BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective pr...BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.展开更多
Due to the high potential risk and many influencing factors of subsea horizontal X-tree installation,to guarantee the successful completion of sea trials of domestic subsea horizontal X-trees,this paper established a ...Due to the high potential risk and many influencing factors of subsea horizontal X-tree installation,to guarantee the successful completion of sea trials of domestic subsea horizontal X-trees,this paper established a modular risk evaluation model based on a fuzzy fault tree.First,through the analysis of the main process oftree down and combining the Offshore&Onshore Reliability Data(OREDA)failure statistics and the operation procedure and the data provided by the job,the fault tree model of risk analysis of the tree down installation was established.Then,by introducing the natural language of expert comprehensive evaluation and combining fuzzy principles,quantitative analysis was carried out,and the fuzzy number was used to calculate the failure probability of a basic event and the occurrence probability of a top event.Finally,through a sensitivity analysis of basic events,the basic events of top events significantly affected were determined,and risk control and prevention measures for the corresponding high-risk factors were proposed for subsea horizontal X-tree down installation.展开更多
Natural disaster risk monitoring is an important task for disaster prevention and reduction.In the case of immovable cultural relics,however,the feedback mechanism,risk factors,monitoring logic,and monitoring indicato...Natural disaster risk monitoring is an important task for disaster prevention and reduction.In the case of immovable cultural relics,however,the feedback mechanism,risk factors,monitoring logic,and monitoring indicators of natural disaster risk monitoring are complex.How to achieve intelligent perception and monitoring of natural disaster risk for immovable cultural relics has always been a focus and a challenge for researchers.Based on the analysis of the concepts and issues related to the natural disaster risk of immovable cultural relics,this paper proposes a framework for natural disaster risk monitoring for immovable cultural relics based on the digital twin.This framework focuses on risk monitoring,including the physical entities of natural disaster risk for immovable cultural relics,monitoring indicators,and virtual entity construction.A platform for monitoring the natural disaster risk of immovable cultural relics is proposed.Using the Puzhou Ancient City Site as a test bed,the proposed concept can be used for monitoring the natural disaster risk of immovable cultural relics at different scales.展开更多
BACKGROUND Deep learning provides an efficient automatic image recognition method for small bowel(SB)capsule endoscopy(CE)that can assist physicians in diagnosis.However,the existing deep learning models present some ...BACKGROUND Deep learning provides an efficient automatic image recognition method for small bowel(SB)capsule endoscopy(CE)that can assist physicians in diagnosis.However,the existing deep learning models present some unresolved challenges.AIM To propose a novel and effective classification and detection model to automatically identify various SB lesions and their bleeding risks,and label the lesions accurately so as to enhance the diagnostic efficiency of physicians and the ability to identify high-risk bleeding groups.METHODS The proposed model represents a two-stage method that combined image classification with object detection.First,we utilized the improved ResNet-50 classification model to classify endoscopic images into SB lesion images,normal SB mucosa images,and invalid images.Then,the improved YOLO-V5 detection model was utilized to detect the type of lesion and its risk of bleeding,and the location of the lesion was marked.We constructed training and testing sets and compared model-assisted reading with physician reading.RESULTS The accuracy of the model constructed in this study reached 98.96%,which was higher than the accuracy of other systems using only a single module.The sensitivity,specificity,and accuracy of the model-assisted reading detection of all images were 99.17%,99.92%,and 99.86%,which were significantly higher than those of the endoscopists’diagnoses.The image processing time of the model was 48 ms/image,and the image processing time of the physicians was 0.40±0.24 s/image(P<0.001).CONCLUSION The deep learning model of image classification combined with object detection exhibits a satisfactory diagnostic effect on a variety of SB lesions and their bleeding risks in CE images,which enhances the diagnostic efficiency of physicians and improves the ability of physicians to identify high-risk bleeding groups.展开更多
A means to develop a comparative assessment of the risks of available wastewater effluent disposal options on a local scale needs to be developed to help local decision-makers make decisions on options such as direct ...A means to develop a comparative assessment of the risks of available wastewater effluent disposal options on a local scale needs to be developed to help local decision-makers make decisions on options such as direct or indirect potable reuse options. These options have garnered more interest as a result of water supply limitations in many urban areas. This risk assessment was developed from a risk assessment developed at the University of Miami in 2001 and Florida Atlantic University (FAU) in 2023. Direct potable reuse and injection wells were deemed to have the lowest risk in the most recent study by FAU. However, the injection well option may not be available everywhere. As a result, a more local means to assess exposure risk is needed. This paper outlines the process to evaluate the public health risks associated with available disposal alternatives which may be very limited in some areas. The development of exposure pathways can help local decision-makers define the challenges, and support later expert level analysis upon which public health decisions are based.展开更多
Enterprise risk management holds significant importance in fostering sustainable growth of businesses and in serving as a critical element for regulatory bodies to uphold market order.Amidst the challenges posed by in...Enterprise risk management holds significant importance in fostering sustainable growth of businesses and in serving as a critical element for regulatory bodies to uphold market order.Amidst the challenges posed by intricate and unpredictable risk factors,knowledge graph technology is effectively driving risk management,leveraging its ability to associate and infer knowledge from diverse sources.This review aims to comprehensively summarize the construction techniques of enterprise risk knowledge graphs and their prominent applications across various business scenarios.Firstly,employing bibliometric methods,the aim is to uncover the developmental trends and current research hotspots within the domain of enterprise risk knowledge graphs.In the succeeding section,systematically delineate the technical methods for knowledge extraction and fusion in the standardized construction process of enterprise risk knowledge graphs.Objectively comparing and summarizing the strengths and weaknesses of each method,we provide recommendations for addressing the existing challenges in the construction process.Subsequently,categorizing the applied research of enterprise risk knowledge graphs based on research hotspots and risk category standards,and furnishing a detailed exposition on the applicability of technical routes and methods.Finally,the future research directions that still need to be explored in enterprise risk knowledge graphs were discussed,and relevant improvement suggestions were proposed.Practitioners and researchers can gain insights into the construction of technical theories and practical guidance of enterprise risk knowledge graphs based on this foundation.展开更多
