Change in Functional Status from Preoperative to One Year Postoperative in Patients Who Have Undergone Elective Open-Heart Surgery: A Repeated-Measures Study

Purpose: Although patient-related factors affect surgical outcomes, preoperative functional status is not measured by any cardiac risk score. Functional status can, however, be objectively measured using validated outcome tools such as the Late-Life Function and Disability Instrument (LLFDI). The purpose of this study was to determine 1) if there was a change over time in functional status, as measured by the LLFDI, in patients who underwent elective cardiac surgery, and if so, 2) what specific aspect(s) of functional status changed. Methods: A prospective longitudinal study of one year was conducted on elective cardiac surgery patients (n = 43) using the self-reported LLFDI, which measures Disability Frequency (frequency of participation in social tasks), Disability Limitation (ability to participate in social tasks) and Function Total (ease in performing routine activities). Higher scores indicate increased function and decreased disability. LLFDI scores were compared at three times (preoperative, six-week and one-year postoperative) using repeated measures ANOVA. Post hoc pairwise comparison was conducted for specific interactions. Results: Both Function Total and Disability Frequency significantly changed over time (p = 0.047 and p = 0.013, respectively). Specifically, patients’ function level was significantly higher one-year postoperative compared to preoperative (M difference = +3.48, SE = 1.48, p = 0.026). Likewise, Disability Frequency scores were significantly higher (i.e. more active) at one-year postoperative versus preoperative (M difference= +5.98, SE = 2.19, p = 0.033). Disability Limitation scores were not significantly different between any time points (p > 0.05). Conclusion: By one-year postoperative, patients demonstrated increased ease in their routine physical activities and were more participatory in social life tasks. Individuals who underwent elective cardiac surgery took more than six weeks to detect notable improvement in functional status, which was expected with a sternotomy approach. This study provides support for the use of the LLFDI as an effective tool to capture functional status in the cardiac population. These findings may assist cardiac patients in recovery timeline expectations.

Reasons for Elective Surgery Cancellations in a Senegalese Pediatric Surgery Department

Introduction: Cancellation of elective surgery is common in developing countries. This decision is difficult to make as it generates economic and organizational consequences for the healthcare facility and an additional source of stress for patients and their caregivers. This study aimed to analyze the various aspects of this medical problem. Patients and Methods: We conducted a prospective and descriptive study over six months (from January 1st, 2017, to June 30th, 2017) at the pediatric surgery department of Aristide Le Dantec University Teaching Hospital in Senegal. Results: Ninety-one cases were collected. The cancellation rate was 20.8%. Infants were affected in 36.3% of cases. Among anesthesiologists, 83.5% were residents, and 16.5% were specialists. Cancellation in nephroblastoma children with an indication for extended nephrectomy represented 15.4% of cases. Concerning reasons for cancellation, comorbidities, dominated by respiratory infections, accounted for 28.5% of cases, patient absences for 24.2%, and issues related to the anesthesiologist for 17.6%. Cancellations were avoidable in 33% of cases. Patients were responsible for cancellation in 37.4% of cases, the healthcare system in 33%, and medical reasons in 29.7%. Conclusion: Our findings suggest that one-third of cancellations could have been avoided with improvements in the healthcare system. Actions should be taken to reduce the cancellation rate in our context.

The US Election in 2024 and the Trend of the Ukraine Crisis

The crisis in Ukraine,which has dragged on for more than two years,and whether military aid to Ukraine should continue are major issues debated and fought over by the two parties in the United States prior to the 2024 election.Regarding whether to continue to aid Ukraine,various political forces in the United States have chosen sides in the election campaign,which can be roughly divided into the“aid camp”and the“stop-aid camp”according to their positions.

