The rapid growth of biomedical data,particularly multi-omics data including genomes,transcriptomics,proteomics,metabolomics,and epigenomics,medical research and clinical decision-making confront both new opportunities...The rapid growth of biomedical data,particularly multi-omics data including genomes,transcriptomics,proteomics,metabolomics,and epigenomics,medical research and clinical decision-making confront both new opportunities and obstacles.The huge and diversified nature of these datasets cannot always be managed using traditional data analysis methods.As a consequence,deep learning has emerged as a strong tool for analysing numerous omics data due to its ability to handle complex and non-linear relationships.This paper explores the fundamental concepts of deep learning and how they are used in multi-omics medical data mining.We demonstrate how autoencoders,variational autoencoders,multimodal models,attention mechanisms,transformers,and graph neural networks enable pattern analysis and recognition across all omics data.Deep learning has been found to be effective in illness classification,biomarker identification,gene network learning,and therapeutic efficacy prediction.We also consider critical problems like as data quality,model explainability,whether findings can be repeated,and computational power requirements.We now consider future elements of combining omics with clinical and imaging data,explainable AI,federated learning,and real-time diagnostics.Overall,this study emphasises the need of collaborating across disciplines to advance deep learning-based multi-omics research for precision medicine and comprehending complicated disorders.展开更多
Intra-abdominal hypertension(IAH)and abdominal compartment syndrome(ACS)play a pivotal role in the pathophysiology of severe acute pancreatitis(SAP)and contribute to new-onset and persistent organ failure.The optimal ...Intra-abdominal hypertension(IAH)and abdominal compartment syndrome(ACS)play a pivotal role in the pathophysiology of severe acute pancreatitis(SAP)and contribute to new-onset and persistent organ failure.The optimal management of ACS involves a multi-disciplinary approach,from its early recognition to measures aiming at an urgent reduction of intra-abdominal pressure(IAP).A targeted literature search from January 1,2000,to November 30,2022,revealed 20 studies and data was analyzed on the type and country of the study,patient demographics,IAP,type and timing of surgical procedure performed,post-operative wound management,and outcomes of patients with ACS.There was no randomized controlled trial published on the topic.Decom-pressive laparotomy is effective in rapidly reducing IAP(standardized mean difference=2.68,95%confidence interval:1.19-1.47,P<0.001;4 studies).The morbidity and complications of an open abdomen after decompressive laparotomy should be weighed against the inadequately treated but,potentially lethal ACS.Disease-specific patient selection and the role of less-invasive decompressive measures,like subcutaneous linea alba fasciotomy or component separation techniques,is lacking in the 2013 consensus management guidelines by the Abdominal Compartment Society on IAH and ACS.This narrative review focuses on the current evidence regarding surgical decompression techniques for managing ACS in patients with SAP.However,there is a lack of high-quality evidence on patient selection,timing,and modality of surgical decompression.Large prospective trials are needed to identify triggers and effective and safe surgical decompression methods in SAP patients with ACS.展开更多
With the rapid change in the Arctic sea ice,a large number of sea ice observations have been collected in recent years,and it is expected that an even larger number of such observations will emerge in the coming years...With the rapid change in the Arctic sea ice,a large number of sea ice observations have been collected in recent years,and it is expected that an even larger number of such observations will emerge in the coming years.To make the best use of these observations,in this paper we develop a multi-sensor optimal data merging(MODM)method to merge any number of different sea ice observations.Since such merged data are independent on model forecast,they are valid for model initialization and model validation.Based on the maximum likelihood estimation theory,we prove that any model assimilated with the merged data is equivalent to assimilating the original multi-sensor data.This greatly facilitates sea ice data assimilation,particularly for operational forecast with limited computational resources.We apply the MODM method to merge sea ice concentration(SIC)and sea ice thickness(SIT),respectively,in the Arctic.For SIC merging,the Special Sensor Microwave Imager/Sounder(SSMIS)and Advanced Microwave Scanning Radiometer 2(AMSR2)data are merged together with the Norwegian Ice Service ice chart.This substantially reduces the uncertainties at the ice edge and in the coastal areas.For SIT merging,the daily Soil Moisture and Ocean Salinity(SMOS)data is merged with the weekly-mean merged CryoSat-2 and SMOS(CS2SMOS)data.This generates a new daily CS2SMOS SIT data with better spatial coverage for the whole Arctic.展开更多
Missing data can frequently occur in a longitudinal data analysis. In the literature, many methods have been proposed to handle such an issue. Complete case (CC), mean substitution (MS), last observation carried forwa...Missing data can frequently occur in a longitudinal data analysis. In the literature, many methods have been proposed to handle such an issue. Complete case (CC), mean substitution (MS), last observation carried forward (LOCF), and multiple imputation (MI) are the four most frequently used methods in practice. In a real-world data analysis, the missing data can be MCAR, MAR, or MNAR depending on the reasons that lead to data missing. In this paper, simulations under various situations (including missing mechanisms, missing rates, and slope sizes) were conducted to evaluate the performance of the four methods considered using bias, RMSE, and 95% coverage probability as evaluation criteria. The results showed that LOCF has the largest bias and the poorest 95% coverage probability in most cases under both MAR and MCAR missing mechanisms. Hence, LOCF should not be used in a longitudinal data analysis. Under MCAR missing mechanism, CC and MI method are performed equally well. Under MAR missing mechanism, MI has the smallest bias, smallest RMSE, and best 95% coverage probability. Therefore, CC or MI method is the appropriate method to be used under MCAR while MI method is a more reliable and a better grounded statistical method to be used under MAR.展开更多
Highly accurate vegetative type distribution information is of great significance for forestry resource monitoring and management.In order to improve the classification accuracy of forest types,Sentinel-1 and 2 data o...Highly accurate vegetative type distribution information is of great significance for forestry resource monitoring and management.In order to improve the classification accuracy of forest types,Sentinel-1 and 2 data of Changbai Mountain protection development zone were selected,and combined with DEM to construct a multi-featured random forest type classification model incorporating fusing intensity,texture,spectral,vegetation index and topography information and using random forest Gini index(GI)for optimization.The overall accuracy of classification was 94.60%and the Kappa coefficient was 0.933.Comparing the classification results before and after feature optimization,it shows that feature optimization has a greater impact on the classification accuracy.Comparing the classification results of random forest,maximum likelihood method and CART decision tree under the same conditions,it shows that the random forest has a higher performance and can be applied to forestry research work such as forest resource survey and monitoring.展开更多
