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| 1 | Helicobacter pylori eradication therapy for functional dyspepsia: Systematic review and meta-analysis显示文摘AIM: To evaluate whether Helicobacter pylori(H. pylori) eradication therapy benefits patients with functional dyspepsia(FD).METHODS: Randomized controlled trials(RCTs) investigating the efficacy and safety of H. pylori eradication therapy for patients with functional dyspepsia published in English(up to May 2015) were identified by searching Pub Med, EMBASE, and The Cochrane Library. Pooled estimates were measured using the fixed or random effect model. Overall effect was expressed as a pooled risk ratio(RR) or a standard mean difference(SMD). All data were analyzed with Review Manager 5.3 and Stata 12.0.RESULTS: This systematic review included 25 RCTs with a total of 5555 patients with FD. Twenty-three of these studies were used to evaluate the benefits of H. pylori eradication therapy for symptom improvement; the pooled RR was 1.23(95%CI: 1.12-1.36, P < 0.0001). H. pylori eradication therapy demonstrated symptom improvement during long-term follow-up at ≥ 1 year(RR = 1.24; 95%CI: 1.12-1.37, P < 0.0001) but not during short-term follow-up at < 1 year(RR = 1.26; 95%CI: 0.83-1.92, P = 0.27). Seven studies showed no benefit of H. pylori eradication therapy on quality of life with an SMD of-0.01(95%CI:-0.11 to 0.08, P = 0.80). Six studies demonstrated that H. pylori eradication therapy reduced the development of peptic ulcer disease compared to no eradication therapy(RR = 0.35; 95%CI: 0.18-0.68, P = 0.002). Eight studies showed that H. pylori eradication therapy increased the likelihood of treatment-related side effects compared to no eradication therapy(RR = 2.02; 95%CI: 1.12-3.65, P = 0.02). Ten studies demonstrated that patients who received H. pylori eradication therapy were more likely to obtain histologic resolution of chronic gastritis compared to those who did not receive eradication therapy(RR = 7.13; 95%CI: 3.68-13.81, P < 0.00001).CONCLUSION: The decision to eradicate H. pylori in patients with functional dyspepsia requires individual assessment. | Li-Jun Du Bin-Rui Chen John J Kim Sarah Kim Jin-Hua Shen Ning Dai | 2016 | World Journal of Gastroenterology2016，22，12： | 30 |
| 2 | Rapid improvement of PM2.5 pollution and associated health benefits in China during 2013–2017显示文摘Exposure to fine particulate matter(PM2.5)is known to harm public health.In China,after implementation of aggressive emissions control measures under the Action Plan of Air Pollution Prevention and Control(2013-2017),air quality has significantly improved.In this work,we investigated changes in PM2.5 exposure and the associated health impacts in China for the period 2013-2017.We used an optimal estimator of PM2.5 combining in-situ observations,satellite measurements,and simulations from a chemical transport model to derive the spatial and temporal variations in PM2.5 exposure,and then used welldeveloped exposure-response functions to estimate the premature deaths attributable to PM2.5 exposure.We found that national population-weighed annual mean PM2.5 concentrations decreased from 67.4μgm-3 in 2013 to 45.5μgm-3 in 2017(32%reduction).This rapid decrease in PM2.5 pollution led to a 14%reduction in premature deaths due to long-term exposure.We estimated that,during 2013-2017,the premature deaths attributable to long-term PM2.5 exposure decreased from 1.2 million(95%CI:1.0,1.3;fraction of total mortality:13%)in 2013 to 1.0 million(95%CI:0.9,1.2;10%)in 2017.Despite the rapid decrease in annual mean PM2.5 concentrations,health benefits associated with reduced long-term exposure were limited,because for many cities,the PM2.5 levels remain at the portion where the exposure-response function is less steeper than that at the lowconcentration end.We also found that the deaths associated with acute exposure decreased by 61%during 2013-2017 due to rapid reduction in the number of heavily polluted days.Our results confirm that clean air policies in China have mitigated the air pollution crisis;however,continuous emissions reduction efforts are required to protect citizens from air pollution. | Tao XUE Jun LIU Qiang ZHANG Guannan GENG Yixuan ZHENG Dan TONG Zhu LIU Dabo GUAN Yu BO Tong ZHU Kebin HE Jiming HAO | 2019 | Science China Earth Sciences2019，62，12： | 17 |
