Objectives This study aimed to clarify the relationship between the content of proxy decision-making made by families of patients with malignant brain tumors regarding treatment policies and daily care and the cues le...Objectives This study aimed to clarify the relationship between the content of proxy decision-making made by families of patients with malignant brain tumors regarding treatment policies and daily care and the cues leading to those decisions.Methods Semi-structured personal interviews were used to collect data.Seven family members of patients with malignant brain tumors were selected to participate in the study by purposive sampling method from June to August 2022 in the Patient Family Association of Japan.Responses were content analyzed to explore the relationship between the content of decisions regarding“treatment policies”and“daily care”and the cues influencing those decisions.Semi-structured interviews were analyzed by using thematic analysis.Results The contents of proxy decisions regarding“treatment policies”included implementation,interruption,and termination of initial treatments,free medical treatments,use of respirators,and end-of-life sedation and included six cues:treatment policies suggested by the primary physician,information and knowledge about the disease and treatment obtained by the family from limited resources,perceived life threat from symptom worsening,words and reactions from the patient regarding treatment,patient’s personality and way of life inferred from their treatment preferences,family’s thoughts and values hoping for better treatment for the patient.Decisions for“daily care”included meal content and methods,excretion,mobility,maintaining cleanliness,rehabilitation,continuation or resignation from work,treatment settings(outpatient or inpatient),and ways to spend time outside and included seven cues:words and thoughts from the patient about their way of life,patient’s reactions and life history inferred from their preferred way of living,things the patient can do to maintain daily life and roles,awareness of the increasing inability to do things in daily life,family’s underlying thoughts and values about how to spend the remaining time,approval from family members regarding the care setting,advice from medical professionals on living at home.Conclusions For“treatment policies,”guidelines from medical professionals were a key cue,while for“daily care,”the small signs from the patients in their daily lives served as cues for proxy decision-making.This may be due to the lack of information available to families and the limited time available for discussion with the patient.Families of patients with malignant brain tumors repeatedly use multiple cues to make proxy decision-making under high uncertainty.Therefore,nurses supporting proxy decision-making should assess the family’s situation and provide cues that facilitate informed and confident decisions.展开更多
A total of fifty (50) samples of water from Lake Fitri (Chad), with 25 samples per island (Domoro and Maguite). The aim of this study was to analyze the bacteriological, biochemical and physico-chemical quality of the...A total of fifty (50) samples of water from Lake Fitri (Chad), with 25 samples per island (Domoro and Maguite). The aim of this study was to analyze the bacteriological, biochemical and physico-chemical quality of the water in Lake Fitri in Chad. Standard microbiology methods were used. Isolated strains of enterobacteria were characterized by API 20E and API Staph galleries and confirmed by API Web. Antibiotic resistance was performed according to the recommendations of the antibiogram committee (CA-SFM, 2019). Physico-chemical analysis of the water was carried out by (Rodier, 2009). The microbiological results revealed an abundance on the Domoro islands (5.37.106 ± 1.5.105 and 1.97.105 ± 4.94.104), successively for total aerobic mesophilic flora (FMAT), and thermotolerant coliform (E. coli) and on the Maguite Islands (4.71.106 ± 7.14.105 and 2.32.105 ± 2.86.104), alternately for total aerobic mesophilic flora (FMAT), and thermotolerant coliform (E. coli). The results obtained after incubation of the biochemical tests using the API 20E and API Staph galleries and their proposed numerical profile analyzed using Api software and confirmed by Api Web confirmed the contamination of the waters of Lake Fitri by pathogenic strains of E. coli, Staphylococcus and Salmonella spp. The results of the antibiogram carried out show the emergence of certain resistances to Tobramycin, Flucytosine and Teicoplanin. The average levels of BOD5, COD, SS, Nitrate (NO3) and Nitrite (NO2) for Domoro Island were 32.14 ± 2.37 mg/L, 423.86 ± 4.78 mg/L, 65.42 ± 2.27 mg/L, 0.04 ± 0.01 mg/L and 3.32 ± 1.48 mg/L respectively. The water from the islands of Lake Fitri must therefore be rigorously treated before consumption.展开更多
Background: Social determinants of health (SDOH) significantly influence diseases with environmental components, like vector-borne parasitic diseases. This study aims to examine how these factors influence vector-born...Background: Social determinants of health (SDOH) significantly influence diseases with environmental components, like vector-borne parasitic diseases. This study aims to examine how these factors influence vector-borne parasitic diseases (VBPDs) transmission in Chad and provide recommendations for policy improvements. Methods: The study adopts the WHO Conceptual Framework of SDOH to compare two regions in Southern Chad: Kouh-Est, which has an ongoing vector control program, and Grand-Sido, which lacks such a program. The study includes both nomadic and sedentary populations to provide a comprehensive understanding of the SDOH influencing VBPDs. Households were randomly selected. Data on sociodemographic characteristics, literacy, knowledge of VBPDs and protective measures, and access to education and health facilities were collected. Results: A total of 202 households from 17 villages, including 820 participants, were surveyed. Agriculture, livestock, and fishing were the main occupations, involving 84.1% of participants. Literacy was low, with 36.7% non-educated, 47.7% completing primary school, 14.5% secondary school, and only 0.3% reaching tertiary education. Most villages lacked schools beyond the primary level, and nomadic populations were significantly less educated than sedentary ones (p Conclusion: Educational deficiencies, lack of protective measures against vectors, inadequate healthcare resources, and lifestyle conditions aggravated by poor road infrastructure, limited transportation, and economic constraints contribute to worsened VBPDs outcomes in these rural populations. Addressing these systemic issues in the surveyed communities is essential for improving health equity and VBPDs outcomes in these regions specifically and in similar populations settings more broadly.展开更多
The Nutri-Score is a 5-color front-of-pack nutrition label designed to provide consumers with an easily understandable guideline to the healthiness of food products.The impact that the Nutri-Score may have on consumer...The Nutri-Score is a 5-color front-of-pack nutrition label designed to provide consumers with an easily understandable guideline to the healthiness of food products.The impact that the Nutri-Score may have on consumers'choices is unclear since different experimental paradigms have found vastly different effect sizes.In the present study,we have investigated how student participants change a hypothetical personal 1-daydietary plan after a learning phase during which they learn about the Nutri-Scores of the available food items.Participants were instructed to compose a healthy diet plan in order that the question of whether the NutriScore would improve their ability to compose a healthy dietary plan could be investigated,independent of the question of whether they would apply this knowledge in their ordinary lives.We found a substantial(Cohen's d=0.86)positive impact on nutritional quality(as measured by the Nutrient Profiling System score of the Food Standards Agency)and a medium-sized(Cohen's d=0.43)reduction of energy content.Energy content reduction was larger for participants who had initially composed plans with higher energy content.The results suggest that the Nutri-Score has the potential to guide consumers to healthier food choices.It remains unclear,however,whether this potential will be reflected in real-life dietary choices.展开更多
The use of medicinal plants occupies an important place in traditional Chadian medicine, this study was carried out with the aim of listing the medicinal plants sold in the markets of the city of N’Djamena, and knowl...The use of medicinal plants occupies an important place in traditional Chadian medicine, this study was carried out with the aim of listing the medicinal plants sold in the markets of the city of N’Djamena, and knowledge of the medicinal flora Chad, such as the leaves of Guiera senegalensis in Arabic called Khibeche, the roots of Cassia occidentalis called Am kwala-Kinkéliba in Arabic;the bark of Khaya senegalensis (Desv) A. Juss called Muraї in Arabic and the seeds of Trigonella foenum-graecum called Helbé in Arabic in order to treat the most frequently cited diseases such as malaria, the common cold, mother and newborn care, and typhoid. Ethnobotanical surveys were conducted from September to December 2022, in three markets in the city of N’Djamena, based on individual interviews using a semi-structured questionnaire, with 30 herbalists and traditional practitioners. Phytochemical screening analyses of the organs of four plants were carried out in the chemistry and biology laboratory of the Faculty of Exact and Applied Sciences (FSEA) following a standard protocol established by [1] and slightly modified by [2] [3]. The results of the surveys identified 68 species divided into fifty-five (55) genera and twenty-seven (27) families, the most represented of which were Caesalpiniaceae (10 species), Mimosaceae (5 species) and Combretaceae (4 species). The leaves were the most commonly used parts (43%), with decoction (70%) the most frequently used method of preparation. The oral route was the most popular with 73% of recipes. The phytochemical study revealed a wealth of secondary metabolites such as Trapezoidal Sterols, Alkaloids, Tannins, Flavonoids, Free Quinones, Anthocyane, Anthraquinones, Saponosides and Heterosides. These results can be considered as a source of information for scientific research in the field of phytochemistry and pharmacology.展开更多
