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Medical consultation in ulcerative colitis:Key elements for improvement

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World Journal of Gastroenterology 2023年第6期29卷 917-925页

作者： Yago González-lama Elena Ricart Ana Cábez Pilar Fortes Susana Gómez Francesc Casellas Inflammatory Bowel Disease Unit Department of Gastroenterology and HepatologyHospital Universitario Puerta de Hierro-MajadahondaMadrid 28222Spain Inflammatory Bowel Disease Unit Department of GastroenterologyHospital ClínicBarcelona 08036Spain Biomedical Research Networking Center in Hepatic and Digestive Diseases(CIBERehd) Barcelona 08036Spain Department of Medical Pfizer SpainMadrid 28108Spain Servicio de Reumatología Hospital Universitario de SalamancaSalamanca 37007Spain Department of Gastroenterology Vall d'Hebron Research InstituteBarcelona 08035Spain

Ulcerative colitis(UC)is a chronic inflammatory disease with a high *** order to improve patient outcomes,the clinician-patient relationship in daily practice is *** guidelines provide a framework for UC diagnosis and ***,standard procedures and the medical content focused upon medical consultations in UC patients has not yet been ***,UC is a complex disease,given that patient characteristics and patient needs have been proven to vary during clinical consultation since establishing the diagnosis and upon the course of the *** this article,we have discussed the key elements and specific objectives to consider in medical consultation,such as diagnosis,first visits,follow-up visits,active disease patients,patients on topical therapies,new treatment initiation,refractory patients,extra-intestinal manifestations,as well as challenging *** key elements have been mentioned to comprise effective communication techniques,motivational interviewing(MI),as well as information and educational aspects,or organizational *** key elements to be implemented in daily practice were reported to comprise several general principles like duly prepared consultations,in addition to honesty and empathy with patients,as well as effective communication techniques,MI,information and educational points,or organizational *** role of other healthcare professionals such as specialized nurses,psychologists,or the use of checklists was also discussed and commented on.

关键词： Ulcerative colitis Patient experience Shared decision making Medical consultation Motivational interviewing Patient education

Explainable Classification Model for Android Malware Analysis Using API and Permission-Based Features

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Computers, Materials & Continua 2023年第9期76卷 3167-3188页

作者： Nida Aslam Irfan Ullah Khan Salma Abdulrahman Bader Aisha Alansari lama Abdullah Alaqeel Razan Mohammed Khormy Zahra Abdultawab AlKubaish Tariq Hussain SAUDI ARAMCO Cybersecurity Chair Department of Computer ScienceCollege of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityP.O.Box 1982Dammam31441Saudi Arabia Department of Computer Science College of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityP.O.Box 1982Dammam31441Saudi Arabia Computer Engineering Department College of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityP.O.Box 1982Dammam31441Saudi Arabia School of Computer Science and Technology Zhejiang Gongshang UniversityHangzhouChina

One of the most widely used smartphone operating systems,Android,is vulnerable to cutting-edge malware that employs sophisticated *** malware attacks could lead to the execution of unauthorized acts on the victims’devices,stealing personal information and causing hardware *** previous studies,machine learning(ML)has shown its efficacy in detecting malware events and classifying their ***,attackers are continuously developing more sophisticated methods to bypass ***,up-to-date datasets must be utilized to implement proactive models for detecting malware events in Android mobile ***,this study employed ML algorithms to classify Android applications into malware or goodware using permission and application programming interface(API)-based features from a recent *** overcome the dataset imbalance issue,RandomOverSampler,synthetic minority oversampling with tomek links(SMOTETomek),and RandomUnderSampler were applied to the Dataset in different *** results indicated that the extra tree(ET)classifier achieved the highest accuracy of 99.53%within an elapsed time of 0.0198 s in the experiment that utilized the RandomOverSampler ***,the explainable Artificial Intelligence(EAI)technique has been applied to add transparency to the high-performance ET *** global explanation using the Shapely values indicated that the top three features contributing to the goodware class are:Ljava/net/URL;->openConnection,Landroid/location/LocationManager;->getLastKgoodwarewnLocation,and *** the other hand,the top three features contributing to themalware class are Receive_Boot_Completed,Get_Tasks,and Kill_Background_*** is believed that the proposedmodel can contribute to proactively detectingmalware events in Android devices to reduce the number of victims and increase users’trust.

