Background: The quality of colon cleansing is a major determinant of quality o f colonoscopy. To our knowledge, the impact of bowel preparation on the quality of colonoscopy has not been assessed prospectively in a la...Background: The quality of colon cleansing is a major determinant of quality o f colonoscopy. To our knowledge, the impact of bowel preparation on the quality of colonoscopy has not been assessed prospectively in a large multicenter study. There fore, this study assessed the factors that determine coloncleansing qualit y and the impact of cleansing quality on the technical performance and diagnosti c yield of colonoscopy.Methods: Twenty-one centers from 11 countries participat ed in this prospective observational study. Colon-cleansing quality was assesse d on a 5-point scale and was categorized on 3 levels.The clinical indication fo r colonoscopy, diagnoses, and technical parameters related to colonoscopy were r ecorded. Results:A total of 5832 patients were included in the study (48.7%men, mean age 57.6 [15.9] years). Cleansing quality was lower in elderly patients and in patients in the hospital. Procedures in poorly prepared patients were longer , more difficult, and more often incomplete. The detection of polyps of any size depended on cleansing quality: odds ratio (OR) 1.73: 95%confidence interval(CI )[1.28, 2.36] for intermediate-quality compared with low-quality preparation; and OR 1.46: 95%CI[1.11, 1.93]for high-quality compared with low-quality pr eparation. For polyps >10 mm in size, corresponding ORs were 1.0 for low-qualit y cleansing, OR 1.83: 95%CI[1.11, 3.05] for intermediate-quality cleansing, an d OR 1.72: 95%CI[1.11,2.67] for high-quality cleansing. Cancers were not detec ted less frequently in the case of poor preparation. Conclusions:Cleansing quali ty critically determines quality,difficulty, speed,and completeness of colonosco py, and is lower in hospitalized patients and patients with higher levels of com orbid conditions.The proportion of patients who undergo polypectomy increases wi th higher cleansing quality, whereas colon cancer detection does not seem to cri tically depend on the quality of bowel preparation.展开更多
Background and Study Aims: Sedation and monitoring practice during colonoscopy varies between centers and over time. Knowledge of current practice is needed to ensure quality of care and help focus future research. Th...Background and Study Aims: Sedation and monitoring practice during colonoscopy varies between centers and over time. Knowledge of current practice is needed to ensure quality of care and help focus future research. The objective of this study was to examine sedation and monitoring practice in endoscopy centers internationally. Patients and Methods: This observational study included consecutive patients referred for colonoscopy at 21 centers in 11 countries. Endoscopists reported sedation and monitoring practice, using a standard questionnaire for each patient. Results: 6004 patients were included in this study, of whom 53%received conscious/moderate sedation during colonoscopy, 30%received deep sedation, and 17%received no sedation. Sedation agents most commonly used were midazolam (47%) and opioids (33%). Pulse oximetry was done during colonoscopy in 77%of patients, blood pressure monitoring in 34%, and electrocardiography in 24%. Pulse oximetry was most commonly used for moderately sedated patients, while blood pressure monitoring and electrocardiography were used predominantly for deeply sedated patients. Sedation and monitoring use ranged from 0%to 100%between centers. Oxygen desaturation (≤85%) occurred in 5%of patients, of whom 80%were moderately sedated. On average, three staff members were involved in procedures. An anesthesiologist was present during 27%of colonoscopies, and during 85%of colonoscopies using deep sedation. Conclusions: Internationally, sedation and monitoring practice during colonoscopy varied widely. Moderate sedation was the most common sedation method used and electronic monitoring was used in three-quarters of patients. Deep sedation tended to be more resource-intensive, implying a greater use of staff and monitoring.展开更多
