Background: The present study was conducted to examine the association between various coronary risk factors and clinical parameters, with special emphasis on ankle-brachial index, in predicting the severity and compl...Background: The present study was conducted to examine the association between various coronary risk factors and clinical parameters, with special emphasis on ankle-brachial index, in predicting the severity and complexity of coronary artery disease. Methods: Patients diagnosed with coronary artery disease at our hospital between September-2012 and December-2014 were examined in this study. Selected patients were screened for cardiovascular risk factors including diabetes, hypertension, smoking, and alcohol habits as well as for clinical parameters including body-mass index, waist-hip ratio, ankle-brachial index, and ejection fraction. All patients underwent coronary angiography and were evaluated for severity of coronary artery disease (based on number of vessels involved) and complexity of coronary angiographic lesions (measured by computer-assisted Syntax score calculator). The collected data were analyzed to determine the role of cardiovascular risk factors and clinical parameters as predictors of complexity and severity of coronary artery disease. Results: A total of 211 patients (mean age: 54.64 ± 9.9 years;81% males) with coronary artery disease were analyzed. Findings revealed that diabetes mellitus (p < 0.001), hypertension (p < 0.001), smoking habits (p = 0.036), and low ankle-brachial index (p < 0.001) were independent predictors of complex coronary artery disease as measured by Syntax score. Significant associations were also evident between severity of coronary artery disease and diabetes mellitus (p < 0.001), hypertension (p < 0.001), and ankle-brachial index (p < 0.001). Conversely, other cardiovascular risk factors including body-mass index, alcohol habits, wait-hip ratio, and ejection fraction did not exhibit significant associations with severity and complexity of coronary artery. Conclusions: The early diagnosis of coronary artery can be predicated by evaluating diabetes, hypertension, and smoking habits in patients presenting with acute coronary syndrome. In addition, ankle-brachial index can be used as an effective non-invasive bed-side tool, as an alternative to Syntax score, in predicting the severity and complexity of coronary artery disease.展开更多
Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Sahara...Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Saharan Africa (SSA), AKI is community-acquired occurring in healthy young adults. We aimed to identify predictors of fatal outcomes in patients with AKI in two tertiary hospitals in Cameroon. Methods: Medical records of adults with confirmed AKI, from January 2018 to March 2020 were retrieved. The outcomes of interest were in-hospital deaths and presumed causes of death. We used multiple logistic regressions modeling to identify predictors of death. The study was approved by the ethics boards of both hospitals. Values were considered significant for a p-value of 0.05. Results: We included 285 patient records (37.2% females). The mean (SD) age was 50.1 (19.0) years. Hypertension (n = 97, 34.0%), organ failure (n = 88, 30.9%), and diabetes (n = 60, 21.1%) were the main comorbidities. The majority of patients had community-acquired AKI (78.6%, n = 224), were KDIGO stage 3 (88.8%, n = 253), and needed dialysis (52.6%, n = 150). Up to 16.7% (n = 25) did not receive what was needed. The in-hospital mortality rate was 29.1% (n = 83). Lack of access to dialysis (OR = 27.8;CI: 5.2 - 149.3, p = 0.001), hypotension (OR = 11.8;CI: 1.3 - 24.8;p = 0.001) and ICU admission (OR = 5.7;CI: 1.3 - 24.8, p = 0.001) were predictors of mortality. The presence of co-morbidities or underlying diseases (n = 46, 55%) were the main causes of death. Conclusions: In-hospital AKI mortality is high, as in other low- and middle-income economies. Lack of access to dialysis and the severity of the underlying illness are major predictors of death.展开更多
BACKGROUND Portal vein thrombosis(PVT)is a commonthsn complication after splenectomy in patients with cirrhosis.However,the predictors of postoperative PVT are not known.AIM To investigate the predictors of PVT after ...BACKGROUND Portal vein thrombosis(PVT)is a commonthsn complication after splenectomy in patients with cirrhosis.However,the predictors of postoperative PVT are not known.AIM To investigate the predictors of PVT after splenectomy in patient with cirrhosis.METHODS A total of 45 patients with cirrhosis who underwent splenectomy were consecutively enrolled from January 2017 to December 2018.The incidence of PVT at 1 months,3 months,and 12 months after splenectomy in patients with cirrhosis was observed.The hematological indicators,biochemical and coagulation parameters,and imaging features were recorded at baseline and at each observation point.The univariable,multivariable,receiver operating characteristic curve and timedependent curve analyses were performed.RESULTS The cumulative incidence of PVT was 40.0%,46.6%,and 48.9%at 1 months,3 months,and 12 months after splenectomy.Multivariable analysis showed that portal vein diameter(PVD)≥14.5 mm and monthsdel end-stage liver disease(MELD)score>10 were independent predictors of PVT at 1 months,3 months,and 12 months after splenectomy(P<0.05).Time-dependent curve showed that the cumulative incidence of PVT was significantly different between patients with MELD score≤10 and>10(P<0.05).In addition,the cumulative incidence of PVT in the PVD≥14.5 mm group was significantly higher than that in the PVD<14.5 mm group(P<0.05).CONCLUSION Wider PVD and MELD score>10 were independent predictors of PVT at 1 months,3 months,and 12 months after splenectomy in patient with cirrhosis.展开更多
BACKGROUND The lack of specific predictors for type-2 diabetes mellitus(T2DM)severely impacts early intervention/prevention efforts.Elevated branched-chain amino acids(BCAAs:Isoleucine,leucine,valine)and aromatic amin...BACKGROUND The lack of specific predictors for type-2 diabetes mellitus(T2DM)severely impacts early intervention/prevention efforts.Elevated branched-chain amino acids(BCAAs:Isoleucine,leucine,valine)and aromatic amino acids(AAAs:Tyrosine,tryptophan,phenylalanine)show high sensitivity and specificity in predicting diabetes in animals and predict T2DM 10-19 years before T2DM onset in clinical studies.However,improvement is needed to support its clinical utility.AIM To evaluate the effects of body mass index(BMI)and sex on BCAAs/AAAs in new-onset T2DM individuals with varying body weight.METHODS Ninety-seven new-onset T2DM patients(<12 mo)differing in BMI[normal weight(NW),n=33,BMI=22.23±1.60;overweight,n=42,BMI=25.9±1.07;obesity(OB),n=22,BMI=31.23±2.31]from the First People’s Hospital of Yunnan Province,Kunming,China,were studied.One-way and 2-way ANOVAs were conducted to determine the effects of BMI and sex on BCAAs/AAAs.RESULTS Fasting serum AAAs,BCAAs,glutamate,and alanine were greater and high-density lipoprotein(HDL)was lower(P<0.05,each)in OB-T2DM patients than in NW-T2DM patients,especially in male OB-T2DM patients.Arginine,histidine,leucine,methionine,and lysine were greater in male patients than in female patients.Moreover,histidine,alanine,glutamate,lysine,valine,methionine,leucine,isoleucine,tyrosine,phenylalanine,and tryptophan were significantly correlated with abdominal adiposity,body weight and BMI,whereas isoleucine,leucine and phenylalanine were negatively correlated with HDL.CONCLUSION Heterogeneously elevated amino acids,especially BCAAs/AAAs,across new-onset T2DM patients in differing BMI categories revealed a potentially skewed prediction of T2DM development.The higher BCAA/AAA levels in obese T2DM patients would support T2DM prediction in obese individuals,whereas the lower levels of BCAAs/AAAs in NW-T2DM individuals may underestimate T2DM risk in NW individuals.This potentially skewed T2DM prediction should be considered when BCAAs/AAAs are to be used as the T2DM predictor.展开更多
