Community engagement is increasingly promoted to strengthen the ethics of medical research in low-income countries. One strategy is to use community advisory boards (CABs): semi-independent groups that can potentially...Community engagement is increasingly promoted to strengthen the ethics of medical research in low-income countries. One strategy is to use community advisory boards (CABs): semi-independent groups that can potentially safeguard the rights of study participants and help improve research. However, there is little published on the experience of operating and sustaining CABs. The Shoklo Malaria Research Unit (SMRU) has been conducting research and providing healthcare in a population of refugees, migrant workers, and displaced people on the Thai-Myanmar border for over 25 years. In 2009 SMRU facilitated the establishment of the Tak Province Community Ethics Advisory Board (T-CAB) in an effort to formally engage with the local communities both to obtain advice and to establish a participatory framework within which studies and the provision of health care can take place. In this paper, we draw on our experience of community engagement in this unique setting, and on our interactions with the past and present CAB members to critically reflect upon the CAB’s goals, structure and operations with a focus on the practicalities, what worked, what did not, and on its future directions.展开更多
Machine learning(ML)is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis,thus creating machines that can complete tasks otherwise requiring human intelligen...Machine learning(ML)is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis,thus creating machines that can complete tasks otherwise requiring human intelligence.Among its various applications,it has proven groundbreaking in healthcare as well,both in clinical practice and research.In this editorial,we succinctly introduce ML applications and present a study,featured in the latest issue of the World Journal of Clinical Cases.The authors of this study conducted an analysis using both multiple linear regression(MLR)and ML methods to investigate the significant factors that may impact the estimated glomerular filtration rate in healthy women with and without non-alcoholic fatty liver disease(NAFLD).Their results implicated age as the most important determining factor in both groups,followed by lactic dehydrogenase,uric acid,forced expiratory volume in one second,and albumin.In addition,for the NAFLD-group,the 5th and 6th most important impact factors were thyroid-stimulating hormone and systolic blood pressure,as compared to plasma calcium and body fat for the NAFLD+group.However,the study's distinctive contribution lies in its adoption of ML methodologies,showcasing their superiority over traditional statistical approaches(herein MLR),thereby highlighting the potential of ML to represent an invaluable advanced adjunct tool in clinical practice and research.展开更多
Breast cancer is the leading cause of cancer-related mortality in women globally,with its incidence continuing to rise,particularly in low-and middle-income countries,presenting a significant public health challenge w...Breast cancer is the leading cause of cancer-related mortality in women globally,with its incidence continuing to rise,particularly in low-and middle-income countries,presenting a significant public health challenge worldwide[1].According to data from the Institute for Health Metrics and Evaluation(IHME)and the World Health Organization(WHO),the gap in access to healthcare services between high-and low-income countries contributes to delayed detection,increased incidence of advanced-stage disease,and,consequently,higher mortality rates(up to 50%higher compared to high-income countries)[1,2].This translates into inequalities in access to screening and early diagnosis methods,which exacerbate the burden of this disease in low-resource settings where infrastructure,funding,and access to trained professionals are limited[3].展开更多
Background:Stretching has wide appeal,but there seems to exist some mismatch between its purported applications and what the evidence shows.There is compelling evidence for some stretching applications,but for others,...Background:Stretching has wide appeal,but there seems to exist some mismatch between its purported applications and what the evidence shows.There is compelling evidence for some stretching applications,but for others,the evidence seems heterogeneous or unsupportive.The discrepancies even affect some systematic reviews,possibly due to heterogeneous eligibility criteria and search strategies.This consensus paper seeks to unify the divergent findings on stretching and its implications for both athletic performance and clinical practices by delivering evidence-based recommendations.Methods:A panel of 20 experts with a blend of practical experience and scholarly knowledge was assembled.The panel meticulously reviewed existing systematic reviews,defined key terminologies(e.g.,consensus definitions for different stretching modes),and crafted guidelines using a Delphi consensus approach(minimum required agreement:80%).The analysis