Intravascular large B-cell lymphoma(IVLBCL),a rare subtype of non-Hodgkin lymphoma,is classified as an independent subtype of extranodal diffuse large B-cell lymphoma(DLBCL)in the 2008 World Health Organization(WHO)Cl...Intravascular large B-cell lymphoma(IVLBCL),a rare subtype of non-Hodgkin lymphoma,is classified as an independent subtype of extranodal diffuse large B-cell lymphoma(DLBCL)in the 2008 World Health Organization(WHO)Classification(Turner et al.,2010).The 5th edition of the World Health Organization(WHO 2022)classification of hematolymphoid tumors retains this subtype(Alaggio et al.,2022).IVLBCL,which is characterized by neoplastic lymphocyte proliferation within the lumen of small blood vessels,tends to invade organs,such as the nervous system,skin,bone marrow(BM),and lung(D'Angelo et al.,2019;Satoh et al.,2019;Vasquez et al.,2019;Fukami et al.,2020).展开更多
Like many river basins in China, water resources in the Fudong Pai River are almost fully allocated. This paper seeks to assess and evaluate water resource problems using water evaluation and planning (WEAP) model via...Like many river basins in China, water resources in the Fudong Pai River are almost fully allocated. This paper seeks to assess and evaluate water resource problems using water evaluation and planning (WEAP) model via its application to Hengshui Basin of Fudong Pai River. This model allows the simulation and analysis of various water allocation scenarios and, above all, scenarios of users' behavior. Water demand management is one of the options discussed in detail. Simulations are proposed for diverse climatic situations from dry years to normal years and results are discussed. Within the limits of data availability, it appears that most water users are not able to meet all their requirements from the river, and that even the ecological reserve will not be fully met during certain years. But the adoption of water demand management procedures offers opportunities for remedying this situation during normal hydrological years. However, it appears that demand management alone will not suffice during dry years. Nevertheless, the ease of use of the model and its user-friendly interfaces make it particularly useful for discussions and dialogue on water resources management among stakeholders.展开更多
Many brain diseases, including schizophrenia, affect men and women unequally-either more or less frequently, or at different times in the life cycle, or to varied degrees of severity. With updates from recent findings...Many brain diseases, including schizophrenia, affect men and women unequally-either more or less frequently, or at different times in the life cycle, or to varied degrees of severity. With updates from recent findings, this paper reviews the work of my research group over the last 40 years and underscores issues that remain critical to the optimal care of women with schizophrenia, issues that overlap with, but are not identical to, the cares and concerns of men with the same diagnosis. Clinicians need to be alert not only to the overarching needs of diagnostic groups, but also to the often unique needs of women and men.展开更多
Objective To calculate unmet need for contraception according to revised definition, mapping the contraception service needs and analyze factors related to the unmet need for contraception in Nusa Tenggara Barat （NTB...Objective To calculate unmet need for contraception according to revised definition, mapping the contraception service needs and analyze factors related to the unmet need for contraception in Nusa Tenggara Barat （NTB）. Methods This research design was cross sectional, using data from Indonesia Demographic and Health Survey 2012. Subjects were from 1 362 household, and were married women aged 15-49 years in NTB Province （685 women）. Calculating method of unmet need for contraception used revised version, and analysis method was univariate, bivariate, and multivariate （Logistic regression）. Results Majority of married women aged 15-49 years in NTB need contraception service （73.1%）. However, it was known that met need for contraception was only 56.0%. Meanwhile, unmet need rate for contraception in NTB was 17.1%, specifically 11.5% for spacing and 5.6% for limiting. Factors contributing to unmet need for contraception in NTB were： household assets at above average （OR=O. 77）, parity of 2-3 children （OR=0. 73）, women with junior high school education level （0R=0.68）, never be visited by health workers （OR=O. 68）. Conclusions Factors that contribute to unmet need for contraception in NTB are household assets, parity, education level and visited by health workers. Government has to prioritize those f our factors in policy intervention and promotion of family planning participation program in NTB.展开更多
Due to the optimal results obtained in kidney transplantation and to the lack of interest of the industries,new innovative drugs in kidney transplantation are difficult to be encountered.The best strategy to find the ...Due to the optimal results obtained in kidney transplantation and to the lack of interest of the industries,new innovative drugs in kidney transplantation are difficult to be encountered.The best strategy to find the new drugs recently developed or under development is to search in the sections of kidney transplantation still not completely covered by the drugs on the market.These unmet needs are the prevention of delayed graft function(DGF),the protection of the graft over the long time and the desensitization of preformed anti human leukocyte antigen antibodies and the treatment of the acute antibody-mediated rejection.These needs are particularly relevant due to the expansion of some kind of kidney transplantation as transplantation from non-heart beating donor and in the case of antibody-incompatible grafts.The first are particularly exposed to DGF,the latter need a safe desensitization and a safe treatments of the antibody mediated rejections that often occur.Particular caution is needed in treating these drugs.First,they are described in very recent studies and the follow-up of their effect is of course rather short.Second,some of these drugs are still in an early phase of study,even if in well-conducted randomized controlled trials.Particular caution and a careful check need to be used in trials launched 2 or 3 years ago.Indeed,is always necessary to verify whether the study is still going on or whether and why the study itself was abandoned.展开更多
