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关键词： Choice architecture   Food environment   SES   Health inequalities   Public health  

摘要： Background: Nudging is increasingly used to promote healthy food choices in supermarkets. Ordering groceries online is gaining in popularity and nudging seems efficacious there as well, but is never comprehensively tested in real-life. We evaluated the real-life effectiveness of nudging in an online supermarket on healthy food purchases. Methods: We conducted a multi-arm, parallel-group, individually randomized controlled trial in an online supermarket. During 1 month, all customers were randomized to (1) control condition, (2) information nudges, (3) position nudges, and (4) information and position nudges combined. Allocation was concealed and customers were not blinded, but unaware of the intervention. Mean differences between the control condition and the intervention arms in the total percentage of healthy purchases were assessed with a linear mixed model. We tested for effect modification by area-level deprivation. Results: Based on sales data from 11,775 shoppers, no overall significant effects were detected. Yet, effects were modified by area-level deprivation (p(Arm 2) < 0.001). Among shoppers from deprived areas, those allocated to information nudges purchased a 2.4% (95%CI 0.8, 4.0) higher percentage of healthy products compared to controls. No significant differences were observed for position (- 1.3%;95%CI - 2.8, 0.3) and combined nudges (- 0.1%;95%CI - 1.7, 1.5). Shoppers from non-deprived areas exposed to information nudges (- 1.6%;95%CI - 3.2, - 0.1) and the combined nudges (- 2.1%;95%CI - 3.6, - 0.6), but not position nudges (- 0.9%;95%CI - 2.4, 0.7), purchased a lower percentage of healthy products. Conclusion: Information nudges in an online supermarket can increase healthy product purchases, but only for those living in deprived areas. The adverse effects found on purchasing behaviors for those from non-deprived areas call for further research. Further research should also focus on real-life effects of online healthy food nudging as part of a bro

关键词： Concentrated solar power   Nonlinear model predictive control   Coalitional control   Distributed solar collector field   Solar thermal applications   Thermal energy efficiency  

摘要： This article focuses on maximizing the thermal energy collected by parabolic-trough solar collector fields to increase the production of the plant. To this end, we propose a market-based clustering model predictive control strategy in which controllers of collector loops may offer and demand heat transfer fluid in a market. When a transaction is made between loop controllers, a coalition is formed, and the corresponding agents act as a single entity. The proposed hierarchical algorithm fosters the formation of coalitions dynamically to improve the overall control objective, increasing the thermal energy delivered by the field. Finally, the proposed controller is assessed via simulation with other control methods in two solar parabolic-trough fields. The results show that the energy efficiency with the clustering strategy outperforms by 12% that of traditional controllers, and the method is implementable in real-time to control large-scale solar collector fields, where significant gains in thermal collected energy can be obtained, due to its scalability.

关键词： Geo-economic variation   Intraoperative ventilation   ARISCAT score   Postoperative pulmonary complications   ventilation   intraoperative ventilation   Ventilator management  

摘要： Background: The aim of this analysis is to determine geo-economic variations in epidemiology, ventilator settings and outcome in patients receiving general anesthesia for surgery. Methods: Posthoc analysis of a worldwide study in 29 countries. Lower and upper middle-income countries (LMIC and UMIC), and high-income countries (HIC) were compared. The coprimary endpoint was the risk for and incidence of postoperative pulmonary complications (PPC);secondary endpoints were intraoperative ventilator settings, intraoperative complications, hospital stay and mortality. Results: Of 9864 patients, 4% originated from LMIC, 11% from UMIC and 85% from HIC. The ARISCAT score was 17.5 [15.0-26.0] in LMIC, 16.0 [3.0-27.0] in UMIC and 15.0 [3.0-26.0] in HIC (P=.003). The incidence of PPC was 9.0% in LMIC, 3.2% in UMIC and 2.5% in HIC (P <.001). Median tidal volume in ml kg(-1) predicted bodyweight (PBW) was 8.6 [7.7-9.7] in LMIC, 8.4 [7.6-9.5] in UMIC and 8.1 [7.2-9.1] in HIC (P<.001). Median positive end-expiratory pressure in cmH(2)O was 3.3 [2.0-5.0]) in LMIC, 4.0 [3.0-5.0] in UMIC and 5.0 [3.0-5.0] in HIC (P<.001). Median driving pressure in cmH(2)O was 14.0 [11.5-18.0] in LMIC, 13.5 [11.0-16.0] in UMIC and 12.0 [10.0-15.0] in HIC (P<.001). Median fraction of inspired oxygen in % was 75 [50-80] in LMIC, 50 [50-63] in UMIC and 53 [45-70] in HIC (P<.001). lntraoperative complications occurred in 25.9% in LMIC, in 18.7% in UMIC and in 37.1% in HIC (P<.001). Hospital mortality was 0.0% in LMIC, 1.3% in UMIC and 0.6% in HIC (P= .009). Conclusion: The risk for and incidence of PPC is higher in LMIC than in UMIC and HIC. Ventilation management could be improved in LMIC and UMIC.

