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Burden of gallstone disease in the United States population:Prepandemic rates and trends

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World Journal of Gastrointestinal Surgery 2024年第4期16卷 1130-1148页

作者： Aynur Unalp-Arida constance E Ruhl National Institute of Diabetes and Digestive and Kidney Diseases National Institutes of HealthBethesdaMD 20892-5458United States Social&Scientific Systems Inc.DLH Holdings Corp CompanySilver SpringMD 20910United States

BACKGROUND Gallstone disease is one of the most common digestive disorders in the United States and leads to significant morbidity,mortality,and health care *** To expand on earlier findings and investigate prepandemic rates and trends in the gallstone disease burden in the United States using national survey and claims *** The National Ambulatory Medical Care Survey,National Inpatient Sample,Nationwide Emergency Department Sample,Nationwide Ambulatory Surgery Sample,Vital Statistics of the United States,Optum Clinformatics®Data Mart,and Centers for Medicare and Medicaid Services Medicare 5%Sample and Medicaid files were used to estimate claims-based prevalence,medical care including cholecystectomy,and mortality with a primary or other gallstone *** were age-adjusted(for national databases)and shown per 100000 *** Gallstone disease prevalence(claims-based,2019)was 0.70%among commercial insurance enrollees,1.03%among Medicaid beneficiaries,and 2.09%among Medicare beneficiaries and rose over the previous ***,in the United States population,gallstone disease contributed to approximately 2.2 million ambulatory care visits,1.2 million emergency department visits,625000 hospital discharges,and 2000 deaths *** had higher medical care rates with a gallstone disease diagnosis,but mortality rates were higher among *** had higher ambulatory care visit and hospital discharge rates compared with Whites,but not mortality *** had lower ambulatory care visit and mortality rates,but similar hospital discharge rates compared with *** the study period,ambulatory care and emergency department visit rates with a gallstone disease diagnosis rose,while hospital discharge and mortality rates *** commercial insurance enrollees,rates were higher compared with national data for ambulatory care visits and hospitalizations,but lower for emergency department ***

关键词： Gallstone disease Burden Cholecystectomy Mortality Health care use Cholelithiasis Gallstones Epidemiology

Comparative Performance Measurement of the Pareto Optimal Combination and Multi-Objective Combination Models for Controller Placement in Software-Defined Networks

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Journal of Computer and Communications 2024年第3期12卷 84-100页

作者： Mission Franklin constance Izuchukwu Amannah Department of Computer Science Ignatius Ajuru University of Education Port Harcourt Nigeria

The evolution of the current network has challenges of programmability, maintainability and manageability, due to network ossification. This challenge led to the concept of software-defined networking (SDN), to decouple the control system from the infrastructure plane caused by ossification. The innovation created a problem with controller placement. That is how to effectively place controllers within a network topology to manage the network of data plane devices from the control plane. The study was designed to empirically evaluate and compare the functionalities of two controller placement algorithms: the POCO and MOCO. The methodology adopted in the study is the explorative and comparative investigation techniques. The study evaluated the performances of the Pareto optimal combination (POCO) and multi-objective combination (MOCO) algorithms in relation to calibrated positions of the controller within a software-defined network. The network environment and measurement metrics were held constant for both the POCO and MOCO models during the evaluation. The strengths and weaknesses of the POCO and MOCO models were justified. The results showed that the latencies of the two algorithms in relation to the GoodNet network are 3100 ms and 2500 ms for POCO and MOCO respectively. In Switch to Controller Average Case latency, the performance gives 2598 ms and 2769 ms for POCO and MOCO respectively. In Worst Case Switch to Controller latency, the performance shows 2776 ms and 2987 ms for POCO and MOCO respectively. The latencies of the two algorithms evaluated in relation to the Savvis network, compared as follows: 2912 ms and 2784 ms for POCO and MOCO respectively in Switch to Controller Average Case latency, 3129 ms and 3017 ms for POCO and MOCO respectively in Worst Case Switch to Controller latency, 2789 ms and 2693 ms for POCO and MOCO respectively in Average Case Controller to Controller latency, and 2873 ms and 2756 ms for POCO and MOCO in Worst Case Switch to Controll

