Practice of Barrier Measures against COVID-19 Among Diabetic People Followed at Departmental University Hospital Center Ouémé-Plateau, Benin, in 2021

Introduction: COVID-19 is a pandemic disease caused by the coronavirus SARS-COV2 appeared in China in 2019. The aim of the study was to evaluate the practice of barrier measures against COVID-19 and to identify associated factors among diabetics followed at Departmental University Hospital Center Ouémé-Plateau, Benin, in 2021. Methods: This was a cross-sectional study conducted from June to August 2021, including diabetics aged 18 and over, hospitalized or received for medical visits in the department of medicine at the target hospital. Data were collected during an interview with each participant thanks to a questionnaire. “Good practice” was defined as regular practice of at least two of three barrier measures: hand washing, physical distancing and mask-wearing. Results: A total of 110 diabetics were included with a female predominance (55.5%) and a mean age of 57 ± 11.3 years. Among them, 89.1% washed their hands, 41.8% respected physical distancing and 12.7% wore a mask. The proportion of good practice was 47.3%. Only 5 practiced the three barrier measures. Only age group was associated with good practice. Conclusion: The study showed a low proportion of good practice of barrier measures against COVID-19 among diabetic people surveyed. It is important to continue the action for COVID-19 prevention among diabetic people in the targeted hospital and in other hospitals in Benin.

Demineralized Bone Matrix Fibers plus Allograft Bone for Multilevel Posterolateral Spine Fusion: A Game Changer?

Introduction: While autograft bone is the gold standard for multilevel posterolateral lumbar fusion, bone substitutes and graft extenders such as allograft bone, ceramics and demineralized bone matrix (DBM) have been used to avoid the morbidity and insufficient quantity associated with harvesting autologous bone. The primary objective of this retrospective study was to determine whether, in patients with increased risk of operative nonunion related to multilevel fusion, adding DBM fibers to mineralized bone allograft resulted in better fusion than using allograft alone. The secondary objectives were to evaluate how adding DBM fibers affects functional disability, low back pain, intraoperative blood loss and the nonunion rate. Methods: This retrospective study involved a chart review of consecutive patients who underwent multilevel lumbar spinal fusion and were operated on by a single surgeon. The patients were divided into two groups: 14 patients received mineralized bone allograft (control group) and 14 patients received a combination of mineralized bone allograft and DBM (experimental group). Patients were reviewed at a mean of 16.4 ± 2.2 months after surgery at which point CT scans were analyzed to determine whether fusion had occurred;Oswestry disability index (ODI) and pain were also evaluated. Results: A mean of 5 levels [min 2, max 13] were fused in these patients. Posterolateral fusion as defined by the Lenke classification was not significantly different between groups. The experimental DBM group had a significantly better composite fusion score than the control group (P Discussion: Adding DBM fibers to allograft bone during multilevel posterolateral spinal fusion was safe and produced better composite fusion than using allograft only as an autograft extender.

Contraceptive Experiences of Women of Procreation Age Who Attended Two HealthCenters in the City of Abidjan (Cote d’Ivoire)

Introduction: Maternal mortality, which is estimated at 614 deaths per 100,000 births in Côte d’Ivoire, is associated with a low national contraceptive prevalence rate of 13.9%. In this study, we are interested in the contraceptive experiences of women who attend health centers to estimate their rate of contraceptive use and to assess the factors involved in the use of modern contraceptive methods among women of childbearing age who are exposed to the risk of pregnancy. Method: A descriptive cross-sectional study was conducted from December 2018 to September 2019 among 423 women, who attended two health centers in Abidjan. A bivariate analysis identified factors associated with contraceptive use by these women. A descriptive analysis determined the means for the quantitative variables and the frequencies and percentages of qualitative variables. Interpretation of results was based on significance (α = 5%, 95% CI). Results: Contraceptive prevalence was 37%. There was a significant relationship between contraceptive use and the socio-demographic and reproductive characteristics of women (p Conclusion: Women who were over 35 years age, uneducated, primary school graduates, housewives, unemployed, in the informal sector, Muslims, nulliparous, and lacking information and decision-making power were less likely to use modern contraceptive methods. They are the target population for strategic interventions to improve contraceptive prevalence.

