Lung cancer is one of the malignant tumor diseases with high morbidity and high mortality in the world. Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer. Currently, chemotherapy, ...Lung cancer is one of the malignant tumor diseases with high morbidity and high mortality in the world. Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer. Currently, chemotherapy, targeted therapy, immunotherapy or combination therapy is the main treatment for NSCLC, but it is still inevitably faced with the challenges of acquired drug resistance and tumor progression. The birth of antibody conjugator provides a new choice for its treatment. Antibody conjugator is a new type of biotherapeutic drug which is connected by monoclonal antibody via linker and cytotoxic drug. It has the characteristics of precision, high efficiency and low toxicity, etc. In recent years, its research and development and clinical trials have been endless. It shows that this new type of drug has great potential in the field of tumor therapy. In this paper, the structural characteristics, mechanism of action, current application, research achievements, challenges, countermeasures and development of ADC in NSCLC treatment are reviewed.展开更多
Background: Non-radiographic axial spondyloarthritis is a progressive and disabling inflammatory disease affecting young adults, with limited treatment options. TNFi are more efficacious than JAKi and IL1-7i in nr-ax ...Background: Non-radiographic axial spondyloarthritis is a progressive and disabling inflammatory disease affecting young adults, with limited treatment options. TNFi are more efficacious than JAKi and IL1-7i in nr-ax SPA and it has a well-known safety profile over a longer duration. Recently, many IL-17i and JAKi were approved for the treatment of nr-ax SPA;however, data comparing IL1-7i and JAKi in terms of efficacy and safety is lacking. This systematized review aimed to compare the existing efficacy and safety data of JAKi vs IL-17i in the treatment of patients with nr-ax SPA. Methods: A systematic literature search was performed using relevant keywords in many databases. According to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA, 2020), relevant articles were included and evaluated in this review. Efficacy and safety data were collected, analyzed and compared through week 52. The first check was done by the end of week 14 and week 16 for upadacitinib and IL-17i respectively. Results: Data from four RCTs evaluating upadacitinib, secukinumab, ixekizumab, and bimekizumab comprising 1425 patients were analyzed. Overall, a comparable efficacy and safety profile were observed across different treatment arms through week 52;however, non-significant variations were encountered in some outcome measures. The primary endpoint among these RCTs (ASAS40 response rate) was met and it was higher in patients treated with bimekizumab 160 mg sc Q 4 weeks in TNFi non responders (48%) and lowest in ixekizumab 80 mg sc Q 4 weeks treated patients, (35%) (p Conclusion: The above-mentioned three IL-17i and the only one JAKi demonstrated comparable safety and efficacy profiles with some minor variations. A head-to-head trial comparing the effectiveness and safety characteristics of JAKi vs IL-17i may be needed in patients with active nr-ax SpA.展开更多
A previous paper showed that the real numbers between 0 and 1 could be represented by an infinite tree structure, called the ‘infinity tree’, which contains only a countably infinite number of nodes and arcs. This p...A previous paper showed that the real numbers between 0 and 1 could be represented by an infinite tree structure, called the ‘infinity tree’, which contains only a countably infinite number of nodes and arcs. This paper discusses how a finite-state Turing machine could, in a countably infinite number of state transitions, write all the infinite paths in the infinity tree to a countably infinite tape. Hence it is argued that the real numbers in the interval [0, 1] are countably infinite in a non-Cantorian theory of infinity based on Turing machines using countably infinite space and time. In this theory, Cantor’s Continuum Hypothesis can also be proved. And in this theory, it follows that the power set of the natural numbers P(ℕ) is countably infinite, which contradicts the claim of Cantor’s Theorem for the natural numbers. However, this paper does not claim there is an error in Cantor’s arguments that [0, 1] is uncountably infinite. Rather, this paper considers the situation as a paradox, resulting from different choices about how to represent and count the continuum of real numbers.展开更多
This paper presents an advanced control strategy for DC-DC buck converters utilizing Non-Minimal State Space (NMSS) representation combined with Proportional-Integral-Plus (PIP) control, optimized through Linear Quadr...This paper presents an advanced control strategy for DC-DC buck converters utilizing Non-Minimal State Space (NMSS) representation combined with Proportional-Integral-Plus (PIP) control, optimized through Linear Quadratic Regulator (LQR) design. The proposed approach leverages NMSS to eliminate the need for state observers, enhancing robustness against model mismatch and improving overall system performance. The PIP controller extends traditional PI control by incorporating additional dynamic feedback. Experimental results demonstrate that the NMSS-PIP-LQR controlled buck converter achieves excellent dynamic performance. The design procedure is fully documented, and microcontroller implementation issues are discussed.展开更多
目的评估血清非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值(non-high density lipoprotein cholesterol/high density lipoprotein cholesterol,NHHR)、血浆致动脉粥样硬化指数(atherogenic index of plasma,AIP)与慢性肾病(chronic k...目的评估血清非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值(non-high density lipoprotein cholesterol/high density lipoprotein cholesterol,NHHR)、血浆致动脉粥样硬化指数(atherogenic index of plasma,AIP)与慢性肾病(chronic kidney disease,CKD)发病风险的关系,为CKD的防治提供依据。方法以金昌队列中25377名未患CKD的参与者作为研究对象,采用Cox比例风险回归模型、限制性立方样条分别评估NHHR和AIP对CKD的发病风险及剂量-反应关系,并进行亚组分析。采用受试者工作特征曲线评估NHHR和AIP对CKD发病风险的预测能力。结果经过平均4.77年的随访调查后,新发CKD患者有1213例,发病密度为10.03/1000人年。调整混杂因素后,相较于Q1组,Q4组人群中NHHR和AIP的CKD发病风险比分别为1.270(95%CI:1.066~1.512)和1.294(95%CI:1.081~1.548),且均存在一定的剂量-反应关系(均P<0.05)。NHHR和AIP预测CKD的AUC值分别为0.750(95%CI:0.736~0.764)和0.735(95%CI:0.721~0.749)。亚组分析发现,吸烟和糖尿病与NHHR、糖尿病和AIP间存在交互作用(均P<0.05)。结论NHHR和AIP是CKD发病的独立危险因素,并对CKD发病风险有一定的预测能力。展开更多
