Prevalence and Predictors of Hemodialysis Inadequacy among Patients on Maintenance Hemodialysis in Mwanza, Tanzania

Introduction: The burden of chronic kidney disease (CKD) is rapidly increasing in Tanzania. There is a rapid expansion of hemodialysis (HD) services to meet this demand. The quality of HD services, which is usually termed HD inadequacy, is under-reported. Therefore, the objective of this study was to determine the prevalence of HD inadequacy using two equations, urea reduction ratio (URR) and Kt/V and its associated factors. The correlation between URR and Kt/V for the diagnosis of HD inadequacy is also determined. Materials and Methods: This was a prospective longitudinal study conducted from March to July 2021 in 98 patients with CKD who underwent maintenance HD at Bugando Medical Centre in Mwanza, Tanzania. Demographic, laboratory, and clinical information was collected and analyzed. The HD inadequacy was estimated by using both the URR and the Kt/V equations. The correlation between the two equations was analyzed by using Cohen’s kappa. Results: The majority (69.4%) of the study participants were male and the mean age was 59 (48 - 68) years. The median hemoglobin level was 10 (8.9 - 11.2) g/dl, and the pre-dialytic urea was 15 (10.6 - 21.3) mmol/L. The prevalence of HD inadequacy was 36 (36.7%). The predictors of HD inadequacy were older age (>50 years) (OR = 3.6, 95 % CI 1.0 - 12.6, p = 0.04), moderate or severe anemia (OR = 4.7, 95 % CI 1.5 - 14.4, p = 0.006) and short duration of HD (OR = 3.1, 95 % CI 1.0 - 9.1, p = 0.04). There was a strong agreement between URR and Kt/V in the diagnosis of HD inadequacy (Kappa = 0.887). Conclusion and Recommendations: HD inadequacy is common, and most predictors can be prevented. Clinicians should use a personalized approach in making sure that anemia is appropriately treated and HD prescription is adhered to for better clinical outcomes among patients with HD.

社会养老保险遗属抚恤法治的反思与重塑

为解决私法制度在面对扶养义务人死亡风险时的失灵问题,现代社会养老保险制度自诞生伊始就涵盖了遗属抚恤。我国劳动保险也早在20世纪50年代就为非因工死亡参保人员遗属设立了抚恤制度。然而,这种劳动保险遗属抚恤制度已难以适应新时代的要求。我们亟须探索建立一套新型社会养老保险遗属抚恤制度,以充分发挥互助共济功能,实现死亡风险的社会化治理。其主要特点包括:制度模式上统一于由社会养老保险基金负责提供资金;遗属范围上与民法扶养义务人的范围保持一致;抚恤金申请上以遗属有抚恤必要为前提;死亡事由上具有无条件性;待遇标准上实现对民法扶养费的替代。

论黄哲伦戏剧对东方主义解构的不彻底性——以《蝴蝶君》和《中式英语》为个案

著名文学理论家与批评家萨义德于1979年出版的《东方主义》一书中提出的“东方主义”理论为研究和解读后殖民时期的文学作品提供了全新视阈。拟以该理论为基础,以美籍华裔作家黄哲伦的两部戏剧代表作《蝴蝶君》和《中式英语》为个案,分析其对东方主义解构的不彻底性,并进一步从作者身份的特殊性探究这种不彻底解构的可能原因。

Effects of dosimetric inadequacy on local control and toxicities in the patients with T4 nasopharyngeal carcinoma extending into the intracranial space and treated with intensity.modulated radiotherapy plus chemotherapy

Background:To protect neurological tissues,underdosing occurs in most cases of T4 nasopharyngeal carcinoma(NPC) with intracranial extension.In this study,we aimed to evaluate the effect of dosimetric inadequacy on local control and late neurological toxicities for patients treated with intensity-modulated radiotherapy(IMRT) plus chemotherapy.Methods:We prospectively enrolled patients who had non-metastaticT4 NPC with intracranial extension treated between January 2009 and November 2013.The prescribed dose was 66.0-70.4 Gy to the primary planning target volume(primary gross tumor volume [GTVp;i.e.,the nasopharyngeal tumor] +5.0 mm).Dose-volume histogram parameters were calculated,including minimum point dose(D_(min)) and dose to 95% of the target volume(D95).All patients received chemotherapy with the cisplatin,5-fluorouracil,and docetaxel regimen.Survivals were estimated using the Kaplan-Meier method and compared using the log-rank test.Results:In total,41 patients were enrolled.The local partial response rate was 87.8% after induction chemotherapy.With a median follow-up of 51 months,7 patients experienced failure in the nasopharynx;the 3-year local failure-free survival and overall survival rates of the 41 patients were 87.4% and 90.2%,respectively.The actual mean D_(min) to the GTVp was 55.2 Gy(range 48.3-67.3 Gy),and D95 was 61.6 Gy(range 52.6-69.0 Gy).All doses received by neurological organs remained well within their dose constraints.No patients developed temporal lobe necrosis or other neurological dysfunctions.Conclusions:With relative underdosed IMRT plus effective chemotherapy,the patients achieved satisfactory local control with few late toxicities of the central nervous system.Determining the acceptable extent of dosimetric inadequacy requires further exploration.

