Asset-backed securities are developed through complex processes such as asset restructuring and credit enhancement.Therefore,the information asymmetry between issuers and investors is greater compared to traditional s...Asset-backed securities are developed through complex processes such as asset restructuring and credit enhancement.Therefore,the information asymmetry between issuers and investors is greater compared to traditional securities,which imposes higher requirements on information disclosure for asset-backed securities.Asset-backed securities have characteristics such as diversified disclosers,differentiated disclosure content,and specialized risk factors.China has already formulated a series of rules and regulations regarding information disclosure of asset-backed securities.It is imperative to develop specialized laws and regulations for asset-backed securities,encompass original equity holders and credit enhancement agencies as information disclosers,incorporate information such as underlying asset details,cash flow projections,and credit ratings and enhancements into the disclosure content,and improve the legal liability rules to effectively address false disclosures.展开更多
Creditors,such as banks,often use disclosed environmental information to assess a company’s environmental risk and ensure the safety of debt funds.Consequently,carbon disclosures have become an important consideratio...Creditors,such as banks,often use disclosed environmental information to assess a company’s environmental risk and ensure the safety of debt funds.Consequently,carbon disclosures have become an important consideration for creditors when making investments.This study explores the relationship between carbon disclosure and debt financing costs using data on listed companies from 2008 to 2019.The results show that carbon disclosure can reduce the debt financing costs of enterprises,and that this influence is more significant for private companies than for state-owned enterprises.Instrumental variables and Propensity Score Matching(PSM)were used to evaluate the robustness of negative relationships.Furthermore,carbon disclosure has a more significant impact on debt costs with less environmental supervision pressure,weak residents’environmental awareness,and weak product market competition.These findings provide guidance for companies’carbon information disclosure and support the establishment of official carbon disclosure standards.展开更多
HIV status disclosure to partners is critical in improving the health and well-being of mother-infant dyad in the prevention of HIV transmission from mother to child (PMTCT) program. This study assesses the HIV disclo...HIV status disclosure to partners is critical in improving the health and well-being of mother-infant dyad in the prevention of HIV transmission from mother to child (PMTCT) program. This study assesses the HIV disclosure rate to intimate partners, associated factors, and outcomes among women in the PMTCT program in two large HIV clinics in Abuja, Nigeria. A descriptive cross-sectional study employed a multi-stage sampling technique in selecting 220 pregnant women enrolled in PMTCT care in two clinics. Outcomes measures include HIV status disclosure to intimate partner, women’s viral suppression status (suppressed < 1000 copies/mL, unsuppressed ≥ 1000 copies/mL), and previous MTCT experience. Exposure variables include the participant’s socio-demographic characteristics and HIV care history. Data were presented using frequency tables. Simple and multivariate logistic regression was done to ascertain the predictors of HIV status disclosure and assess the association between HIV disclosure, viral suppression, and MTCT experience at a p-value of less than 0.05. Only 205 (96.7%) entries were completed and analyzed A larger percentage of the participants were married women, 158 (77.1%), within the age group 26 - 35 years (53.3%). Women’s HIV status disclosure rate to intimate partners was 49.3% (101/205). Factors associated with HIV disclosure rate to intimate partners at the univariate level were the participant’s age, Christian religion [COR: 1.80, 95%CI: 1.04 - 3.21, p = 0.04], full employment [COR: 1.92, 95%CI: 1.10 - 3.34, p = 0.02], HIV positivity prior to PMTCT enrollment [COR: 2.88, 95%CI: 1.26 - 6.59, p < 0.01], duration on antiretroviral therapy [COR: 1.07, 95%CI: 1.01 - 1.13, p = 0.03], and knowledge of partner’s HIV status [COR: 0.20, 95%CI: 0.08 - 0.51, p < 0.01]. Only HIV positivity prior to PMTCT enrollment [AOR: 3.27, 95%CI: 1.23 - 8.70, p < 0.01] and awareness of the partner’s HIV status, [AOR: 0.17, 95%CI: 0.06 - 0.49, p < 0.01] were significant predictors of HIV status disclosure after controlling for confounder. The two study outcomes;women’s viral suppression and MTCT experience were not significantly associated with participants’ HIV status disclosure to intimate partners. Our study shows that HIV disclosure to intimate partners is still a big challenge among pregnant women in PMTCT settings in Nigeria, with awareness of the partner’s HIV status and the type of patient enrollment in the PMTCT setting being the two strong predictors of pregnant women’s HIV disclosure status to partners.展开更多
This study aimed to investigate the relationship between <span style="font-family:Verdana;">sense</span><span style="font-family:Verdana;"> of coherence and depression and the med...This study aimed to investigate the relationship between <span style="font-family:Verdana;">sense</span><span style="font-family:Verdana;"> of coherence and depression and the mediating role of self-disclosure in lung cancer patients. Α cross-sectional study was conducted in “Sotiria” Chest Diseases Hospital, Greece, with a sample of 200 lung cancer patients. </span><span style="font-family:Verdana;">The</span><span style="font-family:Verdana;"> administered questionnaires included demographic-medical information, SOC-13, Distress Disclosure Index, and CES-D scale. </span><span style="font-family:Verdana;">Analysis</span><span style="font-family:Verdana;"> was performed by SPSS v.23 and PROCESS. Depression was common (41%) and negatively correlated to SOC (rho = -</span><span><span><span style="font-family:;" "=""><span><span style="font-family:Verdana;">0.843, df = 198, p < 0.001), while self-disclosure did not mediate this relationship. Hierarchical linear regression analysis showed that patients with weak SOC, disease recurrence, metastases, low income, and receiving therapy in Day clinic had higher levels of depression. In conclusion, a strong SOC represents a protective factor against depression in lung cancer patients. Consequently, there is a need for targeted interventions, which should mainly increase </span><span style="font-family:Verdana;">SOC</span><span style="font-family:Verdana;"> of these patients.</span></span></span></span></span>展开更多
