Atrial fibrillation(AF)is a major public health problem and poses a substantial economic burden on healthcare systems worldwide.[1-4]The emergency department(ED)serves as the first point of contact with the healthcare...Atrial fibrillation(AF)is a major public health problem and poses a substantial economic burden on healthcare systems worldwide.[1-4]The emergency department(ED)serves as the first point of contact with the healthcare system and plays a key role in the management of patients with AF,which accounts for 3%-10%of all hospital admissions.[5]Treatment plans are often discussed and initiated at the ED.展开更多
In this editorial,I address the mental health status of patients who have been discharged from intensive care units(ICUs)after battling coronavirus disease 2019(COVID-19).An ICU admission is generally a stressful expe...In this editorial,I address the mental health status of patients who have been discharged from intensive care units(ICUs)after battling coronavirus disease 2019(COVID-19).An ICU admission is generally a stressful experience,and for severe COVID-19 survivors prolonged treatment in the ICU can lead to significant psychological consequences.These individuals may experience psychiatric distress,including symptoms such as insomnia,anxiety,depression,and even posttraumatic psychological issues.Research indicates that during the first 6 months to 1 year following an ICU stay,nearly one-third of survivors exhibit symptoms similar to those of depression and post-traumatic stress disorder.Several factors may have contributed to the development of depressive and anxious symptoms during the COVID-19 pandemic,particularly for those who underwent an ICU stay.The ICU environment itself is inherently stressful,filled with the constant noise of various medical devices.Studies have provided strong evidence that the prolonged need for ventilation support and the loss of freedom of movement are key factors in the development of psychological problems among COVID-19 patients who had been treated in the ICU.展开更多
Background The prognosis and survival of patients with lung cancer are likely to deteriorate with metastasis.Using deep-learning in the detection of lymph node metastasis can facilitate the noninvasive calculation of ...Background The prognosis and survival of patients with lung cancer are likely to deteriorate with metastasis.Using deep-learning in the detection of lymph node metastasis can facilitate the noninvasive calculation of the likelihood of such metastasis,thereby providing clinicians with crucial information to enhance diagnostic precision and ultimately improve patient survival and prognosis.Methods In total,623 eligible patients were recruited from two medical institutions.Seven deep learning models,namely Alex,GoogLeNet,Resnet18,Resnet101,Vgg16,Vgg19,and MobileNetv3(small),were utilized to extract deep image histological features.The dimensionality of the extracted features was then reduced using the Spearman correlation coefficient(r≥0.9)and Least Absolute Shrinkage and Selection Operator.Eleven machine learning methods,namely Support Vector Machine,K-nearest neighbor,Random Forest,Extra Trees,XGBoost,LightGBM,Naive Bayes,AdaBoost,Gradient Boosting Decision Tree,Linear Regression,and Multilayer Perceptron,were employed to construct classification prediction models for the filtered final features.The diagnostic performances of the models were assessed using various metrics,including accuracy,area under the receiver operating characteristic curve,sensitivity,specificity,positive predictive value,and negative predictive value.Calibration and decision-curve analyses were also performed.Results The present study demonstrated that using deep radiomic features extracted from Vgg16,in conjunction with a prediction model constructed via a linear regression algorithm,effectively distinguished the status of mediastinal lymph nodes in patients with lung cancer.The performance of the model was evaluated based on various metrics,including accuracy,area under the receiver operating characteristic curve,sensitivity,specificity,positive predictive value,and negative predictive value,which yielded values of 0.808,0.834,0.851,0.745,0.829,and 0.776,respectively.The validation set of the model was assessed using clinical decision curves,calibration curves,and confusion matrices,which collectively demonstrated the model's stability and accuracy.Conclusion In this study,information on the deep radiomics of Vgg16 was obtained from computed tomography images,and the linear regression method was able to accurately diagnose mediastinal lymph node metastases in patients with lung cancer.展开更多
BACKGROUND Benign gallbladder diseases have become a high-prevalence condition not only in China but also worldwide.The main types of benign gallbladder diseases include gallbladder polyps,acute and chronic cholecysti...BACKGROUND Benign gallbladder diseases have become a high-prevalence condition not only in China but also worldwide.The main types of benign gallbladder diseases include gallbladder polyps,acute and chronic cholecystitis,and gallstones,with gallstones being the most common,accounting for over 70%of cases.Although the mortality rate of benign gallbladder diseases is low,they carry obvious potential risks.Studies have shown that an increased incidence of benign gallbladder diseases can increase the risk of cardiovascular diseases and gallbladder cancer,resulting in a substantial disease burden on patients and their families.AIM To assess the medical utility of the Configuration-Procedure-Consequence(CPC)three-dimensional quality evaluation model in modulating the prognosis of laparoscopic cholecystectomy patients.METHODS A total of 98 patients who underwent laparoscopic cholecystectomy in our hospital from February 2020 to January 2022 were selected as the subjects.According to the random number table method,they were divided into a study group and a control group,with 49 patients in each group.The control group received routine perioperative care,while the study group had the addition of the CPC three-dimensional quality evaluation.The postoperative recovery-related indicators(time to first flatus,time to oral intake,time to ambulation,hospital stay),stress indicators(cortisol and adrenaline levels),distinctions in anxiety and RESULTS The time to first flatus,time to oral intake,time to ambulation,and hospital stay of the study group patients were obviously lower than those of the control group patients,with statistical significance(P<0.05).On the 1st day after admission,there were no obvious distinctions in cortisol and adrenaline levels in blood samples,as well as in the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)scores between the study group and the control group(P>0.05).However,on the 3rd day after surgery,the cortisol and adrenaline levels,as well as SAS and SDS scores of the study group patients,were obviously lower than those of the control group patients(P<0.05).The study group had 2 cases of incisional infection and 1 case of pulmonary infection,with a total incidence of complications of 6.12%(3/49),which was obviously lower than the 20.41%(10/49)in the control group(P<0.05).CONCLUSION Implementing the CPC three-dimensional quality evaluation model for patients undergoing laparoscopic cholecystectomy can help accelerate their perioperative recovery process,alleviate perioperative stress symptoms,mitigate anxiety,depression,and other adverse emotions,and to some extent,reduce the incidence of perioperative complications.展开更多
BACKGROUND Patients in neurology intensive care units(ICU)are prone to pressure injuries(PU)due to factors such as severe illness,long-term bed rest,and physiological dysfunction.PU not only causes pain and complicati...BACKGROUND Patients in neurology intensive care units(ICU)are prone to pressure injuries(PU)due to factors such as severe illness,long-term bed rest,and physiological dysfunction.PU not only causes pain and complications to patients,but also increases medical burden,prolongs hospitalization time,and affects the recovery process.AIM To evaluate and optimize the effectiveness of pressure injury prevention nursing measures in neurology ICU patients.METHODS A retrospective study was conducted,and 60 patients who were admitted to the ICU of the Department of Neurology were selected and divided into an observation group and a control group according to the order of admission,with 30 people in each group.The observation group implemented pressure injury prevention and nursing measures,while the control group adopted routine care.RESULTS Comparison between observation and control groups following pressure injury prevention nursing intervention revealed significantly lower incidence rates in the observation group compared to the control group at 48 h(8.3%vs 26.7%),7 d(16.7%vs 43.3%),and 14 d(20.0%vs 50.0%).This suggests a substantial reduction in pressure injury incidence in the observation group,with the gap widening over time.Additionally,patients in the observation group exhibited quicker recovery,with a shorter average time to get out of bed(48 h vs 72 h)and a shorter average length of stay(12 d vs 15 d)compared to the control group.Furthermore,post-intervention,patients in the observation group reported significantly improved quality of life scores,including higher scores in body satisfaction,feeling and function,and comfort(both psychological and physiological),indicating enhanced overall well-being and comfort following the implementation of pressure injury prevention nursing measures.CONCLUSION Implementing pressure injury preventive care measures for neurology ICU patients will have better results.展开更多