Examining Social Media and Technology Attitudes in Older-Aged and Middle-Aged Adults: Relationship With Cognitive Flexibility and Sense of Inadequacy

The main purpose of this study is to reveal the relationship between the perceived cognitive flexibility and sense of inadequacy of older adults and middle adults with their attitudes towards social media use and technology.Of the participants,210(68.2%)were female and 98(31.8%)were male.The sample consisted of 49.4%of middle adults aged between 50-59 years,and a total of 308 adults,50.6%of whom were older adults aged 60 and over.“Personal Information Form”,“Sense of Inadequacy Scale”,“Cognitive Flexibility Scale”,and“Media and Technology Use and Attitudes Scale”were used to collect data in the research.According to the findings of the study,older-and middle-aged adults differed in their sense of inadequacy and cognitive flexibility capacity.A significant difference was found between social media use and technology attitudes of older and middle adults.The findings were discussed within the framework of the relevant literature.

Literature Review on the Translator's Subjectivity

Translator’s subjectivity plays an important role in the whole translation process.With"the cultural turn"in translation studies in 1970s,scholars became concerned about the study of the translator’s subjectivity.Especially,in recent years,the research of the translator’s subjectivity has been one of hot areas in the circle of the domestic translation theories.This study is about to make an overview of the translator’s subjectivity,aiming at offering some guidance for further study of the translator’s subjectivity.

Rethinking the Translator's Voice

This paper presents an effort to clarify the conceptual confusion of the translator's voice.Drawing on the the theoretical integration of narrative theories and translation studies.It begins with a sketch of the conceptual development of the translator's voice. The major finding of the paper is that the significance of the translator's voice has long been interpreted in a one-sided way,tracing the translator's voice is not only a way of perceiving the translator's subjectivity,but also a perspective from which the implication of the interrelations between the translator's use of language and the translator's subject positions for the target- reader may be better observed and understood.

On C-E Translation of Network Hot Words from the Perspective of Translator's Subjectivity

As a special kind of vocabularies originated from the network language,the network hot words are the manifcstation of the diversification of thec nctwork cra as well as of people's social consciousncss,To improve the translation quality of Chinese network hot words is not only conducive to promoting the Chinese network culure,but also an important way for foreigner to better understand China.This paper starts from the cases of network hot words translation,making the specific analysis of those words and the relationship among the translator,original writer and target readers.It also analyzes the factors that limit the translator's subjectivity and the translation skills of the network hot words,aiming at further clarifying the translator's subjectivity in the translation of network hot words.Through this research,this paper expectes to have a positive impact on the translation of Chinese network hot words and the promotion of Chinese culture.

Prevalence of Inadequacy Intake for Older People:The Use of National Cancer Institute (NCI) Method

A purpose of dietary assessment is to evaluate the dietary intake of a group or a population. In Brazil few studies have been carried out to identify dietary intake of older people population. Then, the aim of this work is to estimate the distribution as well as estimate the prevalence of inadequacy of the usual intake in a representative sample of older population from Botucatu city, S?o Paulo, applying the NCI method. A sample of 365 older was used and some instruments to evaluate quality of life, activities of daily living and instrumental of daily living were applied as well as three 24-hour recalls. Data from the recalls were transformed in consumption of macro and micronutrients using NDSR software and were analyzed using NCI method in order to estimate the inadequacy prevalence. The energy and macronutrients intake of the studied population agree with their needs, however, the consumption of minerals and vitamins were below the recommendation even after including the covariates. This can reflects a monotone intake that is characteristic of this age and this inadequateness can be a serious public health problem that can carry on development of chronic diseases. Also, it is important to highlight that NCI method provides a good estimate of the usual intake.

