Objective:To investigate and analyze the annual physical examination results of retired employees from a unit in the civil aviation system,focusing on blood lipids,blood glucose,blood uric acid,and blood routine resul...Objective:To investigate and analyze the annual physical examination results of retired employees from a unit in the civil aviation system,focusing on blood lipids,blood glucose,blood uric acid,and blood routine results.The study aims to provide relevant references for formulating reasonable disease management measures for preventing and controlling hyperlipidemia,hyperuricemia,and other conditions in retired employees.Methods:The examination results of 231 participants were collected and analyzed.The participants were divided into four groups based on age:middle-aged group,young-old group,middle-old group,and old-old group.The blood test results were compared across these groups,and an assessment of atherosclerotic cardiovascular disease(ASCVD)risk levels was completed in conjunction with medical history.Blood test results were also compared by gender.Results:There were no significant statistical differences in blood test results when grouped by age.However,the prevalence of hyperuricemia was higher in males than in females,while the prevalence of hypercholesterolemia was higher in females than in males.The LDL-C target achievement rate was lower in the moderate-and-high-risk group as well as the very high-risk group as defined by ASCVD risk levels.Conclusion:Management of hyperuricemia and hyperlipidemia in retired employees(elderly patients)should be strengthened to reduce the risk of ASCVD events and alleviate the potential medical burden associated with disease progression.展开更多
[Objectives]This study was conducted to analyze effects of antimicrobial peptides added to the diet of Tan sheep on their production, slaughter performance and blood composition. [Methods] Ninety two four-month-old Ta...[Objectives]This study was conducted to analyze effects of antimicrobial peptides added to the diet of Tan sheep on their production, slaughter performance and blood composition. [Methods] Ninety two four-month-old Tan sheep were randomly divided into two treatment groups according to their body weight, 46 in each group. The control check group(CK) was feed with conventional diet, and the experimental group was fed with the addition of antimicrobial peptide on the basis of the conventional diet, with the added amount of 2.5 g/sheep per day. The experimental period was 60 d. [Results] The incidence rate was 75.06% lower in the experimental group than in the CK. The average daily weight gain per sheep was 11.27% higher in the experimental group than in the CK(P<0.05). The feed conversion ratio was 8.45% lower in the experimental group than in the CK(P<0.05). The average daily gross profit per sheep was 12.12% higher in the experimental group than in the CK. For slaughter performance, the data difference of each item was not significant. The PH at 45 min and 24 h after slaughter was within the normal range of fresh mutton. The cooked meat percentage and water loss rate showed no significant differences(P>0.05). The marbling ranged from 2.45 to 2.50, indicating that the fat content was moderate, and the difference between groups was not significant(P>0.05). The flesh color ranged from 3.00 to 3.15, between light red and bright red, belonging to the normal color of mutton, and the difference between groups was not significant(P>0.05). The shear force was between 2.50 and 2.65, without a significant difference between groups(P>0.05). The white blood cells, lymphocytes and platelets in the experimental group were lower than those in the CK(P<0.01). The erythrocytes and hemoglobin in the erythrocyte group were higher than those in the CK(P<0.05). The neutrophils and monocytes in the experimental group were lower than those in the CK(P<0.05). [Conclusions] This study provides a technical basis for the rational use of antimicrobial peptides and their application in ruminants.展开更多
[Objectives]To study the microscopic characteristics and routine detection of Hedyotis hedyotidea(DC.)Merr.[Methods]The microscopic characteristics of the root,stem cross section and the whole plant powder of H.hedyot...[Objectives]To study the microscopic characteristics and routine detection of Hedyotis hedyotidea(DC.)Merr.[Methods]The microscopic characteristics of the root,stem cross section and the whole plant powder of H.hedyotidea were studied by the methods of slide-shaft section,biological staining and microscopic imaging;the routine detection items such as moisture,ash,acid-insoluble ash and extract were detected and analyzed in accordance with the requirements of Chinese Pharmacopoeia.[Results]The microscopic characteristics of the root,the stem and the whole plant powder of H.hedyotidea were obtained.The moisture content of 10 batches of H.hedyotidea samples was in the range of 4.25%-7.90%,the water-soluble extract is in the range of 15.08%-22.52%,the total ash was in the scope of 8.27%-10.45%,and the acid-insoluble ash was in 0.13%-0.95%.The proposed water content of H.hedyotidea should not exceed 10.00%,the water-soluble extract should not be less than 12.00%,the total ash content should not exceed 13.00%,and the acid-insoluble ash content should not exceed 1.20%.[Conclusions]The results of this experiment can provide a reference for the quality control and quality standard of H.hedyotidea.展开更多
Objective:To study the levels of serum cystatin C(Cys-C),total bile acid(TBA),and other routine blood parameters on patients with decompensated hepatitis B cirrhosis.Methods:Study group 1 consisted of 30 patients with...Objective:To study the levels of serum cystatin C(Cys-C),total bile acid(TBA),and other routine blood parameters on patients with decompensated hepatitis B cirrhosis.Methods:Study group 1 consisted of 30 patients with hepatitis B-related decompensated cirrhosis,and study group 2 consisted of 30 patients with hepatitis B;while the control group consisted of 30 healthy people who underwent physical examination.The blood parameters were used to evaluate the clinical treatment effect of patients.Results:The TBA,Cys-C,alanine transaminase(ALT),total bilirubin(TBIL),aspartate aminotransferase(AST),and international normalized ratio(INR)in study group 1 were significantly higher than those of study group 2 and the control group;while the platelet count(PLT),hemoglobin(Hb),albumin(ALB),and estimated glomerular filtration rate(eGFR)were significantly lower in the study group 1 compared to the control group and study group 2(P<0.05).The Cys-C,PLT,TBA,AST,TBIL,and INR of patients in study group 1 who were successfully treated were significantly lower than the patients who were not successfully treated(P<0.05).Conclusion:Serum Cys-C,TBA,and routine blood parameters are useful in predicting the condition and the prognosis of patients of hepatitis B-related decompensated cirrhosis.展开更多
In order to reduce the risk of non-performing loans, losses, and improve the loan approval efficiency, it is necessary to establish an intelligent loan risk and approval prediction system. A hybrid deep learning model...In order to reduce the risk of non-performing loans, losses, and improve the loan approval efficiency, it is necessary to establish an intelligent loan risk and approval prediction system. A hybrid deep learning model with 1DCNN-attention network and the enhanced preprocessing techniques is proposed for loan approval prediction. Our proposed model consists of the enhanced data preprocessing and stacking of multiple hybrid modules. Initially, the enhanced data preprocessing techniques using a combination of methods such as standardization, SMOTE oversampling, feature construction, recursive feature elimination (RFE), information value (IV) and principal component analysis (PCA), which not only eliminates the effects of data jitter and non-equilibrium, but also removes redundant features while improving the representation of features. Subsequently, a hybrid module that combines a 1DCNN with an attention mechanism is proposed to extract local and global spatio-temporal features. Finally, the comprehensive experiments conducted validate that the proposed model surpasses state-of-the-art baseline models across various performance metrics, including accuracy, precision, recall, F1 score, and AUC. Our proposed model helps to automate the loan approval process and provides scientific guidance to financial institutions for loan risk control.展开更多
