Background: To examine the differences in prevalence of respiratory distress syndrome, early-onset sepsis and jaundice, between late preterm infants versus term infants in Ecuadorian newborns. Methods: Study design: E...Background: To examine the differences in prevalence of respiratory distress syndrome, early-onset sepsis and jaundice, between late preterm infants versus term infants in Ecuadorian newborns. Methods: Study design: Epidemiological, observational, and cross-sectional, with two cohorts of patients. Settings: IESS Quito Sur Hospital at Quito, Ecuador, from February to April of 2020. Participants: This study included 204 newborns, 102 preterm infants, 102 term infants. Results: There are significant differences between late preterm infants and term infants, with a p-value of 0.000 in the prevalence of early sepsis, 70.59% vs. 35.29%. In respiratory distress syndrome between late and term premature infants, significant differences were observed with a p-value of 0.000, the proportion being 55.58% vs. 24.51% respectively. The prevalence of jaundice is higher in term infants with a p value of 0.002, 72.55%, versus 51.96% in late preterm infants, and the mean value of bilirubins in mg/dL was higher in term infants 14.32 versus 12.33 in late preterm infants;this difference is statistically significant with a p value of 0.004. Admission to the NICU is more frequent in late preterm infants with a p-value of 0.000, being 42.16% for late preterm infants vs. 7.84% in term infants;the mean of the hospital days with p-value 0.005, was higher in late preterm infants 4.97 days vs. 3.55 days for term newborns. Conclusion: Due to the conditions of their immaturity, late preterm infants are 2.86 times more likely to present early sepsis than full-term newborns. It is shown that late preterm infants are 2.69 times more likely to have respiratory distress syndrome compared to term infants, therefore, late preterm infants have a longer hospital stay of 4.97 days versus 3.55 days in term infants. Jaundice and mean bilirubin levels are higher in term infants due to blood group incompatibility and insufficient breastfeeding.展开更多
BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study pre...BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.AIM To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with DC.METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic reevaluation.The study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years post-surgery.RESULTS Thirty-seven patients completed the 10-year follow-up.At 10 years,patients treated at the PIP joint exhibited a 100%recurrence.However,patients treated at the MCP joint only showed a 50%recurrence.Patient satisfaction varied,with a lower satisfaction reported in PIP joint cases.Recurrence exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained efficacy.Significant differences were noted between outcomes at the 7-year and 10-year intervals.CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint.However,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction.Re-intervention is needed within a decade of treatment.展开更多
Introduction: Pregnancy as much as childbirth constitutes a risky situation, potentially fraught with sometimes dramatic complications: maternal death. Objective: We conducted this study with the aim of establishing t...Introduction: Pregnancy as much as childbirth constitutes a risky situation, potentially fraught with sometimes dramatic complications: maternal death. Objective: We conducted this study with the aim of establishing the profile of those giving birth in our context with the aim to anticipate operationally in the future on morbidity but more on maternal deaths. Methodology: We conducted, using a structured questionnaire, a prospective descriptive study in representative maternity wards in the city of Douala;the study variables were socio-economic, anthropometric, obstetrical and clinical. Statistical analyses were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables and the percentages. Results: We recruited 305 births for our study. The average age of our births was 28.7 years ± 6.1 with an average height of 161.6 cm ± 5.06;an average body mass index at the start of pregnancy of 28.0 kilograms/square meter and 31.3 kilograms/square meter at delivery;the average weight gain was 8.4 g ± 5.37;an average gestation of 2.84±1.90;an average parity of 2.2 ± 2.1 with an average birth interval of 27.7 months ± 23.7. The average gestational age was 39.2 weeks ± 1.21 with pregnancy pathology dominated by malaria;85.9% began their prenatal follow-up before the 14th week of amenorrhea. Conclusion: The profile of childbirth in urban Cameroon does not seem potentially dystocic compared to that of the same regional and racial area.展开更多
BACKGROUND Endoscopic submucosal dissection(ESD)for over 2 cm in size undifferentiated type(UD type)early gastric cancer(EGC)confined to the mucosa is not only challenging,but also long-term outcomes are not well know...BACKGROUND Endoscopic submucosal dissection(ESD)for over 2 cm in size undifferentiated type(UD type)early gastric cancer(EGC)confined to the mucosa is not only challenging,but also long-term outcomes are not well known.AIM To evaluate the long-term outcomes of ESD done for UD type EGCs confined to the mucosa over 2 cm in size and compare the results with those where the lesions were less than 2 cm.METHODS 143 patients with UD type EGC confirmed on histology after ESD at a tertiary hospital were reviewed.Cases with synchronous and metachronous lesions and a case with emergency surgery after ESD were excluded.A total of 137 cases were enrolled.79 cases who underwent R0 resection were divided into 2 cm or less(group A)and over 2 cm(group B)in size.RESULTS Among 79 patients who underwent R0 resection,the number in group A and B were 51 and 28,respectively.The mean follow-up period(SD)was 79.71±45.42 months.There was a local recurrence in group A(1/51,2%)and group B(1/28,3.6%)respectively.This patient in group A underwent surgery while the patient in group B underwent repeated ESD with no further recurrences in both patients.There was no regional lymph node metastasis,distant metastasis,and deaths in both groups.With R0 resection strategy for ESD on lesions over 2 cm,20.4%(28/137)of patients were able to avoid surgery compared with expanded indication.CONCLUSION If R0 resection is achieved by ESD,UD type EGCs over 2 cm also showed good and similar clinical outcomes as compared to lesions less than 2 cm when followed for over 5 years.With R0 resection strategy,several patients can avoid surgery.展开更多
