The incidence of colorectal cancer(CRC)is characterized by rapid declines in the wake of widespread screening.Colonoscopy is the gold standard for CRC screening,but its accuracy is related to high quality of bowel pre...The incidence of colorectal cancer(CRC)is characterized by rapid declines in the wake of widespread screening.Colonoscopy is the gold standard for CRC screening,but its accuracy is related to high quality of bowel preparation(BP).In this review,we aimed to summarized the current strategy to increase bowel cleansing before colonoscopy.Newly bowel cleansing agents were developed with the same efficacy of previous agent but requiring less amount of liquid to improve patients’acceptability.The role of the diet before colonoscopy was also changed,as well the contribution of educational intervention and the use of adjunctive drugs to improve patients’tolerance and/or quality of BP.The review also described BP in special situations,as lower gastrointestinal bleeding,elderly people,patients with chronic kidney disease,patients with inflammatory bowel disease,patients with congestive heart failure,inpatient,patient with previous bowel resection,pregnant/lactating patients.The review underlined the quality of BP should be described using a validate scale in colonoscopy report and it explored the available scales.Finally,the review explored the possible contribution of bowel cleansing in post-colonoscopy syndrome that can be related by a transient alteration of gut microbiota.Moreover,the study underlined several points needed to further investigations.展开更多
Evaluation of the quality of small-bowel cleansing is required to assess the reliability of findings in capsule endoscopy(CE). Moreover, consensus regarding the need of intestinal preparation for CE remains to be achi...Evaluation of the quality of small-bowel cleansing is required to assess the reliability of findings in capsule endoscopy(CE). Moreover, consensus regarding the need of intestinal preparation for CE remains to be achieved. The presence of multiple grading scales for smallbowel preparation in CE, which are time-consuming and complicated, adds difficulty to the comparison of different small-bowel cleansing regimens and their application in clinical practice. Nowadays, a validated scale universally accepted for grading small-bowel cleansing is lacking. In fact, there are numerous grading systems with very different technical characteristics, namely, the parameters and the portion of the CE video that are analyzed, the objectivity of the analysis, the lesser or greater dependency on the operator, and the validation of the score. The authors performed a review which aims to systematize and summarize currently available smallbowel grading scales in CE.展开更多
AIM:To suggest a new cleansing score system for small bowel preparation and to evaluate its clinical efficacy.METHODS:Twenty capsule endoscopy cases were reviewed and small bowel preparation was assessed with the new ...AIM:To suggest a new cleansing score system for small bowel preparation and to evaluate its clinical efficacy.METHODS:Twenty capsule endoscopy cases were reviewed and small bowel preparation was assessed with the new scoring system.For the assessment,two visual parameters were used:proportion of visualized mucosa and degree of obscuration.Representative frames from small bowel images were serially selected and scored at 5-min intervals.Intraclass correlation coefficient(ICC)was obtained to assess the reliability of the new scoring system.For efficacy evaluation and validation,scores of our new scoring system were compared with another previously reported cleansing grading system.RESULTS:Concordance with the previous system,inter-observer agreement,and intra-patient agreement were excellent with ICC values of 0.82,0.80,and 0.76,respectively.The intra-observer agreements at four-week intervals were also excellent.The cutoff value of adequate image quality was found to be 2.25.CONCLUSION:Our new scoring system is simple,efficient,and can be considered to be applicable in clinical practice and research.展开更多
BACKGROUND Four-liter polyethylene glycol(PEG)solutions are effective for bowel cleansing,but their large volume might hinder patient compliance.Due to the unique features of Asians,4 L PEG might be a suboptimal bowel...BACKGROUND Four-liter polyethylene glycol(PEG)solutions are effective for bowel cleansing,but their large volume might hinder patient compliance.Due to the unique features of Asians,4 L PEG might be a suboptimal bowel preparation in predominantly ethnically Asian countries.In view of this,a balance should be achieved between the volume and effectiveness.The ideal bowel cleansing regimen for a colonoscopy has yet to be determined in a Chinese population.AIM To compare the cleansing efficacy of 3 L PEG plus simethicone with 4 L PEG.METHODS A total of 291 patients were randomly allocated to two groups:Group 1(n=145)received 4 L split-dose PEG(4-P);group 2(n=146)received 3 L split-dose PEG plus simethicone(3-PS).Bowel-cleansing efficacy was evaluated by endoscopists using the Boston bowel preparation scale(BBPS)and the bubbles score.RESULTS Although there were no significant differences in the total BBPS score or the adequate rate of bowel preparation between the two groups,the BBPS score of the right-side colon was significantly higher in the 3-SP group(2.37±0.54 vs 2.21±0.78;P=0.04).Moreover,the use of simethicone significantly reduced bubbles in all colon segments(P<0.001).The mean withdrawal time was significantly shorter in the 3-PS group(8.8±3.4 vs 9.6±2.3;P=0.02).Furthermore,significantly more proximal adenomas were detected in the 3-PS group(53.6%vs 45.7%;P=0.03).In addition,the proportions of patients with nausea and bloating were significantly lower in the 3-SP group(P<0.01 for both).More patients in the 3-PS group expressed willingness to repeat the bowel preparation(87.7%vs 76.6%,P=0.01).CONCLUSION Three-liter PEG shows satisfactory bowel cleansing despite the decrease in dosage,and addition of simethicone with better bubble elimination and enhanced patient acceptance offers excellent potential impact on the detection of proximal adenomas in Chinese patients.展开更多
BACKGROUND Research data from patient reports indicate that the least bearable part of colonoscopy is the administration of laxatives for bowel preparation.AIM To observe the intestinal cleansing efficacy and safety o...BACKGROUND Research data from patient reports indicate that the least bearable part of colonoscopy is the administration of laxatives for bowel preparation.AIM To observe the intestinal cleansing efficacy and safety of sodium picosulfate/magnesium citrate and to discuss the patients’experiences due to the procedure.METHODS Subjects hospitalized in the International Medical Center Ward of Peking University International Hospital,Beijing,China,from April 29 to October 29,2020,for whom the colonoscopy was planned,were enrolled.Bowel preparation was performed using sodium picosulfate/magnesium citrate.The effect of bowel cleansing was evaluated according to the Ottawa Bowel Preparation Scale,defecation conditions and adverse reactions were recorded,and the comfort level and subjective satisfaction concerning medication were evaluated by the visual analogue scale/score(VAS).RESULTS The bowel preparation procedure was planned for all patients enrolled,which included 42 males and 22 females.The results showed an average liquid rehydration volume of 3000 mL,an average onset of action for the first dose at 89.04 min,an average number of bowel movements of 4.3 following the first dose,an average onset of action for the second dose at 38.90 min and an average number of bowel movements of 5.0 after the second dose.The total average Ottawa Bowel Preparation Scale score was 3.6,with 93.55%of bowel preparations in the“qualified”and 67.74%in the“excellent”grade.The average VAS score of effect on sleep was 0,and the average VAS score of perianal pain was also 0.The average VAS score for ease of taking and taste perception of the bowel cleanser was 10.Side effects included mild to moderate nausea(15.63%),mild vomiting(4.69%),mild to moderate abdominal pain(7.81%),mild to moderate abdominal distension(20.31%),mild palpitation(7.81%)and mild dizziness(4.69%).CONCLUSION Sodium picosulfate/magnesium citrate is effective and safe for bowel preparation before colonoscopy with high subjective patient acceptance,thus improving overall patient compliance.展开更多
