Teaching reform is an important work indispensable for the long-term development of the open university,and it is also the development trend of the advertising art design major in open education to keep up with the ne...Teaching reform is an important work indispensable for the long-term development of the open university,and it is also the development trend of the advertising art design major in open education to keep up with the new media era.Based on the current situation of advertising art design major in open education,this paper analyzes the necessity of implementing the online and offline mixed teaching reform in this major,and puts forward the specific teaching reform measures in three aspects.展开更多
Under the tide of"Internet+education",the new means of information technology education is constantly used in education and teaching,and the traditional teaching models and teaching methods urgently need to ...Under the tide of"Internet+education",the new means of information technology education is constantly used in education and teaching,and the traditional teaching models and teaching methods urgently need to be changed.There is no doubt about the integration of online teaching and offline teaching.On the basis of reviewing the research on the mixed teaching model at home and abroad,this paper puts forward the idea of constructing the mixed teaching model in colleges and universities in the context of"Internet+",and sets up the mixed teaching model in colleges and universities in the context of"Internet+".Through the detailed and concrete design of the operation process of the mixed teaching model,we can break the single shackles of online teaching and face-to-face teaching,and form an interactive and collaborative teaching ecosystem to realize the common development of online teaching and offline teaching.展开更多
Objective:To observe the application effect of“online+offline”mixed teaching mode in clinical nursing teaching.Methods:A total of 72 clinical nursing workers,who work in PLA General Hospital and participated in the ...Objective:To observe the application effect of“online+offline”mixed teaching mode in clinical nursing teaching.Methods:A total of 72 clinical nursing workers,who work in PLA General Hospital and participated in the experiment from March 2019 to March 2021,were selected as the subjects of this study.According to the odd numbers assigned to the participants’names,the participants were divided into two groups:the experimental group and the control group,with 36 cases in each group.The experimental group received“online+offline”hybrid teaching,whereas the control group received traditional offline teaching.In order to evaluate the efficacy and safety of the two groups of nursing workers,their assessment scores,teaching satisfaction scores,and teaching evaluation indicators were observed.Results:The experimental group was significantly better than the control group in terms of assessment scores,teaching satisfaction scores,and teaching evaluation indicators(P<0.05).Conclusion:In clinical nursing teaching,the“online+offline”mixed teaching mode plays a unique role in improving students’scores and teaching quality;thus,it should be promoted.展开更多
Under the premise of building an innovative country and cultivating innovative talents,teaching innovative learning,cultivating students’innovative thinking and improving the teaching mode and curriculum form have al...Under the premise of building an innovative country and cultivating innovative talents,teaching innovative learning,cultivating students’innovative thinking and improving the teaching mode and curriculum form have already become one of the main directions of deepening the reform of higher education.Data Structure is essential part in the undergraduate program.It is crucial for student to carry out research and project.In the actual teaching activities,the problems of content updating,practice ability for research projects of data structures are to be improved.Therefore,the course reform is imperative.This paper analyzed the main problems of the current data structures course,explored the solution of the problems,and proposed a new mixed teaching mode and evaluation method.展开更多
The mixed teaching mode plays an increasingly important role in stimulating students’interest and autonomy in learning,and strengthening students’learning ability.The full integration of mixed teaching mode and micr...The mixed teaching mode plays an increasingly important role in stimulating students’interest and autonomy in learning,and strengthening students’learning ability.The full integration of mixed teaching mode and microelectronics teaching can not only achieve the teaching objectives smoothly,but also enable students to deepen their understanding and memory of relevant knowledge with the help of diversified and interesting teaching methods.Therefore,this paper takes the microelectronics course as an example to practice and explore the effective ways to carry out the mixed teaching mode.Teachers should not make full use of online and offline teaching resources,but also actively improve the traditional assessment systems.Through the continuous improvement of the practicality of online and offline teaching content,an easy-to-complex teaching method with a coherent content structure can be adopted to stimulate students’learning motivation,improve their enthusiasm for participation,and lay a solid foundation for further improvements in the teaching of microelectronics technology.展开更多
The current MOOC platform gradually enters the college classroom,which has a great impact on improving the quality and efficiency of classroom teaching in colleges and universities.This paper mainly introduces the mea...The current MOOC platform gradually enters the college classroom,which has a great impact on improving the quality and efficiency of classroom teaching in colleges and universities.This paper mainly introduces the meaning and content of MOOC and the related teaching mode,and introduces its development and characteristics.In view of the shortcomings of the current MOOC platform courses and the problems existing in the hybrid teaching,the two are fully combined to propose a hybrid teaching mode based on MOOC.This kind of teaching mode is discussed.Taking the college English class as an example,the analysis is carried out from the teaching object to discuss whether the teaching mode is in line with the current teaching development.From the aspects of curriculum structure setting,teaching resource construction and teaching design,it is analyzed how to implement this teaching mode better in the teaching of college English.Further guidance and optimization of MOOC application in college English teaching,and the application of MOOC-based hybrid teaching mode in teaching.展开更多
