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Genome-wide Scan for Seed Composition Provides Insights into Soybean quality improvement and the Impacts of Domestication and Breeding

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Molecular Plant 2018年第3期11卷 460-472页

作者： Jiaoping Zhang Xianzhi Wang Yaming Lu Siddhi J. Bhusal Qijian Song Perry B. Cregan Yang Yen Michael Brown Guo-Liang Jiang Plant Science Department South Dakota State University Brookings SD 57006 USA Soybean Genomics and improvement Laboratory US Department of Agriculture Agricultural Research Services (USDA-ARS) 10300 Baltimore Avenue BeltsvilleMD 20705 USA Department of Biology and Microbiology South Dakota State University Brookings SD 57006 USA Department of Natural Resource Management South Dakota State University Brookings SD 57006 USA Agricultural Research Station Virginia State University PO Box 9061 Petersburg VA 23806 USA Present address: School of Agriculture Yunnan University Kunming Yunnan Province China These authors contributed equally to this article.

The complex genetic architecture of quality traits has hindered efforts to modify seed nutrients in soybean. Genome-wide association studies were conducted for seed composition, including protein, oil, fatty acids, and amino acids, using 313 diverse soybean germplasm accessions genotyped with a high-density SNP array. A total of 87 chromosomal regions were identified to be associated with seed composition, explain- ing 8%-89% of genetic variances. The candidate genes GmSAT1, AK-HSDH, SACPD-C, and FAD3A of known function, and putative MtN21 nodulin, FATB, and steroid-5-^-reductase involved in N2 fixation, amino acid biosynthesis, and fatty acid metabolism were found at the major-effect loci. Further analysis of additional germplasm accessions indicated that these major-effect loci had been subjected to domes- tication or modern breeding selection, and the allelic variants and distributions were relevant to geographic regions. We also revealed that amino acid concentrations related to seed weight and to total protein had a different genetic basis. This helps uncover the in-depth genetic mechanism of the intricate relationships among the seed compounds. Thus, our study not only provides valuable genes and markers for soybean nutrient improvement, both quantitatively and qualitatively, but also offers insights into the alteration of soybean quality during domestication and breeding.

关键词： genome-wide association study GWAS soybean seed composition candidate genes quality improvement domestication and breeding

The Accountable Care Organization results:Population health management and quality improvement programs associated with increased quality of care and decreased utilization and cost of care

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Family Medicine and Community Health 2015年第1期3卷 30-38页

作者： Ronald O’Donnell Nishant Shaun Anand Caroline Ganser Nancy Wexler Arizona State University College of Health Solutions500 N.3rd St.PhoenixArizona 85004USA Banner Health Network 1441 N.12th St.PhoenixArizona 85006USA Ambulatory Clinical Performance Assessment and improvement Banner Health1441 N.3rd St.PhoenixArizona 85006USA University of Arizona Health Plans Banner Health Network500 N.3rd St.PhoenixArizona 85004USA

Objective:The Accountable Care Organization(ACO)model of health care delivery is based on new payment models for general practice to reward improved quality and decreased cost of ***:Banner Health Network(BHN)is one of the original CMS Pioneer ACO programs and implemented a comprehensive disease management program based on the collaborative care *** performance indicators for CMS reflected quality and cost of ***:BHN has demonstrated both improved quality and cost savings in the first two years of the pilot *** disease management program based on the collaborative care model appears to have improved patient health outcomes based on quality improvement *** addition the program has reduced emergency department and hospital utilization,resulting in cost ***:The BHN quality improvement program is the platform for analyzing and improving on the BHN ACO *** model appears to have excellent application to the China health care system that is also focused on prevention and improvement of chronic disease and cost-effectiveness.