Learning by Living: Empathy Learned through an Extended Medical Education Immersion Project

Introduction: Medical student training and experiences in nursing homes are often viewed as negative;however, long-term care services represent a growing aspect of our medical system that receives little attention in medical education. The University of New England College of Osteopathic Medicine Learning by Living Nursing Home Immersion Project accelerates students learning about older adult care and the importance of empathy. Methods: Learning by Living applies qualitative ethnographic/autobiographic research methods to answer the question: “What is it like for me to live the life of an older adult nursing home resident?” Two first year medical students (female, 25 y/o & male, 27 y/o) were “admitted” into two different nursing homes for 11 days each. The students were wheelchair reliant from their assigned diagnoses of dominant-side paralysis secondary to stroke and aspiration pneumonia;requiring standard procedures of care experienced by older adults residents with similar conditions. Data were collected in the form of journal notes for pre-fieldwork, fieldwork, and post-fieldwork and included subjective and objective reporting of observations, experiences, and resident encounters. Analyses included journal review and thematic categorization and coding through content analysis. Results: Four themes of significance intersected for the two medical students: 1) control;2) quality of life;3) communication;and 4) isolation. Being immersed in nursing home life provided the students with firsthand experiences of loss and challenges faced by nursing home residents. This aided students’ learning about empathy and communication as key components of providing health care. Conclusion: This experience imparted knowledge to the medical students’ about aging, dignity, and the importance of making meaningful connections in order to thrive. These insights provided a gateway to establish a model of patient-centered care that is comprehensive and empathic for the older adult population.

针刺治疗神经性耳鸣的系统评价和Meta分析

[目的]对针刺相比于药物治疗神经性耳鸣的优效性进行系统评价和Meta分析。[方法]对相关数据库进行检索,收集近5年内针刺治疗神经性耳鸣的随机对照试验,根据纳入和排除标准,选择符合研究标准的文献,根据Cochrane系统评价手册5.0版推荐的方法进行文献质量分析,并采用Rev Man5.3进行Meta分析,并采用漏斗图进行偏倚分析。[结果]以受试者数量为计数单位的7篇文献中,针刺组330例,对照组284例,合并效应量OR=3.26,95%CI(2.09,5.08),Z=5.23,P<0.000 01,提示针刺治疗神经性耳鸣总有效率优于常规药物治疗,差异有统计学意义。以患耳数量为计数单位的2篇文献中,针刺组280例,对照组280例,合并效应量OR=1.39,95%CI(0.93,2.08),Z=1.62,P=0.11,提示针刺治疗神经性耳鸣相比于常规药物治疗的差异不具有统计学意义,但这两篇文献的数据很可能存在重叠。[结论]对于神经性耳鸣的治疗,针刺的总有效率优于常规药物治疗,且具有统计学意义。但由于文献质量的限制,该结果尚有待进一步论证。

Kasabach-Merritt现象诊断与治疗中国专家共识

Kasabach-Merritt现象(卡-梅现象)是主要由卡波西样血管内皮细胞瘤或丛状血管瘤所引起的严重血小板减少和消耗性凝血功能障碍为特征的一类疾病。该类疾病好发于婴幼儿,往往起病较急,病情进展迅速,若得不到及时诊治,可引起严重并发症,甚至危及生命。鉴于当前在卡-梅现象的诊断和治疗方面还存在一定分歧,为了提高国内对卡-梅现象的认识和诊治水平,规范临床治疗,我们组织国内相关专家讨论并制定了本专家共识。该共识对卡-梅现象的发病机制、临床表现、诊断方法及治疗流程等给出了规范化建议,可供临床实践参考。

All-Optical Reconfigurable Metamaterial Employing the Self-Assembly of CdTe Quantum Dots