Prediabetes is a heterogeneous condition,encompassing various pathological phenotypes such as hyperinsulinemia,tissue-specific insulin resistance(IR),systemic IR,andβ-cell dysfunction.A significant proportion of indi...Prediabetes is a heterogeneous condition,encompassing various pathological phenotypes such as hyperinsulinemia,tissue-specific insulin resistance(IR),systemic IR,andβ-cell dysfunction.A significant proportion of individuals with prediabetes remain undiagnosed.Furthermore,although lifestyle interventions have demonstrated efficacy in improving prediabetic conditions,some individuals with prediabetes progress to type 2 diabetes mellitus.This study aims to summarize effective evaluation methods for identifying distinct pathological phenotypes of prediabetes and targeted lifestyle intervention strategies to mitigate the progression from prediabetes to diabetes.展开更多
Background:Given the strikingly high diagnostic error rate in hospitals,and the recent development of Large Language Models(LLMs),we set out to measure the diagnostic sensitivity of two popular LLMs:GPT-4 and PaLM2.Sm...Background:Given the strikingly high diagnostic error rate in hospitals,and the recent development of Large Language Models(LLMs),we set out to measure the diagnostic sensitivity of two popular LLMs:GPT-4 and PaLM2.Small-scale studies to evaluate the diagnostic ability of LLMs have shown promising results,with GPT-4 demonstrating high accuracy in diagnosing test cases.However,larger evaluations on real electronic patient data are needed to provide more reliable estimates.Methods:To fill this gap in the literature,we used a deidentified Electronic Health Record(EHR)data set of about 300,000 patients admitted to the Beth Israel Deaconess Medical Center in Boston.This data set contained blood,imaging,microbiology and vital sign information as well as the patients'medical diagnostic codes.Based on the available EHR data,doctors curated a set of diagnoses for each patient,which we will refer to as ground truth diagnoses.We then designed carefully-written prompts to get patient diagnostic predictions from the LLMs and compared this to the ground truth diagnoses in a random sample of 1000 patients.Results:Based on the proportion of correctly predicted ground truth diagnoses,we estimated the diagnostic hit rate of GPT-4 to be 93.9%.PaLM2 achieved 84.7%on the same data set.On these 1000 randomly selected EHRs,GPT-4 correctly identified 1116 unique diagnoses.Conclusion:The results suggest that artificial intelligence(AI)has the potential when working alongside clinicians to reduce cognitive errors which lead to hundreds of thousands of misdiagnoses every year.However,human oversight of AI remains essential:LLMs cannot replace clinicians,especially when it comes to human understanding and empathy.Furthermore,a significant number of challenges in incorporating AI into health care exist,including ethical,liability and regulatory barriers.展开更多
Research Background: Cervical cancer is the second most common cancer in women and the third leading cause of female cancer death in Bangladesh. Delay in initiation of treatment in advanced stage cervical cancer patie...Research Background: Cervical cancer is the second most common cancer in women and the third leading cause of female cancer death in Bangladesh. Delay in initiation of treatment in advanced stage cervical cancer patients is an important modifiable risk factor for cancer-related mortality. Identifying elements associated with delay of diagnosis will help reduce barriers to timely treatment of cervical cancer. Research Objectives: The objective of this study was to analyze the factors leading to delay in diagnosis and treatment of women with advanced stage cervical cancer. Methods: A cross-sectional observational study analyzed the factors associated with delay in initiation of treatment for 138 patients with advanced-stage cervical cancer from November 2019 to October 2020 at the National Institute of Cancer Research and Hospital (NICRH) in Dhaka, Bangladesh. Advanced-stage cervical cancer patients between the ages of 30 to 70 years were included in this study. Face-to-face interviews with the participants used a predesigned data collection sheet. In this study, three components of delay were identified: primary delay due to patient factors, healthcare provider delay, and healthcare-system infrastructure delay. Factors associated with delay were the independent variables and durations of delay were the outcome variables. Descriptive statistics were expressed as mean + standard deviation, median, percentage, and frequency. Results: One hundred and thirty-eight patients with advanced stage cervical cancer were included in the study. The mean age of the patients was 48.74 (±9.57) years. Thirty-four percent of patients were illiterate. More than half (57.25%) of the patients were from lower middle-class families. Delays were categorized as patient-related, healthcare provider delay, and healthcare-system infrastructure related. Patient-related factors included low monthly income, residence in a rural area, embarrassment, fear, lack of knowledge regarding cervical cancer, delay in contacting a spouse, family member or friend prior to the first medical encounter. These elements predicted a primary delay of more than 60 days (P value Conclusion: Three broad categories of delay in diagnosis and treatment of cervical cancer: patient-related factors, healthcare provider-related factors, and healthcare-system infrastructure factors were analyzed. Illiteracy, lack of awareness regarding cervical cancer, lack of health-seeking behavior, and poor income status were associated with patient-related primary delay. Nonperformance of speculum examination in the initial consultation, misdiagnosis, inappropriate management, and delay in referral to the cancer treatment center by primary healthcare providers were the contributing factors for healthcare provider delay. Lack of availability and accessibility of health services and limitation of radiotherapy resources led to healthcare-system infrastructure delays. All three categories of delay must be addressed through the education of communities, the gynecologic training of community healthcare providers, the improvement of medical infrastructure, and the increase of medical resources.展开更多
Background:Limited data are available for sirolimus-eluting stent(SES,Cypher)implantation in patients with coronary artery disease in small vessels.The clinical longtermoutcomes of SES in patients with coronary artery...Background:Limited data are available for sirolimus-eluting stent(SES,Cypher)implantation in patients with coronary artery disease in small vessels.The clinical longtermoutcomes of SES in patients with coronary artery disease after intracoronary stenting in small vessels has not been yet evaluated.展开更多
BACKGROUND Traumatic injuries,such as falling,car accidents,and crushing mostly cause spinal fractures in young and middle-aged people,and>50%of them are thoracolumbar fractures.This kind of fracture is easily comb...BACKGROUND Traumatic injuries,such as falling,car accidents,and crushing mostly cause spinal fractures in young and middle-aged people,and>50%of them are thoracolumbar fractures.This kind of fracture is easily combined with serious injuries to peripheral nerves and soft tissues,which causes paralysis of the lower limbs if there is no timely rehabilitation treatment.Young patients with thoracolumbar fractures find it difficult to recover after the operation,and they are prone to depression,low self-esteem,and other negative emotions.AIM To investigate the association between anxiety,depression,and social stress in young patients with thoracolumbar spine fractures and the effect on rehabilitation outcomes.METHODS This study retrospectively analyzed 100 patients admitted to the orthopedic department of Honghui Hospital,Xi’an Jiaotong University who underwent thoracolumbar spine fracture surgery from January 2022 to June 2023.The general data of the patients were assessed with the Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),life events scale,and social support rating scale(SSRS)to identify the correlation between anxiety,depression scores,and social stress and social support.The Japanese Orthopedic Association(JOA)was utilized to evaluate the rehabilitation outcomes of the patients and to analyze the effects of anxiety and depression scores on rehabilitation.RESULTS According to the scores of HAMD and HAMA in all patients,the prevalence of depression in patients was 39%(39/100),and the prevalence of anxiety was 49%(49/100).Patients were categorized into non-depression(n=61)and depression(n=39),non-anxiety(n=51),and anxiety(n=49)groups.Statistically significant differences in gender,occupation,Pittsburgh Sleep Quality Index(PSQI)score,and monthly family income were observed between the non-depression and depression groups(P<0.05).A significant difference in occupation and PSQI score was found between the non-anxiety and anxiety groups.Both depression(r=0.207,P=0.038)and anxiety scores(r=0.473,P<0.001)were significantly and positively correlated with negative life events.The difference in negative life event scores as well as SSRS total and item scores was statist-ically significant between patients in the non-depression and depression groups(P<0.05).The difference between the non-anxiety and anxiety groups was statistically significant(P<0.05)in the negative life event scores as well as the total SSRS scores.Additionally,JOA scores were significantly lower in both anxious and depressed patients.CONCLUSION Young patients with thoracolumbar fractures are prone to anxiety and depression.Patients’anxiety and depression are closely associated with social pressure,which reduces the life pressure of young patients with thoracolumbar fractures,enhances social support,and improves the psychology of anxiety and depression.,which affects patients’recovery.展开更多
