Cervical cancer is a form of malignant tumor that seriously threatens women’s health. In China,according to the cancer statistics, 98,900 new cervical cancer cases and 30,500 deaths due to cervical cancer were estima...Cervical cancer is a form of malignant tumor that seriously threatens women’s health. In China,according to the cancer statistics, 98,900 new cervical cancer cases and 30,500 deaths due to cervical cancer were estimated to have occurred in2015, and the incidence and mortality rates still exhibited an upward trend[1].展开更多
Exercise is an essential element in managing several of the non-communicable diseases after spinal cord injury(SCI).Awareness of the importance of prescribing a customized exercise program that meets the goals of pers...Exercise is an essential element in managing several of the non-communicable diseases after spinal cord injury(SCI).Awareness of the importance of prescribing a customized exercise program that meets the goals of persons with SCI should be highly considered in the rehabilitation community.The barriers of implementing specific exercise program as well as the factors that may mask the outcomes of regular exercise regimen need to be continuously addressed as a part of patients’rehabilitation care.The focus of this editorial is to encourage the medical community to consider routine physical activity as one of the necessary vital signs that needs to be routinely checked in patients with SCI.Providing education tips,nutritional counseling and engaging in recreational programs may provide motivational route to the community of SCI.This may result in reinforcing active lifestyle in survivors with SCI as well as to reduce the impact of chronic life threatening medical disorders.展开更多
Rationale:Rabies is a zoonotic disease with a high mortality,primarily transmitted through the bite of infected mammals,particularly dogs and cats.Despite being a well-known disease since ancient times,it continues to...Rationale:Rabies is a zoonotic disease with a high mortality,primarily transmitted through the bite of infected mammals,particularly dogs and cats.Despite being a well-known disease since ancient times,it continues to cause a significant number of human deaths worldwide,with approximately 65000 fatalities reported annually.Patient concerns:We present two fatal cases of rabies in a 12-year-old immigrant boy and a 7-year-old boy.The first case was subject to a 24-hour delay in receiving appropriate medical attention and rabies preventive measures due to the lack of awareness among emergency hospital staff,leading to the administration of wound dressing only.The second case received timely rabies immunoglobulin administration;however,there was a 4-day delay in administering the fourth dose of the rabies vaccine,despite presenting evident symptoms of rabies.Diagnosis:Postmortem examination of brain samples from both patients confirmed the presence of rabies virus.Interventions:Post-exposure prophylaxis for rabies.Outcomes:Both patients were admitted to the hospital after the manifestation of rabies-related symptoms,with the 12-year-old child seeking medical care 47 days after the animal bite and the 7-year-old child seeking medical care 58 days after the exposure.Finally,the first patient died after 27 days and the second patient died after 40 days of hospitalization.Lessons:There is an urgent need for heightened awareness and education among both healthcare professionals and the public regarding the urgency of seeking immediate medical attention after potential rabies exposure.Timely recognition and initiation of post-exposure prophylaxis are pivotal in preventing the progression of the disease.Strengthening surveillance and reporting systems,coupled with continuous training for healthcare professionals,can contribute to early detection and management of rabies cases.展开更多
AIM: To investigate knee awareness and functional outcomes in patients treated with simultaneous bilateral vs unilateral total knee arthroplasty(TKA).METHODS: Through a database search, we identified 210 patients who ...AIM: To investigate knee awareness and functional outcomes in patients treated with simultaneous bilateral vs unilateral total knee arthroplasty(TKA).METHODS: Through a database search, we identified 210 patients who had undergone unilateral TKA(UTKA) and 65 patients who had undergone simultaneous bilateral TKA(SBTKA) at our institution between 2010 and 2012. All TKAs were cemented and cruciate retaining. The mean follow-up period was 3.2(2 to 4) years. All the patients had symptomatic and debilitating unilateral or bilateral osteoarthritis for which all conservative and non-surgical treatments were failed, thus preoperatively the patients had poor functionality. All patients were asked to complete Forgotten Joint Score(FJS) and Oxford Knee Score(OKS) questionnaires. The patients were matched according to age, gender, year of surgery, Kellgren-Lawrence score and pre- andpostoperative overall knee alignment. The FJS and OKS questionnaire results of the two groups were then compared. RESULTS: A mixed-effects model was used to analyze differences between SBTKA and UTKA. OKS: The mean difference in the OKS between the patients who had undergone SBTKA and those who had undergone UTKA was 1.5, which was not statistically significant(CI =-0.9:4.0, P-value = 0.228). The mean OKS of the SBTKA patients was 37.6(SD = 9.0), and the mean OKS of the UTKA patients was 36.1(SD = 9.9). FJS: The mean difference in the FJS between the patients who had undergone SBTKA and those who had undergone UTKA was 2.3, which was not statistically significant(CI =-6.2:10.8, P-value = 0.593). The mean FJS of the SBTKA patients was 59.9(SD = 27.5), and the mean FJS of the UTKA patients was 57.5(SD = 28.8). CONCLUSION: SBTKA and UTKA patients exhibited similar joint functionality and knee awareness. Our results support the use of SBTKA in selected patients suffering from clinically symptomatic bilateral osteoarthritis.展开更多
<strong>Background: </strong>This study aims to evaluate the infertility reflection in early pregnancy after assistive reproductive therapy (ART), including 1) process evaluation (the use and evaluation of...<strong>Background: </strong>This study aims to evaluate the infertility reflection in early pregnancy after assistive reproductive therapy (ART), including 1) process evaluation (the use and evaluation of infertility reflection) and 2) outcome evaluation (satisfaction of care needs, anticipatory anxiety towards the loss of a pregnancy or fetus, cognition of infertility experience, and depression and anxiety). <strong>Methods: </strong>This program evaluation study used a one-group pre-post-test design. The participants were 50 primiparas who had undergone ART at two fertility treatment facilities in a metropolitan area in Japan. For the infertility reflection, they conducted an online reflection. Data were collected three times: at the 5th week of pregnancy (Time 1), the 8th week of pregnancy as the final consultation at the clinic (Time 2), and the 16th week of pregnancy as the final point of early pregnancy (Time 3). <strong>Results: </strong>The data from 40 participants were analyzed. More than 80% of the users of the online reflection positively evaluated the appropriateness and usefulness of the methods and contents. Organized thoughts and feelings by reflection were shown as the reasons for the usefulness. The evaluation of the online reflection showed a relatively strong correlation with the Care Need Satisfaction Scale (CNSS) for both Time 2 and Time 3, but the online reflection did not show a significant correlation with the other outcome variables. There were no significant differences in outcome variables between users and non-users of online reflection between Time 2 and Time 3. <strong>Conclusions:</strong> Attempts at the reflection in early pregnancy require modified methods that do not have a negative impact and lead to the fulfillment of needs.展开更多
<b>Background:</b> Accidental awareness during general anesthesia (AAGA) is an uncommon condition with possible long-term sequela. Here, we identify and describe a case of awareness in the perioperative se...<b>Background:</b> Accidental awareness during general anesthesia (AAGA) is an uncommon condition with possible long-term sequela. Here, we identify and describe a case of awareness in the perioperative setting and the resulting sequelae of symptoms consistent with post-traumatic stress disorder using the first-hand experience of a patient with awareness during anesthesia. <b>Aim:</b> This case report aims to identify and describe the symptomatic sequelae of perioperative awareness events and the importance of close patient follow-up and management. <b>Case Presentation:</b> A 34-year-old female developed uncontrolled tonsillar hemorrhage 2 days after successful adenotonsillectomy that necessitated bedside intubation. During regular clinic follow-up, the patient presented with symptoms suggestive of post-traumatic stress disorder (PTSD) secondary to recall events while under anesthesia. <b>Conclusion:</b> The contributory factors predisposing to perioperative awareness in the surgical environment need to be understood and avoided as much as possible. When awareness is suspected or known to have occurred the patient needs to be assisted through the post-op period and guided through the psychological sequelae that follow.展开更多
