针对SCOPE(soil canopy observation of photosynthesis and energy fluxes)模型模拟冠层净辐射(0.4~2.5μm短波净辐射+2.5~50μm长波净辐射)时假设叶片空间随机分布的问题,开发考虑叶片空间聚集的冠层净辐射模拟新模型。将SCOPE模型的...针对SCOPE(soil canopy observation of photosynthesis and energy fluxes)模型模拟冠层净辐射(0.4~2.5μm短波净辐射+2.5~50μm长波净辐射)时假设叶片空间随机分布的问题,开发考虑叶片空间聚集的冠层净辐射模拟新模型。将SCOPE模型的短波净辐射模块和长波净辐射模块分别用考虑叶片空间聚集的GOST2模型和UFR97模型替换,形成新的冠层净辐射模拟模型NRC(modeling canopy net radiation considering spatial clumping index of leaves);通过浙江省安吉县1个毛竹(Phyllostachys edulis)林样地(1~4年生异龄林,4500株/hm^(2))2023年整年的观测数据验证,对比SCOPE模型和NRC模型对冠层净辐射的模拟结果。SCOPE模型和NRC模型对冠层净辐射的模拟结果都与观测值有强相关性,决定系数(R^(2))分别为0.97和0.99,均方根误差(RMSE)分别为47.24和13.31 W/m^(2)。SCOPE模型模拟得到的短波净辐射(R_(notot))存在低估(R^(2)=0.96,平均偏差MBE=-14.17 W/m^(2)),长波净辐射(R nttot)存在高估(R^(2)=0.46;MBE=50.27 W/m^(2)),而NRC模型分别成功模拟了R_(notot)(R^(2)=0.99,MBE=1.44 W/m^(2))和R nttot(R^(2)=0.71;MBE=1.34 W/m^(2))。NRC模型具备模拟叶片空间聚集条件下冠层净辐射的潜力。展开更多
Purpose:To examine variations in Chinese nurses’Actual Scope of Practice(ASCOP)by educational qualifications and professional titles,and to identify regulatory gaps in competency-based role assignments within China’...Purpose:To examine variations in Chinese nurses’Actual Scope of Practice(ASCOP)by educational qualifications and professional titles,and to identify regulatory gaps in competency-based role assignments within China’s evolving healthcare system.Method:A nationwide cross-sectional study using the validated Chinese Nurses’ASCOP Questionnaire is used.Data from 1,540 nurses were analyzed through descriptive statistics,independent t-tests,one-way ANOVA,and Bonferroni correction.ASCOP scores(1–5 scale)were compared across education levels(diploma,bachelor’s,postgraduate)and titles(junior/senior).Results:The overall ASCOP score was 3.95,with significant disparities in high-complexity tasks:postgraduate nurses(4.25)and senior nurses outperformed diploma holders(3.71)and juniors(p<0.01).Low-complexity tasks showed no educational differences(p>0.05),though bachelor’s or postgraduate nurses reported higher frequencies(4.12 vs.3.89).Alarmingly,37.6%of junior nurses routinely performed high-risk procedures beyond their competency.Conclusion:A systemic mismatch exists between nurses’qualifications and assigned responsibilities,reflecting inadequate regulatory oversight.To address this,this study recommends:(1)competency-based tiered authorization systems,(2)legal framework updates aligning with China’s healthcare reforms,and(3)dynamic monitoring mechanisms.These measures could standardize practice boundaries,mitigate occupational risks,and optimize nursing workforce utilization,particularly in resource-constrained settings.展开更多
The understanding of the scope of protection for the right to health should not be limited to fragmented descriptions in departmental laws,such as those focusing on rights,interests,or legal benefits.Instead,it should...The understanding of the scope of protection for the right to health should not be limited to fragmented descriptions in departmental laws,such as those focusing on rights,interests,or legal benefits.Instead,it should be analyzed holistically within the constitutional framework of fundamental rights.From the perspective of defense right function,the right to health addresses physiological harm that progresses through stages of“risk-danger-infringement,”psychological harm that targets inner distress,and minor harm arising from challenges in social adaptation,to clarify the negative defensive obligations of the state to prevent health-related harm.From the perspectives of the beneficiary right function and the objective value order function,the right to health requires a minimum level of constitutional protection and delineating the positive obligations of the state to ensure it through the fulfillment of basic obligations in healthcare and health promotion.展开更多