Transferring patients with critical illnesses from general wards to intensive care units (ICUs) is a crucial and time-sensitive process. This article presents strategies for improving the efficiency of patient transfe...Transferring patients with critical illnesses from general wards to intensive care units (ICUs) is a crucial and time-sensitive process. This article presents strategies for improving the efficiency of patient transfers, particularly in hospitals where intensive care units are located in buildings separate from general wards. Patient transfers comprise several steps: physicians issue orders, relatives are notified, equipment is prepared, and medical staff coordinate. We identified three factors that influence transfer time: preparation time for bed transfer, time required for shift handovers, and time required for between-ward patient movement. Unfamiliarity with transfer routes and long elevator wait times were factors that also influenced transfer time. The following strategies were proposed: develop a standardized material checklist, design key notes for patient transfers, and optimize transfer routes. These strategies reduced transfer times by 40% to 43%. This study demonstrates that by addressing logistical challenges and streamlining relevant procedures, hospitals can enhance safety and quality of care during patient transfers.展开更多
Background:Rosa chinensis Jacq.and Rosa rugosa Thunb.are not only of ornamental value,but also edible flowers and the flower buds have been listed in the Chinese Pharmacopoeia as traditional medicines.The two plants h...Background:Rosa chinensis Jacq.and Rosa rugosa Thunb.are not only of ornamental value,but also edible flowers and the flower buds have been listed in the Chinese Pharmacopoeia as traditional medicines.The two plants have some differences in efficacy,but the flower buds are easily confused for similar traits.In addition,large-scale cultivation of ornamental rose flowers may lead to a decrease in the effective components of medicinal roses.Therefore,it is necessary to study the chemical composition and make quality evaluation of Rosae Chinensis Flos(Yueji)and Rosae Rugosae Flos(Meigui).Methods:In this study,40 batches of samples including Meigui and Yueji from different regions in China were collected to establish high-performance liquid chromatography fingerprints.Then,the fingerprints data was analyzed using principal component analysis,hierarchical cluster analysis,and partial least squares discriminant analysis analysis chemometrics to obtain information on intergroup differences,and non-targeted metabolomic techniques were applied to identify and compare chemical compositions of samples which were chosen from groups with large differences.Differential compounds were screened by orthogonal partial least-squares discriminant analysis and S-plot,and finally multi-component quantification was performed to comprehensively evaluate the quality of Yueji and Meigui.Results:The similarity between the fingerprints of 40 batches roses and the reference print R was 0.73 to 0.93,indicating that there were similarities and differences between the samples.Through principal component analysis and hierarchical cluster analysis of fingerprints data,the samples from different origins and varieties were intuitively divided into four groups.Partial least-squares discriminant analysis analysis showed that Meigui and Yueji cluster into two categories and the model was reliable.A total of 89 compounds were identified by high resolution mass spectrometry,mainly were flavonoids and flavonoid glycosides,as well as phenolic acids.Eight differential components were screened out by orthogonal partial least-squares discriminant analysis and S-plot analysis.Quantitative analyses of the eight compounds,including gallic acid,ellagic acid,hyperoside,isoquercitrin,etc.,showed that Yueji was generally richer in phenolic acids and flavonoids than Meigui,and the quality of Yueji from Shandong and Hebei was better.It is worth noting that Xinjiang rose is rich in various components,which is worth focusing on more in-depth research.Conclusion:In this study,the fingerprints of Meigui and Yueji were established.The chemical components information of roses was further improved based on non-targeted metabolomics and mass spectrometry technology.At the same time,eight differential components of Meigui and Yueji were screened out and quantitatively analyzed.The research results provided a scientific basis for the quality control and rational development and utilization of Rosae Chinensis Flos and Rosae Rugosae Flos,and also laid a foundation for the study of their pharmacodynamic material basis.展开更多
Introduction: The WHO’s measles control strategy is based on epidemiological surveillance and vaccination. Little is currently known about the performance of the surveillance system, particularly in outlying areas. I...Introduction: The WHO’s measles control strategy is based on epidemiological surveillance and vaccination. Little is currently known about the performance of the surveillance system, particularly in outlying areas. It is in this context that the present study was carried out to evaluate the measles epidemiological surveillance system in the Kangaba health district. Method: This was a descriptive cross-sectional study with retrospective data collection for the period from 1 January to 31 December 2022 in the Kangaba health district with 18 epidemiological surveillance officers. Data were collected using an observation grid and documentary analysis. Results: We found a simplicity of 97%, a representativeness of 95% and a reactivity of 53%. Not all notified cases were sampled (64%). Of the 17 CSCom, 8 were positive. A total of 34 confirmed cases of measles were recorded, with one death. Conclusion: Overall, the system is functional and well-established in the health centres, but it remains important to ensure that suspected cases are investigated and that the time between sampling and the availability of laboratory results is respected.展开更多
Under the rapid impetus of artificial intelligence(AI)technology,human society is stepping into the age of intelligence at an unprecedented speed.A new generation of information technology such as AI is not only a new...Under the rapid impetus of artificial intelligence(AI)technology,human society is stepping into the age of intelligence at an unprecedented speed.A new generation of information technology such as AI is not only a new engine of economic development,but also a gas pedal of social development,which has had a profound impact on the field of education.In the face of the opportunities and challenges of the AI era,it is particularly urgent to build a scientific and reasonable education evaluation system.This paper combines the context of the times with the new technology of AI to discuss the opportunities,challenges,and implementation strategies of educational evaluation reform in the era of AI,with a view to providing references for the construction of the educational evaluation system and the development of high-quality education in the new era.展开更多
Introduction: Diabetes remains a real public health problem today, due to its associated morbidity and mortality. It induces numerous metabolic, biochemical, hematological, and immunological changes, responsible for m...Introduction: Diabetes remains a real public health problem today, due to its associated morbidity and mortality. It induces numerous metabolic, biochemical, hematological, and immunological changes, responsible for multiple complications. The objective of this study was to characterize clinically and biologically type 2 diabetic patients followed at the National Center for Diabetology and Arterial Hypertension of the Central Hospital of Yaoundé. Method: This prospective, cross-sectional, and analytical study took place from April 5 to July 31, 2023 (4 months) on 100 diabetic patients of both sexes (61 women and 39 men), aged from 31 to 88 years. Body Mass Index, systolic and diastolic blood pressure, and cardiac frequency were measured on each of the patients. Subsequently, blood was collected from the patients for the determination of the complete blood count, HBA1c, lipid profile, serum albumin, TNF-α, and IL-6 levels. The data were analyzed using SPSS 17.0 software. Results: The age average of our population was 56.99 ± 11.51 years, the population was primarily female (61%) and primarily between the ages of 55 and 88. 67% of respondents were married. 59% went to secondary school. 73% of them lived in urban areas. 30% were obese and 40% were overweight, with an average BMI of 28.75 kg/m2. 76% of patients took oral antidiabetic medications. HbA1c level average was 8.65%, with 60% having readings above 6.5%. Low hemoglobin and hypochromia were among the abnormalities of red blood cells observed. Lipid profiles revealed low HDL-cholesterol and high triglycerides and cholesterol. Elevated levels of TNF-α and IL-6 indicated inflammation and cardiovascular risk. Conclusion: These results indicate the necessity of focused diabetic care and management on diabetic patients attending the central hospital of Yaoundé, Cameroon.展开更多