The network arbitration cases arising from the network lending disputes are pouring into the courts in large numbers.It is reported that the network arbitration system of some arbitration institutions even“can accept...The network arbitration cases arising from the network lending disputes are pouring into the courts in large numbers.It is reported that the network arbitration system of some arbitration institutions even“can accept more than 10,000 cases every day,”while online lending is booming,it has also caused a lot of contradictions and disputes,and traditional dispute resolution methods have failed to effectively respond to the need for efficient and convenient resolution of online lending disputes.This paper tries to study the arbitral award of online loans and proposes the construction of implementation review rules.展开更多
BACKGROUND Rivaroxaban is a non-vitamin K antagonist oral anticoagulant that does not require coagulation monitoring based on current recommendations. Our goal is to explore whether routine coagulation monitoring shou...BACKGROUND Rivaroxaban is a non-vitamin K antagonist oral anticoagulant that does not require coagulation monitoring based on current recommendations. Our goal is to explore whether routine coagulation monitoring should not be required for all patients receiving oral rivaroxaban, what relationship between routine coagulation abnormalities and bleeding, and how to deal with the above clinical situations through our case and review of the literature.CASE SUMMARY We report a 67-year-old woman with a history of atrial fibrillation who presented to the hospital with worsening dyspnea and cough. Based on electrocardiogram,venous compression ultrasonography, and computed tomography pulmonary angiography, the diagnosis of atrial fibrillation, deep venous thrombosis, and acute pulmonary embolism was confirmed. Her coagulation assays and renal function were normal on admission; she was not underweight, did not have a history of hemorrhagic disease, and her CHA2 DS2-VAS, HAS-BLED, and simplified Pulmonary Embolism Severity Index scores were 3, 0, and 0,respectively. Oral rivaroxaban(15 mg twice daily) was administered. The following day, she presented gastrointestinal and gum bleeding, combined with coagulation abnormalities. Following cessation of rivaroxaban, her bleeding stopped and tests improved over the next 2 d. Rivaroxaban was begun again 3 d after recovery. However, she again presented with gastrointestinal and gum bleeding and the abnormal tests, and the therapy was discontinued. At 30-d follow-up after discharge, she presented normal coagulation tests without bleeding.CONCLUSION Although current guidelines recommend that using non-vitamin K antagonist oral anticoagulants including rivaroxaban do not require coagulation monitoring,a small number of patients may develop routine coagulation test changes and bleeding during rivaroxaban therapy, especially in the elderly. Clinicians should pay attention to these patients and further obtain evidence in practice.展开更多
[Objectives] In this study,routine blood indexes of Guike pig were detected to clarify quantity variation and morphology distribution of different functional cells( red blood cells,white blood cells and platelets),t...[Objectives] In this study,routine blood indexes of Guike pig were detected to clarify quantity variation and morphology distribution of different functional cells( red blood cells,white blood cells and platelets),thus providing reference data for immunological evaluation and disease resistance research of Guike pig. [Methods] Blood samples were collected from forty-four 49-day-old healthy Guike pigs( 22 males and 22 females) once a week for seven consecutive weeks to detect routine blood indexes,and the results were compared with routine blood indexes of Landrace pig and Enshi black pig. [Results]Among red blood cell indexes of Guike pig at different day ages,red blood cell count( RBC) and hemoglobin count( HGB) both reached the lowest levels( 6. 85 × 10^12/L and 97. 1 g/L)at 70 days of age,which were significantly lower than the corresponding indexes at 49,56,63,84 and 91 days of age( P 〈 0. 05,similarly hereinafter); mean corpuscular hemoglobin( MCH) and mean corpuscular hemoglobin concentration( MCHC) demonstrated basically the same variation pattern,which both reached the lowest levels( 15. 11 pg and 275. 70 g/L) at 70 days of age and reached the highest levels( 16. 40 pg and 314. 30 g/L) at 91 days of age; hematocrit( HCT),mean corpuscular volume( MCV) and red blood cell distribution width( RDW) exhibited relatively stable changes with no significant differences among different day ages( P 〉 0. 05,similarly hereinafter). Among white blood cell indexes of Guike pig at different day ages,white blood cell count( WBC) reached the lowest level( 13. 71 × 10^9/L) at 63 days of age and reached the highest level( 17. 52 × 10^9/L) at 84 days of age,with significant differences; neutrophil count( NEUT)reached the lowest level( 3. 61 × 10^9/L) at 70 days of age,which was significantly lower than that at 49,56 and 77 days of age; lymphocyte count( LYMPH) exhibited relatively stable changes and was not significantly affected by the increase in day age. Among platelet indexes of Guike pig at different day ages,platelet count( PLT),thrombocytocrit( PCT) and platelet volume distribution width( PDW) exhibited relatively stable changes among different day ages,which were not significantly affected by the increase in day age. Compared to 35-day-old Landrace pig and 5-month-old Enshi black pig,most routine blood indexes of Guike pig were similar to or ranged between those of Landrace pig and Enshi black pig except HCT,mean platelet volume( MPV),PCT and PDW. [Conclusions]Guike pig has a certain uniqueness in routine blood indexes,which has developed a stable immune system at 49-91 days of age.展开更多
The paper tends to make an empirical analysis on the experimental site of new countryside construction of Xianhong in Hubei, pointing out that the inner and outer dependence on routines of experimental construction. T...The paper tends to make an empirical analysis on the experimental site of new countryside construction of Xianhong in Hubei, pointing out that the inner and outer dependence on routines of experimental construction. The paper also puts forward the beneficial policies, focusing on the agricultural production and fostering professional farmers, to reduce much dependence on routines.展开更多