Objective:To review the current status of research on kinesiophobia,assessment tools,influencing factors,and intervention strategies in patients with chronic obstructive pulmonary disease,aiming to provide a reference...Objective:To review the current status of research on kinesiophobia,assessment tools,influencing factors,and intervention strategies in patients with chronic obstructive pulmonary disease,aiming to provide a reference for promoting pulmonary rehabilitation in these patients.Methods:A scoping review framework was employed to search databases including CNKI,Wanfang,VIP,China Biology Medicine(CBM),PubMed,Web of Science,and Wiley Online Library.The search time frame spanned from the database inception to May 20,2024.Two researchers independently screened the literature,summarized,and analyzed the data.Results:A total of 18 articles were included.Commonly used assessment tools included the Tampa Scale for kinesiophobia and the dyspnea beliefs questionnaire.Influencing factors encompassed demographic,disease-related,psychosocial,and BMI-related factors.Intervention methods included inspiratory muscle training,narrative nursing,and cognitive interventions combined with active cycle of breathing techniques.Conclusion:The incidence of kinesiophobia in COPD patients is relatively high and varies among individuals,influenced by multiple factors.There is a need to develop localized assessment tools to identify kinesiophobia in a timely and accurate manner and to further refine intervention strategies.展开更多
AIM： To compare dgid proctoscope and flexible endoscope for elastic band ligation of internal hemorrhoids. METHODS： Patients between 18 and 80 years old, with chronic complaints （blood loss, pain, itching or prola...AIM： To compare dgid proctoscope and flexible endoscope for elastic band ligation of internal hemorrhoids. METHODS： Patients between 18 and 80 years old, with chronic complaints （blood loss, pain, itching or prolapse） of internal hemorrhoids of grade 1-91, were randomized to elastic band ligation by rigid proctoscope or flexible endoscope （preloaded with 7 bands）. Patients were retreated every 6 wk until the cessation of complaints. Evaluation by three-dimensional anal endosonography was performed. RESULTS： Forty-one patients were included （median age 52.0, range 27-79 years, 20 men）. Nineteen patients were treated with a rigid proctoscope and twenty two with a flexible endoscope. Twenty-nine patients had grade I hemorrhoids, 9 patients had grade 11 hemorrhoids and 3 patients had grade 91 hemorrhoids. All patients needed a minimum of 1 treatment and a maximum of 3 treatments. A median of 4.0 bands was used in the rigid proctoscope group and a median of 6.0 bands was used in the flexible endoscope group （P 〈 0.05）. Pain after ligation tended to be more frequent in patients treated with the flexible endoscope （first treatment： 3 vs 20 patients, P 〈 0.05）. Three- dimensional endosonography showed no sphincter defects or alterations in submucosal thickness. CONCLUSION： Both techniques are easy to perform, well tolerated and have a good and fast effect. It is easier to perform more ligations with the flexible endoscope. Additional advantages of the flexible scope are the maneuverability and photographic documentation. However, treatment with the flexible endoscope might be more painful and is more expensive.展开更多
Advances in endoscopic and surgical techniques have increased the frequency and complexity of these procedures and associated complications such as gastrointestinal perforation. With the advancements in the field of g...Advances in endoscopic and surgical techniques have increased the frequency and complexity of these procedures and associated complications such as gastrointestinal perforation. With the advancements in the field of gastroenterology, the promising use of an over the scope clips(OTSC) has fulfilled the unmet need for a reliable endoscopic devise in approximation of gastrointestinal perforation. This novel approach has raised the level of confidence in endoscopist in dealing with this serious complication during endoscopy. Here we have shared our experience with OTSC to evaluate its efficacy and safety in managing iatrogenic gastrointestinal perforations during endoscopy.展开更多
