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Accelerating the Construction of Remote Medical Service Network in Qinhuangdao City:Countermeasures and Suggestions to Improve Rural Elderly Care Services
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作者 Li Qian 《Proceedings of Business and Economic Studies》 2025年第2期17-22,共6页
With the intensifying aging population,rural elderly care services are facing challenges such as uneven medical resources and inadequate facilities.Taking Qinhuangdao City as an example,this paper explores ways to imp... With the intensifying aging population,rural elderly care services are facing challenges such as uneven medical resources and inadequate facilities.Taking Qinhuangdao City as an example,this paper explores ways to improve rural elderly care services through the construction of a remote medical service network.This paper analyzes the current status of rural elderly care services in Qinhuangdao City,pointing out that issues such as the uneven distribution of medical resources between urban and rural areas,poor accessibility,and low service quality urgently need to be addressed.The necessity of accelerating the construction of a remote medical network is proposed,including reducing medical costs,optimizing resource allocation,and disease prevention.Specific measures cover aspects such as policy support,integration of medical and elderly care services,talent cultivation,and technology promotion.At the same time,the potential challenges and risks faced by the remote medical service network in improving rural elderly care services are evaluated,and corresponding countermeasures and suggestions are proposed.Research shows that remote medical care can effectively improve the quality of rural elderly care services and help achieve proper medical care for the elderly. 展开更多
关键词 TELEMEDICINE Service network Rural elderly care services
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Predicting intensive care unit-acquired weakness:A multilayer perceptron neural network approach 被引量:1
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作者 Carlos Martin Ardila Daniel González-Arroyave Mateo Zuluaga-Gómez 《World Journal of Clinical Cases》 SCIE 2024年第12期2023-2030,共8页
In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(I... In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(ICUAW),a neuromuscular disorder affecting critically ill patients,by employing a novel processing strategy based on repeated machine learning.The editorial presents a dataset comprising clinical,demographic,and laboratory variables from intensive care unit(ICU)patients and employs a multilayer perceptron neural network model to predict ICUAW.The authors also performed a feature importance analysis to identify the most relevant risk factors for ICUAW.This editorial contributes to the growing body of literature on predictive modeling in critical care,offering insights into the potential of machine learning approaches to improve patient outcomes and guide clinical decision-making in the ICU setting. 展开更多
关键词 Intensive care units Intensive care unit-acquired weakness Risk factors Machine learning Computer neural network
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Planning hierarchical hospital service areas for maternal care using a network optimization approach:A case study in Hubei,China
