Thermoelectric power generators have attracted increasing interest in recent years owing to their great potential in wearable electronics power supply.It is noted that thermoelectric power generators are easy to damag...Thermoelectric power generators have attracted increasing interest in recent years owing to their great potential in wearable electronics power supply.It is noted that thermoelectric power generators are easy to damage in the dynamic service process,resulting in the formation of microcracks and performance degradation.Herein,we prepare a new hybrid hydrogel thermoelectric material PAAc/XG/Bi_(2)Se_(0.3)Te_(2.7)by an in situ polymerization method,which shows a high stretchable and self-healable performance,as well as a good thermoelectric performance.For the sample with Bi_(2)Se_(0.3)Te_(2.7)content of 1.5 wt%(i.e.,PAAc/XG/Bi2Se0.3Te27(1.5 wt%)),which has a room temperature Seebeck coefficient of-0.45 mV K^(-1),and exhibits an open-circuit voltage of-17.91 mV and output power of 38.1 nW at a temperature difference of 40 K.After being completely cut off,the hybrid thermoelectric hydrogel automatically recovers its electrical characteristics within a response time of 2.0 s,and the healed hydrogel remains more than 99%of its initial power output.Such stretchable and self-healable hybrid hydrogel thermoelectric materials show promising potential for application in dynamic service conditions,such as wearable electronics.展开更多
Various deep learning models have been proposed for the accurate assisted diagnosis of early-stage Alzheimer’s disease(AD).Most studies predominantly employ Convolutional Neural Networks(CNNs),which focus solely on l...Various deep learning models have been proposed for the accurate assisted diagnosis of early-stage Alzheimer’s disease(AD).Most studies predominantly employ Convolutional Neural Networks(CNNs),which focus solely on local features,thus encountering difficulties in handling global features.In contrast to natural images,Structural Magnetic Resonance Imaging(sMRI)images exhibit a higher number of channel dimensions.However,during the Position Embedding stage ofMulti Head Self Attention(MHSA),the coded information related to the channel dimension is disregarded.To tackle these issues,we propose theRepBoTNet-CESA network,an advanced AD-aided diagnostic model that is capable of learning local and global features simultaneously.It combines the advantages of CNN networks in capturing local information and Transformer networks in integrating global information,reducing computational costs while achieving excellent classification performance.Moreover,it uses the Cubic Embedding Self Attention(CESA)proposed in this paper to incorporate the channel code information,enhancing the classification performance within the Transformer structure.Finally,the RepBoTNet-CESA performs well in various AD-aided diagnosis tasks,with an accuracy of 96.58%,precision of 97.26%,and recall of 96.23%in the AD/NC task;an accuracy of 92.75%,precision of 92.84%,and recall of 93.18%in the EMCI/NC task;and an accuracy of 80.97%,precision of 83.86%,and recall of 80.91%in the AD/EMCI/LMCI/NC task.This demonstrates that RepBoTNet-CESA delivers outstanding outcomes in various AD-aided diagnostic tasks.Furthermore,our study has shown that MHSA exhibits superior performance compared to conventional attention mechanisms in enhancing ResNet performance.Besides,the Deeper RepBoTNet-CESA network fails to make further progress in AD-aided diagnostic tasks.展开更多
The Dirac equation γ<sub>μ</sub>(δ<sub>μ</sub>-eA<sub>μ</sub>)Ψ=mc<sup>2</sup>Ψ describes the bound states of the electron under the action of external potentials...The Dirac equation γ<sub>μ</sub>(δ<sub>μ</sub>-eA<sub>μ</sub>)Ψ=mc<sup>2</sup>Ψ describes the bound states of the electron under the action of external potentials, A<sub>μ</sub>. We assumed that the fundamental form of the Dirac equation γ<sub>μ</sub>(δ<sub>μ</sub>-S<sub>μ</sub>)Ψ=0 should describe the stable particles (the electron, the proton and the dark-matter-particle (dmp)) bound to themselves under the action of their own potentials S<sub>μ</sub>. The new equation reveals that self energy is consequence of self action, it also reveals that the spin angular momentum is consequence of the dynamic structure of the stable particles. The quantitative results are the determination of their relative masses as well as the determination of the electromagnetic coupling constant.展开更多
BACKGROUND Endoscopic management is the first-line therapy for post-liver-transplant anas-tomotic strictures.Although the optimal duration of treatment with plastic stents has been reported to be 8-12 months,data on s...BACKGROUND Endoscopic management is the first-line therapy for post-liver-transplant anas-tomotic strictures.Although the optimal duration of treatment with plastic stents has been reported to be 8-12 months,data on safety and duration for metal stents in this setting is scarce.Due to limited access to endoscopic retrograde cholan-giopancreatography(ERCP)during the coronavirus disease 2019 pandemic in our centre,there was a change in practice towards increased usage and length-of-stay of the Kaffes biliary intraductal self-expanding stent in patients with suitable anatomy.This was mainly due to the theoretical benefit of Kaffes stents allowing for longer indwelling periods compared to the traditional plastic stents.METHODS Adult liver transplant recipients aged 18 years and above who underwent ERCP were retrospectively identified