关键词： Android malware machine learning malware detection explainable artificial intelligence cyber security

Total pancreatectomy with islet cell transplantation vs intrathecal narcotic pump infusion for pain control in chronic pancreatitis

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World Journal of Gastroenterology 2016年第16期22卷 4160-4167页

作者： Mohamad Mokadem lama Noureddine Thomas Howard Lee Mc Henry Stuart Sherman Evan L Fogel James L Watkins Glen A Lehman Division of Gastroenterology and Hepatology Roy J. and Lucille A. Carver College of Medicine University of Iowa Iowa IA 52242 United States Division of Nephrology and Hypertension Roy J. and Lucille A. Carver College of Medicine University of Iowa Iowa IA 52242 United States Community Health Network Indianapolis IN 46219 United States Division of Gastroenterology and Hepatology Indiana University Medical Center Indianapolis IN 46202 United States

AIM: To evaluate pain control in chronic pancreatitis patients who underwent total pancreatectomy with islet cell transplantation or intrathecal narcotic pump ***: We recognized 13 patients who underwent intrathecal narcotic pump(ITNP) infusion and 57 patients who underwent total pancreatectomy with autologous islet cell transplantation(TP + ICT) for chronic pancreatitis(CP) pain control between 1998 and 2008 at Indiana University Hospital. All patients had already failed multiple other modalities for pain control and the decision to proceed with either intervention was made at the discretion of the patients and their treating physicians. All patients were evaluated retrospectively using a questionnaire inquiring about their pain control(using a 0-10 pain scale), daily narcotic dose usage, and hospital admission days for pain control before each intervention and during their last follow-up. RESULTS: All 13 ITNP patients and 30 available TP + ICT patients were evaluated. The mean age was approximately 40 years in both groups. The median duration of pain before intervention was 6 years and 7 years in the ITNP and TP + ICT groups, respectively. The median pain score dropped from 8 to 2.5(on a scale of 0-10) in both groups on their last follow up. The median daily dose of narcotics also decreased from 393 mg equivalent of morphine sulfate to 8 mg in the ITNP group and from 300 mg to 40 mg in the TP + ICT group. No patient had diabetes mellitus(DM) before either procedure whereas 85% of those who underwent pancreatectomy were insulin dependent on their last evaluation despite ICT. CONCLUSION: ITNP and TP + ICT are comparable for pain control in patients with CP however with high incidence of DM among those who underwent TP + ICT. Prospective comparative studies and longer follow up are needed to better define treatment outcomes.

关键词： Chronic pancreatitis Intractable pain Total pancreatectomy Islet cell transplantation Intrathecal narcotic pump infusion

A Tale of Two Neighbors

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Beijing Review 2019年第9期62卷 26-27页

作者： Mahendra P.lama South Asian economies at the Jawaharlal Nehru University

A look at key reforms,successes and some failures in China and *** both China and India,economic reform has been key to ***,it has ramifications as *** two countries’politico-economic backdrops as they sought to unde... 详细信息

关键词： A Tale of Two Neighbors World

不同预处理技术对脱水污泥干式发酵产甲烷性能影响研究

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不同预处理技术对脱水污泥干式发酵产甲烷性能影响研究

作者： Arun lama 清华大学

学位级别：硕士

厌氧消化性能的提高可增加甲烷的产量,并从可生物降解废物(如,生活污水污泥)中回收更多的可再生能源。为了达到这一目的,本文对厌氧消化的多种预处理方法及处理条件的优化设计开展了研究。本研究的目的在于强化脱水污泥(TS为17-20%)的... 详细信息

厌氧消化性能的提高可增加甲烷的产量,并从可生物降解废物(如,生活污水污泥)中回收更多的可再生能源。为了达到这一目的,本文对厌氧消化的多种预处理方法及处理条件的优化设计开展了研究。本研究的目的在于强化脱水污泥(TS为17-20%)的厌氧消化水解能力,从而解决污泥干式发酵效率低的问题。基于生物产甲烷潜势(BMP)和有机物降解率(TS、VS和COD)两项指标,对机械法(超声波)、化学法(酸处理、臭氧)、及机械化学联合法(超声-臭氧)等多种预处理方法的效果进行了评估。其中,超声波预处理在各种单一技术中具有最好的效果,污泥BMP增加了51.15%,而TS、VS及COD分别比对照组降低30.09%、36.92%和33.88%。相比于单一技术,机械化学联合法(超声-臭氧)效果更加显著。经过了联合预处理的污泥相比于对照组其BMP增加了58.01%,而TS、VS及COD降解率则分别提高了53.70%、63.74和57.31%。研究还表明,脱水污泥的BMP增加量与预处理中药剂投加量或能量密度呈正相关,例如,在联合预处理法中,保持超声波能量密度不变(53.5 k J/g VS),在0.05-0.11 O3/g VS投加范围时,BMP随臭氧剂量的增大而增加。本论文首次研究和评估了不同预处理方法对污泥干式厌氧消化性能的影响。研究表明,物理预处理方法优于化学法。这是因为超声波等物理预处理方法不仅能促使污泥菌胶团细胞裂解,强化大分子的水解,同时不会改变裂解所释放物质的化学性质,而直接作为后续厌氧消化的底物。此外,由于在一定范围内污泥BMP性能的增加与预处理能耗及药剂成本呈线性相关关系,在实际工程中,预处理技术的应用需要考虑能耗及药剂的成本。

