BACKGROUND Type 1 diabetes(T1D)contributes to altered lipid profiles and increases the risk of cardiovascular disease(CVD).Youth with T1D may have additional CVD risk factors within the first decade of diagnosis.AIM T...BACKGROUND Type 1 diabetes(T1D)contributes to altered lipid profiles and increases the risk of cardiovascular disease(CVD).Youth with T1D may have additional CVD risk factors within the first decade of diagnosis.AIM To examine risk factors for dyslipidemia in young subjects with T1D.METHODS Longitudinal and cross-sectional retrospective study of 170 young subjects with T1D(86 males;baseline mean age 12.2±5.6 years and hemoglobin A1c 8.4%±1.4%)were followed in a single tertiary diabetes center for a median duration of 15 years.Predictors for outcomes of lipid profiles at last visit(total cholesterol[TC],triglycerides[TGs],low-density lipoprotein-cholesterol[LDL-c],and highdensity lipoprotein-cholesterol[HDL-c])were analyzed by stepwise linear regression models.RESULTS At baseline,79.5%of the patients had at least one additional CVD risk factor(borderline dyslipidemia/dyslipidemia[37.5%],pre-hypertension/hypertension[27.6%],and overweight/obesity[16.5%])and 41.6%had multiple(≥2)CVD risk factors.A positive family history of at least one CVD risk factor in a first-degree relative was reported in 54.1%of the cohort.Predictors of elevated TC:family history of CVD(β[SE]=23.1[8.3],P=0.006);of elevated LDL-c:baseline diastolic blood pressure(DBP)(β[SE]=11.4[4.7],P=0.003)and family history of CVD(β[SE]=20.7[6.8],P=0.017);of elevated TGs:baseline DBP(β[SE]=23.8[9.1],P=0.010)and family history of CVD(β[SE]=31.0[13.1],P=0.020);and of low HDL-c levels:baseline DBP(β[SE]=4.8[2.1],P=0.022]).CONCLUSION Our findings suggest that elevated lipid profiles are associated with DBP and a positive family history of CVD.It is of utmost importance to prevent and control modifiable risk factors such as these,as early as childhood,given that inadequate glycemic control and elevation in blood pressure intensify the risk of dyslipidemia.展开更多
<strong>Introduction:</strong> Many overseas volunteers have worked in low and middle-income countries. However traveling abroad and staying in an unfamiliar environment with inadequate medical infrastruct...<strong>Introduction:</strong> Many overseas volunteers have worked in low and middle-income countries. However traveling abroad and staying in an unfamiliar environment with inadequate medical infrastructure exposes volunteers to a wide range of health risks. The aim of this study was to clarify the relationships among disease knowledge and symptoms, disease risk perception, and self-management skills. <strong>Methods:</strong> This was a questionnaire survey of 189 Japanese who were preparing to volunteer abroad. A factor analysis was conducted on 13 items (six general risk events and seven major diseases) of risk perception. Correlation analysis was performed between the identified risk perception factors and disease knowledge and symptoms. Risk perception scores by factors from the seven disease items were compared between the Self-management Score (SMS) group and disease knowledge and risk of symptoms group, using T-tests. St. Luke’s International University Ethics Committee (19-A092) approved this study. <strong>Results:</strong> Many participants expected to suffer from digestive diseases (69.3%) and dermatitis (55%) in the field. On the other hand, few expected high risk of malaria (26.5%) or dengue fever (36%). Factor analysis yielded robust factor loadings creating a “Dread” and an “Unknown” factor accounting for 62.2% of total variance. Strong correlation was not found between SMS and disease risk perception. A weak negative correlation was observed in dengue fever, digestive disorders, and dermatitis (r = <span style="white-space:nowrap;">−</span>0.20 to <span style="white-space:nowrap;">−</span>0.25, p < 0.001) on the “Unknown” factor. A high SMS score was associated with a lower “Unknown” factor score for malaria, diarrhea, dermatitis, and dental disorders. In addition, higher disease knowledge was significantly associated with higher “Dread” factor score for dental disorders. <strong>Conclusions: </strong>Self-management skills and disease knowledge will enable higher risk awareness of common diseases and high lethality diseases.展开更多
<div style="text-align:justify;"> <strong>Introduction: </strong>Liver transplantation (LT) in children has undergone significant changes over the last years. Especially the use of split an...<div style="text-align:justify;"> <strong>Introduction: </strong>Liver transplantation (LT) in children has undergone significant changes over the last years. Especially the use of split and living donor transplants even for infants has led to new challenges in pre- and post-operative care. Systemic inflammatory response syndromes (SIRS, sepsis) as well-known complications after LT have not yet been systematically examined in the pediatric population. <strong>Methods:</strong> We analyzed clinical data of 39 pediatric liver transplant recipients regarding potential risk factors for post-transplant SIRS and sepsis. Secondly, the prognostic impact of SIRS and sepsis on post-transplant clinical course, patient and transplant-survival has been analyzed. <strong>Results:</strong> 64% of patients developed either SIRS (n = 16, 41%) or sepsis (n = 9, 23%) within 30 days after transplantation. No pre-transplant risk factors for increased susceptibility for SIRS or sepsis could be identified. Secondary closure of the abdomen (p = 0.045) and secondary biliary reconstruction (p = 0.043) were associated with a higher incidence of sepsis and were associated with significantly prolonged mechanical ventilation times in the presence of sepsis (p = 0.001). Patients with sepsis, but not SIRS, stayed significantly longer on PICU (p = 0.021) and suffered from higher mortality (n = 3 versus 0;p = 0.0006). All deaths within 30 days of transplantation were due to septic multiorgan failure. Neither early SIRS nor sepsis were associated with loss of transplant function. <strong>Conclusions:</strong> SIRS and sepsis are frequent events after pediatric liver transplantation. Sepsis increased length of PICU-stay and mortality significantly and prolonged duration of mechanical ventilation. Secondary biliary reconstruction and closure of the abdomen could be identified as potential risk factors for sepsis. </div>展开更多
<strong>Introduction.</strong> Penetrating craniocerebral wounds (PCCWs) are a particular lesion in the category of traumatic brain injury (TBI). The objective of this study was to describe the management ...<strong>Introduction.</strong> Penetrating craniocerebral wounds (PCCWs) are a particular lesion in the category of traumatic brain injury (TBI). The objective of this study was to describe the management of these lesions, and to identify signifiant risk factors associated with mortality in patients with a PCCW. <strong>Methods.</strong> It was a transversal, descriptive and analytical study performed in Departmental Teaching Hospital of Borgou and Alibori in Benin. From January 1, 2015 to June 30, 2020, patients with a PCCW were retained. Risk factors of mortality and morbidity associated to etiological, clinical and surgical parameters were assessed using the chi-square test. p value < 0.05 was considered to be statistically significant. <strong>Results.</strong> During the study period, 1267 cases of traumatic brain injuries (TBI) were admitted. Of these patients, 77 (6.1%) cases of PCCW were retained. These patients were divided into 66 (85.7%) male and 11 (14.3%) female. The mean age of the patients was 22.6 ± 14.8 years (range from 2 years to 70 years). The circumstances of occurrence were a traffic accident in 42 (54.5%) cases, an assault in 33 cases (42.9%) and a fall 2 (2.6%). The PCCW was unilateral in 71 cases (92.2%). A brain CT-scan was performed in 60 (77.9%) patients. Surgery was performed in 69 (89.6%) patients. Post-operative outcomes were simple in 59 (85.5%) cases. GCS, pupillary abnormalities, motor deficit were a statistically significant risk factor associated with death or sequels (p < 0.0001).<strong> Conclusion.</strong> The identification of risk factors of mortality or sequels is a major step for an efficient management of PCCWs and a reduction of morbidity and mortality. Whatever strategies are adopted, prevention must remain a priority.展开更多
