Social Cultural and Economic Factors Affecting the Practice of Secondary Prevention among Patients with Type 2 Diabetes Mellitus at Consolata Nkubu and Meru Level Five Hospital in Meru County

Diabetes is chronic metabolic disorder characterized by states of hyperglycemia with disturbances of carbohydrates, fat and protein metabolism. Diabetes affects millions of people globally every day and the prevalence of the disease is on the rise due to unhealthy diet and lifestyle. The disorder usually results to chronic complications including cardiovascular diseases, diabetic nephropathy, diabetic neuropathy, foot ulcers and diabetic eye diseases that are all preventable through secondary preventive measures. Once an individual has been diagnosed with T2DM, secondary preventive approaches are essential in preventing the occurrence of chronic complications. However, lack of awareness of these measures has been cited as the common reasons for the development of complications. The study aimed to assess the effect of social cultural and economic factors on the practice of secondary diabetes prevention among patients with Type 2 Diabetes Mellitus (T2DM) at Consolata Hospital Nkubu and Meru Level Five Hospital between March and April 2019. A descriptive correlational study design was adopted to collect data from 357 purposively sampled participants with T2DM using questionnaires and Focus Group Discussion Guide. Quantitative data were analyzed using SPSS version 25 at 95% confidence interval and a significance level p ≤ 0.05. Most respondents attended Meru Teaching and Referral Hospital. Majority of the respondents were aged between 40 - 60 years. Most respondents 31.6% had secondary level of education and majority 67% was employed. Concerning secondary prevention, majority did foot examination on every visit 70.6% and BP monitoring 69.5% while 56.5% did annual eye screening. Level of income, affordability of services, health insurance cover of the patients, monthly cost of DM management and traditional beliefs in managing DM all significantly influenced DM secondary prevention at a p value ≤ 0.05. The factors need to be addressed to reduce the global burden posed by the disease.

Build the School of Economics and Management with A Focus on Disaster Prevention and Reduction——Exclusive Interview with Professor Yuan Qinglu,Dean of the School of Economics and Management at the Institute of Disaster Prevention

As the only comprehensive university focusing on disaster prevention and reduction as well as emergency management in China,the Institute of Disaster Prevention has grown with the development of national disaster prevention and reduction as well as emergency management.The School of Economics and Management under the Institute of Disaster Prevention was founded in the year of 2018.

Review of the evolution and prevention of friction,wear,and noise for water-lubricated bearings used in ships

With the development of green tribology in the shipping industry,the application of water lubrication gradually replaces oil lubrication in stern bearings and thrust bearings.In terms of large-scale and high-speed ships,water-lubricated bearings with high performance are more strictly required.However,due to the lubricating medium,water-lubricated bearings have many problems such as friction,wear,vibration,noise,etc.This review focuses on the performance of marine water-lubricated bearings and their failure prevention mechanism.Furthermore,the research of marine water-lubricated bearings is reviewed by discussing its lubrication principle,test technology,friction and wear mechanism,and friction noise generation mechanism.The performance enhancement methods have been overviewed from structure optimization and material modification.Finally,the potential problems and the perspective of water-lubricated bearings are given in detail.

Cost effectiveness of nonpharmacological prevention programs for diabetes:A systematic review of trial-based studies

Trial-based economic value of prevention programs for diabetes is inexplicit.We aimed to review the cost-effectiveness of nonpharmacological interventions to prevent type-2 diabetes mellitus(T2DM)for high-risk people.Six electronic databases were searched up to March 2022.Studies assessing both the cost and health outcomes of nonpharmacological interventions for people at high-risk of T2DM were included.The quality of the study was assessed by the Consolidated Health Economic Evaluation Reporting Standards 2022 checklist.The primary outcome for synthesis was incremental cost-effectiveness ratios(ICER)for quality-adjusted life years(QALYs),and costs were standardized in 2022 US dollars.Narrative synthesis was performed,considering different types and delivery methods of interventions.Sixteen studies included five based on the US diabetes prevention program(DPP),six on non-DPP-based lifestyle interventions,four on health education,and one on screening plus lifestyle intervention.Compared with usual care,lifestyle interventions showed higher potential of cost-effectiveness than educational interventions.Among lifestyle interventions,DPP-based programs were less cost-effective(median of ICERs:$27,077/QALY)than non-DPP-based programs(median of ICERs:$1395/QALY)from healthcare perspectives,but with larger decreases in diabetes incidence.Besides,the cost-effectiveness of interventions was more possibly realized through the combination of different delivery methods.Different interventions to prevent T2DM in high-risk populations are both cost-effective and feasible in various settings.Nevertheless,economic evidence from low-and middle-income countries is still lacking,and interventions delivered by trained laypersons and combined with peer support sessions or mobile technologies could be potentially a cost-effective solution in such settings with limited resources.