关键词：干式发酵脱水污泥生物产甲烷潜势预处理

城市形态对空间活动的影响——约旦尔比德社区的活动模式

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城市形态对空间活动的影响——约旦尔比德社区的活动模式

作者： lama Akmeel 北京交通大学

学位级别：硕士

居住区的新型城市规划未能在社交活动和个人的私人空间之间取得平衡,而建筑环境在塑造人类活动和互动方面起着重要作用,本研究旨在研究居住区的城市形态与建筑间街道活动模式的关系,以及它如何影响居民之间的社会关系。本文将回答一个问... 详细信息

居住区的新型城市规划未能在社交活动和个人的私人空间之间取得平衡,而建筑环境在塑造人类活动和互动方面起着重要作用,本研究旨在研究居住区的城市形态与建筑间街道活动模式的关系,以及它如何影响居民之间的社会关系。本文将回答一个问题:“城市形态的特征如何影响居民区的活动模式?”。这项研究特别关注约旦北部伊尔比德市的四个社区,并对这些社区的分析结果进行比较。通过问卷调查、访谈、城市观察、查阅公开发表的文献和报告等方式,采用定量和定性相结合的方法进行调查;本次调查的数据除了传统的走访住宅及聚集区的方法外,还通过社交媒体平台从各个社区的居民中收集数据。研究结果表明,社区街道的活动模式受城市形态的影响;因此,基于调查结果和对提高人们生活质量的城市形态特征的展望,本论文为规划师、建筑师和决策者进行了推荐和建议。

关键词：社交活动人类行为城市形态活动模式户外公共空间

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颅咽管瘤患者手术前后激素变化经验分析

颅咽管瘤患者手术前后激素变化经验分析

作者： Pooja lama 天津医科大学

学位级别：硕士

在本论文的简要概述本组患者的年龄、性别分布、复发模式和激素变化,以往的报道侧重于患者症状而忽视它的实际比率,我们的研究更注重患者激素波动和内分泌疾病。尽管组织学低度恶性,长期随访和并发症的处理具有挑战性。临床症状包括肿... 详细信息