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作者 TAO Zhuolin CHENG Yang +2 位作者 BAl Lingyao FENG Ling WANG Shaoshuai 《Journal of Geographical Sciences》 SCIE CSCD 2022年第12期2577-2598,共22页
Improving maternal health is one of the Sustainable Development Goals.Hospital service areas(HSAs),which contain most hospitalization behaviors at the local scale,are crucial for health care planning.However,little at... Improving maternal health is one of the Sustainable Development Goals.Hospital service areas(HSAs),which contain most hospitalization behaviors at the local scale,are crucial for health care planning.However,little attention has been given to HSAs for maternal care and the hierarchy structure.Considering Hubei,central China,as a case study,this study aims to fill these gaps by developing a method for delineating hierarchical HSAs for maternal care using a network optimization approach.The approach is driven by actual patient flow data and has an explicit objective to maximize the modularity.It also establishes the hierarchical structure of maternal care HSAs,which is fundamental for the planning of hierarchical maternal care and referral systems.In our case study,45 secondary HSAs and 22tertiary HSAs are delineated to achieve maximal modularity.The HSAs perform well in terms of indices such as the Localization Index and Market Share Index.Furthermore,there is a complementary relationship between secondary and tertiary hospitals,which suggests the need for referral system planning.This study can provide evidence for the validity of the HSA and the planning of maternal care HSAs in China.It also provides transferable methods for planning hierarchical HSAs in other developing countries. 展开更多
关键词 hospital service areas hierarchical structure network optimization MODULARITY maternal care
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Management of Congenital Disorders in a Resource-Limited Country: Organizational Model of a Specialized Working Group within a Perinatal Network
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作者 Mame Diarra Ndiaye Lissoune Cisse +5 位作者 Daouda Ndour Yaye Joor Dieng Hélène Chami Mamadou Mour Traore Maguette Mbaye Pape Moctar Faye 《Open Journal of Obstetrics and Gynecology》 2025年第1期10-20,共11页
Objective: To evaluate the organizational model of a perinatal network and its relevance in a resource-limited country. Methodology: This was a mixed prospective qualitative and quantitative study conducted over a 2-y... Objective: To evaluate the organizational model of a perinatal network and its relevance in a resource-limited country. Methodology: This was a mixed prospective qualitative and quantitative study conducted over a 2-year period, from January 1, 2022, to December 31, 2023. This study took place in Senegal, a country with limited resources and a weakness of hyperspecialized medical technical resources. There was no policy for the management of fetal malformations. The qualitative part was carried out through overt participant observation. The human resources and the organization of the perinatal network were described. For the quantitative part, all fetuses managed during the study period were included. The studied parameters related to neonatal care and outcomes. Qualitative variables were described using dispersion parameters, and quantitative variables were described using proportions. Results: The perinatal network includes several specialists across six