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
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
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
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
High grain protein content(GPC) reduces rice eating and cooking quality(ECQ). We generated OsAAP6 and OsAAP10 knockout mutants in three high-yielding japonica varieties and one japonica line using the CRISPR/Cas9 syst...High grain protein content(GPC) reduces rice eating and cooking quality(ECQ). We generated OsAAP6 and OsAAP10 knockout mutants in three high-yielding japonica varieties and one japonica line using the CRISPR/Cas9 system. Mutation efficiency varied with genetic background in the T_0 generation, and GPC in the T_1 generation decreased significantly,owing mainly to a reduction in glutelin content. Amylose content was down-regulated significantly in some Osaap6 and all Osaap10 mutants. The increased taste value of these mutants was supported by Rapid Visco Analysis(RVA) profiles, which showed higher peak viscosity and breakdown viscosity and lower setback viscosity than the wild type. There were no significant deficiencies in agronomic traits of the mutants. Targeted mutagenesis of OsAAP6 and OsAAP10, especially OsAAP10, using the CRISPR/Cas9 system can rapidly reduce GPC and improve ECQ of rice, providing a new strategy for the breeding cultivars with desired ECQ.展开更多
This article describes the integrated modeling approach for planning the size and the operation of constructed wetlands for maximizing retention of nonpoint source pollutant loads and reservoir water-quality improveme...This article describes the integrated modeling approach for planning the size and the operation of constructed wetlands for maximizing retention of nonpoint source pollutant loads and reservoir water-quality improvement at a catchment scale. The experimental field-scale wetland systems （four sets, 0.88 ha each） have been in operation since 2002, where water depth was maintained at 30-50 cm and hydraulic loading rate was at 6.3-18.8 cm/day. The wetland system was found to be adequate for treating polluted stream water with stable removal efficiency even during the winter. The integrated modeling system （modified-BASINS） was applied to the Seokmoon estuarine reservoir watershed and calibrated with monitoring data from constructed wetland, stream, and reservoir. The calibrated integrated modeling system estimated that constructing wetlands on 0.5% （about 114 ha） of the watershed area at the mouth of reservoir could reduce 11.61% and 13.49% of total external nitrogen and phosphorus loads, respectively. It also might improve the nitrogen and phosphorus concentration of the reservoir by 9.69% and 16.48%, respectively. The study suggested that about 0.1%-1.0% of the watershed area should be allocated for constructed wetland to meet specified water-quality standards for the estuarine reservoir at the polder area where land use planning is relatively less complicated.展开更多
japonica rice is mainly distributed in Northeast China and accounts for 44.6% of the total cultivated area of japonica rice in China. The comprehensive using of inter-subspecies heterosis is the main breeding mode of ...japonica rice is mainly distributed in Northeast China and accounts for 44.6% of the total cultivated area of japonica rice in China. The comprehensive using of inter-subspecies heterosis is the main breeding mode of super japonica rice varieties in this region. Improving rice quality at relative high yielding level is the current research focus. Performing crosses between indica and japonica lines allows for the recombination of regulatory genes and genetic backgrounds, leading to complicated genetic rice quality characteristics, which can be used to explore patterns of quality improvement. In the present study, we utilize recombinant inbred lines （RILs） derived from indica-japonica hybridization to analyze the effect factors of rice quality derived from genetic factors, which contain both regulatory genes concerning rice quality and genetic backgrounds＇ random introduction frequency coming from indica （Di value）, and the improvement strategy was further discussed. The regulatory genes involved in amylase content （Wx） and nitrogen utilization efficiency （NRT1.1B） were the major factors affecting the amylose content （AC） and protein content （PC） in RILs, respectively. Both the Di value and the major grain width gene （GS5） had regulatory effects on milled rice width （MRW） in RILs, and their interaction explained the major variance of MRW in the RILs. With the mediation of MRW and chalkiness degree （C）, Di value had a further impact on head rice rate （HR）, which was relatively poor when the Di value was over 40%. In Northeast China, the Di value should be lowered by backcrossing or multiple crosses during the breeding of indica-japonica hybridization to maintain the whole better HR and further to emphasize the use of favorable genes in individual selection.展开更多