BACKGROUND No consensus has been reached in patients suspected of having inadequate bowel preparation regarding optimal salvage methods, which negatively affects the efficacy and quality of colonoscopy. The most ideal...BACKGROUND No consensus has been reached in patients suspected of having inadequate bowel preparation regarding optimal salvage methods, which negatively affects the efficacy and quality of colonoscopy. The most ideal and reasonable rescue option involves early suspicion and identification of patients with inadequate preparation before sedation, additional oral ingestion of a suitable preparation formulation, and same-day colonoscopy.AIM To compare 0.5-L and 1-L polyethylene glycol containing ascorbic acid(PEG +Asc) as additional bowel cleansing methods after a 2-L split-dose PEG + Asc regimen in patients with expected inadequate bowel preparation before colonoscopy.METHODS Individuals with expected inadequate bowel preparation based on last stool form, such as turbid liquid, particulate liquid, or liquid with small amounts of feces, were randomized to either a 0.5-L PEG + Asc group or a 1-L PEG + Asc group. The primary endpoint was bowel preparation as assessed using the Aronchick bowel preparation scale(ABPS) and Boston bowel preparation scale(BBPS) scores. The secondary endpoints were cecal intubation time, withdrawal time, polyp detection rate(PDR), adenoma detection rate(ADR), individual compliance with additional PEG + Asc, and patient satisfaction.RESULTS Initially, 98 patients were included, but 8 were later excluded due to withdrawal of consent to participate in the study. Adequate bowel preparation(as assessed by ABPS) was observed in 80.9%(38/47) of subjects in the 0.5-L group and in88.4%(38/43) of subjects in the 1-L group(P = 0.617). Mean total BBPS was 6.7 points in the 0.5-L group and 7.0 points in the 1-L group(P = 0.458). ADRs and PDRs were similar in the two groups, and cecal intubation and withdrawal times were not significantly different. However, mean patient satisfaction score was significantly higher in the 0.5-L group(P = 0.041).CONCLUSION The bowel cleaning efficacy of additional 0.5-L PEG + Asc was not inferior to that of 1-L PEG + Asc. Additional 0.5-L PEG + Asc is worthwhile when inadequate bowel preparation is expected before colonoscopy.展开更多
Surfactant, an abbreviation for the surface-active agent, is utilized in almost every industry. It brings two immiscible phases such as oil and water into one single homogeneous phase, leading to various industrial ap...Surfactant, an abbreviation for the surface-active agent, is utilized in almost every industry. It brings two immiscible phases such as oil and water into one single homogeneous phase, leading to various industrial applications such as food, painting, coating, drug delivery as well as cosmetics. The use of surfactants in skin cleansing is very common to keep skin healthy. Their function herein is to lower the interfacial tension at the dirt/water and skin/water interfaces, thereby detaching dirt, extra sebum or oils from the skin surface. But this application could bring side effects attributed to the penetration of surfactants into the skin, including skin proteins denaturation, stratum corneum lipids removal or even lipids organization disruption in the stratum corneum. This review summarizes modern mild skin cleansing technologies, which address the side effects brought by the surfactants.展开更多
Diabetic retinopathy is a critical eye condition that,if not treated,can lead to vision loss.Traditional methods of diagnosing and treating the disease are time-consuming and expensive.However,machine learning and dee...Diabetic retinopathy is a critical eye condition that,if not treated,can lead to vision loss.Traditional methods of diagnosing and treating the disease are time-consuming and expensive.However,machine learning and deep transfer learning(DTL)techniques have shown promise in medical applications,including detecting,classifying,and segmenting diabetic retinopathy.These advanced techniques offer higher accuracy and performance.ComputerAided Diagnosis(CAD)is crucial in speeding up classification and providing accurate disease diagnoses.Overall,these technological advancements hold great potential for improving the management of diabetic retinopathy.The study’s objective was to differentiate between different classes of diabetes and verify the model’s capability to distinguish between these classes.The robustness of the model was evaluated using other metrics such as accuracy(ACC),precision(PRE),recall(REC),and area under the curve(AUC).In this particular study,the researchers utilized data cleansing techniques,transfer learning(TL),and convolutional neural network(CNN)methods to effectively identify and categorize the various diseases associated with diabetic retinopathy(DR).They employed the VGG-16CNN model,incorporating intelligent parameters that enhanced its robustness.The outcomes surpassed the results obtained by the auto enhancement(AE)filter,which had an ACC of over 98%.The manuscript provides visual aids such as graphs,tables,and techniques and frameworks to enhance understanding.This study highlights the significance of optimized deep TL in improving the metrics of the classification of the four separate classes of DR.The manuscript emphasizes the importance of using the VGG16CNN classification technique in this context.展开更多
Nowadays, the deep learning methods are widely applied to analyze and predict the trend of various disaster events and offer the alternatives to make the appropriate decisions. These support the water resource managem...Nowadays, the deep learning methods are widely applied to analyze and predict the trend of various disaster events and offer the alternatives to make the appropriate decisions. These support the water resource management and the short-term planning. In this paper, the water levels of the Pattani River in the Southern of Thailand have been predicted every hour of 7 days forecast. Time Series Transformer and Linear Regression were applied in this work. The results of both were the water levels forecast that had the high accuracy. Moreover, the water levels forecasting dashboard was developed for using to monitor the water levels at the Pattani River as well.展开更多
AIM:To compare the bowel cleansing efficacy,tolerability and acceptability of split 2-L polyethylene glycol(PEG)-citrate-simethicone(PEG-CS)plus bisacodyl(BIS)vs 4-L PEG for fecal occult blood test-positive screening ...AIM:To compare the bowel cleansing efficacy,tolerability and acceptability of split 2-L polyethylene glycol(PEG)-citrate-simethicone(PEG-CS)plus bisacodyl(BIS)vs 4-L PEG for fecal occult blood test-positive screening colonoscopy.METHODS:This was a randomised,observer-blind comparative study.Two hundred and sixty-four subjects underwent screening colonoscopy(mean age 62.5±7.4years,male 61.7%).The primary objective of the study was to compare the bowel cleansing efficacy of the two preparations.Interventions:BIS plus PEG-CS:3 tablets of 5-mg BIS at 16:00,PEG-CS 1-L at 19:00 and 1-L at7:00,4-L PEG:3-L at 17:00,and 1-L at 7:00.Colonoscopy was carried out after 11:00,at least 3 h after the completion of bowel preparation.Bowel cleansing was evaluated using the Harefield Cleansing Scale.RESULTS:Bowel preparation was successful for 92.8%of subjects in the PEG-CS group and for 92.1%of subjects in the 4-L PEG(RR=1.01;95%CI:0.94-1.08).BIS+PEG-CS was better tolerated than 4-L PEG.A greater rate of patients in the BIS+PEG-CS group had no difficulty and/or were willing to repeat the same preparation compared to split-dose 4-L PEG group.Subjects in the BIS+PEG-CS group rated the prep as good or satisfactory in 90.6%as compared to 77%in the 4-L PEG(P=0.003).Subjects receiving BIS+PEGCS stated they fully adhered to instructions drinking all the 2-L solution in 97.1%compared with 87.3%in the4-L PEG(P=0.003).CONCLUSION:BIS plus split 2-L PEG-CS was as effective as but better tolerated and accepted than split4-L PEG for screening colonoscopy.This new procedure may increase the positive attitude and participation to colorectal cancer screening colonoscopy.展开更多
