In a digital world moving at a breakneck speed,consultancy services have emerged as one of the prominent resources for seeking effective,sustainable and economically viable solutions to a given crisis.The present day ...In a digital world moving at a breakneck speed,consultancy services have emerged as one of the prominent resources for seeking effective,sustainable and economically viable solutions to a given crisis.The present day consultancy services are aided by the use of multiple tools and techniques.However,ensuring the security of these tools and techniques is an important concern for the consultants because even a slight malfunction of any tool could alter the results drastically.Consultants usually tackle these functions after establishing the clients’needs and developing the appropriate strategy.Nevertheless,most of the consultants tend to focus more on the intended outcomes only and often ignore the security-specific issues.Our research study is an initiative to recommend the use of a hybrid computational technique based on fuzzy Analytical Hierarchy Process(AHP)and fuzzy Technique for Order Preference by Similarity to Ideal Solutions(TOPSIS)for prioritizing the tools and techniques that are used in consultancy services on the basis of their security features and efficacy.The empirical analysis conducted in this context shows that after implementing the assessment process,the rank of the tools and techniques obtained is:A7>A1>A4>A2>A3>A5>A6>A7,and General Electric McKinsey(GE-McKinsey)Nine-box Matrix(A7)obtained the highest rank.Thus,the outcomes show that this order of selection of the tools and techniques will give the most effective and secure services.The awareness about using the best tools and techniques in consultancy services is as important as selecting the most secure tool for solving a given problem.In this league,the results obtained in this study would be a conclusive and a reliable reference for the consultants.展开更多
China’s opening,reform and economicdevelopment,as well as the worldinformation technology revolution,hasenhanced China’s information consultancyservice.Before 1978,China’s economy wasa product economy governed by a...China’s opening,reform and economicdevelopment,as well as the worldinformation technology revolution,hasenhanced China’s information consultancyservice.Before 1978,China’s economy wasa product economy governed by a highly-centralized planning system with economicinformation basically based on statisticscollected from lower levels and planningcommands to lower levels.The annual productexchange meetings sponsored by specialeconomic departments became the mainchannels for information exchange,soinformation services basically failed to meetneeds.In 1979,China’s economy began itstransfer from a planned to a market one。展开更多
Background/Aim: The purpose of this study was to examine the effect of training and consultancy on women’s knowledge level and health belief regarding the cervical cancer screenings and their participation in screeni...Background/Aim: The purpose of this study was to examine the effect of training and consultancy on women’s knowledge level and health belief regarding the cervical cancer screenings and their participation in screenings. Materials and Methods: The study is designed as pre-experiment with one group pretest-posttest. The sample group of the study consists of 66 women. The data were collected between March and June 2011. “Personal Information Form”, “Information Form of Cervical Cancer Screenings”, “Health Belief Model Scale for Cervical Cancer and Pap Smear Test”, and “Assessment Form Concerning Taking the Pap Smear Test” were used to collect the data. Results: It was determined that at the end of all trainings, 45.5% of women took the relevant test. Among those who participated in the Pap Smear screening, the training and consultancy had an effect of 100%, booklets 100% and telephone calls 25%. The training and consultancy increased the perception of “benefit and motivation” regarding the Pap Smear test and Pap Smear decreased the perception of “barriers”. Regarding the cervical cancer, it decreased the perception of “regard/seriousness”, “susceptibility” and “health motivation”. Conclusions: It was concluded that training and consultancy change the health beliefs regarding cervical cancer screenings, increase the participation in screenings and consequently, contribute to early diagnosis.展开更多
BACKGROUND Venovenous extracorporeal membrane oxygenation(V-V ECMO)has become an important treatment for severe pneumonia,but there are various complications during the treatment.This article describes a case with sev...BACKGROUND Venovenous extracorporeal membrane oxygenation(V-V ECMO)has become an important treatment for severe pneumonia,but there are various complications during the treatment.This article describes a case with severe pneumonia success-fully treated by V-V ECMO,but during treatment,the retrovenous catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.The ECMO was safely withdrawn after multidiscip-linary consultation.Our experience with this case is expected to provide a reference for colleagues who will encounter similar situations.CASE SUMMARY A 64-year-old man had severe pulmonary infection and respiratory failure.He was admitted to our hospital and was given ventilation support(fraction of inspired oxygen 100%).The respiratory failure was not improved and he was treated by V-V ECMO,during which the venous return catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.There was a risk of massive mediastinal bleeding if the catheter was removed directly when the ECMO was withdrawn.Finally,the patient underwent vena cava angiography+balloon attachment+ECMO with-drawal in the operating room(prepared for conversion to thoracotomy for vascular exploration and repair at any time during surgery)after multidiscip-linary consultation.ECMO was safely withdrawn,and the patient recovered and was discharged.CONCLUSION Patients may have different vascular conditions.Multidisciplinary cooperation can ensure patient safety.Our experience will provide a reference for similar cases.展开更多