Dear editor, Chest pain is a frequent complaint of patients presenting to the emergency department (ED), and many of them are referred to the cardiology service for further investigation. At the Charles V. Keating Eme...Dear editor, Chest pain is a frequent complaint of patients presenting to the emergency department (ED), and many of them are referred to the cardiology service for further investigation. At the Charles V. Keating Emergency and Trauma Centre in Halifax, Nova Scotia, Canada, 4,800 (6.6%) of the approximately 73,000 patients per year register with a complaint of “chest pain”, and 20% of patients are referred to cardiology. Coagulation studies, specifi cally international normalized ratio (INR) frequently part of the “routine” panel of blood tests, are ordered for patients in the ED being investigated or treated for chest pain suspected to be cardiac in nature. Recent calls to examine how much of our practice is likely to benefit patients in any way have led us to question the clinical utility of routine use of these tests.展开更多
Objective:Accurate preoperative identification of benign or malignant pancreatic cystic neoplasms(PCN)may help clinicians make better intervention choices and will be essential for individualized treatment.Methods:Pre...Objective:Accurate preoperative identification of benign or malignant pancreatic cystic neoplasms(PCN)may help clinicians make better intervention choices and will be essential for individualized treatment.Methods:Preoperative ultrasound and laboratory examination findings,and demographic characteristics were collected from patients.Multiple logistic regression was used to identify independent risk factors associated with malignant PCN,which were then included in the nomogram and validated with an external cohort.The Net Reclassification Index(NRI)and Integrated Discrimination Improvement(IDI)were calculated to evaluate the improvement in the predictive power of the new model with respect to that of a combined imaging and tumor marker prediction model.Results:Malignant PCN were found in 83(40.7%)and 33(38.7%)of the model and validation cohorts,respectively.Multivariate analysis identified age,tumor location,imaging of tumor boundary,blood type,mean hemoglobin concentration,neutrophil-tolymphocyte ratio,carbohydrate antigen 19-9,and carcinoembryonic antigen as independent risk factors for malignant PCN.The calibration curve indicated that the predictions based on the nomogram were in excellent agreement with the actual observations.A nomogram score cutoff of 192.5 classified patients as having low vs.high risk of malignant PCN.The model achieved good C-statistics of 0.929(95%CI 0.890–0.968,P<0.05)and 0.951(95%CI 0.903–0.998,P<0.05)in predicting malignancy in the development and validation cohorts,respectively.NRI=0.268;IDI=0.271(P<0.001 for improvement).The DCA curve indicated that our model yielded greater clinical benefits than the comparator model.Conclusions:The nomogram showed excellent performance in predicting malignant PCN and may help surgeons select patients for detailed examination and surgery.The nomogram is freely available at https://wangjunjinnomogram.shinyapps.io/DynNomapp/.展开更多
Few studies have examined the effects of different stimuli at a single acupoint using functional magnetic resonance imaging.The present study applied acupuncture at the Neiguan(PC 6),Waiguan(SJ 5),Zhigou(SJ 6) a...Few studies have examined the effects of different stimuli at a single acupoint using functional magnetic resonance imaging.The present study applied acupuncture at the Neiguan(PC 6),Waiguan(SJ 5),Zhigou(SJ 6) and Yanglingquan(GB 34) acupoints in healthy volunteers.fMRI was used to examine the activation of brain areas in response to different types of acupuncture(cutaneous or routine acupuncture) at each acupoint.There were no significant differences in the distribution of activation in the regions of interest between cutaneous and routine acupuncture at the Neiguan,Waiguan,and Zhigou acupoints,but some differences were observed between the two methods of acupuncture at the Yanglingquan acupoint.There were no significant differences in the intensity of induced activation between cutaneous and routine acupuncture at the Neiguan,Zhigou and Yanglingquan acupoints,but the activation intensity in the right cerebellum induced by routine acupuncture at the Waiguan acupoint was greater than that induced by cutaneous acupuncture.Results confirmed that cutaneous and routine acupuncture at the Neiguan,Waiguan,Zhigou and Yanglingquan acupoints activated different functional brain areas,and caused activation of different intensities in some areas.展开更多
Can progesterone be a better alternative to dexamethasone for use in routine brain surgery? Surgical brain injury (SBI) is a form of brain trauma caused by various forms of neurosurgical interventions including bra...Can progesterone be a better alternative to dexamethasone for use in routine brain surgery? Surgical brain injury (SBI) is a form of brain trauma caused by various forms of neurosurgical interventions including brain tumor excision, evacuation of intracere- bral hemorrhage and brain lobectomv (e.g., in epililepsv surger).展开更多
Innovation is managed through the development of processes and routines, considered as critical for business success and value creation. The identification of relevant routines as well as the understanding of which fa...Innovation is managed through the development of processes and routines, considered as critical for business success and value creation. The identification of relevant routines as well as the understanding of which factors affect business innovation is the main objective of this research, based on a survey applied in Portuguese companies and their experience shared in best practices guides. Conclusions highlighted 10 key innovation routines, reinforcing the idea that innovation must be supported through a systematic and sustained management process. Results also indicate that SMEs face greater difficulties in benefiting from the potential of innovation practices and collaboration may present opportunities to overcome their limited resources. Therefore, regardless of size, business activity, science and technology intensity or other factors influencing firms dynamic capabilities, innovation should be considered as a management imperative as it can influence not only the present but also the future of business success.展开更多
The routine monitoring of livestock and poultry products is the monitoring work carried out by the Ministry of Agriculture in order to grasp the quality and safety of national livestock and poultry products,and the sa...The routine monitoring of livestock and poultry products is the monitoring work carried out by the Ministry of Agriculture in order to grasp the quality and safety of national livestock and poultry products,and the sampling work is the first part of routine monitoring. This paper analyzes various factors during the implementation of sampling work such as preparatory work,sampling tools,sampling process,pretreatment,packaging,transfer,storage conditions and sample delivery. Carrying out the effective quality control can help to ensure the impartiality of the test results so as to provide reliable scientific basis for the department to study regulatory measures.展开更多
A Farmer ion chamber with an air cavity volume is the most widely used dosimeter for accurate dose determinations in radiotherapy. The quantity of ionization in the cavity volume occurred a given radiation dose has to...A Farmer ion chamber with an air cavity volume is the most widely used dosimeter for accurate dose determinations in radiotherapy. The quantity of ionization in the cavity volume occurred a given radiation dose has to be corrected to the cavity air temperature according to a dosimetry protocol because the mass of air in the cavity volume is subject to atmospheric variations. In the present study, we aim to measure the thermal equilibration time in the cavity volume of a Farmer ion chamber for the routine dosimetry. The Farmer ion chamber’s electrode was replaced by a thin thermocouple and coated by the PMMA for a waterproofing so that the measurement of the temperature in the cavity performed in water. As a result of the measurement, A Farmer ion chamber in thermal equilibrium with waterproofing equilibrates rapidly, followed by an exponential fall-off. In water, equilibration to less than 10% of the initial temperature difference required only a few minutes. Thermal equilibrium time is hardly affected by the room temperature change.展开更多
