[Inadequate first medical aid on board a sea vessel as a risk factor for crew members' health].

Currently, one of the most important health and social problems in the world is the constant increase in injuries and deaths at work. Statistics show that timely provision of first aid to victims has a positive effect on further medical support and a reduction in the number of deaths. First aid for crew members of sea vessels is a set of simple medical actions performed by seafarers directly on board the ship, as soon as possible after an injury or illness. As a rule, it is associated with emergency resuscitation of the victim. The lack of necessary skills and training among current ship crew members to carry out first aid operations shows an objective need to develop recommendatory measures to revise the current training system.

Fault diagnosis of accelerometer servo circuit output saturation based on feature electrical parameters extraction.

The servo circuit of quartz flexible accelerometer is an extremely vital microelectronic device in inertial system. The paper introduces the traditional analysis process about output saturation fault of accelerometer servo circuit. For the shortcomings of traditional analysis methods, a fault diagnosis method based on feature electrical parameters extraction is proposed. According to the fault phenomenon, combined with the modular characteristics of hybrid integrated circuits, the feature electrical parameters of fault modes are extracted, and the fault modes' judgment basis is set. By the judgment results of the feature electrical parameters of the fault circuit, the circuit with output saturation fault caused by the electrical damage to the differential capacitance detector and other faults can be located quickly and accurately, and it is verified by the analysis of faulty circuit samples. Targeted for these faults, the improvement measures are put forward. This analysis method improves the fault diagnosis efficiency and reliability about the accelerometer servo circuit, and has guiding significance for enhancing the success rate of the failure analysis in the hybrid integrated circuits.

Contributions of Common Foods to Resveratrol Intake in the Chinese Diet.

Resveratrol is a polyphenolic compound with antioxidant and anti-inflammatory properties and therefore has potential health benefits for the prevention and treatment of a wide range of diseases, including cardiovascular disease, cancer, diabetes, and neurodegenerative diseases. The beneficial dose of resveratrol is between 30 and 150 mg. Although the health benefits of resveratrol have been extensively studied, resveratrol intake through the diet of residents in China remains unclear, which restricts the development of resveratrol-rich foods. In this study, a dietary assessment was conducted to reveal that the daily resveratrol intake by Chinese residents through common foods was only 0.783 mg, which was significantly below the beneficial dose. Among the main food types, fruits emerged as the primary source of resveratrol, contributing to 88.35% of the total intake. To improve resveratrol intake, potential methods to increase its consumption were proposed. First method is to increase the resveratrol content of fruits and peanuts. In addition, resveratrol can be extracted from peels. It is also recommended to adopt technical means to improve the bioavailability of resveratrol and develop related supplements and functional drinks.

Characteristics, sources, and improvement measures regarding fine particulate matter in subway station office and the VAC system.

In order to study the characteristics and transport path of PM2.5 in the subway station office, three different types of typical subway station were selected for sampling and analysis. The PM2.5 of mechanical air duct and VAC (ventilation and air conditioning system) were tested simultaneously. Both the particulate matter in the station office and VAC exhibit highly enriched characteristics of metal elements. The mass balance equation with elemental Fe as the tracer element is established firstly in subway station, and the transport path of PM2.5 in the work area is revealed: if the work area is obviously under positive pressure compared to the station hall, metal-enriched fine particles come from the VAC system; otherwise, the particles come both from the VAC system and air infiltration from the station hall. The contribution of air infiltration to metal-enriched fine particles can reach 50%. Finally, following an investigation into the source of fine particles in the office, the measures to improve air quality are proposed and validated.

Artificial oil bodies: A review on composition, properties, biotechnological applications, and improvement methods.

In order to simulate the structure of natural oil body, artificial oil bodies (AOBs) are fabricated by the integration of oleosins, triacylglycerols (TAGs) and phospholipids (PLs) in vitro. Recently, AOBs have gained great research interest both in the food and biological fields due to its ability to act as a novel delivery system for bioactive compounds and as a carrier for target proteins. This review aims to summarize the composition and the preparation methods of AOBs, examine the factors influencing their stability. Moreover, this contribution focusses on exploring the application of AOBs to encapsulate functional ingredients that are prone to oxidation as well as improve efficiency involved in protein purification, renaturation and immobilization by reducing the complex steps. In addition, the improvement measures to further enhance the stability and efficacy of AOBs are also discussed. The application of AOBs is expected to be a big step towards replacing existing bioreactors and delivery systems.