Optimal bowel preparation increases the cecal intubation rate and detection of neoplastic lesions while decreasing the procedural time and procedural-related complications. Although high-volume polyethylene glycol(PEG...Optimal bowel preparation increases the cecal intubation rate and detection of neoplastic lesions while decreasing the procedural time and procedural-related complications. Although high-volume polyethylene glycol(PEG) solution is the most frequently used preparation for bowel cleansing, patients are often unwilling to take PEG solution due to its large volume, poor palatability, and high incidence of adverse events, such as abdominal bloating and nausea. Other purgatives include osmotic agents(e.g., sodium phosphate, magnesium citrate, and sodium sulfate), stimulant agents(e.g., senna, bisacodyl, and sodium picosulfate), and prokinetic agents(e.g., cisapride, mosapride, and itopride). A combination of PEG with an osmotic, stimulant, or prokinetic agent could effectively reduce the PEG solution volume and increase patients' adherence. Some such solutions have been found in several published studies to not be inferior to PEG alone in terms of bowel cleansing quality. Although combination methods showed similar efficacy and safety, the value of these studies is limited by shortcomings in study design. New effective and well-tolerated combination preparations are required, in addition to rigorous new validated studies.展开更多
AIM: To compare the efficacy of different doses of sodium phosphate(NaP) and polyethylenglicol(PEG) alone or with bisacodyl for colonic cleansing in constipated and non-constipated patients.METHODS: Three hundred and ...AIM: To compare the efficacy of different doses of sodium phosphate(NaP) and polyethylenglicol(PEG) alone or with bisacodyl for colonic cleansing in constipated and non-constipated patients.METHODS: Three hundred and forty-nine patients,older than 18 years old,with low risk for renal damage and who were scheduled for outpatient colonoscopy were randomized to receive one of the following preparations(prep): 90 mL of NaP(prep 1);45 mL of NaP + 20 mg of bisacodyl(prep 2);4 L of PEG(prep 3) or 2 L of PEG + 20 mg of bisacodyl(prep 4).Randomization was stratified by constipation.Patients,endoscopists,endoscopists' assistants and data analysts were blinded.A blinding challenge was performed to endoscopist in order to reassure blinding.The primary outcome was the efficacy of colonic cleansing using a previous reported scale.Secondary outcomes were tolerability,compliance,side effects,endoscopist perception about the necessity to repeat the study due to an inadequate colonic preparation and patient overall perceptions.RESULTS: Information about the primary outcome was obtained from 324 patients(93%).There were no significant differences regarding the preparation quality among different groups in the overall analysis.Compliance was higher in the NaP preparations being even higher in half-dose with bisacodyl: 94%(prep 1),100%(prep 2),81%(prep 3) and 87%(prep 4)(2 vs 1,3 and 4,P < 0.01;1 vs 3,4,P < 0.05).The combination of bisacodyl with NaP was associated with insomnia(P = 0.04).In non-constipated patients the preparation quality was also similar between different groups,but endoscopist appraisal about the need to repeat the study was more frequent in the half-dose PEG plus bisacodyl than in whole dose NaP preparation: 11%(prep 4) vs 2%(prep 1)(P < 0.05).Compliance in this group was also higher with the NaP preparations: 95%(prep 1),100%(prep2) vs 80%(prep 3)(P < 0.05).Bisacodyl was associated with abdominal pain: 13%(prep 1),31%(prep 2),21%(prep 3) and 29%(prep 4),(2,4 vs 1,2,P < 0.05).In constipated patients the combination of NaP plus bisacodyl presented higher rates of satisfactory colonic cleansing than whole those PEG: 95%(prep 2) vs 66%(prep 3)(P = 0.03).Preparations containing bisacodyl were not associated with adverse effects in constipated patients.CONCLUSION: In non-constipated patients,compliance is higher with NaP preparations,and bisacodyl is related to adverse effects.In constipated patients NaP plus bisacodyl is the most effective preparation.展开更多
Patients with liver cirrhosis are fragile and present specific clinical hallmarks.When undergoing to gastrointestinal(GI)endoscopy,these subjects require an individual pre evaluation,taking into account:Level of haemo...Patients with liver cirrhosis are fragile and present specific clinical hallmarks.When undergoing to gastrointestinal(GI)endoscopy,these subjects require an individual pre evaluation,taking into account:Level of haemostasis impairment,the individual risk of infection,the impact of sedation on hepatic encephalopathy and other factors.The overall assessment of liver function,employing common scoring systems,should be also assessed in the preprocedural phase.Beside some common general problems,regarding GI endoscopy in cirrhotic subjects,also specific issues are present for some frequent indications or procedures.For instance,despite an increased incidence of adenomas in cirrhosis,colon cancer screening remains suboptimal in subjects with this disease.Several studies in fact demonstrated liver cirrhosis as a negative factor for an adequate colon cleansing before colonoscopy.On the other hand,also the routine assessment of gastroesophageal varices during upper GI endoscopy presents some concern,since important inter-observer variability or incomplete description of endoscopic findings has been reported in some studies.In this review we discussed in details the most relevant issues that may be considered while performing general GI endoscopic practice,in patient with cirrhosis.For most of these issues there are no guidelines or clear indications.Moreover until now,few studies focused on these aspects.We believe that targeting these issues with corrective measures may be helpful to develop a tailored endoscopic approach for cirrhosis,in the future.展开更多
BACKGROUND Bowel preparation in children can be challenging.AIM To describe the efficacy, safety, and tolerability of sodium picosulfate, magnesium oxide, and citric acid(SPMC) bowel preparation in children.METHODS Ph...BACKGROUND Bowel preparation in children can be challenging.AIM To describe the efficacy, safety, and tolerability of sodium picosulfate, magnesium oxide, and citric acid(SPMC) bowel preparation in children.METHODS Phase 3, randomized, assessor-blinded, multicenter study of low-volume, divided dose SPMC enrolled children 9-16 years undergoing elective colonoscopy. Participants 9-12 years were randomized 1:1:1 to SPMC ? dose × 2, SPMC 1 dose × 2, or polyethylene glycol(PEG). Participants 13-16 years were randomized 1:1 to SPMC 1 dose × 2 or PEG. PEG-based bowel preparations were administered per local protocol. Primary efficacy endpoint for quality of bowel preparation was responders(rating of ‘excellent' or ‘good') by modified Aronchick Scale. Secondary efficacy endpoint was participant's tolerability and satisfaction from a 7-item questionnaire. Safety assessments included adverse events(AEs) and laboratory evaluations.RESULTS 78 participants were randomized, 48 were 9-12 years, 30 were 13-16 years. For the primary efficacy endpoint in 9-12 years, 50.0%, 87.5%, and 81.3% were responders for SPMC ? dose × 2, SPMC 1 dose × 2, and PEG groups, respectively. Responder rates for 13-16 years were 81.3% for SPMC 1 dose × 2 and 85.7% for PEG. Overall, 43.8% of participants receiving SPMC 1 dose × 2 reported it was ‘very easy' or ‘easy' to drink, compared with 20.0% receiving PEG. Treatment-emergent AEs were reported by 45.5% of participants receiving SPMC 1 dose × 2 and 63.0% receiving PEG.CONCLUSION SPMC was an efficacious and safe for bowel preparation in children 9-16 years, with comparable efficacy to PEG. Tolerability for SPMC was higher compared to PEG.展开更多
