基于电子舌的穿心莲水煎液的掩味效果评价研究

目的 探讨电子舌用于评价穿心莲掩味效果的可行性,为药物掩味研究提供参考.方法 以穿心莲为苦味中药模型药,选择醋酸钠(NaAc)、甜蜜素(SC)、腺苷-5′-磷酸(AMP)、2,4-二羟基甲苯酸(DA)作为掩味剂,通过电子舌进行测定,所得数据用主成分分析法进行分析,并进行不同维度数据空间内欧氏距离计算,以苦距大小作为评价指标评价掩味效果,并与口尝结果比较.结果 电子舌对SC、AMP、DA 3种掩味剂的掩味效果的区分与口尝法的评价结果基本一致,但对NaAc的评价结果与口尝评价结果不一致,提示使用电子舌评价中药掩味效果需要满足一定的条件.结论 电子舌在满足一定的条件下,可以用于中药掩味效果的评价.利用电子舌进行药物味觉信息评价,应运用药学、化学专业知识及相关学科的知识加以分析,逐步完善这种评价方法和模式.     

Predictions on Structural and Electronic Properties to Synthesize Bismuth-Carbon Compounds in Different Periodicities

This work was carried out to explore the compounds of bismuth with carbon using density functional theory (DFT)-based computations. The structures of the compounds BiC, BiC₂, BiC₃, Bi₂C₃, BiC₅, and Bi₂C₅ were predicted at a generalized gradient approximation (GGA-PBE) level of theory. The calculations were carried out on the structures in unit cell and supercell geometries in slab and bulk periodicities. The structural and electronic properties of the mentioned compounds were investigated in detail. The calculations of the structures revealed lattice constants of the compounds for cubic unit cell as 212.2 pm for BiC, 176.9 pm for BiC₂, 240.5 pm for BiC₃, 232.4 pm for Bi₂C₃, and 354.5 pm for Bi₂C₅. The compounds BiC, BiC₂, BiC₃, BiC₅, and Bi₂C₅ were found to be metallic, whereas Bi₂C₃ exhibited semiconducting character with a band gap of 0.305 eV. This work provides an initial framework for preparing new 2D materials from Bi_xC_y.     

Clinical decision support malfunctions related to medication routes: a case series

ObjectiveTo identify common medication route-related causes of clinical decision support (CDS) malfunctions and best practices for avoiding them.Materials and MethodsCase series of medication route-related CDS malfunctions from diverse healthcare provider organizations.ResultsNine cases were identified and described, including both false-positive and false-negative alert scenarios. A common cause was the inclusion of nonsystemically available medication routes in value sets (eg, eye drops, ear drops, or topical preparations) when only systemically available routes were appropriate.DiscussionThese value set errors are common, occur across healthcare provider organizations and electronic health record (EHR) systems, affect many different types of medications, and can impact the accuracy of CDS interventions. New knowledge management tools and processes for auditing existing value sets and supporting the creation of new value sets can mitigate many of these issues. Furthermore, value set issues can adversely affect other aspects of the EHR, such as quality reporting and population health management.ConclusionValue set issues related to medication routes are widespread and can lead to CDS malfunctions. Organizations should make appropriate investments in knowledge management tools and strategies, such as those outlined in our recommendations.     

Mortality prediction upon hospital admission – the value of clinical assessment: A retrospective,matched cohort study

Accurate prediction of mortality upon hospital admission is of great value, both for the sake of patients and appropriate resources’ allocation. A myriad of assessment tools exists for this purpose. The evidence relating to the comparative value of clinical assessment versus established indexes are scarce. We analyzed the accuracy of a senior physician’s clinical assessment in a retrospective cohort of patients in a crude, general patients’ population and later on a propensity matched patients’ population. In one department of internal medicine in a tertiary hospital, of 9891 admitted patients, 973 (10%) were categorized as prone to death in a 6-months’ duration by a senior physician. The risk of death was significantly higher for these patients [73.1% vs 14.1% mortality within 180 days; hazard ratio (HR) = 7.58; confidence intervals (CI) 7.02‐8.19, P < .001]. After accounting for multiple, other patients’ variables associated with increased risk of mortality, the correlation remained significant (HR = 3.25; CI 2.85‐3.71, P < .001). We further performed a propensity matching analysis (a subgroup of 710 patients, subdivided to two groups with 355 patients each): survival rates were as low as 45% for patients categorized as prone to death compared to 78% in patients who weren’t categorized as such (P < .001). Reliance on clinical evaluation, done by an experienced senior physician, is an appropriate tool for mortality prediction upon hospital admission, achieving high accuracy rates.     

