Many advances have been made in the understanding of Crohn’s disease (CD) pathogenesis during the last decade. CD is currently seen as a predominantly T-lym-phocyte-driven disease characterized by the presence of a c...Many advances have been made in the understanding of Crohn’s disease (CD) pathogenesis during the last decade. CD is currently seen as a predominantly T-lym-phocyte-driven disease characterized by the presence of a complex cocktail of interacting cytokines, chemokines and other mediators produced by a variety of cell types. Prevailing theories of CD pathogenesis suggest that patients’ T-lymphocytes are inappropriately activated in the setting of an immune imbalance, which is itself caused by an unfortunate confluence of genetic and en- vironmental factors. The T-cell response then leads to the chronic inflammation characteristic for the disease. Various environmental factors may play a role in the development of CD, but microbes are most consistently implied. This theory is based on epidemiological, clinico- pathological, genetic and experimental evidence. Despite the abundance of arguments for the implication of bac-teria in the aetiopathogenesis of CD, the precise role of bacteria in this disease still remains elusive. Three not necessarily mutually exclusive theories have been pro- posed: (1) an unidentified persistent pathogen; (2) an abnormally permeable mucosal barrier leading to exces-sive bacterial translocation; and (3) a breakdown in the balance between putative "protective" versus "harmful" intestinal bacteria ("dysbiosis"). At present, one cannot exclude with certainty any of these three proposed hy-potheses; they may all apply to CD to a certain extent.展开更多
According to the European Association of Urology (EAU) guidelines, a life expectancy of〉 10 years is considered an important factor in the treatment of prostate cancer. The Charlson score is used to predict mortali...According to the European Association of Urology (EAU) guidelines, a life expectancy of〉 10 years is considered an important factor in the treatment of prostate cancer. The Charlson score is used to predict mortality based on comorbidities. The purpose of this study was to investigate the relationship between age, Charlson score and outcome in patients with cT3a prostate cancer. Between 1987 and 2004, 200 patients, who were with clinical T3a prostate cancer and who underwent radical prostatectomy (RP), were previously detected by digital rectal examination (DRE). Patients were categorized into two age groups (〈 65 and≥65 years old). Patients were also divided into two groups according to Charlson score ( = 0 and ≥ 1). Both age and Charlson score were analyzed regarding their predictive power of patients' outcomes. The mean follow-up period was 70.6 months, and the mean age of patients was 63.3 years. In all, 106 patients were 〈 65 years old and 94 patients were ≥65 years old. Age was a significant predictor of overall survival (OS). A Charlson score of 0 was found in 110 patients, and of ≥ 1 in 90 patients. Charlson score was not a significant predictor of biochemical progression-free survival (BPFS), clinical progression-free survival (CPFS) or OS. Cox multivariate analysis showed that margin status was a significant independent factor in BPFS, and cancer volume was a significant independent factor in CPFS. Charlson score does not influence the outcome in patients with clinical locally advanced prostate cancer. Age may influence OS. RP can be performed in motivated healthy older patients. However, the patients need to be counseled regarding possible surgery-related side effects, such as urinary incontinence and erectile dysfunction, which are age- and comorbidity-dependent.展开更多
AIM: To study the degree of stigmatization among trainee psychiatrists, individual characteristics potentially leading to higher associative stigma, and coping mechanisms.METHODS: Two hundred and seven trainee psychia...AIM: To study the degree of stigmatization among trainee psychiatrists, individual characteristics potentially leading to higher associative stigma, and coping mechanisms.METHODS: Two hundred and seven trainee psychiatrists in Flanders(Belgium), all member of the Flemish Association of Trainee Psychiatrists, were approached to participate in the survey. A non-demanding questionnaire that was specifically designed for the purpose of the study was sent by mail. The questionnaire consisted of three parts, each emphasizing a different aspect of associative stigma: devaluing and humiliating interactions, the focus on stigma during medical train-ing, and identification with negative stereotypes in the media. Answers were scored on a Likert scale ranging from 0 to 3. The results were analyzed using SPSS Version 18.0. RESULTS: The response rate of the study was 75.1%. The internal consistency of the questionnaire was good, with a Cronbach's α of 0.71. Seventy-five percent of all trainee psychiatrists confirmed hearing denigrating or humiliating remarks