Non-flow aqueous zinc-bromine batteries without auxiliary components(e.g.,pumps,pipes,storage tanks)and ion-selective membranes represent a cost-effective and promising technology for large-scale energy storage.Unfort...Non-flow aqueous zinc-bromine batteries without auxiliary components(e.g.,pumps,pipes,storage tanks)and ion-selective membranes represent a cost-effective and promising technology for large-scale energy storage.Unfortunately,they generally suffer from serious diffusion and shuttle of polybromide(Br^(-),Br^(3-))due to the weak physical adsorption between soluble polybromide and host carbon materials,which results in low energy efficiency and poor cycling stability.Here,we develop a novel self-capture organic bromine material(1,10-bis[3-(trimethylammonio)propyl]-4,4'-bipyridinium bromine,NVBr4)to successfully realize reversible solid complexation of bromide components for stable non-flow zinc-bromine battery applications.The quaternary ammonium groups(NV^(4+)ions)can effectively capture the soluble polybromide species based on strong chemical interaction and realize reversible solid complexation confined within the porous electrodes,which transforms the conventional“liquid-liquid”conversion of soluble bromide components into“liquid-solid”model and effectively suppresses the shuttle effect.Thereby,the developed non-flow zinc-bromide battery provides an outstanding voltage platform at 1.7 V with a notable specific capacity of 325 mAh g^(-1)NVBr4(1 A g^(-1)),excellent rate capability(200 mAh g^(-1)NVBr4 at 20 A g^(-1)),outstanding energy density of 469.6 Wh kg^(-1)and super-stable cycle life(20,000 cycles with 100%Coulombic efficiency),which outperforms most of reported zinc-halogen batteries.Further mechanism analysis and DFT calculations demonstrate that the chemical interaction of quaternary ammonium groups and bromide species is the main reason for suppressing the shuttle effect.The developed strategy can be extended to other halogen batteries to obtain stable charge storage.展开更多
Acute upper gastrointestinal hemorrhage is a highly prevalent clinical condition, with the majority of cases representing acute non-variceal upper gastrointestinal hemorrhage. With the advancement of modern medicine, ...Acute upper gastrointestinal hemorrhage is a highly prevalent clinical condition, with the majority of cases representing acute non-variceal upper gastrointestinal hemorrhage. With the advancement of modern medicine, endoscopy has become an indispensable tool in the diagnosis and treatment of various diseases. In order to achieve optimal results in the endoscopic treatment of non-variceal upper gastrointestinal bleeding, it is essential to make an accurate and timely diagnosis and select the most appropriate treatment method. This article introduces the definition of acute non-variceal upper gastrointestinal bleeding (ANVUGIB) and the importance of endoscopic treatment for this disease. It then presents an overview of various assessment systems for ANVUGIB and an overview of endoscopic advances in thermal coagulation, mechanical hemostasis, and topical pharmacological injection hemostasis for three aspects of ANVUGIB-related bleeding. In particular, this article discusses the therapeutic efficacy and safety of different treatment options for non-variceal upper gastrointestinal bleeding, as well as the advantages and limitations of these treatment options in managing this disease.展开更多
One of the main immune-mediated diseases that lead to avoidable blindness is non-infectious uveitis. Glucocorticoids are the first-line therapy choice for noninfectious uveitis;however, biologics are also showing prom...One of the main immune-mediated diseases that lead to avoidable blindness is non-infectious uveitis. Glucocorticoids are the first-line therapy choice for noninfectious uveitis;however, biologics are also showing promise in the management of this condition. The description of glucocorticoid and biologic usage in non-infectious uveitis is the main topic of this paper.展开更多
Introduction: Vaccination plays a pivotal role in mitigating the repercussions of the COVID-19 pandemic. However, vaccination campaigns encounter obstacles, especially in developing countries like the Democratic Repub...Introduction: Vaccination plays a pivotal role in mitigating the repercussions of the COVID-19 pandemic. However, vaccination campaigns encounter obstacles, especially in developing countries like the Democratic Republic of the Congo (DRC). This study aimed at investigating the roles of vaccine hesitancy, refusal, and access barriers, while identifying individual-level factors associated with non-vaccination in Mbujimayi, DRC. Methods: A community-based cross-sectional survey was conducted in three health districts and included 1496 residents. Attitudes and behaviors related to seeking COVID-19 vaccination were assessed using a standardized questionnaire. Hierarchical logistic regression modeling was used to assess factors potentially affecting non-compliance with vaccination. Results: Among participants (median age = 33, IQR = 23.3, M/F sex ratio = 0.7), 60% displayed misconceptions about COVID-19 or its vaccine, while only 35.2% perceived COVID-19 as a significant health threat. Vaccination coverage was estimated at 49.1% (95% CI: 47.5;52.6), with 71.8% of vaccinated individuals having received one dose. Among the unvaccinated individuals, 50.9% expressed no intention to be vaccinated in the future, citing hesitation (30.4%) or refusal (39.6%) mainly due to side effects or distrust of vaccines. Conversely, 32.7% of the unvaccinated persons expressed access barriers despite willingness to be vaccinated. Misconceptions about COVID-19 and its vaccines were the main drivers of vaccination non-compliance. Conclusion: These findings demonstrate significant vaccine non-compliance driven by hesitancy, refusal, and access barriers. Strategies to enhance vaccination coverage and pandemic preparedness should address misconceptions, sociodemographic barriers, and geographic disparities.展开更多