<strong><em>Introduction</em></strong><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">Cardiovascular dise...<strong><em>Introduction</em></strong><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">Cardiovascular disease is a global public health problem. In Africa, they are increasingly common, however, data on the control of cardiovascular risk factors in the general Senegalese population are rare. The aim of this work was to assess the level of control of cardiovascular risk factors in semi-urban areas in the municipality of Guéoul in Senegal.</span><span style="font-family:Verdana;"> </span><b><i><span style="font-family:Verdana;">Patients and methods</span></i></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">This is a cross-sectional, descriptive and exhaustive survey carried out from 3 November to 3 December 2012 among the population aged at least 35 years and living for more than 6 months in the commune of Gueoul. It was conducted using the WHO STEPS approach to study the prevalence of cardiovascular risk factors and assess their level of control. We looked at clinical history, lifestyle, and anthropometric data. Blood pressure was measured at both arms and fasting blood samples were taken for blood glucose, cholesterol and triglycerides.</span><span style="font-family:Verdana;"> </span><b><i><span style="font-family:Verdana;">Results</span></i></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">We examined 1.411 subjects (1052 women) averaging 48.5 ± 12.7 years of age. The main cardiovascular risk factors were dyslipidemia (61%), sedentary (56%), abdominal obesity (53.9%), high blood pressure (46.4%) and diabetes (7.2%). Dyslipidemia was known in 22 subjects, 6 of whom were on treatment with dyslipidemia control in 1 subject (16.7%). Hypertension was known in 266 subjects. Of these, 205 subjects were prescribed medical treatment, 26 of whom were well controlled (12.7%). The level of hypertension control was lower in subjects at high cardiovascular risk (p = 0.0001) and those with a family history of hypertension (p = 0.001). The male gender (p = 0.24), the short duration of progression of hypertension (p = 0.95) and the noncompliance of the diet (p = 0.176) were not significantly associated with poor control of hypertension. In diabetics, subjects on oral antidiabetic drugs had met fasting glucose targets in 65.5% of cases according to the recommendations of the American Diabetes Association and in 58.6% according to those of the International Diabetes Federation (p = 0.0001). Age, regular physical activity and insulin treatment were not significantly related to fasting blood sugar control.</span><span style="font-family:Verdana;"> </span><b><i><span style="font-family:Verdana;">Conclusion</span></i></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">Our study found inadequate control and high prevalence of cardiovascular risk factors in the general Senegalese population. This situation could be a cause of aggravation of cardiovascular diseases in Senegal and should promote to improve their management.</span>展开更多
Despite not included in the traditional risk scores before surgery, liver cirrhosis, especially in advanced stages, has always influenced strongly final outcome both on short and midterm in patients undergoing cardiac...Despite not included in the traditional risk scores before surgery, liver cirrhosis, especially in advanced stages, has always influenced strongly final outcome both on short and midterm in patients undergoing cardiac surgery. Growing incidence of non-alcoholic fatty liver disease interlinked with metabolic syndrome and significant advancements in medical therapy have actually increased the likelihood of cardiac surgery in cirrhotic patients. To date, Child-Pugh and MELD scores have been commonly used to predict mortality and postoperative hepatic decompensation, but on the other hand, both traditional risk scores show some limitations for evaluation of hepatopathic patients undergoing specifically cardiac surgery. In this context, a specific Heart-Liver score hasn’t been developed yet in the attempt to outline a patient profile able to face surgery, therefore addressing us to adopt the best strategy possible for each case. If CP class A or low MELD score (<11) patients tolerate cardiac surgery with a mild increase in mortality and morbidity, currently state of art recommends particular caution towards surgery idea in presence of advanced hepatic disease. As far as cardiac surgery represents the unique therapeutic strategy in several life-threatening cases, anyway surgical correction of cardiac pathology won’t guarantee an increased life expectancy in accordance with the persistent liver dysfunction. Hereby, this paper will focus on preoperative parameters that should be considered in the future realization of a Heart-Liver prognostic score for overcoming limitations and difficulties related to the impact of liver disease on final clinical outcome.展开更多
Healthcare-associated infections (HCAIs) remain a major public health concern. The aim of this study was to characterize potential pathogenic bacteria isolated in high-risk infectious services at the University Hospit...Healthcare-associated infections (HCAIs) remain a major public health concern. The aim of this study was to characterize potential pathogenic bacteria isolated in high-risk infectious services at the University Hospital Center of Suru-Léré in Benin. A cross-sectional, descriptive study was carried out on 215 samples with 8 air samples, 20 hand samples and 187 samples of medical-technical material. Genes for resistance to <i>β</i>-lactam antibiotics (blaTEM, blaSHV, blaCTX-M and blaOXA-1) were sought. The data were processed and analyzed using EPI Info version 3.5.4 software. A total of 10 bacterial species were identified. Of the 319 bacterial strains identified, <i>Staphylococcus saprophyticus</i>, <i>Staphylococcus aureus</i> and <i>Enterococcus faecalis</i> were predominant at 20.06%, 17.87% and 11.28% respectively. Antibiotic susceptibility showed that the majority of bacterial strains were multidrug-resistant. Of the 4 resistance genes sought, only the blaTEM and blaSHV genes were found. The poor microbiological quality observed in high-risk infectious services could be a risk factor for healthcare-associated infections. It is therefore useful to implement preventive measures in order to prevent or reduce the risk of healthcare-associated infections.展开更多
Personal credit risk assessment is an important part of the development of financial enterprises. Big data credit investigation is an inevitable trend of personal credit risk assessment, but some data are missing and ...Personal credit risk assessment is an important part of the development of financial enterprises. Big data credit investigation is an inevitable trend of personal credit risk assessment, but some data are missing and the amount of data is small, so it is difficult to train. At the same time, for different financial platforms, we need to use different models to train according to the characteristics of the current samples, which is time-consuming. <span style="font-family:Verdana;">In view of</span><span style="font-family:Verdana;"> these two problems, this paper uses the idea of transfer learning to build a transferable personal credit risk model based on Instance-based Transfer Learning (Instance-based TL). The model balances the weight of the samples in the source domain, and migrates the existing large dataset samples to the target domain of small samples, and finds out the commonness between them. At the same time, we have done a lot of experiments on the selection of base learners, including traditional machine learning algorithms and ensemble learning algorithms, such as decision tree, logistic regression, </span><span style="font-family:Verdana;">xgboost</span> <span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> so on. The datasets are from P2P platform and bank, the results show that the AUC value of Instance-based TL is 24% higher than that of the traditional machine learning model, which fully proves that the model in this paper has good application value. The model’s evaluation uses AUC, prediction, recall, F1. These criteria prove that this model has good application value from many aspects. At present, we are trying to apply this model to more fields to improve the robustness and applicability of the model;on the other hand, we are trying to do more in-depth research on domain adaptation to enrich the model.</span>展开更多