In the era of highly effective direct acting antiviral(DAA) drugs for the treatment of chronic hepatitis C(CHC) infection, where eradication is almost ensured with minimal side effects, all hepatitis C carriers should...In the era of highly effective direct acting antiviral(DAA) drugs for the treatment of chronic hepatitis C(CHC) infection, where eradication is almost ensured with minimal side effects, all hepatitis C carriers should benefit theoretically. In the real world setting however, only a small proportion will benefit at this time point due to the multiple barriers to accessing therapy. Given that universal treatment is unlikely, treatment with DAAs will likely be restricted to those with the highest health benefits, and for those who can afford the high expense of a treatment course. Those with the highest unmet needs include those who have failed previous interferon-based therapy or who are interferon-ineligible with evidence of active disease, those with advance liver disease, and those with recurrence of hepatitis C after liver transplantation. In the future, the focus should be on increasing access to treatment for those infected with CHC.展开更多
Objective:To assess the factors associated with knowledge,attitude and behavior of contraception use among urban slum population in Chennai.Methods:A cross-sectional study was conducted in the urban slum of Anakaputhu...Objective:To assess the factors associated with knowledge,attitude and behavior of contraception use among urban slum population in Chennai.Methods:A cross-sectional study was conducted in the urban slum of Anakaputhur,Chennai.Married couples between ages of 19-49 years and living in slum areas were taken up for the study by simple random sampling.Pregnant women,postnatal and postmenopausal women were excluded from the study.Data collection was done using a pretested structured questionnaire focusing on details regarding contraception knowledge,attitude,and practices.Data analysis was done using IBM SPSS version 22.Analytical test like Chi square and odds ratio(OR)were used to identify association between knowledge,attitude,and behavior of contraception with the associated variables and enter method of logistic regression analysis was done.Results:Out of the 360 respondents,228 were females,with a mean age of(34±5)years.Approximately 43%demonstrated adequate knowledge of contraception use,and 91%were aware of at least one contraceptive method.Notably,72%exhibited a positive attitude towards contraceptive use.Nevertheless,43%(155 individuals)did not utilize any contraceptive method.Among contraceptive users,intrauterine devices were the most commonly adopted,followed by barrier methods and female sterilization.There was significant association between knowledge of contraception and education(aOR 7.29,95%CI 2.93-18.10,P<0.05),age(aOR 2.04,95%CI 1.19-3.50,P<0.05)and socioeconomic class(aOR 3.66,95%CI 1.71-7.85,P<0.05;aOR 3.97,95%CI 2.12-7.49,P<0.05).Regarding attitude towards contraception use,education(aOR 8.54,95%CI 2.35-31.03,P<0.05),sex(aOR 0.15,95%CI 0.06-0.37,P<0.05),age(aOR 0.53,95%CI 0.28-0.99,P<0.05),socio-economic class(aOR 4.42,95%CI 1.97-9.92,P<0.05;aOR 9.83,95%CI 3.63-26.58,P<0.05)and number of children(aOR 10.04,95%CI 4.26-23.66,P<0.05)were the variables that had a significant association.Conclusions:These findings underscore the imperative for enhanced dissemination of health education pertaining to contraception use within the slum population.The health sectors of the area and other stakeholders need to make sure to extend penetration of family planning related services to the urban slum population.展开更多
Objectives: Immigrants of Chinese ethnicity and young people (between 18 and 30 years of age) are known to access health services less frequently and may be at greater risk for experiencing unmet health needs. The pur...Objectives: Immigrants of Chinese ethnicity and young people (between 18 and 30 years of age) are known to access health services less frequently and may be at greater risk for experiencing unmet health needs. The purpose of this study was to examine the health beliefs, health behaviors, primary care access, and perceived unmet healthcare needs of Chinese young adults.Methods: Semi-structured in-depth interviews were carried out with eight Chinese young adults in Vancouver, Canada. Results: A content analysis revealed that these Chinese young adults experienced unmet healthcare needs, did not have a primary care provider, and did not access preventive services. Cultural factors such as strong family ties, filial piety, and the practice of Traditional Chinese Medicine influenced their health behaviors and healthcare access patterns. Conclusion: Chinese young adults share similar issues with other young adults in relation to not having a primary care provider and accessing preventive care but their health beliefs and practices make their needs for care unique from other young adults.展开更多
Background: Understanding the magnitude of unmet contraceptive need and the underlying determinants will help the programs and services to respond effectively. Aim: Identify the prevalence and determinants of unmet co...Background: Understanding the magnitude of unmet contraceptive need and the underlying determinants will help the programs and services to respond effectively. Aim: Identify the prevalence and determinants of unmet contraceptive need among married women in the childbearing period in Minia Governorate. Methods: Community-based cross-sectional study was done among married women of child bearing age (18 - 49 years). Total 534 study participants were selected randomly and interviewed by using pretested structured questionnaire. Results: Overall level of unmet need was 12.7%. Women age > 35 years old were about three times (adjusted OR = 2.88, 95% CI: 1.13 - 7.35) more likely to have unmet need for family planning compared to younger women. Women who had more children (adjusted OR = 1.32, 95% CI: 1.04 - 1.67), more female offspring (adjusted OR = 1.37, 95% CI: 1.09 - 1.65), and women whose partner had non-supportive attitude towards family planning (adjusted OR = 2.96, 95% CI: 1.53 - 5.72) were more likely to have unmet need. Conclusion: The prevalence of unmet need of family planning among women in Minia Governorate remains high. Therefore, family planning programs that cover the older woman’s need for limiting and that focus on couples could be useful in reducing the rate of unmet need.展开更多
The study was conducted to assess the magnitude and associated factors of unmet need for family planning among women of reproductive age group with disabilities who are members of disabled associations in Bahir Dar to...The study was conducted to assess the magnitude and associated factors of unmet need for family planning among women of reproductive age group with disabilities who are members of disabled associations in Bahir Dar town. Institution based cross-sectional study was carried out. A total of 337 women of reproductive age group with disabilities were included in the study with simple random sampling. Data were collected through face-to-face interview, coded, cleaned and entered by Epi info 2002 and analyzed with SPSS version 16 computer software. Logistic regression was used to assess possible associations. The magnitude of unmet need for family planning among women with disabilities was 24.3%. Women with disabilities in the age group of 25-29 had 80% less likely to have unmet need than women above 35 years old. Women with disability who have no education were 11 times more likely to have unmet need than those who have secondary education. Women who desire to have more than 3 children have more likely to have unmet need than those who need to have 1-2 children. Unmet need for family planning among women with disabilities was high in Bahir Dar town. Age, Educational status and desired number of children were found to have statistically significant association with unmet need for family planning. Hence, it is important to encourage people with disabilities to attained formal education and the associations should provide short term trainings in accordance with their age group.展开更多