By studying the light isotopic compositions of carbon,oxygen,and hydrogen,combined with previous research results on the ore-forming source of the deposit,the authors try to uncover its metallogenic origin.The δ^(18)...By studying the light isotopic compositions of carbon,oxygen,and hydrogen,combined with previous research results on the ore-forming source of the deposit,the authors try to uncover its metallogenic origin.The δ^(18)O and δ^(13)C isotope signatures of dolomite samples vary between 10.2 and 13.0‰,and between−7.2 and−5.2‰,respectively,implying that the carbon derives from the upper mantle.δD and δ^(18) O of quartz,biotite,and muscovite from diff erent ore veins of the deposit vary between−82 and−59‰,and between 11.6 and 12.4‰,respectively,implying that the metallogenic solutions are mainly magmatic.According to the relevant research results of many isotope geologists,the fractionation degree of hydrogen isotopes increases as the depth to the Earth’s core increases,and the more diff erentiated the hydrogen isotopes are,the lower their values will be.In other words,mantle-derived solutions can have extremely low hydrogen isotope values.This means that the δD‰ value−134 of the pyrrhotite sample numbered SD-34 in this article may indicate mantle-derived oreforming fl uid of the deposit.The formation of the Dashuigou tellurium deposit occurred between 91.71 and 80.19 Ma.展开更多
This article documents socio-demographic predictors of anxiety and depression among Maasai women in resource poor settings in Northern Kenya.These findings emerged from the findings of a dissertation research that aim...This article documents socio-demographic predictors of anxiety and depression among Maasai women in resource poor settings in Northern Kenya.These findings emerged from the findings of a dissertation research that aimed to establish the treatment effectiveness of an eclectic model of psychoeducation(PE)in treating depressive and anxiety symptoms among the women.The study adopted a quasi-experimental research design which had an experimental group(EG)and control group(CG).The population for the study was 686 female members of Conservation Enterprise Groups(CEG)in Laikipia County,from which a sample of 200 were recruited for the study(EG,n=100 and CG,n=100),at 80%power and 30%effective size.The Beck’s Depression Inventory(BDI)and Beck’s Anxiety Inventory(BAI)tools were used to assess the symptoms of depression and anxiety,respectively.The PE was provided as an intervention treatment to the EG at the middle and end of the study,after which the respondents were tested for symptoms of depression.The study established the prevalence of depression as 26.7%and 31.3%for anxiety and disorders,among women in the region.Data was analyzed using SPSS Version 21.0.展开更多
The energy norm convergence rate of the finite element solution of the heat equation is reduced by the time-regularity of the exact solution. This paper presents an adaptive finite element treatment of time-dependent ...The energy norm convergence rate of the finite element solution of the heat equation is reduced by the time-regularity of the exact solution. This paper presents an adaptive finite element treatment of time-dependent singularities on the one-dimensional heat equation. The method is based on a Fourier decomposition of the solution and an extraction formula of the coefficients of the singularities coupled with a predictor-corrector algorithm. The method recovers the optimal convergence rate of the finite element method on a quasi-uniform mesh refinement. Numerical results are carried out to show the efficiency of the method.展开更多
Hepatocellular carcinoma(HCC)is the most frequent liver neoplasm,and its incidence rates are constantly increasing.Despite the availability of potentially curative treatments(liver transplantation,surgical resection,t...Hepatocellular carcinoma(HCC)is the most frequent liver neoplasm,and its incidence rates are constantly increasing.Despite the availability of potentially curative treatments(liver transplantation,surgical resection,thermal ablation),long-term outcomes are affected by a high recurrence rate(up to 70%of cases 5 years after treatment).HCC recurrence within 2 years of treatment is defined as“early”and is generally caused by the occult intrahepatic spread of the primary neoplasm and related to the tumor burden.A recurrence that occurs after 2 years of treatment is defined as“late”and is related to de novo HCC,independent of the primary neoplasm.Early HCC recurrence has a significantly poorer prognosis and outcome than late recurrence.Different pathogenesis corresponds to different predictors of the risk of early or late recurrence.An adequate knowledge of predictive factors and recurrence risk stratification guides the therapeutic strategy and post-treatment surveillance.Patients at high risk of HCC recurrence should be referred to treatments with the lowest recurrence rate and when standardized to combined or adjuvant therapy regimens.This review aimed to expose the recurrence predictors and examine the differences between predictors of early and late recurrence.展开更多
Tumor necrosis factor-α(TNF-α)antagonists,the first biologics approved for treating patients with inflammatory bowel disease(IBD),are effective for the induction and maintenance of remission and significantly improv...Tumor necrosis factor-α(TNF-α)antagonists,the first biologics approved for treating patients with inflammatory bowel disease(IBD),are effective for the induction and maintenance of remission and significantly improving prognosis.However,up to one-third of treated patients show primary nonresponse(PNR)to anti-TNF-αtherapies,and 23%-50%of IBD patients experience loss of response(LOR)to these biologics during subsequent treatment.There is still no recognized predictor for evaluating the efficacy of anti-TNF drugs.This review summarizes the existing predictors of PNR and LOR to anti-TNF in IBD patients.Most predictors remain controversial,and only previous surgical history,disease manifestations,drug concentrations,antidrug antibodies,serum albumin,some biologic markers,and some genetic markers may be potentially predictive.In addition,we also discuss the next steps of treatment for patients with PNR or LOR to TNF antagonists.Therapeutic drug monitoring plays an important role in treatment selection.Dose escalation,combination therapy,switching to a different anti-TNF drug,or switching to a biologic with a different mechanism of action can be selected based on the concentration of the drug and/or antidrug antibodies.展开更多
The most critical obstacle for four-wheel independently driven electric vehicles(4WID-EVs)is the driving range.Being the actuators of 4WID-EVs,motors account for its major power consumption.In this sense,by properly d...The most critical obstacle for four-wheel independently driven electric vehicles(4WID-EVs)is the driving range.Being the actuators of 4WID-EVs,motors account for its major power consumption.In this sense,by properly distributing torques to minimize the power consumption,the driving range of 4WID-EV can be effectively improved.This paper proposes a model predictive control(MPC)-based torque distribution scheme,which minimizes the power consumption of 4WID-EVs while guaranteeing its tracking performance of planar motions.By incorporating the motor model considering iron losses,the optimal torque distribution can be achieved without an additional torque controller.Also,for this reason,the proposed control scheme is computationally efficient,since the power consumption term to be optimized,which is expressed as the product of the motor voltages and currents,is much simpler than that derived from the efficiency map.With reasonable simplification and linearization,the MPC problem is converted to a quadratic programming problem,which can be solved efficiently.The simulation results in MATLAB and CarSim co-simulation environments demonstrate that the proposed scheme effectively reduces power consumption with guaranteed tracking performance.展开更多
