The crisis in Ukraine,which has dragged on for more than two years,and whether military aid to Ukraine should continue are major issues debated and fought over by the two parties in the United States prior to the 2024...The crisis in Ukraine,which has dragged on for more than two years,and whether military aid to Ukraine should continue are major issues debated and fought over by the two parties in the United States prior to the 2024 election.Regarding whether to continue to aid Ukraine,various political forces in the United States have chosen sides in the election campaign,which can be roughly divided into the“aid camp”and the“stop-aid camp”according to their positions.展开更多
The prominent performance of former US President Donald J.Trump in the 2024 presidential election cycle ref lects the ongoing developments of the Trumpification of the Republican Party(GOP).Since Trump left office,the...The prominent performance of former US President Donald J.Trump in the 2024 presidential election cycle ref lects the ongoing developments of the Trumpification of the Republican Party(GOP).Since Trump left office,the Trumpification of the GOP has continued.In terms of ideological shaping,Trumpification is ref lected in the fact that the political stance of the GOP is dominated by Trump.In terms of personal influence,Trumpification is manifested by the overall acceptance of GOP elites and voters toward Trump's presidential candidacy,notwithstanding a decrease in their satisfaction with him.The recent developments in Trumpification are intricately linked to Trump's influence on the GOP's political ecology,such as the formation of a new GOP coalition and the reshaping of GOP elite composition.Additionally,these developments are also inf luenced by specific political factors,including the unique circumstances of the 2020 presidential election that led to Tr ump's“quasi-incumbent”status and the economic and immigration issues in the 2024 election that favor Trump.The role Trump plays in the 2024 election and its outcome will be critical in determining whether the inf luence of Trumpification,especially Trump himself,will persist or undergo changes.展开更多
Purpose: Although patient-related factors affect surgical outcomes, preoperative functional status is not measured by any cardiac risk score. Functional status can, however, be objectively measured using validated out...Purpose: Although patient-related factors affect surgical outcomes, preoperative functional status is not measured by any cardiac risk score. Functional status can, however, be objectively measured using validated outcome tools such as the Late-Life Function and Disability Instrument (LLFDI). The purpose of this study was to determine 1) if there was a change over time in functional status, as measured by the LLFDI, in patients who underwent elective cardiac surgery, and if so, 2) what specific aspect(s) of functional status changed. Methods: A prospective longitudinal study of one year was conducted on elective cardiac surgery patients (n = 43) using the self-reported LLFDI, which measures Disability Frequency (frequency of participation in social tasks), Disability Limitation (ability to participate in social tasks) and Function Total (ease in performing routine activities). Higher scores indicate increased function and decreased disability. LLFDI scores were compared at three times (preoperative, six-week and one-year postoperative) using repeated measures ANOVA. Post hoc pairwise comparison was conducted for specific interactions. Results: Both Function Total and Disability Frequency significantly changed over time (p = 0.047 and p = 0.013, respectively). Specifically, patients’ function level was significantly higher one-year postoperative compared to preoperative (M difference = +3.48, SE = 1.48, p = 0.026). Likewise, Disability Frequency scores were significantly higher (i.e. more active) at one-year postoperative versus preoperative (M difference= +5.98, SE = 2.19, p = 0.033). Disability Limitation scores were not significantly different between any time points (p > 0.05). Conclusion: By one-year postoperative, patients demonstrated increased ease in their routine physical activities and were more participatory in social life tasks. Individuals who underwent elective cardiac surgery took more than six weeks to detect notable improvement in functional status, which was expected with a sternotomy approach. This study provides support for the use of the LLFDI as an effective tool to capture functional status in the cardiac population. These findings may assist cardiac patients in recovery timeline expectations.展开更多
Introduction: Cancellation of elective surgery is common in developing countries. This decision is difficult to make as it generates economic and organizational consequences for the healthcare facility and an addition...Introduction: Cancellation of elective surgery is common in developing countries. This decision is difficult to make as it generates economic and organizational consequences for the healthcare facility and an additional source of stress for patients and their caregivers. This study aimed to analyze the various aspects of this medical problem. Patients and Methods: We conducted a prospective and descriptive study over six months (from January 1st, 2017, to June 30th, 2017) at the pediatric surgery department of Aristide Le Dantec University Teaching Hospital in Senegal. Results: Ninety-one cases were collected. The cancellation rate was 20.8%. Infants were affected in 36.3% of cases. Among anesthesiologists, 83.5% were residents, and 16.5% were specialists. Cancellation in nephroblastoma children with an indication for extended nephrectomy represented 15.4% of cases. Concerning reasons for cancellation, comorbidities, dominated by respiratory infections, accounted for 28.5% of cases, patient absences for 24.2%, and issues related to the anesthesiologist for 17.6%. Cancellations were avoidable in 33% of cases. Patients were responsible for cancellation in 37.4% of cases, the healthcare system in 33%, and medical reasons in 29.7%. Conclusion: Our findings suggest that one-third of cancellations could have been avoided with improvements in the healthcare system. Actions should be taken to reduce the cancellation rate in our context.展开更多
Variations in the allocation of university resources,teachers’course selection preferences and teaching commitment levels,as well as students’course preferences and assessment requirements,create subjective differen...Variations in the allocation of university resources,teachers’course selection preferences and teaching commitment levels,as well as students’course preferences and assessment requirements,create subjective differences.These differences,compounded by the demands of the new liberal arts reform,place significant challenges and pressure on elective course instructors.To meet these demands,elective course teachers should enhance their teaching methods and explore new instructional models.The International Trade in Services course,for instance,has implemented six areas of curriculum reform,enriching the practice of elective course improvement.展开更多