关键词： Latency Measurement Metrics Performance POCO MOKO Architecture Provision

Constructing Electron Microscope Labs: Challenges and Solutions

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Journal of Building Construction and Planning Research 2024年第3期12卷 53-68页

作者： Limei Cha Markus Walkling-Ribeiro Zhenxi Guo Yaron Kauffman constance Van Horne Department of Materials Science and Engineering Guangdong-Technion Israel Institute of Technology Shantou China Department of Food Science University of Copenhagen Copenhagen Denmark School of Life Science and Cryo EM core facility Beijing University Beijing China Department of Materials Science and Engineering Technion Israel Institute of Technology Haifa Israel Abu Dhabi School of Management Abu Dhabi United Arab Emirates

The construction of advanced laboratories for precision instruments, such as electron microscopes, involves unique challenges that are influenced by the specific environmental conditions required for optimal functionality. These include mitigating interference from magnetic fields and vibrations, which are critical for maintaining the precision and accuracy of the instruments used. This study aims to offer enhanced project management strategies and detailed construction solutions that address the environmental and technical needs specific to electron microscopy labs, thereby facilitating effective lab operations and extending the lifecycle of high-end precision instruments. Case studies of existing laboratory constructions, onsite investigations, and comprehensive reviews of the technical and environmental requirements provide the basis for a best practice for constructing sophisticated electron microscopy labs. The approach integrates both pre-construction planning and post-construction adjustments to create optimal operational environments. The findings suggest that successful lab constructions are those that incorporate thorough onsite assessments, strategic location choices, and the use of advanced construction materials and techniques specifically designed to counteract environmental challenges like magnetic and vibration interferences. Actionable guidelines for both planning and executing the construction of electron microscope labs highlighted in this tutorial are intended as an important resource to troubleshoot or upgrade existing lab facilities and to consult in preparation of future lab construction projects.

关键词： Laboratory Construction Development Strategies Management Case Study Electron Microscope Magnetic Shielding Vibration

Surgical Treatment of Nephroblastoma in a 4-Year Male Child: A Case Report and Literature Review

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Case Reports in Clinical Medicine 2024年第2期13卷 43-51页

作者： Alexander Kofi Egote Samuel Kolonziah Blay constance Amuzuah Egote Cardinal Kofi Newton Albert Afriyie Akowuah Emmanuel Nana Bosoma Urology Unit Sunyani Teaching Hospital Sunyani Ghana

Herein we report a patient with nephroblastoma which was successfully removed at the Sunyani Teaching Hospital CJ Oppong theatre in Ghana in sub-Saharan Africa by extended below umbilical incision. Our patient had a family history of Wilms tumour predisposing him to the disease. His main symptoms were haematuria and abdominal mass which was noticed later. Examination and investigation were suggestive of a late-stage unilateral Nephroblastoma resulting in the need for nephrectomy. To reduce the need for such radical surgeries among children at an early stage, there is the need for early screening of children for Wilms tumours especially, those with family predisposition as in our case study. The case report presented here constitutes a rare case of nephroblastoma in the literature.

关键词： Nephroblastoma Wilms Tumour Nephrectomy Screening

Serum Calcium Ionised Rate and Materno-Perinatal Prognosis in Arterial Hypertension in Pregnancy at the Reference General Hospital of Panzi

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Open Journal of Obstetrics and Gynecology 2024年第3期14卷 422-434页

作者： Mushera Aganze Alain Raha Maroyi Kenny Kakisingi Mibi De Joseph Musese Nguru Marie constance Julien Bwama Botalatala Mbozi Andrea Koko Kasengire Euphrasie Imani Erahamoba Pince Olivier Nyakio Department of Gynecology and Obstetrics Panzi General Referral Hospital Bukavu Democratic Republic of the Congo Department of Medicine and Public Health Evangelical University in Africa Bukavu Democratic Republic of the Congo Biopharm Hospital Bukavu Democratic Republic of the Congo International Institute of Tropical Agriculture IITA Olusegun Obasanjo Campus Kalambo Station South Kivu Democratic Republic of the Congo School of Medicine Official University of Bukavu Bukavu Democratic Republic of the Congo

Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries. Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries, maternal hypocalcaemia being a factor favouring the onset of arterial hypertension during pregnancy. The aim was to determine the maternal and perinatal prognosis of patients with hypertensive disorders of pregnancy as a function of serum ionised calcium levels. Material and Methods: A cross-sectional analytical study of 114 patients with arterial hypertension during pregnancy or during pregnancy or in the postpartum period at the HGR/Panzi from 1 January 2021 to 30 June 2022, text was entered using Microsoft Office Word 2010 and the tables were analysed using Excel 2010. The data was analysed using SPSS version 20.0 and Stata 14.0. The associations of the variables were calculated using Pearson's chi-square test, with a significance threshold set at a value of p < 0.05. Study of risk factors, Odds ratios and their confidence intervals were estimated in a univariate analysis. The most determining factors were identified by multivariate analysis using the Forward conditional logistic regression model. Results: The mean gestational age was 34.43 ± 4.327 amenorheas weeks, 46.6% of patients had a vaginal delivery, 66.65% of which were indicated for maternal prognosis, maternal complications were associated with maternal hypocalcaemia in 81, 82% (P = 0.043) and an OR = 3.255 (P = 0.0158) threefold risk that the patient presenting with a complication is likely to be in a state of hypocalcaemia at 95% confidence index, and fetal prognosis was not significantly related to maternal calcaemia. Conclusion: Maternal hypocalcaemia is one of the factors that can influence maternal-foetal complications maternal-fetal complications, early management and prevention of this pathology is patholog

关键词： Hypocalcaemia Arterial Hypertension During Pregnancy and Maternal and Perinatal Prognosis

Pilot testing of CO_(2) capture from a coal-fired power plant-Part 2:Results from 1-MWe pilot tests

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Clean Energy 2020年第1期4卷 12-25页

作者： Sharon Sjostrom constance Senior ADA-ES-Inc. 640 Plaza DriveSuite 270Highlands RanchCO 80129USA

Using a 1-MWe slipstream pilot plant,solid-sorbent-based post-combustion CO_(2) capture was tested at a coal-fired power *** from pilot testing were used to develop a preliminary full-scale commercial *** sorbent selected for pilot-scale evaluation during this project consisted of an ion-exchange resin that incorporated amines covalently bonded to the substrate.A unique temperature-swing-absorption(TSA)process was developed that incorporated a three-stage fluidized-bed adsorber integrated with a single-stage fluidized-bed ***,following start-up and commissioning challenges that are often associated with first-of-a-kind pilots,the pilot plant operated as designed and expected,with a few key *** two primary exceptions were associated with:(i)handling characteristics of the sorbent,which were sufficiently different at operating temperature than at ambient temperature when design specifications were established with lab-scale testing;and(ii)CO_(2) adsorption in the transport line between the regenerator and adsorber that preloaded the sorbent with CO_(2) prior to entering the *** from the pilot programme demonstrate that solid-sorbent-based post-combustion capture can be utilized to achieve 90%CO_(2) capture from coal-fired power plants.

关键词： CO_(2)capture coal-fired power plant CCS solid sorbent temperature-swing adsorption

Pilot testing of CO_(2) capture from a coal-fired power plant-Part 1:Sorbent characterization

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Clean Energy 2019年第2期3卷 144-162页

作者： Sharon Sjostrom and constance Senior ADA-ES-Inc. 640 Plaza DriveSuite 270Highlands RanchCO 80129USA

