方法组建研究小组,围绕提高婴幼儿尿标本留取成功率的主题,根据证据的6S模式“由上至下”查找最佳证据并确立...目的开展提高婴幼儿尿标本留取成功率的循证实践,制订护理质量审查指标,分析实践过程中的障碍因素,以期为临床实施提供参考。方法组建研究小组,围绕提高婴幼儿尿标本留取成功率的主题,根据证据的6S模式“由上至下”查找最佳证据并确立审查指标,以整合式健康服务领域研究成果应用的行动促进(integrated promoting action on research implementation in health services,i-PARIHS)框架为理论指导,对执行率低于90%的指标进行障碍因素分析并制订策略。2019年5月28日至7月27日,采用整群抽样方法选取收治于广州市妇女儿童医疗中心呼吸科病房的46例患儿作为研究对象,评估相关循证实践审查指标的执行情况。结果基线审查时,10项指标中有5项(指标2、3、5、6、8)执行率为0,4项(指标1、4、7、9)执行率低于90%;第1轮审查(证据转化应用2个月后)发现,5项审查指标(指标2、3、5、6、9)执行率有所提高,4项指标(指标1、4、8、10)执行率均大于90%。结论基于循证制订的婴幼儿尿标本留取质量审查指标具有较好的科学性、可操作性和实用性。基于i-PARIHS框架进行证据应用障碍因素分析,能有效提高审查指标执行率、促进提高婴幼儿尿标本留取成功率最佳证据的临床应用。展开更多
文摘目的基于健康服务领域研究成果应用的整合性行动促进框架(integrated-promoting action on research implement action in health services framework,i-PARIHS)模式构建创伤骨科患者手术部位感染(surgical site infection,SSI)防控的审查指标,分析临床实践障碍因素并提出改进策略。方法成立循证团队、文献检索、总结最佳证据、制定审查指标,于2024年7—8月开展基线调查,调查创伤骨科医护、麻醉手术中心医护执行率及患者知晓率,从“变革、接受者、组织环境”3个要素识别障碍因素,拟定变革策略。结果根据最佳证据评估并裁剪审查指标共23项,涵盖评估与监测、内外环境优化、术中关注重点、跟踪与随访和环境因素控制5个方面,涉及创伤骨科医生的14个指标平均执行率为72.14%,涉及病房护士的14个指标平均执行率为74.11%,涉及麻醉医生的5个指标平均执行率为60.50%,涉及手术室护士的10个指标平均执行率为61.75%,涉及患者知晓的5个直接指标平均知晓率为44.54%;障碍因素分析后拟定相应促进因素8条,拟定变革策略17条。结论临床实践与循证证据存在差距,基于i-PARIHS模式构建的审查指标与障碍分析为SSI防控提供了系统化改进框架,但需进一步验证策略的临床效果。
文摘目的基于i-PARIHS框架从变革、接受者、组织环境三个层面梳理医护人员实施临床实践指南的影响因素,为指南制订和证据转化提供参考。方法检索中国知网、万方、维普、PubMed、Web of Science数据库中的相关文献,检索时限为2014年1月1日至2024年2月1日。基于i-PARIHS框架归纳影响因素。结果纳入分析的文献共23篇。变革层面影响因素包括指南的适用性、可操作性、可信度、可获得性等;接受者层面影响因素包括医护人员的态度、知识水平、技能水平、工作习惯、自我效能、工作负荷/时间缺乏等,以及团队合作程度、管理水平等;组织环境层面影响因素包括文化氛围、配套资源、监管机制、信息化建设等。结论指南、医护人员、团队及组织环境因素均会影响指南实施。应重视指南制订与传播,提升医护人员和团队指南实施能力,改善指南实施组织环境,从而促进证据顺利转化。
文摘Under hydrothermal and solvothermal conditions,two novel cobalt-based complexes,{[Co_(2)(CIA)(OH)(1,4-dtb)]·3.2H_(2)O}n(HU23)and{[Co_(2)(CIA)(OH)(1,4-dib)]·3.5H2O·DMF}n(HU24),were successfully constructed by coordinatively assembling the semi-rigid multidentate ligand 5-(1-carboxyethoxy)isophthalic acid(H₃CIA)with the Nheterocyclic ligands 1,4-di(4H-1,2,4-triazol-4-yl)benzene(1,4-dtb)and 1,4-di(1H-imidazol-1-yl)benzene(1,4-dib),respectively,around Co^(2+)ions.Single-crystal X-ray diffraction analysis revealed that in both complexes HU23 and HU24,the CIA^(3-)anions adopt aκ^(7)-coordination mode,bridging six Co^(2+)ions via their five carboxylate oxygen atoms and one ether oxygen atom.This linkage forms tetranuclear[Co4(μ3-OH)2]^(6+)units.These Co-oxo cluster units were interconnected by CIA^(3-)anions to assemble into 2D kgd-type structures featuring a 3,6-connected topology.The 2D layers were further connected by 1,4-dtb and 1,4-dib,resulting in 3D pillar-layered frameworks for HU23 and HU24.Notably,despite the similar configurations of 1,4-dtb and 1,4-dib,differences in their coordination spatial orientations lead to topological divergence in the 3D frameworks of HU23 and HU24.Topological analysis indicates that the frameworks of HU23 and HU24 can be simplified into a 3,10-connected net(point symbol:(4^(10).6^(3).8^(2))(4^(3))_(2))and a 3,8-connected tfz-d net(point symbol:(4^(3))_(2)((4^(6).6^(18).8^(4)))),respectively.This structural