AIM: To compare between 2 and 4 d colon cleansing protocols. METHODS: Children who were scheduled for colonoscopy procedure (2010-2012) for various medical reasons, were recruited from the pediatric gastroenterology c...AIM: To compare between 2 and 4 d colon cleansing protocols. METHODS: Children who were scheduled for colonoscopy procedure (2010-2012) for various medical reasons, were recruited from the pediatric gastroenterology clinic at Marshall University School of Medicine, Huntington, WV. Exclusion criteria were patients who were allergic to the medication used in the protocols [polyethylene glycol (PEG) 3350, Bisacodyl], or chil- dren with metabolic or renal diseases. Two PEG 3350 protocols for 4 d (A) and 2 d (B) were prescribed as previously described. A questionnaire describing the volume of PEG consumed, clinical data, and side effects were recorded. Colon preparation was graded by two observers according to previously described method. Main outcome measurements: Rate of adequate colon preparation. RESULTS: A total of 78 patients were considered for final calculation (group A: 40, group B: 38). Age and stool consistency at the last day was comparable in both groups, but the number of stools/day was significantly higher in group B (P = 0.001). Adequate colonpreparation was reached in 57.5% (A) and 73.6% (B), respectively (P = 0.206). Side effects were minimal and comparable in both groups. There was no difference in children's age, stool characteristics, or side effects between the children with adequate or inadequate colon preparation. Correlation and agreement between observers was excellent (Pearson correlation = 0.972, kappa = 1.0). CONCLUSION: No difference between protocols was observed, but the 2 d protocol was superior for its shorter time. Direct comparison between different colon cleansing protocols is crucial in order to establish the "gold standard" protocol for children.展开更多
Association rules’learning is a machine learning method used in finding underlying associations in large datasets.Whether intentionally or unintentionally present,noise in training instances causes overfitting while ...Association rules’learning is a machine learning method used in finding underlying associations in large datasets.Whether intentionally or unintentionally present,noise in training instances causes overfitting while building the classifier and negatively impacts classification accuracy.This paper uses instance reduction techniques for the datasets before mining the association rules and building the classifier.Instance reduction techniques were originally developed to reduce memory requirements in instance-based learning.This paper utilizes them to remove noise from the dataset before training the association rules classifier.Extensive experiments were conducted to assess the accuracy of association rules with different instance reduction techniques,namely:DecrementalReduction Optimization Procedure(DROP)3,DROP5,ALL K-Nearest Neighbors(ALLKNN),Edited Nearest Neighbor(ENN),and Repeated Edited Nearest Neighbor(RENN)in different noise ratios.Experiments show that instance reduction techniques substantially improved the average classification accuracy on three different noise levels:0%,5%,and 10%.The RENN algorithm achieved the highest levels of accuracy with a significant improvement on seven out of eight used datasets from the University of California Irvine(UCI)machine learning repository.The improvements were more apparent in the 5%and the 10%noise cases.When RENN was applied,the average classification accuracy for the eight datasets in the zero-noise test enhanced from 70.47%to 76.65%compared to the original test.The average accuracy was improved from 66.08%to 77.47%for the 5%-noise case and from 59.89%to 77.59%in the 10%-noise case.Higher confidence was also reported in building the association rules when RENN was used.The above results indicate that RENN is a good solution in removing noise and avoiding overfitting during the construction of the association rules classifier,especially in noisy domains.展开更多
BACKGROUND The prevalence of constipation in the Chinese population over 60 years of age is 11.5%, and this prevalence increases with age, which seriously affects the quality of life in older adults. Therefore, reduci...BACKGROUND The prevalence of constipation in the Chinese population over 60 years of age is 11.5%, and this prevalence increases with age, which seriously affects the quality of life in older adults. Therefore, reducing the incidence of constipation in older adults is necessary to promote a healthy lifestyle as well as biochemical health.AIM To explore the value of preoperative guidance and education to improve the effects of bowel cleaning in older adult patients undergoing colonoscopy.METHODS In this study, 160 older adult patients with constipation requiring colonoscopy at Shandong Provincial Hospital between January 2019 and March 2021 were selected and randomly divided into a study group and a control group, with 80patients in each group. The study group received medication guidance and targeted educational guidance before the operation, while the control group received only medication and dietary guidance. The baseline data, colonoscopy duration, bowel preparation compliance, Boston bowel preparation(BBPS)assessment score, intestinal bubble score, the incidence of adverse reactions during bowel preparation, and nursing appointment satisfaction were compared between the two groups.RESULTS The colonoscopy duration times and intestinal bubble scores of the study group were shorter than those of the control group, with statistically significant differences. The BBPS scores for the right, left, and interrupted colon in the study group were also higher than those in the control group, and the difference was statistically significant. Additionally, the study group had a higher rate of liquid diet one day before the examination, higher rate of correct bowel-clearing agent dilution method, higher rate of accurate time of ingesting the bowel-clearing agent, and a higher proportion of patients ingesting bowelclearing agent at the specified time than the control group, with statistically significant differences.The incidence of nausea and vomiting during bowel clearance in the study group was significantly lower than that in the control group. The incidence of abdominal pain, abdominal distension,dizziness, and fatigue was compared between the two groups, but the difference was not statistically significant. The scores of service attitude, detailed notification of dietary precautions, clear and easy-to-understand health educational content, and receiving care and comfort in the study group were significantly higher than those in the control group.CONCLUSION Preoperative special guidance and education were shown to significantly improve bowel clearance and compliance and reduce the incidence of adverse reactions in older adult patients with constipation undergoing colonoscopy. These factors are beneficial for improving patient satisfaction with nursing services.展开更多
