Invalid Cases Research Articles

Canonical correlation-based relationships between social support and sleep quality in a hospital psychiatric outpatient population with examining the mediating roles of anxiety and depressive symptoms

Objective: This study aims to examine the associations between various dimensions of social support and sleep quality in a hospital psychiatric outpatient population using canonical correlation analysis, while also investigating the potential mediating roles of anxiety and depressive symptoms. Methods: Employing a cross-sectional design, survey data were collected from 10,071 individuals visiting Hangzhou Seventh People’s Hospital between October 2020 and October 2023. After excluding invalid cases, a total of 10,063 participants were included for analysis. The survey encompassed gathering basic demographic information as well as administering the Social Support Rating Scale, Self-rating Depression Scale, Self-rating Anxiety Scale, and Pittsburgh Sleep Quality Index Scale. Data analysis was conducted using SPSS 27.0 statistical software with canonical correlation analysis employed to examine the relationships. Additionally, the mediating effects of anxiety and depression symptoms were examined using the SPSS PROCESS macro. Results: Canonical correlation analysis reveals a significant positive correlation between social support dimensions and various aspects of sleep quality. The first pair of canonical variables (r = 0.586, p < 0.001) accounts for an impressive 97% of the cumulative contribution. It is found that this pair of canonical variables explains 68.9% of the variance in social support and 49.0% in sleep quality. Mediation analysis revealed that anxiety and depressive symptoms significantly mediated the relationship between social support and sleep quality, accounting for 88% of the total effect. Specifically, anxiety accounted for 47% mediation while depression accounted for 41%. Conclusion: The study findings revealed a significant positive correlation between social support and sleep quality dimensions, indicating a robust association between increased social support and enhanced individual sleep quality. Furthermore, the results indicated that anxiety and depression partially mediated the relationship between social support and sleep quality, offering novel insights into the intricate connection between mental health and sleep quality.

DeepCNP: An Efficient White-Box Testing of Deep Neural Networks by Aligning Critical Neuron Paths

ContextErroneous decisions of Deep Neural Networks may pose a significant threat to Deep Learning systems deployed in security-critical domains. The key to testing DNNs is to propose a testing technique to generate test cases that can detect more defects of the models. It has been demonstrated that coverage-guided fuzz testing methods are difficult to detect the correctness defects of model's decision logic. Meanwhile, the neuron activation threshold is set based on experience, which increases the uncertainty of the test even more. In addition, the randomly selected seed mutations are prone to generate a large number of invalid test cases, which has a great impact on the testing efficiency. ObjectiveThis paper introduces DeepCNP, a method that combines Critical Neuron Paths alignment and dynamic seeds selection strategy, which can comprehensively and efficiently test all the decision paths of DNN and generate as many different classes of test cases as possible to expose misbehaviors of the model and thus finding defects. MethodDeepCNP utilizes training data to construct decision paths determined by the neuron output distribution, and aligns different decision paths in order to generate test cases. Seeds that are easy to align are dynamically selected based on the decision paths to be tested, and the labeling of seed mutations is specified during the path alignment process, thus improving the efficiency of fuzz testing. ResultsExperimental results show that DeepCNP achieves new state-of-the-art results, pioneering the testing of all decision logics of the model through critical neuron path alignment, which greatly enhances the number of defects found, the efficiency and number of generated test cases. ConclusionDeepCNP comprehensively tests the decision logic of DNNs, efficiently generating a large number of test cases of different categories to expose model's misbehaviors and thus finding additional defects.