| 3 | Computed tomography scan imaging in diagnosing acute uncomplicated pancreatitis: Usefulness vs cost显示文摘BACKGROUND Literature has suggested that imaging is over-utilized in the diagnosis of pancreatitis. If the diagnosis of acute pancreatitis(AP) is established with abdominal pain and increased serum amylase or lipase activity without systemic signs of severe disease, computed tomography(CT) imaging may not be necessary. We hypothesize that among patients with uncomplicated acute pancreatitis(AUP), there is a significant number of unwarranted CT imaging studies. This imposes increased expenditure and cost in our healthcare system and does not improve hospital stay or management of AUP.AIM To assess the overutilization and associated cost of CT imaging among patients meeting diagnostic criteria for AUP.METHODS In this Institutional Review Board-approved retrospective, single-center study,we identified all adult patients admitted with AP from January 1, 2012 through October 1, 2017. Patients were identified via International Classification of Diseases(ICD-9) code for AP(577.0) and ICD-10 codes for different etiological AP(K85.9 unspecified, K85.0 idiopathic, K85.1 biliary, K85.2 alcohol-induced, K85.3 drug-induced, and K85.8 other). Diagnosis was confirmed by chart review using established non-imaging diagnostic criteria(presence of typical abdominal pain and elevated lipase or amylase greater than 3 times upper limit of normal).Ranson criteria and BISAP scores on presentation were calculated and patients that met scores less than or equal to 2 for both were included to suggest AUP.The utilization and cost of imaging in these patients were recorded.RESULTS Between January 2012 and October 2017, 1305 patients presented to the emergency department with AP, and 405 patients(31%) met our inclusion criteria for AUP(201 males, 204 females; mean age 49 years, range 18-98). Of those, 210 patients(51.85%) underwent CT imaging. One patient(0.47%) had evidence of pancreatic necrosis, one patient had cyst formation(0.47%), and the remaining208 patients(99.05%) had either normal CT scan imaging or findings consistent with mild AP without necrosis. The average cost of CT scan imaging was $4510 with a total cost of $947056. Median length of hospitalization stay was 3 d among both groups. Combining Ranson's Criteria and BISAP score identified AUP in our patient population with an accuracy of 99.5%.CONCLUSION CT imaging is unnecessary when AUP is diagnosed clinically and biochemically.Reducing overuse of diagnostic CT scans will decrease healthcare expenditure and radiation exposure to patients. | Shana Kothari Michael Kalinowski Matthew Kobeszko Tarek Almouradi | 2019 | World Journal of Gastroenterology2019，25，9： | 5 |
| 4 | Interventions and targets aimed at improving quality in inflammatory bowel disease ambulatory care显示文摘Over the past decade,there has been increasing focus on improving the quality of healthcare delivered to patients with chronic diseases,including inflammatory bowel disease.Inflammatory bowel disease is a complex,chronic condition with associated morbidity,health care costs,and reductions in quality of life.The condition is managed primarily in the outpatient setting.The delivery of high quality of care is suboptimal in several ambulatory inflammatory bowel disease domains including objective assessments of disease activity,the use of steroid-sparing agents,screening prior to anti-tumor necrosis factor therapy,and monitoring thiopurine therapy.This review outlines these gaps in performance and provides potential initiatives aimed at improvement including reimbursement programs,quality improvement frameworks,collaborative efforts in quality improvement,and the use of healthcare information technology. | Adam V Weizman Geoffrey C Nguyen | 2013 | World Journal of Gastroenterology2013，19，38： | 4 |
| 5 | 一种河湖水系连通方案的综合评估方法——以汤逊湖湖泊群为例(英文)显示文摘The Interconnected River System Network (IRSN) plays a crucial role in water resource allocation, water ecological restoration and water quality improvement. It has become a key part of the urban lake management. An evaluation methodology system for IRSN project can provide important guidance for the selection of different water diversion schemes. However, few if any comprehensive evaluation systems have been developed to evaluate the hydrodynamics and water quality of connected lakes. This study developed a comprehensive evaluation system based on multi-indexes including aspects of water hydrodynamics, water quality and socioeconomics. A two-dimensional (2-D) mathematical hydrodynamics and water quality model was built, using NH_3-N, TN and TP as water quality index. The IRSN project in Tangxun Lake group was used as a testbed here, and five water diversion schemes were simulated and evaluated. Results showed that the IRSN project can improve the water fluidity and the water quality obviously after a short time of water diversion, while the improvement rates decreased gradually as the water diversion went on. Among these five schemes, Scheme V showed the most noticeable improvement in hydrodynamics and water quality, and brought the most economic benefits. This comprehensive evaluation method can provide useful reference for the implementation of other similar IRSN projects. | 杨卫 张利平 张艳军 李宗礼 肖宜 夏军 | 2019 | Journal of Geographical Sciences2019，29，3： | 4 |