In Japan, herpes zoster is not monitored officially or nationwide. Recently, the databases of all electronic medical claims nationwide (NDBEMC) have been available for research. We use NDBEMC from April 2011 to March ...In Japan, herpes zoster is not monitored officially or nationwide. Recently, the databases of all electronic medical claims nationwide (NDBEMC) have been available for research. We use NDBEMC from April 2011 to March 2015. To evaluate the effects of initiation of routine immunization for varicella in children, we regressed the number of herpes zoster patients on the dummy variable for the routine immunization for varicella in children with and without a linear time trend. The estimated coefficient for the routine immunization for varicella was 0.5157 and its p-value was 0.001. However, if the time trend was added as an explanatory variable, the estimated coefficient for the routine immunization for varicella changed to be -0.039 and its p-value was 0.384. It means that the routine immunization for varicella was 7.8% higher after introduction than before. However, it was presumed to reflect such an upward trend.展开更多
Computer-based conceptual design for routine design has made great strides, yet non-routine design has not been given due attention, and it is still poorly automated. Considering that the function-behavior-structure(...Computer-based conceptual design for routine design has made great strides, yet non-routine design has not been given due attention, and it is still poorly automated. Considering that the function-behavior-structure(FBS) model is widely used for modeling the conceptual design process, a computer-based creativity enhanced conceptual design model(CECD) for non-routine design of mechanical systems is presented. In the model, the leaf functions in the FBS model are decomposed into and represented with fine-grain basic operation actions(BOA), and the corresponding BOA set in the function domain is then constructed. Choosing building blocks from the database, and expressing their multiple functions with BOAs, the BOA set in the structure domain is formed. Through rule-based dynamic partition of the BOA set in the function domain, many variants of regenerated functional schemes are generated. For enhancing the capability to introduce new design variables into the conceptual design process, and dig out more innovative physical structure schemes, the indirect function-structure matching strategy based on reconstructing the combined structure schemes is adopted. By adjusting the tightness of the partition rules and the granularity of the divided BOA subsets, and making full use of the main function and secondary functions of each basic structure in the process of reconstructing of the physical structures, new design variables and variants are introduced into the physical structure scheme reconstructing process, and a great number of simpler physical structure schemes to accomplish the overall function organically are figured out. The creativity enhanced conceptual design model presented has a dominant capability in introducing new deign variables in function domain and digging out simpler physical structures to accomplish the overall function, therefore it can be utilized to solve non-routine conceptual design problem.展开更多
Background: Pregnant women are important stakeholders regarding prenatal ultrasound (US) scanning. Their specific needs and preferences have to be ascertained by healthcare providers to ameliorate service delivery. Ob...Background: Pregnant women are important stakeholders regarding prenatal ultrasound (US) scanning. Their specific needs and preferences have to be ascertained by healthcare providers to ameliorate service delivery. Objective: To assess the pregnant woman’s expectations during routine prenatal US scan and her perspective ofUSsafety during pregnancy in a Central African obstetric population. Methods: A cross-sectional descriptive survey of consenting pregnant women who reported for routine prenatal US scan using an anonymous questionnaire. A convenient sample of 200 participants was adopted. Results: Thirty-three (16.8%) respondents (on a total of 196) declared they had never done anUSscan. One hundred and eleven (58.4%) on a total of 190 stated that they had not received any information on what ultrasonography is all about. Before theUSscan the respondents would like to receive information on the aim or purpose of ultrasonography, possible inconveniences or risks, and on how to prepare before the scan. The most reported expectations were assurance of the wellbeing of the fetus (58%), gender determination (44.5%) and information on fetal position (20.5%). Thirty-four respondents considered ultrasonography as not perfectly safe for the mother or the “baby”, with the relevant reasons being the use or production of some potentially harmful “rays”. Conclusion: Pregnant women would want to be assured of the wellbeing of the fetus, the gender and position during routine prenatal US. They however need to be informed of its purpose and safety.展开更多
Background: Each year around 1.5 million women living with Human immuno deficiency Virus (HIV) become pregnant, and without antiretroviral drugs there is a chance that their child will become infected. Following the i...Background: Each year around 1.5 million women living with Human immuno deficiency Virus (HIV) become pregnant, and without antiretroviral drugs there is a chance that their child will become infected. Following the introduction of Routine Human immuno deficiency Virus testing policy in Zambia, the Human immuno deficiency Virus test is offered to all pregnant women unless they decline. However, more pregnant women are declining to be tested. Objective: The main objective of this study was to investigate factors that influence acceptability of routine HIV testing by pregnant women in Lusaka district urban clinics. Materials and Methods: A cross sectional study using a quantitative approach was conducted in Lusaka District clinics. The sample size was 366 ante natal pregnant women who were selected by simple random sampling, selected from three (3) selected research setting. The study population included pregnant women aged 15 to 49 years, coming for ante natal visit for the first time, before being tested for HIV, were eligible and agreed to participate in the study. A pretested semi structured interview schedule was used to collect data. Data were entered and analysed with Statistical Package for Social Sciences (SPSS) version 20 program. Chi-square was used to test for significant associations and Binary Logistic regression modelling was carried out to predict the outcome. A 5% level of significance (p value) 0.05 confidence interval was set. Results: Study findings revealed that majority 85.6% (317) of respondents indicated willingness to undergo routine HIV testing in pregnancy though 77.3% perceived it a compulsory test. Binary logistic regression revealed that maternal age, educational level and information education and communication (IEC) contributed significantly to the model. The odds revealed that acceptability of routine HIV testing by older pregnant women (37 - 49 years) were 8 times (OR = 7.67, p = 0.003) higher than the younger ones. The odds of acceptability by respondents with tertiary education were 141 times (OR-141.23, p-0.0001), likely to accept HIV testing than those with primary or no education. And the odds also revealed that acceptability by women who cited adequate IEC (OR-2.6, p-0.024) were 3 times higher than those who cited inadequate IEC. Conclusion: The study showed that majority of the pregnant women was willing to undergo Routine HIV testing however a percentage regarded the test as a mandatory test without any choice of denial. Therefore there is need to address some factors that are likely to affect the routine HIV testing and impede the success of implementation of the PMTCT programme in the country which goes beyond testing for HIV alone. Recommendations: Ministry of Health needs to provide health education messages in different tribes. MOH should also intensify male involvement in HIV Testing and Counselling. LDHO should consider training more community health care givers as Voluntary Counselling and Testing providers. The District should organize regular refresher courses and presentations on Routine HIV testing to health workers and Ministry of Health should consider conducting a country wide study.展开更多