Various deep learning models have been proposed for the accurate assisted diagnosis of early-stage Alzheimer’s disease(AD).Most studies predominantly employ Convolutional Neural Networks(CNNs),which focus solely on l...Various deep learning models have been proposed for the accurate assisted diagnosis of early-stage Alzheimer’s disease(AD).Most studies predominantly employ Convolutional Neural Networks(CNNs),which focus solely on local features,thus encountering difficulties in handling global features.In contrast to natural images,Structural Magnetic Resonance Imaging(sMRI)images exhibit a higher number of channel dimensions.However,during the Position Embedding stage ofMulti Head Self Attention(MHSA),the coded information related to the channel dimension is disregarded.To tackle these issues,we propose theRepBoTNet-CESA network,an advanced AD-aided diagnostic model that is capable of learning local and global features simultaneously.It combines the advantages of CNN networks in capturing local information and Transformer networks in integrating global information,reducing computational costs while achieving excellent classification performance.Moreover,it uses the Cubic Embedding Self Attention(CESA)proposed in this paper to incorporate the channel code information,enhancing the classification performance within the Transformer structure.Finally,the RepBoTNet-CESA performs well in various AD-aided diagnosis tasks,with an accuracy of 96.58%,precision of 97.26%,and recall of 96.23%in the AD/NC task;an accuracy of 92.75%,precision of 92.84%,and recall of 93.18%in the EMCI/NC task;and an accuracy of 80.97%,precision of 83.86%,and recall of 80.91%in the AD/EMCI/LMCI/NC task.This demonstrates that RepBoTNet-CESA delivers outstanding outcomes in various AD-aided diagnostic tasks.Furthermore,our study has shown that MHSA exhibits superior performance compared to conventional attention mechanisms in enhancing ResNet performance.Besides,the Deeper RepBoTNet-CESA network fails to make further progress in AD-aided diagnostic tasks.展开更多
Background: Cancer diagnosis disclosure is still a challenge for patients and health care providers in Saudi Arabia which may affect the patient’s ability to cope with a cancer diagnosis and it is subsequent treatmen...Background: Cancer diagnosis disclosure is still a challenge for patients and health care providers in Saudi Arabia which may affect the patient’s ability to cope with a cancer diagnosis and it is subsequent treatments. Aim: This study is aimed to assess the effect of cancer diagnosis disclosure on patient’s coping self-efficacy at King Abdul-Aziz University Hospital, KSA-Jeddah. Methods: The data collected through a structured interview guided by coping Self-efficacy Scale (CSE) to measure the patients’ ability to perceive and cope effectively with their new diagnosis and the subsequent events related to it. It consists of 26 items subdivided into three factors. Distributed to adult patients above 18 years old who is newly diagnosed with cancer and willing to participate. Results: Among 102 participants enrolled in this study the relationship between age, marital status, educational level, income, and CSE showed no significant relationship, where p-value was higher than 0.05. Also, the relationship between diagnosis time and CSE show no significant relationship, where p-value was higher than 0.05, as no differences in CSE among patients who were diagnosed with cancer within two weeks, one month, one year ago, two years ago of interviewing them. The overall mean for their coping self-efficacy was moderate coping self-efficacy (3.86 ± 0.552). Conclusion: This study showed that the majority of cancer patients in this study had moderate coping self-efficacy and this could be explained by the strong faith, ideal living environment which involves family support, groups’ participation, reinforcement and daily activities which helped them to control their emotions and their abilities for coping with their experience of cancer diagnosis disclosure.展开更多
The Dirac equation γ<sub>μ</sub>(δ<sub>μ</sub>-eA<sub>μ</sub>)Ψ=mc<sup>2</sup>Ψ describes the bound states of the electron under the action of external potentials...The Dirac equation γ<sub>μ</sub>(δ<sub>μ</sub>-eA<sub>μ</sub>)Ψ=mc<sup>2</sup>Ψ describes the bound states of the electron under the action of external potentials, A<sub>μ</sub>. We assumed that the fundamental form of the Dirac equation γ<sub>μ</sub>(δ<sub>μ</sub>-S<sub>μ</sub>)Ψ=0 should describe the stable particles (the electron, the proton and the dark-matter-particle (dmp)) bound to themselves under the action of their own potentials S<sub>μ</sub>. The new equation reveals that self energy is consequence of self action, it also reveals that the spin angular momentum is consequence of the dynamic structure of the stable particles. The quantitative results are the determination of their relative masses as well as the determination of the electromagnetic coupling constant.展开更多
