分类： 医学、药学 >> 基础医学 提交时间： 2024-04-15 合作期刊: 《中国全科医学》
摘要： 背景膝骨关节炎（KOA）是临床常见急性病，病程长达数十年，在社区医院开展长期和个性化健康管理是KOA防治的最佳途径，非手术治疗是延缓关节退变和推迟关节置换手术的有效方式。目的 了解社区医院KOA就诊人群的人群特征、临床分期和治疗方式特点，为优化基层KOA治疗方案提供依据。方法 对北京市市区所有街道采用整群抽样方法，随机抽取北京市东城区和平里街道KOA患者为研究对象，普查该街道所属的所有社区医院（7家）2022年1—6月就诊的所有患者，采集一般资料、既往史、个人史、临床分期、KL分级、治疗方式等资料。结果 本研究共纳入3615例KOA患者，男1327例（36.71%）、女2288例（63.29%），年龄（71.8±13.3）岁，发作期867例（23.98%）、缓解期2009例（55.57%）、康复期739例（20.45%）。不同临床分期患者的性别、年龄与临床分期无相关性（P>0.05），BMI（K=0.235）、KL分级（K=0.406）与临床分期相关（P<0.001）。发作期，多选用4~5种治疗方式联合治疗（48.67%），治疗方式主要为外用中成药（68.97%）、中成药口服475例（54.79%）、健康教育396例（45.67%）；缓解期多选用2~3种治疗方式联合治疗（48.58%），治疗方式主要为中成药外用1084例（53.96%）、健康教育1047例（52.12%）、拔罐790例（39.32%）；康复期多选用2~3种治疗方式联合治疗（47.23%），治疗方式主要为健康教育488例（66.04%）、传统功法286例（38.70%）、中成药外用279例（37.75%）。临床分期与联合治疗方式的种类相关（K=0.356，P<0.05）。结论 社区医院就诊患者以缓解期为主，治疗多采用多种方式结合，中成药和传统功法也有广泛的应用。
分类： 医学、药学 >> 预防医学与公共卫生学 提交时间： 2024-04-15 合作期刊: 《中国全科医学》
摘要： 背景绝经后发生盆底功能障碍的患者逐渐增加，压力性尿失禁严重影响女性身心健康。目的 探索绝经期激素治疗（MHT）联合Kegel运动对轻中度压力性尿失禁（SUI）患者盆底结构以及临床症状的影响。方法 选取2022年就诊于北京世纪坛医院更年期门诊的绝经综合征伴轻中度SUI患者75例，按照随机数字表法2∶1分为MHT组和对照组，MHT组再按1∶1随机分为替勃龙亚组和雌孕激素联合治疗（EPT）亚组。对照组和MHT组均给予盆底肌训练（PFMT）治疗，又称Kegel运动，15~30min/次，2~3次/d，2~3次/周，连续12个月。对照组在PFMT基础上口服坤泰胶囊，4粒/次，3次/d，持续治疗12个月。MHT组在PFMT基础上，同时给予绝经激素治疗。EPT亚组包括雌孕激素连续联合（戊酸雌二醇片1mg+地屈孕酮片10mg，1次/d）、雌孕激素连续序贯疗法（芬吗通12个疗程），替勃龙亚组口服替勃龙，连续用药12个月。检查治疗前后各组及亚组间血清雌二醇（E2）和卵泡刺激素（FSH）水平、尿道旋转角（URA）、逼尿肌厚度（BDT）、膀胱尿道后角（PVUA）、肛提肌裂孔面积（LHA）以及尿失禁量、尿失禁评分、临床疗效、改良Kupperman绝经指数（KMI）评分、改良牛津肌力分级的变化。结果 研究结束时，MHT组失访7例（其中替勃龙亚组失访5例，EPT亚组失访2例），对照组失访3例；最终共纳入65例。治疗1年后，MHT组和对照组FSH、E2、MOS分级比较，差异均无统计学意义（P>0.05）。治疗1年后，MHT组和对照组PUVA、BDT、URA比较，差异均无统计学意义（P>0.05）；MHT组LHA低于对照组（P=0.028）。治疗1年后，EPT亚组和替勃龙亚组PUVA、BDT、URA、LHA比较，差异均无统计学意义（P>0.05）。对照组和MHT组临床疗效比较，差异有统计学意义（P=0.010）；EPT亚组和替勃龙亚组临床疗效比较，差异无统计学意义（P=0.724）。治疗1年后，MHT组尿失禁量、尿失禁评分、KMI评分低于对照组（P0.05）。结论 MHT联合盆底肌锻炼对盆底结构有一定改善作用，并且可以显著缓解尿失禁症状；然而，EPT和替勃龙在改善患者盆底结构和缓解临床症状方面并无明显差别。
分类： 心理学 >> 管理心理学 提交时间： 2024-04-15
摘要： 作为组织中重要的战略人才资本，明星员工虽然占组织总人数的比重很低，但却能做出极为突出的贡献。他们不仅凭借自身持续且不均衡的高绩效、高社会资本和高知名度为组织绩效的提升做出直接贡献，还可通过影响其他同事间接助力组织的价值创造活动，即明星员工的涟漪效应。在系统回顾文献的基础上，本文以社会影响理论为框架，分别阐述了组织情境下，明星员工如何对团队内非明星员工及团队整体产生近端涟漪效应，以及如何对团队外同事产生远端涟漪效应，并从人力资源管理实践和明星员工人际特征的角度探究了不同涟漪效应的边界条件。具体而言，我们设计了3个研究模块，涵盖4个理论模型。本文构建的理论框架不仅有助于学者们更全面、深入地理解明星员工如何对组织的价值创造产生积极或消极的社会影响，还将为中国各类组织的明星员工管理实践提供有价值的建议。
分类： 地球科学 >> 地理学 提交时间： 2024-04-15 合作期刊: 《干旱区科学》
摘要： Arid areas with low precipitation and sparse vegetation typically yield compact urban pattern, and drought directly impacts urban site selection, growth processes, and future scenarios. Spatial simulation and projection based on cellular automata (CA) models is important to achieve sustainable urban development in arid areas. We developed a new CA model using bat algorithm (BA) named bat algorithm-probability-of-occurrence-cellular automata (BA-POO-CA) model by considering drought constraint to accurately delineate urban growth patterns and project future scenarios of Urumqi City and its surrounding areas, located in Xinjiang Uygur Autonomous Region, China. We calibrated the BA-POO-CA model for the drought-prone study area with 2000 and 2010 data and validated the model with 2010 and 2020 data, and finally projected its urban scenarios in 2030. The results showed