Positively and negatively charged polyelectrolytes, namely, Poly(diallyldimethylammonium chloride) and Poly(styrene sulfonate), respectively, were employed to disperse and deploy negatively charged quantum dots on an otherwise passive metamaterial structure with a resonant frequency of 0.62 THz, by employing a layer-by-layer, self-assembly scheme. Upon exposure to a UV source with a wavelength of 365 nm the amplitude modulation was observed to increase with increases in the number of deposited bi-layers, until a modulation maximum of 2.68% was recorded enabling an all-optical, dynamically reconfigurable metamaterial geometry. Furthermore, amplitude modulation was subsequently observed to decrease with further increases in the number of layers employed due to quenching and shadowing effects. The experimental observations reported herein will enable the utilization of all-optical reconfigurable THz devices for communication and data transmission applications.

Predicting the Curvature of the Cosmos, and Point of Volume Contraction in a Big Bounce Scenario

Based on the latest Planck surveys, the universe is close to being remarkably flat, and yet, within observational error, there is still room for a slight curvature. If the curvature is positive, then this would lead to a closed universe, as well as allow for a big bounce scenario. Working within these assumptions, and using a simple model, we predict that the cosmos may have a positive curvature in the amount, Ω0=1.001802, a value within current observational bounds. For the scaling laws associated with the density parameters in Friedmann’s equations, we will assume a susceptibility model for space, where, , equals the smeared cosmic susceptibility. If we allow the to decrease with increasing cosmic scale parameter, “a”, then we can predict a maximum Hubble volume, with minimum CMB temperature for the voids, before contraction begins, as well as a minimum volume, with maximum CMB temperature, when expansion starts. A specific heat engine model for the cosmos is also entertained for this model of a closed universe.

Does Space Have a Gravitational Susceptibility? A Model for the ΛCDM Density Parameters in the Friedmann Equation

We propose a model for gravity based on the gravitational polarization of space. With this model, we can relate the density parameters within the Friedmann model, and show that dark matter is bound mass formed from massive dipoles set up within the vacuum surrounding ordinary matter. Aggregate matter induces a gravitational field within the surrounding space, which reinforces the original field. Dark energy, on the other hand, is the energy density associated with gravitational fields both for ordinary matter, and bound, or induced dipole matter. At high CBR temperatures, the cosmic susceptibility, induced by ordinary matter vanishes, as it is a smeared or average value for the cosmos as a whole. Even though gravitational dipoles do exist, no large-scale alignment or ordering is possible. Our model assumes that space, i.e., the vacuum, is filled with a vast assembly (sea) of positive and negative mass particles having Planck mass, called planckions, which is based on extensive work by Winterberg. These original particles form a very stiff two-component superfluid, where positive and negative mass species neutralize one another already at the submicroscopic level, leading to zero net mass, zero net gravitational pressure, and zero net entropy, for the undisturbed medium. It is theorized that the gravitational dipoles form from such material positive and negative particles, and moreover, this causes an intrinsic polarization of the vacuum for the universe as a whole. We calculate that in the present epoch, the smeared or average susceptibility of the cosmos equals, , and the overall resulting polarization equals, =2.396kg/m2. Moreover, due to all the ordinary mass in the universe, made up of quarks and leptons, we calculate a net gravitational field having magnitude, =3.771E-10m/s2. This smeared or average value permeates all of space, and can be deduced by any observer, irrespective of location within the universe. This net gravitational field is forced upon us by Gauss’s law, and although technically a surface gravitational field, it is argued that this surface, smeared value holds point for point in the observable universe. A complete theory of gravitational polarization is presented. In contrast to electrostatics, gravistatics leads to anti-screening of the original source field, increasing the original value, , to, , where is the induced or polarized field. In the present epoch, this leads to a bound mass, , where MF is the sum of all ordinary source matter in the universe, and equals the relative permittivity. A new radius, and new mass, for the observable universe is dictated by the density parameters in Friedmann’s equation, and Gauss’s law. These lead to the very precise values, R0=3.217E27 meters, and, MF=5.847E55kg, respectively, somewhat larger than current less accurate estimates.