The real-time energy flow data obtained in industrial production processes are usually of low quality.It is difficult to accurately predict the short-term energy flow profile by using these field data,which diminishes...The real-time energy flow data obtained in industrial production processes are usually of low quality.It is difficult to accurately predict the short-term energy flow profile by using these field data,which diminishes the effect of industrial big data and artificial intelligence in industrial energy system.The real-time data of blast furnace gas(BFG)generation collected in iron and steel sites are also of low quality.In order to tackle this problem,a three-stage data quality improvement strategy was proposed to predict the BFG generation.In the first stage,correlation principle was used to test the sample set.In the second stage,the original sample set was rectified and updated.In the third stage,Kalman filter was employed to eliminate the noise of the updated sample set.The method was verified by autoregressive integrated moving average model,back propagation neural network model and long short-term memory model.The results show that the prediction model based on the proposed three-stage data quality improvement method performs well.Long short-term memory model has the best prediction performance,with a mean absolute error of 17.85 m3/min,a mean absolute percentage error of 0.21%,and an R squared of 95.17%.展开更多
A novel sound quality simulation approach was proposed to optimize the acoustic performance of a four-cylinder diesel engine.Finite element analysis,single-input and multiple-output technology,flexible multi-body dyna...A novel sound quality simulation approach was proposed to optimize the acoustic performance of a four-cylinder diesel engine.Finite element analysis,single-input and multiple-output technology,flexible multi-body dynamics,and boundary element codes were used to acquire the hexahedron-element model,experimental modal frequencies,vibration velocities,and structurally radiated noise of the block,respectively.The simulated modal frequencies and vibration velocities agreed well with the experimental data,which validated the finite-element block.The acoustic response showed that considerable acoustic power levels existed in 1500-1900 Hz and 2300-2800 Hz as the main frequency ranges to optimize the block acoustics.Then,the optimal block is determined in accordance with the novel approach,which reduces the overall value,high-frequency amplitudes,and peak values of acoustic power;thus,the loudness,sharpness,and roughness decline to make the sound quieter,lower-pitched,and smoother,respectively.Finally,the optimal block was cast and bench-tested.The results reveal that the sound quality of the optimal-block engine is substantially improved as numerically expected,which verifies the effectiveness of the research approach.展开更多
Purpose:Patients'complaints can be predictors of patient care quality and safety.Understanding patients'complaints could help healthcare organizations target the areas for improvements.The purpose of this stud...Purpose:Patients'complaints can be predictors of patient care quality and safety.Understanding patients'complaints could help healthcare organizations target the areas for improvements.The purpose of this study is to use a mixed method analysis to a)examine the characteristics and categories of patients'complaints,b)explore the relationships of patients'complaints with professions and units,and c)propose theory-based strategies to improve care quality.Methods:This is a descriptive mixed method study.Data examined are patients'complaints filed at a university-affiliated hospital in China from January 2016 to December 2017.A qualitative content analysis was conducted to categorize complaints.A TwoStep cluster analysis was performed to provide an overall profile of patients'complaints.Chi-Square tests were conducted to investigate the relationships among complaints,professions,and units.Results:838 complaints were filed,with 821 valid cases for analysis.Six categories surfaced from the qualitative analysis:uncaring attitudes,unsatisfactory quality of treatment or competence,communication problems,the process of care,fees and billing issues,and other miscellaneous causes.Physicians received most of the complaints(56.6%).The unit receiving the most complaints were outpatient clinics and medical support units(52.7%).The cluster analysis indicated four distinct clusters.Significant relationships existed between complaints and professions(x2(20)=178.82,P<0.01),and between complaints and units(x2(15)=42.72,P<0.01).Conclusions:Patients'complaints are valuable sources for quality improvements.Healthcare providers should be not only scientifically knowledgeable,but also humanistic caring.Caring-based theories may provide guidance in clinical practice.展开更多