With the vigorous development of higher vocational education,public elective courses,as one of the core components of the higher vocational curriculum system,occupy a pivotal position.Based on the perspective of acade...With the vigorous development of higher vocational education,public elective courses,as one of the core components of the higher vocational curriculum system,occupy a pivotal position.Based on the perspective of academic affairs management and taking Guangdong C Vocational College as an example,this paper meticulously analyzes the operational problems in the declaration,setting,teaching,and management of public elective courses through questionnaire surveys and other methods.It also puts forward a series of targeted solutions,with a view to continuously improving the teaching quality and management level of public elective courses.展开更多
Sentiment analysis plays a vital role in understanding public opinions and sentiments toward various topics.In recent years,the rise of social media platforms(SMPs)has provided a rich source of data for analyzing publ...Sentiment analysis plays a vital role in understanding public opinions and sentiments toward various topics.In recent years,the rise of social media platforms(SMPs)has provided a rich source of data for analyzing public opinions,particularly in the context of election-related conversations.Nevertheless,sentiment analysis of electionrelated tweets presents unique challenges due to the complex language used,including figurative expressions,sarcasm,and the spread of misinformation.To address these challenges,this paper proposes Election-focused Bidirectional Encoder Representations from Transformers(ElecBERT),a new model for sentiment analysis in the context of election-related tweets.Election-related tweets pose unique challenges for sentiment analysis due to their complex language,sarcasm,andmisinformation.ElecBERT is based on the Bidirectional Encoder Representations from Transformers(BERT)language model and is fine-tuned on two datasets:Election-Related Sentiment-Annotated Tweets(ElecSent)-Multi-Languages,containing 5.31 million labeled tweets in multiple languages,and ElecSent-English,containing 4.75million labeled tweets in English.Themodel outperforms othermachine learning models such as Support Vector Machines(SVM),Na飗e Bayes(NB),and eXtreme Gradient Boosting(XGBoost),with an accuracy of 0.9905 and F1-score of 0.9816 on ElecSent-Multi-Languages,and an accuracy of 0.9930 and F1-score of 0.9899 on ElecSent-English.The performance of differentmodels was compared using the 2020 United States(US)Presidential Election as a case study.The ElecBERT-English and ElecBERT-Multi-Languages models outperformed BERTweet,with the ElecBERT-English model achieving aMean Absolute Error(MAE)of 6.13.This paper presents a valuable contribution to sentiment analysis in the context of election-related tweets,with potential applications in political analysis,social media management,and policymaking.展开更多
BACKGROUND At present,many studies have reported the risk factors for postoperative intracranial reinfection,including age,sex,time to surgery,duration of postoperative catheterization,emergency procedures,type of dis...BACKGROUND At present,many studies have reported the risk factors for postoperative intracranial reinfection,including age,sex,time to surgery,duration of postoperative catheterization,emergency procedures,type of disease and cerebrospinal fluid leakage,but the academic community has not reached a unified conclusion.AIM To find factors influencing the surveillance of re-emerging intracranial infections in elective neurosurgical patients.METHODS Ninety-four patients who underwent elective craniotomy from January 1,2015 to December 31,2022 in the Department of Neurosurgery,First Hospital of Jilin University,were included in this study.Of those,45 patients were enrolled in the infection group,and 49 were enrolled in the control group.The clinical data of the patients were collected and divided into three categories,including preoperative baseline conditions,intraoperative characteristics and postoperative infection prevention.The data were analyzed using SPSS 26.0 software.RESULTS There were 23 males and 22 females in the infection group with a mean age of 52.8±15.1 years and 17 males and 32 females in the control group with a mean age of 48.9±15.2 years.The univariate analysis showed that the infection group had higher systolic blood pressures and postoperative temperatures,fewer patients who underwent a supratentorial craniotomy,more patients with a history of hypertension and higher initial postoperative white blood cell counts than the control group,with statistically significant differences(P<0.05).The multifactorial logistic regression analysis showed that a history of hypertension and a high postoperative body temperature were independent risk factors for postoperative infection in neurosurgical patients.CONCLUSION The results obtained in this study indicated that a history of hypertension and a high postoperative body temperature were independent risk factors for postoperative neurological symptoms.展开更多
Predicting election outcomes is a crucial undertaking,and various methods are employed for this purpose,such as traditional opinion polling,and social media analysis.However,traditional polling approaches often strugg...Predicting election outcomes is a crucial undertaking,and various methods are employed for this purpose,such as traditional opinion polling,and social media analysis.However,traditional polling approaches often struggle to capture the intricate nuances of voter sentiment at local levels,resulting in a limited depth of analysis and understanding.In light of this challenge,this study focuses on predicting elections at the state/regional level along with the country level,intending to offer a comprehensive analysis and deeper insights into the electoral process.To achieve this,the study introduces the Location-Based Election Prediction Model(LEPM),which utilizes social media data,specifically Twitter,and integrates location-aware sentiment analysis techniques at both the state/region and country levels.LEPM predicts the support and opposing strength of each political party/candidate.To determine the location of users/voters who have not disclosed their location information in tweets,the model utilizes a Voter Location Detection(VotLocaDetect)approach,which leverages recent tweets/posts.The sentiment analysis techniques employed in this study include rule-based sentiment analysis,Valence Aware Dictionary and Sentiment Reasoner(VADER)as well as transformers-based sentiment analysis such as Bidirectional Encoder Representations from Transformers(BERT),BERTweet,and Election based BERT(ElecBERT).This study uses the 2020 United States(US)Presidential Election as a case study.By applying the LEPM model to the election,the study demonstrates its ability to accurately predict outcomes in forty-one states,achieving an 0.84 accuracy rate at the state level.Moreover,at the country level,the LEPM model outperforms traditional polling results.With a low Mean Absolute Error(MAE)of 0.87,the model exhibits more precise predictions and serves as a successful alternative to conventional polls and other methodologies.Leveraging the extensive social media data,the LEPM model provides nuanced insights into voter behavior,enabling policymakers to make informed decisions and facilitating in-depth analyses of elections.The study emphasizes the importance of using social media data for reliable election prediction and offers implications for enhancing prediction accuracy and understanding voter sentiment and behavior.展开更多