文摘Objective:To investigate and analyze the annual physical examination results of retired employees from a unit in the civil aviation system,focusing on blood lipids,blood glucose,blood uric acid,and blood routine results.The study aims to provide relevant references for formulating reasonable disease management measures for preventing and controlling hyperlipidemia,hyperuricemia,and other conditions in retired employees.Methods:The examination results of 231 participants were collected and analyzed.The participants were divided into four groups based on age:middle-aged group,young-old group,middle-old group,and old-old group.The blood test results were compared across these groups,and an assessment of atherosclerotic cardiovascular disease(ASCVD)risk levels was completed in conjunction with medical history.Blood test results were also compared by gender.Results:There were no significant statistical differences in blood test results when grouped by age.However,the prevalence of hyperuricemia was higher in males than in females,while the prevalence of hypercholesterolemia was higher in females than in males.The LDL-C target achievement rate was lower in the moderate-and-high-risk group as well as the very high-risk group as defined by ASCVD risk levels.Conclusion:Management of hyperuricemia and hyperlipidemia in retired employees(elderly patients)should be strengthened to reduce the risk of ASCVD events and alleviate the potential medical burden associated with disease progression.
基金Supported by Ningxia Agricultural Reclamation Group Science and Technology Innovation ProjectNew Feed Technology Promotion Project of Ningxia Agriculture and Rural DepartmentNingxia Feed Industry Expert Technical Service Group Project。
文摘[Objectives]This study was conducted to analyze effects of antimicrobial peptides added to the diet of Tan sheep on their production, slaughter performance and blood composition. [Methods] Ninety two four-month-old Tan sheep were randomly divided into two treatment groups according to their body weight, 46 in each group. The control check group(CK) was feed with conventional diet, and the experimental group was fed with the addition of antimicrobial peptide on the basis of the conventional diet, with the added amount of 2.5 g/sheep per day. The experimental period was 60 d. [Results] The incidence rate was 75.06% lower in the experimental group than in the CK. The average daily weight gain per sheep was 11.27% higher in the experimental group than in the CK(P<0.05). The feed conversion ratio was 8.45% lower in the experimental group than in the CK(P<0.05). The average daily gross profit per sheep was 12.12% higher in the experimental group than in the CK. For slaughter performance, the data difference of each item was not significant. The PH at 45 min and 24 h after slaughter was within the normal range of fresh mutton. The cooked meat percentage and water loss rate showed no significant differences(P>0.05). The marbling ranged from 2.45 to 2.50, indicating that the fat content was moderate, and the difference between groups was not significant(P>0.05). The flesh color ranged from 3.00 to 3.15, between light red and bright red, belonging to the normal color of mutton, and the difference between groups was not significant(P>0.05). The shear force was between 2.50 and 2.65, without a significant difference between groups(P>0.05). The white blood cells, lymphocytes and platelets in the experimental group were lower than those in the CK(P<0.01). The erythrocytes and hemoglobin in the erythrocyte group were higher than those in the CK(P<0.05). The neutrophils and monocytes in the experimental group were lower than those in the CK(P<0.05). [Conclusions] This study provides a technical basis for the rational use of antimicrobial peptides and their application in ruminants.
基金Supported by 2019-2021 Guangxi First-class Discipline Construction Open Project of Guangxi University of Chinese Medicine(2019XK096).
文摘[Objectives]To study the microscopic characteristics and routine detection of Hedyotis hedyotidea(DC.)Merr.[Methods]The microscopic characteristics of the root,stem cross section and the whole plant powder of H.hedyotidea were studied by the methods of slide-shaft section,biological staining and microscopic imaging;the routine detection items such as moisture,ash,acid-insoluble ash and extract were detected and analyzed in accordance with the requirements of Chinese Pharmacopoeia.[Results]The microscopic characteristics of the root,the stem and the whole plant powder of H.hedyotidea were obtained.The moisture content of 10 batches of H.hedyotidea samples was in the range of 4.25%-7.90%,the water-soluble extract is in the range of 15.08%-22.52%,the total ash was in the scope of 8.27%-10.45%,and the acid-insoluble ash was in 0.13%-0.95%.The proposed water content of H.hedyotidea should not exceed 10.00%,the water-soluble extract should not be less than 12.00%,the total ash content should not exceed 13.00%,and the acid-insoluble ash content should not exceed 1.20%.[Conclusions]The results of this experiment can provide a reference for the quality control and quality standard of H.hedyotidea.
基金SPPH Incubator Fund for Development of Science and Technology(2021YJY-19)SPPH Foundation for Development of Science and Technology(2021BJ-26)International Science and Technology Cooperation Projects of Shaanxi Province(2022KW-14).
文摘Objective:To study the levels of serum cystatin C(Cys-C),total bile acid(TBA),and other routine blood parameters on patients with decompensated hepatitis B cirrhosis.Methods:Study group 1 consisted of 30 patients with hepatitis B-related decompensated cirrhosis,and study group 2 consisted of 30 patients with hepatitis B;while the control group consisted of 30 healthy people who underwent physical examination.The blood parameters were used to evaluate the clinical treatment effect of patients.Results:The TBA,Cys-C,alanine transaminase(ALT),total bilirubin(TBIL),aspartate aminotransferase(AST),and international normalized ratio(INR)in study group 1 were significantly higher than those of study group 2 and the control group;while the platelet count(PLT),hemoglobin(Hb),albumin(ALB),and estimated glomerular filtration rate(eGFR)were significantly lower in the study group 1 compared to the control group and study group 2(P<0.05).The Cys-C,PLT,TBA,AST,TBIL,and INR of patients in study group 1 who were successfully treated were significantly lower than the patients who were not successfully treated(P<0.05).Conclusion:Serum Cys-C,TBA,and routine blood parameters are useful in predicting the condition and the prognosis of patients of hepatitis B-related decompensated cirrhosis.
