Evidence is not homogeneous on indicators able to monitor and assess qualityperformance for organ donation. This may be related to differences in healthcareorganizations among countries but also to the scarcity of dat...Evidence is not homogeneous on indicators able to monitor and assess qualityperformance for organ donation. This may be related to differences in healthcareorganizations among countries but also to the scarcity of data on this topic so far.In the present review, we assessed available evidence on quality metrics in solidorgan procurement in the United States and in Europe by means of a PubMedsearch. Evidence was summarized according to countries, considering that thedonation and transplantation systems differ from country to country. In UnitedStates, the assessment of these indicators is periodically performed by the nationalnetwork for organ sharing to evaluate the performance of each Organ ProcurementOrganization (OPO). Quality metrics consider several factors, in primispopulation characteristics (i.e. race/ethnicity, age, socio-economic status). That iswhy the assessment of each OPO performance relies on several quality metrics,not only one single indicator. In Europe, quality improvement programs representa structural element of organ and transplant system in several countries, but fewpapers have to date addressed the results obtained by a quality improvementprogram based on indicators. In Poland, the use of quality indicators and improvementprocedures were associated with better results in those hospitals whichimplemented these programs in respect to hospitals who did not. In TuscanyRegion (Italy) the implementation of a monitoring and reporting approach basedon indicators by the Regional Transplant Center was associated with an increasedin transplant and donation activity (especially in cDCD donors). According toavailable evidence, the development of a method for quality assessment andquality improvement has been recognized as pivotal for donation and transplantauthorities to identify key interventions either at national and/or hospital levels.展开更多
Sign language dataset is essential in sign language recognition and translation(SLRT). Current public sign language datasets are small and lack diversity, which does not meet the practical application requirements for...Sign language dataset is essential in sign language recognition and translation(SLRT). Current public sign language datasets are small and lack diversity, which does not meet the practical application requirements for SLRT. However, making a large-scale and diverse sign language dataset is difficult as sign language data on the Internet is scarce. In making a large-scale and diverse sign language dataset, some sign language data qualities are not up to standard. This paper proposes a two information streams transformer(TIST) model to judge whether the quality of sign language data is qualified. To verify that TIST effectively improves sign language recognition(SLR), we make two datasets, the screened dataset and the unscreened dataset. In this experiment, this paper uses visual alignment constraint(VAC) as the baseline model. The experimental results show that the screened dataset can achieve better word error rate(WER) than the unscreened dataset.展开更多
University student Party branches serve as the Party’s grassroots organizations within universities and act as a bridge and link between the Party and students.Therefore,it is essential to strengthen the development ...University student Party branches serve as the Party’s grassroots organizations within universities and act as a bridge and link between the Party and students.Therefore,it is essential to strengthen the development of student Party branches and enhance the effectiveness of student Party member education and training.This paper summarizes and analyzes the issues in the construction of student Party branches in universities and explores strategies for improving their quality,aiming to provide a reference for relevant personnel.展开更多
Objective:Early thrombolytic therapy for ischemic stroke within the therapeutic window is associated with improved clinical outcomes.This study investigated whether optimizing intravenous thrombolytic(IVT)therapy stra...Objective:Early thrombolytic therapy for ischemic stroke within the therapeutic window is associated with improved clinical outcomes.This study investigated whether optimizing intravenous thrombolytic(IVT)therapy strategies for stroke could reduce treatment delays.Methods:To reduce delays in IVT therapy for ischemic stroke,a series of quality improvement measures were implemented at a tertiary hospital in Hangzhou,Zhejiang Province,from June 2021 to August 2023,which included developing a timeline process management system,forming a nurse-led stroke process management team,providing homogeneous training,standardizing the IVT therapy process for ischemic stroke,and introducing an incentive policy.During the pre-(from June 2021 to February 2022,group A)and post-(from March to November 2022,group B1;from December 2022 to August 2023,group B2[implementation of an additional incentive policy])of the implementation the strategy,the door-tocomputed tomographic angiography(CTA)time(DCT),CTA time,neurology consultation to consent for IVT,CTA-to-needle time(CNT),and door-to-needle time(DNT),the percentage of people who underwent CTA within 20 min,15 min,and 10 min and DNT within 60 min,45 min,and 30 min were collected and compared.Results:Following the implementation of the standardized IVT process management strategy for stroke,the DNT for group B1 and group B2 were 30(24,44)min and 31(24,41)min,respectively,both significantly lower than the 46(38,58)min in group A(P<0.001);the median DCT were both 13 min in group B1 and B2 lower than 17min in group A(P<0.001);the median CTA were 12 min in Group B1 and 9 min in Group B2 lower than 14 min in group A(P<0.001);similar results were observed during the neurology consultation to obtain consent for IVT and CNT.Compared with group A,the proportion of DCT20 min,15 min,and 10 min was higher in groups B1 and B2(P<0.05),and the same result was observed at DNT60 min,45 min,and 30 min(P<0.05).However,the additional incentive policy did not significantly differ between Group B2 and Group B1.Conclusions:Optimizing IVT therapy for ischemic stroke is a feasible approach to limit the DNT to 30 min in ischemic stroke,significantly reducing delays within the therapeutic window and increasing the number of patients meeting target time segments.Additionally,generating a timeline for the IVT therapy process by scanning positioning quick response codes was a significant breakthrough in achieving the informatization of IVT quality management for stroke.展开更多
BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for ...BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for neoadjuvant therapy in gallbladder cancer.As investigations continue to analyze the regimen and benefit of NACT for ongoing care of gallbladder cancer patients,we examined American College of Surgeons National Surgical Quality Improvement Program(NSQIP)database to determine if there was higher morbidity among the neo-adjuvant group within the 30-day post-operative period.We hypothesized patients who underwent NACT were more likely to have higher post-operative morbidity.AIM To investigate the 30-day post-operative morbidity outcomes between patients who received NACT and underwent surgery and patients who only had surgery.METHODS A retrospective analysis of the targeted hepatectomy NSQIP data between 2015 and 2019 was performed to determine if NACT in gallbladder cancer increased the risk for post-operative morbidity(bile leak,infection rate,rate of converting to open surgery,etc.)compared to the group who only had surgery.To calculate the odds ratio for the primary and secondary outcomes,a crude logistic regression was performed.RESULTS Of the 452 patients,52 patients received NACT prior to surgery.There were no statistically significant differences in the odds of morbidity between the two groups,including bile leak[odds ratio(OR),0.69;95%confidence interval(95%CI):0.16-2.10;P=0.55],superficial wound infection(OR,0.58;95%CI:0.03-3.02;P=0.61),and organ space wound infection(OR,0.63;95%CI:0.18-1.63;P=0.61).CONCLUSION There was no significant difference in the risk of 30-day post-operative morbidity between the NACT and surgery group and the surgery only group.展开更多
Objective:To explore the effect of the Plan-Do-Check-Action(PDCA)cycle on hand hygiene and nosocomial infection quality of or thopedic medical staff.Methods:The whole year of 2021 was selected to monitor the quality o...Objective:To explore the effect of the Plan-Do-Check-Action(PDCA)cycle on hand hygiene and nosocomial infection quality of or thopedic medical staff.Methods:The whole year of 2021 was selected to monitor the quality of hand hygiene and hospitalization.Follow-up monitoring and real-time recording during the period of morning shift and medical operation concentration time,and compare the compliance of hand hygiene before and after implementation,and evaluate the quality of nosocomial infection.Results:The hand hygiene compliance of doctors and nurses in stage P was 82%.The compliance of medical staff in stage D was 93%.The compliance of stage C was 94%and that of stage A was 95%.The quality score of hospital self-examination nosocomial infection was also significantly increased.Conclusions:The PDCA management cycle can effectively improve the compliance of hand hygiene and the nosocomial infection quality,which is wor thy of circulatory application in or thopedic nosocomial infection quality control,especially improving the quality of hand hygiene.展开更多
The time-varying difference-in-difference model is used to identify the impact of payment technology on residents’consumption,and the moderation effect analysis method is used to identify its mechanism.It is found th...The time-varying difference-in-difference model is used to identify the impact of payment technology on residents’consumption,and the moderation effect analysis method is used to identify its mechanism.It is found that payment technology promotes consumption capacity expansion and quality improvement(CEQI)through three pathways of alleviating liquidity constraints,reducing transaction costs and weakening the payment of pain.The parallel and serial mechanisms of the three are further explored.The effect of payment technology on the CEQI of residents’consumption shows obvious heterogeneity due to differences in urban and rural household registration and financial literacy.Based on the empirical research results and the national conditions of China,targeted policy recommendations are proposed from the demand side,the supply side and the technological side.展开更多
Background: Nigeria, a nation grappling with rapid population growth, economic intricacies, and complex healthcare challenges, particularly in Lagos State, the economic hub and most populous state, faces the challenge...Background: Nigeria, a nation grappling with rapid population growth, economic intricacies, and complex healthcare challenges, particularly in Lagos State, the economic hub and most populous state, faces the challenge of ensuring quality healthcare access. The overview of the effect of quality improvement initiatives in this paper focuses on private healthcare providers in Lagos State, Nigeria. The study assesses the impact of donor-funded quality improvement projects on these private healthcare facilities. It explores the level of participation, perceived support, and tangible effects of the initiatives on healthcare delivery within private healthcare facilities. It also examines how these initiatives influence patient inflow and facility ratings, and bring about additional benefits and improvements, provides insights into the challenges faced by private healthcare providers in implementing quality improvement projects and elicits recommendations for improving the effectiveness of such initiatives. Methods: Qualitative research design was employed for in-depth exploration, utilizing semi-structured interviews. Private healthcare providers in Lagos involved in the SP4FP Quality Improvement Project were purposively sampled for diversity. Face-to-face interviews elicited insights into participation, perceived support, and project effects. Questions covered participation levels, support perception, changes observed, challenges faced, and recommendations. Thematic analysis identified recurring themes from interview transcripts. Adherence to ethical guidelines ensured participant confidentiality and informed consent. Results: Respondents affirmed active involvement in the SP4FP Quality