that BA-POO-CA model yielded overall accuracy of 97.70% and figure-of-merits (FOMs) of 35.50% in 2010, and 97.70% and 26.70% in 2020, respectively. The inclusion of drought intensity factor improved the performance of BA-POO-CA model in terms of FOMs, with increases of 5.50% in 2010 and 7.90% in 2020 than the model excluding drought intensity factor. This suggested that the urban growth of Urumqi City was affected by drought, and therefore taking drought intensity factor into account would contribute to simulation accuracy. The BA-POO-CA model including drought intensity factor was used to project two possible scenarios (i.e., business-as-usual (BAU) scenario and ecological scenario) in 2030. In the BAU scenario, the urban growth dominated mainly in urban fringe areas, especially in the northern part of Toutunhe District, Xinshi District, and Midong District. Using exceptional and extreme drought areas as a spatial constraint, the urban growth was mainly concentrated in the "main urban areas-Changji-Hutubi" corridor urban pattern in the ecological scenario. The results of this research can help to adjust urban planning and development policies. Our model is readily applicable to simulating urban growth and future scenarios in global arid areas such as Northwest China and Africa.
分类： 生物学 >> 生态学 提交时间： 2024-04-15 合作期刊: 《干旱区科学》
摘要： Land use change affects the balance of organic carbon (C) reserves and the global C cycle. Microbial residues are essential constituents of stable soil organic C (SOC). However, it remains unclear how microbial residue changes over time following afforestation. In this study, 16-, 23-, 52-, and 62-year-old Mongolian pine stands and 16-year-old cropland were studied in the Horqin Sandy Land, China. We analyzed changes in SOC, amino sugar content, and microbial parameters to assess how microbial communities influence soil C transformation and preservation. The results showed that SOC storage increased with stand age in the early stage of afforestation but remained unchanged at about 1.27−1.29 kg/m2 after 52 a. Moreover, there were consistent increases in amino sugars and microbial residues with increasing stand age. As stand age increased from 16 to 62 a, soil pH decreased from 6.84 to 5.71, and the concentration of total amino sugars increased from 178.53 to 509.99 mg/kg. A significant negative correlation between soil pH and the concentration of specific and total amino sugars was observed, indicating that the effects of soil acidification promote amino sugar stabilization during afforestation. In contrast to the Mongolian pine plantation of the same age, the cropland accumulated more SOC and microbial residues because of fertilizer application. Across Mongolian pine plantation with different ages, there was no significant change in calculated contribution of bacterial or fungal residues to SOC, suggesting that fungi were consistently the dominant contributors to SOC with increasing time. Our results indicate that afforestation in the Horqin Sandy Land promotes efficient microbial growth and residue accumulation in SOC stocks and has a consistent positive impact on SOC persistence.