BACKGROUND High flow priapism(HFP)is a rare type of priapism.Perineal trauma is the most common cause of HFP.Trauma-induced penile artery injury may lead to an arterial-cavernosal fistula,whereas persistent irregular ...BACKGROUND High flow priapism(HFP)is a rare type of priapism.Perineal trauma is the most common cause of HFP.Trauma-induced penile artery injury may lead to an arterial-cavernosal fistula,whereas persistent irregular arterial blood flow entering the corpora cavernosum can cause a persistent penile erection.The routine treatment of HFP focuses on addressing the abnormal penile erectile status and avoiding post-treatment erectile dysfunction.Interventional embolization is an important therapeutic modality for HFP,and bilateral embolization therapy is currently the most commonly used technique for patients with bilateral cavernous artery fistulas;however,unilateral embolization therapy has yet to be reported.CASE SUMMARY Herein,we report of the case of a 26-year-old Chinese male who presented with a persistent abnormal erection for 12 h after perineal impact injury.Medical history,cavernous arterial blood gas analysis and radiological examinations led to a diagnosis of HFP caused by bilateral cavernous artery fistulas.We performed routine conservative treatment(compression therapy and ice application)for the patient after admission;however,10 d later,his symptoms had not been relieved.After completion of the preoperative workup,right(severe side)selective perineal artery embolization was performed;the left cavernous artery fistula was left untreated.After postoperative continuation of conservative treatment for 72 h,the patient experienced complete penile thinning.The patient had no symptoms of erectile dysfunction over a follow-up period of 12 mo.CONCLUSION Compared with bilateral cavernous artery fistula embolization,we believe that unilateral cavernous artery fistula embolization can achieve positive clinical efficacy and reduce the risk of postoperative erectile dysfunction secondary to penile ischemia.展开更多
The rapid progress of flexible electronics tremendously stimulates the urgent demands for the matching power supply systems. Flexible transparent electrochemical energy conversion and storage devices (FT–EECSDs), wit...The rapid progress of flexible electronics tremendously stimulates the urgent demands for the matching power supply systems. Flexible transparent electrochemical energy conversion and storage devices (FT–EECSDs), with endurable mechanical flexibility, outstanding optical transmittance, excellent electrochemical performance, and additional intelligent functions, are considered as preferable energy supplies for future self-powered flexible electronic systems. A comprehensive review of the reasonable design of flexible transparent electrode and recent progress on the FT–EECSDs is presented herein. The manufacturing techniques of generally classified three types of flexible transparent electrodes are systematically summarized. Emphasis is given to the recent developments in the transparent solid-state electrolyte, flexible transparent energy conversion, and storage devices. The standard evaluation methods and reasonable evaluation parameters to evaluate the flexibility and transparency of FT–EECSDs are highlighted. Additionally, the typical integrated applications of FT–EECSDs are also described. Finally, the current challenges and a future perspective on the research and development direction are further outlined.展开更多
The disease burden of diverticulitis is high across inpatient and outpatient settings,and the prevalence of diverticulitis has increased.Historically,patients with acute diverticulitis were admitted routinely for intr...The disease burden of diverticulitis is high across inpatient and outpatient settings,and the prevalence of diverticulitis has increased.Historically,patients with acute diverticulitis were admitted routinely for intravenous antibiotics and many had urgent surgery with colostomy or elective surgery after only a few episodes.Several recent studies have challenged the standards of how acute and recurrent diverticulitis are managed,and many clinical practice guidelines(CPGs)have pivoted to recommend outpatient management and individualized decisions about surgery.Yet the rates of diverticulitis hospitalizations and operations are increasing in the United States,suggesting there is a disconnect from or delay in adoption of CPGs across the spectrum of diverticular disease.In this review,we propose approaching diverticulitis care from a population level to understand the gaps between contemporary studies and real-world practice and suggest strategies to implement and improve future care.展开更多
Background: Blood loss during caesarean section (C/S) may lead to postpartum haemorrhage, and is one of the direct causes of maternal mortality and morbidity globally. Tranexamic acid is recommended in the treatment o...Background: Blood loss during caesarean section (C/S) may lead to postpartum haemorrhage, and is one of the direct causes of maternal mortality and morbidity globally. Tranexamic acid is recommended in the treatment of postpartum haemorrhage (PPH) if oxytocin and other utertonics are ineffective in controlling PPH. In this centre it is not used prophylactically to reduce blood during caesarean section. Aim: To assess the effect of prophylactic intravenous tranexamic acid on blood loss during and after elective C/S at the University of Port Harcourt Teaching Hospital (UPTH). Methods: This was a prospective, single-blind, randomized, placebo-controlled interventional study conducted at the Obstetric theatre of UPTH from July 2020 to March 2021. Eligible women were randomized into two groups;seventy-two women received intravenous tranexamic acid while seventy-one women received a placebo. Socio-demographic data and the result of the study were collected through a proforma. Data collected was analyzed using Statistical Package for Social Sciences (SPSS) Version 22.0. The results were expressed in tables and charts as frequencies, percentages and mean. Chi-square test, Fisher’s exact, and T-test were used to determine the relationship between variables. P-value ≤ 0.05 was considered statistically significant. Results: The findings showed that tranexamic acid significantly reduced mean blood loss during and after C/S (p-value post-surgery was significantly lower in the tranexamic acid group (624.88 ± 200.76 ml) in comparison to the placebo group (864.24 ± 229.09 ml), p-value = 0.001. The mean post-C/S packed cell volume (PCV) was significantly higher among the tranexamic acid group (30.68% ± 2.80%) in comparison to the placebo group (28.07% ± 3.27%), t = 5.131, p-value = 0.0001. The maternal side effects were nausea and vomiting, 9 (12.5%) and 1 (1.4%) participants respectively. Conclusion: Tranexamic acid significantly reduced blood loss during and after elective C/S. Maternal side effects were less with tranexamic acid use.展开更多