The performance of five models compared with atrial high rate episodes predicts new atrial fibrillation after cardiac implantable electronic devices implantation

AimsSeveral predicting models have been evaluated for new‐onset atrial fibrillation (AF) in several clinical conditions, but never in patients with cardiac implantable electronic devices (CIED). We aimed to evaluate the five predicting models compared with atrial high rate episodes (AHRE) to predict new AF in patients with CIED.Methods and ResultsWe retrospective enrolled 470 consecutive patients with CIED and without a history of AF. The five predicting models, including CHA₂DS₂‐VASc score, C₂HEST score, mCHEST score, HAT₂CH₂ score, and HAVOC score were used. The primary endpoint was new AF documented by 12‐lead electrocardiography (ECG) or 30‐s ECG strip. Multivariable Cox regression analysis was used to determine variables associated with independent factors of new AF. Patients'' median age was 76 years and 58.7% were male. During follow‐up (median 29 months), 34 new AF occurred (incidence rate 2.99/100 patient‐years, 95% CI 1.67–6.20). Multivariable Cox regression analysis showed AHRE ≥6 min and 24 h, and HAT₂CH₂ score were independent predictors for new AF. Optimal AHRE cutoff value was 9.3 min with highest Youden index (AUC, 0.806; 95% CI, 0.722–0.889; p < .001). The AF occurrence rate of AHRE ≥9.3 min was 7 times AHRE <9.3 min (p < .001).ConclusionsWe compared 5 predicting models for new AF in patients with CIED and without a history of AF. AHRE ≥6 min and 24 h, and HAT₂CH₂ score were independent predictors for AF.     

A Novel Interstitial Site in Binary Rock-Salt Compounds

The energetic and mechanical stability of interstitial point defects in binary rock-salt materials were studied using the first-principles method. A novel, stable, and energetically competitive interstitial site (base-interstitial) was identified for anion interstitials in rock-salts. The formation energies of base-interstitial defects were compared with well-explored tetrahedral (body-interstitial) and split interstitials and were found to be energetically highly competitive. For alkali halides and silver bromide, the lowest formation energies are associated with the base-interstitial site and the <110> split interstitial, which are therefore the predominant interstitial sites. However, split interstitials were found to be the energetically preferred configuration in metal monochalcogenide systems. Electronic band structures are affected by the presence of interstitial defects in rock-salt structures. In particular, the Fermi level is shifted below the valence band maxima for the body, base, and split interstitials in metal halides, indicating p-type conductivity. However, the Fermi level remains within the bandgap for metal monochalcogenides, indicating no preferred conductivity for base- and split-interstitial defects. Allowing the defects to be charged changes the relative stability of the interstitial sites. However, the new base-interstitial site remains preferred over a range of potentials for alkali halides. The anion base-interstitial is found to form a triatomic entity with the nearest lattice anions that affect the electronic structure relative to the body interstitial. The discovery of a new interstitial site affects our understanding of defects in binary rock-salts, including structure and dynamics as well as associated thermodynamic and kinetic properties that are interstitial dependent.     

