Objective:Nurse-led virtual outpatient clinics are now a familiar component of healthcare delivery across many disciplines,including cancer care,or thopedics,rheumatology,and gastroenterology.However,establishing a nu...Objective:Nurse-led virtual outpatient clinics are now a familiar component of healthcare delivery across many disciplines,including cancer care,or thopedics,rheumatology,and gastroenterology.However,establishing a nurse-led vir tual clinic is challenging for nursing management,par ticularly regarding resources.We aimed to investigate nursing practices and processes and patient experiences in relation to vir tual outpatient clinics.Methods:This was a cross-sectional,descriptive study using mixed data collection methods.Patients(n=324)from 4 specialist clinics completed the Virtual Clinics Patient Satisfaction Questionnaire(VCSQ)survey.Five Nurse Specialists participated in a focus group interview.Results:Most participants(86.3%)reported being satisfied/very satisfied with the virtual clinics,particularly those that were nurse-led.Nurse specialists identified electronic health records(EHRs)and additional IT and administrative support as important for efficiency and effectiveness of the clinics.Conclusions:Nurse-led virtual clinics can be an effective and efficient way to provide care to patients.Nurse managers need to ensure supportive structures are in place,for example,dedicated administrators,IT support and infrastructure,education/training,and relevant policies/procedures.The success of nurse-led virtual services requires key infrastructure to support nursing staff and sustain this service.展开更多
The purpose of this study is to investigate the effectiveness of the“expiration manager”mini program in managing the validity of ward items.The program was used to manage frequently and infrequently used consumables...The purpose of this study is to investigate the effectiveness of the“expiration manager”mini program in managing the validity of ward items.The program was used to manage frequently and infrequently used consumables by setting up an automatic reminder function.The item failure rate and the time required for nurses to conduct counts over 6 months before and after implementation were compared,as well as evaluated system availability using the System Usability scale(SUS).Results showed that after implementing the mini program,both the item failure rate and non-recognition rate significantly decreased(P<0.05),while the inspection pass rate significantly increased(P<0.05),and the monthly inventory time was reduced(P<0.05).The SUS evaluation yielded a total score of 74.38±11.73,with learnability at 80.21±20.27 and availability at 72.92±11.18,all indicating good user acceptance.In conclusion,the“expiration manager”mini program can effectively improve the efficiency of item expiration management,reduce the risk of expiration,and save inspection time,thereby demonstrating high user acceptance and promising potential for wider adoption.展开更多
思维导图工具软件Mindjet Mind Manager作为一种可视化工具,最初在商业领域中得到广泛应用。近年来,国内外学者在图式理论研究基础上逐渐把其发展为一种教学手段。本文在介绍该软件的特性以及教育心理学背景的基础上,以《微波技术与天...思维导图工具软件Mindjet Mind Manager作为一种可视化工具,最初在商业领域中得到广泛应用。近年来,国内外学者在图式理论研究基础上逐渐把其发展为一种教学手段。本文在介绍该软件的特性以及教育心理学背景的基础上,以《微波技术与天线》绪论课程的实例具体说明了其在高等教育教学中有力促进教与学的优势。展开更多
介绍了应用R egion m anager软件绘制等高线的方法:测出所要绘制等高线的区域内各高程控制点的高程值,将处理后的数据输入软件,建立空间数据库,生成数字高程图并创建三角网,根据需要由软件提取出相应等高距的区域等高线.该方法简便、精...介绍了应用R egion m anager软件绘制等高线的方法:测出所要绘制等高线的区域内各高程控制点的高程值,将处理后的数据输入软件,建立空间数据库,生成数字高程图并创建三角网,根据需要由软件提取出相应等高距的区域等高线.该方法简便、精度高、节省工期、节约人力资源,还可根据系统中生成的数字高程图,进行土方量、面积、周长和距离的量算.展开更多
Purpose-Interface management is the process of managing communications,responsibilities and coordination of project parties,phases or physical entities which are dependent on one another.Interface management is a cruc...Purpose-Interface management is the process of managing communications,responsibilities and coordination of project parties,phases or physical entities which are dependent on one another.Interface management is a crucial part of managing any construction project-but particularly important for high-speed railway projects that often have several contractual parties and stakeholders,very long project timelines and huge upfront cost overlays.This paper discusses how various project interfaces were managed during the design and construction of the civil engineering infrastructure for the High Speed Two(HS2)project in the United Kingdom.Design/methodology/approach-The paper uses the case study methodology.Key interfaces on the HS2 project are grouped into various categories and the paper discusses how they were managed within the Area North Integrated Project Team(IPT)of the HS2 project made up of contractor Balfour Beatty VINCI(BBV),the Mott MacDonald SYSTRA Design Joint Venture(DJV)and client HS2 Ltd.3 different case studies