Though Frost and Laurence carry some similiar notes in the ar poems,this can not obscure their differenccs. Frist.Frost’s After APPle-picking can be regarded as the exampleof that dominant mode of the oppening 25 yea...Though Frost and Laurence carry some similiar notes in the ar poems,this can not obscure their differenccs. Frist.Frost’s After APPle-picking can be regarded as the exampleof that dominant mode of the oppening 25 years of the century.It is aquietly reflective pome of the actual New England farmer’s life.HereForst takes the mask of a New England farmer and speaks to展开更多
Hypertension, a non-communicable disease, is considered a major public health challenge because of its widespread prevalence globally coupled with its huge morbidity and mortality burden, which is largely preventable ...Hypertension, a non-communicable disease, is considered a major public health challenge because of its widespread prevalence globally coupled with its huge morbidity and mortality burden, which is largely preventable if early detection and prompt initiation of management are done. Hypertension prevalence is increasing especially in the developing world, despite this, its awareness among the general population is low. This study aimed at determining the prevalence of hypertension among adult attendees of the General Outpatient Clinic of the Federal University Teaching Hospital (FUTH), Owerri, with an assessment of the proportion of hypertensives who were aware of their hypertensive status, and identifying risk factors of hypertension in the study participants. A cross-sectional analytical study was conducted between October and November 2022 at the General Outpatient Clinic of the FUTH, Owerri. A total of 257 consenting and eligible adult patients made up of 135 males and 122 females, aged 18 years and above, were selected by systematic random sampling method. The overall prevalence of hypertension was 34.6%. The prevalence was higher in females than in males (37.7% vs 31.9%, P = 0.325). Among the hypertensive subjects 56.2% had awareness of their hypertensive status. Following a multiple regression analysis, hypertension was independently associated with age, family history of hypertension, occupation (retirees, traders, farmers and the unemployed), and marital status (being widowed). Hypertension is prevalent in our environment;the prevalence rate from this study is higher than in most studies in our environment, suggesting possibly, a rising burden. The results from the study underscore the need for increased and sustained advocacy for implementation of policies and programs directed at increased detection and management of hypertension in the different population groups such as annual wellness check for employees in the formal sector, largescale dietary and lifestyle adjustments, and know your numbers (an approach to population driven blood pressure check for all adults). Also, health workers should use any opportunity of contact with a patient to screen for hypertension.展开更多
During spacecraft re-entry,the challenge of measuring plasma sheath parameters directly contributes to difficulties in addressing communication blackout.In this work,we have discovered a phenomenon of multiple peaks i...During spacecraft re-entry,the challenge of measuring plasma sheath parameters directly contributes to difficulties in addressing communication blackout.In this work,we have discovered a phenomenon of multiple peaks in reflection data caused by the inhomogeneous plasma.Simulation results show that the multi-peak points fade away as the characteristic frequency is approached,resembling a series of gradually decreasing peaks.The positions and quantities of these points are positively correlated with electron density,yet they show no relation to collision frequency.This phenomenon is of significant reference value for future studies on the spatial distribution of plasmas,particularly for using microwave reflection signals in diagnosing the plasma sheath.展开更多
Research Background: Sickle cell trait has no treatment or cure and predominantly affects people who are Black, but can affect anyone of any race or ethnicity. While commonly incorrectly considered benign by providers...Research Background: Sickle cell trait has no treatment or cure and predominantly affects people who are Black, but can affect anyone of any race or ethnicity. While commonly incorrectly considered benign by providers and the public, people with a sickle cell trait experience life-threatening outcomes that are exacerbated by extreme conditions. There is a severe lack of awareness and understanding of sickle cell trait and the associated health complications among sickle cell trait carriers and healthcare providers. Purpose/Aim: Interventions that aim to improve awareness of sickle cell trait differ in approaches and are not well documented in the literature. This typology aims to highlight current efforts to inform targeted interventions that raise awareness through consistent messaging, educate people and providers on sickle cell trait and the related health complications, and support the design and implementation of comprehensive sickle cell trait awareness initiatives. Methods: We conducted a scoping review of United States-based sickle cell trait interventions and performed a content analysis to identify the categories and characteristics of these efforts. We then organized the results into a typology according to established protocols. Results: Among 164 interventions, twenty-five (15%) met the typology inclusion criteria described above and were grouped into categories: Seven of twenty-five interventions were Educational Interventions (28%), three of twenty-five interventions (12%) were Combined Screening and Educational-Based Interventions, eight of twenty-five interventions (32%) were Policy and Guideline-Based Intervention, and six of twenty-five interventions (24%) were Sickle Cell Trait Organization-Led Interventions. Conclusions: There is a lack of consistency in messaging across interventions whether delivered by credible healthcare institutions or national organizations, which can result in lack of education and awareness and confusion around sickle cell trait. Categorizing interventions through a typology allows clarity and informs consistency in messaging, which should be at the forefront of future sickle cell trait efforts.展开更多
This study explores household solid waste management (HSWM) practices and awareness among residents of Windhoek West, a rapidly urbanizing constituency in the Khomas Region of Namibia. Employing a descriptive methodol...This study explores household solid waste management (HSWM) practices and awareness among residents of Windhoek West, a rapidly urbanizing constituency in the Khomas Region of Namibia. Employing a descriptive methodology, the research investigates the interplay between public awareness, regulatory frameworks, and the availability of waste management facilities to assess their impact on waste management behaviors. Our findings indicate significant gaps in both knowledge and infrastructure that hinder effective waste management. The study reveals that while there is a high willingness among residents to engage in recycling and waste reduction, actual practices are limited due to inadequate facilities and lack of stringent enforcement of waste policies. This research identifies key factors that influence waste management practices, including demographic characteristics and access to waste management facilities. It also proposes actionable strategies such as expanding recycling and sorting facilities, enhancing educational campaigns tailored to local needs, and implementing regular enforcement mechanisms. These strategies are aimed at improving compliance with waste management protocols and fostering a culture of environmental responsibility. The results of this investigation show the critical role of ongoing education and infrastructural improvement in bridging existing knowledge gaps and facilitating effective waste management practices. This research lays a foundational step toward enhancing sustainable urban development and effective waste management in Windhoek, providing valuable insights for policymakers, community leaders, and stakeholders engaged in urban environmental management.展开更多