| 6 | Quality monitoring in colonoscopy: Time to act显示文摘Colonoscopy is the gold standard test for colorectal cancer screening. The primary advantage of colonoscopy as opposed to other screening modalities is the ability to provide therapy by removal of precancerous lesions at the time of detection. However, colonoscopy may miss clinically important neoplastic polyps. The value of colonoscopy in reducing incidence of colorectal cancer is dependent on many factors including, the patient, provider, and facility level. A high quality examination includes adequate bowel preparation, optimal colonoscopy technique, meticulous inspection during withdrawal, identification of subtle flat lesions, and complete polypectomy. Considerable variation among institutions and endoscopists has been reported in the literature. In attempt to diminish this disparity, various approaches have been advocated to improve the quality of colonoscopy. The overall impact of these interventions is not yet well defined. Implementing optimal education and training and subsequently analyzing the impact of these endeavors in improvement of quality will be essential to augment the utility of colonoscopy for the prevention of colorectal cancer. | Mary A Atia Francisco C Ramirez Suryakanth R Gurudu | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，4： | 3 |
| 7 | Using quality improvement methods to increase use of pain prevention strategies for childhood vaccination显示文摘AIM To increase evidence-based pain prevention strategy use during routine vaccinations in a pediatric primary care clinic using quality improvement methodology.METHODS Specific intervention strategies(i.e.,comfort positioning,nonnutritive sucking and sucrose analgesia,distraction) were identified,selected and introduced in three waves,using a Plan-Do-Study-Act framework.System-wide change was measured from baseline to post-intervention by:(1) percent of vaccination visits during which an evidence-based pain prevention strategy was reported as being used; and(2) caregiver satisfaction ratings following the visit.Additionally,self-reported staff and caregiver attitudes and beliefs about pain prevention were measured at baseline and 1-year post-intervention to assess for possible long-term cultural shifts.RESULTS Significant improvements were noted post-intervention.Use of at least one pain prevention strategy was documented at 99% of patient visits and 94% of caregivers were satisfied or very satisfied with the pain prevention care received.Parents/caregivers reported greater satisfaction with the specific pain prevention strategy used [t(143) = 2.50,P ≤ 0.05],as well as greater agreement that the pain prevention strategies used helped their children's pain [t(180) = 2.17,P ≤ 0.05] and that they would be willing to use the same strategy again in the future [t(179) = 3.26,P ≤ 0.001] as compared to baseline.Staff and caregivers also demonstrated a shift in attitudes from baseline to 1-year post-intervention.Specifically,staff reported greater agreement that the pain felt from vaccinations can result in harmful effects [2.47 vs 3.10; t(70) =-2.11,P ≤ 0.05],less agreement that pain from vaccinations is 'just part of the process' [3.94 vs 3.23; t(70) = 2.61,P ≤ 0.05],and less agreement that parents expect their children to experience pain during vaccinations [4.81 vs 4.38; t(69) = 2.24,P ≤ 0.05].Parents/caregivers reported more favorable attitudes about pain prevention strategies for vaccinations across a variety of areas,including safety,cost,time,and effectiveness,as well as less concern about the pain their children experience with vaccination [4.08 vs 3.26; t(557) = 6.38,P ≤ 0.001],less need for additional pain prevention strategies [3.33 vs 2.81; t(476) = 4.51,P ≤ 0.001],and greater agreement that their doctors' office currently offers pain prevention for vaccinations [3.40 vs 3.75; t(433) =-2.39,P ≤ 0.05].CONCLUSION Quality improvement methodology can be used to help close the gap in implementing pain prevention strategies during routine vaccination procedures for children. | Jennifer Verrill Schurman Amanda D Deacy Rebecca J Johnson Jolynn Parker Kristi Williams Dustin Wallace Mark Connelly Lynn Anson Kevin Mroczka | 2017 | World Journal of Clinical Pediatrics2017，6，1： | 3 |
| 8 | Variation and trends in dough rheological properties and flour quality in 330 Chinese wheat varieties显示文摘The objective of this study was to investigate variation and trends in dough rheological properties and flour quality traits in 330 Chinese wheat varieties. The dough rheological properties of development time(DT), stability time(ST), and farinograph quality number(FQN)were evaluated, as well as the flour quality traits of protein(PC), wet gluten content(WGC), and sedimentation value(SV). The coefficients of variation of DT(40.5%), ST(58.1%), and FQN(42.4%) were higher than those of PC(9.1%), WGC(10.1%), and SV(15.3%). Normal distributions were observed for the flour quality indices but not for the rheological parameters. SV was strongly correlated with the three rheological parameters and accordingly might be used as a primary indicator for dough rheological property evaluation. Our results showed that there has been marked improvement in dough rheological properties for Chinese wheat varieties released since 1986, while flour quality has remained stable. | Xiushi Yang Li Wu Zhihua Zhu Guixing Ren Sancai Liu | 2014 | The Crop Journal2014，2，4： | 2 |