Background: Congenital heart disease is a public health issue due to its incidence and mortality rate. The aim of this study was to investigate the long-term mortality of children with congenital heart disease admitte...Background: Congenital heart disease is a public health issue due to its incidence and mortality rate. The aim of this study was to investigate the long-term mortality of children with congenital heart disease admitted to the Departmental University Hospital of Borgou/Alibori (CHUD-B/A) from 2011 to 2022. Methods: This descriptive longitudinal study with analytical aims covered 11 years (April 1, 2011 to December 31, 2022). It consisted of a review of the records of children under 15 years of age with echocardiographically confirmed congenital heart disease. This was followed by an interview with the parents to assess the children’s current condition. Data were entered using Kobocollect software and analyzed using R Studio 4.2.2. software. Results: A total of 143 complete files were retained. The median age at diagnosis was 14 months (IIQ: Q1 = 4;Q3 = 60) with a range of 2 days and 175 months, and the sex-ratio (M/F) was 0.96. Left-to-right shunts were the most frequent cardiopathy group (62.9%). Only 35 children (24.5%) benefited from restorative treatment. The mortality rate was 31.5%. Median survival under the maximum bias assumption was 114 months and 216 months under the assumption of minimum bias. Survival was significantly better in children with right-to-left shunts (p = 0.0049) under the assumption of minimum bias. The death risk factors were: age at diagnosis less than 12 months (aHR = 7.58;95% CI = 3.36 - 17.24;p Conclusion: The long-term mortality of congenital heart disease is high and favoured by the absence of restorative treatment. Local correction of congenital heart disease and medical follow-up will help to reduce this mortality.展开更多
Introduction: Anthropometry applied to newborns is a reliable indicator of the quality of fetal growth. The latter is influenced by genetic, racial and nutritional factors varying from one population to another, expla...Introduction: Anthropometry applied to newborns is a reliable indicator of the quality of fetal growth. The latter is influenced by genetic, racial and nutritional factors varying from one population to another, explaining why a standard cannot be applied to all populations. Research question: should the Caucasian frame of reference be dogmatically applied in our African context? Multicenter studies are therefore necessary;hence the interest of this work, the main objective of which was to describe the anthropometric profile of full-term newborns in the city of Douala. Methodology: We carried out a cross-sectional study with an analytical aim and prospective data collection in the maternity wards of the Douala General Hospital, Laquintinie Hospital, District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given consent. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using structured and pre-tested survey sheets. The study variables were obstetric and anthropometric. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The average anthropometric parameters of the full-term newborn in the city of Douala were: average weight: 3305 grams, average height: 49.8 centimeters, average head circumference: 34.6 centimeters, average upper arm circumference: 11.3 centimeters, circumference average thoracic: 32.8 centimeters. The percentile distribution showed a 10th percentile at 2656 grams and a 90th percentile at 3966 grams for weight defining the limits for small-for-gestational-age neonates and macrosomes. Conclusion: The anthropometric data of the full-term newborn in the city of Douala were: an average weight of 3305.4 grams, an average height of 49.8 centimeters, an average head circumference of 34.2 centimeters, an average upper arm circumference of 11.3 centimeters, and an average thoracic circumference of 32.8 centimeters with higher valuesin male newborns.展开更多
Background: To prevent infectious diseases and deaths of children, vaccinations play a crucial role in public health strategies in Kuwait. However, it remained uncertain to demonstrate the potential long-term health o...Background: To prevent infectious diseases and deaths of children, vaccinations play a crucial role in public health strategies in Kuwait. However, it remained uncertain to demonstrate the potential long-term health outcomes of vaccination, including neurodevelopmental disorders (NDD) and autism. This study aimed to evaluate the long-term health outcomes of vaccination among Kuwait children from birth to thirteen years old. Objectives: This study included the significant objectives: (1) to compare long-term health effects, including chronic and acute conditions for unvaccinated, partially vaccinated, and vaccinated children, and (2) to evaluate the association of vaccination with the neurodevelopmental disorders (NDD) and autism, and the preventable illnesses. Methods: This prospective study involved a sample of 976 children from Kuwait based on mothers’ reporting. Data collection about the vaccination status of children and various health outcomes relevant to chronic and acute illnesses was performed based on structured questionnaires through an online survey. However, participants were classified into unvaccinated (n = 40), partially vaccinated (n = 222), and fully vaccinated (n = 714). Statistical analyses, including the chi-square test, Odds Ratios (OR), 95% Confidence Interval (CI), and logistic regression, were performed using SAS (Version 9.4) to determine the associations between vaccination status and health outcomes among children. Results: The study disclosed that vaccinated children showed an increased diagnosis of chronic (allergic rhinitis, allergies, autism spectrum, eczema, neuro-developmental disorders, learning disability, ADHD, and any chronic condition) and acute (whooping cough, pneumonia, rubella, hepatitis A or B, measles, mumps, meningitis, influenza, rotavirus, cancer, chronic fatigue, Crohn’s disease, inflammatory bowel disease, conduct disorder, diabetes type 1 or 2, rheumatoid arthritis, obesity, seizures, hearing loss, polio, diphtheria, tetanus, and depression) illnesses than unvaccinated children. The fully vaccinated children showed an increased prevalence of influenza diagnosis, while partially vaccinated children were more likely to be diagnosed with rheumatoid arthritis than unvaccinated children. In contrast, unvaccinated were more likely to have been diagnosed with chickenpox and encephalopathy than fully and partially vaccinated. Males with chronic and acute conditions had a lower incidence of allergies and pneumonia, respectively, whereas females had a reduced prevalence of acute illnesses, such as whooping cough, inflammatory bowel disease, and hepatitis A or B among vaccinated (n = 936;combination of partially vaccinated and fully vaccinated) children. Regarding medication use and health service applications, vaccinated