Diabetes and susceptibility to COVID-19:Risk factors and preventive and therapeutic strategies

Coronavirus disease 2019(COVID-19)is a highly infectious disease caused by a novel human coronavirus called severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Diabetes is a well-known risk factor for infectious diseases with high prevalence and increased severity.Here,we elucidated the possible factors for the increased vulnerability of diabetic patients to SARS-CoV-2 infection and the more severe COVID-19 illness.The worsened prognosis of patients with both COVID-19 and diabetes may be attributable to host receptor angiotensinconverting enzyme 2-assisted viral uptake.Moreover,insulin resistance is often associated with impaired mucosal and skin barrier integrity,resulting in microbiota dysbiosis,which increases susceptibility to viral infections.It may also be associated with higher levels of pro-inflammatory cytokines resulting from an impaired immune system in diabetics,inducing a cytokine storm and excessive inflammation.This review describes diabetes mellitus and its complications,explains the risk factors,such as disease characteristics and patient lifestyle,which may contribute to the high susceptibility of diabetic patients to COVID-19,and discusses preventive and therapeutic strategies for COVID-19-positive diabetic patients.

Assessment of public perspectives and barriers towards dengue preventive practices using the Health Belief Model in Puducherry,India:A cross-sectional study

Objective:To assess the perspectives and barriers towards dengue preventive practices among the residents of Puducherry,India.Methods:A cross-sectional survey was conducted in 300 households in Puducherry,using a population-proportionate(7:3)distribution from urban and rural areas by grid sampling.One adult interview per household was conducted and the participants were selected using a KISH grid.A semi-structured questionnaire based on the Health Belief Model(HBM)with additional questions on knowledge assessment was used.Knowledge was assessed based on the correctness of answers and the HBM scores were calculated on a 5-point Likert scale.Participants were categorized based on the median score under each domain.Logistic regression was used for adjusted analysis and models were built to predict the performances in each domain.Results:Four percent of the participants lacked basic knowledge regarding dengue transmission.While 208(69.3%)participants did not consider themselves at risk of contracting dengue within the next year,majority perceived dengue as a disease with low severity.Around 49.3%(148)were skeptical about the benefit of time and money spent on dengue prevention.Inadequate government efforts were stated as the major barrier(47.0%)and frequent reminders(142,47.3%)as the major cue to action.Age above 50 years(aOR 1.78,95%CI 1.04-3.06,P=0.037)and rural locality(aOR 2.68,95%CI 1.52-4.71,P=0.001)were found to be significantly associated with poor knowledge scores.Urban participants had a significantly higher chance to perceive low susceptibility as compared to the rural counterparts(aOR 1.74,95%CI 1.05-2.9,P=0.03).Participants with less than a high school education had low perceived benefits(aOR 2.46,95%CI 1.52-3.96,P<0.001)and low self-efficacy scores(aOR 2.66,95%CI 1.61-4.39,P<0.001).Conclusions:This study identifies key gaps in dengue prevention,including low perceived susceptibility,mild disease perception,limited knowledge of breeding sites,and overreliance on government efforts.Tailoring interventions to community needs,stratified to factors influencing the community perspectives can significantly improve dengue prevention efforts.

Low Birth Weight and Intermittent Preventive Treatment of Malaria in Pregnant Women in Lomé (Togo) in 2021: A Cross-Sectional Study

Background: Since 2012, the World Health Organization has recommended intermittent preventive treatment with sulfadoxine-pyrimethamine (IPT-SP) to prevent malaria-related complications in pregnant women. Ten years following these recommendations, we conducted this study to estimate the coverage for three doses of IPT-SP (IPT3) as well as the prevalence of low birth weight (LBW), and its associated factors in Lomé (Togo) in 2021. Methods: A cross-sectional study was conducted between January and March 2021. An exhaustive recruitment of women and their newborns was carried out in the maternity wards of the Sylvanus Olympio University Hospital Center. Data from antenatal consultations and clinical data of the newborns were collected. Multivariate logistic regression was carried out to determine factors associated with LBW. Results: A total of 252 mother-child pairs were included in this study. Median age of the mothers was 27 years, IQR [24-31]. More than a third (35.3%) of the mothers were primigravida. IPT3 coverage was 66.7% and 14.7% of newborns had a LBW. The prevalence of LBW was 33.3% [23.3-43.4] in women who had received fewer than 3 doses of IPT-SP and 5.4% [2.0-8.8] in those who had received at least 3 doses of IPT-SP (p Conclusion: Ten years following recommendations of the WHO on IPT-SP, malaria prevention based on IPT-SP is not optimal among pregnant women in Lomé, and the proportion of LBW children remains high. Actions to strengthen the three-dose IPT-SP policy are needed to prevent malaria and its consequences among newborns in Togo.