during a 10-year period through a database query.Unplanned admissions post-Kaffes stent insertion were identified manually through electronic and scanned medical records.The main outcome was the incidence of complications when stents were left indwelling for 3 months vs 6 months.Stent efficacy was calculated via rates of stricture recurrence between patients that had stenting courses for≤120 d or>120 d.RESULTS During the study period,a total of 66 ERCPs with Kaffes insertion were performed in 54 patients throughout their stenting course.In 33 ERCPs,the stent was removed or exchanged on a 3-month interval.No pancreatitis,perfor-ations or deaths occurred.Minor post-ERCP complications were similar between the 3-month(abdominal pain and intraductal migration)and 6-month(abdominal pain,septic shower and embedded stent)groups-6.1%vs 9.1%respectively,P=0.40.All strictures resolved at the end of the stenting course,but the stenting course was variable from 3 to 22 months.The recurrence rate for stenting courses lasting for up to 120 d was 71.4%and 21.4%for stenting courses of 121 d or over(P=0.03).There were 28 patients that were treated with a single ERCP with Kaffes,21 with removal after 120 d and 7 within 120 d.There was a significant improvement in stricture recurrence when the Kaffes was removed after 120 d when a single ERCP was used for the entire stenting course(71.0%vs 10.0%,P=0.01).CONCLUSION Utilising a single Kaffes intraductal fully-covered metal stent for at least 4 months is safe and efficacious for the management of post-transplant anastomotic strictures.展开更多
By heating up the embedded carbon fiber reinforced cement based material (CFRC), the carrying capacity and deformation of concrete member could be adjusted. The relationship between temperature difference and expans...By heating up the embedded carbon fiber reinforced cement based material (CFRC), the carrying capacity and deformation of concrete member could be adjusted. The relationship between temperature difference and expansion strain of CFRC was demonstrated, and the temperature-deformation-load effect of concrete embedded with CFRC was studied. Heating the CFRC up to different temperatures resulted in different degree of inner pre-stress in concrete. Thus, the load capacity of concrete could be regulated owing to counteracting the pre-stress.展开更多
Objective: Describe the status quo of self-disclosure and social support in breast cancer patients and analyze the correlation between them. Methods: General data questionnaire, distress disclosure Index scale and Chi...Objective: Describe the status quo of self-disclosure and social support in breast cancer patients and analyze the correlation between them. Methods: General data questionnaire, distress disclosure Index scale and Chinese version of medical social support scale were used to investigate the correlation between self-disclosure and social support in breast cancer patients by Pearson correlation analysis. Results: 1) The total self-disclosure score was (38.75 ± 9.18);the total score of social support was (70.57 ± 14.04) scores, including emotional information support dimension (28.39 ± 6.06) scores, practical support dimension (15.62 ± 3.31) scores, elastic support dimension (14.85 ± 3.23) scores, and emotional support dimension (11.70 ± 2.56) scores. 2) Self-disclosure was positively correlated with social support (r = 0.433, p Conclusion: Breast cancer patients had a moderate level of self-disclosure, and the higher the level of self-disclosure, the better the social support. It is suggested that improving the self-disclosure level of breast cancer patients can help them obtain more social support.展开更多
Background: Self-assessed health (SAH) is used as a common method of sociology research to understand the implications of self-reported health and the link to social factors like education, income, and occupation. The...Background: Self-assessed health (SAH) is used as a common method of sociology research to understand the implications of self-reported health and the link to social factors like education, income, and occupation. The paper explores the impact of socio-economic and health indicators on self-assessed health in the middle-aged to the senior population in a rural community in Thailand. Methods: Primary data were collected after conducting a randomized sampling for 100 people using direct interviews in two locations within the sub-district of Phai Tha Pho, Thailand. The target demographic was the middle-age to elderly population. A logit model was applied to the collected samples. Results: The study highlights that higher education, income, and sleep are high predictors for positive SAH while high blood sugar level has significant adverse effects on SAH. Detection of metabolic syndrome further indicates degraded overall health perception over time. Conclusion: The study demonstrated the relationship between socio-economic indicators and illnesses alongside individual SAH in rural Thailand. Accordingly, policies have been proposed that include targeted subsidies for healthy food alternatives, promoting work-rest balance at all levels, and an expansion of sub-district education up to secondary school. SAH can be performed regularly and expanded across communities including areas of low-income living due to its low implementation costs. It could also be used as a tool to support the government’s public health initiatives complementing the existing five-year direct health check-up programme. A comparative study of SAH across regions is recommended for future research.展开更多
Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified a...Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified as a crucial tool in enhancing the knowledge, attitudes, and abilities necessary for self-management among individuals with diabetes. Aim: To assess the impact of diabetes self-management education on medication adherence and glycemic control in Sudanese adults with type 2 diabetes before and 3 months after the DSME intervention. Method: The study was conducted in Sudan between September 2022 and March 2023, it was an interventional, one-group, pre- and post-test study that aimed to assess the impact of diabetes self-management education (DSME) on medication adherence and diabetes control in Sudanese adults with type 2 diabetes. The research was conducted in primary health care centers in six cities in Sudan and involved 244 participants. The data entry and statistical analysis were conducted using the Statistical Package for Social Sciences version 27.0. A paired t test was used for analysis. Results: The study included 244 participants, 67% of whom were males. The age mean ± SD was 48.6 ± 9.3 years, and 85.3% of participants were married. Age at onset of diabetes mean ± SD was 40.60 ± 7.81 years;44.6% had diabetes for less than 5 years;and 84.1% had a positive family history of diabetes mellitus. The levels of poor, low, and partial adherence to medication decreased by 8.2%, 4%, and 20.6%, respectively, after the intervention. The levels of good and high medication regime adherence increased by 13% and 19.8%, respectively;BMI decreased by 1.1 ± 0.73 kg/m<sup>2</sup> (p = 0.005). The fasting blood sugar decreased by 69 ± 32.9 mg/dl (p = 0.049), and the glycated hemoglobin decreased by 1.21 ± 0.28% (p = 0.001). Conclusions: The findings of this study reinforce the importance of patient education in improving glycemic control and enhancing self-management behaviors. Patient education plays a critical role in enhancing glycemic control and self-management behaviors. It is essential for healthcare providers to adopt a patient-centered approach, taking into account the individual's beliefs, attitudes, and knowledge about their illness and treatment. Overcoming these challenges necessitates a comprehensive approach, including enhancing healthcare professionals’ knowledge and communication skills, offering accessible and culturally sensitive diabetes education programs, and addressing barriers to resources and support for self-management.展开更多
Self-efficacy plays an important role in the management of type 2 diabetes mellitus (T2DM) patients, and it runs through the whole process of diabetes treatment, which is conducive to controlling and delaying the occu...Self-efficacy plays an important role in the management of type 2 diabetes mellitus (T2DM) patients, and it runs through the whole process of diabetes treatment, which is conducive to controlling and delaying the occurrence and development of complications, as well as improving the quality of life of patients. This paper mainly describes the concept of self-efficacy, the current situation of self-efficacy of diabetic patients at home and abroad, the functional aspects and their influencing factors, so as to take relevant measures on how to improve self-efficacy. It aims to provide a theoretical basis for the development of self-efficacy interventions for patients with type 2 diabetes mellitus.展开更多
Diabetes is a chronic pathology whose evolution is marked by micro and macroangiopathic complications. Optimal management can prevent the onset of complications and improve patients’ quality of life. Objectives: To d...Diabetes is a chronic pathology whose evolution is marked by micro and macroangiopathic complications. Optimal management can prevent the onset of complications and improve patients’ quality of life. Objectives: To determine the frequency of self-monitoring of blood glucose and to describe the errors found during self-monitoring in diabetic patients followed at the Endocrinology Department of Donka University Hospital in Guinea. Materials and methods: Descriptive cross-sectional study carried out between August and September 2020 involving diabetic patients followed up at the Endocrinology and Diabetology Department of the Donka National Hospital, CHU Conakry. Results: A total of 301 patients were enrolled, with an average age of 44.24 ± 21.01 years. 64.12% were female. Type 2 diabetes predominated in 64% of cases. The mean duration of diabetes was 6.14 ± 4.67 years, and 75.08% of patients lived in urban areas. Patients were on insulin in 36.21% of cases, insulin and biguanides (26.25%), hypoglycemic sulfonamide and biguanides (19.27%) and biguanides in 18.27% of cases. The frequency of self-monitoring of blood glucose was 43%, and 38% of patients made errors, notably reusing lancets (60%), not checking the expiration date (55.65%) and not washing their hands (48%). Conclusion: This study shows that self-monitoring of blood glucose is not performed by the majority of patients. Numerous errors were identified during blood glucose testing. Continued therapeutic education on the use of blood glucose meters will help empower patients and improve their quality of life.展开更多