BACKGROUND Endoscopic management is the first-line therapy for post-liver-transplant anas-tomotic strictures.Although the optimal duration of treatment with plastic stents has been reported to be 8-12 months,data on s...BACKGROUND Endoscopic management is the first-line therapy for post-liver-transplant anas-tomotic strictures.Although the optimal duration of treatment with plastic stents has been reported to be 8-12 months,data on safety and duration for metal stents in this setting is scarce.Due to limited access to endoscopic retrograde cholan-giopancreatography(ERCP)during the coronavirus disease 2019 pandemic in our centre,there was a change in practice towards increased usage and length-of-stay of the Kaffes biliary intraductal self-expanding stent in patients with suitable anatomy.This was mainly due to the theoretical benefit of Kaffes stents allowing for longer indwelling periods compared to the traditional plastic stents.METHODS Adult liver transplant recipients aged 18 years and above who underwent ERCP were retrospectively identified during a 10-year period through a database query.Unplanned admissions post-Kaffes stent insertion were identified manually through electronic and scanned medical records.The main outcome was the incidence of complications when stents were left indwelling for 3 months vs 6 months.Stent efficacy was calculated via rates of stricture recurrence between patients that had stenting courses for≤120 d or>120 d.RESULTS During the study period,a total of 66 ERCPs with Kaffes insertion were performed in 54 patients throughout their stenting course.In 33 ERCPs,the stent was removed or exchanged on a 3-month interval.No pancreatitis,perfor-ations or deaths occurred.Minor post-ERCP complications were similar between the 3-month(abdominal pain and intraductal migration)and 6-month(abdominal pain,septic shower and embedded stent)groups-6.1%vs 9.1%respectively,P=0.40.All strictures resolved at the end of the stenting course,but the stenting course was variable from 3 to 22 months.The recurrence rate for stenting courses lasting for up to 120 d was 71.4%and 21.4%for stenting courses of 121 d or over(P=0.03).There were 28 patients that were treated with a single ERCP with Kaffes,21 with removal after 120 d and 7 within 120 d.There was a significant improvement in stricture recurrence when the Kaffes was removed after 120 d when a single ERCP was used for the entire stenting course(71.0%vs 10.0%,P=0.01).CONCLUSION Utilising a single Kaffes intraductal fully-covered metal stent for at least 4 months is safe and efficacious for the management of post-transplant anastomotic strictures.展开更多
Two new conceptual styles of self-disclosure were identified in a previous study—“announcers” and “confessors”. The styles and characteristics of each had been derived from disclosures made during Somerset Health...Two new conceptual styles of self-disclosure were identified in a previous study—“announcers” and “confessors”. The styles and characteristics of each had been derived from disclosures made during Somerset Health Panel discussions in 2001 on attitudes to stress and depression. The aim of this article is to validate and refine the concepts of “announcer” and “confessor” styles of self-disclosure. Data from archived qualitative data of seven focus groups collected in 2006 for the Cultural Context of Youth Suicide study was analysed. The results validated the concept of two styles of self-disclosure (announcers and confessors) and highlight additional factors that impact on disclosure. This study adds new insights in how people disclose personal or sensitive information and the impact of specific factors (contextual, individual and methodological) on the disclosure style used. Importantly, this article also demonstrates that qualitative data can be reused successfully in the development of models in communication and social interaction theory.展开更多
Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified a...Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified as a crucial tool in enhancing the knowledge, attitudes, and abilities necessary for self-management among individuals with diabetes. Aim: To assess the impact of diabetes self-management education on medication adherence and glycemic control in Sudanese adults with type 2 diabetes before and 3 months after the DSME intervention. Method: The study was conducted in Sudan between September 2022 and March 2023, it was an interventional, one-group, pre- and post-test study that aimed to assess the impact of diabetes self-management education (DSME) on medication adherence and diabetes control in Sudanese adults with type 2 diabetes. The research was conducted in primary health care centers in six cities in Sudan and involved 244 participants. The data entry and statistical analysis were conducted using the Statistical Package for Social Sciences version 27.0. A paired t test was used for analysis. Results: The study included 244 participants, 67% of whom were males. The age mean ± SD was 48.6 ± 9.3 years, and 85.3% of participants were married. Age at onset of diabetes mean ± SD was 40.60 ± 7.81 years;44.6% had diabetes for less than 5 years;and 84.1% had a positive family history of diabetes mellitus. The levels of poor, low, and partial adherence to medication decreased by 8.2%, 4%, and 20.6%, respectively, after the intervention. The levels of good and high medication regime adherence increased by 13% and 19.8%, respectively;BMI decreased by 1.1 ± 0.73 kg/m<sup>2</sup> (p = 0.005). The fasting blood sugar decreased by 69 ± 32.9 mg/dl (p = 0.049), and the glycated hemoglobin decreased by 1.21 ± 0.28% (p = 0.001). Conclusions: The findings of this study reinforce the importance of patient education in improving glycemic control and enhancing self-management behaviors. Patient education plays a critical role in enhancing glycemic control and self-management behaviors. It is essential for healthcare providers to adopt a patient-centered approach, taking into account the individual's beliefs, attitudes, and knowledge about their illness and treatment. Overcoming these challenges necessitates a comprehensive approach, including enhancing healthcare professionals’ knowledge and communication skills, offering accessible and culturally sensitive diabetes education programs, and addressing barriers to resources and support for self-management.展开更多