Background: Cancer patients frequently suffer from mental health problems because of their reactions to their cancer diagnosis, cancer type, treatment effects, recurrence, fear of the end-of-life, survival, and financ...Background: Cancer patients frequently suffer from mental health problems because of their reactions to their cancer diagnosis, cancer type, treatment effects, recurrence, fear of the end-of-life, survival, and financial burden. Some hospitals have integrated mental health assessments into cancer care, but our centre has little experience with this practice. Aim and Objectives: To ascertain the prevalence and predictors of anxiety and depression in patients with gynaecological cancer at a tertiary health facility in southern Nigeria. Materials and Methods: This was a facility-based cross-sectional descriptive study of 75 women with histologically confirmed gynaecological cancer managed at the University of Port Harcourt Teaching Hospital, Port Harcourt, from January 1, 2022, to December 31, 2022. Individuals having a history of drug addiction, severe cognitive impairment, non-consenting patients, and those with communication difficulties were excluded from the study. A data collection form was used to obtain socio-demographic, reproductive, and clinical characteristics, while the Hospital Anxiety and Depression Scale (HADS) was used to assess for anxiety and depression. Data was analyzed using descriptive statistics to determine the association of variables with anxiety and depression. Results: Most 27 (36.0%) of the respondents were in 40 - 49 age group with a mean age of 50.4 ± 12.3 years. The study showed that 39 (52.0%) of the respondents exhibited symptoms of anxiety, of which 14 (35.9%) were mild, 20 (51.3%) had moderate anxiety and 5 (12.8%) experienced severe anxiety. In addition, 46 (61.3%) of them showed symptoms of depression, of which 17 (37.0%) were mild, 15 (32.6%) were moderate and 14 (30.4%) experienced severe depression. The ratio of respondents who showed anxiety to those that showed symptoms of depression was 5: 6. The factors associated with anxiety were partner’s educational level (X<sup>2</sup> = 4.745, p = 0.029), parity (X<sup>2</sup> = 6.651, p = 0.036) and duration of diagnosis (X<sup>2</sup> = 8.321, p = 0.004), while partner’s educational level (X<sup>2</sup> = 6.810, p = 0.009), parity (X<sup>2</sup> = 7.129, p = 0.028), age of coitarche (X<sup>2</sup> = 6.512, p = 0.039) and duration of diagnosis (X<sup>2</sup> = 4.955, p = 0.026) were significantly associated with depression. Conclusion: More than half of the respondents experienced anxiety, while about two-thirds experienced depression. There is a need to incorporate psychological evaluation into the care of gynaecological cancer patients.展开更多
Background: Type 2 diabetes mellitus (T2DM) is currently a major global public health burden associated with elevated blood glucose. The use of herbal medicine in the management of type 2 diabetes is currently on the ...Background: Type 2 diabetes mellitus (T2DM) is currently a major global public health burden associated with elevated blood glucose. The use of herbal medicine in the management of type 2 diabetes is currently on the rise both in developed and developing countries. This study sets out to determine the prevalence of herbal medicine use and to identify the factors associated with herbal medicine use amongst type 2 diabetes patients. Methods: A community based cross-sectional study involves 123 adults living with type 2 diabetes (90 males and 30 females), mean age 58.7 ± 9.5 years in the Bamenda III health district of the North West Region of Cameroon. Data on the different types of herbs used, frequency and mode of herbal medicine use as well as reasons for using herbal medicines in the management of T2DM were assessed using a structured questionnaire. Anthropometric and diabetes related measurements were carried out following standard procedures. Logistic regression analysis was used to identify the independent predictors of herbal medicine use. Results: The prevalence of herbal medicine use was 24.4% (n = 30) amongst which 37.4 % used both herbs and orthodox medicine. A higher proportion of diabetic males used herbal medicines compared to females and this difference was significant (X<sup>2</sup> = 5.243, p X<sup>2</sup> = 10.75, p = 0.005). The most commonly used herbs were Vernonia amygdalina leaves (19.10%), Aloe vera (13.48%), Mangifera indica leaves (11.24%) including its bark and Carica papaya leaves (8.99%). Bivariate analysis indicated that being male (OR 2.8, 95% CI, 1.14 -6.79) and having attained secondary/tertiary education (OR 13.2, 95% CI, 1.6 - 29.9) were significantly (p 0.05) associated with herbal medicine use. Multivariate analysis revealed that having attained secondary /tertiary education (OR 10.5, 95% CI, 1.30 - 35.23) was an independent predictor of herbal medicine use in the study population. Conclusion: This study has demonstrated that amongst T2DM patients in Cameroon having attained secondary/tertiary education positively influences the use of herbal medicine in the management of T2DM.展开更多
Background: Obesity, especially central obesity, is a major risk factor for cardiovascular diseases and type-2 diabetes, known for their significant morbidity and mortality. University students are at increased risk o...Background: Obesity, especially central obesity, is a major risk factor for cardiovascular diseases and type-2 diabetes, known for their significant morbidity and mortality. University students are at increased risk of obesity due to adoption of unhealthy lifestyles and school-related stress. However, there is scant information regarding the prevalence and risk factors of obesity among university students in Kenya. The study aimed to determine the prevalence and factors associated with general and abdominal obesity among undergraduate students of The Catholic University of Eastern Africa, Kenya. Methods: A cross-sectional study design was employed among undergraduate students (n = 245) of The Catholic University of Eastern Africa, Nairobi. A systematic random sampling method was used to select the study participants. Lifestyle risk factors associated with obesity were collected using a structured questionnaire adopted from the WHO STEP-wise approach to non-communicable disease risk factor surveillance. Anthropometric measures of weight, height, and waist circumference were appropriately measured. The data were analyzed using SPSS software (ver: 22). The chi-square test of independence and binary logistic regression was used to establish an association between dependent and independent variables. Results: The prevalence of general and abdominal obesity was 19.6% and 27.8%, respectively. Risk factors of general obesity were age ≥ 20 years (OR, 9.95;95% CI, 3.09 - 32.08, p < 0.001), sedentary lifestyle (OR, 11.36;95% CI, 2.08 - 61.96, p = 0.005), staying with parents (OR, 3.22;95% CI, 1.09 - 9.58, p = 0.035), consumption of fast/processed foods (OR, 7.83;95% CI, 1.90 - 32.21, p = 0.004). Risk factors for abdominal obesity were being female (OR, 38.76;95% CI, 5.07 - 296.54, p < 0.001), staying with parents (OR, 3.02;95% CI, 1.14 - 7.99, p = 0.026) and sedentary lifestyle (OR, 6.55;95% CI, 1.80 - 23.81, p = 0.004). Conclusion: Being female, sedentary lifestyle, and consumption of fast/processed foods were found as predictors of obesity. Behavioural intervention is required to mitigate the burden of obesity among university students in Kenya. This can be achieved through promoting intervention programmes that lead to changing the built environment, counseling, and behavioral-lifestyle modification of students.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