Background: Self-monitoring is important for recognizing the situations one is facing and assessing one’s own competence to respond appropriately to situations that require multitasking. Purpose: This study aimed to ...Background: Self-monitoring is important for recognizing the situations one is facing and assessing one’s own competence to respond appropriately to situations that require multitasking. Purpose: This study aimed to examine the surface and content validity of the Advanced Beginner Nurses’ Self-Monitoring Scale While Multitasking and refine the scale items accordingly. It is expected that the development of such scale will allow for reflection on advanced beginner nurses’ response to multitasking, leading to further capacity building. Methods: The surface validity of 96 items of the Advanced Beginner Nurses’ Self-Monitoring Scale While Multitasking was examined at a meeting with five expert researchers. Five researchers and five nurses examined the items’ content using an item-level content validity index through a questionnaire survey. Results and Conclusion: The Advanced Beginner Nurses’ Self-Monitoring Scale While Multitasking was organized into 73 items that were refined into scales with surface and content validity. Consequently, five sub-concepts were identified: recognizing the situation one’s facing, seeing one’s self from multiple perspectives, devising concrete strategies depending on the situation, considering a predictable time schedule, and being aware of the situation surrounding one’s self. In the future, it will be necessary to examine the reliability and validity of the scale.展开更多
This article employs a combined approach of biology and economics to reveal that biological evolution has an economic nature, evolving towards improved energy efficiency. The orthodox Darwinian theory of evolution des...This article employs a combined approach of biology and economics to reveal that biological evolution has an economic nature, evolving towards improved energy efficiency. The orthodox Darwinian theory of evolution describes evolution as the random variation of organisms and their survival through natural selection. In fact, the natural environment itself is a constantly changing context, and the strategy to adapt to this change is to enhance behavioral capabilities, thereby expanding the range and dimensions of behavior. Therefore, the improvement of behavioral capabilities is an important aspect of evolution. The enhancement of behavioral capabilities expands the range of adaptation to the natural environment and increases the space for behavioral choices. Within this space of behavioral choices, some options are more effective and superior to others;thus, the ability to select is necessary to make the improved behavioral capabilities more beneficial to the organism itself. The birth and development of the brain serve the purpose of selection. By using the brain to make selections, at least the “better” behavior will be chosen between two alternatives. Once the better behavior yields better results, and the organism can associate these results with the corresponding behavior, it will persist in this behavior. The persistent repetition of a behavior over generations will form a habit. Habits passed down through generations constitute a new environment, causing the organism’s genes to activate or deactivate certain functions, ultimately leading to genetic changes that are beneficial to that habit. Since the brain’s selection represents the organism’s self-selection, it differs from random variation;it is also a rational selection, choosing behaviors that either obtain more energy or reduce energy consumption. Thus, this evolution possesses an economic nature.展开更多
Background: The aetiology of Testicular Cancer (TC) is still unknown to researchers but many of the associated risk factors have been identified. These include family history, age, racial origin, cryptorchidism, uroge...Background: The aetiology of Testicular Cancer (TC) is still unknown to researchers but many of the associated risk factors have been identified. These include family history, age, racial origin, cryptorchidism, urogenital malformations, testicular atrophy, and infertility. Given the lack of scientific data on the causes of the disease, it has been asserted in previous studies that the promotion of awareness and early detection are prerequisites to mitigating risks of metastasis as well as improving survival. This study is to assess the awareness, practice, and intention to practice testicular self-examination among professional working males in Accra. Methods: A quantitative cross-sectional design with a structured research instrument was used to collect data from respondants. The purposive and convenience sampling techniques were used to collect data from 300 men at Accra in Ghana. The study was conducted at two (2) Universities and a Senior High school at Accra in Ghana. The data was then analysed using descriptive statistics, logistic regression, multiple linear regression, and structural equation modeling. Results: From the study findings, 37% of male participants rated their knowledge of testicular self-examination and related symptoms as good, 28% of participants practised testicular self-examination monthly, while 65% of respondents expressed their intention to practice monthly testicular self-examination. The findings from logistic regression demonstrated that level of education, age, and marital status of participants had a significant influence on testicular self-examination. Additionally, the multiple linear regression results revealed knowledge and self-efficacy significantly predict testicular self-examination intention. The path coefficient results from the structural equation model are consistent with results from the regression models. Conclusion: This research is the first to investigate testicular self-examination among men in Ghana. The findings revealed awareness and practice of TSE are low among participants. Therefore, the research findings would improve the expertise of physicians and nurses in providing counsel, intervention, and support for patients at risk of testicular cancer.展开更多
Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobeha...Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.展开更多
The federated self-supervised framework is a distributed machine learning method that combines federated learning and self-supervised learning, which can effectively solve the problem of traditional federated learning...The federated self-supervised framework is a distributed machine learning method that combines federated learning and self-supervised learning, which can effectively solve the problem of traditional federated learning being difficult to process large-scale unlabeled data. The existing federated self-supervision framework has problems with low communication efficiency and high communication delay between clients and central servers. Therefore, we added edge servers to the federated self-supervision framework to reduce the pressure on the central server caused by frequent communication between both ends. A communication compression scheme using gradient quantization and sparsification was proposed to optimize the communication of the entire framework, and the algorithm of the sparse communication compression module was improved. Experiments have proved that the learning rate changes of the improved sparse communication compression module are smoother and more stable. Our communication compression scheme effectively reduced the overall communication overhead.展开更多
基金supported by the National Natural Science Foundation of China under Grant Nos.92163211,52002137,51872102,and 51802070the Fundamental Research Funds for the Central Universities under Grant Nos.2021XXJS008 and 2018KFYXKJC002Graduates’Innovation Fund,Huazhong University of Science and Technology under Grant No.2020yjs CXCY022
文摘Thermoelectric power generators have attracted increasing interest in recent years owing to their great potential in wearable electronics power supply.It is noted that thermoelectric power generators are easy to damage in the dynamic service process,resulting in the formation of microcracks and performance degradation.Herein,we prepare a new hybrid hydrogel thermoelectric material PAAc/XG/Bi_(2)Se_(0.3)Te_(2.7)by an in situ polymerization method,which shows a high stretchable and self-healable performance,as well as a good thermoelectric performance.For the sample with Bi_(2)Se_(0.3)Te_(2.7)content of 1.5 wt%(i.e.,PAAc/XG/Bi2Se0.3Te27(1.5 wt%)),which has a room temperature Seebeck coefficient of-0.45 mV K^(-1),and exhibits an open-circuit voltage of-17.91 mV and output power of 38.1 nW at a temperature difference of 40 K.After being completely cut off,the hybrid thermoelectric hydrogel automatically recovers its electrical characteristics within a response time of 2.0 s,and the healed hydrogel remains more than 99%of its initial power output.Such stretchable and self-healable hybrid hydrogel thermoelectric materials show promising potential for application in dynamic service conditions,such as wearable electronics.
基金the Key Project of Zhejiang Provincial Natural Science Foundation under Grants LD21F020001,Z20F020022the National Natural Science Foundation of China under Grants 62072340,62076185the Major Project of Wenzhou Natural Science Foundation under Grants 2021HZSY0071,ZS2022001.
文摘Various deep learning models have been proposed for the accurate assisted diagnosis of early-stage Alzheimer’s disease(AD).Most studies predominantly employ Convolutional Neural Networks(CNNs),which focus solely on local features,thus encountering difficulties in handling global features.In contrast to natural images,Structural Magnetic Resonance Imaging(sMRI)images exhibit a higher number of channel dimensions.However,during the Position Embedding stage ofMulti Head Self Attention(MHSA),the coded information related to the channel dimension is disregarded.To tackle these issues,we propose theRepBoTNet-CESA network,an advanced AD-aided diagnostic model that is capable of learning local and global features simultaneously.It combines the advantages of CNN networks in capturing local information and Transformer networks in integrating global information,reducing computational costs while achieving excellent classification performance.Moreover,it uses the Cubic Embedding Self Attention(CESA)proposed in this paper to incorporate the channel code information,enhancing the classification performance within the Transformer structure.Finally,the RepBoTNet-CESA performs well in various AD-aided diagnosis tasks,with an accuracy of 96.58%,precision of 97.26%,and recall of 96.23%in the AD/NC task;an accuracy of 92.75%,precision of 92.84%,and recall of 93.18%in the EMCI/NC task;and an accuracy of 80.97%,precision of 83.86%,and recall of 80.91%in the AD/EMCI/LMCI/NC task.This demonstrates that RepBoTNet-CESA delivers outstanding outcomes in various AD-aided diagnostic tasks.Furthermore,our study has shown that MHSA exhibits superior performance compared to conventional attention mechanisms in enhancing ResNet performance.Besides,the Deeper RepBoTNet-CESA network fails to make further progress in AD-aided diagnostic tasks.