To analyze and compare the cleaning power and moisturizing effect of different shower gels.Choose six types of shower gel,soap-based shower gel 1,soap-based shower gel 2,amino acid shower gel 1,amino acid shower gel 2...To analyze and compare the cleaning power and moisturizing effect of different shower gels.Choose six types of shower gel,soap-based shower gel 1,soap-based shower gel 2,amino acid shower gel 1,amino acid shower gel 2,cream shower gel 1,cream shower gel 2.Control clinical studies,using the left and right arms for comparison.Apply special grease on the selected area on the forearm’s flexion side,before and after applying the grease and after cleaning with shower gel,use Sebumeter SM815 for skin oil detection.Use shower gel on the other area on the forearm flexion side.Use Corneometer CM825 and Tewameter TM300 before and after cleaning.The moisture content of the stratum corneum and the amount of water loss through the epidermis were detected.Analyze the change rate of skin oil,stratum corneum moisture content,and transepidermal water loss,analyze and compare the cleansing and moisturizing effects of six shower gels of different systems.Results:After using the six shower gels to clean,the skin oil was significantly reduced while the moisture content of the stratum corneum and the amount of transepidermal water loss changed to different degrees.Layer moisture content and transepidermal water loss have varying degrees of influence.Conclusion:Amino acid shower gels and cream shower gels are stronger than soap-based shower gels in terms of moisturizing ability,and at the same time show similar effects to soap-based shower gels in terms of cleansing ability.展开更多
Although the recent load information is critical to very short-term load forecasting(VSTLF), power companies often have difficulties in collecting the most recent load values accurately and timely for VSTLF applicatio...Although the recent load information is critical to very short-term load forecasting(VSTLF), power companies often have difficulties in collecting the most recent load values accurately and timely for VSTLF applications.This paper tackles the problem of real-time anomaly detection in most recent load information used by VSTLF.This paper proposes a model-based anomaly detection method that consists of two components, a dynamic regression model and an adaptive anomaly threshold. The case study is developed using the data from ISO New England. This paper demonstrates that the proposed method significantly outperforms three other anomaly detection methods including two methods commonly used in the field and one state-of-the-art method used by a winning team of the Global Energy Forecasting Competition 2014. Finally, a general anomaly detection framework is proposed for the future research.展开更多
文摘The incidence of colorectal cancer(CRC)is characterized by rapid declines in the wake of widespread screening.Colonoscopy is the gold standard for CRC screening,but its accuracy is related to high quality of bowel preparation(BP).In this review,we aimed to summarized the current strategy to increase bowel cleansing before colonoscopy.Newly bowel cleansing agents were developed with the same efficacy of previous agent but requiring less amount of liquid to improve patients’acceptability.The role of the diet before colonoscopy was also changed,as well the contribution of educational intervention and the use of adjunctive drugs to improve patients’tolerance and/or quality of BP.The review also described BP in special situations,as lower gastrointestinal bleeding,elderly people,patients with chronic kidney disease,patients with inflammatory bowel disease,patients with congestive heart failure,inpatient,patient with previous bowel resection,pregnant/lactating patients.The review underlined the quality of BP should be described using a validate scale in colonoscopy report and it explored the available scales.Finally,the review explored the possible contribution of bowel cleansing in post-colonoscopy syndrome that can be related by a transient alteration of gut microbiota.Moreover,the study underlined several points needed to further investigations.
文摘Evaluation of the quality of small-bowel cleansing is required to assess the reliability of findings in capsule endoscopy(CE). Moreover, consensus regarding the need of intestinal preparation for CE remains to be achieved. The presence of multiple grading scales for smallbowel preparation in CE, which are time-consuming and complicated, adds difficulty to the comparison of different small-bowel cleansing regimens and their application in clinical practice. Nowadays, a validated scale universally accepted for grading small-bowel cleansing is lacking. In fact, there are numerous grading systems with very different technical characteristics, namely, the parameters and the portion of the CE video that are analyzed, the objectivity of the analysis, the lesser or greater dependency on the operator, and the validation of the score. The authors performed a review which aims to systematize and summarize currently available smallbowel grading scales in CE.
文摘AIM:To suggest a new cleansing score system for small bowel preparation and to evaluate its clinical efficacy.METHODS:Twenty capsule endoscopy cases were reviewed and small bowel preparation was assessed with the new scoring system.For the assessment,two visual parameters were used:proportion of visualized mucosa and degree of obscuration.Representative frames from small bowel images were serially selected and scored at 5-min intervals.Intraclass correlation coefficient(ICC)was obtained to assess the reliability of the new scoring system.For efficacy evaluation and validation,scores of our new scoring system were compared with another previously reported cleansing grading system.RESULTS:Concordance with the previous system,inter-observer agreement,and intra-patient agreement were excellent with ICC values of 0.82,0.80,and 0.76,respectively.The intra-observer agreements at four-week intervals were also excellent.The cutoff value of adequate image quality was found to be 2.25.CONCLUSION:Our new scoring system is simple,efficient,and can be considered to be applicable in clinical practice and research.
文摘BACKGROUND Four-liter polyethylene glycol(PEG)solutions are effective for bowel cleansing,but their large volume might hinder patient compliance.Due to the unique features of Asians,4 L PEG might be a suboptimal bowel preparation in predominantly ethnically Asian countries.In view of this,a balance should be achieved between the volume and effectiveness.The ideal bowel cleansing regimen for a colonoscopy has yet to be determined in a Chinese population.AIM To compare the cleansing efficacy of 3 L PEG plus simethicone with 4 L PEG.METHODS A total of 291 patients were randomly allocated to two groups:Group 1(n=145)received 4 L split-dose PEG(4-P);group 2(n=146)received 3 L split-dose PEG plus simethicone(3-PS).Bowel-cleansing efficacy was evaluated by endoscopists using the Boston bowel preparation scale(BBPS)and the bubbles score.RESULTS Although there were no significant differences in the total BBPS score or the adequate rate of bowel preparation between the two groups,the BBPS score of the right-side colon was significantly higher in the 3-SP group(2.37±0.54 vs 2.21±0.78;P=0.04).Moreover,the use of simethicone significantly reduced bubbles in all colon segments(P<0.001).The mean withdrawal time was significantly shorter in the 3-PS group(8.8±3.4 vs 9.6±2.3;P=0.02).Furthermore,significantly more proximal adenomas were detected in the 3-PS group(53.6%vs 45.7%;P=0.03).In addition,the proportions of patients with nausea and bloating were significantly lower in the 3-SP group(P<0.01 for both).More patients in the 3-PS group expressed willingness to repeat the bowel preparation(87.7%vs 76.6%,P=0.01).CONCLUSION Three-liter PEG shows satisfactory bowel cleansing despite the decrease in dosage,and addition of simethicone with better bubble elimination and enhanced patient acceptance offers excellent potential impact on the detection of proximal adenomas in Chinese patients.
基金Beijing Science and Technology Program,China,Early Endoscopic Diagnosis for Colorectal Cancer—The Guidance Study,No.D17110002617002.