Objectives: Engaging, enhancing and embedding clinical audit improvement activities into everyday practice to develop capacity, capability and culture in continuous improvement.Method: Through the implementation of an...Objectives: Engaging, enhancing and embedding clinical audit improvement activities into everyday practice to develop capacity, capability and culture in continuous improvement.Method: Through the implementation of an electronic quality management system called Governance, Evidence, Knowledge and Outcome (GEKO), the key aspects of governance, evidence knowledge and outcomes were able to be applied to quality initiatives. Implementation of the GEKO system incorporated the principles of total quality control and management to include strategic management control and marketing in parallel with leadership strategies. The vision was to motivate staff to enable ownership of the quality cycle of continuous improvement of patient care to incorporate underlying systems and processes that impact on patient care. Results: A continuous improvement pathway was successfully established 4 months post hospital commissioning. Over 890 (approximately 16% workforce) multidisciplinary and multi-professional staff received training and support for QIs in 12 months;over 535 quality proposals were received on GEKO. Submissions by profession: nursing and midwifery 46% (246), medical 33%(177), allied health 9% (48), pharmacy 5%(27), and non-clinical staff 7%(37). Average new submissions per month were 42. Reviews demonstrated the application of a rapid cycle approach to develop, test, modify and refine improvements and enhanced clinical care. Conclusion: Appropriate governance structure, processes, extensive education and training together with collaborative relationships are the keys to embed clinical audit improvement into everyday practice. The availability of a quality management system like GEKO is very useful to make QI accessible to all staff.展开更多
AIM: To create and apply a framework for quality assessment and improvement in care for inflammatory bowel disease (IBD) patients. METHODS A framework for quality assessment and improvement was created for IBD based o...AIM: To create and apply a framework for quality assessment and improvement in care for inflammatory bowel disease (IBD) patients. METHODS A framework for quality assessment and improvement was created for IBD based on two generally acknowledged quality models. The model of Donabedian (Df) offers a logistical and productive perspective and the Clinical Value Compass (CVC) model adds a management and service perspective. The framework creates a pedagogical tool to understand the balance between the dimensions of clinical care (CVC) and the components of clinical outcome (Df). The merged models create a framework of the care process dimensions as a whole, reflecting important parts of the IBD care delivery system in a local setting. Clinical and organizational quality measures were adopted from clinical experience and the literature and were integrated into the framework. Data were collected at the yearly check-up for 481 IBD patients during 2008. The application of the quality assessment framework was tested and evaluated in a local clinical IBD care setting in Jnkping County, Sweden. RESULTS: The main outcome was the presentation of how locally-selected clinical quality measures, integrated into two complementary models to develop a frame-work, could be instrumental in assessing the quality of care delivered to patients with IBD. The selected quality measures of the framework noted less anemia in the population than previously reported, provided information about hospitalization rates and the few surgical procedures reported, and noted good access to the clinic. CONCLUSION: The applied local quality framework was feasible and useful for assessing the quality of care delivered to IBD patients in a local setting.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
Objectives: In the post-surgical setting,active involvement of family caregivers has the potential to improve patient outcomes by prevention of surgical complications that are sensitive to fundamental care.This paper ...Objectives: In the post-surgical setting,active involvement of family caregivers has the potential to improve patient outcomes by prevention of surgical complications that are sensitive to fundamental care.This paper describes the development of a theoretically grounded program to enhance the active involvement of family caregivers in fundamental care for post-surgical patients.Methods: We used a quality improvement project following a multi-phase design.In Phase 1,an iterative method was used to combine evidence from a narrative review and professionals' preferences.In Phase 2,the logic model underlying the program was developed guided by four steps: (1) confirm situation,intervention aim,and target population;(2) documented expected outcomes,and outputs of the intervention;(3) identify and describe assumptions,external factors and inputs;and (4) confirm intervention components.Results: Phase 1 identified a minimum set of family involvement activities that were both supported by staff and the narrative review.In Phase 2,the logic model was developed and includes (1) the inputs (e.g.educational-and environmental support),(2) the ultimate outcomes (e.g.reduction of postoperative complications),(3) the intermediate outcomes (e.g.behavioural changes),and (4) immediate outcomes (e.g.improved knowledge,skills and attitude).Conclusions: We demonstrated how we aimed to change our practice to an environment in which family caregivers were stimulated to be actively involved in postoperative care on surgical wards,and how we took different factors into account.The description of this program may provide a solid basis for professionals to implement the family involvement program in their own setting.展开更多