文摘The Dirac equation γ<sub>μ</sub>(δ<sub>μ</sub>-eA<sub>μ</sub>)Ψ=mc<sup>2</sup>Ψ describes the bound states of the electron under the action of external potentials, A<sub>μ</sub>. We assumed that the fundamental form of the Dirac equation γ<sub>μ</sub>(δ<sub>μ</sub>-S<sub>μ</sub>)Ψ=0 should describe the stable particles (the electron, the proton and the dark-matter-particle (dmp)) bound to themselves under the action of their own potentials S<sub>μ</sub>. The new equation reveals that self energy is consequence of self action, it also reveals that the spin angular momentum is consequence of the dynamic structure of the stable particles. The quantitative results are the determination of their relative masses as well as the determination of the electromagnetic coupling constant.
文摘BACKGROUND Endoscopic management is the first-line therapy for post-liver-transplant anas-tomotic strictures.Although the optimal duration of treatment with plastic stents has been reported to be 8-12 months,data on safety and duration for metal stents in this setting is scarce.Due to limited access to endoscopic retrograde cholan-giopancreatography(ERCP)during the coronavirus disease 2019 pandemic in our centre,there was a change in practice towards increased usage and length-of-stay of the Kaffes biliary intraductal self-expanding stent in patients with suitable anatomy.This was mainly due to the theoretical benefit of Kaffes stents allowing for longer indwelling periods compared to the traditional plastic stents.METHODS Adult liver transplant recipients aged 18 years and above who underwent ERCP were retrospectively identified during a 10-year period through a database query.Unplanned admissions post-Kaffes stent insertion were identified manually through electronic and scanned medical records.The main outcome was the incidence of complications when stents were left indwelling for 3 months vs 6 months.Stent efficacy was calculated via rates of stricture recurrence between patients that had stenting courses for≤120 d or>120 d.RESULTS During the study period,a total of 66 ERCPs with Kaffes insertion were performed in 54 patients throughout their stenting course.In 33 ERCPs,the stent was removed or exchanged on a 3-month interval.No pancreatitis,perfor-ations or deaths occurred.Minor post-ERCP complications were similar between the 3-month(abdominal pain and intraductal migration)and 6-month(abdominal pain,septic shower and embedded stent)groups-6.1%vs 9.1%respectively,P=0.40.All strictures resolved at the end of the stenting course,but the stenting course was variable from 3 to 22 months.The recurrence rate for stenting courses lasting for up to 120 d was 71.4%and 21.4%for stenting courses of 121 d or over(P=0.03).There were 28 patients that were treated with a single ERCP with Kaffes,21 with removal after 120 d and 7 within 120 d.There was a significant improvement in stricture recurrence when the Kaffes was removed after 120 d when a single ERCP was used for the entire stenting course(71.0%vs 10.0%,P=0.01).CONCLUSION Utilising a single Kaffes intraductal fully-covered metal stent for at least 4 months is safe and efficacious for the management of post-transplant anastomotic strictures.
基金the National Natural Science Foundation of China (No. 50238040).
文摘By heating up the embedded carbon fiber reinforced cement based material (CFRC), the carrying capacity and deformation of concrete member could be adjusted. The relationship between temperature difference and expansion strain of CFRC was demonstrated, and the temperature-deformation-load effect of concrete embedded with CFRC was studied. Heating the CFRC up to different temperatures resulted in different degree of inner pre-stress in concrete. Thus, the load capacity of concrete could be regulated owing to counteracting the pre-stress.
文摘Objective: Describe the status quo of self-disclosure and social support in breast cancer patients and analyze the correlation between them. Methods: General data questionnaire, distress disclosure Index scale and Chinese version of medical social support scale were used to investigate the correlation between self-disclosure and social support in breast cancer patients by Pearson correlation analysis. Results: 1) The total self-disclosure score was (38.75 ± 9.18);the total score of social support was (70.57 ± 14.04) scores, including emotional information support dimension (28.39 ± 6.06) scores, practical support dimension (15.62 ± 3.31) scores, elastic support dimension (14.85 ± 3.23) scores, and emotional support dimension (11.70 ± 2.56) scores. 2) Self-disclosure was positively correlated with social support (r = 0.433, p Conclusion: Breast cancer patients had a moderate level of self-disclosure, and the higher the level of self-disclosure, the better the social support. It is suggested that improving the self-disclosure level of breast cancer patients can help them obtain more social support.
文摘Background: Self-assessed health (SAH) is used as a common method of sociology research to understand the implications of self-reported health and the link to social factors like education, income, and occupation. The paper explores the impact of socio-economic and health indicators on self-assessed health in the middle-aged to the senior population in a rural community in Thailand. Methods: Primary data were collected after conducting a randomized sampling for 100 people using direct interviews in two locations within the sub-district of Phai Tha Pho, Thailand. The target demographic was the middle-age to elderly population. A logit model was applied to the collected samples. Results: The study highlights that higher education, income, and sleep are high predictors for positive SAH while high blood sugar level has significant adverse effects on SAH. Detection of metabolic syndrome further indicates degraded overall health perception over time. Conclusion: The study demonstrated the relationship between socio-economic indicators and illnesses alongside individual SAH in rural Thailand. Accordingly, policies have been proposed that include targeted subsidies for healthy food alternatives, promoting work-rest balance at all levels, and an expansion of sub-district education up to secondary school. SAH can be performed regularly and expanded across communities including areas of low-income living due to its low implementation costs. It could also be used as a tool to support the government’s public health initiatives complementing the existing five-year direct health check-up programme. A comparative study of SAH across regions is recommended for future research.
