Introduction: Cancer is a chronic debilitating disease that unnerves patients, communities, and nations. At some point in cancer patient’s disease experience, chemotherapy is used, and the patient is expected to adhe...Introduction: Cancer is a chronic debilitating disease that unnerves patients, communities, and nations. At some point in cancer patient’s disease experience, chemotherapy is used, and the patient is expected to adhere to treatment to improve survival and quality of life. Methods: This multisite Cluster Randomized Trial (CRT) evaluated the effectiveness of mobile phone Short Message Service (SMS) support on the adherence to treatment schedules among adult cancer patients in Kenya. Data was collected using questionnaires. Ethical approvals were obtained from relevant Ethical Review Boards (ERBs). Results: The mean adherence was 83%. There was a significant difference between treatment arms in relation to the adherence. The intervention arm had a higher mean adherence difference, M = 3.913, 95% CI 2.632-5.193, t (402) = 6.006, p ≤ 0.001), with Cohen’s d = 0.60. Although not significant, (χ<sup>2</sup>dd = 0.151, df = 1, p = 2.064), more women were perfect adheres than males. Perfect adherers were satisfied with SMS support (χ<sup>2</sup>dd = 7.620, df = 1, p = 0.06), were in the intervention arm (χ<sup>2</sup>dd = 22.942, df = 1, p ≤ 0.001), and had trust in the care provider (χ<sup>2</sup>dd = 10.591 p ≤ 0.001). SMS support was not significant in the multivariate analysis but had an estimated effect size of 0.958 (z = 1.424, p = 0.154, CI = 0.242-3.781), indicating that mean adherence was slightly better in the presence of the intervention. Conclusions: SMS-support intervention has demonstrated superiority in influencing adherence. Further, health system-related factors have a significant influence on the adherence to chemotherapy treatment. Interventions to re-design health systems that are responsive to unmet care needs of cancer patients must be explored. .展开更多
Background: Off-pump coronary artery bypass grafting (OPCAB) is considered a safer alternative to on-pump surgery, especially in patients with left ventricular dysfunction (LVD). Objectives: This study assessed short-...Background: Off-pump coronary artery bypass grafting (OPCAB) is considered a safer alternative to on-pump surgery, especially in patients with left ventricular dysfunction (LVD). Objectives: This study assessed short-term outcomes and functional improvements in LVD patients post-OPCAB. Methods: The study included 200 coronary artery disease patients who underwent isolated off-pump coronary artery bypass grafting (OPCAB) at the National Heart Foundation Hospital and Research Institute between January 2019 and June 2020. Patients were categorized into Group 1, with a left ventricular ejection fraction (LVEF) of 30% - 39%, and Group 2, with an LVEF of 40% or higher. Echocardiographic assessments of left ventricular dimensions and ejection fraction were performed preoperatively, at discharge, and one month postoperatively. Results: In Group 1, preoperative left ventricular internal dimensions during diastole (LVIDd) and systole (LVIDs) were 53.48 ± 4.40 mm and 44.23 ± 3.93 mm, respectively, with a left ventricular ejection fraction (LVEF) of 35.28% ± 2.26%. At discharge, these values improved to 51.58 ± 4.04 mm (LVIDd), 41.23 ± 5.30 mm (LVIDs), and 39.25% ± 3.75% (LVEF). One month postoperatively, further improvements were observed: 46.29 ± 3.76 mm (LVIDd), 37.45 ± 3.68 mm (LVIDs), and 43.22% ± 4.67% (LVEF). Group 2 showed similar positive outcomes, with preoperative values of 47.09 ± 5.06 mm (LVIDd), 35.11 ± 5.25 mm (LVIDs), and 50.13% ± 7.25% (LVEF), improving to 42.37 ± 4.18 mm (LVIDd), 31.05 ± 4.19 mm (LVIDs), and 55.33% ± 7.05% (LVEF) at one month postoperatively. Both groups demonstrated significant improvements in left ventricular function and NYHA class, with most patients moving from class III/IV to I/II. Complications were minimal, and no mortality was observed. Conclusion: OPCAB is safe and effective for patients with LVEF 30% - 39% and LVEF ≥ 40%, providing significant short-term functional improvements without increased risk.展开更多
The most common cause of intestinal failure is short bowel syndrome (SBS), occurring as a result of a small functional intestine length, usually less than 200 cm, leading to intestinal malabsorption. A 59-year-old fem...The most common cause of intestinal failure is short bowel syndrome (SBS), occurring as a result of a small functional intestine length, usually less than 200 cm, leading to intestinal malabsorption. A 59-year-old female with a past medical history of Crohns disease status post total colectomy with ileostomy over 20 years ago came to the hospital due to progressive weakness. Despite medical management, the patient had high ileostomy output, leading to electrolyte disbalance, metabolic acidosis, dehydration, and progressive kidney decline. Due to the high dependence on continuous fluid supplementation, it was decided to place a port for parenteral hydration to maintain fluid replacements and homeostasis after discharge. Prompt initiation of parenteral fluid replacement and close follow-up on patients with ileostomy and intestinal failure is strongly recommended to avoid complications and prevent intestinal, liver, or kidney transplants.展开更多