Self-efficacy plays an important role in the management of type 2 diabetes mellitus (T2DM) patients, and it runs through the whole process of diabetes treatment, which is conducive to controlling and delaying the occu...Self-efficacy plays an important role in the management of type 2 diabetes mellitus (T2DM) patients, and it runs through the whole process of diabetes treatment, which is conducive to controlling and delaying the occurrence and development of complications, as well as improving the quality of life of patients. This paper mainly describes the concept of self-efficacy, the current situation of self-efficacy of diabetic patients at home and abroad, the functional aspects and their influencing factors, so as to take relevant measures on how to improve self-efficacy. It aims to provide a theoretical basis for the development of self-efficacy interventions for patients with type 2 diabetes mellitus.展开更多
Diabetes is a chronic pathology whose evolution is marked by micro and macroangiopathic complications. Optimal management can prevent the onset of complications and improve patients’ quality of life. Objectives: To d...Diabetes is a chronic pathology whose evolution is marked by micro and macroangiopathic complications. Optimal management can prevent the onset of complications and improve patients’ quality of life. Objectives: To determine the frequency of self-monitoring of blood glucose and to describe the errors found during self-monitoring in diabetic patients followed at the Endocrinology Department of Donka University Hospital in Guinea. Materials and methods: Descriptive cross-sectional study carried out between August and September 2020 involving diabetic patients followed up at the Endocrinology and Diabetology Department of the Donka National Hospital, CHU Conakry. Results: A total of 301 patients were enrolled, with an average age of 44.24 ± 21.01 years. 64.12% were female. Type 2 diabetes predominated in 64% of cases. The mean duration of diabetes was 6.14 ± 4.67 years, and 75.08% of patients lived in urban areas. Patients were on insulin in 36.21% of cases, insulin and biguanides (26.25%), hypoglycemic sulfonamide and biguanides (19.27%) and biguanides in 18.27% of cases. The frequency of self-monitoring of blood glucose was 43%, and 38% of patients made errors, notably reusing lancets (60%), not checking the expiration date (55.65%) and not washing their hands (48%). Conclusion: This study shows that self-monitoring of blood glucose is not performed by the majority of patients. Numerous errors were identified during blood glucose testing. Continued therapeutic education on the use of blood glucose meters will help empower patients and improve their quality of life.展开更多
Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobeha...Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.展开更多
The federated self-supervised framework is a distributed machine learning method that combines federated learning and self-supervised learning, which can effectively solve the problem of traditional federated learning...The federated self-supervised framework is a distributed machine learning method that combines federated learning and self-supervised learning, which can effectively solve the problem of traditional federated learning being difficult to process large-scale unlabeled data. The existing federated self-supervision framework has problems with low communication efficiency and high communication delay between clients and central servers. Therefore, we added edge servers to the federated self-supervision framework to reduce the pressure on the central server caused by frequent communication between both ends. A communication compression scheme using gradient quantization and sparsification was proposed to optimize the communication of the entire framework, and the algorithm of the sparse communication compression module was improved. Experiments have proved that the learning rate changes of the improved sparse communication compression module are smoother and more stable. Our communication compression scheme effectively reduced the overall communication overhead.展开更多
Recycled large aggregate self-compacting concrete (RLA-SCC) within multiple weak areas. These weak areas have poor resistance to chloride ion erosion, which affects the service life of RLA-SCC in the marine environmen...Recycled large aggregate self-compacting concrete (RLA-SCC) within multiple weak areas. These weak areas have poor resistance to chloride ion erosion, which affects the service life of RLA-SCC in the marine environment. A three-dimensional multi-phase mesoscopic numerical model of RLA-SCC was established to simulate the chloride ions transportation in concrete. Experiments of RLA-SCC immersing in chloride solution were carried out to verify the simulation results. The effects of recycled large aggregate (RLA) content and RLA particle size on the service life of concrete were explored. The results indicate that the mesoscopic numerical simulation results are in good agreement with the experimental results. At the same depth, the closer to the surface of the RLA, the greater the chloride ion concentration. The service life of RLA-SCC in marine environment decreases with the increase of RLA content. Compared with the service life of 20% content, the service life of 25% and 30% content decreased by 20% and 42% respectively. Increasing the particle size of RLA can effectively improve the service life of RLA-SCC in chloride environment. Compared with the service life of 50 mm particle size, the service life of 70 mm and 90 mm increased by 61% and 163%, respectively. .展开更多