The purpose of this research is to investigate the decision-making process for cybersecurity investments in organizations through development and utilization of a digital cybersecurity risk management framework. The i...The purpose of this research is to investigate the decision-making process for cybersecurity investments in organizations through development and utilization of a digital cybersecurity risk management framework. The initial article, Optimum Spending on Cybersecurity Measures is published on Emerald Insight at: </span><a href="https://www.emerald.com/insight/1750-6166.htm"><span style="font-size:12px;font-family:Verdana;">https://www.emerald.com/insight/1750-6166.htm</span></a><span style="font-size:12px;font-family:Verdana;">, contains the detailed literature review, and the data results from Phase I and Phase II of this research </span><span times="" new="" roman","serif";"="" style="font-size: 10pt;"> <span style="font-family:Verdana;font-size:12px;">REF _Ref61862658 \r \h</span> <span style="font-family:Verdana;font-size:12px;">\* MERGEFORMAT </span></span><span style="font-size:12px;font-family:Verdana;">[1]</span><span style="font-size:10pt;font-family:""></span><span times="" new="" roman","serif";"="" style="font-size: 10pt;"></span><span style="font-size:12px;font-family:Verdana;">. This article will highlight the research completed in the area of organizational decision-making on cybersecurity spend. In leveraging the review of additional studies, this research utilizes a regression framework and case study methodology to demonstrate that effective risk-based decisions are necessary when implementing cybersecurity controls. Through regression analysis, the effectiveness of current implemented cybersecurity measures in organizations </span><span style="font-size:12px;font-family:Verdana;">is</span><span style="font-size:12px;font-family:Verdana;"> explored when connecting a dependent variable with several independent variables. The focus of this article is on the strategic decisions made by organizations when implementing cybersecurity measures. This research belongs to the area of risk management, and various models within the field of 1) information security</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> 2) strategic management</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> and 3) organizational decision-making to determine optimum spending on cybersecurity measures for risk taking organizations. This research resulted in the develop</span><span style="font-size:12px;font-family:Verdana;">ment</span><span style="font-size:10pt;font-family:""><span style="font-family:Verdana;font-size:12px;"> of a cyber risk investment model and a digital cybersecurity risk man</span><span style="font-family:Verdana;font-size:12px;">agement framework. Using a case study methodology, this model an</span><span style="font-family:Verdana;font-size:12px;">d framework w</span></span><span style="font-size:12px;font-family:Verdana;">ere</span><span style="font-size:12px;font-family:Verdana;"> leveraged to evaluate and implement cybersecurity measures. The case study methodology provides an in-depth view of a risk-taking organization’s risk mitigation strategy within the bounds of the educational environment focusing on five areas identified within a digital cyber risk model: 1) technology landscape and application portfolio</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> 2) data centric focus</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> 3) risk management practices</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> 4) cost-benefit analysis for cybersecurity measures</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> and 5) strategic development. The outcome of this research provides greater insight into how an organization makes decisions when implementing cybersecurity controls. This research shows that most organizations are diligently implementing security measures to effectively monitor and detect cyber security attacks</span><span style="font-size:12px;font-family:Verdana;">,</span><span style="font-size:12px;font-family:Verdana;"> specifically showing that risk taking organizations implemented cybersecurity measures to meet compliance and audit obligations with an annual spend of $3.18 million. It also indicated that 23.6% of risk-taking organizations incurred more than 6 cybersecurity breaches with an average dollar loss of $3.5 million. In addition, the impact of a cybersecurity breach on risk taking organizations is as follows: 1) data loss</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> 2) brand/reputational impact</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> 3) financial loss fines</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> 4) increase oversight by regulators/internal audit</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> and 5) customer/client impact. The implication this research has on practice is extensive, as it focuses on a broad range of areas to include risk, funding and type and impact of cyber security breaches encountered. The survey study clearly demonstrated the need to develop and utilize a digital cybersecurity risk management framework to integrate current industry frameworks within the risk management practice to include continuous compliance management. This type of framework would provide a balanced approach to managing the gap between a risk-taking organization and a risk averse organization when implementing cybersecurity measures.展开更多
Check dams are commonly constructed around the world for alleviating soil erosion and preventing sedimentation of downstream rivers and reservoirs.Check dams are more vulnerable to failure due to their less stringent ...Check dams are commonly constructed around the world for alleviating soil erosion and preventing sedimentation of downstream rivers and reservoirs.Check dams are more vulnerable to failure due to their less stringent flood control standards compared to other dams.Determining the critical precipitation that will result in overtopping of a dam is a useful approach to assessing the risk of failure on a probabilistic basis and for providing early warning in case of an emergency.However,many check dams are built in groups,spreading in several tributaries in cascade forms,comprising a complex network.Determining the critical precipitation for dam overtopping requires a knowledge of its upstream dams on whether they survived or were overtopped during the same storm,while these upstream dams in turn need the information for their upstream dams.The current paper presents an approach of decomposing the dam cluster into(1)the heading dam,(2)border dams,and(3)intermediate dams.The algorithm begins with the border dams that have no upstream dams and proceeds with upgraded maps without the previous border dams until all the dams have been checked.It is believed that this approach is applicable for small-scale check dam systems where the time lag of flood routing can be neglected.As a pilot study,the current paper presents the analytical results for the Wangmaogou Check Dam System that has 22 dams connected in series and parallel.The algorithm clearly identified 7 surviving dams,with the remaining ones being overtopped for a storm of 179.6 mm in 12 h,which is associated with a return period of one in 200 years.展开更多