分类： 生物学 >> 植物学 提交时间： 2024-04-15 合作期刊: 《干旱区科学》
摘要： Vegetation restoration and reconstruction are effective approaches to desertification control and achieving social and economic sustainability in desert areas. However, the self-succession ability of native plants during the later periods of vegetation restoration remains unclear. Therefore, this study was conducted to bridge the knowledge gap by investigating the regeneration dynamics of artificial forest under natural conditions. The information of seed rain and soil seed bank was collected and quantified from an artificial Caragana korshinskii Kom. forest in the Tengger Desert, China. The germination tests were conducted in a laboratory setting. The analysis of species quantity and diversity in seed rain and soil seed bank was conducted to assess the impact of different durations of sand fixation (60, 40, and 20 a) on the progress of vegetation restoration and ecological conditions in artificial C. korshinskii forest. The results showed that the top three dominant plant species in seed rain were Echinops gmelinii Turcz., Eragrostis minor Host., and Agropyron mongolicum Keng., and the top three dominant plant species in soil seed bank were E. minor, Chloris virgata Sw., and E. gmelinii. As restoration period increased, the density of seed rain and soil seed bank increased first and then decreased. While for species richness, as restoration period increased, it gradually increased in seed rain but decreased in soil seed bank. There was a positive correlation between seed rain density and soil seed bank density among all the three restoration periods. The species similarity between seed rain or soil seed bank and aboveground vegetation decreased with the extension of restoration period. The shape of the seeds, specifically those with external appendages such as spines and crown hair, clearly had an effect on their dispersal, then resulting in lower seed density in soil seed bank. In addition, precipitation was a crucial factor in promoting rapid germination, also resulting in lower seed density in soil seed bank. Our findings provide valuable insights for guiding future interventions during the later periods of artificial C. korshinskii forest, such as sowing and restoration efforts using unmanned aerial vehicles.
分类： 生物学 >> 植物学 提交时间： 2024-04-15 合作期刊: 《干旱区科学》
摘要： The maintenance of sand-fixing vegetation is important for the stability of artificial sand-fixing systems in which seed dispersal plays a key role. Based on field wind tunnel experiments using 11 common plant species on the southeastern edge of the Tengger Desert, China, we studied the secondary seed dispersal in the fixed and semi-fixed sand dunes as well as in the mobile dunes in order to understand the limitations of vegetation regeneration and the maintenance of its stability. Our results indicated that there were significant variations among the selected 11 plant species in the threshold of wind speed (TWS). The TWS of Caragana korshinskii was the highest among the 11 plant species, whereas that of Echinops gmelinii was the lowest. Seed morphological traits and underlying surface could generally explain the TWS. During the secondary seed dispersal processes, the proportions of seeds that did not disperse (no dispersal) and only dispersed over short distance (short-distance dispersal within the wind tunnel test section) were significantly higher than those of seeds that were buried (including lost seeds) and dispersed over long distance (long-distance dispersal beyond the wind tunnel test section). Compared with other habitats, the mobile dunes were the most difficult places for secondary seed dispersal. Buried seeds were the easiest to be found in the semi-fixed sand dunes, whereas fixed sand dunes were the best sites for seeds that dispersed over long distance. The results of linear mixed models showed that after controlling the dispersal distance, smaller and rounder seeds dispersed farther. Shape index and wind speed were the two significant influencing factors on the burial of seeds. The explanatory power of wind speed, underlying surface, and seed morphological traits on the seeds that did not disperse and dispersed over short distance was far greater than that on the seeds that were buried and dispersed over long distance, implying that the processes and mechanisms of burial and long-distance dispersal are more complex. In summary, most seeds in the study area either did not move, were buried, or dispersed over short distance, promoting local vegetation regeneration.