文摘BACKGROUND Research data from patient reports indicate that the least bearable part of colonoscopy is the administration of laxatives for bowel preparation.AIM To observe the intestinal cleansing efficacy and safety of sodium picosulfate/magnesium citrate and to discuss the patients’experiences due to the procedure.METHODS Subjects hospitalized in the International Medical Center Ward of Peking University International Hospital,Beijing,China,from April 29 to October 29,2020,for whom the colonoscopy was planned,were enrolled.Bowel preparation was performed using sodium picosulfate/magnesium citrate.The effect of bowel cleansing was evaluated according to the Ottawa Bowel Preparation Scale,defecation conditions and adverse reactions were recorded,and the comfort level and subjective satisfaction concerning medication were evaluated by the visual analogue scale/score(VAS).RESULTS The bowel preparation procedure was planned for all patients enrolled,which included 42 males and 22 females.The results showed an average liquid rehydration volume of 3000 mL,an average onset of action for the first dose at 89.04 min,an average number of bowel movements of 4.3 following the first dose,an average onset of action for the second dose at 38.90 min and an average number of bowel movements of 5.0 after the second dose.The total average Ottawa Bowel Preparation Scale score was 3.6,with 93.55%of bowel preparations in the“qualified”and 67.74%in the“excellent”grade.The average VAS score of effect on sleep was 0,and the average VAS score of perianal pain was also 0.The average VAS score for ease of taking and taste perception of the bowel cleanser was 10.Side effects included mild to moderate nausea(15.63%),mild vomiting(4.69%),mild to moderate abdominal pain(7.81%),mild to moderate abdominal distension(20.31%),mild palpitation(7.81%)and mild dizziness(4.69%).CONCLUSION Sodium picosulfate/magnesium citrate is effective and safe for bowel preparation before colonoscopy with high subjective patient acceptance,thus improving overall patient compliance.
文摘BACKGROUND No consensus has been reached in patients suspected of having inadequate bowel preparation regarding optimal salvage methods, which negatively affects the efficacy and quality of colonoscopy. The most ideal and reasonable rescue option involves early suspicion and identification of patients with inadequate preparation before sedation, additional oral ingestion of a suitable preparation formulation, and same-day colonoscopy.AIM To compare 0.5-L and 1-L polyethylene glycol containing ascorbic acid(PEG +Asc) as additional bowel cleansing methods after a 2-L split-dose PEG + Asc regimen in patients with expected inadequate bowel preparation before colonoscopy.METHODS Individuals with expected inadequate bowel preparation based on last stool form, such as turbid liquid, particulate liquid, or liquid with small amounts of feces, were randomized to either a 0.5-L PEG + Asc group or a 1-L PEG + Asc group. The primary endpoint was bowel preparation as assessed using the Aronchick bowel preparation scale(ABPS) and Boston bowel preparation scale(BBPS) scores. The secondary endpoints were cecal intubation time, withdrawal time, polyp detection rate(PDR), adenoma detection rate(ADR), individual compliance with additional PEG + Asc, and patient satisfaction.RESULTS Initially, 98 patients were included, but 8 were later excluded due to withdrawal of consent to participate in the study. Adequate bowel preparation(as assessed by ABPS) was observed in 80.9%(38/47) of subjects in the 0.5-L group and in88.4%(38/43) of subjects in the 1-L group(P = 0.617). Mean total BBPS was 6.7 points in the 0.5-L group and 7.0 points in the 1-L group(P = 0.458). ADRs and PDRs were similar in the two groups, and cecal intubation and withdrawal times were not significantly different. However, mean patient satisfaction score was significantly higher in the 0.5-L group(P = 0.041).CONCLUSION The bowel cleaning efficacy of additional 0.5-L PEG + Asc was not inferior to that of 1-L PEG + Asc. Additional 0.5-L PEG + Asc is worthwhile when inadequate bowel preparation is expected before colonoscopy.
文摘Surfactant, an abbreviation for the surface-active agent, is utilized in almost every industry. It brings two immiscible phases such as oil and water into one single homogeneous phase, leading to various industrial applications such as food, painting, coating, drug delivery as well as cosmetics. The use of surfactants in skin cleansing is very common to keep skin healthy. Their function herein is to lower the interfacial tension at the dirt/water and skin/water interfaces, thereby detaching dirt, extra sebum or oils from the skin surface. But this application could bring side effects attributed to the penetration of surfactants into the skin, including skin proteins denaturation, stratum corneum lipids removal or even lipids organization disruption in the stratum corneum. This review summarizes modern mild skin cleansing technologies, which address the side effects brought by the surfactants.
文摘Diabetic retinopathy is a critical eye condition that,if not treated,can lead to vision loss.Traditional methods of diagnosing and treating the disease are time-consuming and expensive.However,machine learning and deep transfer learning(DTL)techniques have shown promise in medical applications,including detecting,classifying,and segmenting diabetic retinopathy.These advanced techniques offer higher accuracy and performance.ComputerAided Diagnosis(CAD)is crucial in speeding up classification and providing accurate disease diagnoses.Overall,these technological advancements hold great potential for improving the management of diabetic retinopathy.The study’s objective was to differentiate between different classes of diabetes and verify the model’s capability to distinguish between these classes.The robustness of the model was evaluated using other metrics such as accuracy(ACC),precision(PRE),recall(REC),and area under the curve(AUC).In this particular study,the researchers utilized data cleansing techniques,transfer learning(TL),and convolutional neural network(CNN)methods to effectively identify and categorize the various diseases associated with diabetic retinopathy(DR).They employed the VGG-16CNN model,incorporating intelligent parameters that enhanced its robustness.The outcomes surpassed the results obtained by the auto enhancement(AE)filter,which had an ACC of over 98%.The manuscript provides visual aids such as graphs,tables,and techniques and frameworks to enhance understanding.This study highlights the significance of optimized deep TL in improving the metrics of the classification of the four separate classes of DR.The manuscript emphasizes the importance of using the VGG16CNN classification technique in this context.
文摘Nowadays, the deep learning methods are widely applied to analyze and predict the trend of various disaster events and offer the alternatives to make the appropriate decisions. These support the water resource management and the short-term planning. In this paper, the water levels of the Pattani River in the Southern of Thailand have been predicted every hour of 7 days forecast. Time Series Transformer and Linear Regression were applied in this work. The results of both were the water levels forecast that had the high accuracy. Moreover, the water levels forecasting dashboard was developed for using to monitor the water levels at the Pattani River as well.
文摘AIM:To compare the bowel cleansing efficacy,tolerability and acceptability of split 2-L polyethylene glycol(PEG)-citrate-simethicone(PEG-CS)plus bisacodyl(BIS)vs 4-L PEG for fecal occult blood test-positive screening colonoscopy.METHODS:This was a randomised,observer-blind comparative study.Two hundred and sixty-four subjects underwent screening colonoscopy(mean age 62.5±7.4years,male 61.7%).The primary objective of the study was to compare the bowel cleansing efficacy of the two preparations.Interventions:BIS plus PEG-CS:3 tablets of 5-mg BIS at 16:00,PEG-CS 1-L at 19:00 and 1-L at7:00,4-L PEG:3-L at 17:00,and 1-L at 7:00.Colonoscopy was carried out after 11:00,at least 3 h after the completion of bowel preparation.Bowel cleansing was evaluated using the Harefield Cleansing Scale.RESULTS:Bowel preparation was successful for 92.8%of subjects in the PEG-CS group and for 92.1%of subjects in the 4-L PEG(RR=1.01;95%CI:0.94-1.08).BIS+PEG-CS was better tolerated than 4-L PEG.A greater rate of patients in the BIS+PEG-CS group had no difficulty and/or were willing to repeat the same preparation compared to split-dose 4-L PEG group.Subjects in the BIS+PEG-CS group rated the prep as good or satisfactory in 90.6%as compared to 77%in the 4-L PEG(P=0.003).Subjects receiving BIS+PEGCS stated they fully adhered to instructions drinking all the 2-L solution in 97.1%compared with 87.3%in the4-L PEG(P=0.003).CONCLUSION:BIS plus split 2-L PEG-CS was as effective as but better tolerated and accepted than split4-L PEG for screening colonoscopy.This new procedure may increase the positive attitude and participation to colorectal cancer screening colonoscopy.