Post-combustion CO_(2)capture followed by sequestration is one of the only feasible means to significantly reduce CO_(2)emissions from existing fossil-fuel-fired power *** paper is Part 1 of a two-part paper highlighting key results from a project sponsored by the US Department of Energy and supported by industrial groups with the objective of demonstrating the viability of solid sorbents for CO_(2)*** overall objective of the effort was to validate solid sorbent-based post-combustion CO_(2)capture through slipstream pilot testing at a coal-fired power plant using a temperature-swing adsorption *** Part 1 of this work,the results from laboratory characterization of the sorbent selected for the pilot-scale demonstration are presented.A great deal of research related to sorbent development and evaluation has occurred to date but,for the most part,these promising materials have yet to be paired with a feasible process and demonstrated at the pilot *** sorbent selected for pilot-scale evaluation under this project consisted of an ion-exchange resin that incorporated amines that were covalently bonded to the *** the sorbent characterization portion of this work,the sorbent was characterized by a range of methods intended to provide information to support the design and operation of the pilot-scale CO_(2)-capture process,including equilibrium adsorption isotherms,adsorption and regeneration kinetics,impact of moisture and oxygen on CO_(2)working capacity,sorbent thermal properties,sorbent strength and attrition,and optimum particle-size *** paper reports results from sorbent characterization testing and how these characteristics influenced the type and size of the CO_(2)-capture process *** Part 2 of this work,results from tests of 1-MWe pilot-scale process equipment loaded with the sorbent described in Part 1 will be presented and analysed.

关键词： CO_(2)capture coal-fired power plant solid sorbent temperature-swing adsorption

The First Documented Experience of Qi and an Account of Healing Failure:4th-Century BCE

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Chinese Medicine and Culture 2023年第2期6卷 139-146页

作者： constance A.Cook Professor&Chair Modern Languages and LiteraturesLehigh UniversityBethlehemPA 18015USA

This essay will review the earliest case that documents a patient’s experience of qi,one found on a bamboo text buried with the patient who died in the 318 *** of the healing encounter and of concepts of illness show how non-transmitted documents hidden from later editors in tombs preserve an older layer of medical understanding than that in transmitted canons,such as the Huang Di Nei Jing(Inner Canon of the Yellow Emperor).The 4th-century BCE case record described below is the longest early medical record concerning the treatment of a specific *** is also an account of failure formally recorded for the sake of the survivors and buried with the dead to be transmitted to the world of the *** essay begins with a reevaluation of ancient concept of qi and then moves on to the individual case record.

关键词： Ancient Divination Heart Magic Manuscript Qi Wu Xing Yin-yang

An evolutionary algorithm approach for the constrained multi-depot vehicle routing problem

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International Journal of Intelligent Computing and Cybernetics 2016年第1期9卷 2-22页

作者： Carin Lightner-Laws Vikas Agrawal constance Lightner Neal Wagner Clayton State University MorrowGeorgiaUSA Jacksonville University JacksonvilleFloridaUSA Fayetteville State University FayettevilleNorth CarolinaUSA MIT Lincoln Laboratory LexingtonMassachusettsUSA

Purpose-The purpose of this paper is to explore a real world vehicle routing problem(VRP)that has multi-depot subcontractors with a heterogeneous fleet of vehicles that are available to pickup/deliver jobs with varying time windows and *** the overall job completion time and number of drivers utilized are analyzed for the automated job allocations and manual job assignments from transportation field ***/methodology/approach-A nested genetic algorithm(GA)is used to automate the job allocation process and minimize the overall time to deliver all jobs,while utilizing the fewest number of drivers-as a secondary ***-Three different real world data sets were used to compare the results of the GA vs transportation field experts’manual *** job assignments from the GA improved the overall job completion time in 100 percent(30/30)of the cases and maintained the same or fewer drivers as BS Logistics(BSL)in 47 percent(14/30)of the ***/value-This paperprovidesa novel approach to solving a real world VRPthathasmultiple *** there have been numerous models to capture a select number of these variants,the value of this nested GA lies in its ability to incorporate multiple depots,a heterogeneous fleet of vehicles as well as varying pickup times,pickup locations,delivery times and delivery locations for each job into a single *** research does not provide models to collectively address all of these variants.

关键词： Genetic algorithms Evolutionary computation Vehicle routing Multiple depot transportation Hard/soft time windows