The role of personality,social economic and prevention strategy effects on health-related quality of life among people living with HIV/AIDS

Background::HIV/AIDS has transformed into a chronic controllable but not yet curable infectious disease as other chronic diseases to some extent.The additional of so called fourth 90%that included the improved health-related quality of life(HRQoL)for people living with HIV(PLWHIV)required solutions beyond antiretroviral therapy and viral load suppression.This study will explore the role of personality,social economic and prevention strategy effection on HRQoL among people living with HIV/AIDS.Methods::A cross-sectional study was conducted among PLWHIV aged more than 16 years old in the 10 municipalities in Yunnan Province,China from October 2019 to May 2020,enrolling total 1997 participants.Individual-level HRQoL data were measured by 12-item Short Form Health Survey(SF-12)and EuroQol Five Dimensions Questionnaire(EQ-5D-5L).We assembled municipal-level data about social economic from Yunnan Statistical Yearbook in 2020 and strategy practice information from the self-evaluation system.We used the principal component analysis to build the social economic and strategy effect on each area respectively and one-way ANOVA was used to perform univariate analysis to identify the predictors with significant differences.Finally we used multi-level model(MLM)to explore the personality,social economic and strategy effects in health-related quality of life among PLWHIV.Results::The global score for quality of life measured using EQ-5D-5L had an estimated mean score(standard deviation,SD)of 0.901±0.146.The HRQoL score measured using PCS-12 had an estimated mean score(SD)of 46.62±8.55.The mean MCS-12 score(SD)was estimated to be 47.80±9.71.The area-level predictors explained a proportion of 13.6-17.2%for the between-area variation of the HRQoL scores,regardless of the total HRQoL,physical component and mental component.The impacts of stigma(P<0.01),social support(P<0.001),anxiety(P<0.001),depression(P<0.05)and social economic status(P<0.05)on HRQoL at the individual-level were significantly different.The plots visualized the impact of individual-level factors on a respondent’s HRQoL was modified by the area-level characteristics.Conclusions::The study identified the possible strategy determinant of individual HRQoL of PLWHIV and also the area effect on HRQoL.Stigma,social support,anxiety,depression and social economic status were the individual-level determinants on HRQoL.These could be a valuable resource for evaluating the overall health of the areas and help improve local decision making.

金属矿山高浓度充填管道磨损规律与防控技术

金属矿高浓度充填能有效消除尾矿库和采空区危害,但充填管道磨损问题也成为制约充填效率的因素之一。基于对管道磨损类型的划分,从颗粒性质、料浆性质、料浆—管壁接触条件、管材性质和管道所处外部环境5个方面综述了充填管道磨损的影响因素;基于理论分析和现场实测归纳了5种不同形式充填管道的磨损规律,以此总结了充填管道磨损的防控技术。现有研究结果表明,不满管流时,充填管道最主要的磨损形式是冲蚀磨损,料浆流速的影响最显著;满管流时,磨蚀和腐蚀对管道磨损起重要作用,料浆浓度的影响最显著。垂直管道中,料浆—空气交界面处磨损最严重,提高满管率并采用等倍线设计可有效控制其磨损。水平直管和倾斜直管底部磨损最严重,水平弯管的底部和垂直弯管外侧为易磨部位。使用新型管道结构和耐磨管材,提高料浆均质性,优化充填骨料级配,改进充填作业制度,全面监测管网压力,革新管道磨损数据获取手段,采用数值模拟技术深入揭示管道磨损规律等措施,可直接或间接对充填管道磨损防控起到积极作用。研究结果可为矿山充填管道磨损控制提供指导。