Context: Non-communicable diseases, including hypertension, are major causes of complications during pregnancy, posing significant risks to maternal and fetal health. Pregnancy increases cardiovascular risks, particul...Context: Non-communicable diseases, including hypertension, are major causes of complications during pregnancy, posing significant risks to maternal and fetal health. Pregnancy increases cardiovascular risks, particularly through the development of gestational hypertension and preeclampsia, requiring early screening and close monitoring to prevent adverse outcomes. Objectives: This study aimed to evaluate the frequency of cardiovascular risk factors in pregnant women in Senegal and identify associated socio-behavioral and economic determinants. Methodology: A descriptive, analytical cross-sectional study with prospective data collection was conducted over three months (April 10 to July 10, 2023). The study included pregnant women aged 15 and older from three public hospital maternity wards in Senegal. We studied sociodemographic aspects, cardiovascular risk factors, and collected information on previous and current pregnancies, including the number of pregnancies, parity, miscarriages, the number of prenatal consultations, and the number of fetuses. Written consent was obtained. A p-value ≤ 0.05 was considered statistically significant. Results: A total of 222 pregnant women were enrolled, representing 28% of prenatal consultations. The average age was 29.18 years (range 15 - 47). Most participants (90%) lived in Dakar suburbs, 74.20% had no medical coverage, 84% worked in the informal sector (p = 0.043), and 18% had no education. Among them, 30.63% were in their first pregnancy, 34% were nulliparous, and 3.15% were grand multiparous. The average number of prenatal visits was 3.5, with about 40% having more than four visits. Risk factors included hypertension (17%), more prevalent in women over 30 (p = 0.043), diabetes (4%), and smoking (2%). Conclusion: The study highlights critical prenatal health needs and socio-economic challenges faced by pregnant women, emphasizing the need for targeted strategies to improve healthcare access and health education.展开更多
Ghanaian construction projects encounter a number of challenges, including low health, safety, and environmental requirements, poor performance, and time and cost overruns. To provide value for money (VFM) on governme...Ghanaian construction projects encounter a number of challenges, including low health, safety, and environmental requirements, poor performance, and time and cost overruns. To provide value for money (VFM) on government infrastructure projects in Ghana, this research assesses the roles of project consultants, specifically architects and quantity surveyors, and highlights important obstacles. A cross-sectional survey design involving architects and quantity surveyors yielded a 96% response rate after 100 questionnaires were distributed. Consultants’ responsibilities also include monitoring standards compliance, providing advice on delays, controlling budgets, and advising on project completion dates. Difficulties encompass a lack of promptness in decision-making, unethical conduct, political pressure, and inadequate focus on contract administration and construction audits. Project urgency, longevity, political clout, timely decision-making, and team experience are important variables that impact VFM. Policy makers and construction management practitioners should take note of the implications for Ghana’s public infrastructure projects.展开更多
IN a classroom of the Costume Schoolwith the Textile University of China inShanghai,a young female teacher drewseven faces on the blackboard.She pointedto a rhomboid face and asked her students,“If someone with this ...IN a classroom of the Costume Schoolwith the Textile University of China inShanghai,a young female teacher drewseven faces on the blackboard.She pointedto a rhomboid face and asked her students,“If someone with this shaped face raisedtheir eyes,what woud they look like?” “A fox,”burst out a student. “Yes.This shape,with a thin foreheadand a pointed chin,appears very caustic.Ihave this face.”展开更多
