The Relationship between Father-Love Absence and Loneliness:Based on the Perspective of the Social Functionalist Theory and the Social Needs Theory

Fathers play an important role in adolescents’development,which is significant for their development and influences their mental health,including feeling of loneliness.However,the effects and mechanisms of father-love absence on individual loneliness are not clear.Based on the social functionalist theory and the social needs theory,this study examines the influence of individual fatherlove absence on loneliness and its underlying mechanisms.A questionnaire survey was administered to 319 junior high school students and 1,476 high school students.The results showed that adolescents with father-love absence had higher levels of loneliness,and that father-love absence affected loneliness levels through mediating pathways of individual gratitude,peer relationships,and gratitude to peer relationships.This study not only confirms the negative effects of father-love absence on adolescents’loneliness,but also explains the mediate roles of individual gratitude and peer relationships.It enriches the theoretical system related to family education and has important theoretical and practical implications for further interventions on adolescents’mental health from the perspective of fatherless parenting.

Congenital Absence of Pericardium:The Largest Systematic Review in the Field on 247 Worldwide Cases(1977-Now)

Background:Congenital absence of pericardium(CAP),also known as pericardial agenesis,represents an uncommon cardiac abnormality and mostly incidental finding.It can be subdivided into complete and partial(left or right-sided)forms.Because of its infrequency,just case reports and a few case series have been released so far.This paper represents the largest systematic review in the field.Nine features(age at diagnosis,type,gender,clinical presentation,electrocardiography,imaging(ultrasounds,CT/MRI),concomitant cardiac defects,and outcome)were analysed.Methods:The electronic database PubMed was investigated from its establishment up to July 15th,2023.Just case reports and case series were included.Animal studies,papers that were not in English,Spanish,and Italian,and those manuscripts not reporting at least seven of the nine analysed features.were ruled out.The analysed data were reported mostly in terms of percentage.Results:One hundred eighty studies were included encompassing 247 patients.More than half of reviewed CAP cases were in males(63.2%).The mean age at diagnosis was 31.8±19.3 years;a range of 32 weeks of gestation-81 years).23.5%of the patients did not report any symptoms.The most common clinical presentations were chest pain(35.2%)and dyspnoea(29.2%).The most commonly seen ECG changes were right axis deviation(28.7%)and right bundle branch block(23.9%).CAP was suspected or diagnosed by echocardiography in 20.1%of cases.The diagnosis was made by CT and/or MRI in 61.9%of cases.CAP was left-sided in 71.2%,complete in 23.1%,and right-sided in 5.7%.A concomitant congenital heart defect was found in 22.7%,especially in the form of atrial septal defect(6.5%)and patency of ductus arteriosus(2.8%).The pericardial repair was required in 12.9% of the incomplete forms of the disease.Never did the complete form require surgical correction.The outcome appeared favourable in the vast majority of cases,with just 18 deaths(7.3%).Discussion:The main limitation of this systematic review is that it is based just on case reports and case series,due to the lack of large studies on CAP.However,it represents the largest analysis in the field.Due to the rarity of CAP establishing an International Registry is recommended.

Typical Zollinger-Ellison syndrome-atypical location of gastrinoma and absence of hypergastrinemia:A case report and review of literature

BACKGROUND Zollinger–Ellison syndrome(ZES)results from hypersecretion of gastrin from pancreatic or duodenal neuroendocrine tumors,commonly referred to as gastrinomas.The high levels of gastrin lead to a typical presentation involving watery diarrhea and multiple ulcers in the duodenum.Here,we have presented the rare case of a patient with ZES and absence of hypergastrinemia as well as an atypical location of gastrinoma.CASE SUMMARY A 72-year-old woman presented with the typical clinical manifestations of ZES,including upper abdominal pain,significant watery diarrhea,and acidic liquid vomitus.Surprisingly,however,she did not have an increased level of serum gastrin.In addition,there was no evidence of gastrinoma or any other ulcerogenic tumor.Esophagogastroduodenoscopy was conducted to examine the upper digestive tract.Revised diagnoses were considered,and an individualized treatment plan was developed.The patient responded to antacid medication while experiencing intermittent,recurring bouts of ZES.18F-AlF-NOTAoctreotide positron emission tomography(18F-OC PET)/computed tomography(CT)helped locate the tumor.Postoperative pathology and immunohistochemistry results suggested that the tumor was a gastrinoma located at an unconventional site.CONCLUSION This present case study demonstrates the possibility of ZES-like manifestation in patients with absence of hypergastrinemia.18F-OC PET/CT is a relatively new imaging technique that can be applied for diagnosing even tiny gastrinomas that are atypical in terms of location.