Factors associated with cleaning quality of reusable medical devices at a single center in China.

Background: Improper cleaning is one of the main causes of sub-optimal levels of sterilization, and also a risk factor in terms of nosocomial infections. We aimed to investigate the factors associated with the cleaning quality of the reusable medical devices and prescribe improvement measures for ensuring the safe use of the devices and for iatrogenic infection control. Methods: An expert consultation was conducted to identify the factors associated with the cleaning quality of reusable medical devices. A self-designed quality inspection form for reusable medical device cleaning was used to collect the data concerning the factors associated with the cleaning quality of the reusable medical devices cleaned at our hospital's central sterile supply department (CSSD) during January to June 2022. We also investigated the cleaning personnel's perceptions and knowledge of medical devices cleaning by means of a self-designed questionnaire. Results: Statistically significant differences (P < 0.05) were identified among incorrect cleaning procedures, improper cleaning methods, non-standard pre-treatment, wrong perceptions or lack of knowledge of medical device cleaning, and complex device structure. Correct cleaning procedures (odds ratio (OR) = 0.216, 95 % confidential interval (CI): 0.170-0.275), choice of cleaning method (ultrasonic cleaning OR = 3.995, 95 % CI: 2.937-5.434; spray cleaning OR = 0.893, 95 % CI: 0.735-1.085), standard pre-treatment (OR = 1.470, 95 % CI: 1.191-1.815), complex device structure (OR = 1.534, 95 % CI: 1.247-1.888) and cleaning personnel's correct perceptions of medical device cleaning (OR = 0.530, 95 % CI: 0.436-0.645) were the independent factors associated with the cleaning quality. Conclusions: The quality of reusable medical device cleaning should be improved by: adherence to standard cleaning procedures, choosing the correct cleaning method and pre-treatment, improving cleaning personnel's knowledge and perceptions of medical device cleaning, and disassembling the medical devices with complex structures so as to reduce the quality defects of medical device cleaning.

Comprehensive evaluation of disease coding quality in gastroenterology and its impact on the diagnosis-related group system: a cross-sectional study.

OBJECTIVE: According to the diagnosis-related group (DRG) requirement, issues of diagnosis and procedure coding in the gastroenterology department of our hospital were analyzed and improvement plans were proposed to lay the foundation for effective implementation of DRGs. METHODS: The title page of case-history of 1600 patients admitted to the Department of Gastroenterology of this hospital from January 1, 2021 to December 31, 2021 was sampled as a data source, and the primary and other diagnostic codes, operation or procedure codes involved in the title page of case-history were categorized and statistically analyzed. RESULTS: Of the 531 cases treated with gastrointestinal endoscopy in our hospital in 2021, coding errors were identified in 66 cases and unsuccessful DRG enrollment in 35 cases, including 14 cases with incorrect coding of the primary diagnosis (8 cases with unsuccessful DRG enrollment), 37 cases with incorrect coding of the primary operation (23 cases with unsuccessful DRG enrollment), and 8 cases with incorrect coding of both the primary diagnosis and the primary operation (4 cases with unsuccessful DRG enrollment). Analysis of 66 inpatient cases with coding problems showed a total of 167 deficiencies, including 36 deficiencies in major diagnoses, 84 deficiencies in other diagnoses, and 47 deficiencies in surgery or operation coding. CONCLUSION: The accuracy of coding of disease diagnosis and surgical operation is the basis for the smooth implementation of DRGs. The medical staff of this hospital has poor cognition of DRGs coding and fails to recognize the important role of the title page of case-history quality to DRGs system, and their attention to DRGs and knowledge base of disease classification coding should be improved. In addition, the high incidence of coding errors, especially the omission of disease diagnosis, requires increased training of physicians and nurses on clinical knowledge and requirements for DRGs medical records, thereby improving the quality of medical cases and ensuring the accuracy of DRGs information.

Hydrogen Storage Performance of Mg/MgH2 and Its Improvement Measures: Research Progress and Trends.