focused on 8 topics,including stretching's acute and chronic(long-term)effects on range of motion,strength performance,muscle hypertrophy,stiffness,injury prevention,muscle recovery,posture correction,and cardiovascular health.Results:There was consensus that chronic and acute stretching(a)improves range of motion(although alternatives exist)and(b)reduces muscle stiffness(which may not always be desirable);the panel also agreed that chronic stretching(c)may promote vascular health,but more research is warranted.In contrast,consensus was found that stretch training does not(a)contribute substantively to muscle growth,(b)serve as an allencompassing injury prevention strategy,(c)improve posture,or(d)acutely enhance post-exercise recovery.Conclusion:These recommendations provide guidance for athletes and practitioners,highlighting research gaps that should be addressed to more comprehensively understand the full scope of stretching effects.展开更多
Brain-computer interface(BCI)technology is rapidly advancing in medical research and application.As an emerging biomedical engineering technology,it has garnered significant attention in the clinical research of brain...Brain-computer interface(BCI)technology is rapidly advancing in medical research and application.As an emerging biomedical engineering technology,it has garnered significant attention in the clinical research of brain disease diagnosis and treatment,neurological rehabilitation,and mental health.However,BCI also raises several challenges and ethical concerns in clinical research.In this article,the authors investigate and discuss three aspects of BCI in medicine and healthcare:the state of international ethical governance,multidimensional ethical challenges pertaining to BCI in clinical research,and suggestive concerns for ethical review.Despite the great potential of frontier BCI research and development in the field of medical care,the ethical challenges induced by itself and the complexities of clinical research and brain function have put forward new special fields for ethics in BCI.To ensure"responsible innovation"in BCI research in healthcare and medicine,the creation of an ethical global governance framework and system,along with special guidelines for cutting-edge BCI research in medicine,is suggested.展开更多
The present study, carried out in the forest (Daloa) and pre-forest (M’Bahiakro) zones of Cote d’Ivoire, aims to determine soil landscape units using the coding method. Geological maps and satellite images (SRTM and...The present study, carried out in the forest (Daloa) and pre-forest (M’Bahiakro) zones of Cote d’Ivoire, aims to determine soil landscape units using the coding method. Geological maps and satellite images (SRTM and Landsat) were used for this purpose. The methodological approach adopted consisted in producing maps of slope, geology, land use and topography using the codification method. These various maps, integrated into a GIS using the coding aggregation method, were used to generate soil landscape maps. Twenty-seven (27) soil landscapes have been identified for the pre-forest zone (M’Bahiakro), with a strong dominance of acid rock over a moderate relief under savannah, forest/degraded forest and crops/fallow. However, the forest zone (Daloa), with forty-one (41) soil landscapes identified over the entire zone, is characterized by a majority of mafic rocks on a medium altitude under forest/degraded forest, water and crops/fallow. The criteria used from the codification method (sum of aggregations) made it possible to predict the spatial distribution of soil map units according to agro-ecological environments in the humid intertropical zone. This is essential for the orientation and reinforcement of soil survey tools. However, a comparative evaluation of the different multicriteria analysis methods for coding and weighting soil landscape unit mapping would enable us to identify the most suitable and efficient method for drawing up base maps for soil surveys.展开更多
Introduction: Cardiovascular disease represents a major public health burden worldwide. Research and management of risk factors contribute to the prevention of these diseases. The aim of this study was to assess the p...Introduction: Cardiovascular disease represents a major public health burden worldwide. Research and management of risk factors contribute to the prevention of these diseases. The aim of this study was to assess the prevalence of dyslipidemia in the biochemistry unit of the Charles De Gaulle Pediatric University Hospital (CHUP-CDG) in Ouagadougou. Material and Methods: This was a descriptive and analytical cross-sectional study, with retrospective data collection from January 1, 2020 to December 31, 2022. Patients of all ages who performed a lipid panel in the CHUP-CDG biochemistry unit during the study period have been included. Results: A total of 2872 patients have been included. The mean age of the study population was 27.72 ± 19.51 years and the M/F sex ratio was 0.81. Among the patients, 22.84% had at least one dyslipidemia. The prevalences of hypercholesterolemia, hypo-HDL cholesterolemia and hyper-LDL cholesterolemia were 11.57%, 49.19% and 57.50% respectively. Hypertriglyceridemia and mixed hyperlipidemia were present in 9.04% and 2.08% of patients. Hypercholesterolemia was significantly more frequent in the female sex (p = 0.0077);hyper-LDL cholesterolemia (p = 0.0255) and mixed hyperlipidemia (p Conclusion: The relatively high prevalence of dyslipidemia in the study indicates a worrying situation. It would therefore appear essential to extend the search for risk factors nationwide, particularly those that can be modified, in order to reduce morbidity and mortality linked to cardiovascular disease.展开更多
