Difficulties Faced by Physicians in the Diagnosis of Endometriosis in the Brazilian Public Health System

Endometriosis is a clinical and recurrent condition characterized by the presence of functional endometrial tissue outside the uterine cavity and myometrium. It is estimated that 6% to 10% of women of reproductive age, 50% to 60% of adolescents and adults with pelvic pain, and up to 50% of women with infertility are pregnant from the condition. However, this proportion tends to be even greater due to the difficulty in diagnosing it: because it presents different symptoms, lack of information from health professionals, and a high-cost diagnostic test. Another aggravating factor is the average time from the onset of symptoms to the medical diagnosis, which even today ranges from five to ten years;this delay has consequences for disease progression, as it prevents early treatment, which is important for improving pain levels and physical and psychological well-being. Aware of these mishaps, it is therefore important to assess the difficulties faced by doctors in the diagnosis of endometriosis in the public health system, in Brazil, the Unified Health System (SUS). With this purpose, a cross sectional was carried out, developed in the virtual environment using traffic in Google forms, with the difficulties quantified in the Likert scale. Participating physicians pointed out a medium difficulty for patients with endometriosis to access the consultation (58%) and moderate difficulty (52%) to perform an ultrasound examination;also signaled great difficulty in performing magnetic resonance imaging (77%) and laparotomy (61%) in these patients. It is hoped that knowledge about the difficulties faced by physicians in the diagnosis of endometriosis in the SUS will give these physicians a voice and corroborate, even if minimally, so that there is more research that provokes the search for these difficulties, in order to improving the quality of life of these women.

Intestinal complications in patients with Crohn's disease in the Brazilian public healthcare system between 2011 and 2020

BACKGROUND This is a secondary database study using the Brazilian public healthcare system database.AIM To describe intestinal complications(ICs)of patients in the Brazilian public healthcare system with Crohn’s disease(CD)who initiated and either only received conventional therapy(CVT)or also initiated anti-tumor necrosis factor(anti-TNF)therapy between 2011 and 2020.METHODS This study included patients with CD[international classification of diseases–10th revision(ICD-10):K50.0,K50.1,or K50.8](age:≥18 years)with at least one claim of CVT(sulfasalazine,azathioprine,mesalazine,or methotrexate).IC was defined as a CD-related hospitalization,pre-defined procedure codes(from rectum or intestinal surgery groups),and/or associated disease(pre-defined ICD-10 codes),and overall(one or more type of ICs).RESULTS In the 16809 patients with CD that met the inclusion criteria,the mean follow-up duration was 4.44(2.37)years.In total,14697 claims of ICs were found from 4633 patients.Over the 1-and 5-year of follow-up,8.3%and 8.2%of the patients with CD,respectively,presented at least one IC,of which fistula(31%)and fistulotomy(48%)were the most commonly reported.The overall incidence rate(95%CI)of ICs was 6.8(6.5–7.04)per 100 patient years for patients using only-CVT,and 9.2(8.8–9.6)for patients with evidence of anti-TNF therapy.CONCLUSION The outcomes highlighted an important and constant rate of ICs over time in all the CD populations assessed,especially in patients exposed to anti-TNF therapy.This outcome revealed insights into the real-world treatment and complications relevant to patients with CD and highlights that this disease remains a concern that may require additional treatment strategies in the Brazilian public healthcare system.

Reacting to Epidemics:The Innovative Imperial Public Health System during the Late Northern Song Dynasty

Song China was a period in which China experienced a great increase in its population.Concurrently,the Song dynasty also experienced a rise in the frequency of epidemics and two major wars with the Western Xia and Liao dynasties during the 1000s and 1040s.The consequences of these changes were exacerbated by the increased geographical mobility of certain social groups such as traders and examinees attending civil service examinations.Thus,casualties of wars,epidemics,or disease,especially of people whose families were far away and could not care for them were left without care and“their corpses often lay bare along the roads.”This new social environment created a need for general relief.The Northern Song government(960-1127 CE),especially during the reign of Emperor Huizong,established an innovative public health system to address this issue.The public health system included poorhouses,public hospitals,and pauper’s cemeteries.The first were more of charity organizations,whereas the latter two promoted public health by providing medical services for the poor and burial for those that nobody cared for.In terms of rationale behind these institutions,on the one hand,they constituted an attempt to get the poor and homeless off the streets while providing them relief or burial.On the other hand,it seems that Huizong’s deep concern with medicine propelled him to design and implement a comprehensive public health system oriented to prevent contagion and outbreak of epidemics.This article depicts the background,the organization,and the functions of the system.The article also discusses the conditions and reasons that gave rise to such a unique undertaking by the Northern Song government.