Introduction: Resection of malignant pelvic tumors has long been considered to be associated with higher postoperative mortality and morbidity than resection of malignant limb tumors. We compared the postoperative adv...Introduction: Resection of malignant pelvic tumors has long been considered to be associated with higher postoperative mortality and morbidity than resection of malignant limb tumors. We compared the postoperative adverse events of pelvic tumor surgery and limb tumor surgery using a national inpatient database. Methods: We identified patients who underwent surgery for primary musculoskeletal malignant tumors of the pelvis or limbs between July and December in 2007- 2010 using the Japanese Diagnosis Procedure Combination inpatient database. We calculated the risk-adjusted odds ratio for the occurrence of postoperative complications following pelvic tumor surgery with reference to limb tumor surgery using a multivariable logistic regression analysis. Results: Of 3255 eligible patients, 3116 underwent limb tumor surgery and 139 underwent pelvic tumor surgery. In-hospital mortality was 0.6% and 0.7% and postoperative complication rates were 8.2% and 18.7%, respectively. The rate of blood transfusion and duration of anesthesia over 480 min were higher in the pelvic tumor group. Blood transfusion volume and duration of anesthesia were independently associated with worse outcomes, but there was no significant association between tumor location and occurrence of postoperative complications (odds ratio 1.18, 95% confidence interval 0.73 - 1.88, p = 0.502). Conclusions: Blood transfusion volume and duration of anesthesia were significant predictors of outcome. Our data demonstrate that the higher morbidity rate after pelvic tumor resection could result from the larger blood transfusion volume and longer anesthesia duration.展开更多
Objective This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction(MI)in patients with both coronary heart disease(CHD)and type 2 diabetes(T2D).Methods W...Objective This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction(MI)in patients with both coronary heart disease(CHD)and type 2 diabetes(T2D).Methods We conducted a retrospective cohort study of 33,238 patients with both CHD and T2D in Shenzhen,China.Patients were categorized into 6 groups based on baseline fasting plasma glucose(FPG)levels and diabetes duration(from the date of diabetes diagnosis to the baseline date)to examine their combined effects on subsequent MI.Cox proportional hazards regression models were used,with further stratification by age,sex,and comorbidities to assess potential interactions.Results Over a median follow-up of 2.4 years,2,110 patients experienced MI.Compared to those with optimal glycemic control(FPG<6.1 mmol/L)and shorter diabetes duration(<10 years),the fullyadjusted hazard ratio(HR)(95%Confidence Interval[95%CI])for those with a diabetes duration of≥10 years and FPG>8.0 mmol/L was 1.93(95%CI:1.59,2.36).The combined effects of FPG and diabetes duration on MI were largely similar across different age,sex,and comorbidity groups,although the excess risk of MI associated with long-term diabetes appeared to be more pronounced among those with atrial fibrillation.Conclusion Our study indicates that glycemic control and diabetes duration significant influence the subsequent occurrence of MI in patients with both CHD and T2D.Tailored management strategies emphasizing strict glycemic control may be particularly beneficial for patients with longer diabetes duration and atrial fibrillation.展开更多
Background:This study aimed to discover whether Cistanche tubulosa affects the AKT/CASP3 pathway by regulating m6A methylation,to exert a protective effect against peripheral nerve injury in a Parkinson's Disease(...Background:This study aimed to discover whether Cistanche tubulosa affects the AKT/CASP3 pathway by regulating m6A methylation,to exert a protective effect against peripheral nerve injury in a Parkinson's Disease(PD)mouse model.Methods:In this study,network pharmacology analysis and the molecular docking virtual screening technique was used to filter Acteoside(Act),a potential neuroprotective agent of active components in Cistanche tubulosa.A PD-related peripheral neuropathy mouse model was established by MPTP induction,followed by 21 days treatment of oral Act(25,50,and 100 mg kg^(−1)).Pole climbing,automatic avoidance ability and hot plate sensory tests were evaluated to determine behavioral changes caused by central and peripheral nerve injury.The pathological alterations of dorsal root ganglion tissue and the protein levels of IL-6,AKT,and CASP3 under Act intervention,as well as the dynamic changes of FTO,METTL3,and YTHDF2 which are closely related to m6A methylation,were comprehensively analyzed to observe the peripheral nerve protective efficacy of Act.Results:The results showed that peripheral neuropathy occurring with PD in the mouse model,which could be verified by behavioral tests and pathological histological changes.In addition to the previously established protective effect of Act on dopaminergic neurons in substantia nigra(SN),extensive follow-up studies demonstrated that Act effectively induced m6A methylation,which could further regulate the AKT/CASP3 pathway to play a therapeutic role.In this study,medium and high doses of Act played more obvious therapeutic roles.Conclusion:These findings suggest that Act may regulate the severity of peripheral nerve injury under the activation of the AKT/CASP3 signaling pathway by balancing the methylation level of m6A.These results provide a theoretical basis and experimental evidence for further research on the protective effect of Cistanche tubulosa on both the central and peripheral nerves in the treatment of PD.展开更多
Evidence on the association between osteoporosis and dementia is not fully clear.This study aimed to investigate the potential association between osteoporosis and the subsequent risk of dementia among older adults.We...Evidence on the association between osteoporosis and dementia is not fully clear.This study aimed to investigate the potential association between osteoporosis and the subsequent risk of dementia among older adults.We performed a cohort study of176150 community-dwelling older adults aged≥65 years and free of cognitive impairment between 2018 and 2022 using integrated healthcare data from Shenzhen,China.Diagnoses of osteoporosis,osteoporotic fractures,and dementia were identified through linked outpatient and inpatient medical records and death registration records.Multivariate Cox proportional hazards models were used to estimate the adjusted hazard ratios(HRs)and 95%confidence intervals(CIs)of incident dementia associated with osteoporosis and osteoporotic fractures.The mean(SD)age of the total study population was 70.7(5.4)years,and 9605 had a previous diagnosis of osteoporosis.Over a median follow-up of 2.2(IQR:1.8–4.3,maximum:5.5)years,corresponding to 505423person-years at risk,1367 incident all-cause dementia cases,including 617 Alzheimer's disease and 298 vascular dementia cases,occurred.Physician-diagnosed osteoporosis was associated with a higher risk of all-cause dementia(HR:1.80,95%CI:1.53–2.12).The increased dementia risk tended to be more prominent among patients with osteoporotic fractures(HR:2.43,95%CI:1.83–3.23)than those without(HR:1.63,95%CI:1.35–1.97).Results were similar for Alzheimer's disease and vascular dementia.This study provides evidence that older adults with osteoporosis,especially those with osteoporotic fractures,have an elevated risk of incident dementia.Effective prevention and management of osteoporosis among the older population may be promising to mitigate the dual burden of osteoporosis and dementia.展开更多
It is often challenging to diagnose acute myocardial infarction(AMI)in patients with elevated high-sensitivity cardiac troponin T(hs-cTnT)before observing a significant rise and/or fall in hs-cTnT.The current study ai...It is often challenging to diagnose acute myocardial infarction(AMI)in patients with elevated high-sensitivity cardiac troponin T(hs-cTnT)before observing a significant rise and/or fall in hs-cTnT.The current study aimed to identify an optimal cut-off to rule in AMI.A total of 76411 patients with elevated hs-cTnT were included.The predictive cut-off values for diagnosing ST-segment elevation myocardial infarction(STEMI)and non-STsegment elevation myocardial infarction(NSTEMI)were assessed using the area under the receiver operating characteristic curve(AUC).Among the patients,50466(66.0%)had non-cardiac diseases,25945(34.0%)had cardiac diseases,and 15502(20.3%)had AMI,including 816(1.1%)with STEMI and 14686(19.2%)with NSTEMI.The median hs-cTnT level was 3788.0 ng/L in STEMI patients and 67.2 ng/L in NSTEMI patients.The optimal cut-off for diagnosing STEMI was 251.9 ng/L,with a sensitivity of 90.7%,specificity of 86.5%,and an AUC of 0.942;the optimal cut-off for diagnosing NSTEMI was 130.5 ng/L,with a sensitivity of 40.9%,specificity of 83.8%,and an AUC of 0.638.Collectively,optimizing the cut-off values for diagnosing STEMI and NSTEMI to 251.9 ng/L and 130.5 ng/L,respectively,demonstrated high accuracy in a large cohort of Chinese patients with elevated hs-cTnT.展开更多