The population plagued with the HIV/AIDS pandemic in Cameroon is young, a generation that may desire or control fertility. For those who may become pregnant, the desire to have children may not be there. We carried ou...The population plagued with the HIV/AIDS pandemic in Cameroon is young, a generation that may desire or control fertility. For those who may become pregnant, the desire to have children may not be there. We carried out this study to look at the picture of the reproductive health needs of women living with HIV/AIDS in our setting. In this cross-sectional non-analytic design that lasted for three years, we employed both qualitative and quantitative methods to collect data from them after receiving ethical clearance (N221/CM/2009) from the National Ethics Committee. Consenting HIV infected women who were attending the “HIV Day Care” clinics and those who delivered and were in the post partum wards in four of our major hospitals in Yaounde were enrolled. Interviews were individualized. We used both CSPro version 4.1 and Statistical Package for Social Sciences (SPSS) version 19.0 softwares for data analysis. Four hundred and fifteen (415) women were enrolled;the mean age was 29 ± 7.8 years;the most represented age group was 24 -29 years. They were single (36.14%), well educated (5 out of 10 had attained university level of education), 61.20% revealed that their partners knew their HIV status, 82.4% believed that screening for cancer of the cervix was necessary for their status and 47.70% would want to be screened for some or all STIs. About 36.86% had the desire to have children, 57.1% of those who delivered did not plan to have the pregnancies out of which 82% would have wanted a modern method of contraception but did not have (82% unmet needs). Modern contraceptive use was associated with age and individual characteristics such as level of education. It was 64.34% among women who had secondary level of education and below as against 35.66% among those who had high school level of education and above. Contraceptive use was also high among women who were unmarried as against those who were married (89.64% vs 10.36%). The desire to have children decreased as age increased (43.85% vs 18.79%) and was lower among married women compared to those who were single (13.01% versus 49.64%). These women were found to have high unmet needs for modern contraception and showed interest in STIs and cervical cancer screening.展开更多
Purpose: Many health systems are considered ill-equipped to adequately meet future demand. Although academic entrepreneurs and small and medium-sized enterprises (SMEs) drive health technology innovation, they often s...Purpose: Many health systems are considered ill-equipped to adequately meet future demand. Although academic entrepreneurs and small and medium-sized enterprises (SMEs) drive health technology innovation, they often suboptimally consider important market and stakeholder requirements. This can result in missed opportunities to improve health system performance, address demand-supply gaps, and achieve financial rewards. Market intelligence can provide crucial information in this regard, but scientifically sourced guidance on how to perform market research for biopharmaceutics is scarce. Our objective was, therefore, to create and provide an easily accessible biopharmaceutics market research toolbox that can be perused by academic entrepreneurs and SMEs to improve the alignment of their developments with stakeholder needs. Design: Guided by market orientation theory, we interviewed senior managers and commercialisation experts from the biopharmaceutics sector. We asked them which information they consider most relevant, and how they collect, analyse and respond to new information to align product features, positioning and stakeholder-relationship management with market needs. Findings: Our innovator toolbox consists of a high-level overview of market intelligence considerations mapped against a novel innovation framework, a stakeholder reasoning and value model, and detailed considerations (checklists) per stakeholder of biopharmaceutics interventions. Originality: We provide here the first market orientation-based overview of market intelligence considerations for the biopharmaceutics sector. Although primarily collated for academic entrepreneurs and SMEs, our innovator toolbox for the biopharmaceutics sector can help all stakeholders better understand their orientation towards markets.展开更多
Worldwide women have to cope up with heavy burden of unwanted pregnancies, mistimed, unplanned, with risk to their health. Their children and families also suf-fer. Such pregnancies are root cause of induced abortions...Worldwide women have to cope up with heavy burden of unwanted pregnancies, mistimed, unplanned, with risk to their health. Their children and families also suf-fer. Such pregnancies are root cause of induced abortions （safe/unsafe） and grave consequences. Women, their partners can, for most part, prevent unwanted pregnancies by using contraceptives. However many women either do not use any contraceptive or use methods, with high failure rates. These women account for 82% of pregnancies that are not desired. Remaining unintended pregnancies occur among women who use modern contraceptive, either because they had diffculty using method consistently or because of failure. Helping women, their partner use modern contracep-tives effectively is essential in achieving Millennium Development Goals for improving women’s health, reducing poverty. If all women in developing countries use modern contraceptives, there would be 22 million less unplanned births, 25 million fewer induced, 15 million fewer unsafe abortions, 90000 less maternal deaths and 390000 less children losing their mothers. Also making abortion services broadly legal, by understand-ing size, type of unmet needs, most important by creating awareness in communities can surely help tackle this problem to a large extent.展开更多