Estimating the Monetary Value of Hours Lost to the Nigerian Public Healthcare System When Full-Time Government Employee Doctors Engage in Dual Practice

Background: Dual Practice (DP) allows full-time public sector doctors to concurrently offer the same clinical services in the private sector. The debate against this practice seems to be largely influenced by its potential to reduce the contracted hours in the public sector and shift attention to private work. Purpose: The purpose of this secondary research is to estimate the monetary value of hours lost to the Nigerian public healthcare system when full-time government employee doctors are engaged in private practice. It attempts to quantify the amount of resource outflow from the public system due to absences and lateness arising from competition for time between the public system’s contracted hours and private practice. Methods: Sensitivity analysis in Excel 2010 was used to calculate doctors’ hourly pay in the public sector using the 2015 Consolidated Medical Salary Structure for medical and dental officers in Nigeria’s federal public service. The parameters used for the calculation were the official 40-hour working week and the average monthly gross pay of doctors on different grade levels. Hypothetical scenarios of hours lost due to absences associated with DP were created. The value of different hypothetical hour losses by the percentage of doctors assumed to engage in dual practice across all doctor grade levels was then computed. Results: The estimated annual value of hours lost from dual practice to a single public tertiary care hospital was N4,851,754 or 15,855 USD (best case scenario) and N19,407,017 or 63,422 USD (worst case scenario) for the normal routine work and N1,800,133 or 5883 USD (best case scenario) and N3,600,266 or 11,766 USD (worst case scenario) for the on-call duty. Conclusion: The government may have been paying salaries for large volumes of work not rendered in the public sector. The overall financial impact of dual practice in the Nigerian public system might be negative.

Analysis of the Harmonious Discourse of Publicity Documentary Seasons of China Based on Transitivity System

Publicity documentaries play an important role in shaping the image of one country during the international communication.Seasons of China is a publicity documentary introducing the traditional Chinese culture 24 solar terms.Under the guidance of the framework of Harmonious Discourse Analysis,this thesis uses a combination of quantitative and qualitative methods to analyze the harmonious discourse of this documentary based on the transitivity system.The research finds that the discourse of Seasons of China conveys the China’s ecological concept of respecting,following and protecting the nature,while telling the stories of Chinese traditional culture 24 solar terms,highlighting the image of China as a responsible country for ecological civilization construction.

Discreet investors exert greater influence on cooperation in the public goods game

This paper studies the evolutionary process of cooperative behavior in a public goods game model with heterogeneous investment strategies in square lattices.In the proposed model,players are divided into defectors,cooperators and discreet investors.Among these,defectors do not participate in investing,discreet investors make heterogeneous investments based on the investment behavior and cooperation value of their neighbors,and cooperators invest equally in each neighbor.In real life,heterogeneous investment is often accompanied by time or economic costs.The discreet investors in this paper pay a certain price to obtain their neighbors'investment behavior and cooperation value,which quantifies the time and economic costs of the heterogeneous investment process.The results of Monte Carlo simulation experiments in this study show that discreet investors can effectively resist the invasion of the defectors,form a stable cooperative group and expand the cooperative advantage in evolution.However,when discreet investors pay too high a price,they lose their strategic advantage.The results in this paper help us understand the role of heterogeneous investment in promoting and maintaining human social cooperation.

Users’ Perception on Operation and Performance of Public Transport Systems in African Developing Countries: The Case of Bus Rapid Transit (BRT) in Dar es Salaam City, Tanzania

Public transport system has been a means of addressing transportation challenges in urban areas, such as traffic congestion, traffic jam and long travel time in cities worldwide. Transportation in Africa is unique in that it has the least developed public transport systems in the world, while also being one of the fastest urbanizing continents. Bus Rapid Transit being one of the public transport systems was introduced in Africa in 2008 as a means to provide solution on urban transportation challenges. Despite of public transport being the main means of transport in African developing countries, there have been a number of challenges that affects efficiency of performance of the system and makes its users uncomfortable. Therefore, the study aimed at exploring the setbacks or challenges associated with operation and performance of the BRT system in the African developing countries and address them. The study employed mixed methods research design that integrates both qualitative and quantitative data collection methods and analysis. The study findings reveal that, there is an improvement on the perspectives of the commuters on public transport after introduction of BRT system. However, some challenges such as long waiting time, passengers overcrowding during peak hours, as well as safety and security can slowly change the perspective of the commuters. Therefore, to address these challenges it is recommended to reduce the long waiting time and improve accessibility by introduction of passenger information displays (bus information system) and automated fare collection system;reduce travel time by introduction of bus priority signal;and improve safety and security by introduction of signage and CCTV Camera within the bus and bus stops.