Transient Stability Preventive Control of Wind Farm Connected Power System Considering the Uncertainty

To address uncertainty as well as transient stability constraints simultaneously in the preventive control of windfarm systems, a novel three-stage optimization strategy is established in this paper. In the first stage, the probabilisticmulti-objective particle swarm optimization based on the point estimate method is employed to cope with thestochastic factors. The transient security region of the system is accurately ensured by the interior point methodin the second stage. Finally, the verification of the final optimal objectives and satisfied constraints are enforcedin the last stage. Furthermore, the proposed strategy is a general framework that can combine other optimizationalgorithms. The proposed methodology is tested on the modified WSCC 9-bus system and the New England 39-bussystem. The results verify the feasibility of the method.

Addressing mucosal ulcers during orthodontic treatment:An urgent call for preventive strategies

Mucosal ulcers are a common yet often overlooked complication during orthodontic treatment,significantly impacting patient comfort and compliance.This letter aims to highlight the prevalence,potential causes,and management strategies for mucosal ulcers in orthodontic patients.By reviewing recent literature and clinical observations,we underscore the necessity for proactive measures and tailored interventions to mitigate the incidence and severity of these lesions.Emphasizing the role of patient education and the use of protective devices,we call for a multidisciplinary approach to enhance patient care and treatment outcomes.This discussion is particularly relevant in the context of evolving orthodontic techniques and materials,which necessitate continuous adaptation of clinical practices to ensure patient safety and well-being.

Prevalence and Individual-Level Determinants of Uptake of Three or More Doses of Sulphadoxine-Pyrimethamine for Intermittent Preventive Treatment of Malaria in Pregnancy in Busia County, Kenya

Background: Malaria in pregnancy causes maternal anemia, low birth weight, intrauterine growth retardation, and preterm deliveries. In malaria-endemic regions in Kenya, percentage of pregnant women hospitalized with malaria reach up to 60%. WHO recommends at least three doses of sulphadoxine pyrimethamine for Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) antenatally. This study sought to ascertain the prevalence and individual-level factors influencing the uptake of IPTp-SP3+. Methods: A facility-based cross-sectional study at Busia County Referral Hospital. 384 mothers were consecutively sampled at the maternity unit during delivery. Semi-structured questionnaires were used to collect data. Odds ratio (OR) and adjusted OR were used to determine statistical significance of individual factors influencing uptake of three or more IPTp-SP. Results: 43.0% of participants took IPTp-SP3+. Individual factors that affected the uptake of IPTp-SP3+ included starting ANC visits in the first trimester (adjusted odds ratio (aOR) = 2.1, 95% CI: 1.23 – 3.67, p = 0.046), having more than four ANC visits (aOR = 3.1, 95% CI: 1.49 – 6.50, p = 0.002), having a higher monthly income (aOR = 2.6, 95% CI: 1.24 – 5.36, p = 0.012), being aware of the advantages of IPTp-SP medications (aOR = 3.7, 95% CI: 1.40 – 9.74, p = 0.008), and having a positive attitude toward ANC services (aOR = 3.2, 95% CI: 1.61 – 6.31, p = 0.001). Conclusion: Less than half of the pregnant mothers are complyingIPTp-SP3+. There should be aggressive efforts by the County and National Ministries of Health promoting initiation of ANC attendance early and attendance of all the recommended eight visits together with ensuring availability of the drugs.