Introduction: Arbovirus diseases such as dengue and chikungunya threaten public health worldwide. Early and rapid diagnosis and surveillance of dengue virus (DENV) and chikungunya virus (CHIKV) infections are essentia...Introduction: Arbovirus diseases such as dengue and chikungunya threaten public health worldwide. Early and rapid diagnosis and surveillance of dengue virus (DENV) and chikungunya virus (CHIKV) infections are essential to the control of these diseases. In this study, we evaluate the diagnostic performance of our new in-house multiplex RT-qPCR method for detecting DENV serotypes and CHIKV in an external laboratory. Methodology: The evaluation study was conducted on 200 clinical samples of suspected patients for arbovirus disease infection, collected in Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso. Our new multiplex RT-qPCR was compared to the commercial kit, the Zika, Dengue, and Chikungunya (ZDC) Real-Time PCR Assays kit (Bio-Rad, California, USA). Results and Conclusions: Among 200 samples, 21.5% (43/200) were DENV-positive by multiplex RT-qPCR, and 21.5% (43/200) were also DENV-positive by reference real-time RT-PCR. 157 (78.5%) samples tested negative for DENV by both tests (new mRT-qPCR and reference test). The sensitivity and specificity of mRT-qPCR were 100%. The DENV serotypes detected were DENV-1 60.5% (26/43) and DENV-3 39.5% (17/43). CHIKV was not detected in this study. Our new mRT-qPCR is sensitive, cost-effective, simple, and can be used in developing country laboratories.展开更多
BACKGROUND Despite the developments in the field of kidney transplantation,the already existing diagnostic techniques for patient monitoring are considered insufficient.Protein biomarkers that can be derived from mode...BACKGROUND Despite the developments in the field of kidney transplantation,the already existing diagnostic techniques for patient monitoring are considered insufficient.Protein biomarkers that can be derived from modern approaches of proteomic analysis of liquid biopsies(serum,urine)represent a promising innovation in the monitoring of kidney transplant recipients.AIM To investigate the diagnostic utility of protein biomarkers derived from proteomics approaches in renal allograft assessment.METHODS A systematic review was conducted in accordance with PRISMA guidelines,based on research results from the PubMed and Scopus databases.The primary focus was on evaluating the role of biomarkers in the non-invasive diagnosis of transplant-related com-plications.Eligibility criteria included protein biomarkers and urine and blood samples,while exclusion criteria were language other than English and the use of low resolution and sensitivity methods.The selected research articles,were categorized based on the biological sample,condition and methodology and the significantly and reproducibly differentiated proteins were manually selected and extracted.Functional and network analysis of the selected proteins was performed.RESULTS In 17 included studies,58 proteins were studied,with the cytokine CXCL10 being the most investigated.Biological pathways related to immune response and fibrosis have shown to be enriched.Applications of biomarkers for the assessment of renal damage as well as the prediction of short-term and long-term function of the graft were reported.Overall,all studies have shown satisfactory diagnostic accuracy of proteins alone or in combination with conventional methods,as far as renal graft assessment is concerned.CONCLUSION Our review suggests that protein biomarkers,evaluated in specific biological fluids,can make a significant contribution to the timely,valid and non-invasive assessment of kidney graft.展开更多
In order to identify the nutrient level and environmental quality of paddy fields in Wanchang area,and to provide scientific basis and technical support for planting rice in Wanchang area, the soil geochemicalsurvey w...In order to identify the nutrient level and environmental quality of paddy fields in Wanchang area,and to provide scientific basis and technical support for planting rice in Wanchang area, the soil geochemicalsurvey was carried out, 30 samples were collected from paddy soil in Wanchang area, and 20 elements(indicators) were analyzed. The characterization of the elemental content of soils in the study area was carriedout, and the geochemical level for soil nutrients, the geochemical level for the soil environment, and thecomprehensive geochemical level of soil quality were evaluated. The results showed that the average valuesof K content and pH of the soil in the study area were smaller than the background values of Jilin Province,and the average values of 18 elements including N, P, Ca, S, Pb, Zn etc. were bigger than the backgroundvalues of Jilin Province. The results of the evaluation of soil single element nutrient in the study area showedthat the available state nutrient levels of Mn, Zn, Cu, and K increased compared with the total amounts ofnutrients level, with Cu increasing the most;the available state nutrient level of N, P, B, and Mo decreasedcompared with the total amounts of nutrients level, with Mo decreasing the most. The comprehensive levelof soil nutrients geochemistry in paddy fields was mainly Level III (medium), accounting for 53.33%, andthe low abundance level was caused by the lack of P element;the comprehensive level of soil environmentalgeochemistry was mainly Level I (clean), accounting for 96.67%, with only slight pollution caused byCd. The comprehensive geochemical level of soil quality was mainly Level II, accounting for 66.67%.Suggestions were put forward for the rational utilization of soil resources in paddy fields in the study area.展开更多
Implantable cardioverter defibrillators(ICDs)represent an established therapeutic strategy for the prevention of sudden cardiac death and reduction of mortality in high-risk patients,while ICDs with cardiac resynchron...Implantable cardioverter defibrillators(ICDs)represent an established therapeutic strategy for the prevention of sudden cardiac death and reduction of mortality in high-risk patients,while ICDs with cardiac resynchronization therapy defibrillators improve morbidity,quality of life,and mortality in eligible patients with heart failure who are on optimal medical therapy.However,these devices may adversely affect the patients’psychological status after the delivery of shock therapies or even because of the fear of impending therapy.On the other hand,the potential of effective treatment of malignant arrhythmias may provide a‘safety’sensation in most treated patients without significant impairment in the quality of life during periods of clinical stability.During the past few years,an increasing number of reports have investigated psychological distress,including depression and anxiety status in ICD/cardiac resynchronization therapy defibrillator recipients.However,heterogeneous results have been reported while data on the variation of these psychological indexes over time in implanted patients are quite limited.Several intrinsic and extrinsic factors affect the psychological status of these patients while variations of these disturbances in specific populations are evident.Factors that seem to be associated with a greater risk for depression and anxiety in this setting include female gender,younger age,and device shock therapies.Moreover,depression and anxiety may have an adverse impact on patients’clinical outcomes exacerbating heart failure and increasing the arrhythmic risk.In this brief review article,we provide a concise and critical overview of the current literature on this topic,and we also discuss unresolved and conflicting issues delineating future perspectives.展开更多
Objective To evaluate the prevalence and one-year prognosis associated with frailty in a contemporary cohort of older patients with non-ST-elevation acute coronary syndrome(NSTEACS).Methods The IMPACT-TIMING-GO regist...Objective To evaluate the prevalence and one-year prognosis associated with frailty in a contemporary cohort of older patients with non-ST-elevation acute coronary syndrome(NSTEACS).Methods The IMPACT-TIMING-GO registry(IMPACT of Time of Intervention in patients with Myocardial Infarction with Non-ST seGment elevation.ManaGement and Outcomes)prospectively included 1020 patients with NSTEACS undergoing invasive coronary angiography between April and May 2021.For this sub-study,patients≥65 years were selected.Frailty was assessed according to FRAIL scale.We studied all-cause mortality and the composite of all-cause mortality or all-cause hospitalizations at one-year follow-up after discharge.Results Five hundred and sixty seven patients(mean age:75.8±6.7 years,28.2%women)were included:316(55.7%)were robust,183(32.3%)prefrail,and 68(12.0%)frail.Frail patients were significantly older,more often women,and presented a worse baseline clinical profile.There were no differences among groups regarding pretreatment with a P2Y12 inhibitor.An urgent angiography(<24 h)was less frequently performed in frail patients,with no differences regarding revascularization approach or in main in-hospital adverse events,although acute kidney disease occurred more frequently in frail patients.At 1-year follow-up,20 patients died(3.6%).Chronic kidney disease was independently associated with 1-year all-cause death,although a trend towards higher mortality was observed in frail patients(HR=3.01;95%CI:0.93-9.78;P=0.065).Frailty was independently associated with higher 1-year all-cause mortality or all-cause rehospitalizations(HR=2.23;95%CI:1.43-3.46;P<0.001)Conclusions In older patients with NSTEACS,frailty independently associates higher all-cause mortality or all-cause hospital admissions at one-year follow-up.展开更多
文摘Atrial fibrillation(AF)is a major public health problem and poses a substantial economic burden on healthcare systems worldwide.[1-4]The emergency department(ED)serves as the first point of contact with the healthcare system and plays a key role in the management of patients with AF,which accounts for 3%-10%of all hospital admissions.[5]Treatment plans are often discussed and initiated at the ED.
