Demand uncertainty is a key factor for the seller's decision making, especially in the e-business environment, for the website to sell products through the online auction. In this paper, two kinds of demand uncert...Demand uncertainty is a key factor for the seller's decision making, especially in the e-business environment, for the website to sell products through the online auction. In this paper, two kinds of demand uncertainties are considered: the consumer regime uncertainty and the inherent randomness of the market environment. Then, how to use a novel business model and group-buying auction (GBA) is analyzed in such a market environment. Based on the comparison of the GBA and the posted price mechanism, some conditions that favor the GBA are provided.展开更多
Objective:The rehospitalization rate of children<5 years old with pneumonia is still high.The risk of hospitalization becomes higher in mothers with low knowledge of their child’s disease.The purpose of this study...Objective:The rehospitalization rate of children<5 years old with pneumonia is still high.The risk of hospitalization becomes higher in mothers with low knowledge of their child’s disease.The purpose of this study was to determine the effect of post-health-education maternal knowledge in cases of rehospitalization and to determine the differences in rehospitalization rate based on the type of health education media.Methods:This study is a quasi-experiment.Health education was given to both groups:one group received education through audiovisual media and the other group through leaflet media.The level of post-health-education knowledge was measured on the third day,then followed up until the 30th day after the patient was discharged from the hospital.Results:Post-health-education knowledge significantly reduced the cases of rehospitalization in both groups.However,the rehospitalization rate in the audiovisual group was lower than in the leaflet group(P=0.047,odds ratio=5.870).Conclusions:Post-health-education knowledge is effective in reducing the risk of rehospitalization,and health education using audiovisual media is more effective,compared to health education using leaflets,in reducing the cases of rehospitalization in children<5 years of age with pneumonia.展开更多
Infection caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV2)virus,responsible for the coronavirus disease 2019(COVID-19)pandemic,induces symptoms including increased inflammatory response,severe ...Infection caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV2)virus,responsible for the coronavirus disease 2019(COVID-19)pandemic,induces symptoms including increased inflammatory response,severe acute respiratory syndrome(SARS),cognitive dysfunction like brain fog,and cardiovascular defects.Long-term effects of SARS-CoV2 COVID-19 syndrome referred to as post-COVID-19 syndrome on age-related progressive neurodegenerative disorders such as Alzheimer's disease remain understudied.Using the targeted misexpression of individual SARS-CoV2 proteins in the retinal neurons of the Drosophila melanogaster eye,we found that misexpression of nonstructural protein 3(Nsp3),a papain-like protease,ablates the eye and generates dark necrotic spots.Targeted misexpression of Nsp3 in the eye triggers reactive oxygen species production and leads to apoptosis as shown by cell death reporters,terminal deoxynucleotidyl transferase(TdT)dUTP Nick-end labeling(TUNEL)assay,and dihydroethidium staining.Furthermore,Nsp3 misexpression activates both apoptosis and autophagy mechanism(s)to regulate tissue homeostasis.Transient expression of SARS-CoV2 Nsp3 in murine neuroblastoma,Neuro-2a cells,significantly reduced the metabolic activity of these cells and triggers cell death.Misexpression of SARS-CoV2 Nsp3 in an Alzheimer's disease transgenic fly eye model(glass multiple repeats[GMR]>amyloidβ42)further enhances the neurodegenerative rough eye phenotype due to increased cell death.These findings suggest that SARS-CoV2 utilizes Nsp3 protein to potentiate cell death response in a neurodegenerative disease background that has high pre-existing levels of neuroinflammation and cell death.展开更多
Although accelerated urbanization has led to economic prosperity,it has also resulted in urban heat island effects.Therefore,identifying methods of using limited urban spaces to alleviate heat islands has become an ur...Although accelerated urbanization has led to economic prosperity,it has also resulted in urban heat island effects.Therefore,identifying methods of using limited urban spaces to alleviate heat islands has become an urgent issue.In this study,we assessed the spatiotemporal evolution of urban heat islands within the central urban area of Fuzhou City,China from 2010 to 2019.This assessment was based on a morphological spatial pattern analysis(MSPA)model and an urban thermal environment spatial network constructed us-ing the minimum cumulative resistance(MCR)model.Optimization measures for the spatial network were proposed to provide a theor-etical basis for alleviating urban heat islands.The results show that the heat island area within the study area gradually increased while that of urban cold island area gradually decreased.The core area was the largest of the urban heat island patch landscape elements with a significant impact on other landscape elements,and represented an important factor underlying urban heat island network stability.The thermal environment network revealed a total of 197 thermal environment corridors and 93 heat island sources.These locations were then optimized according to the current land use,which maximized the potential of 1599.83 ha.Optimization based on current land use led to an increase in climate resilience,with effective measures showing reduction in thermal environment spatial network structure and function,contributing to the mitigation of urban heat island.These findings support the use of current land use patterns during urban heat island mitigation measure planning,thus providing an important reference basis for alleviating urban heat island effects.展开更多
Glued timber structure is one of the main forms of modern wood architecture,which has gradually developed towards mid-and high-rise buildings.Glue-laminated timber(GLT)is comprised of several laminates of parallel-to-...Glued timber structure is one of the main forms of modern wood architecture,which has gradually developed towards mid-and high-rise buildings.Glue-laminated timber(GLT)is comprised of several laminates of parallel-to-grain dimension lumber that are bonded together with durable,moisture resistant structural adhesives.GLT can be used in horizontal applications as a beam and in vertical applications as a post.So,its compressive performance has a significant impact on structural safety.Fiber reinforced polymers(FRPs)were commonly used to improve the bearing capacity of GLT components,and the structural and process parameters largely determined the reinforcement effect.This study was aimed at investigating the influence of structural and process parameters on the axial compression performance of GLT components.Three wrapping methods(middle-part,end-part and full wrapping)and three lengths(0.6,0.8,and 1.0 m)of wood post specimens were designed in this work and the axial compression performance and ductility of GLT post specimens modified by basalt fiber reinforced polymer(BFRP)were