drawn from across the IPT are used,each of them highlighting different interfaces and how these interfaces were managed.Findings-The paper shows how innovative technical designs and modern methods of construction were used to address some of the unique and peculiar challenges of designing a brand-new railway in the United Kingdom.Addressing the contrasting and often competing requirements of different stakeholders,coupled with challenging physical constraints of the very limited land available for the project and the use of a rarely used Act of Parliament in the delivery of the project required different approach to interface management.Collaboration and proactive stakeholder engagement are necessary for successful interface management on megaprojects.The authors posit that adopting an integrated approach to engineering and construction management is an essential ingredient for the successful delivery of high-speed railway projects.Originality/value-With many high-speed railway projects around the world coming up in the next few years,understanding the context and challenges for each country will help engineering and design managers adopt appropriate approaches for their projects.The lessons learned on the HS2 project are also transferable to other mega infrastructure projects with complex project interfaces.展开更多
Submission All manuscripts are submitted and reviewed via the journal's web-based manuscript submission system Editorial Manager:https://www.editorialmanager.com/lers/default.aspx.New authors should create an acco...Submission All manuscripts are submitted and reviewed via the journal's web-based manuscript submission system Editorial Manager:https://www.editorialmanager.com/lers/default.aspx.New authors should create an account prior to submitting a manuscript for consideration.If you have any questions about submitting,please contact the editorial office:lersurgery@srrsh.com.展开更多
With the development of autonomous driving technologies,modern vehicles are confronted with two major challenges.On one hand,the rapid growth in electronic control units and data-intensive applications has led to a sh...With the development of autonomous driving technologies,modern vehicles are confronted with two major challenges.On one hand,the rapid growth in electronic control units and data-intensive applications has led to a sharp increase in invehicle data traffic,thereby demanding much higher communication bandwidth,lower latency,and enhanced security.On the other hand,ensuring driving safety calls for more advanced thermal management systems,as traditional point-type sensors face deployment challenges due to their limited monitoring range.展开更多
The proton exchange membrane fuel cell(PEMFC)and the hydrogen hybrid power system are studied by the fuzzy-PID(FPID)controlmethod and the fuzzy-PID controlmethod by Artificial Bee Colony algorithm(ABCFPID),respectivel...The proton exchange membrane fuel cell(PEMFC)and the hydrogen hybrid power system are studied by the fuzzy-PID(FPID)controlmethod and the fuzzy-PID controlmethod by Artificial Bee Colony algorithm(ABCFPID),respectively.The results reveal that compared with the FPID control method,the temperature overshoot of the PEMFC stack under the ABC-FPID control method is decreased by 0.6%.Moreover,the circulating water flow rate within the full operating envelope(about 3 min)is reduced by 19.46 L,which means the ABC-FPID control method is more effective in regulating the stack temperature.Then,the ABC-FPID control method is proposed to study the hydrogen hybrid power system,and the system output power matching,operating characteristic curve of the fuel cell,state of charge(SOC)of the lithium battery,system efficiency and hydrogen demand are obtained.The results indicate that the maximum system efficiency reaches 46.3%,the average system efficiency is 33.8%,and the average hydrogen demand is 0.192 kg/s.Overall,the ABC-FPID control method can efficiently ensure the stability of the fuel cell’s output power,and actively prompt the lithium battery to fulfill the function of“peak shaving and valley filling”under variable load power conditions.展开更多