Social media platforms collect information from complex human social behaviors.It has been shown that they significantly impact capital markets.This article conducts a bibliometric analysis of 363 high-quality article...Social media platforms collect information from complex human social behaviors.It has been shown that they significantly impact capital markets.This article conducts a bibliometric analysis of 363 high-quality articles from the Web of Science on social media and capital markets.First,a descriptive analysis was performed,including discipline distribution,growth trends,institutions,publication sources,influential authors,articles,and countries.Second,collaborative networks identify cooperation between countries and institutions in the network analysis section.Bibliometric coupling analysis determines the relationship between journals of different disciplines.Cluster analysis and keyword co-occurrence networks identify hot research topics.Burst detection and keyword time zone analysis track field development.Finally,keyword analysis and clustering analysis are conducted on the research of different disciplines.These sample papers mainly include seven hot topics,including sentiment analysis and financial market prediction.Articles in business and finance focus more on social media’s impact on capital markets.In contrast,information technology articles focus more on extracting information from social media.Each field also has its unique research directions.This paper contributes to a comprehensive understanding of the research on social media and capital markets.It offers perspectives on disciplinary differences,serving as a valuable scholarly reference for conducting in-depth research.展开更多
AIM： To assess the use of capecitabine-based therapy and associated complication rates in patients with gastroesophageal cancer （GEC） in a real-world treat- ment setting. METHODS： Patients with claims between 2004...AIM： To assess the use of capecitabine-based therapy and associated complication rates in patients with gastroesophageal cancer （GEC） in a real-world treat- ment setting. METHODS： Patients with claims between 2004 and 2005 were identified from the Thomson Reuters MarketScan databases. Capecitabine regimens were compared with 5-fluorouracU （5-FU） and other chemotherapy regimens, and were stratified by treatment setting. RESULTS： We identified 1013 patients with GEC： approximately half had treatment initiated with a 5-FU regimen, whereas 11% had therapy initiated with a capecitabine regimen. The mean capecitabine dose overall was 2382 ± 1118 mg/d, and capecitabine was used as monotherapy more often than in combination. Overall, 5-FU regimens were the most common treat- ment option in neoadjuvant and adjuvant settings, while other non-capecitabine regimens were used more widely in first- and second-line settings. The overall unadjusted complication rate for capecitabine regimens was about half of that seen with 5-FU regimens. In multivariate analyses, capecitabine recipients had a 51% （95% CI： 26%-81%） lower risk of developing any complication than 5-FU recipients did. The risk of developing bone marrow, constitutional, gastrointestinal tract, infectious, or skin complications was lower with capecitabine therapy than with 5-FU.CONCLUSION： Capecitabine appeared to have a favorable side effect profile compared with 5-FU, which indicates that it may be a treatment option for GEC.展开更多
BACKGROUND The current understanding of the magnitude and consequences of multimorbidity in Chinese older adults with coronary heart disease(CHD)is insufficient.We aimed to assess the association and population-attrib...BACKGROUND The current understanding of the magnitude and consequences of multimorbidity in Chinese older adults with coronary heart disease(CHD)is insufficient.We aimed to assess the association and population-attributable fractions(PAFs)between multimorbidity and mortality among hospitalized older patients who were diagnosed with CHD in Shenzhen,China.METHODS We conducted a retrospective cohort study of older Chinese patients(aged≥65 years)who were diagnosed with CHD.Cox proportional hazards models were used to estimate the associations between multimorbidity and all-cause and cardiovascular disease(CVD)mortality.We also calculated the PAFs.RESULTS The study comprised 76,455 older hospitalized patients who were diagnosed with CHD between January 1,2016,and August 31,2022.Among them,70,217(91.9%)had multimorbidity,defined as the presence of at least one of the predefined 14 chronic conditions.Those with cancer,hemorrhagic stroke and chronic liver disease had the worst overall death risk,with adjusted HRs(95%CIs)of 4.05(3.77,4.38),2.22(1.94,2.53),and 1.85(1.63,2.11),respectively.For CVD mortality,the highest risk was observed for hemorrhagic stroke,ischemic stroke,and chronic kidney disease;the corresponding adjusted HRs(95%CIs)were 3.24(2.77,3.79),1.91(1.79,2.04),and 1.81(1.64,1.99),respectively.All-cause mortality was mostly attributable to cancer,heart failure and ischemic stroke,with PAFs of 11.8,10.2,and 9.1,respectively.As for CVD mortality,the leading PAFs were heart failure,ischemic stroke and diabetes;the corresponding PAFs were 18.0,15.7,and 6.1,respectively.CONCLUSIONS Multimorbidity was common and had a significant impact on mortality among older patients with CHD in Shenzhen,China.Cancer,heart failure,ischemic stroke and diabetes are the primary contributors to PAFs.Therefore,prioritizing improved treatment and management of these comorbidities is essential for the survival prognosis of CHD patients from a holistic public health perspective.展开更多
Objective:To determine the influence of geographic,knowledge and behavioral factors on Opisthorchis(O.)viverrini infection in the Northeast of Thailand.Methods:This cross-sectional study was conducted by using four da...Objective:To determine the influence of geographic,knowledge and behavioral factors on Opisthorchis(O.)viverrini infection in the Northeast of Thailand.Methods:This cross-sectional study was conducted by using four datasets of years 2016 and 2017.Generalized linear mixed model was employed to analyze association between geographic,knowledge and behavioral factors and O.viverrini infection.Results:Totally there were 1885 participants.The prevalence of O.viverrini infection was 10.03%.Geographic factors that showed statistically significant association with O.viverrini infection in the Northeast region were featured by at least a dam and reservoir(Adj.OR=4.21,95%CI:2.49-7.13,P<0.001),at least a weir(Adj.OR=1.74,95%CI:1.09-2.77,P=0.020),>50 dogs and cats per village(Adj.OR=3.40,95%CI:2.17-5.31,P<0.001),and rice fields covered>50%of its areas(Adj.OR=1.91,95%CI:1.04-4.01,P=0.036),as well as low to moderate levels of knowledge(Adj.OR=1.60,95%CI:1.32 to 1.94,P<0.001),consumed raw fish(Adj.OR=1.90,95%CI:1.02 to 3.52,P=0.040)and consumed processed raw fish(Adj.OR=3.03,95%CI:2.20 to 4.18,P<0.001).Other significant covariates were gender and age of the respondents.Conclusions:O.viverrini infection still remains a public health problem of the Northeast of Thailand.Geographic and demographic factors,knowledge,and consumption behaviors of raw fish products are significantly associated with O.viverrini infection.展开更多
Nairobi County experiences rapid industrialization and urbanization that contributes to the deteriorating state of air quality, posing a potential health risk to its growing population. Currently, in Nairobi County, m...Nairobi County experiences rapid industrialization and urbanization that contributes to the deteriorating state of air quality, posing a potential health risk to its growing population. Currently, in Nairobi County, most air quality monitoring stations use low-cost, inaccurate monitors prone to defects. The study’s objective was to map Nairobi County’s air quality using freely available remotely sensed imagery. The Air Pollution Index (API) formula was used to characterize the air quality from cloud-free Landsat satellite images i.e., Landsat 5 TM, Landsat 7 ETM+, and Landsat 8 OLI from Google Earth Engine. The API values were computed based on vegetation indices namely NDVI, TVI, DVI, and the SWIR1 and NIR bands on the QGIS platform. Qualitative accuracy assessment was done using sample points drawn from residential, industrial, green spaces, and traffic hotspot categories, based on a passive-random sampling technique. In this study, Landsat 5 API imagery for 2010 provided a reliable representation of local conditions but indicated significant pollution in green spaces, with recorded values ranging from -143 to 334. The study found that Landsat 7 API imagery in 2002 showed expected results with the range of values being -55 to 287, while Landsat 8 indicated high pollution levels in Nairobi. The results emphasized the importance of air quality factors in API calibration and the unmatched spatial coverage of satellite observations over ground-based monitoring techniques. The study recommends the recalibration of the API formula for characteristic regions, exploring newer satellite sensors like those onboard Landsat 9 and Sentinel 2, and involving key stakeholders in a discourse to develop a suitable Kenyan air quality index.展开更多