BACKGROUND Melatonin is reported to be related to diabetes mellitus(DM)risk;however,the effect of melatonin on diabetic retinopathy(DR)risk remains unclear.AIM The aim of this study was to determine the effect of mela...BACKGROUND Melatonin is reported to be related to diabetes mellitus(DM)risk;however,the effect of melatonin on diabetic retinopathy(DR)risk remains unclear.AIM The aim of this study was to determine the effect of melatonin on DR risk.METHODS A hospital-based case-control study was conducted from January 2020 to June 2020.DR was assessed using the Diabetic Retinopathy preferred practice pattern(PPP)-updated 2019 criteria.The participants were divided into the DM cases without DR(NDR)group,non-proliferative DR(NPDR)group and proliferative DR(PDR)group.Plasma melatonin concentration was detected with the enzymelinked immunosorbent assay kit.The relationship between plasma melatonin concentration and DR risk as well as severity was assessed.RESULTS It was found that plasma melatonin was 72.83±16.25,60.38±13.43,44.48±10.30 and 44.69±8.95 pg/mL in healthy controls,NDR group,NPDR and PDR group,respectively.In addition,it was found that plasma melatonin could be used as a potential diagnostic biomarker for DR(AUC=0.893,P<0.001).There was a significant positive relationship between total bilirubin and melatonin content(P<0.001)based on the correlation assay.Significant associations between total bilirubin and melatonin content were also detected in the NPDR(R2=0.360,P<0.001)and PDR(R2=0.183,P<0.001)groups.CONCLUSION The data obtained in this study demonstrated that plasma melatonin concentration was decreased in DR cases and could be used as a sensitive and specific marker for the diagnosis of DR.A significant positive relationship between total bilirubin and melatonin was detected.More related studies are required to understand the role of melatonin in DR.展开更多
BACKGROUND There have been few reports on the risk factors for acute respiratory distress syndrome(ARDS)in coronavirus disease 2019(COVID-19),and there were obvious differences regarding the incidence of ADRS between ...BACKGROUND There have been few reports on the risk factors for acute respiratory distress syndrome(ARDS)in coronavirus disease 2019(COVID-19),and there were obvious differences regarding the incidence of ADRS between Wuhan and outside Wuhan in China.AIM To investigate the risk factors associated with ARDS in COVID-19,and compare the characteristics of ARDS between Wuhan and outside Wuhan in China.METHODS Patients were enrolled from two medical centers in Hunan Province.A total of 197 patients with confirmed COVID-19,who had either been discharged or had died by March 15,2020,were included in this study.We retrospectively collected the patients’clinical data,and the factors associated with ARDS were compared by theχ²test,Fisher’s exact test,and Mann-Whitney U test.Significant variables were chosen for the univariate and multivariate logistic regression analyses.In addition,literature in the PubMed database was reviewed,and the characteristics of ARDS,mortality,and biomarkers of COVID-19 severity were compared between Wuhan and outside Wuhan in China.RESULTS Compared with the non-ARDS group,patients in the ARDS group were significantly older,had more coexisting diseases,dyspnea,higher D-dimer,lactate dehydrogenase(LDH),and C-reactive protein.In univariate logistic analysis,risk factors associated with the development of ARDS included older age[odds ratio(OR)=1.04),coexisting diseases(OR=3.94),dyspnea(OR=17.82),dry/moist rales(OR=9.06),consolidative/mixed opacities(OR=2.93),lymphocytes(OR=0.68 for high lymphocytes compared to low lymphocytes),D-dimer(OR=1.41),albumin(OR=0.69 for high albumin compared to low albumin),alanine aminotransferase(OR=1.03),aspartate aminotransferase(OR=1.02),LDH(OR=1.02),C-reactive protein(OR=1.04)and procalcitonin(OR=17.01).In logistic multivariate analysis,dyspnea(adjusted OR=27.10),dry/moist rales(adjusted OR=9.46),and higher LDH(adjusted OR=1.02)were independent risk factors.The literature review showed that patients in Wuhan had a higher incidence of ARDS,higher mortality rate,a展开更多
The arcuate fasciculus is a critical component of the neural substrate of human language function.Surgical resection of glioma adjacent to the arcuate fasciculus likely damages this region.In this study,we evaluated t...The arcuate fasciculus is a critical component of the neural substrate of human language function.Surgical resection of glioma adjacent to the arcuate fasciculus likely damages this region.In this study,we evaluated the outcome of surgical resection of glioma adjacent to the arcuate fasciculus under the guidance of magnetic resonance imaging and diffusion tensor imaging,and we aimed to identify the risk factors for postoperative linguistic deficit.In total,54 patients with primary glioma adjacent to the arcuate fasciculus were included in this observational study.These patients comprised 38 men and 16 women(aged 43±11 years).All patients underwent surgical resenction of glioma under the guidance of magnetic resonance imaging and diffusion tensor imaging.Intraoperative images were updated when necessary for further resection.The gross total resection rate of the 54 patients increased from 38.9%to 70.4%by intraoperative magnetic resonance imaging.Preoperative language function and glioma-to-arcuate fasciculus distance were associated with poor language outcome.Multivariable logistic regression analyses showed that glioma-to-arcuate fasciculus distance was the major independent risk factor for poor outcome.The cutoff point of glioma-to-arcuate fasciculus distance for poor outcome was 3.2 mm.These findings suggest that intraoperative magnetic resonance imaging combined with diffusion tensor imaging of the arcuate fasciculus can help optimize tumor resection and result in the least damage to the arcuate fasciculus.Notably,glioma-to-arcuate fasciculus distance is a key independent risk factor for poor postoperative language outcome.This study was approved by the Ethics Committee of the Chinese PLA General Hospital,China(approval No.S2014-096-01)on October 11,2014.展开更多
The prolonged mei-yu/baiu system with anomalous precipitation in the year 2020 has swollen many rivers and lakes,caused flash flooding,urban flooding and landslides,and consistently wreaked havoc across large swathes ...The prolonged mei-yu/baiu system with anomalous precipitation in the year 2020 has swollen many rivers and lakes,caused flash flooding,urban flooding and landslides,and consistently wreaked havoc across large swathes of China,particularly in the Yangtze River basin.Significant precipitation and flooding anomalies have already been seen in magnitude and extension so far this year,which have been exerting much higher pressure on emergency responses in flood control and mitigation than in other years,even though a rainy season with multiple ongoing serious flood events in different provinces is not that uncommon in China.Instead of delving into the causes of the uniqueness of this year’s extreme precipitation-flooding situation,which certainly warrants in-depth exploration,in this article we provide a short view toward a more general hydrometeorological solution to this annual nationwide problem.A“glocal”(global to local)hydrometeorological solution for floods(GHS-F)is considered to be critical for better preparedness,mitigation,and management of different types of significant precipitation-caused flooding,which happen extensively almost every year in many countries such as China,India and the United States.Such a GHS-F model is necessary from both scientific and operational perspectives,with the strength in providing spatially consistent flood definitions and spatially distributed flood risk classification considering the heterogeneity in vulnerability and resilience across the entire domain.Priorities in the development of such a GHS-F are suggested,emphasizing the user’s requirements and needs according to practical experiences with various flood response agencies.展开更多
基金The study was reviewed and approved by the Institutional Review Board at Rabin Medical Center,approval No.0075-17-RMC.
