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Storylines of family medicine Ⅹ:standing up for diversity,equity and inclusion

Family medicine and Community Health 2024年第S3期12卷 89-98页

作者： William B Ventres Leslie A Stone Wayne W Bryant Jr mario F Pacheco Edgar Figueroa francis N Chu Shailendra Prasad David N Blane Na'amah Razon Ranit mishori Robert L Ferrer Garrett S Kneese Family and Preventive medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Family and Community medicine University of New Mexico School of MedicineAlbuquerqueNew MexicoUSA medicine Weill Cornell Medical CollegeNew YorkNew YorkUSA San Jose Family medicine Residency Kaiser PermanenteSan JoseCaliforniaUSA Family medicine and Community Health University of Minnesota Medical School—Twin Cities CampusMinneapolisMinnesotaUSA School of Health and Wellbeing University of GlasgowGlasgowUK Family and Community medicine University of CaliforniaDavisSacramentoCaliforniaUSA Family medicine Georgetown University School of MedicineWashingtonDistrict of ColumbiaUSA Family and Community medicine UT Health San Antonio Long School of MedicineSan AntonioTexasUSA UC San Diego Family medicine Residency Program San DiegoCaliforniaUSA

Storylines of Family medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine as interpreted by individual family physicians and medical educators in the USA and elsewhere around the ***‘Ⅹ:standing up for diversity,equity and inclusion’,authors address the following themes:‘The power of diversity—why inclusivity is essential to equity in healthcare’,‘medical education for whom?’,‘Growing a diverse and inclusive workforce’,‘Therapeutic judo—an inclusive approach to patient care’,‘Global family medicine—seeing the world“upside down”’,‘The inverse care law‘,‘Social determinants of health as a lens for care’,‘Why family physicians should care about human rights’and‘Toward health equity—the opportunome’.may the essays that follow inspire readers to promote change.

关键词： illustration education family

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Polycystic Ovarian Syndrome (PCOS): Exploring Its Impact on Obstetrical Outcomes

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Open Journal of Obstetrics and Gynecology 2024年第8期14卷 1111-1123页

作者： Ranjitha Vasa Gayatri Venkataraman Kelly Gorman Rythika francis Elise Zwicklbauer Julia Fisher Polina Safovich mudar Dalloul Ozgul muneyyirci-Delale Department of Obstetrics and Gynecology SUNY Downstate Health Science University Brooklyn United States of America Department of Obstetrics and Gynecology Kings County Hospital Center NYC Health and Hospitals Brooklyn United States of America

Polycystic ovarian syndrome (PCOS) disrupts ovulation leading to both infertility and miscarriage;yet, its impact on obstetrical outcomes remains largely uncertain due to conflicting findings. We analyzed data from the CDC Pregnancy Risk Assessment of monitoring System, specifically Standard Core and Phase 8 responses, with 9549 respondents across the United States through SPSS 28 software in this cross-sectional study. Two variables assessed PCOS status in respondents: history of PCOS and PCOS during pregnancy. With a history of PCOS, there were significantly increased odds of diabetic (OR 1.665, p mortality (OR 1.550, p m prelabor rupture of membranes (PPROm) (OR 2.081, p mall for gestational age (2 standard deviations) (OR 0.337, p = 0.024). PCOS is a significant risk factor that contributes to maternal morbidity. Our results support the hypothesis that PCOS’ impact extends well into a woman’s obstetrical journey, with varying degrees of associated adverse maternal and fetal risks. Preliminary pathophysiologic explanations associated with PCOS gestational diabetes include pre-existing insulin resistance. meanwhile, altered placentation and endovascular changes associated with PCOS secondary to a baseline deranged metabolic environment predispose patients to developing hypertensive disorders, PPROm, and preterm delivery. Associations between neonatal mortality and C/S can be attributed to elevated maternal body mass index. The pathophysiologic link between PCOS and the above obstetrical outcomes still remains unknown, necessitating further investigation;however, this study identifies the outcomes that

关键词： PCOS Polycystic Ovarian Syndrome Obstetrics Reproduction Pregnancy

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Systematic Analysis of Factors Associated with Late Breast Cancer Screening in Women in Sub-Saharan Africa from 2014 to 2020

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Open Journal of Epidemiology 2024年第3期14卷 480-492页

作者： Akossito Hermine Tognon Ahmed Kabore Nayi Zongo Nestor Bationo francis Tognon Tchegnonsi Ludmila Akoyi Abdoul Halim Bague maxime Koine Drabo Department of Public Health University Joseph KI-ZERBO Ouagadougou Burkina Faso Yalgado Ouédraogo University Hospital Center Ouagadougou Burkina Faso Institute of Training in Nursing and Obstetrics Parakou Benin National Center for Scientific and Technological Research (CNRT) Ouagadougou Burkina Faso

