A Qualitative Study on the Psychological Experience of Pregnant Women with Abnormal Induced Abortion of Fetuses under 20 Weeks of Pregnancy

Objective: This paper aims to understand the psychological experience and needs of pregnant women who need induction of labor due to fetal abnormalities at less than 20 weeks of gestation through in-depth interviews. Methods: Using the phenomenological research method in qualitative research, 12 pregnant women with fetal abnormalities less than 20 weeks of gestation in the obstetrics department of a hospital from January to April 2023 were selected as the research objects for semi-structured in-depth interviews. After information was collected to saturation, Colaizzi content analysis method was used to sort out, analyze and refine the data. Results: Through the interview results, three themes were refined from the transcript. Those are: 1) the support and assistance needed during the induction of labor;2) inner feelings after labor induction;3) The vision of future life. Conclusion: Abnormal fetal development at <20 weeks of gestation can cause anxiety, depression, guilt, loneliness and other negative emotions for pregnant women, and they need to get corresponding psychological support, especially during the period from fetal abnormality to induction of labor, pregnant women have to experience many physical and mental suffering, and need to get the care of family, relatives, friends, medical staff and society. Medical staff can help them seek multi-directional support, provide professional knowledge, and help them with self-management.

Three Weeks Carboplatin/Paclitaxel versus Weekly Regimen in Egyptian Women Cohort Treated for Ovarian Carcinoma

Introduction: Epithelial Ovarian Carcinoma (EOC) comprises the vast majority (almost 90%) of ovarian carcinomas. Chemotherapy is the main treatment in ovarian cancers. The standard of care in the chemotherapeutic is the combination of a platinum (carboplatin or cisplatin) and a taxane (paclitaxel or docetaxel). Studies were done to determine whether this combination to be given weekly or every 3 weeks. Patient and Method: Inclusion criteria: 1) Female patients between the ages of 17 - 78 years. 2) Baseline hematological, renal and liver laboratory profiles were within accepted ranges. 3) Performance status of the patients was 0-II. 4) Patients were pathologically proven ovarian cancer. 5) A follow-up period for at least 6 months was required. Exclusion criteria: 1) Patients who had double malignancy were excluded. 2) Performance status more than II. 3) Other comorbidity. Results: We reviewed 69 female patients with EOC, with 60% received every three weeks regimen. Mean age was 53.22 years. At a median follow up of 45.9 months, there was no significant different between the two protocols in terms of mean PFS, 62.35 months (95% CI: 50.08 - 74.63 months) for the three-weekly cohort, and 69.25 months (95% CI: 55.24 - 83.26 months) for weekly protocol (p = 0.613). The three weekly regimen patients had a higher incidence of hospital admission (40% vs 18.5% for the weekly protocol patients), but it didn’t reach a statistical significance (p = 0.063). The three weekly protocol had a significantly higher incidence of causing a neutropenic fever (p = 0.003). Conclusion: In our cohort of Egyptian women with EOC, no significant difference in PFS was found when compared the weekly Carboplatin/paclitaxel when compared to the classic three weeks, although the weekly protocol may be causing less febrile neutropenia and fewer hospital admissions.

Evaluation of Adherence to Nevirapine for Prevention of Mother-to-Child Transmission amongst Infants of HIV Positive Mothers in the First 6 Weeks of Life in Lagos Nigeria