文摘Optimal bowel preparation increases the cecal intubation rate and detection of neoplastic lesions while decreasing the procedural time and procedural-related complications. Although high-volume polyethylene glycol(PEG) solution is the most frequently used preparation for bowel cleansing, patients are often unwilling to take PEG solution due to its large volume, poor palatability, and high incidence of adverse events, such as abdominal bloating and nausea. Other purgatives include osmotic agents(e.g., sodium phosphate, magnesium citrate, and sodium sulfate), stimulant agents(e.g., senna, bisacodyl, and sodium picosulfate), and prokinetic agents(e.g., cisapride, mosapride, and itopride). A combination of PEG with an osmotic, stimulant, or prokinetic agent could effectively reduce the PEG solution volume and increase patients' adherence. Some such solutions have been found in several published studies to not be inferior to PEG alone in terms of bowel cleansing quality. Although combination methods showed similar efficacy and safety, the value of these studies is limited by shortcomings in study design. New effective and well-tolerated combination preparations are required, in addition to rigorous new validated studies.
文摘AIM: To compare the efficacy of different doses of sodium phosphate(NaP) and polyethylenglicol(PEG) alone or with bisacodyl for colonic cleansing in constipated and non-constipated patients.METHODS: Three hundred and forty-nine patients,older than 18 years old,with low risk for renal damage and who were scheduled for outpatient colonoscopy were randomized to receive one of the following preparations(prep): 90 mL of NaP(prep 1);45 mL of NaP + 20 mg of bisacodyl(prep 2);4 L of PEG(prep 3) or 2 L of PEG + 20 mg of bisacodyl(prep 4).Randomization was stratified by constipation.Patients,endoscopists,endoscopists' assistants and data analysts were blinded.A blinding challenge was performed to endoscopist in order to reassure blinding.The primary outcome was the efficacy of colonic cleansing using a previous reported scale.Secondary outcomes were tolerability,compliance,side effects,endoscopist perception about the necessity to repeat the study due to an inadequate colonic preparation and patient overall perceptions.RESULTS: Information about the primary outcome was obtained from 324 patients(93%).There were no significant differences regarding the preparation quality among different groups in the overall analysis.Compliance was higher in the NaP preparations being even higher in half-dose with bisacodyl: 94%(prep 1),100%(prep 2),81%(prep 3) and 87%(prep 4)(2 vs 1,3 and 4,P < 0.01;1 vs 3,4,P < 0.05).The combination of bisacodyl with NaP was associated with insomnia(P = 0.04).In non-constipated patients the preparation quality was also similar between different groups,but endoscopist appraisal about the need to repeat the study was more frequent in the half-dose PEG plus bisacodyl than in whole dose NaP preparation: 11%(prep 4) vs 2%(prep 1)(P < 0.05).Compliance in this group was also higher with the NaP preparations: 95%(prep 1),100%(prep2) vs 80%(prep 3)(P < 0.05).Bisacodyl was associated with abdominal pain: 13%(prep 1),31%(prep 2),21%(prep 3) and 29%(prep 4),(2,4 vs 1,2,P < 0.05).In constipated patients the combination of NaP plus bisacodyl presented higher rates of satisfactory colonic cleansing than whole those PEG: 95%(prep 2) vs 66%(prep 3)(P = 0.03).Preparations containing bisacodyl were not associated with adverse effects in constipated patients.CONCLUSION: In non-constipated patients,compliance is higher with NaP preparations,and bisacodyl is related to adverse effects.In constipated patients NaP plus bisacodyl is the most effective preparation.
文摘Patients with liver cirrhosis are fragile and present specific clinical hallmarks.When undergoing to gastrointestinal(GI)endoscopy,these subjects require an individual pre evaluation,taking into account:Level of haemostasis impairment,the individual risk of infection,the impact of sedation on hepatic encephalopathy and other factors.The overall assessment of liver function,employing common scoring systems,should be also assessed in the preprocedural phase.Beside some common general problems,regarding GI endoscopy in cirrhotic subjects,also specific issues are present for some frequent indications or procedures.For instance,despite an increased incidence of adenomas in cirrhosis,colon cancer screening remains suboptimal in subjects with this disease.Several studies in fact demonstrated liver cirrhosis as a negative factor for an adequate colon cleansing before colonoscopy.On the other hand,also the routine assessment of gastroesophageal varices during upper GI endoscopy presents some concern,since important inter-observer variability or incomplete description of endoscopic findings has been reported in some studies.In this review we discussed in details the most relevant issues that may be considered while performing general GI endoscopic practice,in patient with cirrhosis.For most of these issues there are no guidelines or clear indications.Moreover until now,few studies focused on these aspects.We believe that targeting these issues with corrective measures may be helpful to develop a tailored endoscopic approach for cirrhosis,in the future.
文摘BACKGROUND Bowel preparation in children can be challenging.AIM To describe the efficacy, safety, and tolerability of sodium picosulfate, magnesium oxide, and citric acid(SPMC) bowel preparation in children.METHODS Phase 3, randomized, assessor-blinded, multicenter study of low-volume, divided dose SPMC enrolled children 9-16 years undergoing elective colonoscopy. Participants 9-12 years were randomized 1:1:1 to SPMC ? dose × 2, SPMC 1 dose × 2, or polyethylene glycol(PEG). Participants 13-16 years were randomized 1:1 to SPMC 1 dose × 2 or PEG. PEG-based bowel preparations were administered per local protocol. Primary efficacy endpoint for quality of bowel preparation was responders(rating of ‘excellent' or ‘good') by modified Aronchick Scale. Secondary efficacy endpoint was participant's tolerability and satisfaction from a 7-item questionnaire. Safety assessments included adverse events(AEs) and laboratory evaluations.RESULTS 78 participants were randomized, 48 were 9-12 years, 30 were 13-16 years. For the primary efficacy endpoint in 9-12 years, 50.0%, 87.5%, and 81.3% were responders for SPMC ? dose × 2, SPMC 1 dose × 2, and PEG groups, respectively. Responder rates for 13-16 years were 81.3% for SPMC 1 dose × 2 and 85.7% for PEG. Overall, 43.8% of participants receiving SPMC 1 dose × 2 reported it was ‘very easy' or ‘easy' to drink, compared with 20.0% receiving PEG. Treatment-emergent AEs were reported by 45.5% of participants receiving SPMC 1 dose × 2 and 63.0% receiving PEG.CONCLUSION SPMC was an efficacious and safe for bowel preparation in children 9-16 years, with comparable efficacy to PEG. Tolerability for SPMC was higher compared to PEG.