Purpose – The vibration of the rails is a significant source of railway rolling noise, often forming the dominantcomponent of noise in the important frequency region between 400 and 2000 Hz. The purpose of the paper ...Purpose – The vibration of the rails is a significant source of railway rolling noise, often forming the dominantcomponent of noise in the important frequency region between 400 and 2000 Hz. The purpose of the paper is toinvestigate the influence of the ground profile and the presence of the train body on the sound radiation fromthe rail.Design/methodology/approach – Two-dimensional boundary element calculations are used, in which therail vibration is the source. The ground profile and various different shapes of train body are introduced in themodel, and results are observed in terms of sound power and sound pressure. Comparisons are also made withvibro-acoustic measurements performed with and without a train present.Findings – The sound radiated by the rail in the absence of the train body is strongly attenuated by shieldingdue to the ballast shoulder. When the train body is present, the sound from the vertical rail motion is reflectedback down toward the track where it is partly absorbed by the ballast. Nevertheless, the sound pressure at thetrackside is increased by typically 0–5 dB. For the lateral vibration of the rail, the effects are much smaller. Oncethe sound power is known, the sound pressure with the train present can be approximated reasonably well withsimple line source directivities.Originality/value – Numerical models used to predict the sound radiation from railway rails have generallyneglected the influence of the ground profile and reflections from the underside of the train body on the soundpower and directivity of the rail. These effects are studied in a systematic way including comparisons with measurements.展开更多
Purpose–The safety of high-speed rail operation environments is an important guarantee for the safe operation of high-speed rail.The operating environment of the high-speed rail is complex,and the main factors affect...Purpose–The safety of high-speed rail operation environments is an important guarantee for the safe operation of high-speed rail.The operating environment of the high-speed rail is complex,and the main factors affecting the safety of high-speed rail operating environment include meteorological disasters,perimeter intrusion and external environmental hazards.The purpose of the paper is to elaborate on the current research status and team research progress on the perception of safety situation in high-speed rail operation environment and to propose directions for further research in the future.Design/methodology/approach–In terms of the mechanism and spatio-temporal evolution law of the main influencing factors on the safety of high-speed rail operation environments,the research status is elaborated,and the latest research progress and achievements of the team are introduced.This paper elaborates on the research status and introduces the latest research progress and achievements of the team in terms of meteorological,perimeter and external environmental situation perception methods for high-speed rail operation.Findings–Based on the technical route of“situational awareness evaluation warning active control,”a technical system for monitoring the safety of high-speed train operation environments has been formed.Relevant theoretical and technical research and application have been carried out around the impact of meteorological disasters,perimeter intrusion and the external environment on high-speed rail safety.These works strongly support the improvement of China’s railway environmental safety guarantee technology.Originality/value–With the operation of CR450 high-speed trains with a speed of 400 kmper hour and the application of high-speed train autonomous driving technology in the future,new and higher requirements have been put forward for the safety of high-speed rail operation environments.The following five aspects of work are urgently needed:(1)Research the single factor disaster mechanism of wind,rain,snow,lightning,etc.for high-speed railways with a speed of 400 kms per hour,and based on this,study the evolution characteristics of multiple safety factors and the correlation between the high-speed driving safety environment,revealing the coupling disastermechanism ofmultiple influencing factors;(2)Research covers multi-source data fusion methods and associated features such as disaster monitoring data,meteorological information,route characteristics and terrain and landforms,studying the spatio-temporal evolution laws of meteorological disasters,perimeter intrusions and external environmental hazards;(3)In terms of meteorological disaster situation awareness,research high-precision prediction methods for meteorological information time series along high-speed rail lines and study the realization of small-scale real-time dynamic and accurate prediction of meteorological disasters along high-speed rail lines;(4)In terms of perimeter intrusion,research amulti-modal fusion perception method for typical scenarios of high-speed rail operation in all time,all weather and all coverage and combine artificial intelligence technology to achieve comprehensive and accurate perception of perimeter security risks along the high-speed rail line and(5)In terms of external environment,based on the existing general network framework for change detection,we will carry out research on change detection and algorithms in the surrounding environment of highspeed rail.展开更多
Taiyuan formation is the main exploration strata in Ordos Basin, and coals are widely developed. Due to the interference of strong reflection of coals, we cannot completely identify the effective reservoir information...Taiyuan formation is the main exploration strata in Ordos Basin, and coals are widely developed. Due to the interference of strong reflection of coals, we cannot completely identify the effective reservoir information of coal-bearing reservoir on seismic data. Previous researchers have studied the reservoir by stripping or weakening the strong reflection, but it is difficult to determine the effectiveness of the remaining reflection seismic data. In this paper, through the establishment of 2D forward model of coal-bearing strata, the corresponding geophysical characteristics of different reflection types of coal-bearing strata are analyzed, and then the favorable sedimentary facies zones for reservoir development are predicted. On this basis, combined with seismic properties, the coal-bearing reservoir is quantitatively characterized by seismic inversion. The above research shows that the Taiyuan formation in LS block of Ordos Basin is affected by coals and forms three or two peaks in different locations. The reservoir plane sedimentary facies zone is effectively characterized by seismic reflection structure. Based on the characteristics of sedimentary facies belt and petrophysical analysis, the reservoir is semi quantitatively characterized by attribute analysis and waveform indication, and quantitatively characterized by pre stack geostatistical inversion. Based on the forward analysis of coal measure strata, this technology characterizes the reservoir facies belt through seismic reflection characteristics, and describes coal measure reservoirs step by step. It effectively guides the exploration of LS block in Ordos Basin, and has achieved good practical application effect.展开更多
Objective: To analyze the effect of health management on improving the awareness rate of disease prevention and treatment in patients with prehypertension, so as to provide guidance for clinical management of patients...Objective: To analyze the effect of health management on improving the awareness rate of disease prevention and treatment in patients with prehypertension, so as to provide guidance for clinical management of patients with prehypertension. Methods: 108 patients diagnosed with prehypertension in our hospital were divided into a control group and an experimental group. The control group was not given management measures, while the experimental group was given health management. The incidence of hypertension and cognition level of hypertension knowledge were compared between the two groups after management. Results: The incidence of hypertension in the experimental group was 7.41% lower than that in the control group 29.63%. The cognitive level of hypertension in the patients (66.54 ± 1.25) was significantly higher than that in the patients without health management (41.45 ± 2.45), and P < 0.05;Conclusion: For patients with prehypertension, the implementation of health management is helpful to improve their cognition of hypertension, master related prevention knowledge, and reduce the incidence of hypertension.展开更多