The technological revolution has spawned a new generation of industrial systems,but it has also put forward higher requirements for safety management accuracy,timeliness,and systematicness.Risk assessment needs to evo...The technological revolution has spawned a new generation of industrial systems,but it has also put forward higher requirements for safety management accuracy,timeliness,and systematicness.Risk assessment needs to evolve to address the existing and future challenges by considering the new demands and advancements in safety management.The study aims to propose a systematic and comprehensive risk assessment method to meet the needs of process system safety management.The methodology first incorporates possibility,severity,and dynamicity(PSD)to structure the“51X”evaluation indicator system,including the inherent,management,and disturbance risk factors.Subsequently,the four-tier(risk point-unit-enterprise-region)risk assessment(RA)mathematical model has been established to consider supervision needs.And in conclusion,the application of the PSD-RA method in ammonia refrigeration workshop cases and safety risk monitoring systems is presented to illustrate the feasibility and effectiveness of the proposed PSD-RA method in safety management.The findings show that the PSD-RA method can be well integrated with the needs of safety work informatization,which is also helpful for implementing the enterprise's safety work responsibility and the government's safety supervision responsibility.展开更多
Objective:To investigate the interrelationship between cardiovascular health awareness,risk perception,behavioural intention,and INTERHEART risk stratification in a middle-aged adult population in Malaysia.Methods:A c...Objective:To investigate the interrelationship between cardiovascular health awareness,risk perception,behavioural intention,and INTERHEART risk stratification in a middle-aged adult population in Malaysia.Methods:A cross-sectional survey with convenience sampling was conducted during November 2022 and January 2023.Participants completed validated questionnaires assessing cardiovascular health awareness,risk perception of cardiovascular diseases,behavioural intention towards adopting healthy habits,and INTERHEART risk stratification score(IHRS)based on established risk factors.A total of 602 respondents were included in the final analysis.Data were analysed with independent t-test/one-way ANOVA or Mann-Whitney/Kruskal-Wallis to test the differences,Pearson correlation or linear regression test to analyze the association of independent and dependent variables.Results:There was a significant positive correlation between medical knowledge related to cardiovascular disease(CVD)and knowledge related to CVD risk prevention,risk perception,behavioural intention and IHRS(P<0.05,Pearson correlation).Notably,individuals with higher IHRS tended to have lower knowledge related to CVD and CVD risk prevention,risk perception,and behavioural intention.Males,laborers,active/former smokers,individuals with lower household income and educational levels,those involved in occupations not related to the healthcare sector,and those who did not receive the CVD health brochure or are unaware of health self-assessment tools are likely to have lower levels of knowledge,risk perception,and poorer behavioural intention regarding cardiovascular health(P<0.05,one-way ANOVA).While educational level,smoking status,awareness about CVD poster,self-assessment tools were repeatedly significantly associated with knowledge related to CVD and CVD risk prevention,risk perception,behavioral intention and/or IHRS(P<0.05,linear regression).Conclusions:These findings underscore the importance of promoting cardiovascular health awareness and risk perception among middle-aged adults to foster positive BI and reduce CVD risk.Tailored interventions targeting specific risk factors identified by INTERHEART may enhance risk stratification accuracy and facilitate targeted preventive strategies.展开更多
Objectives:Anastomotic leakage(AL)stands out as a prevalent and severe complication following gastric cancer surgery.It frequently precipitates additional serious complications,significantly influencing the overall su...Objectives:Anastomotic leakage(AL)stands out as a prevalent and severe complication following gastric cancer surgery.It frequently precipitates additional serious complications,significantly influencing the overall survival time of patients.This study aims to enhance the risk-assessment strategy for AL following gastrectomy for gastric cancer.Methods:This study included a derivation cohort and validation cohort.The derivation cohort included patients who underwent radical gastrectomy at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,from January 1,2015 to December 31,2020.An evidence-based predictor questionnaire was crafted through extensive literature review and panel discussions.Based on the questionnaire,inpatient data were collected to form a model-derivation cohort.This cohort underwent both univariate and multivariate analyses to identify factors associated with AL events,and a logistic regression model with stepwise regression was developed.A 5-fold cross-validation ensured model reliability.The validation cohort included patients from August 1,2021 to December 31,2021 at the same hospital.Using the same imputation method,we organized the validation-queue data.We then employed the risk-prediction model constructed in the earlier phase of the study to predict the risk of AL in the subjects included in the validation queue.We compared the predictions with the actual occurrence,and evaluated the external validation performance of the model using model-evaluation indicators such as the area under the receiver operating characteristic curve(AUROC),Brier score,and calibration curve.Results:The derivation cohort included 1377 patients,and the validation cohort included 131 patients.The independent predictors of AL after radical gastrectomy included age65 y,preoperative albumin<35 g/L,resection extent,operative time240 min,and intraoperative blood loss90 mL.The predictive model exhibited a solid AUROC of 0.750(95%CI:0.694e0.806;p<0.001)with a Brier score of 0.049.The 5-fold cross-validation confirmed these findings with a calibrated C-index of 0.749 and an average Brier score of 0.052.External validation showed an AUROC of 0.723(95%CI:0.564e0.882;p?0.006)and a Brier score of 0.055,confirming reliability in different clinical settings.Conclusions:We successfully developed a risk-prediction model for AL following radical gastrectomy.This tool will aid healthcare professionals in anticipating AL,potentially reducing unnecessary interventions.展开更多
Introduction: Non-communicable diseases constitute a major public health problem, due to their morbi-mortality. The aim was to study knowledge of cardiovascular risk factors among residents of Dakar. Patients and Meth...Introduction: Non-communicable diseases constitute a major public health problem, due to their morbi-mortality. The aim was to study knowledge of cardiovascular risk factors among residents of Dakar. Patients and Methods: This was a descriptive cross-sectional study. Our investigations were recruited over a six-month period (October 17, 2021 to March 21, 2022). Results: Two hundred and twenty-six (226) patients were enrolled. The mean age was 45.9 years. The under-40 age group was the most represented with 37.2%. There were 129 men (57.1%), giving a male/female sex ratio of 1.33. The highest level was represented by 159 people (70.4%). Those who responded (heart disease) were in the majority (38.1%). Hypertension was the most common CVD for 101 people (44.7%). One hundred and ninety (190) people (84%) knew the risk factors for CVD. Good knowledge of risk factors concerned 103 people (54.2%). Obesity was the best-known risk factor in 156 cases (69%). The media was the most important source of information for 121 people (53.5%). Hypertensives were the most represented with 8.4%. One hundred and thirty (130) people (57.5%) had previously paid attention to these FDRCVs. Awareness campaigns were the most effective means of communication for 170 cases (75.2%). Sixteen (16) people (35.6%) were taking antihypertensive medication. Walking was the most popular physical activity for 102 people (45%). People with a balanced diet were in the majority, with 174 respondents (77.0%). Conclusion: NCDs are a major cause of morbidity and mortality. It is essential to develop and implement a prevention and management program.展开更多