Evaluation of the effectiveness of preventive nursing measures for pressure injuries in patients in the neurology intensive care unit

BACKGROUND Patients in neurology intensive care units(ICU)are prone to pressure injuries(PU)due to factors such as severe illness,long-term bed rest,and physiological dysfunction.PU not only causes pain and complications to patients,but also increases medical burden,prolongs hospitalization time,and affects the recovery process.AIM To evaluate and optimize the effectiveness of pressure injury prevention nursing measures in neurology ICU patients.METHODS A retrospective study was conducted,and 60 patients who were admitted to the ICU of the Department of Neurology were selected and divided into an observation group and a control group according to the order of admission,with 30 people in each group.The observation group implemented pressure injury prevention and nursing measures,while the control group adopted routine care.RESULTS Comparison between observation and control groups following pressure injury prevention nursing intervention revealed significantly lower incidence rates in the observation group compared to the control group at 48 h(8.3%vs 26.7%),7 d(16.7%vs 43.3%),and 14 d(20.0%vs 50.0%).This suggests a substantial reduction in pressure injury incidence in the observation group,with the gap widening over time.Additionally,patients in the observation group exhibited quicker recovery,with a shorter average time to get out of bed(48 h vs 72 h)and a shorter average length of stay(12 d vs 15 d)compared to the control group.Furthermore,post-intervention,patients in the observation group reported significantly improved quality of life scores,including higher scores in body satisfaction,feeling and function,and comfort(both psychological and physiological),indicating enhanced overall well-being and comfort following the implementation of pressure injury prevention nursing measures.CONCLUSION Implementing pressure injury preventive care measures for neurology ICU patients will have better results.

Influencing factors and preventive measures of infectious complications after intestinal resection for Crohn’s disease

The incidence of Crohn’s disease(CD)has increased in recent years,with most patients requiring intestinal resection.Complications after intestinal resection for CD can lead to poor prognosis and recurrence,among which infectious complic-ations are the most common.This study aimed to investigate the common risk factors,including medications,preoperative nutritional status,surgery-related factors,microorganisms,lesion location and type,and so forth,causing infectious complications after intestinal resection for CD,and to propose corresponding preventive measures.The findings provided guidance for identifying suscept-ibility factors and the early intervention and prevention of infectious complic-ations after intestinal resection for CD in clinical practice.

Reliability-BasedModel for Incomplete Preventive ReplacementMaintenance of Photovoltaic Power Systems

At present,the operation and maintenance of photovoltaic power generation systems mainly comprise regular maintenance,breakdown maintenance,and condition-based maintenance,which is very likely to lead to over-or under-repair of equipment.Therefore,a preventive maintenance and replacement strategy for PV power generation systems based on reliability as a constraint is proposed.First,a hybrid failure function with a decreasing service age factor and an increasing failure rate factor is introduced to describe the deterioration of PV power generation equipment,and the equipment is replaced when its reliability drops to the replacement threshold in the last cycle.Then,based on the reliability as a constraint,the average maintenance cost and availability of the equipment are considered,and the non-periodic incomplete maintenance model of the PV power generation system is established to obtain the optimal number of repairs,each maintenance cycle and the replacement cycle of the PV power generation system components.Next,the inverter of a PV power plant is used as a research object.The model in this paper is compared and analyzed with the equal cycle maintenance model without considering reliability and the maintenance model without considering the equipment replacement threshold,Through model comparison,when the optimal maintenance strategy is(0.80,4),the average maintenance cost of this paper’s model are decreased by 20.3%and 5.54%and the availability is increased by 0.2395% and 0.0337%,respectively,compared with the equal-cycle maintenance model without considering the reliability constraint and the maintenance model without considering the equipment replacement threshold.Therefore,this maintenance model can ensure the high reliability of PV plant operation while increasing the equipment availability to improve the system economy.

Preventive Diplomacy in Asia-Pacific Context

Preventive diplomacy, a nascent security issue of heated debate at the Asean Re-gional Forum last year, is expected to come up again in the session this year,notwithstanding the current overriding issue of regional financial crisis. Closescrutiny on the topic will help member nations to choose the appropriate form to actupon. when conditions are ripe for it, so as to build a favorable regional securityenvironment.