hospitals. Of these hospitals, only one provided emergency pediatric surgery. The network included highly specialized human resources in prenatal diagnosis, congenital heart defects, pediatric surgery, anesthesia, and other medical specialties in perinatology. Advanced ultrasound was centralized by an obstetrician. The team decided on the follow-up methods, timing, and mode of delivery. The newborn was immediately transferred to the appropriate specialty. Over the 2-year period, 201 fetuses were managed. The rate of cesarean delivery was 76.3%. Neonatal mortality was 51.4%. Discussion: Centralizing care improves the quality of prenatal diagnosis and management of congenital defects. Mortality remains high when emergency surgery is not well available. This mortality is also due to the lack of a single center offering all perinatal care and so, the transfer of newborns. The cesarean rate increases due to underlying conditions and organizational factors. Conclusion: Public policies should prioritize the centralization of care for congenital disorders to reduce the costs of disability and mortality. 展开更多
关键词 Congenital Disorders Perinatal network Resource-Limited Country Antenatal Diagnosis care Centralization
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Fault Diagnosis Method for Open-circuit Faults in NPC Three-level Inverter based on WKCNN
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作者 Guozheng Zhang Menghui Li +1 位作者 Xin Gu Wei Chen 《CES Transactions on Electrical Machines and Systems》 2025年第2期234-245,共12页
With the increasing demand for high reliability and availability in power conversion equipment within power electronics systems,the fault diagnosis of neutral-point-clamped(NPC) three-level inverters has garnered wide... With the increasing demand for high reliability and availability in power conversion equipment within power electronics systems,the fault diagnosis of neutral-point-clamped(NPC) three-level inverters has garnered widespread attention.To address the challenges of fault feature extraction,this article proposes an end-to-end diagnostic approach based on a wavelet kernel convolutional neural network (WKCNN),capable of extracting multi-scale features from current signals to significantly enhance diagnostic accuracy.This method directly uses raw three-phase current signals as input,applying wavelet kernel convolution to automatically capture frequency-domain fault features,combined with a Softmax classifier optimized by the Adam algorithm to achieve fault diagnosis for NPC threelevel inverters.Experimental results under various operating conditions demonstrate that this approach maintains robust diagnostic accuracy across multiple fault scenarios,with comparative analysis further confirming its advantages in diagnostic efficiency and performance over traditional machine learning and other deep learning methods. 展开更多
关键词 NPC three-level inverter Open-circuit fault Wavelet transform Convolutional neural network END-TO-END
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社会网络与农村老年人互助养老参与意愿
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作者 聂建亮 郭雨晨 《华中科技大学学报(社会科学版)》 北大核心 2026年第2期102-115,共14页
探讨社会网络与农村老年人互助养老参与意愿的关系,有助于理解人口老龄化背景下农村互助养老实现的内在机理,对推广农村互助养老,化解农村养老服务供给困境具有借鉴意义。本研究基于对全国11个省份1126名60周岁及以上农村老年人的问卷... 探讨社会网络与农村老年人互助养老参与意愿的关系,有助于理解人口老龄化背景下农村互助养老实现的内在机理,对推广农村互助养老,化解农村养老服务供给困境具有借鉴意义。本研究基于对全国11个省份1126名60周岁及以上农村老年人的问卷调查数据,探讨了社会网络对农村老年人互助养老参与意愿的影响。研究表明,社会网络规模越大,农村老年人互助养老参与意愿越高;网络异质性程度越高,农村老年人互助养老参与意愿也越高;与强关系网络的互动不会对农村老年人互助养老参与意愿产生影响,但与弱关系网络的互动则可以提高农村老年人互助养老参与意愿。研究进一步发现,社会网络主要通过改善人际信任、改变资源获取能力等机制来影响农村老年人的互助养老参与意愿。 展开更多
