The effectiveness of continuing education programmes for health workers in rural and remote areas: a systematic review and meta-analysis

Introduction: Health workers in rural and remote areas shoulder heavy responsibilities for rural residents. This systematic review aims to assess the effectiveness of continuing education programs for health workers in rural and remote areas. Methods: Eight electronic databases were searched on 28 November 2021. Randomized controlled trials (RCTs) and quasi-experimental studies evaluating the effectiveness of continuing education for health workers in rural and remote areas were included. The quality of the studies was assessed using the risk of bias tool provided by Effective Practice and Organization of Care. A meta-analysis was performed for eligible trials, and the other findings were presented as a narrative review because of inconsistent study types and outcomes. Results: A total of 17 studies were included, four of which were RCTs. The results of the meta-analysis showed that compared to no intervention, continuing education programs significantly improved the knowledge awareness rate of participants (odds ratio=4.09, 95% confidence interval 2.51-6.67, p<0.05). Qualitative analysis showed that 12 studies reported on the level of knowledge of participants, with all showing positive changes. Eight studies measured the performance of health workers in rural and remote areas, with 87.50% (n=7) finding improved performance. Two studies reported on the impact of continuing education programs for health workers in rural and remote areas on patient health, with only one showing a positive change. One study from India measured the health of communities, which showed a positive change. Conclusion: The results of this study showed that continuing education programs are an effective way to address the lack of knowledge and skills among health workers in rural and remote areas. Few studies have examined the effectiveness of education programs for health workers in rural and remote areas in improving patient health outcomes. It is not yet known whether the delivery of continuing education programs to health workers in rural areas has a positive impact on patient and community health. Future attention should continue to be paid to the impact on these outcomes

Memorizing environmental signals through feedback and feedforward loops.

Cells in diverse organisms can store the information of previous environmental conditions for long periods of time. This form of cellular memory adjusts the cells responses to future challenges, providing fitness advantages in fluctuating environments. Many biological functions, including cellular memory, are mediated by specific recurring patterns of interactions among proteins and genes, known as network motifs. In this review, we focus on three well-characterized network motifs - negative feedback loops, positive feedback loops, and feedforward loops, which underlie different types of cellular memories. We describe the latest studies identifying these motifs in various molecular processes and discuss how the topologies and dynamics of these motifs can enable memory encoding and storage

Research of Preventive Maintenance Task Optimization of Military Aircraft Based on S4000P

Preventive maintenance is the main measure to restore and maintain the safety and reliability of the aircraft, and its optimization as a common concern is concerned by both aircraft manufacturers and users. The international mainstream preventive maintenance task optimization methods and their applicable objects are investigated. Based on the S4000P ISMO (in-service maintenance optimization) process suitable for equipment, the characteristics of military aircraft is combined to perform the adjustment and personalized design for the original process, and construct the logic process of preventive maintenance task optimization. The results show that the task optimization process can be used for the optimization analysis of military aircraft preventive maintenance task

The Mechanism for siRNA Transmembrane Assisted by PMAL

The capacity of silencing genes makes small interfering RNA (siRNA) appealing for curing fatal diseases. However, the naked siRNA is vulnerable to and degraded by endogenous enzymes and is too large and too negatively charged to cross cellular membranes. An effective siRNA carrier, PMAL (poly(maleic anhydride-alt-1-decene) substituted with 3-(dimethylamino) propylamine), has been demonstrated to be able to assist siRNA transmembrane by both experiments and molecular simulation. In the present work, the mechanism of siRNA transmembrane assisted by PMAL was studied using steered molecular dynamics simulations based on the martini coarse-grained model. Here two pulling rates, i.e., 10−6 and 10−5 nm·ps−1, were chosen to imitate the passive and active transport of siRNA, respectively. Potential of mean force (PMF) and interactions among siRNA, PMAL, and lipid bilayer membrane were calculated to describe the energy change during siRNA transmembrane processes at various conditions. It is shown that PMAL-assisted siRNA delivery is in the mode of passive transport. The PMAL can help siRNA insert into lipid bilayer membrane by lowering the energy barrier caused by siRNA and lipid bilayer membrane. PMAL prefers to remain in the lipid bilayer membrane and release siRNA. The above simulations establish a molecular insight of the interaction between siRNA and PMAL and are helpful for the design and applications of new carriers for siRNA delivery

Effects of Epichloë endophyte on antioxidant enzymes activities, photosynthesis and growth of three ecotypes of Elymus dahuricus