The Yongding New River is essential for the water supplies of Tianjin.To date,there is no comprehensive report that assesses the year-round water quality of the Yongding New River Main stream.Moreover,little attention...The Yongding New River is essential for the water supplies of Tianjin.To date,there is no comprehensive report that assesses the year-round water quality of the Yongding New River Main stream.Moreover,little attention has been given to determining a combined weight for improving the traditional comprehensive water quality identification index(ICWQII)by the game theory.Seven water quality parameters were investigated monthly along the main stream of the Yongding New River from May 2018 to April 2019.Organic contaminants and nitrogen pollution were mainly caused by point sources pollution,and the total phosphorus mainly by non-point source pollution.Dramatic spatio-temporal variations of water quality parameters were jointly caused by different pollutant sources and hydrometeorological factors.In terms of this study,an improved comprehensive water quality identification index(ICWQII)based on entropy weight or variation coefficient and traditional CWQII underestimated the water qualities,and an ICWQII based on the superstandard multiple method overvalued the assessments.By contrast,water qualities assessments done with an ICWQII based on the game theory matched perfectly with the practical situation.The ICWQII based on game theory proposed in this study takes into account not only the degree of disorder and variation of water quality data,but also the influence of standard-exceeded pollution indicators,whose results are relatively reasonable.All findings and the ICWQII based on game theory can provide scientific support for decisions related to the water environment management of the Yongding New River and other waters.展开更多
To solve the problem that soybean has narrow genetic base, we constructed a series of male sterile recurrent selection populations, and studied the effects of quality improvement and practical value. An LD-base popula...To solve the problem that soybean has narrow genetic base, we constructed a series of male sterile recurrent selection populations, and studied the effects of quality improvement and practical value. An LD-base population, which fits to our ecology type was constructed by 6 years＇ gene enrichment through the introduction of new genes from 23 local varieties and recurrent selection. The LD-base populations were then improved by making crosses with high protein and high oil genotypes. As a result we obtained a high protein sub-population （db） and a high oil sub-population （gy）, For the db sub-population, the protein content is 1.18% higher than the base population, 22.38% of the individuals contain 45% or more of protein, which is 10.99% higher than the base population. For the gy sub-population, oil content is 0.24% higher than the base population. Individuals with oil content of 20% or more are 11.05% higher than the base population. The quantitative characters such as flowering date, mature date, pod habit, and hilum color, etc., all showed wide range of separation, and the segregation ratio approached balance. The c.v. of branch number of ms1 recurrent population （72.8%） is higher than general cross-population （57.3%）, and the c.v. of 100 seed weight of ms1 （18.1%） is higher than general cross population （16.5%）, the coefficient of variation of plant height, pods per plant, and seeds per pod were not significantly different. It was demonstrated in this paper that the quality character of ms 1 male sterile recurrent selection population was improved by adding new genes. And the segregation of other characters widened, making the populations suitable for the objective of soybean breeding. In this paper, we also discussed the breeding method, key technology, and selection effect of soybean ms 1 population.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
Rice is one of the most important staple food for over half of the world＇s population,and a substantial increase in productivity and quality of rice grain will be required to feed a growing human population.Grain siz...Rice is one of the most important staple food for over half of the world＇s population,and a substantial increase in productivity and quality of rice grain will be required to feed a growing human population.Grain size and shape are the two important components contributing to grain yield and quality,because they impact both yield potential and end-use quality.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 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.