| 9 | Rates of surgical site infection as a performance measure:Are we ready?显示文摘With the introduction of quality assurance in health care delivery,there has been a proliferation of research studies that compare patient outcomes for similar conditions among many health care delivery facilities.Since the 1990s,increasing interest has been placed in the incorporation of clinical adverse events as quality indicators in hospital quality assurance programs.Adverse post-operative events,and very especially surgical site infection(SSI) rates after specif ic procedures,gained popularity as hospital quality indicators in the 1980s.For a SSI rate to be considered a valid indicator of the quality of care,it is essential that a proper adjustment for patient case mix be performed,so that meaningful comparisons of SSI rates can be made among surgeons,institutions,or over time.So far,a signif icant impediment to developing meaningful hospital-acquired infection rates that can be used for intra-and inter-hospital comparisons has been the lack of an adequate means of adjusting for case mix.This paper discusses what we have learned in the last years regarding risk adjustment of SSI rates for provider performance assessment,and identif ies areas in which signif icant improvement is still needed. | Fernando Martín Biscione | 2009 | World Journal of Gastrointestinal Surgery2009，1，1： | 2 |
| 10 | Improving cirrhosis care: The potential for telemedicine and mobile health technologies显示文摘Decompensated cirrhosis is a condition associated with significant morbidity and mortality. While there have been significant efforts to develop quality metrics that ensure high-value care of these patients, wide variations in clinical practice exist. In this opinion review, we discuss the quality gap in the care of patients with cirrhosis, including low levels of compliance with recommended cancer screening and other clinical outcome and patient-reported outcome measures. We posit that innovations in telemedicine and mobile health (mHealth) should play a key role in closing the quality gaps in liver disease management. We highlight interventions that have been performed to date in liver disease and heart failurefrom successful teleconsultation interventions in the care of veterans with cirrhosis to the use of telemonitoring to reduce hospital readmissions and decrease mortality rates in heart failure. Telemedicine and mHealth can effectively address unmet needs in the care of patients with cirrhosis by increasing preventative care, expanding outreach to rural communities, and increasing high-value care. We aim to highlight the benefits of investing in innovative solutions in telemedicine and mHealth to improve care for patients with cirrhosis and create downstream cost savings. | Matthew Jonathon Stotts Justin Alexander Grischkan Vandana Khungar | 2019 | World Journal of Gastroenterology2019，25，29： | 2 |
| 11 | Quality of care delivered to hospitalized inflammatory bowel disease patients显示文摘Hospitalized patients with inflammatory bowel disease(IBD)are at high risk for morbidity,mortality,and health care utilization costs.While the literature on trends in hospitalization rates for this disease is conflicting,there does appear to be significant variation in the delivery of care to this complex group,which may be a marker of suboptimal quality of care.There is a need for improvement in identifying patients at risk for hospitalization in an effort to reduce admissions.Moreover,appropriate screening for a number of hospital acquired complications such as venous thromboembolism and Clostridium difficile infection is suboptimal.This review discusses areas of inpatient care for IBD patients that are in need of improvement and outlines a number of potential quality improvement initiatives such as payfor-performance models,quality improvement frameworks,and healthcare information technology. | Adam V Weizman Geoffrey C Nguyen | 2013 | World Journal of Gastroenterology2013，19，38： | 1 |