In the field of robotics and in the health sciences, transitions have been occurring in the control of robots operating with predetermined logic and rules. Robotics in health care are influencing human caring dynamics...In the field of robotics and in the health sciences, transitions have been occurring in the control of robots operating with predetermined logic and rules. Robotics in health care are influencing human caring dynamics in many ways such as enhancing dependency and surrender to machine technologies. Situations such as these are charged with possibilities of legal liabilities triggered by influences and consequences of advancing robotic technology dependency. The purpose of this paper is to identify, describe, and explain legal issues and/or dilemmas centered on robotics in healthcare while providing engaging opportunities to limit consequent legalities thus forming beneficial human health care outcomes. Laying bare these liabilities will provide critically informative data that can foster proactive encounters which can or may deter health care liabilities while ensuring quality healthcare outcomes. An attempt is made to re-conceptualize how to view agency, causality, liability responsibility, culpability, and autonomy for the new age of autonomous robots. While it is still not clear how this would turn out, a clear framing of the problem is the first step in the project.展开更多
AIM： To investigate the changing pattern of different histological parameters occurring in the stomach tissue of Helicobacter pylori （H pylori） infected tribal populations and duodenal ulcer patients among ethnic B...AIM： To investigate the changing pattern of different histological parameters occurring in the stomach tissue of Helicobacter pylori （H pylori） infected tribal populations and duodenal ulcer patients among ethnic Bengalis and correlation of the genotypes of H pylori with different histological parameters. METHODS： One hundred and twelve adult individuals were enrolled into this study between 2002 and 2004. Among them, 72 had clinical features of duodenal ulcer （DU） from ethnic Bengali population and 40 were asymptomatic ethnic tribals. Endoscopic gastric biopsy samples were processed for histology, genotyping and rapid urease test. Histologically, haematoxylin and eosin staining was applied to assess the pathomorphological changes and a modified Giemsa staining was used for better detection of Hpylori. For intestinal metaplasia, special stainings, i.e. Alcian blue periodic acid-Schiff and high iron diamine-Alcian blue staining, were performed. PCR was performed on bacterial DNA to characterize the presence or absence of virulence-associated genes, like cagA, and distribution of different alleles of vacA and iceA. RESULTS： Intraglandular neutrophil infiltration, a hallmark of activity of gastritis, was present in 34 （94%） of tribals （TRs） and 42 （84%） of DU individuals infected with H pylori. Lymphoid follicles and aggregates, which are important landmarks in H pylori infection, were positive amongst 15 （41%） of TRs and 20 （40%） of DU subjects. Atrophic changes were observed in 60% and 27.7%, respectively, among DU cases and tribals （P 〉 0.003）. Metaplastic changes were detected in low numbers in both groups. Moderate to severe density distribution of Hpylori in the gastric mucosa was 63% among TRs, whereas it was 62% in DU subjects. There were no significant differences in the distribution of virulence-associated genes like cagA, vacA and iceA of H pylori strains carried by these two populations. CONCLUSION： Our study showed almost similar distribution of inflammatory cells among asymptomatic tribals and DU Bengali patients. Interestingly, the tribal population are free from any clinical symptoms despite evidence of active histologic gastritis and infection with Hpylori strains carrying similar virulence markers as of strains isolated from patients with DU. There was an increased cellular response, especially in terms of neutrophil infiltration, but much lower risk of developing atrophy and metaplastic changes among the tribal population.展开更多
Purpose: We describe the commonest pathology responsible for lower urinary tract obstruction (LUTO) and associated symptoms such as UTI, etc. among males at the Komfo Anokye Teaching Hospital (KATH) in Kumasi. Materia...Purpose: We describe the commonest pathology responsible for lower urinary tract obstruction (LUTO) and associated symptoms such as UTI, etc. among males at the Komfo Anokye Teaching Hospital (KATH) in Kumasi. Materials and Methods: Between January and December 2009, prospective cross sectional hospital based study was conducted involving 103 subjects. Patients with symptoms of LUTO and who were on short admission (up to 48 hours) at the accident and emergency unit of KATH were identified as potential study subjects. All the patients presented with acute retention of urine at the emergency unit of KATH and urethral catheterization was attempted to relieve them of the retention under sterile conditions. Those patients whose initial catheterization failed went through suprapubic cystostomy (suprapubic catheterization). Urine specimens for culture and sensitivity tests were then collected into sterile urine containers immediately after the catheterization (irrespective of type). Ultrasound Scan was requested for all the patients to assist in diagnosing enlargement of the prostate and other associated urological pathologies. Retrograde urethrogram was however, requested for those patients with suprapubic catheterization and which helped in the diagnosis of the urethral stricture. For a particular child, urethral catheter was passed under sterile condition and Micturicting Cysto-Urethrogram (MCUG) was done to assist in diagnosing posterior urethral valve and other conditions. Those subjects whose urinalysis revealed pyuria and positive urine culture and who had voluntarily agreed to enter the study were enrolled. Subjects whose urine culture had multiple bacteria growth that was deemed to be contaminants were excluded from the study. Results: The mean age for males with LUTO was 62 years. The youngest male with LUTO was aged 2 years whilst the maximum age was 93 years. LUTO due to prostatic hyperplasia was found in 79 (76.7%) men;23 (22.3%) had LUTO due to urethral stricture and 1 (1.0%) (youngest male). The mean age of patients that had LUTO due to urethral stricture was approximately 39 years. The youngest patient with LUTO due to urethral stricture aged 22 years whilst the maximum age was 72 years. Microbiological results indicated that Escherichia coli caused 53 (51.5%) of urinary tract infection (UTI) due to LUTO;Klebsiella = 23 (22.3%);Staphylococcus aureus = 14 (14.6%);Pseudomonas spp. = 8 (7.8%) Proteus = 2 (2.0%);Citrobacter = 1 (1.0%) and Salmonella spp. =1 (1.0%). Conclusion: The most common cause of lower urinary tract obstruction (LUTO) in Kumasi, Ghana is prostatic hyperplasia and the commonest causative organism of the associated UTI symptom is Escherichia coli.展开更多
文摘The rapid growth of biomedical data,particularly multi-omics data including genomes,transcriptomics,proteomics,metabolomics,and epigenomics,medical research and clinical decision-making confront both new opportunities and obstacles.The huge and diversified nature of these datasets cannot always be managed using traditional data analysis methods.As a consequence,deep learning has emerged as a strong tool for analysing numerous omics data due to its ability to handle complex and non-linear relationships.This paper explores the fundamental concepts of deep learning and how they are used in multi-omics medical data mining.We demonstrate how autoencoders,variational autoencoders,multimodal models,attention mechanisms,transformers,and graph neural networks enable pattern analysis and recognition across all omics data.Deep learning has been found to be effective in illness classification,biomarker identification,gene network learning,and therapeutic efficacy prediction.We also consider critical problems like as data quality,model explainability,whether findings can be repeated,and computational power requirements.We now consider future elements of combining omics with clinical and imaging data,explainable AI,federated learning,and real-time diagnostics.Overall,this study emphasises the need of collaborating across disciplines to advance deep learning-based multi-omics research for precision medicine and comprehending complicated disorders.