differentiation confirms the precise regulatory role of ligands on the topology of metal-organic frameworks.Moreover,the ultraviolet-visible absorption spectra confirmed that HU23 and HU24 have strong absorption capabilities for ultraviolet and visible light.According to the Kubelka-Munk method,their bandwidths were 2.15 and 2.08 eV,respectively,which are consistent with those of typical semiconductor materials.Variable-temperature magnetic susceptibility measurements(2-300 K)revealed significant antiferromagnetic coupling in both complexes,with their effective magnetic moments decreasing markedly as the temperature lowered.CCDC:2457554,HU23;2457553,HU24.
基金supported by National Natural Science Foundation of China(32494793).
文摘Cellulose frameworks have emerged as promising materials for light management due to their exceptional light-scattering capabilities and sustainable nature.Conventional biomass-derived cellulose frameworks face a fundamental trade-off between haze and transparency,coupled with impractical thicknesses(≥1 mm).Inspired by squid’s skin-peeling mechanism,this work develops a peroxyformic acid(HCOOOH)-enabled precision peeling strategy to isolate intact 10-μm-thick bamboo green(BG)frameworks—100×thinner than wood-based counterparts while achieving an unprecedented optical performance(88%haze with 80%transparency).This performance surpasses delignified biomass(transparency<40%at 1 mm)and matches engineered cellulose composites,yet requires no energy-intensive nanofibrillation.The preserved native cellulose I crystalline structure(64.76%crystallinity)and wax-coated uniaxial fibril alignment(Hermans factor:0.23)contribute to high mechanical strength(903 MPa modulus)and broadband light scattering.As a light-management layer in polycrystalline silicon solar cells,the BG framework boosts photoelectric conversion efficiency by 0.41%absolute(18.74%→19.15%),outperforming synthetic anti-reflective coatings.The work establishes a scalable,waste-to-wealth route for optical-grade cellulose materials in next-generation optoelectronics.
基金supported by the National Natural Science Foundation of China (Grant Nos.T2325027,12274448,T2350007,12404239,12174041,12325405,12090054,and T2221001)the National Key R&D Program of China (Grant No.2022YFF0503504)。
文摘The intrinsic pressure framework,which treats self-propelling force as an external force,provides a convenient and consistent description of mechanical equilibrium in active matter.However,direct experimental evidence is still lacking.To validate this framework,here we employ a programmable robotic platform,where a single light-controlled wheeled robot travels in an activity landscape.Our experiments quantitatively demonstrate that the intrinsic pressure difference across the activity interface is balanced by the emerged polarization force.This result unambiguously confirms the theoretical predictions,thus validating the intrinsic pressure framework and laying the experimental foundation for the intrinsic pressure-based mechanical description of dry active matter.