基于骨料运移的高浓度充填管道磨损机制

高浓度充填管道磨损威胁矿山安全,但磨损机制尚不明析。采用CFD-DEM模拟高浓度充填管道磨蚀、骨料运移、骨料与管壁接触,结合理论分析和现场实测揭示管道磨损机制。结果表明:料浆承载力充足时,固液两相在管内呈柱塞流,骨料向管道中心运移,管壁处形成减磨滑移层,管道四周磨损较均匀;反之,骨料在管底呈滑动床,管底磨损最严重。滑动床对管壁的作用力是柱塞流时的2.46~2.76倍,管底磨损是柱塞流时的1.48倍。骨料在管壁附近的运动轨迹类似波形线,以小角度接触管壁并滑滚,对管壁的切向力是法向力的27.44~30.84倍,管壁磨损受骨料切向刮擦主导。非稳态输送、粗糙管壁和过高浓度会劣化滑移层的减磨效果。根据模拟结果提出六条磨损防控措施,可供相关矿山借鉴。

数字经济时代区域经济下行风险防范与应对:基于GaR模型的实证分析

防范化解重大经济金融风险是保障我国经济高质量发展的关键,数字经济发展为积极应对经济下行压力、快速转换经济增长动力、统筹兼顾“稳增长”与“防风险”提供了新的契机。基于内生增长理论模型和“在险增长”(GaR)实证研究框架,演绎了数字经济发展的理论机理,使用我国2011-2022年期间226个地级市的季度数据测度了区域经济下行风险,实证考察了数字经济发展对区域经济下行风险的作用效果。结论表明:数字经济发展能够有力防范区域经济下行风险;通过促进产业转型升级、挖掘城市市场潜力、激活乡村消费活力以及增强大众创业动力,数字经济能够发挥资本渗透与技术溢出的间接效应。进一步分析表明,数字经济在缺乏区位优势、经济基础较弱的城市作用效果并不显著,加快数字基础设施建设能够调节风险防范效应的空间异质性。研究结果对研判宏观经济增长不确定性、加快发展新质生产力、推动经济实现质的有效提升和量的合理增长具有重要意义。

Who should be screened for colorectal cancer and how can it be prevented more effectively?

In this editorial,we comment on the article published by Agatsuma et al in a recent issue of the World J Gastroenterol(2024;30:1368-1376).We firmly concur with Agatsuma et al regarding the vital significance of colorectal cancer(CRC)screening as a public health strategy to diminish disease burden.Individuals exposed to risk factors for CRC,those with comorbid conditions,and those with limited health literacy should undergo screening.However,we believe that more regular screenings should be accompanied by a greater focus on primary prevention(PP)of CRC.CRC remains a significant global health challenge,and its incidence is strongly linked to age,lifestyle,and socioeconomic factors.It is particularly noteworthy that the majority of CRC patients are diagnosed outside of established screening pathways and frequently at an advanced stage of the disease,and the majority of patients possess inadequate or even nonexistent knowledge regarding CRC,which significantly impacts the prognosis and imposes a substantial economic burden.This study revealed that CRC identified during hospital visits for comorbid conditions was typically diagnosed at an earlier stage than detected via symptomatic pathways.Remarkably,early incidental detection of CRC aligns closely with the timing of discovery through routine cancer screenings.This suggests that by adopting more inclusive screening protocols that combine opportunistic testing with traditional screening methods,health care systems can create a more comprehensive safety net for individuals at risk of CRC.However,before maximizing the health benefits of screening programs,it is essential to make additional efforts prior to screening,such as raising awareness via public education,risk assessment,and personalized recommendations,enhancing the knowledge and skills of health care professionals,optimizing the accessibility and convenience of screening processes,ensuring the quality and safety of screening services,strengthening follow-up and support systems,and providing policy support and financial investment.The establishment of a comprehensive screening system often requires substantial investment in human,material,and financial resources,which can be challenging to achieve in regions with limited health care resources.Strengthening PP strategies can reduce the disease burden by targeting the cause,representing a more cost-effective and impactful approach.Establishing a comprehensive cancer PP service platform that integrates authoritative public education on malignant tumor PP,individualized malignant tumor risk assessment,and self-health management assistance accessible to the entire population will significantly enhance the overall effectiveness of CRC PP strategies.