The aim of this paper is to given an algebraic computational method for finding maximal independent sets as well as the independent number of an arbitrary finite graph of n vertices G by strengthening the problem of f...The aim of this paper is to given an algebraic computational method for finding maximal independent sets as well as the independent number of an arbitrary finite graph of n vertices G by strengthening the problem of finding maximal independent sets of G to the problem of finding k-independent sets in G for. It is shown that the existence of k-independent sets in G is equivalent to the existence of solutions of a system of multivariate polynomial equations. It follows that the problem of finding k-independent sets can be realized by using Gröbner bases of polynomial ideals. Since the number of k-independent sets is finite, the triangular equations composed by Gröbner bases are easier to be solved. Consequently, the maximal independent sets and the independent number of G are obtained after solving at most n such equations. Finally, the numerical example is presented to illustrate the effectiveness of this algebraic computational method.展开更多
Background: 25% of all people requiring surgical care are not able to access it due to its high cost. These people stand a high risk of preventable severe morbidity and mortality due to poor prognosis of surgically co...Background: 25% of all people requiring surgical care are not able to access it due to its high cost. These people stand a high risk of preventable severe morbidity and mortality due to poor prognosis of surgically correctable illnesses. Ambulatory surgical care services are significantly cheaper than orthodox surgical care and have become very relevant in this time and age where health conditions that can only be treated with surgical intervention are on the rise. The acceptability of ambulatory surgical care services will determine how this model increases universal health coverage. Objective: To assess the acceptability of ambulatory surgical services and its predictors among residents of Budondo Sub-County—Jinja district. Methods: The study was cross-sectional targeting 371 household heads in Budondo Sub-County, which was stratified by parish, with villages in each randomly sampled. Systematic random sampling was used to sample households and households therein were purposively sampled. Structured interviews and questionnaires were the data collection techniques, and data was analyzed in SPSS version 25 using descriptive statistics and a binomial logit model. Results: The level of acceptability of ambulatory surgical care services among residents of Budondo Sub-County was found to be near-universal, at 96.5%. The odds of accepting ambulatory surgical care were least among household heads who agreed that surgery done in a hospital would be cheaper than surgery done at community level (aOR = 0.174 [CI = 0.055 - 0.553]), those who had health insurance (aOR = 0.105 [95% CI = 0.030 - 0.371]), and household heads who were covered with private health insurance (aOR = 0.078 [95% CI = 0.008 - 0.792]). Acceptability of ASC was higher among household heads who agreed that they would trust ambulatory surgical centers with their life were more likely to accept ambulatory surgical care (aOR = 1.124, [95% CI = 1.122 - 3.218], P = 0.000), and household heads from households that had less than five members with surgery history were twice as likely to accept ambulatory surgical care (aOR = 2.431 [95% CI = 1.122 - 5.898], P = 0.000). Conclusion: Acceptability of ambulatory surgical care services among residents of Budondo Sub-County is high, and near-universal. It is mainly predicted by intrapersonal correlates and to a small extent by socio-demographic characteristics, with the implication that the administration of Global Surgical Initiatives in Kyabirwa ought to focus on modifying or uphold the intrapersonal characteristics found to be antagonists and protagonists of acceptability, respectively.展开更多
Background: The many dangers and stressors associated with police work often place police officers at a great risk of a variety of mental health morbidity, including suicidality. The causation of suicidality is multi-...Background: The many dangers and stressors associated with police work often place police officers at a great risk of a variety of mental health morbidity, including suicidality. The causation of suicidality is multi-dimensional, however, there are insufficient studies which have examined the burden and risk factors of suicidality in Nigerian police officers. Objective: To determine the prevalence and predictors of suicidality among police officers in Lagos, Nigeria. Methods: This was a cross-sectional study of 600 police officers who were selected using a non-probability sampling method. Questionnaires used were: Suicide Behaviour Questionnaire-Revised (SBQ-R), State-Trait Anxiety Inventory (STAI), and a Socio-Demographic Questionnaire. Results: Prevalence of suicidality was 14%, and the predictors of suicidality were: state anxiety (p 0.001), trait anxiety (p 0.001), substance use (p = 0.03), being unmarried (p = 0.03), and female gender (p = 0.02). Conclusion: Suicidality is prevalent among Nigerian police officers, with a higher risk in those who are vulnerable. The creation of government policies and infrastructure which promote mental health in police officers is necessary.展开更多
The robust stability study of the classic Smith predictor-based control system for uncertain fractional-order plants with interval time delays and interval coefficients is the emphasis of this work.Interval uncertaint...The robust stability study of the classic Smith predictor-based control system for uncertain fractional-order plants with interval time delays and interval coefficients is the emphasis of this work.Interval uncertainties are a type of parametric uncertainties that cannot be avoided when modeling real-world plants.Also,in the considered Smith predictor control structure it is supposed that the controller is a fractional-order proportional integral derivative(FOPID)controller.To the best of the authors'knowledge,no method has been developed until now to analyze the robust stability of a Smith predictor based fractional-order control system in the presence of the simultaneous uncertainties in gain,time-constants,and time delay.The three primary contributions of this study are as follows:ⅰ)a set of necessary and sufficient conditions is constructed using a graphical method to examine the robust stability of a Smith predictor-based fractionalorder control system—the proposed method explicitly determines whether or not the FOPID controller can robustly stabilize the Smith predictor-based fractional-order control system;ⅱ)an auxiliary function as a robust stability testing function is presented to reduce the computational complexity of the robust stability analysis;andⅲ)two auxiliary functions are proposed to achieve the control requirements on the disturbance rejection and the noise reduction.Finally,four numerical examples and an experimental verification are presented in this study to demonstrate the efficacy and significance of the suggested technique.展开更多