This literature review primarily aims to explore and synthesise the previous studies in simulation education research conducted over the past five years related to the effects of simulation training on the self-effica...This literature review primarily aims to explore and synthesise the previous studies in simulation education research conducted over the past five years related to the effects of simulation training on the self-efficacy of undergraduate pre-registration nursing students. The second aim of this study is to explore additional outcome variables that were examined in the previous studies. Five electronic databases were searched systematically. These databases were MEDLINE, CINAHL Plus, Scopus, Embase and PsycINFO. The PICO model was employed to identify the search terms, with a thesaurus being used to provide synonyms. Reference lists of relevant articles were examined and hand searches of journals were also undertaken. The quality of each study was assessed using the Simulation Research Rubric (SRR). A total of 11 studies were included. All studies explored the impact of simulation education on undergraduate pre-registration nursing. Six studies explored nursing students’ competence and performance and two papers examined their critical thinking. Problem solving, learning motivation, communication skills and knowledge acquisition were examined once. The majority of studies indicated that simulation training has a positive impact on pre-registration nursing students’ self-efficacy and other outcome variables. Furthermore, the study results indicate that simulation training is more dependable than traditional training, and students were extremely satisfied with the simulation training. However, most of the studies included in this review had several gaps, including study design, sample size and dissimilarities between the scales used. Further research with large samples, reliable and valid instruments, and outcomes measures (such as critical thinking and transferability of skills) is required to provide better insight into the effectiveness of simulation in undergraduate nursing education. .展开更多
文摘Asset-backed securities are developed through complex processes such as asset restructuring and credit enhancement.Therefore,the information asymmetry between issuers and investors is greater compared to traditional securities,which imposes higher requirements on information disclosure for asset-backed securities.Asset-backed securities have characteristics such as diversified disclosers,differentiated disclosure content,and specialized risk factors.China has already formulated a series of rules and regulations regarding information disclosure of asset-backed securities.It is imperative to develop specialized laws and regulations for asset-backed securities,encompass original equity holders and credit enhancement agencies as information disclosers,incorporate information such as underlying asset details,cash flow projections,and credit ratings and enhancements into the disclosure content,and improve the legal liability rules to effectively address false disclosures.
文摘Creditors,such as banks,often use disclosed environmental information to assess a company’s environmental risk and ensure the safety of debt funds.Consequently,carbon disclosures have become an important consideration for creditors when making investments.This study explores the relationship between carbon disclosure and debt financing costs using data on listed companies from 2008 to 2019.The results show that carbon disclosure can reduce the debt financing costs of enterprises,and that this influence is more significant for private companies than for state-owned enterprises.Instrumental variables and Propensity Score Matching(PSM)were used to evaluate the robustness of negative relationships.Furthermore,carbon disclosure has a more significant impact on debt costs with less environmental supervision pressure,weak residents’environmental awareness,and weak product market competition.These findings provide guidance for companies’carbon information disclosure and support the establishment of official carbon disclosure standards.
文摘HIV status disclosure to partners is critical in improving the health and well-being of mother-infant dyad in the prevention of HIV transmission from mother to child (PMTCT) program. This study assesses the HIV disclosure rate to intimate partners, associated factors, and outcomes among women in the PMTCT program in two large HIV clinics in Abuja, Nigeria. A descriptive cross-sectional study employed a multi-stage sampling technique in selecting 220 pregnant women enrolled in PMTCT care in two clinics. Outcomes measures include HIV status disclosure to intimate partner, women’s viral suppression status (suppressed < 1000 copies/mL, unsuppressed ≥ 1000 copies/mL), and previous MTCT experience. Exposure variables include the participant’s socio-demographic characteristics and HIV care history. Data were presented using frequency tables. Simple and multivariate logistic regression was done to ascertain the predictors of HIV status disclosure and assess the association between HIV disclosure, viral suppression, and MTCT experience at a p-value of less than 0.05. Only 205 (96.7%) entries were completed and analyzed A larger percentage of the participants were married women, 158 (77.1%), within the age group 26 - 35 years (53.3%). Women’s HIV status disclosure rate to intimate partners was 49.3% (101/205). Factors associated with HIV disclosure rate to intimate partners at the univariate level were the participant’s age, Christian religion [COR: 1.80, 95%CI: 1.04 - 3.21, p = 0.04], full employment [COR: 1.92, 95%CI: 1.10 - 3.34, p = 0.02], HIV positivity prior to PMTCT enrollment [COR: 2.88, 95%CI: 1.26 - 6.59, p < 0.01], duration on antiretroviral therapy [COR: 1.07, 95%CI: 1.01 - 1.13, p = 0.03], and knowledge of partner’s HIV status [COR: 0.20, 95%CI: 0.08 - 0.51, p < 0.01]. Only HIV positivity prior to PMTCT enrollment [AOR: 3.27, 95%CI: 1.23 - 8.70, p < 0.01] and awareness of the partner’s HIV status, [AOR: 0.17, 95%CI: 0.06 - 0.49, p < 0.01] were significant predictors of HIV status disclosure after controlling for confounder. The two study outcomes;women’s viral suppression and MTCT experience were not significantly associated with participants’ HIV status disclosure to intimate partners. Our study shows that HIV disclosure to intimate partners is still a big challenge among pregnant women in PMTCT settings in Nigeria, with awareness of the partner’s HIV status and the type of patient enrollment in the PMTCT setting being the two strong predictors of pregnant women’s HIV disclosure status to partners.