Due to its high hydrogen storage efficiency and safety, Mg/MgH2 stands out from many solid hydrogen storage materials and is considered as one of the most promising solid hydrogen storage materials. However, thermodynamic/kinetic deficiencies of the performance of Mg/MgH2 limit its practical applications for which a series of improvements have been carried out by scholars. This paper summarizes, analyzes and organizes the current research status of the hydrogen storage performance of Mg/MgH2 and its improvement measures, discusses in detail the hot studies on improving the hydrogen storage performance of Mg/MgH2 (improvement measures, such as alloying treatment, nano-treatment and catalyst doping), and focuses on the discussion and in-depth analysis of the catalytic effects and mechanisms of various metal-based catalysts on the kinetic and cyclic performance of Mg/MgH2. Finally, the challenges and opportunities faced by Mg/MgH2 are discussed, and strategies to improve its hydrogen storage performance are proposed to provide ideas and help for the next research in Mg/MgH2 and the whole field of hydrogen storage.

[Response of Topsoil Fungal Community Structure to Soil Improvement Measures in Degraded Forest of Red Soil Region].

Soil fungal community structure and diversity are highly sensitive to variations in the external environment, as well as soil improvement measures. In order to clarify the effects of soil improvement measures on topsoil fertility or quality, a field experiment was conducted in eroded forest of a red soil region. Organic fertilizer, biochar, and lime+microbial fertilizer were added to the topsoil, respectively. After four years, the chemistry properties and nutrients in the topsoil were measured, and the diversity and composition of fungi were analyzed. The results showed that the additions of organic fertilizer, biochar, and lime+microbial fertilizer reduced fungal richness in topsoil, compared to that with no fertilizer addition (CK). Among them, lime+microbial fertilizer had the most negative effect on fungal richness. The three soil improvement measures also affected the diversity of topsoil fungi, but the impacts were not significant. The dominant fungal phyla in the topsoil were Ascomycota (31.29%-46.55%) and Basidiomycota (30.07%-70.71%), and the dominant fungal genera were Amphinema and Archaeorhizomyces. The effects of soil improvement measures on fungal community structure in the topsoil were different; organic fertilizer increased the relative abundance of Ascomycetes and Archaeopteroides, and biochar enhanced the relative abundance of Basidiomycetes and Archaeopteroides, whereas lime+microbial fertilizer improved the relative abundance of Basidiomycetes and Archaeopteroides. Fungal diversity and community structure in the topsoil was affected by edaphic factors, and fungal richness was regulated by pH value, whereas fungal community structure was influenced by pH, total nitrogen, and organic carbon. This study provides scientific guidance for soil improvement and ecological restoration below the canopy in eroded forests of red soil regions.

Measures to improve patient needs assessments and reduce practice variation in Dutch home care organizations.

AIM: Worldwide, long-term care tends to shift from institutional care towards home care. In order to deliver high-quality and adequate care, the type, amount and cost of care is determined by a patient needs assessment. However, there are indications that this patient needs assessment varies between comparable patients. In the Netherlands, some home care organizations aim to improve patient needs assessments by implementing improvement measures to reduce this practice variation. The goal of this study was to explore the type and perceived impact of those implemented improvement measures. DESIGN: A cross-sectional explorative survey study was conducted among Dutch home care organizations between January and April 2021. METHODS: An online questionnaire with 26 items was developed by the research team, which was distributed through Dutch nationwide home care sector organizations, the Dutch nurses' association (V&VN) and the Dutch society for home care nursing (NWG). RESULTS: The survey was completed by 184 respondents, including home care nurses, managers and staff who are responsible for training, policy and quality of care. Intervision and peer review for home care nurses were the most common reported improvement measures that were implemented in home care organizations. The experiences of those improvement measures have been perceived as creating greater uniformity in the patient needs assessment, making home care nurses feel more supported and secure performing their patient needs assessment and that the provided care is more in line with patients' demand. Our findings give insights into type and perceived impact of improvement measures that Dutch home care organizations implemented. Further research is needed to find out whether improvement measures actually improve patient needs assessments and reduce practice variation.