The relationship between age,acceptable noise level,and listening effort in middle-aged and older-aged individuals

Objective:The purpose of the study was to evaluate listening effort in adults who experience varied annoyance towards noise.Materials and methods:Fifty native Kannada-speaking adults aged 41e68 years participated.We evaluated the participant's acceptable noise level while listening to speech.Further,a sentence-final wordidentification and recall test at 0 dB SNR(less favorable condition)and 4 dB SNR(relatively favorable condition)was used to assess listening effort.The repeat and recall scores were obtained for each condition.Results:The regression model revealed that the listening effort increased by 0.6%at 0 dB SNR and by 0.5%at 4 dB SNR with every one-year advancement in age.Listening effort increased by 0.9%at 0 dB SNR and by 0.7%at 4 dB SNR with every one dB change in the value of Acceptable Noise Level(ANL).At 0 dB SNR and 4 dB SNR,a moderate and mild negative correlation was noted respectively between listening effort and annoyance towards noise when the factor age was controlled.Conclusion:Listening effort increases with age,and its effect is more in less favorable than in relatively favorable conditions.However,if the annoyance towards noise was controlled,the impact of age on listening effort was reduced.Listening effort correlated with the level of annoyance once the age effect was controlled.Furthermore,the listening effort was predicted from the ANL to a moderate degree.

Coverage and Factors Associated with Acceptance and Satisfaction of Seasonal Malaria Chemoprevention in Six Health Zones in Benin

Introduction: Seasonal malaria chemoprevention (SMC) was adopted in 2019 in two health zones in Benin where malaria transmission is very high. Positive results led to the extension of the intervention to other zones with additional financial support. Annual SMC campaigns from 2021 to 2023 were carried out in all six health zones in the Atacora and Alibori departments. In five years of implementation, various approaches have been developed on the basis of a communication plan facilitating buy-in and acceptance by all stakeholders. The aim of this study was to assess the effective coverage and acceptance of the SMC by their beneficiary populations in 2023. Methods: It was a cross-sectional study with an analytical focus. Data collection took place from November 30 to December 13, 2023. The study population consisted of children under 5 years of age residing in the departments of Atacora and Alibori in northern Benin. A total of 3573 children under 5 years of age were included in the study, and their parents or guardians were interviewed. Results: During the 2023 campaign, 87.7% of targets were reached by SMC administration and 100.00% of children had received at least one dose of SMC by the fourth visit. Effective therapeutic coverage of SMC was 70.55%, with 99.60% in BNK, 69.40% in KGS, 16.20% in MK, 56.10% in 2KP, 92.40% in NBT and 89.60% in TMC. This coverage was statistically related to child and respondent ages (p Conclusion: SMC is a strategy accepted by the population, and the main reasons for non-participation in SMC were dominated by the absence of mothers or babysitters when the agents visited.

Acceptance and Experience of HIV-Infected Adolescents in Two Hospitals in Yaoundé

Introduction: Access to antiretroviral drugs has improved the survival of children infected with the Human Immunodeficiency Virus (HIV). As they reach adolescence, they are confronted with various constraints related to the infection and its treatment, in addition to those of the growth period they are going through. The main aim of the study was to assess the acceptance and describe the experience of HIV infection by infected adolescents but also to investigate the factors associated with good acceptance and a positive experience. Methodology: The cross-sectional analytic study concerned HIV-infected adolescents aged 15 to 19 followed up at the Chantal Biya Foundation-Mother and Child Centre (CME-FCB) and the Yaoundé University Hospital Centre (CHUY) between February 2020 and June 2020. The study saw participants complete a questionnaire containing socio-demographic data and assessing acceptance and experience with the infection. Data analysis was accomplished using Epi info software version 7.2.2.6. Results: One hundred and thirteen HIV-infected adolescents were included in the study. The sex ratio was 0.68 and the mean age was 17 years. More than half of the adolescents had a good acceptance and positive experience with the infection. Related factors were the adolescent’s perception of good health and participation in an association with other infected adolescents. Conclusion: Emphasizing the psychological and educational follow-up of infected adolescents and encouraging their participation in associations for adolescents living with HIV could reduce the consequences of poor acceptance and ensure a better transition to adulthood. .