文摘This study aimed to investigate the relationship between <span style="font-family:Verdana;">sense</span><span style="font-family:Verdana;"> of coherence and depression and the mediating role of self-disclosure in lung cancer patients. Α cross-sectional study was conducted in “Sotiria” Chest Diseases Hospital, Greece, with a sample of 200 lung cancer patients. </span><span style="font-family:Verdana;">The</span><span style="font-family:Verdana;"> administered questionnaires included demographic-medical information, SOC-13, Distress Disclosure Index, and CES-D scale. </span><span style="font-family:Verdana;">Analysis</span><span style="font-family:Verdana;"> was performed by SPSS v.23 and PROCESS. Depression was common (41%) and negatively correlated to SOC (rho = -</span><span><span><span style="font-family:;" "=""><span><span style="font-family:Verdana;">0.843, df = 198, p < 0.001), while self-disclosure did not mediate this relationship. Hierarchical linear regression analysis showed that patients with weak SOC, disease recurrence, metastases, low income, and receiving therapy in Day clinic had higher levels of depression. In conclusion, a strong SOC represents a protective factor against depression in lung cancer patients. Consequently, there is a need for targeted interventions, which should mainly increase </span><span style="font-family:Verdana;">SOC</span><span style="font-family:Verdana;"> of these patients.</span></span></span></span></span>
基金the Key Project of Zhejiang Provincial Natural Science Foundation under Grants LD21F020001,Z20F020022the National Natural Science Foundation of China under Grants 62072340,62076185the Major Project of Wenzhou Natural Science Foundation under Grants 2021HZSY0071,ZS2022001.
文摘Various deep learning models have been proposed for the accurate assisted diagnosis of early-stage Alzheimer’s disease(AD).Most studies predominantly employ Convolutional Neural Networks(CNNs),which focus solely on local features,thus encountering difficulties in handling global features.In contrast to natural images,Structural Magnetic Resonance Imaging(sMRI)images exhibit a higher number of channel dimensions.However,during the Position Embedding stage ofMulti Head Self Attention(MHSA),the coded information related to the channel dimension is disregarded.To tackle these issues,we propose theRepBoTNet-CESA network,an advanced AD-aided diagnostic model that is capable of learning local and global features simultaneously.It combines the advantages of CNN networks in capturing local information and Transformer networks in integrating global information,reducing computational costs while achieving excellent classification performance.Moreover,it uses the Cubic Embedding Self Attention(CESA)proposed in this paper to incorporate the channel code information,enhancing the classification performance within the Transformer structure.Finally,the RepBoTNet-CESA performs well in various AD-aided diagnosis tasks,with an accuracy of 96.58%,precision of 97.26%,and recall of 96.23%in the AD/NC task;an accuracy of 92.75%,precision of 92.84%,and recall of 93.18%in the EMCI/NC task;and an accuracy of 80.97%,precision of 83.86%,and recall of 80.91%in the AD/EMCI/LMCI/NC task.This demonstrates that RepBoTNet-CESA delivers outstanding outcomes in various AD-aided diagnostic tasks.Furthermore,our study has shown that MHSA exhibits superior performance compared to conventional attention mechanisms in enhancing ResNet performance.Besides,the Deeper RepBoTNet-CESA network fails to make further progress in AD-aided diagnostic tasks.
文摘Background: Cancer diagnosis disclosure is still a challenge for patients and health care providers in Saudi Arabia which may affect the patient’s ability to cope with a cancer diagnosis and it is subsequent treatments. Aim: This study is aimed to assess the effect of cancer diagnosis disclosure on patient’s coping self-efficacy at King Abdul-Aziz University Hospital, KSA-Jeddah. Methods: The data collected through a structured interview guided by coping Self-efficacy Scale (CSE) to measure the patients’ ability to perceive and cope effectively with their new diagnosis and the subsequent events related to it. It consists of 26 items subdivided into three factors. Distributed to adult patients above 18 years old who is newly diagnosed with cancer and willing to participate. Results: Among 102 participants enrolled in this study the relationship between age, marital status, educational level, income, and CSE showed no significant relationship, where p-value was higher than 0.05. Also, the relationship between diagnosis time and CSE show no significant relationship, where p-value was higher than 0.05, as no differences in CSE among patients who were diagnosed with cancer within two weeks, one month, one year ago, two years ago of interviewing them. The overall mean for their coping self-efficacy was moderate coping self-efficacy (3.86 ± 0.552). Conclusion: This study showed that the majority of cancer patients in this study had moderate coping self-efficacy and this could be explained by the strong faith, ideal living environment which involves family support, groups’ participation, reinforcement and daily activities which helped them to control their emotions and their abilities for coping with their experience of cancer diagnosis disclosure.
文摘The Dirac equation γ<sub>μ</sub>(δ<sub>μ</sub>-eA<sub>μ</sub>)Ψ=mc<sup>2</sup>Ψ describes the bound states of the electron under the action of external potentials, A<sub>μ</sub>. We assumed that the fundamental form of the Dirac equation γ<sub>μ</sub>(δ<sub>μ</sub>-S<sub>μ</sub>)Ψ=0 should describe the stable particles (the electron, the proton and the dark-matter-particle (dmp)) bound to themselves under the action of their own potentials S<sub>μ</sub>. The new equation reveals that self energy is consequence of self action, it also reveals that the spin angular momentum is consequence of the dynamic structure of the stable particles. The quantitative results are the determination of their relative masses as well as the determination of the electromagnetic coupling constant.