关键词： Accountable care organization population health management patient centered medical home disease management quality improvement

Quieting the neonatal intensive care unit:A quality improvement initiative

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World Journal of Clinical Pediatrics 2024年第3期13卷 53-60页

作者： Darshan Rajatadri Rangaswamy Niranjan Kamble Amulya Veeramachaneni Department of Pediatrics Subbaiah Institute of Medical SciencesShimoga 577222KarnatakaIndia

BACKGROUND The neonatal intensive care unit(NICU)is vital for preterm infants but is often plagued by harmful noise *** noise,ranging from medical equipment to conversations,poses significant health risks,including hearing impairment and neurodevelopmental *** American Academy of Pediatrics recommends strict sound limits to safeguard neonatal *** such as education,environmental modifications,and quiet hours have shown to reduce noise ***,up to 60%of the noises remain *** noise exposure exacerbates physiological disturbances,impacting vital functions and long-term neurological *** noise reduction in the NICU is crucial for promoting optimal neonatal *** To measure the sound levels in a NICU and reduce ambient sound levels by at least 10%from *** A quasi-experimental quality improvement project was conducted over 4 mo in a 20-bed level 3 NICU in a tertiary care medical *** noise levels were recorded continuously using a sound level *** interventions included targeted education,environmental modifications,and organizational changes,and were implemented through three rapid Plan-Do-Study-Act(PDSA)*** feedback and monitoring were conducted,and statistical process control charts were used for *** mean noise values were compared using the paired *** The baseline mean ambient noise level in the NICU was 67.8 dB,which decreased to 50.5 dB after the first cycle,and further decreased to 47.4 dB and 51.2 dB after subsequent *** reduction in noise levels was 21%during the day and 28%PDSA cycle(mean difference of−17.3 dB,P<0.01).Peak noise levels decreased from 110 dB to 88.24 dB after the *** A multifaceted intervention strategy reduced noise in the NICU by 25%over 4 *** success of this initiative emphasizes the significance of comprehensive interventions for noise reduction.

关键词： quality improvement Noise pollution Preterm care Sound measurement Plan-Do-Study-Act

Rationale and protocol for estimating the economic value of a multicomponent quality improvement strategy for diabetes care in South Asia

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Global Health Research and Policy 2019年第1期4卷 333-342页

作者： Kavita Singh Mohammed KAli Raji Devarajan Roopa Shivashankar Dimple Kondal Vamadevan S.Ajay VUsha Menon Premlata KVarthakavi Vijay Viswanathan Mala Dharmalingam Ganapati Bantwal Rakesh Kumar Sahay Muhammad Qamar Masood Rajesh Khadgawat Ankush Desai Dorairaj Prabhakaran K.M.Venkat Narayan Victoria LPhillips Nikhil Tandon On behalf of the CARRS Trial Group Public Health Foundation of India Center of Excellence-Center for CArdio-metabolic Risk Reduction in South Asia4th FloorPlot No.47Sector 44Institutional AreaGurgaonHaryana 122002India Rollins School of Public Health Emory University1518 Clifton RoadRm CNR 7041AtlantaGA 30322USA Department of Endocrinology&Diabetes Amrita Institute of Medical SciencesAmrita Vishwa VidyapeethamPonekkara P.O.KochiKerala 682041India Department of Endocrinology TNM College&BYL Nair Charity HospitalDr.A.L.Nair RoadMumbai CentralMumbaiMaharashtra 400008India MV Hospital for Diabetes&Diabetes Research Centre No 4West Madha Church StreetRoyapuramChennaiTamil Nadu 600013India Bangalore Endocrinology&Diabetes Research Centre #355th CrossMalleswaram CircleBangaloreKarnataka 560003India Department of Endocrinology St.John’s Medical College&HospitalSarjapur RoadKoramangalaBangaloreKarnataka 560034India Department of Endocrinology Osmania General Hospital2nd FloorGolden Jubilee BlockAfzalgunjHyderabadTelangana 500012India Department of Medicine Section of Endocrinology and DiabetesAga Khan UniversityStadium RoadKarachi 74800Pakistan Department of Endocrinology&Metabolism All India Institute of Medical SciencesBiotechnology Block3rd FloorAnsari NagarNew Delhi 110029India Endocrine Unit Department of MedicineGoa Medical CollegeBambolimGoa 403202India Public Health Foundation of India 4th FloorPlot No.47Sector 44Institutional AreaGurgaonHaryana 122002India Rollins School of Public Health Emory University1518 Clifton RoadRm CNR 7049AtlantaGA 30322USA Rollins School of Public Health Emory University1518 Clifton RoadAtlantaGA 30322USA Department of Endocrinology&Metabolism All India Institute of Medical SciencesBiotechnology Block3rd FloorRm#312Ansari NagarNew Delhi 110029India Centre for Chronic Disease Control C 1/52Second FloorSafdarjung Development AreaNew Delhi110016India London School of Hygiene and Tropical Medicine Keppel StBloomsburyLondon WC1E 7HTUK. 不详