10195-MET-11 THE PREDICTIVE FACTORS OF EFFICACY OF PEMBROLIZUMAB IN BRAIN METASTASES OF LUNG CANER

Abstract The main treatment for metastatic brain tumors is radiation therapy or surgical removal. Since the pembrolizumab, an anti-PD1 monoclonal antibody, was revealed to be effective for brain metastases of lung cancer, it has been used as a therapeutic option. However, the predictive factors of its efficacy have been unclear. If the efficacy of pembrolizumab can be predicted prior to the treatment of metastatic brain tumors, it will have a significant impact on subsequent treatment strategies. In this study, we performed a retrospective analysis of patients with metastatic brain tumors from lung cancer treated with pembrolizumab to investigate predictive factors of pembrolizumab efficacy. From January 2018 to July 2023, 73 patients were treated with pembrolizumab for brain metastases of lung cancer at our institution. Among them, 16 patients who had received pembrolizumab for at least 1 year were included. Median age was 68 years (45-86), 10 were male (63%), and median period of pembrolizumab treatment was 105 months (49-319). Patients with brain metastasis which was well controlled for at least 2 years after starting pembrolizumab were defined as effective, and those who required new treatment were defined as invalid. There were 11 effective cases and 5 invalid cases. We compared clinical characteristics, genetic characteristics of the primary tumor, and imaging characteristics of metastatic brain tumors between the effective and ineffective cases, and identified predictive factors for efficacy of pembrolizumab.

Rapid screening for suicide risk: An algorithmic approach.

In the United States, primary medical care settings are the first accessed resource for both medical and behavioral health care. Thus, there is a clear need for accurate and efficient behavioral health screening in this setting, including routine surveillance screening for suicide risk. The Multidimensional Behavioral Health Screen (MBHS), a broadband but very brief screening tool developed specifically for primary care, has been updated to include an algorithm that classifies suicide risk based on the interpersonal-psychological theory of suicide, and associated interview and decision framework. This study aims to evaluate the predictive accuracy of the new MBHS 2.0 suicide risk algorithm, with actual risk determined by clinical suicide risk interview. Data were collected as part of a larger study that, overall, included 551 college student participants. Of these, 309 completed the MBHS 2.0 and the clinical suicide risk interview, the two measures reported here. The final participant count was 299 following the removal of incomplete or invalid cases. Predicted suicide risk as determined by the MBHS 2.0 (Low, Mild, At least Moderate) was compared to actual risk as determined by clinical interview (Low, Moderate, Severe, Extreme). Utilizing chi-square analyses, data show a significant association between the predicted suicide risk category based on the MBHS 2.0 algorithm and the actual risk category based on the semi-structured clinical interview. Furthermore, classification analyses suggest that primary care providers will be able to confidently assess the suicide risk level for the majority of their patients when using the MBHS. Findings suggest that the MBHS 2.0 can be an accurate and efficient tool for use by primary care providers in classifying suicide risk. Future research will be useful to evaluate the utility of the suicide risk algorithm among primary care populations.

85 Performance Consistency on a Measure of Sustained and Selective Attention

Objective:Attention concerns, particularly difficulties with focusing and regulating attention, are reported in diverse clinical contexts. The Ruff 2&amp;7 Selective Attention Test (Ruff 2&amp;7; Ruff &amp; Allen, 1996) is a measure of sustained and selective attention that assesses automatic detection and effortful processing. The goal of this study was to create an internal consistency metric within this test and to determine cognitive predictors by evaluating associations with executive control of attention and other cognitive skills. It was hypothesized that those who are more consistent across Ruff 2&amp;7 performance would have more robust executive functioning skills, particularly those related to regulating and directing attention and the planning and utilization of cognitive resources.Participants and Methods:The current study examined a clinical sample of 98 United States veterans with a history of mild traumatic brain injury. After excluding invalid cases (n=24), the final sample consisted of 74 veterans (Age=38.5 (8.9) years old; 13.9 (2.2) years of education; 78% male; 82% white, 7% Black, 8% Hispanic, 2% Asian). A consistency score was defined as the absolute value of the intertrial change in target hits plus errors across each pair of trials of the same stimulus type (Automatic Detection, AD, and Controlled Search, CS). Hierarchical linear regression modeling was used to evaluate the relative contributions of memory and executive functions (Rey Auditory Verbal Learning Test, Delis-Kaplan Executive Function System Tower Test, phonemic fluency, Trail Making Test B) and subjective symptom report (PTSD Checklist for DSM-5, Barkley Adult ADHD Rating Scale for DSM-IV).Results:The mean deviation scores for the two trial types were similar (AD mean=13.6, SD=5.9; CS mean=13.6, SD=5.3). In predicting consistency across AD trials, delayed recall contributed 11% unique variance (p=.013), while no other block was statistically significant. For CS trials, self-reported PTSD and inattention symptoms contributed a combined 20% of unique variance to the model (p=.007), while there were no statistically significant cognitive predictors in this model.Conclusions:Contrary to expectation, executive function measures did not explain statistically significant variance in performance across either trial type. Less consistent performance on AD trials was associated with weaker verbal memory. Less consistent performance on CS trials, which theoretically require greater executive control, was not associated with any cognitive scores, but was associated with more severe self-reported psychological and inattention symptoms. These findings buttress the conceptual distinction between AD and CS trial types, and they point to both cognitive and non-cognitive underpinnings of performance consistency.