分类： 农、林、牧、渔 >> 土壤学 提交时间： 2024-04-15 合作期刊: 《干旱区科学》
摘要： The unique geomorphological features and farming methods in the Mollisol region of Northeast China increase water catchment flow and aggravate the erosion of ephemeral gully (EG). Vegetation suffers from rain erosion and damage during the growth stage, which brings serious problems to the restoration of grass in the early stage. Therefore, effects of coir geotextile and geocell on EG erosion under four confluence intensities were researched in this study. Results of the simulated water discharge erosion test showed that when the confluence strength was less than 30 L/min, geocell and coir geotextile had a good effect on controlling EG erosion, and sediment yield of geocell and coir geotextile was reduced by 25.95%–37.82% and 73.73%–88.96%, respectively. However, when confluence intensity increased to 40 L/min, protective effect of coir geotextile decreased, and sediment yield rate increased sharply by 189.03%. When confluence intensity increased to 50 L/min, the protective effect of coir geotextile was lost. On the other hand, geocell showed that the greater the flow rate, the better the protective effect. In addition, with the increase in confluence intensity, erosion pattern of coir geotextile developed from sheet erosion to intermittent fall and then to completion of main rill, and the protective effect was gradually weakened. In contrast, the protective effect of EG under geocell was gradually enhanced from the continuous rill to the intermittent rill and finally to the intermittent fall. This study shows that coir geotextile and geocell can prevent EG erosion, and the effect of geocell is better than that of coir geotextile on the surface of EG.
分类： 测绘科学技术 >> 测绘科学技术其他学科 提交时间： 2024-04-15 合作期刊: 《干旱区科学》
摘要： Gobi spans a large area of China, surpassing the combined expanse of mobile dunes and semi-fixed dunes. Its presence significantly influences the movement of sand and dust. However, the complex origins and diverse materials constituting the Gobi result in notable differences in saltation processes across various Gobi surfaces. It is challenging to describe these processes according to a uniform morphology. Therefore, it becomes imperative to articulate surface characteristics through parameters such as the three-dimensional (3D) size and shape of gravel. Collecting morphology information for Gobi gravels is essential for studying its genesis and sand saltation. To enhance the efficiency and information yield of gravel parameter measurements, this study conducted field experiments in the Gobi region across Dunhuang City, Guazhou County, and Yumen City (administrated by Jiuquan City), Gansu Province, China in March 2023. A research framework and methodology for measuring 3D parameters of gravel using point cloud were developed, alongside improved calculation formulas for 3D parameters including gravel grain size, volume, flatness, roundness, sphericity, and equivalent grain size. Leveraging multi-view geometry technology for 3D reconstruction allowed for establishing an optimal data acquisition scheme characterized by high point cloud reconstruction efficiency and clear quality. Additionally, the proposed methodology incorporated point cloud clustering, segmentation, and filtering techniques to isolate individual gravel point clouds. Advanced point cloud algorithms, including the Oriented Bounding Box (OBB), point cloud slicing method, and point cloud triangulation, were then deployed to calculate the 3D parameters of individual gravels. These systematic processes allow precise and detailed characterization of individual gravels. For gravel grain size and volume, the correlation coefficients between point cloud and manual measurements all exceeded 0.9000, confirming the feasibility of the proposed methodology for measuring 3D parameters of individual gravels. The proposed workflow yields accurate calculations of relevant parameters for Gobi gravels, providing essential data support for subsequent studies on Gobi environments.
分类： 地球科学 >> 大气科学 提交时间： 2024-04-15 合作期刊: 《干旱区科学》
摘要： Rain-on-snow (ROS) events involve rainfall on snow surfaces, and the occurrence of ROS events can exacerbate water scarcity and ecosystem vulnerability in the arid region of Northwest China (ARNC). In this study, using daily snow depth data and daily meteorological data from 68 meteorological stations provided by the China Meteorological Administration National Meteorological Information Centre, we investigated the spatiotemporal variability of ROS events in the ARNC from 1978 to 2015 and examined the factors affecting these events and possible changes of future ROS events in the ARNC. The results showed that ROS events in the ARNC mainly occurred from October to May of the following year and were largely distributed in the Qilian Mountains, Tianshan Mountains, Ili River Valley, Tacheng Prefecture, and Altay Prefecture, with the Ili River Valley, Tacheng City, and Altay Mountains exhibiting the most occurrences. Based on the intensity of ROS events, the areas with the highest risk of flooding resulting from ROS events in the ARNC were the Tianshan Mountains, Ili River Valley, Tacheng City, and Altay Mountains. The number and intensity of ROS events in the ARNC largely increased from 1978 to 2015, mainly influenced by air temperature and the number of rainfall days. However, due to the snowpack abundance in areas experiencing frequent ROS events in the ARNC, snowpack changes exerted slight impact on ROS events, which is a temporary phenomenon. Furthermore, elevation imposed lesser impact on ROS events in the ARNC than other factors. In the ARNC, the start time of rainfall and the end time of snowpack gradually advanced from the spring of the current year to the winter of the previous year, while the end time of rainfall and the start time of snowpack gradually delayed from autumn to winter. This may lead to more ROS events in winter in the future. These results could provide a sound basis for managing water resources and mitigating related disasters caused by ROS events in the ARNC.