Biologics have greatly improved the management of rheumatoid arthritis (RA), demonstrating efficacy and safety in alleviating symptoms, inhibiting bone erosion, and preventing loss of function. Unmet therapeutic needs...Biologics have greatly improved the management of rheumatoid arthritis (RA), demonstrating efficacy and safety in alleviating symptoms, inhibiting bone erosion, and preventing loss of function. Unmet therapeutic needs in RA remain;however, further advances require an understanding of issues left unaddressed under the current treatment paradigm. Most biologic-na?ve and biologic-pretreated patients who initiate a biologic therapy, for example, do not reach American College of Rheumatology 50% (ACR50) response, and few achieve remission. Responses are often not durable, prompting frequent treatment switching. Predictive markers are unavailable to guide therapy selection, and clinical trial data are lacking on whether a tumor necrosis factor inhibitor (TNFi) is the best first-line biologic and on the optimal sequence of use for the different biologics. Risk of serious infection is the major safety concern. Translating preclinical and clinical findings into new therapeutics may help address unmet needs. An increasing body of evidence indicates that the cytokine interleukin (IL)-17A represents an important therapeutic target;ongoing trials with IL-17A inhibitors will determine whether these agents can address some of the unmet needs associated with current biologics.展开更多
A statistician from the Re-gional F amily Planning Committee told reporters that a su1vey on the deliverability and public requirement for contraception services was con-ducted in December 1996 through-out the Tibet A...A statistician from the Re-gional F amily Planning Committee told reporters that a su1vey on the deliverability and public requirement for contraception services was con-ducted in December 1996 through-out the Tibet Autonomous Re gion by the Technical Service Station of the Committee.展开更多
Many adolescent girls are pressured into having sex at an early age, which puts them at high risk of unwanted pregnancies and unsafe abortions. The overall objective of this study was to evaluate the unmet needs of ad...Many adolescent girls are pressured into having sex at an early age, which puts them at high risk of unwanted pregnancies and unsafe abortions. The overall objective of this study was to evaluate the unmet needs of adolescents who give birth. A descriptive cross-sectional study was carried out in three university hospitals in Yaoundé, Cameroon: Yaoundé Central Hospital, Yaoundé Gyneco-Obstetrics and Pediatric Hospital and the District Hospital of Biyem-Assi, from February 1, 2020 to June 30, 2020. Included were any teenage mothers speaking English or French. Data were entered using CSPRO 7.3, analyzed by Excel 2010 and SPSS version 23.0. The tools used to express our results were the number, the frequency, the mean, the odds ratio (OR) and the P. P was significant if less than 5%. Of a total of 2692 births recorded, 188 (7%) were from adolescents. Of these, 157 fulfilling our selection criteria were recruited and data analyzed. The average age of the participants was 17.9 ± 1.12 years with extremes of 13 and 19, the average parity was 1.2 ± 0.4 with extremes of 1 and 3. Out of 157 participants, 2 who fell in the age range of 10 to 14 years (100%) and 106 of 155 (68.4%) whose age ranged from 15 to 19 years had unmet need for family planning. Only unmarried participants had unmet needs after multivariate analysis [aOR 2.4 (1.1 - 5.3);p = 0.035)]. Being unmarried was independently associated with the occurrence of unmet needs. The intensification of campaigns for provider behavior changes communication and the creation of services dedicated to the sexual and reproductive health of adolescents would help to reduce the rate of unmet needs for family planning among adolescent girls.展开更多
Introduction: Unmet need for family planning (UNFP) is defined as women with unmet needs who want to stop or delay childbearing but are not using any method of contraception. The objective of this study was to analyze...Introduction: Unmet need for family planning (UNFP) is defined as women with unmet needs who want to stop or delay childbearing but are not using any method of contraception. The objective of this study was to analyze the factors associated with unmet needs for family planning among couples living in rural and urban areas of Guinea in 2019. Methodology: This was a prospective, analytical cross-sectional, multicenter study of a six-month period from August 1, 2018 to January 31, 2019, focusing on couples with unmet needs for family planning. Result: Among 189 couples interviewed, 567 had UNFP (33.3%), the reasons for not using modern contraceptive methods were desire for pregnancy (AOR = 2.74, 95% CI: 1.74, 4.31), husband’s refusal (AOR = 0.23, 95% CI: 0.06, 0.81), spousal attitude (AOR = 0.20, 95% CI: 0.130, 30), birth spacing (AOR = 2.10% to 95%: 1.16, 3.82), difficulty with a new pregnancy (AOR = 0.17, 95% CI: 0.04, 0.74), and spousal attitude (AOR = 0.20, 95% CI: 0.14, 0.30). Conclusion: The involvement of spouses, especially in rural communities, would help achieve family planning objectives and reduce unmet needs for family planning.展开更多
Background:Identifying and managing patients'supportive care needs is an essential component of health care.The cancer patients'needs are multidimensional and it is important to identify these needs.This study...Background:Identifying and managing patients'supportive care needs is an essential component of health care.The cancer patients'needs are multidimensional and it is important to identify these needs.This study was conducted to assess supportive care needs of women with gynecologic cancer and affecting factors.Methods:This cross-sectional study consisted of 98 women with gynecologic cancer.The data of the study was gathered using“Personal Information Form”and the“James Supportive Care Screening”.Results:The most frequently reported unmet needs of gynecologic cancer patients were emotional issues,including uncertainty(87.6%),fears(85.7%),feeling down(86.7%),worry(87.6%),loss of interest in usual activities(73.3%)and physical symptoms including fatigue/lack of energy(81.9%),weakness(81.9%),lack of appetite(76.2%).The most frequently reported social/practical problems was transportation problems(50%).The mean scores for JSCS was 29.72±15.57.There were a statistically significant difference was found only between family type,stage of the disease,and time of diagnosis,and the total mean scores of the JSCS(p<0.05).Conclusion:It has been determined that patients with gynecological cancer mostly experience emotional and physical problems.Health professionals working in the oncology unit should be aware of unmet needs.Certain programs and services to address the identified unmet needs should be provided.展开更多