Gastrointestinal (GI) defects such as fistulas and leaks can be potentially closed endoscopically using hemo-clips and loops. However, hemoclips may not allow for closure of large defects and they do not exert enough ...Gastrointestinal (GI) defects such as fistulas and leaks can be potentially closed endoscopically using hemo-clips and loops. However, hemoclips may not allow for closure of large defects and they do not exert enough tensile force to keep fibrotic defects larger than 5 mm approximated. Herein we present a case of successful endoscopic closure of a gastrocolic fistula in a severely malnourished patient with complex post-surgical upper GI anatomy. We strongly believe that this device is a major breakthrough for the management of various types of discontinuity defects or fistulas. In addition, we show the usefulness of placing a direct jejunostomy using the double balloon enteroscopy (DBE) technique during the same procedure. The concept of providing direct jejunal feedings while allowing for upper gas-trointestinal bowel rest to promote the healing of the minimally invasive endoscopic operation is novel. Thus, our case is unique and exemplifies the utility of mini-mally invasive endoscopic endoluminal surgery.展开更多
Percutaneous endoscopic gastrostomy(PEG) is a common practice for long-term nutrition of patients who are unable to take oral food. We report of an 85-year old man with a history of recurrent larynx carcinoma and hemi...Percutaneous endoscopic gastrostomy(PEG) is a common practice for long-term nutrition of patients who are unable to take oral food. We report of an 85-year old man with a history of recurrent larynx carcinoma and hemicolectomy many years ago due to unknown reason. Laryngectomy was indicated. Preoperatively a PEG was inserted endoscopically after an abdominal ultrasonography without abnormal findings. Few months after PEG insertion, the patient was evaluated for diarrhea and insufficient feeding without signs of infection or peritonism. An upper endoscopy and computed tomography scan confirmed a buried bumper syndrome with migration of the PEG tube into the colon as a rare complication. He underwent successful colonoscopic removal of the internal bumper and closure of the colonic orifice of the fistula with the over-the-scope-clip system(OTSC). OTSC is an endoscopic device for treatment of bleeding, perforation, leak and fistula in the gastrointestinal tract. To the best of our knowledge, this is the first report of the use of OTSC for colonoscopic closure of a gastrocolocutaneous fistula due to a buried bumper syndrome with transcolonic PEG tube migration.展开更多
文摘针对SCOPE(soil canopy observation of photosynthesis and energy fluxes)模型模拟冠层净辐射(0.4~2.5μm短波净辐射+2.5~50μm长波净辐射)时假设叶片空间随机分布的问题,开发考虑叶片空间聚集的冠层净辐射模拟新模型。将SCOPE模型的短波净辐射模块和长波净辐射模块分别用考虑叶片空间聚集的GOST2模型和UFR97模型替换,形成新的冠层净辐射模拟模型NRC(modeling canopy net radiation considering spatial clumping index of leaves);通过浙江省安吉县1个毛竹(Phyllostachys edulis)林样地(1~4年生异龄林,4500株/hm^(2))2023年整年的观测数据验证,对比SCOPE模型和NRC模型对冠层净辐射的模拟结果。SCOPE模型和NRC模型对冠层净辐射的模拟结果都与观测值有强相关性,决定系数(R^(2))分别为0.97和0.99,均方根误差(RMSE)分别为47.24和13.31 W/m^(2)。SCOPE模型模拟得到的短波净辐射(R_(notot))存在低估(R^(2)=0.96,平均偏差MBE=-14.17 W/m^(2)),长波净辐射(R nttot)存在高估(R^(2)=0.46;MBE=50.27 W/m^(2)),而NRC模型分别成功模拟了R_(notot)(R^(2)=0.99,MBE=1.44 W/m^(2))和R nttot(R^(2)=0.71;MBE=1.34 W/m^(2))。NRC模型具备模拟叶片空间聚集条件下冠层净辐射的潜力。
基金Central Universities Basic Research Fund(Science,Engineering,and Medicine)of Jinan University:“Development of a Nursing Work Time Tracking System Based on the Fourth-Generation Nursing Workload Theory”(Project No.:21619326)。