Improving Sentiment Analysis in Election-Based Conversations on Twitter with ElecBERT Language Model

Sentiment analysis plays a vital role in understanding public opinions and sentiments toward various topics.In recent years,the rise of social media platforms(SMPs)has provided a rich source of data for analyzing public opinions,particularly in the context of election-related conversations.Nevertheless,sentiment analysis of electionrelated tweets presents unique challenges due to the complex language used,including figurative expressions,sarcasm,and the spread of misinformation.To address these challenges,this paper proposes Election-focused Bidirectional Encoder Representations from Transformers(ElecBERT),a new model for sentiment analysis in the context of election-related tweets.Election-related tweets pose unique challenges for sentiment analysis due to their complex language,sarcasm,andmisinformation.ElecBERT is based on the Bidirectional Encoder Representations from Transformers(BERT)language model and is fine-tuned on two datasets:Election-Related Sentiment-Annotated Tweets(ElecSent)-Multi-Languages,containing 5.31 million labeled tweets in multiple languages,and ElecSent-English,containing 4.75million labeled tweets in English.Themodel outperforms othermachine learning models such as Support Vector Machines(SVM),Na飗e Bayes(NB),and eXtreme Gradient Boosting(XGBoost),with an accuracy of 0.9905 and F1-score of 0.9816 on ElecSent-Multi-Languages,and an accuracy of 0.9930 and F1-score of 0.9899 on ElecSent-English.The performance of differentmodels was compared using the 2020 United States(US)Presidential Election as a case study.The ElecBERT-English and ElecBERT-Multi-Languages models outperformed BERTweet,with the ElecBERT-English model achieving aMean Absolute Error(MAE)of 6.13.This paper presents a valuable contribution to sentiment analysis in the context of election-related tweets,with potential applications in political analysis,social media management,and policymaking.

Factors influencing the surveillance of re-emerging intracranial infections in elective neurosurgical patients:A single-center retrospective study

BACKGROUND At present,many studies have reported the risk factors for postoperative intracranial reinfection,including age,sex,time to surgery,duration of postoperative catheterization,emergency procedures,type of disease and cerebrospinal fluid leakage,but the academic community has not reached a unified conclusion.AIM To find factors influencing the surveillance of re-emerging intracranial infections in elective neurosurgical patients.METHODS Ninety-four patients who underwent elective craniotomy from January 1,2015 to December 31,2022 in the Department of Neurosurgery,First Hospital of Jilin University,were included in this study.Of those,45 patients were enrolled in the infection group,and 49 were enrolled in the control group.The clinical data of the patients were collected and divided into three categories,including preoperative baseline conditions,intraoperative characteristics and postoperative infection prevention.The data were analyzed using SPSS 26.0 software.RESULTS There were 23 males and 22 females in the infection group with a mean age of 52.8±15.1 years and 17 males and 32 females in the control group with a mean age of 48.9±15.2 years.The univariate analysis showed that the infection group had higher systolic blood pressures and postoperative temperatures,fewer patients who underwent a supratentorial craniotomy,more patients with a history of hypertension and higher initial postoperative white blood cell counts than the control group,with statistically significant differences(P<0.05).The multifactorial logistic regression analysis showed that a history of hypertension and a high postoperative body temperature were independent risk factors for postoperative infection in neurosurgical patients.CONCLUSION The results obtained in this study indicated that a history of hypertension and a high postoperative body temperature were independent risk factors for postoperative neurological symptoms.

Effect of Intravenous Tranexamic Acid in Reducing Blood Loss during and after Elective Caesarean Section in a Third Level Health Institution: A Randomized Controlled Study

