Urban shrinkage has emerged as a widespread phenomenon globally and has a significant impact on land,particularly in terms of land use and price.This study focuses on 2851 county-level cities in China in 2005–2018(ex...Urban shrinkage has emerged as a widespread phenomenon globally and has a significant impact on land,particularly in terms of land use and price.This study focuses on 2851 county-level cities in China in 2005–2018(excluding Hong Kong,Macao,Taiwan,and‘no data’areas in Qinhai-Tibet Plateau)as the fundamental units of analysis.By employing nighttime light(NTL)data to identify shrinking cities,the propensity score matching(PSM)model was used to quantitatively examine the impact of shrinking cities on land prices,and evaluate the magnitude of this influence.The findings demonstrate the following:1)there were 613 shrinking cities in China,with moderate shrinkage being the most prevalent and severe shrinkage being the least.2)Regional disparities are evident in the spatial distribution of shrinking cities,especially in areas with diverse terrain.3)The spatial pattern of land price exhibits a significant correlated to the economic and administrative levels.4)Shrinking cities significantly negatively impact on the overall land price(ATT=–0.1241,P<0.05).However,the extent of the effect varies significantly among different spatial regions.This study contributes novel insights into the investigation of land prices and shrinking cities,ultimately serving as a foundation for government efforts to promote the sustainable development of urban areas.展开更多
Sickle cell disease (SCD) is a prevalent condition, particularly in the countries of sub-Saharan Africa, where the presence of specific genes associated with Malaria contributes to its high prevalence. Patients with s...Sickle cell disease (SCD) is a prevalent condition, particularly in the countries of sub-Saharan Africa, where the presence of specific genes associated with Malaria contributes to its high prevalence. Patients with sickle cell disease frequently experience painful episodes necessitating hospitalization, and their hemoglobin levels are typically lower than those of the general population. There are different treatment options available to manage complications, such as transfusing blood, hydroxyurea, and strong anti-pains. However, with all these treatments, patients still commonly experience pain crises and suffer from organ damage. Hydroxyurea, the sole approved medication for sickle cell anemia in developed and developing countries, is widely used in children despite being primarily indicated for adults. Multiple studies have demonstrated the efficacy of hydroxyurea in inducing HbF production in young children with SCD. Elevated HbF levels have been associated with improved clinical outcomes, including a reduction in vaso-occlusive crises, acute chest syndrome, and the need for blood transfusions. Furthermore, increased HbF levels have been shown to ameliorate disease-related organ damage, such as pulmonary hypertension and sickle cell retinopathy. The response to hydroxyurea treatment in young children with SCD is variable. Some patients achieve substantial increases in HbF levels and experience significant clinical benefits, while others may have a more modest response. Factors influencing the response include baseline HbF levels, genetic modifiers, treatment adherence, and dose optimization. Safety is a crucial consideration when using hydroxyurea in young children. Studies have shown that hydroxyurea is generally well-tolerated, with the most common adverse effects being myelosuppression, gastrointestinal symptoms, and dermatological manifestations. However,long-term effects and potential risks, such as renal dysfunction and reproductive impacts, require further investigation. The effectiveness of hydroxyurea in young children with SCD has been demonstrated in various clinical trials and observational studies. These studies have shown a significant reduction in disease-related complications and improved quality of life. However, optimal dosing, treatment duration, and long-term outcomes are still areas of ongoing research. This review focuses on recent studies investigating the benefits, effectiveness, responses, and safety of hydroxyurea in pediatric individuals diagnosed with sickle cell disease.展开更多
Objective: To evaluate the role of prevention and control strategies for nosocomial infection in a tertiary teaching hospital during the sudden outbreak of Corona Virus Disease 2019 (COVID-19). Methods: The hospital i...Objective: To evaluate the role of prevention and control strategies for nosocomial infection in a tertiary teaching hospital during the sudden outbreak of Corona Virus Disease 2019 (COVID-19). Methods: The hospital initiated an emergency plan involving multi-departmental defense and control. It adopted a series of nosocomial infection prevention and control measures, including strengthening pre-examination and triage, optimizing the consultation process, improving the hospital’s architectural composition, implementing graded risk management, enhancing personal protection, and implementing staff training and supervision. Descriptive research was used to evaluate the short-term effects of these in-hospital prevention and control strategies. The analysis compared changes in related evaluation indicators between January 24, 2020 and February 12, 2020 (Chinese Lunar New Year’s Eve 2020 to lunar January 19) and the corresponding lunar period of the previous year. Results: Compared to the same period last year, the outpatient fever rate increased by 1.85-fold (P P Conclusion: The nosocomial infection prevention and control strategies implemented during this specific period improved the detection and control abilities for the COVID-19 source of infection and enhanced the compliance with measures. This likely contributed significantly to avoiding the occurrence of nosocomial infection.展开更多
A good quality Environmental Impact Statement (EIS) is key for the effectiveness of Environmental Impact Assessment (EIA) processes and consequently to the acceptability of projects subject to EIA. The international l...A good quality Environmental Impact Statement (EIS) is key for the effectiveness of Environmental Impact Assessment (EIA) processes and consequently to the acceptability of projects subject to EIA. The international literature has contributed to the understanding of the essential aspects to be verified regarding the quality of EIS, offering a wide spectrum of good practice examples related to the content of the studies. Even so, there is a need for empirical studies that allow the identification of specific aspects related to the context of application of the EIS, which could lead to the identification of opportunities to improve both the quality of the reports and also the effectiveness of EIA. Therefore, the present paper is focused on the quality review of a number of EIS submitted to the Brazilian Federal Environmental Agency (Ibama) to instruct the assessment of electric power transmission systems. Based on the application of the EIS quality review package as proposed by Lee and Colley (1992), the outcomes reveal opportunities for improving the scope of EIA, analysis of alternatives, prediction of magnitude and the assessment of impact significance. Finally, the development and/or adaptation of a similar tool for the systematic review of the quality of EIA reports is recommended.展开更多
Objective:To investigate the effectiveness and efficiency of combining levamlodipine besylate and valsartan in the treatment of hypertension.Methods:This study selected 28 patients with hypertension as observation sub...Objective:To investigate the effectiveness and efficiency of combining levamlodipine besylate and valsartan in the treatment of hypertension.Methods:This study selected 28 patients with hypertension as observation subjects.The treatment duration ranged from January 2020 to June 2023.Using the random number table method,patients were divided into two groups.The control group received treatment with valsartan,while the observation group received a combination of valsartan and levamlodipine besylate.Therapeutic effects and safety were compared between the groups,and changes in the patient’s blood pressure and renal function index levels were assessed.Results:The total clinical effective rate of the observation group was significantly higher than that of the control group(P<0.05).The observation group demonstrated better diastolic blood pressure,systolic blood pressure,and renal function indicators compared to the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combined treatment of levamlodipine besylate and valsartan in patients with hypertension showed significant clinical efficacy and holds broad application value.展开更多