Geoelectric and hydrochemical approaches are employed to delineate the groundwater potential zones in District Okara,a part of Bari Doab,Punjab,Pakistan.Sixty-seven VES surveys are conducted with the Electrical Resist...Geoelectric and hydrochemical approaches are employed to delineate the groundwater potential zones in District Okara,a part of Bari Doab,Punjab,Pakistan.Sixty-seven VES surveys are conducted with the Electrical Resistivity Meter.The resultant resistivity verses depth model for each site is estimated using computer-based software IX1D.Aquifer thickness maps and interpreted resistivity maps were generated from interpreted VES results.Dar-Zarrouk parameters,transverse resistance(TR),longitudinal conductance(SL)and anisotropy(λ)were also calculated from resistivity data to delineate the potential zones of aquifer.70%of SL value is≤3S,30%of SL value is>3S.According to SL and TR values,the whole area is divided into three potential zones,high,medium and low potential zones.The spatial distribution maps show that north,south and central parts of study area are marked as good potential aquifer zones.Longitudinal conductance values are further utilized to determine aquifer protective capacity of area.The whole area is characterized by moderate to good and up to some extent very good aquifer protective area on the basis of SL values.The groundwater samples from sixty-seven installed tube wells are collected for hydro-chemical analysis.The electrical conductivity values are determined.Correlation is then developed between the EC(μS/cm)of groundwater samples vs.interpreted aquifer resistivity showing R2 value 0.90.展开更多
Until recently, the synaptic transmission and excitatory amino acid transporters activation of neurons are very well discussed in the previous studies and are considered to be the two distinct features of Synapse. It ...Until recently, the synaptic transmission and excitatory amino acid transporters activation of neurons are very well discussed in the previous studies and are considered to be the two distinct features of Synapse. It is also found that a large number of interactions take place in the domain of ionic exchanges and protein interactions in synapses. It is evolutionary to have destined to release of Neurotransmitters to conduct an impulse to the other consecutive neurons, which forms the most important characteristic of synapse. From the popular perspective, it has been identified that detailed theoretical closer correlation of data produced through various studies about synapse can unravel many mysteries related to functions of synapse. Hence, this research paper tries to concentrate on a selected group of prominent characteristics and properties of synapse and also highlights some noteworthy discoveries, emphasizing the influential capabilities of them in the thought process and improving the knowledge of the field. It also highlights the expressive properties and forms of synapse brought out through the evidences available in sparse to dense data in a correlational way.展开更多
Objective:To document the recent livestock related practices and possible unhygienic ways of pathogen entry.Identification of the potential risk factors for the spread of infection is important to design an evidence-b...Objective:To document the recent livestock related practices and possible unhygienic ways of pathogen entry.Identification of the potential risk factors for the spread of infection is important to design an evidence-based disease control programme.Methods:Rapid assessment method was adopted and a purposive sample of 60 dairy farmers were interviewed.The following factors were noted for contributing in primary and secondary transmission of zoonotic infections:(i) persons who come in close contact with animals and their secretions,(ii) management strategies of farm animals(sheds and environment),(iii) management practices adopted at farms,(iv) small scale farmers and rural livestock production systems,(v)milk collection systems.Results:This research unveiled the certain routes of zoonotic disease transmission.Certain management practices,precautionary measures and strategies were the pivotal risk factors.Conclusions:The study emphasizes the need to educate the poor livestock keepers.展开更多
Artificial intelligence (AI) based technology, machine learning, and cognitive systems have played a very active role in society’s economic and technological transformation. For industrial value chains and internatio...Artificial intelligence (AI) based technology, machine learning, and cognitive systems have played a very active role in society’s economic and technological transformation. For industrial value chains and international businesses, it means that a structural change is necessary since these machines can learn and apply new information in making forecasts, processing, and interacting with people. Artificial intelligence (AI) is a science that uses powerful enough techniques, strategies, and mathematical modelling to tackle complex actual problems. Because of its inevitable progress further into the future, there have been considerable safety