The study took a comprehensive approach to understanding mastitis in lactating camels, a disease that significantly impacts milk quantity and quality. This complex and multifactorial disease poses a significant challe...The study took a comprehensive approach to understanding mastitis in lactating camels, a disease that significantly impacts milk quantity and quality. This complex and multifactorial disease poses a significant challenge to dairy camel farming, particularly in Somalia. The studys objective was to determine the prevalence of mastitis and the risk factors associated with it among lactating camels on dairy farms in Benadir, Somalia. To achieve this, a cross-sectional study was conducted from May to September 2022 in the Benadir region of Somalia. A total of 96 lactating camels underwent examination using the California Mastitis Test (CMT) to identify clinical and subclinical mastitis cases. Additionally, a questionnaire survey was conducted among 20 farm employees/owners to gather information on hygiene practices, parity, lactation stage, tick infestation, and the presence of udder/teat lesions. Data regarding parity and lactation stage were obtained through owner interviews. The data collected on specifically designed forms were recorded and entered into a Microsoft Excel spreadsheet for analysis using SPSS version 20 statistical software, ensuring a comprehensive and reliable analysis of the data. The studys findings revealed a significant prevalence of camel mastitis, with 34.4% (33/96) of lactating camels affected and clinical and subclinical cases constituting 5.2% and 29.2%, respectively. Quarter-level prevalence was 46.3%, with clinical and subclinical mastitis at 4.7% and 41.6%, respectively. The study also identified significant associations (P < 0.05) among risk factors such as stage of lactation, parity, and age, indicating a higher susceptibility to mastitis in older camels during early lactation compared to those in late lactation and younger camels. These findings underscore the crucial role of inadequate hygienic conditions on camel farms and udder tick infestations in driving the elevated prevalence of mastitis, highlighting the need for improved management practices in dairy farming in Benadir, Somalia. Effective interventions, including improved management practices and extension services, are essential to reduce the burden of mastitis in dairy camels.展开更多
Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and deterioration of bone architecture, resulting in reduced bone strength and, consequently, increased susceptibility to fra...Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and deterioration of bone architecture, resulting in reduced bone strength and, consequently, increased susceptibility to fractures which poses a significant public health concern worldwide, particularly in aging populations [1]. The health-economic impact of vertebral and hip fractures has been extensively explored and it is well known that these fractures are associated with morbidity/disability and increased mortality;they also account for a substantial portion of the direct fracture costs. This review aims to provide a comprehensive overview of osteoporosis, including its pathophysiology, risk factors, diagnostic approaches, and management strategies. By elucidating the multifaceted nature of this condition, healthcare providers can better identify individuals at risk, implement preventive measures, and optimize treatment to reduce the burden of osteoporotic fractures.展开更多
This review focuses on major contemporary empirical studies that examine both the physical and regulatory sides of climate risk. These studies explore how climate risk affects firms’ operating performance and leverag...This review focuses on major contemporary empirical studies that examine both the physical and regulatory sides of climate risk. These studies explore how climate risk affects firms’ operating performance and leverage, stock and bond valuation, cost of capital, and managerial behavior. We also discuss how the effect of climate risk on real estate markets depends on individuals’ beliefs about climate change. Furthermore, we summarize papers on climate risk activism and how firms can employ financial devices and technology to mitigate their climate risk. Finally, we make some recommendations for further research areas.展开更多
Nutritional status expresses the physiological and nutritional needs to maintain the composition and adequate functioning of the organism. NRS 2002 and MNA protocols were applied to short-term institutionalized patien...Nutritional status expresses the physiological and nutritional needs to maintain the composition and adequate functioning of the organism. NRS 2002 and MNA protocols were applied to short-term institutionalized patients in Rio Verde (Brazil). Older adults and people with special needs of all ages, both sexes, regardless of possible pathology they may have, except if it causes contagion, were included, patients duly authorized by the person responsible for the institution and who were able to undergo evaluation. Thirty-eight patients from the institution were evaluated, of which ten were excluded from the research according to pre-established criteria. More than 50% of participants were male, with an overall average age of 63.43 years. The characteristics related to nutritional status by NRS 2002 and MNA showed that the risk of malnutrition and its absence are associated with a wide age range. The MNA presents a more nuanced nutritional risk classification, showing that even 61% of the 96% of participants who would be out of nutrition risk, according to the NRS 2002, are “at risk of malnutrition”. Applying the MNA can demonstrate more conservative results than the NRS 2002.展开更多
Introduction: Obesity and overweight are a public health problem. The general objective was to determine the epidemiological aspects of obesity, overweight and associated risk factors in a semi-urban environment. Pati...Introduction: Obesity and overweight are a public health problem. The general objective was to determine the epidemiological aspects of obesity, overweight and associated risk factors in a semi-urban environment. Patients and Methods: This was a cross-sectional, descriptive study conducted on November 28 and 29, 2023 in Sébikotane. It focused on volunteers for screening for chronic non-communicable diseases. Epidemiological and clinical data were evaluated. Results: One hundred and twenty-nine cases of obesity were recorded (28%). Two hundred and eighty-two cases were overweight or obese (61.3%). The mean age was 49.55 years, with a standard deviation of 12.41 years. The age group [40 - 49 years] was the most representative, with 85 cases (30.1%), and the majority were female, with 264 cases (93.6%). Primary education was the most common, with 75 cases (46.3%). Grade 1 obesity concerned ninety-seven cases (75.2%), and diabetes was present in thirty cases (23%). Hypertension was present in ninety-five cases (33.7%). Obesity was more marked in the age group [40 - 49 years] with 45 cases (36%). Conclusion: Obesity and overweight are a major cause of morbidity and mortality. The development and implementation of a prevention and management program is essential.展开更多
Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of...Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of the adults with hypertension are unaware of their hypertensive status due to factors that bother on poor management and poor screening approaches. The implication is that people who have poor access to healthcare especially those in the rural communities are at increased risk of cardiovascular complications and all-cause mortality. Unfortunately, not much has been done to ascertain the burden of undiagnosed hypertension and associated risk factors in rural communities in Nigeria. Methods: We conducted a community-based cross-sectional study in a rural community in Imo State, Nigeria, on burden of undiagnosed hypertension with participants recruited via a multi-stage sampling method. An interviewer-administered questionnaire was used, and standardized instruments were applied to obtain, process and analyze the data. Tests of association between the independent variables and outcome were conducted using logistic regression. P-value of Results: A total of 380 adults participated in the study. The mean age was 44.2 years. The prevalence of undiagnosed hypertension was 35.8%. Logistic regression revealed that age, with the respondents in the age groups 26 - 35 years (OR = 10.647, 1.910 - 59.345, p-value = 0.007), 36 - 45 (OR = 3.680, 1.263 - 10.723, p-value = 0.017), 46 - 55 years (OR = 2.737, 1.114 - 6.727, p-value = 0.039), 56 - 65 years old (OR = 3.384, 1.610 - 7.115, p-value = 0.001);and being married (OR = 3.846, 1.118 - 13.233, p-value = 0.033), were independent risk factors for undiagnosed hypertension. Conclusion: The prevalence of undiagnosed hypertension in the rural population of South-East Nigeria is high. Younger age (26 - 35 years) had the highest odds of risk for occurrence of hypertension. Also being married was identified as a risk factor for undiagnosed hypertension.展开更多