The potential impact of quantum computing on various industries such as finance, healthcare, cryptography, and transportation is significant;therefore, sectors face challenges in understanding where to start because o...The potential impact of quantum computing on various industries such as finance, healthcare, cryptography, and transportation is significant;therefore, sectors face challenges in understanding where to start because of the complex nature of this technology. Starting early to explore what is supposed to be done is crucial for providing sectors with the necessary knowledge, tools, and processes to keep pace with rapid advancements in quantum computing. This article emphasizes the importance of consultancy and governance solutions that aid sectors in preparing for the quantum computing revolution. The article begins by discussing the reasons why sectors need to be prepared for quantum computing and emphasizes the importance of proactive preparation. It illustrates this point by providing a real-world example of a partnership. Subsequently, the article mentioned the benefits of quantum computing readiness, including increased competitiveness, improved security, and structured data. In addition, this article discusses the steps that various sectors can take to achieve quantum readiness, considering the potential risks and opportunities in industries. The proposed solutions for achieving quantum computing readiness include establishing a quantum computing office, contracting with major quantum computing companies, and learning from quantum computing organizations. This article provides the detailed advantages and disadvantages of each of these steps and emphasizes the need to carefully evaluate their potential drawbacks to ensure that they align with the sector’s unique needs, goals, and available resources. Finally, this article proposes various solutions and recommendations for sectors to achieve quantum-computing readiness.展开更多
Ulcerative colitis(UC)is a chronic inflammatory disease with a high impact.In order to improve patient outcomes,the clinician-patient relationship in daily practice is critical.Clinical guidelines provide a framework ...Ulcerative colitis(UC)is a chronic inflammatory disease with a high impact.In order to improve patient outcomes,the clinician-patient relationship in daily practice is critical.Clinical guidelines provide a framework for UC diagnosis and treatment.However,standard procedures and the medical content focused upon medical consultations in UC patients has not yet been defined.Moreover,UC is a complex disease,given that patient characteristics and patient needs have been proven to vary during clinical consultation since establishing the diagnosis and upon the course of the disease.In this article,we have discussed the key elements and specific objectives to consider in medical consultation,such as diagnosis,first visits,follow-up visits,active disease patients,patients on topical therapies,new treatment initiation,refractory patients,extra-intestinal manifestations,as well as challenging situations.The key elements have been mentioned to comprise effective communication techniques,motivational interviewing(MI),as well as information and educational aspects,or organizational issues.The key elements to be implemented in daily practice were reported to comprise several general principles like duly prepared consultations,in addition to honesty and empathy with patients,as well as effective communication techniques,MI,information and educational points,or organizational issues.The role of other healthcare professionals such as specialized nurses,psychologists,or the use of checklists was also discussed and commented on.展开更多
BACKGROUND Hip fractures(HF)are common among the aging population,and surgery within 48 h is recommended.Patients can be hospitalized for surgery through different pathways,either trauma or medicine admitting services...BACKGROUND Hip fractures(HF)are common among the aging population,and surgery within 48 h is recommended.Patients can be hospitalized for surgery through different pathways,either trauma or medicine admitting services.AIM To compare management and outcomes among patients admitted through the trauma pathway(TP)vs medical pathway(MP).METHODS This Institutional Review Board-approved retrospective study included 2094 patients with proximal femur fractures(AO/Orthopedic Trauma Association Type 31)who underwent surgery at a level 1 trauma center between 2016-2021.There were 69 patients admitted through the TP and 2025 admitted through the MP.To ensure comparability between groups,66 of the 2025 MP patients were propensity matched to 66 TP patients by age,sex,HF type,HF surgery,and American Society of Anesthesiology score.The statistical analyses included multivariable analysis,group characteristics,and bivariate correlation comparisons with theχ^(2)test and t-test.RESULTS After propensity matching,the mean age in both groups was 75-years-old,62%of both groups were females,the main HF type was intertrochanteric(TP 52%vs MP 62%),open reduction internal fixation was the most common surgery(TP 68%vs MP 71%),and the mean American Society of Anesthesiology score was 2.8 for TP and 2.7 for MP.The majority of patients in TP and MP(71%vs 74%)were geriatric(≥65-years-old).Falls were the main mechanism of injury in both groups(77%vs 97%,P=0.001).There were no significant differences in pre-surgery anticoagulation use(49%vs 41%),admission day of the week,or insurance status.The incidence of comorbidities was equal(94%for both)with cardiac comorbidities being dominant in both groups(71%vs 73%).The number of preoperative consultations was similar for TP and MP,with the most common consultation being cardiology in both(44%and 36%).HF displacement occurred more among TP patients(76%vs 39%,P=0.000).Time to surgery was not statistically different(23 h in both),but length of surgery was significantly longer for TP(59 min vs 41 min,P=0.000).Intensive care unit and hospital length of stay were not statistically different(5 d vs 8 d and 6 d for both).There were no statistical differences in discharge disposition and mortality(3%vs 0%).CONCLUSION There were no differences in outcomes of surgeries between admission through TP vs MP.The focus should be on the patient’s health condition and on prompt surgical intervention.展开更多