Toxoplasmic chorioretinitis also known as ocular toxoplasmosis is a parasitic infection caused by the obligately intracellular multiplying protozoan called Toxoplasma gondii. Active toxoplasmic chorioretinitis is a ra...Toxoplasmic chorioretinitis also known as ocular toxoplasmosis is a parasitic infection caused by the obligately intracellular multiplying protozoan called Toxoplasma gondii. Active toxoplasmic chorioretinitis is a rare condition in immunocompetent people. We report a case of a 47-year-old patient who received reduced right visual acuity, left hemiparesis and eye pain. Examination of the right anterior segment of the eye is unremarkable. In the fundus of the right eye, there was a focus of active toxoplasmic chorioretinitis located in the macula at 1.5 mm papillary diameter next to old scar lesions. The ophthalmological examination of the left eye was unremarkable. The paraclinical assessment carried out on the patient shows a positive Remington test on two occasions three weeks apart. The clinical outcome after initiation of treatment was favorable with a healing of the active site within four weeks.展开更多
The problem of access to quality water is a major challenge, as it has a major impact on the socio-economic conditions of people in developing countries. The water from the islands of Lake Fitri is one of the main sou...The problem of access to quality water is a major challenge, as it has a major impact on the socio-economic conditions of people in developing countries. The water from the islands of Lake Fitri is one of the main sources of drinking water for the population. The aim of this study is to characterise and assess the quality of the water and sediment from the islands (Moudou and Birguime) of Lake Fitri, and to confirm the strains isolated using the PCR method. A total of fifty (50) samples of water and fifty (50) sediments from the islands of Lake Fitri were analyzed. Standard methods of microbiological and biochemical analysis of water and sediments were used. Isolated Enterobacteriaceae strains were characterized by API 20 E and API Staph galleries and Salmonella was confirmed by PCR method. Antibiotic resistance was determined using a technique recommended by the antibiogram committee of the French microbiology society (CA-SFM, 2019). The microbiological results for the water showed an abundance of total aerobic mesophilic flora (TAMF) (4.31 × 106 ± 8.05 × 105 and 5.29 × 106 ± 2.55 × 105) on the Birguime and Moudou islands successively. The microbiological results for the sediment from Birguime and Moudou islands showed an abundance of thermotolerant coliforms (E. coli) (2.05 × 105 ± 5.43 × 104 and 2.27 × 105 ± 3.49 × 104) alternately. The results obtained after incubation of the biochemical tests by the API 20E, API Staph gallery and their numerical profile proposed by the Api software confirmed the contamination. The antibiogram results showed the emergence of certain resistances to the antibiotics Tobramycin, Flucytosine, Amikacin and Teicoplani. The PCR results for Salmonella spp strains were confirmed. As a result, strict monitoring of the water on the various islands of Lake Fitri must be carried out throughout the annual cycle, by specialized personnel, to ensure proper bio-monitoring of these ecosystems.展开更多
Introduction: Caesarean section is a surgical procedure which allows childbirth after opening the abdominal wall and the uterus. Objective: To study caesarean section in the N’Djamena Mother and Child University Hosp...Introduction: Caesarean section is a surgical procedure which allows childbirth after opening the abdominal wall and the uterus. Objective: To study caesarean section in the N’Djamena Mother and Child University Hospital (NMCUH). Patients and Method: This was a cross-sectional, analytic descriptive study over a 5-month period from 10 January to 10 June 2023, focusing on caesarean sections section in the N’Djamena Mother and Child University Hospital (NMCUH). Studied variables were epidemiological, clinical and prognostic. Patients were divided according to the classification of Robson into 10 groups. Results: During the study period, we recorded 724 caesareans sections among 3,565 deliveries, giving a rate of 20.3%. The age group from 25 to 29 represented 39.2%. The average age was 31.2 ± 2.8 years, with extreme ranging from 14 to 44 years. Nulliparous women accounted for 42% and 26% had at least one previous caesarean section (n = 188). Patients with full-term pregnancies (37 - 40 gestational weeks + 6 days) represented 64.1%. Emergency caesareans accounted for 92.8% (n = 672). Robson’s group 1 was noted to be 40.3%. Hemorrhage was the main intraoperative complication, with 7.2%. In post-operatively, anemia was the main complication at 23.8%. We recorded 16 maternal deaths, giving a maternal death rate of 2.2%. Live newborns accounted for 81.1%. Conclusion: Caesarean section is a common procedure in the CHUME maternity unit. The main indications are those of Robson’s group I. Caesarean sections are associated with both maternal and fetal complications.展开更多
Introduction: Infection disease is a real publique health problem. The rise of resistance for modern antibiotic in infections treatment imposed us order alternatives. The study objective was to contribute in the knowl...Introduction: Infection disease is a real publique health problem. The rise of resistance for modern antibiotic in infections treatment imposed us order alternatives. The study objective was to contribute in the knowledge of medicinal plants uses in urinary infections treatment in N’Djamena (Chad) in view for amelioration the traditional medicine in future. Methodology: The study was conducted in the city of N’Djamena in the Republic of Chad that interviewed 60 traditherapists on using 11 plants for urinary tract infections treatment. The methodology of this study consisted of the knowledge of medicinal plants that used by traditherapists, and the plants identification was done in the laboratory of IRED at Farcha. Results: A total of 60 traditherapists was interrogated on the plants used in the treatment of urinary tract infections among the population of N’Djamena. The majority of traditherapists interrogated in this study were male with the rate of 61.67% against female with the rate of 38.33%. The age range of traditherapists was between 20 to 80 years, 25 (41.67%) from the age range between 30 - 50 years and 35 (58.33%) in age range from 50 to 70 years. For the origin of their knowledge, the study showed that 72% of traditherapists inherited the knowledge from their family, while 15% inherited from the family and from training. The ethnic groups of the traditherapists were Sara (16%), Maraba (12%) and Massa (11%). According to the results, 18.33% were illiterates, 49% attended primary school and 33.34% the secondary school. Our study found that 11 species of plants belonging to 11 families were used in the treatment of urinary tract infection and the Ziziphus spina-christi was the most represented. According to traditherapists the Ziziphus spina-christi, Cassia obovata and Euphorbia hirta were the most frequent plants used in the urinary tract infections treatment. The parts of plants used in the treatment were leaves and bark, grained leaves and entire plants with the proportion of 50%, 16.67 and 15% respectively. Conclusion: This study revealed that the medicinal plants are variously used in the treatment of infection urinary tract in the city of N’Djamena.展开更多
The inadequacy of drinking water distribution by the Chadian Water Company (STE) has led to the proliferation of private wells and boreholes in the city of Abéché. This study aims to evaluate the microbiolog...The inadequacy of drinking water distribution by the Chadian Water Company (STE) has led to the proliferation of private wells and boreholes in the city of Abéché. This study aims to evaluate the microbiological quality of the drinking water from these wells and boreholes in the city. Methodology: To carry out this study, a randomized selection of forty-five (45) water points, including nine (9) wells and thirty-six (36) boreholes, was identified, and samples were collected. These samples were sent to the National Water Laboratory (LNE) to test for several microbiological parameters, namely Escherichia coli, total coliforms, fecal coliforms, fecal enterococci, and total aerobic flora. The technique used for this analysis was spread plating and membrane filtration. Results: The average values obtained in the well water are 0.338*104 CFU/100 ml for total coliforms, 0.156*104 CFU/100 ml for fecal coliforms, 0.319*103 CFU/100 ml for Escherichia coli, 33.33 CFU/100 ml for fecal enterococci and 1.385*104 CFU/100 ml for total aerobic flora. For borehole water, the average values obtained are 0.469*104 CFU/100 ml for total coliforms, 0.134*104 CFU/100 ml for fecal coliforms, 0.337*103 CFU/100 ml for Escherichia coli, 16.67 CFU/100 ml for fecal enterococci and 1.47*104 CFU/100 ml for total aerobic flora. Conclusion: According to the tolerance thresholds set by the WHO, the average values obtained significantly exceed the recommended standards for drinking water. Therefore, these waters must be treated alongside environmental sanitation measures at water points to ensure a safe drinking water supply that poses no major health risks to the population. For this fact, an appropriate health survey and the implementation of community water and sanitation projects are recommended.展开更多