Most distribution system operators may not accurately record or completely maintain the phase connections for the numerous LV customers.Different consumer phase identification(CPI)approaches based on voltages,powers o...Most distribution system operators may not accurately record or completely maintain the phase connections for the numerous LV customers.Different consumer phase identification(CPI)approaches based on voltages,powers or other measurements are proposed in the literature.Due to the technical challenges in collecting voltage measurements,power measurement based approaches are preferable.Hence,this paper proposes a novel power based CPI methodology applying Graph Neural Networks(GNNs).The CPI methodology generates synthetic transformer power profiles assuming random combinations of phases for the measured load profiles,which are used altogether to train the GNN model.The GNN model is then tested using measured transformer and load power profiles.The performance of the methodology is evaluated in a test low voltage grid of 55 loads under various conditions of Photovoltaic penetration,Photovoltaics under maintenance,measurement errors,unmetered consumption,uncertain grid asset parameters and inaccurate phase connections.Further tests on a real low voltage grid with 111 loads prove the scalability of the methodology.The attained results show that the GNN model can achieve accuracy above 90%in most cases,outperforming various state-of-the-art methods.展开更多
Biomaterials and materiobiology are revolutionizing the approaches to solving aging-related medical challenges.With our society facing increasing aging-related diseases such as cancer,osteoporosis,Alzheimer's dise...Biomaterials and materiobiology are revolutionizing the approaches to solving aging-related medical challenges.With our society facing increasing aging-related diseases such as cancer,osteoporosis,Alzheimer's disease,Parkinson's disease,diabetes,and cardiovascular diseases,interdisciplinary efforts are crucial to connect material design,biological insights,and clinical unmet needs.展开更多
文摘Intravascular large B-cell lymphoma(IVLBCL),a rare subtype of non-Hodgkin lymphoma,is classified as an independent subtype of extranodal diffuse large B-cell lymphoma(DLBCL)in the 2008 World Health Organization(WHO)Classification(Turner et al.,2010).The 5th edition of the World Health Organization(WHO 2022)classification of hematolymphoid tumors retains this subtype(Alaggio et al.,2022).IVLBCL,which is characterized by neoplastic lymphocyte proliferation within the lumen of small blood vessels,tends to invade organs,such as the nervous system,skin,bone marrow(BM),and lung(D'Angelo et al.,2019;Satoh et al.,2019;Vasquez et al.,2019;Fukami et al.,2020).
文摘Like many river basins in China, water resources in the Fudong Pai River are almost fully allocated. This paper seeks to assess and evaluate water resource problems using water evaluation and planning (WEAP) model via its application to Hengshui Basin of Fudong Pai River. This model allows the simulation and analysis of various water allocation scenarios and, above all, scenarios of users' behavior. Water demand management is one of the options discussed in detail. Simulations are proposed for diverse climatic situations from dry years to normal years and results are discussed. Within the limits of data availability, it appears that most water users are not able to meet all their requirements from the river, and that even the ecological reserve will not be fully met during certain years. But the adoption of water demand management procedures offers opportunities for remedying this situation during normal hydrological years. However, it appears that demand management alone will not suffice during dry years. Nevertheless, the ease of use of the model and its user-friendly interfaces make it particularly useful for discussions and dialogue on water resources management among stakeholders.
文摘Many brain diseases, including schizophrenia, affect men and women unequally-either more or less frequently, or at different times in the life cycle, or to varied degrees of severity. With updates from recent findings, this paper reviews the work of my research group over the last 40 years and underscores issues that remain critical to the optimal care of women with schizophrenia, issues that overlap with, but are not identical to, the cares and concerns of men with the same diagnosis. Clinicians need to be alert not only to the overarching needs of diagnostic groups, but also to the often unique needs of women and men.
文摘Objective To calculate unmet need for contraception according to revised definition, mapping the contraception service needs and analyze factors related to the unmet need for contraception in Nusa Tenggara Barat （NTB）. Methods This research design was cross sectional, using data from Indonesia Demographic and Health Survey 2012. Subjects were from 1 362 household, and were married women aged 15-49 years in NTB Province （685 women）. Calculating method of unmet need for contraception used revised version, and analysis method was univariate, bivariate, and multivariate （Logistic regression）. Results Majority of married women aged 15-49 years in NTB need contraception service （73.1%）. However, it was known that met need for contraception was only 56.0%. Meanwhile, unmet need rate for contraception in NTB was 17.1%, specifically 11.5% for spacing and 5.6% for limiting. Factors contributing to unmet need for contraception in NTB were： household assets at above average （OR=O. 77）, parity of 2-3 children （OR=0. 73）, women with junior high school education level （0R=0.68）, never be visited by health workers （OR=O. 68）. Conclusions Factors that contribute to unmet need for contraception in NTB are household assets, parity, education level and visited by health workers. Government has to prioritize those f our factors in policy intervention and promotion of family planning participation program in NTB.
文摘Due to the optimal results obtained in kidney transplantation and to the lack of interest of the industries,new innovative drugs in kidney transplantation are difficult to be encountered.The best strategy to find the new drugs recently developed or under development is to search in the sections of kidney transplantation still not completely covered by the drugs on the market.These unmet needs are the prevention of delayed graft function(DGF),the protection of the graft over the long time and the desensitization of preformed anti human leukocyte antigen antibodies and the treatment of the acute antibody-mediated rejection.These needs are particularly relevant due to the expansion of some kind of kidney transplantation as transplantation from non-heart beating donor and in the case of antibody-incompatible grafts.The first are particularly exposed to DGF,the latter need a safe desensitization and a safe treatments of the antibody mediated rejections that often occur.Particular caution is needed in treating these drugs.First,they are described in very recent studies and the follow-up of their effect is of course rather short.Second,some of these drugs are still in an early phase of study,even if in well-conducted randomized controlled trials.Particular caution and a careful check need to be used in trials launched 2 or 3 years ago.Indeed,is always necessary to verify whether the study is still going on or whether and why the study itself was abandoned.