文摘In this editorial,I address the mental health status of patients who have been discharged from intensive care units(ICUs)after battling coronavirus disease 2019(COVID-19).An ICU admission is generally a stressful experience,and for severe COVID-19 survivors prolonged treatment in the ICU can lead to significant psychological consequences.These individuals may experience psychiatric distress,including symptoms such as insomnia,anxiety,depression,and even posttraumatic psychological issues.Research indicates that during the first 6 months to 1 year following an ICU stay,nearly one-third of survivors exhibit symptoms similar to those of depression and post-traumatic stress disorder.Several factors may have contributed to the development of depressive and anxious symptoms during the COVID-19 pandemic,particularly for those who underwent an ICU stay.The ICU environment itself is inherently stressful,filled with the constant noise of various medical devices.Studies have provided strong evidence that the prolonged need for ventilation support and the loss of freedom of movement are key factors in the development of psychological problems among COVID-19 patients who had been treated in the ICU.
基金the Science and Technology Funding Project of Hunan Province,China(2023JJ50410)(HX)Key Laboratory of Tumor Precision Medicine,Hunan colleges and Universities Project(2019-379)(QL).
文摘Background The prognosis and survival of patients with lung cancer are likely to deteriorate with metastasis.Using deep-learning in the detection of lymph node metastasis can facilitate the noninvasive calculation of the likelihood of such metastasis,thereby providing clinicians with crucial information to enhance diagnostic precision and ultimately improve patient survival and prognosis.Methods In total,623 eligible patients were recruited from two medical institutions.Seven deep learning models,namely Alex,GoogLeNet,Resnet18,Resnet101,Vgg16,Vgg19,and MobileNetv3(small),were utilized to extract deep image histological features.The dimensionality of the extracted features was then reduced using the Spearman correlation coefficient(r≥0.9)and Least Absolute Shrinkage and Selection Operator.Eleven machine learning methods,namely Support Vector Machine,K-nearest neighbor,Random Forest,Extra Trees,XGBoost,LightGBM,Naive Bayes,AdaBoost,Gradient Boosting Decision Tree,Linear Regression,and Multilayer Perceptron,were employed to construct classification prediction models for the filtered final features.The diagnostic performances of the models were assessed using various metrics,including accuracy,area under the receiver operating characteristic curve,sensitivity,specificity,positive predictive value,and negative predictive value.Calibration and decision-curve analyses were also performed.Results The present study demonstrated that using deep radiomic features extracted from Vgg16,in conjunction with a prediction model constructed via a linear regression algorithm,effectively distinguished the status of mediastinal lymph nodes in patients with lung cancer.The performance of the model was evaluated based on various metrics,including accuracy,area under the receiver operating characteristic curve,sensitivity,specificity,positive predictive value,and negative predictive value,which yielded values of 0.808,0.834,0.851,0.745,0.829,and 0.776,respectively.The validation set of the model was assessed using clinical decision curves,calibration curves,and confusion matrices,which collectively demonstrated the model's stability and accuracy.Conclusion In this study,information on the deep radiomics of Vgg16 was obtained from computed tomography images,and the linear regression method was able to accurately diagnose mediastinal lymph node metastases in patients with lung cancer.
基金reviewed and approved by the Institutional Review Board of The Second People's Hospital of Lianyungang(Approval No.LW-20220707001).
文摘BACKGROUND Benign gallbladder diseases have become a high-prevalence condition not only in China but also worldwide.The main types of benign gallbladder diseases include gallbladder polyps,acute and chronic cholecystitis,and gallstones,with gallstones being the most common,accounting for over 70%of cases.Although the mortality rate of benign gallbladder diseases is low,they carry obvious potential risks.Studies have shown that an increased incidence of benign gallbladder diseases can increase the risk of cardiovascular diseases and gallbladder cancer,resulting in a substantial disease burden on patients and their families.AIM To assess the medical utility of the Configuration-Procedure-Consequence(CPC)three-dimensional quality evaluation model in modulating the prognosis of laparoscopic cholecystectomy patients.METHODS A total of 98 patients who underwent laparoscopic cholecystectomy in our hospital from February 2020 to January 2022 were selected as the subjects.According to the random number table method,they were divided into a study group and a control group,with 49 patients in each group.The control group received routine perioperative care,while the study group had the addition of the CPC three-dimensional quality evaluation.The postoperative recovery-related indicators(time to first flatus,time to oral intake,time to ambulation,hospital stay),stress indicators(cortisol and adrenaline levels),distinctions in anxiety and RESULTS The time to first flatus,time to oral intake,time to ambulation,and hospital stay of the study group patients were obviously lower than those of the control group patients,with statistical significance(P<0.05).On the 1st day after admission,there were no obvious distinctions in cortisol and adrenaline levels in blood samples,as well as in the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)scores between the study group and the control group(P>0.05).However,on the 3rd day after surgery,the cortisol and adrenaline levels,as well as SAS and SDS scores of the study group patients,were obviously lower than those of the control group patients(P<0.05).The study group had 2 cases of incisional infection and 1 case of pulmonary infection,with a total incidence of complications of 6.12%(3/49),which was obviously lower than the 20.41%(10/49)in the control group(P<0.05).CONCLUSION Implementing the CPC three-dimensional quality evaluation model for patients undergoing laparoscopic cholecystectomy can help accelerate their perioperative recovery process,alleviate perioperative stress symptoms,mitigate anxiety,depression,and other adverse emotions,and to some extent,reduce the incidence of perioperative complications.