With the deepening of globalization,intercultural communication has become an important part of people’s daily lives and work.English,as an international language,plays a vital role in intercultural communication.How...With the deepening of globalization,intercultural communication has become an important part of people’s daily lives and work.English,as an international language,plays a vital role in intercultural communication.However,simple language knowledge can no longer meet the needs of modern society.Students need to have intercultural awareness and competence to better adapt to the development of globalization.Therefore,it is particularly important to improve students’intercultural awareness and competence in English teaching.This paper will discuss how to improve students’intercultural awareness and competence in English teaching,which includes three parts.The first part introduces the definition of intercultural awareness and competence.The second part explores the importance of intercultural awareness and competence to students,which can help students better understand and respect different cultures,stimulate students’innovative thinking and creativity,and cultivate critical thinking skills,and is also of great significance to students’professional development,personal growth,and social responsibility.The third part discusses the effective methods and strategies to improve students’intercultural awareness and competence in teaching,including carrying out cultural discussion and debate,introducing diverse materials,creating intercultural experience teaching activities,and using virtual learning tools.To a certain extent,this study can enrich the theoretical research in the field of intercultural awareness and competence,help to improve students’intercultural awareness and competence,and provide certain practical guidance for educators to teach intercultural courses.展开更多
Objective:This study aimed to assess breast cancer(BC)awareness among reproductive women in low-and middle-income countries(LMICs),identify influencing factors,and propose feasible interventions or programs.Methods:We...Objective:This study aimed to assess breast cancer(BC)awareness among reproductive women in low-and middle-income countries(LMICs),identify influencing factors,and propose feasible interventions or programs.Methods:We followed a 5-step process using a modified version of Arksey and O’Malley framework methodology.A comprehensive search was conducted on the Embase,PubMed,and CINAHL electronic databases for literature published within 10 years(from 2012 to 2022).Results:Thirty-three papers published between 2012 and 2020,spanning 18 countries,were included.Of these,45.6%described a good level of knowledge,while 24.2%reported that women at reproductive ages had good awareness.Twelve influencing factors were identified in 3 categories:socio-demographic(family history,personal history,marital status,age,religion,income status,living place,and occupation),personal(self-efficacy,education,and perceived level),and external(advertisements promoting awareness).Educational programs were recommended in most(>72%)of the included studies.Conclusions:While most studies reported high levels of knowledge and awareness,some found low prevalence among certain groups.Factors affecting knowledge and awareness were classified into socio-demographic,personal,and external categories,with socio-demographic factors such as age,education,income,and marital status being the most frequently cited.The studies recommended implementing educational programs,health prevention strategies,and social interventions to increase BC knowledge and awareness.展开更多
AIM: To study the role of ultrasound biomicroscopy(UBM) in the assessment of the bleb function after trabeculectomy with mitomycin C(MMC). METHODS: This was a cross-sectional study including all cases had underg...AIM: To study the role of ultrasound biomicroscopy(UBM) in the assessment of the bleb function after trabeculectomy with mitomycin C(MMC). METHODS: This was a cross-sectional study including all cases had undergone trabeculectomy with MMC 0.2 mg/mL for 3 min. Participants were recruited from the follow-up cases at Department of Ophthalmology, Tanta University in the period from August 2015 to August 2016. Full history taking and ophthalmological examination were performed. Intraocular pressure(IOP) was measured using Goldmann applanation tonometry and the history of prescribed postoperative antiglaucoma medications was recorded. Accordingly, the trabeculectomy blebs were divided clinically into successful blebs when the IOP post-operative was ≤18 mmHg without medications. Scanning examination of the filtering bleb using UBM examination was performed at the period from 2 to 36 mo after trabeculectomy(13.6±9.7 m o). RESULTS: This study included 33 trabeculectomy filtering blebs of 25 patients(9 males and 16 females). The mean age of patients was 53.2±14.2 y(range 25-71y). We had 20 eyes with complete success, 9 eyes with qualified success, and 4 eyes with failure after trabeculectomy with MMC. The blebs were classified into successful blebs(IOP ≤18 mmHg without antiglaucoma medications), others were classified into qualified successful and failed blebs. There was a significant correlation between certain UBM findings(intra-bleb reflectivity, draining sub-scleral tract, bleb height, and intrableb fluid cysts) and cases with different grades of clinical functional success(P〈0.01).CONCLUSION: UBM is an objective tool in the functional assessment of the post-trabeculectomy filtering bleb through a significant correlation between certain UBM parameters and the different grades of clinical functional success.展开更多
AIM: To characterize hydraulic right ventricle (RV) af- terload by pulmonary arterial pressure waveform analy- sis in an acute pulmonary hypertension (PH) model. METHODS: Pulmonary artery (PA) flow and pressure were r...AIM: To characterize hydraulic right ventricle (RV) af- terload by pulmonary arterial pressure waveform analy- sis in an acute pulmonary hypertension (PH) model. METHODS: Pulmonary artery (PA) flow and pressure were recorded in six anesthetized sheep. Acute iso- baric PH was induced by phenylephrine (active) and PA mechanical constriction (passive). We estimated the amplitude of the forward and reflected pressure waves according to the inflection point. In most cases the in- flection pressure was smooth, thus the inflection point was defined as the time at which the first derivative ofpulmonary arterial pressure reached its first minimum. We calculated the input and characteristic (Z C , time- domain Li method) impedances, the capacitance index (stroke volume/pulse pressure), the augmentation index (AI) (reflected pressure/pulse pressure), the frac- tional pulse pressure (pulse pressure/mean pressure) and the wasted energy generated by the RV due to wave reflection during ejection (E W ). RESULTS: Pulse pressure, fractional pulse pressure, AI and Z C increased and capacitance index decreased during passive PH with respect to control (P < 0.05). In contrast, Z C and the capacitance index did not change and E W and the AI decreased during active PH. Pulse pressure correlated with E W and Z C and the AI was cor- related with E W (r > 0.6, P < 0.05). CONCLUSION: PA pressure waveform analysis al- lows the quantification of the dynamic RV afterload. Prospective clinical studies will be necessary to validate this time-domain approach to evaluate the dynamic RV afterload in chronic PH.展开更多
Objective:To identify the knowledge and awareness level of human mpox viral infection among healthcare workers in southwestern Nigeria.Methods:A cross-sectional study was conducted in Ekiti State,southwest Nigeria amo...Objective:To identify the knowledge and awareness level of human mpox viral infection among healthcare workers in southwestern Nigeria.Methods:A cross-sectional study was conducted in Ekiti State,southwest Nigeria among 316 healthcare workers that were selected through a systematic random sampling.Data were collected with the aid of a semi-structured,self-administered questionnaire.The Chi-square test and binary logistic regression were used to find the association between the independent and dependent variables.The significance level was set at P-value<0.05.Results:Two hundred and twenty-two(70.3%)of the respondents were aged≤40 years,mean age(36±9)years,189(59.8%)were female,306(96.8%)were Christians,and 203(64.2%)were married.Three hundred and fourteen(99.4%)of the respondents were aware of mpox infection.Main sources of information about mpox were medical education(44.0%),radio/television(32.0%)and newspaper(21.0%).However,among those aware of the disease,209(67.0%)demonstrated poor knowledge levels.Longer than 5 years’experience of medical practice was the only significant predictor of higher knowledge level of the disease(OR 1.76,95%CI 1.01-3.06;P=0.046).Conclusions:Despite the high awareness level of mpox infection among healthcare workers,there still exists a huge knowledge gap.It is recommended that targeted intervention could be directed towards continuous medical education and simulation exercises on re-emerging infectious diseases like mpox to improve the knowledge of the healthcare workers.展开更多
基金supported by the Natural Science Foundation of Hubei Province,China [Grant No.2017CKC891]the Health Commission Of Hubei Province,China [Grant No.WJ2019H286]
文摘Cervical cancer is a form of malignant tumor that seriously threatens women’s health. In China,according to the cancer statistics, 98,900 new cervical cancer cases and 30,500 deaths due to cervical cancer were estimated to have occurred in2015, and the incidence and mortality rates still exhibited an upward trend[1].