基于医院信息系统和Oracle9i数据库的网络化口腔电子病历安全体系的研究

目的 探讨网络化口腔电子病历安全体系的实现方式. 方法在Windows 2000/XP平台上,结合基于HL7标准的XML语言、Oracle9i数据库构建多层分布式的网络化口腔电子病历系统,通过用户名和密码MD5技术加密、角色分配、分级权限、痕迹保留、审计追踪、DES数据加密、数据备份、实时监控、网络管理、服务器双机热备份等方法构建网络化口腔电子病历系统的安全体系.结果 本研究构建了基于局域网的网络化口腔电子病历系统安全体系,可确保电子病历信息录入、修改、存储和传输的安全. 结论该网络化口腔专科电子病历符合口腔专科医院信息系统安全管理的需要,有助于推动口腔专科医院的信息化管理建设.     

The role of electronic medical records in improving health care quality: A quasi-experimental study

The Teleprimary Care—Oral Health Clinical Information System (TPC-OHCIS) is an updated electronic medical record (EMR) that has been applied in Malaysian primary healthcare. Recognizing the level of patient satisfaction following EMR implementation is crucial for assessing the performance of health care services. Hence, the main objective of this study was to compare the level of patient satisfaction between EMR-based clinics and paper-based clinics.The study was a quasi-experimental design that used a control group and was conducted among patients in 14 public primary healthcare facilities in the Seremban district of Malaysia from May 10, to June 30, 2021. Patient satisfaction was assessed using the validated Short-Form Patient Satisfaction Questionnaire, which consisted of 7 subscales. All data were analyzed using the IBM Statistical Package for Social Sciences version 21.A total of 321 patients consented to participate in this study, and 48.9% of them were from EMR clinics. The mean score for the communication subscale was the highest at 4.08 and 3.96 at EMR-adopted clinics and paper-based record clinics. There were significant differences in general satisfaction and communication subscales, with higher patient satisfaction found in clinics using EMR.With the utilization of EMR, patient satisfaction and communication in delivering healthcare services have improved.     

Forecasting the Post-Pandemic Effects of the SARS-CoV-2 Virus Using the Bullwhip Phenomenon Alongside Use of Nanosensors for Disease Containment and Cure

The COVID-19 pandemic has the tendency to affect various organizational paradigm alterations, which civilization hasyet to fully comprehend. Personal to professional, individual to corporate, and across most industries, the spectrum of transformations is vast. Economically, the globe has never been more intertwined, and it has never been subjected to such widespread disruption. While many people have felt and acknowledged the pandemic’s short-term repercussions, the resultant paradigm alterations will certainly have long-term consequences with an unknown range and severity. This review paper aims at acknowledging various approaches for the prevention, detection, and diagnosis of the SARS-CoV-2 virus using nanomaterials as a base material. A nanostructure is a material classification based on dimensionality, in proportion to the characteristic diameter and surface area. Nanoparticles, quantum dots, nanowires (NW), carbon nanotubes (CNT), thin films, and nanocomposites are some examples of various dimensions, each acting as a single unit, in terms of transport capacities. Top-down and bottom-up techniques are used to fabricate nanomaterials. The large surface-to-volume ratio of nanomaterials allows one to create extremely sensitive charge or field sensors (electrical sensors, chemical sensors, explosives detection, optical sensors, and gas sensing applications). Nanowires have potential applications in information and communication technologies, low-energy lightning, and medical sensors. Carbon nanotubes have the best environmental stability, electrical characteristics, and surface-to-volume ratio of any nanomaterial, making them ideal for bio-sensing applications. Traditional commercially available techniques have focused on clinical manifestations, as well as molecular and serological detection equipment that can identify the SARS-CoV-2 virus. Scientists are expressing a lot of interest in developing a portable and easy-to-use COVID-19 detection tool. Several unique methodologies and approaches are being investigated as feasible advanced systems capable of meeting the demands. This review article attempts to emphasize the pandemic’s aftereffects, utilising the notion of the bullwhip phenomenon’s short-term and long-term effects, and it specifies the use of nanomaterials and nanosensors for detection, prevention, diagnosis, and therapy in connection to the SARS-CoV-2.     

智慧医院互联网化服务设计与应用研究

以北京大学第三医院互联网诊疗服务应用为例,介绍智慧医院互联网化服务体系与安全体系设计以及具体应用实践,阐述智慧医院互联网诊疗服务构建策略.