Improvement Project, echoing literature emphasizing private-sector collaboration with the public sector. While acknowledging positive influences on facility ratings, respondents highlighted challenges within the broader Nigerian healthcare landscape affecting patient numbers. Respondents cited tangible improvements, particularly in staff management and patient care processes, validating the positive influence of quality improvement projects. Financial constraints emerged as a significant challenge, aligning with existing literature emphasizing the pragmatic difficulties faced by private healthcare providers. Conclusions: This study illuminates the complex landscape of private healthcare provision in Lagos State, emphasizing the positive impact of donor-funded quality improvement projects. The findings provide nuanced insights, guiding policymakers, healthcare managers, and practitioners toward collaborative, sustainable improvements. As Nigeria progresses, these lessons will be crucial in shaping healthcare policies prioritizing population well-being.展开更多
With the development of cities,China has entered an era of stock planning.The functions of old residential areas in urban development can no longer meet the needs of residents in the new era for a better life,and new ...With the development of cities,China has entered an era of stock planning.The functions of old residential areas in urban development can no longer meet the needs of residents in the new era for a better life,and new standards have been put forward for the quality of public spaces for living.This paper analyzes and sorts out the characteristics and problems of the public space in the old residential areas of Baihuazhou district.Combining superposition and intervention techniques,the spatial,historical,cultural and other characteristic elements of the residential areas are preserved to the greatest extent.The public space in the old residential areas of Baihuazhou District is updated and reconstructed in order to achieve the goal of improving the quality of its public space.展开更多
BACKGROUND The neonatal intensive care unit(NICU)is vital for preterm infants but is often plagued by harmful noise levels.Excessive noise,ranging from medical equipment to conversations,poses significant health risks...BACKGROUND The neonatal intensive care unit(NICU)is vital for preterm infants but is often plagued by harmful noise levels.Excessive noise,ranging from medical equipment to conversations,poses significant health risks,including hearing impairment and neurodevelopmental issues.The American Academy of Pediatrics recommends strict sound limits to safeguard neonatal well-being.Strategies such as education,environmental modifications,and quiet hours have shown to reduce noise levels.However,up to 60%of the noises remain avoidable.High noise exposure exacerbates physiological disturbances,impacting vital functions and long-term neurological outcomes.Effective noise reduction in the NICU is crucial for promoting optimal neonatal development.AIM To measure the sound levels in a NICU and reduce ambient sound levels by at least 10%from baseline.METHODS A quasi-experimental quality improvement project was conducted over 4 mo in a 20-bed level 3 NICU in a tertiary care medical college.Baseline noise levels were recorded continuously using a sound level meter.The interventions included targeted education,environmental modifications,and organizational changes,and were implemented through three rapid Plan-Do-Study-Act(PDSA)cycles.Weekly feedback and monitoring were conducted,and statistical process control charts were used for analysis.The mean noise values were compared using the paired t-test.RESULTS The baseline mean ambient noise level in the NICU was 67.8 dB,which decreased to 50.5 dB after the first cycle,and further decreased to 47.4 dB and 51.2 dB after subsequent cycles.The reduction in noise levels was 21%during the day and 28%PDSA cycle(mean difference of−17.3 dB,P<0.01).Peak noise levels decreased from 110 dB to 88.24 dB after the intervention.CONCLUSION A multifaceted intervention strategy reduced noise in the NICU by 25%over 4 months.The success of this initiative emphasizes the significance of comprehensive interventions for noise reduction.展开更多
Clinical teaching is an important link for nursing professional students to transform theoretical knowledge into practical skills. This paper takes Dazhou City Central Hospital as an example to explore strategies and ...Clinical teaching is an important link for nursing professional students to transform theoretical knowledge into practical skills. This paper takes Dazhou City Central Hospital as an example to explore strategies and practices for enhancing the quality of internal medicine nursing clinical teaching, aiming to provide reference and guidance for internal medicine nursing clinical teaching in China.展开更多
In today’s higher education system,the physical education program is not only for teaching sports skills and exercising physical fitness but also an important position for cultivating students’character,emotions,and...In today’s higher education system,the physical education program is not only for teaching sports skills and exercising physical fitness but also an important position for cultivating students’character,emotions,and values.With the in-depth development of the concept of ideological education,the ideology of college physical education courses has become an important direction of educational reform.In this paper,we will discuss the connotation of the concept of ideology and politics in college physical education courses,analyze the methods to effectively integrate the ideology and politics elements while guaranteeing the quality of teaching,and put forward the corresponding strategies to improve the quality,with a view to providing new ideas and methods for the construction of ideology and politics in college physical education courses.展开更多
We applied water releasing from rootstocks technique and Juglans sigillata in Yangbi was pruned in the shape of opened-heart or round-heart shape. By bal- anced fertilization, survival rate of grafted walnuts can be i...We applied water releasing from rootstocks technique and Juglans sigillata in Yangbi was pruned in the shape of opened-heart or round-heart shape. By bal- anced fertilization, survival rate of grafted walnuts can be improved. We reviewed technologies to enhance walnut quality and production efficiency in Gongshan Derung and Nu Autonomous County for reference.展开更多