Background: Over 90% of infection in children is acquired through mother to child transmission (MTCT). Nevirapine’s efficacy, safety and affordable cost make it the most preferred non-nucleoside reverse transcriptase inhibitor (NNRTI) for paediatric prophylactic use in resource limited settings. There are very few studies on pediatric adherence to antiretroviral prophylaxis, especially in very young infants. The objective of the study was to evaluate the adherence to nevirapine for prevention of mother to child transmission (PMTCT) amongst infants of HIV positive mothers in the first 6 weeks of life. Methods: This was a questionnaire based prospective cross-sectional multicenter study initiated in July 2015 and concluded in December 2017. The study was carried out at the Aids Prevention in Nigeria (APIN/HIV) human immunodeficiency paediatric clinics of the Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos State, 68 Nigerian Army Reference Hospital Yaba (68NARHY) Lagos, Nigeria and the Holy Family Catholic Hospital, Festac Town, Amuwo Odofin, Lagos State. Nevirapine adherence, in infants of 0 - 6 weeks was measured by maternal verbal reports. Results: Eighty-one (81) infants receiving nevirapine within the age of 0 - 6 weeks completed the study. Majority of the infants started treatment at birth (32%) and after 4 weeks (31%). 54% of the 81 respondents do not miss or skip their doses while 46% of respondents skip doses. Majority of the respondents 18 (49%) missed their doses for 24 - 48 hours while 25% missed their doses because they were away from home and 23% ran out of pills. 85.2% took ≥95% of the prescribed medications (good or high adherence ), 8.2% took 80% - 95% of doses (moderate adherence) while 6.2% took 0.05). Conclusions: The adherence rates found in this study are comparable to other studies in developing countries. But these rates are still low for good clinical outcomes. Different levels of adherence were documented with the majority having good or high adherence. Not all of the infants started treatment at birth and Institutional delivery should be encouraged to improve early initiation of prophylaxis. The finding of patients with low adherence rates among the study population calls for intensification of counselling on adherence and should continue to be an integral part of prevention of mother to child transmission. Improved access to antiretroviral agents and improved care delivery systems are important.

Weeks将被任命为康宁公司首席执行官

康宁公司近日宣布69岁的James R.Houghton计划放弃自己首席执行官的职务,而45岁的Wendell P.Weeks将成为总裁兼首席执行官。另外,49岁的Peter F.Volanakis 将接替Weeks出任首席运营官。这些举措已获董事会批准并将于今年4月28日召开的公司年度股东大会上正式生效,Houghton将继任董事会主席一职。

Weeks-Ahead Epidemiological Predictions of Varicella Cases From Univariate Time Series Data Applying Artificial Intelligence

Background:"Chickenpox"is a highly infectious disease caused by the varicella-zoster virus,influenced by seasonal and spatial factors.Dealing with varicella-zoster epidemics can be a substantial drain on health-authority resources.Methods that improve the ability to locally predict case numbers from time-series data sets every week are therefore worth developing.Methods:Simple-to-extract trend attributes from published univariate weekly case-number univariate data sets were used to generate multivariate data for Hungary covering 10 years.That attribute-enhanced data set was assessed by machine learning(ML)and deep learning(DL)models to generate weekly case forecasts from next week(t0)to 12 weeks forward(t+12).The ML and DL predictions were compared with those generated by multilinear regression and univariate prediction methods.Results:Support vector regression generates the best predictions for weeks t0 and t+1,whereas extreme gradient boosting generates the best predictions for weeks t+3 to t+12.Long-short-term memory only provides comparable prediction accuracy to the ML models for week t+12.Multi-K-fold cross validation reveals that overall the lowest prediction uncertainty is associated with the tree-ensemble ML models.Conclusion:The novel trend-attribute method offers the potential to reduce prediction errors and improve transparency for chickenpox timeseries.

混凝土徐变柔度函数的高效逼近方法

混凝土徐变是引起安全壳预应力损失的主要因素之一,采用指数算法求解混凝土徐变效应时需要将混凝土徐变柔度函数采用Dirichlet级数表达,如何获得精确表征柔度函数的Dirichlet级数是实现指数算法的关键。基于连续延迟谱法,本文提出一种求解拉普拉斯逆变换的Weeks方法来逼近Dirichlet级数。对工程中常用的CEB MC90徐变模型,构建了基于Weeks方法的Dirichlet级数逼近算法,并给出了提高方法效率的相关参数取值范围。结果表明,提出的方法仅需对原混凝土徐变柔度函数求1阶导数,即可返回时域函数的显示表达式,避免了高阶求导存在计算复杂和计算效率低的问题。将本文方法计算结果与原柔度函数解析解进行对比,验证了方法的有效性。

Editor-in-Chief articles of choice and comments at the year-end of 2023

As the Editor-in-Chief of World Journal of Gastroenterology,every week prior to a new issue’s online publication,I perform a careful review of all encompassed articles,including the title,clinical and/or research importance,originality,novelty,and ratings by the peer reviewers.Based on this review,I select the papers of choice and suggest pertinent changes(e.g.,in the title)to the Company Editors responsible for publication.This process,while time-consuming,is very important for assuring the quality of publications and highlighting important articles that Readers may revisit.