In order to study the effects of in-class and out-of-class activities of college English based on the mixed teaching model on the fostering of students' English learning and application ability,the attitudes of 21...In order to study the effects of in-class and out-of-class activities of college English based on the mixed teaching model on the fostering of students' English learning and application ability,the attitudes of 215 freshmen of Agricultural College,Yanbian University towards inclass and out-of-class activities and their participation and completion of tasks were investigated by a questionnaire. The results show that a series of in-class and out-of-class activities could help improve the students' language competence as well as non-language competence such as learning strategies,emotional attitudes,and cultural awareness. The implementation and effect of school online courses were inferior to classroom teaching,but they provide reference and experience for future mixed teaching.展开更多
Mixed neuroendocrine non-neuroendocrine neoplasms(MiNENs)are a hetero-geneous group of malignant neoplasms that can settle in the gastroenteropan-creatic tract.They are composed of a neuroendocrine(NE)and a non-NE com...Mixed neuroendocrine non-neuroendocrine neoplasms(MiNENs)are a hetero-geneous group of malignant neoplasms that can settle in the gastroenteropan-creatic tract.They are composed of a neuroendocrine(NE)and a non-NE compo-nent in at least 30%of each tumour.The non-NE component can include different histological combinations of glandular,squamous,mucinous and sarcomatoid phenotypes,and one or both of the components can be low-or high grade malignant.Recent changes in the nomenclature of these neoplasms might lead to great deal of confusion,and the lack of specific clinical trials is the main reason why their management is difficult.The review aims to clarify the definition of MiNEN and analyze available evidence about their diagnosis and treatment options according to their location and extension through careful analysis of the available data.It would be important to reach a general consensus on their diagnosis in order to construct a classification that remains stable over time and facilitates the design of clinical trials that,due to their low incidence,will require long recruitment periods.展开更多
The migration of healthcare professionals,including nurses,is a global phenomenon.It is driven by various factors,including the pursuit of better opportunities,living conditions,and professional development,as well as...The migration of healthcare professionals,including nurses,is a global phenomenon.It is driven by various factors,including the pursuit of better opportunities,living conditions,and professional development,as well as political instability or conflict in their home countries.The World Health Organization(WHO)has noted that high-income countries often rely on foreign-trained nurses to fill gaps in their healthcare systems[1].For instance,as of 2021,over 40%(52 million)of all nurses in the United States(US)were expatriates[2].In the United Kingdom(UK),the percentage of expatriate nurses was even higher,reaching approximately 18%in 2021[3].Owing to globalization and migration,healthcare providers must possess cultural competence to deliver improved care[4,5].Culturally responsive teaching(CRT)is rooted in the idea that culture plays a vital role in shaping people’s behaviors,beliefs,values,and communication styles[6].Furthermore,these cultural factors influence patients’perspectives on health,illness,healing,and their preferences for care and communication[7].By recognizing and embracing these cultural differences,nurses can provide more effective and compassionate care to their diverse patient population[8].展开更多
A summary of the exploration of the teaching mode of the general practice teaching clinic, a summary of the deficiencies of the teaching clinic and a summary of the significance of the establishment of the general pra...A summary of the exploration of the teaching mode of the general practice teaching clinic, a summary of the deficiencies of the teaching clinic and a summary of the significance of the establishment of the general practice teaching clinic are presented with a view to promoting the development of general practice and cultivating more excellent successors in general practice.展开更多
Tree-ring chronologies were developed for Sabina saltuaria and Abies faxoniana in mixed forests in the Qionglai Mountains of the eastern Tibetan Plateau.Climate-growth relationship analysis indicated that the two co-e...Tree-ring chronologies were developed for Sabina saltuaria and Abies faxoniana in mixed forests in the Qionglai Mountains of the eastern Tibetan Plateau.Climate-growth relationship analysis indicated that the two co-exist-ing species reponded similarly to climate factors,although S.saltuaria was more sensitive than A.faxoniana.The strong-est correlation was between S.saltuaria chronology and regional mean temperatures from June to November.Based on this relationship,a regional mean temperature from June to November for the period 1605-2016 was constructed.Reconstruction explained 37.3%of the temperature variance during th period 1961-2016.Six major warm periods and five major cold periods were identified.Spectral analysis detected significant interannual and multi-decadal cycles.Reconstruction also revealed the influence of the Atlantic Multi-decadal Oscillation,confirming its importance on climate change on the eastern Tibetan Plateau.展开更多