Amazake is a sweet and non-alcoholic beverage with a long history in Japan.There are two types of amazake,koji amazake produced from rice koji and sakekasu amazake made from sake lees.Amazake has been suggested to be ...Amazake is a sweet and non-alcoholic beverage with a long history in Japan.There are two types of amazake,koji amazake produced from rice koji and sakekasu amazake made from sake lees.Amazake has been suggested to be a functional food with various health benefits and cosmetic effects.The efficacy of both koji amazake and sakekasu amazake in improving bowel movements and defecation has been well studied.Amazake may be useful as a food with constipation relieving effects.Furthermore,beneficial effects of amazake on skin barrier function and skin water content in humans have been well established in randomized controlled trials.The findings of amazake effects on gut microbiota,intestinal environment and gut barrier function,mainly demonstrated in animal models,suggest a role of substances contained in amazake as prebiotics.Preliminary evidence indicates the potential value of amazake in the management of obesity,metabolic syndrome and nonalcoholic fatty liver disease.Long-term and excessive intake tests have demonstrated that the consumption of koji amazake is safe.There are few concerns regarding weight gain or increases in blood sugar levels.The functional compounds and mechanisms involved in the health effects of amazake need to be identified in future research.展开更多
Opportunistic mobile crowdsensing(MCS)non-intrusively exploits human mobility trajectories,and the participants’smart devices as sensors have become promising paradigms for various urban data acquisition tasks.Howeve...Opportunistic mobile crowdsensing(MCS)non-intrusively exploits human mobility trajectories,and the participants’smart devices as sensors have become promising paradigms for various urban data acquisition tasks.However,in practice,opportunistic MCS has several challenges from both the perspectives of MCS participants and the data platform.On the one hand,participants face uncertainties in conducting MCS tasks,including their mobility and implicit interactions among participants,and participants’economic returns given by the MCS data platform are determined by not only their own actions but also other participants’strategic actions.On the other hand,the platform can only observe the participants’uploaded sensing data that depends on the unknown effort/action exerted by participants to the platform,while,for optimizing its overall objective,the platform needs to properly reward certain participants for incentivizing them to provide high-quality data.To address the challenge of balancing individual incentives and platform objectives in MCS,this paper proposes MARCS,an online sensing policy based on multi-agent deep reinforcement learning(MADRL)with centralized training and decentralized execution(CTDE).Specifically,the interactions between MCS participants and the data platform are modeled as a partially observable Markov game,where participants,acting as agents,use DRL-based policies to make decisions based on local observations,such as task trajectories and platform payments.To align individual and platform goals effectively,the platform leverages Shapley value to estimate the contribution of each participant’s sensed data,using these estimates as immediate rewards to guide agent training.The experimental results on real mobility trajectory datasets indicate that the revenue of MARCS reaches almost 35%,53%,and 100%higher than DDPG,Actor-Critic,and model predictive control(MPC)respectively on the participant side and similar results on the platform side,which show superior performance compared to baselines.展开更多
Over the past decade,several biochemical pathways have been investigated to understand the underlying mechanisms involved in the beneficial effects of physical exercise on cognition.1,2 Lourenco et al.,3 in an elegant...Over the past decade,several biochemical pathways have been investigated to understand the underlying mechanisms involved in the beneficial effects of physical exercise on cognition.1,2 Lourenco et al.,3 in an elegant study published in Nature Medicine,examined the relationship between exercise training and hippocampal memory function.Mechanistically,the authors showed that FNDC5/irisin is an important mediator of beneficial effects of physical exercise in a mouse model of Alzheimer's disease.展开更多
Background:As the effectiveness of breast cancer treatment has improved,a growing number of long-term breast cancer survivors are seeking help for unique health problems.These patients may be at increased risk of card...Background:As the effectiveness of breast cancer treatment has improved,a growing number of long-term breast cancer survivors are seeking help for unique health problems.These patients may be at increased risk of cardiovascular disease due to the side effects of treatment.The positive impact of most types of exercise has been repeatedly reported in people with cancer,but the most effective exercise approaches for maximum beneficial adaptations remain controversial.Thus,this study aimed to compare the effects of high-intensity interval training(HIIT)and moderate-intensity continuous training(MICT) on inflammatory indices,adipokines,metabolic markers,body composition,cardiorespiratory fitness,and quality of life in breast cancer patients during adjuvant endocrine therapy.Methods:Thirty non-metastatic breast cancer patients during adjuvant endocrine therapy who had been treated with chemotherapy and/or radiotherapy were recruited from Iran and randomized to HIIT,MICT,or control groups for a supervised exercise intervention that took place 3 times a week for 12 weeks.The training intensity was determed based on the peak oxygen uptake(VO2peak),and the volume of training was matched in HIIT and MICT based on the VO2peak.Body composition,functional capacity,cardiorespiratory fitness,metabolic indices,sex hormones,adipokines,and inflammatory markers were assessed before and after the intervention.Results:The VO2peakincreased by 16.8% in the HIIT group in comparison to baseline values(mean difference=3.61 mL/kg/min).HIIT significantly improved the VO2peakcompared to control(mean difference=3.609 mL/kg/min) and MICT(mean differences=2.974 mL/kg/min)groups.Both HIIT(mean difference=9.172 mg/dL) and MICT(mean difference=7.879 mg/dL) interventions significantly increased highdensity lipoprotein cholesterol levels compared to the control group.The analysis of covariance showed that physical well-being significantly improved in MICT compared to control group(mean difference=3.268).HIIT significantly improved the social well-being compared to the control group(mean difference=4.412).Emotional well-being subscale was significantly improved in both MICT(mean difference=4.248)and HIIT(mean difference=4.412) compared to the control group.Functional well-being scores significantly increased in HIIT group compared with control group(mean difference=3.35).Significant increase were also observed in total functional assessment of cancer therapy-General scores in both HIIT(mean difference=14.204) and MICT groups(mean difference=10.036) compared with control group.The serum level of suppressor of cytokine signaling 3 increased significantly(mean difference=0.09 pg/mL) in the HIIT group compared to the baseline.There were no significant differences between groups for body weight,body mass index,fasting blood glucose,insulin resistance,sex hormone binding globulin,total cholesterol,low-density lipoprotein cholesterol,adipokines,interleukin-6,tumor necrosis factor-a,or interleukin-10.Conclusion:HIIT can be used as a safe,feasible,and time-efficient intervention to improve cardiovascular fitness in breast cancer patients.Both HIIT and MICT modalities enhance quality of life.Further large-scale studies will help determine whether these promising results translate into improved clinical and oncological outcomes.展开更多
Implementation is expected to be a measure for sustainable forest management by providing benefit for forest users based on their efforts. Without careful attention for the social safeguard, the mechanism of reducing ...Implementation is expected to be a measure for sustainable forest management by providing benefit for forest users based on their efforts. Without careful attention for the social safeguard, the mechanism of reducing greenhouse gas emissions from deforestation and forest degradation with forest management (REDD+) might cause negative impact such as depriving of customary forest use rights under unclear tenure and forest use rights typical in Indonesia. This study aimed to explore how REDD+ Safeguard can be applied in readiness activities by analyzing practical forest use situations in a conservation forest, the Gunung Palung National Park as study site. From the results of the questionnaire survey and interviews, characteristics of forest users were identified and compared. The households, mostly Malays, practicing traditional durian collection, were recognized as main forest users depending on on-farm income especially from non-timber forest product (NTFP). Since the income structure is relatively low and unstable, some of them practice farming in forest area or sell their forest use rights to other households. They are inclined to be lack in legal farm land and certain forest use rights. Based on the findings, consideration for diverse forest users and potential readiness activities were discussed and proposed. For achieving REDD+ implementation with sustainable forest management and social safeguard, it will be necessary to respect for customary rights and take comprehensive measures as readiness efforts.展开更多