文摘Purpose:To examine variations in Chinese nurses’Actual Scope of Practice(ASCOP)by educational qualifications and professional titles,and to identify regulatory gaps in competency-based role assignments within China’s evolving healthcare system.Method:A nationwide cross-sectional study using the validated Chinese Nurses’ASCOP Questionnaire is used.Data from 1,540 nurses were analyzed through descriptive statistics,independent t-tests,one-way ANOVA,and Bonferroni correction.ASCOP scores(1–5 scale)were compared across education levels(diploma,bachelor’s,postgraduate)and titles(junior/senior).Results:The overall ASCOP score was 3.95,with significant disparities in high-complexity tasks:postgraduate nurses(4.25)and senior nurses outperformed diploma holders(3.71)and juniors(p<0.01).Low-complexity tasks showed no educational differences(p>0.05),though bachelor’s or postgraduate nurses reported higher frequencies(4.12 vs.3.89).Alarmingly,37.6%of junior nurses routinely performed high-risk procedures beyond their competency.Conclusion:A systemic mismatch exists between nurses’qualifications and assigned responsibilities,reflecting inadequate regulatory oversight.To address this,this study recommends:(1)competency-based tiered authorization systems,(2)legal framework updates aligning with China’s healthcare reforms,and(3)dynamic monitoring mechanisms.These measures could standardize practice boundaries,mitigate occupational risks,and optimize nursing workforce utilization,particularly in resource-constrained settings.
文摘The understanding of the scope of protection for the right to health should not be limited to fragmented descriptions in departmental laws,such as those focusing on rights,interests,or legal benefits.Instead,it should be analyzed holistically within the constitutional framework of fundamental rights.From the perspective of defense right function,the right to health addresses physiological harm that progresses through stages of“risk-danger-infringement,”psychological harm that targets inner distress,and minor harm arising from challenges in social adaptation,to clarify the negative defensive obligations of the state to prevent health-related harm.From the perspectives of the beneficiary right function and the objective value order function,the right to health requires a minimum level of constitutional protection and delineating the positive obligations of the state to ensure it through the fulfillment of basic obligations in healthcare and health promotion.
文摘Objective:To review the current status of research on kinesiophobia,assessment tools,influencing factors,and intervention strategies in patients with chronic obstructive pulmonary disease,aiming to provide a reference for promoting pulmonary rehabilitation in these patients.Methods:A scoping review framework was employed to search databases including CNKI,Wanfang,VIP,China Biology Medicine(CBM),PubMed,Web of Science,and Wiley Online Library.The search time frame spanned from the database inception to May 20,2024.Two researchers independently screened the literature,summarized,and analyzed the data.Results:A total of 18 articles were included.Commonly used assessment tools included the Tampa Scale for kinesiophobia and the dyspnea beliefs questionnaire.Influencing factors encompassed demographic,disease-related,psychosocial,and BMI-related factors.Intervention methods included inspiratory muscle training,narrative nursing,and cognitive interventions combined with active cycle of breathing techniques.Conclusion:The incidence of kinesiophobia in COPD patients is relatively high and varies among individuals,influenced by multiple factors.There is a need to develop localized assessment tools to identify kinesiophobia in a timely and accurate manner and to further refine intervention strategies.
