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Analyzing the Effectiveness of Policy Implementation at the Local Level: A Case Study of Management of the 2009–2010 Drought in Yunnan Province, China

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International Journal of Disaster Risk Science 2017年第1期8卷 64-77页

作者： neera shrestha pradhan Yufang Su Yao Fu Liyun Zhang Yongping Yang University of Chinese Academy of Sciences Beijing 100049China International Centre for Integrated Mountain Development(ICIMOD) KathmanduNepal Kunming Institute of Botany(KIB) Chinese Academy of SciencesKunming 650201YunnanChina Centre for Mountain Ecosystem Studies Kunming Institute of BotanyKunming 650201YunnanChina Yunnan Academy of Social Science Kunming 650034YunnanChina Institute of International Rivers and Eco-Security Yunnan UniversityKunming 650091YunnanChina

Several research efforts have focused primarily on policy implementation and improving innovative actions to address disaster risks. Discussions are ongoing on how to measure the effectiveness of policy implementation at the local level. But there is no definitive theory of effective policy implementation, and very few frameworks have been found acceptable as the basis of an analysis of the effectiveness of policy implementation, especially on droughts. Based on the 2009–2010 extreme drought in Yunnan, China, this article presents a modified framework to assess the effectiveness of policy implementation by defining policy, practice, and performance, as well as a feedback loop by which to share the lessons learned. Water conservancy projects in Luliang County and the agricultural diversity program in Longyang County in Yunnan Province were analyzed from a farmers' perspective. It was found that farmers are highly dependent on government policies and projects, and the effectiveness of policies is measured by short-term, immediate, and tangible benefits rather than long-term adaptation strategies. The results highlight the urgent need to reduce risks by developing better awareness about climate change and drought and its impacts, increased understanding of drought hazards, and implementation of appropriate measures for long-term adaptation.

关键词： China Community perception Drought impact Local adaptation strategies Policy implementation and effectiveness Yunnan Province

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Nano-formulations for transdermal drug delivery:A review

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Chinese Chemical Letters 2018年第12期29卷 1713-1724页

作者： Xingli Zhou Ying Hao Liping Yuan Sushmita pradhan Krista shrestha Ojaswi pradhan Hongjie Liu Wei Li Department of Dermatovenereology State Key Laboratory of BiotherapyWest China HospitalSichuan University

Transdermal drug delivery refers to a means of delivering drugs through the surface of the skin for local or systemic treatment. The drug functions after absorption through the skin into the systemic circulation via capillary action at a certain rate. Use of traditional physical and chemical enhancers to improve the transdermal permeation rate by increasing drug solubility, diffusion coefficient, and reservoir effect is not feasible owing to the toxic side effects of the overuse of chemical penetration enhancers. Nanoformulations generally vary in size and range from 10 nm to 100 nm. The smaller particle size leads to increased drug permeability, stability, retention, and targeting, making nano-formulations suitable for transdermal drug delivery. The different applications of nano-formulations(vesicles or nanoparticles and nanoemulsions) have been widely studied. Here, the classification, characteristics, transdermal mechanism, and application of the most popular nano-formulations in transdermal drug delivery system are reviewed.

关键词： Nano-formulation Transdermal drug delivery system Classification Mechanism Application

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基于MODIS的西藏高原土地覆盖分类研究

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资源科学 2010年第11期32卷 2152-2159页

作者：除多 Basanta shrestha 王伟张镱锂刘林山 Shushil pradhan 西藏高原大气环境科学研究所拉萨850000 International Centre for Integrated Mountain Development(ICIMOD) KathmanduNepal 中国科学院地理科学与资源研究所北京100101

嵌的MODIS遥感图像,用最大似然估计分类器对西藏高原的土地覆盖类型进行了分类,并采用西藏高原数字高程模型(DEM)对MODIS分类结果进行了分析和改进,最后分别用混淆矩阵和图集中西藏高原植被分类汇总面积对MODIS土地覆盖分类结果进行了... 详细信息

嵌的MODIS遥感图像,用最大似然估计分类器对西藏高原的土地覆盖类型进行了分类,并采用西藏高原数字高程模型(DEM)对MODIS分类结果进行了分析和改进,最后分别用混淆矩阵和图集中西藏高原植被分类汇总面积对MODIS土地覆盖分类结果进行了分类精度评价。结果表明:①MODIS遥感图像能够有效地分类出西藏高原的主要土地覆盖类型;②根据西藏高原植被的垂直带性分布特点,由DEM改进的MODIS土地覆盖分类精度明显提高,主要土地覆盖类型的面积绝对误差都小于2%,其中,河流与湖泊、森林、高寒荒漠、作物和山地草原的绝对误差都在1%以下;③混淆矩阵分析的平均分类精度为87.68%。

关键词：土地覆盖分类 EOS/MODIS 西藏高原

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Prevalence of Preoperative Anemia in Elective Rheumatic Valve Surgery at a Tertiary Care Center in Nepal