Dynamic analysis of major public health emergency transmission considering the dual-layer coupling of community–resident complex networks

We construct a dual-layer coupled complex network of communities and residents to represent the interconnected risk transmission network between communities and the disease transmission network among residents. It characterizes the process of infectious disease transmission among residents between communities through the SE2IHR model considering two types of infectors. By depicting a more fine-grained social structure and combining further simulation experiments, the study validates the crucial role of various prevention and control measures implemented by communities as primary executors in controlling the epidemic. Research shows that the geographical boundaries of communities and the social interaction patterns of residents have a significant impact on the spread of the epidemic, where early detection, isolation and treatment strategies at community level are essential for controlling the spread of the epidemic. In addition, the study explores the collaborative governance model and institutional advantages of communities and residents in epidemic prevention and control.

A comparative study on characteristics of retracted publications across different open access levels

Purpose:Recently,global science has shown an increasing open trend,however,the characteristics of research integrity of open access(OA)publications have rarely been studied.The aim of this study is to compare the characteristics of retracted articles across different OA levels and discover whether OA level influences the characteristics of retracted articles.Design/methodology/approach:The research conducted an analysis of 6,005 retracted publications between 2001 and 2020 from the Web of Science and Retraction Watch databases.These publications were categorized based on their OA levels,including Gold OA,Green OA,and non-OA.The study explored retraction rates,time lags and reasons within these categories.Findings:The findings of this research revealed distinct patterns in retraction rates among different OA levels.Publications with Gold OA demonstrated the highest retraction rate,followed by Green OA and non-OA.A comparison of retraction reasons between Gold OA and non-OA categories indicated similar proportions,while Green OA exhibited a higher proportion due to falsification and manipulation issues,along with a lower occurrence of plagiarism and authorship issues.The retraction time lag was shortest for Gold OA,followed by non-OA,and longest for Green OA.The prolonged retraction time for Green OA could be attributed to an atypical distribution of retraction reasons.A comparative study on characteristics of retracted publications across different open access levels Research limitations:There is no exploration of a wider range of OA levels,such as Hybrid OA and Bronze OA.Practical implications:The outcomes of this study suggest the need for increased attention to research integrity within the OA publications.The occurrences offalsification,manipulation,and ethical concerns within Green OA publications warrant attention from the scientific community.Originality/value:This study contributes to the understanding of research integrity in the realm of OA publications,shedding light on retraction patterns and reasons across different OA levels.

How to enhance agricultural plastic waste management in China?Insights from public participation

Agricultural plastics play a pivotal role in agricultural production.However,due to expensive costs,agricultural plastic waste management(APWM)encounters a vast funding gap.As one of the crucial stakeholders,the public deserves to make appropriate efforts for APWM.Accordingly,identifying whether the public is willing to pay for APWM and clarifying the decisions’driving pathways to explore initiatives for promoting their payment intentions are essential to address the dilemma confronting APWM.To this end,by applying the extended theory of planned behavior(TPB),the study conducted an empirical analysis based on 1,288 residents from four provinces(autonomous regions)of northern China.Results illustrate that:1)respondents hold generally positive and relatively strong payment willingness towards APWM;2)respondents’attitude(AT),subjective norm(SN),and perceived behavioral control(PBC)are positively correlated with their payment intentions(INT);3)environmental cognition(EC)and environmental emotion(EE)positively moderate the relationships between AT and INT,and between SN and INT,posing significant indirect impacts on INT.The study’s implications extend to informing government policies,suggesting that multi-entity cooperation,specifically public payment for APWM,can enhance agricultural non-point waste management.

A Blind Batch Encryption and Public Ledger-Based Protocol for Sharing Sensitive Data

For the goals of security and privacy preservation,we propose a blind batch encryption-and public ledger-based data sharing protocol that allows the integrity of sensitive data to be audited by a public ledger and allows privacy information to be preserved.Data owners can tightly manage their data with efficient revocation and only grant one-time adaptive access for the fulfillment of the requester.We prove that our protocol is semanticallly secure,blind,and secure against oblivious requesters and malicious file keepers.We also provide security analysis in the context of four typical attacks.