about the psychiatric profession more than once. Additionally, more than half of them had had remarks about the incompetence of psychiatrists directed at them. Only 1.3% remembered having stigma as a topic during their psychiatric training. Trainees who had been in training for a longer period of time had experienced a significantly higher level of stigmatization than trainees with fewer years of experience(mean total stigma scores of 16.93 ± SD 7.8 vs 14.45 ± SD 6.1, t =-2.179 and P < 0.05). In addition, senior trainees effectively kept quiet about their profession significantly more often than their junior colleagues(mean item score 0.44 ± SD 0.82 vs 0.13 ± SD 0.48, t = 2.874, P < 0.01). Comparable results were found in trainees working in adult psychiatry as were found in those working in child or youth psychiatry(mean item score 0.38 ± SD 0.77 vs 0.15 ± SD 0.53, t =-2.153, P < 0.05). Biologically oriented trainees were more inclined to give preventive explanations about their profession, which can be seen as a coping mechanism used to deal with this stigma(mean item score 2.05 ± SD 1.05 vs 1.34 ± SD 1.1, t =-3.403, P < 0.01).CONCLUSION: Associative stigma in trainee psychiatrists is underestimated. More attention should be paid to this potentially harmful phenomenon in training.展开更多
Despite many attempts to evaluate the effectiveness of case management for frail older people, systematic reviews including experimental designs show inconsistent results. Starting from the view that case management i...Despite many attempts to evaluate the effectiveness of case management for frail older people, systematic reviews including experimental designs show inconsistent results. Starting from the view that case management is a complex intervention occurring in multilayered realities, we conducted a realist evaluation of case management in Belgium, where this type of intervention is new. Realist approaches are particularly well suited to evaluate complex interventions as they seek to investigate iteratively the literature and empirical data to uncover mid-range theories underpinning the intervention under study. As such, realist evaluations are works in progress which provide tools to describe how, why and for whom an intervention is supposed to work. In this paper, we describe two mid-range theories that can explain why case management can help frail older people to remain at home, through the lens of capacity and social support.展开更多
The optimization investment policy decision of SCM-Supply Chain Management-implementation has been analysed under symmetric and asymmetric information conditions. For both conditions, SCM implementation options’ deci...The optimization investment policy decision of SCM-Supply Chain Management-implementation has been analysed under symmetric and asymmetric information conditions. For both conditions, SCM implementation options’ decision optimizing models have been developed. In these models, both clients and vendors try to pursue their own benefits. Based upon the principal-agent theory, the models show to what extent a principal (a client) needs to pay more to an agent (a vendor) in a context of asymmetric information. For the client, it is important to understand the extra costs to be able to adopt effective strategies to stimulate a vendor to perform an optimal implementation of a SCM system. The results of a simulation experiment regarding SCM implementation options illustrate and verify the theoretical findings and confirm the general notion that the less informed party is obliged to pay information rent to the better-informed party.展开更多
One of the major problems in prostate cancer (PCa) diagnosis and treatment relates to the difficulty in discriminating between slowgrowing, indolent cancers and more aggress- ive tumors with a lethal outcome. There...One of the major problems in prostate cancer (PCa) diagnosis and treatment relates to the difficulty in discriminating between slowgrowing, indolent cancers and more aggress- ive tumors with a lethal outcome. Therefore, much research has been devoted to the identification of reliable biomarkers that predict disease progression and treatment outcome.展开更多
AIM: To investigate the relationship between prostatespecific antigen(PSA) levels and(1) bladder outlet obstruction(BOO) and(2) the severity of prostate inflammation.METHODS: Two hundred and twenty-two consecutive pat...AIM: To investigate the relationship between prostatespecific antigen(PSA) levels and(1) bladder outlet obstruction(BOO) and(2) the severity of prostate inflammation.METHODS: Two hundred and twenty-two consecutive patients undergoing transurethral resection of the prostate(TURP) were prospectively included. Patients with proven urinary tract infection and/or known prostate cancer were excluded. PSA levels, International Prostate Symptoms Score(IPSS), prostate weight, post residual volume and pressure flow parameters were determined. A histopathological assessment of the presence and severity of