studied.The results showed that the effect of different BFRP wrapping methods on the compressive strength and elastic modulus of laminated wood was not statistically significant(P>0.05).The compressive bearing capacity of unreinforced GLT posts decreased with the increase of aspect ratio.The GLT posts with middle-part and end-part wrapping still followed this pattern,while the compressive bearing capacity of GLT posts with full wrapping showed a pattern of first decreasing and then increasing.For GLT with low aspect ratios(4.0 or 5.3),there was no correlation between the wrapping method and the compressive bearing capacity,while the compressive bearing capacity of GLT with a high aspect ratio(6.7)for middle-part,end-part and full wrapping increased by 3.5%,7.5%and 9.7%,respectively.Compared to the unreinforced group,the ultimate axial compressive strength and modulus of elasticity(MOE)of the 6-E series specimens reinforced at both ends decreased by 2.58%and 6.70%,respectively.The ultimate axial compressive strength of the 8-E specimens reinforced at both ends increased by 8.62%and the MOE decreased by 1.91%.The compressive strength of the 10-E specimens reinforced at both ends increased by 7.51%and the MOE increased by 8.14%.The failure modes of GLT with different aspects were consistent under the same BFRP wrapping,while the failure modes of GLT with the same aspect ratio were different for different BFRP wrapping methods.The ductility performance of GLT with different aspects ratio was improved by the BFRP wrapping.展开更多
AIM:To describe the gonioscopic profile and intraocular pressure(IOP)in primary angle-closure(PAC)disease in patients presenting to a tertiary eye care network in India.METHODS:A cross-sectional hospital-based study t...AIM:To describe the gonioscopic profile and intraocular pressure(IOP)in primary angle-closure(PAC)disease in patients presenting to a tertiary eye care network in India.METHODS:A cross-sectional hospital-based study that included 31484 new patients presenting between 2011 and 2021.Patients with a clinical diagnosis of PAC/suspect/glaucoma were included.The data was collected from an electronic medical record system.RESULTS:PAC glaucoma(PACG)(47.55%)was the most common diagnosis followed by PAC(39.49%)and PAC suspect(PACS;12.96%).Female preponderance(54.6%)was noted with higher mean age at presentation among males(P<0.0001).PACS and PAC showed the highest prevalence in 6th decade but PACG was higher at 7th decade.The probability of angle opening was 95.93%,90.32%and 63.36%in PACS,PAC and PACG eyes respectively post peripheral iridotomy(PI).Plateau iris syndrome(PIS)was noted in 252 eyes and all showed post dilated rise of IOP.A post dilated IOP rise was also noted with 8.86%,33.95%and 57.19%eyes with PACS,PAC and PACG respectively with IOP rise between 6-8 mm Hg across the disease spectrum.CONCLUSION:The superior quadrant is the narrowest angle and difficult to open with indentation and post PI.The probability of angle opening is less in PIS especially the complete variety along with post dilated IOP rise.The post dilated IOP rise in angle closure eyes warrants a careful dilatation,especially with PIS.展开更多
BACKGROUND Delayed post hypoxic leukoencephalopathy syndrome(DPHLS),also known as Grinker’s myelinopathy,is a rare but significant neurological condition that manifests days to weeks after a hypoxic event.Characteriz...BACKGROUND Delayed post hypoxic leukoencephalopathy syndrome(DPHLS),also known as Grinker’s myelinopathy,is a rare but significant neurological condition that manifests days to weeks after a hypoxic event.Characterized by delayed onset of neurological and cognitive deficits,DPHLS presents substantial diagnostic and therapeutic challenges.AIM To consolidate current knowledge on pathophysiology,clinical features,diagnostic approaches,and management strategies for DPHLS,providing a comprehensive overview and highlighting gaps for future research.METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guidelines,we systematically searched PubMed,ScienceDirect and Hinari databases using terms related to delayed post-hypoxic leukoencephalopathy.Inclusion criteria were original research articles,case reports,and case series involving human subjects with detailed clinical,neuroimaging,or pathological data on DPHLS.Data were extracted on study characteristics,participant demographics,clinical features,neuroimaging findings,pathological findings,treatment,and outcomes.The quality assessment was performed using the Joanna Briggs Institute critical appraisal checklist.RESULTS A total of 73 cases were reviewed.Common comorbidities included schizoaffective disorder,bipolar disorder,hypertension,and substance use disorder.The primary causes of hypoxia were benzodiazepine overdose,opioid overdose,polysubstance overdose,and carbon monoxide(CO)poisoning.Symptoms frequently include decreased level of consciousness,psychomotor agitation,cognitive decline,parkinsonism,and encephalopathy.Neuroimaging commonly revealed diffuse T2 hyperintensities in cerebral white matter,sometimes involving the basal ganglia and the globus pallidus.Magnetic resonance spectroscopy often showed decreased N-acetylaspartate,elevated choline,choline-to-creatinine ratio,and normal or elevated lactate.Treatment is often supportive,including amantadine,an antioxidant cocktail,and steroids.Hyperbaric oxygen therapy may be beneficial in those with CO poisoning.Parkinsonism was often treated with levodopa.Most of the patients had substantial recovery over the course of months and many cases had some residual neurocognitive deficits.CONCLUSION DPHLS remains a complex and multifaceted condition with various etiologies and clinical manifestations.Early recognition and appropriate management are crucial to improving patient outcomes.Future research should focus on standardizing diagnostic criteria,using advanced imaging techniques,and exploring therapeutic interventions to improve understanding and treatment of DPHLS.Conducting prospective cohort studies and developing biomarkers for early diagnosis and monitoring will be essential to advance patient care.展开更多
We focus on the importance and necessity of post-competency-based training in medical education alongside its current challenges and opportunities.Integrating post competency training into standardized educational fra...We focus on the importance and necessity of post-competency-based training in medical education alongside its current challenges and opportunities.Integrating post competency training into standardized educational frameworks is increasingly recognized as a critical component of preparing residents and postgraduates for real-world clinical practice.Post competency training represents a commitment to excellence in medical education,striving to produce competent,skilled practitioners to meet the challenges of modern healthcare.展开更多
