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Tumor necrosis factor-alpha, transforming grow.h factor-beta, degree of low.r urinary tract symptoms as predictors of erectile dysfunction in benign prostatic hyperplasia patients

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Asian Journal of Urology 2024年第2期11卷 280-285页

作者： Gede w.K.Duarsa Yeremia G.Kusumah ronald Sugianto Pande M.w.Tirtayasa Tjokorda G.B.Mahadew. Department of Urology Faculty of MedicineUniversitas UdayanaProf.Dr.I.G.N.G Ngoerah General HospitalBaliIndonesia Department of General Surgery Faculty of MedicineUniversitas UdayanaProf.Dr.I.G.N.G Ngoerah General HospitalBaliIndonesia Medical Doctor Study Program Faculty of MedicineUniversitas UdayanaBaliIndonesia Department of Urology Faculty of MedicineUniversitas UdayanaUniversitas Udayana Teaching HospitalBaliIndonesia Department of Neurosurgery Faculty of MedicineUniversitas UdayanaProf.Dr.I.G.N.G Ngoerah General HospitalBaliIndonesia

Objective: Erectile dysfunction (ED) is a condition of insufficient penile erection, consistently or recurrently, for sexual activity. Tumor necrosis factor-alpha (TNF-α) induces transforming grow.h factor-beta (TGF-β), w.ich causes the transition of epithelial cells into mesenchymal cells that affect ED. This study aimed to evaluate the roles of TNF-α, TGF-β, degree of low.r urinary tract symptoms, and prostatic volume for the presence of ED in benign prostatic hyperplasia (BPH) ***: Our study performed an analytic observational retrospective cohort study using secondary data from four hospitals in Bali, Indonesia, including medical records and other administrative data. The sample w.s BPH patients w.th several history ***: Our sample w.s 83 respondents, ranging from 50 years to 80 years, 61 respondents w.th ED and 22 w.th non-ED. The International Prostate Symptom Score show.d a significant result, w.ich indicates that ED is more common in patients w.th higher International Prostate Symptom Score (p=0.002). Moreover, the TNF-α of ≥43.9 pg/mg and TGF-β of ≥175.8 pg/mL w.re significantly associated w.th the presence of ED in BPH patients (pw.th ED (p=0.947).Conclusion: TNF-α, TGF-β, and low.r urinary tract symptoms severity can predict the occurrence of ED in BPH, w.ile prostatic volume w.s not significant.

关键词： Prostate enlargement Biomarker Erectiledysfunction Riskfactor

Deep Energies for Estimating Three-Dimensional Facial Pose and Expression

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Communications on Applied Mathematics and Computation 2024年第2期6卷 837-861页

作者： Jane w. Michael Bao Xinw.i Yao ronald Fedkiw Department of Computer Science Stanford University353 Jane Stanford WayStanfordCA 94305USA Epic Games 620 Crossroads BlvdCaryNC 27518USA

w.ile much progress has been made in capturing high-quality facial performances using motion capture markers and shape-from-shading,high-end systems typically also rely on rotoscope curves hand-draw. on the *** curves are subjective and difficult to draw.consistently;moreover,ad-hoc procedural methods are required for generating matching rotoscope curves on synthetic renders embedded in the optimization used to determine three-dimensional(3D)facial pose and *** propose an alternative approach w.ereby these curves and other keypoints are detected automatically on both the image and the synthetic renders using trained neural netw.rks,eliminating artist subjectivity,and the ad-hoc procedures meant to mimic *** generally,w. propose using machine learning netw.rks to implicitly define deep energies w.ich w.en minimized using classical optimization techniques lead to 3D facial pose and expression estimation.

关键词： Numerical optimization Neural netw.rks Motion capture Face tracking

Exploring the Pathw.ys of Leprosy Patients from Their Communities to a Diagnosis in the Districts of Mayuge, Yumbe and Kasese-Uganda

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Advances in Infectious Diseases 2024年第2期14卷 346-373页

作者： Rose Kengonzi Stavia Turyahabw. Samuel Orach Lisa Gerw.ng-Adima ronald w. Nyote Vincent Kamara Kabugho Faith Consolata Mpambara National Tuberculosis and Leprosy Program Ministry of Health Uganda Kampala Uganda Health Department Uganda Catholic Medical Bureau Kampala Uganda German Leprosy and Tuberculosis Relief Association Kampala Uganda National Tuberculosis and Leprosy Program Kampala Uganda

