An evaluation of outpatient satisfaction based on the national standard questionnaire: a satisfaction survey conducted in a tertiary hospital in Shenyang, China

BackgroundPatient satisfaction survey serves as a pivotal tool in evaluating the quality of healthcare services. China’s nationwide standard patient satisfaction measurement tool was introduced in 2019. This study aimed to assess the model fit of the national standard outpatient satisfaction questionnaire in a tertiary hospital and evaluate the outpatient satisfaction levels using this tool.MethodA cross-sectional survey using the national outpatient satisfaction questionnaire was conducted via message links to all hospital outpatients who registered between April and July 2022. The data collected underwent descriptive analysis, comparative analysis, and confirmatory factor analysis (CFA).ResultsA total of 6,012 valid responses were received and analyzed during this period, with 52.9% of the participants being women. The confirmatory factor analysis (CFA) model showed a good fit and identified doctor communication as having a positive effect and environmental factors as having a negative effect on outpatients’ satisfaction, with standardized regression weights of 0.46 and 0.42, respectively. Despite the remarkably high satisfaction levels, patients’ recommendation for using the services of this hospital surpassed the overall evaluation and total satisfaction scores.ConclusionA disparity was identified between the expectations and real experiences of outpatients, leading to some extent of dissatisfaction. To enhance satisfaction levels, the hospital should improve the communication skills of all clinical staff, simplify the environment layout for first-time visitors, and manage patient overloads

Rare microbial taxa as the major drivers of nutrient acquisition under moss biocrusts in karst area

Karst rocky desertification refers to the process of land degradation caused by various factors such as climate change and human activities including deforestation and agriculture on a fragile karst substrate. Nutrient limitation is common in karst areas. Moss crust grows widely in karst areas. The microorganisms associated with bryophytes are vital to maintaining ecological functions, including climate regulation and nutrient circulation. The synergistic effect of moss crusts and microorganisms may hold great potential for restoring degraded karst ecosystems. However, our understanding of the responses of microbial communities, especially abundant and rare taxa, to nutrient limitations and acquisition in the presence of moss crusts is limited. Different moss habitats exhibit varying patterns of nutrient availability, which also affect microbial diversity and composition. Therefore, in this study, we investigated three habitats of mosses: autochthonal bryophytes under forest, lithophytic bryophytes under forest and on cliff rock. We measured soil physicochemical properties and enzymatic activities. We conducted high-throughput sequencing and analysis of soil microorganisms. Our finding revealed that autochthonal moss crusts under forest had higher nutrient availability and a higher proportion of copiotrophic microbial communities compared to lithophytic moss crusts under forest or on cliff rock. However, enzyme activities were lower in autochthonal moss crusts under forest. Additionally, rare taxa exhibited distinct structures in all three habitats. Analysis of co-occurrence network showed that rare taxa had a relatively high proportion in the main modules. Furthermore, we found that both abundant and rare taxa were primarily assembled by stochastic processes. Soil properties significantly affected the community assembly of the rare taxa, indirectly affecting microbial diversity and complexity and finally nutrient acquisition. These findings highlight the importance of rare taxa under moss crusts for nutrient acquisition. Addressing this knowledge gap is essential for guiding ongoing ecological restoration projects in karst rocky desertification regions

Nasopharyngeal Carcinoma: The Role of the EGFR in Epstein–Barr Virus Infection

Epstein–Barr virus (EBV), a type 4 γ herpes virus, is recognized as a causative agent in nasopharyngeal carcinoma (NPC). Incidence of EBV-positive NPC have grown in recent decades along with worse outcomes compared with their EBV-negative counterparts. Latent membrane protein 1 (LMP1), encoded by EBV, induces NPC progression. The epidermal growth factor receptor (EGFR), a member of the ErbB family of receptor tyrosine kinases (RTK), is a driver of tumorigenesis, including for NPC. Little data exist on the relationship between EGFR and EBV-induced NPC. In our initial review, we found that LMP1 promoted the expression of EGFR in NPC in two main ways: the NF-κB pathway and STAT3 activation. On the other hand, EGFR also enhances EBV infection in NPC cells. Moreover, activation of EGFR signalling affects NPC cell proliferation, cell cycle progression, angiogenesis, invasion, and metastasis. Since EGFR promotes tumorigenesis and progression by downstream signalling pathways, causing poor outcomes in NPC patients, EGFR-targeted drugs could be considered a newly developed anti-tumor drug. Here, we summarize the major studies on EBV, EGFR, and LMP1-regulatory EGFR expression and nucleus location in NPC and discuss the clinical efficacy of EGFR-targeted agents in locally advanced NPC (LA NPC) and recurrent or metastatic NPC (R/M NPC) patients

Effects of a physical activity promotion programme on body composition in emerging adults with physical inactivity: a study protocol of a randomised controlled trial