英国1964年《产业培训法》的实施对我国开展学徒制的启示

英国1964年《产业培训法》在组织推动、法律实施、征发培训附加费等方面开启了职业教育及学徒培训的支持,明确了学徒的选拔标准,对学徒进行了分类,界定了学徒制课程类型、课程内容和课程考核方法,切实提升了职业教育及学徒培训的培训质量。但重产业培训轻技术教育、未能改革学徒制及制定产业培训标准、直接退款操作困难和中小企业难以享受培训补助待遇等也是其不足之处。英国1964年《产业培训法》的成效与不足揭示我国开展学徒制时,要促进企业新型学徒制与现代学徒制的衔接和统一、加快职业教育与技术技能培训的全面融合、打造职业教育与技术技能培训融合型育人体系、加大财政对学徒制人才培养的经费支持力度。

基于对线装书《通志略》的民间修复实践研究

本文以民间流通的古籍《通志略》修复为研究个例,介绍了《通志略》的版本情况、破损状况,着重分析了修复用纸的选用、多种修补技法的应用,“整旧如旧”修复原则的运用情况,总结和反思修复实践中存在的不足,同时提出一点自己的愚见,希望能引起相关工作者的重视,使民间流通的古籍修复技艺得到进一步的完善和提高。

全媒体视阈下我国档案宣传工作的思考

我国的档案宣传工作应该紧跟全媒体发展的步伐寻求更大的进步。本文分析利用全媒体促进档案宣传工作发展的可行性,阐述全媒体在我国档案宣传工作中的重要作用及应该遵循的具体原则,指出全媒体视阈下档案宣传工作的不足及开展档案宣传工作的路径和方法,以期我国档案部门能够利用全媒体发展的优势,科学规范地促进档案宣传事业的发展。

我国民政事业发展不平衡不充分问题研究

“十四五”时期,我国民政事业的不平衡不充分发展问题依然严峻。民政事业作为社会治理体系的重要组成部分,在区域投入、城乡发展、供给结构、代际保障方面表现不平衡,在有效供给保障、思想观念解放、社会力量参与、产业潜力释放方面表现不充分。经济发展水平、政策法治环境、人口构成变动和城乡二元结构是这些问题的主要影响因素。健全法治环境,做好民政平衡充分发展的分阶段工作规划,继续推动区域协调发展战略和城乡融合发展,鼓励多主体民政工作改革创新,建立复合型社会工作人才培养培训机制,灵活运用信息化技术,是促进中国民政事业平衡充分发展的有效措施。

补齐短板:基于云技术的脱贫村数字乡村建设聚焦

巩固脱贫成果与乡村振兴有效衔接,脱贫村数字乡村建设起着至关紧要的作用。卫星-地面主站-互联网-用户终端组成的云技术系统是数字乡村建设的信息网络技术核心,揭示云技术与数字乡村建设联系的规律性,探索IaaS、SaaS、PaaS等服务模式在脱贫村数字乡村建设中的共享与复用;瞄准脱贫村数字乡村建设居住分散、投资大难题破解;补齐脱贫村脱贫村数字乡村建设网络技术、两大平台、数据处理等云技术短板和终端客户、App开发、5大领域、21着力点等应用短板;构建以互联网平台为载体,以物联网、云技术、大数据等新兴技术为手段,以网络、服务器、存储器、服务终端为数字资源基础的数字乡村模式。助推脱贫村“经济-生态-文化-治理-惠民”一体化数字体系建成,助力其巩固脱贫成果,乡村全面振兴,夯实脱贫村与全国同步发展的数字基础。

孤独、抑郁情绪及其相互关系探讨

目的 :探讨孤独感及其产生基础 ,了解孤独与抑郁情绪的关系。方法 :采用状态与特质性孤独量表和自评抑郁量表 (SDS)对 113名大学生进行了评定。结果 :在状态与特质性孤独量表的因子分析中各提取出三个因子 ,即情感孤独因子、社交孤独因子及孤独程度因子。其中 ,社交状态孤独因子与社交特质孤独因子得分均为男性高于女性 (P <0 0 5 )。相关分析显示 ,状态孤独量表总分与特质孤独量表总分之间呈正相关 (r =0 73 ,P <0 0 0 1) ;状态和特质孤独量表总分均与社交孤独因子的关系较密切 (r =0 82 ,r =0 80 ,P <0 0 0 1)。抑郁量表得分主要与孤独量表中的情感因子呈正相关 ,而与其它因子的关系不明确。结论 :孤独感的产生与孤独素质有关 ,社交缺陷是产生孤独感的重要因素之一 ,孤独与抑郁情绪的关系可受多种因素影响。

DRASTIC模型的缺陷与改进方法探讨

从模型原理、模型计算方法、评价结果三个方面系统地总结了DRASTIC模型的缺陷,并指出国内在地下水防污性能评价上的误区,提出模型的改进方法,在此基础上提出了基于DRASTIC模型的模糊综合评价模型,并应用于九江市的地下水防污性能评价工作,取得了较好的效果。