文摘Intra-abdominal hypertension(IAH)and abdominal compartment syndrome(ACS)play a pivotal role in the pathophysiology of severe acute pancreatitis(SAP)and contribute to new-onset and persistent organ failure.The optimal management of ACS involves a multi-disciplinary approach,from its early recognition to measures aiming at an urgent reduction of intra-abdominal pressure(IAP).A targeted literature search from January 1,2000,to November 30,2022,revealed 20 studies and data was analyzed on the type and country of the study,patient demographics,IAP,type and timing of surgical procedure performed,post-operative wound management,and outcomes of patients with ACS.There was no randomized controlled trial published on the topic.Decom-pressive laparotomy is effective in rapidly reducing IAP(standardized mean difference=2.68,95%confidence interval:1.19-1.47,P<0.001;4 studies).The morbidity and complications of an open abdomen after decompressive laparotomy should be weighed against the inadequately treated but,potentially lethal ACS.Disease-specific patient selection and the role of less-invasive decompressive measures,like subcutaneous linea alba fasciotomy or component separation techniques,is lacking in the 2013 consensus management guidelines by the Abdominal Compartment Society on IAH and ACS.This narrative review focuses on the current evidence regarding surgical decompression techniques for managing ACS in patients with SAP.However,there is a lack of high-quality evidence on patient selection,timing,and modality of surgical decompression.Large prospective trials are needed to identify triggers and effective and safe surgical decompression methods in SAP patients with ACS.
基金EUMETSAT,Norwegian Ice Service,University of Bremen,University of Hamburg,and Alfred Wegener Institute are gratefully acknowledged for providing the dataWe thank two anonymous reviewers for their helpful commentsThis study was supported by the Norwegian Research Council through the SPARSE project(Grant no.254765)and CIRFA project(Grant no.237906).
文摘With the rapid change in the Arctic sea ice,a large number of sea ice observations have been collected in recent years,and it is expected that an even larger number of such observations will emerge in the coming years.To make the best use of these observations,in this paper we develop a multi-sensor optimal data merging(MODM)method to merge any number of different sea ice observations.Since such merged data are independent on model forecast,they are valid for model initialization and model validation.Based on the maximum likelihood estimation theory,we prove that any model assimilated with the merged data is equivalent to assimilating the original multi-sensor data.This greatly facilitates sea ice data assimilation,particularly for operational forecast with limited computational resources.We apply the MODM method to merge sea ice concentration(SIC)and sea ice thickness(SIT),respectively,in the Arctic.For SIC merging,the Special Sensor Microwave Imager/Sounder(SSMIS)and Advanced Microwave Scanning Radiometer 2(AMSR2)data are merged together with the Norwegian Ice Service ice chart.This substantially reduces the uncertainties at the ice edge and in the coastal areas.For SIT merging,the daily Soil Moisture and Ocean Salinity(SMOS)data is merged with the weekly-mean merged CryoSat-2 and SMOS(CS2SMOS)data.This generates a new daily CS2SMOS SIT data with better spatial coverage for the whole Arctic.
文摘Missing data can frequently occur in a longitudinal data analysis. In the literature, many methods have been proposed to handle such an issue. Complete case (CC), mean substitution (MS), last observation carried forward (LOCF), and multiple imputation (MI) are the four most frequently used methods in practice. In a real-world data analysis, the missing data can be MCAR, MAR, or MNAR depending on the reasons that lead to data missing. In this paper, simulations under various situations (including missing mechanisms, missing rates, and slope sizes) were conducted to evaluate the performance of the four methods considered using bias, RMSE, and 95% coverage probability as evaluation criteria. The results showed that LOCF has the largest bias and the poorest 95% coverage probability in most cases under both MAR and MCAR missing mechanisms. Hence, LOCF should not be used in a longitudinal data analysis. Under MCAR missing mechanism, CC and MI method are performed equally well. Under MAR missing mechanism, MI has the smallest bias, smallest RMSE, and best 95% coverage probability. Therefore, CC or MI method is the appropriate method to be used under MCAR while MI method is a more reliable and a better grounded statistical method to be used under MAR.
基金Supported by projects of National Natural Science Foundation of China(Nos.42171407,42077242)Natural Science Foundation of Jilin Province(No.20210101098JC)+1 种基金Open Fund of Key Laboratory of Urban Land Resources Monitoring and Simulation,MNR(No.KF-2020-05-024)National Key R&D Program of China(No.2021YFD1500100).
文摘Highly accurate vegetative type distribution information is of great significance for forestry resource monitoring and management.In order to improve the classification accuracy of forest types,Sentinel-1 and 2 data of Changbai Mountain protection development zone were selected,and combined with DEM to construct a multi-featured random forest type classification model incorporating fusing intensity,texture,spectral,vegetation index and topography information and using random forest Gini index(GI)for optimization.The overall accuracy of classification was 94.60%and the Kappa coefficient was 0.933.Comparing the classification results before and after feature optimization,it shows that feature optimization has a greater impact on the classification accuracy.Comparing the classification results of random forest,maximum likelihood method and CART decision tree under the same conditions,it shows that the random forest has a higher performance and can be applied to forestry research work such as forest resource survey and monitoring.
文摘Introduction: Resection of malignant pelvic tumors has long been considered to be associated with higher postoperative mortality and morbidity than resection of malignant limb tumors. We compared the postoperative adverse events of pelvic tumor surgery and limb tumor surgery using a national inpatient database. Methods: We identified patients who underwent surgery for primary musculoskeletal malignant tumors of the pelvis or limbs between July and December in 2007- 2010 using the Japanese Diagnosis Procedure Combination inpatient database. We calculated the risk-adjusted odds ratio for the occurrence of postoperative complications following pelvic tumor surgery with reference to limb tumor surgery using a multivariable logistic regression analysis. Results: Of 3255 eligible patients, 3116 underwent limb tumor surgery and 139 underwent pelvic tumor surgery. In-hospital mortality was 0.6% and 0.7% and postoperative complication rates were 8.2% and 18.7%, respectively. The rate of blood transfusion and duration of anesthesia over 480 min were higher in the pelvic tumor group. Blood transfusion volume and duration of anesthesia were independently associated with worse outcomes, but there was no significant association between tumor location and occurrence of postoperative complications (odds ratio 1.18, 95% confidence interval 0.73 - 1.88, p = 0.502). Conclusions: Blood transfusion volume and duration of anesthesia were significant predictors of outcome. Our data demonstrate that the higher morbidity rate after pelvic tumor resection could result from the larger blood transfusion volume and longer anesthesia duration.