基金supported by the Department of Veteran Affairs, Rehabilitation Research and Development Service
文摘Exercise is an essential element in managing several of the non-communicable diseases after spinal cord injury(SCI).Awareness of the importance of prescribing a customized exercise program that meets the goals of persons with SCI should be highly considered in the rehabilitation community.The barriers of implementing specific exercise program as well as the factors that may mask the outcomes of regular exercise regimen need to be continuously addressed as a part of patients’rehabilitation care.The focus of this editorial is to encourage the medical community to consider routine physical activity as one of the necessary vital signs that needs to be routinely checked in patients with SCI.Providing education tips,nutritional counseling and engaging in recreational programs may provide motivational route to the community of SCI.This may result in reinforcing active lifestyle in survivors with SCI as well as to reduce the impact of chronic life threatening medical disorders.
文摘Rationale:Rabies is a zoonotic disease with a high mortality,primarily transmitted through the bite of infected mammals,particularly dogs and cats.Despite being a well-known disease since ancient times,it continues to cause a significant number of human deaths worldwide,with approximately 65000 fatalities reported annually.Patient concerns:We present two fatal cases of rabies in a 12-year-old immigrant boy and a 7-year-old boy.The first case was subject to a 24-hour delay in receiving appropriate medical attention and rabies preventive measures due to the lack of awareness among emergency hospital staff,leading to the administration of wound dressing only.The second case received timely rabies immunoglobulin administration;however,there was a 4-day delay in administering the fourth dose of the rabies vaccine,despite presenting evident symptoms of rabies.Diagnosis:Postmortem examination of brain samples from both patients confirmed the presence of rabies virus.Interventions:Post-exposure prophylaxis for rabies.Outcomes:Both patients were admitted to the hospital after the manifestation of rabies-related symptoms,with the 12-year-old child seeking medical care 47 days after the animal bite and the 7-year-old child seeking medical care 58 days after the exposure.Finally,the first patient died after 27 days and the second patient died after 40 days of hospitalization.Lessons:There is an urgent need for heightened awareness and education among both healthcare professionals and the public regarding the urgency of seeking immediate medical attention after potential rabies exposure.Timely recognition and initiation of post-exposure prophylaxis are pivotal in preventing the progression of the disease.Strengthening surveillance and reporting systems,coupled with continuous training for healthcare professionals,can contribute to early detection and management of rabies cases.
文摘AIM: To investigate knee awareness and functional outcomes in patients treated with simultaneous bilateral vs unilateral total knee arthroplasty(TKA).METHODS: Through a database search, we identified 210 patients who had undergone unilateral TKA(UTKA) and 65 patients who had undergone simultaneous bilateral TKA(SBTKA) at our institution between 2010 and 2012. All TKAs were cemented and cruciate retaining. The mean follow-up period was 3.2(2 to 4) years. All the patients had symptomatic and debilitating unilateral or bilateral osteoarthritis for which all conservative and non-surgical treatments were failed, thus preoperatively the patients had poor functionality. All patients were asked to complete Forgotten Joint Score(FJS) and Oxford Knee Score(OKS) questionnaires. The patients were matched according to age, gender, year of surgery, Kellgren-Lawrence score and pre- andpostoperative overall knee alignment. The FJS and OKS questionnaire results of the two groups were then compared. RESULTS: A mixed-effects model was used to analyze differences between SBTKA and UTKA. OKS: The mean difference in the OKS between the patients who had undergone SBTKA and those who had undergone UTKA was 1.5, which was not statistically significant(CI =-0.9:4.0, P-value = 0.228). The mean OKS of the SBTKA patients was 37.6(SD = 9.0), and the mean OKS of the UTKA patients was 36.1(SD = 9.9). FJS: The mean difference in the FJS between the patients who had undergone SBTKA and those who had undergone UTKA was 2.3, which was not statistically significant(CI =-6.2:10.8, P-value = 0.593). The mean FJS of the SBTKA patients was 59.9(SD = 27.5), and the mean FJS of the UTKA patients was 57.5(SD = 28.8). CONCLUSION: SBTKA and UTKA patients exhibited similar joint functionality and knee awareness. Our results support the use of SBTKA in selected patients suffering from clinically symptomatic bilateral osteoarthritis.