Convolutional neural networks(CNNs) have been widely studied and found to obtain favorable results in statistical downscaling to derive high-resolution climate variables from large-scale coarse general circulation mod...Convolutional neural networks(CNNs) have been widely studied and found to obtain favorable results in statistical downscaling to derive high-resolution climate variables from large-scale coarse general circulation models(GCMs).However, there is a lack of research exploring the predictor selection for CNN modeling. This paper presents an effective and efficient greedy elimination algorithm to address this problem. The algorithm has three main steps: predictor importance attribution, predictor removal, and CNN retraining, which are performed sequentially and iteratively. The importance of individual predictors is measured by a gradient-based importance metric computed by a CNN backpropagation technique, which was initially proposed for CNN interpretation. The algorithm is tested on the CNN-based statistical downscaling of monthly precipitation with 20 candidate predictors and compared with a correlation analysisbased approach. Linear models are implemented as benchmarks. The experiments illustrate that the predictor selection solution can reduce the number of input predictors by more than half, improve the accuracy of both linear and CNN models,and outperform the correlation analysis method. Although the RMSE(root-mean-square error) is reduced by only 0.8%,only 9 out of 20 predictors are used to build the CNN, and the FLOPs(Floating Point Operations) decrease by 20.4%. The results imply that the algorithm can find subset predictors that correlate more to the monthly precipitation of the target area and seasons in a nonlinear way. It is worth mentioning that the algorithm is compatible with other CNN models with stacked variables as input and has the potential for nonlinear correlation predictor selection.展开更多
文摘Background: The present study was conducted to examine the association between various coronary risk factors and clinical parameters, with special emphasis on ankle-brachial index, in predicting the severity and complexity of coronary artery disease. Methods: Patients diagnosed with coronary artery disease at our hospital between September-2012 and December-2014 were examined in this study. Selected patients were screened for cardiovascular risk factors including diabetes, hypertension, smoking, and alcohol habits as well as for clinical parameters including body-mass index, waist-hip ratio, ankle-brachial index, and ejection fraction. All patients underwent coronary angiography and were evaluated for severity of coronary artery disease (based on number of vessels involved) and complexity of coronary angiographic lesions (measured by computer-assisted Syntax score calculator). The collected data were analyzed to determine the role of cardiovascular risk factors and clinical parameters as predictors of complexity and severity of coronary artery disease. Results: A total of 211 patients (mean age: 54.64 ± 9.9 years;81% males) with coronary artery disease were analyzed. Findings revealed that diabetes mellitus (p < 0.001), hypertension (p < 0.001), smoking habits (p = 0.036), and low ankle-brachial index (p < 0.001) were independent predictors of complex coronary artery disease as measured by Syntax score. Significant associations were also evident between severity of coronary artery disease and diabetes mellitus (p < 0.001), hypertension (p < 0.001), and ankle-brachial index (p < 0.001). Conversely, other cardiovascular risk factors including body-mass index, alcohol habits, wait-hip ratio, and ejection fraction did not exhibit significant associations with severity and complexity of coronary artery. Conclusions: The early diagnosis of coronary artery can be predicated by evaluating diabetes, hypertension, and smoking habits in patients presenting with acute coronary syndrome. In addition, ankle-brachial index can be used as an effective non-invasive bed-side tool, as an alternative to Syntax score, in predicting the severity and complexity of coronary artery disease.
文摘Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Saharan Africa (SSA), AKI is community-acquired occurring in healthy young adults. We aimed to identify predictors of fatal outcomes in patients with AKI in two tertiary hospitals in Cameroon. Methods: Medical records of adults with confirmed AKI, from January 2018 to March 2020 were retrieved. The outcomes of interest were in-hospital deaths and presumed causes of death. We used multiple logistic regressions modeling to identify predictors of death. The study was approved by the ethics boards of both hospitals. Values were considered significant for a p-value of 0.05. Results: We included 285 patient records (37.2% females). The mean (SD) age was 50.1 (19.0) years. Hypertension (n = 97, 34.0%), organ failure (n = 88, 30.9%), and diabetes (n = 60, 21.1%) were the main comorbidities. The majority of patients had community-acquired AKI (78.6%, n = 224), were KDIGO stage 3 (88.8%, n = 253), and needed dialysis (52.6%, n = 150). Up to 16.7% (n = 25) did not receive what was needed. The in-hospital mortality rate was 29.1% (n = 83). Lack of access to dialysis (OR = 27.8;CI: 5.2 - 149.3, p = 0.001), hypotension (OR = 11.8;CI: 1.3 - 24.8;p = 0.001) and ICU admission (OR = 5.7;CI: 1.3 - 24.8, p = 0.001) were predictors of mortality. The presence of co-morbidities or underlying diseases (n = 46, 55%) were the main causes of death. Conclusions: In-hospital AKI mortality is high, as in other low- and middle-income economies. Lack of access to dialysis and the severity of the underlying illness are major predictors of death.
基金Supported by the National Natural Science Foundation of China,No.81800528Natural Science Foundation of Gansu Province,No.20JR5RA364Key Research and Development Project of Gansu Province,No.20YF2FA011。
文摘BACKGROUND Portal vein thrombosis(PVT)is a commonthsn complication after splenectomy in patients with cirrhosis.However,the predictors of postoperative PVT are not known.AIM To investigate the predictors of PVT after splenectomy in patient with cirrhosis.METHODS A total of 45 patients with cirrhosis who underwent splenectomy were consecutively enrolled from January 2017 to December 2018.The incidence of PVT at 1 months,3 months,and 12 months after splenectomy in patients with cirrhosis was observed.The hematological indicators,biochemical and coagulation parameters,and imaging features were recorded at baseline and at each observation point.The univariable,multivariable,receiver operating characteristic curve and timedependent curve analyses were performed.RESULTS The cumulative incidence of PVT was 40.0%,46.6%,and 48.9%at 1 months,3 months,and 12 months after splenectomy.Multivariable analysis showed that portal vein diameter(PVD)≥14.5 mm and monthsdel end-stage liver disease(MELD)score>10 were independent predictors of PVT at 1 months,3 months,and 12 months after splenectomy(P<0.05).Time-dependent curve showed that the cumulative incidence of PVT was significantly different between patients with MELD score≤10 and>10(P<0.05).In addition,the cumulative incidence of PVT in the PVD≥14.5 mm group was significantly higher than that in the PVD<14.5 mm group(P<0.05).CONCLUSION Wider PVD and MELD score>10 were independent predictors of PVT at 1 months,3 months,and 12 months after splenectomy in patient with cirrhosis.
基金Supported by the Open Project Grant for Clinical Medical Center of Yunnan Province,No.2019LCZXKF-NM03Medical Leader Training Grant,No.L-201624and Yunnan Province Ten Thousand Talents:“Medical Expert”grant,No.YNWR-MY-2019-020.