| 12 | Impact of endoscopic ultrasound quality assessment on improving endoscopic ultrasound reports and procedures显示文摘AIM: To evaluate the impact of endoscopic ultrasonography(EUS) quality assessment on EUS procedures by comparing the most recent 2013-2014 local EUS procedural reports against relevant corresponding data from a 2009 survey of EUS using standardized quality indicators(QIs). METHODS: Per EUS exam, 27 QIs were assessed individually and by grouping pre-, intra-, and postprocedural parameters. The recorded QI frequencies from 200 reports(2013-2014) were compared to corresponding data of 100 reports from the quality control study of EUS in 2009. Data for QIs added after 2009 to professional guidelines(added after 2010) were also tabulated. RESULTS: Significant differences(P-value < 0.05) were found for 13 of 20 of the relevant QIs examined. 4 of 5 pre-procedural QIs, 6 of 10 intra-procedural QIs, and 3 of 5 post-procedural QIs all demonstrated significant upgrading with a P-value < 0.05. CONCLUSION: Significant improvements were demonstrated in QI adherence and thus EUS reporting and delivery quality when the 2013-2014 reports were compared to 2009 results. QI implementation facilitates effective high-quality EUS exams by ensuring comprehensive documentation while limiting error. | Ryan Schwab Eugene Pahk Jesse Lachter | 2016 | World Journal of Gastrointestinal Endoscopy2016，8，8： | 1 |
| 13 | Preoperative bowel preparation does not favor the management of colorectal anastomotic leak显示文摘BACKGROUND Controversy exists regarding the impact of preoperative bowel preparation on patients undergoing colorectal surgery. This is due to previous research studies,which fail to demonstrate protective effects of mechanical bowel preparation against postoperative complications. However, in recent studies, combination therapy with oral antibiotics(OAB) and mechanical bowel preparation seems to be beneficial for patients undergoing an elective colorectal operation.AIM To determine the association between preoperative bowel preparation and postoperative anastomotic leak management(surgical vs non-surgical).METHODS Patients with anastomotic leak after colorectal surgery were identified from the 2013 and 2014 Colectomy Targeted American College of Surgeons National Surgical Quality Improvement Program(ACS-NSQIP) database and were employed for analysis. Every patient was assigned to one of three following groups based on the type of preoperative bowel preparation: first groupmechanical bowel preparation in combination with OAB, second groupmechanical bowel preparation alone, and third group-no preparation.RESULTS A total of 652 patients had anastomotic leak after a colectomy from January 1,2013 through December 31, 2014. Baseline characteristics were assessed and found that there were no statistically significant differences between the three groups in terms of age, gender, race, American Society of Anesthesiologists score,and other preoperative characteristics. A χ~2 test of homogeneity was conducted and there was no statistically/clinically significant difference between the three categories of bowel preparation in terms of reoperation.CONCLUSION The implementation of mechanical bowel preparation and antibiotic use in patients who are going to undergo a colon resection does not influence the treatment of any possible anastomotic leakage. | Konstantinos A Zorbas Daohai Yu Aruj Choudhry Howard M Ross Matthew Philp | 2019 | World Journal of Gastrointestinal Surgery2019，11，4： | 1 |
| 14 | Outpatient telephonic transitional care after hospital discharge improves survival in cirrhotic patients显示文摘BACKGROUND Intervention to improve outcomes in cirrhotic patients (CP) after hospital discharge often focus on 30 d readmission rate (RR). However, recent studies suggest dissociation between RR and survival. At our center, CP are now offered outpatient telephonic transitional care (OTTC) by a care coordinator for 30 d after hospital discharge. AIM To determine the effect of OTTC on survival in CP. METHODS In this cohort study from a tertiary center, CP who received OTTC formed the intervention group. They were compared with a control group discharged during the same period. Mortality and RR were compared between the groups. RESULTS After OTTC introduction, 194 CP were discharged. After applying exclusion criteria, 169 CP (51% male, mean age 58 years ± 12 years) were included. OTTC group comprised 76 patients and was compared with 93 controls. Baseline disease and index admission related characteristics were not significantly different between the groups. The intervention group showed significantly higher 6 mo survival compared to controls (84.2% vs 68.8%;P = 0.03), while RR at 1, 3, and 6 mo were comparable. On multivariable analysis, the intervention group showed lower odds for mortality compared to the controls (hazard ratio: 0.4;95% confidence interval: 0.2-0.82;P = 0.012), while higher model for endstage liver disease scores were associated with higher mortality (hazard ratio: 1.05;95% confidence interval: 1.01-1.1;P = 0.024).CONCLUSION CP provided OTTC had higher 6 mo survival compared to controls without a difference in RR. Use of RR to gauge quality of care provided during hospitalization or subsequent transitional care programs should be revisited. | Bhavana Bhagya Rao Anastasia Sobotka Rocio Lopez Carlos Romero-Marrero William Carey | 2019 | World Journal of Hepatology2019，11，8： | 0 |