OnabotulinumtoxinA Nerve Blocks in the Treatment of Occipital Neuralgia

Occipital neuralgia is characterized by severe pain, accompanied by tenderness and trigger points, in the distribution of the greater, lesser, and/or third occipital nerves. Occipital neuralgia is typically idiopathic, but also is characterized as a common form of posttraumatic headache. Typical treatments include nerve blocks with local anesthetic, nerve stimulation, pulsed radiofrequency, and cryoablation. OnabotulinumtoxinA (ONA) has recently been utilized in nerve blocks to treat occipital neuralgia, with the potential for a longer duration of pain relief than local anesthetic. Our study retrospectively examined 63 patients treated for occipital neuralgia, including 19 with ONA. 80 - 155 units of ONA were administered bilaterally in the surrounding musculature. A total of 61 patients, including 17 of those subsequently treated with ONA, were treated with local anesthetic, using a 1:1 mixture of 0.25% bupivacaine and 1% lidocaine, plus triamcinolone. Patients reported VAS pain scores before and after their procedures, and again during 4-week follow-up visits. Information on opioid use, overall pain relief, and duration of full relief was also recorded upon follow-up. Patients treated with ONA exhibited significant decreases in average VAS pain scores from 4.1 ± 2.6 pre-procedure to 2.1 ± 2.4 post-procedure (p = 2 × 10 -5), and 3.0 ± 2.5 4 weeks later (p = 0.0234). Mean overall relief was 75.8% ± 25.0%. Treatment with local anesthetic suggested equally efficacious reduction of VAS scores;however, treatment with ONA showed a significantly higher percentage of overall pain relief leading to follow-up. Opioid use did not exhibit significant change, regardless of treatment type. Our results support the hypothesis that use of Onabotulinum-toxinA in occipital nerve blocks leads to significant decreases in pain, while possibly exhibiting a longer duration of action than that of local anesthetic.

Is the Higgs Field a Positive and Negative Mass Planckion Condensate, and Does the LHC Produce Extreme Dark Energy?

Assuming a two-component, positive and negative mass, superfluid/supersolid for space (the Winterberg model), we model the Higgs field as a condensate made up of a positive and a negative mass, planckion pair. The connection is shown to be consistent (compatible) with the underlying field equations for each field, and the continuity equation is satisfied for both species of planckions, as well as for the Higgs field. An inherent length scale for space (the vacuum) emerges, which we estimate from previous work to be of the order of, l+ (0) = l- (0) = 5.032E-19 meters, for an undisturbed (unperturbed) vacuum. Thus we assume a lattice structure for space, made up of overlapping positive and negative mass wave functions, ψ+, and, ψ-, which together bind to form the Higgs field, giving it its rest mass of 125.35 Gev/c2 with a coherence length equal to its Compton wavelength. If the vacuum experiences an extreme disturbance, such as in a LHC pp collision, it is conjectured that severe dark energy results, on a localized level, with a partial disintegration of the Higgs force field in the surrounding space. The Higgs boson as a quantum excitation in this field results when the vacuum reestablishes itself, within 10-22 seconds, with positive and negative planckion mass number densities equalizing in the disturbed region. Using our fundamental equation relating the Higgs field, φ, to the planckion ψ+ and ψ- wave functions, we calculate the overall vacuum pressure (equal to vacuum energy density), as well as typical ψ+ and ψ- displacements from equilibrium within the vacuum.

自动分拣仓库中多载量AGV调度与路径规划算法

在自动分拣仓库中,多载量自动导引小车(AGV)具有强运输能力,但其多载量特征也增加了调度与路径规划的复杂性。针对多载量AGV调度与路径规划的协同优化问题,以最小化最大搬运完成时间为目标,建立了该问题的混合整数线性规划模型,并提出一种聚类协同优化算法。算法首先定义了包裹相似度,设计聚类算法划分包裹组,使每个包裹组可由多载量AGV在一次作业中完成分拣;进而针对问题的多决策特征,设计协同进化遗传算法对包裹组进行指派和排序,并将无冲突路径规划算法引入到协同进化遗传算法的解码方案中,用以搜索最优路径并解决多AGV路径冲突,从而实现了多载量AGV调度与路径规划的协同优化。通过不同问题规模的仿真实验验证了所提算法的高效性和稳定性。