关键词 社会网络 互助养老 农村老年人 参与意愿
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网站式决策辅助工具在预立医疗照护计划中的应用进展
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作者 罗玉红 石娟 +1 位作者 崔立敏 程珊珊 《护理研究》 北大核心 2026年第7期1220-1225,共6页
对网站式预立医疗照护计划决策辅助工具的设计模式、设计特征、可行性评价进行综述,探讨其在临床实践与公众健康中的潜在价值,提出此类工具存在的不足和建议,为构建网站式预立医疗照护计划决策辅助工具提供参考。
关键词 决策辅助工具 预立医疗照护计划 网络 网站 综述
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上海全科医学科研网络中基层医务人员的研究环境和回报偏好:一项混合方法研究
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作者 汪洋 潘莹 +3 位作者 金花 杨辉 Helen Elizabeth Smith 于德华 《中国全科医学》 北大核心 2026年第1期24-34,共11页
背景全科医学科研网络(PBRN)将医务人员与研究人员连接,共同开展以全科医学和社区健康为导向的研究。自2023年以来,我国已创建了多个本土PBRN,但对其中的基层医务人员所处的科研环境及其所期望的回报仍了解不足。目的本研究旨在探索在... 背景全科医学科研网络(PBRN)将医务人员与研究人员连接,共同开展以全科医学和社区健康为导向的研究。自2023年以来,我国已创建了多个本土PBRN,但对其中的基层医务人员所处的科研环境及其所期望的回报仍了解不足。目的本研究旨在探索在初创的上海全科医学科研网络(SGPRN)中,对从事全科医学和基本医疗研究怀有兴趣的基层医务人员所面临的科研环境,以及其希望通过相关科研活动获得的回报。上述工作将为我国PBRN的组织构建、科研能力提升及科研设计提供相应信息,从而支持制订相应的策略。方法本研究采用混合方法研究的解释性时间序列设计。定量部分通过目的性抽样,于2024-10-12,对SGPRN中有意参与科研活动的145名基层医务人员进行了在线电子问卷调查,收集背景信息、科研能力、所处的科研环境及参加PBRN组织的相关研究时希望得到的回报相关的信息,并使用描述统计分析和卡诺模型(Kano Model)对其进行分析和分类。定性部分在定量部分的被调查者中,选取了24名基层医务人员,运用定性描述方法进行了1次焦点小组访谈和21次半结构式访谈,并对访谈数据进行迭代分析,以对定量数据进行验证和补充。最终通过联合展示和元合成的方法整合了定量和定性数据。结果在参与调查的基层医务人员中,84.83%(123/145)报告所在的社区卫生服务中心提供了有利于开展科研工作的环境,68.97%(100/145)报告科研工作与临床工作可以紧密结合,66.89%(97/145)报告易于获得学习科研知识和技能的资源,60.00%(87/145)报告拥有开展科研工作所需的资源,50.34%(73/145)报告可以找到科研合作伙伴,42.75%(62/145)报告拥有充足的科研时间。定性结果确证了全部定量结果,并对其进行了一定程度的拓展性补充。基层医务人员最希望从科研网络获得的回报,包括获得开展科研工作的知识和技能、主持完成对自己感兴趣的问题的研究、获得主要的作者署名、在可以运用数据的情况下获得共享数据,上述回报均与社区卫生服务中心乃至医疗卫生体系的科研激励政策设计密切相关。此外,定性结果还强调,前置、公开、透明的合作规则,以及参与者之间的相互信任,是吸引基层医务人员参与PBRN组织的科研工作的必要条件。结论本研究发现,SGPRN中的社区医务人员所处的科研环境处于中性而略偏有利的情况,并被当前医疗卫生机构科研激励和职业发展政策显著影响。基层医务人员希望在科研工作中取得的回报,聚焦于突破自身专业科研知识和技能不足的限制,以取得科研绩效产出这一根本目的。上述发现提示,我国PBRN未来的发展应在借鉴国际成熟经验,为基层医务人员提供支持其提升科研知识和技能的系统资源的同时,制订相应策略,以缓解和克服当前科研政策对全科医学和基本医疗研究的消极影响,并开展以改进实践、造福患者为主要导向的,求真、务实、高质量的研究。 展开更多
关键词 基本医疗研究 全科医学科研网络 科研能力建设 全科医生 科研合作 全科医学
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2型糖尿病患者出院准备度的研究进展
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作者 李若丹 陶慧 都志杰 《当代护士(上旬刊)》 2026年第4期49-53,共5页
2型糖尿病(type 2 diabetes mellitus,T2DM)患者的出院准备管理是慢性病全过程管理中的关键环节,相关研究已从现状描述逐步拓展至评估工具的信度及效度验证、多层级影响因素研究以及创新护理干预策略的构建等方面,形成了较为系统的理论... 2型糖尿病(type 2 diabetes mellitus,T2DM)患者的出院准备管理是慢性病全过程管理中的关键环节,相关研究已从现状描述逐步拓展至评估工具的信度及效度验证、多层级影响因素研究以及创新护理干预策略的构建等方面,形成了较为系统的理论基础和实践模式。然而,现有研究仍存在评估工具标准化不足、个体化干预策略缺乏以及连续护理衔接薄弱等问题。本文旨在系统综述T2DM患者出院准备度的概念、研究现状、评估工具、影响因素及护理干预,并展望未来智慧护理在提升出院准备度中的应用前景。 展开更多
关键词 2型糖尿病 出院准备度 评估工具 三级照护网络 护理干预
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不同口腔护理方法预防新生儿呼吸机相关性肺炎效果的网状Meta分析
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作者 李诗雨 丁晓华 +6 位作者 马云云 朱珍娥 张雪芬 钱鲜鲜 彭思利 王娜 张瑜 《上海护理》 2026年第2期1-7,共7页
目的探讨不同口腔护理方法对新生儿呼吸机相关性肺炎预防效果。方法检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方、维普和中国生物医学文献数据库中不同口腔护理方法对新生儿呼吸机相关性肺炎预防效果的随机... 目的探讨不同口腔护理方法对新生儿呼吸机相关性肺炎预防效果。方法检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方、维普和中国生物医学文献数据库中不同口腔护理方法对新生儿呼吸机相关性肺炎预防效果的随机对照试验,检索时限均为建库至2025年2月。由2名研究员独立进行文献筛查、数据提取、质量评价,对符合纳排标准的文献采用Stata 15.1软件进行数据分析。结果共纳入24篇文献,涉及7种口腔护理方法,包括2.0%或2.5%碳酸氢钠溶液(以下简称“碳酸氢钠溶液”)擦拭、母乳擦拭、碳酸氢钠溶液联合母乳擦拭、生理盐水擦拭、碳酸氢钠溶液联合过氧化氢溶液擦拭、碳酸氢钠溶液擦拭联合生理盐水冲洗、无菌水擦拭。网状Meta分析显示,不同口腔护理方法预防新生儿呼吸机相关性肺炎效果不同,效果最好的是碳酸氢钠溶液擦拭联合生理盐水冲洗、碳酸氢钠溶液联合过氧化氢溶液擦拭及碳酸氢钠溶液联合母乳擦拭,其他方式效果略差。结论当前有限证据显示,碳酸氢钠溶液擦拭联合生理盐水冲洗是预防新生儿呼吸机相关性肺炎的有效口腔护理方法之一,其次是碳酸氢钠溶液联合过氧化氢溶液擦拭、碳酸氢钠溶液联合母乳擦拭、母乳擦拭、无菌水擦拭,碳酸氢钠溶液擦拭、生理盐水擦拭的效果排最后。受纳入文献数量和质量的限制,上述结论尚需开展更多高质量研究予以验证。 展开更多