文摘In order to reduce the risk of non-performing loans, losses, and improve the loan approval efficiency, it is necessary to establish an intelligent loan risk and approval prediction system. A hybrid deep learning model with 1DCNN-attention network and the enhanced preprocessing techniques is proposed for loan approval prediction. Our proposed model consists of the enhanced data preprocessing and stacking of multiple hybrid modules. Initially, the enhanced data preprocessing techniques using a combination of methods such as standardization, SMOTE oversampling, feature construction, recursive feature elimination (RFE), information value (IV) and principal component analysis (PCA), which not only eliminates the effects of data jitter and non-equilibrium, but also removes redundant features while improving the representation of features. Subsequently, a hybrid module that combines a 1DCNN with an attention mechanism is proposed to extract local and global spatio-temporal features. Finally, the comprehensive experiments conducted validate that the proposed model surpasses state-of-the-art baseline models across various performance metrics, including accuracy, precision, recall, F1 score, and AUC. Our proposed model helps to automate the loan approval process and provides scientific guidance to financial institutions for loan risk control.
文摘The network arbitration cases arising from the network lending disputes are pouring into the courts in large numbers.It is reported that the network arbitration system of some arbitration institutions even“can accept more than 10,000 cases every day,”while online lending is booming,it has also caused a lot of contradictions and disputes,and traditional dispute resolution methods have failed to effectively respond to the need for efficient and convenient resolution of online lending disputes.This paper tries to study the arbitral award of online loans and proposes the construction of implementation review rules.
文摘BACKGROUND Rivaroxaban is a non-vitamin K antagonist oral anticoagulant that does not require coagulation monitoring based on current recommendations. Our goal is to explore whether routine coagulation monitoring should not be required for all patients receiving oral rivaroxaban, what relationship between routine coagulation abnormalities and bleeding, and how to deal with the above clinical situations through our case and review of the literature.CASE SUMMARY We report a 67-year-old woman with a history of atrial fibrillation who presented to the hospital with worsening dyspnea and cough. Based on electrocardiogram,venous compression ultrasonography, and computed tomography pulmonary angiography, the diagnosis of atrial fibrillation, deep venous thrombosis, and acute pulmonary embolism was confirmed. Her coagulation assays and renal function were normal on admission; she was not underweight, did not have a history of hemorrhagic disease, and her CHA2 DS2-VAS, HAS-BLED, and simplified Pulmonary Embolism Severity Index scores were 3, 0, and 0,respectively. Oral rivaroxaban(15 mg twice daily) was administered. The following day, she presented gastrointestinal and gum bleeding, combined with coagulation abnormalities. Following cessation of rivaroxaban, her bleeding stopped and tests improved over the next 2 d. Rivaroxaban was begun again 3 d after recovery. However, she again presented with gastrointestinal and gum bleeding and the abnormal tests, and the therapy was discontinued. At 30-d follow-up after discharge, she presented normal coagulation tests without bleeding.CONCLUSION Although current guidelines recommend that using non-vitamin K antagonist oral anticoagulants including rivaroxaban do not require coagulation monitoring,a small number of patients may develop routine coagulation test changes and bleeding during rivaroxaban therapy, especially in the elderly. Clinicians should pay attention to these patients and further obtain evidence in practice.
基金Supported by Major Scientific and Technological Special Project of Guangxi Zhuang Autonomous Region"Innovation and Demonstration of Ecological Comprehensive Prevention and Control Technology for Major Diseases of Livestock and Poultry"(GKAA17204057)Natural Science Foundation of Guangxi Zhuang Autonomous Region(2015GXNSFAA139070)+1 种基金Open-end Fund for Key Laboratory of Livestock Genetic Improvement of Guangxi Zhuang Autonomous Region(2014GXKLLGI-07)Project of Aquatic Animal Husbandry Science and Technology Extension and Application of Guangxi Zhuang Autonomous Region(GYMK201528030,GYMK201633034)
文摘[Objectives] In this study,routine blood indexes of Guike pig were detected to clarify quantity variation and morphology distribution of different functional cells( red blood cells,white blood cells and platelets),thus providing reference data for immunological evaluation and disease resistance research of Guike pig. [Methods] Blood samples were collected from forty-four 49-day-old healthy Guike pigs( 22 males and 22 females) once a week for seven consecutive weeks to detect routine blood indexes,and the results were compared with routine blood indexes of Landrace pig and Enshi black pig. [Results]Among red blood cell indexes of Guike pig at different day ages,red blood cell count( RBC) and hemoglobin count( HGB) both reached the lowest levels( 6. 85 × 10^12/L and 97. 1 g/L)at 70 days of age,which were significantly lower than the corresponding indexes at 49,56,63,84 and 91 days of age( P 〈 0. 05,similarly hereinafter); mean corpuscular hemoglobin( MCH) and mean corpuscular hemoglobin concentration( MCHC) demonstrated basically the same variation pattern,which both reached the lowest levels( 15. 11 pg and 275. 70 g/L) at 70 days of age and reached the highest levels( 16. 40 pg and 314. 30 g/L) at 91 days of age; hematocrit( HCT),mean corpuscular volume( MCV) and red blood cell distribution width( RDW) exhibited relatively stable changes with no significant differences among different day ages( P 〉 0. 05,similarly hereinafter). Among white blood cell indexes of Guike pig at different day ages,white blood cell count( WBC) reached the lowest level( 13. 71 × 10^9/L) at 63 days of age and reached the highest level( 17. 52 × 10^9/L) at 84 days of age,with significant differences; neutrophil count( NEUT)reached the lowest level( 3. 61 × 10^9/L) at 70 days of age,which was significantly lower than that at 49,56 and 77 days of age; lymphocyte count( LYMPH) exhibited relatively stable changes and was not significantly affected by the increase in day age. Among platelet indexes of Guike pig at different day ages,platelet count( PLT),thrombocytocrit( PCT) and platelet volume distribution width( PDW) exhibited relatively stable changes among different day ages,which were not significantly affected by the increase in day age. Compared to 35-day-old Landrace pig and 5-month-old Enshi black pig,most routine blood indexes of Guike pig were similar to or ranged between those of Landrace pig and Enshi black pig except HCT,mean platelet volume( MPV),PCT and PDW. [Conclusions]Guike pig has a certain uniqueness in routine blood indexes,which has developed a stable immune system at 49-91 days of age.