Acceptability of Caesarean Section among Pregnant Women Seeking Antenatal Care at Women and Newborn Hospital-University Teaching Hospitals, Lusaka Zambia

Caesarean section remains one of the most common obstetric and major operations performed on women during pregnancy and has contributed to improving maternal and foetal health. Consequently, significant mortality and morbidity from pregnancy and labour-related causes can be eliminated by a timely caesarean section. The acceptance of the life-saving procedure remains unsatisfactory in most sub-Saharan nations. The study aimed to assess the acceptability of caesarean section and associated factors among pregnant women seeking antenatal care at Women and Newborn Hospital-University Teaching Hospitals in Lusaka Zambia. The study utilised a quantitative cross-sectional analytical study design involving 420 pregnant women selected using systematic random sampling at Women and Newborn Hospital-University Teaching Hospitals Lusaka Zambia. Data was obtained using an Interview schedule and analysed using R software version 4.3.2. Chi-square, Fisher’s exact test, Wilcoxon rank sum test and binary logistic regression for statistical analysis at a 5% level of significance. The study found that the acceptability of Caesarean section as a mode of delivery was low (29%) among respondents at Women and Newborn Hospital-University Teaching Hospitals. This was influenced by marital status (P = 0.002), socioeconomic status (P = 0.050), parity (P = 0.004), gestation age (P = 0.008), previous history of caesarean section (P = 0.003), knowledge (P < 0.001), attitude (P < 0.001), and sociocultural beliefs (P = 0.045). Low acceptability of Caesarean section delivery is common among women at Women and Newborn Hospital-University Teaching Hospitals, despite its potential benefits for maternal and neonatal health. Socio-demographic and maternal characteristics, knowledge, attitude, perception, and socio-cultural beliefs play a major role in determining acceptability. Therefore, efforts to enhance acceptability should focus on improving knowledge, enhancing positive perceptions and attitudes, and allaying negative socio-cultural beliefs towards caesarean section.

Monitor and Acceptance among Couples in Romantic Relationships:Actor-Partner Interdependence Models Based on the Monitor and Acceptance Theory

Communication could be an essential part of couples in their daily life.Based on Monitor and Acceptance Theory(MAT),the present study explored the mediating role of communication in the relationship between mindfulness and relationship quality among college-student couples.The research examined the dynamic relationship of monitoring and acceptance to relationship satisfaction in the Actor-Partner Interdependence Model(APIM),and the mediating effect of positive or negative communications in these relationships.A total of 96 pairs of couples in the universities in Nanjing,China participated in the research.Momentary measurements were used to measure the momentary levels of their monitor,acceptance,positive/negative communication,and relationship satisfaction.A Hierarchical Linear Model(HLM)was used to deal with the APIM.Results showed that the women’s monitor facet of state mindfulness negatively predicted men’s relationship satisfaction through women’s negative communication,and the women’s acceptance facet of state mindfulness positively predicted women’s relationship satisfaction through women’s positive and negative communication at the within-person level.The study highlights the importance of cooperation in monitoring and acceptance for couples to own and hold high levels of relationship satisfaction.

COVID-19 Vaccine Acceptance and Hesitancy among Pregnant Women: A Knowledge, Attitude, and Perceived Risks Survey in Lusaka, Zambia