The Preventive Effect of Comprehensive Nursing Intervention on Arteriovenous Fistula Failure in Patients in the Hemodialysis Room

Objective:To explore the preventive effect of comprehensive nursing intervention on arteriovenous fistula failure in patients in the hemodialysis room.Methods:82 patients with arteriovenous fistula in the hemodialysis chamber treated in our hospital from July 2022 to October 2023 were selected as the research subjects.The random number table method divided them into a control group and an experimental group of 41 cases each.The control group received general nursing intervention measures,while the experimental group underwent comprehensive nursing intervention.The incidence of complications(internal fistula failure,bleeding,thrombosis,infection),psychological emotions(SAS scale,SDS scale),quality of life(physical pain,physiological function,emotional function,social function),and nursing satisfaction(very satisfied,basically satisfied,satisfied,dissatisfied)were compared between the two groups of patients.Results:The incidence of complications in the experimental group(4,9.76%)was significantly lower than that in the control group(29,70.73%);the SAS scores and SDS scores of the patients in the experimental group after intervention were both lower than those in the control group;the quality of life score(physical pain,physiological function,emotional function,and social function)was all higher than those of the control group;the post-intervention nursing satisfaction of the experimental group(40,97.57%)was also significantly higher than that of the control group(29,73.17%);and the listed differences were statistically significant(P<0.01).Conclusion:For patients with hemodialysis ventricular arteriovenous fistula failure,comprehensive nursing intervention can reduce the incidence of complications,relieve anxiety and stress,improve quality of life and nursing satisfaction,and achieve better preventive effects.

Single-machine scheduling with preventive periodic maintenance and resumable jobs in remanufacturing system

A single-machine scheduling with preventive periodic maintenance activities in a remanufacturing system including resumable and non-resumable jobs is studied.The objective is to find a schedule to minimize the makespan and an LPT-LS algorithm is proposed.Non-resumable jobs are first scheduled in a machine by the longest processing time（LPT） rule,and then resumable jobs are scheduled by the list scheduling（LS） rule.And the worst-case ratios of this algorithm in three different cases in terms of the value of the total processing time of the resumable jobs（denoted as S2） are discussed.When S2 is longer than the spare time of the machine after the non-resumable jobs are assigned by the LPT rule,it is equal to 1.When S2 falls in between the spare time of the machine by the LPT rule and the optimal schedule rule,it is less than 2.When S2 is less than the spare time of the machine by the optimal schedule rule,it is less than 2.Finally,numerical examples are presented for verification.

Screening of Saprolegniasis Preventive Drugs for Golden Trout (Oncorhynchus mykiss) Fertilized Eggs During Hatching

In order to screen the effective preventive drugs for saprolegniasis occurred during hatching of the fertilized eggs of golden trout, effects of two kinds of self-made Chinese herbal compounds（AB） and two kinds of chemical bactericides（peroxyacetic acid andhydrogen peroxide, CD） with three disinfection concentrations were compared in this study. The fertilized eggs of golden trout were randomly divided into 13 groups, each group with two parallels of 1 000 eggs. Drugs at high,medium and low concentration were respectively used to immerse the fertilized eggs35 min for disinfection once a day. The numbers of live and dead eggs were recorded each day before disinfection and the numbers of survival eyed eggs were counted in each experimental group after finishing the whole test. The results indicated that all of four kinds of drugs used here had a certain effect on prevention and control of saprolegniasis during hatching of fertilized eggs of golden trout, and also showed a correlation between the concentrations and effects. After the selection of several drugs, we found that group B-medium, C-medium and D-high exhibited the most remarkable effects on control of saprolegniasis. However, careful consideration should be given to chemical drugs residues and their potential hazard to the eyed eggs. Therefore, Chinese herbal compound B was suggested to be used for prevention and control of saprolegniasis to achieve the healthy aquaculture. And the concentration and operation time of Chinese herbal compound B should be strictly controlled when used in disinfection of fertilized eggs.