Introduction: Low birth weight (LBW) is defined by the World Health Organization (WHO) as a birth weight strictly below 2500 g, whatever the term of pregnancy. It constitutes a major public health problem, both in dev...Introduction: Low birth weight (LBW) is defined by the World Health Organization (WHO) as a birth weight strictly below 2500 g, whatever the term of pregnancy. It constitutes a major public health problem, both in developed and developing countries, due to its magnitude and its strong association with infant morbidity and mortality. Main objective was to study the factors associated with the occurrence of small-for-gestational-age newborns in Douala. Methodology: We carried out a cross-sectional analytical study with prospective data collection using a technical pretested sheet in the maternity wards of the Douala General Hospital, the Laquintinie Hospital, and the District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, of low weight, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given her consent. Our sampling was consecutive and non-exhaustive. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using survey sheets. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The percentage of small-for-gestational-age newborns was 9.8%;after multivariate analysis by logistic regression to eliminate confounding factors, we found maternal factors associated with small for gestational age newborns;maternal age less than 20 years, primiparity, gestational age (37 - 38), a delay in prenatal visits greater than 14 weeks, anemia in pregnancy, positive toxoplasmosis serology in pregnancy, a body mass index of Conclusion: Our study revealed the potential determinants of low birth weight at term in the Cameroonian urban context and specifically in Douala.展开更多
Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The ob...Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The objective of our study was to determine the factors associated with second trimester spontaneous abortions at Laquintinie Hospital in Douala. Methodology for this purpose: We conducted a case-control study from January to May 2019 on pregnant women who may or may not have had spontaneous second trimester abortions. Results: In total we recorded 1609 pregnancies and recruited 184 patients, including 46 cases and 138 controls;which gave a frequency of spontaneous abortion in the second trimester of pregnancy of 2.85%. A correlative analysis showed that spontaneous abortions in the second trimester were associated with housewife status (OR = 2.89;CI = 1.21 - 6.79;p = 0.010), gestation > 5 (OR = 4.09;CI = 1.02 - 17.66;p = 0.040), multiparity (OR = 3.81;CI = 1.59 - 9.16;p = 0.002), history of endouterine maneuvers (OR = 5.64;CI = 2.43 - 13 .03;p = 0.000), malaria in pregnancy (OR = 3.99;CI = 1.1 - 14.76;p = 0.030), incompleteness on the second trimester ultrasound (OR = 2.37;CI = 1.18 - 4.70;p = 0.010), jolts when traveling (OR = 46.04;CI = 17.29 - 123.66;p = 0.000), long car journeys (OR = 7.05;CI = 1.99 - 27.77;p = 0.000). After logistic regression eliminating the confounding factors, only the following were associated with abortions: Multiparity (OR = 13.90;CI = 2.96 - 65.18;p = 0.000), endo uterine maneuvers (OR = 3.69;CI = 1. 01 - 13.44;p = 0.047), jolts when traveling (OR = 72.63;CI = 19.47 - 270.96;p = 0.000), long car journeys (OR = 15.41;CI = 2.7 - 85, 95;p = 0.000). Conclusion: Our study reveals that a set of factors contribute to the occurrence of spontaneous abortions in the second trimester of pregnancy in our context.展开更多
Efficient storage and handling facilities play a pivotal role in ensuring the quality and longevity of date palm produce. This study aims to contribute to the assessment of the operation of refrigeration units in the ...Efficient storage and handling facilities play a pivotal role in ensuring the quality and longevity of date palm produce. This study aims to contribute to the assessment of the operation of refrigeration units in the Drâa Tafilalet region through a diagnostic study conducted by surveying 12 date-packing units. Interviews and surveys were conducted among 12 date packaging units provided by the State to Economic Interest Groups (EIG) in the Drâa-Tafilalet region. Data focused on general EIG information, unit identification, a four-year operational overview, and 2021 palm date processing activities. To streamline analysis, units were categorized into two groups based on packaging capacity: Group 1 (≥400 tons) and Group 2 (<400 tons). The assessment revealed that the packaging units