分类： 地球科学 >> 水文学 提交时间： 2024-04-15 合作期刊: 《干旱区科学》
摘要： Quantitative assessment of the impact of climate variability and human activities on runoff plays a pivotal role in water resource management and maintaining ecosystem integrity. This study considered six sub-basins in the upper reaches of the Yangtze River basin, China, to reveal the trend of the runoff evolution and clarify the driving factors of the changes during 1956–2020. Linear regression, Mann-Kendall test, and sliding t-test were used to study the trend of the hydrometeorological elements, while cumulative distance level and ordered clustering methods were applied to identify mutation points. The contributions of climate change and human disturbance to runoff changes were quantitatively assessed using three methods, i.e., the rainfall-runoff relationship method, slope variation method, and variable infiltration capacity (Budyko) hypothesis method. Then, the availability and stability of the three methods were compared. The results showed that the runoff in the upper reaches of the Yangtze River basin exhibited a decreasing trend from 1956 to 2020, with an abrupt change in 1985. For attribution analysis, the runoff series could be divided into two phases, i.e., 1961–1985 (baseline period) and 1986–2020 (changing period); and it was found that the rainfall-runoff relationship method with precipitation as the representative of climate factors had limited usability compared with the other two methods, while the slope variation and Budyko hypothesis methods had highly consistent results. Different factors showed different effects in the sub-basins of the upper reaches of the Yangtze River basin. Moreover, human disturbance was the main factor that contributed to the runoff changes, accounting for 53.0%–82.0%; and the contribution of climate factors to the runoff change was 17.0%–47.0%, making it the secondary factor, in which precipitation was the most representative climate factor. These results provide insights into how climate and anthropogenic changes synergistically influence the runoff of the upper reaches of the Yangtze River basin.