Background:Economic dimensions of implementing quality improvement for diabetes care are understudied *** describe the economic evaluation protocol within a randomised controlled trial that tested a multicomponent quality improvement(QI)strategy for individuals with poorly-controlled type 2 diabetes in South ***/design:This economic evaluation of the Centre for Cardiometabolic Risk Reduction in South Asia(CARRS)randomised trial involved 1146 people with poorly-controlled type 2 diabetes receiving care at 10 diverse diabetes clinics across India and *** economic evaluation comprises both a within-trial cost-effectiveness analysis(mean 2.5 years follow up)and a microsimulation model-based cost-utility analysis(life-time horizon).Effectiveness measures include multiple risk factor control(achieving HbA1cquality adjusted life years(QALYs)measured by EQ-5D-3 L,hospitalizations,and diabetes related complications at the trial *** measures include direct medical and non-medical costs relevant to outpatient care(consultation fee,medicines,laboratory tests,supplies,food,and escort/accompanying person costs,transport)and inpatient care(hospitalization,transport,and accompanying person costs)of the intervention compared to usual diabetes ***,healthcare system,and societal perspectives will be applied for *** cost and health effects will be discounted at 3%per year for within trial cost-effectiveness analysis over 2.5 years and decision modelling analysis over a lifetime *** will be reported as the incremental cost-effectiveness ratios(ICER)to achieve multiple risk factor control,avoid diabetes-related complications,or QALYs gained against varying levels of willingness to pay threshold *** analyses will be performed to assess uncertainties around ICER estimates by varying costs(95%CIs)across publ

关键词： Economic evaluation Diabetes care Multicomponent strategy quality improvement South Asia

Stroke nurse-led intravenous thrombolytic therapy strategy for ischemic stroke based on timeline process:A quality improvement program from China

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International Journal of Nursing Sciences 2024年第5期11卷 521-527,I0001页

作者： Baiyu Li Zhufeng Zhang Keye Li Lingdie Zhao Rong Niu Department of Emergency Medicine Zhejiang HospitalHangzhouZhejiang ProvinceChina

Objective:Early thrombolytic therapy for ischemic stroke within the therapeutic window is associated with improved clinical *** study investigated whether optimizing intravenous thrombolytic(IVT)therapy strategies for stroke could reduce treatment ***:To reduce delays in IVT therapy for ischemic stroke,a series of quality improvement measures were implemented at a tertiary hospital in Hangzhou,Zhejiang Province,from June 2021 to August 2023,which included developing a timeline process management system,forming a nurse-led stroke process management team,providing homogeneous training,standardizing the IVT therapy process for ischemic stroke,and introducing an incentive *** the pre-(from June 2021 to February 2022,group A)and post-(from March to November 2022,group B1;from December 2022 to August 2023,group B2[implementation of an additional incentive policy])of the implementation the strategy,the door-tocomputed tomographic angiography(CTA)time(DCT),CTA time,neurology consultation to consent for IVT,CTA-to-needle time(CNT),and door-to-needle time(DNT),the percentage of people who underwent CTA within 20 min,15 min,and 10 min and DNT within 60 min,45 min,and 30 min were collected and ***:Following the implementation of the standardized IVT process management strategy for stroke,the DNT for group B1 and group B2 were 30(24,44)min and 31(24,41)min,respectively,both significantly lower than the 46(38,58)min in group A(P<0.001);the median DCT were both 13 min in group B1 and B2 lower than 17min in group A(P<0.001);the median CTA were 12 min in Group B1 and 9 min in Group B2 lower than 14 min in group A(P<0.001);similar results were observed during the neurology consultation to obtain consent for IVT and *** with group A,the proportion of DCT20 min,15 min,and 10 min was higher in groups B1 and B2(P<0.05),and the same result was observed at DNT60 min,45 min,and 30 min(P<0.05).However,the additional incentive policy did