Purpose:?The aim of this study was to describe Thai psychiatric nurses’ experiences and perceptions of their professional role when caring for older people whom displayed symptoms of clinical depression.?Methods:?A q...Purpose:?The aim of this study was to describe Thai psychiatric nurses’ experiences and perceptions of their professional role when caring for older people whom displayed symptoms of clinical depression.?Methods:?A qualitative descriptive research design was used. Thirteen psychiatric nurses working in the field of mental health and psychiatric nursing at a rural district hospital were purposively included. The data were collected through in-depth,?face to face interviews and analyzed using qualitative latent content analysis.?Results:?All participants were female, and the mean age was 43 years, and the mean experience of caring for mentally ill patients was 8.3 years. The psychiatric nurses’ experiences and perceptions of their professional role were mirrored in the following themes:?1) managing a central role in the care of the patients;?2) conflicting interests between the professional needs of caregiving and other requests;and?3) being compassionate beyond the profession.?Conclusion: The psychiatric nurses were challenged by the complexity of the caregiving situations and the partners involved in the process of caring for older people with depression. Professionally, the psychiatric nurses played an important role in preventive care and managerial work. They underwent stress under the influence of stakeholders, but they also contributed to the holistic patient care.?Health service authorities may use these results to develop plans for psychiatric nurses in managing a central role and in advocating for holistic care to mitigate the influence of stakeholders to enhance quality of caring for older?individuals with depression.展开更多
REDD plus activities corresponded in Central Kalimantan Province, Indonesia and their GHG emission reductions potential were analyzed. Target area is located in a remote area from Pa-langkaraya, Capital of Central Kal...REDD plus activities corresponded in Central Kalimantan Province, Indonesia and their GHG emission reductions potential were analyzed. Target area is located in a remote area from Pa-langkaraya, Capital of Central Kalimantan Province and consisted of immigrating people mainly from Java Island. In the target area, most of local people conducted unsustainable land use activities (e.g. slash-and-burn agriculture). From analysis of past land use in the target area, there were drastic changes in land use from 1989 after migration began. Natural secondary forest with high density was greatly reduced (2010 levels are approximately 80% of 1996 levels) and converted to cropland and settlement. Also, the reduction in natural secondary forest with high density allowed Melaleuca cajuputi Powell forest to rapidly increase in size (2010 levels are approximately 3.7 times as 1996 levels). Additionally, as marked point, there was an increase in oil palm plantations from 2008 and onwards. From results of land use change in the past, mean annual GHG emissions of 5450 Gg CO2e year-1 had been continued until year 2010. To consider counter-measure for reducing GHG emissions in the target area, the relationship between past land use changes and human activities was analyzed through workshops with stakeholders of 6 different groups (village authorities, forest fire fighting team, members of farmers group, large landowners, workers outside of village and oil palm plantation and mother having small children). The results of the workshops showed that the core problem of unsustainable land use faced by 4 of the 6 groups of stakeholders was the lack of job opportunities (means to earn a living) in the target area. Also, it was learned that core groups considered oil palm plantations is to alleviate the problem and provide a source of alternative income. Furthermore, the workshops indicated that future land use scenario (reference scenario) will be based on income from oil palm plantations and, to prevent such land conversion, counter-measures (REDD plus project scenario) of indirect activities of local people’s lifestyle improvement (e.g. A new forestry system which uses abundant resources of M. cajuputi forest) and reducing pressures on forest resources should be introduced. This study indicated, by implementing REDD plus project in the target area, potential reduction in GHG emissions is quite large and such GHG reduction will be essential as mitigation activities under the new mitigation mechanism, the Joint Crediting Mechanism (JCM) between Indonesia and Japan.展开更多
The association between aortic insufficiency and sinus dysfunction is rare. We reported a case of significant chronic degenerative aortic insufficiency associated with sinus dysfunction. This was a 66-year-old patient...The association between aortic insufficiency and sinus dysfunction is rare. We reported a case of significant chronic degenerative aortic insufficiency associated with sinus dysfunction. This was a 66-year-old patient on follow-up for asymptomatic chronic aortic insufficiency who was referred to us for a preoperative invasive hemodynamic assessment. The indication for surgery was based on the left ventricular dilation criteria. The echocardiography and cardiac catheterization showed a disappearance between the aortic insufficiency and the left ventricular repercussion. Upon discovery of the sinus bradycardia, the patient received a single chamber pacemaker set at a base rate of 70 seconds in AAIR at first and then the patient was measured remotely. At five months, cardiac pacing resulted in a significant reduction in the left ventricular diameter and volume on the echocardiography and magnetic resonance imaging;therefore surgery was postponed.展开更多
This article presents the sexual perception of young Lebanese students. We hypothesized that, in Lebanon and the Arab countries, premarital sex is forbidden by most cultures because of conservative societies and backg...This article presents the sexual perception of young Lebanese students. We hypothesized that, in Lebanon and the Arab countries, premarital sex is forbidden by most cultures because of conservative societies and backgrounds. Sexuality lives as a “myth” in these conservative societies. We examined the influence of demographics and genders among a group of 706 Lebanese university students, from public and private universities, as well as the fluctuation of sexual beliefs and practices, based on their gender, demographics and social pressure. The method used was a questionnaire collected form n = 706 students, 446 females and 260 males. The female population of our sample is 62.9% of the total volunteers while the male population is 36.7%. They come from different religions (Christian, Muslim, Druze and Other), between May 2015 and December 2015. Quantitative significant results: 1) A non-conformity with the social and demographic pressure and an openness of the new generations. Similarly, it shows more permissiveness in flirting. Even though, parts of the negative answers were significantly linked to understanding the rules of prohibited sex (NO 32.4% for belief and NO 34.5% for practice);2) the reality of Lebanese youth, their integrity in engaging in a relationship, and their true daily happening of social and peer pressure;3) An opening to a natural outlook of sexual life, (25.5%) with reluctance on dating (51.1%);4) An important significance is showed in the percentage between beliefs and practice: 18% in belief and 78.3% in practice (Q1) and 34.2% in belief and 60.8% in practice (Q2) emphasizing on the reality of sexual engagement within Lebanese youth;5) However, reluctance in engaging in sexual activity and attachment and fear to social sanctions toward premarital sex and agreeing on abstinence before marriage. Quantitative findings supported the lack of sexual education and the prevalence of religious and social norms. This article examines Young Lebanese adolescents do not always have the same views neither the same patterns of sexual behaviors between men and women. Education and awareness are the keys to a healthy sexual life. Specifically, it considers the way they receive their sexual education, the acceptance and refusal of differences between genders, beliefs and practices. It becomes a real challenge when it comes to early learning and education, openness, and real communication of sexual life, being a natural part of life, with honesty and transparency.