children were more likely to use medications for fever, antibiotics, and allergies. In addition, they showed an increased rate of sick visits and emergency visits in the past twelve months. On the other hand, factors like age (2 - 5 years, 6 - 9 years, and 10 - 13 years), birth type (cesarian), and mother suffering during pregnancy (gestational diabetes) were significantly associated with NDD (learning disability, autism spectrum, and attention deficient hyperactivity disorder) in the adjusted analysis. In the interaction model of age and birth type, age (6 - 9 years;OR 5.3, 95% CI: 1.1, 25.3) and mother suffering (gestational diabetes;OR 2.5, 95% CI: 1.2, 5.2) during pregnancy were associated with NDD. Conclusion: The findings of this study showed that there are some cases where the infection rate is higher among the vaccinated compared to unvaccinated children, or there are no significant differences between the two groups in Kuwait. Upon controlling the factors in the interaction model, the age of 6 to 9 years and gestational diabetic mothers during pregnancy were associated with the synergistic increment of odds with NDD. These data findings are recommended to verify a larger and diverse group of samples to optimize the vaccination on health outcomes in Kuwait children.展开更多
Background: Off-pump coronary artery bypass grafting (OPCAB) is considered a safer alternative to on-pump surgery, especially in patients with left ventricular dysfunction (LVD). Objectives: This study assessed short-...Background: Off-pump coronary artery bypass grafting (OPCAB) is considered a safer alternative to on-pump surgery, especially in patients with left ventricular dysfunction (LVD). Objectives: This study assessed short-term outcomes and functional improvements in LVD patients post-OPCAB. Methods: The study included 200 coronary artery disease patients who underwent isolated off-pump coronary artery bypass grafting (OPCAB) at the National Heart Foundation Hospital and Research Institute between January 2019 and June 2020. Patients were categorized into Group 1, with a left ventricular ejection fraction (LVEF) of 30% - 39%, and Group 2, with an LVEF of 40% or higher. Echocardiographic assessments of left ventricular dimensions and ejection fraction were performed preoperatively, at discharge, and one month postoperatively. Results: In Group 1, preoperative left ventricular internal dimensions during diastole (LVIDd) and systole (LVIDs) were 53.48 ± 4.40 mm and 44.23 ± 3.93 mm, respectively, with a left ventricular ejection fraction (LVEF) of 35.28% ± 2.26%. At discharge, these values improved to 51.58 ± 4.04 mm (LVIDd), 41.23 ± 5.30 mm (LVIDs), and 39.25% ± 3.75% (LVEF). One month postoperatively, further improvements were observed: 46.29 ± 3.76 mm (LVIDd), 37.45 ± 3.68 mm (LVIDs), and 43.22% ± 4.67% (LVEF). Group 2 showed similar positive outcomes, with preoperative values of 47.09 ± 5.06 mm (LVIDd), 35.11 ± 5.25 mm (LVIDs), and 50.13% ± 7.25% (LVEF), improving to 42.37 ± 4.18 mm (LVIDd), 31.05 ± 4.19 mm (LVIDs), and 55.33% ± 7.05% (LVEF) at one month postoperatively. Both groups demonstrated significant improvements in left ventricular function and NYHA class, with most patients moving from class III/IV to I/II. Complications were minimal, and no mortality was observed. Conclusion: OPCAB is safe and effective for patients with LVEF 30% - 39% and LVEF ≥ 40%, providing significant short-term functional improvements without increased risk.展开更多
Users face the threat of trajectory privacy leakage when using location-based service applications, especially when their behavior is collected and stored for a long period of time. This accumulated information is exp...Users face the threat of trajectory privacy leakage when using location-based service applications, especially when their behavior is collected and stored for a long period of time. This accumulated information is exploited by opponents, greatly increasing the risk of trajectory privacy leakage. This attack method is called a long-term observation attack. On the premise of ensuring lower time overhead and higher cache contribution rate, the existing methods cannot utilize cache to answer subsequent queries while also resisting long-term observation attacks. So this article proposes a trajectory privacy protection method to resist long-term observation attacks. This method combines caching technology and improves the existing differential privacy mechanism, while incorporating randomization factors that are difficult for attackers to recognize after long-term observation to enhance privacy. Search for locations in the cache of both the mobile client and edge server that can replace the user’s actual location. If there are replacement users in the cache, the query results can be obtained more quickly. Simultaneously obfuscating the spatiotemporal correlation of actual trajectories by generating confusion regions. If it does not exist, the obfuscated location generation method that resists long-term observation attacks is executed to generate the real anonymous area and send it to the service provider. The above steps can comprehensively protect the user’s trajectory privacy. The experimental results show that this method can protect user trajectories from long-term observation attacks while ensuring low time overhead and a high cache contribution rate.展开更多
The results of an experimental study of long-term relaxation of the photoelectret state of polycrystalline CdTe:(Ag, Cu, Cd) and Sb<sub>2</sub>Se<sub>3</sub>:Se films with an anomalous photovol...The results of an experimental study of long-term relaxation of the photoelectret state of polycrystalline CdTe:(Ag, Cu, Cd) and Sb<sub>2</sub>Se<sub>3</sub>:Se films with an anomalous photovoltaic property are presented. In such films, the residual photovoltage is caused by the separation of photocarriers by the built-in electrostatic field of the near-surface region of space charges and their asymmetric capture by deep levels of impurities or complexes, including impurity atoms and intrinsic defects, both in the bulk and on the surface of crystal grains. It has been shown that in activated films, a two-step exponential temporary relaxation of the initial photovoltage of the order of V<sub>APV</sub> ≈ (500-600) V is detected, and only 10% of it experiences long-term relaxation (t ≈ 100-120 min).展开更多