Non-communicable diseases (NCDs) account for 63% of mortalities. Approximately 80% of these NCD-related deaths occur in LMICs. A quasi-experimental study utilizing a non-equivalent pre-and post-test was conducted from...Non-communicable diseases (NCDs) account for 63% of mortalities. Approximately 80% of these NCD-related deaths occur in LMICs. A quasi-experimental study utilizing a non-equivalent pre-and post-test was conducted from May 2022 to March 2023 with 370 study participants. Multistage cluster and random sampling were used to select ten community units, and therefore, 150 CHVs were chosen for the control unit, and 150 were used to form the interventional group. Data was collected from the KOBO app. Six (6) homogenous FGDs comprised ten members, and 10 KII were conducted across study sites. Quantitative data was analyzed using SPSS version 28.0, and qualitative data was audio-recorded, transcribed, and analyzed via N-Vivo 12. The study shows that 59.3% of respondents have minimal information, and 92.7% (n = 139) have no clear understanding of NCDs, with a pre-intervention capacity of 48.8%. Independent sample t-test showed a significant difference in capacity from a pre-intervention average of 48.75 (SD ± 5.7)%, which increased to 68.28 (SD ± 7.6)%, p < 0.001. A well-designed community interventional model plays a pivotal role in grassroots healthcare delivery but requires optimization for NCD management.展开更多
Background: The increasing use of non-steroidal anti-inflammatory drugs (NSAIDs) both on prescription and over the counter raises a major global health concern because of the risks associated with their use if no prop...Background: The increasing use of non-steroidal anti-inflammatory drugs (NSAIDs) both on prescription and over the counter raises a major global health concern because of the risks associated with their use if no proper guidance is given by the health care provider. This study assessed the roles of community pharmacists in screening and disseminating information about the risks associated with NSAID use in Zambia. Methodology: This was a national cross-sectional study in which a structured self-administered questionnaire was administered to 245 registered community pharmacists in Zambia. Stata/BE, version 15.1 (Stata Corporation, College Station, Texas, USA) and multivariate logistic regression model was used to determine factors associated with information dissemination about ADRs of NS-NSAIDs. Results: 231 of the 245 distributed questionnaires were returned giving a response rate of 94.3%. All (100%) participating community pharmacists claimed to have practiced dispensing NSAIDs. However, only 26 (11.0%) and 71 (30.8%) regularly screened for risk factor of selective COX-2 NSAIDS (SC2-NSAIDS) and non-selective NSAIDS (NS-NSAIDs) respectively. Information dissemination on adverse drug reactions (ADRs) of SC2-NSAIDS was regularly provided by only 22 (9.5%) of pharmacists while that of NS-NSAIDs was regularly provided by 49 (21.2%). In the multivariate logistic regression model, being the owner of a pharmacy (AOR: 5.4, CI: 1.84 - 16.4) was significantly associated with information dissemination about ADRs of NS-NSAIDs while an hour increase in the working hours per day (AOR: 0.9, CI: 0.64 - 0.95) was associated with less likelihood of information dissemination. Conclusion: Pharmacists working in community pharmacies in Zambia did not regularly screen and disseminate information about the risks associated with NSAID use. Therefore, pharmacists should be able to screen and monitor patients at risk and be aware of the majority of risk factors while dispensing NSAIDs to minimize the associated complications.展开更多
Malignant non-Hodgkins lymphoma (MHNL) of the uterus is uncommon. We report a case diagnosed on the basis of histologic and immunohistochemical studies of a hysterectomy specimen induced by a very painful pelvic mass ...Malignant non-Hodgkins lymphoma (MHNL) of the uterus is uncommon. We report a case diagnosed on the basis of histologic and immunohistochemical studies of a hysterectomy specimen induced by a very painful pelvic mass in a 50-year-old patient with no previous history of the disease. It was classified as Ann Arbor IV Bb after imaging, given the medullary infiltration and signs of clinical and biological evolutivity: the patient had received two courses of chemotherapy, CHOP protocol. She died 23 days after the second treatment due to a hypertensive crisis.展开更多
Non-communicable diseases (NCDs) are a significant global health challenge, contributing to 50% of worldwide morbidity and 63% of mortality. The burden is particularly substantial in low—and middle-income countries (...Non-communicable diseases (NCDs) are a significant global health challenge, contributing to 50% of worldwide morbidity and 63% of mortality. The burden is particularly substantial in low—and middle-income countries (LMICs), where 80% of NCD-related deaths occur. A quasi-experimental study addressed this challenge from May 2022 to March 2023. This study utilized a non-equivalent pre-and post-test design, with 300 participants in the quantitative and 70 in the qualitative. The study employed multistage cluster and random sampling to select ten community units, resulting in 150 community health volunteers (CHVs) in the control unit and 150 in the intervention group. Data collection was facilitated through the KOBO app. Qualitative data analysis involved six homogeneous focus group discussions (FGDs) and ten key informant interviews (KIIs), audio-recorded, transcribed, and analyzed using N-Vivo 12. Despite efforts to implement screening programs and improve linkages to care, significant barriers persist. This article reviews these barriers, drawing on current literature and empirical evidence. Key obstacles identified include limited awareness, inadequate healthcare infrastructure, cultural beliefs, financial constraints, fragmented healthcare systems, and challenges linking individuals to appropriate care services. The article explores strategies to overcome these barriers, emphasizing