and ethical concerns. Creating an environment that is AI friendly for the people and vice versa might be a solution for humans and machines to discover a common set of values. In this context, the goal of this study is to investigate the emerging trends of AI (the benefits that it brings to the society), the moral challenges that come from ethical algorithms, learned or pre-set ideals, as well as address the ethical issues and malpractices of AI and AI security. This paper will address the consequences of AI in relation to investors and financial services. The article will examine the challenges and possible alternatives for resolving the potential unethical issues in finance and will propose the necessity of new AI governance mechanisms to protect the efficiency of the capital markets as well as the role of financial authority in the regulation and monitoring of the huge expansion of AI in finance.展开更多
文摘Background: The quality of colon cleansing is a major determinant of quality o f colonoscopy. To our knowledge, the impact of bowel preparation on the quality of colonoscopy has not been assessed prospectively in a large multicenter study. There fore, this study assessed the factors that determine coloncleansing qualit y and the impact of cleansing quality on the technical performance and diagnosti c yield of colonoscopy.Methods: Twenty-one centers from 11 countries participat ed in this prospective observational study. Colon-cleansing quality was assesse d on a 5-point scale and was categorized on 3 levels.The clinical indication fo r colonoscopy, diagnoses, and technical parameters related to colonoscopy were r ecorded. Results:A total of 5832 patients were included in the study (48.7%men, mean age 57.6 [15.9] years). Cleansing quality was lower in elderly patients and in patients in the hospital. Procedures in poorly prepared patients were longer , more difficult, and more often incomplete. The detection of polyps of any size depended on cleansing quality: odds ratio (OR) 1.73: 95%confidence interval(CI )[1.28, 2.36] for intermediate-quality compared with low-quality preparation; and OR 1.46: 95%CI[1.11, 1.93]for high-quality compared with low-quality pr eparation. For polyps >10 mm in size, corresponding ORs were 1.0 for low-qualit y cleansing, OR 1.83: 95%CI[1.11, 3.05] for intermediate-quality cleansing, an d OR 1.72: 95%CI[1.11,2.67] for high-quality cleansing. Cancers were not detec ted less frequently in the case of poor preparation. Conclusions:Cleansing quali ty critically determines quality,difficulty, speed,and completeness of colonosco py, and is lower in hospitalized patients and patients with higher levels of com orbid conditions.The proportion of patients who undergo polypectomy increases wi th higher cleansing quality, whereas colon cancer detection does not seem to cri tically depend on the quality of bowel preparation.
文摘Background and Study Aims: Sedation and monitoring practice during colonoscopy varies between centers and over time. Knowledge of current practice is needed to ensure quality of care and help focus future research. The objective of this study was to examine sedation and monitoring practice in endoscopy centers internationally. Patients and Methods: This observational study included consecutive patients referred for colonoscopy at 21 centers in 11 countries. Endoscopists reported sedation and monitoring practice, using a standard questionnaire for each patient. Results: 6004 patients were included in this study, of whom 53%received conscious/moderate sedation during colonoscopy, 30%received deep sedation, and 17%received no sedation. Sedation agents most commonly used were midazolam (47%) and opioids (33%). Pulse oximetry was done during colonoscopy in 77%of patients, blood pressure monitoring in 34%, and electrocardiography in 24%. Pulse oximetry was most commonly used for moderately sedated patients, while blood pressure monitoring and electrocardiography were used predominantly for deeply sedated patients. Sedation and monitoring use ranged from 0%to 100%between centers. Oxygen desaturation (≤85%) occurred in 5%of patients, of whom 80%were moderately sedated. On average, three staff members were involved in procedures. An anesthesiologist was present during 27%of colonoscopies, and during 85%of colonoscopies using deep sedation. Conclusions: Internationally, sedation and monitoring practice during colonoscopy varied widely. Moderate sedation was the most common sedation method used and electronic monitoring was used in three-quarters of patients. Deep sedation tended to be more resource-intensive, implying a greater use of staff and monitoring.