Introduction: Highly active antiretroviral tritherapies have improved the quality of life of people living with HIV (PVVIH) and extended their life expectancy. However, the nervous system is faced with a neurotropic v...Introduction: Highly active antiretroviral tritherapies have improved the quality of life of people living with HIV (PVVIH) and extended their life expectancy. However, the nervous system is faced with a neurotropic virus that evolves chronically, sometimes creating neurological disorders directly or indirectly linked to stigmatization or therapeutic effects. Objective: to determine the prevalence of depression associated with suicidal risk (SR) and identify associated factors. Patients and method: This was a prospective descriptive and analytical study from January 1 to November 30, 2022, including all HIV-positive patients receiving or not receiving antiretroviral therapy. The study took place in the infectious diseases department of Brazzaville University Hospital. This department has an inpatient capacity of 36 beds, and an outpatient capacity of 25 patients per day, three times a week. This is the largest center for PVVIH in Brazzaville. The Patient Heath Questionnaire 9 (PHQ-9) was used to assess the degree of depression and suicidal risk. Therapeutic adherence was assessed using the Morisky questionnaire. Data were analyzed using SPSS version 23 software. Qualitative variables were expressed as numbers and percentages, and quantitative variables as means and standard deviations. Statistical tests were used according to their applicability criteria. For all tests, the significance threshold was set at 0.05. Results: A total of 150 patients were consulted, constituting the sample size. The prevalence of depression and suicidal risk was 32%. These patients had an average age of 42.83 ± 10.24 years, were female (n = 101;67.3%), Christian (n = 97;64%), single (n = 68;45.3%). Stigmatization (n = 75;50%) was the reason for attempted suicide. HIV was perceived as treatable (n = 103;68.7%), unlucky (n = 62;41.3%). Patients were WHO stage 1 (n = 105;70%). RS was present in 47 cases (31.3%). Factors associated with depression and suicidal risk were age (p = 0.000), residence (p = 0.028), suicide attempt (p = 0.000), desire to procreate (p = 0.000) and ARV (antiretrovirals) side effects (p Conclusion: The prevalence of depression and suicidal risk was high, in line with stigma and socio-economic conditions. The associated factors were in line with those identified in the literature. Mental health needs to be integrated into the overall care of people living with HIV.展开更多
Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompete...Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompetent subjects. The aim of this study was to determine the endoscopic prevalence, clinical characteristics and risk factors for the occurrence of oesophageal mycosis in our department. Patients and Method: This was a prospective cross-sectional study of all patients who underwent oeso-gastroduodenal fibroscopy during the period from 1<sup>st </sup>January to 31<sup>st</sup> December 2022, i.e. one year, at the digestive endoscopy unit of the hepato-gastroenterology department of the Donka CHU national hospital in Conakry. All patients found to have oesophageal mycosis by FOGD were included. The endoscopy was performed using appropriate equipment: A Fujinon 4400 video endoscopy column;Three Fujinon EG 590 video gastroscopes;A hoover;Data were collected using a pre-established survey form and analysed using Epi info software version 6.0.4;Pearson’s Chi2 test as a test of independence and the exact 5% threshold ficher test. Results: Out of 1343 upper gastrointestinal endoscopies performed, 107 cases of oesophageal mycosis were found, representing a prevalence of 7.96%. The mean age was 40 years, with a male predominance of 55.42%. The sex ratio M/F was 1.24. The 45 and over age group was the most affected, with a prevalence of 40.43%, followed by the [35 - 45] age group, with a prevalence of 22.43%. Clinical symptoms were dominated by epigastralgia in 74.76% of cases, followed by odynophagia in 37.38% of cases, nausea and vomiting in 28.03% of cases, and pyrosis in 26.16% of cases. Oesophageal mycosis without oesophagitis was the most common endoscopic finding in 70% of cases. The main associated endoscopic lesions were erythemato-erosive and congestive gastropathy in 28.03% of cases, peptic oesophagitis (9.34%) and gastric ulcer (5.60%). The main risk factors found were positive HIV serology in 39.25% of cases, and diabetes in 24.30% of cases, with a statistically significant relationship of 0.02 and 0.01 respectively. Conclusion: Oesophageal mycosis is the most common opportunistic infection in patients with impaired cellular immunity. The prevalence of oesophageal mycosis in our series was 7.96%. This study enabled us to identify the main risk factors for the occurrence of oesophageal mycosis. Our country needs to step up its programme to combat and prevent immunodeficiency diseases, particularly HIV and diabetes.展开更多
Background:The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladderpreserving surgery.This study aimed to investigate the risk factors for gallstone recurrence after gallbladder-pres...Background:The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladderpreserving surgery.This study aimed to investigate the risk factors for gallstone recurrence after gallbladder-preserving surgery and to establish an individualized nomogram model to predict the risk of gallstone recurrence.Methods:The clinicopathological and follow-up data of 183 patients who were initially diagnosed with gallstones and treated with gallbladder-preserving surgery at our hospital from January 2012 to January 2019 were retrospectively collected.The independent predictive factors for gallstone recurrence following gallbladder-preserving surgery were identified by multivariate logistic regression analysis.A nomogram model for the prediction of gallstone recurrence was constructed based on the selected variables.The C-index,receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the predictive power of the nomogram model for gallstone recurrence.Results:During the follow-up period,a total of 65 patients experienced gallstone recurrence,and the recurrence rate was 35.5%.Multivariate logistic regression analysis revealed that the course of gallstones>2 years[odds ratio(OR)=2.567,95%confidence interval(CI):1.270-5.187,P=0.009],symptomatic gallstones(OR=2.589,95%CI:1.059-6.329,P=0.037),multiple gallstones(OR=2.436,95%CI:1.133-5.237,P=0.023),history of acute cholecystitis(OR=2.778,95%CI:1.178-6.549,P=0.020)and a greasy diet(OR=2.319,95%CI:1.186-4.535,P=0.014)were independent risk factors for gallstone recurrence after gallbladder-preserving surgery.A nomogram model for predicting the recurrence of gallstones was established based on the above five variables.The results showed that the C-index of the nomogram model was 0.692,suggesting it was valuable to predict gallstone recurrence.Moreover,the calibration curve showed good consistency between the predicted probability and actual probability.Conclusions:The nomogram model for the prediction of gallstone recurrence might help clinicians develop a proper treatment strategy for patients with gallstones.Gallbladder-preserving surgery should be cautiously considered for patients with high recurrence risks.展开更多
This study aims to reveal the occurrence and origin of typical groundwater with high arsenic and fluoride concentrations in the loess area of the Guanzhong Basin—a Neogene faulted basin.Key findings are as follows:(1...This study aims to reveal the occurrence and origin of typical groundwater with high arsenic and fluoride concentrations in the loess area of the Guanzhong Basin—a Neogene faulted basin.Key findings are as follows:(1)Groundwater samples with high arsenic and fluoride concentrations collected from the loess area and the terraces of the Weihe River accounted for 26%and 30%,respectively,of the total samples,with primary hydrochemical type identified as HCO_(3)-Na.The karst and sand areas exhibit relatively high groundwater quality,serving as preferred sources for water supply.It is recommended that local governments fully harness groundwater in these areas;(2)groundwater with high arsenic and fluoride concentrations in the loess area and the alluvial plain of rivers in Dali County is primarily distributed within the Guanzhong Basin,which represents the drainage zone of groundwater;(3)arsenic and fluoride in groundwater originate principally from natural and anthropogenic sources;(4)the human health risk assessments reveal that long-term intake of groundwater with high arsenic and fluoride concentrations pose cancer or non-cancer risks,which are more serious to kids compared to adults.This study provides a theoretical basis for the prevention and treatment of groundwater with high arsenic and fluoride concentrations in loess areas.展开更多
基金Supported by Science and Technology Support Program of Qiandongnan Prefecture,No.Qiandongnan Sci-Tech Support[2021]12Guizhou Province High-Level Innovative Talent Training Program,No.Qiannan Thousand Talents[2022]201701.