This editorial explores the impact of non-steroidal anti-inflammatory drugs(NSAIDs)on postoperative recovery in hand fracture patients,amidst shifting pain management strategies away from opioids due to their adverse ...This editorial explores the impact of non-steroidal anti-inflammatory drugs(NSAIDs)on postoperative recovery in hand fracture patients,amidst shifting pain management strategies away from opioids due to their adverse effects.With hand fractures being significantly common and postoperative pain management crucial for recovery,the potential of NSAIDs offers a non-addictive pain control alternative.However,the controversy over NSAIDs'effects on bone healing—stemming from their Cyclooxygenase-2 inhibition and associated risks of fracture non-union or delayed union—necessitates further investigation.Despite a comprehensive literature search,the study finds a lack of specific research on NSAIDs in postoperative hand fracture management,highlighting an urgent need for future studies to balance their benefits against possible risks.展开更多
Through the analysis of the overall landscape,revetments and roads and plant landscape,10 evaluation factors were determined.The comprehensive evaluation model for the campus space of Anhui Xinhua University was const...Through the analysis of the overall landscape,revetments and roads and plant landscape,10 evaluation factors were determined.The comprehensive evaluation model for the campus space of Anhui Xinhua University was constructed by analytic hierarchy process(AHP).The results showed that revetment safety,road convenience,plant disease resistance and campus activity space were important factors affecting the spatial form planning of campus.Through the comparative analysis of the collected data,optimization suggestions were put forward to provide a basis for the establishment of“people-oriented”campus open space system.展开更多
Background: World Health Organization recommends the implementation of contact tracing and Leprosy Post Exposure prophylaxis (LPEP) to interrupt the chain of transmission. To accelerate the uptake of this recommendati...Background: World Health Organization recommends the implementation of contact tracing and Leprosy Post Exposure prophylaxis (LPEP) to interrupt the chain of transmission. To accelerate the uptake of this recommendation, a cross-sectional study among contacts of leprosy patients was conducted to investigate the feasibility of integrating leprosy systematic contact tracing and post-exposure prophylaxis (PEP) into the routine leprosy control program. Methods: This was a mixed methods cross-sectional study. The study was implemented in Kumi, Ngora, Serere, Soroti, Budaka and Kibuku Districts. Results: The 45 enrolled index patients (97.8% of the registered) identified a total of 135 contacts, of which 134 (99·2%) consented and were screened. Among them, one new leprosy patient was identified and started on treatment with multidrug therapy (MDT). All the eligible contacts, received the prophylactic treatment with Single Dose Rifampicin (SDR). Overall, SDR was administered to 133(98.5% of the listed contacts) with no adverse event reported. Factors associated with successful contact investigation and management included: Involvement of index patients, health care workers during the contact screening and SDR A administration, counselling of the index patients and contacts by the health care works, LPEP being administered as Directly observed Therapy (DOT) among others. Results Interpretation: The integration of leprosy post-exposure prophylaxis with administration of SDR and contact tracing is feasible, generally accepted by the patient, their contacts and health workers and can be integrated into the National Leprosy control programmes with minimal additional efforts once contact tracing has been established. Therefore, we recommend integration of administration of SDR in to the routine leprosy control program.展开更多
Viral infections have been considered as a major cause of morbidity and mortality after kidney transplantation in pediatric cohort.Children are at high risk of acquiring virus-related complications due to immunologica...Viral infections have been considered as a major cause of morbidity and mortality after kidney transplantation in pediatric cohort.Children are at high risk of acquiring virus-related complications due to immunological immaturity and the enhanced alloreactivity risk that led to maintenance of high immunosuppressive regimes.Hence,prevention,early detection,and prompt treatment of such infections are of paramount importance.Among all viral infections,herpes viruses(herpes simplex virus,varicella zoster virus,Epstein-Barr virus,cytomegalovirus),hepatitis B and C viruses,BK polyomavirus,and respiratory viruses(respiratory syncytial virus,parainfluenza virus,influenza virus and adenovirus)are common in kidney transplant recipients.These viruses can cause systemic disease or allograft dysfunction affecting the clinical outcome.Recent advances in technology and antiviral therapy have improved management strategies in screening,monitoring,adoption of prophylactic or preemptive therapy and precise treatment in the immunocompromised host,with significant impact on the outcome.This review discusses the etiology,screening and monitoring,diagnosis,prevention,and treatment of common viral infections in pediatric renal transplant recipients.展开更多
This article reviews the concept and clinical manifestations of post embolism syndrome after transarterial chemoembolization(TACE),and the prevention or timely intervention of post embolism syndrome in advance is expe...This article reviews the concept and clinical manifestations of post embolism syndrome after transarterial chemoembolization(TACE),and the prevention or timely intervention of post embolism syndrome in advance is expected to reduce its incidence and degree in clinical treatment,and to improve the quality of treatment of Hepatocellular Carcinoma Carcinoma(HCC).展开更多
Colonoscopy is the gold standard for the screening and diagnosis of colorectal cancer,resulting in a decrease in the incidence and mortality of colon cancer.However,it has a 21%rate of missed polyps.Several strategies...Colonoscopy is the gold standard for the screening and diagnosis of colorectal cancer,resulting in a decrease in the incidence and mortality of colon cancer.However,it has a 21%rate of missed polyps.Several strategies have been devised to increase polyp detection rates and improve their characterization and delimi-tation.These include chromoendoscopy(CE),the use of other devices such as Endo cuffs,and major advances in endoscopic equipment[high definition,magnification,narrow band imaging,i-scan,flexible spectral imaging color enhancement,texture and color enhancement imaging(TXI),etc.].In the retrospective study by Hiramatsu et al,they compared white-light imaging with CE,TXI,and CE+TXI to determine which of these strategies allows for better definition and delimitation of polyps.They concluded that employing CE associated with TXI stands out as the most effective method to utilize.It remains to be demonstrated whether these results are extrapolatable to other types of virtual CE.Additionally,further investigation is needed in order to ascertain whether this strategy could lead to a reduction in the recurrence of excised lesions and potentially lower the occurrence of interval cancer.展开更多