Objective:To evaluate the effect of hysteroscopic electroresection in treating submucosal uterine fibroids.Methods:Using the random number table method,70 patients with submucosal uterine fibroids were divided into tw...Objective:To evaluate the effect of hysteroscopic electroresection in treating submucosal uterine fibroids.Methods:Using the random number table method,70 patients with submucosal uterine fibroids were divided into two groups,35 cases/group.The control group underwent laparoscopic myomectomy,and the observation group underwent hysteroscopic electroresection.Surgical indicators,sex hormone indicators,inflammation indicators,and treatment effects were compared between the two groups.Results:The surgical indicators,sex hormone indicators,and inflammatory indicators three months after operation in the observation group were all more ideal than those of the control group.The total effective rate of the observation group(97.14%)was higher than that of the control group(P<0.05).Conclusion:Hysteroscopic electroresection for the treatment of submucosal uterine fibroids was less invasive,accelerates recovery,and is more effective.展开更多
Objective:To analyze the effectiveness of modified non-traumatic filling technology in the treatment of pediatric dental caries.Methods:Ninety-seven children with dental caries who were treated in our hospital(Panyu M...Objective:To analyze the effectiveness of modified non-traumatic filling technology in the treatment of pediatric dental caries.Methods:Ninety-seven children with dental caries who were treated in our hospital(Panyu Maternal and Child Care Service Center of Guangzhou)from January 2022 to December 2023 were selected and randomly divided into two groups,with 48 cases in the experimental group and 49 in the control group.The experimental group was treated with modified non-traumatic filling techniques,while the control group was treated with conventional filling techniques.Observation indicators such as the total effectiveness of the treatment,incidence of adverse events,treatment compliance,and pain scores were analyzed after the intervention.Result:After intervention,the total effectiveness of the treatment in the experimental group was higher than that in the control group(P<0.05).The incidence of adverse events in the experimental group was lower than that of the control group(P<0.05).The treatment compliance of patients in the experimental group was higher than that in the control group(P<0.05).The pain score of the experimental group was lower than that of the control group(P<0.05).Conclusion:The application of modified non-traumatic filling technology in the treatment of pediatric dental caries showed good therapeutic outcomes.After the intervention,the child’s symptoms were significantly alleviated,the incidence of adverse events such as filling material falling off was reduced,their compliance was improved,and the pain was relieved.This procedure is worth to be promoted for clinical application.展开更多
Exploring the synergy types and optimization paths between Poverty Alleviation Effectiveness and Rural Revitalization is necessary for achieving the two centenary goals.Taking poverty alleviation counties in Hunan Pro...Exploring the synergy types and optimization paths between Poverty Alleviation Effectiveness and Rural Revitalization is necessary for achieving the two centenary goals.Taking poverty alleviation counties in Hunan Province,China as an example,our study proposed an indicator to measure the synergistic development between Poverty Alleviation Effectiveness and Rural Revitalization using the multi-index integrated evaluation method.Then,the coupling types were classified based on both the proposed indicator and regional characteristics.Besides,the corresponding optimization path for each coupling type was proposed to promote the synergistic development of Poverty Alleviation and Rural Revitalization.Results are as follows:1)Lower synergy focused on the southwestern Hunan,while low synergy is widely distributed(such as the west,southwest,northwest,and midland).Moderate synergy is in the midland,such as Huaihua and Chenzhou cities.High synergy is distributed in Yongzhou,Huaihua,Xiangxi cities,etc.Besides,only Hecheng City belongs to the higher synergy.2)This paper proposes corresponding development paths for different development characteristics and main problems from multiple perspectives of the protection system,industrial planning,and rural market.Continuously consolidate and enhance the effectiveness of Poverty Alleviation and Rural Revitalization to achieve coupled and synergistic development of the two systems.Our research results can provide theoretical support for implementing Poverty Alleviation and Rural Revitalization in Hunan Province,China.展开更多
As one of the most important part of weapon system of systems(WSoS),quantitative evaluation of reconnaissance satellite system(RSS)is indispensable during its construction and application.Aiming at the problem of nonl...As one of the most important part of weapon system of systems(WSoS),quantitative evaluation of reconnaissance satellite system(RSS)is indispensable during its construction and application.Aiming at the problem of nonlinear effectiveness evaluation under small sample conditions,we propose an evaluation method based on support vector regression(SVR)to effectively address the defects of traditional methods.Considering the performance of SVR is influenced by the penalty factor,kernel type,and other parameters deeply,the improved grey wolf optimizer(IGWO)is employed for parameter optimization.In the proposed IGWO algorithm,the opposition-based learning strategy is adopted to increase the probability of avoiding the local optima,the mutation operator is used to escape from premature convergence and differential convergence factors are applied to increase the rate of convergence.Numerical experiments of 14 test functions validate the applicability of IGWO algorithm dealing with global optimization.The index system and evaluation method are constructed based on the characteristics of RSS.To validate the proposed IGWO-SVR evaluation method,eight benchmark data sets and combat simulation are employed to estimate the evaluation accuracy,convergence performance and computational complexity.According to the experimental results,the proposed method outperforms several prediction based evaluation methods,verifies the superiority and effectiveness in RSS operational effectiveness evaluation.展开更多
Some attributes are uncertain for evaluation work because of incomplete or limited information and knowledge.It leads to uncertainty in evaluation results.To that end,an evaluation method,uncertainty entropy-based exp...Some attributes are uncertain for evaluation work because of incomplete or limited information and knowledge.It leads to uncertainty in evaluation results.To that end,an evaluation method,uncertainty entropy-based exploratory evaluation(UEEE),is proposed to guide the evaluation activities,which can iteratively and gradually reduce uncertainty in evaluation results.Uncertainty entropy(UE)is proposed to measure the extent of uncertainty.First,the belief degree distributions are assumed to characterize the uncertainty in attributes.Then the belief degree distribution of the evaluation result can be calculated by using uncertainty theory.The obtained result is then checked based on UE to see if it could meet the requirements of decision-making.If its uncertainty level is high,more information needs to be introduced to reduce uncertainty.An algorithm based on the UE is proposed to find which attribute can mostly affect the uncertainty in results.Thus,efforts can be invested in key attribute(s),and the evaluation results can be updated accordingly.This update should be repeated until the evaluation result meets the requirements.Finally,as a case study,the effectiveness of ballistic missiles with uncertain attributes is evaluated by UEEE.The evaluation results show that the target is believed to be destroyed.展开更多
Objective:To evaluate the effectiveness and safety of seven oral Chinese patent medicines(CPMs)as adjuvant therapy for cancer-related anemia(CRA)by network meta-analysis(NMA).Methods:A literature search to obtain rand...Objective:To evaluate the effectiveness and safety of seven oral Chinese patent medicines(CPMs)as adjuvant therapy for cancer-related anemia(CRA)by network meta-analysis(NMA).Methods:A literature search to obtain randomized controlled trials(RCTs)of seven oral CPMs in the adjuvant treatment of CRA was conducted in multiple databases from the inception to April 2022.The RevMan5.3 and R 4.1.1 software were used for NMA.Results:We ultimately included 29 RCTs with 2140 patients.Traditional meta-analysis showed that Fufang E'jiao syrup(FFEJS),Shengxuebao mixture(SXBM),Shengxuening tablets(SXNT),Jianpi Shengxue granules(JPSXG),and Yixuesheng capsule(YXSC)combined with basic Western treatment(BWT)could improve the hemoglobin(HGB)level.JPSXG combined with BWT could improve the red blood cell(RBC).FFEJS combined with BWT improved the Karnofsky performance status(KPS).NMA showed that FFEJS,JPSXG,SXBM,and SXNT plus BWT improved HGB better than Shengxue tablets(SXT)plus BWT,with top three ranking results being JPSXG plus BWT>SXNT plus BWT>FFEJS plus BWT.FFEJS plus BWT,JPSXG plus BWT,SXBM plus BWT,SXNT plus BWT,and SXT plus BWT improved RBC better than BWT,with top three ranking results being SXNT plus BWT>JPSXG plus BWT>FFEJS plus BWT.In terms of the KPS score,compared with SXT plus BWT,FFEJS,JPSXG,SXBM,SXNT,and Yizhong Shengxue capsule(YZSXC)plus BWT had higher KPS,with top three ranking results being SXBM plus BWT>JPSXG plus BWT>FFEJS plus BWT.Conclusions:Our NMA demonstrated that seven oral CPMs used as adjuvant treatment of CRA had a definite clinical effect.JPSXG not only increases the levels of HGB and RBC to enhance the clinical effect but also improves patients'quality of life.More accurate conclusions need to be verified by more high-quality RCTs.展开更多