Understanding the complex interactions between human activities and ecosystem functions is a prerequisite for achieving sustainable development.Since the implementation of the“Grain for Green”Project in 1999,ecosyst...Understanding the complex interactions between human activities and ecosystem functions is a prerequisite for achieving sustainable development.Since the implementation of the“Grain for Green”Project in 1999,ecosystem functions in China’s Loess Plateau have significantly improved.However,intensified human activities have also exacerbated the pressures on the region’s fragile ecological environment.This study investigates the spatiotemporal variations in the human activity intensity index(HAI)and net ecosystem benefits(NEB)from 2000 to 2020,using expert-based assessments and an enhanced cost-benefit evaluation framework.Results indicate that HAI increased by 16.7% and 16.6% at the grid and county levels,respectively.NEB exhibited pronounced spatial heterogeneity,with a total increase of USD 36.2 trillion at the grid scale.At the county level,the average NEB rose by 75%.The degree of trade-off was higher at the grid scale than at the county scale,while the synergistic areas initially expanded and then declined at both scales.Key areas for improvement and regions of lagging development were identified as priority zones for ecological management and spatial planning at both spatial resolutions.This study offers scientific insights and practical guidance for harmonizing ecological conservation with high-quality development in ecologically vulnerable regions.展开更多
Objective:To investigate the application effect of intelligent empowerment standardized airway management process in patients receiving mechanical ventilation.Methods:A retrospective analysis was conducted on the clin...Objective:To investigate the application effect of intelligent empowerment standardized airway management process in patients receiving mechanical ventilation.Methods:A retrospective analysis was conducted on the clinical data of 79 EICU inpatients who underwent tracheal intubation and mechanical ventilation treatment at our hospital from January 2023 to May 2025.The patients were divided into a control group(conventional airway management process,n=40)and a study group(intelligent empowerment standardized airway management process,n=39)based on the intervention protocols they received.Oral health scores,dental plaque index,oral odor,serum inflammatory markers[C-reactive protein(CRP),procalcitonin(PCT)],clinical pulmonary infection score(CPIS),as well as the incidence of ventilator-associated pneumonia(VAP),duration of mechanical ventilation,and length of stay in the EICU were assessed before and after treatment.Results:The baseline values of all indicators were consistent between the two groups before intervention(p>0.05).After corresponding interventions,both groups showed significant improvements in Beck oral health scores,dental plaque index,and oral odor,with more pronounced improvements observed in the study group(p<0.05).After the intervention,the research group showed a significant decrease in serum CRP and PCT levels,as well as CPIS scores(p<0.05).In contrast,the control group experienced an increase in these three indicators to a certain extent(p<0.05).Moreover,the incidence of ventilator-associated pneumonia(VAP),duration of mechanical ventilation,and length of stay in the EICU were all lower in the research group compared to the control group,while the nurse’s compliance rate with the protocol was higher in the research group(p<0.05).Conclusion:The standardized airway management protocol empowered by intelligent technology can significantly improve nursing compliance,benefit oral health status,reduce the risk of pulmonary infection and systemic inflammation levels,and promote rapid patient recovery,demonstrating considerable potential for widespread adoption.展开更多
基金supported by Nursing and Midwifery Practice Development Unit(NMPDU),Dublin South,Kildare,and Wicklow,Nurses preparedness for end of life conversations(No.P210537)。
文摘Objective:Nurse-led virtual outpatient clinics are now a familiar component of healthcare delivery across many disciplines,including cancer care,or thopedics,rheumatology,and gastroenterology.However,establishing a nurse-led vir tual clinic is challenging for nursing management,par ticularly regarding resources.We aimed to investigate nursing practices and processes and patient experiences in relation to vir tual outpatient clinics.Methods:This was a cross-sectional,descriptive study using mixed data collection methods.Patients(n=324)from 4 specialist clinics completed the Virtual Clinics Patient Satisfaction Questionnaire(VCSQ)survey.Five Nurse Specialists participated in a focus group interview.Results:Most participants(86.3%)reported being satisfied/very satisfied with the virtual clinics,particularly those that were nurse-led.Nurse specialists identified electronic health records(EHRs)and additional IT and administrative support as important for efficiency and effectiveness of the clinics.Conclusions:Nurse-led virtual clinics can be an effective and efficient way to provide care to patients.Nurse managers need to ensure supportive structures are in place,for example,dedicated administrators,IT support and infrastructure,education/training,and relevant policies/procedures.The success of nurse-led virtual services requires key infrastructure to support nursing staff and sustain this service.