inflammation was also performed.RESULTS: Patients had a mean age of 69.1 ± 8.6 years(45-90 years), with mean preoperative PSA levels of 4.7 ± 5.4 ng/m L(0.2-32.5 ng/m L) and IPSS of 15.7 ± 6.9(0-32). Mean Pdet Q max was 96.3 ± 34.4 cm H2O(10-220 cm H2O). The mean resected prostate weight was 39.4 ± 27.3 g(3-189 g). Correlations were observed between PSA(logarithmic) and resected prostate weight(r = 0.54; P < 0.001), PSA(logarithmic) and Pdet Q max(r = 0.17; P = 0.032), and resected prostate weight and Pdet Q max(r = 0.39; P < 0.001). Furthermore, low correlations were observed between PSA(logarithmic) and active(r = 0.21; P < 0.0001) and chronic(r = 0.19; P = 0.005) inflammation. CONCLUSION: In this study we showed a correlation between BOO(Pdet Q max) and PSA(logarithmic). Furthermore, we demonstrated a weak correlation between PSA(logarithmic) and active as well as chronic prostatic inflammation.展开更多
Pollution cost control is key to solve pollution problem.The paper takes pollution control cost of pollution control contract between management authority and pollutant discharge enterprise as research object,consider...Pollution cost control is key to solve pollution problem.The paper takes pollution control cost of pollution control contract between management authority and pollutant discharge enterprise as research object,considers pollution control quality level,pollution control quality inspection and pollution control cost model,and establishes pollution control cost model of management authority and pollutant discharge enterprise,including rational constraints of pollutant discharge enterprise.And it analyzes principal-agent relationship between the two under condition of asymmetric information,and un-observability of pollution control level is shown as hiding information of sewage enterprises.In essence,it is problem of adverse selection in principal-agent.Pollution control cost of management is objective function.The first order condition of pollution control cost of sewage enterprise is transformed into state space equation,and optimal control of problem is solved by using maximum principle.In particular,management authority,as principal,uses pollution control provisions to reward,punish and encourage pollutant discharge enterprises as agents.展开更多
Under dynamic pricing, stable and accurate electricity price forecasting on the demand side is essential forefficient energy management. We have developed a new electricity price forecasting model that providesconsist...Under dynamic pricing, stable and accurate electricity price forecasting on the demand side is essential forefficient energy management. We have developed a new electricity price forecasting model that providesconsistently accurate forecasts. The base prediction model decomposes the time series using wavelet transformand then predicts it by Long Short-Term Memory. Previous studies using this model have always decomposedtime series in the same way without changing the mother wavelet. However, this makes it difficult to respond tochanges in time series that vary daily or seasonally. Therefore, we periodically switch the mother wavelet, i.e.,flexibly change the time series decomposition method, to achieve stable and highly accurate electricity priceforecasting. In an experiment, the model improved prediction accuracy by up to 42.8% compared to predictionwith a fixed mother wavelet. Experimental results show that the proposed flexible forecasting method canconsistently provide highly accurate forecasts.展开更多
文摘Many advances have been made in the understanding of Crohn’s disease (CD) pathogenesis during the last decade. CD is currently seen as a predominantly T-lym-phocyte-driven disease characterized by the presence of a complex cocktail of interacting cytokines, chemokines and other mediators produced by a variety of cell types. Prevailing theories of CD pathogenesis suggest that patients’ T-lymphocytes are inappropriately activated in the setting of an immune imbalance, which is itself caused by an unfortunate confluence of genetic and en- vironmental factors. The T-cell response then leads to the chronic inflammation characteristic for the disease. Various environmental factors may play a role in the development of CD, but microbes are most consistently implied. This theory is based on epidemiological, clinico- pathological, genetic and experimental evidence. Despite the abundance of arguments for the implication of bac-teria in the aetiopathogenesis of CD, the precise role of bacteria in this disease still remains elusive. Three not necessarily mutually exclusive theories have been pro- posed: (1) an unidentified persistent pathogen; (2) an abnormally permeable mucosal barrier leading to exces-sive bacterial translocation; and (3) a breakdown in the balance between putative "protective" versus "harmful" intestinal bacteria ("dysbiosis"). At present, one cannot exclude with certainty any of these three proposed hy-potheses; they may all apply to CD to a certain extent.