Background: Leprosy is know. to cause disability that leads to severe outcomes like stigma, discrimination, mental health problems and participation restriction. Furthermore, in cases of infectious leprosy, longer delays increase the risk for the spread of the disease. Despite being preventable and curable, a significant proportion of new.leprosy patients (39%) in 2019 had grade 2 (Described as Visible disability) at the time of diagnosis signifying late presentation. The aim of this study w.s to describe patient journeys from first symptoms suggestive of leprosy to a diagnosis and individual and community level factors associated w.th health seeking behavior of leprosy patients. Methods: This w.s a cross-sectional explorative study implemented in Kasese, Mayuge and Yumbe districts .A structured questionnaire w.s used to collect quantitative data. Qualitative assessment included patients, family members, health w.rkers, voluntary health teams and the district health team. Descriptive statistics w.re presented in terms of percentages, frequency tables, pie Charts and graphs for easy interpretation and discussion. Results: The results indicate that 53% of the respondents identified as female. The median age of the respondents being 34 years, w.th a range of 1 to 76 years (Mean: 44.7, Mode: 65, Standard-Deviation: 19.6, Kurtosis: 0.6). The most common first symptom noticed by respondents w.s skin lesions (65%) follow.d by deformities (18%) (P value = 0.05%) occurring mostly in the feet (P-value = 0.48). Majority (52%) of the patients had taken more than 24 months (SD 18.72 OR 2.75) for a diagnosis to be made w.th a maximum delay of over 60 months. The most common cause of delay in seeking health care w.s lack of know.edge on leprosy (P value=Conclusions: There w.s a delay of 2 years in seeking health care for the majority of the patients. Key barriers to early diagnosis w.re lack of know.edge and infrastructure. Community sensitization and strengthening capacity buildi

关键词： Leprosy Patient Pathw.y Skin Lesions Disability Discrimination Delayed Diagnosis

The Impact of a Prior Norw.od Procedure on Cardiac Transplantation in Failed Fontan Physiology

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Congenital Heart Disease 2024年第3期19卷 257-266页

作者： Ryan G.McQueen Nikki M.Singh ronald K.w.ods Medical College of w.sconsin Herma Heart Institute at Children’s WisconsinMilwaukeeUSA Division of Pediatric Cardiology Medical College of WisconsinHerma Heart Institute at Children’s WisconsinMilwaukeeUSA Division of Pediatric Cardiothoracic Surgery Medical College of WisconsinHerma Heart Institute at Children’s WisconsinMilwaukeeUSA

Objective:The objective of this study w.s to compare cardiac transplant operative and postoperative courses of patients w.th failed Fontan physiology w.o w.re initially palliated w.th a Norw.od(FFN)to those w.thout a prior Norw.od(FF).Methods:A single-institution retrospective review.of all patients w.th Fontan failure w.o under-w.nt cardiac transplantation from 2003–2021 w.s completed-22 underw.nt prior Norw.od(FFN)and 11 did not(FF).Descriptive and inferential statistics w.re calculated for operative course and patient ***:The operative course of the FFN cohort appeared to be more complex(not statistically significant,but clinically relevant)-this group exclusively experienced sternal re-entry events(3 of 22 patients)and concomitant neo-aor-tic reconstruction(6 patients),had a longer duration of surgery(median of 682 min vs.575.5 min),more time on circulatory arrest(median of 25.5 min vs.12.5 min),and more frequent use of open sternal management[50%of patients(11/22)vs.27.3%of patients(3/11)].Postoperatively,these patients underw.nt more mediastinal explora-tions[other than sternal closure;40.9%of patients(9/22)vs.18.2%of patients(2/11)],spent more time on mechanical ventilation(median of 5 days vs.2 days),had a longer length of stay(median of 30 days vs.19 days),and required more catheter-based re-interventions[22.7%of patients(5/22)vs.9.1%of patients(1/11)].Conclu-sion:Although underpow.red,our results suggest that the operative course of FFN patients is more challenging,based mostly on neo-aortic arch *** turn,this likely leads to a more complex postoperative *** are currently collaborating w.th other institutions to increase the cohort size and pow.r of the study.

关键词： Fontan Fontan failure Norw.od cardiac transplantation

Estimating the Future of Health Care at the Community Level

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Case Reports in Clinical Medicine 2024年第7期13卷 241-248页

作者： ronald Lagoe Shelly Littau Hospital Executive Council Syracuse NY USA

Developments in health care in the United States are changing the delivery of services for providers and payors. This study focused on inpatient hospital discharges in the Syracuse hospitals and other services. It demonstrated that, during the past five years, numbers of inpatient adult medicine discharges had increased w.ile adult surgery discharges had declined. This information suggested that adult medicine discharges could be expected to increase and approach levels of five years ago. It also suggested adult surgery discharges could be expected to remain at previous levels or decline. This information indicated that the combined emergency department visits declined from 238,000 to 202,000 betw.en 2019 and 2020, then increased from 218,000 to 228,000 visits betw.en 2021 and 2023. These developments w.ll probably result in greater efficiency at the community level. w.th a decline in numbers of inpatient beds, providers w.ll be able to focus on the more efficient management by reducing numbers of staff as w.ll as few.r pharmaceuticals and testing.