Introduction: Renal transplant artery stenosis (RTAS) is a common and early complication of renal transplantation, which can lead to severe post-transplant hypertension, as well as significant morbidity and mortality,...Introduction: Renal transplant artery stenosis (RTAS) is a common and early complication of renal transplantation, which can lead to severe post-transplant hypertension, as well as significant morbidity and mortality, particulary graft loss. The aim of this study is to determine the prevalence, clinico-radiological characteristics and evaluate the outcomes of luminal angioplasty as a first-line treatment for RTAS, through the analysis of medical records of 27 kidney transplant patients. Material and Methods: This is a retrospective, single-center, and descriptive study conducted at the Nephrology department of the Ibn-Sina Hospital in Rabat, including 27 renal transplant patients with RTAS during the period from 1998 to 2023. All patients with clinically suspected RTAS and confirmed by Doppler ultrasound of the transplanted renal artery were included in the study. Results: The mean age of donors was 48.66 ± 13.55 years, with a female predominance (65%). The donor was deceased in 15% of cases. The mean age of the recipients was 39 ± 16 years with a male-to-female ratio of 4.4. The median onset of RTAS was 3.6 ± 3.4 months after renal transplantation. Seven patients (26%) had high blood pressure (HBP) before their transplantation. Six patients (22%) had hypertriglyceridemia and 7 patients (26%) had pure hypercholesterolemia. The main clinical signs were worsening of preexisting HBP, de novo HBP and acute renal failure (ARF). Stenosis was confirmed by renal Doppler ultrasound in all patients. It was severe in 63%, with a stenosis degree greater than 70%. Six patients underwent angioplasty, resulting in the stabilization of graft function with a nadir of 15 mg/l creatinine and blood pressure control with dual therapy in 5 patients. No graft loss cases were noted. Conclusion: RTAS is a significant vascular complication of renal transplantation that predicts unfavorable outcomes for both the patient and the graft. Early diagnosis is crucial to successfully restore graft function and prevent complications.展开更多
Postoperative complications represent important indicators for the quality of surgical care. The objectives of this work were to study post-operative complications in the general surgery department of the Cs ref of co...Postoperative complications represent important indicators for the quality of surgical care. The objectives of this work were to study post-operative complications in the general surgery department of the Cs ref of commune I in Mali, to determine the frequency of post-operative complications, to identify the factors of occurrence, to describe the clinical aspects, diagnostic and therapeutic in order to assess the additional cost linked to post-operative complications. This study was prospective, carried out in the general surgery department on 300 cases of surgical interventions. It covered all patients aged at least 15 years, operated on and hospitalized or not, and who presented complications during the 30 days postoperatively. Patients under the age of 15 were not included (our general surgery department is not a pediatric surgery department). We collected 300 patients among whom 199 (66.33%) were men and 101 (33.66%) women, i.e. a sex ratio = 1.9. The average age was 38 years with extremes of 15 and 87 years. The main initial diagnoses were: acute appendicitis, peritonitis, occlusions, wall hernias, hemorrhoids, uterine prolapse, uterine myomas, ovarian cysts and acute cholecystitis. Emergencies represented 43% (N = 129) of interventions with 6.98% post-operative complications (POC). Postoperative complications were dominated by surgical site infections, 75% of cases (N = 20), wall hemorrhage 5% (N = 1), testicular necrosis 5% (N = 1) and testicular calcification 5% (N = 1), wire rejection 5% (N = 1) and death 5% (N = 1). The management of postoperative complications was surgical in 95% and medical in 100%. Their occurrence extended the hospital stay by 3.65 days and increased the average cost of care by 60541.85 CFA francs. The mortality index lowered by efficient management of complications (IMAGE) calculated in relation to deaths was 95% of cases. Anemia, ASA score ≥ III, Alteimeir II and IV classes, duration of surgery and post-operative hospitalization were factors contributing to post-operative complications.展开更多
Pain is the predominant symptom troubling patients.Pain management is one of the most important aspects in the management of surgical patients leading to early recovery from surgical procedures or in patients with chr...Pain is the predominant symptom troubling patients.Pain management is one of the most important aspects in the management of surgical patients leading to early recovery from surgical procedures or in patients with chronic diseases or malignancy.Various groups of drugs are used for dealing with this;however,they have their own implications in the form of adverse effects and dependence.In this article,we review the concerns of different pain-relieving medicines used postoperatively in gastrointestinal surgery and for malignant and chronic diseases.展开更多
In today’s rapid widespread of digital technologies into all live aspects to enhance efficiency and productivity on the one hand and on the other hand ensure customer engagement, personal data counterfeiting has beco...In today’s rapid widespread of digital technologies into all live aspects to enhance efficiency and productivity on the one hand and on the other hand ensure customer engagement, personal data counterfeiting has become a major concern for businesses and end-users. One solution to ensure data security is encryption, where keys are central. There is therefore a need to find robusts key generation implementation that is effective, inexpensive and non-invasive for protecting and preventing data counterfeiting. In this paper, we use the theory of electromagnetic wave propagation to generate encryption keys.展开更多
Today, the advent of quantum computers and algorithms is calling into question the semantic security of symmetrical and asymmetrical cryptosystems. The security of objects connected to the network, which must provide ...Today, the advent of quantum computers and algorithms is calling into question the semantic security of symmetrical and asymmetrical cryptosystems. The security of objects connected to the network, which must provide a security service and protect the privacy of users by providing protection against attacks such as identity theft, denial of service, eavesdropping and unauthorised access to personal and sensitive data. It is therefore necessary to find a robust method of using the key that is effective in protecting and preventing data tampering. In this paper, we design and implement a security and data protection method using a key generated on the basis of electromagnetic wave propagation theories. Modelling and implementation of a data security and protection method using a key generated on the basis of electromagnetic wave propagation theories.展开更多
基金the National Natural Science Foundation of China (No.70329001 and No. 70321001)
文摘Demand uncertainty is a key factor for the seller's decision making, especially in the e-business environment, for the website to sell products through the online auction. In this paper, two kinds of demand uncertainties are considered: the consumer regime uncertainty and the inherent randomness of the market environment. Then, how to use a novel business model and group-buying auction (GBA) is analyzed in such a market environment. Based on the comparison of the GBA and the posted price mechanism, some conditions that favor the GBA are provided.