Antenatal care is a safe way to prevent pregnancy-related health problems, difficult deliveries and even further to anticipate low birth weight [1]. But pregnant women, especially in Africa, do not attend antenatal cl...Antenatal care is a safe way to prevent pregnancy-related health problems, difficult deliveries and even further to anticipate low birth weight [1]. But pregnant women, especially in Africa, do not attend antenatal clinics as recommended by the WHO. The general objective of this study was to study the norm in terms of Antenatal Consultation (ANC) frequency as well as the determinants of the frequency among women who gave birth in the maternity hospitals of Agbangnizoun. Our research was a cross-sectional, descriptive, retrospective and quantitative type, which was carried out among 335 women in Agbangnizoun, Benin from 1 February to 3 April 2020 (3 months), in order to find out the general or specific characteristics of women that we associate with the frequency of prenatal consultation. At the end of the study, we found that 60%, 68% and 15% of the surveyed population had received ANC in the first, second and third trimesters, respectively. Ethnicity, income level of spouses over the three trimesters as well as the level of their knowledge and overall practice of ANC are determinants of the frequency of prenatal consultation.展开更多
Purpose: To contribute to the improvement of the quality of prenatal consultation at the reference health center of the commune IV of the district of Bamako. Patients Methods: This was a qualitative cross-sectional st...Purpose: To contribute to the improvement of the quality of prenatal consultation at the reference health center of the commune IV of the district of Bamako. Patients Methods: This was a qualitative cross-sectional study to assess the quality of prenatal consultation that took place from December 1, 2017 to January 31, 2018. It included 139 pregnant women whose consultations were monitored by the investigator and then the women were interviewed upon discharge from the facility to collect their opinions on the services they received. Results: The age group of 20 to 29 years was the most represented with 60.44%. In our study, 50% of our patients were managed by midwives. Among the antecedents constituting the risk factors sought in pregnant women, scar uterus was more frequent with 33.93% followed by arterial hypertension with 14.28% and multiparity with 7.14%. Conclusion: This study shows that the evaluation of the quality of services is an absolute necessity for the improvement of services in integrated reproductive health care centers.展开更多
Introduction: Torsion of the spermatic cord is an emergency whose delay in treatment conditions the functional prognosis of the testicle. The aim of this study was to analyze the management of spermatic cord torsion i...Introduction: Torsion of the spermatic cord is an emergency whose delay in treatment conditions the functional prognosis of the testicle. The aim of this study was to analyze the management of spermatic cord torsion in the Urology Andrology Department of the Ignace Deen National Hospital in Conakry. Material and methods: This was a ten-year retrospective descriptive study from January 1, 2012 to December 31, 2021. It involved all patients admitted for torsion of the spermatic cord, confirmed at surgical exploration. Results: We identified 21 cases of torsion of the spermatic cord. The mean age of the patients was 17.9 ± 4.4 years. The average consultation time was 19.2 ± 21.4 hours with extremes of [2 h and 98 h]. Only 6 patients (28.6%) consulted before the sixth hour. All patients presented with scrotal swelling. At scrototomy, all torsions were intravaginal with two turns of spiral in 13 cases and three turns in 8 cases. Orchiectomy followed by contralateral orchidopexy was performed in 6 cases. In the other cases, bilateral orchidopexy was performed after detorsion. The average hospital stay was 4.5 days. We recorded 4 cases of testicular atrophy after orchidopexy. Conclusion: Spermatic cord torsion is an infrequent emergency in our department. The delay in consultation remains the main predictive factor of testicular necrosis. Emergency exploratory scrotomy should be the rule.展开更多
Objective:The Delphi method was used to propose health effect evaluation indicators to assess foods for special medical purposes(FSMPs).This lays the foundation for the formation of a big data model for human health t...Objective:The Delphi method was used to propose health effect evaluation indicators to assess foods for special medical purposes(FSMPs).This lays the foundation for the formation of a big data model for human health testing,as well as a big data platform for the health and safety evaluation of special medical foods.Methods:The Delphi method was used to conduct two rounds of expert consultation on the constructed FSMP health effect evaluation indicators.Results:Ten major items were identified after two rounds of expert consultation.Among these,there were 10 primary entries,32 secondary entries,50 tertiary entries,and 28 quaternary entries.Conclusion:The complete list of evaluation indicators contains 10 entries,which can comprehensively and systematically monitor adverse reactions to the use of FSMPs.The present findings lay the foundation for a big data platform to evaluate the health and safety of special foods.展开更多