Introduction: The coronavirus disease 2019 (COVID-19) is an infectious disease of the respiratory tract caused by SARS-CoV-2. Since its emergence, there have been increased rates of transmission and spread, morbidity and mortality which led to the development of COVID-19 vaccines to address the pandemic. This study assessed acceptance, knowledge, attitude, and perceived risks regarding COVID-19 vaccines among pregnant women attending antenatal care at two First-Level Hospitals in Lusaka, Zambia. Materials and Methods: This was a cross-sectional study that was conducted among 241 pregnant women using a questionnaire from August 2023 to October 2023 in two First-Level Hospitals in Lusaka district, Zambia. The collected data were analyzed using IBM Statistical Package for Social Sciences (SPSS) version 22.0. Statistical analysis was performed using a Chi-square test. The statistical significance was set at a 95% confidence level. Results: Of the 241 participants, 107 (42.7%) were aged between 24 and 34 years. Overall, 64.3% accepted the COVID-19 vaccines, of which 122 (50.6%) were already vaccinated. Further, 203 (84.6%) of the pregnant women had good knowledge, and 199 (82.6%) had positive attitudes towards COVID-19 vaccines. However, 58.5% thought COVID-19 vaccines were not safe and could cause infertility. Alongside this, 70.1% thought that COVID-19 vaccines were harmful during pregnancy. Having good knowledge of COVID-19 vaccines was associated with age (p = 0.049), education status (p = 0.001), and employment status (p = 0.001). Having a positive attitude towards COVID-19 vaccines was associated with education status (p = 0.001) and employment status (p = 0.001). Conclusion: This study found that most pregnant women had good knowledge, and positive attitudes, and the majority accepted the COVID-19 vaccine. Encouragingly, most of the pregnant women who accepted the COVID-19 vaccines were already vaccinated. Most pregnant women thought that COVID-19 vaccines had side effects, were not safe, and could be harmful during pregnancy. Consequently, this could have contributed to the hesitancy to receive a vaccine among some participants. The findings of this study demonstrate the need to provide pregnant women with continuous educational programs on the benefits of vaccinations for themselves and their children.

Status Quo of Acceptance of Illness among Reproductive Age Cervical Cancer Patients and Its Influencing Factors

Objective: To explore the status quo of acceptance of illness among reproductive-age cervical cancer patients and its influencing factors, to provide a theoretical basis for the implementation of targeted interventions. Methods: The convenience sampling method was used to investigate 256 reproductive-age cervical cancer patients using the general information questionnaire, Acceptance of Illness Scale, Reproductive Concerns After Cancer Scale, and Medical Coping Style Scale. Results: The total score of the acceptance of illness was (18.03 ± 3.24), and reproductive concerns were (57.02 ± 6.30), among reproductive-age cervical cancer patients. Multivariate analysis showed that age, number of children, income level, treatment method, level of reproductive concerns, and the yield and avoidance dimensions of medical coping style were the main influencing factors on patients’ level of illness acceptance (all P Conclusion: The acceptance of illness levels in reproductive-age cervical cancer patients was low to intermediate, and medical staff should timely identify high-risk groups and take preventive management measures based on influencing factors.

Design of a large momentum acceptance proton therapy gantry utilizing AG-CCT magnets

The application of superconducting(SC)technology enables magnets to excite strong fields with small footprints,which has great potential for miniaturizing proton therapy gantries.However,the slow ramping rate of SC magnets results in a low treatment efficiency compared with normal-conducting(NC)gantries.To address this problem,this study proposes a compact proton therapy gantry design with a large momentum acceptance utilizing alternating-gradient canted-cosine-theta(AG-CCT)SC magnets.In our design,a high-transmission degrader is mounted in the middle of the gantry,and the upstream beamline employs NC magnets with small apertures.Downstream of the degrader,large-bore AG-CCT magnets with strong alternating focusing gradients are set symmetrically as a local achromat,which realizes a momentum acceptance of 20%(or 40%in the energy domain).Therefore,only three magnetic working points are required to cover a treatment energy of 70-230 Me V.Owing to the large momentum acceptance,the proton beam after the degrader can be directly delivered to the isocenter without truncating its energy spectrum,which can significantly increase the treatment efficiency but causes severe dispersion effects during pencil beam scanning.Therefore,a compensation method was introduced by tuning the normal and skewed quadrupoles during the scanning process.As a result,the new gantry not only presents a remarkable reduction in the size and weight of the facility but also shows good potential for fast treatment.

Acceptability of Kangaroo Mother Care (KMC) by Mothers with Low-Birth-Weight Babies at Arthur Davison Children’s Hospital, in Ndola, Zambia