Background: Surgery is a traumatic process that may subject patients to physiological and psychological responses leading to pre and post-operative effects. Preoperative anxiety, if severe may be associated with sever...Background: Surgery is a traumatic process that may subject patients to physiological and psychological responses leading to pre and post-operative effects. Preoperative anxiety, if severe may be associated with several complications including cancellation of surgery, poor intra- and post-operative analgesic control, altered post-operative healing, and longer hospital stays to mention a few. Objective: The main purpose was to determine the prevalence and predictors of pre-operative anxiety among elective surgical patients and their hemodynamic changes in these patients in the Surgical department in MNH. Methodology: This was a prospective descriptive and analytical study performed at MNH which involved patients admitted for elective surgical procedures from June 2021 to February 2022. Information was gathered in a structured questionnaire along with APAIS scores. Results: 169 patients for elective surgery in General Surgery and Urology units were included in the study. Among them, 94 males and 74 females. The overall pre-operative anxiety was 11.8%, 80.5% had moderate to severe Information-Related anxiety, while 26% and 17.2% had moderate-to-severe surgery-related and anesthesia-related types of anxiety respectively. Conclusion: Pre-operative anxiety was comparatively lower in our settings as well no factor was found with a significant relation to pre-operative anxiety, hence further and broader evaluation is recommended to result in the assessment and management of patients before elective surgery.展开更多
Background: Rheumatic Valvular Heart disease (RVHD) is common in developing countries often associated with anemia;however its burden is often overlooked. Anemic patients undergoing surgery are likely to receive blood...Background: Rheumatic Valvular Heart disease (RVHD) is common in developing countries often associated with anemia;however its burden is often overlooked. Anemic patients undergoing surgery are likely to receive blood transfusion, increasing morbidity and mortality. Prevalence of anemia in cardiac surgical patients are studied extensively, however its burden in RVHD is lacking. This study attempted to investigate the prevalence of preoperative anemia in RVHD and its effect on blood transfusion, morbidity and mortality in patients undergoing valve surgery. Methods: This is a retrospective observational study conducted at a tertiary care hospital in Nepal. We considered 340 patients who underwent Rheumatic valve replacement surgery from 2014 January to December 2016 and data on their socio-demographic and clinical characteristics were extracted from the patient’s records. The analyses meeting the study objectives were conducted using IBM SPSS v25 for Windows (IBM Statistical Package for Social Sciences, 2015IBM Corporation, New York, United States). Results: The prevalence of no anemia, mild, moderate, and severe anemia was 34.1%, 57.7%, 39.6%, 2.5%, respectively. The units of Red Blood Cell used for transfusion were 1.2 units, 2.0 units, 2.3 units, and 1.6 units in patients without anemia, and those with mild, moderate and severe anemia respectively. The incidence of reexploration was higher in patients with severe anemia as compared to the non anemic with an incidence of 66.6%. A proportion of the patients with no anemia, mild, moderate and severe anemia with less than 7 days stay in the intensive care unit were 89%, 82%, 84.7% and 100% respectively. The length of hospital stay more than 10 days was seen in 58.9%, 71.6%, 63% and 100% in patients with no anemia, mild, moderate and severe anemia. An overall incidence of mortality in anemic patients was 11% while in non anemic patients was 5.3%. Conclusions: The prevalence of anemia was high in the Nepalese patients with Rheumatic valvular heart disease planned for elective surgery. There was an increased incidence of blood transfusion, longer hospital stay, and increased mortality in anemic patients compared to their non anemic counterparts.展开更多
Background: The timing of elective repeat cesarean delivery at 38 weeks versus 39 weeks is still a debatable subject, both regarding maternal and neonatal outcomes. In the Saudi context, there is lack of local data to...Background: The timing of elective repeat cesarean delivery at 38 weeks versus 39 weeks is still a debatable subject, both regarding maternal and neonatal outcomes. In the Saudi context, there is lack of local data to aid decision-making regarding the timing of elective repeat cesarean delivery. Objectives: To estimate the rate of spontaneous onset of labor before the planned gestational age for repeat cesarean section in women who were booked at gestational age of (39 0/7 - 39 6/7) weeks (W39) versus (38 0/7 - 38 6/7) weeks (W38) and to compare the rate of maternal composite outcome between these groups. Design: Retrospective cohort. Setting: This study was conducted at King Abdulaziz Medical City, Jeddah, KSA. Method: Delivery registry books were reviewed to identify all deliveries from 1 January 2014 to 31 December 2016 (3 years). All low-risk pregnant women who had 2 or more cesarean deliveries and who met the inclusion criteria were included. Results: A total of 440 women were included of whom 318 (72.3%) were planned for elective cesarean section at W38 gestational age and 122 women at W39 gestational age. Mothers planned at W39 had higher rate of emergency cesarean deliveries versus those planned at W38 (18.0% versus 10.4%, p = 0.030;RR = 13.06), most frequently due to early onset of contractions (16.4% versus 8.2%, p = 0.012;RR = 12.17) or cervical dilatation (11.6% versus 5.4%, p = 0.024, RR = 16.15). No difference in the incidence of individual or composite maternal complications was noted between the two groups. Mother’s age (OR 0.93, p = 0.018) and schedule date at W39 (OR = 1.94, p = 0.028) were independently associated with spontaneous onset of labor before the scheduled gestational age, while no association was found with parity, previous number of spontaneous vaginal deliveries, number of previous cesarean deliveries or interval from last cesarean delivery. Conclusion: Elective cesarean section scheduled at 39 weeks of gestation or beyond carries a higher risk of emergency cesarean section, with no significant increase in maternal complications. The identification of factors associated with spontaneous onset of labor before the planned gestational age should be carefully identified to determine the optimal timing.展开更多
Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divid...Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.展开更多
文摘The crisis in Ukraine,which has dragged on for more than two years,and whether military aid to Ukraine should continue are major issues debated and fought over by the two parties in the United States prior to the 2024 election.Regarding whether to continue to aid Ukraine,various political forces in the United States have chosen sides in the election campaign,which can be roughly divided into the“aid camp”and the“stop-aid camp”according to their positions.