For the purpose of Kunming City’s landscaping development and satisfying the needs of botanical garden workers who demand to quickly obtain landscaping plants information and select tree species, a landscaping plant ...For the purpose of Kunming City’s landscaping development and satisfying the needs of botanical garden workers who demand to quickly obtain landscaping plants information and select tree species, a landscaping plant information database was established, which contained almost all Kunming botanical garden plants information. This database was based on Kunming natural environment conditions, and finished by hard work of collecting and analyzing relevant written materials as well as pictures of garden plants. By using B/S Structure model, dynamic web programming language ASP and Photoshop, Dreamweaver as software tools, a Web-based illustrated remote consultation service system of landscaping plants information was constructed.展开更多
基金Funding for this study was received from the Taif University Researchers Supporting Projects at Taif University,Kingdom of Saudi Arabia under Grant No.TURSP-2020/254.
文摘In a digital world moving at a breakneck speed,consultancy services have emerged as one of the prominent resources for seeking effective,sustainable and economically viable solutions to a given crisis.The present day consultancy services are aided by the use of multiple tools and techniques.However,ensuring the security of these tools and techniques is an important concern for the consultants because even a slight malfunction of any tool could alter the results drastically.Consultants usually tackle these functions after establishing the clients’needs and developing the appropriate strategy.Nevertheless,most of the consultants tend to focus more on the intended outcomes only and often ignore the security-specific issues.Our research study is an initiative to recommend the use of a hybrid computational technique based on fuzzy Analytical Hierarchy Process(AHP)and fuzzy Technique for Order Preference by Similarity to Ideal Solutions(TOPSIS)for prioritizing the tools and techniques that are used in consultancy services on the basis of their security features and efficacy.The empirical analysis conducted in this context shows that after implementing the assessment process,the rank of the tools and techniques obtained is:A7>A1>A4>A2>A3>A5>A6>A7,and General Electric McKinsey(GE-McKinsey)Nine-box Matrix(A7)obtained the highest rank.Thus,the outcomes show that this order of selection of the tools and techniques will give the most effective and secure services.The awareness about using the best tools and techniques in consultancy services is as important as selecting the most secure tool for solving a given problem.In this league,the results obtained in this study would be a conclusive and a reliable reference for the consultants.
文摘China’s opening,reform and economicdevelopment,as well as the worldinformation technology revolution,hasenhanced China’s information consultancyservice.Before 1978,China’s economy wasa product economy governed by a highly-centralized planning system with economicinformation basically based on statisticscollected from lower levels and planningcommands to lower levels.The annual productexchange meetings sponsored by specialeconomic departments became the mainchannels for information exchange,soinformation services basically failed to meetneeds.In 1979,China’s economy began itstransfer from a planned to a market one。
文摘Background/Aim: The purpose of this study was to examine the effect of training and consultancy on women’s knowledge level and health belief regarding the cervical cancer screenings and their participation in screenings. Materials and Methods: The study is designed as pre-experiment with one group pretest-posttest. The sample group of the study consists of 66 women. The data were collected between March and June 2011. “Personal Information Form”, “Information Form of Cervical Cancer Screenings”, “Health Belief Model Scale for Cervical Cancer and Pap Smear Test”, and “Assessment Form Concerning Taking the Pap Smear Test” were used to collect the data. Results: It was determined that at the end of all trainings, 45.5% of women took the relevant test. Among those who participated in the Pap Smear screening, the training and consultancy had an effect of 100%, booklets 100% and telephone calls 25%. The training and consultancy increased the perception of “benefit and motivation” regarding the Pap Smear test and Pap Smear decreased the perception of “barriers”. Regarding the cervical cancer, it decreased the perception of “regard/seriousness”, “susceptibility” and “health motivation”. Conclusions: It was concluded that training and consultancy change the health beliefs regarding cervical cancer screenings, increase the participation in screenings and consequently, contribute to early diagnosis.