基金The First Affiliated Hospital of Shaoyang University,China(Project No.:23FY1015)。
文摘The purpose of this study is to investigate the effectiveness of the“expiration manager”mini program in managing the validity of ward items.The program was used to manage frequently and infrequently used consumables by setting up an automatic reminder function.The item failure rate and the time required for nurses to conduct counts over 6 months before and after implementation were compared,as well as evaluated system availability using the System Usability scale(SUS).Results showed that after implementing the mini program,both the item failure rate and non-recognition rate significantly decreased(P<0.05),while the inspection pass rate significantly increased(P<0.05),and the monthly inventory time was reduced(P<0.05).The SUS evaluation yielded a total score of 74.38±11.73,with learnability at 80.21±20.27 and availability at 72.92±11.18,all indicating good user acceptance.In conclusion,the“expiration manager”mini program can effectively improve the efficiency of item expiration management,reduce the risk of expiration,and save inspection time,thereby demonstrating high user acceptance and promising potential for wider adoption.
文摘思维导图工具软件Mindjet Mind Manager作为一种可视化工具,最初在商业领域中得到广泛应用。近年来,国内外学者在图式理论研究基础上逐渐把其发展为一种教学手段。本文在介绍该软件的特性以及教育心理学背景的基础上,以《微波技术与天线》绪论课程的实例具体说明了其在高等教育教学中有力促进教与学的优势。
文摘介绍了应用R egion m anager软件绘制等高线的方法:测出所要绘制等高线的区域内各高程控制点的高程值,将处理后的数据输入软件,建立空间数据库,生成数字高程图并创建三角网,根据需要由软件提取出相应等高距的区域等高线.该方法简便、精度高、节省工期、节约人力资源,还可根据系统中生成的数字高程图,进行土方量、面积、周长和距离的量算.
文摘Purpose-Interface management is the process of managing communications,responsibilities and coordination of project parties,phases or physical entities which are dependent on one another.Interface management is a crucial part of managing any construction project-but particularly important for high-speed railway projects that often have several contractual parties and stakeholders,very long project timelines and huge upfront cost overlays.This paper discusses how various project interfaces were managed during the design and construction of the civil engineering infrastructure for the High Speed Two(HS2)project in the United Kingdom.Design/methodology/approach-The paper uses the case study methodology.Key interfaces on the HS2 project are grouped into various categories and the paper discusses how they were managed within the Area North Integrated Project Team(IPT)of the HS2 project made up of contractor Balfour Beatty VINCI(BBV),the Mott MacDonald SYSTRA Design Joint Venture(DJV)and client HS2 Ltd.3 different case studies drawn from across the IPT are used,each of them highlighting different interfaces and how these interfaces were managed.Findings-The paper shows how innovative technical designs and modern methods of construction were used to address some of the unique and peculiar challenges of designing a brand-new railway in the United Kingdom.Addressing the contrasting and often competing requirements of different stakeholders,coupled with challenging physical constraints of the very limited land available for the project and the use of a rarely used Act of Parliament in the delivery of the project required different approach to interface management.Collaboration and proactive stakeholder engagement are necessary for successful interface management on megaprojects.The authors posit that adopting an integrated approach to engineering and construction management is an essential ingredient for the successful delivery of high-speed railway projects.Originality/value-With many high-speed railway projects around the world coming up in the next few years,understanding the context and challenges for each country will help engineering and design managers adopt appropriate approaches for their projects.The lessons learned on the HS2 project are also transferable to other mega infrastructure projects with complex project interfaces.
文摘Submission All manuscripts are submitted and reviewed via the journal's web-based manuscript submission system Editorial Manager:https://www.editorialmanager.com/lers/default.aspx.New authors should create an account prior to submitting a manuscript for consideration.If you have any questions about submitting,please contact the editorial office:lersurgery@srrsh.com.
文摘With the development of autonomous driving technologies,modern vehicles are confronted with two major challenges.On one hand,the rapid growth in electronic control units and data-intensive applications has led to a sharp increase in invehicle data traffic,thereby demanding much higher communication bandwidth,lower latency,and enhanced security.On the other hand,ensuring driving safety calls for more advanced thermal management systems,as traditional point-type sensors face deployment challenges due to their limited monitoring range.
基金supported by the Natural Science Foundation of Jiangsu Province(BK20231445)Aeronautical Science Foundation of China(20230028052001).