Improving the quality of life for Earth's growing population is a complex task that requires the development of new technologies and materials. Perhaps the biggest challenge is access to clean and renewable energy...Improving the quality of life for Earth's growing population is a complex task that requires the development of new technologies and materials. Perhaps the biggest challenge is access to clean and renewable energy sources that can drive a sustainable future. Photovoltaics, today mainly represented by silicon-based solar cells, convert solar energy into electricity and is already an important component in the renewable energy portfolio.展开更多
In order to improve the purchased goods quality management level of food processing enterprises, the causes of quality management problems were ana- lyzed, which were classified into four categories, namely, natural t...In order to improve the purchased goods quality management level of food processing enterprises, the causes of quality management problems were ana- lyzed, which were classified into four categories, namely, natural toxins in raw ma- terials, quality problems in planting and breeding, quality problems in transportation, quality problems in delivery acceptance. Then, based on the causes, eight measures to improve goods purchasing management were put forward, and graphs were used to illustrate the corresponding countermeasure to each cause. This study is of theo- retical significance for the food processing enterprises to improve the quality man- agement of purchased goods through formulating improvement measures based on their operating states.展开更多
Pediatric emergency care(PEC)encompasses the specialized medical care delivered to infants,children,and adolescents facing urgent medical situations,addressing critical conditions such as infections,allergic responses...Pediatric emergency care(PEC)encompasses the specialized medical care delivered to infants,children,and adolescents facing urgent medical situations,addressing critical conditions such as infections,allergic responses,seizures,respiratory distress,and trauma.PEC calls for prompt,focused interventions to address each child's developmental and physiological needs.The literature was searched using Google Scholar,PubMed,and the Cochrane Library to retrieve studies assessing quality indicators and outcomes in pediatric emergencies.The search was limited to papers published in peer-reviewed journals between 01 Jan 2000 and 15 Dec 2024.This review evaluates current PEC standards such as patient safety,diagnostic precision,timeliness,and patient and family satisfaction.Patient safety is vital because children are particularly vulnerable to medical errors,such as inappropriate doses of medication.The provision of high-quality PEC is hampered by systemic issues such as inadequate training,a lack of re-sources,and restricted access to treatment.Telemedicine,pediatric transport units,artificial intelligence applications for diagnostics,and simulation-based training are suggested approaches to overcome these challenges.Research net-works and quality improvement initiatives are important steps to improve PEC care.展开更多
Dear Editor,The Veterans Health Administration(VHA)plays a crucial role in the U.S.healthcare system,particularly for a population with a high prevalence of skin cancer[1].Timely total body skin examination(TBSE)is vi...Dear Editor,The Veterans Health Administration(VHA)plays a crucial role in the U.S.healthcare system,particularly for a population with a high prevalence of skin cancer[1].Timely total body skin examination(TBSE)is vital for managing cutaneous malignancies[2].Despite National Comprehensive Cancer Network(NCCN)guidelines advocating regular TBSE post-diagnosis[3].展开更多
December 2024 China boosts opportunities for people living with disabilities China has reached fruitful results of improving the living quality of disabled people by boosting their employment and enabling them to get ...December 2024 China boosts opportunities for people living with disabilities China has reached fruitful results of improving the living quality of disabled people by boosting their employment and enabling them to get easier access to barrier-free services.The China Disabled Persons’Federation said so far,the nation has about 85 million people living with disabilities.展开更多
In this paper,different stands in Xianzhong Nursery of Pingjiang were selected as the research object to study the runoff generation and soil loss characteristics of different stands.The results showed that the annual...In this paper,different stands in Xianzhong Nursery of Pingjiang were selected as the research object to study the runoff generation and soil loss characteristics of different stands.The results showed that the annual surface runoff of each model in Pingjiang was between 50.50 and 70.38 mm,and the annual surface runoff of each stand decreased with years.There was no significant difference in the annual runoff between each stand,nor between each stand and its control.There were significant differences in soil erosion modulus among the models,and the number ranged from 139.20 to 197.79 t/(km^(2)·y).展开更多
The efficiency of phytosynthetic bacteria (PSB) to improve the water quality in saline alkali ponds was studied, the result showed that (1) PSB application could increase the content of DO, NO\+-\-3\|N and effective ...The efficiency of phytosynthetic bacteria (PSB) to improve the water quality in saline alkali ponds was studied, the result showed that (1) PSB application could increase the content of DO, NO\+-\-3\|N and effective phosphorus (EP) in ponds; (2) the changes of COD were not evident, just effective in later period after PSB application; (3) PSB application could decrease the contents of NH\+-\-4\|N (NH\-3\|N), NO\+-\-2\|N ; (4) PSB application could improve the structure of the effective nitrogen (EN) and EP, stimulate the growth of phytoplankton, and increase primary productivity, and finally increase the commercial profits of ponds because of the increase of EP and the decrease of EN contents; (5) the effect exerting speed of PSB was slower, but the effect sustaining time was longer; (6) the appropriate concentration of PSB application in saline alkali wetland ponds was 10×10 -6 mg/L, one time effective period was more than 15 days. So PSB was an efficient water quality improver in saline alkali ponds.展开更多