the importance of collaborative approaches involving stakeholders at various levels. Addressing these challenges aims to strengthen NCD screening and linkages to care, ultimately improving health outcomes for populations globally. Several recommendations emerge from the study’s findings and literature review. Raising awareness about NCDs and preventive measures is crucial and can be achieved through targeted health education campaigns and community outreach programs. Addressing healthcare infrastructure deficiencies, such as inadequate facilities and workforce shortages, is essential to ensure access to quality care. Cultural beliefs and practices also play a significant role in shaping health-seeking behavior. Engaging with local communities and incorporating cultural sensitivity into healthcare delivery can help bridge the gap between traditional beliefs and modern healthcare practices. Financial constraints pose a significant barrier to healthcare services, particularly in LMICs. Innovative financing mechanisms, such as health insurance schemes or subsidies, can help alleviate this burden and improve access to care. Furthermore, the fragmented nature of healthcare systems can hinder effective NCD management. Enhancing coordination and integration between primary care providers, specialists, and community health workers is essential to ensure seamless care delivery and patient follow-up. Finally, strengthening linkages between screening programs and care services is critical for the timely diagnosis and management of NCDs. This requires establishing robust referral systems and ensuring continuity of care for patients throughout their healthcare journey. In conclusion, addressing the multifaceted barriers to NCD screening and care linkage is essential for improving health outcomes globally. By implementing targeted interventions and fostering collaboration among stakeholders, progress can be made towards reducing the burden of NCDs and promoting population health.展开更多
Background: Fractures of humeral shaft in adults are common injuries. Humeral shafts non-union either from late presentation after initial treatment by traditional bone setters or failed non-operative orthodox care is...Background: Fractures of humeral shaft in adults are common injuries. Humeral shafts non-union either from late presentation after initial treatment by traditional bone setters or failed non-operative orthodox care is a major problem in this part of the world. This non-union is a major treatment challenge with increased cost of care and morbidity in this part of the world. Humeral shaft non-union can be treated with locked intra-medullary nailing (LIMN) or dynamic compression plating (DCP). Study on comparison of these methods of fixation in this part of the world is scarce in literature search, hence the reason for this study. Objective: The objectives of this study are: (1) to compare early clinical outcome following fixation of humeral shaft fracture nonunion with DCP versus LIMN;(2) to compare the time of radiologic fracture union of DCP with LIMN;(3) to compare complications following fixation of humeral shaft fracture nonunion with DCP versus LIMN. Patients and Methods: This was a randomized control study done for 2 years in which fifty adult patients with humeral shaft non-union were recruited. The patients were grouped into 2 (P = DCP & N = LIMN). Forty five of the patients completed the follow up periods of the study and then analyzed. The P group had ORIF with DCP while the N group had ORIF with LIMN. Both groups had grafting with cancellous bones. Each patient was followed up for a period of 6 months at the time which radiographic union is expected. Any patient without clinical and/or radiographic evidence of union after six months of surgery was diagnosed as having recurrent non-union. The data generated was analyzed using SPSS Version 23. The results were presented in charts and tables. The paired t-test was used while considering p value Result: Forty five patients completed follow up. There was a male preponderance (4:1), right humerus predominated (3:2). Motor vehicular accidents were the commonest cause of the fractures (62%). Most non-union fractures occurred at the level of the middle 3<sup>rd</sup> of the humeral shaft (60%). Failed TBS treatment was the commonest indication for the osteosynthesis (71%). More patients had plating (53%) compared to 47% who had LIMN. Most patients (93.4%) had union between 3 to 6 months irrespective of fixation type with no significant statistical difference between the union rate of DCP and LIMN (p value 0.06) with similar functional outcome and complication rates irrespective of the type of fixation. Conclusion: This study showed that the success rates in term of fracture union, outcome functional grades and complication rates were not directly dependent on the types of the fixation: plating or locked intra-medullary nailing.展开更多
Inflammatory bowel disease (IBD) is a group of chronic, nonspecific intestinal inflammatory disorders characterized by localized and systemic inflammation. The use of biologic agents in the treatment of IBD patients i...Inflammatory bowel disease (IBD) is a group of chronic, nonspecific intestinal inflammatory disorders characterized by localized and systemic inflammation. The use of biologic agents in the treatment of IBD patients is widespread, and the occurrence of primary non-responsiveness during treatment is also significant. This review briefly summarizes the possible reasons for primary non-responsiveness in IBD patients, as well as predictive markers and current strategies to address it, providing a theoretical reference for early identification and management of IBD patients who do not respond to treatment.展开更多