基金supported by Hibah PITTA (Grant A 2019)funded by DRPM Universitas Indonesia (No. NKB-0346/UN2.R3.1/HKP.05.00/2019)
文摘Objective:The rehospitalization rate of children<5 years old with pneumonia is still high.The risk of hospitalization becomes higher in mothers with low knowledge of their child’s disease.The purpose of this study was to determine the effect of post-health-education maternal knowledge in cases of rehospitalization and to determine the differences in rehospitalization rate based on the type of health education media.Methods:This study is a quasi-experiment.Health education was given to both groups:one group received education through audiovisual media and the other group through leaflet media.The level of post-health-education knowledge was measured on the third day,then followed up until the 30th day after the patient was discharged from the hospital.Results:Post-health-education knowledge significantly reduced the cases of rehospitalization in both groups.However,the rehospitalization rate in the audiovisual group was lower than in the leaflet group(P=0.047,odds ratio=5.870).Conclusions:Post-health-education knowledge is effective in reducing the risk of rehospitalization,and health education using audiovisual media is more effective,compared to health education using leaflets,in reducing the cases of rehospitalization in children<5 years of age with pneumonia.
基金supported by 1RO1EY032959-01 from NIHSchuellein Chair Endowment FundSTEM Catalyst Grant from the University of Dayton(all to AS)。
文摘Infection caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV2)virus,responsible for the coronavirus disease 2019(COVID-19)pandemic,induces symptoms including increased inflammatory response,severe acute respiratory syndrome(SARS),cognitive dysfunction like brain fog,and cardiovascular defects.Long-term effects of SARS-CoV2 COVID-19 syndrome referred to as post-COVID-19 syndrome on age-related progressive neurodegenerative disorders such as Alzheimer's disease remain understudied.Using the targeted misexpression of individual SARS-CoV2 proteins in the retinal neurons of the Drosophila melanogaster eye,we found that misexpression of nonstructural protein 3(Nsp3),a papain-like protease,ablates the eye and generates dark necrotic spots.Targeted misexpression of Nsp3 in the eye triggers reactive oxygen species production and leads to apoptosis as shown by cell death reporters,terminal deoxynucleotidyl transferase(TdT)dUTP Nick-end labeling(TUNEL)assay,and dihydroethidium staining.Furthermore,Nsp3 misexpression activates both apoptosis and autophagy mechanism(s)to regulate tissue homeostasis.Transient expression of SARS-CoV2 Nsp3 in murine neuroblastoma,Neuro-2a cells,significantly reduced the metabolic activity of these cells and triggers cell death.Misexpression of SARS-CoV2 Nsp3 in an Alzheimer's disease transgenic fly eye model(glass multiple repeats[GMR]>amyloidβ42)further enhances the neurodegenerative rough eye phenotype due to increased cell death.These findings suggest that SARS-CoV2 utilizes Nsp3 protein to potentiate cell death response in a neurodegenerative disease background that has high pre-existing levels of neuroinflammation and cell death.
基金Under the auspices of Special Funds for Education and Scientific Research of the Department of Finance(Min Cai Zhi[2022]No.840)Fujian Province Key Laboratory of Geographic Information Technology and Resource Optimization Construction Project(No.PTJH17014)。
文摘Although accelerated urbanization has led to economic prosperity,it has also resulted in urban heat island effects.Therefore,identifying methods of using limited urban spaces to alleviate heat islands has become an urgent issue.In this study,we assessed the spatiotemporal evolution of urban heat islands within the central urban area of Fuzhou City,China from 2010 to 2019.This assessment was based on a morphological spatial pattern analysis(MSPA)model and an urban thermal environment spatial network constructed us-ing the minimum cumulative resistance(MCR)model.Optimization measures for the spatial network were proposed to provide a theor-etical basis for alleviating urban heat islands.The results show that the heat island area within the study area gradually increased while that of urban cold island area gradually decreased.The core area was the largest of the urban heat island patch landscape elements with a significant impact on other landscape elements,and represented an important factor underlying urban heat island network stability.The thermal environment network revealed a total of 197 thermal environment corridors and 93 heat island sources.These locations were then optimized according to the current land use,which maximized the potential of 1599.83 ha.Optimization based on current land use led to an increase in climate resilience,with effective measures showing reduction in thermal environment spatial network structure and function,contributing to the mitigation of urban heat island.These findings support the use of current land use patterns during urban heat island mitigation measure planning,thus providing an important reference basis for alleviating urban heat island effects.