在本论文的简要概述本组患者的年龄、性别分布、复发模式和激素变化,以往的报道侧重于患者症状而忽视它的实际比率,我们的研究更注重患者激素波动和内分泌疾病。尽管组织学低度恶性,长期随访和并发症的处理具有挑战性。临床症状包括肿瘤在鞍旁生长导致继发于颅内压增高,脑积水,或压迫中枢神经系统的重要结构,引起头痛,恶心,视力模糊,以及多尿和烦渴。它是众所周知,颅咽管瘤通常导致内分泌异常由于其起源部位同下丘脑之间关系密切。由于肿瘤对下丘脑结构的破坏及各种内分泌失常的治疗反过来对患者的生活质量产生影响。大多数患者(85-95%)遭受多种下丘脑-垂体功能缺陷,包括完成垂体功能不全,而术前缺乏激素全面恢复只发生在极少数情况下,生长激素替代疗法是治疗生长激素缺乏一个被证实的有效、安全的治疗方案。然而,肿瘤对下丘脑结构的破坏和或其治疗的紊乱被认为是贪食和肥胖主要的致病原因,下丘脑损伤程度和后遗症由影像学评估。无论初始手术治疗与手术和／或放射治疗,在随访的过程中内分泌及代谢紊乱更加明显。而术前缺乏激素全面恢复只发生在极少数情况下。通过单变量分析,神经、血管和视觉并发症和患者术后内分泌病变相关,而和患者年龄关系不明显。因此,为了减少内分泌对患者的影响,我们对患者的内分泌情况进行研究。目的 ·分析术前和术后颅咽管瘤患者垂体前叶激素的变化。 ·观察平均年龄,性别比例,甲状腺功能减退症在研究样本中的频率。 ·要查看哪些激素对术后患者的整体内分泌不足的比例最大,并帮助采取必要的措施,在未来患者进一步管理中以尽量减少其影响。 ·检讨生长激素在成人颅咽管瘤病人在我们的研究结果。方法和材料 (一)研究人群/纳入标准：年龄>18年手术类型：肿瘤整体全切除手术。手术方式：额外侧入路单人操作,以减少外科医生的手术技术偏见。 (二)研究设计：在环湖医院2008至2013年手术治疗的34例成人患者的病历资料进行回顾性研究。学习的参考值是按照环湖医院实验室。 T3:1.3-3.1nmol/L T4:66-181nmol/L TSH:0.27-4.2UIU/毫升 GH：0.06-5.0纳克/毫升 PRL：2.5-17纳克/毫升 LH:0.8-7.6MIU/毫升 ADH：2.2-14皮克/毫升促肾上腺皮质激素：0-46皮克/毫升 COR：5-25微克/分升 FSH:0.7-11.7mIU/L 数据采用统计软件包社会科学(SPSS软件版本17.0)进行统计学分析。使用非参数2依赖性样品测试(Wilcoxon符号秩检验)统计显着性进行了评估。数据以0.05为检验标准。结果 1.平均年龄及病人的标准偏差纳入本研究分别为(47.11±1.2)岁,平均50岁。 2.女性与男性的比例,在我们的研究为1：1.3 3.甲状腺激素的手术前和手术后激素状态如下：手术前T3,T4, TSH的血浆平均水平分别为2.41nmol/L,48.99nmol/L,2.05uIU/ml,术后***分别为1.73nmol/L,23.47nmol/L和0.16UIU/ml。 4.有其他垂体前叶激素水平如下：手术前后LH血浆平均水平分别为3.35MIU/ml和1.78MIU/ml时,泌乳素分别为24.04ng/mL和18.59ng/ml,促肾上腺皮质激素和生长激素均为是0.372ng/ml和0.34ng/ml,肾上腺皮质激素分别为15.81微克／分升和8.30微克／毫升,FSH分别为是8.94MIU/L和4.87MIU/***手术前后的平均血浆值有显著差异,PRL手术前后激素平均值的差异不明显。讨论：手术前内分泌疾病常见于颅咽管瘤患者。临床特征可能不是很明显,细致的手术前的内分泌评估是必不可少的。未能认识到并解决手术前尿崩症和继受任何手术治疗后会使内分泌功能障碍进一步恶化。研究显示,激素功能障碍的下降趋势。预言这个趋势可以很容易,但要知道激素的模式也是必不可少的。不是所有的激素均往下掉。我们研究了单个激素,得到了各激素的术前和术后的比例。甲状腺功能和促甲状腺激素：我们对甲状腺激素的研究和以往文献尽管有所不同;甲状腺功能减退症总体发生率在手术前后分别为61%和73.5%(P<0.01)。Honegger等人报道,甲状腺功能减退症手术前后的发病率分别为24.5%和38.5%,均较我们的研究要低得多。其结果是基于T3和T4手术后三个月的测量,但我们的结果是根据手术后一周测量。两项研究之间的时间间隔可能有助于解释他们的区别。另一项研究中甲状腺功能减退症在手术前后的发病率分别70%和95%,较我们的研究高,这项研究表明,甲状腺素应全部切除颅咽管瘤术后常规服用。我们的结果发现TSH是最常见的激素缺乏类型,LH激素缺乏紧随其后。甲状腺激素是最常见的激素功

关键词：颅咽管瘤激素手术治疗

Awareness and Usage of Computer and Internet among Medical Faculties’ Students at the University of Jordan

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Journal of Software Engineering and Applications 2016年第5期9卷 147-154页

作者： Tamara Almarabeh lama Rajab Yousef Kh. Majdalawi Computer Information Systems Department The University of Jordan Amman Jordan

The rapid development of information communication technology blazed a trail in our learning, work, and lives. This study was conducted to ascertain the computer and internet literacy level of medical faculties’ students. 171 first-year medical students from 4 different medical colleges of the University of Jordan participated in the study. A semi-structured questionnaire was used to collect the data and the data analysis was done by using SPSS, Version 17. The results indicated that most medical students have average 5 or advance knowledge on the basic use of computer and internet. Google was found to be the most commonly used search engine. Also the study found that ICT (Information and Communication Technology) can be a useful tool in medical education but the lack of time, internet connectivity and resources is still a serious constraint.

关键词： ICT Jordan Internet Attitudes Literacy

Is it inflammatory linear verrucous epidermal nevus or linear psoriasis？

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Chinese Medical Journal 2013年第9期126卷 1794-1795页

作者： YIN Bin RAN Yu-ping WANG Peng Jebina lama Department of Dermatovenereology West China Hospital Sichuan UmversityChengdu Sichuan 610041 China

To the editor： Inflammatory linear verrucous epidermal nevus （ILVEN） is an epidermal nevus reflecting genetic mosaicism.1It resembles linear psoriasis clinically and histologically, and there are no generally accepted pathognomonic features.2 Therefore differentiation of the two diseases has always been difficult in clinical settings.

关键词： ILVEN