关键词 新生儿 呼吸机相关性肺炎 口腔护理 网状Meta分析
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《卓越胸痛中心建设与验收标准》解读
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作者 向定成 张静 +3 位作者 翟振国 王春生 葛均波 霍勇 《中国介入心脏病学杂志》 2026年第2期74-78,共5页
当前,我国胸痛中心网络覆盖已日趋完善,但急性心肌梗死合并心源性休克、主动脉夹层及高危肺栓塞等胸痛危重症的残余死亡率仍处于较高水平,相关病症救治规范性亟待进一步加强。卓越胸痛中心建设以具备循环支持与多专科救治能力的标准版... 当前,我国胸痛中心网络覆盖已日趋完善,但急性心肌梗死合并心源性休克、主动脉夹层及高危肺栓塞等胸痛危重症的残余死亡率仍处于较高水平,相关病症救治规范性亟待进一步加强。卓越胸痛中心建设以具备循环支持与多专科救治能力的标准版胸痛中心为基础,核心目标是构建区域协同救治体系,提升心血管危重症的规范化诊疗水平。本文旨在对《卓越胸痛中心建设与验收标准》进行解读。解读内容围绕三大核心要素展开:(1)资质与基本条件,涵盖组织架构、多学科快速响应团队建设、专科诊疗能力与数据管理体系;(2)救治规范与流程,强调以指南为依据,制订诊疗路径;(3)持续质量改进,明确关键质控与评价指标。本文亦对验收申请条件与流程作了说明,以期为各级医院的相关建设工作提供指导,最终实现降低胸痛危重症死亡率的目标。 展开更多
关键词 卓越胸痛中心 胸痛危重症 循环支持 区域协同救治
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基于6种机器学习模型的ICU患者多重耐药菌感染预测模型构建与评价
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作者 王珂璇 金晓灵 茅一萍 《中华医院感染学杂志》 北大核心 2026年第3期422-426,共5页
目的分析重症监护室患者感染多重耐药菌的危险因素,通过6种机器学习算法构建患者感染多重耐药菌的预测模型,通过评价模型相关指标选出最佳模型,为临床工作者早期识别高危患者,及时采取相应的预防措施提供参考。方法纳入2019年6月-2023年... 目的分析重症监护室患者感染多重耐药菌的危险因素,通过6种机器学习算法构建患者感染多重耐药菌的预测模型,通过评价模型相关指标选出最佳模型,为临床工作者早期识别高危患者,及时采取相应的预防措施提供参考。方法纳入2019年6月-2023年6月入住徐州医科大学附属医院重症监护室患者946例(多重耐药菌感染者473例,非感染者473例)。采用二元logistic回归分析,将筛选的危险因素作为构建预测模型的特征变量进行模型构建,分别构建并评价逻辑回归模型、人工神经网络模型、决策树模型、随机森林模型、支持向量机模型和极限梯度增强模型。结果从外院或急诊入院(OR=2.635)、入住重症监护室时长≥7 d(OR=1.291)、手术(OR=3.089)、慢性肺部疾病(OR=3.664)、外周静脉置管(OR=2.111)、留置腹腔引流管(OR=3.382)、抗菌药物使用种类≥3种(OR=1.001)、抗菌药物使用时长≥1周(OR=2.323)是重症监护室患者感染多重耐药菌的危险因素(P<0.05)。通过机器学习算法构建的重症监护室患者感染多重耐药菌预测模型中,逻辑回归模型受试者工作特征曲线下面积、灵敏度、特异度、阳性预测值、阴性预测值、F1值均优于其他模型,为最优模型。结论临床应重视患者易感染多重耐药菌的危险因素,尽早给予针对性干预,降低重症监护室患者感染多重耐药菌的风险。 展开更多
关键词 机器学习 重症监护室 多重耐药菌 预测模型 逻辑回归模型 人工神经网络模型 决策树模型 随机森林模型 支持向量机模型 极限梯度增强模型
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养老机构人身伤害事故致因因素的识别与社会网络分析
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作者 王灿友 吕嘉瑞 赵惠婧 《安全与环境学报》 北大核心 2026年第4期1439-1447,共9页
为系统识别养老机构人身伤害事故中的致因因素并揭示其相互关联结构,以2010—2024年73起典型案例为样本,在人为因素分析与分类系统(Human Factors Analysis and Classification System, HFACS)的基础上,结合扎根式编码提取致因因素,形... 为系统识别养老机构人身伤害事故中的致因因素并揭示其相互关联结构,以2010—2024年73起典型案例为样本,在人为因素分析与分类系统(Human Factors Analysis and Classification System, HFACS)的基础上,结合扎根式编码提取致因因素,形成社会网络分析(Social Network Analysis, SNA)的共现关系矩阵并构建关联网络,进而通过拓扑指标检验网络结构特征,识别整体事故具备的网络特性。在此基础上,采用中心性指标量化核心节点,结合块模型与关联方向指数进一步揭示致因因素的结构位置与传导路径。最后,通过干预模拟评估核心节点控制对网络稳定性的影响。研究发现:养老机构人身伤害事故致因分类体系涵盖4个层级,16项底层致因因素;致因网络具有显著的小世界特性;监控监管不到位、防护措施不到位和应急处理不当为核心致因因素,其中监控监管不到位起关键桥梁作用;在实施针对性风险干预措施后,网络密度与聚类系数分别下降51%和30%。 展开更多
关键词 安全社会工程 人身伤害事故 人为因素分析与分类系统 社会网络分析 养老机构安全
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基于BP神经网络的甘肃省机构养老床位供需预测
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作者 刘兴伟 杨勇林 +1 位作者 王宗奇 张涛涛 《兰州石化职业技术大学学报》 2026年第1期15-20,共6页
使用BP神经网络模型对甘肃省老年人口发展进行预测,进而推算出养老机构床位需求,为促进甘肃省养老事业的健康发展及相关部门制定政策提供参考。利用Matlab 2024b软件构建BP神经网络模型,对甘肃省老年人口和养老床位数量进行预测。预测... 使用BP神经网络模型对甘肃省老年人口发展进行预测,进而推算出养老机构床位需求,为促进甘肃省养老事业的健康发展及相关部门制定政策提供参考。利用Matlab 2024b软件构建BP神经网络模型,对甘肃省老年人口和养老床位数量进行预测。预测结果显示,甘肃老年人口数量2027年达到339.22万人,2026年养老床位的需求将达到17.19万张,通过对线性回归模型、随机森林模型和支持向量机模型对比,从训练集和测试集的R^(2)、MSE、MAE指标看出,BP神经网络模型测试集表现最佳,其对数据的拟合优度较高,预测误差较小。甘肃省养老机构床位难以满足老人需求,建议政府出台政策、加大投入、完善从业保障,推动行业发展,让老人享受高品质生活。 展开更多
关键词 BP神经网络 MATLAB 养老床位 供需预测