Background: Blood loss during caesarean section (C/S) may lead to postpartum haemorrhage, and is one of the direct causes of maternal mortality and morbidity globally. Tranexamic acid is recommended in the treatment of postpartum haemorrhage (PPH) if oxytocin and other utertonics are ineffective in controlling PPH. In this centre it is not used prophylactically to reduce blood during caesarean section. Aim: To assess the effect of prophylactic intravenous tranexamic acid on blood loss during and after elective C/S at the University of Port Harcourt Teaching Hospital (UPTH). Methods: This was a prospective, single-blind, randomized, placebo-controlled interventional study conducted at the Obstetric theatre of UPTH from July 2020 to March 2021. Eligible women were randomized into two groups;seventy-two women received intravenous tranexamic acid while seventy-one women received a placebo. Socio-demographic data and the result of the study were collected through a proforma. Data collected was analyzed using Statistical Package for Social Sciences (SPSS) Version 22.0. The results were expressed in tables and charts as frequencies, percentages and mean. Chi-square test, Fisher’s exact, and T-test were used to determine the relationship between variables. P-value ≤ 0.05 was considered statistically significant. Results: The findings showed that tranexamic acid significantly reduced mean blood loss during and after C/S (p-value post-surgery was significantly lower in the tranexamic acid group (624.88 ± 200.76 ml) in comparison to the placebo group (864.24 ± 229.09 ml), p-value = 0.001. The mean post-C/S packed cell volume (PCV) was significantly higher among the tranexamic acid group (30.68% ± 2.80%) in comparison to the placebo group (28.07% ± 3.27%), t = 5.131, p-value = 0.0001. The maternal side effects were nausea and vomiting, 9 (12.5%) and 1 (1.4%) participants respectively. Conclusion: Tranexamic acid significantly reduced blood loss during and after elective C/S. Maternal side effects were less with tranexamic acid use.

Prevalence of Pre-Operative Anxiety and Predictors among Elective Surgical Patients and Their Pre-Operative Hemodynamic Changes at Muhimbili National Hospital

Background: Surgery is a traumatic process that may subject patients to physiological and psychological responses leading to pre and post-operative effects. Preoperative anxiety, if severe may be associated with several complications including cancellation of surgery, poor intra- and post-operative analgesic control, altered post-operative healing, and longer hospital stays to mention a few. Objective: The main purpose was to determine the prevalence and predictors of pre-operative anxiety among elective surgical patients and their hemodynamic changes in these patients in the Surgical department in MNH. Methodology: This was a prospective descriptive and analytical study performed at MNH which involved patients admitted for elective surgical procedures from June 2021 to February 2022. Information was gathered in a structured questionnaire along with APAIS scores. Results: 169 patients for elective surgery in General Surgery and Urology units were included in the study. Among them, 94 males and 74 females. The overall pre-operative anxiety was 11.8%, 80.5% had moderate to severe Information-Related anxiety, while 26% and 17.2% had moderate-to-severe surgery-related and anesthesia-related types of anxiety respectively. Conclusion: Pre-operative anxiety was comparatively lower in our settings as well no factor was found with a significant relation to pre-operative anxiety, hence further and broader evaluation is recommended to result in the assessment and management of patients before elective surgery.

From Social Media to Ballot Box:Leveraging Location-Aware Sentiment Analysis for Election Predictions

Predicting election outcomes is a crucial undertaking,and various methods are employed for this purpose,such as traditional opinion polling,and social media analysis.However,traditional polling approaches often struggle to capture the intricate nuances of voter sentiment at local levels,resulting in a limited depth of analysis and understanding.In light of this challenge,this study focuses on predicting elections at the state/regional level along with the country level,intending to offer a comprehensive analysis and deeper insights into the electoral process.To achieve this,the study introduces the Location-Based Election Prediction Model(LEPM),which utilizes social media data,specifically Twitter,and integrates location-aware sentiment analysis techniques at both the state/region and country levels.LEPM predicts the support and opposing strength of each political party/candidate.To determine the location of users/voters who have not disclosed their location information in tweets,the model utilizes a Voter Location Detection(VotLocaDetect)approach,which leverages recent tweets/posts.The sentiment analysis techniques employed in this study include rule-based sentiment analysis,Valence Aware Dictionary and Sentiment Reasoner(VADER)as well as transformers-based sentiment analysis such as Bidirectional Encoder Representations from Transformers(BERT),BERTweet,and Election based BERT(ElecBERT).This study uses the 2020 United States(US)Presidential Election as a case study.By applying the LEPM model to the election,the study demonstrates its ability to accurately predict outcomes in forty-one states,achieving an 0.84 accuracy rate at the state level.Moreover,at the country level,the LEPM model outperforms traditional polling results.With a low Mean Absolute Error(MAE)of 0.87,the model exhibits more precise predictions and serves as a successful alternative to conventional polls and other methodologies.Leveraging the extensive social media data,the LEPM model provides nuanced insights into voter behavior,enabling policymakers to make informed decisions and facilitating in-depth analyses of elections.The study emphasizes the importance of using social media data for reliable election prediction and offers implications for enhancing prediction accuracy and understanding voter sentiment and behavior.