基金financially supported by National Key Research and Development Program of China(2016YFD0100501)the National Natural Science Foundation of China(31871241,31371233)+3 种基金the Natural Science Foundation of Jiangsu Province(BE2017345,PZCZ201702,BE2018351)the Research and Innovation Program of Postgraduate in Jiangsu Province(KYCX17_1886)the Priority Academic Program Development of Jiangsu Higher Education Institutionsthe Yangzhou University International Academic Exchange Fund。
文摘High grain protein content(GPC) reduces rice eating and cooking quality(ECQ). We generated OsAAP6 and OsAAP10 knockout mutants in three high-yielding japonica varieties and one japonica line using the CRISPR/Cas9 system. Mutation efficiency varied with genetic background in the T_0 generation, and GPC in the T_1 generation decreased significantly,owing mainly to a reduction in glutelin content. Amylose content was down-regulated significantly in some Osaap6 and all Osaap10 mutants. The increased taste value of these mutants was supported by Rapid Visco Analysis(RVA) profiles, which showed higher peak viscosity and breakdown viscosity and lower setback viscosity than the wild type. There were no significant deficiencies in agronomic traits of the mutants. Targeted mutagenesis of OsAAP6 and OsAAP10, especially OsAAP10, using the CRISPR/Cas9 system can rapidly reduce GPC and improve ECQ of rice, providing a new strategy for the breeding cultivars with desired ECQ.
文摘This article describes the integrated modeling approach for planning the size and the operation of constructed wetlands for maximizing retention of nonpoint source pollutant loads and reservoir water-quality improvement at a catchment scale. The experimental field-scale wetland systems （four sets, 0.88 ha each） have been in operation since 2002, where water depth was maintained at 30-50 cm and hydraulic loading rate was at 6.3-18.8 cm/day. The wetland system was found to be adequate for treating polluted stream water with stable removal efficiency even during the winter. The integrated modeling system （modified-BASINS） was applied to the Seokmoon estuarine reservoir watershed and calibrated with monitoring data from constructed wetland, stream, and reservoir. The calibrated integrated modeling system estimated that constructing wetlands on 0.5% （about 114 ha） of the watershed area at the mouth of reservoir could reduce 11.61% and 13.49% of total external nitrogen and phosphorus loads, respectively. It also might improve the nitrogen and phosphorus concentration of the reservoir by 9.69% and 16.48%, respectively. The study suggested that about 0.1%-1.0% of the watershed area should be allocated for constructed wetland to meet specified water-quality standards for the estuarine reservoir at the polder area where land use planning is relatively less complicated.
基金sponsored by the National Natural Science Foundation of China(31371587,31430062)the Cultivation Plan for Youth Agricultural Science Technology Innovative Talents of Liaoning Province,China(2015035,2015036)the Program for Changjiang Scholars and Innovative Research Team in University,China(IRT13079)
文摘japonica rice is mainly distributed in Northeast China and accounts for 44.6% of the total cultivated area of japonica rice in China. The comprehensive using of inter-subspecies heterosis is the main breeding mode of super japonica rice varieties in this region. Improving rice quality at relative high yielding level is the current research focus. Performing crosses between indica and japonica lines allows for the recombination of regulatory genes and genetic backgrounds, leading to complicated genetic rice quality characteristics, which can be used to explore patterns of quality improvement. In the present study, we utilize recombinant inbred lines （RILs） derived from indica-japonica hybridization to analyze the effect factors of rice quality derived from genetic factors, which contain both regulatory genes concerning rice quality and genetic backgrounds＇ random introduction frequency coming from indica （Di value）, and the improvement strategy was further discussed. The regulatory genes involved in amylase content （Wx） and nitrogen utilization efficiency （NRT1.1B） were the major factors affecting the amylose content （AC） and protein content （PC） in RILs, respectively. Both the Di value and the major grain width gene （GS5） had regulatory effects on milled rice width （MRW） in RILs, and their interaction explained the major variance of MRW in the RILs. With the mediation of MRW and chalkiness degree （C）, Di value had a further impact on head rice rate （HR）, which was relatively poor when the Di value was over 40%. In Northeast China, the Di value should be lowered by backcrossing or multiple crosses during the breeding of indica-japonica hybridization to maintain the whole better HR and further to emphasize the use of favorable genes in individual selection.