文摘The prominent performance of former US President Donald J.Trump in the 2024 presidential election cycle ref lects the ongoing developments of the Trumpification of the Republican Party(GOP).Since Trump left office,the Trumpification of the GOP has continued.In terms of ideological shaping,Trumpification is ref lected in the fact that the political stance of the GOP is dominated by Trump.In terms of personal influence,Trumpification is manifested by the overall acceptance of GOP elites and voters toward Trump's presidential candidacy,notwithstanding a decrease in their satisfaction with him.The recent developments in Trumpification are intricately linked to Trump's influence on the GOP's political ecology,such as the formation of a new GOP coalition and the reshaping of GOP elite composition.Additionally,these developments are also inf luenced by specific political factors,including the unique circumstances of the 2020 presidential election that led to Tr ump's“quasi-incumbent”status and the economic and immigration issues in the 2024 election that favor Trump.The role Trump plays in the 2024 election and its outcome will be critical in determining whether the inf luence of Trumpification,especially Trump himself,will persist or undergo changes.
文摘Purpose: Although patient-related factors affect surgical outcomes, preoperative functional status is not measured by any cardiac risk score. Functional status can, however, be objectively measured using validated outcome tools such as the Late-Life Function and Disability Instrument (LLFDI). The purpose of this study was to determine 1) if there was a change over time in functional status, as measured by the LLFDI, in patients who underwent elective cardiac surgery, and if so, 2) what specific aspect(s) of functional status changed. Methods: A prospective longitudinal study of one year was conducted on elective cardiac surgery patients (n = 43) using the self-reported LLFDI, which measures Disability Frequency (frequency of participation in social tasks), Disability Limitation (ability to participate in social tasks) and Function Total (ease in performing routine activities). Higher scores indicate increased function and decreased disability. LLFDI scores were compared at three times (preoperative, six-week and one-year postoperative) using repeated measures ANOVA. Post hoc pairwise comparison was conducted for specific interactions. Results: Both Function Total and Disability Frequency significantly changed over time (p = 0.047 and p = 0.013, respectively). Specifically, patients’ function level was significantly higher one-year postoperative compared to preoperative (M difference = +3.48, SE = 1.48, p = 0.026). Likewise, Disability Frequency scores were significantly higher (i.e. more active) at one-year postoperative versus preoperative (M difference= +5.98, SE = 2.19, p = 0.033). Disability Limitation scores were not significantly different between any time points (p > 0.05). Conclusion: By one-year postoperative, patients demonstrated increased ease in their routine physical activities and were more participatory in social life tasks. Individuals who underwent elective cardiac surgery took more than six weeks to detect notable improvement in functional status, which was expected with a sternotomy approach. This study provides support for the use of the LLFDI as an effective tool to capture functional status in the cardiac population. These findings may assist cardiac patients in recovery timeline expectations.
文摘Introduction: Cancellation of elective surgery is common in developing countries. This decision is difficult to make as it generates economic and organizational consequences for the healthcare facility and an additional source of stress for patients and their caregivers. This study aimed to analyze the various aspects of this medical problem. Patients and Methods: We conducted a prospective and descriptive study over six months (from January 1st, 2017, to June 30th, 2017) at the pediatric surgery department of Aristide Le Dantec University Teaching Hospital in Senegal. Results: Ninety-one cases were collected. The cancellation rate was 20.8%. Infants were affected in 36.3% of cases. Among anesthesiologists, 83.5% were residents, and 16.5% were specialists. Cancellation in nephroblastoma children with an indication for extended nephrectomy represented 15.4% of cases. Concerning reasons for cancellation, comorbidities, dominated by respiratory infections, accounted for 28.5% of cases, patient absences for 24.2%, and issues related to the anesthesiologist for 17.6%. Cancellations were avoidable in 33% of cases. Patients were responsible for cancellation in 37.4% of cases, the healthcare system in 33%, and medical reasons in 29.7%. Conclusion: Our findings suggest that one-third of cancellations could have been avoided with improvements in the healthcare system. Actions should be taken to reduce the cancellation rate in our context.
文摘Variations in the allocation of university resources,teachers’course selection preferences and teaching commitment levels,as well as students’course preferences and assessment requirements,create subjective differences.These differences,compounded by the demands of the new liberal arts reform,place significant challenges and pressure on elective course instructors.To meet these demands,elective course teachers should enhance their teaching methods and explore new instructional models.The International Trade in Services course,for instance,has implemented six areas of curriculum reform,enriching the practice of elective course improvement.
文摘With the vigorous development of higher vocational education,public elective courses,as one of the core components of the higher vocational curriculum system,occupy a pivotal position.Based on the perspective of academic affairs management and taking Guangdong C Vocational College as an example,this paper meticulously analyzes the operational problems in the declaration,setting,teaching,and management of public elective courses through questionnaire surveys and other methods.It also puts forward a series of targeted solutions,with a view to continuously improving the teaching quality and management level of public elective courses.
基金funded by the BeijingMunicipal Natural Science Foundation(Grant No.4212026)Foundation Enhancement Program(Grant No.2021-JCJQ-JJ-0059).