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World Journal of Cardiovascular Surgery 2023年第1期13卷 1-9页

作者： Priska Bastola Bibhush shrestha Bishwas pradhan Arjun Gurung Basanta Ghimire Anil Bhattarai Department of Cardiothoracic and Vascular Anaesthesiology Manmohan Cardiothoracic Vascular and Transplant Center Tribhuvan University Kathmandu Nepal Department of Cardiothoracic & Vascular Surgery Manmohan Cardiothoracic Vascular and Transplant Center Tribhuvan University Kathmandu Nepal

Background: Rheumatic Valvular Heart disease (RVHD) is common in developing countries often associated with anemia;however its burden is often overlooked. Anemic patients undergoing surgery are likely to receive blood transfusion, increasing morbidity and mortality. Prevalence of anemia in cardiac surgical patients are studied extensively, however its burden in RVHD is lacking. This study attempted to investigate the prevalence of preoperative anemia in RVHD and its effect on blood transfusion, morbidity and mortality in patients undergoing valve surgery. Methods: This is a retrospective observational study conducted at a tertiary care hospital in Nepal. We considered 340 patients who underwent Rheumatic valve replacement surgery from 2014 January to December 2016 and data on their socio-demographic and clinical characteristics were extracted from the patient’s records. The analyses meeting the study objectives were conducted using IBM SPSS v25 for Windows (IBM Statistical Package for Social Sciences, 2015IBM Corporation, New York, United States). Results: The prevalence of no anemia, mild, moderate, and severe anemia was 34.1%, 57.7%, 39.6%, 2.5%, respectively. The units of Red Blood Cell used for transfusion were 1.2 units, 2.0 units, 2.3 units, and 1.6 units in patients without anemia, and those with mild, moderate and severe anemia respectively. The incidence of reexploration was higher in patients with severe anemia as compared to the non anemic with an incidence of 66.6%. A proportion of the patients with no anemia, mild, moderate and severe anemia with less than 7 days stay in the intensive care unit were 89%, 82%, 84.7% and 100% respectively. The length of hospital stay more than 10 days was seen in 58.9%, 71.6%, 63% and 100% in patients with no anemia, mild, moderate and severe anemia. An overall incidence of mortality in anemic patients was 11% while in non anemic patients was 5.3%. Conclusions: The prevalence of anemia was high in the Nepalese patients wi

关键词： Anemia Rheumatic Heart Disease Elective Valve Surgery Blood Transfusion

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Microbiological and Antibiotic Susceptibility Patterns in Cardiothoracic and Vascular Intensive Care Unit of a Tertiary Level Hospital in Nepal

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World Journal of Cardiovascular Surgery 2023年第3期13卷 61-70页

作者： Bibhush shrestha Priska Bastola Bishwas pradhan Arjun Gurung Basanta Ghimire Anil Bhattarai Department of Cardiothoracic and Vascular Anesthesiology Manmohan Cardiothoracic Vascular and Transplant Center Tribhuvan University Kathmandu Nepal Department of Cardiothoracic and Vascular Surgery Manmohan Cardiothoracic Vascular and Transplant Center Tribhuvan University Kathmandu Nepal

Background: Sepsis has been one of the most important conditions for morbidity and mortality of Intensive care unit (ICU) patients. Antibiotics remain one of the major combating factors for it. Indiscriminate antimicrobial usage and poor prescription practices have contributed to the development of multidrug resistant (MDR) organisms. Therefore, the current study was designed to evaluate the spectrum, and susceptibility patterns of pathogens isolated from patients admitted to our Cardiothoracic and Vascular Intensive care unit. Materials and Methods: The study was conducted in Cardiothoracic and Vascular ICU of a tertiary care teaching hospital from February 2019 to March 2021. Samples (blood, urine, wound swab, tracheal aspirate, and central venous catheter tip) for culture were taken from all the patients in Sepsis admitted in Cardiothoracic and Vascular ICU above 18 years of age during the study period. The culture reports (microbiological profile and their susceptibility pattern) were collected and data collection of all enrolled patients was done. Results: Out of the total 128 samples studied 75 (58.5%) were culture positive. The predominant organisms isolated were Gram negative organisms (Klebsiella, Pseudomonas, Acinetobacter, followed by E. coli). The highest prevalence of microbial growth was found in tracheal aspirate (46.8%), followed by blood (21.8%). Antibiotic susceptibility results showed the highest sensitivity of those common pathogens towards higher antibiotics only (especially Polymyxin B and Colistin). Conclusion: The emergence of multidrug resistant organisms and lesser availability of a higher group of antibiotics is a major concern. So there is a need for regular hospital based antibiograms, strict infection control programs, and implementation of antimicrobial stewardship programmes for guiding clinicians in choosing appropriate therapy and preventing the surge of multidrug resistant organisms.

关键词： Sepsis Antibiotics Intensive Care Unit

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