文摘Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified as a crucial tool in enhancing the knowledge, attitudes, and abilities necessary for self-management among individuals with diabetes. Aim: To assess the impact of diabetes self-management education on medication adherence and glycemic control in Sudanese adults with type 2 diabetes before and 3 months after the DSME intervention. Method: The study was conducted in Sudan between September 2022 and March 2023, it was an interventional, one-group, pre- and post-test study that aimed to assess the impact of diabetes self-management education (DSME) on medication adherence and diabetes control in Sudanese adults with type 2 diabetes. The research was conducted in primary health care centers in six cities in Sudan and involved 244 participants. The data entry and statistical analysis were conducted using the Statistical Package for Social Sciences version 27.0. A paired t test was used for analysis. Results: The study included 244 participants, 67% of whom were males. The age mean ± SD was 48.6 ± 9.3 years, and 85.3% of participants were married. Age at onset of diabetes mean ± SD was 40.60 ± 7.81 years;44.6% had diabetes for less than 5 years;and 84.1% had a positive family history of diabetes mellitus. The levels of poor, low, and partial adherence to medication decreased by 8.2%, 4%, and 20.6%, respectively, after the intervention. The levels of good and high medication regime adherence increased by 13% and 19.8%, respectively;BMI decreased by 1.1 ± 0.73 kg/m<sup>2</sup> (p = 0.005). The fasting blood sugar decreased by 69 ± 32.9 mg/dl (p = 0.049), and the glycated hemoglobin decreased by 1.21 ± 0.28% (p = 0.001). Conclusions: The findings of this study reinforce the importance of patient education in improving glycemic control and enhancing self-management behaviors. Patient education plays a critical role in enhancing glycemic control and self-management behaviors. It is essential for healthcare providers to adopt a patient-centered approach, taking into account the individual's beliefs, attitudes, and knowledge about their illness and treatment. Overcoming these challenges necessitates a comprehensive approach, including enhancing healthcare professionals’ knowledge and communication skills, offering accessible and culturally sensitive diabetes education programs, and addressing barriers to resources and support for self-management.
文摘Self-efficacy plays an important role in the management of type 2 diabetes mellitus (T2DM) patients, and it runs through the whole process of diabetes treatment, which is conducive to controlling and delaying the occurrence and development of complications, as well as improving the quality of life of patients. This paper mainly describes the concept of self-efficacy, the current situation of self-efficacy of diabetic patients at home and abroad, the functional aspects and their influencing factors, so as to take relevant measures on how to improve self-efficacy. It aims to provide a theoretical basis for the development of self-efficacy interventions for patients with type 2 diabetes mellitus.
文摘Diabetes is a chronic pathology whose evolution is marked by micro and macroangiopathic complications. Optimal management can prevent the onset of complications and improve patients’ quality of life. Objectives: To determine the frequency of self-monitoring of blood glucose and to describe the errors found during self-monitoring in diabetic patients followed at the Endocrinology Department of Donka University Hospital in Guinea. Materials and methods: Descriptive cross-sectional study carried out between August and September 2020 involving diabetic patients followed up at the Endocrinology and Diabetology Department of the Donka National Hospital, CHU Conakry. Results: A total of 301 patients were enrolled, with an average age of 44.24 ± 21.01 years. 64.12% were female. Type 2 diabetes predominated in 64% of cases. The mean duration of diabetes was 6.14 ± 4.67 years, and 75.08% of patients lived in urban areas. Patients were on insulin in 36.21% of cases, insulin and biguanides (26.25%), hypoglycemic sulfonamide and biguanides (19.27%) and biguanides in 18.27% of cases. The frequency of self-monitoring of blood glucose was 43%, and 38% of patients made errors, notably reusing lancets (60%), not checking the expiration date (55.65%) and not washing their hands (48%). Conclusion: This study shows that self-monitoring of blood glucose is not performed by the majority of patients. Numerous errors were identified during blood glucose testing. Continued therapeutic education on the use of blood glucose meters will help empower patients and improve their quality of life.