文摘According to the European Association of Urology (EAU) guidelines, a life expectancy of〉 10 years is considered an important factor in the treatment of prostate cancer. The Charlson score is used to predict mortality based on comorbidities. The purpose of this study was to investigate the relationship between age, Charlson score and outcome in patients with cT3a prostate cancer. Between 1987 and 2004, 200 patients, who were with clinical T3a prostate cancer and who underwent radical prostatectomy (RP), were previously detected by digital rectal examination (DRE). Patients were categorized into two age groups (〈 65 and≥65 years old). Patients were also divided into two groups according to Charlson score ( = 0 and ≥ 1). Both age and Charlson score were analyzed regarding their predictive power of patients' outcomes. The mean follow-up period was 70.6 months, and the mean age of patients was 63.3 years. In all, 106 patients were 〈 65 years old and 94 patients were ≥65 years old. Age was a significant predictor of overall survival (OS). A Charlson score of 0 was found in 110 patients, and of ≥ 1 in 90 patients. Charlson score was not a significant predictor of biochemical progression-free survival (BPFS), clinical progression-free survival (CPFS) or OS. Cox multivariate analysis showed that margin status was a significant independent factor in BPFS, and cancer volume was a significant independent factor in CPFS. Charlson score does not influence the outcome in patients with clinical locally advanced prostate cancer. Age may influence OS. RP can be performed in motivated healthy older patients. However, the patients need to be counseled regarding possible surgery-related side effects, such as urinary incontinence and erectile dysfunction, which are age- and comorbidity-dependent.
文摘AIM: To study the degree of stigmatization among trainee psychiatrists, individual characteristics potentially leading to higher associative stigma, and coping mechanisms.METHODS: Two hundred and seven trainee psychiatrists in Flanders(Belgium), all member of the Flemish Association of Trainee Psychiatrists, were approached to participate in the survey. A non-demanding questionnaire that was specifically designed for the purpose of the study was sent by mail. The questionnaire consisted of three parts, each emphasizing a different aspect of associative stigma: devaluing and humiliating interactions, the focus on stigma during medical train-ing, and identification with negative stereotypes in the media. Answers were scored on a Likert scale ranging from 0 to 3. The results were analyzed using SPSS Version 18.0. RESULTS: The response rate of the study was 75.1%. The internal consistency of the questionnaire was good, with a Cronbach's α of 0.71. Seventy-five percent of all trainee psychiatrists confirmed hearing denigrating or humiliating remarks about the psychiatric profession more than once. Additionally, more than half of them had had remarks about the incompetence of psychiatrists directed at them. Only 1.3% remembered having stigma as a topic during their psychiatric training. Trainees who had been in training for a longer period of time had experienced a significantly higher level of stigmatization than trainees with fewer years of experience(mean total stigma scores of 16.93 ± SD 7.8 vs 14.45 ± SD 6.1, t =-2.179 and P < 0.05). In addition, senior trainees effectively kept quiet about their profession significantly more often than their junior colleagues(mean item score 0.44 ± SD 0.82 vs 0.13 ± SD 0.48, t = 2.874, P < 0.01). Comparable results were found in trainees working in adult psychiatry as were found in those working in child or youth psychiatry(mean item score 0.38 ± SD 0.77 vs 0.15 ± SD 0.53, t =-2.153, P < 0.05). Biologically oriented trainees were more inclined to give preventive explanations about their profession, which can be seen as a coping mechanism used to deal with this stigma(mean item score 2.05 ± SD 1.05 vs 1.34 ± SD 1.1, t =-3.403, P < 0.01).CONCLUSION: Associative stigma in trainee psychiatrists is underestimated. More attention should be paid to this potentially harmful phenomenon in training.
文摘Despite many attempts to evaluate the effectiveness of case management for frail older people, systematic reviews including experimental designs show inconsistent results. Starting from the view that case management is a complex intervention occurring in multilayered realities, we conducted a realist evaluation of case management in Belgium, where this type of intervention is new. Realist approaches are particularly well suited to evaluate complex interventions as they seek to investigate iteratively the literature and empirical data to uncover mid-range theories underpinning the intervention under study. As such, realist evaluations are works in progress which provide tools to describe how, why and for whom an intervention is supposed to work. In this paper, we describe two mid-range theories that can explain why case management can help frail older people to remain at home, through the lens of capacity and social support.