This study is an exploratory analysis of applying natural language processing techniques such as Term Frequency-Inverse Document Frequency and Sentiment Analysis on Twitter data. The uniqueness of this work is establi...This study is an exploratory analysis of applying natural language processing techniques such as Term Frequency-Inverse Document Frequency and Sentiment Analysis on Twitter data. The uniqueness of this work is established by determining the overall sentiment of a politician’s tweets based on TF-IDF values of terms used in their published tweets. By calculating the TF-IDF value of terms from the corpus, this work displays the correlation between TF-IDF score and polarity. The results of this work show that calculating the TF-IDF score of the corpus allows for a more accurate representation of the overall polarity since terms are given a weight based on their uniqueness and relevance rather than just the frequency at which they appear in the corpus.展开更多
A digital watermarking technique is a multi-scientific discipline which is developed rapidly in last several years for digital content protection, such as copyright protection, authentication protection, source tracin...A digital watermarking technique is a multi-scientific discipline which is developed rapidly in last several years for digital content protection, such as copyright protection, authentication protection, source tracing, etc. However, in realistic scenarios, the digital watermarking system faces significant secure issues, for example, the attackers want to remove, detect, or embed illegal watermark signals. Therefore, the aim of this contribution is to illustrate recent results of robust and secure watermarking to the signal processing community, and highlight both benefits and still open issues. Specifically, this paper is intended to introduce the concept of secure and robust digital watermarking system, and provide with problems and their countermeasures. First of all, the classic watermark model and cryptosystem will be reviewed and then, the concept of secure and robust digital watermarking system will be described. Next, the watermark attack will be classified and described. Finally, some countermeasures that can help to improve secure and robustness are considered.展开更多
Mr. Wiseman believes that Western medical terms chosen as equivalents of Chinese medical terms should be the words known to all speakers and not requiring any specialist knowledge or instrumentation to understand or i...Mr. Wiseman believes that Western medical terms chosen as equivalents of Chinese medical terms should be the words known to all speakers and not requiring any specialist knowledge or instrumentation to understand or identify, and strictly technical Western medical terms should be avoided regardless of their conceptual conformity to the Chinese terms. Accordingly, many inappropriate Western medical terms are selected as English equivalents by the authors of the Dictionary, and on the other hand, many ready-made appropriate Western medical terms are replaced by loan English terms with the Chinese style of word formation. The experience gained in solving the problems of translating Western medical terms into Chinese when West- ern medicine was first introduced to China is helpful for translating Chinese medical terms into English. However, the authors of the Dictionary adhere to their own opinions, ignoring others" experience. The English terms thus created do not reflect the genuine meaning of the Chinese terms, but make the English glossary in chaos. The so-called true face of traditional Chinese revealed by such terms is merely the Chinese custom of word formation and metaphoric rhetoric. In other words, traditional Chinese medicine is not regarded as a system of medicine but merely some Oriental folklore.展开更多
AIM: To retrospectively analyze factors affecting the long-term survival of patients with pancreatic cancer who underwent pancreatic resection.METHODS: From January 2000 to December 2011,195 patients underwent pancrea...AIM: To retrospectively analyze factors affecting the long-term survival of patients with pancreatic cancer who underwent pancreatic resection.METHODS: From January 2000 to December 2011,195 patients underwent pancreatic resection in our hospital.The prognostic factors after pancreatic resection were analyzed in all 195 patients.After excluding the censored cases within an observational period,the clinicopathological characteristics of 20 patients who survived ≥ 5(n = 20) and < 5(n = 76) years were compared.For this comparison,we analyzed the patients who underwent surgery before June 2008 and were observed for more than 5 years.For statistical analyses,the log-rank test was used to compare the cumulative survival rates,and the χ2 and Mann-Whitney tests were used to compare the two groups.The CoxHazard model was used for a multivariate analysis,and P values less than 0.05 were considered significant.A multivariate analysis was conducted on the factors that were significant in the univariate analysis.RESULTS: The median survival for all patients was 27.1 months,and the 5-year actuarial survival rate was 34.5%.The median observational period was 595 d.With the univariate analysis,the UICC stage was significantly associated with survival time,and the CA19-9 ≤ 200 U/m L,DUPAN-2 ≤ 180 U/m L,t u m o r s i ze ≤ 2 0 m m,R 0 re s e c t i o n,a b s e n c e o f lymph node metastasis,absence of extrapancreatic neural invasion,and absence of portal invasion were favorable prognostic factors.The multivariate analysis showed that tumor size ≤ 20 mm(HR = 0.40; 95%CI: 0.17-0.83,P = 0.012) and negative surgical margins(R0 resection)(HR = 0.48; 95%CI: 0.30-0.77,P = 0.003) were independent favorable prognostic factors.Among the 96 patients,20 patients survived for 5 years or more,and 76 patients died within 5 years after operation.Comparison of the 20 5-year survivors with the 76 non-survivors showed that lower concentrations of DUPAN-2(79.5 vs 312.5 U/mL,P = 0.032),tumor size ≤ 20 mm(35% vs 8%,P = 0.008),R0 resection(95% vs 61%,P = 0.004),and absence of lymph nodemetastases(60% vs 18%,P = 0.036) were significantly associated with the 5-year survival.CONCLUSION: Negative surgical margins and a tumor size ≤ 20 mm were independent favorable prognostic factors.Histologically curative resection and early tumor detection are important factors in achieving long-term survival.展开更多
This is a continued study about how to understand and translate the names of diseases in the external medicine of TCM included in the WPRO Standard and the WFCMS Standard according to the discussion made in the book e...This is a continued study about how to understand and translate the names of diseases in the external medicine of TCM included in the WPRO Standard and the WFCMS Standard according to the discussion made in the book entitled International Standardization of English Translation of Traditional Chinese Medicine: Study of Theory, Summarization of Practice and Exploration of Methodst, the explanation made in A Concise Dictionary of Traditional Chinese Medicine,展开更多