文摘BACKGROUND The lack of specific predictors for type-2 diabetes mellitus(T2DM)severely impacts early intervention/prevention efforts.Elevated branched-chain amino acids(BCAAs:Isoleucine,leucine,valine)and aromatic amino acids(AAAs:Tyrosine,tryptophan,phenylalanine)show high sensitivity and specificity in predicting diabetes in animals and predict T2DM 10-19 years before T2DM onset in clinical studies.However,improvement is needed to support its clinical utility.AIM To evaluate the effects of body mass index(BMI)and sex on BCAAs/AAAs in new-onset T2DM individuals with varying body weight.METHODS Ninety-seven new-onset T2DM patients(<12 mo)differing in BMI[normal weight(NW),n=33,BMI=22.23±1.60;overweight,n=42,BMI=25.9±1.07;obesity(OB),n=22,BMI=31.23±2.31]from the First People’s Hospital of Yunnan Province,Kunming,China,were studied.One-way and 2-way ANOVAs were conducted to determine the effects of BMI and sex on BCAAs/AAAs.RESULTS Fasting serum AAAs,BCAAs,glutamate,and alanine were greater and high-density lipoprotein(HDL)was lower(P<0.05,each)in OB-T2DM patients than in NW-T2DM patients,especially in male OB-T2DM patients.Arginine,histidine,leucine,methionine,and lysine were greater in male patients than in female patients.Moreover,histidine,alanine,glutamate,lysine,valine,methionine,leucine,isoleucine,tyrosine,phenylalanine,and tryptophan were significantly correlated with abdominal adiposity,body weight and BMI,whereas isoleucine,leucine and phenylalanine were negatively correlated with HDL.CONCLUSION Heterogeneously elevated amino acids,especially BCAAs/AAAs,across new-onset T2DM patients in differing BMI categories revealed a potentially skewed prediction of T2DM development.The higher BCAA/AAA levels in obese T2DM patients would support T2DM prediction in obese individuals,whereas the lower levels of BCAAs/AAAs in NW-T2DM individuals may underestimate T2DM risk in NW individuals.This potentially skewed T2DM prediction should be considered when BCAAs/AAAs are to be used as the T2DM predictor.
基金Support for this study was received from Orient Resources Ltd.in Canada,Wuhan Institute of Technology,China,and College of Earth Sciences,Jilin University,China.
文摘By studying the light isotopic compositions of carbon,oxygen,and hydrogen,combined with previous research results on the ore-forming source of the deposit,the authors try to uncover its metallogenic origin.The δ^(18)O and δ^(13)C isotope signatures of dolomite samples vary between 10.2 and 13.0‰,and between−7.2 and−5.2‰,respectively,implying that the carbon derives from the upper mantle.δD and δ^(18) O of quartz,biotite,and muscovite from diff erent ore veins of the deposit vary between−82 and−59‰,and between 11.6 and 12.4‰,respectively,implying that the metallogenic solutions are mainly magmatic.According to the relevant research results of many isotope geologists,the fractionation degree of hydrogen isotopes increases as the depth to the Earth’s core increases,and the more diff erentiated the hydrogen isotopes are,the lower their values will be.In other words,mantle-derived solutions can have extremely low hydrogen isotope values.This means that the δD‰ value−134 of the pyrrhotite sample numbered SD-34 in this article may indicate mantle-derived oreforming fl uid of the deposit.The formation of the Dashuigou tellurium deposit occurred between 91.71 and 80.19 Ma.
文摘This article documents socio-demographic predictors of anxiety and depression among Maasai women in resource poor settings in Northern Kenya.These findings emerged from the findings of a dissertation research that aimed to establish the treatment effectiveness of an eclectic model of psychoeducation(PE)in treating depressive and anxiety symptoms among the women.The study adopted a quasi-experimental research design which had an experimental group(EG)and control group(CG).The population for the study was 686 female members of Conservation Enterprise Groups(CEG)in Laikipia County,from which a sample of 200 were recruited for the study(EG,n=100 and CG,n=100),at 80%power and 30%effective size.The Beck’s Depression Inventory(BDI)and Beck’s Anxiety Inventory(BAI)tools were used to assess the symptoms of depression and anxiety,respectively.The PE was provided as an intervention treatment to the EG at the middle and end of the study,after which the respondents were tested for symptoms of depression.The study established the prevalence of depression as 26.7%and 31.3%for anxiety and disorders,among women in the region.Data was analyzed using SPSS Version 21.0.
文摘The energy norm convergence rate of the finite element solution of the heat equation is reduced by the time-regularity of the exact solution. This paper presents an adaptive finite element treatment of time-dependent singularities on the one-dimensional heat equation. The method is based on a Fourier decomposition of the solution and an extraction formula of the coefficients of the singularities coupled with a predictor-corrector algorithm. The method recovers the optimal convergence rate of the finite element method on a quasi-uniform mesh refinement. Numerical results are carried out to show the efficiency of the method.
基金This study was funded by grants from the Ministry of Science and Technology and the Ministry of Health of the People＇s Republic of China： National Science and Technology Major Project of China （No. 2008ZX09312-008）, the National Science Foundation （No. 81071115）, and the Beijing Science and Technology Committee （No. 7102050）.
文摘Hepatocellular carcinoma(HCC)is the most frequent liver neoplasm,and its incidence rates are constantly increasing.Despite the availability of potentially curative treatments(liver transplantation,surgical resection,thermal ablation),long-term outcomes are affected by a high recurrence rate(up to 70%of cases 5 years after treatment).HCC recurrence within 2 years of treatment is defined as“early”and is generally caused by the occult intrahepatic spread of the primary neoplasm and related to the tumor burden.A recurrence that occurs after 2 years of treatment is defined as“late”and is related to de novo HCC,independent of the primary neoplasm.Early HCC recurrence has a significantly poorer prognosis and outcome than late recurrence.Different pathogenesis corresponds to different predictors of the risk of early or late recurrence.An adequate knowledge of predictive factors and recurrence risk stratification guides the therapeutic strategy and post-treatment surveillance.Patients at high risk of HCC recurrence should be referred to treatments with the lowest recurrence rate and when standardized to combined or adjuvant therapy regimens.This review aimed to expose the recurrence predictors and examine the differences between predictors of early and late recurrence.
文摘Tumor necrosis factor-α(TNF-α)antagonists,the first biologics approved for treating patients with inflammatory bowel disease(IBD),are effective for the induction and maintenance of remission and significantly improving prognosis.However,up to one-third of treated patients show primary nonresponse(PNR)to anti-TNF-αtherapies,and 23%-50%of IBD patients experience loss of response(LOR)to these biologics during subsequent treatment.There is still no recognized predictor for evaluating the efficacy of anti-TNF drugs.This review summarizes the existing predictors of PNR and LOR to anti-TNF in IBD patients.Most predictors remain controversial,and only previous surgical history,disease manifestations,drug concentrations,antidrug antibodies,serum albumin,some biologic markers,and some genetic markers may be potentially predictive.In addition,we also discuss the next steps of treatment for patients with PNR or LOR to TNF antagonists.Therapeutic drug monitoring plays an important role in treatment selection.Dose escalation,combination therapy,switching to a different anti-TNF drug,or switching to a biologic with a different mechanism of action can be selected based on the concentration of the drug and/or antidrug antibodies.
基金supported in part by National Natural Science Foundation of China(NSFC)under Project No.51737010.