文摘Sentiment analysis plays a vital role in understanding public opinions and sentiments toward various topics.In recent years,the rise of social media platforms(SMPs)has provided a rich source of data for analyzing public opinions,particularly in the context of election-related conversations.Nevertheless,sentiment analysis of electionrelated tweets presents unique challenges due to the complex language used,including figurative expressions,sarcasm,and the spread of misinformation.To address these challenges,this paper proposes Election-focused Bidirectional Encoder Representations from Transformers(ElecBERT),a new model for sentiment analysis in the context of election-related tweets.Election-related tweets pose unique challenges for sentiment analysis due to their complex language,sarcasm,andmisinformation.ElecBERT is based on the Bidirectional Encoder Representations from Transformers(BERT)language model and is fine-tuned on two datasets:Election-Related Sentiment-Annotated Tweets(ElecSent)-Multi-Languages,containing 5.31 million labeled tweets in multiple languages,and ElecSent-English,containing 4.75million labeled tweets in English.Themodel outperforms othermachine learning models such as Support Vector Machines(SVM),Na飗e Bayes(NB),and eXtreme Gradient Boosting(XGBoost),with an accuracy of 0.9905 and F1-score of 0.9816 on ElecSent-Multi-Languages,and an accuracy of 0.9930 and F1-score of 0.9899 on ElecSent-English.The performance of differentmodels was compared using the 2020 United States(US)Presidential Election as a case study.The ElecBERT-English and ElecBERT-Multi-Languages models outperformed BERTweet,with the ElecBERT-English model achieving aMean Absolute Error(MAE)of 6.13.This paper presents a valuable contribution to sentiment analysis in the context of election-related tweets,with potential applications in political analysis,social media management,and policymaking.
文摘BACKGROUND At present,many studies have reported the risk factors for postoperative intracranial reinfection,including age,sex,time to surgery,duration of postoperative catheterization,emergency procedures,type of disease and cerebrospinal fluid leakage,but the academic community has not reached a unified conclusion.AIM To find factors influencing the surveillance of re-emerging intracranial infections in elective neurosurgical patients.METHODS Ninety-four patients who underwent elective craniotomy from January 1,2015 to December 31,2022 in the Department of Neurosurgery,First Hospital of Jilin University,were included in this study.Of those,45 patients were enrolled in the infection group,and 49 were enrolled in the control group.The clinical data of the patients were collected and divided into three categories,including preoperative baseline conditions,intraoperative characteristics and postoperative infection prevention.The data were analyzed using SPSS 26.0 software.RESULTS There were 23 males and 22 females in the infection group with a mean age of 52.8±15.1 years and 17 males and 32 females in the control group with a mean age of 48.9±15.2 years.The univariate analysis showed that the infection group had higher systolic blood pressures and postoperative temperatures,fewer patients who underwent a supratentorial craniotomy,more patients with a history of hypertension and higher initial postoperative white blood cell counts than the control group,with statistically significant differences(P<0.05).The multifactorial logistic regression analysis showed that a history of hypertension and a high postoperative body temperature were independent risk factors for postoperative infection in neurosurgical patients.CONCLUSION The results obtained in this study indicated that a history of hypertension and a high postoperative body temperature were independent risk factors for postoperative neurological symptoms.
基金funded by the Beijing Municipal Natural Science Foundation(Grant No.4212026)the Foundation Enhancement Program(Grant No.2021-JCJQ-JJ-0059).
文摘Predicting election outcomes is a crucial undertaking,and various methods are employed for this purpose,such as traditional opinion polling,and social media analysis.However,traditional polling approaches often struggle to capture the intricate nuances of voter sentiment at local levels,resulting in a limited depth of analysis and understanding.In light of this challenge,this study focuses on predicting elections at the state/regional level along with the country level,intending to offer a comprehensive analysis and deeper insights into the electoral process.To achieve this,the study introduces the Location-Based Election Prediction Model(LEPM),which utilizes social media data,specifically Twitter,and integrates location-aware sentiment analysis techniques at both the state/region and country levels.LEPM predicts the support and opposing strength of each political party/candidate.To determine the location of users/voters who have not disclosed their location information in tweets,the model utilizes a Voter Location Detection(VotLocaDetect)approach,which leverages recent tweets/posts.The sentiment analysis techniques employed in this study include rule-based sentiment analysis,Valence Aware Dictionary and Sentiment Reasoner(VADER)as well as transformers-based sentiment analysis such as Bidirectional Encoder Representations from Transformers(BERT),BERTweet,and Election based BERT(ElecBERT).This study uses the 2020 United States(US)Presidential Election as a case study.By applying the LEPM model to the election,the study demonstrates its ability to accurately predict outcomes in forty-one states,achieving an 0.84 accuracy rate at the state level.Moreover,at the country level,the LEPM model outperforms traditional polling results.With a low Mean Absolute Error(MAE)of 0.87,the model exhibits more precise predictions and serves as a successful alternative to conventional polls and other methodologies.Leveraging the extensive social media data,the LEPM model provides nuanced insights into voter behavior,enabling policymakers to make informed decisions and facilitating in-depth analyses of elections.The study emphasizes the importance of using social media data for reliable election prediction and offers implications for enhancing prediction accuracy and understanding voter sentiment and behavior.
