2035年中国入围科技期刊“世界第一方阵”:基础、差距与推进思路

【目的】 在“中国科技期刊卓越行动计划”实施三周年之际,有必要对我国科技期刊2035年迈入“世界第一方阵”目标的具体任务进行重新审视和预判,以进一步明确发展方向,动态调整推进思路。【方法】 采用国内外科技期刊、科技论文、科技期刊评价成果的系统性发展数据对科技期刊“世界第一方阵” 国家(或地区)在高水平科技期刊数量与质量层面的入围标准进行界定,在深入总结现有基础和优势的同时,对我国科技期刊综合实力与“世界第一方阵”国家(或地区)的现实差距进行逐一梳理和剖析,并对实现目标的可行性和推进思路进行研判和设计。【结果】 必须继续加强高水平英文科技期刊创办和培育力度、持续加大优秀中文科技期刊的建设强度、快速推进国内外科技期刊论文等质同效评价制度的建设与引导,并积极探索建立科学家和科研机构办好一流科技期刊的责任制度和贡献激励机制、创新发展编辑人才队伍培养与激励管理思路、深入实践灵活多样的期刊出版市场资本运作模式、稳步推进期刊出版市场机制和管理制度改革,为我国科技期刊事业的高质量发展提速增效。【结论】 虽然当前阶段目标任务艰巨,但迈入“世界第一方阵”未来可期。     

Cirrhosis is independently associated with complications and mortality following operative treatment of acetabular fractures

IntroductionPatients with cirrhosis are at higher risk for morbidity after injury. Acetabular fractures represent a highly morbid injury pattern. Few studies have specifically examined an effect of cirrhosis on risk of complications after acetabular fracture. We hypothesized that cirrhosis is independently associated with increased risk of inpatient complications following operative treatment of acetabular fractures.MethodsAdults patients with acetabular fracture who underwent operative treatment were identified from Trauma Quality Improvement Program data from 2015 to 2019. Patients with and without cirrhosis were matched on a propensity score predicting cirrhotic status and inpatient complications based on patient, injury, and treatment characteristics. The primary outcome was overall complication rate. Secondary outcomes included serious adverse event rate, overall infection rate, and mortality.ResultsAfter propensity score matching, 137 cirrhosis+ and 274 cirrhosis- remained. No significant differences existed in observed characteristics after matching. Compared to cirrhosis- patients, cirrhosis+ patients experienced 43.4% (83.9 vs 40.5%, p < 0.001) greater absolute risk difference of any inpatient complication, 29.9% (51.8 vs 21.9%, p < 0.001) greater absolute risk difference of serious adverse events, 28.5% (41.6 vs 13.1%, p < 0.001) greater absolute risk difference of any infection, and 2.9% (2.9% vs 0.0%, p = 0.02) greater absolute risk difference of inpatient mortality.ConclusionCirrhosis is associated with higher rates of inpatient complications, serious adverse events, infection, and mortality among patients undergoing operative repair of acetabular fracture.Level of EvidencePrognostic Level III.     

组织气氛在护士知识与行为间的中介效应:以脑卒中吞咽障碍护理为例

目的探究组织气氛在护士吞咽障碍知识水平与护理行为之间的中介效应。方法2019年6-7月,便利抽样法选取15个省市33所医院及医疗机构神经科、康复科具有吞咽障碍护理经验的231名护士为研究对象采用脑卒中吞咽障碍知识水平问卷、脑卒中吞咽障碍护理行为问卷及团队创新气氛量表对其进行调查。结果护士吞咽障碍知识水平总分为(56.69±13.50)分、护理行为得分为(140.65土32.02)分、组织气氛得分为(157.63±26.56)分。组织气氛与吞咽障碍知识水平(r=0.49,P<0.01)、护理行为(r=0.50,P<0.01)均呈正相关。组织气氛在知识水平和护理行为之间起中介作用,中介效应占总效应的83.18%。结论组织气氛在护士吞咽障碍知识水平与护理行为之间起中介作用,临床管理者可在提升护士吞咽障碍知识水平的基础上,通过提高组织气氛水平推进其护理行为。     

Differentiating autoimmune pancreatitis from pancreatic ductal adenocarcinoma with CT radiomics features

PurposeThe purpose of this study was to determine whether computed tomography (CT)-based machine learning of radiomics features could help distinguish autoimmune pancreatitis (AIP) from pancreatic ductal adenocarcinoma (PDAC).Materials and MethodsEighty-nine patients with AIP (65 men, 24 women; mean age, 59.7 ± 13.9 [SD] years; range: 21–83 years) and 93 patients with PDAC (68 men, 25 women; mean age, 60.1 ± 12.3 [SD] years; range: 36–86 years) were retrospectively included. All patients had dedicated dual-phase pancreatic protocol CT between 2004 and 2018. Thin-slice images (0.75/0.5 mm thickness/increment) were compared with thick-slices images (3 or 5 mm thickness/increment). Pancreatic regions involved by PDAC or AIP (areas of enlargement, altered enhancement, effacement of pancreatic duct) as well as uninvolved parenchyma were segmented as three-dimensional volumes. Four hundred and thirty-one radiomics features were extracted and a random forest was used to distinguish AIP from PDAC. CT data of 60 AIP and 60 PDAC patients were used for training and those of 29 AIP and 33 PDAC independent patients were used for testing.ResultsThe pancreas was diffusely involved in 37 (37/89; 41.6%) patients with AIP and not diffusely in 52 (52/89; 58.4%) patients. Using machine learning, 95.2% (59/62; 95% confidence interval [CI]: 89.8–100%), 83.9% (52:67; 95% CI: 74.7–93.0%) and 77.4% (48/62; 95% CI: 67.0–87.8%) of the 62 test patients were correctly classified as either having PDAC or AIP with thin-slice venous phase, thin-slice arterial phase, and thick-slice venous phase CT, respectively. Three of the 29 patients with AIP (3/29; 10.3%) were incorrectly classified as having PDAC but all 33 patients with PDAC (33/33; 100%) were correctly classified with thin-slice venous phase with 89.7% sensitivity (26/29; 95% CI: 78.6–100%) and 100% specificity (33/33; 95% CI: 93–100%) for the diagnosis of AIP, 95.2% accuracy (59/62; 95% CI: 89.8–100%) and area under the curve of 0.975 (95% CI: 0.936–1.0).ConclusionsRadiomic features help differentiate AIP from PDAC with an overall accuracy of 95.2%.     

Epidemiology of burn-related fatalities in Australia and New Zealand, 2009–2015

BackgroundKnowledge of the epidemiology of burn-related fatalities is limited, with most previous studies based on hospital and burn centre data only.AimsTo describe the epidemiological characteristics of all burn-related fatalities in Australia and New Zealand, and to identify any trends in burn-related fatality incidence over the study period.MethodsData from the National Coronial Information System, including data for pre-hospital and in-hospital burn-related fatality cases, was used to examine the characteristics of burn-related fatalities occurring in Australia and New Zealand from 2009 to 2015. Burn-related fatality rates per 100,000 population were estimated, and incidence trends assessed using Poisson regression analysis.ResultsOf the 310 burn-related fatalities that occurred in Australia and New Zealand, 2009–2015, 41% occurred in a pre-hospital setting. Overall, most burn-related fatality cases were fire related, occurred at home, and were of people aged 41–80 years. One quarter of all burn-related fatalities were a result of intentional self-harm. The population incidence of all burn-related fatalities combined, and for NSW, decreased over the study period.ConclusionsThis study has identified the importance of examining all burn-related fatalities. If this is not done, vulnerable population subgroups will be missed and prevention efforts poorly targeted.