文摘The most critical obstacle for four-wheel independently driven electric vehicles(4WID-EVs)is the driving range.Being the actuators of 4WID-EVs,motors account for its major power consumption.In this sense,by properly distributing torques to minimize the power consumption,the driving range of 4WID-EV can be effectively improved.This paper proposes a model predictive control(MPC)-based torque distribution scheme,which minimizes the power consumption of 4WID-EVs while guaranteeing its tracking performance of planar motions.By incorporating the motor model considering iron losses,the optimal torque distribution can be achieved without an additional torque controller.Also,for this reason,the proposed control scheme is computationally efficient,since the power consumption term to be optimized,which is expressed as the product of the motor voltages and currents,is much simpler than that derived from the efficiency map.With reasonable simplification and linearization,the MPC problem is converted to a quadratic programming problem,which can be solved efficiently.The simulation results in MATLAB and CarSim co-simulation environments demonstrate that the proposed scheme effectively reduces power consumption with guaranteed tracking performance.
文摘Background: Cancer patients frequently suffer from mental health problems because of their reactions to their cancer diagnosis, cancer type, treatment effects, recurrence, fear of the end-of-life, survival, and financial burden. Some hospitals have integrated mental health assessments into cancer care, but our centre has little experience with this practice. Aim and Objectives: To ascertain the prevalence and predictors of anxiety and depression in patients with gynaecological cancer at a tertiary health facility in southern Nigeria. Materials and Methods: This was a facility-based cross-sectional descriptive study of 75 women with histologically confirmed gynaecological cancer managed at the University of Port Harcourt Teaching Hospital, Port Harcourt, from January 1, 2022, to December 31, 2022. Individuals having a history of drug addiction, severe cognitive impairment, non-consenting patients, and those with communication difficulties were excluded from the study. A data collection form was used to obtain socio-demographic, reproductive, and clinical characteristics, while the Hospital Anxiety and Depression Scale (HADS) was used to assess for anxiety and depression. Data was analyzed using descriptive statistics to determine the association of variables with anxiety and depression. Results: Most 27 (36.0%) of the respondents were in 40 - 49 age group with a mean age of 50.4 ± 12.3 years. The study showed that 39 (52.0%) of the respondents exhibited symptoms of anxiety, of which 14 (35.9%) were mild, 20 (51.3%) had moderate anxiety and 5 (12.8%) experienced severe anxiety. In addition, 46 (61.3%) of them showed symptoms of depression, of which 17 (37.0%) were mild, 15 (32.6%) were moderate and 14 (30.4%) experienced severe depression. The ratio of respondents who showed anxiety to those that showed symptoms of depression was 5: 6. The factors associated with anxiety were partner’s educational level (X<sup>2</sup> = 4.745, p = 0.029), parity (X<sup>2</sup> = 6.651, p = 0.036) and duration of diagnosis (X<sup>2</sup> = 8.321, p = 0.004), while partner’s educational level (X<sup>2</sup> = 6.810, p = 0.009), parity (X<sup>2</sup> = 7.129, p = 0.028), age of coitarche (X<sup>2</sup> = 6.512, p = 0.039) and duration of diagnosis (X<sup>2</sup> = 4.955, p = 0.026) were significantly associated with depression. Conclusion: More than half of the respondents experienced anxiety, while about two-thirds experienced depression. There is a need to incorporate psychological evaluation into the care of gynaecological cancer patients.
文摘Background: Type 2 diabetes mellitus (T2DM) is currently a major global public health burden associated with elevated blood glucose. The use of herbal medicine in the management of type 2 diabetes is currently on the rise both in developed and developing countries. This study sets out to determine the prevalence of herbal medicine use and to identify the factors associated with herbal medicine use amongst type 2 diabetes patients. Methods: A community based cross-sectional study involves 123 adults living with type 2 diabetes (90 males and 30 females), mean age 58.7 ± 9.5 years in the Bamenda III health district of the North West Region of Cameroon. Data on the different types of herbs used, frequency and mode of herbal medicine use as well as reasons for using herbal medicines in the management of T2DM were assessed using a structured questionnaire. Anthropometric and diabetes related measurements were carried out following standard procedures. Logistic regression analysis was used to identify the independent predictors of herbal medicine use. Results: The prevalence of herbal medicine use was 24.4% (n = 30) amongst which 37.4 % used both herbs and orthodox medicine. A higher proportion of diabetic males used herbal medicines compared to females and this difference was significant (X<sup>2</sup> = 5.243, p X<sup>2</sup> = 10.75, p = 0.005). The most commonly used herbs were Vernonia amygdalina leaves (19.10%), Aloe vera (13.48%), Mangifera indica leaves (11.24%) including its bark and Carica papaya leaves (8.99%). Bivariate analysis indicated that being male (OR 2.8, 95% CI, 1.14 -6.79) and having attained secondary/tertiary education (OR 13.2, 95% CI, 1.6 - 29.9) were significantly (p 0.05) associated with herbal medicine use. Multivariate analysis revealed that having attained secondary /tertiary education (OR 10.5, 95% CI, 1.30 - 35.23) was an independent predictor of herbal medicine use in the study population. Conclusion: This study has demonstrated that amongst T2DM patients in Cameroon having attained secondary/tertiary education positively influences the use of herbal medicine in the management of T2DM.
文摘Background: Obesity, especially central obesity, is a major risk factor for cardiovascular diseases and type-2 diabetes, known for their significant morbidity and mortality. University students are at increased risk of obesity due to adoption of unhealthy lifestyles and school-related stress. However, there is scant information regarding the prevalence and risk factors of obesity among university students in Kenya. The study aimed to determine the prevalence and factors associated with general and abdominal obesity among undergraduate students of The Catholic University of Eastern Africa, Kenya. Methods: A cross-sectional study design was employed among undergraduate students (n = 245) of The Catholic University of Eastern Africa, Nairobi. A systematic random sampling method was used to select the study participants. Lifestyle risk factors associated with obesity were collected using a structured questionnaire adopted from the WHO STEP-wise approach to non-communicable disease risk factor surveillance. Anthropometric measures of weight, height, and waist circumference were appropriately measured. The data were analyzed using SPSS software (ver: 22). The chi-square test of independence and binary logistic regression was used to establish an association between dependent and independent variables. Results: The prevalence of general and abdominal obesity was 19.6% and 27.8%, respectively. Risk factors of general obesity were age ≥ 20 years (OR, 9.95;95% CI, 3.09 - 32.08, p < 0.001), sedentary lifestyle (OR, 11.36;95% CI, 2.08 - 61.96, p = 0.005), staying with parents (OR, 3.22;95% CI, 1.09 - 9.58, p = 0.035), consumption of fast/processed foods (OR, 7.83;95% CI, 1.90 - 32.21, p = 0.004). Risk factors for abdominal obesity were being female (OR, 38.76;95% CI, 5.07 - 296.54, p < 0.001), staying with parents (OR, 3.02;95% CI, 1.14 - 7.99, p = 0.026) and sedentary lifestyle (OR, 6.55;95% CI, 1.80 - 23.81, p = 0.004). Conclusion: Being female, sedentary lifestyle, and consumption of fast/processed foods were found as predictors of obesity. Behavioural intervention is required to mitigate the burden of obesity among university students in Kenya. This can be achieved through promoting intervention programmes that lead to changing the built environment, counseling, and behavioral-lifestyle modification of students.