External medicine, also frequently described as surgery, has a history as long as that of traditional Chinese medicine (TCM). There were important doctors in each dynasty who devoted themselves to the study and prac...External medicine, also frequently described as surgery, has a history as long as that of traditional Chinese medicine (TCM). There were important doctors in each dynasty who devoted themselves to the study and practice of external medicine. In TCM external medicine, diseases are named either according to their location (such as neck abscess and back carbuncle), or viscera involved (such as intestinal abscess and lung abscess), or causes (such as tetanus and chilblain, which are literally known respectively as wind damage of wound and sore caused by cold in TCM), or shape (such as snake head boil and goose web wind), or the color (such as erysipelas and vitiligo which are literally known respectively as red toxin and white skin wind), etc.展开更多
文摘Background: To examine the differences in prevalence of respiratory distress syndrome, early-onset sepsis and jaundice, between late preterm infants versus term infants in Ecuadorian newborns. Methods: Study design: Epidemiological, observational, and cross-sectional, with two cohorts of patients. Settings: IESS Quito Sur Hospital at Quito, Ecuador, from February to April of 2020. Participants: This study included 204 newborns, 102 preterm infants, 102 term infants. Results: There are significant differences between late preterm infants and term infants, with a p-value of 0.000 in the prevalence of early sepsis, 70.59% vs. 35.29%. In respiratory distress syndrome between late and term premature infants, significant differences were observed with a p-value of 0.000, the proportion being 55.58% vs. 24.51% respectively. The prevalence of jaundice is higher in term infants with a p value of 0.002, 72.55%, versus 51.96% in late preterm infants, and the mean value of bilirubins in mg/dL was higher in term infants 14.32 versus 12.33 in late preterm infants;this difference is statistically significant with a p value of 0.004. Admission to the NICU is more frequent in late preterm infants with a p-value of 0.000, being 42.16% for late preterm infants vs. 7.84% in term infants;the mean of the hospital days with p-value 0.005, was higher in late preterm infants 4.97 days vs. 3.55 days for term newborns. Conclusion: Due to the conditions of their immaturity, late preterm infants are 2.86 times more likely to present early sepsis than full-term newborns. It is shown that late preterm infants are 2.69 times more likely to have respiratory distress syndrome compared to term infants, therefore, late preterm infants have a longer hospital stay of 4.97 days versus 3.55 days in term infants. Jaundice and mean bilirubin levels are higher in term infants due to blood group incompatibility and insufficient breastfeeding.
文摘BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.AIM To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with DC.METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic reevaluation.The study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years post-surgery.RESULTS Thirty-seven patients completed the 10-year follow-up.At 10 years,patients treated at the PIP joint exhibited a 100%recurrence.However,patients treated at the MCP joint only showed a 50%recurrence.Patient satisfaction varied,with a lower satisfaction reported in PIP joint cases.Recurrence exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained efficacy.Significant differences were noted between outcomes at the 7-year and 10-year intervals.CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint.However,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction.Re-intervention is needed within a decade of treatment.
文摘Introduction: Pregnancy as much as childbirth constitutes a risky situation, potentially fraught with sometimes dramatic complications: maternal death. Objective: We conducted this study with the aim of establishing the profile of those giving birth in our context with the aim to anticipate operationally in the future on morbidity but more on maternal deaths. Methodology: We conducted, using a structured questionnaire, a prospective descriptive study in representative maternity wards in the city of Douala;the study variables were socio-economic, anthropometric, obstetrical and clinical. Statistical analyses were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables and the percentages. Results: We recruited 305 births for our study. The average age of our births was 28.7 years ± 6.1 with an average height of 161.6 cm ± 5.06;an average body mass index at the start of pregnancy of 28.0 kilograms/square meter and 31.3 kilograms/square meter at delivery;the average weight gain was 8.4 g ± 5.37;an average gestation of 2.84±1.90;an average parity of 2.2 ± 2.1 with an average birth interval of 27.7 months ± 23.7. The average gestational age was 39.2 weeks ± 1.21 with pregnancy pathology dominated by malaria;85.9% began their prenatal follow-up before the 14th week of amenorrhea. Conclusion: The profile of childbirth in urban Cameroon does not seem potentially dystocic compared to that of the same regional and racial area.
基金This study was approved by the ethical committee of the Medical Center(IRB No.2018-07-028).
文摘BACKGROUND Endoscopic submucosal dissection(ESD)for over 2 cm in size undifferentiated type(UD type)early gastric cancer(EGC)confined to the mucosa is not only challenging,but also long-term outcomes are not well known.AIM To evaluate the long-term outcomes of ESD done for UD type EGCs confined to the mucosa over 2 cm in size and compare the results with those where the lesions were less than 2 cm.METHODS 143 patients with UD type EGC confirmed on histology after ESD at a tertiary hospital were reviewed.Cases with synchronous and metachronous lesions and a case with emergency surgery after ESD were excluded.A total of 137 cases were enrolled.79 cases who underwent R0 resection were divided into 2 cm or less(group A)and over 2 cm(group B)in size.RESULTS Among 79 patients who underwent R0 resection,the number in group A and B were 51 and 28,respectively.The mean follow-up period(SD)was 79.71±45.42 months.There was a local recurrence in group A(1/51,2%)and group B(1/28,3.6%)respectively.This patient in group A underwent surgery while the patient in group B underwent repeated ESD with no further recurrences in both patients.There was no regional lymph node metastasis,distant metastasis,and deaths in both groups.With R0 resection strategy for ESD on lesions over 2 cm,20.4%(28/137)of patients were able to avoid surgery compared with expanded indication.CONCLUSION If R0 resection is achieved by ESD,UD type EGCs over 2 cm also showed good and similar clinical outcomes as compared to lesions less than 2 cm when followed for over 5 years.With R0 resection strategy,several patients can avoid surgery.