Thinning is an effective management step for sustainable forest development,yet less attention is paid to the restoration of soil microbiota after thinning.In this study,both abundant and rare soil microbial communiti...Thinning is an effective management step for sustainable forest development,yet less attention is paid to the restoration of soil microbiota after thinning.In this study,both abundant and rare soil microbial communities(i.e.,bacterial,fungal),were evaluated under various thinning treatments in a mixed stand of Cunninghamia lanceolata and Sassafras tzumu using Mi Seq sequencing.Thinning did not significantly change either abundant or rare bacterial and fungal community composition,but affected their alpha diversity.The Shannon–Wiener indexes of rare fungal taxa under medium thinning were significantly lower than in the light thinning(P<0.05 level).Xanthobacteraceae dominated the abundant bacterial taxa,and Saitozyma and Mortierlla the abundant fungal taxa.The most common rare bacterial taxa varied;there was no prevalent rare fungal taxa under different thinnings.In addition,soil available nitrogen,total phosphorus,and p H had significant effects on rare bacterial taxa.Nutrients,especially available phosphorus,but not nitrogen,affected abundant and rare soil fungi.The results indicate that soil properties rather than plant factors affect abundant and rare microbial communities in soils of mixed stands.Thinning,through mediating soil properties,influences both abundant and rare bacterial and fungal communities in the mixed C.lanceolata and S.tzumu stand.展开更多
BACKGROUND With the continuous development and progress of medical technology,the position of surgical nursing in the field of clinical medicine is becoming in-creasingly prominent.As an important branch of the surgic...BACKGROUND With the continuous development and progress of medical technology,the position of surgical nursing in the field of clinical medicine is becoming in-creasingly prominent.As an important branch of the surgical field,the nursing requirements and difficulty of gastrointestinal surgery are also increasing.In order to improve the teaching quality of nursing care in gastrointestinal surgery,many educators and researchers are actively exploring new teaching methods.Among them,the teaching method case-based learning(CBL),scene-simulated learning(SSL),task-based learning(TBL),combining self-evaluation and training mode is considered as an effective method.This method aims to help students to better master knowledge and skills and improve their comprehensive quality by cultivating their self-evaluation ability.AIM To explore the practical effect of CBL-SSL-TBL combined with training mode and student self-assessment in nursing teaching of gastrointestinal surgery.METHODS Seventy-one nursing interns in our hospital from December 2020 to December 2021 were selected.According to different teaching modes,they were divided into observation group CBL-SSL-TBL combined with training mode combined with student self-assessment and control group(conventional teaching mode),of which 36 were in observation group and 35 were in control group.The results of operational skills,theoretical knowledge,nursing students'satisfaction,learning effectiveness questionnaire and teaching effect were compared between the two groups.RESULTS Compared between the two groups,the operational skills and theoretical knowledge scores of the observation group were higher than those of the control group,and the difference was statistically significant(P<0.05).Compared between the two groups,the total satisfaction ratio of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).Compared between the two groups,the observation group was lower than the control group in the questionnaire results of learning efficacy,and the difference was statistically significant(P<0.05).Compared between the two groups,the proportion of thinking ability,subjective initiative and understanding of theoretical knowledge in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).CONCLUSION The use of CBL-SSL-TBL combined with training mode and student self-assessment in gastrointestinal surgery nursing teaching can improve the operational skills of nursing interns,theoretical knowledge and satisfaction scores of nursing students,improve the results of learning efficiency questionnaire and teaching effect,which can be popularized in clinical teaching.展开更多
In time-variant reliability problems,there are a lot of uncertain variables from different sources.Therefore,it is important to consider these uncertainties in engineering.In addition,time-variant reliability problems...In time-variant reliability problems,there are a lot of uncertain variables from different sources.Therefore,it is important to consider these uncertainties in engineering.In addition,time-variant reliability problems typically involve a complexmultilevel nested optimization problem,which can result in an enormous amount of computation.To this end,this paper studies the time-variant reliability evaluation of structures with stochastic and bounded uncertainties using a mixed probability and convex set model.In this method,the stochastic process of a limit-state function with mixed uncertain parameters is first discretized and then converted into a timeindependent reliability problem.Further,to solve the double nested optimization problem in hybrid reliability calculation,an efficient iterative scheme is designed in standard uncertainty space to determine the most probable point(MPP).The limit state function is linearized at these points,and an innovative random variable is defined to solve the equivalent static reliability analysis model.The effectiveness of the proposed method is verified by two benchmark numerical examples and a practical engineering problem.展开更多
In order to better carry out research on education and teaching,the author consulted relevant literature on blended teaching mode from 2011-2021 through CNKI,Web of Science and other websites,summarized and analyzed t...In order to better carry out research on education and teaching,the author consulted relevant literature on blended teaching mode from 2011-2021 through CNKI,Web of Science and other websites,summarized and analyzed the research status of blended teaching mode,in order to lay a good foundation for studying blended teaching mode in course teaching.展开更多