| 15 | Empirical Research on Quality Improvement and Effect Increase of Rural Tourist Destination Under the Strategic Background of Rural Revitalization: A Case Study of Xishan District, Kunming City, Yunnan Province显示文摘As one of important channels in rural revitalization and development, rural tourism obtains a lot of remarkable achievements in rural development. However, relatively single product and homogenized development model make competition gradually intensify, and many once glorious rural tourist destinations gradually decline. Xishan District of Kunming City of Yunnan Province is taken as research object in this paper. Via literature research, field survey and depth interview, development process, status quo and existing problems of its rural tourism are deeply explored. Based on above research results, development idea, strategy and countermeasure for quality improvement and effect increase of traditional rural tourism destination are proposed, and cooperative development, mutual benefit and win-win are taken as the ultimate development goals. | MA Ying ZHANG Chaoxuan | 2019 | Journal of Landscape Research2019，11，1： | 0 |
| 16 | How to Protect Physician Whistleblower—Patient Advocates—From Retaliation to Benefit Patients:A Legal Analysis Regarding Summary Suspension,Retaliation,Peer Review and Remedies显示文摘Public safety provides new statutory protections for whistleblowers:Legislation enacted in order to address medical error and failures of hospital quality systems has paradoxically created mechanisms that are used to silence physicians and other caregivers who seek to protect patient safety by reporting breaches of professional quality and integrity.The laws enacted to protect patients can be and are currently misused to silence whistleblowers through punitive legal proceedings against patient safety advocates.Summary suspensions,deprivation of due process,and transfer of adjudicative authority to the hands of the institutions that most require oversight undermines transparency and patient advocacy.A modest set of statutory amendments,prophylactic and remedial,especially to prevent premature reporting of summary suspensions,can counteract these inequities and rebalance the House of Medicine so as to protect both patients and those who would seek to ensure their safety,so it may do no harm. | Gil Mileikowsky MD Bartholomew Lee | 2019 | US-China Law Review2019，16，1： | 0 |
| 17 | Effects of Fleckvieh on the Performance of Dual-Purpose Cattle Improved by Hybridization with Local Beef Cows显示文摘[Objective] The paper aimed to study the improved effect of local beef cattle with Fleckvieh cattle and provide theoretical basic data for local cattle industry in central plain agricultural area in China. [Method] With 500 local beef cattle as female parents and Fleckvieh cattle as male parents,hybridization improvement was conducted via artificial insemination. The growth performance,slaughter performance,milk performance and milk components of F1 and F2 hybrids were measured. [Result] The birth body weights of F2 were significantly higher than those of local beef cow,but there was no remarkable difference between F1 and local beef cow or F1 and F2. The growth rates of F1 and F2 at different stages were higher than those of local beef cattle. The slaughter performance,such as carcass weight( P < 0. 05),dressing percentage,net meat rate( P < 0. 05),marbling score of F1 and F2 were higher than those of local beef cow. Milk production performance,such as actual milk yield,305 d corrected milk yield and 4% standard milk yield of F2 were signally higher than those of F1 and local beef cattle( P< 0. 05),and F1 was markedly higher than local beef cattle( P < 0. 05). For milk composition,although milk fat percentage,milk protein rate,lactose rate and total solids( TS) of F1 and F2 were slightly lowered compared with local beef cattle at varying degrees,they were still at high levels compared with Holstein cows.[Conclusion]Fleckvieh cattle,as a male parent,can significantly improved growth performance,slaughter performance and milk performance of offsprings. It would also increases the economic efficiency of local beef cattle by higher quality and price,as well as changing production model from beef to dual purpose of beef and milk. | Wang Linfeng Yang Gaiqing Lian Hongxia Yan Ping Liu Xian Liu Yan Wang Wenhui Zhu Ruiguang Li Ming Yang Guoyu | 2015 | Animal Husbandry and Feed Science2015，7，6： | 0 |