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has been an emotionally challenging time,especially for young adults.It is associated with a substantial increase in the prevalence of mental health problems,n...BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has been an emotionally challenging time,especially for young adults.It is associated with a substantial increase in the prevalence of mental health problems,negative symptoms,and stressful experiences that compromise well-being.In low-income countries,internet-delivered psychological services could have a remarkable impact on the population’s mental health,given the lack of mental health professionals.AIM To investigate the efficacy of internet-delivered cognitive-behavior therapy(CBT)-transdiagnostic intervention for adults with emotional disorders.METHODS In this internet-delivered randomized controlled trial,102 students with an emotional disorder(mean age=28.20 years,standard deviation=5.07)were randomly allocated to receive unified protocol(UP)(n=51)or treatment as the usual intervention.Following a semi-structured clinical interview,participants completed an online survey including the Overall Anxiety Severity and Impairment Scale,Overall Depression Severity and Impairment Scale,Difficulties in Emotion Regulation Scale,Positive and Negative Affect Schedule,and Emotional Style Questionnaire.RESULTS The participants showed a high degree of adherence.In total,78%(n=40)of the experimental group participants completed the UP treatment.Considering the intention to treat procedure,the results of the analysis of covariance indicated that participants who received UP showed statistically significant changes in depression symptoms[Cohen’s d=-1.50 with 95%confidence interval(CI):-1.90 to-1.10],anxiety(Cohen’s d=-1.06 with 95%CI:-1.48 to-0.65),difficulties with emotion regulation(Cohen’s d=-0.33 with 95%CI:-0.7 to-0.06),positive affect(Cohen's d=1.27 with 95%CI:0.85 to 1.68),negative affect(Cohen’s d=-1.04 with 95%CI:-1.46 to-0.63),and healthy emotionality(Cohen’s d=0.53 with 95%CI:0.09 to 0.13)compared with the control group.CONCLUSION This study’s findings highlight the potential value of transdiagnostic internet-delivered programs for young adults with an emotional disorder during the COVID-19 pandemic,and expand the research examining emotional well-being improvements resulting from CBT-transdiagnostic interventions.The findings suggest that UP,which generally concentrates on reducing negative effects,can increase positive effects.展开更多
文摘Objectives This study aimed to clarify the relationship between the content of proxy decision-making made by families of patients with malignant brain tumors regarding treatment policies and daily care and the cues leading to those decisions.Methods Semi-structured personal interviews were used to collect data.Seven family members of patients with malignant brain tumors were selected to participate in the study by purposive sampling method from June to August 2022 in the Patient Family Association of Japan.Responses were content analyzed to explore the relationship between the content of decisions regarding“treatment policies”and“daily care”and the cues influencing those decisions.Semi-structured interviews were analyzed by using thematic analysis.Results The contents of proxy decisions regarding“treatment policies”included implementation,interruption,and termination of initial treatments,free medical treatments,use of respirators,and end-of-life sedation and included six cues:treatment policies suggested by the primary physician,information and knowledge about the disease and treatment obtained by the family from limited resources,perceived life threat from symptom worsening,words and reactions from the patient regarding treatment,patient’s personality and way of life inferred from their treatment preferences,family’s thoughts and values hoping for better treatment for the patient.Decisions for“daily care”included meal content and methods,excretion,mobility,maintaining cleanliness,rehabilitation,continuation or resignation from work,treatment settings(outpatient or inpatient),and ways to spend time outside and included seven cues:words and thoughts from the patient about their way of life,patient’s reactions and life history inferred from their preferred way of living,things the patient can do to maintain daily life and roles,awareness of the increasing inability to do things in daily life,family’s underlying thoughts and values about how to spend the remaining time,approval from family members regarding the care setting,advice from medical professionals on living at home.Conclusions For“treatment policies,”guidelines from medical professionals were a key cue,while for“daily care,”the small signs from the patients in their daily lives served as cues for proxy decision-making.This may be due to the lack of information available to families and the limited time available for discussion with the patient.Families of patients with malignant brain tumors repeatedly use multiple cues to make proxy decision-making under high uncertainty.Therefore,nurses supporting proxy decision-making should assess the family’s situation and provide cues that facilitate informed and confident decisions.
文摘A total of fifty (50) samples of water from Lake Fitri (Chad), with 25 samples per island (Domoro and Maguite). The aim of this study was to analyze the bacteriological, biochemical and physico-chemical quality of the water in Lake Fitri in Chad. Standard microbiology methods were used. Isolated strains of enterobacteria were characterized by API 20E and API Staph galleries and confirmed by API Web. Antibiotic resistance was performed according to the recommendations of the antibiogram committee (CA-SFM, 2019). Physico-chemical analysis of the water was carried out by (Rodier, 2009). The microbiological results revealed an abundance on the Domoro islands (5.37.106 ± 1.5.105 and 1.97.105 ± 4.94.104), successively for total aerobic mesophilic flora (FMAT), and thermotolerant coliform (E. coli) and on the Maguite Islands (4.71.106 ± 7.14.105 and 2.32.105 ± 2.86.104), alternately for total aerobic mesophilic flora (FMAT), and thermotolerant coliform (E. coli). The results obtained after incubation of the biochemical tests using the API 20E and API Staph galleries and their proposed numerical profile analyzed using Api software and confirmed by Api Web confirmed the contamination of the waters of Lake Fitri by pathogenic strains of E. coli, Staphylococcus and Salmonella spp. The results of the antibiogram carried out show the emergence of certain resistances to Tobramycin, Flucytosine and Teicoplanin. The average levels of BOD5, COD, SS, Nitrate (NO3) and Nitrite (NO2) for Domoro Island were 32.14 ± 2.37 mg/L, 423.86 ± 4.78 mg/L, 65.42 ± 2.27 mg/L, 0.04 ± 0.01 mg/L and 3.32 ± 1.48 mg/L respectively. The water from the islands of Lake Fitri must therefore be rigorously treated before consumption.
文摘Background: Social determinants of health (SDOH) significantly influence diseases with environmental components, like vector-borne parasitic diseases. This study aims to examine how these factors influence vector-borne parasitic diseases (VBPDs) transmission in Chad and provide recommendations for policy improvements. Methods: The study adopts the WHO Conceptual Framework of SDOH to compare two regions in Southern Chad: Kouh-Est, which has an ongoing vector control program, and Grand-Sido, which lacks such a program. The study includes both nomadic and sedentary populations to provide a comprehensive understanding of the SDOH influencing VBPDs. Households were randomly selected. Data on sociodemographic characteristics, literacy, knowledge of VBPDs and protective measures, and access to education and health facilities were collected. Results: A total of 202 households from 17 villages, including 820 participants, were surveyed. Agriculture, livestock, and fishing were the main occupations, involving 84.1% of participants. Literacy was low, with 36.7% non-educated, 47.7% completing primary school, 14.5% secondary school, and only 0.3% reaching tertiary education. Most villages lacked schools beyond the primary level, and nomadic populations were significantly less educated than sedentary ones (p Conclusion: Educational deficiencies, lack of protective measures against vectors, inadequate healthcare resources, and lifestyle conditions aggravated by poor road infrastructure, limited transportation, and economic constraints contribute to worsened VBPDs outcomes in these rural populations. Addressing these systemic issues in the surveyed communities is essential for improving health equity and VBPDs outcomes in these regions specifically and in similar populations settings more broadly.
文摘The Nutri-Score is a 5-color front-of-pack nutrition label designed to provide consumers with an easily understandable guideline to the healthiness of food products.The impact that the Nutri-Score may have on consumers'choices is unclear since different experimental paradigms have found vastly different effect sizes.In the present study,we have investigated how student participants change a hypothetical personal 1-daydietary plan after a learning phase during which they learn about the Nutri-Scores of the available food items.Participants were instructed to compose a healthy diet plan in order that the question of whether the NutriScore would improve their ability to compose a healthy dietary plan could be investigated,independent of the question of whether they would apply this knowledge in their ordinary lives.We found a substantial(Cohen's d=0.86)positive impact on nutritional quality(as measured by the Nutrient Profiling System score of the Food Standards Agency)and a medium-sized(Cohen's d=0.43)reduction of energy content.Energy content reduction was larger for participants who had initially composed plans with higher energy content.The results suggest that the Nutri-Score has the potential to guide consumers to healthier food choices.It remains unclear,however,whether this potential will be reflected in real-life dietary choices.