Problematic Internet Use among Adolescents 18 Months after the Onset of the COVID-19 Pandemic.

Studies in recent years and especially since the beginning of the COVID-19 pandemic have shown a significant increase in the problematic use of computer games and social media. Adolescents having difficulties in regulating their unpleasant emotions are especially prone to Problematic Internet Use (PIU), which is why emotion dysregulation has been considered a risk factor for PIU. The aim of the present study was to assess problematic internet use (PIU) in adolescents after the third wave (nearly 1.5 years after the onset in Europe) of the COVID-19 pandemic. In the German region of Siegen-Wittgenstein, all students 12 years and older from secondary-level schools, vocational schools and universities were offered a prioritized vaccination in August 2021 with an approved vaccine against COVID-19. In this context, the participants filled out the Short Compulsive Internet Use Scale (SCIUS) and two additional items to capture a possible change in digital media usage time and regulation of negative affect due to the COVID-19 pandemic. A multiple regression analysis was performed to identify predictors of PIU. The original sample consisted of 1477 participants, and after excluding invalid cases the final sample size amounted to 1268 adolescents aged 12-17 (x = 14.37 years, SD = 1.64). The average prevalence of PIU was 43.69%. Gender, age, digital media usage time and the intensity of negative emotions during the COVID-19 pandemic were all found to be significant predictors of PIU: female gender, increasing age, longer digital media usage time and higher intensity of negative emotions during the COVID-19 pandemic were associated with higher SCIUS total scores. This study found a very high prevalence of PIU among 12- to 17-year-olds for the period after the third wave of the COVID-19 pandemic, which has increased significantly compared to pre-pandemic prevalence rates. PIU is emerging as a serious problem among young people in the pandemic. Besides gender and age, pandemic-associated time of digital media use and emotion regulation have an impact on PIU, which provides starting points for preventive interventions.

Clinical Study of Different Treatment Methods for Tuberculous Pleuritis Complicated with Pleural Tuberculoma.

Objective To compare the clinical efficacy and adverse drug reactions of four different schemes in the treatment of pleural tuberculoma. Methods A total of 120 patients with pleural tuberculoma admitted to the Tuberculosis Department of our hospital from January 2018 to January 2021 were selected as the research subjects. According to different treatment methods, the patients were divided into four groups, with 30 cases in each group. They were as follows: group A received classical HRZE regimen, group B received HRZE+pleural injection, group C received HZE+rifabutin, and group D received HZE+rifabutin+pleural injection. All patients were treated intensively for 3 months and then consolidated treatment for 6 months according to the patient's condition. The absorption of lesions in the four groups at different time was compared, and the occurrences of adverse drug reactions and treatment outcomes during treatment were recorded. Results After 3 months of treatment, compared with groups A, B, and C, the number of significantly absorbed cases and effective cases in group D increased, while the number of invalid cases decreased. However, there was no statistical significance in the absorption of lesions between the four groups (χ2 = 8.272, P = 0.507). In addition, pairwise comparison showed no significant difference in the absorption of lesions (P > 0.05). After 9 months of treatment, there was no significant difference in the absorption of lesions among the four groups (χ2 = 8.795, P = 0.185), but the absorption of lesions in group D was significantly better than that in group A (P < 0.05). During treatment, the incidence of adverse reactions in the four groups was significantly different (χ2 = 8.779, P = 0.032). Pairwise comparison showed that the incidence of adverse reactions in groups C and D was significantly lower than that in group A (P < 0.05). The total treatment course of group A was 9-16 months, and 10 cases (33.33%) still had residual lesions or pleural thickening at the end of treatment. The total course of treatment in group B was 9-12 months, and 7 cases (23.33%) still had residual lesions or pleural thickening at the end of the course of treatment. The total treatment course of group C was 9-16 months, and 8 cases (26.67%) still had residual lesions or pleural thickening at the end of treatment. The total course of treatment in group D was 9-12months, and there were still 2 cases of residual lesions (6.67%) at the end of the course. Conclusions HZE+rifabutin+pleural injection against tuberculosis therapy has a significant clinical efficacy in the treatment of pleural tuberculoma, which can more effectively improve the clinical symptoms of patients, improve the efficacy, and reduce complications, with a good prognosis, worthy of clinical promotion.