The East African short rainy season (October-November-December) is one of the major flood seasons in the East African region. The amount of rainfall during the short rainy season is closely related to the lives of the...The East African short rainy season (October-November-December) is one of the major flood seasons in the East African region. The amount of rainfall during the short rainy season is closely related to the lives of the people and the socio-economic development of the area. By using precipitation data and sea surface temperature data, this study reveals the spatial and temporal variation patterns of extreme precipitation during the East African short rainy season. Key findings include significant rainfall variability, with Tanzania experiencing the highest amounts in December due to the southward shift of the Intertropical Convergence Zone (ITCZ), while other regions receive less than 100 mm. Extreme rainfall events (90th percentiles) are evenly distributed, averaging 2 to 10 days annually. Historical data shows maximum seasonal rainfall often peaks at 15 mm, with frequent occurrences of daily rainfall exceeding 10 mm during OND. Additionally, a positive correlation (0.48) between OND precipitation extremes and Indian Ocean Dipole (IOD) anomalies is statistically significant. These findings highlight the climatic variability and potential trends in extreme rainfall events in East Africa, providing valuable insights for regional climate adaptation strategies.展开更多
针对畜禽疫病文本语料匮乏、文本内包含大量疫病名称及短语等未登录词问题,提出了一种结合词典匹配的BERT-BiLSTM-CRF畜禽疫病文本分词模型。以羊疫病为研究对象,构建了常见疫病文本数据集,将其与通用语料PKU结合,利用BERT(Bidirectiona...针对畜禽疫病文本语料匮乏、文本内包含大量疫病名称及短语等未登录词问题,提出了一种结合词典匹配的BERT-BiLSTM-CRF畜禽疫病文本分词模型。以羊疫病为研究对象,构建了常见疫病文本数据集,将其与通用语料PKU结合,利用BERT(Bidirectional encoder representation from transformers)预训练语言模型进行文本向量化表示;通过双向长短时记忆网络(Bidirectional long short-term memory network,BiLSTM)获取上下文语义特征;由条件随机场(Conditional random field,CRF)输出全局最优标签序列。基于此,在CRF层后加入畜禽疫病领域词典进行分词匹配修正,减少在分词过程中出现的疫病名称及短语等造成的歧义切分,进一步提高了分词准确率。实验结果表明,结合词典匹配的BERT-BiLSTM-CRF模型在羊常见疫病文本数据集上的F1值为96.38%,与jieba分词器、BiLSTM-Softmax模型、BiLSTM-CRF模型、未结合词典匹配的本文模型相比,分别提升11.01、10.62、8.3、0.72个百分点,验证了方法的有效性。与单一语料相比,通用语料PKU和羊常见疫病文本数据集结合的混合语料,能够同时对畜禽疫病专业术语及疫病文本中常用词进行准确切分,在通用语料及疫病文本数据集上F1值都达到95%以上,具有较好的模型泛化能力。该方法可用于畜禽疫病文本分词。展开更多
Although short implants are seen as alternative treatments that require additional surgical techniques in posterior region, they can be applied to anterior maxilla and various studies are required on this subject. The...Although short implants are seen as alternative treatments that require additional surgical techniques in posterior region, they can be applied to anterior maxilla and various studies are required on this subject. The purpose of this study was to examine and compare the peak von Mises stress distributions in the crown, implant and abutment by using finite element analysis (FEA). Besides, a comparison of the implant-abutment connection types in the short implant with the FEA method was established. A short implant (4 × 5 mm) with a taper-lock connection and a regular implant (4 × 9 mm) with a screw connection were used in maxillary central incisor tooth area. Three different titanium abutments with 0?, 15? and 25? angles were used for abutments. In addition, in order to determine whether the stress change in short implants is due to the length of the implant-abutment connection, a screw was designed for a short implant and it was also evaluated in the same three angles. A total of three groups and nine models were generated. 114.6N load was applied to the cingulum area of the crown at an angle of 135? to the long axis of the crowns. A torque load of 25 Ncm was applied to the regular and short implant screw. Von Mises stress distributions of implants, abutments and crowns were evaluated by using FEA. Increased angle in implants increased von Mises stress values of implant, abutment and crown. Screw connection was found higher at all angles in short implants. Close values were found at different angles in taper-lock short implant crowns. The length and the angle in the bone of implant with the type of implant-abutment connection results in the accumulated stress values. Clinical Implications Taper implant-abutment connection system was found to be more promising in terms of stress accumulation in crowns. Although the amount of stress on the abutment increased due to the length of the implant in short implants, taper implant-abutment connection system slightly reduced related to this increase.展开更多
基金This study was jointly funded by the National Key R&D Program of China[grant number 2022YFC3004103]the National Natural Foundation of China[grant number 42275003]+2 种基金the Beijing Science and Technology Program[grant number Z221100005222012]the Beijing Meteorological Service Science and Technology Program[grant number BMBKJ202302004]the China Meteorological Administration Youth Innovation Team[grant number CMA2023QN10].