文摘The optimization investment policy decision of SCM-Supply Chain Management-implementation has been analysed under symmetric and asymmetric information conditions. For both conditions, SCM implementation options’ decision optimizing models have been developed. In these models, both clients and vendors try to pursue their own benefits. Based upon the principal-agent theory, the models show to what extent a principal (a client) needs to pay more to an agent (a vendor) in a context of asymmetric information. For the client, it is important to understand the extra costs to be able to adopt effective strategies to stimulate a vendor to perform an optimal implementation of a SCM system. The results of a simulation experiment regarding SCM implementation options illustrate and verify the theoretical findings and confirm the general notion that the less informed party is obliged to pay information rent to the better-informed party.
文摘One of the major problems in prostate cancer (PCa) diagnosis and treatment relates to the difficulty in discriminating between slowgrowing, indolent cancers and more aggress- ive tumors with a lethal outcome. Therefore, much research has been devoted to the identification of reliable biomarkers that predict disease progression and treatment outcome.
基金the ‘Kwaliteitsfonds Jessa ZH’ for the financial support
文摘AIM: To investigate the relationship between prostatespecific antigen(PSA) levels and(1) bladder outlet obstruction(BOO) and(2) the severity of prostate inflammation.METHODS: Two hundred and twenty-two consecutive patients undergoing transurethral resection of the prostate(TURP) were prospectively included. Patients with proven urinary tract infection and/or known prostate cancer were excluded. PSA levels, International Prostate Symptoms Score(IPSS), prostate weight, post residual volume and pressure flow parameters were determined. A histopathological assessment of the presence and severity of inflammation was also performed.RESULTS: Patients had a mean age of 69.1 ± 8.6 years(45-90 years), with mean preoperative PSA levels of 4.7 ± 5.4 ng/m L(0.2-32.5 ng/m L) and IPSS of 15.7 ± 6.9(0-32). Mean Pdet Q max was 96.3 ± 34.4 cm H2O(10-220 cm H2O). The mean resected prostate weight was 39.4 ± 27.3 g(3-189 g). Correlations were observed between PSA(logarithmic) and resected prostate weight(r = 0.54; P < 0.001), PSA(logarithmic) and Pdet Q max(r = 0.17; P = 0.032), and resected prostate weight and Pdet Q max(r = 0.39; P < 0.001). Furthermore, low correlations were observed between PSA(logarithmic) and active(r = 0.21; P < 0.0001) and chronic(r = 0.19; P = 0.005) inflammation. CONCLUSION: In this study we showed a correlation between BOO(Pdet Q max) and PSA(logarithmic). Furthermore, we demonstrated a weak correlation between PSA(logarithmic) and active as well as chronic prostatic inflammation.
基金2021 Ph.D.Program of Hainan Normal University(RC2100004363)。
文摘Pollution cost control is key to solve pollution problem.The paper takes pollution control cost of pollution control contract between management authority and pollutant discharge enterprise as research object,considers pollution control quality level,pollution control quality inspection and pollution control cost model,and establishes pollution control cost model of management authority and pollutant discharge enterprise,including rational constraints of pollutant discharge enterprise.And it analyzes principal-agent relationship between the two under condition of asymmetric information,and un-observability of pollution control level is shown as hiding information of sewage enterprises.In essence,it is problem of adverse selection in principal-agent.Pollution control cost of management is objective function.The first order condition of pollution control cost of sewage enterprise is transformed into state space equation,and optimal control of problem is solved by using maximum principle.In particular,management authority,as principal,uses pollution control provisions to reward,punish and encourage pollutant discharge enterprises as agents.
基金supported by JSPS,Japan KAKENHI Grant Number 22H03697,and DAIKIN Industries,Ltd.
文摘Under dynamic pricing, stable and accurate electricity price forecasting on the demand side is essential forefficient energy management. We have developed a new electricity price forecasting model that providesconsistently accurate forecasts. The base prediction model decomposes the time series using wavelet transformand then predicts it by Long Short-Term Memory. Previous studies using this model have always decomposedtime series in the same way without changing the mother wavelet. However, this makes it difficult to respond tochanges in time series that vary daily or seasonally. Therefore, we periodically switch the mother wavelet, i.e.,flexibly change the time series decomposition method, to achieve stable and highly accurate electricity priceforecasting. In an experiment, the model improved prediction accuracy by up to 42.8% compared to predictionwith a fixed mother wavelet. Experimental results show that the proposed flexible forecasting method canconsistently provide highly accurate forecasts.