文摘The use of medicinal plants occupies an important place in traditional Chadian medicine, this study was carried out with the aim of listing the medicinal plants sold in the markets of the city of N’Djamena, and knowledge of the medicinal flora Chad, such as the leaves of Guiera senegalensis in Arabic called Khibeche, the roots of Cassia occidentalis called Am kwala-Kinkéliba in Arabic;the bark of Khaya senegalensis (Desv) A. Juss called Muraї in Arabic and the seeds of Trigonella foenum-graecum called Helbé in Arabic in order to treat the most frequently cited diseases such as malaria, the common cold, mother and newborn care, and typhoid. Ethnobotanical surveys were conducted from September to December 2022, in three markets in the city of N’Djamena, based on individual interviews using a semi-structured questionnaire, with 30 herbalists and traditional practitioners. Phytochemical screening analyses of the organs of four plants were carried out in the chemistry and biology laboratory of the Faculty of Exact and Applied Sciences (FSEA) following a standard protocol established by [1] and slightly modified by [2] [3]. The results of the surveys identified 68 species divided into fifty-five (55) genera and twenty-seven (27) families, the most represented of which were Caesalpiniaceae (10 species), Mimosaceae (5 species) and Combretaceae (4 species). The leaves were the most commonly used parts (43%), with decoction (70%) the most frequently used method of preparation. The oral route was the most popular with 73% of recipes. The phytochemical study revealed a wealth of secondary metabolites such as Trapezoidal Sterols, Alkaloids, Tannins, Flavonoids, Free Quinones, Anthocyane, Anthraquinones, Saponosides and Heterosides. These results can be considered as a source of information for scientific research in the field of phytochemistry and pharmacology.
文摘Toxoplasmic chorioretinitis also known as ocular toxoplasmosis is a parasitic infection caused by the obligately intracellular multiplying protozoan called Toxoplasma gondii. Active toxoplasmic chorioretinitis is a rare condition in immunocompetent people. We report a case of a 47-year-old patient who received reduced right visual acuity, left hemiparesis and eye pain. Examination of the right anterior segment of the eye is unremarkable. In the fundus of the right eye, there was a focus of active toxoplasmic chorioretinitis located in the macula at 1.5 mm papillary diameter next to old scar lesions. The ophthalmological examination of the left eye was unremarkable. The paraclinical assessment carried out on the patient shows a positive Remington test on two occasions three weeks apart. The clinical outcome after initiation of treatment was favorable with a healing of the active site within four weeks.
文摘The problem of access to quality water is a major challenge, as it has a major impact on the socio-economic conditions of people in developing countries. The water from the islands of Lake Fitri is one of the main sources of drinking water for the population. The aim of this study is to characterise and assess the quality of the water and sediment from the islands (Moudou and Birguime) of Lake Fitri, and to confirm the strains isolated using the PCR method. A total of fifty (50) samples of water and fifty (50) sediments from the islands of Lake Fitri were analyzed. Standard methods of microbiological and biochemical analysis of water and sediments were used. Isolated Enterobacteriaceae strains were characterized by API 20 E and API Staph galleries and Salmonella was confirmed by PCR method. Antibiotic resistance was determined using a technique recommended by the antibiogram committee of the French microbiology society (CA-SFM, 2019). The microbiological results for the water showed an abundance of total aerobic mesophilic flora (TAMF) (4.31 × 106 ± 8.05 × 105 and 5.29 × 106 ± 2.55 × 105) on the Birguime and Moudou islands successively. The microbiological results for the sediment from Birguime and Moudou islands showed an abundance of thermotolerant coliforms (E. coli) (2.05 × 105 ± 5.43 × 104 and 2.27 × 105 ± 3.49 × 104) alternately. The results obtained after incubation of the biochemical tests by the API 20E, API Staph gallery and their numerical profile proposed by the Api software confirmed the contamination. The antibiogram results showed the emergence of certain resistances to the antibiotics Tobramycin, Flucytosine, Amikacin and Teicoplani. The PCR results for Salmonella spp strains were confirmed. As a result, strict monitoring of the water on the various islands of Lake Fitri must be carried out throughout the annual cycle, by specialized personnel, to ensure proper bio-monitoring of these ecosystems.
文摘Introduction: Caesarean section is a surgical procedure which allows childbirth after opening the abdominal wall and the uterus. Objective: To study caesarean section in the N’Djamena Mother and Child University Hospital (NMCUH). Patients and Method: This was a cross-sectional, analytic descriptive study over a 5-month period from 10 January to 10 June 2023, focusing on caesarean sections section in the N’Djamena Mother and Child University Hospital (NMCUH). Studied variables were epidemiological, clinical and prognostic. Patients were divided according to the classification of Robson into 10 groups. Results: During the study period, we recorded 724 caesareans sections among 3,565 deliveries, giving a rate of 20.3%. The age group from 25 to 29 represented 39.2%. The average age was 31.2 ± 2.8 years, with extreme ranging from 14 to 44 years. Nulliparous women accounted for 42% and 26% had at least one previous caesarean section (n = 188). Patients with full-term pregnancies (37 - 40 gestational weeks + 6 days) represented 64.1%. Emergency caesareans accounted for 92.8% (n = 672). Robson’s group 1 was noted to be 40.3%. Hemorrhage was the main intraoperative complication, with 7.2%. In post-operatively, anemia was the main complication at 23.8%. We recorded 16 maternal deaths, giving a maternal death rate of 2.2%. Live newborns accounted for 81.1%. Conclusion: Caesarean section is a common procedure in the CHUME maternity unit. The main indications are those of Robson’s group I. Caesarean sections are associated with both maternal and fetal complications.
文摘Introduction: Infection disease is a real publique health problem. The rise of resistance for modern antibiotic in infections treatment imposed us order alternatives. The study objective was to contribute in the knowledge of medicinal plants uses in urinary infections treatment in N’Djamena (Chad) in view for amelioration the traditional medicine in future. Methodology: The study was conducted in the city of N’Djamena in the Republic of Chad that interviewed 60 traditherapists on using 11 plants for urinary tract infections treatment. The methodology of this study consisted of the knowledge of medicinal plants that used by traditherapists, and the plants identification was done in the laboratory of IRED at Farcha. Results: A total of 60 traditherapists was interrogated on the plants used in the treatment of urinary tract infections among the population of N’Djamena. The majority of traditherapists interrogated in this study were male with the rate of 61.67% against female with the rate of 38.33%. The age range of traditherapists was between 20 to 80 years, 25 (41.67%) from the age range between 30 - 50 years and 35 (58.33%) in age range from 50 to 70 years. For the origin of their knowledge, the study showed that 72% of traditherapists inherited the knowledge from their family, while 15% inherited from the family and from training. The ethnic groups of the traditherapists were Sara (16%), Maraba (12%) and Massa (11%). According to the results, 18.33% were illiterates, 49% attended primary school and 33.34% the secondary school. Our study found that 11 species of plants belonging to 11 families were used in the treatment of urinary tract infection and the Ziziphus spina-christi was the most represented. According to traditherapists the Ziziphus spina-christi, Cassia obovata and Euphorbia hirta were the most frequent plants used in the urinary tract infections treatment. The parts of plants used in the treatment were leaves and bark, grained leaves and entire plants with the proportion of 50%, 16.67 and 15% respectively. Conclusion: This study revealed that the medicinal plants are variously used in the treatment of infection urinary tract in the city of N’Djamena.
文摘The inadequacy of drinking water distribution by the Chadian Water Company (STE) has led to the proliferation of private wells and boreholes in the city of Abéché. This study aims to evaluate the microbiological quality of the drinking water from these wells and boreholes in the city. Methodology: To carry out this study, a randomized selection of forty-five (45) water points, including nine (9) wells and thirty-six (36) boreholes, was identified, and samples were collected. These samples were sent to the National Water Laboratory (LNE) to test for several microbiological parameters, namely Escherichia coli, total coliforms, fecal coliforms, fecal enterococci, and total aerobic flora. The technique used for this analysis was spread plating and membrane filtration. Results: The average values obtained in the well water are 0.338*104 CFU/100 ml for total coliforms, 0.156*104 CFU/100 ml for fecal coliforms, 0.319*103 CFU/100 ml for Escherichia coli, 33.33 CFU/100 ml for fecal enterococci and 1.385*104 CFU/100 ml for total aerobic flora. For borehole water, the average values obtained are 0.469*104 CFU/100 ml for total coliforms, 0.134*104 CFU/100 ml for fecal coliforms, 0.337*103 CFU/100 ml for Escherichia coli, 16.67 CFU/100 ml for fecal enterococci and 1.47*104 CFU/100 ml for total aerobic flora. Conclusion: According to the tolerance thresholds set by the WHO, the average values obtained significantly exceed the recommended standards for drinking water. Therefore, these waters must be treated alongside environmental sanitation measures at water points to ensure a safe drinking water supply that poses no major health risks to the population. For this fact, an appropriate health survey and the implementation of community water and sanitation projects are recommended.