Fungal endophytes of some cultivated grasses can increase plant performance and competitive abilities, especially under stress. Far less is known about the influence of Epichloë infections in wild populations of wild grasses. In this study, plants of three Elymus dahuricus ecotypes (WLS, QY and WTS) either infected with Epichloë endophyte (E+) or uninfected (E–) were grown in the field. The activities of the antioxidant enzymes ascorbate peroxidase, catalase, peroxidase and superoxide dismutase, and concentrations of H2O2 and malondialdehyde were examined in the leaves of E+ and E– plants. We also determined photosynthesis parameters, leaf blade and sheath carbohydrate concentration and plant growth parameters of both E+ and E– plants. E+ plants from the WLS and QY populations had significantly higher antioxidant enzyme activities and photosynthetic capability (P<0.05), superior growth characteristics including more abundant carbohydrate concentration than E– plants. In contrast, in plants from the WTS population, the endophyte had no significant effect on reactive oxygen species scavenging capability and growth performance (P>0.05), and even displayed some negative effects on plant photosynthetic capability. Thus, endophyte infection significantly affected E. dahuricus antioxidant enzyme activities (P<0.05), photosynthesis and growth capability, although, the effects varied with plant ecotypes

PROTOCOL: Home‐based care for people with dementia: A systematic review

Abstract The abstract section should read: This is the protocol for a Campbell systematic review. The objectives are as follows: (1) Which formal HBC services for people with dementia have been tested in an RCT? (2) How effective are the different formal HBC services in improving the physical and mental health outcomes of people with dementia? (3) What is the cost and patient's health service usage of different formal HBC services

Research of preventive maintenance task interval optimization model and method of aircraft

Aircraft maintenance order specifies all preventive maintenance tasks involved in aircraft basic level maintenance. During the beginning of aircraft service,the maintenance tasks are intended to be conservative. With the accumulation of aircraft use and maintenance experience,the demand for optimization of maintenance task interval is becoming more and more obvious. Taking the service data as the analysis object and the system reliability as the measurement standard,the optimization analysis method of preventive maintenance task interval is constructed and a realizable mathematical model is formed in this paper. Taking a maintenance task as an example,its service data are analyzed and suggestions on maintenance interval optimization are given. The example has proved the feasibility of the mathematical method and model which can be used as a reference for military aircraft maintenance task interval optimization analysis

Numerical simulation of the law of response to high-frequency acoustic-induced vibration along gas pipeline with corrosion defects

[Objective] High-frequency acoustic energy generated by gas passing through decompression devices induces high-order modes of the pipeline wall, leading to acoustic-induced vibrations of the pipeline structure. These vibrations can potentially trigger fatigue failures at discontinuous, such as welded supports, tees, and areas of pipeline corrosion defects, over a short period. [Methods] Initially, the infuence of sound source strength was quantified by calculating the noise spectrum and converting the sound power levels into sound pressure levels.A finite element model was created to simulate acoustic-induced vibrations in a gas pipeline featuring corrosion defects. Acoustic pressure was applied to the pipeline wall within the model to investigate the impact of corrosion defect dimensions on acoustic-induced vibrations,i.e. length, width, and depth. Subsequently, the obtained results were compared against the evaluation outcomes derived from the Energy Institute(EI) guidelines. [Results] Under varying dimensionless lengths of corrosion defects, the gas pipeline exhibited stress responses characterized by hump-like fuctuations. Specifically, the stress level initially increased and then decreased corresponding to increases in dimensionless defect length. However, the stress concentration weakened with increasing dimensionless defect lengths. As the defect width increased, the gas pipeline showed a uniform stress distribution. Additionally, the pipeline stress fuctuated in a saddle shape with increases in dimensionless defect depth. Specifically, the gas pipeline experienced initial decreases followed by rises in the stress level. [Conclusion] This study reveals the substantial impact of corrosion defects on gas pipeline's stress responses, highlighting the most noticeable impact from the length of corrosion defects. Furthermore, corrosion defects with dimensionless depths over 0.6 lead to significant increases in their infuence on the stress and vibration modes of gas pipelines. Consequently, future research should focus on investigating the impact of corrosion defect depths on acoustic-induced vibrations. The quantitative analysis outcomes of acoustic-induced vibration responses in gas pipelines with corrosion defects not only offer theoretical support for mitigating strong vibrations of gas pipelines but also serve as a reference basis for gas pipelines across design, construction, operation, and maintenance stages