基金Supported by the Social and Scientific Funds Projects of Hubei Province in 2009 (203004)
文摘The paper tends to make an empirical analysis on the experimental site of new countryside construction of Xianhong in Hubei, pointing out that the inner and outer dependence on routines of experimental construction. The paper also puts forward the beneficial policies, focusing on the agricultural production and fostering professional farmers, to reduce much dependence on routines.
文摘Dear editor, Chest pain is a frequent complaint of patients presenting to the emergency department (ED), and many of them are referred to the cardiology service for further investigation. At the Charles V. Keating Emergency and Trauma Centre in Halifax, Nova Scotia, Canada, 4,800 (6.6%) of the approximately 73,000 patients per year register with a complaint of “chest pain”, and 20% of patients are referred to cardiology. Coagulation studies, specifi cally international normalized ratio (INR) frequently part of the “routine” panel of blood tests, are ordered for patients in the ED being investigated or treated for chest pain suspected to be cardiac in nature. Recent calls to examine how much of our practice is likely to benefit patients in any way have led us to question the clinical utility of routine use of these tests.
基金supported by the National Natural Science Foundation of China(Grant Nos.82030092,81720108028,and 81802433)the Key Program of Prevention and Treatment of Chronic Diseases of Tianjin(Grant No.17ZXMFSY00010).
文摘Objective:Accurate preoperative identification of benign or malignant pancreatic cystic neoplasms(PCN)may help clinicians make better intervention choices and will be essential for individualized treatment.Methods:Preoperative ultrasound and laboratory examination findings,and demographic characteristics were collected from patients.Multiple logistic regression was used to identify independent risk factors associated with malignant PCN,which were then included in the nomogram and validated with an external cohort.The Net Reclassification Index(NRI)and Integrated Discrimination Improvement(IDI)were calculated to evaluate the improvement in the predictive power of the new model with respect to that of a combined imaging and tumor marker prediction model.Results:Malignant PCN were found in 83(40.7%)and 33(38.7%)of the model and validation cohorts,respectively.Multivariate analysis identified age,tumor location,imaging of tumor boundary,blood type,mean hemoglobin concentration,neutrophil-tolymphocyte ratio,carbohydrate antigen 19-9,and carcinoembryonic antigen as independent risk factors for malignant PCN.The calibration curve indicated that the predictions based on the nomogram were in excellent agreement with the actual observations.A nomogram score cutoff of 192.5 classified patients as having low vs.high risk of malignant PCN.The model achieved good C-statistics of 0.929(95%CI 0.890–0.968,P<0.05)and 0.951(95%CI 0.903–0.998,P<0.05)in predicting malignancy in the development and validation cohorts,respectively.NRI=0.268;IDI=0.271(P<0.001 for improvement).The DCA curve indicated that our model yielded greater clinical benefits than the comparator model.Conclusions:The nomogram showed excellent performance in predicting malignant PCN and may help surgeons select patients for detailed examination and surgery.The nomogram is freely available at https://wangjunjinnomogram.shinyapps.io/DynNomapp/.
基金the National Basic Research Program of China (973 Program), No. 2006CB504505the National Natural Science Foundation of China, No. 90709027
文摘Few studies have examined the effects of different stimuli at a single acupoint using functional magnetic resonance imaging.The present study applied acupuncture at the Neiguan(PC 6),Waiguan(SJ 5),Zhigou(SJ 6) and Yanglingquan(GB 34) acupoints in healthy volunteers.fMRI was used to examine the activation of brain areas in response to different types of acupuncture(cutaneous or routine acupuncture) at each acupoint.There were no significant differences in the distribution of activation in the regions of interest between cutaneous and routine acupuncture at the Neiguan,Waiguan,and Zhigou acupoints,but some differences were observed between the two methods of acupuncture at the Yanglingquan acupoint.There were no significant differences in the intensity of induced activation between cutaneous and routine acupuncture at the Neiguan,Zhigou and Yanglingquan acupoints,but the activation intensity in the right cerebellum induced by routine acupuncture at the Waiguan acupoint was greater than that induced by cutaneous acupuncture.Results confirmed that cutaneous and routine acupuncture at the Neiguan,Waiguan,Zhigou and Yanglingquan acupoints activated different functional brain areas,and caused activation of different intensities in some areas.
文摘Can progesterone be a better alternative to dexamethasone for use in routine brain surgery? Surgical brain injury (SBI) is a form of brain trauma caused by various forms of neurosurgical interventions including brain tumor excision, evacuation of intracere- bral hemorrhage and brain lobectomv (e.g., in epililepsv surger).
文摘Innovation is managed through the development of processes and routines, considered as critical for business success and value creation. The identification of relevant routines as well as the understanding of which factors affect business innovation is the main objective of this research, based on a survey applied in Portuguese companies and their experience shared in best practices guides. Conclusions highlighted 10 key innovation routines, reinforcing the idea that innovation must be supported through a systematic and sustained management process. Results also indicate that SMEs face greater difficulties in benefiting from the potential of innovation practices and collaboration may present opportunities to overcome their limited resources. Therefore, regardless of size, business activity, science and technology intensity or other factors influencing firms dynamic capabilities, innovation should be considered as a management imperative as it can influence not only the present but also the future of business success.
文摘The routine monitoring of livestock and poultry products is the monitoring work carried out by the Ministry of Agriculture in order to grasp the quality and safety of national livestock and poultry products,and the sampling work is the first part of routine monitoring. This paper analyzes various factors during the implementation of sampling work such as preparatory work,sampling tools,sampling process,pretreatment,packaging,transfer,storage conditions and sample delivery. Carrying out the effective quality control can help to ensure the impartiality of the test results so as to provide reliable scientific basis for the department to study regulatory measures.