文摘BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.
基金financially supported by the National Ministry of Industry and Information Technology Innovation Special Project-Engineering Demonstration Application of Subsea Production System,Topic 4:Research on Subsea X-Tree and Wellhead Offshore Testing Technology(Grant No.MC-201901-S01-04)the Key Research and Development Program of Shandong Province(Major Innovation Project)(Grant Nos.2022CXGC020405,2023CXGC010415)。
文摘Due to the high potential risk and many influencing factors of subsea horizontal X-tree installation,to guarantee the successful completion of sea trials of domestic subsea horizontal X-trees,this paper established a modular risk evaluation model based on a fuzzy fault tree.First,through the analysis of the main process oftree down and combining the Offshore&Onshore Reliability Data(OREDA)failure statistics and the operation procedure and the data provided by the job,the fault tree model of risk analysis of the tree down installation was established.Then,by introducing the natural language of expert comprehensive evaluation and combining fuzzy principles,quantitative analysis was carried out,and the fuzzy number was used to calculate the failure probability of a basic event and the occurrence probability of a top event.Finally,through a sensitivity analysis of basic events,the basic events of top events significantly affected were determined,and risk control and prevention measures for the corresponding high-risk factors were proposed for subsea horizontal X-tree down installation.
基金National Natural Science Foundation of China(Nos.42171444,42301516)Beijing Natural Science Foundation Project-Municipal Education Commission Joint Fund Project(No.KZ202110016021)Beijing Municipal Education Commission Scientific Research Project-Science and Technology Plan General Project(No.KM202110016005).
文摘Natural disaster risk monitoring is an important task for disaster prevention and reduction.In the case of immovable cultural relics,however,the feedback mechanism,risk factors,monitoring logic,and monitoring indicators of natural disaster risk monitoring are complex.How to achieve intelligent perception and monitoring of natural disaster risk for immovable cultural relics has always been a focus and a challenge for researchers.Based on the analysis of the concepts and issues related to the natural disaster risk of immovable cultural relics,this paper proposes a framework for natural disaster risk monitoring for immovable cultural relics based on the digital twin.This framework focuses on risk monitoring,including the physical entities of natural disaster risk for immovable cultural relics,monitoring indicators,and virtual entity construction.A platform for monitoring the natural disaster risk of immovable cultural relics is proposed.Using the Puzhou Ancient City Site as a test bed,the proposed concept can be used for monitoring the natural disaster risk of immovable cultural relics at different scales.
基金The Shanxi Provincial Administration of Traditional Chinese Medicine,No.2023ZYYDA2005.
文摘BACKGROUND Deep learning provides an efficient automatic image recognition method for small bowel(SB)capsule endoscopy(CE)that can assist physicians in diagnosis.However,the existing deep learning models present some unresolved challenges.AIM To propose a novel and effective classification and detection model to automatically identify various SB lesions and their bleeding risks,and label the lesions accurately so as to enhance the diagnostic efficiency of physicians and the ability to identify high-risk bleeding groups.METHODS The proposed model represents a two-stage method that combined image classification with object detection.First,we utilized the improved ResNet-50 classification model to classify endoscopic images into SB lesion images,normal SB mucosa images,and invalid images.Then,the improved YOLO-V5 detection model was utilized to detect the type of lesion and its risk of bleeding,and the location of the lesion was marked.We constructed training and testing sets and compared model-assisted reading with physician reading.RESULTS The accuracy of the model constructed in this study reached 98.96%,which was higher than the accuracy of other systems using only a single module.The sensitivity,specificity,and accuracy of the model-assisted reading detection of all images were 99.17%,99.92%,and 99.86%,which were significantly higher than those of the endoscopists’diagnoses.The image processing time of the model was 48 ms/image,and the image processing time of the physicians was 0.40±0.24 s/image(P<0.001).CONCLUSION The deep learning model of image classification combined with object detection exhibits a satisfactory diagnostic effect on a variety of SB lesions and their bleeding risks in CE images,which enhances the diagnostic efficiency of physicians and improves the ability of physicians to identify high-risk bleeding groups.
文摘A means to develop a comparative assessment of the risks of available wastewater effluent disposal options on a local scale needs to be developed to help local decision-makers make decisions on options such as direct or indirect potable reuse options. These options have garnered more interest as a result of water supply limitations in many urban areas. This risk assessment was developed from a risk assessment developed at the University of Miami in 2001 and Florida Atlantic University (FAU) in 2023. Direct potable reuse and injection wells were deemed to have the lowest risk in the most recent study by FAU. However, the injection well option may not be available everywhere. As a result, a more local means to assess exposure risk is needed. This paper outlines the process to evaluate the public health risks associated with available disposal alternatives which may be very limited in some areas. The development of exposure pathways can help local decision-makers define the challenges, and support later expert level analysis upon which public health decisions are based.
基金supported by the Shandong Province Science and Technology Project(2023TSGC0509,2022TSGC2234)Qingdao Science and Technology Plan Project(23-1-5-yqpy-2-qy).
文摘Enterprise risk management holds significant importance in fostering sustainable growth of businesses and in serving as a critical element for regulatory bodies to uphold market order.Amidst the challenges posed by intricate and unpredictable risk factors,knowledge graph technology is effectively driving risk management,leveraging its ability to associate and infer knowledge from diverse sources.This review aims to comprehensively summarize the construction techniques of enterprise risk knowledge graphs and their prominent applications across various business scenarios.Firstly,employing bibliometric methods,the aim is to uncover the developmental trends and current research hotspots within the domain of enterprise risk knowledge graphs.In the succeeding section,systematically delineate the technical methods for knowledge extraction and fusion in the standardized construction process of enterprise risk knowledge graphs.Objectively comparing and summarizing the strengths and weaknesses of each method,we provide recommendations for addressing the existing challenges in the construction process.Subsequently,categorizing the applied research of enterprise risk knowledge graphs based on research hotspots and risk category standards,and furnishing a detailed exposition on the applicability of technical routes and methods.Finally,the future research directions that still need to be explored in enterprise risk knowledge graphs were discussed,and relevant improvement suggestions were proposed.Practitioners and researchers can gain insights into the construction of technical theories and practical guidance of enterprise risk knowledge graphs based on this foundation.
基金key technology project for the prevention and control of major workplace safety accidents in 2017 from the State Administration of Work Safety of China-the research on the identification and assessment technology and control system of major risks of enterprises for the prevention and control of severe accidents(Hubei-0002-2017AQ)supported by the Department of Emergency Management of Hubei Province,Wuhan 430064,China.