文摘BACKGROUND Endoscopic management is the first-line therapy for post-liver-transplant anas-tomotic strictures.Although the optimal duration of treatment with plastic stents has been reported to be 8-12 months,data on safety and duration for metal stents in this setting is scarce.Due to limited access to endoscopic retrograde cholan-giopancreatography(ERCP)during the coronavirus disease 2019 pandemic in our centre,there was a change in practice towards increased usage and length-of-stay of the Kaffes biliary intraductal self-expanding stent in patients with suitable anatomy.This was mainly due to the theoretical benefit of Kaffes stents allowing for longer indwelling periods compared to the traditional plastic stents.METHODS Adult liver transplant recipients aged 18 years and above who underwent ERCP were retrospectively identified during a 10-year period through a database query.Unplanned admissions post-Kaffes stent insertion were identified manually through electronic and scanned medical records.The main outcome was the incidence of complications when stents were left indwelling for 3 months vs 6 months.Stent efficacy was calculated via rates of stricture recurrence between patients that had stenting courses for≤120 d or>120 d.RESULTS During the study period,a total of 66 ERCPs with Kaffes insertion were performed in 54 patients throughout their stenting course.In 33 ERCPs,the stent was removed or exchanged on a 3-month interval.No pancreatitis,perfor-ations or deaths occurred.Minor post-ERCP complications were similar between the 3-month(abdominal pain and intraductal migration)and 6-month(abdominal pain,septic shower and embedded stent)groups-6.1%vs 9.1%respectively,P=0.40.All strictures resolved at the end of the stenting course,but the stenting course was variable from 3 to 22 months.The recurrence rate for stenting courses lasting for up to 120 d was 71.4%and 21.4%for stenting courses of 121 d or over(P=0.03).There were 28 patients that were treated with a single ERCP with Kaffes,21 with removal after 120 d and 7 within 120 d.There was a significant improvement in stricture recurrence when the Kaffes was removed after 120 d when a single ERCP was used for the entire stenting course(71.0%vs 10.0%,P=0.01).CONCLUSION Utilising a single Kaffes intraductal fully-covered metal stent for at least 4 months is safe and efficacious for the management of post-transplant anastomotic strictures.
文摘Two new conceptual styles of self-disclosure were identified in a previous study—“announcers” and “confessors”. The styles and characteristics of each had been derived from disclosures made during Somerset Health Panel discussions in 2001 on attitudes to stress and depression. The aim of this article is to validate and refine the concepts of “announcer” and “confessor” styles of self-disclosure. Data from archived qualitative data of seven focus groups collected in 2006 for the Cultural Context of Youth Suicide study was analysed. The results validated the concept of two styles of self-disclosure (announcers and confessors) and highlight additional factors that impact on disclosure. This study adds new insights in how people disclose personal or sensitive information and the impact of specific factors (contextual, individual and methodological) on the disclosure style used. Importantly, this article also demonstrates that qualitative data can be reused successfully in the development of models in communication and social interaction theory.
文摘Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified as a crucial tool in enhancing the knowledge, attitudes, and abilities necessary for self-management among individuals with diabetes. Aim: To assess the impact of diabetes self-management education on medication adherence and glycemic control in Sudanese adults with type 2 diabetes before and 3 months after the DSME intervention. Method: The study was conducted in Sudan between September 2022 and March 2023, it was an interventional, one-group, pre- and post-test study that aimed to assess the impact of diabetes self-management education (DSME) on medication adherence and diabetes control in Sudanese adults with type 2 diabetes. The research was conducted in primary health care centers in six cities in Sudan and involved 244 participants. The data entry and statistical analysis were conducted using the Statistical Package for Social Sciences version 27.0. A paired t test was used for analysis. Results: The study included 244 participants, 67% of whom were males. The age mean ± SD was 48.6 ± 9.3 years, and 85.3% of participants were married. Age at onset of diabetes mean ± SD was 40.60 ± 7.81 years;44.6% had diabetes for less than 5 years;and 84.1% had a positive family history of diabetes mellitus. The levels of poor, low, and partial adherence to medication decreased by 8.2%, 4%, and 20.6%, respectively, after the intervention. The levels of good and high medication regime adherence increased by 13% and 19.8%, respectively;BMI decreased by 1.1 ± 0.73 kg/m<sup>2</sup> (p = 0.005). The fasting blood sugar decreased by 69 ± 32.9 mg/dl (p = 0.049), and the glycated hemoglobin decreased by 1.21 ± 0.28% (p = 0.001). Conclusions: The findings of this study reinforce the importance of patient education in improving glycemic control and enhancing self-management behaviors. Patient education plays a critical role in enhancing glycemic control and self-management behaviors. It is essential for healthcare providers to adopt a patient-centered approach, taking into account the individual's beliefs, attitudes, and knowledge about their illness and treatment. Overcoming these challenges necessitates a comprehensive approach, including enhancing healthcare professionals’ knowledge and communication skills, offering accessible and culturally sensitive diabetes education programs, and addressing barriers to resources and support for self-management.