had enhanced this crucial link in the dating industry and introduced a new dynamic in the date marketing chain. However, operational expertise and optimal equipment utilization often fall short, with over 50% of the EIG failing to use provided equipment, except for cold storage rooms. The chain involves a series of operations to preserve the stored product’s intrinsic and extrinsic quality. Evaluated practices include fumigation, meticulous sorting to eliminate visually anomalous dates, calibration during packaging, and storage at temperatures ranging from 0 to 4˚C with humidity levels between 50 and 80%, varying based on the date’s nature (soft, dry, or semi-dry). Expertise in this process mitigates the risk of desiccation or excessive rehydration, preventing date fermentation. Finally, to reduce their energy consumption and solve the balance sheet deficit issue, the government has equipped all the date packaging units from Group 1 and one from Group 2 in the Daraa Tafilalet region with photovoltaic energy. The date packaging infrastructure has boosted the value of Moroccan dates, benefiting small-scale agriculture. Despite improved packaging quality and job creation, suboptimal equipment usage by over 50% of EIGs emphasizes the need for enhanced operational efficiency.展开更多
BACKGROUND The rising prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)in neonatal intensive care units(NICUs)represents an escalating challenge in healthcare settings,particularly in managing hospital-...BACKGROUND The rising prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)in neonatal intensive care units(NICUs)represents an escalating challenge in healthcare settings,particularly in managing hospital-acquired infections(HAIs).Studies across various World Health Organization regions have documented a significant incidence of CRAB-related HAIs,with rates as high as 41.7 cases per 1000 patients in ICUs,accounting for 13.6%of all HAIs.These infections pose a doubled mortality risk compared to infections with carbapenem-susceptible Acinetobacter baumannii.A particularly concerning aspect of CRAB colonization is its asymptomatic nature,enabling its transmission through healthcare workers(HCWs)or the NICU environment to vulnerable neonates with developing immune systems.AIM To explore the prevalence of CRAB colonization in NICUs,focusing on neonates,healthcare workers,and the environmental samples,to enhance epidemiological understanding and inform targeted interventions.METHODS We conducted according to PRISMA 2020 checklist guidelines,a comprehensive literature search across multiple databases including MEDLINE(Ovid),EMBASE(Ovid),Global Health(Ovid),Web of Science,and Global Index Me-dicus.Studies were selected based on predetermined criteria,primarily involving neonates,HCWs,and environmental swabs,using culture or molecular methods to detect CRAB colonization.We excluded studies that did not specifically focus on NICUs,were duplicates,or lacked necessary data.The study selection and quality assessment were conducted independently by two reviewers.Data extraction involved collecting comprehensive details about each study.Our statistical analysis used a random-effects model to calculate the pooled prevalence and confidence intervals,stratifying results by regional location.We assessed study heterogeneity using Cochran's Q statistic and I²statistic,with regression tests employed to evaluate potential publication bias.RESULTS We analyzed 737 records from five databases,ultimately including 13 studies from ten countries.For neonates,the pooled prevalence was 4.8%(95%CI:1.1%to 10.5%)with the highest rates observed in South-East Asia(10.5%;95%CI:2.4%to 23.3%).Among HCWs,a single Indian study reported a 3.3%prevalence.Environmental samples showed a prevalence of 2.3%(95%CI:0%to 9.3%),with the highest rates in South-East Asia(10%;95%CI:4.2%to 17.7%).Significant heterogeneity was found across studies,and no publication bias was detected.CONCLUSION This systematic review highlights a significant prevalence of CRAB colonization in neonates across various regions,particularly in South-East Asia,contrasting with lower rates in high-income countries.The study reveals a gap in research on HCWs colonization,with only a single study from India reporting moderate prevalence.Environmental samples indicate moderate levels of CRAB contamination,again higher in South-East Asia.These findings underscore the need for more extensive and focused research on CRAB colonization in NICUs,including exploring the roles of HCWs and the environment in transmission,understanding antimicrobial resistance patterns,and developing effective prevention measures.展开更多
目的探讨多模式预康复策略对老年衰弱结直肠癌手术患者的功能状态及短期预后的影响。方法回顾性收集2021年1月—2023年6月接受手术治疗的老年衰弱结直肠癌患者的临床资料,所有患者均采用加速康复外科(enhanced recovery after surgery,E...目的探讨多模式预康复策略对老年衰弱结直肠癌手术患者的功能状态及短期预后的影响。方法回顾性收集2021年1月—2023年6月接受手术治疗的老年衰弱结直肠癌患者的临床资料,所有患者均采用加速康复外科(enhanced recovery after surgery,ERAS)路径管理,依据是否实行多模式预康复分为预康复组和对照组。采用1∶2倾向性评分匹配平衡组间基线差异所致的混杂偏倚,比较匹配后两组患者资料,卡钳值设为0.1。主要观察指标为术后4周6分钟步行距离(6-minute walk distance,6MWD);次要观察指标为衰弱指数(frail index,FI)、手术时间、术中出血量、术后并发症、术后住院时间、术后30 d再入院率/再手术率及术后90 d死亡率。结果本研究最终共纳入182例患者(上海交通大学医学院附属第九人民医院62例,临沂市人民医院61例,聊城市人民医院59例),预康复组31例,对照组151例。经1∶2匹配后成功匹配93例患者,预康复组31例,对照组62例。术后4周预康复组6MWD改善值大于对照组[(46.3±33.7)m vs(7.6±30.2)m,P=0.002],预康复组6MWD改善值>20 m的患者数占比多于对照组(55%vs 9.9%,P=0.033)。FI预康复组小于对照组(中位数2 vs 3,P=0.024)。两组间手术时间、并发症发生率、术后30 d再入院率/再手术率及术后90 d死亡率差异无统计学意义(P>0.05)。术后住院时间预康复组长于对照组[(14.0±4.3)d vs(11.3±4.2)d,P=0.007]。结论多模式预康复策略未增加围手术期风险,有助于改善老年衰弱结直肠癌患者术后功能状态,可能提高患者对手术应激的耐受性,从而使其更好地从ERAS中获益。展开更多