文摘BACKGROUND Venovenous extracorporeal membrane oxygenation(V-V ECMO)has become an important treatment for severe pneumonia,but there are various complications during the treatment.This article describes a case with severe pneumonia success-fully treated by V-V ECMO,but during treatment,the retrovenous catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.The ECMO was safely withdrawn after multidiscip-linary consultation.Our experience with this case is expected to provide a reference for colleagues who will encounter similar situations.CASE SUMMARY A 64-year-old man had severe pulmonary infection and respiratory failure.He was admitted to our hospital and was given ventilation support(fraction of inspired oxygen 100%).The respiratory failure was not improved and he was treated by V-V ECMO,during which the venous return catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.There was a risk of massive mediastinal bleeding if the catheter was removed directly when the ECMO was withdrawn.Finally,the patient underwent vena cava angiography+balloon attachment+ECMO with-drawal in the operating room(prepared for conversion to thoracotomy for vascular exploration and repair at any time during surgery)after multidiscip-linary consultation.ECMO was safely withdrawn,and the patient recovered and was discharged.CONCLUSION Patients may have different vascular conditions.Multidisciplinary cooperation can ensure patient safety.Our experience will provide a reference for similar cases.
文摘Context: Non-communicable diseases, including hypertension, are major causes of complications during pregnancy, posing significant risks to maternal and fetal health. Pregnancy increases cardiovascular risks, particularly through the development of gestational hypertension and preeclampsia, requiring early screening and close monitoring to prevent adverse outcomes. Objectives: This study aimed to evaluate the frequency of cardiovascular risk factors in pregnant women in Senegal and identify associated socio-behavioral and economic determinants. Methodology: A descriptive, analytical cross-sectional study with prospective data collection was conducted over three months (April 10 to July 10, 2023). The study included pregnant women aged 15 and older from three public hospital maternity wards in Senegal. We studied sociodemographic aspects, cardiovascular risk factors, and collected information on previous and current pregnancies, including the number of pregnancies, parity, miscarriages, the number of prenatal consultations, and the number of fetuses. Written consent was obtained. A p-value ≤ 0.05 was considered statistically significant. Results: A total of 222 pregnant women were enrolled, representing 28% of prenatal consultations. The average age was 29.18 years (range 15 - 47). Most participants (90%) lived in Dakar suburbs, 74.20% had no medical coverage, 84% worked in the informal sector (p = 0.043), and 18% had no education. Among them, 30.63% were in their first pregnancy, 34% were nulliparous, and 3.15% were grand multiparous. The average number of prenatal visits was 3.5, with about 40% having more than four visits. Risk factors included hypertension (17%), more prevalent in women over 30 (p = 0.043), diabetes (4%), and smoking (2%). Conclusion: The study highlights critical prenatal health needs and socio-economic challenges faced by pregnant women, emphasizing the need for targeted strategies to improve healthcare access and health education.
文摘Ghanaian construction projects encounter a number of challenges, including low health, safety, and environmental requirements, poor performance, and time and cost overruns. To provide value for money (VFM) on government infrastructure projects in Ghana, this research assesses the roles of project consultants, specifically architects and quantity surveyors, and highlights important obstacles. A cross-sectional survey design involving architects and quantity surveyors yielded a 96% response rate after 100 questionnaires were distributed. Consultants’ responsibilities also include monitoring standards compliance, providing advice on delays, controlling budgets, and advising on project completion dates. Difficulties encompass a lack of promptness in decision-making, unethical conduct, political pressure, and inadequate focus on contract administration and construction audits. Project urgency, longevity, political clout, timely decision-making, and team experience are important variables that impact VFM. Policy makers and construction management practitioners should take note of the implications for Ghana’s public infrastructure projects.
文摘IN a classroom of the Costume Schoolwith the Textile University of China inShanghai,a young female teacher drewseven faces on the blackboard.She pointedto a rhomboid face and asked her students,“If someone with this shaped face raisedtheir eyes,what woud they look like?” “A fox,”burst out a student. “Yes.This shape,with a thin foreheadand a pointed chin,appears very caustic.Ihave this face.”