Structured Multi-Head Attention Stock Index Prediction Method Based Adaptive Public Opinion Sentiment Vector

The present study examines the impact of short-term public opinion sentiment on the secondary market,with a focus on the potential for such sentiment to cause dramatic stock price fluctuations and increase investment risk.The quantification of investment sentiment indicators and the persistent analysis of their impact has been a complex and significant area of research.In this paper,a structured multi-head attention stock index prediction method based adaptive public opinion sentiment vector is proposed.The proposedmethod utilizes an innovative approach to transform numerous investor comments on social platforms over time into public opinion sentiment vectors expressing complex sentiments.It then analyzes the continuous impact of these vectors on the market through the use of aggregating techniques and public opinion data via a structured multi-head attention mechanism.The experimental results demonstrate that the public opinion sentiment vector can provide more comprehensive feedback on market sentiment than traditional sentiment polarity analysis.Furthermore,the multi-head attention mechanism is shown to improve prediction accuracy through attention convergence on each type of input information separately.Themean absolute percentage error(MAPE)of the proposedmethod is 0.463%,a reduction of 0.294% compared to the benchmark attention algorithm.Additionally,the market backtesting results indicate that the return was 24.560%,an improvement of 8.202% compared to the benchmark algorithm.These results suggest that themarket trading strategy based on thismethod has the potential to improve trading profits.

Use of cognitive-behavioral career coaching to reduce work anxiety and depression in public employees

BACKGROUND Public employees worldwide are increasingly concerned about work anxiety and depression.Cognitive-behavioral career coaching has emerged as a promising strategy for addressing these mental health disorders,which can negatively impact on a person's overall well-being and performance.AIM To examine whether cognitive-behavioral career coaching reduces work anxiety and depression among Nigerian public employees.METHODS A total of 120 public employees(n=60)suffering from severe anxiety and depression were randomly assigned to the treatment or control groups in this study.Cognitive behavioral coaching was provided twice a week to those in the treatment group,whereas no treatment was given to those in the control group.As part of the study,the Hamilton Anxiety Rating Scales and Beck Depression Inventory were used to collect data.RESULTS Analysis of covariance of the data from participants indicates a significant effect of cognitive-behavioral career coaching on work anxiety and depression.CONCLUSION Insights into the underlying mechanisms by which cognitive behavior career coaching exerts its effects have been gained from this study.Also,the study has gathered valuable data that can inform future practice and guide the development of strategies for supporting mental health at work.

The coordinated evolution of ecological environment,public service,and tourism economy along the Silk Road Economic Belt,using the Dual-Carbon Targets

Carbon peak and carbon neutrality(dual-carbon)are important targets for the international response to climate change.The Silk Road Economic Belt is a strategic resource region and is important for future ecological environment and tourism development.Based on the“dual-carbon”targets,the Single index quantification,Multiple index synthesis,and Poly-criteria integration evaluation model were used in this study to measure the coordinated development index of the ecological environment,public service,and tourism economy along the Silk Road Economic Belt and to analyze its spatial and temporal evolution.Further,it explores the dynamic evolution and development trend of the three systems using the Kernel Density and Grey Markov Prediction Model.The results show that the coordinated development index along this region needs to be improved during the study period.Furthermore,the coordinated development index of the Southwest region is relatively higher than that of the Northwest region.From the development trend of the three systems,all of them develop in a stable manner;however,the tourism economy system is easily affected by external disturbances.The coordinated development index of the three systems changes dynamically and tends to be in a good state of coordination.There is a certain spatial and temporal heterogeneity.The gravity center of the coordinated development index has been in the Southwest region.During the forecast period,the coordinated development index along this region will improve significantly,while insufficient and unbalanced development will continue.

Data Collection and Research on the Vitality of Public Space in Traditional Villages: A Case Study of Cuandixia Village

The optimization and renewal of rural space is the foundation for building livable,business friendly and harmonious countryside.Three types of data on the spatial vitality of traditional villages are collected and analyzed.A street and alley axis map model is established using spatial syntax,and the degree of industry aggregation is quantified using POI data,and the results of syntactic calculation are validated with the help of popular review text preferences.Taking Cuandixia Village as an example,this paper found that its public space nodes have a pattern of one axis and scattered points;the street and alley space is well preserved but slightly lacking in transportation;the user group is single and the form is traditional.This paper could provide corresponding suggestions for stimulating the vitality of public spaces in traditional villages,in order to provide inspiration for the revitalization design of public spaces in traditional villages.