Objective: Investigate the efficacy and safety of Yao Medicine in the treatment of advanced non-small-cell lung carcinoma, and explore the best therapeutic measure for clinical benefit. Methods: From July 2020 to July...Objective: Investigate the efficacy and safety of Yao Medicine in the treatment of advanced non-small-cell lung carcinoma, and explore the best therapeutic measure for clinical benefit. Methods: From July 2020 to July 2022, 84 patients with advanced non-small-cell lung carcinoma were selected and randomly divided into the Observation Group and control group, and the control group was treated with routine Western medicine, with 42 cases in each group. The activity of daily living (ADL) was assessed before and after treatment, meanwhile, the self-rating depression scale (SDS) and self-rating anxiety SAS (SAS) were used to assess the improvement of a bad mood, and quality of life SF-36 was used to assess the quality of life, to judge the efficacy and safety. Results: The effective rate of observation group was 91.67%. The effective rate of the control group was 76.19%. The effective rate of the observation group was significantly higher than that of the control group (P 0.05). There were no significant differences in the scores of SDS, SAS and quality of life between the two groups before treatment (P > 0.05), and after treatment, the scores of SDS, SAS and quality of life in the two groups were compared with those in the control group (P > 0.05), the scores of VAS, SDS and SAS decreased significantly, while ESCV, angle of straight leg elevation, ADL, physiological score, emotional score, social score and health status score increased significantly, the difference was statistically significant (P 0.05). Conclusion: Yao Medicine can improve the psychosomatic symptoms of patients with advanced non-small-cell lung carcinoma better, with better efficacy and higher safety.展开更多
文摘Lung cancer is one of the malignant tumor diseases with high morbidity and high mortality in the world. Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer. Currently, chemotherapy, targeted therapy, immunotherapy or combination therapy is the main treatment for NSCLC, but it is still inevitably faced with the challenges of acquired drug resistance and tumor progression. The birth of antibody conjugator provides a new choice for its treatment. Antibody conjugator is a new type of biotherapeutic drug which is connected by monoclonal antibody via linker and cytotoxic drug. It has the characteristics of precision, high efficiency and low toxicity, etc. In recent years, its research and development and clinical trials have been endless. It shows that this new type of drug has great potential in the field of tumor therapy. In this paper, the structural characteristics, mechanism of action, current application, research achievements, challenges, countermeasures and development of ADC in NSCLC treatment are reviewed.
文摘Background: Non-radiographic axial spondyloarthritis is a progressive and disabling inflammatory disease affecting young adults, with limited treatment options. TNFi are more efficacious than JAKi and IL1-7i in nr-ax SPA and it has a well-known safety profile over a longer duration. Recently, many IL-17i and JAKi were approved for the treatment of nr-ax SPA;however, data comparing IL1-7i and JAKi in terms of efficacy and safety is lacking. This systematized review aimed to compare the existing efficacy and safety data of JAKi vs IL-17i in the treatment of patients with nr-ax SPA. Methods: A systematic literature search was performed using relevant keywords in many databases. According to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA, 2020), relevant articles were included and evaluated in this review. Efficacy and safety data were collected, analyzed and compared through week 52. The first check was done by the end of week 14 and week 16 for upadacitinib and IL-17i respectively. Results: Data from four RCTs evaluating upadacitinib, secukinumab, ixekizumab, and bimekizumab comprising 1425 patients were analyzed. Overall, a comparable efficacy and safety profile were observed across different treatment arms through week 52;however, non-significant variations were encountered in some outcome measures. The primary endpoint among these RCTs (ASAS40 response rate) was met and it was higher in patients treated with bimekizumab 160 mg sc Q 4 weeks in TNFi non responders (48%) and lowest in ixekizumab 80 mg sc Q 4 weeks treated patients, (35%) (p Conclusion: The above-mentioned three IL-17i and the only one JAKi demonstrated comparable safety and efficacy profiles with some minor variations. A head-to-head trial comparing the effectiveness and safety characteristics of JAKi vs IL-17i may be needed in patients with active nr-ax SpA.
文摘A previous paper showed that the real numbers between 0 and 1 could be represented by an infinite tree structure, called the ‘infinity tree’, which contains only a countably infinite number of nodes and arcs. This paper discusses how a finite-state Turing machine could, in a countably infinite number of state transitions, write all the infinite paths in the infinity tree to a countably infinite tape. Hence it is argued that the real numbers in the interval [0, 1] are countably infinite in a non-Cantorian theory of infinity based on Turing machines using countably infinite space and time. In this theory, Cantor’s Continuum Hypothesis can also be proved. And in this theory, it follows that the power set of the natural numbers P(ℕ) is countably infinite, which contradicts the claim of Cantor’s Theorem for the natural numbers. However, this paper does not claim there is an error in Cantor’s arguments that [0, 1] is uncountably infinite. Rather, this paper considers the situation as a paradox, resulting from different choices about how to represent and count the continuum of real numbers.
文摘This paper presents an advanced control strategy for DC-DC buck converters utilizing Non-Minimal State Space (NMSS) representation combined with Proportional-Integral-Plus (PIP) control, optimized through Linear Quadratic Regulator (LQR) design. The proposed approach leverages NMSS to eliminate the need for state observers, enhancing robustness against model mismatch and improving overall system performance. The PIP controller extends traditional PI control by incorporating additional dynamic feedback. Experimental results demonstrate that the NMSS-PIP-LQR controlled buck converter achieves excellent dynamic performance. The design procedure is fully documented, and microcontroller implementation issues are discussed.