三峡大坝运行20年泄洪安全评价

近年来国内外高坝泄水建筑物破坏事故时有发生,三峡大坝泄洪流量和落差大,泄洪功率居世界第一,其泄洪安全备受关注。结合三峡大坝自2003年蓄水以来的历次水力学原型观测和以往水工模型试验结果,围绕泄水建筑物布置、泄流能力、动水压强、水流空化、水流掺气与通气风速、空蚀磨损、消能防冲7个要素指标,依据有关技术标准和工程经验建立了一套完整的高坝泄洪安全评价方法,提出了定性标准和量化阈值,并据此对三峡大坝深孔、表孔、排沙孔和排漂孔进行泄洪安全评价。结果表明:大坝泄水建筑物布置是合理的;大坝实际泄流量与设计值符合良好;大坝泄洪流道未见空蚀磨损破坏;三峡大坝运行20 a,泄水建筑物和坝下消能区运行性态正常,泄洪安全可靠。

内蒙古参与“中蒙俄经济走廊”建设的对策研究

内蒙古是“一带一路”特别是“中蒙俄经济走廊”的重要组成部分,加强与蒙古国、俄罗斯合作,既是国家发展大局的需要,也是内蒙古高质量发展的要求。“一带一路”倡议逐步向纵深推进,中国也加大了对沿线国家直接投资的力度。因受到沿线国家在政治、经济、文化等多种因素的差异化影响,中国开展的对外投资具有巨大的风险和挑战。中蒙俄三个国家深入进行经济合作,共建基础设施、共同构建经济风险预防机制、共同打造文旅融合,为中蒙俄三国的经济合作创造了坚实的基础。本文的研究内容是“一带一路”背景下,中蒙俄三国合作的现状,以及内蒙古参与“中蒙俄经济走廊”建设中的优势,在此基础上分析了“中蒙俄经济走廊”对内蒙古发展的促进作用,三国间要强化政府之间的合作、完善对外投资的法律制度,建立经济风险预防机制,加强专业人才的培养,有效防范内蒙古对外投资所带来的风险。

跨境数据流动限制对自然灾害经济损失的影响

进入数字化时代,跨境数据交互共享已成为自然灾害治理的核心影响因素。利用2004—2019年世界主要经济体的跨境数据流动限制数据和自然灾害损失数据进行实证分析,结果表明跨境数据流动限制程度与自然灾害经济损失之间存在显著正相关性。进一步研究表明,跨境数据流动限制是通过阻碍信息技术交流共享这一机制来影响自然灾害经济损失的。此外,跨境数据流动限制对自然灾害经济损失的影响存在一定异质性,在灾害类型层面,气象灾害与地球物理灾害中的经济损失受跨境数据流动限制的影响更为显著且强烈;在经济体类型层面,相较于发展中经济体,发达经济体中跨境数据流动限制对自然灾害损失的影响更小。研究结果拓展了跨境数据流动理论在灾害经济领域的运用,为各国在自然灾害防治领域建立更加开放和高效的信息共享机制提供一个参考。

大数据背景下网络经济犯罪发展趋势及侦防对策

大数据背景下,网络经济犯罪具有虚拟化、组织化、涉众性等新特点,呈现出虚实结合、产业链化、跨境、资金流转快、影响危害大等发展趋势。公安机关应推动网络经济犯罪侦防理念由“侦查优先”向“预防优先”、由“以人为主”向“信息数据导侦”、由“就案办案”向“源头治理”转变,更新公安机关信息数据系统,加强数据模型建设应用,强化复合型人才培养,深入推进相关法制建设,持续提高网络经济犯罪侦防水平。

日本癌症全生命周期防控体系构建及启示

中国作为癌症新发病例和死亡人数最多的国家,面临着癌症人口基数大,相对生存率低,癌症筛查依从性不高的严峻形势。邻国日本是世界上最长寿的国家,尽管患癌率同样偏高,但是相对生存率远超中国,原因是其在癌症防控上建立了完备的体系。同为亚洲国家,中日主要流行的癌谱相似,可参考性较大。本文从日本癌症防治事业的三大目标入手,介绍日本“癌症预防”“癌症照护”“与癌症共存”的癌症全生命周期防控体系的建构,重点阐述了日本提高癌症筛查率的手段与方式,以期对中国癌症防控事业提供参考。