基金Supported by Foundation of the General Hospital of Western Command,No.2021-XZYG-C04。
文摘BACKGROUND High flow priapism(HFP)is a rare type of priapism.Perineal trauma is the most common cause of HFP.Trauma-induced penile artery injury may lead to an arterial-cavernosal fistula,whereas persistent irregular arterial blood flow entering the corpora cavernosum can cause a persistent penile erection.The routine treatment of HFP focuses on addressing the abnormal penile erectile status and avoiding post-treatment erectile dysfunction.Interventional embolization is an important therapeutic modality for HFP,and bilateral embolization therapy is currently the most commonly used technique for patients with bilateral cavernous artery fistulas;however,unilateral embolization therapy has yet to be reported.CASE SUMMARY Herein,we report of the case of a 26-year-old Chinese male who presented with a persistent abnormal erection for 12 h after perineal impact injury.Medical history,cavernous arterial blood gas analysis and radiological examinations led to a diagnosis of HFP caused by bilateral cavernous artery fistulas.We performed routine conservative treatment(compression therapy and ice application)for the patient after admission;however,10 d later,his symptoms had not been relieved.After completion of the preoperative workup,right(severe side)selective perineal artery embolization was performed;the left cavernous artery fistula was left untreated.After postoperative continuation of conservative treatment for 72 h,the patient experienced complete penile thinning.The patient had no symptoms of erectile dysfunction over a follow-up period of 12 mo.CONCLUSION Compared with bilateral cavernous artery fistula embolization,we believe that unilateral cavernous artery fistula embolization can achieve positive clinical efficacy and reduce the risk of postoperative erectile dysfunction secondary to penile ischemia.
基金We gratefully acknowledge the financial support from the National Natural Science Foundation of China (Grant No.52175534,51702095)the science and technology innovation Program of Hunan Province (2021RC3052)+1 种基金the Fundamental Research Funds for the Central Universities (531118010016)Science and Technology Bureau Foundation of Changsha City (kh1904005).
文摘The rapid progress of flexible electronics tremendously stimulates the urgent demands for the matching power supply systems. Flexible transparent electrochemical energy conversion and storage devices (FT–EECSDs), with endurable mechanical flexibility, outstanding optical transmittance, excellent electrochemical performance, and additional intelligent functions, are considered as preferable energy supplies for future self-powered flexible electronic systems. A comprehensive review of the reasonable design of flexible transparent electrode and recent progress on the FT–EECSDs is presented herein. The manufacturing techniques of generally classified three types of flexible transparent electrodes are systematically summarized. Emphasis is given to the recent developments in the transparent solid-state electrolyte, flexible transparent energy conversion, and storage devices. The standard evaluation methods and reasonable evaluation parameters to evaluate the flexibility and transparency of FT–EECSDs are highlighted. Additionally, the typical integrated applications of FT–EECSDs are also described. Finally, the current challenges and a future perspective on the research and development direction are further outlined.
文摘The disease burden of diverticulitis is high across inpatient and outpatient settings,and the prevalence of diverticulitis has increased.Historically,patients with acute diverticulitis were admitted routinely for intravenous antibiotics and many had urgent surgery with colostomy or elective surgery after only a few episodes.Several recent studies have challenged the standards of how acute and recurrent diverticulitis are managed,and many clinical practice guidelines(CPGs)have pivoted to recommend outpatient management and individualized decisions about surgery.Yet the rates of diverticulitis hospitalizations and operations are increasing in the United States,suggesting there is a disconnect from or delay in adoption of CPGs across the spectrum of diverticular disease.In this review,we propose approaching diverticulitis care from a population level to understand the gaps between contemporary studies and real-world practice and suggest strategies to implement and improve future care.
文摘Background: Blood loss during caesarean section (C/S) may lead to postpartum haemorrhage, and is one of the direct causes of maternal mortality and morbidity globally. Tranexamic acid is recommended in the treatment of postpartum haemorrhage (PPH) if oxytocin and other utertonics are ineffective in controlling PPH. In this centre it is not used prophylactically to reduce blood during caesarean section. Aim: To assess the effect of prophylactic intravenous tranexamic acid on blood loss during and after elective C/S at the University of Port Harcourt Teaching Hospital (UPTH). Methods: This was a prospective, single-blind, randomized, placebo-controlled interventional study conducted at the Obstetric theatre of UPTH from July 2020 to March 2021. Eligible women were randomized into two groups;seventy-two women received intravenous tranexamic acid while seventy-one women received a placebo. Socio-demographic data and the result of the study were collected through a proforma. Data collected was analyzed using Statistical Package for Social Sciences (SPSS) Version 22.0. The results were expressed in tables and charts as frequencies, percentages and mean. Chi-square test, Fisher’s exact, and T-test were used to determine the relationship between variables. P-value ≤ 0.05 was considered statistically significant. Results: The findings showed that tranexamic acid significantly reduced mean blood loss during and after C/S (p-value post-surgery was significantly lower in the tranexamic acid group (624.88 ± 200.76 ml) in comparison to the placebo group (864.24 ± 229.09 ml), p-value = 0.001. The mean post-C/S packed cell volume (PCV) was significantly higher among the tranexamic acid group (30.68% ± 2.80%) in comparison to the placebo group (28.07% ± 3.27%), t = 5.131, p-value = 0.0001. The maternal side effects were nausea and vomiting, 9 (12.5%) and 1 (1.4%) participants respectively. Conclusion: Tranexamic acid significantly reduced blood loss during and after elective C/S. Maternal side effects were less with tranexamic acid use.
文摘Background: Surgery is a traumatic process that may subject patients to physiological and psychological responses leading to pre and post-operative effects. Preoperative anxiety, if severe may be associated with several complications including cancellation of surgery, poor intra- and post-operative analgesic control, altered post-operative healing, and longer hospital stays to mention a few. Objective: The main purpose was to determine the prevalence and predictors of pre-operative anxiety among elective surgical patients and their hemodynamic changes in these patients in the Surgical department in MNH. Methodology: This was a prospective descriptive and analytical study performed at MNH which involved patients admitted for elective surgical procedures from June 2021 to February 2022. Information was gathered in a structured questionnaire along with APAIS scores. Results: 169 patients for elective surgery in General Surgery and Urology units were included in the study. Among them, 94 males and 74 females. The overall pre-operative anxiety was 11.8%, 80.5% had moderate to severe Information-Related anxiety, while 26% and 17.2% had moderate-to-severe surgery-related and anesthesia-related types of anxiety respectively. Conclusion: Pre-operative anxiety was comparatively lower in our settings as well no factor was found with a significant relation to pre-operative anxiety, hence further and broader evaluation is recommended to result in the assessment and management of patients before elective surgery.