| 18 | Post-endoscopic procedure satisfaction scores: Can we improve?显示文摘AIM To organize post-procedure satisfaction data into a useful reference and analyze patient-centered parameters to find trends that influence patient satisfaction.METHODS A robust database of two cohorts of outpatients that underwent an endoscopic procedure at Georgetown University Hospital at two separate three-month intervals ranging from November 2012 to January 2013 and November 2015 to January 2016 was compiled. Time of year was identical to control for weather/seasonal issues that may have contributed to the patient experience. The variables recorded included age, sex, body mass index(BMI), type of procedure, indication for procedure, time of the procedure, length of the procedure, type of prep used, endoscopist, satisfactory score, and comments/reasons for score. For continuous variables, differences in averages were tested by two sample t-test, Wilcoxon rank sum test, and ANOVA as appropriate. For categorical variables, differences in proportions between two groups were tested by χ~2 test. Correlation test and linear regression analyses were conducted to examine relationships between length of procedure and continuous predictors. A P value < 0.05 used to indicate statistically significant relationship.RESULTS The primary outcome of this study was to assess if telephone outreach after an endoscopic intervention was a satisfactory method of obtaining post-procedure satisfaction scores from patients at a tertiary care center. With the addition of post-procedure calls, instilled in January 2014, the response rate was 40.5%(508/1256 patients) from a prior completion rate of 3.4%(31/918) with the mail out survey initially. There was a statistically significant improved response rate pre and post intervention with P < 0001. The secondary outcome of this study was to assess if we could use predictive analytics to identify independent predictors of procedure length, such as gender, age, type of procedure, time of procedure, or BMI. The combined pre and post intervention data was used in order to optimize the power to identify independent predictors of procedure length. The total number of patient's data analyzed was 2174. There was no statistically significant difference in procedure length between males and females with P value 0.5282. However, there was a small(1 min), but statistically significant difference(P = 0.0185) in procedure length based on the time of day the procedure took place, with afternoon procedures having a longer duration than morning procedures. The type of procedure was an independent predictor of procedure length as demonstrated with P value < 0.0001. There is a statistically significant correlation between age and procedure length, although it is only a weak relationship with a correlation coefficient < 0.3. Contrary to patient age, BMI did not have a statistically significant correlation with procedure length(P = 0.9993), which was also confirmed by linear regression analysis.CONCLUSION Our study proves calling patients after endoscopy improves post-procedure satisfaction response rates and changing procedural time allotment based on patient characteristics would not change endoscopic workflow. | Ankita Munjal Joshua M Steinberg Afnan Mossaad Samuel J Kallus Mark C Mattar Nadim G Haddad | 2018 | World Journal of Gastrointestinal Endoscopy2018，10，1： | 0 |
| 19 | Land reclamation pattern of iron mine in Tangshan显示文摘Based on the analyses of the character of the exploitation of the iron ore resource and its destruction of eco-environment in Tangshan area, this paper puts forward the patterns of land reclamation which fits for this area. The patterns include the reclamation of ecological agriculture, planting directly on the tailing bin without covering soil, reclamation of mine tailings in the pool, and improvement of the soil quality by using tailings etc. Now, over 700hm^2 land has been reclaimed by taking advantage of the pattern in Tangshan and eight typical reclamation districts have been built. The rates of reclamation exceed 80% and have reached the advanced level of the world. Practice has proved that the eco-environment of the ore area has been greatly improved and the remarkable economic and social benefits have been gained. | LI Fu-ping~(1,2), LIU Ren-yi~(2), ZHANG Jin-rui~(1,2), GUO Qiao-zhen~(2), WANG Hong-xin~(2) (1. University of Science and Technology Beijing, Beijing 100083, China 2. Hebei Institute of Technology, Tangshan 063009, China) | 2005 | 中国有色金属学会会刊:英文版2005，15，S1： | 0 |
| 20 | Reflections on Perfecting Teaching Quality Monitoring System in Secondary Medical Vocational Colleges显示文摘Teaching quality is an important component which constitutes secondary and higher medical colleges,at the same time teaching quality monitoring system is the key content of teaching quality.In the current,teaching quality system of many Chinese schools is comparatively inadequate and the construction of quality assessment is comparatively backward and unsystematic.This research made further exploration into the above question with effective scheme found question,among which finding effective scheme is the main method to guarantee the improvement and soundness of teaching quality monitoring system. | Yunhong Wei | 2018 | Journal of Advances in Medicine Science2018，1，2： | 0 |
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