文摘Evidence is not homogeneous on indicators able to monitor and assess qualityperformance for organ donation. This may be related to differences in healthcareorganizations among countries but also to the scarcity of data on this topic so far.In the present review, we assessed available evidence on quality metrics in solidorgan procurement in the United States and in Europe by means of a PubMedsearch. Evidence was summarized according to countries, considering that thedonation and transplantation systems differ from country to country. In UnitedStates, the assessment of these indicators is periodically performed by the nationalnetwork for organ sharing to evaluate the performance of each Organ ProcurementOrganization (OPO). Quality metrics consider several factors, in primispopulation characteristics (i.e. race/ethnicity, age, socio-economic status). That iswhy the assessment of each OPO performance relies on several quality metrics,not only one single indicator. In Europe, quality improvement programs representa structural element of organ and transplant system in several countries, but fewpapers have to date addressed the results obtained by a quality improvementprogram based on indicators. In Poland, the use of quality indicators and improvementprocedures were associated with better results in those hospitals whichimplemented these programs in respect to hospitals who did not. In TuscanyRegion (Italy) the implementation of a monitoring and reporting approach basedon indicators by the Regional Transplant Center was associated with an increasedin transplant and donation activity (especially in cDCD donors). According toavailable evidence, the development of a method for quality assessment andquality improvement has been recognized as pivotal for donation and transplantauthorities to identify key interventions either at national and/or hospital levels.
基金supported by the National Language Commission to research on sign language data specifications for artificial intelligence applications and test standards for language service translation systems (No.ZDI145-70)。
文摘Sign language dataset is essential in sign language recognition and translation(SLRT). Current public sign language datasets are small and lack diversity, which does not meet the practical application requirements for SLRT. However, making a large-scale and diverse sign language dataset is difficult as sign language data on the Internet is scarce. In making a large-scale and diverse sign language dataset, some sign language data qualities are not up to standard. This paper proposes a two information streams transformer(TIST) model to judge whether the quality of sign language data is qualified. To verify that TIST effectively improves sign language recognition(SLR), we make two datasets, the screened dataset and the unscreened dataset. In this experiment, this paper uses visual alignment constraint(VAC) as the baseline model. The experimental results show that the screened dataset can achieve better word error rate(WER) than the unscreened dataset.
文摘University student Party branches serve as the Party’s grassroots organizations within universities and act as a bridge and link between the Party and students.Therefore,it is essential to strengthen the development of student Party branches and enhance the effectiveness of student Party member education and training.This paper summarizes and analyzes the issues in the construction of student Party branches in universities and explores strategies for improving their quality,aiming to provide a reference for relevant personnel.
基金supported by Zhejiang Provincial Medical and Health Science and Technology Plan Project(2023KY448).
文摘Objective:Early thrombolytic therapy for ischemic stroke within the therapeutic window is associated with improved clinical outcomes.This study investigated whether optimizing intravenous thrombolytic(IVT)therapy strategies for stroke could reduce treatment delays.Methods:To reduce delays in IVT therapy for ischemic stroke,a series of quality improvement measures were implemented at a tertiary hospital in Hangzhou,Zhejiang Province,from June 2021 to August 2023,which included developing a timeline process management system,forming a nurse-led stroke process management team,providing homogeneous training,standardizing the IVT therapy process for ischemic stroke,and introducing an incentive policy.During the pre-(from June 2021 to February 2022,group A)and post-(from March to November 2022,group B1;from December 2022 to August 2023,group B2[implementation of an additional incentive policy])of the implementation the strategy,the door-tocomputed tomographic angiography(CTA)time(DCT),CTA time,neurology consultation to consent for IVT,CTA-to-needle time(CNT),and door-to-needle time(DNT),the percentage of people who underwent CTA within 20 min,15 min,and 10 min and DNT within 60 min,45 min,and 30 min were collected and compared.Results:Following the implementation of the standardized IVT process management strategy for stroke,the DNT for group B1 and group B2 were 30(24,44)min and 31(24,41)min,respectively,both significantly lower than the 46(38,58)min in group A(P<0.001);the median DCT were both 13 min in group B1 and B2 lower than 17min in group A(P<0.001);the median CTA were 12 min in Group B1 and 9 min in Group B2 lower than 14 min in group A(P<0.001);similar results were observed during the neurology consultation to obtain consent for IVT and CNT.Compared with group A,the proportion of DCT20 min,15 min,and 10 min was higher in groups B1 and B2(P<0.05),and the same result was observed at DNT60 min,45 min,and 30 min(P<0.05).However,the additional incentive policy did not significantly differ between Group B2 and Group B1.Conclusions:Optimizing IVT therapy for ischemic stroke is a feasible approach to limit the DNT to 30 min in ischemic stroke,significantly reducing delays within the therapeutic window and increasing the number of patients meeting target time segments.Additionally,generating a timeline for the IVT therapy process by scanning positioning quick response codes was a significant breakthrough in achieving the informatization of IVT quality management for stroke.