文摘Amazake is a sweet and non-alcoholic beverage with a long history in Japan.There are two types of amazake,koji amazake produced from rice koji and sakekasu amazake made from sake lees.Amazake has been suggested to be a functional food with various health benefits and cosmetic effects.The efficacy of both koji amazake and sakekasu amazake in improving bowel movements and defecation has been well studied.Amazake may be useful as a food with constipation relieving effects.Furthermore,beneficial effects of amazake on skin barrier function and skin water content in humans have been well established in randomized controlled trials.The findings of amazake effects on gut microbiota,intestinal environment and gut barrier function,mainly demonstrated in animal models,suggest a role of substances contained in amazake as prebiotics.Preliminary evidence indicates the potential value of amazake in the management of obesity,metabolic syndrome and nonalcoholic fatty liver disease.Long-term and excessive intake tests have demonstrated that the consumption of koji amazake is safe.There are few concerns regarding weight gain or increases in blood sugar levels.The functional compounds and mechanisms involved in the health effects of amazake need to be identified in future research.
基金sponsored by Qinglan Project of Jiangsu Province,and Jiangsu Provincial Key Research and Development Program(No.BE2020084-1).
文摘Opportunistic mobile crowdsensing(MCS)non-intrusively exploits human mobility trajectories,and the participants’smart devices as sensors have become promising paradigms for various urban data acquisition tasks.However,in practice,opportunistic MCS has several challenges from both the perspectives of MCS participants and the data platform.On the one hand,participants face uncertainties in conducting MCS tasks,including their mobility and implicit interactions among participants,and participants’economic returns given by the MCS data platform are determined by not only their own actions but also other participants’strategic actions.On the other hand,the platform can only observe the participants’uploaded sensing data that depends on the unknown effort/action exerted by participants to the platform,while,for optimizing its overall objective,the platform needs to properly reward certain participants for incentivizing them to provide high-quality data.To address the challenge of balancing individual incentives and platform objectives in MCS,this paper proposes MARCS,an online sensing policy based on multi-agent deep reinforcement learning(MADRL)with centralized training and decentralized execution(CTDE).Specifically,the interactions between MCS participants and the data platform are modeled as a partially observable Markov game,where participants,acting as agents,use DRL-based policies to make decisions based on local observations,such as task trajectories and platform payments.To align individual and platform goals effectively,the platform leverages Shapley value to estimate the contribution of each participant’s sensed data,using these estimates as immediate rewards to guide agent training.The experimental results on real mobility trajectory datasets indicate that the revenue of MARCS reaches almost 35%,53%,and 100%higher than DDPG,Actor-Critic,and model predictive control(MPC)respectively on the participant side and similar results on the platform side,which show superior performance compared to baselines.
基金supported by the German Research Foundation (DFG BU 1837/5-1BU 1837/5-2)
文摘Over the past decade,several biochemical pathways have been investigated to understand the underlying mechanisms involved in the beneficial effects of physical exercise on cognition.1,2 Lourenco et al.,3 in an elegant study published in Nature Medicine,examined the relationship between exercise training and hippocampal memory function.Mechanistically,the authors showed that FNDC5/irisin is an important mediator of beneficial effects of physical exercise in a mouse model of Alzheimer's disease.
基金supported by the Sport Sciences Research Institute of Iran
文摘Background:As the effectiveness of breast cancer treatment has improved,a growing number of long-term breast cancer survivors are seeking help for unique health problems.These patients may be at increased risk of cardiovascular disease due to the side effects of treatment.The positive impact of most types of exercise has been repeatedly reported in people with cancer,but the most effective exercise approaches for maximum beneficial adaptations remain controversial.Thus,this study aimed to compare the effects of high-intensity interval training(HIIT)and moderate-intensity continuous training(MICT) on inflammatory indices,adipokines,metabolic markers,body composition,cardiorespiratory fitness,and quality of life in breast cancer patients during adjuvant endocrine therapy.Methods:Thirty non-metastatic breast cancer patients during adjuvant endocrine therapy who had been treated with chemotherapy and/or radiotherapy were recruited from Iran and randomized to HIIT,MICT,or control groups for a supervised exercise intervention that took place 3 times a week for 12 weeks.The training intensity was determed based on the peak oxygen uptake(VO2peak),and the volume of training was matched in HIIT and MICT based on the VO2peak.Body composition,functional capacity,cardiorespiratory fitness,metabolic indices,sex hormones,adipokines,and inflammatory markers were assessed before and after the intervention.Results:The VO2peakincreased by 16.8% in the HIIT group in comparison to baseline values(mean difference=3.61 mL/kg/min).HIIT significantly improved the VO2peakcompared to control(mean difference=3.609 mL/kg/min) and MICT(mean differences=2.974 mL/kg/min)groups.Both HIIT(mean difference=9.172 mg/dL) and MICT(mean difference=7.879 mg/dL) interventions significantly increased highdensity lipoprotein cholesterol levels compared to the control group.The analysis of covariance showed that physical well-being significantly improved in MICT compared to control group(mean difference=3.268).HIIT significantly improved the social well-being compared to the control group(mean difference=4.412).Emotional well-being subscale was significantly improved in both MICT(mean difference=4.248)and HIIT(mean difference=4.412) compared to the control group.Functional well-being scores significantly increased in HIIT group compared with control group(mean difference=3.35).Significant increase were also observed in total functional assessment of cancer therapy-General scores in both HIIT(mean difference=14.204) and MICT groups(mean difference=10.036) compared with control group.The serum level of suppressor of cytokine signaling 3 increased significantly(mean difference=0.09 pg/mL) in the HIIT group compared to the baseline.There were no significant differences between groups for body weight,body mass index,fasting blood glucose,insulin resistance,sex hormone binding globulin,total cholesterol,low-density lipoprotein cholesterol,adipokines,interleukin-6,tumor necrosis factor-a,or interleukin-10.Conclusion:HIIT can be used as a safe,feasible,and time-efficient intervention to improve cardiovascular fitness in breast cancer patients.Both HIIT and MICT modalities enhance quality of life.Further large-scale studies will help determine whether these promising results translate into improved clinical and oncological outcomes.
文摘Implementation is expected to be a measure for sustainable forest management by providing benefit for forest users based on their efforts. Without careful attention for the social safeguard, the mechanism of reducing greenhouse gas emissions from deforestation and forest degradation with forest management (REDD+) might cause negative impact such as depriving of customary forest use rights under unclear tenure and forest use rights typical in Indonesia. This study aimed to explore how REDD+ Safeguard can be applied in readiness activities by analyzing practical forest use situations in a conservation forest, the Gunung Palung National Park as study site. From the results of the questionnaire survey and interviews, characteristics of forest users were identified and compared. The households, mostly Malays, practicing traditional durian collection, were recognized as main forest users depending on on-farm income especially from non-timber forest product (NTFP). Since the income structure is relatively low and unstable, some of them practice farming in forest area or sell their forest use rights to other households. They are inclined to be lack in legal farm land and certain forest use rights. Based on the findings, consideration for diverse forest users and potential readiness activities were discussed and proposed. For achieving REDD+ implementation with sustainable forest management and social safeguard, it will be necessary to respect for customary rights and take comprehensive measures as readiness efforts.