目的磁共振化学交换饱和转移(chemical exchange saturation transfer,CEST)技术是一种可以无创测量生物体组织代谢物的分子影像新方法,它利用代谢物上不稳定基团与水分子的化学交换过程,实施微弱代谢信号的探测和成像。高场强对代谢物...目的磁共振化学交换饱和转移(chemical exchange saturation transfer,CEST)技术是一种可以无创测量生物体组织代谢物的分子影像新方法,它利用代谢物上不稳定基团与水分子的化学交换过程,实施微弱代谢信号的探测和成像。高场强对代谢物有着更强的分辨能力,但同时也面临BO、B1不均匀的挑战。本研究在脑肿瘤病人采集了酰胺质子转移成像(amide proton transfer imaging CEST,APT-CEST)和谷氨酸质子转移成像(glutamate CEST,Glu-CEST)图像,探究高场强(5T)磁共振下不同组织CEST技术的可重复性。方法招募14例脑肿瘤患者,对所有患者分别进行两次APT-CEST和Glu-CEST成像,每位患者均勾画2处感兴趣区(region of interest,ROI),分别在肿瘤区域和对侧正常脑组织。评估两次扫描两个ROI磁化转移率的平均值,计算病灶和对侧健康组织ROI两次扫描间均值之差在所有受试者中中的标准差(the standard deviation across all participants of the within-participant difference between two scans,SDdiff)和组内相关系数(interclass correlation coefficient,ICC)。结果(1)在5T磁共振上,两类CEST成像都表现出较好的重复性;(2)相较于正常组织,肿瘤组织在5T磁共振上CEST成像的可重复性更好,表现为更低的SDdiff以及更高的ICC。结论CEST在5T场强下有着较好的可重复性,尤其是在脑肿瘤组织中。这为CEST技术应用于脑肿瘤的影像学研究提供了可靠的基础。展开更多
英国和爱尔兰高血压学会(BIHS)总结了英国国家卫生与医疗优化研究所(NICE)、欧洲心脏病协会(ECS)和欧洲高血压协会(ESH)推出的高血压管理指南,于2023年1月9日在国际高血压杂志Journal of Human Hypertension上发表了《成人高血压转诊路...英国和爱尔兰高血压学会(BIHS)总结了英国国家卫生与医疗优化研究所(NICE)、欧洲心脏病协会(ECS)和欧洲高血压协会(ESH)推出的高血压管理指南,于2023年1月9日在国际高血压杂志Journal of Human Hypertension上发表了《成人高血压转诊路径及治疗管理共识声明》(以下简称共识声明)。基于现有的证据以及专家意见,共识声明重点提出了高血压患者转诊的标准以及转诊等待期间患者的管理,以优化基层医生对高血压患者的管理。本文旨在对共识声明的核心要点进行解读,为我国基层医生管理高血压患者提供建议。鉴于我国基层医疗问题具有复杂性和地域性,仍需要基层医生进行综合评估,践行最有利于患者的临床实践方案。展开更多
文摘Community engagement is increasingly promoted to strengthen the ethics of medical research in low-income countries. One strategy is to use community advisory boards (CABs): semi-independent groups that can potentially safeguard the rights of study participants and help improve research. However, there is little published on the experience of operating and sustaining CABs. The Shoklo Malaria Research Unit (SMRU) has been conducting research and providing healthcare in a population of refugees, migrant workers, and displaced people on the Thai-Myanmar border for over 25 years. In 2009 SMRU facilitated the establishment of the Tak Province Community Ethics Advisory Board (T-CAB) in an effort to formally engage with the local communities both to obtain advice and to establish a participatory framework within which studies and the provision of health care can take place. In this paper, we draw on our experience of community engagement in this unique setting, and on our interactions with the past and present CAB members to critically reflect upon the CAB’s goals, structure and operations with a focus on the practicalities, what worked, what did not, and on its future directions.
文摘Machine learning(ML)is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis,thus creating machines that can complete tasks otherwise requiring human intelligence.Among its various applications,it has proven groundbreaking in healthcare as well,both in clinical practice and research.In this editorial,we succinctly introduce ML applications and present a study,featured in the latest issue of the World Journal of Clinical Cases.The authors of this study conducted an analysis using both multiple linear regression(MLR)and ML methods to investigate the significant factors that may impact the estimated glomerular filtration rate in healthy women with and without non-alcoholic fatty liver disease(NAFLD).Their results implicated age as the most important determining factor in both groups,followed by lactic dehydrogenase,uric acid,forced expiratory volume in one second,and albumin.In addition,for the NAFLD-group,the 5th and 6th most important impact factors were thyroid-stimulating hormone and systolic blood pressure,as compared to plasma calcium and body fat for the NAFLD+group.However,the study's distinctive contribution lies in its adoption of ML methodologies,showcasing their superiority over traditional statistical approaches(herein MLR),thereby highlighting the potential of ML to represent an invaluable advanced adjunct tool in clinical practice and research.
文摘Breast cancer is the leading cause of cancer-related mortality in women globally,with its incidence continuing to rise,particularly in low-and middle-income countries,presenting a significant public health challenge worldwide[1].According to data from the Institute for Health Metrics and Evaluation(IHME)and the World Health Organization(WHO),the gap in access to healthcare services between high-and low-income countries contributes to delayed detection,increased incidence of advanced-stage disease,and,consequently,higher mortality rates(up to 50%higher compared to high-income countries)[1,2].This translates into inequalities in access to screening and early diagnosis methods,which exacerbate the burden of this disease in low-resource settings where infrastructure,funding,and access to trained professionals are limited[3].