文摘BACKGROUND Type 1 diabetes(T1D)contributes to altered lipid profiles and increases the risk of cardiovascular disease(CVD).Youth with T1D may have additional CVD risk factors within the first decade of diagnosis.AIM To examine risk factors for dyslipidemia in young subjects with T1D.METHODS Longitudinal and cross-sectional retrospective study of 170 young subjects with T1D(86 males;baseline mean age 12.2±5.6 years and hemoglobin A1c 8.4%±1.4%)were followed in a single tertiary diabetes center for a median duration of 15 years.Predictors for outcomes of lipid profiles at last visit(total cholesterol[TC],triglycerides[TGs],low-density lipoprotein-cholesterol[LDL-c],and highdensity lipoprotein-cholesterol[HDL-c])were analyzed by stepwise linear regression models.RESULTS At baseline,79.5%of the patients had at least one additional CVD risk factor(borderline dyslipidemia/dyslipidemia[37.5%],pre-hypertension/hypertension[27.6%],and overweight/obesity[16.5%])and 41.6%had multiple(≥2)CVD risk factors.A positive family history of at least one CVD risk factor in a first-degree relative was reported in 54.1%of the cohort.Predictors of elevated TC:family history of CVD(β[SE]=23.1[8.3],P=0.006);of elevated LDL-c:baseline diastolic blood pressure(DBP)(β[SE]=11.4[4.7],P=0.003)and family history of CVD(β[SE]=20.7[6.8],P=0.017);of elevated TGs:baseline DBP(β[SE]=23.8[9.1],P=0.010)and family history of CVD(β[SE]=31.0[13.1],P=0.020);and of low HDL-c levels:baseline DBP(β[SE]=4.8[2.1],P=0.022]).CONCLUSION Our findings suggest that elevated lipid profiles are associated with DBP and a positive family history of CVD.It is of utmost importance to prevent and control modifiable risk factors such as these,as early as childhood,given that inadequate glycemic control and elevation in blood pressure intensify the risk of dyslipidemia.
文摘<strong>Introduction:</strong> Many overseas volunteers have worked in low and middle-income countries. However traveling abroad and staying in an unfamiliar environment with inadequate medical infrastructure exposes volunteers to a wide range of health risks. The aim of this study was to clarify the relationships among disease knowledge and symptoms, disease risk perception, and self-management skills. <strong>Methods:</strong> This was a questionnaire survey of 189 Japanese who were preparing to volunteer abroad. A factor analysis was conducted on 13 items (six general risk events and seven major diseases) of risk perception. Correlation analysis was performed between the identified risk perception factors and disease knowledge and symptoms. Risk perception scores by factors from the seven disease items were compared between the Self-management Score (SMS) group and disease knowledge and risk of symptoms group, using T-tests. St. Luke’s International University Ethics Committee (19-A092) approved this study. <strong>Results:</strong> Many participants expected to suffer from digestive diseases (69.3%) and dermatitis (55%) in the field. On the other hand, few expected high risk of malaria (26.5%) or dengue fever (36%). Factor analysis yielded robust factor loadings creating a “Dread” and an “Unknown” factor accounting for 62.2% of total variance. Strong correlation was not found between SMS and disease risk perception. A weak negative correlation was observed in dengue fever, digestive disorders, and dermatitis (r = <span style="white-space:nowrap;">−</span>0.20 to <span style="white-space:nowrap;">−</span>0.25, p < 0.001) on the “Unknown” factor. A high SMS score was associated with a lower “Unknown” factor score for malaria, diarrhea, dermatitis, and dental disorders. In addition, higher disease knowledge was significantly associated with higher “Dread” factor score for dental disorders. <strong>Conclusions: </strong>Self-management skills and disease knowledge will enable higher risk awareness of common diseases and high lethality diseases.
文摘<div style="text-align:justify;"> <strong>Introduction: </strong>Liver transplantation (LT) in children has undergone significant changes over the last years. Especially the use of split and living donor transplants even for infants has led to new challenges in pre- and post-operative care. Systemic inflammatory response syndromes (SIRS, sepsis) as well-known complications after LT have not yet been systematically examined in the pediatric population. <strong>Methods:</strong> We analyzed clinical data of 39 pediatric liver transplant recipients regarding potential risk factors for post-transplant SIRS and sepsis. Secondly, the prognostic impact of SIRS and sepsis on post-transplant clinical course, patient and transplant-survival has been analyzed. <strong>Results:</strong> 64% of patients developed either SIRS (n = 16, 41%) or sepsis (n = 9, 23%) within 30 days after transplantation. No pre-transplant risk factors for increased susceptibility for SIRS or sepsis could be identified. Secondary closure of the abdomen (p = 0.045) and secondary biliary reconstruction (p = 0.043) were associated with a higher incidence of sepsis and were associated with significantly prolonged mechanical ventilation times in the presence of sepsis (p = 0.001). Patients with sepsis, but not SIRS, stayed significantly longer on PICU (p = 0.021) and suffered from higher mortality (n = 3 versus 0;p = 0.0006). All deaths within 30 days of transplantation were due to septic multiorgan failure. Neither early SIRS nor sepsis were associated with loss of transplant function. <strong>Conclusions:</strong> SIRS and sepsis are frequent events after pediatric liver transplantation. Sepsis increased length of PICU-stay and mortality significantly and prolonged duration of mechanical ventilation. Secondary biliary reconstruction and closure of the abdomen could be identified as potential risk factors for sepsis. </div>
文摘<strong>Introduction.</strong> Penetrating craniocerebral wounds (PCCWs) are a particular lesion in the category of traumatic brain injury (TBI). The objective of this study was to describe the management of these lesions, and to identify signifiant risk factors associated with mortality in patients with a PCCW. <strong>Methods.</strong> It was a transversal, descriptive and analytical study performed in Departmental Teaching Hospital of Borgou and Alibori in Benin. From January 1, 2015 to June 30, 2020, patients with a PCCW were retained. Risk factors of mortality and morbidity associated to etiological, clinical and surgical parameters were assessed using the chi-square test. p value < 0.05 was considered to be statistically significant. <strong>Results.</strong> During the study period, 1267 cases of traumatic brain injuries (TBI) were admitted. Of these patients, 77 (6.1%) cases of PCCW were retained. These patients were divided into 66 (85.7%) male and 11 (14.3%) female. The mean age of the patients was 22.6 ± 14.8 years (range from 2 years to 70 years). The circumstances of occurrence were a traffic accident in 42 (54.5%) cases, an assault in 33 cases (42.9%) and a fall 2 (2.6%). The PCCW was unilateral in 71 cases (92.2%). A brain CT-scan was performed in 60 (77.9%) patients. Surgery was performed in 69 (89.6%) patients. Post-operative outcomes were simple in 59 (85.5%) cases. GCS, pupillary abnormalities, motor deficit were a statistically significant risk factor associated with death or sequels (p < 0.0001).<strong> Conclusion.</strong> The identification of risk factors of mortality or sequels is a major step for an efficient management of PCCWs and a reduction of morbidity and mortality. Whatever strategies are adopted, prevention must remain a priority.