文摘BACKGROUND Patients in neurology intensive care units(ICU)are prone to pressure injuries(PU)due to factors such as severe illness,long-term bed rest,and physiological dysfunction.PU not only causes pain and complications to patients,but also increases medical burden,prolongs hospitalization time,and affects the recovery process.AIM To evaluate and optimize the effectiveness of pressure injury prevention nursing measures in neurology ICU patients.METHODS A retrospective study was conducted,and 60 patients who were admitted to the ICU of the Department of Neurology were selected and divided into an observation group and a control group according to the order of admission,with 30 people in each group.The observation group implemented pressure injury prevention and nursing measures,while the control group adopted routine care.RESULTS Comparison between observation and control groups following pressure injury prevention nursing intervention revealed significantly lower incidence rates in the observation group compared to the control group at 48 h(8.3%vs 26.7%),7 d(16.7%vs 43.3%),and 14 d(20.0%vs 50.0%).This suggests a substantial reduction in pressure injury incidence in the observation group,with the gap widening over time.Additionally,patients in the observation group exhibited quicker recovery,with a shorter average time to get out of bed(48 h vs 72 h)and a shorter average length of stay(12 d vs 15 d)compared to the control group.Furthermore,post-intervention,patients in the observation group reported significantly improved quality of life scores,including higher scores in body satisfaction,feeling and function,and comfort(both psychological and physiological),indicating enhanced overall well-being and comfort following the implementation of pressure injury prevention nursing measures.CONCLUSION Implementing pressure injury preventive care measures for neurology ICU patients will have better results.
文摘Prediabetes is a heterogeneous condition,encompassing various pathological phenotypes such as hyperinsulinemia,tissue-specific insulin resistance(IR),systemic IR,andβ-cell dysfunction.A significant proportion of individuals with prediabetes remain undiagnosed.Furthermore,although lifestyle interventions have demonstrated efficacy in improving prediabetic conditions,some individuals with prediabetes progress to type 2 diabetes mellitus.This study aims to summarize effective evaluation methods for identifying distinct pathological phenotypes of prediabetes and targeted lifestyle intervention strategies to mitigate the progression from prediabetes to diabetes.
文摘Background:Given the strikingly high diagnostic error rate in hospitals,and the recent development of Large Language Models(LLMs),we set out to measure the diagnostic sensitivity of two popular LLMs:GPT-4 and PaLM2.Small-scale studies to evaluate the diagnostic ability of LLMs have shown promising results,with GPT-4 demonstrating high accuracy in diagnosing test cases.However,larger evaluations on real electronic patient data are needed to provide more reliable estimates.Methods:To fill this gap in the literature,we used a deidentified Electronic Health Record(EHR)data set of about 300,000 patients admitted to the Beth Israel Deaconess Medical Center in Boston.This data set contained blood,imaging,microbiology and vital sign information as well as the patients'medical diagnostic codes.Based on the available EHR data,doctors curated a set of diagnoses for each patient,which we will refer to as ground truth diagnoses.We then designed carefully-written prompts to get patient diagnostic predictions from the LLMs and compared this to the ground truth diagnoses in a random sample of 1000 patients.Results:Based on the proportion of correctly predicted ground truth diagnoses,we estimated the diagnostic hit rate of GPT-4 to be 93.9%.PaLM2 achieved 84.7%on the same data set.On these 1000 randomly selected EHRs,GPT-4 correctly identified 1116 unique diagnoses.Conclusion:The results suggest that artificial intelligence(AI)has the potential when working alongside clinicians to reduce cognitive errors which lead to hundreds of thousands of misdiagnoses every year.However,human oversight of AI remains essential:LLMs cannot replace clinicians,especially when it comes to human understanding and empathy.Furthermore,a significant number of challenges in incorporating AI into health care exist,including ethical,liability and regulatory barriers.
文摘Research Background: Cervical cancer is the second most common cancer in women and the third leading cause of female cancer death in Bangladesh. Delay in initiation of treatment in advanced stage cervical cancer patients is an important modifiable risk factor for cancer-related mortality. Identifying elements associated with delay of diagnosis will help reduce barriers to timely treatment of cervical cancer. Research Objectives: The objective of this study was to analyze the factors leading to delay in diagnosis and treatment of women with advanced stage cervical cancer. Methods: A cross-sectional observational study analyzed the factors associated with delay in initiation of treatment for 138 patients with advanced-stage cervical cancer from November 2019 to October 2020 at the National Institute of Cancer Research and Hospital (NICRH) in Dhaka, Bangladesh. Advanced-stage cervical cancer patients between the ages of 30 to 70 years were included in this study. Face-to-face interviews with the participants used a predesigned data collection sheet. In this study, three components of delay were identified: primary delay due to patient factors, healthcare provider delay, and healthcare-system infrastructure delay. Factors associated with delay were the independent variables and durations of delay were the outcome variables. Descriptive statistics were expressed as mean + standard deviation, median, percentage, and frequency. Results: One hundred and thirty-eight patients with advanced stage cervical cancer were included in the study. The mean age of the patients was 48.74 (±9.57) years. Thirty-four percent of patients were illiterate. More than half (57.25%) of the patients were from lower middle-class families. Delays were categorized as patient-related, healthcare provider delay, and healthcare-system infrastructure related. Patient-related factors included low monthly income, residence in a rural area, embarrassment, fear, lack of knowledge regarding cervical cancer, delay in contacting a spouse, family member or friend prior to the first medical encounter. These elements predicted a primary delay of more than 60 days (P value Conclusion: Three broad categories of delay in diagnosis and treatment of cervical cancer: patient-related factors, healthcare provider-related factors, and healthcare-system infrastructure factors were analyzed. Illiteracy, lack of awareness regarding cervical cancer, lack of health-seeking behavior, and poor income status were associated with patient-related primary delay. Nonperformance of speculum examination in the initial consultation, misdiagnosis, inappropriate management, and delay in referral to the cancer treatment center by primary healthcare providers were the contributing factors for healthcare provider delay. Lack of availability and accessibility of health services and limitation of radiotherapy resources led to healthcare-system infrastructure delays. All three categories of delay must be addressed through the education of communities, the gynecologic training of community healthcare providers, the improvement of medical infrastructure, and the increase of medical resources.
文摘Background:Limited data are available for sirolimus-eluting stent(SES,Cypher)implantation in patients with coronary artery disease in small vessels.The clinical longtermoutcomes of SES in patients with coronary artery disease after intracoronary stenting in small vessels has not been yet evaluated.
文摘BACKGROUND Traumatic injuries,such as falling,car accidents,and crushing mostly cause spinal fractures in young and middle-aged people,and>50%of them are thoracolumbar fractures.This kind of fracture is easily combined with serious injuries to peripheral nerves and soft tissues,which causes paralysis of the lower limbs if there is no timely rehabilitation treatment.Young patients with thoracolumbar fractures find it difficult to recover after the operation,and they are prone to depression,low self-esteem,and other negative emotions.AIM To investigate the association between anxiety,depression,and social stress in young patients with thoracolumbar spine fractures and the effect on rehabilitation outcomes.METHODS This study retrospectively analyzed 100 patients admitted to the orthopedic department of Honghui Hospital,Xi’an Jiaotong University who underwent thoracolumbar spine fracture surgery from January 2022 to June 2023.The general data of the patients were assessed with the Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),life events scale,and social support rating scale(SSRS)to identify the correlation between anxiety,depression scores,and social stress and social support.The Japanese Orthopedic Association(JOA)was utilized to evaluate the rehabilitation outcomes of the patients and to analyze the effects of anxiety and depression scores on rehabilitation.RESULTS According to the scores of HAMD and HAMA in all patients,the prevalence of depression in patients was 39%(39/100),and the prevalence of anxiety was 49%(49/100).Patients were categorized into non-depression(n=61)and depression(n=39),non-anxiety(n=51),and anxiety(n=49)groups.Statistically significant differences in gender,occupation,Pittsburgh Sleep Quality Index(PSQI)score,and monthly family income were observed between the non-depression and depression groups(P<0.05).A significant difference in occupation and PSQI score was found between the non-anxiety and anxiety groups.Both depression(r=0.207,P=0.038)and anxiety scores(r=0.473,P<0.001)were significantly and positively correlated with negative life events.The difference in negative life event scores as well as SSRS total and item scores was statist-ically significant between patients in the non-depression and depression groups(P<0.05).The difference between the non-anxiety and anxiety groups was statistically significant(P<0.05)in the negative life event scores as well as the total SSRS scores.Additionally,JOA scores were significantly lower in both anxious and depressed patients.CONCLUSION Young patients with thoracolumbar fractures are prone to anxiety and depression.Patients’anxiety and depression are closely associated with social pressure,which reduces the life pressure of young patients with thoracolumbar fractures,enhances social support,and improves the psychology of anxiety and depression.,which affects patients’recovery.