文摘Background:Stretching has wide appeal,but there seems to exist some mismatch between its purported applications and what the evidence shows.There is compelling evidence for some stretching applications,but for others,the evidence seems heterogeneous or unsupportive.The discrepancies even affect some systematic reviews,possibly due to heterogeneous eligibility criteria and search strategies.This consensus paper seeks to unify the divergent findings on stretching and its implications for both athletic performance and clinical practices by delivering evidence-based recommendations.Methods:A panel of 20 experts with a blend of practical experience and scholarly knowledge was assembled.The panel meticulously reviewed existing systematic reviews,defined key terminologies(e.g.,consensus definitions for different stretching modes),and crafted guidelines using a Delphi consensus approach(minimum required agreement:80%).The analysis focused on 8 topics,including stretching's acute and chronic(long-term)effects on range of motion,strength performance,muscle hypertrophy,stiffness,injury prevention,muscle recovery,posture correction,and cardiovascular health.Results:There was consensus that chronic and acute stretching(a)improves range of motion(although alternatives exist)and(b)reduces muscle stiffness(which may not always be desirable);the panel also agreed that chronic stretching(c)may promote vascular health,but more research is warranted.In contrast,consensus was found that stretch training does not(a)contribute substantively to muscle growth,(b)serve as an allencompassing injury prevention strategy,(c)improve posture,or(d)acutely enhance post-exercise recovery.Conclusion:These recommendations provide guidance for athletes and practitioners,highlighting research gaps that should be addressed to more comprehensively understand the full scope of stretching effects.
基金supported by the Ministry of Science and Tech-nology of the People's Republic of China(2021ZD0201900),Project 5(2021ZD0201905).
文摘Brain-computer interface(BCI)technology is rapidly advancing in medical research and application.As an emerging biomedical engineering technology,it has garnered significant attention in the clinical research of brain disease diagnosis and treatment,neurological rehabilitation,and mental health.However,BCI also raises several challenges and ethical concerns in clinical research.In this article,the authors investigate and discuss three aspects of BCI in medicine and healthcare:the state of international ethical governance,multidimensional ethical challenges pertaining to BCI in clinical research,and suggestive concerns for ethical review.Despite the great potential of frontier BCI research and development in the field of medical care,the ethical challenges induced by itself and the complexities of clinical research and brain function have put forward new special fields for ethics in BCI.To ensure"responsible innovation"in BCI research in healthcare and medicine,the creation of an ethical global governance framework and system,along with special guidelines for cutting-edge BCI research in medicine,is suggested.
文摘The present study, carried out in the forest (Daloa) and pre-forest (M’Bahiakro) zones of Cote d’Ivoire, aims to determine soil landscape units using the coding method. Geological maps and satellite images (SRTM and Landsat) were used for this purpose. The methodological approach adopted consisted in producing maps of slope, geology, land use and topography using the codification method. These various maps, integrated into a GIS using the coding aggregation method, were used to generate soil landscape maps. Twenty-seven (27) soil landscapes have been identified for the pre-forest zone (M’Bahiakro), with a strong dominance of acid rock over a moderate relief under savannah, forest/degraded forest and crops/fallow. However, the forest zone (Daloa), with forty-one (41) soil landscapes identified over the entire zone, is characterized by a majority of mafic rocks on a medium altitude under forest/degraded forest, water and crops/fallow. The criteria used from the codification method (sum of aggregations) made it possible to predict the spatial distribution of soil map units according to agro-ecological environments in the humid intertropical zone. This is essential for the orientation and reinforcement of soil survey tools. However, a comparative evaluation of the different multicriteria analysis methods for coding and weighting soil landscape unit mapping would enable us to identify the most suitable and efficient method for drawing up base maps for soil surveys.
文摘Introduction: Cardiovascular disease represents a major public health burden worldwide. Research and management of risk factors contribute to the prevention of these diseases. The aim of this study was to assess the prevalence of dyslipidemia in the biochemistry unit of the Charles De Gaulle Pediatric University Hospital (CHUP-CDG) in Ouagadougou. Material and Methods: This was a descriptive and analytical cross-sectional study, with retrospective data collection from January 1, 2020 to December 31, 2022. Patients of all ages who performed a lipid panel in the CHUP-CDG biochemistry unit during the study period have been included. Results: A total of 2872 patients have been included. The mean age of the study population was 27.72 ± 19.51 years and the M/F sex ratio was 0.81. Among the patients, 22.84% had at least one dyslipidemia. The prevalences of hypercholesterolemia, hypo-HDL cholesterolemia and hyper-LDL cholesterolemia were 11.57%, 49.19% and 57.50% respectively. Hypertriglyceridemia and mixed hyperlipidemia were present in 9.04% and 2.08% of patients. Hypercholesterolemia was significantly more frequent in the female sex (p = 0.0077);hyper-LDL cholesterolemia (p = 0.0255) and mixed hyperlipidemia (p Conclusion: The relatively high prevalence of dyslipidemia in the study indicates a worrying situation. It would therefore appear essential to extend the search for risk factors nationwide, particularly those that can be modified, in order to reduce morbidity and mortality linked to cardiovascular disease.