Preliminary discussion on the causes and influencing factors of blood discarding / 中国输血杂志

【Objective】 To conduct a retrospective statistical analysis of the blood discarding situation in Xuzhou Central Blood Station in the past 5 years, so as to explore relevant measures and strategies to reduce blood discarding and save blood resources. 【Methods】 The discarding situation of our station from 2018 to 2022 was systematically sorted out, and Big data analysis base on the two causes, which was unqualified testing and non unqualified testing, was conducted. 【Results】 The total blood discarding rate of our station from 2018 to 2022 was 9.57% (94 273/985 178), and there was a difference in the total discarding rate between different years (Panti-TP(0.23%, 2 263/985 178)>anti-HCV(0.14%, 1 354/985 178)> HBsAg(0.13%, 1 285/985 178)>anti-HIV (0.12%, 1 140/985 178). The unqualified rate of ALT in males (0.63%, 1 993/317 437) was significantly higher than that in females (0.19%, 388/209 601) (P<0.05). The unqualified rate of ALT at the age of 18-25 accounted for 55% (0.49/0.89) of the total unqualified rate of ALT, and was significantly higher than other age groups (P <0.05). 【Conclusion】 It is suggested to improve the public awareness of voluntary blood donation, strengthen health consultation before blood donation, promote staff training so as to reduce blood discarding rate, as well as ensure sufficient, safe and effective clinical blood use.

Spatial-Temporal Evolution and Improvement Measures of Embodied Carbon Emissions in Interprovincial Trade for Coal Energy Supply Bases: Case Study of Anhui, China.

On account of the long-term dependence on energy trade and the phenomenon of embodied carbon emissions in interprovincial trade (ECEs-IPT), energy supply bases (ESBs) in the economic integration regions (EIRs) are under unprecedented dual pressure of achieving carbon emissions (CEs) reduction targets and ensuring security and stability of the energy supply. This problem has attracted more and more attention and research by experts and scholars. This paper took Anhui, the coal ESB of the Yangtze River Economic Belt (YREB), as an example and took the key stage of rapid development of regional economic integration (REI) and accelerated the realization of CEs reduction targets in YREB from 2007 to 2017 as the study period. From the perspectives of regions and industry sectors, we calculated the transfer amount of ECEs-IPT in Anhui among the YREB, analyzed the spatial-temporal evolution pattern of ECEs-IPT, and revealed the industrial characteristics of ECEs-IPT. Then, we classified the industry sectors and proposed the direction of industrial improvement measures. The results showed that, during the decade, the amount of provinces undertaking the net ECEs-IPT outflow from Anhui increased significantly and spatially expanded from only Jiangxi Province to almost all of the YREB. In addition, 39.77% of the net ECEs-IPT outflow of Anhui was concentrated in petroleum processing, coking, and nuclear fuel processing (RefPetraol), metal smelting and rolling processing (MetalSmelt), and electricity and heat production and supply (ElectpowerProd) that trade with Shanghai, Jiangsu, Zhejiang, and Jiangxi. The analytical model and results will provide a useful reference for the global similar coal ESBs, especially the coal ESBs within the EIRs, to formulate improvement measures for regions or even the world to ensure stability of the energy supply and achieve regional CEs reduction targets.

Healthcare Professionals' Views of the Integrated County Healthcare Consortium in Zhejiang, China.

Introduction: The integrated county healthcare consortium (ICHC) is becoming an important measure to improve the capacity of primary-level medical services and to achieve grading diagnosis and treatment system in China. However, it is not clear whether health professionals are satisfied with this reform and what are the problems with it. This study aimed to understand the satisfaction of healthcare professionals to the ICHC in Zhejiang Province, China, and analyze the problems and improvement measures of the ICHC. Methods: A cross-sectional study was carried out in the 11 pilot counties (cities and districts) implementing the construction of the ICHC in Zhejiang in November 2019. Healthcare professionals from the leading county-level hospital, three township health centers (THCs) or community health centers (CHCs) in each ICHC were invited to participate in this survey. Results: A total of 3531 healthcare professionals were included, 85.92% of the participants agreed that the integration of the Centers for Disease Control and Prevention (CDC) and other professional public health institutions into the construction of ICHC could actively promote basic public health work. The most severe problem was the lack of financial guarantee fund input (severity score: 2.92 ± 1.76). The most crucial measure to promote the construction of the ICHC was to increase government financial input and improve the security mechanism (importance score: 4.81 ± 0.47). The satisfaction of the healthcare professionals to the ICHC was 89.41%. The satisfaction of healthcare professionals from county-level hospitals was 2.37 (95% CI: 1.760-3.238) times higher than that of healthcare professionals from the township health centers (THCs) or community health centers (CHCs). The satisfaction of health professionals with a college degree or below was 3.215 (95% CI: 1.413-6.786) times higher than that of health professionals with a master's degree or above. Conclusions: Zhejiang Province has taken adequate measures to promote the construction of the ICHC. However, there are still some problems. Appropriate and effective policies should be implemented to enhance policy coordination and promote competition among ICHCs, as well as to strengthen medical service quality management and improve performance appraisal scheme.