分类： 医学、药学 >> 预防医学与公共卫生学 提交时间： 2024-04-15 合作期刊: 《中国全科医学》
摘要： 老年人潜在不适当处方筛查工具（STOPP）/处方遗漏筛查工具（START）由2008年爱尔兰Cork大学附属医院专家组首次发表并予2015年进行第二次更新。自发表以来，该标准在发现老年人潜在不适当用药、加强对老年人滥用药物的监管、减少老年人药品不良事件等方面发挥了积极作用。2023年第3版STOPP/START标准发布，在第2版基础上增加、修订和删减了一些标准，最终形成190条潜在不适当用药标准。新标准根据最新的老年人合理用药研究结果和临床证据，提供了更新、更实用的循证医学依据。本文对STOPP/START标准（第3版）进行了详细的解读，为我国潜在不适当用药标准更新和完善提供参考，并对未来该领域的研究方向提出思考和建议。
分类： 医学、药学 >> 基础医学 提交时间： 2024-04-15 合作期刊: 《中国全科医学》
摘要： 全科教学门诊是培养规培全科医生临床思维、提升全科诊疗能力的重要培训方法。本文用1例以乏力为主要表现的患者为教学案例，介绍全科教学门诊中采用澳大利亚著名全科医学专家JohnMurtagh提出Murtagh安全诊断策略启发规培全科医生对乏力进行诊断与鉴别诊断：（1）引起乏力的常见疾病有哪些?（2）哪些重要疾病是不能忽视的？（3）乏力有什么容易被遗漏的疾病？（4）是否存在潜在的容易被掩盖的疾病？（5）患者是否有话没有说？结合病史、体格检查和实验室检查结果初步诊断为抗中性粒细胞胞浆抗体相关性血管炎引起急进性肾小球肾炎可能性大，及时转诊，肾病理确诊乏力的病因为抗中性粒细胞胞浆抗体相关性肾小球肾炎，取得满意疗效。带教老师基于Murtagh安全诊断策略帮助规培全科医生构建乏力鉴别、分析的系统知识框架，从而提升规培全科医生的临床逻辑思维能力和解决临床实际问题的能力；以思维导图为辅助工具，将Murtagh安全诊断策略诊断与鉴别诊断思路可视化、形象化，优化教学效果。
分类： 医学、药学 >> 临床医学 提交时间： 2024-04-15 合作期刊: 《中国全科医学》
摘要： 背景慢性萎缩性胃炎是一种临床常见癌前病变，容易反复发作，严重影响患者生活质量。目前西医治疗慢性萎缩性胃炎效果有限，而针灸治疗慢性萎缩性胃炎具有良好的效果，但具体哪种针灸疗法治疗效果更好，仍未有定论。目的 运用网状Meta分析方法评价不同针灸疗法治疗慢性萎缩性胃炎对临床疗效、胃镜疗效、病理疗效差异性。方法 计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务数据库、PubMed、Embase、WebofScience数据库建库至2023-04-30针灸治疗慢性萎缩性胃炎的随机对照试验，按照纳排标准进行筛选。基于ROB2偏倚风险评估工具进行文献质量评估，使用Rstudio软件进行网状Meta分析，使用Stata软件绘制漏斗图进行发表偏倚风险评估。结果 纳入文献26篇涉及10种干预措施，样本量2068例。网状Meta分析结果显示，在临床疗效上，西药联合穴位注射、穴位埋线、西药联合针刺、温针灸、针刺等干预措施均优于常规西药治疗（P穴位埋线（0.80）>西药联合针刺（0.67）>温针灸（0.59）>西药联合雷火灸（0.58）>针刺（0.48）>西药联合隔姜灸（0.40）>雷火灸（0.31）>西药联合电针（0.24）>常规西药（0.06）；在胃镜疗效上，穴位埋线、温针灸、西药联合针刺、针刺、西药联合穴位注射均优于常规西药治疗（P温针灸（0.72）>西药联合针刺（0.58）>针刺（0.47）>西药联合穴位注射（0.41）>常规西药（0.01）；在病理疗效上，穴位埋线、温针灸优于常规西药治疗（P西药联合针刺（0.59）>温针灸（0.53）>针刺（0.52）>西药联合穴位注射（0.51）>常规西药（0.06）。结论 临床症状明显患者可选用西药联合穴位注射缓解症状，而临床症状不明显的患者则优先选用穴位埋线，穴位埋线不仅能改善临床症状，在改善胃镜疗效及病理疗效上较其他针灸疗法效果更显著。
分类： 医学、药学 >> 预防医学与公共卫生学 提交时间： 2024-04-15 合作期刊: 《中国全科医学》