关键词： Ischemic stroke Intravenous thrombolytic therapy Nurses Stroke process quality improvement

Developing an evidence-based and theory informed intervention to involve families in patients care after surgery: A quality improvement project

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International Journal of Nursing Sciences 2019年第4期6卷 352-361页

作者： Anne Maria Eskes Anne Marthe Schreuder Hester Vermeulen Els Jacqueline Maria Nieveen van Dijkum Wendy Chaboyer Department of Surgery Amsterdam UMCUniversity of AmsterdamUniversity of AmsterdamAmsterdamthe Netherlands Menzies Health Institute Queensland and School of Nursing and Midwifery Griffith UniversityGold CoastAustralia IQ Healthcare Radboud Institute of Health SciencesScientific Center for Quality of HealthcareNijmegenthe Netherlands

Objectives: In the post-surgical setting,active involvement of family caregivers has the potential to improve patient outcomes by prevention of surgical complications that are sensitive to fundamental *** paper describes the development of a theoretically grounded program to enhance the active involvement of family caregivers in fundamental care for post-surgical ***: We used a quality improvement project following a multi-phase *** Phase 1,an iterative method was used to combine evidence from a narrative review and professionals' *** Phase 2,the logic model underlying the program was developed guided by four steps: (1) confirm situation,intervention aim,and target population;(2) documented expected outcomes,and outputs of the intervention;(3) identify and describe assumptions,external factors and inputs;and (4) confirm intervention ***: Phase 1 identified a minimum set of family involvement activities that were both supported by staff and the narrative *** Phase 2,the logic model was developed and includes (1) the inputs (***-and environmental support),(2) the ultimate outcomes (*** of postoperative complications),(3) the intermediate outcomes (*** changes),and (4) immediate outcomes (*** knowledge,skills and attitude).Conclusions: We demonstrated how we aimed to change our practice to an environment in which family caregivers were stimulated to be actively involved in postoperative care on surgical wards,and how we took different factors into *** description of this program may provide a solid basis for professionals to implement the family involvement program in their own setting.

关键词： Family caregivers Hospital surgery department Nursing care Nursing models quality improvement

Interventions to Improve HIV Viral Load Suppression among the Adolescents: Evidence of improvement Science through a quality improvement Approach in Eastern Uganda

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World Journal of AIDS 2020年第2期10卷 94-106页

作者： Bonniface Oryokot Yunus Miya Barbara Logose Eunice Ajambo Abraham Ignatius Oluka Charles Odoi Bernard Michael Etukoit Levicatus Mugenyi Kenneth Mugisha Department of Program Management and Capacity Development The AIDS Support Organization (TASO) Kampala Uganda