文摘In the era of highly effective direct acting antiviral(DAA) drugs for the treatment of chronic hepatitis C(CHC) infection, where eradication is almost ensured with minimal side effects, all hepatitis C carriers should benefit theoretically. In the real world setting however, only a small proportion will benefit at this time point due to the multiple barriers to accessing therapy. Given that universal treatment is unlikely, treatment with DAAs will likely be restricted to those with the highest health benefits, and for those who can afford the high expense of a treatment course. Those with the highest unmet needs include those who have failed previous interferon-based therapy or who are interferon-ineligible with evidence of active disease, those with advance liver disease, and those with recurrence of hepatitis C after liver transplantation. In the future, the focus should be on increasing access to treatment for those infected with CHC.
文摘Objective:To assess the factors associated with knowledge,attitude and behavior of contraception use among urban slum population in Chennai.Methods:A cross-sectional study was conducted in the urban slum of Anakaputhur,Chennai.Married couples between ages of 19-49 years and living in slum areas were taken up for the study by simple random sampling.Pregnant women,postnatal and postmenopausal women were excluded from the study.Data collection was done using a pretested structured questionnaire focusing on details regarding contraception knowledge,attitude,and practices.Data analysis was done using IBM SPSS version 22.Analytical test like Chi square and odds ratio(OR)were used to identify association between knowledge,attitude,and behavior of contraception with the associated variables and enter method of logistic regression analysis was done.Results:Out of the 360 respondents,228 were females,with a mean age of(34±5)years.Approximately 43%demonstrated adequate knowledge of contraception use,and 91%were aware of at least one contraceptive method.Notably,72%exhibited a positive attitude towards contraceptive use.Nevertheless,43%(155 individuals)did not utilize any contraceptive method.Among contraceptive users,intrauterine devices were the most commonly adopted,followed by barrier methods and female sterilization.There was significant association between knowledge of contraception and education(aOR 7.29,95%CI 2.93-18.10,P<0.05),age(aOR 2.04,95%CI 1.19-3.50,P<0.05)and socioeconomic class(aOR 3.66,95%CI 1.71-7.85,P<0.05;aOR 3.97,95%CI 2.12-7.49,P<0.05).Regarding attitude towards contraception use,education(aOR 8.54,95%CI 2.35-31.03,P<0.05),sex(aOR 0.15,95%CI 0.06-0.37,P<0.05),age(aOR 0.53,95%CI 0.28-0.99,P<0.05),socio-economic class(aOR 4.42,95%CI 1.97-9.92,P<0.05;aOR 9.83,95%CI 3.63-26.58,P<0.05)and number of children(aOR 10.04,95%CI 4.26-23.66,P<0.05)were the variables that had a significant association.Conclusions:These findings underscore the imperative for enhanced dissemination of health education pertaining to contraception use within the slum population.The health sectors of the area and other stakeholders need to make sure to extend penetration of family planning related services to the urban slum population.
文摘Objectives: Immigrants of Chinese ethnicity and young people (between 18 and 30 years of age) are known to access health services less frequently and may be at greater risk for experiencing unmet health needs. The purpose of this study was to examine the health beliefs, health behaviors, primary care access, and perceived unmet healthcare needs of Chinese young adults.Methods: Semi-structured in-depth interviews were carried out with eight Chinese young adults in Vancouver, Canada. Results: A content analysis revealed that these Chinese young adults experienced unmet healthcare needs, did not have a primary care provider, and did not access preventive services. Cultural factors such as strong family ties, filial piety, and the practice of Traditional Chinese Medicine influenced their health behaviors and healthcare access patterns. Conclusion: Chinese young adults share similar issues with other young adults in relation to not having a primary care provider and accessing preventive care but their health beliefs and practices make their needs for care unique from other young adults.
文摘Background: Understanding the magnitude of unmet contraceptive need and the underlying determinants will help the programs and services to respond effectively. Aim: Identify the prevalence and determinants of unmet contraceptive need among married women in the childbearing period in Minia Governorate. Methods: Community-based cross-sectional study was done among married women of child bearing age (18 - 49 years). Total 534 study participants were selected randomly and interviewed by using pretested structured questionnaire. Results: Overall level of unmet need was 12.7%. Women age > 35 years old were about three times (adjusted OR = 2.88, 95% CI: 1.13 - 7.35) more likely to have unmet need for family planning compared to younger women. Women who had more children (adjusted OR = 1.32, 95% CI: 1.04 - 1.67), more female offspring (adjusted OR = 1.37, 95% CI: 1.09 - 1.65), and women whose partner had non-supportive attitude towards family planning (adjusted OR = 2.96, 95% CI: 1.53 - 5.72) were more likely to have unmet need. Conclusion: The prevalence of unmet need of family planning among women in Minia Governorate remains high. Therefore, family planning programs that cover the older woman’s need for limiting and that focus on couples could be useful in reducing the rate of unmet need.