Flexible Transparent Electrochemical Energy Conversion and Storage: From Electrode Structures to Integrated Applications

The rapid progress of flexible electronics tremendously stimulates the urgent demands for the matching power supply systems. Flexible transparent electrochemical energy conversion and storage devices (FT–EECSDs), with endurable mechanical flexibility, outstanding optical transmittance, excellent electrochemical performance, and additional intelligent functions, are considered as preferable energy supplies for future self-powered flexible electronic systems. A comprehensive review of the reasonable design of flexible transparent electrode and recent progress on the FT–EECSDs is presented herein. The manufacturing techniques of generally classified three types of flexible transparent electrodes are systematically summarized. Emphasis is given to the recent developments in the transparent solid-state electrolyte, flexible transparent energy conversion, and storage devices. The standard evaluation methods and reasonable evaluation parameters to evaluate the flexibility and transparency of FT–EECSDs are highlighted. Additionally, the typical integrated applications of FT–EECSDs are also described. Finally, the current challenges and a future perspective on the research and development direction are further outlined.

Prevalence of Preoperative Anemia in Elective Rheumatic Valve Surgery at a Tertiary Care Center in Nepal

Background: Rheumatic Valvular Heart disease (RVHD) is common in developing countries often associated with anemia;however its burden is often overlooked. Anemic patients undergoing surgery are likely to receive blood transfusion, increasing morbidity and mortality. Prevalence of anemia in cardiac surgical patients are studied extensively, however its burden in RVHD is lacking. This study attempted to investigate the prevalence of preoperative anemia in RVHD and its effect on blood transfusion, morbidity and mortality in patients undergoing valve surgery. Methods: This is a retrospective observational study conducted at a tertiary care hospital in Nepal. We considered 340 patients who underwent Rheumatic valve replacement surgery from 2014 January to December 2016 and data on their socio-demographic and clinical characteristics were extracted from the patient’s records. The analyses meeting the study objectives were conducted using IBM SPSS v25 for Windows (IBM Statistical Package for Social Sciences, 2015IBM Corporation, New York, United States). Results: The prevalence of no anemia, mild, moderate, and severe anemia was 34.1%, 57.7%, 39.6%, 2.5%, respectively. The units of Red Blood Cell used for transfusion were 1.2 units, 2.0 units, 2.3 units, and 1.6 units in patients without anemia, and those with mild, moderate and severe anemia respectively. The incidence of reexploration was higher in patients with severe anemia as compared to the non anemic with an incidence of 66.6%. A proportion of the patients with no anemia, mild, moderate and severe anemia with less than 7 days stay in the intensive care unit were 89%, 82%, 84.7% and 100% respectively. The length of hospital stay more than 10 days was seen in 58.9%, 71.6%, 63% and 100% in patients with no anemia, mild, moderate and severe anemia. An overall incidence of mortality in anemic patients was 11% while in non anemic patients was 5.3%. Conclusions: The prevalence of anemia was high in the Nepalese patients with Rheumatic valvular heart disease planned for elective surgery. There was an increased incidence of blood transfusion, longer hospital stay, and increased mortality in anemic patients compared to their non anemic counterparts.

Timing of Elective Repeat Cesarean Delivery at 38 Weeks versus 39 Weeks: Rate of Spontaneous Onset of Labor before Planned Cesarean Section and Impact on Maternal Outcome: A Retrospective Cohort Study