红细胞生成素治疗前后肾性贫血患儿网织红细胞参数变化情况及临床意义

目的探讨红细胞生成素(EPO)治疗前后肾性贫血患儿网织红细胞参数变化情况及临床意义。方法采用Beckm an cou lter LH 750全自动血液分析仪及Beckm an LX20全自动生化分析仪,检测EPO治疗前65例慢性肾功能不全不同病期患儿和65名正常对照的红细胞(RBC)计数、血红蛋白(Hb)含量、网织红细胞百分比(Ret%)、网织红细胞不成熟度(IRF)和平均网织红细胞体积(MRV),同时检测其血清肌酐(Cr)和尿素氮(BUN)含量,并进行比较分析;比较EPO治疗前、后肾性贫血患儿Ret%、RBC、Hb、IRF、MRV等参数的变化。结果EPO治疗前,氮质血症组和肾功能衰竭组的Ret%较对照组均有升高,但IRF值基本正常或略低;经过EPO治疗后肾功能不全患儿的贫血状态明显得到改善,IRF值和MRV值明显升高,IRF值升高的程度比Ret%更加明显。结论Ret参数尤其是IRF值的检测,有助于了解肾性贫血患儿的骨髓增生程度和红系的生长情况。

缺陷感量表的信效度检验

目的:检验缺陷感量表(TheFeelingsofInadequacyScale,FIS)信度、效度是否符合心理测量学要求。方法:分层整群抽取河南新乡三所高校512名在校大学生,另取26例抑郁症住院患者,采用缺陷感量表、自尊量表(SES)进行测量。结果:缺陷感量表总量表及各个分量表的Cronbachs’α系数分别在0.92和0.73～0.87之间;重测信度分别为0.86和0.74￣0.94之间;条目间平均相关系数在0.25和0.29～0.41之间;总分与各因子的相关系数在0.67～0.87之间;各因子间的相关系数在0.38～0.57之间;各条目对因子负荷系数在0.34～0.84之间;验证性因子分析的指标:GFI为0.844,AGFI为0.822,IFI为0.845,CFI为0.844,"2/df为2.701,REME为0.058。与自尊量表(SES)相关系数r=0.639(P<0.01),大学生被试与抑郁症患者在分量表及总量表的平均得分间的差异非常显著(P<0.01)。结论:缺陷感量表(FIS)具有良好信度和效度,达到了心理测量学的要求。

北京城区老年妇女维生素D营养状况

目的 了解北京城区老年妇女维生素D营养状况.方法 随机选取北京市3个城区17个社区中60岁以上的老年妇女399人,在2008年5轮？旬至7月初采集清晨空腹静脉血分离血清,采用美国DiaSorin公司生产的放射免疫试剂盒测定血25-羟维生素D（25（OH）D）的浓度.结果 在春末夏初,北京市城区老年妇女血清25（OH）D平均水平为（14.4±5.7）ng/ml,维生素D缺乏率（25（OH）D〈10 ng/ml）为21.8%,维生素D不足率（10 ng/ml≤25（OH）D〈20 ng/ml）为62.4%;从5月到7月,研究对象血清25（OH）D水平逐渐升高.而随着年龄的增大,血清25（OH）D水平有下降的趋势.结论 北京市城区老年妇女维生素D不足的现象比较普遍.

65例腭裂术后MVPI患者构音特点及治疗策略探讨

目的：探讨边缘性腭咽闭合不全（marginal or borderline velopharyngeal inadequacy,MVPI）的诊断,MVPI患者构音障碍的特点、语言治疗策略等.方法：对2010-05 ～2012-06我院语言治疗门诊接诊的65例腭裂术后MVPI患者的语音评估和语言治疗的回顾性分析,通过主观判听和鼻咽纤维镜检查两方面的腭咽功能评估,诊断MVPI,对语音评估的结果进行音韵历程分析；回顾接受语言治疗的治疗策略及周期；并分析构音特点对不同治疗状态（语言治疗和手术）的影响.结果：MVPI患者构音错误以声母省略和后置构音为多见,声母省略主要见于不送气音.声母省略的治疗重点为选择有效的目标音诱发策略（facilitative techniques）,后置构音的治疗重点为前移构音位置,改善整体构音规则.MVPI患者类化到短语水平的平均语言治疗周期为10次.接受进一步手术治疗的患者均存在长句的低压力构音问题.结论：声母省略对语言清晰度的影响大,是MVPI患者语言治疗的重点.长句中的低压力构音问题是进行手术决策的指征之一.