文摘<strong>Background: </strong>This study aims to evaluate the infertility reflection in early pregnancy after assistive reproductive therapy (ART), including 1) process evaluation (the use and evaluation of infertility reflection) and 2) outcome evaluation (satisfaction of care needs, anticipatory anxiety towards the loss of a pregnancy or fetus, cognition of infertility experience, and depression and anxiety). <strong>Methods: </strong>This program evaluation study used a one-group pre-post-test design. The participants were 50 primiparas who had undergone ART at two fertility treatment facilities in a metropolitan area in Japan. For the infertility reflection, they conducted an online reflection. Data were collected three times: at the 5th week of pregnancy (Time 1), the 8th week of pregnancy as the final consultation at the clinic (Time 2), and the 16th week of pregnancy as the final point of early pregnancy (Time 3). <strong>Results: </strong>The data from 40 participants were analyzed. More than 80% of the users of the online reflection positively evaluated the appropriateness and usefulness of the methods and contents. Organized thoughts and feelings by reflection were shown as the reasons for the usefulness. The evaluation of the online reflection showed a relatively strong correlation with the Care Need Satisfaction Scale (CNSS) for both Time 2 and Time 3, but the online reflection did not show a significant correlation with the other outcome variables. There were no significant differences in outcome variables between users and non-users of online reflection between Time 2 and Time 3. <strong>Conclusions:</strong> Attempts at the reflection in early pregnancy require modified methods that do not have a negative impact and lead to the fulfillment of needs.
文摘<b>Background:</b> Accidental awareness during general anesthesia (AAGA) is an uncommon condition with possible long-term sequela. Here, we identify and describe a case of awareness in the perioperative setting and the resulting sequelae of symptoms consistent with post-traumatic stress disorder using the first-hand experience of a patient with awareness during anesthesia. <b>Aim:</b> This case report aims to identify and describe the symptomatic sequelae of perioperative awareness events and the importance of close patient follow-up and management. <b>Case Presentation:</b> A 34-year-old female developed uncontrolled tonsillar hemorrhage 2 days after successful adenotonsillectomy that necessitated bedside intubation. During regular clinic follow-up, the patient presented with symptoms suggestive of post-traumatic stress disorder (PTSD) secondary to recall events while under anesthesia. <b>Conclusion:</b> The contributory factors predisposing to perioperative awareness in the surgical environment need to be understood and avoided as much as possible. When awareness is suspected or known to have occurred the patient needs to be assisted through the post-op period and guided through the psychological sequelae that follow.
文摘Though Frost and Laurence carry some similiar notes in the ar poems,this can not obscure their differenccs. Frist.Frost’s After APPle-picking can be regarded as the exampleof that dominant mode of the oppening 25 years of the century.It is aquietly reflective pome of the actual New England farmer’s life.HereForst takes the mask of a New England farmer and speaks to
文摘Hypertension, a non-communicable disease, is considered a major public health challenge because of its widespread prevalence globally coupled with its huge morbidity and mortality burden, which is largely preventable if early detection and prompt initiation of management are done. Hypertension prevalence is increasing especially in the developing world, despite this, its awareness among the general population is low. This study aimed at determining the prevalence of hypertension among adult attendees of the General Outpatient Clinic of the Federal University Teaching Hospital (FUTH), Owerri, with an assessment of the proportion of hypertensives who were aware of their hypertensive status, and identifying risk factors of hypertension in the study participants. A cross-sectional analytical study was conducted between October and November 2022 at the General Outpatient Clinic of the FUTH, Owerri. A total of 257 consenting and eligible adult patients made up of 135 males and 122 females, aged 18 years and above, were selected by systematic random sampling method. The overall prevalence of hypertension was 34.6%. The prevalence was higher in females than in males (37.7% vs 31.9%, P = 0.325). Among the hypertensive subjects 56.2% had awareness of their hypertensive status. Following a multiple regression analysis, hypertension was independently associated with age, family history of hypertension, occupation (retirees, traders, farmers and the unemployed), and marital status (being widowed). Hypertension is prevalent in our environment;the prevalence rate from this study is higher than in most studies in our environment, suggesting possibly, a rising burden. The results from the study underscore the need for increased and sustained advocacy for implementation of policies and programs directed at increased detection and management of hypertension in the different population groups such as annual wellness check for employees in the formal sector, largescale dietary and lifestyle adjustments, and know your numbers (an approach to population driven blood pressure check for all adults). Also, health workers should use any opportunity of contact with a patient to screen for hypertension.
文摘During spacecraft re-entry,the challenge of measuring plasma sheath parameters directly contributes to difficulties in addressing communication blackout.In this work,we have discovered a phenomenon of multiple peaks in reflection data caused by the inhomogeneous plasma.Simulation results show that the multi-peak points fade away as the characteristic frequency is approached,resembling a series of gradually decreasing peaks.The positions and quantities of these points are positively correlated with electron density,yet they show no relation to collision frequency.This phenomenon is of significant reference value for future studies on the spatial distribution of plasmas,particularly for using microwave reflection signals in diagnosing the plasma sheath.
文摘Research Background: Sickle cell trait has no treatment or cure and predominantly affects people who are Black, but can affect anyone of any race or ethnicity. While commonly incorrectly considered benign by providers and the public, people with a sickle cell trait experience life-threatening outcomes that are exacerbated by extreme conditions. There is a severe lack of awareness and understanding of sickle cell trait and the associated health complications among sickle cell trait carriers and healthcare providers. Purpose/Aim: Interventions that aim to improve awareness of sickle cell trait differ in approaches and are not well documented in the literature. This typology aims to highlight current efforts to inform targeted interventions that raise awareness through consistent messaging, educate people and providers on sickle cell trait and the related health complications, and support the design and implementation of comprehensive sickle cell trait awareness initiatives. Methods: We conducted a scoping review of United States-based sickle cell trait interventions and performed a content analysis to identify the categories and characteristics of these efforts. We then organized the results into a typology according to established protocols. Results: Among 164 interventions, twenty-five (15%) met the typology inclusion criteria described above and were grouped into categories: Seven of twenty-five interventions were Educational Interventions (28%), three of twenty-five interventions (12%) were Combined Screening and Educational-Based Interventions, eight of twenty-five interventions (32%) were Policy and Guideline-Based Intervention, and six of twenty-five interventions (24%) were Sickle Cell Trait Organization-Led Interventions. Conclusions: There is a lack of consistency in messaging across interventions whether delivered by credible healthcare institutions or national organizations, which can result in lack of education and awareness and confusion around sickle cell trait. Categorizing interventions through a typology allows clarity and informs consistency in messaging, which should be at the forefront of future sickle cell trait efforts.
文摘This study explores household solid waste management (HSWM) practices and awareness among residents of Windhoek West, a rapidly urbanizing constituency in the Khomas Region of Namibia. Employing a descriptive methodology, the research investigates the interplay between public awareness, regulatory frameworks, and the availability of waste management facilities to assess their impact on waste management behaviors. Our findings indicate significant gaps in both knowledge and infrastructure that hinder effective waste management. The study reveals that while there is a high willingness among residents to engage in recycling and waste reduction, actual practices are limited due to inadequate facilities and lack of stringent enforcement of waste policies. This research identifies key factors that influence waste management practices, including demographic characteristics and access to waste management facilities. It also proposes actionable strategies such as expanding recycling and sorting facilities, enhancing educational campaigns tailored to local needs, and implementing regular enforcement mechanisms. These strategies are aimed at improving compliance with waste management protocols and fostering a culture of environmental responsibility. The results of this investigation show the critical role of ongoing education and infrastructural improvement in bridging existing knowledge gaps and facilitating effective waste management practices. This research lays a foundational step toward enhancing sustainable urban development and effective waste management in Windhoek, providing valuable insights for policymakers, community leaders, and stakeholders engaged in urban environmental management.