Evaluation of the Introduction of a Colorectal Bundle in Left Sided Colorectal Resections (EvaCol): Study Protocol of a Multicentre, Observational Trial.

Purpose: Overall complication and leak rates in colorectal surgery showed only minor improvements over the last years and remain still high. While the introduction of the WHO Safer Surgery Checklist has shown a reduction of overall operative mortality and morbidity in general surgery, only minor attempts have been made to improve outcomes by standardizing perioperative processes in colorectal surgery. Nevertheless, a number of singular interventions have been found reducing postoperative complications in colorectal surgery. The aim of the present study is to combine nine of these measures to a catalogue called colorectal bundle (CB). This will help to standardize pre-, intra-, and post-operative processes and therefore eventually reduce complication rates after colorectal surgery. Methods: The study will be performed among nine contributing hospitals in the extended north-western part of Switzerland. In the 6-month lasting control period the patients will be treated according to the local standard of each contributing hospital. After a short implementation phase all patients will be treated according to the CB for another 6 months. Afterwards complication rates before and after the implementation of the CB will be compared. Discussion: The overall complication rate in colorectal surgery is still high. The fact that only little progress has been made in recent years underlines the relevance of the current project. It has been shown for other areas of surgery that standardization is an effective measure of reducing postoperative complication rates. We hypothesize that the combination of effective, individual components into the CB can reduce the complication rate. Trial registration: Registered in ClinicalTrials.gov on 11/03/2020; NCT04550156. Highlights: Purpose: Overall complications in colorectal surgery remain still highStandardizing can reduce overall operative mortality and morbidityOnly minor attempts have been made to standardize perioperative processes in colorectal surgerySingular interventions have been found reducing postoperative complicationsThe aim is to combine nine of these measures to a colorectal bundle (CB)The CB will help to reduce complication rates after colorectal surgery Methods: The observational study will be performed among nine hospitals in SwitzerlandSix month the patients will be treated according to the local standardsAfterwards patients will be treated according to the CB for another six monthsComplication rates before and after the implementation of the CB will be compared Discussion: Only little progress has been made to reduce complication rate in colorectal surgeryStandardization is an effective measure of reducing complication ratesThe combination of effective, individual components into the CB can reduce the complication rate.

Assessment of the spatial distribution of cereal yields on sandy soil related to the application of soil-improving cropping systems (SICS).

Sandy soils occur in different regions throughout the world. In spite of poor quality, they are being used in crop production. The use of sandy soils for crop production requires soil-improving cropping systems (SICS). The aim of this study was to determine the spatial relationships of soil properties including intrinsic texture and relatively stable organic carbon, pH(KCl), cation exchange capacity, and cereal yield (grain and straw yields and plant height) in response to random application of SICS using geostatistics and maps. A 4-year field experiment included the following crop rotation: oat, wheat, wheat and oat and SICS: the control (C) and SICS: liming (L), leguminous catch crops for green manure (LU), farmyard manure (M), and farmyard manure+liming+leguminous catch crops together (M + L + LU). The use of the soil properties as auxiliary variables in the cross-semivariograms improved the prediction of the spatial distribution of the cereal yield, compared to the semi-variograms. The cokriging maps showed positional similarity between the cereal yield, the application of some SICS, and soil textural fractions. The application of M and M + L + LU providing the greatest amounts of organic matter and nitrogen was an effective measure in increasing cereal yields in sub-areas with low contents of sand, compared with the C, L, and LU variants. This increase in the yield was most pronounced in the last study year with an adequate rainfall amount and distribution during the growing season. The similar spatial effects of the SICS M and M + L + LU suggest that the application of M can be in part replaced by incorporation of atmospheric nitrogen-fixing legume catch crops and liming with maintenance of the same productivity and nitrogen supply. The spatial interrelations of the yield response, soil texture, and SICS type will help in selection of the most effective SICS in terms of cereal productivity, depending on local soil conditions.