Research background: Breast cancer remains a major public health problem, with a high number of new cases and deaths each year. However, despite advances in research to improve this disease, there is a high rate of late detection, leading to diagnosis at an advanced stage and a reduced chance of survival. Objective: The aim of this study is to identify the factors associated with late detection of breast cancer in women in Sub-Saharan Africa from 2014 to ***: This systematic review focuses on sub-Saharan Africa. methods: We searched for articles in four databases (Pubmed, Embase, Global-Health and CINAHL) between 2014 and 2020 and performed a narrative synthesis to organize and group the different factors associated with late breast cancer detection. Result: After reviewing 583 publications, 6 studies were selected, highlighting factors such as lack of awareness, knowledge gaps, difficulties in accessing health services and financial constraints associated with late breast cancer screening. The participants, who ranged in number from 20 to 1776, were mainly aged between 18 and 25, with a mean age of 25 years and 6 months. Conclusion: The analysis enabled us to identify various factors associated with late breast cancer screening. Collaboration between health professionals, community organizations and policy-makers is essential to foster an environment conducive to the prevention and early detection of breast cancer.

关键词： Associated Factors Late Screening Breast Cancer Women Sub-Saharan Africa

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A Grid middleware for Distributed Java Computing with mPI Binding and Process migration Supports

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Journal of Computer Science & Technology 2003年第4期18卷 505-514页

作者：陈琳王卓立 francis C.m.Lau Department of Computer Science and Information Systems The University of Hong Kong P.R. China

"Grid" computing has emerged as an important new research field. With years of efforts, grid researchers have successfully developed grid technologies including security solutions,resource management protocols, information query protocols, and data management services. However, as the ultimate goal of grid computing is to design an infrastructure which supports dynamic,cross-organizational resource sharing, there is a need of solutions for efficient and transparent task re-scheduling in the *** this research, a new grid middleware is proposed, called G-JavamPI. This middleware adds the parallel computing capability of Java to the grid with the support of a Grid-enabled message passing interface (mPI) for inter-process communication between Java processes executed at different grid points. A special feature of the proposed G-JavamPI is the support of Java process migration with post-migration message redirection. With these supports, it is possible to migrate executing Java process from site to site for continuous computation, if some site is scheduled to be turned down for system reconfiguration. moreover, the proposed G-JavamPI middleware is very portable since it requires no modification of underlying OS, Java virtual machine, and mPI package. Preliminary performance tests have been conducted. The proposed mechanisms have shown good migration efficiency in a simulated grid environment.

关键词： grid middleware mPI Java process migration

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Problematic Use of Video Games in Schools in Northern Benin (2023)

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Open Journal of Psychiatry 2024年第2期14卷 120-141页

作者： Ireti Nethania Elie Ataigba David Sinet Koivogui Damega Wenkourama marcos Tohou Eurydice Elvire Djossou Anselme Djidonou francis Tognon Tchegnonsi Prosper Gandaho Josiane Ezin Houngbe Faculté de médecine & Institut de Formation en Soins Infirmiers et Obstétricaux Université de Parakou Parakou Bénin Service de Psychiatrie Centre Hospitalier Universitaire Départemental du Borgou Alibori Parakou Bénin Organisation Non Gouvernementale de Soutien Réhabilitation Insertion et Réinsertion (SouRIR ONG) Parakou Bénin Faculté des Sciences et Techniques de Santé Université Gamal Abder Nasser de Conakry Conakry Guinée Faculté des Sciences de la Santé Université de Kara Kara Togo Service de Psychiatrie Centre Hospitalier Universitaire de Kara Kara Togo Facultés des Sciences de la Santé Université d’Abomey-Calavi Cotonou Bénin Centre Nationale Hospitalier Universitaire Hubert Koutoucou maga de Cotonou Cotonou Bénin