文摘<strong><em>Introduction</em></strong><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">Cardiovascular disease is a global public health problem. In Africa, they are increasingly common, however, data on the control of cardiovascular risk factors in the general Senegalese population are rare. The aim of this work was to assess the level of control of cardiovascular risk factors in semi-urban areas in the municipality of Guéoul in Senegal.</span><span style="font-family:Verdana;"> </span><b><i><span style="font-family:Verdana;">Patients and methods</span></i></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">This is a cross-sectional, descriptive and exhaustive survey carried out from 3 November to 3 December 2012 among the population aged at least 35 years and living for more than 6 months in the commune of Gueoul. It was conducted using the WHO STEPS approach to study the prevalence of cardiovascular risk factors and assess their level of control. We looked at clinical history, lifestyle, and anthropometric data. Blood pressure was measured at both arms and fasting blood samples were taken for blood glucose, cholesterol and triglycerides.</span><span style="font-family:Verdana;"> </span><b><i><span style="font-family:Verdana;">Results</span></i></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">We examined 1.411 subjects (1052 women) averaging 48.5 ± 12.7 years of age. The main cardiovascular risk factors were dyslipidemia (61%), sedentary (56%), abdominal obesity (53.9%), high blood pressure (46.4%) and diabetes (7.2%). Dyslipidemia was known in 22 subjects, 6 of whom were on treatment with dyslipidemia control in 1 subject (16.7%). Hypertension was known in 266 subjects. Of these, 205 subjects were prescribed medical treatment, 26 of whom were well controlled (12.7%). The level of hypertension control was lower in subjects at high cardiovascular risk (p = 0.0001) and those with a family history of hypertension (p = 0.001). The male gender (p = 0.24), the short duration of progression of hypertension (p = 0.95) and the noncompliance of the diet (p = 0.176) were not significantly associated with poor control of hypertension. In diabetics, subjects on oral antidiabetic drugs had met fasting glucose targets in 65.5% of cases according to the recommendations of the American Diabetes Association and in 58.6% according to those of the International Diabetes Federation (p = 0.0001). Age, regular physical activity and insulin treatment were not significantly related to fasting blood sugar control.</span><span style="font-family:Verdana;"> </span><b><i><span style="font-family:Verdana;">Conclusion</span></i></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">Our study found inadequate control and high prevalence of cardiovascular risk factors in the general Senegalese population. This situation could be a cause of aggravation of cardiovascular diseases in Senegal and should promote to improve their management.</span>
文摘Despite not included in the traditional risk scores before surgery, liver cirrhosis, especially in advanced stages, has always influenced strongly final outcome both on short and midterm in patients undergoing cardiac surgery. Growing incidence of non-alcoholic fatty liver disease interlinked with metabolic syndrome and significant advancements in medical therapy have actually increased the likelihood of cardiac surgery in cirrhotic patients. To date, Child-Pugh and MELD scores have been commonly used to predict mortality and postoperative hepatic decompensation, but on the other hand, both traditional risk scores show some limitations for evaluation of hepatopathic patients undergoing specifically cardiac surgery. In this context, a specific Heart-Liver score hasn’t been developed yet in the attempt to outline a patient profile able to face surgery, therefore addressing us to adopt the best strategy possible for each case. If CP class A or low MELD score (<11) patients tolerate cardiac surgery with a mild increase in mortality and morbidity, currently state of art recommends particular caution towards surgery idea in presence of advanced hepatic disease. As far as cardiac surgery represents the unique therapeutic strategy in several life-threatening cases, anyway surgical correction of cardiac pathology won’t guarantee an increased life expectancy in accordance with the persistent liver dysfunction. Hereby, this paper will focus on preoperative parameters that should be considered in the future realization of a Heart-Liver prognostic score for overcoming limitations and difficulties related to the impact of liver disease on final clinical outcome.
文摘Healthcare-associated infections (HCAIs) remain a major public health concern. The aim of this study was to characterize potential pathogenic bacteria isolated in high-risk infectious services at the University Hospital Center of Suru-Léré in Benin. A cross-sectional, descriptive study was carried out on 215 samples with 8 air samples, 20 hand samples and 187 samples of medical-technical material. Genes for resistance to <i>β</i>-lactam antibiotics (blaTEM, blaSHV, blaCTX-M and blaOXA-1) were sought. The data were processed and analyzed using EPI Info version 3.5.4 software. A total of 10 bacterial species were identified. Of the 319 bacterial strains identified, <i>Staphylococcus saprophyticus</i>, <i>Staphylococcus aureus</i> and <i>Enterococcus faecalis</i> were predominant at 20.06%, 17.87% and 11.28% respectively. Antibiotic susceptibility showed that the majority of bacterial strains were multidrug-resistant. Of the 4 resistance genes sought, only the blaTEM and blaSHV genes were found. The poor microbiological quality observed in high-risk infectious services could be a risk factor for healthcare-associated infections. It is therefore useful to implement preventive measures in order to prevent or reduce the risk of healthcare-associated infections.