Harnessing electronic clinical data to report adult and prenatal immunization quality measures.

OBJECTIVE: To explore the use of health plan quality measures specified for electronic clinical data to monitor immunizations. MATERIALS AND METHODS: We analyzed 2018 data submitted by health plans reporting 2 new Healthcare Effectiveness Data and Information Set measures assessing receipt of clinically recommended vaccines among pregnant women and adults. We analyzed the number of plans reporting a valid performance rate and electronic data source used. We consulted expert panels and reviewed coverage rates from other sources to understand the results. RESULTS: We received 136 data submissions across commercial, Medicaid and Medicare plans and 87 submissions across commercial and Medicaid plans for the adult and prenatal immunization measures, respectively. These submissions represent approximately 15% of possible submissions. Plans used claims, registries and electronic health records. Mean performance rates for adult immunizations were 21.2 (commercial), 14.0 (Medicaid) and 19.5% (Medicare). Mean rates for prenatal immunizations were 33.1 (commercial) and 16.7% (Medicaid). DISCUSSION: Results from the first year of reporting 2 electronic clinical data measures suggest health plans can feasibly report these measures and are seeking electronic data to supplement claims. Comparison of rates to other national results showed lower than expected rates for the adult immunization measure. However, prenatal immunization rates were on par with those from a national survey, suggesting this measure is closer to use for quality improvement. CONCLUSION: Quality measure reporting that encourages connection to electronic data sources is a step forward in performance monitoring and improvement. The use of electronic sources may advance health information exchange for patient care.

Application of layered double hydroxide-biochar composites in wastewater treatment: Recent trends, modification strategies, and outlook.

In recent years, layered double hydroxide-biochar (LDH-BC) composites as adsorbents and catalysts for contaminants removal (inorganic anions, heavy metals, and organics) have received increasing attention and became a new research point. It is because of the good chemical stability, abundant surface functional groups, excellent anion exchange ability, and good electronic properties of LDH-BC composites. Hence, we offer an overall review on the developments and processes in the synthesis of LDH-BC composites as adsorbents and catalysts. Special attention is devoted to the strategies for enhancing the properties of LDH-BC composites, including (1) magnetic treatment, (2) acid treatment, (3) alkali treatment, (4) controlling metal ion ratios, (5) LDHs intercalation, and (6) calcination. In addition, further studies are called for LDH-BC composites and potential areas for future application of LDH-BC composites are also proposed.

Regular performance feedback may be key to maintain good quality DKA management: results from a five-year study.

Objectives: We postulate that performance feedback is a prerequisite to ensure sustained improvement in diabetic ketoacidosis (DKA) management. Design: The study was based on 'theory of change' concept that suggests changes of primary drivers determine the main outcome. A set of secondary drivers can be implemented to achieve improvements in these primary drivers and thus the main outcome. Setting: This study was conducted at a large tertiary care center in the West Midlands, UK. The region has above average prevalence of diabetes and DKA admissions in the country. Participants: All participants diagnosed with DKA as per national guidelines, except those managed in intensive care unit from April 2014 to March 2018, were included in this study. Interventions: Monthly feedback of performance was the main intervention. Development of a real-time live DKA audit tool, automatic referral system of DKA to the specialist team, electronic monitoring of blood gas measurements and education and redesigning of local (trust) guidelines were the other interventions in this study. Main outcome measures: Total DKA duration, appropriateness of fixed rate intravenous insulin infusion, fluid prescription, glucose monitoring, ketone monitoring and referral to specialists. Results: There was a significant reduction in the duration of DKA postintervention compared with baseline results. However, in the absence of regular feedback, the duration of DKA showed an upward trend nearing baseline values. Similar trends were noted in secondary drivers influencing DKA duration. Conclusion: Based on these results, we recommend regular audit and feedback is required to sustain improvements in DKA management.