Objective: To study the problematic use of video games among secondary school students in the city of Parakou in 2023. methods: Descriptive cross-sectional study conducted in the commune of Parakou from December 2022 to July 2023. The study population consisted of students regularly enrolled in public and private secondary schools in the city of Parakou for the 2022-2023 academic year. A two-stage non-proportional stratified sampling technique combined with simple random sampling was adopted. The Problem Video Game Playing (PVP) scale was used to assess problem gambling in the study population, while anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Results: A total of 1030 students were included. The mean age of the pupils surveyed was 15.06 ± 2.68 years, with extremes of 10 and 28 years. The [13 - 18] age group was the most represented, with a proportion of 59.6% (614) in the general population. Females predominated, at 52.8% (544), with a sex ratio of 0.89. The prevalence of problematic video game use was 24.9%, measured using the Video Game Playing scale. Associated factors were male gender (p = 0.005), pocket money under 10,000 cfa (p = 0.001) and between 20,000 - 90,000 cfa (p = 0.030), addictive family behavior (p monogamous family (p = 0.023), good relationship with father (p = 0.020), organization of video game competitions (p = 0.001) and definite anxiety (p Conclusion: Substance-free addiction is struggling to attract the attention it deserves, as it did in its infancy everywhere else. This study complements existing data and serves as a reminder of the need to focus on this group of addictions, whose problematic use of video games remains the most frequent due to its accessibility and social tolerance. Preventive action combined with curative measures remains the most effective means of combating the problem at national level.

关键词： Gaming Problem Video Games Benin 2023

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Feasibility of Integrating Leprosy Post-Exposure Prophylaxis with Single-Dose Rifampicin (LPEP) into Routine Leprosy Control Program in Bukedi and Teso Regions in Uganda

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Advances in Infectious Diseases 2024年第3期14卷 563-580页

作者： Rose Kengonzi Turyahabwe Stavia Lisa Gerwing-Adima Nyote Ronald Kamara Vincent Consolata mbambara Yusuf Wanyama Buyinza Godfrey Tinyo Daniel mulwani Elisa Namuyode Damali Aloket francis ministry of Health National Tuberculosis and Leprosy Program Kampala Uganda German Tuberculosis and Leprosy Relief Association Kampala Uganda Kibuku District Local Government Kibuku Uganda Budaka District Local Government Budaka Uganda Department of Internal medicine Mbale Regional Referral Hospital Mbale Uganda Department of Internal medicine Soroti Regional Referral Hospital Soroti Uganda

Background: World Health Organization recommends the implementation of contact tracing and Leprosy Post Exposure prophylaxis (LPEP) to interrupt the chain of transmission. To accelerate the uptake of this recommendation, a cross-sectional study among contacts of leprosy patients was conducted to investigate the feasibility of integrating leprosy systematic contact tracing and post-exposure prophylaxis (PEP) into the routine leprosy control program. methods: This was a mixed methods cross-sectional study. The study was implemented in Kumi, Ngora, Serere, Soroti, Budaka and Kibuku Districts. Results: The 45 enrolled index patients (97.8% of the registered) identified a total of 135 contacts, of which 134 (99·2%) consented and were screened. Among them, one new leprosy patient was identified and started on treatment with multidrug therapy (mDT). All the eligible contacts, received the prophylactic treatment with Single Dose Rifampicin (SDR). Overall, SDR was administered to 133(98.5% of the listed contacts) with no adverse event reported. Factors associated with successful contact investigation and management included: Involvement of index patients, health care workers during the contact screening and SDR A administration, counselling of the index patients and contacts by the health care works, LPEP being administered as Directly observed Therapy (DOT) among others. Results Interpretation: The integration of leprosy post-exposure prophylaxis with administration of SDR and contact tracing is feasible, generally accepted by the patient, their contacts and health workers and can be integrated into the National Leprosy control programmes with minimal additional efforts once contact tracing has been established. Therefore, we recommend integration of administration of SDR in to the routine leprosy control program.

关键词： Leprosy Post Exposure Prophylaxis Single Dose Rifampicin

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Disinfection byproduct regulatory compliance surrogates and bromide-associated risk

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Journal of Environmental Sciences 2017年第8期29卷 191-207页

作者： Chelsea Kolb Royce A.francis Jeanne m.VanBriesen Department of Ciuil and Environmental Engineering Carnegie Mellon Uniuersity Pittsburgh PA 15213 USA Department of Engineering management and Systems Engineering The George Washington University Washington DC 20052 USA Department of Engineering and Public Policy Carnegie Mellon University Pittsburgh PA 15213 USA