Mifepristone in Combination with Misoprostol for the Termination of Pregnancy at 8-16 Weeks' Gestational Age: A Multicentre Randomized Controlled Trial

Objective To compare the efficacy and safety of medical abortion of different regimens for termination of pregnancy at 8-16 weeks of gestation. Methods Healthy pregnant women requesting medical abortion at 8-16 weeks＇ gestation within 12 hospitals in Shanghai were randomly allocated to four treatment groups. Three intervention groups were given mifepristone 200 mg as a single dose then 24 h later misoprostol 600 #g at 3 h intervals vaginally, orally or vaginally followed by orally, respectively. Control group was given mifepristone 100 mg for 2 d, followed at 48 h by initiation of misoprostol 600 μg vaginally every 12 h. The primary outcome measures were the successful abortion rate, the induction-to-abortion interval, vaginal bleeding and side effects. Results Efficacy outcomes were analyzed for 1 112 women （92.67%）, excluding 88 protocol violations. Termination successful rates were similar among the four groups from 97.1% to 97.8%. The average dose of misoprostol and the incidence of side effects in control group were lower than those in three intervention groups. Stratified analysis showed that the interval of induction-to-abortion at gestation of 1116 weeks was decreased in control group. Conclusion The four regimens have the similar termination successful rates in spite of different administration intervals or routes. Control group was recommended for the advantages of reduced dose of misoprostol and fewer side effects.

Ultrasound Screening of Fetal Anomalies at 11-13^(+6)Weeks

During the past decades,early fetal ultrasound and diagnosis have increasingly gained attention in pregnancy care with the development of high-frequency transducers,which make it possible to obtain detailed images of the early fetus and its organs,and thus move part of the anatomy and anomaly scan from the second to the first-trimester.By transabdominal sonography or transvaginal sonography,or a combination of both approaches,it is now able to diagnose a wide variety of fetal abnormalities at 11-13^(+6)weeks.

Weeks将被任命为康宁公司首席执行官

康宁公司近日宣布69岁的James R．Houghton计划放弃自己首席执行官的职务，而45岁的Wendell P．Weeks将成为总裁兼首席执行官。另外，49岁的Peter F．Volanakls将接替Weeks出任首席营运官。这些举措已获董事会批准并将于2005年4月28日召开的公司年度股东大会上正式生效，Houghton将继任董事会主席一职。

Two Weeks in the Bathroom?

翻译难!译此短文,让我满头冒汗!标题看似简单,其实不然。什么是bathroom?不就是“浴室”吗?读了文章的第一段,我便轻易认为:文章讲美国人在“浴室”里平均每年要待上两周时间。读完全文,方才醒悟:文章主要不是讲“洗浴”,而是讲“如厕”!这里的bathroom并不宜译“浴室”,而应译“卫生间”,甚至“厕所”!我们所说的家里的“卫生间”,在美国则被称为bathroom!另外,文中反复出现overactive bladder,我们绝对不能将它直译成“过分积极的膀胱”!an unexpected call from nature也绝不能直译成“一个没有预料到的自然的号召”,另 外,Altering daily activities to accommodate immediate access to a bathroom is a behavior often consistent with symptoms of overactive bladder一句说得何等文绉绉!岂能直译?笔者虽已尽力,译文谬误一定不少,请读者指正。】

Home Alone Nearly Three Weeks,Tot Survives

此消息来自美国的美国佛罗里州达东南部港市迈阿密。一个20岁的年轻母亲被拘捕后,她的两岁大的女孩被独自关在家中,时间长达近三周,女孩居然生存了下来。这位年轻母亲因此又多了一条罪名:child abuse(摧残儿童;虐待儿童)

SHER Grade IIIb Placenta Abruptio Complicating Severe Superimposed Pre-Eclampsia at 19 WA: A Case Report