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Sensor Networking: Concepts, Applications, and Challenges 被引量:8
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作者 YAO Kung 《自动化学报》 EI CSCD 北大核心 2006年第6期839-845,共7页
Sensor network has experienced world-wide explosive interests in recent years. It combines the technology of modern microelectronic sensors, embedded computational processing systems, and modern computer and wireless ... Sensor network has experienced world-wide explosive interests in recent years. It combines the technology of modern microelectronic sensors, embedded computational processing systems, and modern computer and wireless networking methodologies. In this overview paper, we first provide some rationales for the growth of sensor networking. Then we discuss various basic concepts and hardware issues. Four basic application cases in the US. National Science Foundation funded Ceneter for Embedded Networked Sensing program at UCLA are presented. Finally, six challenging issues in sensor networks are discussed. Numerous references including relevant papers, books, and conferences that have appeared in recent years are given. 展开更多
关键词 Sensor networks wireless communication embedded processing information processing environmental monitoring health care system ROBOTICS automated manufacturing
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政策创新扩散理论下我国基层医疗卫生机构医养结合政策扩散特征研究
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作者 王健 马晓龙 +2 位作者 宋科瑜 王国文 王强 《卫生软科学》 2026年第1期31-38,共8页
[目的]基于政策创新扩散理论,分析我国基层医疗卫生机构医养结合政策的扩散规律与特征,为优化政策实施与推广提供参考。[方法]检索2013—2024年颁布的中央及地方基层医疗卫生机构医养结合相关政策。运用政策参照网络分析方法与时间序列... [目的]基于政策创新扩散理论,分析我国基层医疗卫生机构医养结合政策的扩散规律与特征,为优化政策实施与推广提供参考。[方法]检索2013—2024年颁布的中央及地方基层医疗卫生机构医养结合相关政策。运用政策参照网络分析方法与时间序列分析方法,从政策扩散强度、广度、速度及方向等多维度进行量化分析。[结果]共纳入232项政策文本,包括中央政策25项,地方政策207项。研究发现:政策扩散呈显著的中央驱动与阶段性脉冲特征,扩散轨迹符合S形曲线,2016—2018年为爆发期;中央政策(如通知与意见)凭借其高政治势能、强兼容性与相对优势,在扩散强度、广度与速度上均占据主导地位;扩散路径呈现“自上而下”垂直传导与“平行扩散”并存的双重属性,但后者因隐性知识传递不畅而效能有限;政策效能在传递中出现层级衰减,东部、中部、西部地区的资源禀赋与治理能力结构性差异是导致政策在基层悬浮与空转的根本原因。[结论]我国基层医养结合政策扩散呈现文本快速覆盖与执行效能递减并存的复杂图景。政策属性、地区资源禀赋差异与平行学习机制失灵是导致此困境的核心机制。未来政策优化应超越对扩散量的追求,转向对服务质的提升,通过构建差异化的协同治理体系、深化府际知识共创、建立动态反馈机制,并优先聚焦于医联体与家庭医生等核心领域,以实现政策的有效落地。 展开更多
关键词 基层医疗卫生机构 医养结合 政策扩散 政策创新扩散理论 网络分析
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Dominance network structure across reproductive contexts in the cooperatively breeding cichlid fish Neolamprologus pulcher 被引量:5
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作者 Cody J. DEY Q.Y. Joanne TAN +3 位作者 Constance M. O'CONNOR Adam R. REDDON J. Ryan CALDWELL Sigal BALSHINE 《Current Zoology》 SCIE CAS CSCD 2015年第1期45-54,共10页
While a large number of studies have described animal social networks, we have a poor understanding of how these networks vary with ecological and social conditions. For example, reproductive periods are an important ... While a large number of studies have described animal social networks, we have a poor understanding of how these networks vary with ecological and social conditions. For example, reproductive periods are an important life-history stage that may involve changes in dominance relationships among individuals, yet no study to date has compared social networks of do- minance interactions (i.e. dominance networks) across reproductive contexts. We first analyzed a long-term dataset on captive so- cial groups of the cooperatively breeding cichlid Neolamprologuspulcher, and found that eviction events were