文摘Introduction: Low birth weight (LBW) is defined by the World Health Organization (WHO) as a birth weight strictly below 2500 g, whatever the term of pregnancy. It constitutes a major public health problem, both in developed and developing countries, due to its magnitude and its strong association with infant morbidity and mortality. Main objective was to study the factors associated with the occurrence of small-for-gestational-age newborns in Douala. Methodology: We carried out a cross-sectional analytical study with prospective data collection using a technical pretested sheet in the maternity wards of the Douala General Hospital, the Laquintinie Hospital, and the District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, of low weight, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given her consent. Our sampling was consecutive and non-exhaustive. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using survey sheets. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The percentage of small-for-gestational-age newborns was 9.8%;after multivariate analysis by logistic regression to eliminate confounding factors, we found maternal factors associated with small for gestational age newborns;maternal age less than 20 years, primiparity, gestational age (37 - 38), a delay in prenatal visits greater than 14 weeks, anemia in pregnancy, positive toxoplasmosis serology in pregnancy, a body mass index of Conclusion: Our study revealed the potential determinants of low birth weight at term in the Cameroonian urban context and specifically in Douala.
文摘Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The objective of our study was to determine the factors associated with second trimester spontaneous abortions at Laquintinie Hospital in Douala. Methodology for this purpose: We conducted a case-control study from January to May 2019 on pregnant women who may or may not have had spontaneous second trimester abortions. Results: In total we recorded 1609 pregnancies and recruited 184 patients, including 46 cases and 138 controls;which gave a frequency of spontaneous abortion in the second trimester of pregnancy of 2.85%. A correlative analysis showed that spontaneous abortions in the second trimester were associated with housewife status (OR = 2.89;CI = 1.21 - 6.79;p = 0.010), gestation > 5 (OR = 4.09;CI = 1.02 - 17.66;p = 0.040), multiparity (OR = 3.81;CI = 1.59 - 9.16;p = 0.002), history of endouterine maneuvers (OR = 5.64;CI = 2.43 - 13 .03;p = 0.000), malaria in pregnancy (OR = 3.99;CI = 1.1 - 14.76;p = 0.030), incompleteness on the second trimester ultrasound (OR = 2.37;CI = 1.18 - 4.70;p = 0.010), jolts when traveling (OR = 46.04;CI = 17.29 - 123.66;p = 0.000), long car journeys (OR = 7.05;CI = 1.99 - 27.77;p = 0.000). After logistic regression eliminating the confounding factors, only the following were associated with abortions: Multiparity (OR = 13.90;CI = 2.96 - 65.18;p = 0.000), endo uterine maneuvers (OR = 3.69;CI = 1. 01 - 13.44;p = 0.047), jolts when traveling (OR = 72.63;CI = 19.47 - 270.96;p = 0.000), long car journeys (OR = 15.41;CI = 2.7 - 85, 95;p = 0.000). Conclusion: Our study reveals that a set of factors contribute to the occurrence of spontaneous abortions in the second trimester of pregnancy in our context.
文摘Efficient storage and handling facilities play a pivotal role in ensuring the quality and longevity of date palm produce. This study aims to contribute to the assessment of the operation of refrigeration units in the Drâa Tafilalet region through a diagnostic study conducted by surveying 12 date-packing units. Interviews and surveys were conducted among 12 date packaging units provided by the State to Economic Interest Groups (EIG) in the Drâa-Tafilalet region. Data focused on general EIG information, unit identification, a four-year operational overview, and 2021 palm date processing activities. To streamline analysis, units were categorized into two groups based on packaging capacity: Group 1 (≥400 tons) and Group 2 (<400 tons). The assessment revealed that the packaging units had enhanced this crucial link in the dating industry and introduced a new dynamic in the date marketing chain. However, operational expertise and optimal equipment utilization often fall short, with over 50% of the EIG failing to use provided equipment, except for cold storage rooms. The chain involves a series of operations to preserve the stored product’s intrinsic and extrinsic quality. Evaluated practices include fumigation, meticulous sorting to eliminate visually anomalous dates, calibration during packaging, and storage at temperatures ranging from 0 to 4˚C with humidity levels between 50 and 80%, varying based on the date’s nature (soft, dry, or semi-dry). Expertise in this process mitigates the risk of desiccation or excessive rehydration, preventing date fermentation. Finally, to reduce their energy consumption and solve the balance sheet deficit issue, the government has equipped all the date packaging units from Group 1 and one from Group 2 in the Daraa Tafilalet region with photovoltaic energy. The date packaging infrastructure has boosted the value of Moroccan dates, benefiting small-scale agriculture. Despite improved packaging quality and job creation, suboptimal equipment usage by over 50% of EIGs emphasizes the need for enhanced operational efficiency.