文摘目的评估血清非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值(non-high density lipoprotein cholesterol/high density lipoprotein cholesterol,NHHR)、血浆致动脉粥样硬化指数(atherogenic index of plasma,AIP)与慢性肾病(chronic kidney disease,CKD)发病风险的关系,为CKD的防治提供依据。方法以金昌队列中25377名未患CKD的参与者作为研究对象,采用Cox比例风险回归模型、限制性立方样条分别评估NHHR和AIP对CKD的发病风险及剂量-反应关系,并进行亚组分析。采用受试者工作特征曲线评估NHHR和AIP对CKD发病风险的预测能力。结果经过平均4.77年的随访调查后,新发CKD患者有1213例,发病密度为10.03/1000人年。调整混杂因素后,相较于Q1组,Q4组人群中NHHR和AIP的CKD发病风险比分别为1.270(95%CI:1.066~1.512)和1.294(95%CI:1.081~1.548),且均存在一定的剂量-反应关系(均P<0.05)。NHHR和AIP预测CKD的AUC值分别为0.750(95%CI:0.736~0.764)和0.735(95%CI:0.721~0.749)。亚组分析发现,吸烟和糖尿病与NHHR、糖尿病和AIP间存在交互作用(均P<0.05)。结论NHHR和AIP是CKD发病的独立危险因素,并对CKD发病风险有一定的预测能力。
基金the Guangdong Basic and Applied Basic Research Foundation(grant number:2019A1515011819,2021B1515120004)National Natural Science Foundation of China(22005207)Open Research Fund of Songshan Lake Materials Laboratory(2021SLABFN04).
文摘Non-flow aqueous zinc-bromine batteries without auxiliary components(e.g.,pumps,pipes,storage tanks)and ion-selective membranes represent a cost-effective and promising technology for large-scale energy storage.Unfortunately,they generally suffer from serious diffusion and shuttle of polybromide(Br^(-),Br^(3-))due to the weak physical adsorption between soluble polybromide and host carbon materials,which results in low energy efficiency and poor cycling stability.Here,we develop a novel self-capture organic bromine material(1,10-bis[3-(trimethylammonio)propyl]-4,4'-bipyridinium bromine,NVBr4)to successfully realize reversible solid complexation of bromide components for stable non-flow zinc-bromine battery applications.The quaternary ammonium groups(NV^(4+)ions)can effectively capture the soluble polybromide species based on strong chemical interaction and realize reversible solid complexation confined within the porous electrodes,which transforms the conventional“liquid-liquid”conversion of soluble bromide components into“liquid-solid”model and effectively suppresses the shuttle effect.Thereby,the developed non-flow zinc-bromide battery provides an outstanding voltage platform at 1.7 V with a notable specific capacity of 325 mAh g^(-1)NVBr4(1 A g^(-1)),excellent rate capability(200 mAh g^(-1)NVBr4 at 20 A g^(-1)),outstanding energy density of 469.6 Wh kg^(-1)and super-stable cycle life(20,000 cycles with 100%Coulombic efficiency),which outperforms most of reported zinc-halogen batteries.Further mechanism analysis and DFT calculations demonstrate that the chemical interaction of quaternary ammonium groups and bromide species is the main reason for suppressing the shuttle effect.The developed strategy can be extended to other halogen batteries to obtain stable charge storage.
文摘Acute upper gastrointestinal hemorrhage is a highly prevalent clinical condition, with the majority of cases representing acute non-variceal upper gastrointestinal hemorrhage. With the advancement of modern medicine, endoscopy has become an indispensable tool in the diagnosis and treatment of various diseases. In order to achieve optimal results in the endoscopic treatment of non-variceal upper gastrointestinal bleeding, it is essential to make an accurate and timely diagnosis and select the most appropriate treatment method. This article introduces the definition of acute non-variceal upper gastrointestinal bleeding (ANVUGIB) and the importance of endoscopic treatment for this disease. It then presents an overview of various assessment systems for ANVUGIB and an overview of endoscopic advances in thermal coagulation, mechanical hemostasis, and topical pharmacological injection hemostasis for three aspects of ANVUGIB-related bleeding. In particular, this article discusses the therapeutic efficacy and safety of different treatment options for non-variceal upper gastrointestinal bleeding, as well as the advantages and limitations of these treatment options in managing this disease.
文摘One of the main immune-mediated diseases that lead to avoidable blindness is non-infectious uveitis. Glucocorticoids are the first-line therapy choice for noninfectious uveitis;however, biologics are also showing promise in the management of this condition. The description of glucocorticoid and biologic usage in non-infectious uveitis is the main topic of this paper.
文摘Introduction: Vaccination plays a pivotal role in mitigating the repercussions of the COVID-19 pandemic. However, vaccination campaigns encounter obstacles, especially in developing countries like the Democratic Republic of the Congo (DRC). This study aimed at investigating the roles of vaccine hesitancy, refusal, and access barriers, while identifying individual-level factors associated with non-vaccination in Mbujimayi, DRC. Methods: A community-based cross-sectional survey was conducted in three health districts and included 1496 residents. Attitudes and behaviors related to seeking COVID-19 vaccination were assessed using a standardized questionnaire. Hierarchical logistic regression modeling was used to assess factors potentially affecting non-compliance with vaccination. Results: Among participants (median age = 33, IQR = 23.3, M/F sex ratio = 0.7), 60% displayed misconceptions about COVID-19 or its vaccine, while only 35.2% perceived COVID-19 as a significant health threat. Vaccination coverage was estimated at 49.1% (95% CI: 47.5;52.6), with 71.8% of vaccinated individuals having received one dose. Among the unvaccinated individuals, 50.9% expressed no intention to be vaccinated in the future, citing hesitation (30.4%) or refusal (39.6%) mainly due to side effects or distrust of vaccines. Conversely, 32.7% of the unvaccinated persons expressed access barriers despite willingness to be vaccinated. Misconceptions about COVID-19 and its vaccines were the main drivers of vaccination non-compliance. Conclusion: These findings demonstrate significant vaccine non-compliance driven by hesitancy, refusal, and access barriers. Strategies to enhance vaccination coverage and pandemic preparedness should address misconceptions, sociodemographic barriers, and geographic disparities.