基金supported by the R&D project of Pazhou Lab(Huangpu)under Grant 2023K0610the National Natural Science Foundation of China(Grants 12126602)+4 种基金the National Natural Science Foundation of China(Grants 82030102)the Shenzhen Medical Research Fund(Grants C2302001)the Shenzhen Science and Technology Innovation Committee(No.ZDSYS20200810171403013)the Chinese Postdoctoral Science Foundation(No.2022M721463)the Ministry of Science and Technology of China(Grants 2022YFC3702703).
文摘Objective This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction(MI)in patients with both coronary heart disease(CHD)and type 2 diabetes(T2D).Methods We conducted a retrospective cohort study of 33,238 patients with both CHD and T2D in Shenzhen,China.Patients were categorized into 6 groups based on baseline fasting plasma glucose(FPG)levels and diabetes duration(from the date of diabetes diagnosis to the baseline date)to examine their combined effects on subsequent MI.Cox proportional hazards regression models were used,with further stratification by age,sex,and comorbidities to assess potential interactions.Results Over a median follow-up of 2.4 years,2,110 patients experienced MI.Compared to those with optimal glycemic control(FPG<6.1 mmol/L)and shorter diabetes duration(<10 years),the fullyadjusted hazard ratio(HR)(95%Confidence Interval[95%CI])for those with a diabetes duration of≥10 years and FPG>8.0 mmol/L was 1.93(95%CI:1.59,2.36).The combined effects of FPG and diabetes duration on MI were largely similar across different age,sex,and comorbidity groups,although the excess risk of MI associated with long-term diabetes appeared to be more pronounced among those with atrial fibrillation.Conclusion Our study indicates that glycemic control and diabetes duration significant influence the subsequent occurrence of MI in patients with both CHD and T2D.Tailored management strategies emphasizing strict glycemic control may be particularly beneficial for patients with longer diabetes duration and atrial fibrillation.
基金Xinjiang Uygur Autonomous Region Science and Technology Department-Tianshan Innovation Team Program Project,Grant/Award Number:2023D14006Xinjiang Uygur Autonomous Region Science and Technology Department-Natural Science Foundation,Grant/Award Number:2023D01C115。
文摘Background:This study aimed to discover whether Cistanche tubulosa affects the AKT/CASP3 pathway by regulating m6A methylation,to exert a protective effect against peripheral nerve injury in a Parkinson's Disease(PD)mouse model.Methods:In this study,network pharmacology analysis and the molecular docking virtual screening technique was used to filter Acteoside(Act),a potential neuroprotective agent of active components in Cistanche tubulosa.A PD-related peripheral neuropathy mouse model was established by MPTP induction,followed by 21 days treatment of oral Act(25,50,and 100 mg kg^(−1)).Pole climbing,automatic avoidance ability and hot plate sensory tests were evaluated to determine behavioral changes caused by central and peripheral nerve injury.The pathological alterations of dorsal root ganglion tissue and the protein levels of IL-6,AKT,and CASP3 under Act intervention,as well as the dynamic changes of FTO,METTL3,and YTHDF2 which are closely related to m6A methylation,were comprehensively analyzed to observe the peripheral nerve protective efficacy of Act.Results:The results showed that peripheral neuropathy occurring with PD in the mouse model,which could be verified by behavioral tests and pathological histological changes.In addition to the previously established protective effect of Act on dopaminergic neurons in substantia nigra(SN),extensive follow-up studies demonstrated that Act effectively induced m6A methylation,which could further regulate the AKT/CASP3 pathway to play a therapeutic role.In this study,medium and high doses of Act played more obvious therapeutic roles.Conclusion:These findings suggest that Act may regulate the severity of peripheral nerve injury under the activation of the AKT/CASP3 signaling pathway by balancing the methylation level of m6A.These results provide a theoretical basis and experimental evidence for further research on the protective effect of Cistanche tubulosa on both the central and peripheral nerves in the treatment of PD.
基金supported by the Shenzhen Medical Academy of Research and Translation(Grant C2302001)the Noncommunicable Chronic Diseases-National Science and Technology Major Project(Grant 2023ZD0503500)+5 种基金the National Natural Science Foundation of China(Grants 82030102,12126602)the Shenzhen Science and Technology Innovation Committee(No.ZDSYS20200810171403013)the Talents enlisted in major talent programs of Guangdong Province(20210N020921)the Shenzhen Development and Reform Committee(No.XMHT20230108022)the Medical Research Innovation Project(Grant G030410001)the Shenzhen Medical Research Funds(Grant A2402041)。
文摘Evidence on the association between osteoporosis and dementia is not fully clear.This study aimed to investigate the potential association between osteoporosis and the subsequent risk of dementia among older adults.We performed a cohort study of176150 community-dwelling older adults aged≥65 years and free of cognitive impairment between 2018 and 2022 using integrated healthcare data from Shenzhen,China.Diagnoses of osteoporosis,osteoporotic fractures,and dementia were identified through linked outpatient and inpatient medical records and death registration records.Multivariate Cox proportional hazards models were used to estimate the adjusted hazard ratios(HRs)and 95%confidence intervals(CIs)of incident dementia associated with osteoporosis and osteoporotic fractures.The mean(SD)age of the total study population was 70.7(5.4)years,and 9605 had a previous diagnosis of osteoporosis.Over a median follow-up of 2.2(IQR:1.8–4.3,maximum:5.5)years,corresponding to 505423person-years at risk,1367 incident all-cause dementia cases,including 617 Alzheimer's disease and 298 vascular dementia cases,occurred.Physician-diagnosed osteoporosis was associated with a higher risk of all-cause dementia(HR:1.80,95%CI:1.53–2.12).The increased dementia risk tended to be more prominent among patients with osteoporotic fractures(HR:2.43,95%CI:1.83–3.23)than those without(HR:1.63,95%CI:1.35–1.97).Results were similar for Alzheimer's disease and vascular dementia.This study provides evidence that older adults with osteoporosis,especially those with osteoporotic fractures,have an elevated risk of incident dementia.Effective prevention and management of osteoporosis among the older population may be promising to mitigate the dual burden of osteoporosis and dementia.
基金funded in part by the National Key R&D Program of China(Grant No.2022YFC2402404)the National Natural Science Foundation of China(Grant Nos.82170351 and 82370342)+1 种基金the Natural Science Foundation of Jiangsu Province(Grant Nos.BK20222002 and BK20231145)the Clinical Capacity Enhancement Project of Jiangsu Province Hospital(the First Affiliated Hospital of Nanjing Medical University)(Grant No.J SPH-MA-2022-3)。
文摘It is often challenging to diagnose acute myocardial infarction(AMI)in patients with elevated high-sensitivity cardiac troponin T(hs-cTnT)before observing a significant rise and/or fall in hs-cTnT.The current study aimed to identify an optimal cut-off to rule in AMI.A total of 76411 patients with elevated hs-cTnT were included.The predictive cut-off values for diagnosing ST-segment elevation myocardial infarction(STEMI)and non-STsegment elevation myocardial infarction(NSTEMI)were assessed using the area under the receiver operating characteristic curve(AUC).Among the patients,50466(66.0%)had non-cardiac diseases,25945(34.0%)had cardiac diseases,and 15502(20.3%)had AMI,including 816(1.1%)with STEMI and 14686(19.2%)with NSTEMI.The median hs-cTnT level was 3788.0 ng/L in STEMI patients and 67.2 ng/L in NSTEMI patients.The optimal cut-off for diagnosing STEMI was 251.9 ng/L,with a sensitivity of 90.7%,specificity of 86.5%,and an AUC of 0.942;the optimal cut-off for diagnosing NSTEMI was 130.5 ng/L,with a sensitivity of 40.9%,specificity of 83.8%,and an AUC of 0.638.Collectively,optimizing the cut-off values for diagnosing STEMI and NSTEMI to 251.9 ng/L and 130.5 ng/L,respectively,demonstrated high accuracy in a large cohort of Chinese patients with elevated hs-cTnT.