文摘Background: Congenital heart disease is a public health issue due to its incidence and mortality rate. The aim of this study was to investigate the long-term mortality of children with congenital heart disease admitted to the Departmental University Hospital of Borgou/Alibori (CHUD-B/A) from 2011 to 2022. Methods: This descriptive longitudinal study with analytical aims covered 11 years (April 1, 2011 to December 31, 2022). It consisted of a review of the records of children under 15 years of age with echocardiographically confirmed congenital heart disease. This was followed by an interview with the parents to assess the children’s current condition. Data were entered using Kobocollect software and analyzed using R Studio 4.2.2. software. Results: A total of 143 complete files were retained. The median age at diagnosis was 14 months (IIQ: Q1 = 4;Q3 = 60) with a range of 2 days and 175 months, and the sex-ratio (M/F) was 0.96. Left-to-right shunts were the most frequent cardiopathy group (62.9%). Only 35 children (24.5%) benefited from restorative treatment. The mortality rate was 31.5%. Median survival under the maximum bias assumption was 114 months and 216 months under the assumption of minimum bias. Survival was significantly better in children with right-to-left shunts (p = 0.0049) under the assumption of minimum bias. The death risk factors were: age at diagnosis less than 12 months (aHR = 7.58;95% CI = 3.36 - 17.24;p Conclusion: The long-term mortality of congenital heart disease is high and favoured by the absence of restorative treatment. Local correction of congenital heart disease and medical follow-up will help to reduce this mortality.
文摘Introduction: Anthropometry applied to newborns is a reliable indicator of the quality of fetal growth. The latter is influenced by genetic, racial and nutritional factors varying from one population to another, explaining why a standard cannot be applied to all populations. Research question: should the Caucasian frame of reference be dogmatically applied in our African context? Multicenter studies are therefore necessary;hence the interest of this work, the main objective of which was to describe the anthropometric profile of full-term newborns in the city of Douala. Methodology: We carried out a cross-sectional study with an analytical aim and prospective data collection in the maternity wards of the Douala General Hospital, Laquintinie Hospital, District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given consent. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using structured and pre-tested survey sheets. The study variables were obstetric and anthropometric. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The average anthropometric parameters of the full-term newborn in the city of Douala were: average weight: 3305 grams, average height: 49.8 centimeters, average head circumference: 34.6 centimeters, average upper arm circumference: 11.3 centimeters, circumference average thoracic: 32.8 centimeters. The percentile distribution showed a 10th percentile at 2656 grams and a 90th percentile at 3966 grams for weight defining the limits for small-for-gestational-age neonates and macrosomes. Conclusion: The anthropometric data of the full-term newborn in the city of Douala were: an average weight of 3305.4 grams, an average height of 49.8 centimeters, an average head circumference of 34.2 centimeters, an average upper arm circumference of 11.3 centimeters, and an average thoracic circumference of 32.8 centimeters with higher valuesin male newborns.
文摘Background: To prevent infectious diseases and deaths of children, vaccinations play a crucial role in public health strategies in Kuwait. However, it remained uncertain to demonstrate the potential long-term health outcomes of vaccination, including neurodevelopmental disorders (NDD) and autism. This study aimed to evaluate the long-term health outcomes of vaccination among Kuwait children from birth to thirteen years old. Objectives: This study included the significant objectives: (1) to compare long-term health effects, including chronic and acute conditions for unvaccinated, partially vaccinated, and vaccinated children, and (2) to evaluate the association of vaccination with the neurodevelopmental disorders (NDD) and autism, and the preventable illnesses. Methods: This prospective study involved a sample of 976 children from Kuwait based on mothers’ reporting. Data collection about the vaccination status of children and various health outcomes relevant to chronic and acute illnesses was performed based on structured questionnaires through an online survey. However, participants were classified into unvaccinated (n = 40), partially vaccinated (n = 222), and fully vaccinated (n = 714). Statistical analyses, including the chi-square test, Odds Ratios (OR), 95% Confidence Interval (CI), and logistic regression, were performed using SAS (Version 9.4) to determine the associations between vaccination status and health outcomes among children. Results: The study disclosed that vaccinated children showed an increased diagnosis of chronic (allergic rhinitis, allergies, autism spectrum, eczema, neuro-developmental disorders, learning disability, ADHD, and any chronic condition) and acute (whooping cough, pneumonia, rubella, hepatitis A or B, measles, mumps, meningitis, influenza, rotavirus, cancer, chronic fatigue, Crohn’s disease, inflammatory bowel disease, conduct disorder, diabetes type 1 or 2, rheumatoid arthritis, obesity, seizures, hearing loss, polio, diphtheria, tetanus, and depression) illnesses than unvaccinated children. The fully vaccinated children showed an increased prevalence of influenza diagnosis, while partially vaccinated children were more likely to be diagnosed with rheumatoid arthritis than unvaccinated children. In contrast, unvaccinated were more likely to have been diagnosed with chickenpox and encephalopathy than fully and partially vaccinated. Males with chronic and acute conditions had a lower incidence of allergies and pneumonia, respectively, whereas females had a reduced prevalence of acute illnesses, such as whooping cough, inflammatory bowel disease, and hepatitis A or B among vaccinated (n = 936;combination of partially vaccinated and fully vaccinated) children. Regarding medication use and health service applications, vaccinated children were more likely to use medications for fever, antibiotics, and allergies. In addition, they showed an increased rate of sick visits and emergency visits in the past twelve months. On the other hand, factors like age (2 - 5 years, 6 - 9 years, and 10 - 13 years), birth type (cesarian), and mother suffering during pregnancy (gestational diabetes) were significantly associated with NDD (learning disability, autism spectrum, and attention deficient hyperactivity disorder) in the adjusted analysis. In the interaction model of age and birth type, age (6 - 9 years;OR 5.3, 95% CI: 1.1, 25.3) and mother suffering (gestational diabetes;OR 2.5, 95% CI: 1.2, 5.2) during pregnancy were associated with NDD. Conclusion: The findings of this study showed that there are some cases where the infection rate is higher among the vaccinated compared to unvaccinated children, or there are no significant differences between the two groups in Kuwait. Upon controlling the factors in the interaction model, the age of 6 to 9 years and gestational diabetic mothers during pregnancy were associated with the synergistic increment of odds with NDD. These data findings are recommended to verify a larger and diverse group of samples to optimize the vaccination on health outcomes in Kuwait children.