Introduction: Achieving viral load suppression among the adolescents living with HIV continues to hold back attainment of sustainable development goals. TASO Mbale realized a viral load suppression rate of 63.1% among the adolescents living with HIV in care in quarter 4 of 2016. We therefore, instituted a quality imrpovement project to improve Viral load suppression from 63.1% in quarter 4 2016 to 90% by the end of quarter 4 2017. Method: Baseline data from the Uganda viral load dashboard were analyzed, and fishbone diagram was utilized to provide root causes of low viral load suppression among the adolescents living with HIV at TASO Mbale. The identified barriers were Knowlegde gap, among the adolescents, on positive living, Missing clinic appointments, Sub-optimal adherence, Poorly planned adolescent HIV clinic, Inadequate follow-up and Low use of data for informed decisions. A plan-do-study-act (PDSA) model was applied to implement tested changes. Strategies that worked included introduction of appointment register to track appointment behaviour of the adolescents, generating lists of clients on appointment who were due for Viral Load bleeding, telephone calls for follow up, increasing the frequency of reviewing adolescents from once a month to twice a week, committing a dedicated team responsible for adolescent care. Results: The viral load suppression improved from 63.1% in quarter 4 of 2016 to 63.8% in the first quarter of 2017, to 87.5% in quarter 2 of 2017, 97.6% in the third quarter and 91.4% in quarter 4 of 2017. Conclusion: The use of quality improvement in addressing gaps in HIV service delivery is highly effective.

关键词： HIV Adolescents Viral Load Suppression quality improvement

Reducing the Prevalence of Catheter-Related Infections by quality improvement: Six-Year Follow-Up Study

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Open Journal of Nursing 2016年第2期6卷 79-87页

作者： Dan Malm Bo Rolander Eva-Marie Ebefors Lisa Conlon Annette Nygårdh Department of Nursing School of Health and Welfare J&oumlnk&oumlping University J&oumlnk&oumlping Sweden Department of Internal Medicine County Hospital Ryhov J&oumlnk&oumlping Sweden Futurum Academy for Healthcare J&oumlnk&oumlping Sweden Department of Behavioral Science and Social Work School of Health and Welfare J&oumlnk&oumlping University J&oumlnk&oumlping Sweden

Background: Peripheral venous catheter (PVC) insertion is a crucial nursing action during life support. Several factors that increase the risk of thrombophlebitis associated with PVCs have been reported. Objective: We wish to evaluate the impact of a quality improvement regarding PVC treatment for patients with coronary heart diseases. Method: A longitudinal, quantitative observational study was carried out in 2008 and 2013 in a hospital in southern Sweden with 360 consecutive patients suffering from acute chest pain. New routines for PVC treatment were included in the hospital with daily inspection according to a checklist. A structured observation protocol was used to survey the prevalence of thrombophlebitis between 2008 and 2013. Also, we examined the relationship between the location and luminal diameters of PVCs. Results: The student’s t-test showed significant differences between 2008 and 2013 with respect to luminal diameter of PVCs (p = 0.002), prevalence of thrombophlebitis (p = 0.003) and number of days with PVC left in situ (p quality and safety in patients with acute chest pain having PVC-based treatment.

关键词： Bloodstream Infection Peripheral Venous Catheter quality improvement Thrombophlebitis

Research on the Construction and quality improvement of Art Curriculum in Rural Primary Schools

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Journal of Contemporary Educational Research 2023年第10期7卷 145-149页

作者： Yanjin Li Sichuan Normal University Chengdu 610066Sichuan ProvinceChina

Curriculum quality is the foundation of education development and the core element of primary education and *** is a key indicator to measure and evaluate the level of educational development in a country and *** quality needs to be examined not only from the perspective of the degree of achievement of the preset curriculum goals,but also from the perspective of students’subjective feelings and *** course is the core service provided by the school for students,and the quality of the course is judged by the acquisition and development of *** the same time,the value of aesthetic education also calls for the reform and improvement of the fine arts curriculum,which requires the fine arts curriculum in all stages in rural areas to get closer and change in this *** the promulgation of art curriculum standards,the fine arts curriculum of rural primary schools should follow high quality standards,which is a process of optimization and iteration of various elements of primary art *** fine arts curriculum of rural primary schools needs to meet the exploration needs of current students,effectively and appropriately develop excellent local resources while enriching the curriculum content,introduce the essence of regional culture and art,improve the evaluation of curriculum quality,and form a scientific curriculum management system,so as to promote the sustainable development of *** to this understanding,we can improve the quality of art curriculum in rural primary schools from four dimensions:curriculum objectives,curriculum content,curriculum implementation,and curriculum evaluation.

关键词： Primary school Art curriculum quality improvement