Herein,binary mixed brushes consisting of poly(2-methyl-2-oxazoline)(PMOXA)and poly(2-(dimethylamine)ethyl methacrylate)(PDMAEMA)with different chain lengths were fabricated by successive grafting of NH_(2)-terminated...Herein,binary mixed brushes consisting of poly(2-methyl-2-oxazoline)(PMOXA)and poly(2-(dimethylamine)ethyl methacrylate)(PDMAEMA)with different chain lengths were fabricated by successive grafting of NH_(2)-terminated PMOXA and SH-terminated PDMAEMA onto polydopamine-anchored substrates.The mixed-brush coating was characterized by variable-angle spectroscopic ellipsometry,X-ray photoelectron spectroscopy,Fourier transform infrared spectroscopy,zeta potential measurements,water contact angle,and atomic force microscopy.The mixed brushes showed tunable surface charge,wettability,and surface roughness,depending on the degree of PDMAEMA swelling under varying pH and ionic strength(Ⅰ).Then the adsorption behaviors of pepsin,bovine serum albumin(BSA),γ-globulin,and lysozyme,four very different proteins with regard to isoelectric point,on the mixed brushes coating were studied by using fluorescence microscopy and surface plasmon resonance.When the chain length of PDMAEMA was about twice as long as PMOXA,the mixed brushes not only had high adsorption capacity for pepsin,BSA,and y-globulin but also had a desorption efficiency of 86.9%,87.1%,and 93.5%,respectively.It is explained that electrostatic attraction between the protonated PDMAEMA and positively charged acidic proteins(pepsin and BSA,whose isoelectric points were below the pK_(a) of PDMAEMA)would drive the intensive adsorption(at pH 3,I=10^(-3)mol·L^(-1)for pepsin,and pH 5,I=10^(-5)mol·L^(-1)for BSA),while desorption was dominated by the hydrophilic PMOXA when PDMAEMA was shrinking(at pH 7,I=10^(-1)mol·L^(-1)for pepsin,and pH 9,I=10^(-1)mol·L^(-1)for BSA).Furthermore,the isoelectric precipitation led to the adsorption of neutral protein(γ-globulin,whose isoelectric point was near the pK_a of PDMAEMA)at pH 7,I=10^(-5)mol·L^(-1),while electrostatic repulsion and antifouling PMOXA triggered the desorption of y-globulin at pH 3,I-10^(-1)mol·L^(-1).However,alkaline protein(lysozyme,whose isoelectric point was higher than the pK_(a) of PDMAEMA)exhibited slight adsorption on PMOXA/PDMAEMA mixed brushes under test conditions,regardless of whether PMOXA or PDMAEMA occupied the outermost layer.The antibacterial property of the mixed brushes against Escherichia coli was investigated.PMOXA/PDMAEMA mixed brushes showed significant bactericidal activity at pH 3,I=10^(-3)mol·L^(-1),while the rinse of pH 9,I=10^(-1)mol·L^(-1)solution could remove most of the residual bacteria.This work not only enables controlled adsorption of proteins with different isoelectric points but also ensures that the surface of the coating is minimized from bacterial contamination.展开更多
Background: The rate of accidental dural puncture is particularly high during the period of training, especially in novices. The structured epidural teaching model (SETM) includes three standardized video lessons, the...Background: The rate of accidental dural puncture is particularly high during the period of training, especially in novices. The structured epidural teaching model (SETM) includes three standardized video lessons, the construction of a 3D epidural module by trainees and practical training by using an epidural simulator with and without the CompuFlo™ Epidural instrument. In this study we report the retrospective analysis of the accidental dural puncture rate of inexperienced trainees during their 6 months clinical practice rotation in obstetrics before and after the introduction of the SETM in our Institution. Method: We evaluated the incidence of accidental dural puncture before the introduction of the SETM methodology and afterwards by analyzing our departmental database from February 2019 to January 2023. All epidural blocks were executed by trainees who had never previously performed an epidural block and were about to begin their obstetrics rotation. Results: We analyzed 7415 epidurals: 3703 were performed before the introduction of the SETM methodology (control group) and 3712 afterwards (study group). The incidence of accidental dural puncture was 0.37% for the control group and 0.13% for the study group (p<.05). The probability of making an accidental dural puncture was 64% (OR: 0.36) lower for trainees who had the training than for those who did not. Conclusions: After the introduction of the structured teaching method, we observed a significant reduction of accidental dural puncture during the training period. We hope that our observation will encourage a constructive discussion among experts about the need to use standardized and validated tools as a valuable aid in teaching epidural anesthesia.展开更多
Based on the current situation of academic English teaching, this paper discusses “student-centered” teaching strategy in the Academic English Reading and Writing, and explore how to integrate it in classroom activi...Based on the current situation of academic English teaching, this paper discusses “student-centered” teaching strategy in the Academic English Reading and Writing, and explore how to integrate it in classroom activities.展开更多
基金Ningbo Open University 2023 university-level teaching reform project“Exploration and Practice of Online and Offline Mixed Teaching Reform in Advertising Art Design Major”(Project number:JG23-005)。
文摘Teaching reform is an important work indispensable for the long-term development of the open university,and it is also the development trend of the advertising art design major in open education to keep up with the new media era.Based on the current situation of advertising art design major in open education,this paper analyzes the necessity of implementing the online and offline mixed teaching reform in this major,and puts forward the specific teaching reform measures in three aspects.