文摘BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for neoadjuvant therapy in gallbladder cancer.As investigations continue to analyze the regimen and benefit of NACT for ongoing care of gallbladder cancer patients,we examined American College of Surgeons National Surgical Quality Improvement Program(NSQIP)database to determine if there was higher morbidity among the neo-adjuvant group within the 30-day post-operative period.We hypothesized patients who underwent NACT were more likely to have higher post-operative morbidity.AIM To investigate the 30-day post-operative morbidity outcomes between patients who received NACT and underwent surgery and patients who only had surgery.METHODS A retrospective analysis of the targeted hepatectomy NSQIP data between 2015 and 2019 was performed to determine if NACT in gallbladder cancer increased the risk for post-operative morbidity(bile leak,infection rate,rate of converting to open surgery,etc.)compared to the group who only had surgery.To calculate the odds ratio for the primary and secondary outcomes,a crude logistic regression was performed.RESULTS Of the 452 patients,52 patients received NACT prior to surgery.There were no statistically significant differences in the odds of morbidity between the two groups,including bile leak[odds ratio(OR),0.69;95%confidence interval(95%CI):0.16-2.10;P=0.55],superficial wound infection(OR,0.58;95%CI:0.03-3.02;P=0.61),and organ space wound infection(OR,0.63;95%CI:0.18-1.63;P=0.61).CONCLUSION There was no significant difference in the risk of 30-day post-operative morbidity between the NACT and surgery group and the surgery only group.
基金supported by Henan Province Higher Education Teaching Reform Research and Practice Project(No.2021SJGLX333)。
文摘Objective:To explore the effect of the Plan-Do-Check-Action(PDCA)cycle on hand hygiene and nosocomial infection quality of or thopedic medical staff.Methods:The whole year of 2021 was selected to monitor the quality of hand hygiene and hospitalization.Follow-up monitoring and real-time recording during the period of morning shift and medical operation concentration time,and compare the compliance of hand hygiene before and after implementation,and evaluate the quality of nosocomial infection.Results:The hand hygiene compliance of doctors and nurses in stage P was 82%.The compliance of medical staff in stage D was 93%.The compliance of stage C was 94%and that of stage A was 95%.The quality score of hospital self-examination nosocomial infection was also significantly increased.Conclusions:The PDCA management cycle can effectively improve the compliance of hand hygiene and the nosocomial infection quality,which is wor thy of circulatory application in or thopedic nosocomial infection quality control,especially improving the quality of hand hygiene.
基金Foundation items:National Natural Science Foundation of China(No.71874027)Ministry of Education Humanities and Social Sciences Research Youth Fund Project(No.23YJC760028)。
文摘The time-varying difference-in-difference model is used to identify the impact of payment technology on residents’consumption,and the moderation effect analysis method is used to identify its mechanism.It is found that payment technology promotes consumption capacity expansion and quality improvement(CEQI)through three pathways of alleviating liquidity constraints,reducing transaction costs and weakening the payment of pain.The parallel and serial mechanisms of the three are further explored.The effect of payment technology on the CEQI of residents’consumption shows obvious heterogeneity due to differences in urban and rural household registration and financial literacy.Based on the empirical research results and the national conditions of China,targeted policy recommendations are proposed from the demand side,the supply side and the technological side.