The placenta abruptio is an extremely serious pathology which involves the maternal-fetal prognosis. We report the case of a 19-year-old patient who consulted for abdominopelvic pain associated with heavy vaginal bleeding on 19SA in a context of arterial hypertension. The symptomatology suddenly worsened with the onset of hemorrhagic shock, which prompted an emergency hysterotomy. The diagnosis of placenta abruptio grade III b of SHER was evoked. Uterine atony was objectified intraoperatively and uterine compression by the B-Lynch technique was performed. The evolution of the patient was favorable after a stay of 5 days in intensive care.

Regional variation in routes to diagnosis of cholangiocarcinoma in England from 2006 to 2017

BACKGROUND Incidence of cholangiocarcinoma(CCA)is rising,with overall prognosis remaining very poor.Reasons for the high mortality of CCA include its late presentation in most patients,when curative options are no longer feasible,and poor response to systemic therapies for advanced disease.Late presentation presents a large barrier to improving outcomes and is often associated with diagnosis via mergency presentation(EP).Earlier diagnoses may be made by Two Week Wait(TWW)referrals through General practitioner(GP).We hypothesise that TWW referrals and EP routes to diagnosis differ across regions in England.AIM To investigate routes to diagnosis of CCA over time,regional variation and influencing factors.METHODS We linked patient records from the National Cancer Registration Dataset to Hospital Episode Statistics,Cancer Waiting Times and Cancer Screening Programme datasets to define routes to diagnosis and certain patient characteristics for patients diagnosed 2006-2017 in England.We used linear probability models to investigate geographic variation by assessing the proportions of patients diagnosed via TWW referral or EP across Cancer Alliances in England,adjusting for potential confounders.Correlation between the proportion of people diagnosed by TWW referral and EP was investigated with Spearman’s correlation coefficient.RESULTS Of 23632 patients diagnosed between 2006-2017 in England,the most common route to diagnosis was EP(49.6%).Non-TWW GP referrals accounted for 20.5%of diagnosis routes,13.8%were diagnosed by TWW referral,and the remainder 16.2%were diagnosed via an‘other’or Unknown route.The proportion diagnosed via a TWW referral doubled between 2006-2017 rising from 9.9%to 19.8%,conversely EP diagnosis route declined,falling from 51.3%to 46.0%.Statistically significant variation in both the TWW referral and EP proportions was found across Cancer Alliances.Age,presence of comorbidity and underlying liver disease were independently associated with both a lower proportion of patients diagnosed via TWW referral,and a higher proportion diagnosed by EP after adjusting for other potential confounders.CONCLUSION There is significant geographic and socio-demographic variation in routes to diagnosis of CCA in England.Knowledge sharing of best practice may improve diagnostic pathways and reduce unwarranted variation.

Evaluating the weekly changes in terrestrial water storage estimated by two different inversion strategies in the Amazon River Basin

In this study,we estimated the weekly Gravity Recovery and Climate Experiment(GRACE)spherical harmonic(SH)solutions and regional mascon solutions using GRACE-based Geopotential Difference(GPD)data and investigated their abilities in retrieving terrestrial water storage(TWS)changes over the Amazon River Basin(ARB)from January 2003 to February 2013.The performance of the weekly GPD-SH and GPDmascon solutions was evaluated by comparing them with the weekly GFZ-SH solutions,Global Land Data Assimilation Systems(GLDAS)-NOAH hydrological model outputs,and monthly GFZ-SH,GPD-SH,and CSRmascon solutions in the spatio-temporal and spectral domains.The results demonstrate that the weekly GPD-SH and GPD-mascon present good consistency with the weekly GFZ-SH solutions and GLDAS-NOAH estimates in the spatio-temporal domains,but GPD-mascon presents stronger signal amplitudes and more spatial details.The comparison of the monthly average of weekly estimates and monthly solutions demonstrates that the weekly GPD-mascon and GFZ-SH with DDK1 filtering are close to the monthly CSRmascon and GFZ-SH solutions,respectively.However,the signal amplitudes of TWS changes from GPD-SH and GFZ-SH with 650 km Gaussian filtering are smaller than the monthly solutions,and the corresponding Root Mean Square Errors between the TWS change time series from the monthly average of weekly solutions and monthly estimates are 18.12 mm(GPD-mascon),18.81 mm(GFZ-SH-DDK1),24.93 mm(GPDSH-G650km),and 33.07 mm(GFZ-SH-G650km),respectively.Additionally,the TWS change time series derived from weekly solutions present more high-frequency time-varying information than monthly solutions.Furthermore,the 300 km Gaussian filtering can improve the signal amplitudes of TWS changes from the weekly GPD-SH solutions more than those with 650 km Gaussian filtering,but the corresponding noise level is higher.The weekly GPD-SH and GPD-mascon solutions can extend the application scopes of GRACE and provide good complements to the current GRACE monthly solutions.