基金Educational and Scientific Research Planning Project of Anhui Vocational and Adult Education Society—Exploration and Practice of the Mixed Teaching Model of Public Relations in Higher Vocational Colleges in the Context of"Internet+"(AGZ18121)。
文摘Under the tide of"Internet+education",the new means of information technology education is constantly used in education and teaching,and the traditional teaching models and teaching methods urgently need to be changed.There is no doubt about the integration of online teaching and offline teaching.On the basis of reviewing the research on the mixed teaching model at home and abroad,this paper puts forward the idea of constructing the mixed teaching model in colleges and universities in the context of"Internet+",and sets up the mixed teaching model in colleges and universities in the context of"Internet+".Through the detailed and concrete design of the operation process of the mixed teaching model,we can break the single shackles of online teaching and face-to-face teaching,and form an interactive and collaborative teaching ecosystem to realize the common development of online teaching and offline teaching.
文摘Objective:To observe the application effect of“online+offline”mixed teaching mode in clinical nursing teaching.Methods:A total of 72 clinical nursing workers,who work in PLA General Hospital and participated in the experiment from March 2019 to March 2021,were selected as the subjects of this study.According to the odd numbers assigned to the participants’names,the participants were divided into two groups:the experimental group and the control group,with 36 cases in each group.The experimental group received“online+offline”hybrid teaching,whereas the control group received traditional offline teaching.In order to evaluate the efficacy and safety of the two groups of nursing workers,their assessment scores,teaching satisfaction scores,and teaching evaluation indicators were observed.Results:The experimental group was significantly better than the control group in terms of assessment scores,teaching satisfaction scores,and teaching evaluation indicators(P<0.05).Conclusion:In clinical nursing teaching,the“online+offline”mixed teaching mode plays a unique role in improving students’scores and teaching quality;thus,it should be promoted.
文摘Under the premise of building an innovative country and cultivating innovative talents,teaching innovative learning,cultivating students’innovative thinking and improving the teaching mode and curriculum form have already become one of the main directions of deepening the reform of higher education.Data Structure is essential part in the undergraduate program.It is crucial for student to carry out research and project.In the actual teaching activities,the problems of content updating,practice ability for research projects of data structures are to be improved.Therefore,the course reform is imperative.This paper analyzed the main problems of the current data structures course,explored the solution of the problems,and proposed a new mixed teaching mode and evaluation method.
文摘The mixed teaching mode plays an increasingly important role in stimulating students’interest and autonomy in learning,and strengthening students’learning ability.The full integration of mixed teaching mode and microelectronics teaching can not only achieve the teaching objectives smoothly,but also enable students to deepen their understanding and memory of relevant knowledge with the help of diversified and interesting teaching methods.Therefore,this paper takes the microelectronics course as an example to practice and explore the effective ways to carry out the mixed teaching mode.Teachers should not make full use of online and offline teaching resources,but also actively improve the traditional assessment systems.Through the continuous improvement of the practicality of online and offline teaching content,an easy-to-complex teaching method with a coherent content structure can be adopted to stimulate students’learning motivation,improve their enthusiasm for participation,and lay a solid foundation for further improvements in the teaching of microelectronics technology.
基金This paper is one of the research results of the“Research on the Construction and Application of College English Mixed Teaching Mode Based on MOOC”of the 2018 Professor Cultivation Project of Nanning University(2018JSGC13)Research on the“Online and Offline”Mixed“Teaching Mode of College English Listening and Speaking Course Based on U Campus Intelligent Teaching Cloud Platform“of Education Reform Project of Nanning University in 2019(2019XJJG04)Teaching Team Construction Project of College English Course of Nanning University in 2017(2017XJJXTD05).