关键词： Airway management   Glottic exposure classification   General anesthesia   SaCoVLM (TM) video laryngeal mask   Sealing pressure  

摘要： Background: To preliminary evaluate the application of SaCoVLM (TM) video laryngeal mask airway in airway management of general anesthesia. Methods: We recruited 100 adult patients (ages 18-78 years, male 19, female 81, weight 48-90 kg) with normal predicted airway (Mallampati I similar to II, unrestricted mouth opening, normal head and neck mobility) and ASA I-II who required general anaesthesia. The SaCoVLM (TM) was inserted after anesthesia induction and connected with the anesthesia machine for ventilation. Our primary outcome was glottic visualization grades. Secondary outcomes included seal pressure, success rate of insertion, intraoperative findings (gastric reflux and contraposition), gastric drainage and 24-h complications after operation. Results: The laryngeal inlet was exposed in all the patients and shown on the video after SaCoVLM (TM) insertion. The status of glottic visualization was classified: grade 1 in 55 cases, grade 2 in 23 cases, grade 3 in 14 cases and grade 4 in 8 cases. The first-time success rate of SaCoVLM (TM) insertion was 95% (95% CI = 0.887 to 0.984), and the total success rate was 96% (95% CI = 0.901 to 0.989). The sealing pressure of SaCoVLM (TM) was 34.1 +/- 6.2 cmH(2)O and the gastric drainage were smooth. Only a small number of patients developed mild complications after SaCoVLM (TM) was removed (such as blood stains on SaCoVLM (TM) and sore throat). Conclusions: The SaCoVLM (TM) can visualize partial or whole laryngeal inlets during the surgery, with a high success rate, a high sealing pressure and smooth gastroesophageal drainage. SaCoVLM (TM) could be a promise new effective supraglottic device to airway management during general anesthesia.

关键词： 维修   易损件   管理   平台  

摘要： 油气长输管道中的机、泵、炉、管、罐等设备担负着油气增压、储存和运输的主要任务,是油气储运系统的核心设备,设备完好是完成生产任务的保障。本文通过对输油设备易损件科学管理方法进行研究,通过制订科学的管理制度、搭建数字化管理平台、探索易损件分级和完好性评价方法,实现公司油气输送设备易损件的全生命周期的管理,有利于统一管理、资源共享、减少资金占压和大数据分析,为公司易损件的管理提供新的模式,为设备高质量维保提供平台。

关键词： 创建模式   优化系统   科学管理   教育主阵地   落地   育人   关键环节   日常运行  

摘要： 随着"双减"政策的出台,作业的重要性、作业问题的复杂性,以及解决作业问题的紧迫性,从来没有像现在这样受政府、学校和社会高度关注。学校作为教育主阵地,有必要且有责任对作业问题重新审视,进一步促进全面系统的作业治理与改革,这也将对"双减"工作产生重要的推动作用。我们在继承优良做法的基础上,升维观念,优化系统,创建模式,科学管理,让作业真正成为育人的关键环节,让"双减"在学校日常运行中平稳落地。

摘要： 糖尿病常被认为是肥胖人的"专利",其实这并不绝对.虽然肥胖是糖尿病的危险因素,但瘦人也不代表就进了"保险箱".张先生今年40出头,双亲均有糖尿病.半年前,因为不明原因体重下降,查出有"2型糖尿病".