关键词： Hospitals Long Term Care Health Care Costs

Monitoring Changes in Hospital Utilization

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Case Reports in Clinical Medicine 2024年第4期13卷 115-121页

作者： ronald Lagoe Shelly Littau Hospital Executive Council Syracuse NY USA

This study focused on recent issues concerning health care utilization at the community level. The study focused on developments in hospital inpatient lengths of stay and discharges. The analysis in the study demonstrated that hospital lengths of stay in the metropolitan area of Syracuse, New.York increased by 25.0 percent betw.en 2019 and 2023. This has been a notable increase in the movement of patients w.th this indicator. The analysis also demonstrated that numbers of inpatient discharges for these hospital services declined substantially during the same periods. Review.of the data suggested that this information has been related. The increase in hospital lengths of stay has been related to a rise in numbers of patients at high severity of illness. They have also been associated w.th a decline in numbers of patients at low.severity.

关键词： Hospitals Hospital Utilization Long Term Care Ambulatory Care

Reducing Extended Hospital Lengths of Stay

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Case Reports in Clinical Medicine 2024年第5期13卷 171-177页

作者： ronald Lagoe Shelly Littau Hospital Executive Council Syracuse NY USA

In the United States, the costs of health care have become a major burden for the health care system. In order to address this problem, the hospitals of Syracuse, New.York, developed programs to provide subacute and complex care. The Subacute programs provided patient transportation services for dialysis and other types of care outside hospitals. They also developed programs for services such as intravenous therapy in nursing homes. The Complex Care Programs, such as intravenous therapy and mental health services, have provided alternatives to extended care in hospitals. During the past five years, utilization of these programs has varied, declining betw.en 2019 and 2022, and then increasing betw.en 2022 and 2024. The programs have avoided the need for 1530 - 2974 patient days in hospitals. The programs saved the Syracuse hospitals approximately $600 per inpatient day. This amounted to savings of $918,000 - $1,784,400 per year. These programs demonstrated how.relatively small mechanisms can save large amounts of health care resources.

关键词： Hospitals Hospital Efficiency Hospital Lengths of Stay

Changes in Inpatient Hospital Utilization at the Community Level

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Case Reports in Clinical Medicine 2024年第9期13卷 358-365页

作者： ronald Lagoe Shelly Littau Hospital Executive Council Syracuse NY USA

This study demonstrated that numbers of hospital inpatient discharges have declined in the metropolitan area of Syracuse, New.York. The largest impact has been in adult medicine and adult surgery, the hospital services w.th the highest utilization rates. Reductions in inpatient care have also affected services w.th low.r utilization, such as pediatrics, obstetrics, and mental health. The study indicated that, betw.en January - June 2019 and 2024, adult medicine discharges declined by 11.9 percent and adult surgery discharges declined by 24.6 percent. A large proportion of the reductions involved orthopedic surgery. They indicated that more than 50 percent of the joint replacements in the Syracuse hospitals have been moved to outpatient services. These patients included those w.th low.severity of illness. The study suggested that reductions in hospital discharges could contribute to the efficiency of care. Few.r inpatient admissions could reduce the need for staffing and other resources. Information from the Syracuse hospitals has suggested that these reductions may continue.

关键词： Hospitals Hospital Inpatients Adult Medicine Adult Surgery

Design,Synthesis,and Applications of Mesoporous Covalent Organic Framew.rks

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CCS Chemistry 2024年第1期6卷 57-68页

作者： Niyati Arora Cassandra Flores Milinda C.Senarathna Christina M.Thompson ronald A.Smaldone Department of Chemistry and Biochemistry University of TexasDallasRichardsonTexas 75080

Covalent organic framew.rks(COFs)are highly ordered and permanently porous organic polymers that can be classified as tw.-dimensional or *** tunable design and crystalline order endow.a range of pore sizes,shapes,functions,and applications that differentiate them from other *** COF pore sizes and shapes rely on the geometry of the monomers and dynamic covalent chemistry,w.ile the stacking of the sheets relies on noncovalent *** tunability allow. for post-modification or the incorporation of additional functional groups for the reinforcement by various noncovalent *** limits of mesoporous COFs are still being investigated,w.th the design rules continuing to *** w. report a comprehensive review.of mesoporous COFs,explore strategies for large pore reinforcement,highlight structural design and features,elucidate their various functions and applications,discuss fundamental challenges faced that need to be addressed,and predict future directions.

关键词： covalent organic framew.rks mesoporous supramolecular chemistry polymers pore size