文摘Non-communicable diseases (NCDs) account for 63% of mortalities. Approximately 80% of these NCD-related deaths occur in LMICs. A quasi-experimental study utilizing a non-equivalent pre-and post-test was conducted from May 2022 to March 2023 with 370 study participants. Multistage cluster and random sampling were used to select ten community units, and therefore, 150 CHVs were chosen for the control unit, and 150 were used to form the interventional group. Data was collected from the KOBO app. Six (6) homogenous FGDs comprised ten members, and 10 KII were conducted across study sites. Quantitative data was analyzed using SPSS version 28.0, and qualitative data was audio-recorded, transcribed, and analyzed via N-Vivo 12. The study shows that 59.3% of respondents have minimal information, and 92.7% (n = 139) have no clear understanding of NCDs, with a pre-intervention capacity of 48.8%. Independent sample t-test showed a significant difference in capacity from a pre-intervention average of 48.75 (SD ± 5.7)%, which increased to 68.28 (SD ± 7.6)%, p < 0.001. A well-designed community interventional model plays a pivotal role in grassroots healthcare delivery but requires optimization for NCD management.
文摘Background: The increasing use of non-steroidal anti-inflammatory drugs (NSAIDs) both on prescription and over the counter raises a major global health concern because of the risks associated with their use if no proper guidance is given by the health care provider. This study assessed the roles of community pharmacists in screening and disseminating information about the risks associated with NSAID use in Zambia. Methodology: This was a national cross-sectional study in which a structured self-administered questionnaire was administered to 245 registered community pharmacists in Zambia. Stata/BE, version 15.1 (Stata Corporation, College Station, Texas, USA) and multivariate logistic regression model was used to determine factors associated with information dissemination about ADRs of NS-NSAIDs. Results: 231 of the 245 distributed questionnaires were returned giving a response rate of 94.3%. All (100%) participating community pharmacists claimed to have practiced dispensing NSAIDs. However, only 26 (11.0%) and 71 (30.8%) regularly screened for risk factor of selective COX-2 NSAIDS (SC2-NSAIDS) and non-selective NSAIDS (NS-NSAIDs) respectively. Information dissemination on adverse drug reactions (ADRs) of SC2-NSAIDS was regularly provided by only 22 (9.5%) of pharmacists while that of NS-NSAIDs was regularly provided by 49 (21.2%). In the multivariate logistic regression model, being the owner of a pharmacy (AOR: 5.4, CI: 1.84 - 16.4) was significantly associated with information dissemination about ADRs of NS-NSAIDs while an hour increase in the working hours per day (AOR: 0.9, CI: 0.64 - 0.95) was associated with less likelihood of information dissemination. Conclusion: Pharmacists working in community pharmacies in Zambia did not regularly screen and disseminate information about the risks associated with NSAID use. Therefore, pharmacists should be able to screen and monitor patients at risk and be aware of the majority of risk factors while dispensing NSAIDs to minimize the associated complications.
文摘Malignant non-Hodgkins lymphoma (MHNL) of the uterus is uncommon. We report a case diagnosed on the basis of histologic and immunohistochemical studies of a hysterectomy specimen induced by a very painful pelvic mass in a 50-year-old patient with no previous history of the disease. It was classified as Ann Arbor IV Bb after imaging, given the medullary infiltration and signs of clinical and biological evolutivity: the patient had received two courses of chemotherapy, CHOP protocol. She died 23 days after the second treatment due to a hypertensive crisis.