文摘Background: Nigeria, a nation grappling with rapid population growth, economic intricacies, and complex healthcare challenges, particularly in Lagos State, the economic hub and most populous state, faces the challenge of ensuring quality healthcare access. The overview of the effect of quality improvement initiatives in this paper focuses on private healthcare providers in Lagos State, Nigeria. The study assesses the impact of donor-funded quality improvement projects on these private healthcare facilities. It explores the level of participation, perceived support, and tangible effects of the initiatives on healthcare delivery within private healthcare facilities. It also examines how these initiatives influence patient inflow and facility ratings, and bring about additional benefits and improvements, provides insights into the challenges faced by private healthcare providers in implementing quality improvement projects and elicits recommendations for improving the effectiveness of such initiatives. Methods: Qualitative research design was employed for in-depth exploration, utilizing semi-structured interviews. Private healthcare providers in Lagos involved in the SP4FP Quality Improvement Project were purposively sampled for diversity. Face-to-face interviews elicited insights into participation, perceived support, and project effects. Questions covered participation levels, support perception, changes observed, challenges faced, and recommendations. Thematic analysis identified recurring themes from interview transcripts. Adherence to ethical guidelines ensured participant confidentiality and informed consent. Results: Respondents affirmed active involvement in the SP4FP Quality Improvement Project, echoing literature emphasizing private-sector collaboration with the public sector. While acknowledging positive influences on facility ratings, respondents highlighted challenges within the broader Nigerian healthcare landscape affecting patient numbers. Respondents cited tangible improvements, particularly in staff management and patient care processes, validating the positive influence of quality improvement projects. Financial constraints emerged as a significant challenge, aligning with existing literature emphasizing the pragmatic difficulties faced by private healthcare providers. Conclusions: This study illuminates the complex landscape of private healthcare provision in Lagos State, emphasizing the positive impact of donor-funded quality improvement projects. The findings provide nuanced insights, guiding policymakers, healthcare managers, and practitioners toward collaborative, sustainable improvements. As Nigeria progresses, these lessons will be crucial in shaping healthcare policies prioritizing population well-being.
文摘With the development of cities,China has entered an era of stock planning.The functions of old residential areas in urban development can no longer meet the needs of residents in the new era for a better life,and new standards have been put forward for the quality of public spaces for living.This paper analyzes and sorts out the characteristics and problems of the public space in the old residential areas of Baihuazhou district.Combining superposition and intervention techniques,the spatial,historical,cultural and other characteristic elements of the residential areas are preserved to the greatest extent.The public space in the old residential areas of Baihuazhou District is updated and reconstructed in order to achieve the goal of improving the quality of its public space.
文摘BACKGROUND The neonatal intensive care unit(NICU)is vital for preterm infants but is often plagued by harmful noise levels.Excessive noise,ranging from medical equipment to conversations,poses significant health risks,including hearing impairment and neurodevelopmental issues.The American Academy of Pediatrics recommends strict sound limits to safeguard neonatal well-being.Strategies such as education,environmental modifications,and quiet hours have shown to reduce noise levels.However,up to 60%of the noises remain avoidable.High noise exposure exacerbates physiological disturbances,impacting vital functions and long-term neurological outcomes.Effective noise reduction in the NICU is crucial for promoting optimal neonatal development.AIM To measure the sound levels in a NICU and reduce ambient sound levels by at least 10%from baseline.METHODS A quasi-experimental quality improvement project was conducted over 4 mo in a 20-bed level 3 NICU in a tertiary care medical college.Baseline noise levels were recorded continuously using a sound level meter.The interventions included targeted education,environmental modifications,and organizational changes,and were implemented through three rapid Plan-Do-Study-Act(PDSA)cycles.Weekly feedback and monitoring were conducted,and statistical process control charts were used for analysis.The mean noise values were compared using the paired t-test.RESULTS The baseline mean ambient noise level in the NICU was 67.8 dB,which decreased to 50.5 dB after the first cycle,and further decreased to 47.4 dB and 51.2 dB after subsequent cycles.The reduction in noise levels was 21%during the day and 28%PDSA cycle(mean difference of−17.3 dB,P<0.01).Peak noise levels decreased from 110 dB to 88.24 dB after the intervention.CONCLUSION A multifaceted intervention strategy reduced noise in the NICU by 25%over 4 months.The success of this initiative emphasizes the significance of comprehensive interventions for noise reduction.
文摘Clinical teaching is an important link for nursing professional students to transform theoretical knowledge into practical skills. This paper takes Dazhou City Central Hospital as an example to explore strategies and practices for enhancing the quality of internal medicine nursing clinical teaching, aiming to provide reference and guidance for internal medicine nursing clinical teaching in China.
文摘In today’s higher education system,the physical education program is not only for teaching sports skills and exercising physical fitness but also an important position for cultivating students’character,emotions,and values.With the in-depth development of the concept of ideological education,the ideology of college physical education courses has become an important direction of educational reform.In this paper,we will discuss the connotation of the concept of ideology and politics in college physical education courses,analyze the methods to effectively integrate the ideology and politics elements while guaranteeing the quality of teaching,and put forward the corresponding strategies to improve the quality,with a view to providing new ideas and methods for the construction of ideology and politics in college physical education courses.