BACKGROUND In the United States,sorafenib monotherapy was approved in 2007 for first-line(1L)treatment of patients with unresectable hepatocellular carcinoma(uHCC).As other therapies have been approved in recent years...BACKGROUND In the United States,sorafenib monotherapy was approved in 2007 for first-line(1L)treatment of patients with unresectable hepatocellular carcinoma(uHCC).As other therapies have been approved in recent years for hepatocellular carcinoma treatment in later lines,it is essential to assess clinical effectiveness of older therapies in actual clinical practice to inform healthcare practitioners’decisions for better patient care.AIM To assess patient characteristics/clinical effectiveness of 1L sorafenib in uHCC patients treated in United States academic and community practice settings.METHODS A retrospective observational study was conducted among adult patients(≥18 years)in the United States initiating sorafenib monotherapy as 1L systemic therapy for uHCC with Eastern Cooperative Oncology Group status of 0 or 1 between January 2016 and December 2019 at City of Hope and Advent Health.Data were extracted by trained abstractionists from individual patients’electronic health records and captured in electronic case report forms.Institutional Review Board approvals were obtained prior to study initiation.Data were captured from the time of sorafenib initiation until death or the end of follow-up.All data were de-identified prior to analyses.Clinical outcomes assessed included provider-reported best response,progression-free survival(PFS),and overall survival(OS).PFS and OS were estimated using Kaplan-Meier methods.RESULTS Among 134 uHCC patients treated with 1L sorafenib,majority were male(75%),and most were Caucasian(62%)or Asian(19%).Median patient age was 64 years.The most common etiologies of liver disease were hepatitis C(54%),alcohol-related liver disease(16%),and hepatitis B(11%).Most patients were reported to have Barcelona Clinic Liver Cancer stage B(19%)or stage C(70%)disease.Of 134 patients,110(82%)were reported to have discontinued treatment or died during follow-up.Primary reasons for sorafenib discontinuation were reported as progression(35%)and toxicity(30%).Best overall response was reported for 124 patients,of which 7.3%reported complete or partial response.Median time to treatment discontinuation was 2.3 mo.Overall,103 patients(77%)had disease progression or died during sorafenib therapy.Median PFS was estimated to be 2.9 mo.At the end of follow-up,82 patients(61%)were deceased.Median OS was 8.5 mo.CONCLUSION Newer therapeutic options that have reported higher PFS and OS in real-world clinical practice should be considered to enhance patient outcomes.展开更多
BACKGROUND Diabetic gastroparesis(DGP)is a prevalent complication of diabetes that impairs people's quality of life and places a significant financial burden on them.The gastrointestinal symptoms of DGP patients c...BACKGROUND Diabetic gastroparesis(DGP)is a prevalent complication of diabetes that impairs people's quality of life and places a significant financial burden on them.The gastrointestinal symptoms of DGP patients can be improved by several Traditional Chinese Medicine(TCM)decoctions that have been shown to be effective in treating the disease.There are still many unanswered questions regarding the identification of appropriate therapeutic agents for the treatment of DGP in clinical practice.AIM To analyze the efficacy of several TCM decoctions in the treatment of DGP using Bayesian network meta-analysis for reference.METHODS PubMed,EMBASE,Cochrane Library,Web of Science,China National Knowledge Infrastructure,The China Biology Medicine DVD,Wanfang,and CQVIP were searched from inception to September 17,2022,to collect randomized controlled trials(RCTs)about TCM decoctions for DGP.Clinical effects and symptom scores were the primary outcomes.Additionally,we assessed motilin(MOT),somatostatin(SS),gastrin(GAS),gastric emptying rate,gastric emptying time,and adverse drug events as secondary outcomes.RESULTS A total of 67 eligible RCTs involving 4790 DGP patients and 7 TCM decoctions were included.The results of network meta-analysis(NMA)and surface under the cumulative ranking curve showed that with western medicine(WM)as a common control,the Banxia Xiexin Decoction(BXXD)+WM was most effective in clinical effects and enhancing early satiety scores;the Simo decoction(SMD)+WM was most effective in improving nausea and vomiting scores and anorexia scores,bloating scores;the Chaishao Liujunzi Decoction(CSLJD)was most effective in MOT,the Zhishi Xiaopi Decoction(ZSXPD)was most effective in SS and upgrading emptying rate;the Jianpi Xiaozhi Decoction was most effective in GAS;the CSLJD+WM was most effective in improving gastric emptying time.CONCLUSION These NMA results suggest that the BXXD+WM and SMD+WM may be one of the potential optimal treatments.Due to various limitations,further large-sample,double-blind,multi-center randomized RCTs are needed.展开更多
Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can...Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases,including diabetes;hypertension;atherosclerosis;coronary artery disease and stroke;obstructive sleep apnea;depression;weight-related arthropathies and endometrial and breast cancer.A body weight 20%above ideal for age,gender and height is a severe health risk.Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet,increased physical activity,behavioral changes and drugs have failed.The two most common procedures currently used are sleeve gastrectomy and gastric bypass.This procedure has gained popularity recently and is generally considered safe and effective.Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved,more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures.This review aims to synthesize and summarize the growing evidence on the long-term effectiveness,outcomes and complications of bariatric surgery.展开更多
BACKGROUND Schizophrenia is a psychiatric disorder characterized by chronic or recurrent symptoms.Lurasidone was licensed in China in 2019 for the treatment of adult schizophrenia in adults with a maximum dose of 80 m...BACKGROUND Schizophrenia is a psychiatric disorder characterized by chronic or recurrent symptoms.Lurasidone was licensed in China in 2019 for the treatment of adult schizophrenia in adults with a maximum dose of 80 mg/d.However,post-market surveillance(PMS)with an adequate sample size is required for further validation of the drug’s safety profile and effectiveness.AIM To conduct PMS in real-world clinical settings and evaluate the safety and effectiveness of lurasidone in the Chinese population.METHODS A prospective,multicenter,open-label,12-wk surveillance was conducted in China's Mainland.All patients with schizophrenia from 10 sites who had begun medication with lurasidone between September 2019 and August 2022 were eligible for enrollment.Safety assessments included adverse events(AEs),adverse drug reactions(ADRs),extrapyramidal symptoms(EPS),akathisia,use of EPS drugs,weight gain,and laboratory values as metabolic parameters and the QTc interval.The effectiveness was assessed using the brief psychiatric rating scale(BPRS)from baseline to the end of treatment.RESULTS A total of 965 patients were enrolled in the full analysis set and 894 in the safety set in this interim analysis.The average daily dose was 61.7±19.08 mg(mean±SD)during the treatment.AEs and ADRs were experienced by 101 patients(11.3%)and 78 patients(8.7%),respectively,which were mostly mild.EPS occurred in 25 individuals with a 2.8%incidence,including akathisia in 20 individuals(2.2%).Moreover,59 patients received drugs for treating EPS during the treatment,with an incidence of 6.6%which dropped to 5.4%at the end of the treatment.The average weight change was 0.20±2.36 kg(P=0.01687)with 0.8%of patients showing a weight gain of≥7%at week 12 compared with that at the baseline.The mean values of metabolic parameters and the QTc interval at baseline and week 12 were within normal ranges.The mean changes in total BPRS scores were-8.9±9.76(n=959),-13.5±12.29(n=959),and-16.8±13.97(n=959)after 2/4,6/8,and 12 wk,respectively(P<0.001 for each visit compared with the baseline)using the last-observation-carried-forward method.CONCLUSION The interim analysis of the PMS of adult patients with schizophrenia demonstrate the safety and effectiveness of lurasidone in the Chinese population.No new safety or efficacy concerns were identified.展开更多