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The aim of this paper is to given an algebraic computational method for finding maximal independent sets as well as the independent number of an arbitrary finite graph of n vertices G by strengthening the problem of finding maximal independent sets of G to the problem of finding k-independent sets in G for. It is shown that the existence of k-independent sets in G is equivalent to the existence of solutions of a system of multivariate polynomial equations. It follows that the problem of finding k-independent sets can be realized by using Gröbner bases of polynomial ideals. Since the number of k-independent sets is finite, the triangular equations composed by Gröbner bases are easier to be solved. Consequently, the maximal independent sets and the independent number of G are obtained after solving at most n such equations. Finally, the numerical example is presented to illustrate the effectiveness of this algebraic computational method.
文摘Background: 25% of all people requiring surgical care are not able to access it due to its high cost. These people stand a high risk of preventable severe morbidity and mortality due to poor prognosis of surgically correctable illnesses. Ambulatory surgical care services are significantly cheaper than orthodox surgical care and have become very relevant in this time and age where health conditions that can only be treated with surgical intervention are on the rise. The acceptability of ambulatory surgical care services will determine how this model increases universal health coverage. Objective: To assess the acceptability of ambulatory surgical services and its predictors among residents of Budondo Sub-County—Jinja district. Methods: The study was cross-sectional targeting 371 household heads in Budondo Sub-County, which was stratified by parish, with villages in each randomly sampled. Systematic random sampling was used to sample households and households therein were purposively sampled. Structured interviews and questionnaires were the data collection techniques, and data was analyzed in SPSS version 25 using descriptive statistics and a binomial logit model. Results: The level of acceptability of ambulatory surgical care services among residents of Budondo Sub-County was found to be near-universal, at 96.5%. The odds of accepting ambulatory surgical care were least among household heads who agreed that surgery done in a hospital would be cheaper than surgery done at community level (aOR = 0.174 [CI = 0.055 - 0.553]), those who had health insurance (aOR = 0.105 [95% CI = 0.030 - 0.371]), and household heads who were covered with private health insurance (aOR = 0.078 [95% CI = 0.008 - 0.792]). Acceptability of ASC was higher among household heads who agreed that they would trust ambulatory surgical centers with their life were more likely to accept ambulatory surgical care (aOR = 1.124, [95% CI = 1.122 - 3.218], P = 0.000), and household heads from households that had less than five members with surgery history were twice as likely to accept ambulatory surgical care (aOR = 2.431 [95% CI = 1.122 - 5.898], P = 0.000). Conclusion: Acceptability of ambulatory surgical care services among residents of Budondo Sub-County is high, and near-universal. It is mainly predicted by intrapersonal correlates and to a small extent by socio-demographic characteristics, with the implication that the administration of Global Surgical Initiatives in Kyabirwa ought to focus on modifying or uphold the intrapersonal characteristics found to be antagonists and protagonists of acceptability, respectively.
文摘Background: The many dangers and stressors associated with police work often place police officers at a great risk of a variety of mental health morbidity, including suicidality. The causation of suicidality is multi-dimensional, however, there are insufficient studies which have examined the burden and risk factors of suicidality in Nigerian police officers. Objective: To determine the prevalence and predictors of suicidality among police officers in Lagos, Nigeria. Methods: This was a cross-sectional study of 600 police officers who were selected using a non-probability sampling method. Questionnaires used were: Suicide Behaviour Questionnaire-Revised (SBQ-R), State-Trait Anxiety Inventory (STAI), and a Socio-Demographic Questionnaire. Results: Prevalence of suicidality was 14%, and the predictors of suicidality were: state anxiety (p 0.001), trait anxiety (p 0.001), substance use (p = 0.03), being unmarried (p = 0.03), and female gender (p = 0.02). Conclusion: Suicidality is prevalent among Nigerian police officers, with a higher risk in those who are vulnerable. The creation of government policies and infrastructure which promote mental health in police officers is necessary.
基金supported by the Estonian Research Council(PRG658)。
文摘The robust stability study of the classic Smith predictor-based control system for uncertain fractional-order plants with interval time delays and interval coefficients is the emphasis of this work.Interval uncertainties are a type of parametric uncertainties that cannot be avoided when modeling real-world plants.Also,in the considered Smith predictor control structure it is supposed that the controller is a fractional-order proportional integral derivative(FOPID)controller.To the best of the authors'knowledge,no method has been developed until now to analyze the robust stability of a Smith predictor based fractional-order control system in the presence of the simultaneous uncertainties in gain,time-constants,and time delay.The three primary contributions of this study are as follows:ⅰ)a set of necessary and sufficient conditions is constructed using a graphical method to examine the robust stability of a Smith predictor-based fractionalorder control system—the proposed method explicitly determines whether or not the FOPID controller can robustly stabilize the Smith predictor-based fractional-order control system;ⅱ)an auxiliary function as a robust stability testing function is presented to reduce the computational complexity of the robust stability analysis;andⅲ)two auxiliary functions are proposed to achieve the control requirements on the disturbance rejection and the noise reduction.Finally,four numerical examples and an experimental verification are presented in this study to demonstrate the efficacy and significance of the suggested technique.
基金supported by the following grants: National Basic R&D Program of China (2018YFA0606203)Strategic Priority Research Program of Chinese Academy of Sciences (XDA23090102 and XDA20060501)+2 种基金Guangdong Major Project of Basic and Applied Basic Research (2020B0301030004)Special Fund of China Meteorological Administration for Innovation and Development (CXFZ2021J026)Special Fund for Forecasters of China Meteorological Administration (CMAYBY2020094)。
文摘Convolutional neural networks(CNNs) have been widely studied and found to obtain favorable results in statistical downscaling to derive high-resolution climate variables from large-scale coarse general circulation models(GCMs).However, there is a lack of research exploring the predictor selection for CNN modeling. This paper presents an effective and efficient greedy elimination algorithm to address this problem. The algorithm has three main steps: predictor importance attribution, predictor removal, and CNN retraining, which are performed sequentially and iteratively. The importance of individual predictors is measured by a gradient-based importance metric computed by a CNN backpropagation technique, which was initially proposed for CNN interpretation. The algorithm is tested on the CNN-based statistical downscaling of monthly precipitation with 20 candidate predictors and compared with a correlation analysisbased approach. Linear models are implemented as benchmarks. The experiments illustrate that the predictor selection solution can reduce the number of input predictors by more than half, improve the accuracy of both linear and CNN models,and outperform the correlation analysis method. Although the RMSE(root-mean-square error) is reduced by only 0.8%,only 9 out of 20 predictors are used to build the CNN, and the FLOPs(Floating Point Operations) decrease by 20.4%. The results imply that the algorithm can find subset predictors that correlate more to the monthly precipitation of the target area and seasons in a nonlinear way. It is worth mentioning that the algorithm is compatible with other CNN models with stacked variables as input and has the potential for nonlinear correlation predictor selection.