Natural and anthropogenic factors can alter bromide concentrations in drinking water sources. Increasing source water bromide concentrations increases the formation and alters the speciation of disinfection byproducts（DBPs） formed during drinking water *** DBPs are more toxic than their chlorinated analogs, and thus have a greater impact on human health. However, DBPs are regulated based on the mass sum of DBPs within a given class（e.g., trihalomethanes and haloacetic acids）, not based on species-specific risk or extent of bromine incorporation. The regulated surrogate measures are intended to protect against not only the species they directly represent, but also against unregulated DBPs that are not routinely measured. Surrogates that do not incorporate effects of increasing bromide may not adequately capture human health risk associated with drinking water when source water bromide is elevated. The present study analyzes trihalomethanes（THms）, measured as TTHm,with varying source water bromide concentrations, and assesses its correlation with brominated THm, TTHm risk and species-specific THm concentrations and associated *** potential surrogates are evaluated to assess their ability to capture THm risk under different source water bromide concentration conditions. The results of the present study indicate that TTHm does not adequately capture risk of the regulated species when source water bromide concentrations are elevated, and thus would also likely be an inadequate surrogate for many unregulated brominated species. Alternative surrogate measures,including THm3 and the bromodichloromethane concentration, are more robust surrogates for species-specific THm risk at varying source water bromide concentrations.

关键词： Disinfection byproducts Bromide Disinfection byproduct regulation Trihalomethanes Disinfection byproduct risk

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Deterministic approaches for noncoherent communicationswith chaotic carriers

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Journal of Systems Engineering and Electronics 2005年第2期16卷 253-257页

作者： LiuXiongying QiuShuisheng francis.C.m.Lau CollegeofElectronicandInformationEngineering SouthChinaUniversityofTechnologyGuangzhou510640P.R.China DepartmentofElectronicandInformationEngineering HongkongPolytechnicUniversityHongkongP.R.China

Two problems are proposed. The first one is the noise decontamination of chaotic carriers using a deterministic approach to reconstruct pseudo trajectories, the second is the design of communications schemes with chaotic carriers. After presenting our deterministic noise decontamination algorithm, conventional chaos shift keying (CSK) communication system is applied. The difference of Euclidean distance between noisy trajectory and decontaminated trajectory in phase space could be utilized to non-coherently detect the sent symbol simply and effectively. It is shown that this detection method can achieve the bit error rate performance comparable to other non-coherent systems.

关键词： gradient descent reconstruction chaotic communications noncoherent detection.

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Determination of contact parameters for discrete element method simulations of granular systems

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Particuology 2008年第6期6卷 521-528页

作者： Kevin francis malone Institute of Particle Science and Engineering University of Leeds

Both linear-spring-dashpot （LSD） and non-linear Hertzian-spring-dashpot （HSD） contact models are commonly used for the calculation of contact forces in Discrete Element method （DEm） simulations of granular systems. Despite the popularity of these models, determination of suitable values for the contact parameters of the simulated particles such as stiffness, damping coefficient, coefficient of restitution, and simulation time step, is not altogether obvious. In this work the relationships between these contact parameters for a model system where a particle impacts on a flat base are examined. Recommendations are made concerning the determination of these contact parameters for use in DEm simulations.

关键词： Discrete Element method (DEm) Linear-spring--dashpot model Non-linear Hertzian-spring-dashpot model Contact parameters

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Fate and transport of theβ-adrenergic agonist ractopamine hydrochloride in soil–water systems

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Journal of Environmental Sciences 2016年第7期28卷 40-48页

作者： Heldur Hakk Weilin L.Shelver francis X.m.Casey USDA-ARS Biosciences Research Laboratory 1605 Albrecht Blvd.FargoND 58102USA Department of Soil Sciences North Dakota State UniversityAlbrecht Blvd.FargoND 58108USA

The feed additive ractopamine hydrochloride was fortified at four concentrations into batch vials containing soils that differed in both biological activity and organic matter（Om）.Sampling of the liquid layer for 14 days demonstrated that ractopamine rapidly dissipated from the liquid layer. Less than 20% of the fortified dose remained in the liquid layer after 4 hr,and recoveries of dosed ractopamine ranged from 8 to 18% in the liquid layer at 336 hr. Sorption to soil was the major fate for ractopamine in soil：water systems, i.e., 42%–51% of the dose at14 days. The major portion of the sorbed fraction was comprised of non-extractables; a smaller fraction of the sorbed dose was extracted into water and acetone, portions which would be potentially mobile in the environment. Partitioning coefficients for all soils suggested strong sorption of ractopamine to soil which is governed by hydrophobic interactions and cation exchange complexes within the soil Om. Ractopamine degradation was observed, but to mostly non-polar compounds which had a higher potential than ractopamine to sorb to soil. The formation of volatiles was also suggested. Therefore, despite rapid and extensive soil sorption,these studies indicated a portion of ractopamine, present in manures used to fertilize soils,may be mobile in the environment via water-borne events.

关键词： Ractopamine Transport Degradation β-Adrenergic agonist Soil

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