文摘Glued timber structure is one of the main forms of modern wood architecture,which has gradually developed towards mid-and high-rise buildings.Glue-laminated timber(GLT)is comprised of several laminates of parallel-to-grain dimension lumber that are bonded together with durable,moisture resistant structural adhesives.GLT can be used in horizontal applications as a beam and in vertical applications as a post.So,its compressive performance has a significant impact on structural safety.Fiber reinforced polymers(FRPs)were commonly used to improve the bearing capacity of GLT components,and the structural and process parameters largely determined the reinforcement effect.This study was aimed at investigating the influence of structural and process parameters on the axial compression performance of GLT components.Three wrapping methods(middle-part,end-part and full wrapping)and three lengths(0.6,0.8,and 1.0 m)of wood post specimens were designed in this work and the axial compression performance and ductility of GLT post specimens modified by basalt fiber reinforced polymer(BFRP)were studied.The results showed that the effect of different BFRP wrapping methods on the compressive strength and elastic modulus of laminated wood was not statistically significant(P>0.05).The compressive bearing capacity of unreinforced GLT posts decreased with the increase of aspect ratio.The GLT posts with middle-part and end-part wrapping still followed this pattern,while the compressive bearing capacity of GLT posts with full wrapping showed a pattern of first decreasing and then increasing.For GLT with low aspect ratios(4.0 or 5.3),there was no correlation between the wrapping method and the compressive bearing capacity,while the compressive bearing capacity of GLT with a high aspect ratio(6.7)for middle-part,end-part and full wrapping increased by 3.5%,7.5%and 9.7%,respectively.Compared to the unreinforced group,the ultimate axial compressive strength and modulus of elasticity(MOE)of the 6-E series specimens reinforced at both ends decreased by 2.58%and 6.70%,respectively.The ultimate axial compressive strength of the 8-E specimens reinforced at both ends increased by 8.62%and the MOE decreased by 1.91%.The compressive strength of the 10-E specimens reinforced at both ends increased by 7.51%and the MOE increased by 8.14%.The failure modes of GLT with different aspects were consistent under the same BFRP wrapping,while the failure modes of GLT with the same aspect ratio were different for different BFRP wrapping methods.The ductility performance of GLT with different aspects ratio was improved by the BFRP wrapping.
文摘AIM:To describe the gonioscopic profile and intraocular pressure(IOP)in primary angle-closure(PAC)disease in patients presenting to a tertiary eye care network in India.METHODS:A cross-sectional hospital-based study that included 31484 new patients presenting between 2011 and 2021.Patients with a clinical diagnosis of PAC/suspect/glaucoma were included.The data was collected from an electronic medical record system.RESULTS:PAC glaucoma(PACG)(47.55%)was the most common diagnosis followed by PAC(39.49%)and PAC suspect(PACS;12.96%).Female preponderance(54.6%)was noted with higher mean age at presentation among males(P<0.0001).PACS and PAC showed the highest prevalence in 6th decade but PACG was higher at 7th decade.The probability of angle opening was 95.93%,90.32%and 63.36%in PACS,PAC and PACG eyes respectively post peripheral iridotomy(PI).Plateau iris syndrome(PIS)was noted in 252 eyes and all showed post dilated rise of IOP.A post dilated IOP rise was also noted with 8.86%,33.95%and 57.19%eyes with PACS,PAC and PACG respectively with IOP rise between 6-8 mm Hg across the disease spectrum.CONCLUSION:The superior quadrant is the narrowest angle and difficult to open with indentation and post PI.The probability of angle opening is less in PIS especially the complete variety along with post dilated IOP rise.The post dilated IOP rise in angle closure eyes warrants a careful dilatation,especially with PIS.
文摘BACKGROUND Delayed post hypoxic leukoencephalopathy syndrome(DPHLS),also known as Grinker’s myelinopathy,is a rare but significant neurological condition that manifests days to weeks after a hypoxic event.Characterized by delayed onset of neurological and cognitive deficits,DPHLS presents substantial diagnostic and therapeutic challenges.AIM To consolidate current knowledge on pathophysiology,clinical features,diagnostic approaches,and management strategies for DPHLS,providing a comprehensive overview and highlighting gaps for future research.METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guidelines,we systematically searched PubMed,ScienceDirect and Hinari databases using terms related to delayed post-hypoxic leukoencephalopathy.Inclusion criteria were original research articles,case reports,and case series involving human subjects with detailed clinical,neuroimaging,or pathological data on DPHLS.Data were extracted on study characteristics,participant demographics,clinical features,neuroimaging findings,pathological findings,treatment,and outcomes.The quality assessment was performed using the Joanna Briggs Institute critical appraisal checklist.RESULTS A total of 73 cases were reviewed.Common comorbidities included schizoaffective disorder,bipolar disorder,hypertension,and substance use disorder.The primary causes of hypoxia were benzodiazepine overdose,opioid overdose,polysubstance overdose,and carbon monoxide(CO)poisoning.Symptoms frequently include decreased level of consciousness,psychomotor agitation,cognitive decline,parkinsonism,and encephalopathy.Neuroimaging commonly revealed diffuse T2 hyperintensities in cerebral white matter,sometimes involving the basal ganglia and the globus pallidus.Magnetic resonance spectroscopy often showed decreased N-acetylaspartate,elevated choline,choline-to-creatinine ratio,and normal or elevated lactate.Treatment is often supportive,including amantadine,an antioxidant cocktail,and steroids.Hyperbaric oxygen therapy may be beneficial in those with CO poisoning.Parkinsonism was often treated with levodopa.Most of the patients had substantial recovery over the course of months and many cases had some residual neurocognitive deficits.CONCLUSION DPHLS remains a complex and multifaceted condition with various etiologies and clinical manifestations.Early recognition and appropriate management are crucial to improving patient outcomes.Future research should focus on standardizing diagnostic criteria,using advanced imaging techniques,and exploring therapeutic interventions to improve understanding and treatment of DPHLS.Conducting prospective cohort studies and developing biomarkers for early diagnosis and monitoring will be essential to advance patient care.