significantly more common around reproduction than expected by chance. Next, we compared the structure of dominance networks during early pa- rental care and non-reproductive periods, using one of the first applications of exponential random graph models in behavioral biology. Contrary to our predictions, we found that dominance networks showed few changes between early parental care and non-reproductive periods. We found no evidence that dominance interactions became more skewed towards larger individuals, became more frequent between similar-sized individuals, or became more biased towards a particular sex during parental care. However, we did find that there were relatively more dominance interactions between opposite-sex dyads in the early parental care period, which may be a by-product of increased sexual interactions during this time. This is the first study in behavioral ecology to compare social networks using exponential random graph modeling, and demonstrates a powerful analytical framework for future studies in the field [Current Zoology 61 (1): 45-54, 2015]. 展开更多
关键词 Social network AGGRESSION Submissive HIERARCHY Parental care P* model
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Real-Time Automatic ECG Diagnosis Method Dedicated to Pervasive Cardiac Care 被引量:1
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作者 Haiying ZHOU Kun-Mean HOU Decheng ZUO 《Wireless Sensor Network》 2009年第4期276-283,共8页
Recent developments of the wireless sensor network will revolutionize the way of remote monitoring in dif-ferent domains such as smart home and smart care, particularly remote cardiac care. Thus, it is challenging to ... Recent developments of the wireless sensor network will revolutionize the way of remote monitoring in dif-ferent domains such as smart home and smart care, particularly remote cardiac care. Thus, it is challenging to propose an energy efficient technique for automatic ECG diagnosis (AED) to be embedded into the wireless sensor. Due to the high resource requirements, classical AED methods are unsuitable for pervasive cardiac care (PCC) applications. This paper proposes an embedded real-time AED algorithm dedicated to PCC sys-tems. This AED algorithm consists of a QRS detector and a rhythm classifier. The QRS detector adopts the linear time-domain statistical and syntactic analysis method and the geometric feature extraction modeling technique. The rhythm classifier employs the self-learning expert system and the confidence interval method. Currently, this AED algorithm has been implemented and evaluated on the PCC system for 30 patients in the Gabriel Monpied hospital (CHRU of Clermont-Ferrand, France) and the MIT-BIH cardiac arrhythmias da-tabase. The overall results show that this energy efficient algorithm provides the same performance as the classical ones. 展开更多
关键词 PERVASIVE CARDIAC care Automatic ECG Diagnosis QRS detector RHYTHM CLASSIFIER Wireless Sensor networks
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New avenues for reducing intensive care needs in patients with chronic spinal cord injury
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作者 Pierre A Guertin 《World Journal of Critical Care Medicine》 2016年第4期201-203,共3页