Background: Kangaroo Mother Care is a simple safe method used to care for low-birth-weight babies. Low-birth-weight is a global public health issue that pose significant challenge to perinatal care systems. Globally, complications due to low-birth-weight are the leading cause of neonatal mortality, resulting in an estimated 1 million deaths annually. Kangaroo Mother Care (KMC) is a low-cost method of care for low-birth-weight infants in areas with inadequate incubators and power outages with positive outcomes. Objectives: To assess factors influencing acceptability of Kangaroo Mother Care (KMC) in NICU at Arthur Davison Children’s Hospital in Ndola, Zambia. Methodology: A cross sectional quantitative analytical study design was used. The study was conducted at Arthur Davison Children’s Hospital (ADCH) in Ndola, Zambia. The purposive sampling method was used to select the study participants and a total of 129 mothers with Low Weight Babies A were selected to participate structured closed ended questionnaire was used to collect data from the participants using an interview. Data was analyzed using a Statistical Package for Social Scientists (SPSS) software version 26. Cross tabulations were done to determine association of variables using a Chi square (x2) test at 95% confidence interval and were assumptions where not met, fishers exact test was used. Multivariate binary logistic regression analysis was used to quantify the relationship between the dependent and independent variables. Results: Most of the respondents had male babies 77%, 69% of the babies weighed 1000 g - 1400 g, majority 79% had normal delivery, 71% of the respondents were multigravida and most of the respondents 79% were married. The study reviewed that 85% of those who attained secondary education accepted KMC, 74% of the respondents without monthly income accepted KMC, 80% of the respondents had positive attitude and accepted KMC. 82% of the respondents who had positive perception accepted KMC. Conclusion: Acceptance of Kangaroo Mother Care (KMC) among 75% of the mothers underscores its widespread favourability as a beneficial method for infant care.

Market Research on College Students' Acceptance of Prepared Dishes

With the accelerated pace of life and the demand for dietary diversification,more and more people begin to pay attention to the convenience and health of diet,and the prepared dishes market is getting more and more attention and favor because of its characteristics of convenient and quick.In order to understand the acceptance of college students' to the prepared dishes market,this paper aimed to collect college students' views and suggestions on the prepared dishes market by means of a questionnaire survey.By analyzing the results of the survey,we found that college students' generally have a positive attitude towards prepared dishes markets,and they believe that prepared dishes provides convenient,fast and diversified dietary choices.However,some college students' have some concerns about the quality and food safety of the prepared dishes market,such as adding too many food additives and preservatives.Through the research on college students' acceptance of the prepared dishes market,we can reveal the demand and potential problems of college students' for the prepared dishes market from the consumer s point of view,so as to provide a reference for the future development of the prepared dishes market.

Acceptance of COVID-19 vaccine and its related determinants in Nigeria:An online survey

BACKGROUND Vaccine hesitancy is a major challenge in the fight against the coronavirus disease 2019(COVID-19)pandemic.Identifying the sociodemographic factors associated with vaccine acceptance among Nigerians is crucial for improving vaccine uptake.AIM To assess the acceptance rate of COVID-19 vaccine and its related determinants among Nigerians.METHODS An online cross-sectional survey(observational study)was conducted between February 2021 and May 2021,using a questionnaire hosted on SurveyMonkey.The invitation to take part in the poll was sent out to participants through social networking platforms.A logistic regression was used to determine which sociodemographic factors were associated with vaccine acceptance constructs.RESULTS A total of 1800 persons responded to the survey,a larger proportion of whom were males(53.9%)and within the age group of 21-30 years(29.4%)and earned an average income of less than$500 per month(43.3%).Only 0.56%of participants had a high perceived risk of COVID-19 infection,while only 1.11%had a perceived risk of dying from COVID-19.The perception rate of the COVID-19 vaccine among participants was 51.1%,while the acceptance rate was 63.9%.There was no significant association between the COVID-19 vaccine acceptance rate and related determinants assessed,particularly age(χ²=3.049,P=0.550),sex(χ²=0.102,P=0.749),average income(χ²=3.802,P=0.875),and religion(χ²=2.819,P=0.420).Participants with chronic conditions demonstrated a higher acceptance rate compared to the general population.CONCLUSION Despite the positive perception observed and substantial vaccine acceptance rate among the study participants,more public health interventions are still needed to enhance vaccine acceptability in Nigeria.