Background: Laboratory personnel is at risk of biological contamination leading to laboratory-acquired infections (LAIs). The use of disinfection products is essential in the prevention of these infections. This work ...Background: Laboratory personnel is at risk of biological contamination leading to laboratory-acquired infections (LAIs). The use of disinfection products is essential in the prevention of these infections. This work aimed to evaluate the effectiveness of antimicrobial agents used in disinfection in bacteriology laboratories in Togo. Methods: This was a cross-sectional study conducted from June to December 2021 in all bacteriology laboratories in Togo. Swabs taken before and after disinfection of surfaces and staff hands were immediately plated on agar media. Counting and identification of isolated colonies were done after 24 hours of incubation. The ANOVA test was used to compare calculated means, prevalence ratio (PR) and 95% confidence intervals (CI) to compare bacterial frequencies. Results: A total of 393 samples were taken, of which 41.2% were from hands. Before disinfection, surfaces were more contaminated than hands with respectively 40.4% and 29.6% (PR = 1.3;CI 95% = [0.9 - 1.9]). After surface disinfection with 0.5% of chlorine solution, bacterial elimination was total, but partial on hands washed with soap, with residual contamination of 3.7%. A total of 108 strains were isolated before disinfection of which Klebsiella spp. 38.9% and Staphylococcus spp. 25.0%;after disinfection 4 strains were isolated of which: Staphylococcus spp. 75.0% and Klebsiella spp. 25.0%. Conclusion: Surface disinfection was more effective than hand washing with soap and water. We recommend proper hand washing.展开更多
Objective:The study aimed to assess the effectiveness of lukewarm water compress on breast pain and breast engorgement among post-cesarean primiparous mothers.Materials and Methods:This quasi-experimental posttest-onl...Objective:The study aimed to assess the effectiveness of lukewarm water compress on breast pain and breast engorgement among post-cesarean primiparous mothers.Materials and Methods:This quasi-experimental posttest-only design was conducted with 60 post-cesarean section primiparous mothers between October 2018 and January 2019.A simple random sampling technique was used to allocate 30 participants to both experimental and control groups.The experimental group received lukewarm water compress using a sponge cloth for 20 min twice a day on the second,third,and fourth postnatal days.The control group received routine hospital care.Breast pain and engorgement were assessed using the Visual Analog Pain Scale and Breast Engorgement Assessment Scale on the third,fourth,and fifth postnatal days.Results:Significant differences were observed between the experimental and control groups on day 1 and day 3 in terms of breast pain and engorgement scores among post-cesarean section mothers(P<0.001).In addition,no statistically significant differences were found between sociodemographic and breastfeeding parameters and breast pain and engorgement(P>0.05).Conclusion:Lukewarm water compress is effective in reducing breast pain and engorgement in post-cesarean primiparous mothers.Future research can include randomized controlled trials to evaluate the effectiveness of different therapies in treating breast pain and engorgement.展开更多
Introduction: This study aimed to identify road safety interventions implemented in Africa and to analyze their effectiveness in reducing road crashes, injuries, disabilities and deaths. Materials and Methods: This is...Introduction: This study aimed to identify road safety interventions implemented in Africa and to analyze their effectiveness in reducing road crashes, injuries, disabilities and deaths. Materials and Methods: This is a systematic review including articles relating to the evaluation of road safety interventions implemented in Africa that were searched on electronic databases: PubMed, Scopus, Lissa, Google Scholar, and African Journals Online. Selection of articles and data extraction was conducted by two pairs of reviewers. Data quality was checked according to the type of study. A qualitative analysis of the data was carried out and a narrative approach was adopted to describe and synthesize the results. Results: A total of twenty-nine articles were selected including one cross-sectional study, seven time series, twenty-one quasi-experimental studies of which six randomised and fifteen non-randomised studies. The type of interventions evaluated was aimed at all types of users and was based on different interventions such as institutional strengthening, law enforcement, awareness raising, training or user education, vehicle maintenance and infrastructure improvements. For fourteen studies all the expected indicators had changed favourably and for twelve the indicators had partially changed. The studies that showed significant change were institutional strengthening, law enforcement, awareness raising, training, or user education interventions, development of Uber transport services, distribution of equipment, and a combination of interventions. Conclusion: This situation is indicative of insufficient policy investment in research but also in the field of road safety in general.展开更多
BACKGROUND Randomized controlled trials(RCTs)of direct oral anticoagulants(DOACs)included a low proportion of atrial fibrillation(AF)patients with chronic kidney disease(CKD),and suggested that DOACs are safe and effe...BACKGROUND Randomized controlled trials(RCTs)of direct oral anticoagulants(DOACs)included a low proportion of atrial fibrillation(AF)patients with chronic kidney disease(CKD),and suggested that DOACs are safe and effective in patients with mild-to-moderate CKD.In a metanalysis of RCTs and observational studies,DOACs were associated with better efficacy(vs warfarin)in early CKD and had similar efficacy and safety profiles in patients with stages IV-V CKD.But few studies have provided data on the safety and effectiveness of each DOAC vs warfarin in patients with stage III CKD.The effectiveness and safety of DOACs in those patients are still subject to debate.AIM To assess and compare the effectiveness and safety of apixaban and rivaroxaban vs warfarin in this patient population.METHODS A cohort of patients with an inpatient or outpatient code for AF and stage III CKD who were newly prescribed apixaban and rivaroxaban was created using the administrative databases from the Quebec province of Canada between 2013 and 2017.The primary effectiveness outcome was a composite of ischemic stroke,systemic embolism,and death,whereas the primary safety outcome was a composite of major bleeding within a year of DOAC vs warfarin initiation.Treatment groups were compared in an under-treatment analysis using inverse probability of treatment weighting and Cox proportional hazards.RESULTS A total of 8899 included patients filled out a new oral anticoagulation therapy claim;3335 for warfarin and 5564 for DOACs.Compared with warfarin,15 mg and 20 mg rivaroxaban presented a similar effectiveness and safety composite risk.Apixaban 5.0 mg was associated with a lower effectiveness composite risk[Hazard ratio(HR)0.76;95%confidence interval(CI):0.65-0.88]and a similar safety risk(HR 0.94;95%CI:0.66-1.35).Apixaban 2.5 mg was associated with a similar effectiveness composite(HR 1.00;95%CI:0.79-1.26)and a lower safety risk(HR 0.65;95%CI:0.43-0.99.Although,apixaban 5.0 mg was associated with a better effectiveness(HR 0.76;95%CI:0.65-0.88),but a similar safety risk profile(HR 0.94;95%CI:0.66-1.35).The observed improvement in the effectiveness composite for apixaban 5.0 mg was driven by a reduction in mortality(HR 0.61;95%CI:0.43-0.88).CONCLUSION In comparison with warfarin,rivaroxaban and apixaban appear to be effective and safe in AF patients with stage III CKD.展开更多