文摘Personal credit risk assessment is an important part of the development of financial enterprises. Big data credit investigation is an inevitable trend of personal credit risk assessment, but some data are missing and the amount of data is small, so it is difficult to train. At the same time, for different financial platforms, we need to use different models to train according to the characteristics of the current samples, which is time-consuming. <span style="font-family:Verdana;">In view of</span><span style="font-family:Verdana;"> these two problems, this paper uses the idea of transfer learning to build a transferable personal credit risk model based on Instance-based Transfer Learning (Instance-based TL). The model balances the weight of the samples in the source domain, and migrates the existing large dataset samples to the target domain of small samples, and finds out the commonness between them. At the same time, we have done a lot of experiments on the selection of base learners, including traditional machine learning algorithms and ensemble learning algorithms, such as decision tree, logistic regression, </span><span style="font-family:Verdana;">xgboost</span> <span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> so on. The datasets are from P2P platform and bank, the results show that the AUC value of Instance-based TL is 24% higher than that of the traditional machine learning model, which fully proves that the model in this paper has good application value. The model’s evaluation uses AUC, prediction, recall, F1. These criteria prove that this model has good application value from many aspects. At present, we are trying to apply this model to more fields to improve the robustness and applicability of the model;on the other hand, we are trying to do more in-depth research on domain adaptation to enrich the model.</span>
文摘The purpose of this research is to investigate the decision-making process for cybersecurity investments in organizations through development and utilization of a digital cybersecurity risk management framework. The initial article, Optimum Spending on Cybersecurity Measures is published on Emerald Insight at: </span><a href="https://www.emerald.com/insight/1750-6166.htm"><span style="font-size:12px;font-family:Verdana;">https://www.emerald.com/insight/1750-6166.htm</span></a><span style="font-size:12px;font-family:Verdana;">, contains the detailed literature review, and the data results from Phase I and Phase II of this research </span><span times="" new="" roman","serif";"="" style="font-size: 10pt;"> <span style="font-family:Verdana;font-size:12px;">REF _Ref61862658 \r \h</span> <span style="font-family:Verdana;font-size:12px;">\* MERGEFORMAT </span></span><span style="font-size:12px;font-family:Verdana;">[1]</span><span style="font-size:10pt;font-family:""></span><span times="" new="" roman","serif";"="" style="font-size: 10pt;"></span><span style="font-size:12px;font-family:Verdana;">. This article will highlight the research completed in the area of organizational decision-making on cybersecurity spend. In leveraging the review of additional studies, this research utilizes a regression framework and case study methodology to demonstrate that effective risk-based decisions are necessary when implementing cybersecurity controls. Through regression analysis, the effectiveness of current implemented cybersecurity measures in organizations </span><span style="font-size:12px;font-family:Verdana;">is</span><span style="font-size:12px;font-family:Verdana;"> explored when connecting a dependent variable with several independent variables. The focus of this article is on the strategic decisions made by organizations when implementing cybersecurity measures. This research belongs to the area of risk management, and various models within the field of 1) information security</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> 2) strategic management</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> and 3) organizational decision-making to determine optimum spending on cybersecurity measures for risk taking organizations. This research resulted in the develop</span><span style="font-size:12px;font-family:Verdana;">ment</span><span style="font-size:10pt;font-family:""><span style="font-family:Verdana;font-size:12px;"> of a cyber risk investment model and a digital cybersecurity risk man</span><span style="font-family:Verdana;font-size:12px;">agement framework. Using a case study methodology, this model an</span><span style="font-family:Verdana;font-size:12px;">d framework w</span></span><span style="font-size:12px;font-family:Verdana;">ere</span><span style="font-size:12px;font-family:Verdana;"> leveraged to evaluate and implement cybersecurity measures. The case study methodology provides an in-depth view of a risk-taking organization’s risk mitigation strategy within the bounds of the educational environment focusing on five areas identified within a digital cyber risk model: 1) technology landscape and application portfolio</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> 2) data centric focus</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> 3) risk management practices</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> 4) cost-benefit analysis for cybersecurity measures</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> and 5) strategic development. The outcome of this research provides greater insight into how an organization makes decisions when implementing cybersecurity controls. This research shows that most organizations are diligently implementing security measures to effectively monitor and detect cyber security attacks</span><span style="font-size:12px;font-family:Verdana;">,</span><span style="font-size:12px;font-family:Verdana;"> specifically showing that risk taking organizations implemented cybersecurity measures to meet compliance and audit obligations with an annual spend of $3.18 million. It also indicated that 23.6% of risk-taking organizations incurred more than 6 cybersecurity breaches with an average dollar loss of $3.5 million. In addition, the impact of a cybersecurity breach on risk taking organizations is as follows: 1) data loss</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> 2) brand/reputational impact</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> 3) financial loss fines</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> 4) increase oversight by regulators/internal audit</span><span style="font-size:12px;font-family:Verdana;">;</span><span style="font-size:12px;font-family:Verdana;"> and 5) customer/client impact. The implication this research has on practice is extensive, as it focuses on a broad range of areas to include risk, funding and type and impact of cyber security breaches encountered. The survey study clearly demonstrated the need to develop and utilize a digital cybersecurity risk management framework to integrate current industry frameworks within the risk management practice to include continuous compliance management. This type of framework would provide a balanced approach to managing the gap between a risk-taking organization and a risk averse organization when implementing cybersecurity measures.
基金This research was supported by the National Natural Science Foundation of China,China(Grants No.41731289 and No.51879285)The authors further acknowledge support from the Consultation and Evaluation Project of the Chinese Academy of Sciences,China(2018-Z02-A-008)the Basic Research Project of the China Institute of Water Resources and Hydropower Research,China(GE0145B0112017).
文摘Check dams are commonly constructed around the world for alleviating soil erosion and preventing sedimentation of downstream rivers and reservoirs.Check dams are more vulnerable to failure due to their less stringent flood control standards compared to other dams.Determining the critical precipitation that will result in overtopping of a dam is a useful approach to assessing the risk of failure on a probabilistic basis and for providing early warning in case of an emergency.However,many check dams are built in groups,spreading in several tributaries in cascade forms,comprising a complex network.Determining the critical precipitation for dam overtopping requires a knowledge of its upstream dams on whether they survived or were overtopped during the same storm,while these upstream dams in turn need the information for their upstream dams.The current paper presents an approach of decomposing the dam cluster into(1)the heading dam,(2)border dams,and(3)intermediate dams.The algorithm begins with the border dams that have no upstream dams and proceeds with upgraded maps without the previous border dams until all the dams have been checked.It is believed that this approach is applicable for small-scale check dam systems where the time lag of flood routing can be neglected.As a pilot study,the current paper presents the analytical results for the Wangmaogou Check Dam System that has 22 dams connected in series and parallel.The algorithm clearly identified 7 surviving dams,with the remaining ones being overtopped for a storm of 179.6 mm in 12 h,which is associated with a return period of one in 200 years.
基金National Nature Science Foundation Project for Young Scientists of China,No.81700804The Foundation for Young Medical Talents of Jiangsu Province,No.QNRC2016211+1 种基金Scientific Research Project of Jiangsu Health Commission,No.Z2019044and Youth Project of Henan Provincial Health and Health Commission,Ministry of Education,No.SB201902008.