文摘The proton exchange membrane fuel cell(PEMFC)and the hydrogen hybrid power system are studied by the fuzzy-PID(FPID)controlmethod and the fuzzy-PID controlmethod by Artificial Bee Colony algorithm(ABCFPID),respectively.The results reveal that compared with the FPID control method,the temperature overshoot of the PEMFC stack under the ABC-FPID control method is decreased by 0.6%.Moreover,the circulating water flow rate within the full operating envelope(about 3 min)is reduced by 19.46 L,which means the ABC-FPID control method is more effective in regulating the stack temperature.Then,the ABC-FPID control method is proposed to study the hydrogen hybrid power system,and the system output power matching,operating characteristic curve of the fuel cell,state of charge(SOC)of the lithium battery,system efficiency and hydrogen demand are obtained.The results indicate that the maximum system efficiency reaches 46.3%,the average system efficiency is 33.8%,and the average hydrogen demand is 0.192 kg/s.Overall,the ABC-FPID control method can efficiently ensure the stability of the fuel cell’s output power,and actively prompt the lithium battery to fulfill the function of“peak shaving and valley filling”under variable load power conditions.
基金National Natural Science Foundation of China(Grant No.U2243225)the Strategic Priority Research Program of the Chinese Academy of Sciences(Grant No.XDB40000000)+2 种基金the Natural Science Basic Research Program of Shaanxi(Grant No.Z2024-ZYFS-0065)the Funding of Top Young talents of Ten Thousand talents Plan in China(2021)the Fundamental Research Funds for the Central Universities(Grants No.2452023071 and 2023HHZX002).
文摘Understanding the complex interactions between human activities and ecosystem functions is a prerequisite for achieving sustainable development.Since the implementation of the“Grain for Green”Project in 1999,ecosystem functions in China’s Loess Plateau have significantly improved.However,intensified human activities have also exacerbated the pressures on the region’s fragile ecological environment.This study investigates the spatiotemporal variations in the human activity intensity index(HAI)and net ecosystem benefits(NEB)from 2000 to 2020,using expert-based assessments and an enhanced cost-benefit evaluation framework.Results indicate that HAI increased by 16.7% and 16.6% at the grid and county levels,respectively.NEB exhibited pronounced spatial heterogeneity,with a total increase of USD 36.2 trillion at the grid scale.At the county level,the average NEB rose by 75%.The degree of trade-off was higher at the grid scale than at the county scale,while the synergistic areas initially expanded and then declined at both scales.Key areas for improvement and regions of lagging development were identified as priority zones for ecological management and spatial planning at both spatial resolutions.This study offers scientific insights and practical guidance for harmonizing ecological conservation with high-quality development in ecologically vulnerable regions.
文摘Objective:To investigate the application effect of intelligent empowerment standardized airway management process in patients receiving mechanical ventilation.Methods:A retrospective analysis was conducted on the clinical data of 79 EICU inpatients who underwent tracheal intubation and mechanical ventilation treatment at our hospital from January 2023 to May 2025.The patients were divided into a control group(conventional airway management process,n=40)and a study group(intelligent empowerment standardized airway management process,n=39)based on the intervention protocols they received.Oral health scores,dental plaque index,oral odor,serum inflammatory markers[C-reactive protein(CRP),procalcitonin(PCT)],clinical pulmonary infection score(CPIS),as well as the incidence of ventilator-associated pneumonia(VAP),duration of mechanical ventilation,and length of stay in the EICU were assessed before and after treatment.Results:The baseline values of all indicators were consistent between the two groups before intervention(p>0.05).After corresponding interventions,both groups showed significant improvements in Beck oral health scores,dental plaque index,and oral odor,with more pronounced improvements observed in the study group(p<0.05).After the intervention,the research group showed a significant decrease in serum CRP and PCT levels,as well as CPIS scores(p<0.05).In contrast,the control group experienced an increase in these three indicators to a certain extent(p<0.05).Moreover,the incidence of ventilator-associated pneumonia(VAP),duration of mechanical ventilation,and length of stay in the EICU were all lower in the research group compared to the control group,while the nurse’s compliance rate with the protocol was higher in the research group(p<0.05).Conclusion:The standardized airway management protocol empowered by intelligent technology can significantly improve nursing compliance,benefit oral health status,reduce the risk of pulmonary infection and systemic inflammation levels,and promote rapid patient recovery,demonstrating considerable potential for widespread adoption.