Maize is a staple food in many sub-Saharan African countries, grown on large surfaces and with high production. However, maize’s cultivation is often confronted with attacks by the fall armyworm, which considerably r...Maize is a staple food in many sub-Saharan African countries, grown on large surfaces and with high production. However, maize’s cultivation is often confronted with attacks by the fall armyworm, which considerably reduces production. Thus, the use of biological agents in the control of the fall armyworm would contribute effectively to the sustainability of agriculture. It is in this context that this study, conducted at the La Mé station of the National Centre for Agronomy Research, aims to test the effectiveness of Rhynocoris rapax, a powerful predator of various insect families, on the fall armyworm Spodoptera frugiperda, for biological control of this maize pest in Côte d’Ivoire. Therefore, 3 batches of 1 adult individuals of Rhynocoris rapax were captured in trial plots set up at the La Mé station. These individuals were then put in contact with 3 batches of 5, 20 and 40 larvae of the pest in rearing boxes at an average temperature of 26.4°C and an average relative humidity of 60%, in order to evaluate the efficiency of the predation. The results showed that Rhynocoris rapax kills more larvae when these are in large numbers. The mortality of the high number of larvae was observed during the first three days, probably due to the voracity and aggressiveness of Rhynocoris rapax that period. So R. rapax is a potential predator of fall armyworm and should be protected.展开更多
基金Under the auspices of National Natural Science Foundation of China(No.42071222,41771194)。
文摘Urban shrinkage has emerged as a widespread phenomenon globally and has a significant impact on land,particularly in terms of land use and price.This study focuses on 2851 county-level cities in China in 2005–2018(excluding Hong Kong,Macao,Taiwan,and‘no data’areas in Qinhai-Tibet Plateau)as the fundamental units of analysis.By employing nighttime light(NTL)data to identify shrinking cities,the propensity score matching(PSM)model was used to quantitatively examine the impact of shrinking cities on land prices,and evaluate the magnitude of this influence.The findings demonstrate the following:1)there were 613 shrinking cities in China,with moderate shrinkage being the most prevalent and severe shrinkage being the least.2)Regional disparities are evident in the spatial distribution of shrinking cities,especially in areas with diverse terrain.3)The spatial pattern of land price exhibits a significant correlated to the economic and administrative levels.4)Shrinking cities significantly negatively impact on the overall land price(ATT=–0.1241,P<0.05).However,the extent of the effect varies significantly among different spatial regions.This study contributes novel insights into the investigation of land prices and shrinking cities,ultimately serving as a foundation for government efforts to promote the sustainable development of urban areas.
文摘Sickle cell disease (SCD) is a prevalent condition, particularly in the countries of sub-Saharan Africa, where the presence of specific genes associated with Malaria contributes to its high prevalence. Patients with sickle cell disease frequently experience painful episodes necessitating hospitalization, and their hemoglobin levels are typically lower than those of the general population. There are different treatment options available to manage complications, such as transfusing blood, hydroxyurea, and strong anti-pains. However, with all these treatments, patients still commonly experience pain crises and suffer from organ damage. Hydroxyurea, the sole approved medication for sickle cell anemia in developed and developing countries, is widely used in children despite being primarily indicated for adults. Multiple studies have demonstrated the efficacy of hydroxyurea in inducing HbF production in young children with SCD. Elevated HbF levels have been associated with improved clinical outcomes, including a reduction in vaso-occlusive crises, acute chest syndrome, and the need for blood transfusions. Furthermore, increased HbF levels have been shown to ameliorate disease-related organ damage, such as pulmonary hypertension and sickle cell retinopathy. The response to hydroxyurea treatment in young children with SCD is variable. Some patients achieve substantial increases in HbF levels and experience significant clinical benefits, while others may have a more modest response. Factors influencing the response include baseline HbF levels, genetic modifiers, treatment adherence, and dose optimization. Safety is a crucial consideration when using hydroxyurea in young children. Studies have shown that hydroxyurea is generally well-tolerated, with the most common adverse effects being myelosuppression, gastrointestinal symptoms, and dermatological manifestations. However,long-term effects and potential risks, such as renal dysfunction and reproductive impacts, require further investigation. The effectiveness of hydroxyurea in young children with SCD has been demonstrated in various clinical trials and observational studies. These studies have shown a significant reduction in disease-related complications and improved quality of life. However, optimal dosing, treatment duration, and long-term outcomes are still areas of ongoing research. This review focuses on recent studies investigating the benefits, effectiveness, responses, and safety of hydroxyurea in pediatric individuals diagnosed with sickle cell disease.
文摘Objective: To evaluate the role of prevention and control strategies for nosocomial infection in a tertiary teaching hospital during the sudden outbreak of Corona Virus Disease 2019 (COVID-19). Methods: The hospital initiated an emergency plan involving multi-departmental defense and control. It adopted a series of nosocomial infection prevention and control measures, including strengthening pre-examination and triage, optimizing the consultation process, improving the hospital’s architectural composition, implementing graded risk management, enhancing personal protection, and implementing staff training and supervision. Descriptive research was used to evaluate the short-term effects of these in-hospital prevention and control strategies. The analysis compared changes in related evaluation indicators between January 24, 2020 and February 12, 2020 (Chinese Lunar New Year’s Eve 2020 to lunar January 19) and the corresponding lunar period of the previous year. Results: Compared to the same period last year, the outpatient fever rate increased by 1.85-fold (P P Conclusion: The nosocomial infection prevention and control strategies implemented during this specific period improved the detection and control abilities for the COVID-19 source of infection and enhanced the compliance with measures. This likely contributed significantly to avoiding the occurrence of nosocomial infection.
文摘A good quality Environmental Impact Statement (EIS) is key for the effectiveness of Environmental Impact Assessment (EIA) processes and consequently to the acceptability of projects subject to EIA. The international literature has contributed to the understanding of the essential aspects to be verified regarding the quality of EIS, offering a wide spectrum of good practice examples related to the content of the studies. Even so, there is a need for empirical studies that allow the identification of specific aspects related to the context of application of the EIS, which could lead to the identification of opportunities to improve both the quality of the reports and also the effectiveness of EIA. Therefore, the present paper is focused on the quality review of a number of EIS submitted to the Brazilian Federal Environmental Agency (Ibama) to instruct the assessment of electric power transmission systems. Based on the application of the EIS quality review package as proposed by Lee and Colley (1992), the outcomes reveal opportunities for improving the scope of EIA, analysis of alternatives, prediction of magnitude and the assessment of impact significance. Finally, the development and/or adaptation of a similar tool for the systematic review of the quality of EIA reports is recommended.
文摘Objective:To investigate the effectiveness and efficiency of combining levamlodipine besylate and valsartan in the treatment of hypertension.Methods:This study selected 28 patients with hypertension as observation subjects.The treatment duration ranged from January 2020 to June 2023.Using the random number table method,patients were divided into two groups.The control group received treatment with valsartan,while the observation group received a combination of valsartan and levamlodipine besylate.Therapeutic effects and safety were compared between the groups,and changes in the patient’s blood pressure and renal function index levels were assessed.Results:The total clinical effective rate of the observation group was significantly higher than that of the control group(P<0.05).The observation group demonstrated better diastolic blood pressure,systolic blood pressure,and renal function indicators compared to the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combined treatment of levamlodipine besylate and valsartan in patients with hypertension showed significant clinical efficacy and holds broad application value.