Did weekly economic index and volatility index impact US food sales during the first year of the pandemic?

We explore the impacts of economic and financial dislocations caused by COVID-19 pandemic shocks on food sales in the United States from January 2020 to January 2021.We use the US weekly economic index(WEI)to measure economic dislocations and the Chicago Board Options Exchange volatility index(VIX)to capture the broader stock market dislocations.We validate the NARDL model by testing a battery of models using the autoregressive distributed lags(ARDL)methodology(ARDL,NARDL,and QARDL specifications).Our study postulates that an increase in WEI has a significant negative long-term effect on food sales,whereas a decrease in WEI has no statistically significant(long-run)effect.Thus,policy responses that ignore asymmetric effects and hidden cointegration may fail to promote food security during pandemics.

Effects of glucagon-like peptide-1 receptor agonists on glucose excursion and inflammation in overweight or obese type 2 diabetic patients

BACKGROUND Currently,the lack of comparative studies between weekly and daily formulations of glucagon-like peptide-1 receptor agonists(GLP-1RAs)for glucose excursion is worth investigation.AIM To investigate the effects of weekly and daily formulations of GLP-1RA on glucose excursion and inflammation in overweight and obese patients with type 2 diabetes.METHODS Seventy patients with type 2 diabetes mellitus who were treated at our hospital between January 2019 and January 2022 were enrolled in this retrospective analysis.All patients were treated with metformin.We evaluated changes in blood glucose levels and a series of important indicators in patients before and after treatment with either a weekly or daily preparation of GLP-1RA(group A;n=33 and group B;n=37).RESULTS The degree of decrease in the levels of fasting blood glucose,mean blood glucose,mean amplitude of glycemic excursions,total cholesterol,triglycerides,tumor necrosis factor-α,interleukin-6,and high-sensitivity C-reactive protein after treatment in group A was higher than that in group B(P<0.05),whereas the 2-h postprandial blood glucose levels decreased more so in group B than in group A(P<0.001).However,there were no statistically significant differences in the levels of glycated hemoglobin,standard deviation of blood glucose,coefficient of variation,absolute mean of daily differences,percentage of time with 3.9 mmol/L<glucose<10 mmol/L,and high-and low-density lipoproteins between the two groups(P>0.05).The incidence of adverse reactions was significantly lower in group A than in group B(P<0.05).CONCLUSION The effect of the weekly preparation of GLP-1RA in controlling blood glucose levels in the patients,suppressing inflammation,and reducing adverse reactions was significantly higher than that of the daily preparations,which is worthy of clinical promotion.

Time Series Analysis and Prediction of COVID-19 Pandemic Using Dynamic Harmonic Regression Models

Rapidly spreading COVID-19 virus and its variants, especially in metropolitan areas around the world, became a major health public concern. The tendency of COVID-19 pandemic and statistical modelling represents an urgent challenge in the United States for which there are few solutions. In this paper, we demonstrate combining Fourier terms for capturing seasonality with ARIMA errors and other dynamics in the data. Therefore, we have analyzed 156 weeks COVID-19 dataset on national level using Dynamic Harmonic Regression model, including simulation analysis and accuracy improvement from 2020 to 2023. Most importantly, we provide new advanced pathways which may serve as targets for developing new solutions and approaches.