基层医疗卫生机构经济运行状况分析

目的调查我国基层医疗卫生机构经济运行情况,分析不同类型及经济发展水平地区基层医疗卫生机构资产、收入与费用现状及分布特征。方法研究设计“全国基层医疗卫生机构经济运行情况调查问卷”,用方便抽样的方法收集2019-2021年我国基层医疗卫生机构经济运行相关数据,利用描述性、相关性和比较分析方法对所得数据进行分析。结果2019-2021年,基层医疗卫生机构的财政拨款收入增速大于医疗收入增速,公共卫生费用和人员费用占总费用的比例均呈逐年增加趋势,收入增速小于费用增速;新冠疫情期间,资产负债率、资产收益率等指标出现小幅波动。结论基层医疗卫生机构的经济运行存在区域发展不平衡的现象,收入结构有待优化,正财务杠杆效应不明显,管理人员专业性有待提高。

温度场下功能梯度圆锥壳-环板振动特性分析

针对功能梯度圆锥壳-环板组合结构振动问题,本文采用一阶剪切变形理论和Rayleigh-Ritz法分析了温度场下组合结构的振动特性。组合结构位移变量采用谱几何法来表征,考虑材料参数与温度相关并引入人工边界弹簧建立了组合结构振动特性分析模型。数值算例中,通过将文中求解结果与文献解和有限元法结果进行对比验证了模型的正确性,进而分析尺寸、材料、温度和连接位置等参数对结构振动特性的影响。研究结果表明:组合结构基频随厚度增加而增加,随着幂律指数、半顶角和温度场参数增加而降低,随环板内径和连接位置变化会呈现非单一变化趋势。

蔬菜嫁接用砧木苗位置纠偏机构试验研究

茄果类蔬菜砧木苗由于播种偏差和生长差异导致砧木苗中心偏移穴盘中心,可能在自动嫁接作业时对砧木苗造成损伤。为此,设计了一种砧木苗位置纠偏机构,通过1对拢苗手和砧木推板对砧木进行全方位约束,实现对砧木位置的纠偏。为了考察砧木苗位置纠偏机构对嫁接苗体的损伤情况,进行了砧木位置纠偏对嫁接苗体的损伤试验。结果表明:纠偏机构可以实现砧木苗偏移穴盘中心点4mm范围内的纠偏;当砧木苗向前偏移时,砧木苗位置纠偏机构“搂”回偏移的嫁接苗体的损伤率为4.9%;当砧木苗向后偏移时,砧木苗位置纠偏机构“推”出偏移的嫁接苗体的损伤率12.3%;当拢苗手和砧木推板的缓冲材料使用EVA缓冲时,没有嫁接苗体损伤;当拢苗手和砧木推板的缓冲材料使用0.3mm塑料薄膜缓冲时,嫁接苗体的损伤率为4.9%;当拢苗手和砧木推板没有缓冲材料时,嫁接苗体的损伤率为6.17%。

车身参数对平台翻滚耐撞性影响规律研究

基于平台翻滚的实车试验,建立有限元与多刚体两种整车仿真模型,并对比实车试验结果验证模型的可靠性。结合仿真与理论分析,研究翻滚角速度与车身参数之间的关系,得出翻滚角速度可作为量化车辆翻滚性能的评价指标结论。通过单因素研究,得出各车身参数(质心高度、车身高度和车辆轮距)对翻滚性能影响的基本规律,以翻滚角速度为指标,结合二次回归正交组合设计方法和多刚体仿真技术,构建车辆翻滚性能与车身参数间的经验公式,实现车身参数与翻滚性能间的定量分析,并通过回归检验与实车对比试验检验公式的有效性。