摘要： 背景中老年人腰背痛已成为世界范围内重要的公共卫生问题，身体活动和睡眠是占据24h生命周期的两个核心生活方式组成部分，坚持充足的身体活动和良好的睡眠对健康至关重要，且两者均与腰背痛有关。目的 调查我国中老年人腰背痛发病率，分析身体活动和睡眠两大行为要素对其发病的独立影响和联合影响，为行为健康提供科学依据。方法 基于2018年中国健康与养老追踪调查，排除没有提供人口学、身体活动、睡眠和腰痛数据的参与者，筛选出符合标准的45~69岁中老年13496例，收集其一般人口学信息和行为相关信息。采用二元Logistic回归和多元线性回归检验身体活动、睡眠时间和腰背痛三者之间的关系，并构建睡眠时间在身体活动与腰背痛之间的中介模型进行中介作用分析。结果 13496例调查对象腰背痛患病率为39.0%（5269/13496）；我国中老年人睡眠不足（1.96，且身体活动影响腰背痛的路径不显著（β=0.105，P>0.05），故睡眠时间在身体活动与腰背痛的关联中发挥完全中介效应。结论 有超过1/3的中国中老年人患有腰背痛，身体活动水平越高或睡眠时间越短，腰背痛患病风险越高，睡眠时间在身体活动与腰背痛发挥完全中介效应，即高强度身体活动所带来的腰背痛风险经由睡眠时间锐减所完全传递，充足的睡眠时间在降低高强度身体活动所带来的腰背痛发病风险中发挥重要作用。提示老年人在进行体育锻炼时，应根据自身情况合理安排运动量，并保持充足的睡眠时间，以降低腰背痛患病风险。
分类： 图书馆学、情报学 >> 文献学 提交时间： 2024-04-14
摘要： 目的/意义 探讨智慧医疗主题相关内容及发展演化趋势，为智慧医疗 发展提供参考。 方法/过程 基于知网、万方、维普三大数据库，构建基础词 典及停用词表，通过 BERTopic 模型对智慧医疗进行主题特征分析，并建立线性 回归模型——以预测未来五年发文量。 结果/结论 智慧医疗在未来五年发文 数量持上升趋势，并涵盖智能化、数字化、个性化三个方向。研究有助于医院 加强基础设备的智能化建设，健全相关法律法规及监管机制，国家加强支持力 度及数字化设备的推广以及该领域的人才培养，推进智慧医疗的快速发展。
分类： 图书馆学、情报学 >> 情报资料的利用 提交时间： 2024-04-14
摘要： 目的/意义 为优化在线心理社区信息资源的精细管理与高效利用，对用户信息需求的深层次挖掘并以此构建用户信息需求特征模型。 方法/过程 从信息需求认知层的主题维度对中文语境下在线心理社区内用户提问信息实施内容分析与统计研究，构建用户心理健康信息需求主题模型并对用户的需求特点进行归纳。 结果/结论 结果显示，用户心理健康信息需求的主题包括二次婚姻、未来规划、妯娌关系、婚姻生活、心理疾病史等五大类。 创新性/价值 研究的主要贡献在于:突破了被研究者心理健康需求研究过程中以问卷调查为主导的传统范式，提出了一种基于文本主题内容挖掘的新方案;文章致力于构建线上心理社区的理论模型，并在信息交互设计及功能提升方面提供改进措施以优化心理健康社区的系统结构。
分类： 图书馆学、情报学 >> 情报学 提交时间： 2024-04-14
摘要： 目的/意义 为解决传统电子病历大数据资源交互性差、安全性低等问题，提出具有去中心化、不可篡改以及加密机制的基于区块链的医疗电子病历大数据共享方案。 方法/过程 首先，分析当前区块链技术在医疗领域的应用；然后，采用问卷调查法和访谈法收集医疗市场对电子病历的需求；在此基础上，结合不对称加密技术、共识机制、智能合约等机制，提出五层次的基于区块链技术的医疗电子病历大数据资源共享方案。 结果/结论 该方案重塑医疗大数据资源共享流程，进一步完善区块链在医疗数据安全存储共享方面的应用，可为相关企业医院和研究者提供参考。
分类： 核科学技术 >> 核科学与技术 提交时间： 2024-04-14
摘要： 不确定度量化已经成为反应堆物理分析的普遍需求，核数据的协方差数据是开展不确定度量化的基础数据。在核数据处理程序NECP-Atlas中开发了协方差数据产生模块covar_calc，产生适用于蒙特卡罗程序的连续能量协方差数据库与确定论程序的多群协方差数据库。covar_calc可根据不同核数据在评价核数据库中的存储格式及不同的计算方法，分别处理评价核数据库给出的所有协方差数据，包括：平均裂变中子数、截面、次级粒子角度分布、裂变谱、共振参数、中子活化截面等数据的协方差数据。通过与核数据处理程序NJOY21中协方差数据制作模块的对比验证，表明NECP-Atlas制作的多群协方差数据库的精度与NJOY21相当,最大偏差小于0.1%。在此基础上使用蒙特卡罗计算程序NECP-MCX和不确定度量化程序NECP-UNICORN分别计算得到不同基准题的灵敏度系数，并分别结合连续能量协方差数据库和多群协方差数据库，利用“三明治公式”计算得到最终的不确定度。结果表明，基于NECP-Atlas制作的多群协方差数据库计算得到的不确定度具有与NJOY21相当的精度。连续能量协方差和多群协方差制作精确，满足蒙特卡罗程序和确定论程序使用需求。
分类： 护理学 >> 护理学 提交时间： 2024-04-13
摘要： 本文总结1例月经过少患者行火龙罐综合灸联合耳穴贴压治疗的效果观察及护理经验。基于中医辨证施护理论，采取火龙罐综合灸联合耳穴贴压治疗，配合饮食指导、情志护理、生活起居护理、健康知识宣教等常规护理措施，患者病情明显缓解。
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