基金supported by the TRANSIT project(funded by EU Horizon 2020 and the Europe’s Rail Joint Undertaking under Grant Agreement 881771).
文摘Purpose – The vibration of the rails is a significant source of railway rolling noise, often forming the dominantcomponent of noise in the important frequency region between 400 and 2000 Hz. The purpose of the paper is toinvestigate the influence of the ground profile and the presence of the train body on the sound radiation fromthe rail.Design/methodology/approach – Two-dimensional boundary element calculations are used, in which therail vibration is the source. The ground profile and various different shapes of train body are introduced in themodel, and results are observed in terms of sound power and sound pressure. Comparisons are also made withvibro-acoustic measurements performed with and without a train present.Findings – The sound radiated by the rail in the absence of the train body is strongly attenuated by shieldingdue to the ballast shoulder. When the train body is present, the sound from the vertical rail motion is reflectedback down toward the track where it is partly absorbed by the ballast. Nevertheless, the sound pressure at thetrackside is increased by typically 0–5 dB. For the lateral vibration of the rail, the effects are much smaller. Oncethe sound power is known, the sound pressure with the train present can be approximated reasonably well withsimple line source directivities.Originality/value – Numerical models used to predict the sound radiation from railway rails have generallyneglected the influence of the ground profile and reflections from the underside of the train body on the soundpower and directivity of the rail. These effects are studied in a systematic way including comparisons with measurements.
基金National Natural Science Foundation of China High Speed Rail Joint Fund(U2268217)。
文摘Purpose–The safety of high-speed rail operation environments is an important guarantee for the safe operation of high-speed rail.The operating environment of the high-speed rail is complex,and the main factors affecting the safety of high-speed rail operating environment include meteorological disasters,perimeter intrusion and external environmental hazards.The purpose of the paper is to elaborate on the current research status and team research progress on the perception of safety situation in high-speed rail operation environment and to propose directions for further research in the future.Design/methodology/approach–In terms of the mechanism and spatio-temporal evolution law of the main influencing factors on the safety of high-speed rail operation environments,the research status is elaborated,and the latest research progress and achievements of the team are introduced.This paper elaborates on the research status and introduces the latest research progress and achievements of the team in terms of meteorological,perimeter and external environmental situation perception methods for high-speed rail operation.Findings–Based on the technical route of“situational awareness evaluation warning active control,”a technical system for monitoring the safety of high-speed train operation environments has been formed.Relevant theoretical and technical research and application have been carried out around the impact of meteorological disasters,perimeter intrusion and the external environment on high-speed rail safety.These works strongly support the improvement of China’s railway environmental safety guarantee technology.Originality/value–With the operation of CR450 high-speed trains with a speed of 400 kmper hour and the application of high-speed train autonomous driving technology in the future,new and higher requirements have been put forward for the safety of high-speed rail operation environments.The following five aspects of work are urgently needed:(1)Research the single factor disaster mechanism of wind,rain,snow,lightning,etc.for high-speed railways with a speed of 400 kms per hour,and based on this,study the evolution characteristics of multiple safety factors and the correlation between the high-speed driving safety environment,revealing the coupling disastermechanism ofmultiple influencing factors;(2)Research covers multi-source data fusion methods and associated features such as disaster monitoring data,meteorological information,route characteristics and terrain and landforms,studying the spatio-temporal evolution laws of meteorological disasters,perimeter intrusions and external environmental hazards;(3)In terms of meteorological disaster situation awareness,research high-precision prediction methods for meteorological information time series along high-speed rail lines and study the realization of small-scale real-time dynamic and accurate prediction of meteorological disasters along high-speed rail lines;(4)In terms of perimeter intrusion,research amulti-modal fusion perception method for typical scenarios of high-speed rail operation in all time,all weather and all coverage and combine artificial intelligence technology to achieve comprehensive and accurate perception of perimeter security risks along the high-speed rail line and(5)In terms of external environment,based on the existing general network framework for change detection,we will carry out research on change detection and algorithms in the surrounding environment of highspeed rail.
文摘Taiyuan formation is the main exploration strata in Ordos Basin, and coals are widely developed. Due to the interference of strong reflection of coals, we cannot completely identify the effective reservoir information of coal-bearing reservoir on seismic data. Previous researchers have studied the reservoir by stripping or weakening the strong reflection, but it is difficult to determine the effectiveness of the remaining reflection seismic data. In this paper, through the establishment of 2D forward model of coal-bearing strata, the corresponding geophysical characteristics of different reflection types of coal-bearing strata are analyzed, and then the favorable sedimentary facies zones for reservoir development are predicted. On this basis, combined with seismic properties, the coal-bearing reservoir is quantitatively characterized by seismic inversion. The above research shows that the Taiyuan formation in LS block of Ordos Basin is affected by coals and forms three or two peaks in different locations. The reservoir plane sedimentary facies zone is effectively characterized by seismic reflection structure. Based on the characteristics of sedimentary facies belt and petrophysical analysis, the reservoir is semi quantitatively characterized by attribute analysis and waveform indication, and quantitatively characterized by pre stack geostatistical inversion. Based on the forward analysis of coal measure strata, this technology characterizes the reservoir facies belt through seismic reflection characteristics, and describes coal measure reservoirs step by step. It effectively guides the exploration of LS block in Ordos Basin, and has achieved good practical application effect.
文摘Objective: To analyze the effect of health management on improving the awareness rate of disease prevention and treatment in patients with prehypertension, so as to provide guidance for clinical management of patients with prehypertension. Methods: 108 patients diagnosed with prehypertension in our hospital were divided into a control group and an experimental group. The control group was not given management measures, while the experimental group was given health management. The incidence of hypertension and cognition level of hypertension knowledge were compared between the two groups after management. Results: The incidence of hypertension in the experimental group was 7.41% lower than that in the control group 29.63%. The cognitive level of hypertension in the patients (66.54 ± 1.25) was significantly higher than that in the patients without health management (41.45 ± 2.45), and P < 0.05;Conclusion: For patients with prehypertension, the implementation of health management is helpful to improve their cognition of hypertension, master related prevention knowledge, and reduce the incidence of hypertension.