基金Supported by Education and Teaching Reform Project of the First Clinical College of Chongqing Medical University,No.CMER202305Program for Youth Innovation in Future Medicine,Chongqing Medical University,No.W0138.
文摘We focus on the importance and necessity of post-competency-based training in medical education alongside its current challenges and opportunities.Integrating post competency training into standardized educational frameworks is increasingly recognized as a critical component of preparing residents and postgraduates for real-world clinical practice.Post competency training represents a commitment to excellence in medical education,striving to produce competent,skilled practitioners to meet the challenges of modern healthcare.
文摘This editorial explores the impact of non-steroidal anti-inflammatory drugs(NSAIDs)on postoperative recovery in hand fracture patients,amidst shifting pain management strategies away from opioids due to their adverse effects.With hand fractures being significantly common and postoperative pain management crucial for recovery,the potential of NSAIDs offers a non-addictive pain control alternative.However,the controversy over NSAIDs'effects on bone healing—stemming from their Cyclooxygenase-2 inhibition and associated risks of fracture non-union or delayed union—necessitates further investigation.Despite a comprehensive literature search,the study finds a lack of specific research on NSAIDs in postoperative hand fracture management,highlighting an urgent need for future studies to balance their benefits against possible risks.
基金by National Undergraduate Innovation Training Program of Anhui Xinhua University in 2022(202212216012)Provincial Undergraduate Innovation Training Program of Anhui Xinhua University in 2021(AH202112216119)+1 种基金Key Research Project of Natural Science in Colleges and Universities of Anhui Province(2023AH051816)General Teaching Research Project of Anhui Province(2022jyxm665).
文摘Through the analysis of the overall landscape,revetments and roads and plant landscape,10 evaluation factors were determined.The comprehensive evaluation model for the campus space of Anhui Xinhua University was constructed by analytic hierarchy process(AHP).The results showed that revetment safety,road convenience,plant disease resistance and campus activity space were important factors affecting the spatial form planning of campus.Through the comparative analysis of the collected data,optimization suggestions were put forward to provide a basis for the establishment of“people-oriented”campus open space system.
文摘Background: World Health Organization recommends the implementation of contact tracing and Leprosy Post Exposure prophylaxis (LPEP) to interrupt the chain of transmission. To accelerate the uptake of this recommendation, a cross-sectional study among contacts of leprosy patients was conducted to investigate the feasibility of integrating leprosy systematic contact tracing and post-exposure prophylaxis (PEP) into the routine leprosy control program. Methods: This was a mixed methods cross-sectional study. The study was implemented in Kumi, Ngora, Serere, Soroti, Budaka and Kibuku Districts. Results: The 45 enrolled index patients (97.8% of the registered) identified a total of 135 contacts, of which 134 (99·2%) consented and were screened. Among them, one new leprosy patient was identified and started on treatment with multidrug therapy (MDT). All the eligible contacts, received the prophylactic treatment with Single Dose Rifampicin (SDR). Overall, SDR was administered to 133(98.5% of the listed contacts) with no adverse event reported. Factors associated with successful contact investigation and management included: Involvement of index patients, health care workers during the contact screening and SDR A administration, counselling of the index patients and contacts by the health care works, LPEP being administered as Directly observed Therapy (DOT) among others. Results Interpretation: The integration of leprosy post-exposure prophylaxis with administration of SDR and contact tracing is feasible, generally accepted by the patient, their contacts and health workers and can be integrated into the National Leprosy control programmes with minimal additional efforts once contact tracing has been established. Therefore, we recommend integration of administration of SDR in to the routine leprosy control program.
文摘Viral infections have been considered as a major cause of morbidity and mortality after kidney transplantation in pediatric cohort.Children are at high risk of acquiring virus-related complications due to immunological immaturity and the enhanced alloreactivity risk that led to maintenance of high immunosuppressive regimes.Hence,prevention,early detection,and prompt treatment of such infections are of paramount importance.Among all viral infections,herpes viruses(herpes simplex virus,varicella zoster virus,Epstein-Barr virus,cytomegalovirus),hepatitis B and C viruses,BK polyomavirus,and respiratory viruses(respiratory syncytial virus,parainfluenza virus,influenza virus and adenovirus)are common in kidney transplant recipients.These viruses can cause systemic disease or allograft dysfunction affecting the clinical outcome.Recent advances in technology and antiviral therapy have improved management strategies in screening,monitoring,adoption of prophylactic or preemptive therapy and precise treatment in the immunocompromised host,with significant impact on the outcome.This review discusses the etiology,screening and monitoring,diagnosis,prevention,and treatment of common viral infections in pediatric renal transplant recipients.
文摘This article reviews the concept and clinical manifestations of post embolism syndrome after transarterial chemoembolization(TACE),and the prevention or timely intervention of post embolism syndrome in advance is expected to reduce its incidence and degree in clinical treatment,and to improve the quality of treatment of Hepatocellular Carcinoma Carcinoma(HCC).