基金financially supported by the National Natural Science Foundation of China(No.72471223,No.72231010)。
文摘Social media platforms collect information from complex human social behaviors.It has been shown that they significantly impact capital markets.This article conducts a bibliometric analysis of 363 high-quality articles from the Web of Science on social media and capital markets.First,a descriptive analysis was performed,including discipline distribution,growth trends,institutions,publication sources,influential authors,articles,and countries.Second,collaborative networks identify cooperation between countries and institutions in the network analysis section.Bibliometric coupling analysis determines the relationship between journals of different disciplines.Cluster analysis and keyword co-occurrence networks identify hot research topics.Burst detection and keyword time zone analysis track field development.Finally,keyword analysis and clustering analysis are conducted on the research of different disciplines.These sample papers mainly include seven hot topics,including sentiment analysis and financial market prediction.Articles in business and finance focus more on social media’s impact on capital markets.In contrast,information technology articles focus more on extracting information from social media.Each field also has its unique research directions.This paper contributes to a comprehensive understanding of the research on social media and capital markets.It offers perspectives on disciplinary differences,serving as a valuable scholarly reference for conducting in-depth research.
文摘AIM： To assess the use of capecitabine-based therapy and associated complication rates in patients with gastroesophageal cancer （GEC） in a real-world treat- ment setting. METHODS： Patients with claims between 2004 and 2005 were identified from the Thomson Reuters MarketScan databases. Capecitabine regimens were compared with 5-fluorouracU （5-FU） and other chemotherapy regimens, and were stratified by treatment setting. RESULTS： We identified 1013 patients with GEC： approximately half had treatment initiated with a 5-FU regimen, whereas 11% had therapy initiated with a capecitabine regimen. The mean capecitabine dose overall was 2382 ± 1118 mg/d, and capecitabine was used as monotherapy more often than in combination. Overall, 5-FU regimens were the most common treat- ment option in neoadjuvant and adjuvant settings, while other non-capecitabine regimens were used more widely in first- and second-line settings. The overall unadjusted complication rate for capecitabine regimens was about half of that seen with 5-FU regimens. In multivariate analyses, capecitabine recipients had a 51% （95% CI： 26%-81%） lower risk of developing any complication than 5-FU recipients did. The risk of developing bone marrow, constitutional, gastrointestinal tract, infectious, or skin complications was lower with capecitabine therapy than with 5-FU.CONCLUSION： Capecitabine appeared to have a favorable side effect profile compared with 5-FU, which indicates that it may be a treatment option for GEC.
基金supported by the National Natural Science Foundation of China(Grants 12126602)the R&D project of Pazhou Lab(Huangpu)under Grant 2023K0610+5 种基金the National Natural Science Foundation of China(Grants 82030102)the Shenzhen Medical Academy of Research and Translation(Grants C2302001)the Shenzhen Science and Technology Innovation Committee(No.ZDSYS20200810171403013)the Chinese Postdoctoral Science Foundation(No.2022M721463)the SUSTech Presidential Postdoctoral Fellowshipthe Ministry of Science and Technology of China(Grants 2022YFC3702703).
文摘BACKGROUND The current understanding of the magnitude and consequences of multimorbidity in Chinese older adults with coronary heart disease(CHD)is insufficient.We aimed to assess the association and population-attributable fractions(PAFs)between multimorbidity and mortality among hospitalized older patients who were diagnosed with CHD in Shenzhen,China.METHODS We conducted a retrospective cohort study of older Chinese patients(aged≥65 years)who were diagnosed with CHD.Cox proportional hazards models were used to estimate the associations between multimorbidity and all-cause and cardiovascular disease(CVD)mortality.We also calculated the PAFs.RESULTS The study comprised 76,455 older hospitalized patients who were diagnosed with CHD between January 1,2016,and August 31,2022.Among them,70,217(91.9%)had multimorbidity,defined as the presence of at least one of the predefined 14 chronic conditions.Those with cancer,hemorrhagic stroke and chronic liver disease had the worst overall death risk,with adjusted HRs(95%CIs)of 4.05(3.77,4.38),2.22(1.94,2.53),and 1.85(1.63,2.11),respectively.For CVD mortality,the highest risk was observed for hemorrhagic stroke,ischemic stroke,and chronic kidney disease;the corresponding adjusted HRs(95%CIs)were 3.24(2.77,3.79),1.91(1.79,2.04),and 1.81(1.64,1.99),respectively.All-cause mortality was mostly attributable to cancer,heart failure and ischemic stroke,with PAFs of 11.8,10.2,and 9.1,respectively.As for CVD mortality,the leading PAFs were heart failure,ischemic stroke and diabetes;the corresponding PAFs were 18.0,15.7,and 6.1,respectively.CONCLUSIONS Multimorbidity was common and had a significant impact on mortality among older patients with CHD in Shenzhen,China.Cancer,heart failure,ischemic stroke and diabetes are the primary contributors to PAFs.Therefore,prioritizing improved treatment and management of these comorbidities is essential for the survival prognosis of CHD patients from a holistic public health perspective.
文摘Objective:To determine the influence of geographic,knowledge and behavioral factors on Opisthorchis(O.)viverrini infection in the Northeast of Thailand.Methods:This cross-sectional study was conducted by using four datasets of years 2016 and 2017.Generalized linear mixed model was employed to analyze association between geographic,knowledge and behavioral factors and O.viverrini infection.Results:Totally there were 1885 participants.The prevalence of O.viverrini infection was 10.03%.Geographic factors that showed statistically significant association with O.viverrini infection in the Northeast region were featured by at least a dam and reservoir(Adj.OR=4.21,95%CI:2.49-7.13,P<0.001),at least a weir(Adj.OR=1.74,95%CI:1.09-2.77,P=0.020),>50 dogs and cats per village(Adj.OR=3.40,95%CI:2.17-5.31,P<0.001),and rice fields covered>50%of its areas(Adj.OR=1.91,95%CI:1.04-4.01,P=0.036),as well as low to moderate levels of knowledge(Adj.OR=1.60,95%CI:1.32 to 1.94,P<0.001),consumed raw fish(Adj.OR=1.90,95%CI:1.02 to 3.52,P=0.040)and consumed processed raw fish(Adj.OR=3.03,95%CI:2.20 to 4.18,P<0.001).Other significant covariates were gender and age of the respondents.Conclusions:O.viverrini infection still remains a public health problem of the Northeast of Thailand.Geographic and demographic factors,knowledge,and consumption behaviors of raw fish products are significantly associated with O.viverrini infection.