Investigation of the Effect of Oral Implant Surgery on Clinical Treatment and Oral Function of Patients with Dentition Loss.

In order to investigate the effect of oral implant surgery on clinical treatment and oral function of patients with dentition loss, a total of 118 patients with dentition loss in the Department of Stomatology of our hospital from January 2019 to January 2022 are retrospectively analyzed. They are randomly divided into the conventional group and the implant group. The conventional group is treated with conventional dentition restoration, and the implant group is treated with oral implant restoration. The repair efficiency of the two groups is compared. The swallowing function of the 2 groups is assessed by Standard Swallowing Assessment (SSA) table before and after treatment. Self-rating depression scale (SDS) and self-rating anxiety scale (SAS) are used to compare the negative emotions of the two groups before and after treatment. Experimental results show that the total effective rate of the implant group is significantly higher than that of the conventional group, but no invalid cases occurred in the two groups after treatment.

Electronic document authenticity verification of diploma and transcript using smart contract on Ethereum blockchain

Ethereum is one of the oldest examples of blockchain technology provides a system that converts centralized storage to distributed and records transactions by way of decentralized and not by a centralized system and can be verified by each node, therefore it is suitable for storing fingerprints from official diploma documents and transcripts that are published. Smart contract is needed for making contract transactions to Ethereum with programming code, so contracts such as diplomas and transcripts uploaded on the Ethereum blockchain can distribute and produce diploma validation and the authenticity of transcripts with transaction hash, consensus, and comply with ERC-721 token standardization. The results showed that a sample of 5 electronic documents in pdf format with a transaction speed of 1 second on each file that were published and secured with Ethereum blockchain technology can be easily verified for authenticity, the system proposed and developed by us takes in consideration invalid and failure cases by giving the necessary feedback to the user.

SIoTFuzzer: Fuzzing Web Interface in IoT Firmware via Stateful Message Generation

Cyber attacks against the web management interface of Internet of Things (IoT) devices often have serious consequences. Current research uses fuzzing technologies to test the web interfaces of IoT devices. These IoT fuzzers generate messages (a test case sent from the client to the server to test its functionality) without considering their dependency, which is unlikely to bypass the early check of the server. These invalid test cases significantly reduce the efficiency of fuzzing. To overcome this problem, we propose a stateful message generation (SMG) mechanism for IoT web fuzzing. SMG addresses two problems in IoT fuzzing. First, we retrieve the message dependency by using web front-end analysis and status analysis. These dependent messages, which can easily bypass the server check, are used as a valid seed. Second, we adopt a multi-message seed format to preserve the dependency of the messages when mutating the seed to get a valid test case, so that the test case can bypass the state check of the server to make a valid test. Message dependency preservation is implemented by our proposed parameter mutation and structural mutation methods. We implement SMG in our IoT fuzzer, SIoTFuzzer, which applies IoT firmware on the latest Linux-based simulation tool, FirmAE. We test nine IoT devices including a router and an IP camera and adopt a vulnerability detection mechanism. Our evaluation results show that (1) SIoTFuzzer is capable of finding real-world vulnerabilities in IoT devices; (2) our SMG is effective as it enables Boofuzz (a popular protocol fuzzer) to find command injection and cross-site scripting (XSS) vulnerabilities; and (3) compared to FirmFuzz, SIoTFuzzer found all the vulnerabilities in our benchmarks, while FirmFuzz found only four—the efficiency of our tool increased by 20.57% on average.