文摘The technological revolution has spawned a new generation of industrial systems,but it has also put forward higher requirements for safety management accuracy,timeliness,and systematicness.Risk assessment needs to evolve to address the existing and future challenges by considering the new demands and advancements in safety management.The study aims to propose a systematic and comprehensive risk assessment method to meet the needs of process system safety management.The methodology first incorporates possibility,severity,and dynamicity(PSD)to structure the“51X”evaluation indicator system,including the inherent,management,and disturbance risk factors.Subsequently,the four-tier(risk point-unit-enterprise-region)risk assessment(RA)mathematical model has been established to consider supervision needs.And in conclusion,the application of the PSD-RA method in ammonia refrigeration workshop cases and safety risk monitoring systems is presented to illustrate the feasibility and effectiveness of the proposed PSD-RA method in safety management.The findings show that the PSD-RA method can be well integrated with the needs of safety work informatization,which is also helpful for implementing the enterprise's safety work responsibility and the government's safety supervision responsibility.
基金This work was supported by the Ministry of Higher Education(MOHE),Malaysia,through Fundamental Research Grant Scheme(FRGS/1/2022/SKK10/UTAR/02/1)Universiti Tunku Abdul Rahman,Malaysia,through UTAR-Research Grant(IPSR/RMC/UTARRF/2021-C2/L08)MBBS Community Health Project(2022/2023),UTAR.
文摘Objective:To investigate the interrelationship between cardiovascular health awareness,risk perception,behavioural intention,and INTERHEART risk stratification in a middle-aged adult population in Malaysia.Methods:A cross-sectional survey with convenience sampling was conducted during November 2022 and January 2023.Participants completed validated questionnaires assessing cardiovascular health awareness,risk perception of cardiovascular diseases,behavioural intention towards adopting healthy habits,and INTERHEART risk stratification score(IHRS)based on established risk factors.A total of 602 respondents were included in the final analysis.Data were analysed with independent t-test/one-way ANOVA or Mann-Whitney/Kruskal-Wallis to test the differences,Pearson correlation or linear regression test to analyze the association of independent and dependent variables.Results:There was a significant positive correlation between medical knowledge related to cardiovascular disease(CVD)and knowledge related to CVD risk prevention,risk perception,behavioural intention and IHRS(P<0.05,Pearson correlation).Notably,individuals with higher IHRS tended to have lower knowledge related to CVD and CVD risk prevention,risk perception,and behavioural intention.Males,laborers,active/former smokers,individuals with lower household income and educational levels,those involved in occupations not related to the healthcare sector,and those who did not receive the CVD health brochure or are unaware of health self-assessment tools are likely to have lower levels of knowledge,risk perception,and poorer behavioural intention regarding cardiovascular health(P<0.05,one-way ANOVA).While educational level,smoking status,awareness about CVD poster,self-assessment tools were repeatedly significantly associated with knowledge related to CVD and CVD risk prevention,risk perception,behavioral intention and/or IHRS(P<0.05,linear regression).Conclusions:These findings underscore the importance of promoting cardiovascular health awareness and risk perception among middle-aged adults to foster positive BI and reduce CVD risk.Tailored interventions targeting specific risk factors identified by INTERHEART may enhance risk stratification accuracy and facilitate targeted preventive strategies.
基金This workwas supported by the Medical and Health Science and Technology Project of Zhejiang Province(No.2021KY180).
文摘Objectives:Anastomotic leakage(AL)stands out as a prevalent and severe complication following gastric cancer surgery.It frequently precipitates additional serious complications,significantly influencing the overall survival time of patients.This study aims to enhance the risk-assessment strategy for AL following gastrectomy for gastric cancer.Methods:This study included a derivation cohort and validation cohort.The derivation cohort included patients who underwent radical gastrectomy at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,from January 1,2015 to December 31,2020.An evidence-based predictor questionnaire was crafted through extensive literature review and panel discussions.Based on the questionnaire,inpatient data were collected to form a model-derivation cohort.This cohort underwent both univariate and multivariate analyses to identify factors associated with AL events,and a logistic regression model with stepwise regression was developed.A 5-fold cross-validation ensured model reliability.The validation cohort included patients from August 1,2021 to December 31,2021 at the same hospital.Using the same imputation method,we organized the validation-queue data.We then employed the risk-prediction model constructed in the earlier phase of the study to predict the risk of AL in the subjects included in the validation queue.We compared the predictions with the actual occurrence,and evaluated the external validation performance of the model using model-evaluation indicators such as the area under the receiver operating characteristic curve(AUROC),Brier score,and calibration curve.Results:The derivation cohort included 1377 patients,and the validation cohort included 131 patients.The independent predictors of AL after radical gastrectomy included age65 y,preoperative albumin<35 g/L,resection extent,operative time240 min,and intraoperative blood loss90 mL.The predictive model exhibited a solid AUROC of 0.750(95%CI:0.694e0.806;p<0.001)with a Brier score of 0.049.The 5-fold cross-validation confirmed these findings with a calibrated C-index of 0.749 and an average Brier score of 0.052.External validation showed an AUROC of 0.723(95%CI:0.564e0.882;p?0.006)and a Brier score of 0.055,confirming reliability in different clinical settings.Conclusions:We successfully developed a risk-prediction model for AL following radical gastrectomy.This tool will aid healthcare professionals in anticipating AL,potentially reducing unnecessary interventions.
文摘Introduction: Non-communicable diseases constitute a major public health problem, due to their morbi-mortality. The aim was to study knowledge of cardiovascular risk factors among residents of Dakar. Patients and Methods: This was a descriptive cross-sectional study. Our investigations were recruited over a six-month period (October 17, 2021 to March 21, 2022). Results: Two hundred and twenty-six (226) patients were enrolled. The mean age was 45.9 years. The under-40 age group was the most represented with 37.2%. There were 129 men (57.1%), giving a male/female sex ratio of 1.33. The highest level was represented by 159 people (70.4%). Those who responded (heart disease) were in the majority (38.1%). Hypertension was the most common CVD for 101 people (44.7%). One hundred and ninety (190) people (84%) knew the risk factors for CVD. Good knowledge of risk factors concerned 103 people (54.2%). Obesity was the best-known risk factor in 156 cases (69%). The media was the most important source of information for 121 people (53.5%). Hypertensives were the most represented with 8.4%. One hundred and thirty (130) people (57.5%) had previously paid attention to these FDRCVs. Awareness campaigns were the most effective means of communication for 170 cases (75.2%). Sixteen (16) people (35.6%) were taking antihypertensive medication. Walking was the most popular physical activity for 102 people (45%). People with a balanced diet were in the majority, with 174 respondents (77.0%). Conclusion: NCDs are a major cause of morbidity and mortality. It is essential to develop and implement a prevention and management program.