Bleeding after endoscopic submucosal dissection: Risk factors and preventive methods

Endoscopic submucosal dissection(ESD) has become widely accepted as a standard method of treatment for superficial gastrointestinal neoplasms because it enables en block resection even for large lesions or fibrotic lesions with minimal invasiveness, and decreases the local recurrence rate. Moreover, specimens resected in an en block fashion enable accurate histological assessment. Taking these factors into consideration, ESD seems to be more advantageous than conventional endoscopic mucosal resection(EMR), but the associated risks of perioperative adverse events are higher than in EMR. Bleeding after ESD is the most frequent among these adverse events. Although post-ESD bleeding can be controlled by endoscopic hemostasis in most cases, it may lead to serious conditions including hemorrhagic shock. Even with preventive methods including administration of acid secretion inhibitors and preventive hemostasis, post-ESD bleeding cannot be completely prevented. In addition high-risk cases for post-ESD bleeding, which include cases with the use of antithrombotic agents or which require large resection, are increasing. Although there have been many reports about associated risk factors and methods of preventing post-ESD bleeding, many issues remain unsolved. Therefore, in this review, we have overviewed risk factors and methods of preventing post-ESD bleeding from previous studies. Endoscopists should have sufficient knowledge of these risk factors and preventive methods when performing ESD.

Effects of preventive acupuncture or moxibustion at the Guanyuan acupoint on expression of interleukin-2 and its receptors in hypothalamus, serum, and uterus of menopausal rats

BACKGROUND： Previous studies have indicated preventive acupuncture and moxibustion at the Guanyuan point have positive effects on the immune system of menopausal rats. OBJECTIVE： To observe the effects of preventive acupuncture or moxibustion at the Guanyuan point on interleukin-2 （IL-2） and its receptor （IL-2R mRNA） levels in hypothalamus, serum, and uterus of menopausal rats. DESIGN： Randomized control animal experiment. SETTING： School of Acupuncture and Moxibustion, Beijing University of Chinese Medicine. MATERIALS： This study was performed at the Laboratory of Beijing University of Chinese Medicine from November 2004 to July 2005. The vaginal smear method was used to determine the estrus cycle of 9.5-month-old Sprague Dawley （SD） female rats. Three continuous estrus cycles were measured, and 160 rats with estrus cycle disorder, weighing （300 _＋ 20） g, were included in this study. The rats were randomly divided into four groups： preventive acupuncture group （n =48）, preventive moxibustion group （n =48）, model groups （n =48）, and 10-month-old group （n =16）. Sixteen 3.5-month-old healthy SD female rats, weighing （240 ± 20） g, were also assigned to the young group. All rats were clean grade and were purchased from the Laboratory Animal Center, Beijing University of Chinese Medicine. The experiment was in accordance with animal ethics standards. METHODS： Acupuncture was applied to the preventive acupuncture group at 10 months of age. The needle was inserted upward and perpendicularly two fen to a point that was two fen below the Guanyuan point. The rats freely moved around during needle retention （20 minutes）. Acupuncture was administered twice a week and continued for eight weeks. A moxa cone （small） moxibustion was applied to the preventive moxibustion group at 10 months of age. The rats were caught gently and kept at the same position as the preventive acupuncture group. The moxa cone was ignited and held to the Guanyuan point directly. Only one moxa cone was used each time. After moxibustion, the local skin turned slightly red. Moxibustion was used twice a week and continued for eight weeks. Nothing except gently catching and lying was administered to the model group and the young group. MAIN OUTCOME MEASURES： Radioimmunoassay, in situ hybridization, and similar methods were employed to detect IL-2 in serum and the uterus, as well as IL-2R mRNA expression in the hypothalamus and uterus arcuate nuclei, of the preventive acupuncture group, preventive moxibustion group, model groups （at 12, 14, and 16 months）, 10 month old group （at 10 months）, and the young group （at 4 months）. RESULTS： All 176 rats were included in the final analysis. （1） IL-2R mRNA： IL-2R mRNA expression decreased significantly in the uterus of 12-, 14-, and 16-month-old model groups and in the hypothalamus of 14- and 16-month-old model groups （P 〈 0.05-0.01）. Compared to the same month-aged model groups, the expression of IL-2R mRNA increased significantly in the hypothalamus and uterus of 16-month-old preventive acupuncture or moxibustion groups （P 〈 0.05-0.01）.（2） IL-2：IL-2 in serum of 12- and 14-month-old model groups and in the uterus of 12-, 14-, and 16-month-old model groups decreased significantly compared to the young group （P 〈 0.05-0.01）. IL-2 serum levels increased significantly in the 16-month-old group with preventive moxibustion; in addition, IL-2 expression levels increased significantly in the uterus of the 12-month-old group with preventive moxibustion, as well as the 12- and 16-month-old groups with preventive acupuncture （P 〈 0.05-0.01）. CONCLUSION： As a rat ages and becomes menopausal, IL-2R mRNA expression in the hypothalamus and uterus, as well as IL-2 levels in the serum and uterus, decrease. However, preventive acupuncture and preventive moxibustion can repress the decrease to some extent. This effect is even greater in the late stages of menopause （16-month-old rats）.