文摘Purpose:?The aim of this study was to describe Thai psychiatric nurses’ experiences and perceptions of their professional role when caring for older people whom displayed symptoms of clinical depression.?Methods:?A qualitative descriptive research design was used. Thirteen psychiatric nurses working in the field of mental health and psychiatric nursing at a rural district hospital were purposively included. The data were collected through in-depth,?face to face interviews and analyzed using qualitative latent content analysis.?Results:?All participants were female, and the mean age was 43 years, and the mean experience of caring for mentally ill patients was 8.3 years. The psychiatric nurses’ experiences and perceptions of their professional role were mirrored in the following themes:?1) managing a central role in the care of the patients;?2) conflicting interests between the professional needs of caregiving and other requests;and?3) being compassionate beyond the profession.?Conclusion: The psychiatric nurses were challenged by the complexity of the caregiving situations and the partners involved in the process of caring for older people with depression. Professionally, the psychiatric nurses played an important role in preventive care and managerial work. They underwent stress under the influence of stakeholders, but they also contributed to the holistic patient care.?Health service authorities may use these results to develop plans for psychiatric nurses in managing a central role and in advocating for holistic care to mitigate the influence of stakeholders to enhance quality of caring for older?individuals with depression.
文摘REDD plus activities corresponded in Central Kalimantan Province, Indonesia and their GHG emission reductions potential were analyzed. Target area is located in a remote area from Pa-langkaraya, Capital of Central Kalimantan Province and consisted of immigrating people mainly from Java Island. In the target area, most of local people conducted unsustainable land use activities (e.g. slash-and-burn agriculture). From analysis of past land use in the target area, there were drastic changes in land use from 1989 after migration began. Natural secondary forest with high density was greatly reduced (2010 levels are approximately 80% of 1996 levels) and converted to cropland and settlement. Also, the reduction in natural secondary forest with high density allowed Melaleuca cajuputi Powell forest to rapidly increase in size (2010 levels are approximately 3.7 times as 1996 levels). Additionally, as marked point, there was an increase in oil palm plantations from 2008 and onwards. From results of land use change in the past, mean annual GHG emissions of 5450 Gg CO2e year-1 had been continued until year 2010. To consider counter-measure for reducing GHG emissions in the target area, the relationship between past land use changes and human activities was analyzed through workshops with stakeholders of 6 different groups (village authorities, forest fire fighting team, members of farmers group, large landowners, workers outside of village and oil palm plantation and mother having small children). The results of the workshops showed that the core problem of unsustainable land use faced by 4 of the 6 groups of stakeholders was the lack of job opportunities (means to earn a living) in the target area. Also, it was learned that core groups considered oil palm plantations is to alleviate the problem and provide a source of alternative income. Furthermore, the workshops indicated that future land use scenario (reference scenario) will be based on income from oil palm plantations and, to prevent such land conversion, counter-measures (REDD plus project scenario) of indirect activities of local people’s lifestyle improvement (e.g. A new forestry system which uses abundant resources of M. cajuputi forest) and reducing pressures on forest resources should be introduced. This study indicated, by implementing REDD plus project in the target area, potential reduction in GHG emissions is quite large and such GHG reduction will be essential as mitigation activities under the new mitigation mechanism, the Joint Crediting Mechanism (JCM) between Indonesia and Japan.
文摘The association between aortic insufficiency and sinus dysfunction is rare. We reported a case of significant chronic degenerative aortic insufficiency associated with sinus dysfunction. This was a 66-year-old patient on follow-up for asymptomatic chronic aortic insufficiency who was referred to us for a preoperative invasive hemodynamic assessment. The indication for surgery was based on the left ventricular dilation criteria. The echocardiography and cardiac catheterization showed a disappearance between the aortic insufficiency and the left ventricular repercussion. Upon discovery of the sinus bradycardia, the patient received a single chamber pacemaker set at a base rate of 70 seconds in AAIR at first and then the patient was measured remotely. At five months, cardiac pacing resulted in a significant reduction in the left ventricular diameter and volume on the echocardiography and magnetic resonance imaging;therefore surgery was postponed.
文摘This article presents the sexual perception of young Lebanese students. We hypothesized that, in Lebanon and the Arab countries, premarital sex is forbidden by most cultures because of conservative societies and backgrounds. Sexuality lives as a “myth” in these conservative societies. We examined the influence of demographics and genders among a group of 706 Lebanese university students, from public and private universities, as well as the fluctuation of sexual beliefs and practices, based on their gender, demographics and social pressure. The method used was a questionnaire collected form n = 706 students, 446 females and 260 males. The female population of our sample is 62.9% of the total volunteers while the male population is 36.7%. They come from different religions (Christian, Muslim, Druze and Other), between May 2015 and December 2015. Quantitative significant results: 1) A non-conformity with the social and demographic pressure and an openness of the new generations. Similarly, it shows more permissiveness in flirting. Even though, parts of the negative answers were significantly linked to understanding the rules of prohibited sex (NO 32.4% for belief and NO 34.5% for practice);2) the reality of Lebanese youth, their integrity in engaging in a relationship, and their true daily happening of social and peer pressure;3) An opening to a natural outlook of sexual life, (25.5%) with reluctance on dating (51.1%);4) An important significance is showed in the percentage between beliefs and practice: 18% in belief and 78.3% in practice (Q1) and 34.2% in belief and 60.8% in practice (Q2) emphasizing on the reality of sexual engagement within Lebanese youth;5) However, reluctance in engaging in sexual activity and attachment and fear to social sanctions toward premarital sex and agreeing on abstinence before marriage. Quantitative findings supported the lack of sexual education and the prevalence of religious and social norms. This article examines Young Lebanese adolescents do not always have the same views neither the same patterns of sexual behaviors between men and women. Education and awareness are the keys to a healthy sexual life. Specifically, it considers the way they receive their sexual education, the acceptance and refusal of differences between genders, beliefs and practices. It becomes a real challenge when it comes to early learning and education, openness, and real communication of sexual life, being a natural part of life, with honesty and transparency.
基金Supported by Shaanxi Province Education Science"13th Five-Year"Planning Topic:Drama Teaching Method in Application of Research of Psychological Education of Primary School students,No.SGH17H472Research Team Cultivation Project of Xi'an Eurasia University:Regional Children’s Psychological Development Research,No.2021XJTD.
文摘BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has been an emotionally challenging time,especially for young adults.It is associated with a substantial increase in the prevalence of mental health problems,negative symptoms,and stressful experiences that compromise well-being.In low-income countries,internet-delivered psychological services could have a remarkable impact on the population’s mental health,given the lack of mental health professionals.AIM To investigate the efficacy of internet-delivered cognitive-behavior therapy(CBT)-transdiagnostic intervention for adults with emotional disorders.METHODS In this internet-delivered randomized controlled trial,102 students with an emotional disorder(mean age=28.20 years,standard deviation=5.07)were randomly allocated to receive unified protocol(UP)(n=51)or treatment as the usual intervention.Following a semi-structured clinical interview,participants completed an online survey including the Overall Anxiety Severity and Impairment Scale,Overall Depression Severity and Impairment Scale,Difficulties in Emotion Regulation Scale,Positive and Negative Affect Schedule,and Emotional Style Questionnaire.RESULTS The participants showed a high degree of adherence.In total,78%(n=40)of the experimental group participants completed the UP treatment.Considering the intention to treat procedure,the results of the analysis of covariance indicated that participants who received UP showed statistically significant changes in depression symptoms[Cohen’s d=-1.50 with 95%confidence interval(CI):-1.90 to-1.10],anxiety(Cohen’s d=-1.06 with 95%CI:-1.48 to-0.65),difficulties with emotion regulation(Cohen’s d=-0.33 with 95%CI:-0.7 to-0.06),positive affect(Cohen's d=1.27 with 95%CI:0.85 to 1.68),negative affect(Cohen’s d=-1.04 with 95%CI:-1.46 to-0.63),and healthy emotionality(Cohen’s d=0.53 with 95%CI:0.09 to 0.13)compared with the control group.CONCLUSION This study’s findings highlight the potential value of transdiagnostic internet-delivered programs for young adults with an emotional disorder during the COVID-19 pandemic,and expand the research examining emotional well-being improvements resulting from CBT-transdiagnostic interventions.The findings suggest that UP,which generally concentrates on reducing negative effects,can increase positive effects.