文摘BACKGROUND Melatonin is reported to be related to diabetes mellitus(DM)risk;however,the effect of melatonin on diabetic retinopathy(DR)risk remains unclear.AIM The aim of this study was to determine the effect of melatonin on DR risk.METHODS A hospital-based case-control study was conducted from January 2020 to June 2020.DR was assessed using the Diabetic Retinopathy preferred practice pattern(PPP)-updated 2019 criteria.The participants were divided into the DM cases without DR(NDR)group,non-proliferative DR(NPDR)group and proliferative DR(PDR)group.Plasma melatonin concentration was detected with the enzymelinked immunosorbent assay kit.The relationship between plasma melatonin concentration and DR risk as well as severity was assessed.RESULTS It was found that plasma melatonin was 72.83±16.25,60.38±13.43,44.48±10.30 and 44.69±8.95 pg/mL in healthy controls,NDR group,NPDR and PDR group,respectively.In addition,it was found that plasma melatonin could be used as a potential diagnostic biomarker for DR(AUC=0.893,P<0.001).There was a significant positive relationship between total bilirubin and melatonin content(P<0.001)based on the correlation assay.Significant associations between total bilirubin and melatonin content were also detected in the NPDR(R2=0.360,P<0.001)and PDR(R2=0.183,P<0.001)groups.CONCLUSION The data obtained in this study demonstrated that plasma melatonin concentration was decreased in DR cases and could be used as a sensitive and specific marker for the diagnosis of DR.A significant positive relationship between total bilirubin and melatonin was detected.More related studies are required to understand the role of melatonin in DR.
基金The Natural Science Foundation of Hunan Province,No.2019JJ40435.
文摘BACKGROUND There have been few reports on the risk factors for acute respiratory distress syndrome(ARDS)in coronavirus disease 2019(COVID-19),and there were obvious differences regarding the incidence of ADRS between Wuhan and outside Wuhan in China.AIM To investigate the risk factors associated with ARDS in COVID-19,and compare the characteristics of ARDS between Wuhan and outside Wuhan in China.METHODS Patients were enrolled from two medical centers in Hunan Province.A total of 197 patients with confirmed COVID-19,who had either been discharged or had died by March 15,2020,were included in this study.We retrospectively collected the patients’clinical data,and the factors associated with ARDS were compared by theχ²test,Fisher’s exact test,and Mann-Whitney U test.Significant variables were chosen for the univariate and multivariate logistic regression analyses.In addition,literature in the PubMed database was reviewed,and the characteristics of ARDS,mortality,and biomarkers of COVID-19 severity were compared between Wuhan and outside Wuhan in China.RESULTS Compared with the non-ARDS group,patients in the ARDS group were significantly older,had more coexisting diseases,dyspnea,higher D-dimer,lactate dehydrogenase(LDH),and C-reactive protein.In univariate logistic analysis,risk factors associated with the development of ARDS included older age[odds ratio(OR)=1.04),coexisting diseases(OR=3.94),dyspnea(OR=17.82),dry/moist rales(OR=9.06),consolidative/mixed opacities(OR=2.93),lymphocytes(OR=0.68 for high lymphocytes compared to low lymphocytes),D-dimer(OR=1.41),albumin(OR=0.69 for high albumin compared to low albumin),alanine aminotransferase(OR=1.03),aspartate aminotransferase(OR=1.02),LDH(OR=1.02),C-reactive protein(OR=1.04)and procalcitonin(OR=17.01).In logistic multivariate analysis,dyspnea(adjusted OR=27.10),dry/moist rales(adjusted OR=9.46),and higher LDH(adjusted OR=1.02)were independent risk factors.The literature review showed that patients in Wuhan had a higher incidence of ARDS,higher mortality rate,a
基金Clinical Research Fostering Fund of Chinese PLA General Hospital in China,No.2017FC-TSYS-2012(to FYL)Youth Program of the Natural Science Foundation of Hainan Province of China,No.819QN378(to FYL)+2 种基金the National Natural Science Foundation of China,No.81771481(to XLC)China National Key R&D Program,No.2018YFC1312602(to XLC)National Clinical Research Center for Geriatric Diseases of China,No.NCRCGPLAGH-2017007(to XLC)。
文摘The arcuate fasciculus is a critical component of the neural substrate of human language function.Surgical resection of glioma adjacent to the arcuate fasciculus likely damages this region.In this study,we evaluated the outcome of surgical resection of glioma adjacent to the arcuate fasciculus under the guidance of magnetic resonance imaging and diffusion tensor imaging,and we aimed to identify the risk factors for postoperative linguistic deficit.In total,54 patients with primary glioma adjacent to the arcuate fasciculus were included in this observational study.These patients comprised 38 men and 16 women(aged 43±11 years).All patients underwent surgical resenction of glioma under the guidance of magnetic resonance imaging and diffusion tensor imaging.Intraoperative images were updated when necessary for further resection.The gross total resection rate of the 54 patients increased from 38.9%to 70.4%by intraoperative magnetic resonance imaging.Preoperative language function and glioma-to-arcuate fasciculus distance were associated with poor language outcome.Multivariable logistic regression analyses showed that glioma-to-arcuate fasciculus distance was the major independent risk factor for poor outcome.The cutoff point of glioma-to-arcuate fasciculus distance for poor outcome was 3.2 mm.These findings suggest that intraoperative magnetic resonance imaging combined with diffusion tensor imaging of the arcuate fasciculus can help optimize tumor resection and result in the least damage to the arcuate fasciculus.Notably,glioma-to-arcuate fasciculus distance is a key independent risk factor for poor postoperative language outcome.This study was approved by the Ethics Committee of the Chinese PLA General Hospital,China(approval No.S2014-096-01)on October 11,2014.
基金This study was supported by the National Key R&D Program of China(Grant No.2017YFA0604300)the National Natural Science Foundation of China(Grant Nos.41861144014,41775106 and U1811464)+1 种基金the Program for Guangdong Introducing Innovative and Entrepreneurial Teams(Grant No.2017ZT07X355)the project of the Chinese Ministry of Emergency Management on“Catastrophe Evaluation Modeling Study”.
文摘The prolonged mei-yu/baiu system with anomalous precipitation in the year 2020 has swollen many rivers and lakes,caused flash flooding,urban flooding and landslides,and consistently wreaked havoc across large swathes of China,particularly in the Yangtze River basin.Significant precipitation and flooding anomalies have already been seen in magnitude and extension so far this year,which have been exerting much higher pressure on emergency responses in flood control and mitigation than in other years,even though a rainy season with multiple ongoing serious flood events in different provinces is not that uncommon in China.Instead of delving into the causes of the uniqueness of this year’s extreme precipitation-flooding situation,which certainly warrants in-depth exploration,in this article we provide a short view toward a more general hydrometeorological solution to this annual nationwide problem.A“glocal”(global to local)hydrometeorological solution for floods(GHS-F)is considered to be critical for better preparedness,mitigation,and management of different types of significant precipitation-caused flooding,which happen extensively almost every year in many countries such as China,India and the United States.Such a GHS-F model is necessary from both scientific and operational perspectives,with the strength in providing spatially consistent flood definitions and spatially distributed flood risk classification considering the heterogeneity in vulnerability and resilience across the entire domain.Priorities in the development of such a GHS-F are suggested,emphasizing the user’s requirements and needs according to practical experiences with various flood response agencies.