文摘Transferring patients with critical illnesses from general wards to intensive care units (ICUs) is a crucial and time-sensitive process. This article presents strategies for improving the efficiency of patient transfers, particularly in hospitals where intensive care units are located in buildings separate from general wards. Patient transfers comprise several steps: physicians issue orders, relatives are notified, equipment is prepared, and medical staff coordinate. We identified three factors that influence transfer time: preparation time for bed transfer, time required for shift handovers, and time required for between-ward patient movement. Unfamiliarity with transfer routes and long elevator wait times were factors that also influenced transfer time. The following strategies were proposed: develop a standardized material checklist, design key notes for patient transfers, and optimize transfer routes. These strategies reduced transfer times by 40% to 43%. This study demonstrates that by addressing logistical challenges and streamlining relevant procedures, hospitals can enhance safety and quality of care during patient transfers.
基金supported by the key project at the central government level:The ability establishment of sustainable use for valuable Chinese medicine resources(Grant number 2060302)the National Natural Science Foundation of China(Grant number 82373982,82173929).
文摘Background:Rosa chinensis Jacq.and Rosa rugosa Thunb.are not only of ornamental value,but also edible flowers and the flower buds have been listed in the Chinese Pharmacopoeia as traditional medicines.The two plants have some differences in efficacy,but the flower buds are easily confused for similar traits.In addition,large-scale cultivation of ornamental rose flowers may lead to a decrease in the effective components of medicinal roses.Therefore,it is necessary to study the chemical composition and make quality evaluation of Rosae Chinensis Flos(Yueji)and Rosae Rugosae Flos(Meigui).Methods:In this study,40 batches of samples including Meigui and Yueji from different regions in China were collected to establish high-performance liquid chromatography fingerprints.Then,the fingerprints data was analyzed using principal component analysis,hierarchical cluster analysis,and partial least squares discriminant analysis analysis chemometrics to obtain information on intergroup differences,and non-targeted metabolomic techniques were applied to identify and compare chemical compositions of samples which were chosen from groups with large differences.Differential compounds were screened by orthogonal partial least-squares discriminant analysis and S-plot,and finally multi-component quantification was performed to comprehensively evaluate the quality of Yueji and Meigui.Results:The similarity between the fingerprints of 40 batches roses and the reference print R was 0.73 to 0.93,indicating that there were similarities and differences between the samples.Through principal component analysis and hierarchical cluster analysis of fingerprints data,the samples from different origins and varieties were intuitively divided into four groups.Partial least-squares discriminant analysis analysis showed that Meigui and Yueji cluster into two categories and the model was reliable.A total of 89 compounds were identified by high resolution mass spectrometry,mainly were flavonoids and flavonoid glycosides,as well as phenolic acids.Eight differential components were screened out by orthogonal partial least-squares discriminant analysis and S-plot analysis.Quantitative analyses of the eight compounds,including gallic acid,ellagic acid,hyperoside,isoquercitrin,etc.,showed that Yueji was generally richer in phenolic acids and flavonoids than Meigui,and the quality of Yueji from Shandong and Hebei was better.It is worth noting that Xinjiang rose is rich in various components,which is worth focusing on more in-depth research.Conclusion:In this study,the fingerprints of Meigui and Yueji were established.The chemical components information of roses was further improved based on non-targeted metabolomics and mass spectrometry technology.At the same time,eight differential components of Meigui and Yueji were screened out and quantitatively analyzed.The research results provided a scientific basis for the quality control and rational development and utilization of Rosae Chinensis Flos and Rosae Rugosae Flos,and also laid a foundation for the study of their pharmacodynamic material basis.
文摘Introduction: The WHO’s measles control strategy is based on epidemiological surveillance and vaccination. Little is currently known about the performance of the surveillance system, particularly in outlying areas. It is in this context that the present study was carried out to evaluate the measles epidemiological surveillance system in the Kangaba health district. Method: This was a descriptive cross-sectional study with retrospective data collection for the period from 1 January to 31 December 2022 in the Kangaba health district with 18 epidemiological surveillance officers. Data were collected using an observation grid and documentary analysis. Results: We found a simplicity of 97%, a representativeness of 95% and a reactivity of 53%. Not all notified cases were sampled (64%). Of the 17 CSCom, 8 were positive. A total of 34 confirmed cases of measles were recorded, with one death. Conclusion: Overall, the system is functional and well-established in the health centres, but it remains important to ensure that suspected cases are investigated and that the time between sampling and the availability of laboratory results is respected.
文摘Under the rapid impetus of artificial intelligence(AI)technology,human society is stepping into the age of intelligence at an unprecedented speed.A new generation of information technology such as AI is not only a new engine of economic development,but also a gas pedal of social development,which has had a profound impact on the field of education.In the face of the opportunities and challenges of the AI era,it is particularly urgent to build a scientific and reasonable education evaluation system.This paper combines the context of the times with the new technology of AI to discuss the opportunities,challenges,and implementation strategies of educational evaluation reform in the era of AI,with a view to providing references for the construction of the educational evaluation system and the development of high-quality education in the new era.
文摘Introduction: Diabetes remains a real public health problem today, due to its associated morbidity and mortality. It induces numerous metabolic, biochemical, hematological, and immunological changes, responsible for multiple complications. The objective of this study was to characterize clinically and biologically type 2 diabetic patients followed at the National Center for Diabetology and Arterial Hypertension of the Central Hospital of Yaoundé. Method: This prospective, cross-sectional, and analytical study took place from April 5 to July 31, 2023 (4 months) on 100 diabetic patients of both sexes (61 women and 39 men), aged from 31 to 88 years. Body Mass Index, systolic and diastolic blood pressure, and cardiac frequency were measured on each of the patients. Subsequently, blood was collected from the patients for the determination of the complete blood count, HBA1c, lipid profile, serum albumin, TNF-α, and IL-6 levels. The data were analyzed using SPSS 17.0 software. Results: The age average of our population was 56.99 ± 11.51 years, the population was primarily female (61%) and primarily between the ages of 55 and 88. 67% of respondents were married. 59% went to secondary school. 73% of them lived in urban areas. 30% were obese and 40% were overweight, with an average BMI of 28.75 kg/m2. 76% of patients took oral antidiabetic medications. HbA1c level average was 8.65%, with 60% having readings above 6.5%. Low hemoglobin and hypochromia were among the abnormalities of red blood cells observed. Lipid profiles revealed low HDL-cholesterol and high triglycerides and cholesterol. Elevated levels of TNF-α and IL-6 indicated inflammation and cardiovascular risk. Conclusion: These results indicate the necessity of focused diabetic care and management on diabetic patients attending the central hospital of Yaoundé, Cameroon.