Recently highlighted nutraceuticals for preventive management of osteoarthritis

Osteoarthritis(OA) is a chronic degenerative disease of articular cartilage with limited treatment options. This reality encourages clinicians to suggest preventive measures to delay and contain the outbreak of the pathological conditions. Articular cartilage and synovium suffering from OA are characterised by an inflammatory state and by significant oxidative stress,responsible for pain,swelling and loss of mobility in the advanced stages. This review will focus on the ability of olive oil to exert positive effects on the entire joint to reduce pro-inflammatory cytokine release and increase lubricin synthesis,olive leaf extract,since it maintains lubrication by stimulating high molecular weight hyaluronan synthesis in synovial cells,curcumin,which delays the start of pathological cartilage breakdown,sanguinarine,which downregulates catabolic proteases,vitamin D for its capacity to influence the oxidative and proinflammatory environment,and carnosic acid as an inducer of heme oxygenase-1,which helps preserve cartilage degeneration. These molecules,considered as natural dietary supplements,appear like a cuttingedge answer to this tough health problem,playing a major role in controlling homeostatic balance loss and slowing down the pathology progression. Natural or food-derived molecules that are able to exert potential therapeutic effects are known as "nutraceutical",resulting from the combination of the words "nutrition" and "pharmaceutical". These compounds have gained popularity due to their easy availability,which represents a huge advantage for food and pharmaceutical industries. In addition,the chronic nature of OA implies the use of pharmacological compounds with proven longterm safety,especially because current treatments like nonsteroidal anti-inflammatory drugs and analgesicsimprove pain relief but have no effect on degenerative progression and can also cause serious side effects.

Preventive health measures in inflammatory bowel disease

We aim to review the literature and provide guidance on preventive health measures in inflammatory bowel disease(IBD). Structured searches were performed in Pub Med,MEDLINE,EMBASE,Web of Science and Cochrane Library from January 1976 to June 2016 using the following keywords:(inflammatory bowel disease OR Crohn's disease OR ulcerative colitis) AND(health maintenance OR preventive health OR health promotion). Abstracts of the articles selected from each of these multiple searches were reviewed,and those meeting the inclusion criteria(that is,providing data regarding preventive health or health maintenance in IBD patients) were recorded. Reference lists from the selected articles were manually reviewed to identify further relevant studies. Patients with IBD are at increased risk of developing adverse events related to the disease course,therapeutic interventions,or non-adherence to medication. Recent studies have suggested that IBD patients do not receive preventive services with the same thoroughness as patients with other chronic diseases. Preventive health measures can avert morbidity and improve the quality of life of patients with IBD. Gastroenterologists and primary care physicians(PCPs) should have an up to date working knowledge of preventive health measures for IBD patients. A holistic approach and better communication between gastroenterologists and PCPs with explicit clarification of roles will prevent duplication of services and streamline care.