Introduction A dramatic decline in physical activity may occur in emerging adulthood because of a major transition over the course of a life. The potential for implementing structured behaviour modification strategies to enhance risk-reducing clinical outcomes is widely recognised. The active participation of clients in the discussion and care process is crucial for optimising intervention outcomes and enhancing individuals’ motivation to adopt and maintain healthy behaviours. This study therefore aims to evaluate the effectiveness of a physical activity promotion programme based on the goal attainment theory in relation to emerging adults’ body composition, using a face-to-face and e-health blended interventions.Methods and analysis A two-arm, double-blind, randomised, controlled study will be conducted in 114 university students aged 18–25 years with physical inactivity. The intervention assignment will be blind to study participants, outcome assessors and study statisticians. A goal achievement theory-based physical activity promotion programme is developed in this study, which is a 16-week, face-to-face and e-health-blended physical activity promotion intervention. After informed consent, participants will be randomly assigned to either a control group or a treatment group before the start of the study. The primary outcome is body composition (ie, skeletal muscle mass, body fat mass, body mass index and body fat percentage). Other outcomes include physical activity level, goal attainment scale scores, exercise self-efficacy and motivation level, which will be assessed during the intervention (every 4 weeks) and at the 1 month follow-up. Continuous variables have means and SD, while categorical variables have frequencies and percentages. Independent-samples t-tests will be used to compare continuous variable changes. χ2 tests will be used to compare categorical variable changes. Based on the baseline scores, analysis of covariance will compare the follow-up results.Ethics and dissemination This study was approved by the Ethics Committee of Hangzhou Normal University (ratification date: 14 November 2022, 2022059). The results of the study will be submitted for publication and dissemination in a peer-reviewed journal.Trial registration number NCT05697679

Complex Interrelationships between Ecosystem Services Supply and Tourism Demand: General Framework and Evidence from the Origin of Three Asian Rivers

Over the past two decades, the demands of nature-based tourism have been rapidly growing worldwide, yet it is not clear how tourist demands for water, food, and infrastructure influence the ecosystem services (ES), which are often the bedrock of an area’s economic, cultural, and natural wealth. With a general conceptual model that applies the telecoupling framework, this study identifies complex interrelationships between the demand for nature-based tourism, which is a type of cultural ES, ES supply, and the economy simultaneously, using China’s Qinghai Province as a demonstration site. The province is the origin of three rivers, making it crucial for water retention and prime for tourism. The results indicate that there is a strong spatial interaction between the number of tourism attractions and water retention. The southern Qinghai region’s natural resources are protected by the Sanjiangyuan (three rivers headwater) National Park. From 2010⁻2014, tourists in the Sanjiangyuan region spent more money than those in the northern Qinghai region, which has accelerated the development of tourism infrastructures. The Sanjiangyuan region may face the unexpected degradation of its natural habitats due to rapid tourism development. Our findings suggest that new management plans are needed to minimize the negative impacts from the demands of distant tourists, and preserve the region that supports both the environment and the economy

Underground roadway shape variable monitoring algorithm based on laser radar

In order to solve the problem of correct monitoring of underground roadway shape variables, a monitoring algorithm of underground roadway shape variables based on laser radar is designed based on the installation of high-precision laser radar and vehicle aided positioning system in underground intelligent vehicle; the overall framework of the monitoring algorithm is established, and the key technologies in laser radar data acquisition and preprocessing are described in detail; based on the existing knowledge accumulation of underground roadway scene monitoring and around the feature extraction of discrete points, an improved special point registration algorithm is constructed, which solves the problem that the feature points of roadway scene are sparse and can not be registered effectively; the distance from point to surface is used to pick out outliers, quickly calculate the offset of points, quickly extract high-density outliers through the density clustering algorithm of DBSCAN, quickly screen the deformation area, analyze the deformation degree, and realize the intelligent deformation monitoring of underground roadway surface. The test results show that the roadway deformation monitoring algorithm based on laser radar can monitor the roadway surface shape changes under logging in real time, dynamically and accurately, and can ensure the normal operation of underground roadway and protect the safety of miners’ life and property

A Simple Photonic System for DFS and AOA Simultaneous Measurement

A simple photonics-based dual-channel system is proposed to simultaneously measure the Doppler frequency shift (DFS) and angle of arrival (AOA) of microwave signals. The system applies two parallel push–pull Mach–Zehnder modulators (MZMs) for carrier suppression dual-sideband (CS-DSB) modulation. The introduction of the reference signal results in a DFS measurement without direction ambiguity. The DFS can be determined by measuring the frequency of the down-converted intermediate frequency (IF) signal, and the AOA can be calculated by comparing the phase shift of the two channels. A proof-of-concept experiment shows that the DFS measurement error is less than 0.4 Hz during ±100 kHz, and the AOA measurement error is within 1.5° in a range of 0–70°

A Simple Photonic System for DFS and AOA Simultaneous Measurement

A simple photonics-based dual-channel system is proposed to simultaneously measure the Doppler frequency shift (DFS) and angle of arrival (AOA) of microwave signals. The system applies two parallel push–pull Mach–Zehnder modulators (MZMs) for carrier suppression dual-sideband (CS-DSB) modulation. The introduction of the reference signal results in a DFS measurement without direction ambiguity. The DFS can be determined by measuring the frequency of the down-converted intermediate frequency (IF) signal, and the AOA can be calculated by comparing the phase shift of the two channels. A proof-of-concept experiment shows that the DFS measurement error is less than 0.4 Hz during ±100 kHz, and the AOA measurement error is within 1.5° in a range of 0–70°