低速双燃料柴油机奥托循环下的增压器配机

基于奥托循环的燃烧特点与需求,从柴油机空燃比和增压器特性两方面对低速双燃料柴油机奥托循环下的增压器配机进行分析。柴油机100%负荷处的压比流量应处于增压器的压力流量特性图的中心位置,在高负荷区域预估的增压器效率、扫气压力、扫气量尽可能稍大于设计要求,尽可能采用最小喷嘴环设计,增压器压气机工作线应处于高效区域。在此基础上对X92DF柴油机开展配机策划和试验验证。试验结果表明:该柴油机各项性能满足设计要求,增压器达到预期效果。

带运输时间混合流水车间成组调度的协同进化文化基因算法

研究了一类带有序列相关准备时间和阶段间运输时间的混合流水车间成组调度问题,以最小化最大完工时间为目标建立混合整数线性规划模型,结合问题特征提出一种协同进化文化基因算法.算法采用置换序列的方式对工件组间调度、各工件组内工件间调度以及各工件组在各阶段上并行机的指派3个子问题进行统一编码,基于负载均衡思想和改进的先到先得策略将染色体解码为问题的可行解;进化过程中采用多种遗传算子执行全域搜索,并设计了一种基于破坏和重新构造的协同进化局部搜索策略.通过不同问题规模的数据实验和与对比算法的比较分析,验证了所提模型和算法的有效性.

基于CNN-SVR的作业车间订单完工周期预测方法

经典作业车间生产环境包含多产品、多机器和多工序,提高其完工周期的预测精度对于企业提高客户满意度、优化生产调度等方面都具有重要意义。因此,针对作业车间订单完工周期预测问题提出一种卷积神经网络-支持向量回归(CNN-SVR)方法。首先,将订单完工周期影响因素分类为订单信息与车间实时状态信息,并分析得到其中的关键特征因素。进而,采用ReLU激活函数训练卷积神经网络,对生产数据特征进行自适应提取,并将结果输入至支持向量回归模型中进行预测。最后,设计FlexSim作业车间仿真模型生成车间订单生产数据,确定评价指标并进行试验验证。结果表明,相较于其他对比模型,CNN-SVR预测方法在拟合优度和预测误差等方面均有很好表现,能够得到理想的预测效果。

Review of Laparoscopic Activities at the University Hospital Center (CHU) “Mère-Enfant Luxembourg” in 100 Cases

Introduction: Laparoscopic surgery is a surgical technique that allows to intervene under the control of an endoscope, introduced into the abdominal cavity previously distended by an artificial pneumoperitoneum. We propose in this study to bring the assessment of the laparoscopic activities in the department of general surgery at the CHU MERE-ENFANT “Luxembourg”. Methodology: This was a descriptive cross-sectional study from September 2019 to September 2020 including 100 cases of laparoscopic procedures at the University Hospital Mother and Child “Luxembourg”. All patients regardless of pathology, who underwent laparoscopic surgery with or without conversion to conventional surgery were included in the study. The data were collected from routine media such as the consultation register and the operative report register. Data analysis was performed using SPSS 21 software. Informed consent was obtained from the patients before their inclusion in the study, and each patient was assigned an anonymity number. Results: In our study, the female sex represented of the patients, i.e. 76% with a sex ratio of 3.2. Housewives were 53% of the cases. The majority of patients were in the age range of 16 - 30 in 44% of cases and 75% were married. Overweight/obesity, hypertension and peptic ulcer were the main medical histories with 22%, 12% and 10% respectively. All patients presented with abdominal pain. Cholecystectomy was the main activity during the study with a frequency of 43%, followed by tube surgery and appendectomy. The average duration was 53 minutes for digestive pathologies 48 minutes with extremes of 22 and 66 minutes for gynecological pathologies. One case of injury to the cystic artery was recorded. The conversion rate was 6% of cases. We recorded 5 cases of suppuration as a postoperative complication. The length of stay was 2 - 3 days in 96% of patients. Conclusion: In view of this study, the feasibility of laparoscopic surgery at the CHU Mère Enfant “Luxembourg” is no longer in question. Actions must be taken to reinforce the practice of laparoscopic surgery.