基金supported by the National Natural Science Foundation of China(51734004 and 51704069).
文摘The real-time energy flow data obtained in industrial production processes are usually of low quality.It is difficult to accurately predict the short-term energy flow profile by using these field data,which diminishes the effect of industrial big data and artificial intelligence in industrial energy system.The real-time data of blast furnace gas(BFG)generation collected in iron and steel sites are also of low quality.In order to tackle this problem,a three-stage data quality improvement strategy was proposed to predict the BFG generation.In the first stage,correlation principle was used to test the sample set.In the second stage,the original sample set was rectified and updated.In the third stage,Kalman filter was employed to eliminate the noise of the updated sample set.The method was verified by autoregressive integrated moving average model,back propagation neural network model and long short-term memory model.The results show that the prediction model based on the proposed three-stage data quality improvement method performs well.Long short-term memory model has the best prediction performance,with a mean absolute error of 17.85 m3/min,a mean absolute percentage error of 0.21%,and an R squared of 95.17%.
文摘A novel sound quality simulation approach was proposed to optimize the acoustic performance of a four-cylinder diesel engine.Finite element analysis,single-input and multiple-output technology,flexible multi-body dynamics,and boundary element codes were used to acquire the hexahedron-element model,experimental modal frequencies,vibration velocities,and structurally radiated noise of the block,respectively.The simulated modal frequencies and vibration velocities agreed well with the experimental data,which validated the finite-element block.The acoustic response showed that considerable acoustic power levels existed in 1500-1900 Hz and 2300-2800 Hz as the main frequency ranges to optimize the block acoustics.Then,the optimal block is determined in accordance with the novel approach,which reduces the overall value,high-frequency amplitudes,and peak values of acoustic power;thus,the loudness,sharpness,and roughness decline to make the sound quieter,lower-pitched,and smoother,respectively.Finally,the optimal block was cast and bench-tested.The results reveal that the sound quality of the optimal-block engine is substantially improved as numerically expected,which verifies the effectiveness of the research approach.
文摘Purpose:Patients'complaints can be predictors of patient care quality and safety.Understanding patients'complaints could help healthcare organizations target the areas for improvements.The purpose of this study is to use a mixed method analysis to a)examine the characteristics and categories of patients'complaints,b)explore the relationships of patients'complaints with professions and units,and c)propose theory-based strategies to improve care quality.Methods:This is a descriptive mixed method study.Data examined are patients'complaints filed at a university-affiliated hospital in China from January 2016 to December 2017.A qualitative content analysis was conducted to categorize complaints.A TwoStep cluster analysis was performed to provide an overall profile of patients'complaints.Chi-Square tests were conducted to investigate the relationships among complaints,professions,and units.Results:838 complaints were filed,with 821 valid cases for analysis.Six categories surfaced from the qualitative analysis:uncaring attitudes,unsatisfactory quality of treatment or competence,communication problems,the process of care,fees and billing issues,and other miscellaneous causes.Physicians received most of the complaints(56.6%).The unit receiving the most complaints were outpatient clinics and medical support units(52.7%).The cluster analysis indicated four distinct clusters.Significant relationships existed between complaints and professions(x2(20)=178.82,P<0.01),and between complaints and units(x2(15)=42.72,P<0.01).Conclusions:Patients'complaints are valuable sources for quality improvements.Healthcare providers should be not only scientifically knowledgeable,but also humanistic caring.Caring-based theories may provide guidance in clinical practice.