文摘Background: Off-pump coronary artery bypass grafting (OPCAB) is considered a safer alternative to on-pump surgery, especially in patients with left ventricular dysfunction (LVD). Objectives: This study assessed short-term outcomes and functional improvements in LVD patients post-OPCAB. Methods: The study included 200 coronary artery disease patients who underwent isolated off-pump coronary artery bypass grafting (OPCAB) at the National Heart Foundation Hospital and Research Institute between January 2019 and June 2020. Patients were categorized into Group 1, with a left ventricular ejection fraction (LVEF) of 30% - 39%, and Group 2, with an LVEF of 40% or higher. Echocardiographic assessments of left ventricular dimensions and ejection fraction were performed preoperatively, at discharge, and one month postoperatively. Results: In Group 1, preoperative left ventricular internal dimensions during diastole (LVIDd) and systole (LVIDs) were 53.48 ± 4.40 mm and 44.23 ± 3.93 mm, respectively, with a left ventricular ejection fraction (LVEF) of 35.28% ± 2.26%. At discharge, these values improved to 51.58 ± 4.04 mm (LVIDd), 41.23 ± 5.30 mm (LVIDs), and 39.25% ± 3.75% (LVEF). One month postoperatively, further improvements were observed: 46.29 ± 3.76 mm (LVIDd), 37.45 ± 3.68 mm (LVIDs), and 43.22% ± 4.67% (LVEF). Group 2 showed similar positive outcomes, with preoperative values of 47.09 ± 5.06 mm (LVIDd), 35.11 ± 5.25 mm (LVIDs), and 50.13% ± 7.25% (LVEF), improving to 42.37 ± 4.18 mm (LVIDd), 31.05 ± 4.19 mm (LVIDs), and 55.33% ± 7.05% (LVEF) at one month postoperatively. Both groups demonstrated significant improvements in left ventricular function and NYHA class, with most patients moving from class III/IV to I/II. Complications were minimal, and no mortality was observed. Conclusion: OPCAB is safe and effective for patients with LVEF 30% - 39% and LVEF ≥ 40%, providing significant short-term functional improvements without increased risk.
文摘Users face the threat of trajectory privacy leakage when using location-based service applications, especially when their behavior is collected and stored for a long period of time. This accumulated information is exploited by opponents, greatly increasing the risk of trajectory privacy leakage. This attack method is called a long-term observation attack. On the premise of ensuring lower time overhead and higher cache contribution rate, the existing methods cannot utilize cache to answer subsequent queries while also resisting long-term observation attacks. So this article proposes a trajectory privacy protection method to resist long-term observation attacks. This method combines caching technology and improves the existing differential privacy mechanism, while incorporating randomization factors that are difficult for attackers to recognize after long-term observation to enhance privacy. Search for locations in the cache of both the mobile client and edge server that can replace the user’s actual location. If there are replacement users in the cache, the query results can be obtained more quickly. Simultaneously obfuscating the spatiotemporal correlation of actual trajectories by generating confusion regions. If it does not exist, the obfuscated location generation method that resists long-term observation attacks is executed to generate the real anonymous area and send it to the service provider. The above steps can comprehensively protect the user’s trajectory privacy. The experimental results show that this method can protect user trajectories from long-term observation attacks while ensuring low time overhead and a high cache contribution rate.
文摘The results of an experimental study of long-term relaxation of the photoelectret state of polycrystalline CdTe:(Ag, Cu, Cd) and Sb<sub>2</sub>Se<sub>3</sub>:Se films with an anomalous photovoltaic property are presented. In such films, the residual photovoltage is caused by the separation of photocarriers by the built-in electrostatic field of the near-surface region of space charges and their asymmetric capture by deep levels of impurities or complexes, including impurity atoms and intrinsic defects, both in the bulk and on the surface of crystal grains. It has been shown that in activated films, a two-step exponential temporary relaxation of the initial photovoltage of the order of V<sub>APV</sub> ≈ (500-600) V is detected, and only 10% of it experiences long-term relaxation (t ≈ 100-120 min).