文摘Non-communicable diseases (NCDs) are a significant global health challenge, contributing to 50% of worldwide morbidity and 63% of mortality. The burden is particularly substantial in low—and middle-income countries (LMICs), where 80% of NCD-related deaths occur. A quasi-experimental study addressed this challenge from May 2022 to March 2023. This study utilized a non-equivalent pre-and post-test design, with 300 participants in the quantitative and 70 in the qualitative. The study employed multistage cluster and random sampling to select ten community units, resulting in 150 community health volunteers (CHVs) in the control unit and 150 in the intervention group. Data collection was facilitated through the KOBO app. Qualitative data analysis involved six homogeneous focus group discussions (FGDs) and ten key informant interviews (KIIs), audio-recorded, transcribed, and analyzed using N-Vivo 12. Despite efforts to implement screening programs and improve linkages to care, significant barriers persist. This article reviews these barriers, drawing on current literature and empirical evidence. Key obstacles identified include limited awareness, inadequate healthcare infrastructure, cultural beliefs, financial constraints, fragmented healthcare systems, and challenges linking individuals to appropriate care services. The article explores strategies to overcome these barriers, emphasizing the importance of collaborative approaches involving stakeholders at various levels. Addressing these challenges aims to strengthen NCD screening and linkages to care, ultimately improving health outcomes for populations globally. Several recommendations emerge from the study’s findings and literature review. Raising awareness about NCDs and preventive measures is crucial and can be achieved through targeted health education campaigns and community outreach programs. Addressing healthcare infrastructure deficiencies, such as inadequate facilities and workforce shortages, is essential to ensure access to quality care. Cultural beliefs and practices also play a significant role in shaping health-seeking behavior. Engaging with local communities and incorporating cultural sensitivity into healthcare delivery can help bridge the gap between traditional beliefs and modern healthcare practices. Financial constraints pose a significant barrier to healthcare services, particularly in LMICs. Innovative financing mechanisms, such as health insurance schemes or subsidies, can help alleviate this burden and improve access to care. Furthermore, the fragmented nature of healthcare systems can hinder effective NCD management. Enhancing coordination and integration between primary care providers, specialists, and community health workers is essential to ensure seamless care delivery and patient follow-up. Finally, strengthening linkages between screening programs and care services is critical for the timely diagnosis and management of NCDs. This requires establishing robust referral systems and ensuring continuity of care for patients throughout their healthcare journey. In conclusion, addressing the multifaceted barriers to NCD screening and care linkage is essential for improving health outcomes globally. By implementing targeted interventions and fostering collaboration among stakeholders, progress can be made towards reducing the burden of NCDs and promoting population health.
文摘Background: Fractures of humeral shaft in adults are common injuries. Humeral shafts non-union either from late presentation after initial treatment by traditional bone setters or failed non-operative orthodox care is a major problem in this part of the world. This non-union is a major treatment challenge with increased cost of care and morbidity in this part of the world. Humeral shaft non-union can be treated with locked intra-medullary nailing (LIMN) or dynamic compression plating (DCP). Study on comparison of these methods of fixation in this part of the world is scarce in literature search, hence the reason for this study. Objective: The objectives of this study are: (1) to compare early clinical outcome following fixation of humeral shaft fracture nonunion with DCP versus LIMN;(2) to compare the time of radiologic fracture union of DCP with LIMN;(3) to compare complications following fixation of humeral shaft fracture nonunion with DCP versus LIMN. Patients and Methods: This was a randomized control study done for 2 years in which fifty adult patients with humeral shaft non-union were recruited. The patients were grouped into 2 (P = DCP & N = LIMN). Forty five of the patients completed the follow up periods of the study and then analyzed. The P group had ORIF with DCP while the N group had ORIF with LIMN. Both groups had grafting with cancellous bones. Each patient was followed up for a period of 6 months at the time which radiographic union is expected. Any patient without clinical and/or radiographic evidence of union after six months of surgery was diagnosed as having recurrent non-union. The data generated was analyzed using SPSS Version 23. The results were presented in charts and tables. The paired t-test was used while considering p value Result: Forty five patients completed follow up. There was a male preponderance (4:1), right humerus predominated (3:2). Motor vehicular accidents were the commonest cause of the fractures (62%). Most non-union fractures occurred at the level of the middle 3<sup>rd</sup> of the humeral shaft (60%). Failed TBS treatment was the commonest indication for the osteosynthesis (71%). More patients had plating (53%) compared to 47% who had LIMN. Most patients (93.4%) had union between 3 to 6 months irrespective of fixation type with no significant statistical difference between the union rate of DCP and LIMN (p value 0.06) with similar functional outcome and complication rates irrespective of the type of fixation. Conclusion: This study showed that the success rates in term of fracture union, outcome functional grades and complication rates were not directly dependent on the types of the fixation: plating or locked intra-medullary nailing.
文摘Inflammatory bowel disease (IBD) is a group of chronic, nonspecific intestinal inflammatory disorders characterized by localized and systemic inflammation. The use of biologic agents in the treatment of IBD patients is widespread, and the occurrence of primary non-responsiveness during treatment is also significant. This review briefly summarizes the possible reasons for primary non-responsiveness in IBD patients, as well as predictive markers and current strategies to address it, providing a theoretical reference for early identification and management of IBD patients who do not respond to treatment.
文摘Objective: Investigate the efficacy and safety of Yao Medicine in the treatment of advanced non-small-cell lung carcinoma, and explore the best therapeutic measure for clinical benefit. Methods: From July 2020 to July 2022, 84 patients with advanced non-small-cell lung carcinoma were selected and randomly divided into the Observation Group and control group, and the control group was treated with routine Western medicine, with 42 cases in each group. The activity of daily living (ADL) was assessed before and after treatment, meanwhile, the self-rating depression scale (SDS) and self-rating anxiety SAS (SAS) were used to assess the improvement of a bad mood, and quality of life SF-36 was used to assess the quality of life, to judge the efficacy and safety. Results: The effective rate of observation group was 91.67%. The effective rate of the control group was 76.19%. The effective rate of the observation group was significantly higher than that of the control group (P 0.05). There were no significant differences in the scores of SDS, SAS and quality of life between the two groups before treatment (P > 0.05), and after treatment, the scores of SDS, SAS and quality of life in the two groups were compared with those in the control group (P > 0.05), the scores of VAS, SDS and SAS decreased significantly, while ESCV, angle of straight leg elevation, ADL, physiological score, emotional score, social score and health status score increased significantly, the difference was statistically significant (P 0.05). Conclusion: Yao Medicine can improve the psychosomatic symptoms of patients with advanced non-small-cell lung carcinoma better, with better efficacy and higher safety.