Prevalence and Analysis of Drug Resistance Pattern of MDR-TB in Retreatment Cases at Allied Hospital, Faisalabad, Pakistan

Background: The prevalence of Multi-Drug Resistance-Tuberculosis (MDR-TB) among retreatment cases is very high. It has become a serious public health issue in Pakistan and can affect greatly TB control strategies. So, we conducted the present research work to update a systematic review of the literature available on MDR-TB cases. Objective: To analyze the resistance pattern of multidrug-resistant tuberculosis. To study the prevalence of MDR-TB among new cases, retreatment cases. Study Design: Cross-sectional study. Settings: Pathology department, Allied Hospital, Faisalabad Medical University, Faisalabad, Pakistan. Duration: Six months from January 01, 2020 to June 30, 2020. Methodology: In this study, we included new and retreatment tuberculosis cases. Gene mutation RpoB, DNA band sequence detected by using machine, Cepheid gene Xpert IV – 4 Modules, Sr # 806133. Data was collected and analyzed statistically by using SPSS v 20. Results: 858 cases were included of age 12 years – 100yrs with the mean age (in years) 42.139 ± 16.823.&nbsp; Two groups of males and females were studied separately. Group I included male patients {456 (56.64%)} and further subdivided into IA [age above 30 years, {354(72.84%)}] and IB [age below 30 years {132 (27.15%)}]. Group II included female patients {372 (43.36%)} and further subdivided into IIA [age above 30 years {239 (64.25%)}] and IIB [age below 30 years {133(35.75%)}]. Out of 858 cases, 347 (40.44%) were New cases, 13 (1.51%) New cases with HIV and 408 (47.55%) were Previously Treated patients (PT). 30 (3.45%) cases were unknown (UK). 28 (3.26%) cases were brought by different lady health workers (LHW) and relapse cases were 32 (3.73%). Overall statistical analysis was found to be highly significant (p=0.000, df= 1, CI= 95%). According to our results, in 517 (60.26%) patients, Mycobacterium Tuberculosis was not detected (MTB-ND). In 214 (24.94%) cases, Mycobacterium Tuberculosis was detected (MTB-D), out of which 13 (6.07%) cases were of First-Line Multi Drug Resistance (MDR). Age of MDR cases was in between 17- 70 years with the mean age (in years) 37.307 ± 17.637. Our results showed MDR more in males (53. 85%) as compared to female patients (46. 15%). Our results showed a significant correlation between status of all cases and their reports (p= -.050). For MTB-ND cases p= 0.000, df =1, CI=95% and for invalid cases p= 0.000, df =5, CI=95%. Conclusion: There is a great need to implement national tuberculosis guidelines fully.&nbsp; In order to prevent further emergence of drug resistance, we should focus on effective implementation of directly observed therapy short courses.