文摘Objective:To evaluate the effect of hysteroscopic electroresection in treating submucosal uterine fibroids.Methods:Using the random number table method,70 patients with submucosal uterine fibroids were divided into two groups,35 cases/group.The control group underwent laparoscopic myomectomy,and the observation group underwent hysteroscopic electroresection.Surgical indicators,sex hormone indicators,inflammation indicators,and treatment effects were compared between the two groups.Results:The surgical indicators,sex hormone indicators,and inflammatory indicators three months after operation in the observation group were all more ideal than those of the control group.The total effective rate of the observation group(97.14%)was higher than that of the control group(P<0.05).Conclusion:Hysteroscopic electroresection for the treatment of submucosal uterine fibroids was less invasive,accelerates recovery,and is more effective.
文摘Objective:To analyze the effectiveness of modified non-traumatic filling technology in the treatment of pediatric dental caries.Methods:Ninety-seven children with dental caries who were treated in our hospital(Panyu Maternal and Child Care Service Center of Guangzhou)from January 2022 to December 2023 were selected and randomly divided into two groups,with 48 cases in the experimental group and 49 in the control group.The experimental group was treated with modified non-traumatic filling techniques,while the control group was treated with conventional filling techniques.Observation indicators such as the total effectiveness of the treatment,incidence of adverse events,treatment compliance,and pain scores were analyzed after the intervention.Result:After intervention,the total effectiveness of the treatment in the experimental group was higher than that in the control group(P<0.05).The incidence of adverse events in the experimental group was lower than that of the control group(P<0.05).The treatment compliance of patients in the experimental group was higher than that in the control group(P<0.05).The pain score of the experimental group was lower than that of the control group(P<0.05).Conclusion:The application of modified non-traumatic filling technology in the treatment of pediatric dental caries showed good therapeutic outcomes.After the intervention,the child’s symptoms were significantly alleviated,the incidence of adverse events such as filling material falling off was reduced,their compliance was improved,and the pain was relieved.This procedure is worth to be promoted for clinical application.
基金Under the auspices of the National Natural Science Foundation of China(No.41971219,41571168)Natural Science Foundation of Hunan Province(No.2020JJ4372)Philosophy and Social Science Fund Project of Hunan Province(No.18ZDB015)。
文摘Exploring the synergy types and optimization paths between Poverty Alleviation Effectiveness and Rural Revitalization is necessary for achieving the two centenary goals.Taking poverty alleviation counties in Hunan Province,China as an example,our study proposed an indicator to measure the synergistic development between Poverty Alleviation Effectiveness and Rural Revitalization using the multi-index integrated evaluation method.Then,the coupling types were classified based on both the proposed indicator and regional characteristics.Besides,the corresponding optimization path for each coupling type was proposed to promote the synergistic development of Poverty Alleviation and Rural Revitalization.Results are as follows:1)Lower synergy focused on the southwestern Hunan,while low synergy is widely distributed(such as the west,southwest,northwest,and midland).Moderate synergy is in the midland,such as Huaihua and Chenzhou cities.High synergy is distributed in Yongzhou,Huaihua,Xiangxi cities,etc.Besides,only Hecheng City belongs to the higher synergy.2)This paper proposes corresponding development paths for different development characteristics and main problems from multiple perspectives of the protection system,industrial planning,and rural market.Continuously consolidate and enhance the effectiveness of Poverty Alleviation and Rural Revitalization to achieve coupled and synergistic development of the two systems.Our research results can provide theoretical support for implementing Poverty Alleviation and Rural Revitalization in Hunan Province,China.
基金the National Defense Science and Technology Key Laboratory Fund of China(XM2020XT1023).
文摘As one of the most important part of weapon system of systems(WSoS),quantitative evaluation of reconnaissance satellite system(RSS)is indispensable during its construction and application.Aiming at the problem of nonlinear effectiveness evaluation under small sample conditions,we propose an evaluation method based on support vector regression(SVR)to effectively address the defects of traditional methods.Considering the performance of SVR is influenced by the penalty factor,kernel type,and other parameters deeply,the improved grey wolf optimizer(IGWO)is employed for parameter optimization.In the proposed IGWO algorithm,the opposition-based learning strategy is adopted to increase the probability of avoiding the local optima,the mutation operator is used to escape from premature convergence and differential convergence factors are applied to increase the rate of convergence.Numerical experiments of 14 test functions validate the applicability of IGWO algorithm dealing with global optimization.The index system and evaluation method are constructed based on the characteristics of RSS.To validate the proposed IGWO-SVR evaluation method,eight benchmark data sets and combat simulation are employed to estimate the evaluation accuracy,convergence performance and computational complexity.According to the experimental results,the proposed method outperforms several prediction based evaluation methods,verifies the superiority and effectiveness in RSS operational effectiveness evaluation.
基金the National Natural Science Foundation of China(61872378).
文摘Some attributes are uncertain for evaluation work because of incomplete or limited information and knowledge.It leads to uncertainty in evaluation results.To that end,an evaluation method,uncertainty entropy-based exploratory evaluation(UEEE),is proposed to guide the evaluation activities,which can iteratively and gradually reduce uncertainty in evaluation results.Uncertainty entropy(UE)is proposed to measure the extent of uncertainty.First,the belief degree distributions are assumed to characterize the uncertainty in attributes.Then the belief degree distribution of the evaluation result can be calculated by using uncertainty theory.The obtained result is then checked based on UE to see if it could meet the requirements of decision-making.If its uncertainty level is high,more information needs to be introduced to reduce uncertainty.An algorithm based on the UE is proposed to find which attribute can mostly affect the uncertainty in results.Thus,efforts can be invested in key attribute(s),and the evaluation results can be updated accordingly.This update should be repeated until the evaluation result meets the requirements.Finally,as a case study,the effectiveness of ballistic missiles with uncertain attributes is evaluated by UEEE.The evaluation results show that the target is believed to be destroyed.
基金This work was supported by the National Natural Science Foundation of China(82074240)the Capital Health Research and Development of Special(2020-2-4193).
文摘Objective:To evaluate the effectiveness and safety of seven oral Chinese patent medicines(CPMs)as adjuvant therapy for cancer-related anemia(CRA)by network meta-analysis(NMA).Methods:A literature search to obtain randomized controlled trials(RCTs)of seven oral CPMs in the adjuvant treatment of CRA was conducted in multiple databases from the inception to April 2022.The RevMan5.3 and R 4.1.1 software were used for NMA.Results:We ultimately included 29 RCTs with 2140 patients.Traditional meta-analysis showed that Fufang E'jiao syrup(FFEJS),Shengxuebao mixture(SXBM),Shengxuening tablets(SXNT),Jianpi Shengxue granules(JPSXG),and Yixuesheng capsule(YXSC)combined with basic Western treatment(BWT)could improve the hemoglobin(HGB)level.JPSXG combined with BWT could improve the red blood cell(RBC).FFEJS combined with BWT improved the Karnofsky performance status(KPS).NMA showed that FFEJS,JPSXG,SXBM,and SXNT plus BWT improved HGB better than Shengxue tablets(SXT)plus BWT,with top three ranking results being JPSXG plus BWT>SXNT plus BWT>FFEJS plus BWT.FFEJS plus BWT,JPSXG plus BWT,SXBM plus BWT,SXNT plus BWT,and SXT plus BWT improved RBC better than BWT,with top three ranking results being SXNT plus BWT>JPSXG plus BWT>FFEJS plus BWT.In terms of the KPS score,compared with SXT plus BWT,FFEJS,JPSXG,SXBM,SXNT,and Yizhong Shengxue capsule(YZSXC)plus BWT had higher KPS,with top three ranking results being SXBM plus BWT>JPSXG plus BWT>FFEJS plus BWT.Conclusions:Our NMA demonstrated that seven oral CPMs used as adjuvant treatment of CRA had a definite clinical effect.JPSXG not only increases the levels of HGB and RBC to enhance the clinical effect but also improves patients'quality of life.More accurate conclusions need to be verified by more high-quality RCTs.