Background: The timing of elective repeat cesarean delivery at 38 weeks versus 39 weeks is still a debatable subject, both regarding maternal and neonatal outcomes. In the Saudi context, there is lack of local data to aid decision-making regarding the timing of elective repeat cesarean delivery. Objectives: To estimate the rate of spontaneous onset of labor before the planned gestational age for repeat cesarean section in women who were booked at gestational age of (39 0/7 - 39 6/7) weeks (W39) versus (38 0/7 - 38 6/7) weeks (W38) and to compare the rate of maternal composite outcome between these groups. Design: Retrospective cohort. Setting: This study was conducted at King Abdulaziz Medical City, Jeddah, KSA. Method: Delivery registry books were reviewed to identify all deliveries from 1 January 2014 to 31 December 2016 (3 years). All low-risk pregnant women who had 2 or more cesarean deliveries and who met the inclusion criteria were included. Results: A total of 440 women were included of whom 318 (72.3%) were planned for elective cesarean section at W38 gestational age and 122 women at W39 gestational age. Mothers planned at W39 had higher rate of emergency cesarean deliveries versus those planned at W38 (18.0% versus 10.4%, p = 0.030;RR = 13.06), most frequently due to early onset of contractions (16.4% versus 8.2%, p = 0.012;RR = 12.17) or cervical dilatation (11.6% versus 5.4%, p = 0.024, RR = 16.15). No difference in the incidence of individual or composite maternal complications was noted between the two groups. Mother’s age (OR 0.93, p = 0.018) and schedule date at W39 (OR = 1.94, p = 0.028) were independently associated with spontaneous onset of labor before the scheduled gestational age, while no association was found with parity, previous number of spontaneous vaginal deliveries, number of previous cesarean deliveries or interval from last cesarean delivery. Conclusion: Elective cesarean section scheduled at 39 weeks of gestation or beyond carries a higher risk of emergency cesarean section, with no significant increase in maternal complications. The identification of factors associated with spontaneous onset of labor before the planned gestational age should be carefully identified to determine the optimal timing.

1948年首届中央研究院工程学科院士遴选述略

李协、淩鸿勋、唐炳源、茅以升、王宠佑先后当选中央研究院1935年首届和1940年第二届工程学科聘任评议员,与当然评议员周仁组成评议会工程组“指导联络奖励”工程学科的发展。院士选举过程中,无论是茅以升、淩鸿勋提名候选人还是中央研究院最终确定的参考名单,与正式提名名单相比差距甚大,缺漏甚多,显现出个人提名与机构提名的不同。工程学科正式提名55人名列所有学科中第一,经两次淘汰,王宠佑等11人成为正式候选人,最终周仁、侯德榜、茅以升、淩鸿勋、萨本栋5人当选。当选比例低于总体当选率,也低于数理组其他学科,在一定意义上表明工程学科总体水平未能获得学界共同认可。从聘任评议员到院士选举,相对工程事业而言,更注重学术成就,在一定意义上也说明科学院之外设立工程院的合理性,将纯粹的学术与实践的事业予以区分。

有症状新型冠状病毒感染者感染后30 d内行胃肠恶性肿瘤根治手术安全性的队列研究

背景 胃肠道肿瘤患者在感染新型冠状病毒后是否需要长时间推迟限期手术,目前意见不统一。目的 探讨有症状的新冠病毒感染者在感染后30 d内行胃肠恶性肿瘤根治手术的安全性。方法 采用队列研究,分析2022年11月1日—2023年1月16日于解放军总医院第一医学中心普通外科医学部行手术治疗的胃肠道肿瘤患者的临床资料,比较感染与未感染新冠病毒患者的并发症发生率和并发症严重程度。结果 感染组胃肠道肿瘤患者81例,对照组胃肠道肿瘤患者131例,两组的年龄、性别、体质量指数等基线资料,以及手术方式、手术时长、出血量、术后平均住院日、淋巴结检出数目、疫苗接种率等的差异均无统计学意义(P>0.05)。感染组和对照组并发症发生率[14.8%(12/81) vs 16.8%(22/131),P=0.703]和并发症严重程度[Clavien-Dindo分级(Ⅰ级/Ⅱ级/Ⅲa级/Ⅲb级):2.5%、9.9%、4.9%和2.5%vs 3.8%、9.9%、7.6%和0.8%,P=0.721]等方面的差异亦无统计学意义。结论 有症状的新冠病毒感染者在感染后的30 d内(术前新冠病毒核酸检测转阴)行胃肠道恶性肿瘤根治手术是安全的。