文摘The potential impact of quantum computing on various industries such as finance, healthcare, cryptography, and transportation is significant;therefore, sectors face challenges in understanding where to start because of the complex nature of this technology. Starting early to explore what is supposed to be done is crucial for providing sectors with the necessary knowledge, tools, and processes to keep pace with rapid advancements in quantum computing. This article emphasizes the importance of consultancy and governance solutions that aid sectors in preparing for the quantum computing revolution. The article begins by discussing the reasons why sectors need to be prepared for quantum computing and emphasizes the importance of proactive preparation. It illustrates this point by providing a real-world example of a partnership. Subsequently, the article mentioned the benefits of quantum computing readiness, including increased competitiveness, improved security, and structured data. In addition, this article discusses the steps that various sectors can take to achieve quantum readiness, considering the potential risks and opportunities in industries. The proposed solutions for achieving quantum computing readiness include establishing a quantum computing office, contracting with major quantum computing companies, and learning from quantum computing organizations. This article provides the detailed advantages and disadvantages of each of these steps and emphasizes the need to carefully evaluate their potential drawbacks to ensure that they align with the sector’s unique needs, goals, and available resources. Finally, this article proposes various solutions and recommendations for sectors to achieve quantum-computing readiness.
文摘Ulcerative colitis(UC)is a chronic inflammatory disease with a high impact.In order to improve patient outcomes,the clinician-patient relationship in daily practice is critical.Clinical guidelines provide a framework for UC diagnosis and treatment.However,standard procedures and the medical content focused upon medical consultations in UC patients has not yet been defined.Moreover,UC is a complex disease,given that patient characteristics and patient needs have been proven to vary during clinical consultation since establishing the diagnosis and upon the course of the disease.In this article,we have discussed the key elements and specific objectives to consider in medical consultation,such as diagnosis,first visits,follow-up visits,active disease patients,patients on topical therapies,new treatment initiation,refractory patients,extra-intestinal manifestations,as well as challenging situations.The key elements have been mentioned to comprise effective communication techniques,motivational interviewing(MI),as well as information and educational aspects,or organizational issues.The key elements to be implemented in daily practice were reported to comprise several general principles like duly prepared consultations,in addition to honesty and empathy with patients,as well as effective communication techniques,MI,information and educational points,or organizational issues.The role of other healthcare professionals such as specialized nurses,psychologists,or the use of checklists was also discussed and commented on.
文摘BACKGROUND Hip fractures(HF)are common among the aging population,and surgery within 48 h is recommended.Patients can be hospitalized for surgery through different pathways,either trauma or medicine admitting services.AIM To compare management and outcomes among patients admitted through the trauma pathway(TP)vs medical pathway(MP).METHODS This Institutional Review Board-approved retrospective study included 2094 patients with proximal femur fractures(AO/Orthopedic Trauma Association Type 31)who underwent surgery at a level 1 trauma center between 2016-2021.There were 69 patients admitted through the TP and 2025 admitted through the MP.To ensure comparability between groups,66 of the 2025 MP patients were propensity matched to 66 TP patients by age,sex,HF type,HF surgery,and American Society of Anesthesiology score.The statistical analyses included multivariable analysis,group characteristics,and bivariate correlation comparisons with theχ^(2)test and t-test.RESULTS After propensity matching,the mean age in both groups was 75-years-old,62%of both groups were females,the main HF type was intertrochanteric(TP 52%vs MP 62%),open reduction internal fixation was the most common surgery(TP 68%vs MP 71%),and the mean American Society of Anesthesiology score was 2.8 for TP and 2.7 for MP.The majority of patients in TP and MP(71%vs 74%)were geriatric(≥65-years-old).Falls were the main mechanism of injury in both groups(77%vs 97%,P=0.001).There were no significant differences in pre-surgery anticoagulation use(49%vs 41%),admission day of the week,or insurance status.The incidence of comorbidities was equal(94%for both)with cardiac comorbidities being dominant in both groups(71%vs 73%).The number of preoperative consultations was similar for TP and MP,with the most common consultation being cardiology in both(44%and 36%).HF displacement occurred more among TP patients(76%vs 39%,P=0.000).Time to surgery was not statistically different(23 h in both),but length of surgery was significantly longer for TP(59 min vs 41 min,P=0.000).Intensive care unit and hospital length of stay were not statistically different(5 d vs 8 d and 6 d for both).There were no statistical differences in discharge disposition and mortality(3%vs 0%).CONCLUSION There were no differences in outcomes of surgeries between admission through TP vs MP.The focus should be on the patient’s health condition and on prompt surgical intervention.