文摘The current MOOC platform gradually enters the college classroom,which has a great impact on improving the quality and efficiency of classroom teaching in colleges and universities.This paper mainly introduces the meaning and content of MOOC and the related teaching mode,and introduces its development and characteristics.In view of the shortcomings of the current MOOC platform courses and the problems existing in the hybrid teaching,the two are fully combined to propose a hybrid teaching mode based on MOOC.This kind of teaching mode is discussed.Taking the college English class as an example,the analysis is carried out from the teaching object to discuss whether the teaching mode is in line with the current teaching development.From the aspects of curriculum structure setting,teaching resource construction and teaching design,it is analyzed how to implement this teaching mode better in the teaching of college English.Further guidance and optimization of MOOC application in college English teaching,and the application of MOOC-based hybrid teaching mode in teaching.
基金Supported by the General Project of Higher Education Research of Jilin Association for Higher Education in 2018 (JGJX2018D352)
文摘In order to study the effects of in-class and out-of-class activities of college English based on the mixed teaching model on the fostering of students' English learning and application ability,the attitudes of 215 freshmen of Agricultural College,Yanbian University towards inclass and out-of-class activities and their participation and completion of tasks were investigated by a questionnaire. The results show that a series of in-class and out-of-class activities could help improve the students' language competence as well as non-language competence such as learning strategies,emotional attitudes,and cultural awareness. The implementation and effect of school online courses were inferior to classroom teaching,but they provide reference and experience for future mixed teaching.
文摘Mixed neuroendocrine non-neuroendocrine neoplasms(MiNENs)are a hetero-geneous group of malignant neoplasms that can settle in the gastroenteropan-creatic tract.They are composed of a neuroendocrine(NE)and a non-NE compo-nent in at least 30%of each tumour.The non-NE component can include different histological combinations of glandular,squamous,mucinous and sarcomatoid phenotypes,and one or both of the components can be low-or high grade malignant.Recent changes in the nomenclature of these neoplasms might lead to great deal of confusion,and the lack of specific clinical trials is the main reason why their management is difficult.The review aims to clarify the definition of MiNEN and analyze available evidence about their diagnosis and treatment options according to their location and extension through careful analysis of the available data.It would be important to reach a general consensus on their diagnosis in order to construct a classification that remains stable over time and facilitates the design of clinical trials that,due to their low incidence,will require long recruitment periods.
文摘The migration of healthcare professionals,including nurses,is a global phenomenon.It is driven by various factors,including the pursuit of better opportunities,living conditions,and professional development,as well as political instability or conflict in their home countries.The World Health Organization(WHO)has noted that high-income countries often rely on foreign-trained nurses to fill gaps in their healthcare systems[1].For instance,as of 2021,over 40%(52 million)of all nurses in the United States(US)were expatriates[2].In the United Kingdom(UK),the percentage of expatriate nurses was even higher,reaching approximately 18%in 2021[3].Owing to globalization and migration,healthcare providers must possess cultural competence to deliver improved care[4,5].Culturally responsive teaching(CRT)is rooted in the idea that culture plays a vital role in shaping people’s behaviors,beliefs,values,and communication styles[6].Furthermore,these cultural factors influence patients’perspectives on health,illness,healing,and their preferences for care and communication[7].By recognizing and embracing these cultural differences,nurses can provide more effective and compassionate care to their diverse patient population[8].
文摘A summary of the exploration of the teaching mode of the general practice teaching clinic, a summary of the deficiencies of the teaching clinic and a summary of the significance of the establishment of the general practice teaching clinic are presented with a view to promoting the development of general practice and cultivating more excellent successors in general practice.
基金This study was supported by the National Key Research and Development Program of China(No.2018YFA0605601)Hong Kong Research Grants Council(No.106220169)+1 种基金the National Natural Science Foundation of China(Nos.41671042,42077417,42105155,and 42201083)the National Geographic Society(No.EC-95776R-22).
文摘Tree-ring chronologies were developed for Sabina saltuaria and Abies faxoniana in mixed forests in the Qionglai Mountains of the eastern Tibetan Plateau.Climate-growth relationship analysis indicated that the two co-exist-ing species reponded similarly to climate factors,although S.saltuaria was more sensitive than A.faxoniana.The strong-est correlation was between S.saltuaria chronology and regional mean temperatures from June to November.Based on this relationship,a regional mean temperature from June to November for the period 1605-2016 was constructed.Reconstruction explained 37.3%of the temperature variance during th period 1961-2016.Six major warm periods and five major cold periods were identified.Spectral analysis detected significant interannual and multi-decadal cycles.Reconstruction also revealed the influence of the Atlantic Multi-decadal Oscillation,confirming its importance on climate change on the eastern Tibetan Plateau.