2022年全球癌症统计报告的窄谱总结和展望

根据国际癌症研究机构(IARC)最近更新的全球癌症统计数据,2022年共有近2000万例新发癌症病例,970万例死亡病例。肺癌是最常见的癌症,有近250万例新发病例(占全球所有癌症的12.4%),其次是女性乳腺癌(11.6%)、结直肠癌(9.6%)、前列腺癌(7.3%)和胃癌(4.9%)。肺癌也是导致癌症死亡的主要原因,估计有180万例死亡病例(18.7%),其次是结直肠癌(9.3%)、肝癌(7.8%)、女性乳腺癌(6.9%)和胃癌(6.8%)。根据基于人口统计学的预测表明,到2050年,新发癌症病例将达到3500万例。加大针对癌症关键风险因素(包括吸烟、超重肥胖和感染)的防控投入,可以拯救全球许多生命,为各国未来几十年带来巨大的经济和社会回报。

600MW机组锅炉四管智能诊断系统与智能检测装置融合分析技术

针对燃煤火力发电站,传统的检测手段面临安全风险高、检测数据量少、检测过程烦琐和检测周期长等挑战,有必要通过检测工具的智能升级来降低安全风险并提升检测质量,同时通过智能检测装置采集的大数据可以实时接入软件系统中,制定管壁减薄分析、报警诊断和预防策略,建立可视化的锅炉四管健康分析系统,以方便日常运行和检修数据的积累和分析,提高锅炉防磨防爆管理水平。分析表明,造成四管泄漏的主要原因包括超温、磨损、腐蚀、疲劳等缺陷。建立锅炉四管数字孪生模型和设备数字化台账,通过智能诊断模型预警和精确定位功能,直观量化地展示三维虚拟电厂四管的寿命评价,可以有效地减少锅炉爆管现象。

采煤机截齿破坏分析及预防措施

分析表明,综采工作面采煤机截齿的破坏主要是由于不当的维护和检查、设计和制造质量差、截齿材料不合格和组成结构不合理、以及操作员的操作不当等原因造成的。为了预防采煤机截齿破坏,采取一些措施,如使用高质量的材料制作截齿、通过设计和制造方面的措施来防止截齿破坏、进行定期的视觉检查和测量截齿的磨损和变形、以及对操作员进行专业的培训等。

守牢水旱灾害防御底线护航长江经济带高质量发展

近年来,随着长江流域防洪抗旱体系的不断完善和应对能力的不断提升,水旱灾害防御工作取得了显著的防灾减灾综合效益,为长江经济带高质量发展提供了水安全保障。文章深入分析建设安澜长江的重大意义,总结长江流域水旱灾害防御的主要措施和手段,提炼主要经验和启示,以及取得的巨大成绩,进一步检视长江流域在蓄滞洪区建设运用、中小河流洪水和山洪灾害防御以及水工程联合调度等方面存在的薄弱环节与不足,提出提升长江流域水旱灾害防御能力的对策思路。

Benefits of Dielectric Oil Regeneration Systems in Power Transmission Networks: A Case Study

The criticality of transformers and reactors in the power transmission network and the paramount importance of ensuring their reliability through maintenance of the insulating oil is known. This paper presents a comprehensive examination of the efficacy and economic viability of a dielectric oil regeneration system, as implemented by the Transmission System Maintenance Department (TSMD) of the Independent Power Transmission Operator (IPTO), Greece’s sole transmission operator. Through a detailed chemical analysis and performance evaluation, we assess the impact of the regeneration system on treated insulating oil quality over multiple cycles. The study reveals that the electrical properties of the insulating oil are fully restored after regeneration, negating the need to fully replace it, while the investment becomes cost-neutral within weeks from the commissioning of the regeneration system. This economic analysis, coupled with the system’s environmental benefits of reducing waste oil generation, positions the dielectric oil regeneration system as a compelling solution for the maintenance of power transmission assets.

浅谈外资制造企业财务风险管理与内部控制

文章首先系统地分析了外贸制造企业在全球化浪潮下的现状,然后根据企业实际面临着的货币波动性、不同地区的法规和政策差异,以及全球供应链的日益复杂性等问题,针对性提出了一系列应对策略,包括建立金融衍生品使用策略对抗货币风险、构建一个灵活的全球法规和政策的动态调整机制、建立完善的供应链风险评估和控制机制。建立一个全面的运营和销售控制机制。以上策略的应用可以强化企业内部控制机制,有效降低全球化带来的财务风险,为其在全球市场中稳健发展提供保障。