文摘Geoelectric and hydrochemical approaches are employed to delineate the groundwater potential zones in District Okara,a part of Bari Doab,Punjab,Pakistan.Sixty-seven VES surveys are conducted with the Electrical Resistivity Meter.The resultant resistivity verses depth model for each site is estimated using computer-based software IX1D.Aquifer thickness maps and interpreted resistivity maps were generated from interpreted VES results.Dar-Zarrouk parameters,transverse resistance(TR),longitudinal conductance(SL)and anisotropy(λ)were also calculated from resistivity data to delineate the potential zones of aquifer.70%of SL value is≤3S,30%of SL value is>3S.According to SL and TR values,the whole area is divided into three potential zones,high,medium and low potential zones.The spatial distribution maps show that north,south and central parts of study area are marked as good potential aquifer zones.Longitudinal conductance values are further utilized to determine aquifer protective capacity of area.The whole area is characterized by moderate to good and up to some extent very good aquifer protective area on the basis of SL values.The groundwater samples from sixty-seven installed tube wells are collected for hydro-chemical analysis.The electrical conductivity values are determined.Correlation is then developed between the EC(μS/cm)of groundwater samples vs.interpreted aquifer resistivity showing R2 value 0.90.
文摘Until recently, the synaptic transmission and excitatory amino acid transporters activation of neurons are very well discussed in the previous studies and are considered to be the two distinct features of Synapse. It is also found that a large number of interactions take place in the domain of ionic exchanges and protein interactions in synapses. It is evolutionary to have destined to release of Neurotransmitters to conduct an impulse to the other consecutive neurons, which forms the most important characteristic of synapse. From the popular perspective, it has been identified that detailed theoretical closer correlation of data produced through various studies about synapse can unravel many mysteries related to functions of synapse. Hence, this research paper tries to concentrate on a selected group of prominent characteristics and properties of synapse and also highlights some noteworthy discoveries, emphasizing the influential capabilities of them in the thought process and improving the knowledge of the field. It also highlights the expressive properties and forms of synapse brought out through the evidences available in sparse to dense data in a correlational way.
基金Supported by research fund of University of Veterinary and Animal Sciences,Lahore(Grant No.1353-8/12)NGO named "Foundation for prevention of Zoonosis″(Grant No.12-137/12)
文摘Objective:To document the recent livestock related practices and possible unhygienic ways of pathogen entry.Identification of the potential risk factors for the spread of infection is important to design an evidence-based disease control programme.Methods:Rapid assessment method was adopted and a purposive sample of 60 dairy farmers were interviewed.The following factors were noted for contributing in primary and secondary transmission of zoonotic infections:(i) persons who come in close contact with animals and their secretions,(ii) management strategies of farm animals(sheds and environment),(iii) management practices adopted at farms,(iv) small scale farmers and rural livestock production systems,(v)milk collection systems.Results:This research unveiled the certain routes of zoonotic disease transmission.Certain management practices,precautionary measures and strategies were the pivotal risk factors.Conclusions:The study emphasizes the need to educate the poor livestock keepers.
文摘Artificial intelligence (AI) based technology, machine learning, and cognitive systems have played a very active role in society’s economic and technological transformation. For industrial value chains and international businesses, it means that a structural change is necessary since these machines can learn and apply new information in making forecasts, processing, and interacting with people. Artificial intelligence (AI) is a science that uses powerful enough techniques, strategies, and mathematical modelling to tackle complex actual problems. Because of its inevitable progress further into the future, there have been considerable safety and ethical concerns. Creating an environment that is AI friendly for the people and vice versa might be a solution for humans and machines to discover a common set of values. In this context, the goal of this study is to investigate the emerging trends of AI (the benefits that it brings to the society), the moral challenges that come from ethical algorithms, learned or pre-set ideals, as well as address the ethical issues and malpractices of AI and AI security. This paper will address the consequences of AI in relation to investors and financial services. The article will examine the challenges and possible alternatives for resolving the potential unethical issues in finance and will propose the necessity of new AI governance mechanisms to protect the efficiency of the capital markets as well as the role of financial authority in the regulation and monitoring of the huge expansion of AI in finance.