文摘AIM: To compare between 2 and 4 d colon cleansing protocols. METHODS: Children who were scheduled for colonoscopy procedure (2010-2012) for various medical reasons, were recruited from the pediatric gastroenterology clinic at Marshall University School of Medicine, Huntington, WV. Exclusion criteria were patients who were allergic to the medication used in the protocols [polyethylene glycol (PEG) 3350, Bisacodyl], or chil- dren with metabolic or renal diseases. Two PEG 3350 protocols for 4 d (A) and 2 d (B) were prescribed as previously described. A questionnaire describing the volume of PEG consumed, clinical data, and side effects were recorded. Colon preparation was graded by two observers according to previously described method. Main outcome measurements: Rate of adequate colon preparation. RESULTS: A total of 78 patients were considered for final calculation (group A: 40, group B: 38). Age and stool consistency at the last day was comparable in both groups, but the number of stools/day was significantly higher in group B (P = 0.001). Adequate colonpreparation was reached in 57.5% (A) and 73.6% (B), respectively (P = 0.206). Side effects were minimal and comparable in both groups. There was no difference in children's age, stool characteristics, or side effects between the children with adequate or inadequate colon preparation. Correlation and agreement between observers was excellent (Pearson correlation = 0.972, kappa = 1.0). CONCLUSION: No difference between protocols was observed, but the 2 d protocol was superior for its shorter time. Direct comparison between different colon cleansing protocols is crucial in order to establish the "gold standard" protocol for children.
基金The APC was funded by the Deanship of Scientific Research,Saudi Electronic University.
文摘Association rules’learning is a machine learning method used in finding underlying associations in large datasets.Whether intentionally or unintentionally present,noise in training instances causes overfitting while building the classifier and negatively impacts classification accuracy.This paper uses instance reduction techniques for the datasets before mining the association rules and building the classifier.Instance reduction techniques were originally developed to reduce memory requirements in instance-based learning.This paper utilizes them to remove noise from the dataset before training the association rules classifier.Extensive experiments were conducted to assess the accuracy of association rules with different instance reduction techniques,namely:DecrementalReduction Optimization Procedure(DROP)3,DROP5,ALL K-Nearest Neighbors(ALLKNN),Edited Nearest Neighbor(ENN),and Repeated Edited Nearest Neighbor(RENN)in different noise ratios.Experiments show that instance reduction techniques substantially improved the average classification accuracy on three different noise levels:0%,5%,and 10%.The RENN algorithm achieved the highest levels of accuracy with a significant improvement on seven out of eight used datasets from the University of California Irvine(UCI)machine learning repository.The improvements were more apparent in the 5%and the 10%noise cases.When RENN was applied,the average classification accuracy for the eight datasets in the zero-noise test enhanced from 70.47%to 76.65%compared to the original test.The average accuracy was improved from 66.08%to 77.47%for the 5%-noise case and from 59.89%to 77.59%in the 10%-noise case.Higher confidence was also reported in building the association rules when RENN was used.The above results indicate that RENN is a good solution in removing noise and avoiding overfitting during the construction of the association rules classifier,especially in noisy domains.
文摘BACKGROUND The prevalence of constipation in the Chinese population over 60 years of age is 11.5%, and this prevalence increases with age, which seriously affects the quality of life in older adults. Therefore, reducing the incidence of constipation in older adults is necessary to promote a healthy lifestyle as well as biochemical health.AIM To explore the value of preoperative guidance and education to improve the effects of bowel cleaning in older adult patients undergoing colonoscopy.METHODS In this study, 160 older adult patients with constipation requiring colonoscopy at Shandong Provincial Hospital between January 2019 and March 2021 were selected and randomly divided into a study group and a control group, with 80patients in each group. The study group received medication guidance and targeted educational guidance before the operation, while the control group received only medication and dietary guidance. The baseline data, colonoscopy duration, bowel preparation compliance, Boston bowel preparation(BBPS)assessment score, intestinal bubble score, the incidence of adverse reactions during bowel preparation, and nursing appointment satisfaction were compared between the two groups.RESULTS The colonoscopy duration times and intestinal bubble scores of the study group were shorter than those of the control group, with statistically significant differences. The BBPS scores for the right, left, and interrupted colon in the study group were also higher than those in the control group, and the difference was statistically significant. Additionally, the study group had a higher rate of liquid diet one day before the examination, higher rate of correct bowel-clearing agent dilution method, higher rate of accurate time of ingesting the bowel-clearing agent, and a higher proportion of patients ingesting bowelclearing agent at the specified time than the control group, with statistically significant differences.The incidence of nausea and vomiting during bowel clearance in the study group was significantly lower than that in the control group. The incidence of abdominal pain, abdominal distension,dizziness, and fatigue was compared between the two groups, but the difference was not statistically significant. The scores of service attitude, detailed notification of dietary precautions, clear and easy-to-understand health educational content, and receiving care and comfort in the study group were significantly higher than those in the control group.CONCLUSION Preoperative special guidance and education were shown to significantly improve bowel clearance and compliance and reduce the incidence of adverse reactions in older adult patients with constipation undergoing colonoscopy. These factors are beneficial for improving patient satisfaction with nursing services.
文摘To analyze and compare the cleaning power and moisturizing effect of different shower gels.Choose six types of shower gel,soap-based shower gel 1,soap-based shower gel 2,amino acid shower gel 1,amino acid shower gel 2,cream shower gel 1,cream shower gel 2.Control clinical studies,using the left and right arms for comparison.Apply special grease on the selected area on the forearm’s flexion side,before and after applying the grease and after cleaning with shower gel,use Sebumeter SM815 for skin oil detection.Use shower gel on the other area on the forearm flexion side.Use Corneometer CM825 and Tewameter TM300 before and after cleaning.The moisture content of the stratum corneum and the amount of water loss through the epidermis were detected.Analyze the change rate of skin oil,stratum corneum moisture content,and transepidermal water loss,analyze and compare the cleansing and moisturizing effects of six shower gels of different systems.Results:After using the six shower gels to clean,the skin oil was significantly reduced while the moisture content of the stratum corneum and the amount of transepidermal water loss changed to different degrees.Layer moisture content and transepidermal water loss have varying degrees of influence.Conclusion:Amino acid shower gels and cream shower gels are stronger than soap-based shower gels in terms of moisturizing ability,and at the same time show similar effects to soap-based shower gels in terms of cleansing ability.
基金supported in part by the National Natural Science Foundation of China(No.71701035)the US Department of Energy,Cybersecurity for Energy Delivery Systems(CEDS)Program(No.M616000124)
文摘Although the recent load information is critical to very short-term load forecasting(VSTLF), power companies often have difficulties in collecting the most recent load values accurately and timely for VSTLF applications.This paper tackles the problem of real-time anomaly detection in most recent load information used by VSTLF.This paper proposes a model-based anomaly detection method that consists of two components, a dynamic regression model and an adaptive anomaly threshold. The case study is developed using the data from ISO New England. This paper demonstrates that the proposed method significantly outperforms three other anomaly detection methods including two methods commonly used in the field and one state-of-the-art method used by a winning team of the Global Energy Forecasting Competition 2014. Finally, a general anomaly detection framework is proposed for the future research.
