[Construction of early warning indicators of in-hospital cardiac arrest in adult inpatients].

OBJECTIVE: To establish early warning indicators for Chinese nurses to recognize in-hospital cardiac arrest (IHCA) of adult inpatients. METHODS: Computer retrieval of Chinese and English databases such as CNKI, Wanfang Database, VIP, National Medical Library of the United States PubMed Database, Web of Science, Embase Database of the Netherlands Medical Abstracts, Cochrane Library Database and other international guidelines collaboration network (GIN), National Institute for Health and Clinical Optimization (NICE), Scottish Intercollegiate Guidelines Network (SIGN), BMJ best clinical practice and other guidelines was performed. The retrieval time limit for respiratory and cardiac arrest early warning indicators or risk identification related content of the adult inpatient in the professional website was until June 30, 2020. After literature research and expert group analysis, the research group drew up an expert correspondence questionnaire, and selected 32 medical and nursing experts from Beijing, Tianjin, Jilin, Shandong, Shaanxi, Sichuan, Zhejiang and other grade three first-class general hospitals from July to September 2022. The Delphi method was used to conduct two rounds of expert correspondence, forming the final version of the early warning index of cardiac arrest in adult inpatients. RESULTS: Five first-level indicators, 23 second-level indicators and 41 third-level indicators including vital signs, consciousness and pupils, postoperative blood drainage volume, lab results and other five aspects were initially formed. The effective response rates of the two rounds of expert correspondence were 100% (32/32) and 93.75% (30/32), respectively, the Kendall coordination coefficients W of the first round and the second round were 0.340 and 0.462, respectively, the expert authority coefficients Cr were 0.88 and 0.89, respectively, the mean value of importance assignment was 3.94-5.00, 4.07-5.00, and the coefficient of variation was 0-0.16, 0-0.14, with statistically significant differences (all P < 0.05). Finally, 5 primary indicators, 23 secondary indicators and 43 tertiary indicators were formed, including five aspects of vital signs, consciousness and pupils, postoperative blood drainage, lab results, symptoms and chief complaints. CONCLUSIONS: The expert consultation on the early warning indicators of IHCA for adult patients tends to be consistent and scientific, which is applicable to help nurses detect the changes of patients' condition as early as possible.

Spatial-Temporal Correlations between Soil pH and NPP of Grassland Ecosystems in the Yellow River Source Area, China.

In recent years, ecological concerns such as vegetation destruction, permafrost deterioration, and river drying have been paid much more attention to on the Yellow River Basin in China. Soil pH is regarded to be the fundamental variable among soil properties for vegetation growth, while net primary productivity (NPP) is also an essential indicator to reflect the healthy growth of vegetation. Due to the limitation of on-site samples, the spatial−temporal variations in soil pH and NPP, as well as their intrinsic mechanisms, remain unknown, especially in the Yellow River source area, China. Therefore, it is imperative to investigate the coupling relationship between soil pH and NPP of the area. The study coupled MODIS reflectance data (MOD09A1) with on-site soil pH to estimate spatial−temporal variations in soil pH, explore the response of NPP to soil pH, and assess the extent to which they contribute to grassland ecosystems, thus helping to fill knowledge gaps. Results indicated that the surface spectral reflectance for seven bands could express the geographic pattern of soil pH by applying a multiple linear regression equation; NPP exhibited an increasing trend while soil pH was the contrary in summer from 2000 to 2021. In summer, NPP was negatively correlated with soil pH and there was a lag effect in the response of NPP to soil pH, revealing a correlation between temperate steppes > montane meadows > alpine meadows > swamps in different grassland ecosystems. In addition, contribution indices for temperate steppes and montane meadows were positive whereas they were negative for swamps and alpine meadows, which are apparent findings. The contribution index of montane and alpine meadows was greater than that of temperate steppes and swamps. The approach of the study can enable managers to easily identify and rehabilitate alkaline soil and provides an important reference and practical value for ecological restoration and sustainable development of grassland ecosystems in alpine regions.