The diffuse interstellar band around 8620 Å

Context. Diffuse interstellar bands (DIBs) are interstellar absorption features that widely exist in the optical and near-infrared wavelength range. DIBs play an important role in the lifecycle of the interstellar medium and can also be used to trace the Galactic structure. Aims. We developed a set of procedures to automatically detect and measure the DIB around 8620 Å (the Gaia DIB) for a wide range of temperatures. The method was tested on ~5000 spectra from the Giraffe Inner Bulge Survey (GIBS) that has a spectral window similar to that of the Gaia–RVS spectra. Based on this sample, we studied the correlation between the equivalent width (EW) of the Gaia DIB and the interstellar reddening E(J − KS) toward the inner Galaxy, as well as the DIB intrinsic properties. Methods. Our procedure automatically checks and eliminates invalid cases, and then applies a specific local normalization. The DIB profile is fit with a Gaussian function. Specifically, the DIB feature is extracted from the spectra of late-type stars by subtracting the corresponding synthetic spectra. For early-type stars we applied a specific model based on the Gaussian process that needs no prior knowledge of the stellar parameters. In addition, we provide the errors contributed by the synthetic spectra and from the random noise. Results. After validation, we obtained 4194 reasonable fitting results from the GIBS database. An EW versus E(J − KS) relation is derived as E(J − KS) = 1.875 (±0.152) × EW − 0.011 (±0.048), according to E(B − V)∕EW = 2.721, which is highly consistent with previous results toward similar sightlines. After a correction based on the Vista Variables in the Via Lactea (VVV) database for both EW and reddening, the coefficient derived from individual GIBS fields, E(J − KS)∕EW = 1.884 ± 0.225, is also in perfect agreement with literature values. Based on a subsample of 1015 stars toward the Galactic center within − 3° &lt; b &lt; 3° and − 6° &lt; l &lt; 3°, we determined a rest-frame wavelength of the Gaia DIB as 8620.55 Å. Conclusions. The procedures for automatic detection and measurement of the Gaia DIB are successfully developed and have been applied to the GIBS spectra. A Gaussian profile is proved to be a proper and stable assumption for the Gaia DIB as no intrinsic asymmetry is found. A tight linearity of its correlation with the reddening is derived toward the inner Milky Way, which is consistent with previous results.

An Interleaving Approach to Combinatorial Testing and Failure-Inducing Interaction Identification

Combinatorial testing (CT) seeks to detect potential faults caused by various interactions of factors that can influence the software systems. When applying CT, it is a common practice to first generate a set of test cases to cover each possible interaction and then to identify the failure-inducing interaction after a failure is detected. Although this conventional procedure is simple and forthright, we conjecture that it is not the ideal choice in practice. This is because 1) testers desire to identify the root cause of failures before all the needed test cases are generated and executed 2) the early identified failure-inducing interactions can guide the remaining test case generation so that many unnecessary and invalid test cases can be avoided. For these reasons, we propose a novel CT framework that allows both generation and identification process to interact with each other. As a result, both generation and identification stages will be done more effectively and efficiently. We conducted a series of empirical studies on several open-source software, the results of which show that our framework can identify the failure-inducing interactions more quickly than traditional approaches while requiring fewer test cases.

Strength in Numbers or Quality over Quantity? Examining the Importance of Criterion Measure Selection to Define Validity Groups in Performance Validity Test (PVT) Research

Mirroring clinical guidelines, recent Performance Validity Test (PVT) research emphasizes using ≥ 2 criterion PVTs to optimally identify validity groups when validating/cross-validating PVTs; however, even with multiple measures, the effect of which specific PVTs are used as criterion measures remains incompletely explored. This study investigated the accuracy of varying two-PVT combinations for establishing validity status and how adding a third PVT or applying more liberal failure cut-scores affects overall false-positive (FP)/-negative (FN) rates. Clinically referred veterans (N = 114; 30% clinically identified as invalid) completing a six-PVT protocol as during their evaluation were included. Concordance rates were calculated across all possible two-and three-PVT combinations at conservative and liberal cutoffs. Two-PVT combinations classified 72–91% of valid (0–4% FPs) and 17–74% of invalid (0–40% FNs) cases, and three-PVT combinations classified 67–86% of valid (0–6% FPs) and 57–97% of invalid (0–24% FNs) at conservative cutoffs. Liberal cutoffs classified 53–86% of valid (0–15% FPs) and 39–82% of invalid (0–30% FNs) cases for two-PVT combinations and 46–75% of valid (3–27% FPs) and 60–97% of invalid (0–17% FNs) cases for three-PVT combinations. Irrespective of whether a two-or three-PVT combination or conservative/liberal cutoffs were used, many valid and invalid cases failed only one PVT (3–68%).Two-PVT combinations produced high FNs and were less accurate than three-PVTs for detecting invalid cases, though variable accuracy was found within both types of combinations based on the specific PVTs in the combination. Thus, both PVT quantity and quality are important for accurate validity classification in research studies to ensure reliability and replicability of findings. Applying more liberal cutoffs yielded increased sensitivity, but with generally higher FPs yielding problematic specificity, particularly for three-PVT combinations.