文摘Objectives: Engaging, enhancing and embedding clinical audit improvement activities into everyday practice to develop capacity, capability and culture in continuous improvement.Method: Through the implementation of an electronic quality management system called Governance, Evidence, Knowledge and Outcome (GEKO), the key aspects of governance, evidence knowledge and outcomes were able to be applied to quality initiatives. Implementation of the GEKO system incorporated the principles of total quality control and management to include strategic management control and marketing in parallel with leadership strategies. The vision was to motivate staff to enable ownership of the quality cycle of continuous improvement of patient care to incorporate underlying systems and processes that impact on patient care. Results: A continuous improvement pathway was successfully established 4 months post hospital commissioning. Over 890 (approximately 16% workforce) multidisciplinary and multi-professional staff received training and support for QIs in 12 months;over 535 quality proposals were received on GEKO. Submissions by profession: nursing and midwifery 46% (246), medical 33%(177), allied health 9% (48), pharmacy 5%(27), and non-clinical staff 7%(37). Average new submissions per month were 42. Reviews demonstrated the application of a rapid cycle approach to develop, test, modify and refine improvements and enhanced clinical care. Conclusion: Appropriate governance structure, processes, extensive education and training together with collaborative relationships are the keys to embed clinical audit improvement into everyday practice. The availability of a quality management system like GEKO is very useful to make QI accessible to all staff.
基金Supported by The Futurum Research Council, Jnkping County Council, the Foundation for Clinical Cancer Research in Jnkping CountyVINNVRD-research program for more effective and better health care
文摘AIM: To create and apply a framework for quality assessment and improvement in care for inflammatory bowel disease (IBD) patients. METHODS A framework for quality assessment and improvement was created for IBD based on two generally acknowledged quality models. The model of Donabedian (Df) offers a logistical and productive perspective and the Clinical Value Compass (CVC) model adds a management and service perspective. The framework creates a pedagogical tool to understand the balance between the dimensions of clinical care (CVC) and the components of clinical outcome (Df). The merged models create a framework of the care process dimensions as a whole, reflecting important parts of the IBD care delivery system in a local setting. Clinical and organizational quality measures were adopted from clinical experience and the literature and were integrated into the framework. Data were collected at the yearly check-up for 481 IBD patients during 2008. The application of the quality assessment framework was tested and evaluated in a local clinical IBD care setting in Jnkping County, Sweden. RESULTS: The main outcome was the presentation of how locally-selected clinical quality measures, integrated into two complementary models to develop a frame-work, could be instrumental in assessing the quality of care delivered to patients with IBD. The selected quality measures of the framework noted less anemia in the population than previously reported, provided information about hospitalization rates and the few surgical procedures reported, and noted good access to the clinic. CONCLUSION: The applied local quality framework was feasible and useful for assessing the quality of care delivered to IBD patients in a local setting.
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.
基金This work is supported by an unrestricted innovation research grant of the Amsterdam UMC,location Academic Medical Center in Amsterdam,the Netherlands
文摘Objectives: In the post-surgical setting,active involvement of family caregivers has the potential to improve patient outcomes by prevention of surgical complications that are sensitive to fundamental care.This paper describes the development of a theoretically grounded program to enhance the active involvement of family caregivers in fundamental care for post-surgical patients.Methods: We used a quality improvement project following a multi-phase design.In Phase 1,an iterative method was used to combine evidence from a narrative review and professionals' preferences.In Phase 2,the logic model underlying the program was developed guided by four steps: (1) confirm situation,intervention aim,and target population;(2) documented expected outcomes,and outputs of the intervention;(3) identify and describe assumptions,external factors and inputs;and (4) confirm intervention components.Results: Phase 1 identified a minimum set of family involvement activities that were both supported by staff and the narrative review.In Phase 2,the logic model was developed and includes (1) the inputs (e.g.educational-and environmental support),(2) the ultimate outcomes (e.g.reduction of postoperative complications),(3) the intermediate outcomes (e.g.behavioural changes),and (4) immediate outcomes (e.g.improved knowledge,skills and attitude).Conclusions: We demonstrated how we aimed to change our practice to an environment in which family caregivers were stimulated to be actively involved in postoperative care on surgical wards,and how we took different factors into account.The description of this program may provide a solid basis for professionals to implement the family involvement program in their own setting.