文摘AIM： To compare dgid proctoscope and flexible endoscope for elastic band ligation of internal hemorrhoids. METHODS： Patients between 18 and 80 years old, with chronic complaints （blood loss, pain, itching or prolapse） of internal hemorrhoids of grade 1-91, were randomized to elastic band ligation by rigid proctoscope or flexible endoscope （preloaded with 7 bands）. Patients were retreated every 6 wk until the cessation of complaints. Evaluation by three-dimensional anal endosonography was performed. RESULTS： Forty-one patients were included （median age 52.0, range 27-79 years, 20 men）. Nineteen patients were treated with a rigid proctoscope and twenty two with a flexible endoscope. Twenty-nine patients had grade I hemorrhoids, 9 patients had grade 11 hemorrhoids and 3 patients had grade 91 hemorrhoids. All patients needed a minimum of 1 treatment and a maximum of 3 treatments. A median of 4.0 bands was used in the rigid proctoscope group and a median of 6.0 bands was used in the flexible endoscope group （P 〈 0.05）. Pain after ligation tended to be more frequent in patients treated with the flexible endoscope （first treatment： 3 vs 20 patients, P 〈 0.05）. Three- dimensional endosonography showed no sphincter defects or alterations in submucosal thickness. CONCLUSION： Both techniques are easy to perform, well tolerated and have a good and fast effect. It is easier to perform more ligations with the flexible endoscope. Additional advantages of the flexible scope are the maneuverability and photographic documentation. However, treatment with the flexible endoscope might be more painful and is more expensive.
文摘Advances in endoscopic and surgical techniques have increased the frequency and complexity of these procedures and associated complications such as gastrointestinal perforation. With the advancements in the field of gastroenterology, the promising use of an over the scope clips(OTSC) has fulfilled the unmet need for a reliable endoscopic devise in approximation of gastrointestinal perforation. This novel approach has raised the level of confidence in endoscopist in dealing with this serious complication during endoscopy. Here we have shared our experience with OTSC to evaluate its efficacy and safety in managing iatrogenic gastrointestinal perforations during endoscopy.
文摘Gastrointestinal (GI) defects such as fistulas and leaks can be potentially closed endoscopically using hemo-clips and loops. However, hemoclips may not allow for closure of large defects and they do not exert enough tensile force to keep fibrotic defects larger than 5 mm approximated. Herein we present a case of successful endoscopic closure of a gastrocolic fistula in a severely malnourished patient with complex post-surgical upper GI anatomy. We strongly believe that this device is a major breakthrough for the management of various types of discontinuity defects or fistulas. In addition, we show the usefulness of placing a direct jejunostomy using the double balloon enteroscopy (DBE) technique during the same procedure. The concept of providing direct jejunal feedings while allowing for upper gas-trointestinal bowel rest to promote the healing of the minimally invasive endoscopic operation is novel. Thus, our case is unique and exemplifies the utility of mini-mally invasive endoscopic endoluminal surgery.
文摘Percutaneous endoscopic gastrostomy(PEG) is a common practice for long-term nutrition of patients who are unable to take oral food. We report of an 85-year old man with a history of recurrent larynx carcinoma and hemicolectomy many years ago due to unknown reason. Laryngectomy was indicated. Preoperatively a PEG was inserted endoscopically after an abdominal ultrasonography without abnormal findings. Few months after PEG insertion, the patient was evaluated for diarrhea and insufficient feeding without signs of infection or peritonism. An upper endoscopy and computed tomography scan confirmed a buried bumper syndrome with migration of the PEG tube into the colon as a rare complication. He underwent successful colonoscopic removal of the internal bumper and closure of the colonic orifice of the fistula with the over-the-scope-clip system(OTSC). OTSC is an endoscopic device for treatment of bleeding, perforation, leak and fistula in the gastrointestinal tract. To the best of our knowledge, this is the first report of the use of OTSC for colonoscopic closure of a gastrocolocutaneous fistula due to a buried bumper syndrome with transcolonic PEG tube migration.