Investigating Cervical Risk Factors that Lead to Cytological and Biopsy Examination

Introduction:Cervical cancer ranks the fourth prevalent cancer in women at the global level, and the second in poor countries. The main objectives of the present study were to investigate the risk factors associated with cervical cancer and to study their possible association with the decision to take a cervical biopsy.Aim:The main objectives of this study were to investigate the risk factors associated with cervical cancer and to study their possible association with the decision to take a cervical biopsy.Methods:It was cross-sectional study and we analyzed an online data posted on Kaggle. This Dataset is obtained from UCI Repository. A list of risk factors for cervical cancer leading to biopsy examination was included, such as age, number of sexual partners, first sexual intercourse, number of pregnancies, smoking variables, hormonal contraceptives, IUD, and sexually transmitted disease variables, Hinselmann, Schiller, Cytology, and Biopsy. The dataset was prepared for appropriateness through filtering invalid cases with missing data.Results:The results of the study showed that the following variables were significantly associated with cytological examination: STD-Condylomotosis (p=0.035), STD-Pericondylomotosis (p=0.029), STD_HIV (p=0.006), Hinselmann (p<0.001), Schiller (p<0.001), and biopsy (p<0.001). the results also showed that the following variables were significantly associated with cytological examination.Conclusion:Taken together, cytological variables or biopsy examination variables if carried out at an early stage, lead to better diagnostic and therapeutic options.

The clinical observation on the treatment of semen non-liquefaction with zinc gluconate granule

Objective To investigate the clinical effect of liquid decoction combined with zinc gluconate granule in the treatment of semen non-liquefaction. Methods From May 2016 to February 2017, 68 cases of semen non-liquefier were admitted with an average age of 24 to 43 years, and an average of 25.2 years. Results All patients were followed up and the treatment time was 30-150 days, with an average of 90 days.There were 64 effective cases and 4 invalid cases, the effective rate was 94.1%.And sperm concentration, semen volume, sperm motility significantly increased, dead sperm decreased, abnormal sperm percentage decreased significantly(P<0.05). Conclusions Liquid decoction combined with zinc gluconate granule which is effective to improve the condition of semen in patients with semen non-liquefaction. Key words: SEMEN UNLIQUEFACTION; DRUG THERAPY (TCD); Zinc Compounds

A Mechanism Study of Electroacupuncture for Dry Eye Syndrome by Targeting Conjunctival Cytokine Expressions

ABSTRACTAim: To discuss the immunological mechanism in electroacupuncture (EA) treatment of dry eye syndrome (DES) by targeting the changes in conjunctival cytokine expression profile.Method: Eligible DES patients were randomized into an EA group (EAG) or an acupuncture group (AG). The ocular surface disease index (OSDI), amount of tear production, and tear film break-up time (BUT) were observed to evaluate the efficacy. Conjunctival cells were collected from both effective and invalid cases to observe the expressions of cytokines by protein microarray. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) were used for functional cluster and signaling pathway analysis of the differentially expressed proteins. Enzyme-linked immunosorbent assay (ELISA) was used to verify the specific differential proteins.Result: After treatment, OSDI dropped and BUT extended in both groups, and the tear production increased only in the EAG (all P < .01). Compared with the AG, the improvement in tear production was more significant in the EAG (P < .01). There were 17 differentially expressed conjunctival cytokines between the effective and invalid cases in the EAG, and those expressed higher than the limit of detection (LOD) included monocyte chemoattractant protein 1 (MCP-1), macrophage colony-stimulating factor (M-CSF), regulated on activation in normal T-cell expressed and secreted (RANTES) and tissue inhibitor of metalloproteinases 1 (TIMP-1). GO analysis showed that the differential cytokines were mainly involved in cellular interaction, signaling pathways and reactions to stimuli. KEGG analysis revealed that the signaling pathways of these cytokines were mainly responsible for interactions between cytokines or between cytokines and their receptors, such as Jak-STAT signaling pathway, chemokine signaling pathway, and tumor necrosis factor signaling pathway.Conclusion: EA can effectively treat DES by improving the symptoms, increasing tear secretion and extending BUT, which is possibly related to its regulation on the conjunctival cytokine expressions.