基金supported by the National Natural Science Foundation of China(No.41807386)Tianjin Financial Budget Project of 2018。
文摘The Yongding New River is essential for the water supplies of Tianjin.To date,there is no comprehensive report that assesses the year-round water quality of the Yongding New River Main stream.Moreover,little attention has been given to determining a combined weight for improving the traditional comprehensive water quality identification index(ICWQII)by the game theory.Seven water quality parameters were investigated monthly along the main stream of the Yongding New River from May 2018 to April 2019.Organic contaminants and nitrogen pollution were mainly caused by point sources pollution,and the total phosphorus mainly by non-point source pollution.Dramatic spatio-temporal variations of water quality parameters were jointly caused by different pollutant sources and hydrometeorological factors.In terms of this study,an improved comprehensive water quality identification index(ICWQII)based on entropy weight or variation coefficient and traditional CWQII underestimated the water qualities,and an ICWQII based on the superstandard multiple method overvalued the assessments.By contrast,water qualities assessments done with an ICWQII based on the game theory matched perfectly with the practical situation.The ICWQII based on game theory proposed in this study takes into account not only the degree of disorder and variation of water quality data,but also the influence of standard-exceeded pollution indicators,whose results are relatively reasonable.All findings and the ICWQII based on game theory can provide scientific support for decisions related to the water environment management of the Yongding New River and other waters.
文摘To solve the problem that soybean has narrow genetic base, we constructed a series of male sterile recurrent selection populations, and studied the effects of quality improvement and practical value. An LD-base population, which fits to our ecology type was constructed by 6 years＇ gene enrichment through the introduction of new genes from 23 local varieties and recurrent selection. The LD-base populations were then improved by making crosses with high protein and high oil genotypes. As a result we obtained a high protein sub-population （db） and a high oil sub-population （gy）, For the db sub-population, the protein content is 1.18% higher than the base population, 22.38% of the individuals contain 45% or more of protein, which is 10.99% higher than the base population. For the gy sub-population, oil content is 0.24% higher than the base population. Individuals with oil content of 20% or more are 11.05% higher than the base population. The quantitative characters such as flowering date, mature date, pod habit, and hilum color, etc., all showed wide range of separation, and the segregation ratio approached balance. The c.v. of branch number of ms1 recurrent population （72.8%） is higher than general cross-population （57.3%）, and the c.v. of 100 seed weight of ms1 （18.1%） is higher than general cross population （16.5%）, the coefficient of variation of plant height, pods per plant, and seeds per pod were not significantly different. It was demonstrated in this paper that the quality character of ms 1 male sterile recurrent selection population was improved by adding new genes. And the segregation of other characters widened, making the populations suitable for the objective of soybean breeding. In this paper, we also discussed the breeding method, key technology, and selection effect of soybean ms 1 population.
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 grants from the National Natural Science Foundation of China (No.91635302)the National Key Research and Development Program of China (2016YFD0100401)+1 种基金the Chinese Academy of Sciences (XDA08010101)the State Key Laboratory of Plant Cell and Chromosome Engineering (PCCEKF-2017-04)
文摘Rice is one of the most important staple food for over half of the world＇s population,and a substantial increase in productivity and quality of rice grain will be required to feed a growing human population.Grain size and shape are the two important components contributing to grain yield and quality,because they impact both yield potential and end-use quality.