文摘Background: Self-monitoring is important for recognizing the situations one is facing and assessing one’s own competence to respond appropriately to situations that require multitasking. Purpose: This study aimed to examine the surface and content validity of the Advanced Beginner Nurses’ Self-Monitoring Scale While Multitasking and refine the scale items accordingly. It is expected that the development of such scale will allow for reflection on advanced beginner nurses’ response to multitasking, leading to further capacity building. Methods: The surface validity of 96 items of the Advanced Beginner Nurses’ Self-Monitoring Scale While Multitasking was examined at a meeting with five expert researchers. Five researchers and five nurses examined the items’ content using an item-level content validity index through a questionnaire survey. Results and Conclusion: The Advanced Beginner Nurses’ Self-Monitoring Scale While Multitasking was organized into 73 items that were refined into scales with surface and content validity. Consequently, five sub-concepts were identified: recognizing the situation one’s facing, seeing one’s self from multiple perspectives, devising concrete strategies depending on the situation, considering a predictable time schedule, and being aware of the situation surrounding one’s self. In the future, it will be necessary to examine the reliability and validity of the scale.
文摘This article employs a combined approach of biology and economics to reveal that biological evolution has an economic nature, evolving towards improved energy efficiency. The orthodox Darwinian theory of evolution describes evolution as the random variation of organisms and their survival through natural selection. In fact, the natural environment itself is a constantly changing context, and the strategy to adapt to this change is to enhance behavioral capabilities, thereby expanding the range and dimensions of behavior. Therefore, the improvement of behavioral capabilities is an important aspect of evolution. The enhancement of behavioral capabilities expands the range of adaptation to the natural environment and increases the space for behavioral choices. Within this space of behavioral choices, some options are more effective and superior to others;thus, the ability to select is necessary to make the improved behavioral capabilities more beneficial to the organism itself. The birth and development of the brain serve the purpose of selection. By using the brain to make selections, at least the “better” behavior will be chosen between two alternatives. Once the better behavior yields better results, and the organism can associate these results with the corresponding behavior, it will persist in this behavior. The persistent repetition of a behavior over generations will form a habit. Habits passed down through generations constitute a new environment, causing the organism’s genes to activate or deactivate certain functions, ultimately leading to genetic changes that are beneficial to that habit. Since the brain’s selection represents the organism’s self-selection, it differs from random variation;it is also a rational selection, choosing behaviors that either obtain more energy or reduce energy consumption. Thus, this evolution possesses an economic nature.
文摘Background: The aetiology of Testicular Cancer (TC) is still unknown to researchers but many of the associated risk factors have been identified. These include family history, age, racial origin, cryptorchidism, urogenital malformations, testicular atrophy, and infertility. Given the lack of scientific data on the causes of the disease, it has been asserted in previous studies that the promotion of awareness and early detection are prerequisites to mitigating risks of metastasis as well as improving survival. This study is to assess the awareness, practice, and intention to practice testicular self-examination among professional working males in Accra. Methods: A quantitative cross-sectional design with a structured research instrument was used to collect data from respondants. The purposive and convenience sampling techniques were used to collect data from 300 men at Accra in Ghana. The study was conducted at two (2) Universities and a Senior High school at Accra in Ghana. The data was then analysed using descriptive statistics, logistic regression, multiple linear regression, and structural equation modeling. Results: From the study findings, 37% of male participants rated their knowledge of testicular self-examination and related symptoms as good, 28% of participants practised testicular self-examination monthly, while 65% of respondents expressed their intention to practice monthly testicular self-examination. The findings from logistic regression demonstrated that level of education, age, and marital status of participants had a significant influence on testicular self-examination. Additionally, the multiple linear regression results revealed knowledge and self-efficacy significantly predict testicular self-examination intention. The path coefficient results from the structural equation model are consistent with results from the regression models. Conclusion: This research is the first to investigate testicular self-examination among men in Ghana. The findings revealed awareness and practice of TSE are low among participants. Therefore, the research findings would improve the expertise of physicians and nurses in providing counsel, intervention, and support for patients at risk of testicular cancer.
文摘Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.
文摘The federated self-supervised framework is a distributed machine learning method that combines federated learning and self-supervised learning, which can effectively solve the problem of traditional federated learning being difficult to process large-scale unlabeled data. The existing federated self-supervision framework has problems with low communication efficiency and high communication delay between clients and central servers. Therefore, we added edge servers to the federated self-supervision framework to reduce the pressure on the central server caused by frequent communication between both ends. A communication compression scheme using gradient quantization and sparsification was proposed to optimize the communication of the entire framework, and the algorithm of the sparse communication compression module was improved. Experiments have proved that the learning rate changes of the improved sparse communication compression module are smoother and more stable. Our communication compression scheme effectively reduced the overall communication overhead.