The Dissemination, Acceptance and Evolution of The Romance of the Three Kingdoms in Japan

As one of the Four Great Masterpieces of China,The Romance of the Three Kingdoms has become a landmark of ancient Chinese literature with vivid and profound character images,ups and downs of politics and war descriptions,and appealing historical plots.After being introduced to Japan in the second half of the 17th century,it was spread in Japanese society and was accepted for literary value,social needs and other reasons,then a series of evolutions were produced by combining with local culture,eventually becoming a national culture in Japan.This paper selects the most popular text of The Romance of the Three Kingdoms with 24 chapters and 120 verses in the Wanli period of the Ming Dynasty,and the Japanese translation of The Popular Romance of the Three Kingdoms published by Hunan Wenshan in 1689 as the objects,guided by Ralph Linton’s“Manifestation,Selection,Integration”cultural communication research method,to analyze the dissemination,acceptance and evolution of The Romance of the Three Kingdoms in 17-20 centuries’Japan,which started from the field of literature,then combined with various cultural forms and spread to the civic class,and finally entered politics area and produced a series of evolutions under the influence of Japanese values to become the representative culture of Japan.This paper suggests that in today’s world of frequent cultural exchanges,China should,based on strengthening cultural self-confidence,actively and appropriately select and accept foreign cultures with the attitude of prioritizing our own culture and utilizing foreign culture for our own purposes.The research outcome can provide experience for the current Chinese culture to go to the world with high quality.

On the Dissemination and Acceptance of Dongpo Culture in the UK and the US

This study delves into the intricate dissemination and acceptance of Dongpo Culture,epitomized by Su Shi,in the UK and the US,aiming to bolster the global recognition of Chinese literary and cultural values and advance the national strategy of“Going Out”.Su Shi’s multifaceted contributions—spanning literature,philosophy,calligraphy,and art—serve as a pinnacle of Northern Song Dynasty culture.This research evaluates the varied translations,monographs,biographies,journal articles,and doctoral dissertations about Su Shi in these Western nations,using literature analysis,typical analysis,and comparative methods.The findings reveal a robust interest in Su Shi studies in the US,marked by a proliferation of scholarly works and translations across diverse disciplines,such as literature,art,and aesthetics,establishing the US as a leading center for Dongpo Culture studies.Conversely,the UK,despite its early engagement,shows limited scholarly outputs and significant research papers on the subject.By examining Dongpo Culture’s overseas communication path and influence paradigm,this paper seeks to enhance China’s cultural soft power and self-confidence.It underscores the vital role of international cultural exchange in constructing a positive image of China’s national identity,facilitating its peaceful rise,and providing strategic insights for the global promotion of Chinese culture.

Applying the Technology Acceptance Model (TAM) in Information Technology System to Evaluate the Adoption of Decision Support System

With the beginning of the information systems’ spreading, people started thinking about using them for making business decisions. Computer technology solutions, such as the Decision Support System, make the decision-making process less complex and simpler for problem-solving. In order to make a high-quality business decision, managers need to have a great deal of appropriate information. Nonetheless, this complicates the process of making appropriate decisions. In a situation like that, the possibility of using DSS is quite logical. The aim of this paper is to find out the intended use of DSS for medium and large business organizations in USA by applying the Technology Acceptance Model (TAM). Different models were developed in order to understand and predict the use of information systems, but the information systems community mostly used TAM to ensure this issue. The purpose of the research model is to determine the elements of analysis that contribute to these results. The sample for the research consisted of the target group that was supposed to have completed an online questionnaire about the manager’s use of DSS in medium and large American companies. The information obtained from the questionnaires was analyzed through the SPSS statistical software. The research has indicated that, this is primarily used due to a significant level of Perceived usefulness and For the Perceived ease of use.

A study of current status of acceptance and influencing factors of advance care planning for patients with malignant tumors

Objective:To assess the ACP acceptance among patients with malignant tumor in China and factors affecting adoption and timing.Methods:Quantitative study:The convenience sampling method was adopted from October 2020 to October 2021 to investigate 200 oncology patients by a general information questionnaire,patient's advance care planning acceptance questionnaire(ACPQ).Multiple linear stepwise regression was used to analyze the influencing factors of ACP acceptance.Qualitative study:A purposive sampling method was used to select 31 oncology patients and 13 clinical nurses for semi-structured interviews.The data were analyzed using Colaizzi's seven steps.Results:The quantitative study revealed that patients with malignancy had an upper-middle acceptance score of(66.15±7.684)for ACP,with attitude(11.26±2.064),feelings(36.64±4.208),and intention(18.25±3.275)scores.Multiple linear regression analysis showed that religious beliefs,education,monthly income,bereavement experience and notification of condition were independent risk factors for acceptance of ACP(P<0.05).The qualitative study showed that(1)oncology patients have low awareness,high demand,and low acceptability of ACP intervention;(2)they preferred to discuss ACP when medical condition or treatment plan changes;(3)family members were usually involved in ACP discussions,followed by medical personnel;(4)economy,environment,companion,and doctor-patient relationship will all influence ACP implementation.As for nurses,they(1)were unsure about the dynamic changes of ACP content and its optimal timing;(2)had limited ACP knowledge;(3)were affected by environmental factors and nurse-patient relationships;(4)were prone to have disagreements due to inadequate organization department assistance.Conclusions:clinical practitioners should discuss ACP with patients in specific conditions to increase patient acceptance.ACP development requires updated legislation,professional training,and a standardized ACP system.