基金the Sino-German Cooperation Forestry Major Scientific Research Project(zdczhz2021ky09)the National Natural Science Foundation of China(31971487 and 42277245).
文摘Thinning is an effective management step for sustainable forest development,yet less attention is paid to the restoration of soil microbiota after thinning.In this study,both abundant and rare soil microbial communities(i.e.,bacterial,fungal),were evaluated under various thinning treatments in a mixed stand of Cunninghamia lanceolata and Sassafras tzumu using Mi Seq sequencing.Thinning did not significantly change either abundant or rare bacterial and fungal community composition,but affected their alpha diversity.The Shannon–Wiener indexes of rare fungal taxa under medium thinning were significantly lower than in the light thinning(P<0.05 level).Xanthobacteraceae dominated the abundant bacterial taxa,and Saitozyma and Mortierlla the abundant fungal taxa.The most common rare bacterial taxa varied;there was no prevalent rare fungal taxa under different thinnings.In addition,soil available nitrogen,total phosphorus,and p H had significant effects on rare bacterial taxa.Nutrients,especially available phosphorus,but not nitrogen,affected abundant and rare soil fungi.The results indicate that soil properties rather than plant factors affect abundant and rare microbial communities in soils of mixed stands.Thinning,through mediating soil properties,influences both abundant and rare bacterial and fungal communities in the mixed C.lanceolata and S.tzumu stand.
文摘BACKGROUND With the continuous development and progress of medical technology,the position of surgical nursing in the field of clinical medicine is becoming in-creasingly prominent.As an important branch of the surgical field,the nursing requirements and difficulty of gastrointestinal surgery are also increasing.In order to improve the teaching quality of nursing care in gastrointestinal surgery,many educators and researchers are actively exploring new teaching methods.Among them,the teaching method case-based learning(CBL),scene-simulated learning(SSL),task-based learning(TBL),combining self-evaluation and training mode is considered as an effective method.This method aims to help students to better master knowledge and skills and improve their comprehensive quality by cultivating their self-evaluation ability.AIM To explore the practical effect of CBL-SSL-TBL combined with training mode and student self-assessment in nursing teaching of gastrointestinal surgery.METHODS Seventy-one nursing interns in our hospital from December 2020 to December 2021 were selected.According to different teaching modes,they were divided into observation group CBL-SSL-TBL combined with training mode combined with student self-assessment and control group(conventional teaching mode),of which 36 were in observation group and 35 were in control group.The results of operational skills,theoretical knowledge,nursing students'satisfaction,learning effectiveness questionnaire and teaching effect were compared between the two groups.RESULTS Compared between the two groups,the operational skills and theoretical knowledge scores of the observation group were higher than those of the control group,and the difference was statistically significant(P<0.05).Compared between the two groups,the total satisfaction ratio of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).Compared between the two groups,the observation group was lower than the control group in the questionnaire results of learning efficacy,and the difference was statistically significant(P<0.05).Compared between the two groups,the proportion of thinking ability,subjective initiative and understanding of theoretical knowledge in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).CONCLUSION The use of CBL-SSL-TBL combined with training mode and student self-assessment in gastrointestinal surgery nursing teaching can improve the operational skills of nursing interns,theoretical knowledge and satisfaction scores of nursing students,improve the results of learning efficiency questionnaire and teaching effect,which can be popularized in clinical teaching.
基金partially supported by the National Natural Science Foundation of China(52375238)Science and Technology Program of Guangzhou(202201020213,202201020193,202201010399)GZHU-HKUST Joint Research Fund(YH202109).
文摘In time-variant reliability problems,there are a lot of uncertain variables from different sources.Therefore,it is important to consider these uncertainties in engineering.In addition,time-variant reliability problems typically involve a complexmultilevel nested optimization problem,which can result in an enormous amount of computation.To this end,this paper studies the time-variant reliability evaluation of structures with stochastic and bounded uncertainties using a mixed probability and convex set model.In this method,the stochastic process of a limit-state function with mixed uncertain parameters is first discretized and then converted into a timeindependent reliability problem.Further,to solve the double nested optimization problem in hybrid reliability calculation,an efficient iterative scheme is designed in standard uncertainty space to determine the most probable point(MPP).The limit state function is linearized at these points,and an innovative random variable is defined to solve the equivalent static reliability analysis model.The effectiveness of the proposed method is verified by two benchmark numerical examples and a practical engineering problem.