文摘The study took a comprehensive approach to understanding mastitis in lactating camels, a disease that significantly impacts milk quantity and quality. This complex and multifactorial disease poses a significant challenge to dairy camel farming, particularly in Somalia. The studys objective was to determine the prevalence of mastitis and the risk factors associated with it among lactating camels on dairy farms in Benadir, Somalia. To achieve this, a cross-sectional study was conducted from May to September 2022 in the Benadir region of Somalia. A total of 96 lactating camels underwent examination using the California Mastitis Test (CMT) to identify clinical and subclinical mastitis cases. Additionally, a questionnaire survey was conducted among 20 farm employees/owners to gather information on hygiene practices, parity, lactation stage, tick infestation, and the presence of udder/teat lesions. Data regarding parity and lactation stage were obtained through owner interviews. The data collected on specifically designed forms were recorded and entered into a Microsoft Excel spreadsheet for analysis using SPSS version 20 statistical software, ensuring a comprehensive and reliable analysis of the data. The studys findings revealed a significant prevalence of camel mastitis, with 34.4% (33/96) of lactating camels affected and clinical and subclinical cases constituting 5.2% and 29.2%, respectively. Quarter-level prevalence was 46.3%, with clinical and subclinical mastitis at 4.7% and 41.6%, respectively. The study also identified significant associations (P < 0.05) among risk factors such as stage of lactation, parity, and age, indicating a higher susceptibility to mastitis in older camels during early lactation compared to those in late lactation and younger camels. These findings underscore the crucial role of inadequate hygienic conditions on camel farms and udder tick infestations in driving the elevated prevalence of mastitis, highlighting the need for improved management practices in dairy farming in Benadir, Somalia. Effective interventions, including improved management practices and extension services, are essential to reduce the burden of mastitis in dairy camels.
文摘Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and deterioration of bone architecture, resulting in reduced bone strength and, consequently, increased susceptibility to fractures which poses a significant public health concern worldwide, particularly in aging populations [1]. The health-economic impact of vertebral and hip fractures has been extensively explored and it is well known that these fractures are associated with morbidity/disability and increased mortality;they also account for a substantial portion of the direct fracture costs. This review aims to provide a comprehensive overview of osteoporosis, including its pathophysiology, risk factors, diagnostic approaches, and management strategies. By elucidating the multifaceted nature of this condition, healthcare providers can better identify individuals at risk, implement preventive measures, and optimize treatment to reduce the burden of osteoporotic fractures.
文摘This review focuses on major contemporary empirical studies that examine both the physical and regulatory sides of climate risk. These studies explore how climate risk affects firms’ operating performance and leverage, stock and bond valuation, cost of capital, and managerial behavior. We also discuss how the effect of climate risk on real estate markets depends on individuals’ beliefs about climate change. Furthermore, we summarize papers on climate risk activism and how firms can employ financial devices and technology to mitigate their climate risk. Finally, we make some recommendations for further research areas.
文摘Nutritional status expresses the physiological and nutritional needs to maintain the composition and adequate functioning of the organism. NRS 2002 and MNA protocols were applied to short-term institutionalized patients in Rio Verde (Brazil). Older adults and people with special needs of all ages, both sexes, regardless of possible pathology they may have, except if it causes contagion, were included, patients duly authorized by the person responsible for the institution and who were able to undergo evaluation. Thirty-eight patients from the institution were evaluated, of which ten were excluded from the research according to pre-established criteria. More than 50% of participants were male, with an overall average age of 63.43 years. The characteristics related to nutritional status by NRS 2002 and MNA showed that the risk of malnutrition and its absence are associated with a wide age range. The MNA presents a more nuanced nutritional risk classification, showing that even 61% of the 96% of participants who would be out of nutrition risk, according to the NRS 2002, are “at risk of malnutrition”. Applying the MNA can demonstrate more conservative results than the NRS 2002.
文摘Introduction: Obesity and overweight are a public health problem. The general objective was to determine the epidemiological aspects of obesity, overweight and associated risk factors in a semi-urban environment. Patients and Methods: This was a cross-sectional, descriptive study conducted on November 28 and 29, 2023 in Sébikotane. It focused on volunteers for screening for chronic non-communicable diseases. Epidemiological and clinical data were evaluated. Results: One hundred and twenty-nine cases of obesity were recorded (28%). Two hundred and eighty-two cases were overweight or obese (61.3%). The mean age was 49.55 years, with a standard deviation of 12.41 years. The age group [40 - 49 years] was the most representative, with 85 cases (30.1%), and the majority were female, with 264 cases (93.6%). Primary education was the most common, with 75 cases (46.3%). Grade 1 obesity concerned ninety-seven cases (75.2%), and diabetes was present in thirty cases (23%). Hypertension was present in ninety-five cases (33.7%). Obesity was more marked in the age group [40 - 49 years] with 45 cases (36%). Conclusion: Obesity and overweight are a major cause of morbidity and mortality. The development and implementation of a prevention and management program is essential.
文摘Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of the adults with hypertension are unaware of their hypertensive status due to factors that bother on poor management and poor screening approaches. The implication is that people who have poor access to healthcare especially those in the rural communities are at increased risk of cardiovascular complications and all-cause mortality. Unfortunately, not much has been done to ascertain the burden of undiagnosed hypertension and associated risk factors in rural communities in Nigeria. Methods: We conducted a community-based cross-sectional study in a rural community in Imo State, Nigeria, on burden of undiagnosed hypertension with participants recruited via a multi-stage sampling method. An interviewer-administered questionnaire was used, and standardized instruments were applied to obtain, process and analyze the data. Tests of association between the independent variables and outcome were conducted using logistic regression. P-value of Results: A total of 380 adults participated in the study. The mean age was 44.2 years. The prevalence of undiagnosed hypertension was 35.8%. Logistic regression revealed that age, with the respondents in the age groups 26 - 35 years (OR = 10.647, 1.910 - 59.345, p-value = 0.007), 36 - 45 (OR = 3.680, 1.263 - 10.723, p-value = 0.017), 46 - 55 years (OR = 2.737, 1.114 - 6.727, p-value = 0.039), 56 - 65 years old (OR = 3.384, 1.610 - 7.115, p-value = 0.001);and being married (OR = 3.846, 1.118 - 13.233, p-value = 0.033), were independent risk factors for undiagnosed hypertension. Conclusion: The prevalence of undiagnosed hypertension in the rural population of South-East Nigeria is high. Younger age (26 - 35 years) had the highest odds of risk for occurrence of hypertension. Also being married was identified as a risk factor for undiagnosed hypertension.