Community pharmacists’ lack of access to health records and its impact on targeted MTM interventions

ObjectivesTo describe the adequacy of health record information available to community pharmacists when completing medication therapy management (MTM) interventions and to quantify the time spent on interventions that are ultimately revealed as invalid. MethodsThis prospective cross-sectional study analyzed cases of high-risk medication use in the elderly and statin use in persons with diabetes identified by 3 MTM platforms across 15 grocery chain pharmacies. MTM interventions were completed by phone and fax following a usual care protocol. Collected data included case validity (defined as the case truly requiring a pharmacist’s involvement), case success (defined as achieving the targeted goal of the intervention), time spent on the intervention, and a determination of whether information from an electronic health record (EHR) could have eliminated patient or prescriber contact. ResultsAmong 163 cases analyzed, 54% were found to be valid and 30% successful. The most common reasons for invalidity were allergy or contraindication, patient already taking a statin, and patient not having the targeted condition. Overall, 14% of cases were valid and successful, 40% valid and unsuccessful, 17% invalid and successful, and 29% invalid and unsuccessful. Valid successful cases averaged 15.3 minutes per case, valid unsuccessful cases averaged 9.2 minutes, invalid successful cases averaged 4.2 minutes, and invalid unsuccessful cases averaged 5.1 minutes. Based on the case-by-case determination of the researchers, EHR information would have completed 39% of cases without patient or prescriber contact. The average time spent on cases needing EHR access was 5.5 minutes, compared with 9.5 minutes for cases in which EHR access would not have helped. ConclusionCommunity pharmacists performing MTM interventions are hindered by lack of access to patient health information, imprecise patient targeting by MTM platforms, and cumbersome communication between pharmacists and prescribers.

Value discussion of radical sinus surgery for difficult-to-treat rhinosinusitis

Objective:To investigate the efficacy of radical sinus surgery (RSS) on difficult-to-treat rhinosinusitis(DTRS) with nasal polyps. Method: We retrospectively analyzed the clinical data of 26 patients with DTRS that treated with RSS and patients who were not treated with RSS in our hospital from August 2013 to June 2017.The effect of RSS were evaluated by comparing the CT Lund-Kennery score,endoscope Lund-Kennery score,global VAS score and dysosmia VAS score before operation and 6 months after operation. Result: RSS group had more severe Lund-Kennery score,global VAS score and dysosmia VAS score than non-RSS group,and also had more previous surgeries,higher ratio of olfactory region polyps,and higher ratio of co-existing asthma and allergic rhinitis. However RSS group had a lower ratio with pus anot than non-RSS group. The eosinophil count in periheral blood between two groups had no statistical significance. Six months after RSS,the score of endoscope Lund-Kennery,global VAS and dysosmia VAS dependence. 14 patients were successfully cured(53.8%), 12 patients showed improvement(46.2%), no invalid cases. Conclusion: The global symptoms and olfaction of DTRS patients can be improved by RSS combine individual perioperative drug therapy.

Integration of Digital Cultural Heritage Resources in China: Understanding Public Expectations

AbstractThis paper focuses on the recent development of the National Cultural Information Resources Sharing Project in China. This is a national scale project that was initiated by the Chinese central government and has stimulated immense academic attention. Specifically, this paper attempts to understand people’s expectations and requirements on the project. Moreover, this paper aims to articulate and provide specific and useful suggestions for relevant politicians and project operators so that public expectations and requirements can be carefully met. A survey was used to sample a very large and widely distributed population in China, with a questionnaire designed and disseminated through an online survey service platform. A total of 1,076 usable responses were returned and 29 invalid response cases were discarded, yielding an effective response rate of 97.3 percent. An evident public expectation has emerged from the data collected which shows that the Chinese public primarily expects a comprehensive, convenient and unified one stop online access portal to all types of Chinese digital cultural heritage. This paper is of interest to Chinese government officials as well as professionals working at libraries, museums, archives and other cultural institutions in China. Furthermore, although the context of this study is China, the research findings, insights and experiences gained in this study can be shared across international borders.