文摘Introduction: Arbovirus diseases such as dengue and chikungunya threaten public health worldwide. Early and rapid diagnosis and surveillance of dengue virus (DENV) and chikungunya virus (CHIKV) infections are essential to the control of these diseases. In this study, we evaluate the diagnostic performance of our new in-house multiplex RT-qPCR method for detecting DENV serotypes and CHIKV in an external laboratory. Methodology: The evaluation study was conducted on 200 clinical samples of suspected patients for arbovirus disease infection, collected in Centre de Recherche Biomoléculaire Pietro Annigoni (CERBA), Ouagadougou, Burkina Faso. Our new multiplex RT-qPCR was compared to the commercial kit, the Zika, Dengue, and Chikungunya (ZDC) Real-Time PCR Assays kit (Bio-Rad, California, USA). Results and Conclusions: Among 200 samples, 21.5% (43/200) were DENV-positive by multiplex RT-qPCR, and 21.5% (43/200) were also DENV-positive by reference real-time RT-PCR. 157 (78.5%) samples tested negative for DENV by both tests (new mRT-qPCR and reference test). The sensitivity and specificity of mRT-qPCR were 100%. The DENV serotypes detected were DENV-1 60.5% (26/43) and DENV-3 39.5% (17/43). CHIKV was not detected in this study. Our new mRT-qPCR is sensitive, cost-effective, simple, and can be used in developing country laboratories.
文摘BACKGROUND Despite the developments in the field of kidney transplantation,the already existing diagnostic techniques for patient monitoring are considered insufficient.Protein biomarkers that can be derived from modern approaches of proteomic analysis of liquid biopsies(serum,urine)represent a promising innovation in the monitoring of kidney transplant recipients.AIM To investigate the diagnostic utility of protein biomarkers derived from proteomics approaches in renal allograft assessment.METHODS A systematic review was conducted in accordance with PRISMA guidelines,based on research results from the PubMed and Scopus databases.The primary focus was on evaluating the role of biomarkers in the non-invasive diagnosis of transplant-related com-plications.Eligibility criteria included protein biomarkers and urine and blood samples,while exclusion criteria were language other than English and the use of low resolution and sensitivity methods.The selected research articles,were categorized based on the biological sample,condition and methodology and the significantly and reproducibly differentiated proteins were manually selected and extracted.Functional and network analysis of the selected proteins was performed.RESULTS In 17 included studies,58 proteins were studied,with the cytokine CXCL10 being the most investigated.Biological pathways related to immune response and fibrosis have shown to be enriched.Applications of biomarkers for the assessment of renal damage as well as the prediction of short-term and long-term function of the graft were reported.Overall,all studies have shown satisfactory diagnostic accuracy of proteins alone or in combination with conventional methods,as far as renal graft assessment is concerned.CONCLUSION Our review suggests that protein biomarkers,evaluated in specific biological fluids,can make a significant contribution to the timely,valid and non-invasive assessment of kidney graft.
基金Supported by the Special Study on Mineral Resources Planning in Changchun City(No.JM-2020-11-13594)Jilin Agricultural Geological Survey Project(No.12120105111208)。
文摘In order to identify the nutrient level and environmental quality of paddy fields in Wanchang area,and to provide scientific basis and technical support for planting rice in Wanchang area, the soil geochemicalsurvey was carried out, 30 samples were collected from paddy soil in Wanchang area, and 20 elements(indicators) were analyzed. The characterization of the elemental content of soils in the study area was carriedout, and the geochemical level for soil nutrients, the geochemical level for the soil environment, and thecomprehensive geochemical level of soil quality were evaluated. The results showed that the average valuesof K content and pH of the soil in the study area were smaller than the background values of Jilin Province,and the average values of 18 elements including N, P, Ca, S, Pb, Zn etc. were bigger than the backgroundvalues of Jilin Province. The results of the evaluation of soil single element nutrient in the study area showedthat the available state nutrient levels of Mn, Zn, Cu, and K increased compared with the total amounts ofnutrients level, with Cu increasing the most;the available state nutrient level of N, P, B, and Mo decreasedcompared with the total amounts of nutrients level, with Mo decreasing the most. The comprehensive levelof soil nutrients geochemistry in paddy fields was mainly Level III (medium), accounting for 53.33%, andthe low abundance level was caused by the lack of P element;the comprehensive level of soil environmentalgeochemistry was mainly Level I (clean), accounting for 96.67%, with only slight pollution caused byCd. The comprehensive geochemical level of soil quality was mainly Level II, accounting for 66.67%.Suggestions were put forward for the rational utilization of soil resources in paddy fields in the study area.
文摘Implantable cardioverter defibrillators(ICDs)represent an established therapeutic strategy for the prevention of sudden cardiac death and reduction of mortality in high-risk patients,while ICDs with cardiac resynchronization therapy defibrillators improve morbidity,quality of life,and mortality in eligible patients with heart failure who are on optimal medical therapy.However,these devices may adversely affect the patients’psychological status after the delivery of shock therapies or even because of the fear of impending therapy.On the other hand,the potential of effective treatment of malignant arrhythmias may provide a‘safety’sensation in most treated patients without significant impairment in the quality of life during periods of clinical stability.During the past few years,an increasing number of reports have investigated psychological distress,including depression and anxiety status in ICD/cardiac resynchronization therapy defibrillator recipients.However,heterogeneous results have been reported while data on the variation of these psychological indexes over time in implanted patients are quite limited.Several intrinsic and extrinsic factors affect the psychological status of these patients while variations of these disturbances in specific populations are evident.Factors that seem to be associated with a greater risk for depression and anxiety in this setting include female gender,younger age,and device shock therapies.Moreover,depression and anxiety may have an adverse impact on patients’clinical outcomes exacerbating heart failure and increasing the arrhythmic risk.In this brief review article,we provide a concise and critical overview of the current literature on this topic,and we also discuss unresolved and conflicting issues delineating future perspectives.
文摘Objective To evaluate the prevalence and one-year prognosis associated with frailty in a contemporary cohort of older patients with non-ST-elevation acute coronary syndrome(NSTEACS).Methods The IMPACT-TIMING-GO registry(IMPACT of Time of Intervention in patients with Myocardial Infarction with Non-ST seGment elevation.ManaGement and Outcomes)prospectively included 1020 patients with NSTEACS undergoing invasive coronary angiography between April and May 2021.For this sub-study,patients≥65 years were selected.Frailty was assessed according to FRAIL scale.We studied all-cause mortality and the composite of all-cause mortality or all-cause hospitalizations at one-year follow-up after discharge.Results Five hundred and sixty seven patients(mean age:75.8±6.7 years,28.2%women)were included:316(55.7%)were robust,183(32.3%)prefrail,and 68(12.0%)frail.Frail patients were significantly older,more often women,and presented a worse baseline clinical profile.There were no differences among groups regarding pretreatment with a P2Y12 inhibitor.An urgent angiography(<24 h)was less frequently performed in frail patients,with no differences regarding revascularization approach or in main in-hospital adverse events,although acute kidney disease occurred more frequently in frail patients.At 1-year follow-up,20 patients died(3.6%).Chronic kidney disease was independently associated with 1-year all-cause death,although a trend towards higher mortality was observed in frail patients(HR=3.01;95%CI:0.93-9.78;P=0.065).Frailty was independently associated with higher 1-year all-cause mortality or all-cause rehospitalizations(HR=2.23;95%CI:1.43-3.46;P<0.001)Conclusions In older patients with NSTEACS,frailty independently associates higher all-cause mortality or all-cause hospital admissions at one-year follow-up.