文摘A Farmer ion chamber with an air cavity volume is the most widely used dosimeter for accurate dose determinations in radiotherapy. The quantity of ionization in the cavity volume occurred a given radiation dose has to be corrected to the cavity air temperature according to a dosimetry protocol because the mass of air in the cavity volume is subject to atmospheric variations. In the present study, we aim to measure the thermal equilibration time in the cavity volume of a Farmer ion chamber for the routine dosimetry. The Farmer ion chamber’s electrode was replaced by a thin thermocouple and coated by the PMMA for a waterproofing so that the measurement of the temperature in the cavity performed in water. As a result of the measurement, A Farmer ion chamber in thermal equilibrium with waterproofing equilibrates rapidly, followed by an exponential fall-off. In water, equilibration to less than 10% of the initial temperature difference required only a few minutes. Thermal equilibrium time is hardly affected by the room temperature change.
文摘In Japan, herpes zoster is not monitored officially or nationwide. Recently, the databases of all electronic medical claims nationwide (NDBEMC) have been available for research. We use NDBEMC from April 2011 to March 2015. To evaluate the effects of initiation of routine immunization for varicella in children, we regressed the number of herpes zoster patients on the dummy variable for the routine immunization for varicella in children with and without a linear time trend. The estimated coefficient for the routine immunization for varicella was 0.5157 and its p-value was 0.001. However, if the time trend was added as an explanatory variable, the estimated coefficient for the routine immunization for varicella changed to be -0.039 and its p-value was 0.384. It means that the routine immunization for varicella was 7.8% higher after introduction than before. However, it was presumed to reflect such an upward trend.
基金Supported by National Natural Science Foundation of China (Grant Nos.51375496,51205409)
文摘Computer-based conceptual design for routine design has made great strides, yet non-routine design has not been given due attention, and it is still poorly automated. Considering that the function-behavior-structure(FBS) model is widely used for modeling the conceptual design process, a computer-based creativity enhanced conceptual design model(CECD) for non-routine design of mechanical systems is presented. In the model, the leaf functions in the FBS model are decomposed into and represented with fine-grain basic operation actions(BOA), and the corresponding BOA set in the function domain is then constructed. Choosing building blocks from the database, and expressing their multiple functions with BOAs, the BOA set in the structure domain is formed. Through rule-based dynamic partition of the BOA set in the function domain, many variants of regenerated functional schemes are generated. For enhancing the capability to introduce new design variables into the conceptual design process, and dig out more innovative physical structure schemes, the indirect function-structure matching strategy based on reconstructing the combined structure schemes is adopted. By adjusting the tightness of the partition rules and the granularity of the divided BOA subsets, and making full use of the main function and secondary functions of each basic structure in the process of reconstructing of the physical structures, new design variables and variants are introduced into the physical structure scheme reconstructing process, and a great number of simpler physical structure schemes to accomplish the overall function organically are figured out. The creativity enhanced conceptual design model presented has a dominant capability in introducing new deign variables in function domain and digging out simpler physical structures to accomplish the overall function, therefore it can be utilized to solve non-routine conceptual design problem.
文摘Background: Pregnant women are important stakeholders regarding prenatal ultrasound (US) scanning. Their specific needs and preferences have to be ascertained by healthcare providers to ameliorate service delivery. Objective: To assess the pregnant woman’s expectations during routine prenatal US scan and her perspective ofUSsafety during pregnancy in a Central African obstetric population. Methods: A cross-sectional descriptive survey of consenting pregnant women who reported for routine prenatal US scan using an anonymous questionnaire. A convenient sample of 200 participants was adopted. Results: Thirty-three (16.8%) respondents (on a total of 196) declared they had never done anUSscan. One hundred and eleven (58.4%) on a total of 190 stated that they had not received any information on what ultrasonography is all about. Before theUSscan the respondents would like to receive information on the aim or purpose of ultrasonography, possible inconveniences or risks, and on how to prepare before the scan. The most reported expectations were assurance of the wellbeing of the fetus (58%), gender determination (44.5%) and information on fetal position (20.5%). Thirty-four respondents considered ultrasonography as not perfectly safe for the mother or the “baby”, with the relevant reasons being the use or production of some potentially harmful “rays”. Conclusion: Pregnant women would want to be assured of the wellbeing of the fetus, the gender and position during routine prenatal US. They however need to be informed of its purpose and safety.
文摘Background: Each year around 1.5 million women living with Human immuno deficiency Virus (HIV) become pregnant, and without antiretroviral drugs there is a chance that their child will become infected. Following the introduction of Routine Human immuno deficiency Virus testing policy in Zambia, the Human immuno deficiency Virus test is offered to all pregnant women unless they decline. However, more pregnant women are declining to be tested. Objective: The main objective of this study was to investigate factors that influence acceptability of routine HIV testing by pregnant women in Lusaka district urban clinics. Materials and Methods: A cross sectional study using a quantitative approach was conducted in Lusaka District clinics. The sample size was 366 ante natal pregnant women who were selected by simple random sampling, selected from three (3) selected research setting. The study population included pregnant women aged 15 to 49 years, coming for ante natal visit for the first time, before being tested for HIV, were eligible and agreed to participate in the study. A pretested semi structured interview schedule was used to collect data. Data were entered and analysed with Statistical Package for Social Sciences (SPSS) version 20 program. Chi-square was used to test for significant associations and Binary Logistic regression modelling was carried out to predict the outcome. A 5% level of significance (p value) 0.05 confidence interval was set. Results: Study findings revealed that majority 85.6% (317) of respondents indicated willingness to undergo routine HIV testing in pregnancy though 77.3% perceived it a compulsory test. Binary logistic regression revealed that maternal age, educational level and information education and communication (IEC) contributed significantly to the model. The odds revealed that acceptability of routine HIV testing by older pregnant women (37 - 49 years) were 8 times (OR = 7.67, p = 0.003) higher than the younger ones. The odds of acceptability by respondents with tertiary education were 141 times (OR-141.23, p-0.0001), likely to accept HIV testing than those with primary or no education. And the odds also revealed that acceptability by women who cited adequate IEC (OR-2.6, p-0.024) were 3 times higher than those who cited inadequate IEC. Conclusion: The study showed that majority of the pregnant women was willing to undergo Routine HIV testing however a percentage regarded the test as a mandatory test without any choice of denial. Therefore there is need to address some factors that are likely to affect the routine HIV testing and impede the success of implementation of the PMTCT programme in the country which goes beyond testing for HIV alone. Recommendations: Ministry of Health needs to provide health education messages in different tribes. MOH should also intensify male involvement in HIV Testing and Counselling. LDHO should consider training more community health care givers as Voluntary Counselling and Testing providers. The District should organize regular refresher courses and presentations on Routine HIV testing to health workers and Ministry of Health should consider conducting a country wide study.