文摘In order to better carry out research on education and teaching,the author consulted relevant literature on blended teaching mode from 2011-2021 through CNKI,Web of Science and other websites,summarized and analyzed the research status of blended teaching mode,in order to lay a good foundation for studying blended teaching mode in course teaching.
基金the financial support of the National Natural Science Foundation of China(21674102)。
文摘Herein,binary mixed brushes consisting of poly(2-methyl-2-oxazoline)(PMOXA)and poly(2-(dimethylamine)ethyl methacrylate)(PDMAEMA)with different chain lengths were fabricated by successive grafting of NH_(2)-terminated PMOXA and SH-terminated PDMAEMA onto polydopamine-anchored substrates.The mixed-brush coating was characterized by variable-angle spectroscopic ellipsometry,X-ray photoelectron spectroscopy,Fourier transform infrared spectroscopy,zeta potential measurements,water contact angle,and atomic force microscopy.The mixed brushes showed tunable surface charge,wettability,and surface roughness,depending on the degree of PDMAEMA swelling under varying pH and ionic strength(Ⅰ).Then the adsorption behaviors of pepsin,bovine serum albumin(BSA),γ-globulin,and lysozyme,four very different proteins with regard to isoelectric point,on the mixed brushes coating were studied by using fluorescence microscopy and surface plasmon resonance.When the chain length of PDMAEMA was about twice as long as PMOXA,the mixed brushes not only had high adsorption capacity for pepsin,BSA,and y-globulin but also had a desorption efficiency of 86.9%,87.1%,and 93.5%,respectively.It is explained that electrostatic attraction between the protonated PDMAEMA and positively charged acidic proteins(pepsin and BSA,whose isoelectric points were below the pK_(a) of PDMAEMA)would drive the intensive adsorption(at pH 3,I=10^(-3)mol·L^(-1)for pepsin,and pH 5,I=10^(-5)mol·L^(-1)for BSA),while desorption was dominated by the hydrophilic PMOXA when PDMAEMA was shrinking(at pH 7,I=10^(-1)mol·L^(-1)for pepsin,and pH 9,I=10^(-1)mol·L^(-1)for BSA).Furthermore,the isoelectric precipitation led to the adsorption of neutral protein(γ-globulin,whose isoelectric point was near the pK_a of PDMAEMA)at pH 7,I=10^(-5)mol·L^(-1),while electrostatic repulsion and antifouling PMOXA triggered the desorption of y-globulin at pH 3,I-10^(-1)mol·L^(-1).However,alkaline protein(lysozyme,whose isoelectric point was higher than the pK_(a) of PDMAEMA)exhibited slight adsorption on PMOXA/PDMAEMA mixed brushes under test conditions,regardless of whether PMOXA or PDMAEMA occupied the outermost layer.The antibacterial property of the mixed brushes against Escherichia coli was investigated.PMOXA/PDMAEMA mixed brushes showed significant bactericidal activity at pH 3,I=10^(-3)mol·L^(-1),while the rinse of pH 9,I=10^(-1)mol·L^(-1)solution could remove most of the residual bacteria.This work not only enables controlled adsorption of proteins with different isoelectric points but also ensures that the surface of the coating is minimized from bacterial contamination.
文摘Background: The rate of accidental dural puncture is particularly high during the period of training, especially in novices. The structured epidural teaching model (SETM) includes three standardized video lessons, the construction of a 3D epidural module by trainees and practical training by using an epidural simulator with and without the CompuFlo™ Epidural instrument. In this study we report the retrospective analysis of the accidental dural puncture rate of inexperienced trainees during their 6 months clinical practice rotation in obstetrics before and after the introduction of the SETM in our Institution. Method: We evaluated the incidence of accidental dural puncture before the introduction of the SETM methodology and afterwards by analyzing our departmental database from February 2019 to January 2023. All epidural blocks were executed by trainees who had never previously performed an epidural block and were about to begin their obstetrics rotation. Results: We analyzed 7415 epidurals: 3703 were performed before the introduction of the SETM methodology (control group) and 3712 afterwards (study group). The incidence of accidental dural puncture was 0.37% for the control group and 0.13% for the study group (p<.05). The probability of making an accidental dural puncture was 64% (OR: 0.36) lower for trainees who had the training than for those who did not. Conclusions: After the introduction of the structured teaching method, we observed a significant reduction of accidental dural puncture during the training period. We hope that our observation will encourage a constructive discussion among experts about the need to use standardized and validated tools as a valuable aid in teaching epidural anesthesia.
文摘Based on the current situation of academic English teaching, this paper discusses “student-centered” teaching strategy in the Academic English Reading and Writing, and explore how to integrate it in classroom activities.