Postoperative Nausea and Vomiting Prophylaxis with Ondansetron in Diagnostic Gynecologic Laparoscopy: Preemptive versus Preventive Method

Background and Objective: Post-operative nausea and vomiting (PONV) is a common adverse effect of the anesthesia in laparoscopic surgery. Ondansetron has been used for prevention and treatment of the PONV. The purpose of the present study was to compare the effects of preemptive and preventive intravenous ondansetron on PONV in patients undergoing diagnostic gynecologic laparoscopy. Materials & Methods: In a randomized double-blind clinical trial, 80 women candidate of diagnostic laparoscopy, were enrolled to study in two preemptive or preventive groups (n = 40). Ondansetron 4 mg IV was administered 5 min before anesthesia induction or 5 min before extubation in preemptive or preventive groups, respectively. The frequency and severity of the PONV were compared at post-anesthetic care unit (PACU), 3th, 6th and 24th postoperatively in two groups. Also the first time of need for the antiemetic drug was studied. Results: Demographic data were similar but duration of anesthesia was shorter in preventive group. The PONV rate was similar in two groups [(37.5% and 32.5% in preemptive and preventive groups, respectively (P = 0.815)]. In preemptive group it was more intense at PACU and 24 hours after surgery (P-value <0.05) and rate of vomiting was high (11 vs. 3, P-value 0.037). The first request for antiemetic drug was earlier and the antiemetic consumption dose (P-value <0.05), recovery and hospital stay times were high in preemptive group (P-value = 0.001). Conclusion: Preventive ondansetron is more effective than preemptive form, in reducing the severity of PONV but not rate of the PONV in diagnostic gynecologic laparoscopy.

Pediatric non-alcoholic fatty liver disease:Preventive and therapeutic value of lifestyle intervention

Nonalcoholic fatty liver disease(NAFLD),ranging from simple steatosis to nonalcoholic steatohepatitis(NASH),and eventually cirrhosis and liver failure,is seen to be increasing amongst Western children.NAFLD rates are rising in parallel with the epidemic of childhood obesity,and in particular,fatty liver evolves more easily in NASH when poor dietary habits and sedentary lifestyle are combined.In fact,its general prevalence in the child population varies between 2.6% and 10%,but increases up to 80% in obese children.Since NASH is expected to become the most common cause of pediatric chronic liver disease in the near future,there is broad interest amongst clinical researchers to move forward,both in diagnosis and treatment.Unfortunately,to date,the expensive and invasive procedure of liver biopsy is seen as the gold standard for NASH diagnosis and few noninvasive diagnostic methods can be applied successfully.Moreover,there are still no approved pharmacological interventions for NAFLD/NASH.Therefore,current management paradigms are based upon the presence of associated risk factors and aims to improve an individual's quality of life,thus reducing NAFLD-associated morbidity and mortality.Today,lifestyle intervention(diet and exercise) is the treatment of choice for NAFLD/ NASH.Thus far,no study has evaluated the potential preventive effect of lifestyle intervention on children at risk of NAFLD/NASH.Future studies will be required in this area with the perspective of developing a national program to promote nutrition education and increase physical activity as means of preventing the disease in individuals at risk.Here,we outline the clinical course,pathogenesis and management of NAFLD in children,highlighting the preventive and therapeutic value of lifestyle intervention.

Product Modular Design Incorporating Preventive Maintenance Issues

Traditional modular design methods lead to product maintenance problems, because the module form of a system is created according to either the function requirements or the manufacturing considerations. For solving these problems, a new modular design method is proposed with the considerations of not only the traditional function related attributes, but also the maintenance related ones. First, modularity parameters and modularity scenarios for product modularity are defined. Then the reliability and economic assessment models of product modularity strategies are formulated with the introduction of the effective working age of modules. A mathematical model used to evaluate the difference among the modules of the product so that the optimal module of the product can be established. After that, a multi-objective optimization problem based on metrics for preventive maintenance interval different degrees and preventive maintenance economics is formulated for modular optimization. Multi-objective GA is utilized to rapidly approximate the Pareto set of optimal modularity strategy trade-offs between preventive maintenance cost and preventive maintenance interval difference degree. Finally, a coordinate CNC boring machine is adopted to depict the process of product modularity. In addition, two factorial design experiments based on the modularity parameters are constructed and analyzed. These experiments investigate the impacts of these parameters on the optimal modularity strategies and the structure of module. The research proposes a new modular design method, which may help to improve the maintainability of product in modular design.