Relatively soon after their accident, patients suffering a spinal cord injury(SCI) begin generally experiencing the development of significant, often life-threatening secondary complications. Many of which are associa... Relatively soon after their accident, patients suffering a spinal cord injury(SCI) begin generally experiencing the development of significant, often life-threatening secondary complications. Many of which are associated with chronic physical inactivity-related immune function problems and increasing susceptibility to infection that repeatedly requires intensive care treatment. Therapies capable of repairing the spinal cord or restoring ambulation would normally prevent many of these problems but, as of now, there is no cure for SCI. Thus, management strategies and antibiotics remain the standard of care although antimicrobial resistance constitutes a significant challenge for patients with chronic SCI facing recurrent infections of the urinary tract and respiratory systems. Identifying alternative therapies capable of safe and potent actions upon these serious health concerns should therefore be considered a priority. This editorial presents some of the novel approaches currently in development for the prevention of specific infections after SCI. Among them, brain-permeable small molecule therapeutics acting centrally on spinal cord circuits that can augment respiratory capabilities or bladder functions. If eventually approved by regulatory authorities, some of these new avenues may potentially become clinically-relevant therapies capable of indirectly preventing the occurrence and/or severity of these lifethreatening complications in people with paraplegic or tetraplegic injuries. 展开更多
关键词 Prevention of INTENSIVE care problems Quality of care TEMPORARY recovery of VITAL functions MICTURITION SPINAL networks Central pattern generators
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Unveiling significant risk factors for intensive care unit-acquired weakness:Advancing preventive care
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作者 Chun-Yao Cheng Wen-Rui Hao Tzu-Hurng Cheng 《World Journal of Clinical Cases》 SCIE 2024年第18期3288-3290,共3页
In this editorial,we discuss an article titled,“Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning,”published in a recent issue of the World J... In this editorial,we discuss an article titled,“Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning,”published in a recent issue of the World Journal of Clinical Cases.Intensive care unit-acquired weakness(ICU-AW)is a debilitating condition that affects critically ill patients,with significant implications for patient outcomes and their quality of life.This study explored the use of artificial intelligence and machine learning techniques to predict ICU-AW occurrence and identify key risk factors.Data from a cohort of 1063 adult intensive care unit(ICU)patients were analyzed,with a particular emphasis on variables such as duration of ICU stay,duration of mechanical ventilation,doses of sedatives and vasopressors,and underlying comorbidities.A multilayer perceptron neural network model was developed,which exhibited a remarkable impressive prediction accuracy of 86.2%on the training set and 85.5%on the test set.The study highlights the importance of early prediction and intervention in mitigating ICU-AW risk and improving patient outcomes. 展开更多
关键词 Intensive care unit-acquired weakness Artificial intelligence Machine learning Neural network Risk factors Prediction Critical care
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