Accessibility and Fairness of Public Service Facilities from the Perspective of Supply and Demand Coordination: A Case Study of Old Urban Area of Guangzhou City

The accessibility and fairness of public service facilities are important manifestations of the convenience and equality of urban public service resource allocation.Optimizing the layout of urban public service facilities is an inevitable requirement for promoting the construction of people centered cities.This paper takes the old urban area of Guangzhou as the research area,measures the accessibility of multiple types of public service facilities based on an improved two-step floating catchment method,and combines Palma Ratio and location quotient methods to explore the fairness of urban public service facilities from two dimensions:social equity and spatial equity,with supply and demand relationship analysis as the main line.Research has shown that:①there is a significant spatial difference in the accessibility of public service facilities in the old urban areas of Guangzhou,and the comprehensive accessibility is generally higher in the central and southeastern regions of the old urban areas with fewer residential populations;②from the perspective of social equity,the resource allocation of public service facilities in the old urban areas of Guangzhou is in a seriously unfair state(with a fairness index of 2.99),and there are also varying degrees of unfairness within the streets;③from the perspective of spatial equity,the location quotient of public service facilities in the old urban areas of Guangzhou shows a pattern of multil center circles decreasing,indicating a significant spatial mismatch between the accessibility supply side of public service facilities and the demand side of the residential population.The research conclusion will provide scientific basis for optimizing the allocation of urban public service facilities and ensuring the equalization of public services.

Analysis of Distribution of Public Toilets within Walking Range around Communities of the Elderly under the Model of Community Home-based Care for the Elderly: A Case Study of Changxindian, Fengtai District, Beijing

In recent years,under the influence of multiple factors such as traditional ideas and living economic conditions,the aging population in China continues to increase.Most of the elderly are more inclined to aged at home,and the first places for elderly activities are communities and the surrounding environment,which greatly affects the convenience of life and happiness of the elderly.In this paper,Changxindian area in Fengtai District of Beijing was as the research object,and detailed calculation and analysis were carried out by using POI data and arcGIS software.The relative location of residential areas and surrounding public toilets was explored,and the best location of public toilets in the daily walking area under the model of community home-based care for the elderly was further studied.

Dedicated to Public Welfare and Constantly Giving Back to Society

As the Chairman of the Hong Kong Doyen’s Club Ltd.,Sunny Wu has devoted himself to public welfare undertakings through practical actions over the years,and his down-to-earth ideas contain strong patriotism and a sincere love for Hong Kong.

The Influence of Information Technology(IT)on Accrual Accounting Adoption:The Case of the Jordanian Public Sector

Jordan is one of many countries that intends to reform its public sector by adopting accrual accounting,which is primarily carried out through the International Public Sector Accounting Standards(IPSAS)implementation plan,scheduled to be completed by 2021.Considering the difficulties of adoption,this process cannot be completed without an appropriate Information Technology(IT)system capable of providing the accounting information required for this reform.Therefore,this study aims to examine the influence of IT on accrual accounting adoption in the Jordanian public sector.The study employed the quantitative survey approach.Based on 331 usable questionnaires,the descriptive findings showed that the use of IT in the Jordanian public sector is relevant to daily accounting transactions in general and to accrual accounting in particular.The regression analysis showed a positive,significant relationship between IT use and accrual accounting practice.The IT specialist should be able to understand the needs of public sector in adopting accrual-based accounting.In line with today’s digitalization age,which integrates advanced technologies and numerous techniques,this study suggests that a combination of accounting and IT experts is a value added to sharpen the competitiveness of public sector reform.This study contributes to the extant literature in public sector,concerning the relationship between IT and accrual accounting adoption in the context of Jordan.

Research on Evaluation of Spatial Vitality and Influencing Factors of Guesthouses Public Areas Based on Rural Tourism Development

In recent years,China has continued to promote the strategy of rural revitalization.The rural tourism industry has developed rapidly in the context of rural revitalization.Now the rural B&B industry has become an important pillar in solving the problem of rural tourism accommodation.Most of the villages in China have begun to carry out the construction of rural lodging,for example,there are residents who use idle houses to carry out construction on their own initiative and projects developed by village collectives,so the rural lodging industry has been vigorously developed.The vitality of supporting industries and landscape resources around the distribution of rural lodging has become a hot spot of rural issues research in recent years.Therefore,we can use the method of data analysis to analyze the industry and function of the public area around the distribution of rural B&B.Through the comparison of data and the interpretation of related cases,the core elements affecting the spatial vitality of B&B public areas can be identified.We will analyze and improve the related elements to find a reasonable way to enhance the spatial vitality value.Finally,the article will put forward suggestions to improve the related spatial vitality as a way to promote the development of rural B&B industry and the progress of rural tourism.