文摘The study was conducted to assess the magnitude and associated factors of unmet need for family planning among women of reproductive age group with disabilities who are members of disabled associations in Bahir Dar town. Institution based cross-sectional study was carried out. A total of 337 women of reproductive age group with disabilities were included in the study with simple random sampling. Data were collected through face-to-face interview, coded, cleaned and entered by Epi info 2002 and analyzed with SPSS version 16 computer software. Logistic regression was used to assess possible associations. The magnitude of unmet need for family planning among women with disabilities was 24.3%. Women with disabilities in the age group of 25-29 had 80% less likely to have unmet need than women above 35 years old. Women with disability who have no education were 11 times more likely to have unmet need than those who have secondary education. Women who desire to have more than 3 children have more likely to have unmet need than those who need to have 1-2 children. Unmet need for family planning among women with disabilities was high in Bahir Dar town. Age, Educational status and desired number of children were found to have statistically significant association with unmet need for family planning. Hence, it is important to encourage people with disabilities to attained formal education and the associations should provide short term trainings in accordance with their age group.
文摘The population plagued with the HIV/AIDS pandemic in Cameroon is young, a generation that may desire or control fertility. For those who may become pregnant, the desire to have children may not be there. We carried out this study to look at the picture of the reproductive health needs of women living with HIV/AIDS in our setting. In this cross-sectional non-analytic design that lasted for three years, we employed both qualitative and quantitative methods to collect data from them after receiving ethical clearance (N221/CM/2009) from the National Ethics Committee. Consenting HIV infected women who were attending the “HIV Day Care” clinics and those who delivered and were in the post partum wards in four of our major hospitals in Yaounde were enrolled. Interviews were individualized. We used both CSPro version 4.1 and Statistical Package for Social Sciences (SPSS) version 19.0 softwares for data analysis. Four hundred and fifteen (415) women were enrolled;the mean age was 29 ± 7.8 years;the most represented age group was 24 -29 years. They were single (36.14%), well educated (5 out of 10 had attained university level of education), 61.20% revealed that their partners knew their HIV status, 82.4% believed that screening for cancer of the cervix was necessary for their status and 47.70% would want to be screened for some or all STIs. About 36.86% had the desire to have children, 57.1% of those who delivered did not plan to have the pregnancies out of which 82% would have wanted a modern method of contraception but did not have (82% unmet needs). Modern contraceptive use was associated with age and individual characteristics such as level of education. It was 64.34% among women who had secondary level of education and below as against 35.66% among those who had high school level of education and above. Contraceptive use was also high among women who were unmarried as against those who were married (89.64% vs 10.36%). The desire to have children decreased as age increased (43.85% vs 18.79%) and was lower among married women compared to those who were single (13.01% versus 49.64%). These women were found to have high unmet needs for modern contraception and showed interest in STIs and cervical cancer screening.
文摘Purpose: Many health systems are considered ill-equipped to adequately meet future demand. Although academic entrepreneurs and small and medium-sized enterprises (SMEs) drive health technology innovation, they often suboptimally consider important market and stakeholder requirements. This can result in missed opportunities to improve health system performance, address demand-supply gaps, and achieve financial rewards. Market intelligence can provide crucial information in this regard, but scientifically sourced guidance on how to perform market research for biopharmaceutics is scarce. Our objective was, therefore, to create and provide an easily accessible biopharmaceutics market research toolbox that can be perused by academic entrepreneurs and SMEs to improve the alignment of their developments with stakeholder needs. Design: Guided by market orientation theory, we interviewed senior managers and commercialisation experts from the biopharmaceutics sector. We asked them which information they consider most relevant, and how they collect, analyse and respond to new information to align product features, positioning and stakeholder-relationship management with market needs. Findings: Our innovator toolbox consists of a high-level overview of market intelligence considerations mapped against a novel innovation framework, a stakeholder reasoning and value model, and detailed considerations (checklists) per stakeholder of biopharmaceutics interventions. Originality: We provide here the first market orientation-based overview of market intelligence considerations for the biopharmaceutics sector. Although primarily collated for academic entrepreneurs and SMEs, our innovator toolbox for the biopharmaceutics sector can help all stakeholders better understand their orientation towards markets.
文摘Worldwide women have to cope up with heavy burden of unwanted pregnancies, mistimed, unplanned, with risk to their health. Their children and families also suf-fer. Such pregnancies are root cause of induced abortions （safe/unsafe） and grave consequences. Women, their partners can, for most part, prevent unwanted pregnancies by using contraceptives. However many women either do not use any contraceptive or use methods, with high failure rates. These women account for 82% of pregnancies that are not desired. Remaining unintended pregnancies occur among women who use modern contraceptive, either because they had diffculty using method consistently or because of failure. Helping women, their partner use modern contracep-tives effectively is essential in achieving Millennium Development Goals for improving women’s health, reducing poverty. If all women in developing countries use modern contraceptives, there would be 22 million less unplanned births, 25 million fewer induced, 15 million fewer unsafe abortions, 90000 less maternal deaths and 390000 less children losing their mothers. Also making abortion services broadly legal, by understand-ing size, type of unmet needs, most important by creating awareness in communities can surely help tackle this problem to a large extent.
文摘Biologics have greatly improved the management of rheumatoid arthritis (RA), demonstrating efficacy and safety in alleviating symptoms, inhibiting bone erosion, and preventing loss of function. Unmet therapeutic needs in RA remain;however, further advances require an understanding of issues left unaddressed under the current treatment paradigm. Most biologic-na?ve and biologic-pretreated patients who initiate a biologic therapy, for example, do not reach American College of Rheumatology 50% (ACR50) response, and few achieve remission. Responses are often not durable, prompting frequent treatment switching. Predictive markers are unavailable to guide therapy selection, and clinical trial data are lacking on whether a tumor necrosis factor inhibitor (TNFi) is the best first-line biologic and on the optimal sequence of use for the different biologics. Risk of serious infection is the major safety concern. Translating preclinical and clinical findings into new therapeutics may help address unmet needs. An increasing body of evidence indicates that the cytokine interleukin (IL)-17A represents an important therapeutic target;ongoing trials with IL-17A inhibitors will determine whether these agents can address some of the unmet needs associated with current biologics.