文摘BACKGROUND The rising prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)in neonatal intensive care units(NICUs)represents an escalating challenge in healthcare settings,particularly in managing hospital-acquired infections(HAIs).Studies across various World Health Organization regions have documented a significant incidence of CRAB-related HAIs,with rates as high as 41.7 cases per 1000 patients in ICUs,accounting for 13.6%of all HAIs.These infections pose a doubled mortality risk compared to infections with carbapenem-susceptible Acinetobacter baumannii.A particularly concerning aspect of CRAB colonization is its asymptomatic nature,enabling its transmission through healthcare workers(HCWs)or the NICU environment to vulnerable neonates with developing immune systems.AIM To explore the prevalence of CRAB colonization in NICUs,focusing on neonates,healthcare workers,and the environmental samples,to enhance epidemiological understanding and inform targeted interventions.METHODS We conducted according to PRISMA 2020 checklist guidelines,a comprehensive literature search across multiple databases including MEDLINE(Ovid),EMBASE(Ovid),Global Health(Ovid),Web of Science,and Global Index Me-dicus.Studies were selected based on predetermined criteria,primarily involving neonates,HCWs,and environmental swabs,using culture or molecular methods to detect CRAB colonization.We excluded studies that did not specifically focus on NICUs,were duplicates,or lacked necessary data.The study selection and quality assessment were conducted independently by two reviewers.Data extraction involved collecting comprehensive details about each study.Our statistical analysis used a random-effects model to calculate the pooled prevalence and confidence intervals,stratifying results by regional location.We assessed study heterogeneity using Cochran's Q statistic and I²statistic,with regression tests employed to evaluate potential publication bias.RESULTS We analyzed 737 records from five databases,ultimately including 13 studies from ten countries.For neonates,the pooled prevalence was 4.8%(95%CI:1.1%to 10.5%)with the highest rates observed in South-East Asia(10.5%;95%CI:2.4%to 23.3%).Among HCWs,a single Indian study reported a 3.3%prevalence.Environmental samples showed a prevalence of 2.3%(95%CI:0%to 9.3%),with the highest rates in South-East Asia(10%;95%CI:4.2%to 17.7%).Significant heterogeneity was found across studies,and no publication bias was detected.CONCLUSION This systematic review highlights a significant prevalence of CRAB colonization in neonates across various regions,particularly in South-East Asia,contrasting with lower rates in high-income countries.The study reveals a gap in research on HCWs colonization,with only a single study from India reporting moderate prevalence.Environmental samples indicate moderate levels of CRAB contamination,again higher in South-East Asia.These findings underscore the need for more extensive and focused research on CRAB colonization in NICUs,including exploring the roles of HCWs and the environment in transmission,understanding antimicrobial resistance patterns,and developing effective prevention measures.
文摘目的磁共振化学交换饱和转移(chemical exchange saturation transfer,CEST)技术是一种可以无创测量生物体组织代谢物的分子影像新方法,它利用代谢物上不稳定基团与水分子的化学交换过程,实施微弱代谢信号的探测和成像。高场强对代谢物有着更强的分辨能力,但同时也面临BO、B1不均匀的挑战。本研究在脑肿瘤病人采集了酰胺质子转移成像(amide proton transfer imaging CEST,APT-CEST)和谷氨酸质子转移成像(glutamate CEST,Glu-CEST)图像,探究高场强(5T)磁共振下不同组织CEST技术的可重复性。方法招募14例脑肿瘤患者,对所有患者分别进行两次APT-CEST和Glu-CEST成像,每位患者均勾画2处感兴趣区(region of interest,ROI),分别在肿瘤区域和对侧正常脑组织。评估两次扫描两个ROI磁化转移率的平均值,计算病灶和对侧健康组织ROI两次扫描间均值之差在所有受试者中中的标准差(the standard deviation across all participants of the within-participant difference between two scans,SDdiff)和组内相关系数(interclass correlation coefficient,ICC)。结果(1)在5T磁共振上,两类CEST成像都表现出较好的重复性;(2)相较于正常组织,肿瘤组织在5T磁共振上CEST成像的可重复性更好,表现为更低的SDdiff以及更高的ICC。结论CEST在5T场强下有着较好的可重复性,尤其是在脑肿瘤组织中。这为CEST技术应用于脑肿瘤的影像学研究提供了可靠的基础。
文摘英国和爱尔兰高血压学会(BIHS)总结了英国国家卫生与医疗优化研究所(NICE)、欧洲心脏病协会(ECS)和欧洲高血压协会(ESH)推出的高血压管理指南,于2023年1月9日在国际高血压杂志Journal of Human Hypertension上发表了《成人高血压转诊路径及治疗管理共识声明》(以下简称共识声明)。基于现有的证据以及专家意见,共识声明重点提出了高血压患者转诊的标准以及转诊等待期间患者的管理,以优化基层医生对高血压患者的管理。本文旨在对共识声明的核心要点进行解读,为我国基层医生管理高血压患者提供建议。鉴于我国基层医疗问题具有复杂性和地域性,仍需要基层医生进行综合评估,践行最有利于患者的临床实践方案。