文摘This study is an exploratory analysis of applying natural language processing techniques such as Term Frequency-Inverse Document Frequency and Sentiment Analysis on Twitter data. The uniqueness of this work is established by determining the overall sentiment of a politician’s tweets based on TF-IDF values of terms used in their published tweets. By calculating the TF-IDF value of terms from the corpus, this work displays the correlation between TF-IDF score and polarity. The results of this work show that calculating the TF-IDF score of the corpus allows for a more accurate representation of the overall polarity since terms are given a weight based on their uniqueness and relevance rather than just the frequency at which they appear in the corpus.
基金supported by the Jiangnan University of Science&Technology Young Scholar under Grant No.JUSRP11462
文摘A digital watermarking technique is a multi-scientific discipline which is developed rapidly in last several years for digital content protection, such as copyright protection, authentication protection, source tracing, etc. However, in realistic scenarios, the digital watermarking system faces significant secure issues, for example, the attackers want to remove, detect, or embed illegal watermark signals. Therefore, the aim of this contribution is to illustrate recent results of robust and secure watermarking to the signal processing community, and highlight both benefits and still open issues. Specifically, this paper is intended to introduce the concept of secure and robust digital watermarking system, and provide with problems and their countermeasures. First of all, the classic watermark model and cryptosystem will be reviewed and then, the concept of secure and robust digital watermarking system will be described. Next, the watermark attack will be classified and described. Finally, some countermeasures that can help to improve secure and robustness are considered.
文摘Mr. Wiseman believes that Western medical terms chosen as equivalents of Chinese medical terms should be the words known to all speakers and not requiring any specialist knowledge or instrumentation to understand or identify, and strictly technical Western medical terms should be avoided regardless of their conceptual conformity to the Chinese terms. Accordingly, many inappropriate Western medical terms are selected as English equivalents by the authors of the Dictionary, and on the other hand, many ready-made appropriate Western medical terms are replaced by loan English terms with the Chinese style of word formation. The experience gained in solving the problems of translating Western medical terms into Chinese when West- ern medicine was first introduced to China is helpful for translating Chinese medical terms into English. However, the authors of the Dictionary adhere to their own opinions, ignoring others" experience. The English terms thus created do not reflect the genuine meaning of the Chinese terms, but make the English glossary in chaos. The so-called true face of traditional Chinese revealed by such terms is merely the Chinese custom of word formation and metaphoric rhetoric. In other words, traditional Chinese medicine is not regarded as a system of medicine but merely some Oriental folklore.
文摘AIM: To retrospectively analyze factors affecting the long-term survival of patients with pancreatic cancer who underwent pancreatic resection.METHODS: From January 2000 to December 2011,195 patients underwent pancreatic resection in our hospital.The prognostic factors after pancreatic resection were analyzed in all 195 patients.After excluding the censored cases within an observational period,the clinicopathological characteristics of 20 patients who survived ≥ 5(n = 20) and < 5(n = 76) years were compared.For this comparison,we analyzed the patients who underwent surgery before June 2008 and were observed for more than 5 years.For statistical analyses,the log-rank test was used to compare the cumulative survival rates,and the χ2 and Mann-Whitney tests were used to compare the two groups.The CoxHazard model was used for a multivariate analysis,and P values less than 0.05 were considered significant.A multivariate analysis was conducted on the factors that were significant in the univariate analysis.RESULTS: The median survival for all patients was 27.1 months,and the 5-year actuarial survival rate was 34.5%.The median observational period was 595 d.With the univariate analysis,the UICC stage was significantly associated with survival time,and the CA19-9 ≤ 200 U/m L,DUPAN-2 ≤ 180 U/m L,t u m o r s i ze ≤ 2 0 m m,R 0 re s e c t i o n,a b s e n c e o f lymph node metastasis,absence of extrapancreatic neural invasion,and absence of portal invasion were favorable prognostic factors.The multivariate analysis showed that tumor size ≤ 20 mm(HR = 0.40; 95%CI: 0.17-0.83,P = 0.012) and negative surgical margins(R0 resection)(HR = 0.48; 95%CI: 0.30-0.77,P = 0.003) were independent favorable prognostic factors.Among the 96 patients,20 patients survived for 5 years or more,and 76 patients died within 5 years after operation.Comparison of the 20 5-year survivors with the 76 non-survivors showed that lower concentrations of DUPAN-2(79.5 vs 312.5 U/mL,P = 0.032),tumor size ≤ 20 mm(35% vs 8%,P = 0.008),R0 resection(95% vs 61%,P = 0.004),and absence of lymph nodemetastases(60% vs 18%,P = 0.036) were significantly associated with the 5-year survival.CONCLUSION: Negative surgical margins and a tumor size ≤ 20 mm were independent favorable prognostic factors.Histologically curative resection and early tumor detection are important factors in achieving long-term survival.
文摘This is a continued study about how to understand and translate the names of diseases in the external medicine of TCM included in the WPRO Standard and the WFCMS Standard according to the discussion made in the book entitled International Standardization of English Translation of Traditional Chinese Medicine: Study of Theory, Summarization of Practice and Exploration of Methodst, the explanation made in A Concise Dictionary of Traditional Chinese Medicine,
文摘External medicine, also frequently described as surgery, has a history as long as that of traditional Chinese medicine (TCM). There were important doctors in each dynasty who devoted themselves to the study and practice of external medicine. In TCM external medicine, diseases are named either according to their location (such as neck abscess and back carbuncle), or viscera involved (such as intestinal abscess and lung abscess), or causes (such as tetanus and chilblain, which are literally known respectively as wind damage of wound and sore caused by cold in TCM), or shape (such as snake head boil and goose web wind), or the color (such as erysipelas and vitiligo which are literally known respectively as red toxin and white skin wind), etc.