Exploration of University English Teachers’Acceptance and Willingness to Use Learning Management System Data Analysis Tools

This study investigates university English teachers’acceptance and willingness to use learning management system(LMS)data analysis tools in their teaching practices.The research employs a mixed-method approach,combining quantitative surveys and qualitative interviews to understand teachers’perceptions and attitudes,and the factors influencing their adoption of LMS data analysis tools.The findings reveal that perceived usefulness,perceived ease of use,technical literacy,organizational support,and data privacy concerns significantly impact teachers’willingness to use these tools.Based on these insights,the study offers practical recommendations for educational institutions to enhance the effective adoption of LMS data analysis tools in English language teaching.

Diagnostic value of gamma-glutamyltransferase/aspartate aminotransferase ratio, protein induced by vitamin K absence or antagonist II, and alpha-fetoprotein in hepatitis B virus-related hepatocellular carcinoma

BACKGROUND Researchers have investigated the diagnostic value of protein induced by vitamin K absence or antagonist II (PIVKA-II) and alpha-fetoprotein (AFP) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC), and obtained abundant clinical diagnostic data. However, PIVKA-II and AFP have unsatisfactory specificity and sensitivity in the diagnosis of early-stage HBV-related HCC. Gamma-glutamyltransferase (γ-GT) and aspartate aminotransferase (AST) are common biomarkers for evaluating liver function, and we hypothesized that the γ-GT/AST ratio in combination with PIVKA-II and AFP would improve the diagnosis of early-stage HBV-related HCC. AIM To evaluate the diagnostic value of γ-GT/AST ratio alone or in combination with PIVKA-II and AFP in HBV-related HCC. METHODS Serum levels of γ-GT, AST, PIVKA-II, and AFP were detected and analysed in 176 patients with HBV-related HCC and in 359 patients with chronic hepatitis B. According to tumour size and serum level of HBV DNA, HBV-related HCC patients were divided into the following categories: Early-stage HCC patients, HCC patients, HBV DNA positive (HBV DNA+) HCC patients, and HBV DNA negative (HBV DNA-) HCC patients. Receiver-operating characteristic (ROC) curves were used to analyse and compare the diagnostic value of the single and combined detection of various biomarkers in different types of HBV-related HCC. RESULTS Tumour size was positively correlated with serum levels of PIVKA-II and AFP in HCC patients (r = 0.529, aP < 0.001 and r = 0.270, bP < 0.001, respectively), but there was no correlation between tumour size and the γ-GT/AST ratio (r = 0.073, P = 0.336). The areas under the receiver-operating characteristic curves (AUROCs) of the γ-GT/AST ratio in early-stage HCC patients, HBV DNA+ HCC patients and HBV DNA- HCC patients were not significantly different from that in the total HCC patients (0.754, 0.802, and 0.705 vs 0.779, respectively;P > 0.05). When PIVKA-II was combined with the γ-GT/AST ratio in the diagnosis of earlystage HCC, HCC, and HBV DNA+ HCC, the AUROCs of PIVKA-II increased, with values of 0.857 vs 0.835, 0.925 vs 0.913, and 0.958 vs 0.954, respectively. When AFP was combined with the γ-GT/AST ratio in the diagnosis of early-stage HCC, HCC, HBV DNA+ HCC, and HBV DNA- HCC, the AUROCs of AFP increased, with values of 0.757 vs 0.621, 0.837 vs 0.744, 0.868 vs 0.757, and 0.840 vs 0.828, respectively. CONCLUSION The γ-GT/AST ratio may be better than PIVKA-II and AFP in the diagnosis of early-stage HBV-related HCC, and its combination with PIVKA-II and AFP can improve the diagnostic value for HBV-related HCC.