基金Supported by National Forestry Science and Technology Key Promotion Program([2014]TZYN01)~~
文摘We applied water releasing from rootstocks technique and Juglans sigillata in Yangbi was pruned in the shape of opened-heart or round-heart shape. By bal- anced fertilization, survival rate of grafted walnuts can be improved. We reviewed technologies to enhance walnut quality and production efficiency in Gongshan Derung and Nu Autonomous County for reference.
基金financially supported by the National Science Foundation of China grant (62322407, 22279034, 52261145698, W2421103)Shanghai Science and Technology Innovation Action Plan (22ZR1418900, 24110714100)+1 种基金the Swedish Research Council (project grant no. 2020-04538)the Swedish Government Strategic Research Area in Materials Science on Functional Materials at Link?ping University (Faculty Grant SFO Mat LiU no. 2009 00971)。
文摘Improving the quality of life for Earth's growing population is a complex task that requires the development of new technologies and materials. Perhaps the biggest challenge is access to clean and renewable energy sources that can drive a sustainable future. Photovoltaics, today mainly represented by silicon-based solar cells, convert solar energy into electricity and is already an important component in the renewable energy portfolio.
基金Supported by the Key Scientific Research Program of Beijing Municipal Commission of Education in 2013~~
文摘In order to improve the purchased goods quality management level of food processing enterprises, the causes of quality management problems were ana- lyzed, which were classified into four categories, namely, natural toxins in raw ma- terials, quality problems in planting and breeding, quality problems in transportation, quality problems in delivery acceptance. Then, based on the causes, eight measures to improve goods purchasing management were put forward, and graphs were used to illustrate the corresponding countermeasure to each cause. This study is of theo- retical significance for the food processing enterprises to improve the quality man- agement of purchased goods through formulating improvement measures based on their operating states.
文摘Pediatric emergency care(PEC)encompasses the specialized medical care delivered to infants,children,and adolescents facing urgent medical situations,addressing critical conditions such as infections,allergic responses,seizures,respiratory distress,and trauma.PEC calls for prompt,focused interventions to address each child's developmental and physiological needs.The literature was searched using Google Scholar,PubMed,and the Cochrane Library to retrieve studies assessing quality indicators and outcomes in pediatric emergencies.The search was limited to papers published in peer-reviewed journals between 01 Jan 2000 and 15 Dec 2024.This review evaluates current PEC standards such as patient safety,diagnostic precision,timeliness,and patient and family satisfaction.Patient safety is vital because children are particularly vulnerable to medical errors,such as inappropriate doses of medication.The provision of high-quality PEC is hampered by systemic issues such as inadequate training,a lack of re-sources,and restricted access to treatment.Telemedicine,pediatric transport units,artificial intelligence applications for diagnostics,and simulation-based training are suggested approaches to overcome these challenges.Research net-works and quality improvement initiatives are important steps to improve PEC care.
文摘Dear Editor,The Veterans Health Administration(VHA)plays a crucial role in the U.S.healthcare system,particularly for a population with a high prevalence of skin cancer[1].Timely total body skin examination(TBSE)is vital for managing cutaneous malignancies[2].Despite National Comprehensive Cancer Network(NCCN)guidelines advocating regular TBSE post-diagnosis[3].
文摘December 2024 China boosts opportunities for people living with disabilities China has reached fruitful results of improving the living quality of disabled people by boosting their employment and enabling them to get easier access to barrier-free services.The China Disabled Persons’Federation said so far,the nation has about 85 million people living with disabilities.
基金Supported by Hunan Forestry Science and Technology Plan(OT-S-KTA5,2024YBC15)Science and Technology Plan of Hunan Province(2021SFQ19).
文摘In this paper,different stands in Xianzhong Nursery of Pingjiang were selected as the research object to study the runoff generation and soil loss characteristics of different stands.The results showed that the annual surface runoff of each model in Pingjiang was between 50.50 and 70.38 mm,and the annual surface runoff of each stand decreased with years.There was no significant difference in the annual runoff between each stand,nor between each stand and its control.There were significant differences in soil erosion modulus among the models,and the number ranged from 139.20 to 197.79 t/(km^(2)·y).
文摘The efficiency of phytosynthetic bacteria (PSB) to improve the water quality in saline alkali ponds was studied, the result showed that (1) PSB application could increase the content of DO, NO\+-\-3\|N and effective phosphorus (EP) in ponds; (2) the changes of COD were not evident, just effective in later period after PSB application; (3) PSB application could decrease the contents of NH\+-\-4\|N (NH\-3\|N), NO\+-\-2\|N ; (4) PSB application could improve the structure of the effective nitrogen (EN) and EP, stimulate the growth of phytoplankton, and increase primary productivity, and finally increase the commercial profits of ponds because of the increase of EP and the decrease of EN contents; (5) the effect exerting speed of PSB was slower, but the effect sustaining time was longer; (6) the appropriate concentration of PSB application in saline alkali wetland ponds was 10×10 -6 mg/L, one time effective period was more than 15 days. So PSB was an efficient water quality improver in saline alkali ponds.