文摘Introduction: Cancer is a chronic debilitating disease that unnerves patients, communities, and nations. At some point in cancer patient’s disease experience, chemotherapy is used, and the patient is expected to adhere to treatment to improve survival and quality of life. Methods: This multisite Cluster Randomized Trial (CRT) evaluated the effectiveness of mobile phone Short Message Service (SMS) support on the adherence to treatment schedules among adult cancer patients in Kenya. Data was collected using questionnaires. Ethical approvals were obtained from relevant Ethical Review Boards (ERBs). Results: The mean adherence was 83%. There was a significant difference between treatment arms in relation to the adherence. The intervention arm had a higher mean adherence difference, M = 3.913, 95% CI 2.632-5.193, t (402) = 6.006, p ≤ 0.001), with Cohen’s d = 0.60. Although not significant, (χ<sup>2</sup>dd = 0.151, df = 1, p = 2.064), more women were perfect adheres than males. Perfect adherers were satisfied with SMS support (χ<sup>2</sup>dd = 7.620, df = 1, p = 0.06), were in the intervention arm (χ<sup>2</sup>dd = 22.942, df = 1, p ≤ 0.001), and had trust in the care provider (χ<sup>2</sup>dd = 10.591 p ≤ 0.001). SMS support was not significant in the multivariate analysis but had an estimated effect size of 0.958 (z = 1.424, p = 0.154, CI = 0.242-3.781), indicating that mean adherence was slightly better in the presence of the intervention. Conclusions: SMS-support intervention has demonstrated superiority in influencing adherence. Further, health system-related factors have a significant influence on the adherence to chemotherapy treatment. Interventions to re-design health systems that are responsive to unmet care needs of cancer patients must be explored. .
文摘Background: Off-pump coronary artery bypass grafting (OPCAB) is considered a safer alternative to on-pump surgery, especially in patients with left ventricular dysfunction (LVD). Objectives: This study assessed short-term outcomes and functional improvements in LVD patients post-OPCAB. Methods: The study included 200 coronary artery disease patients who underwent isolated off-pump coronary artery bypass grafting (OPCAB) at the National Heart Foundation Hospital and Research Institute between January 2019 and June 2020. Patients were categorized into Group 1, with a left ventricular ejection fraction (LVEF) of 30% - 39%, and Group 2, with an LVEF of 40% or higher. Echocardiographic assessments of left ventricular dimensions and ejection fraction were performed preoperatively, at discharge, and one month postoperatively. Results: In Group 1, preoperative left ventricular internal dimensions during diastole (LVIDd) and systole (LVIDs) were 53.48 ± 4.40 mm and 44.23 ± 3.93 mm, respectively, with a left ventricular ejection fraction (LVEF) of 35.28% ± 2.26%. At discharge, these values improved to 51.58 ± 4.04 mm (LVIDd), 41.23 ± 5.30 mm (LVIDs), and 39.25% ± 3.75% (LVEF). One month postoperatively, further improvements were observed: 46.29 ± 3.76 mm (LVIDd), 37.45 ± 3.68 mm (LVIDs), and 43.22% ± 4.67% (LVEF). Group 2 showed similar positive outcomes, with preoperative values of 47.09 ± 5.06 mm (LVIDd), 35.11 ± 5.25 mm (LVIDs), and 50.13% ± 7.25% (LVEF), improving to 42.37 ± 4.18 mm (LVIDd), 31.05 ± 4.19 mm (LVIDs), and 55.33% ± 7.05% (LVEF) at one month postoperatively. Both groups demonstrated significant improvements in left ventricular function and NYHA class, with most patients moving from class III/IV to I/II. Complications were minimal, and no mortality was observed. Conclusion: OPCAB is safe and effective for patients with LVEF 30% - 39% and LVEF ≥ 40%, providing significant short-term functional improvements without increased risk.