文摘A statistician from the Re-gional F amily Planning Committee told reporters that a su1vey on the deliverability and public requirement for contraception services was con-ducted in December 1996 through-out the Tibet Autonomous Re gion by the Technical Service Station of the Committee.
文摘Many adolescent girls are pressured into having sex at an early age, which puts them at high risk of unwanted pregnancies and unsafe abortions. The overall objective of this study was to evaluate the unmet needs of adolescents who give birth. A descriptive cross-sectional study was carried out in three university hospitals in Yaoundé, Cameroon: Yaoundé Central Hospital, Yaoundé Gyneco-Obstetrics and Pediatric Hospital and the District Hospital of Biyem-Assi, from February 1, 2020 to June 30, 2020. Included were any teenage mothers speaking English or French. Data were entered using CSPRO 7.3, analyzed by Excel 2010 and SPSS version 23.0. The tools used to express our results were the number, the frequency, the mean, the odds ratio (OR) and the P. P was significant if less than 5%. Of a total of 2692 births recorded, 188 (7%) were from adolescents. Of these, 157 fulfilling our selection criteria were recruited and data analyzed. The average age of the participants was 17.9 ± 1.12 years with extremes of 13 and 19, the average parity was 1.2 ± 0.4 with extremes of 1 and 3. Out of 157 participants, 2 who fell in the age range of 10 to 14 years (100%) and 106 of 155 (68.4%) whose age ranged from 15 to 19 years had unmet need for family planning. Only unmarried participants had unmet needs after multivariate analysis [aOR 2.4 (1.1 - 5.3);p = 0.035)]. Being unmarried was independently associated with the occurrence of unmet needs. The intensification of campaigns for provider behavior changes communication and the creation of services dedicated to the sexual and reproductive health of adolescents would help to reduce the rate of unmet needs for family planning among adolescent girls.
文摘Introduction: Unmet need for family planning (UNFP) is defined as women with unmet needs who want to stop or delay childbearing but are not using any method of contraception. The objective of this study was to analyze the factors associated with unmet needs for family planning among couples living in rural and urban areas of Guinea in 2019. Methodology: This was a prospective, analytical cross-sectional, multicenter study of a six-month period from August 1, 2018 to January 31, 2019, focusing on couples with unmet needs for family planning. Result: Among 189 couples interviewed, 567 had UNFP (33.3%), the reasons for not using modern contraceptive methods were desire for pregnancy (AOR = 2.74, 95% CI: 1.74, 4.31), husband’s refusal (AOR = 0.23, 95% CI: 0.06, 0.81), spousal attitude (AOR = 0.20, 95% CI: 0.130, 30), birth spacing (AOR = 2.10% to 95%: 1.16, 3.82), difficulty with a new pregnancy (AOR = 0.17, 95% CI: 0.04, 0.74), and spousal attitude (AOR = 0.20, 95% CI: 0.14, 0.30). Conclusion: The involvement of spouses, especially in rural communities, would help achieve family planning objectives and reduce unmet needs for family planning.
文摘Background:Identifying and managing patients'supportive care needs is an essential component of health care.The cancer patients'needs are multidimensional and it is important to identify these needs.This study was conducted to assess supportive care needs of women with gynecologic cancer and affecting factors.Methods:This cross-sectional study consisted of 98 women with gynecologic cancer.The data of the study was gathered using“Personal Information Form”and the“James Supportive Care Screening”.Results:The most frequently reported unmet needs of gynecologic cancer patients were emotional issues,including uncertainty(87.6%),fears(85.7%),feeling down(86.7%),worry(87.6%),loss of interest in usual activities(73.3%)and physical symptoms including fatigue/lack of energy(81.9%),weakness(81.9%),lack of appetite(76.2%).The most frequently reported social/practical problems was transportation problems(50%).The mean scores for JSCS was 29.72±15.57.There were a statistically significant difference was found only between family type,stage of the disease,and time of diagnosis,and the total mean scores of the JSCS(p<0.05).Conclusion:It has been determined that patients with gynecological cancer mostly experience emotional and physical problems.Health professionals working in the oncology unit should be aware of unmet needs.Certain programs and services to address the identified unmet needs should be provided.
基金supported by the Common European-scale Energy Artificial Intelligence Federated Testing and Experimentation Facility(EnerTEF),which is a project funded by the European Union’s Horizon Europe Research and Innovation Program(Grant 101172887).
文摘Most distribution system operators may not accurately record or completely maintain the phase connections for the numerous LV customers.Different consumer phase identification(CPI)approaches based on voltages,powers or other measurements are proposed in the literature.Due to the technical challenges in collecting voltage measurements,power measurement based approaches are preferable.Hence,this paper proposes a novel power based CPI methodology applying Graph Neural Networks(GNNs).The CPI methodology generates synthetic transformer power profiles assuming random combinations of phases for the measured load profiles,which are used altogether to train the GNN model.The GNN model is then tested using measured transformer and load power profiles.The performance of the methodology is evaluated in a test low voltage grid of 55 loads under various conditions of Photovoltaic penetration,Photovoltaics under maintenance,measurement errors,unmetered consumption,uncertain grid asset parameters and inaccurate phase connections.Further tests on a real low voltage grid with 111 loads prove the scalability of the methodology.The attained results show that the GNN model can achieve accuracy above 90%in most cases,outperforming various state-of-the-art methods.
文摘Biomaterials and materiobiology are revolutionizing the approaches to solving aging-related medical challenges.With our society facing increasing aging-related diseases such as cancer,osteoporosis,Alzheimer's disease,Parkinson's disease,diabetes,and cardiovascular diseases,interdisciplinary efforts are crucial to connect material design,biological insights,and clinical unmet needs.