文摘Antenatal care is a safe way to prevent pregnancy-related health problems, difficult deliveries and even further to anticipate low birth weight [1]. But pregnant women, especially in Africa, do not attend antenatal clinics as recommended by the WHO. The general objective of this study was to study the norm in terms of Antenatal Consultation (ANC) frequency as well as the determinants of the frequency among women who gave birth in the maternity hospitals of Agbangnizoun. Our research was a cross-sectional, descriptive, retrospective and quantitative type, which was carried out among 335 women in Agbangnizoun, Benin from 1 February to 3 April 2020 (3 months), in order to find out the general or specific characteristics of women that we associate with the frequency of prenatal consultation. At the end of the study, we found that 60%, 68% and 15% of the surveyed population had received ANC in the first, second and third trimesters, respectively. Ethnicity, income level of spouses over the three trimesters as well as the level of their knowledge and overall practice of ANC are determinants of the frequency of prenatal consultation.
文摘Purpose: To contribute to the improvement of the quality of prenatal consultation at the reference health center of the commune IV of the district of Bamako. Patients Methods: This was a qualitative cross-sectional study to assess the quality of prenatal consultation that took place from December 1, 2017 to January 31, 2018. It included 139 pregnant women whose consultations were monitored by the investigator and then the women were interviewed upon discharge from the facility to collect their opinions on the services they received. Results: The age group of 20 to 29 years was the most represented with 60.44%. In our study, 50% of our patients were managed by midwives. Among the antecedents constituting the risk factors sought in pregnant women, scar uterus was more frequent with 33.93% followed by arterial hypertension with 14.28% and multiparity with 7.14%. Conclusion: This study shows that the evaluation of the quality of services is an absolute necessity for the improvement of services in integrated reproductive health care centers.
文摘Introduction: Torsion of the spermatic cord is an emergency whose delay in treatment conditions the functional prognosis of the testicle. The aim of this study was to analyze the management of spermatic cord torsion in the Urology Andrology Department of the Ignace Deen National Hospital in Conakry. Material and methods: This was a ten-year retrospective descriptive study from January 1, 2012 to December 31, 2021. It involved all patients admitted for torsion of the spermatic cord, confirmed at surgical exploration. Results: We identified 21 cases of torsion of the spermatic cord. The mean age of the patients was 17.9 ± 4.4 years. The average consultation time was 19.2 ± 21.4 hours with extremes of [2 h and 98 h]. Only 6 patients (28.6%) consulted before the sixth hour. All patients presented with scrotal swelling. At scrototomy, all torsions were intravaginal with two turns of spiral in 13 cases and three turns in 8 cases. Orchiectomy followed by contralateral orchidopexy was performed in 6 cases. In the other cases, bilateral orchidopexy was performed after detorsion. The average hospital stay was 4.5 days. We recorded 4 cases of testicular atrophy after orchidopexy. Conclusion: Spermatic cord torsion is an infrequent emergency in our department. The delay in consultation remains the main predictive factor of testicular necrosis. Emergency exploratory scrotomy should be the rule.
基金This research was supported by the National Key Research and Development Program of China(2019YFC1606400).
文摘Objective:The Delphi method was used to propose health effect evaluation indicators to assess foods for special medical purposes(FSMPs).This lays the foundation for the formation of a big data model for human health testing,as well as a big data platform for the health and safety evaluation of special medical foods.Methods:The Delphi method was used to conduct two rounds of expert consultation on the constructed FSMP health effect evaluation indicators.Results:Ten major items were identified after two rounds of expert consultation.Among these,there were 10 primary entries,32 secondary entries,50 tertiary entries,and 28 quaternary entries.Conclusion:The complete list of evaluation indicators contains 10 entries,which can comprehensively and systematically monitor adverse reactions to the use of FSMPs.The present findings lay the foundation for a big data platform to evaluate the health and safety of special foods.
文摘For the purpose of Kunming City’s landscaping development and satisfying the needs of botanical garden workers who demand to quickly obtain landscaping plants information and select tree species, a landscaping plant information database was established, which contained almost all Kunming botanical garden plants information. This database was based on Kunming natural environment conditions, and finished by hard work of collecting and analyzing relevant written materials as well as pictures of garden plants. By using B/S Structure model, dynamic web programming language ASP and Photoshop, Dreamweaver as software tools, a Web-based illustrated remote consultation service system of landscaping plants information was constructed.