文摘Background: Rheumatic Valvular Heart disease (RVHD) is common in developing countries often associated with anemia;however its burden is often overlooked. Anemic patients undergoing surgery are likely to receive blood transfusion, increasing morbidity and mortality. Prevalence of anemia in cardiac surgical patients are studied extensively, however its burden in RVHD is lacking. This study attempted to investigate the prevalence of preoperative anemia in RVHD and its effect on blood transfusion, morbidity and mortality in patients undergoing valve surgery. Methods: This is a retrospective observational study conducted at a tertiary care hospital in Nepal. We considered 340 patients who underwent Rheumatic valve replacement surgery from 2014 January to December 2016 and data on their socio-demographic and clinical characteristics were extracted from the patient’s records. The analyses meeting the study objectives were conducted using IBM SPSS v25 for Windows (IBM Statistical Package for Social Sciences, 2015IBM Corporation, New York, United States). Results: The prevalence of no anemia, mild, moderate, and severe anemia was 34.1%, 57.7%, 39.6%, 2.5%, respectively. The units of Red Blood Cell used for transfusion were 1.2 units, 2.0 units, 2.3 units, and 1.6 units in patients without anemia, and those with mild, moderate and severe anemia respectively. The incidence of reexploration was higher in patients with severe anemia as compared to the non anemic with an incidence of 66.6%. A proportion of the patients with no anemia, mild, moderate and severe anemia with less than 7 days stay in the intensive care unit were 89%, 82%, 84.7% and 100% respectively. The length of hospital stay more than 10 days was seen in 58.9%, 71.6%, 63% and 100% in patients with no anemia, mild, moderate and severe anemia. An overall incidence of mortality in anemic patients was 11% while in non anemic patients was 5.3%. Conclusions: The prevalence of anemia was high in the Nepalese patients with Rheumatic valvular heart disease planned for elective surgery. There was an increased incidence of blood transfusion, longer hospital stay, and increased mortality in anemic patients compared to their non anemic counterparts.
文摘Background: The timing of elective repeat cesarean delivery at 38 weeks versus 39 weeks is still a debatable subject, both regarding maternal and neonatal outcomes. In the Saudi context, there is lack of local data to aid decision-making regarding the timing of elective repeat cesarean delivery. Objectives: To estimate the rate of spontaneous onset of labor before the planned gestational age for repeat cesarean section in women who were booked at gestational age of (39 0/7 - 39 6/7) weeks (W39) versus (38 0/7 - 38 6/7) weeks (W38) and to compare the rate of maternal composite outcome between these groups. Design: Retrospective cohort. Setting: This study was conducted at King Abdulaziz Medical City, Jeddah, KSA. Method: Delivery registry books were reviewed to identify all deliveries from 1 January 2014 to 31 December 2016 (3 years). All low-risk pregnant women who had 2 or more cesarean deliveries and who met the inclusion criteria were included. Results: A total of 440 women were included of whom 318 (72.3%) were planned for elective cesarean section at W38 gestational age and 122 women at W39 gestational age. Mothers planned at W39 had higher rate of emergency cesarean deliveries versus those planned at W38 (18.0% versus 10.4%, p = 0.030;RR = 13.06), most frequently due to early onset of contractions (16.4% versus 8.2%, p = 0.012;RR = 12.17) or cervical dilatation (11.6% versus 5.4%, p = 0.024, RR = 16.15). No difference in the incidence of individual or composite maternal complications was noted between the two groups. Mother’s age (OR 0.93, p = 0.018) and schedule date at W39 (OR = 1.94, p = 0.028) were independently associated with spontaneous onset of labor before the scheduled gestational age, while no association was found with parity, previous number of spontaneous vaginal deliveries, number of previous cesarean deliveries or interval from last cesarean delivery. Conclusion: Elective cesarean section scheduled at 39 weeks of gestation or beyond carries a higher risk of emergency cesarean section, with no significant increase in maternal complications. The identification of factors associated with spontaneous onset of labor before the planned gestational age should be carefully identified to determine the optimal timing.
文摘Objective:To explore the effect of continuous non-invasive blood pressure monitoring on intraoperative hemodynamics and postoperative myocardial injury in craniotomy.Methods:120 cases of elective craniotomy were divided into the self-control group(continuous non-invasive blood pressure monitoring and intermittent cuff non-invasive blood pressure monitoring,CNAP group)and propensity score matching group(only intermittent cuff non-invasive blood pressure measurement in previous craniotomy,PSM group);Goal-directed hemodynamic management in CNAP group included heart rate(HR),blood pressure(BP),stroke volume(SV),stroke variability(SVV),and systemic vascular resistance index(SVRI).The main index is to compare the troponin level within 72 hours after operation between the CNAP group and the PSM group;The secondary indicators are the comparison of the hemodynamic conditions between the CNAP group and the PSM at 10 specific time points.Results:The incidence of postoperative myocardial injury in the CNAP group was significantly lower than that in the PSM group(12%vs.30%,P=0.01);in the CNAP group hypotensive episodes(6 vs.3,P=0.01),positive balance of fluid therapy(700 vs.500 mL,P<0.001),more use of vasoactive drugs(29 vs.18,P=0.04),more stable hemodynamics medical status(P=0.03)were recorded.Conclusion:The hemodynamic management strategy based on continuous non-invasive blood pressure monitoring can reduce the incidence of myocardial injury after elective craniotomy and maintain a more stable hemodynamic state.