文摘The most common cause of intestinal failure is short bowel syndrome (SBS), occurring as a result of a small functional intestine length, usually less than 200 cm, leading to intestinal malabsorption. A 59-year-old female with a past medical history of Crohns disease status post total colectomy with ileostomy over 20 years ago came to the hospital due to progressive weakness. Despite medical management, the patient had high ileostomy output, leading to electrolyte disbalance, metabolic acidosis, dehydration, and progressive kidney decline. Due to the high dependence on continuous fluid supplementation, it was decided to place a port for parenteral hydration to maintain fluid replacements and homeostasis after discharge. Prompt initiation of parenteral fluid replacement and close follow-up on patients with ileostomy and intestinal failure is strongly recommended to avoid complications and prevent intestinal, liver, or kidney transplants.
文摘The East African short rainy season (October-November-December) is one of the major flood seasons in the East African region. The amount of rainfall during the short rainy season is closely related to the lives of the people and the socio-economic development of the area. By using precipitation data and sea surface temperature data, this study reveals the spatial and temporal variation patterns of extreme precipitation during the East African short rainy season. Key findings include significant rainfall variability, with Tanzania experiencing the highest amounts in December due to the southward shift of the Intertropical Convergence Zone (ITCZ), while other regions receive less than 100 mm. Extreme rainfall events (90th percentiles) are evenly distributed, averaging 2 to 10 days annually. Historical data shows maximum seasonal rainfall often peaks at 15 mm, with frequent occurrences of daily rainfall exceeding 10 mm during OND. Additionally, a positive correlation (0.48) between OND precipitation extremes and Indian Ocean Dipole (IOD) anomalies is statistically significant. These findings highlight the climatic variability and potential trends in extreme rainfall events in East Africa, providing valuable insights for regional climate adaptation strategies.
文摘针对畜禽疫病文本语料匮乏、文本内包含大量疫病名称及短语等未登录词问题,提出了一种结合词典匹配的BERT-BiLSTM-CRF畜禽疫病文本分词模型。以羊疫病为研究对象,构建了常见疫病文本数据集,将其与通用语料PKU结合,利用BERT(Bidirectional encoder representation from transformers)预训练语言模型进行文本向量化表示;通过双向长短时记忆网络(Bidirectional long short-term memory network,BiLSTM)获取上下文语义特征;由条件随机场(Conditional random field,CRF)输出全局最优标签序列。基于此,在CRF层后加入畜禽疫病领域词典进行分词匹配修正,减少在分词过程中出现的疫病名称及短语等造成的歧义切分,进一步提高了分词准确率。实验结果表明,结合词典匹配的BERT-BiLSTM-CRF模型在羊常见疫病文本数据集上的F1值为96.38%,与jieba分词器、BiLSTM-Softmax模型、BiLSTM-CRF模型、未结合词典匹配的本文模型相比,分别提升11.01、10.62、8.3、0.72个百分点,验证了方法的有效性。与单一语料相比,通用语料PKU和羊常见疫病文本数据集结合的混合语料,能够同时对畜禽疫病专业术语及疫病文本中常用词进行准确切分,在通用语料及疫病文本数据集上F1值都达到95%以上,具有较好的模型泛化能力。该方法可用于畜禽疫病文本分词。
文摘Although short implants are seen as alternative treatments that require additional surgical techniques in posterior region, they can be applied to anterior maxilla and various studies are required on this subject. The purpose of this study was to examine and compare the peak von Mises stress distributions in the crown, implant and abutment by using finite element analysis (FEA). Besides, a comparison of the implant-abutment connection types in the short implant with the FEA method was established. A short implant (4 × 5 mm) with a taper-lock connection and a regular implant (4 × 9 mm) with a screw connection were used in maxillary central incisor tooth area. Three different titanium abutments with 0?, 15? and 25? angles were used for abutments. In addition, in order to determine whether the stress change in short implants is due to the length of the implant-abutment connection, a screw was designed for a short implant and it was also evaluated in the same three angles. A total of three groups and nine models were generated. 114.6N load was applied to the cingulum area of the crown at an angle of 135? to the long axis of the crowns. A torque load of 25 Ncm was applied to the regular and short implant screw. Von Mises stress distributions of implants, abutments and crowns were evaluated by using FEA. Increased angle in implants increased von Mises stress values of implant, abutment and crown. Screw connection was found higher at all angles in short implants. Close values were found at different angles in taper-lock short implant crowns. The length and the angle in the bone of implant with the type of implant-abutment connection results in the accumulated stress values. Clinical Implications Taper implant-abutment connection system was found to be more promising in terms of stress accumulation in crowns. Although the amount of stress on the abutment increased due to the length of the implant in short implants, taper implant-abutment connection system slightly reduced related to this increase.