文摘Nairobi County experiences rapid industrialization and urbanization that contributes to the deteriorating state of air quality, posing a potential health risk to its growing population. Currently, in Nairobi County, most air quality monitoring stations use low-cost, inaccurate monitors prone to defects. The study’s objective was to map Nairobi County’s air quality using freely available remotely sensed imagery. The Air Pollution Index (API) formula was used to characterize the air quality from cloud-free Landsat satellite images i.e., Landsat 5 TM, Landsat 7 ETM+, and Landsat 8 OLI from Google Earth Engine. The API values were computed based on vegetation indices namely NDVI, TVI, DVI, and the SWIR1 and NIR bands on the QGIS platform. Qualitative accuracy assessment was done using sample points drawn from residential, industrial, green spaces, and traffic hotspot categories, based on a passive-random sampling technique. In this study, Landsat 5 API imagery for 2010 provided a reliable representation of local conditions but indicated significant pollution in green spaces, with recorded values ranging from -143 to 334. The study found that Landsat 7 API imagery in 2002 showed expected results with the range of values being -55 to 287, while Landsat 8 indicated high pollution levels in Nairobi. The results emphasized the importance of air quality factors in API calibration and the unmatched spatial coverage of satellite observations over ground-based monitoring techniques. The study recommends the recalibration of the API formula for characteristic regions, exploring newer satellite sensors like those onboard Landsat 9 and Sentinel 2, and involving key stakeholders in a discourse to develop a suitable Kenyan air quality index.
文摘In the field of robotics and in the health sciences, transitions have been occurring in the control of robots operating with predetermined logic and rules. Robotics in health care are influencing human caring dynamics in many ways such as enhancing dependency and surrender to machine technologies. Situations such as these are charged with possibilities of legal liabilities triggered by influences and consequences of advancing robotic technology dependency. The purpose of this paper is to identify, describe, and explain legal issues and/or dilemmas centered on robotics in healthcare while providing engaging opportunities to limit consequent legalities thus forming beneficial human health care outcomes. Laying bare these liabilities will provide critically informative data that can foster proactive encounters which can or may deter health care liabilities while ensuring quality healthcare outcomes. An attempt is made to re-conceptualize how to view agency, causality, liability responsibility, culpability, and autonomy for the new age of autonomous robots. While it is still not clear how this would turn out, a clear framing of the problem is the first step in the project.
基金Supported by The Indian Council of Medical Research, Government of India and Program of Founding Research Center for Emerging and Reemerging Infectious Diseases, Ministry of Education, Culture, Sports, Science and Technology of Japan
文摘AIM： To investigate the changing pattern of different histological parameters occurring in the stomach tissue of Helicobacter pylori （H pylori） infected tribal populations and duodenal ulcer patients among ethnic Bengalis and correlation of the genotypes of H pylori with different histological parameters. METHODS： One hundred and twelve adult individuals were enrolled into this study between 2002 and 2004. Among them, 72 had clinical features of duodenal ulcer （DU） from ethnic Bengali population and 40 were asymptomatic ethnic tribals. Endoscopic gastric biopsy samples were processed for histology, genotyping and rapid urease test. Histologically, haematoxylin and eosin staining was applied to assess the pathomorphological changes and a modified Giemsa staining was used for better detection of Hpylori. For intestinal metaplasia, special stainings, i.e. Alcian blue periodic acid-Schiff and high iron diamine-Alcian blue staining, were performed. PCR was performed on bacterial DNA to characterize the presence or absence of virulence-associated genes, like cagA, and distribution of different alleles of vacA and iceA. RESULTS： Intraglandular neutrophil infiltration, a hallmark of activity of gastritis, was present in 34 （94%） of tribals （TRs） and 42 （84%） of DU individuals infected with H pylori. Lymphoid follicles and aggregates, which are important landmarks in H pylori infection, were positive amongst 15 （41%） of TRs and 20 （40%） of DU subjects. Atrophic changes were observed in 60% and 27.7%, respectively, among DU cases and tribals （P 〉 0.003）. Metaplastic changes were detected in low numbers in both groups. Moderate to severe density distribution of Hpylori in the gastric mucosa was 63% among TRs, whereas it was 62% in DU subjects. There were no significant differences in the distribution of virulence-associated genes like cagA, vacA and iceA of H pylori strains carried by these two populations. CONCLUSION： Our study showed almost similar distribution of inflammatory cells among asymptomatic tribals and DU Bengali patients. Interestingly, the tribal population are free from any clinical symptoms despite evidence of active histologic gastritis and infection with Hpylori strains carrying similar virulence markers as of strains isolated from patients with DU. There was an increased cellular response, especially in terms of neutrophil infiltration, but much lower risk of developing atrophy and metaplastic changes among the tribal population.
文摘Purpose: We describe the commonest pathology responsible for lower urinary tract obstruction (LUTO) and associated symptoms such as UTI, etc. among males at the Komfo Anokye Teaching Hospital (KATH) in Kumasi. Materials and Methods: Between January and December 2009, prospective cross sectional hospital based study was conducted involving 103 subjects. Patients with symptoms of LUTO and who were on short admission (up to 48 hours) at the accident and emergency unit of KATH were identified as potential study subjects. All the patients presented with acute retention of urine at the emergency unit of KATH and urethral catheterization was attempted to relieve them of the retention under sterile conditions. Those patients whose initial catheterization failed went through suprapubic cystostomy (suprapubic catheterization). Urine specimens for culture and sensitivity tests were then collected into sterile urine containers immediately after the catheterization (irrespective of type). Ultrasound Scan was requested for all the patients to assist in diagnosing enlargement of the prostate and other associated urological pathologies. Retrograde urethrogram was however, requested for those patients with suprapubic catheterization and which helped in the diagnosis of the urethral stricture. For a particular child, urethral catheter was passed under sterile condition and Micturicting Cysto-Urethrogram (MCUG) was done to assist in diagnosing posterior urethral valve and other conditions. Those subjects whose urinalysis revealed pyuria and positive urine culture and who had voluntarily agreed to enter the study were enrolled. Subjects whose urine culture had multiple bacteria growth that was deemed to be contaminants were excluded from the study. Results: The mean age for males with LUTO was 62 years. The youngest male with LUTO was aged 2 years whilst the maximum age was 93 years. LUTO due to prostatic hyperplasia was found in 79 (76.7%) men;23 (22.3%) had LUTO due to urethral stricture and 1 (1.0%) (youngest male). The mean age of patients that had LUTO due to urethral stricture was approximately 39 years. The youngest patient with LUTO due to urethral stricture aged 22 years whilst the maximum age was 72 years. Microbiological results indicated that Escherichia coli caused 53 (51.5%) of urinary tract infection (UTI) due to LUTO;Klebsiella = 23 (22.3%);Staphylococcus aureus = 14 (14.6%);Pseudomonas spp. = 8 (7.8%) Proteus = 2 (2.0%);Citrobacter = 1 (1.0%) and Salmonella spp. =1 (1.0%). Conclusion: The most common cause of lower urinary tract obstruction (LUTO) in Kumasi, Ghana is prostatic hyperplasia and the commonest causative organism of the associated UTI symptom is Escherichia coli.