文摘Self-efficacy plays an important role in the management of type 2 diabetes mellitus (T2DM) patients, and it runs through the whole process of diabetes treatment, which is conducive to controlling and delaying the occurrence and development of complications, as well as improving the quality of life of patients. This paper mainly describes the concept of self-efficacy, the current situation of self-efficacy of diabetic patients at home and abroad, the functional aspects and their influencing factors, so as to take relevant measures on how to improve self-efficacy. It aims to provide a theoretical basis for the development of self-efficacy interventions for patients with type 2 diabetes mellitus.
文摘Diabetes is a chronic pathology whose evolution is marked by micro and macroangiopathic complications. Optimal management can prevent the onset of complications and improve patients’ quality of life. Objectives: To determine the frequency of self-monitoring of blood glucose and to describe the errors found during self-monitoring in diabetic patients followed at the Endocrinology Department of Donka University Hospital in Guinea. Materials and methods: Descriptive cross-sectional study carried out between August and September 2020 involving diabetic patients followed up at the Endocrinology and Diabetology Department of the Donka National Hospital, CHU Conakry. Results: A total of 301 patients were enrolled, with an average age of 44.24 ± 21.01 years. 64.12% were female. Type 2 diabetes predominated in 64% of cases. The mean duration of diabetes was 6.14 ± 4.67 years, and 75.08% of patients lived in urban areas. Patients were on insulin in 36.21% of cases, insulin and biguanides (26.25%), hypoglycemic sulfonamide and biguanides (19.27%) and biguanides in 18.27% of cases. The frequency of self-monitoring of blood glucose was 43%, and 38% of patients made errors, notably reusing lancets (60%), not checking the expiration date (55.65%) and not washing their hands (48%). Conclusion: This study shows that self-monitoring of blood glucose is not performed by the majority of patients. Numerous errors were identified during blood glucose testing. Continued therapeutic education on the use of blood glucose meters will help empower patients and improve their quality of life.
文摘Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.
文摘The federated self-supervised framework is a distributed machine learning method that combines federated learning and self-supervised learning, which can effectively solve the problem of traditional federated learning being difficult to process large-scale unlabeled data. The existing federated self-supervision framework has problems with low communication efficiency and high communication delay between clients and central servers. Therefore, we added edge servers to the federated self-supervision framework to reduce the pressure on the central server caused by frequent communication between both ends. A communication compression scheme using gradient quantization and sparsification was proposed to optimize the communication of the entire framework, and the algorithm of the sparse communication compression module was improved. Experiments have proved that the learning rate changes of the improved sparse communication compression module are smoother and more stable. Our communication compression scheme effectively reduced the overall communication overhead.
文摘Recycled large aggregate self-compacting concrete (RLA-SCC) within multiple weak areas. These weak areas have poor resistance to chloride ion erosion, which affects the service life of RLA-SCC in the marine environment. A three-dimensional multi-phase mesoscopic numerical model of RLA-SCC was established to simulate the chloride ions transportation in concrete. Experiments of RLA-SCC immersing in chloride solution were carried out to verify the simulation results. The effects of recycled large aggregate (RLA) content and RLA particle size on the service life of concrete were explored. The results indicate that the mesoscopic numerical simulation results are in good agreement with the experimental results. At the same depth, the closer to the surface of the RLA, the greater the chloride ion concentration. The service life of RLA-SCC in marine environment decreases with the increase of RLA content. Compared with the service life of 20% content, the service life of 25% and 30% content decreased by 20% and 42% respectively. Increasing the particle size of RLA can effectively improve the service life of RLA-SCC in chloride environment. Compared with the service life of 50 mm particle size, the service life of 70 mm and 90 mm increased by 61% and 163%, respectively. .
文摘This literature review primarily aims to explore and synthesise the previous studies in simulation education research conducted over the past five years related to the effects of simulation training on the self-efficacy of undergraduate pre-registration nursing students. The second aim of this study is to explore additional outcome variables that were examined in the previous studies. Five electronic databases were searched systematically. These databases were MEDLINE, CINAHL Plus, Scopus, Embase and PsycINFO. The PICO model was employed to identify the search terms, with a thesaurus being used to provide synonyms. Reference lists of relevant articles were examined and hand searches of journals were also undertaken. The quality of each study was assessed using the Simulation Research Rubric (SRR). A total of 11 studies were included. All studies explored the impact of simulation education on undergraduate pre-registration nursing. Six studies explored nursing students’ competence and performance and two papers examined their critical thinking. Problem solving, learning motivation, communication skills and knowledge acquisition were examined once. The majority of studies indicated that simulation training has a positive impact on pre-registration nursing students’ self-efficacy and other outcome variables. Furthermore, the study results indicate that simulation training is more dependable than traditional training, and students were extremely satisfied with the simulation training. However, most of the studies included in this review had several gaps, including study design, sample size and dissimilarities between the scales used. Further research with large samples, reliable and valid instruments, and outcomes measures (such as critical thinking and transferability of skills) is required to provide better insight into the effectiveness of simulation in undergraduate nursing education. .