文摘Colonoscopy is the gold standard for the screening and diagnosis of colorectal cancer,resulting in a decrease in the incidence and mortality of colon cancer.However,it has a 21%rate of missed polyps.Several strategies have been devised to increase polyp detection rates and improve their characterization and delimi-tation.These include chromoendoscopy(CE),the use of other devices such as Endo cuffs,and major advances in endoscopic equipment[high definition,magnification,narrow band imaging,i-scan,flexible spectral imaging color enhancement,texture and color enhancement imaging(TXI),etc.].In the retrospective study by Hiramatsu et al,they compared white-light imaging with CE,TXI,and CE+TXI to determine which of these strategies allows for better definition and delimitation of polyps.They concluded that employing CE associated with TXI stands out as the most effective method to utilize.It remains to be demonstrated whether these results are extrapolatable to other types of virtual CE.Additionally,further investigation is needed in order to ascertain whether this strategy could lead to a reduction in the recurrence of excised lesions and potentially lower the occurrence of interval cancer.
文摘Introduction: Renal transplant artery stenosis (RTAS) is a common and early complication of renal transplantation, which can lead to severe post-transplant hypertension, as well as significant morbidity and mortality, particulary graft loss. The aim of this study is to determine the prevalence, clinico-radiological characteristics and evaluate the outcomes of luminal angioplasty as a first-line treatment for RTAS, through the analysis of medical records of 27 kidney transplant patients. Material and Methods: This is a retrospective, single-center, and descriptive study conducted at the Nephrology department of the Ibn-Sina Hospital in Rabat, including 27 renal transplant patients with RTAS during the period from 1998 to 2023. All patients with clinically suspected RTAS and confirmed by Doppler ultrasound of the transplanted renal artery were included in the study. Results: The mean age of donors was 48.66 ± 13.55 years, with a female predominance (65%). The donor was deceased in 15% of cases. The mean age of the recipients was 39 ± 16 years with a male-to-female ratio of 4.4. The median onset of RTAS was 3.6 ± 3.4 months after renal transplantation. Seven patients (26%) had high blood pressure (HBP) before their transplantation. Six patients (22%) had hypertriglyceridemia and 7 patients (26%) had pure hypercholesterolemia. The main clinical signs were worsening of preexisting HBP, de novo HBP and acute renal failure (ARF). Stenosis was confirmed by renal Doppler ultrasound in all patients. It was severe in 63%, with a stenosis degree greater than 70%. Six patients underwent angioplasty, resulting in the stabilization of graft function with a nadir of 15 mg/l creatinine and blood pressure control with dual therapy in 5 patients. No graft loss cases were noted. Conclusion: RTAS is a significant vascular complication of renal transplantation that predicts unfavorable outcomes for both the patient and the graft. Early diagnosis is crucial to successfully restore graft function and prevent complications.
文摘Postoperative complications represent important indicators for the quality of surgical care. The objectives of this work were to study post-operative complications in the general surgery department of the Cs ref of commune I in Mali, to determine the frequency of post-operative complications, to identify the factors of occurrence, to describe the clinical aspects, diagnostic and therapeutic in order to assess the additional cost linked to post-operative complications. This study was prospective, carried out in the general surgery department on 300 cases of surgical interventions. It covered all patients aged at least 15 years, operated on and hospitalized or not, and who presented complications during the 30 days postoperatively. Patients under the age of 15 were not included (our general surgery department is not a pediatric surgery department). We collected 300 patients among whom 199 (66.33%) were men and 101 (33.66%) women, i.e. a sex ratio = 1.9. The average age was 38 years with extremes of 15 and 87 years. The main initial diagnoses were: acute appendicitis, peritonitis, occlusions, wall hernias, hemorrhoids, uterine prolapse, uterine myomas, ovarian cysts and acute cholecystitis. Emergencies represented 43% (N = 129) of interventions with 6.98% post-operative complications (POC). Postoperative complications were dominated by surgical site infections, 75% of cases (N = 20), wall hemorrhage 5% (N = 1), testicular necrosis 5% (N = 1) and testicular calcification 5% (N = 1), wire rejection 5% (N = 1) and death 5% (N = 1). The management of postoperative complications was surgical in 95% and medical in 100%. Their occurrence extended the hospital stay by 3.65 days and increased the average cost of care by 60541.85 CFA francs. The mortality index lowered by efficient management of complications (IMAGE) calculated in relation to deaths was 95% of cases. Anemia, ASA score ≥ III, Alteimeir II and IV classes, duration of surgery and post-operative hospitalization were factors contributing to post-operative complications.
文摘Pain is the predominant symptom troubling patients.Pain management is one of the most important aspects in the management of surgical patients leading to early recovery from surgical procedures or in patients with chronic diseases or malignancy.Various groups of drugs are used for dealing with this;however,they have their own implications in the form of adverse effects and dependence.In this article,we review the concerns of different pain-relieving medicines used postoperatively in gastrointestinal surgery and for malignant and chronic diseases.
文摘In today’s rapid widespread of digital technologies into all live aspects to enhance efficiency and productivity on the one hand and on the other hand ensure customer engagement, personal data counterfeiting has become a major concern for businesses and end-users. One solution to ensure data security is encryption, where keys are central. There is therefore a need to find robusts key generation implementation that is effective, inexpensive and non-invasive for protecting and preventing data counterfeiting. In this paper, we use the theory of electromagnetic wave propagation to generate encryption keys.
文摘Today, the advent of quantum computers and algorithms is calling into question the semantic security of symmetrical and asymmetrical cryptosystems. The security of objects connected to the network, which must provide a security service and protect the privacy of users by providing protection against attacks such as identity theft, denial of service, eavesdropping and unauthorised access to personal and sensitive data. It is therefore necessary to find a robust method of using the key that is effective in protecting and preventing data tampering. In this paper, we design and implement a security and data protection method using a key generated on the basis of electromagnetic wave propagation theories. Modelling and implementation of a data security and protection method using a key generated on the basis of electromagnetic wave propagation theories.