文摘BACKGROUND In the United States,sorafenib monotherapy was approved in 2007 for first-line(1L)treatment of patients with unresectable hepatocellular carcinoma(uHCC).As other therapies have been approved in recent years for hepatocellular carcinoma treatment in later lines,it is essential to assess clinical effectiveness of older therapies in actual clinical practice to inform healthcare practitioners’decisions for better patient care.AIM To assess patient characteristics/clinical effectiveness of 1L sorafenib in uHCC patients treated in United States academic and community practice settings.METHODS A retrospective observational study was conducted among adult patients(≥18 years)in the United States initiating sorafenib monotherapy as 1L systemic therapy for uHCC with Eastern Cooperative Oncology Group status of 0 or 1 between January 2016 and December 2019 at City of Hope and Advent Health.Data were extracted by trained abstractionists from individual patients’electronic health records and captured in electronic case report forms.Institutional Review Board approvals were obtained prior to study initiation.Data were captured from the time of sorafenib initiation until death or the end of follow-up.All data were de-identified prior to analyses.Clinical outcomes assessed included provider-reported best response,progression-free survival(PFS),and overall survival(OS).PFS and OS were estimated using Kaplan-Meier methods.RESULTS Among 134 uHCC patients treated with 1L sorafenib,majority were male(75%),and most were Caucasian(62%)or Asian(19%).Median patient age was 64 years.The most common etiologies of liver disease were hepatitis C(54%),alcohol-related liver disease(16%),and hepatitis B(11%).Most patients were reported to have Barcelona Clinic Liver Cancer stage B(19%)or stage C(70%)disease.Of 134 patients,110(82%)were reported to have discontinued treatment or died during follow-up.Primary reasons for sorafenib discontinuation were reported as progression(35%)and toxicity(30%).Best overall response was reported for 124 patients,of which 7.3%reported complete or partial response.Median time to treatment discontinuation was 2.3 mo.Overall,103 patients(77%)had disease progression or died during sorafenib therapy.Median PFS was estimated to be 2.9 mo.At the end of follow-up,82 patients(61%)were deceased.Median OS was 8.5 mo.CONCLUSION Newer therapeutic options that have reported higher PFS and OS in real-world clinical practice should be considered to enhance patient outcomes.
基金Supported by CACMS Outstanding Young Scientific and Technological Talents Program,No. ZZ13-YQ-026Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences,No. CI2021A01601+2 种基金Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine,No. ZYYCXTDD-202001Open Project of National Facility for Translational Medicine,No. TMSK-2021-407GAMIMD Special Fund, 2022DXBZX012
文摘BACKGROUND Diabetic gastroparesis(DGP)is a prevalent complication of diabetes that impairs people's quality of life and places a significant financial burden on them.The gastrointestinal symptoms of DGP patients can be improved by several Traditional Chinese Medicine(TCM)decoctions that have been shown to be effective in treating the disease.There are still many unanswered questions regarding the identification of appropriate therapeutic agents for the treatment of DGP in clinical practice.AIM To analyze the efficacy of several TCM decoctions in the treatment of DGP using Bayesian network meta-analysis for reference.METHODS PubMed,EMBASE,Cochrane Library,Web of Science,China National Knowledge Infrastructure,The China Biology Medicine DVD,Wanfang,and CQVIP were searched from inception to September 17,2022,to collect randomized controlled trials(RCTs)about TCM decoctions for DGP.Clinical effects and symptom scores were the primary outcomes.Additionally,we assessed motilin(MOT),somatostatin(SS),gastrin(GAS),gastric emptying rate,gastric emptying time,and adverse drug events as secondary outcomes.RESULTS A total of 67 eligible RCTs involving 4790 DGP patients and 7 TCM decoctions were included.The results of network meta-analysis(NMA)and surface under the cumulative ranking curve showed that with western medicine(WM)as a common control,the Banxia Xiexin Decoction(BXXD)+WM was most effective in clinical effects and enhancing early satiety scores;the Simo decoction(SMD)+WM was most effective in improving nausea and vomiting scores and anorexia scores,bloating scores;the Chaishao Liujunzi Decoction(CSLJD)was most effective in MOT,the Zhishi Xiaopi Decoction(ZSXPD)was most effective in SS and upgrading emptying rate;the Jianpi Xiaozhi Decoction was most effective in GAS;the CSLJD+WM was most effective in improving gastric emptying time.CONCLUSION These NMA results suggest that the BXXD+WM and SMD+WM may be one of the potential optimal treatments.Due to various limitations,further large-sample,double-blind,multi-center randomized RCTs are needed.
基金Supported by the European Union-NextGenerationEU,through the National Recovery and Resilience Plan of the Republic of Bulgaria,No. BG-RRP-2.004-0008-C01。
文摘Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases,including diabetes;hypertension;atherosclerosis;coronary artery disease and stroke;obstructive sleep apnea;depression;weight-related arthropathies and endometrial and breast cancer.A body weight 20%above ideal for age,gender and height is a severe health risk.Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet,increased physical activity,behavioral changes and drugs have failed.The two most common procedures currently used are sleeve gastrectomy and gastric bypass.This procedure has gained popularity recently and is generally considered safe and effective.Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved,more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures.This review aims to synthesize and summarize the growing evidence on the long-term effectiveness,outcomes and complications of bariatric surgery.
基金Collaborative Innovation Center Project of Translational Medicine,Shanghai Jiaotong University School of Medicine,No.TM202116PT(2021-2023)Clinical Research Plan of SHDC,No.SHDC2022CRS032and the Sumitomo Pharmaceuticals(Suzhou)Co.,Ltd.
文摘BACKGROUND Schizophrenia is a psychiatric disorder characterized by chronic or recurrent symptoms.Lurasidone was licensed in China in 2019 for the treatment of adult schizophrenia in adults with a maximum dose of 80 mg/d.However,post-market surveillance(PMS)with an adequate sample size is required for further validation of the drug’s safety profile and effectiveness.AIM To conduct PMS in real-world clinical settings and evaluate the safety and effectiveness of lurasidone in the Chinese population.METHODS A prospective,multicenter,open-label,12-wk surveillance was conducted in China's Mainland.All patients with schizophrenia from 10 sites who had begun medication with lurasidone between September 2019 and August 2022 were eligible for enrollment.Safety assessments included adverse events(AEs),adverse drug reactions(ADRs),extrapyramidal symptoms(EPS),akathisia,use of EPS drugs,weight gain,and laboratory values as metabolic parameters and the QTc interval.The effectiveness was assessed using the brief psychiatric rating scale(BPRS)from baseline to the end of treatment.RESULTS A total of 965 patients were enrolled in the full analysis set and 894 in the safety set in this interim analysis.The average daily dose was 61.7±19.08 mg(mean±SD)during the treatment.AEs and ADRs were experienced by 101 patients(11.3%)and 78 patients(8.7%),respectively,which were mostly mild.EPS occurred in 25 individuals with a 2.8%incidence,including akathisia in 20 individuals(2.2%).Moreover,59 patients received drugs for treating EPS during the treatment,with an incidence of 6.6%which dropped to 5.4%at the end of the treatment.The average weight change was 0.20±2.36 kg(P=0.01687)with 0.8%of patients showing a weight gain of≥7%at week 12 compared with that at the baseline.The mean values of metabolic parameters and the QTc interval at baseline and week 12 were within normal ranges.The mean changes in total BPRS scores were-8.9±9.76(n=959),-13.5±12.29(n=959),and-16.8±13.97(n=959)after 2/4,6/8,and 12 wk,respectively(P<0.001 for each visit compared with the baseline)using the last-observation-carried-forward method.CONCLUSION The interim analysis of the PMS of adult patients with schizophrenia demonstrate the safety and effectiveness of lurasidone in the Chinese population.No new safety or efficacy concerns were identified.