文摘Introduction: Highly active antiretroviral tritherapies have improved the quality of life of people living with HIV (PVVIH) and extended their life expectancy. However, the nervous system is faced with a neurotropic virus that evolves chronically, sometimes creating neurological disorders directly or indirectly linked to stigmatization or therapeutic effects. Objective: to determine the prevalence of depression associated with suicidal risk (SR) and identify associated factors. Patients and method: This was a prospective descriptive and analytical study from January 1 to November 30, 2022, including all HIV-positive patients receiving or not receiving antiretroviral therapy. The study took place in the infectious diseases department of Brazzaville University Hospital. This department has an inpatient capacity of 36 beds, and an outpatient capacity of 25 patients per day, three times a week. This is the largest center for PVVIH in Brazzaville. The Patient Heath Questionnaire 9 (PHQ-9) was used to assess the degree of depression and suicidal risk. Therapeutic adherence was assessed using the Morisky questionnaire. Data were analyzed using SPSS version 23 software. Qualitative variables were expressed as numbers and percentages, and quantitative variables as means and standard deviations. Statistical tests were used according to their applicability criteria. For all tests, the significance threshold was set at 0.05. Results: A total of 150 patients were consulted, constituting the sample size. The prevalence of depression and suicidal risk was 32%. These patients had an average age of 42.83 ± 10.24 years, were female (n = 101;67.3%), Christian (n = 97;64%), single (n = 68;45.3%). Stigmatization (n = 75;50%) was the reason for attempted suicide. HIV was perceived as treatable (n = 103;68.7%), unlucky (n = 62;41.3%). Patients were WHO stage 1 (n = 105;70%). RS was present in 47 cases (31.3%). Factors associated with depression and suicidal risk were age (p = 0.000), residence (p = 0.028), suicide attempt (p = 0.000), desire to procreate (p = 0.000) and ARV (antiretrovirals) side effects (p Conclusion: The prevalence of depression and suicidal risk was high, in line with stigma and socio-economic conditions. The associated factors were in line with those identified in the literature. Mental health needs to be integrated into the overall care of people living with HIV.
文摘Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompetent subjects. The aim of this study was to determine the endoscopic prevalence, clinical characteristics and risk factors for the occurrence of oesophageal mycosis in our department. Patients and Method: This was a prospective cross-sectional study of all patients who underwent oeso-gastroduodenal fibroscopy during the period from 1<sup>st </sup>January to 31<sup>st</sup> December 2022, i.e. one year, at the digestive endoscopy unit of the hepato-gastroenterology department of the Donka CHU national hospital in Conakry. All patients found to have oesophageal mycosis by FOGD were included. The endoscopy was performed using appropriate equipment: A Fujinon 4400 video endoscopy column;Three Fujinon EG 590 video gastroscopes;A hoover;Data were collected using a pre-established survey form and analysed using Epi info software version 6.0.4;Pearson’s Chi2 test as a test of independence and the exact 5% threshold ficher test. Results: Out of 1343 upper gastrointestinal endoscopies performed, 107 cases of oesophageal mycosis were found, representing a prevalence of 7.96%. The mean age was 40 years, with a male predominance of 55.42%. The sex ratio M/F was 1.24. The 45 and over age group was the most affected, with a prevalence of 40.43%, followed by the [35 - 45] age group, with a prevalence of 22.43%. Clinical symptoms were dominated by epigastralgia in 74.76% of cases, followed by odynophagia in 37.38% of cases, nausea and vomiting in 28.03% of cases, and pyrosis in 26.16% of cases. Oesophageal mycosis without oesophagitis was the most common endoscopic finding in 70% of cases. The main associated endoscopic lesions were erythemato-erosive and congestive gastropathy in 28.03% of cases, peptic oesophagitis (9.34%) and gastric ulcer (5.60%). The main risk factors found were positive HIV serology in 39.25% of cases, and diabetes in 24.30% of cases, with a statistically significant relationship of 0.02 and 0.01 respectively. Conclusion: Oesophageal mycosis is the most common opportunistic infection in patients with impaired cellular immunity. The prevalence of oesophageal mycosis in our series was 7.96%. This study enabled us to identify the main risk factors for the occurrence of oesophageal mycosis. Our country needs to step up its programme to combat and prevent immunodeficiency diseases, particularly HIV and diabetes.
文摘Background:The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladderpreserving surgery.This study aimed to investigate the risk factors for gallstone recurrence after gallbladder-preserving surgery and to establish an individualized nomogram model to predict the risk of gallstone recurrence.Methods:The clinicopathological and follow-up data of 183 patients who were initially diagnosed with gallstones and treated with gallbladder-preserving surgery at our hospital from January 2012 to January 2019 were retrospectively collected.The independent predictive factors for gallstone recurrence following gallbladder-preserving surgery were identified by multivariate logistic regression analysis.A nomogram model for the prediction of gallstone recurrence was constructed based on the selected variables.The C-index,receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the predictive power of the nomogram model for gallstone recurrence.Results:During the follow-up period,a total of 65 patients experienced gallstone recurrence,and the recurrence rate was 35.5%.Multivariate logistic regression analysis revealed that the course of gallstones>2 years[odds ratio(OR)=2.567,95%confidence interval(CI):1.270-5.187,P=0.009],symptomatic gallstones(OR=2.589,95%CI:1.059-6.329,P=0.037),multiple gallstones(OR=2.436,95%CI:1.133-5.237,P=0.023),history of acute cholecystitis(OR=2.778,95%CI:1.178-6.549,P=0.020)and a greasy diet(OR=2.319,95%CI:1.186-4.535,P=0.014)were independent risk factors for gallstone recurrence after gallbladder-preserving surgery.A nomogram model for predicting the recurrence of gallstones was established based on the above five variables.The results showed that the C-index of the nomogram model was 0.692,suggesting it was valuable to predict gallstone recurrence.Moreover,the calibration curve showed good consistency between the predicted probability and actual probability.Conclusions:The nomogram model for the prediction of gallstone recurrence might help clinicians develop a proper treatment strategy for patients with gallstones.Gallbladder-preserving surgery should be cautiously considered for patients with high recurrence risks.
基金funded by the ministry-province cooperation-based pilot project entitled A Technological System for Ecological Remediation Evaluation of Open-Pit Mines initiated by the Ministry of Natural Resources in 2023(2023-03)survey projects of the Land and Resources Investigation Program([2023]06-03-04,1212010634713)a key R&D projects of Shaanxi Province in 2023(2023ZDLSF-63)。
文摘This study aims to reveal the occurrence and origin of typical groundwater with high arsenic and fluoride concentrations in the loess area of the Guanzhong Basin—a Neogene faulted basin.Key findings are as follows:(1)Groundwater samples with high arsenic and fluoride concentrations collected from the loess area and the terraces of the Weihe River accounted for 26%and 30%,respectively,of the total samples,with primary hydrochemical type identified as HCO_(3)-Na.The karst and sand areas exhibit relatively high groundwater quality,serving as preferred sources for water supply.It is recommended that local governments fully harness groundwater in these areas;(2)groundwater with high arsenic and fluoride concentrations in the loess area and the alluvial plain of rivers in Dali County is primarily distributed within the Guanzhong Basin,which represents the drainage zone of groundwater;(3)arsenic and fluoride in groundwater originate principally from natural and anthropogenic sources;(4)the human health risk assessments reveal that long-term intake of groundwater with high arsenic and fluoride concentrations pose cancer or non-cancer risks,which are more serious to kids compared to adults.This study provides a theoretical basis for the prevention and treatment of groundwater with high arsenic and fluoride concentrations in loess areas.