基金The researchers would like to thank the Deanship of Graduate Studies and Scientific Research at Qassim University for financial support(QU-APC-2025)。
文摘The evolution of cities into digitally managed environments requires computational systems that can operate in real time while supporting predictive and adaptive infrastructure management.Earlier approaches have often advanced one dimension—such as Internet of Things(IoT)-based data acquisition,Artificial Intelligence(AI)-driven analytics,or digital twin visualization—without fully integrating these strands into a single operational loop.As a result,many existing solutions encounter bottlenecks in responsiveness,interoperability,and scalability,while also leaving concerns about data privacy unresolved.This research introduces a hybrid AI–IoT–Digital Twin framework that combines continuous sensing,distributed intelligence,and simulation-based decision support.The design incorporates multi-source sensor data,lightweight edge inference through Convolutional Neural Networks(CNN)and Long ShortTerm Memory(LSTM)models,and federated learning enhanced with secure aggregation and differential privacy to maintain confidentiality.A digital twin layer extends these capabilities by simulating city assets such as traffic flows and water networks,generating what-if scenarios,and issuing actionable control signals.Complementary modules,including model compression and synchronization protocols,are embedded to ensure reliability in bandwidth-constrained and heterogeneous urban environments.The framework is validated in two urban domains:traffic management,where it adapts signal cycles based on real-time congestion patterns,and pipeline monitoring,where it anticipates leaks through pressure and vibration data.Experimental results show a 28%reduction in response time,a 35%decrease in maintenance costs,and a marked reduction in false positives relative to conventional baselines.The architecture also demonstrates stability across 50+edge devices under federated training and resilience to uneven node participation.The proposed system provides a scalable and privacy-aware foundation for predictive urban infrastructure management.By closing the loop between sensing,learning,and control,it reduces operator dependence,enhances resource efficiency,and supports transparent governance models for emerging smart cities.
文摘目的基于i-PARIHS(Promoting action on research implementation in health services integrated framework)模式,构建临床实践指南转化和应用路径图。方法以“护士职业性腰背痛预防与护理临床实践指南转化研究”为例,以我国医疗政策环境为背景,以证据转化与临床应用的方法学为参考,围绕i-PARIHS模式的4个阶段,构建临床实践指南临床转化和应用的路径图。结果基于i-PARIHS模式的指南转化动态路径图,包括4个阶段,12个步骤,阐释了指南转化研究的具体过程,明确了相应的步骤内容、预期目标、侧重要素和方法学参考,同时强调了“促进者”在项目实施中的联结价值和驱动作用,并指出促进者和接受者之间需要双向反馈和互动机制。结论基于i-PARIHS模式的指南转化动态路径图,优化了原模式的实施流程,适合指导国内机构开展基于指南证据的循证实践。
文摘目的:描述国内6所综合性儿童医院儿科重症监护室(Pediatric Intensive Care Unit,PICU)在中心静脉导管维护证据应用过程中评估及识别障碍因素的现状。方法:以“PICU中心静脉维护证据应用的多中心研究项目”的6个证据应用场所(PICU)障碍因素分析报告为研究对象,采用i-PARIHS理论框架中“变革”层面7个条目、“变革接受者”层面17个条目以及“组织环境”9个条目的3个评估清单,以单个证据应用场所评估内容完成率、单个条目评估完成率进行评价。结果:6个PICU对“变革”层面评估内容完成率、单个条目评估完成率均为100%,“变革接受者”层面的评估内容完成率为41.2%~82.4%,“组织环境”为11.1%~66.7%。所有的证据应用场所在“变革接受者”层面有3个条目、“组织环境”层面有2个条目均未作评估。结论:PICU中心静脉导管维护证据应用的障碍因素评估缺乏全面性和系统性,应采取有效的策略克服障碍因素以促进证据在临床的成功应用。
文摘目的开展提高婴幼儿尿标本留取成功率的循证实践,制订护理质量审查指标,分析实践过程中的障碍因素,以期为临床实施提供参考。方法组建研究小组,围绕提高婴幼儿尿标本留取成功率的主题,根据证据的6S模式“由上至下”查找最佳证据并确立审查指标,以整合式健康服务领域研究成果应用的行动促进(integrated promoting action on research implementation in health services,i-PARIHS)框架为理论指导,对执行率低于90%的指标进行障碍因素分析并制订策略。2019年5月28日至7月27日,采用整群抽样方法选取收治于广州市妇女儿童医疗中心呼吸科病房的46例患儿作为研究对象,评估相关循证实践审查指标的执行情况。结果基线审查时,10项指标中有5项(指标2、3、5、6、8)执行率为0,4项(指标1、4、7、9)执行率低于90%;第1轮审查(证据转化应用2个月后)发现,5项审查指标(指标2、3、5、6、9)执行率有所提高,4项指标(指标1、4、8、10)执行率均大于90%。结论基于循证制订的婴幼儿尿标本留取质量审查指标具有较好的科学性、可操作性和实用性。基于i-PARIHS框架进行证据应用障碍因素分析,能有效提高审查指标执行率、促进提高婴幼儿尿标本留取成功率最佳证据的临床应用。