文摘With the deepening of globalization,intercultural communication has become an important part of people’s daily lives and work.English,as an international language,plays a vital role in intercultural communication.However,simple language knowledge can no longer meet the needs of modern society.Students need to have intercultural awareness and competence to better adapt to the development of globalization.Therefore,it is particularly important to improve students’intercultural awareness and competence in English teaching.This paper will discuss how to improve students’intercultural awareness and competence in English teaching,which includes three parts.The first part introduces the definition of intercultural awareness and competence.The second part explores the importance of intercultural awareness and competence to students,which can help students better understand and respect different cultures,stimulate students’innovative thinking and creativity,and cultivate critical thinking skills,and is also of great significance to students’professional development,personal growth,and social responsibility.The third part discusses the effective methods and strategies to improve students’intercultural awareness and competence in teaching,including carrying out cultural discussion and debate,introducing diverse materials,creating intercultural experience teaching activities,and using virtual learning tools.To a certain extent,this study can enrich the theoretical research in the field of intercultural awareness and competence,help to improve students’intercultural awareness and competence,and provide certain practical guidance for educators to teach intercultural courses.
文摘Objective:This study aimed to assess breast cancer(BC)awareness among reproductive women in low-and middle-income countries(LMICs),identify influencing factors,and propose feasible interventions or programs.Methods:We followed a 5-step process using a modified version of Arksey and O’Malley framework methodology.A comprehensive search was conducted on the Embase,PubMed,and CINAHL electronic databases for literature published within 10 years(from 2012 to 2022).Results:Thirty-three papers published between 2012 and 2020,spanning 18 countries,were included.Of these,45.6%described a good level of knowledge,while 24.2%reported that women at reproductive ages had good awareness.Twelve influencing factors were identified in 3 categories:socio-demographic(family history,personal history,marital status,age,religion,income status,living place,and occupation),personal(self-efficacy,education,and perceived level),and external(advertisements promoting awareness).Educational programs were recommended in most(>72%)of the included studies.Conclusions:While most studies reported high levels of knowledge and awareness,some found low prevalence among certain groups.Factors affecting knowledge and awareness were classified into socio-demographic,personal,and external categories,with socio-demographic factors such as age,education,income,and marital status being the most frequently cited.The studies recommended implementing educational programs,health prevention strategies,and social interventions to increase BC knowledge and awareness.
文摘AIM: To study the role of ultrasound biomicroscopy(UBM) in the assessment of the bleb function after trabeculectomy with mitomycin C(MMC). METHODS: This was a cross-sectional study including all cases had undergone trabeculectomy with MMC 0.2 mg/mL for 3 min. Participants were recruited from the follow-up cases at Department of Ophthalmology, Tanta University in the period from August 2015 to August 2016. Full history taking and ophthalmological examination were performed. Intraocular pressure(IOP) was measured using Goldmann applanation tonometry and the history of prescribed postoperative antiglaucoma medications was recorded. Accordingly, the trabeculectomy blebs were divided clinically into successful blebs when the IOP post-operative was ≤18 mmHg without medications. Scanning examination of the filtering bleb using UBM examination was performed at the period from 2 to 36 mo after trabeculectomy(13.6±9.7 m o). RESULTS: This study included 33 trabeculectomy filtering blebs of 25 patients(9 males and 16 females). The mean age of patients was 53.2±14.2 y(range 25-71y). We had 20 eyes with complete success, 9 eyes with qualified success, and 4 eyes with failure after trabeculectomy with MMC. The blebs were classified into successful blebs(IOP ≤18 mmHg without antiglaucoma medications), others were classified into qualified successful and failed blebs. There was a significant correlation between certain UBM findings(intra-bleb reflectivity, draining sub-scleral tract, bleb height, and intrableb fluid cysts) and cases with different grades of clinical functional success(P〈0.01).CONCLUSION: UBM is an objective tool in the functional assessment of the post-trabeculectomy filtering bleb through a significant correlation between certain UBM parameters and the different grades of clinical functional success.
基金Supported by Comisión Sectorial de Investigación Científica,Universidad de la República and Programa de Desarrollo de las Ciencias Básicas
文摘AIM: To characterize hydraulic right ventricle (RV) af- terload by pulmonary arterial pressure waveform analy- sis in an acute pulmonary hypertension (PH) model. METHODS: Pulmonary artery (PA) flow and pressure were recorded in six anesthetized sheep. Acute iso- baric PH was induced by phenylephrine (active) and PA mechanical constriction (passive). We estimated the amplitude of the forward and reflected pressure waves according to the inflection point. In most cases the in- flection pressure was smooth, thus the inflection point was defined as the time at which the first derivative ofpulmonary arterial pressure reached its first minimum. We calculated the input and characteristic (Z C , time- domain Li method) impedances, the capacitance index (stroke volume/pulse pressure), the augmentation index (AI) (reflected pressure/pulse pressure), the frac- tional pulse pressure (pulse pressure/mean pressure) and the wasted energy generated by the RV due to wave reflection during ejection (E W ). RESULTS: Pulse pressure, fractional pulse pressure, AI and Z C increased and capacitance index decreased during passive PH with respect to control (P < 0.05). In contrast, Z C and the capacitance index did not change and E W and the AI decreased during active PH. Pulse pressure correlated with E W and Z C and the AI was cor- related with E W (r > 0.6, P < 0.05). CONCLUSION: PA pressure waveform analysis al- lows the quantification of the dynamic RV afterload. Prospective clinical studies will be necessary to validate this time-domain approach to evaluate the dynamic RV afterload in chronic PH.
文摘Objective:To identify the knowledge and awareness level of human mpox viral infection among healthcare workers in southwestern Nigeria.Methods:A cross-sectional study was conducted in Ekiti State,southwest Nigeria among 316 healthcare workers that were selected through a systematic random sampling.Data were collected with the aid of a semi-structured,self-administered questionnaire.The Chi-square test and binary logistic regression were used to find the association between the independent and dependent variables.The significance level was set at P-value<0.05.Results:Two hundred and twenty-two(70.3%)of the respondents were aged≤40 years,mean age(36±9)years,189(59.8%)were female,306(96.8%)were Christians,and 203(64.2%)were married.Three hundred and fourteen(99.4%)of the respondents were aware of mpox infection.Main sources of information about mpox were medical education(44.0%),radio/television(32.0%)and newspaper(21.0%).However,among those aware of the disease,209(67.0%)demonstrated poor knowledge levels.Longer than 5 years’experience of medical practice was the only significant predictor of higher knowledge level of the disease(OR 1.76,95%CI 1.01-3.06;P=0.046).Conclusions:Despite the high awareness level of mpox infection among healthcare workers,there still exists a huge knowledge gap.It is recommended that targeted intervention could be directed towards continuous medical education and simulation exercises on re-emerging infectious diseases like mpox to improve the knowledge of the healthcare workers.