台湾地区2024年“二合一”选举结果及影响分析

台湾地区2024年“二合一”选举在中美战略博弈持续、两岸关系严峻复杂的形势下举行。各主要政党展开激烈竞逐,打破岛内传统政治生态格局。民进党赖清德以未过半的相对多数票当选,立法机构呈“三党不过半”新局,折射出加速分化的岛内民意以及多元竞合的政党政治新态势。未来4年,岛内政局将在民进党当局“三重少数”执政下以立法机构为重心展开角力,政局恐将动荡不安。两岸关系的对抗性和不确定性进一步上升,内地发展进步将持续增强对两岸关系的主导权和主动权,民进党继续执政无法改变两岸关系发展基本格局。

《精细化工与生活》通识教育选修课中的教学模式探索

结合自身教学和实践,分析了新疆大学《精细化工与生活》通识教育选修课教学中存在的现状问题,提出了改善课程教学理念、加强课程的规范化管理、优化课程的教学内容及方法、改革课程的教学考核方式措施,为系列通识教育选修课的课程建设提供有效的新方法与新思路。

入院准备中心管理在择期手术患者中的应用效果分析

目的:分析入院准备中心管理在择期手术患者中的应用效果。方法:选取2019年2月—2020年1月中山大学附属第五医院收治的择期手术患者608例作为研究组,选取2018年3—12月收治的择期手术患者609例作为对照组。对照组实施传统入院管理,研究组实施入院准备中心护理管理。比较两组术前住院时间、总住院时间、住院费用、护理满意度、心理状态。结果:两组术前住院时间比较,差异无统计学意义(P>0.05);研究组总住院时间短于对照组,住院费用低于对照组,差异有统计学意义(P<0.05)。研究组服务态度、服务技术、服务效率、服务质量、时间管理评分均高于对照组,差异有统计学意义(P<0.05)。入院前,两组焦虑、抑郁评分比较,差异无统计学意义(P>0.05);入院后,两组焦虑、抑郁评分低于入院前,且研究组低于对照组,差异有统计意义(P<0.05)。结论:入院准备中心管理在择期手术患者中的应用效果显著,可缩短患者住院时间,减少住院费用,缓解患者负性情绪,提高患者满意度。

通识选修课程光电技术导论课程思政研究与实践

以面向非工专业开设的通识选修课程光电技术导论为例,围绕课程的知识目标、能力目标和素质目标,深入分析课程知识点,知识点所蕴含的思政元素,知识形成过程中的价值理念和科学方法,知识应用过程中涌现的创新实践、协作奋斗和工匠精神,从教学理念、教学内容、教学策略上全方面探讨思想政治教育元素的有机融入方法。给出具体思政案例设计思路和设计方法,从学科特色、社会应用、专业成就及家国情怀等方面着手,将思政元素有机融入课堂教学,为高校将特色学科特色课程引入非本学科专业通识选修教学中,在价值引领、知识教育和能力培养的有机统一上提供探索和实践经验。

2023年选举与“土耳其世纪”大战略

2023年,在土耳其百年国庆之际,埃尔多安和正义与发展党经过两轮选举再次赢得胜利。在连续执政20年后,雷杰普·塔伊普·埃尔多安号召开启“土耳其世纪”的伟大征程,这成为考察土耳其战略趋势的重要契机。土耳其的“大战略”讨论综合考量本国历史、地理、身份等多方面因素,致力于周边安全以及在国际体系转型中的关键地位。2023年大选后的外交政策重申了土耳其的一些基本原则,如埃尔多安的领导地位、战略自主、安全—外交联系、贸易外交、土耳其的国际地位等。在具体表现方面,土耳其国防工业的迅猛发展引人注目,其背后所反映的是土耳其在军事战略方面的自主和扩张需求。与此同时,土耳其从联合国文明联盟倡议的发起者到将文明话语作为意识形态的主要因素,也反映了其在国内和国际政治中的战略愿景。

蓝色经济背景下海洋资源概论思政设计与实践

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