文摘Background: Laboratory personnel is at risk of biological contamination leading to laboratory-acquired infections (LAIs). The use of disinfection products is essential in the prevention of these infections. This work aimed to evaluate the effectiveness of antimicrobial agents used in disinfection in bacteriology laboratories in Togo. Methods: This was a cross-sectional study conducted from June to December 2021 in all bacteriology laboratories in Togo. Swabs taken before and after disinfection of surfaces and staff hands were immediately plated on agar media. Counting and identification of isolated colonies were done after 24 hours of incubation. The ANOVA test was used to compare calculated means, prevalence ratio (PR) and 95% confidence intervals (CI) to compare bacterial frequencies. Results: A total of 393 samples were taken, of which 41.2% were from hands. Before disinfection, surfaces were more contaminated than hands with respectively 40.4% and 29.6% (PR = 1.3;CI 95% = [0.9 - 1.9]). After surface disinfection with 0.5% of chlorine solution, bacterial elimination was total, but partial on hands washed with soap, with residual contamination of 3.7%. A total of 108 strains were isolated before disinfection of which Klebsiella spp. 38.9% and Staphylococcus spp. 25.0%;after disinfection 4 strains were isolated of which: Staphylococcus spp. 75.0% and Klebsiella spp. 25.0%. Conclusion: Surface disinfection was more effective than hand washing with soap and water. We recommend proper hand washing.
文摘Objective:The study aimed to assess the effectiveness of lukewarm water compress on breast pain and breast engorgement among post-cesarean primiparous mothers.Materials and Methods:This quasi-experimental posttest-only design was conducted with 60 post-cesarean section primiparous mothers between October 2018 and January 2019.A simple random sampling technique was used to allocate 30 participants to both experimental and control groups.The experimental group received lukewarm water compress using a sponge cloth for 20 min twice a day on the second,third,and fourth postnatal days.The control group received routine hospital care.Breast pain and engorgement were assessed using the Visual Analog Pain Scale and Breast Engorgement Assessment Scale on the third,fourth,and fifth postnatal days.Results:Significant differences were observed between the experimental and control groups on day 1 and day 3 in terms of breast pain and engorgement scores among post-cesarean section mothers(P<0.001).In addition,no statistically significant differences were found between sociodemographic and breastfeeding parameters and breast pain and engorgement(P>0.05).Conclusion:Lukewarm water compress is effective in reducing breast pain and engorgement in post-cesarean primiparous mothers.Future research can include randomized controlled trials to evaluate the effectiveness of different therapies in treating breast pain and engorgement.
文摘Introduction: This study aimed to identify road safety interventions implemented in Africa and to analyze their effectiveness in reducing road crashes, injuries, disabilities and deaths. Materials and Methods: This is a systematic review including articles relating to the evaluation of road safety interventions implemented in Africa that were searched on electronic databases: PubMed, Scopus, Lissa, Google Scholar, and African Journals Online. Selection of articles and data extraction was conducted by two pairs of reviewers. Data quality was checked according to the type of study. A qualitative analysis of the data was carried out and a narrative approach was adopted to describe and synthesize the results. Results: A total of twenty-nine articles were selected including one cross-sectional study, seven time series, twenty-one quasi-experimental studies of which six randomised and fifteen non-randomised studies. The type of interventions evaluated was aimed at all types of users and was based on different interventions such as institutional strengthening, law enforcement, awareness raising, training or user education, vehicle maintenance and infrastructure improvements. For fourteen studies all the expected indicators had changed favourably and for twelve the indicators had partially changed. The studies that showed significant change were institutional strengthening, law enforcement, awareness raising, training, or user education interventions, development of Uber transport services, distribution of equipment, and a combination of interventions. Conclusion: This situation is indicative of insufficient policy investment in research but also in the field of road safety in general.
文摘BACKGROUND Randomized controlled trials(RCTs)of direct oral anticoagulants(DOACs)included a low proportion of atrial fibrillation(AF)patients with chronic kidney disease(CKD),and suggested that DOACs are safe and effective in patients with mild-to-moderate CKD.In a metanalysis of RCTs and observational studies,DOACs were associated with better efficacy(vs warfarin)in early CKD and had similar efficacy and safety profiles in patients with stages IV-V CKD.But few studies have provided data on the safety and effectiveness of each DOAC vs warfarin in patients with stage III CKD.The effectiveness and safety of DOACs in those patients are still subject to debate.AIM To assess and compare the effectiveness and safety of apixaban and rivaroxaban vs warfarin in this patient population.METHODS A cohort of patients with an inpatient or outpatient code for AF and stage III CKD who were newly prescribed apixaban and rivaroxaban was created using the administrative databases from the Quebec province of Canada between 2013 and 2017.The primary effectiveness outcome was a composite of ischemic stroke,systemic embolism,and death,whereas the primary safety outcome was a composite of major bleeding within a year of DOAC vs warfarin initiation.Treatment groups were compared in an under-treatment analysis using inverse probability of treatment weighting and Cox proportional hazards.RESULTS A total of 8899 included patients filled out a new oral anticoagulation therapy claim;3335 for warfarin and 5564 for DOACs.Compared with warfarin,15 mg and 20 mg rivaroxaban presented a similar effectiveness and safety composite risk.Apixaban 5.0 mg was associated with a lower effectiveness composite risk[Hazard ratio(HR)0.76;95%confidence interval(CI):0.65-0.88]and a similar safety risk(HR 0.94;95%CI:0.66-1.35).Apixaban 2.5 mg was associated with a similar effectiveness composite(HR 1.00;95%CI:0.79-1.26)and a lower safety risk(HR 0.65;95%CI:0.43-0.99.Although,apixaban 5.0 mg was associated with a better effectiveness(HR 0.76;95%CI:0.65-0.88),but a similar safety risk profile(HR 0.94;95%CI:0.66-1.35).The observed improvement in the effectiveness composite for apixaban 5.0 mg was driven by a reduction in mortality(HR 0.61;95%CI:0.43-0.88).CONCLUSION In comparison with warfarin,rivaroxaban and apixaban appear to be effective and safe in AF patients with stage III CKD.
文摘Maize is a staple food in many sub-Saharan African countries, grown on large surfaces and with high production. However, maize’s cultivation is often confronted with attacks by the fall armyworm, which considerably reduces production. Thus, the use of biological agents in the control of the fall armyworm would contribute effectively to the sustainability of agriculture. It is in this context that this study, conducted at the La Mé station of the National Centre for Agronomy Research, aims to test the effectiveness of Rhynocoris rapax, a powerful predator of various insect families, on the fall armyworm Spodoptera frugiperda, for biological control of this maize pest in Côte d’Ivoire. Therefore, 3 batches of 1 adult individuals of Rhynocoris rapax were captured in trial plots set up at the La Mé station. These individuals were then put in contact with 3 batches of 5, 20 and 40 larvae of the pest in rearing boxes at an average temperature of 26.4°C and an average relative humidity of 60%, in order to evaluate the efficiency of the predation. The results showed that Rhynocoris rapax kills more larvae when these are in large numbers. The mortality of the high number of larvae was observed during the first three days, probably due to the voracity and aggressiveness of Rhynocoris rapax that period. So R. rapax is a potential predator of fall armyworm and should be protected.
