This critical review of the literature assembles and compares available data on breast cancer clinical stage, time intervals to care, and access barriers in different countries. It provides evidence that while more th...This critical review of the literature assembles and compares available data on breast cancer clinical stage, time intervals to care, and access barriers in different countries. It provides evidence that while more than 70% of breast cancer patients in most high-income countries are diagnosed in stages Ⅰ and Ⅱ, only 20%-50% patients in the majority of low- and middleincome countries are diagnosed in these earlier stages. Most studies in the developed world show an association between an advanced clinical stage of breast cancer and delays greater than three months between symptom discovery and treatment start. The evidence assembled in this review shows that the median of this interval is 30-48 d in high-income countries but 3-8 mo in low- and middle-income countries. The longest delays occur between the first medical consultation and the beginning of treatment, known as the provider interval. The little available evidence suggests that access barriers and quality deficiencies in cancer care are determinants of provider delay in low- and middle-income countries. Research on specific access barriers and deficiencies in quality of care for the early diagnosis and treatment of breast cancer is practically non-existentin these countries, where it is the most needed for the design of cost-effective public policies that strengthen health systems to tackle this expensive and deadly disease.展开更多
网络技术的发展和多接入边缘计算的兴起使得计算和网络资源的部署逐渐靠近终端.随着服务数量的增多,为了向用户更好地推荐服务,如何在复杂、动态的边缘计算环境中实时、准确地预测服务质量(quality of service,QoS)成为一项挑战.本文提...网络技术的发展和多接入边缘计算的兴起使得计算和网络资源的部署逐渐靠近终端.随着服务数量的增多,为了向用户更好地推荐服务,如何在复杂、动态的边缘计算环境中实时、准确地预测服务质量(quality of service,QoS)成为一项挑战.本文提出一种基于服务负载实时预测QoS的深度神经模型(QPSL),它可以为边缘计算中的QoS预测提供缺少的负载状况感知和周期感知.首先,对服务的负载状况进行特征表示,并通过时序分解模块获取时序特征.其次,将CNN和BiLSTM结合,学习潜在的时序关系,生成不同时刻的状态向量.然后,基于Attention机制为历史时刻的状态向量分配权重,从而构造未来时刻的状态向量.最后,将上下文嵌入向量与状态向量送入感知层完成实时QoS预测.基于真实的融合数据集进行了大量的实验,结果表明QPSL在响应时间和吞吐量任务上的MAE分别平均提升了10.28%和10.87%,优于现有的时间感知QoS预测方法.展开更多
Purpose:Recently,global science has shown an increasing open trend,however,the characteristics of research integrity of open access(OA)publications have rarely been studied.The aim of this study is to compare the char...Purpose:Recently,global science has shown an increasing open trend,however,the characteristics of research integrity of open access(OA)publications have rarely been studied.The aim of this study is to compare the characteristics of retracted articles across different OA levels and discover whether OA level influences the characteristics of retracted articles.Design/methodology/approach:The research conducted an analysis of 6,005 retracted publications between 2001 and 2020 from the Web of Science and Retraction Watch databases.These publications were categorized based on their OA levels,including Gold OA,Green OA,and non-OA.The study explored retraction rates,time lags and reasons within these categories.Findings:The findings of this research revealed distinct patterns in retraction rates among different OA levels.Publications with Gold OA demonstrated the highest retraction rate,followed by Green OA and non-OA.A comparison of retraction reasons between Gold OA and non-OA categories indicated similar proportions,while Green OA exhibited a higher proportion due to falsification and manipulation issues,along with a lower occurrence of plagiarism and authorship issues.The retraction time lag was shortest for Gold OA,followed by non-OA,and longest for Green OA.The prolonged retraction time for Green OA could be attributed to an atypical distribution of retraction reasons.A comparative study on characteristics of retracted publications across different open access levels Research limitations:There is no exploration of a wider range of OA levels,such as Hybrid OA and Bronze OA.Practical implications:The outcomes of this study suggest the need for increased attention to research integrity within the OA publications.The occurrences offalsification,manipulation,and ethical concerns within Green OA publications warrant attention from the scientific community.Originality/value:This study contributes to the understanding of research integrity in the realm of OA publications,shedding light on retraction patterns and reasons a展开更多
BACKGROUND: It is challenging to establish peripheral intravenous access in adult critically patients. This study aims to compare the success rate of the first attempt, procedure time, operator satisfaction with the u...BACKGROUND: It is challenging to establish peripheral intravenous access in adult critically patients. This study aims to compare the success rate of the first attempt, procedure time, operator satisfaction with the used devices, pain score, and complications between intraosseous(IO) access and central venous catheterization(CVC) in critically ill Chinese patients.METHODS: In this prospective clustered randomized controlled trial, eight hospitals were randomly divided into either the IO group or the CVC group. Patients who needed emergency vascular access were included. From April 1, 2017 to December 31, 2018, each center included 12 patients. We recorded the data mentioned above.RESULTS: A total of 96 patients were enrolled in the study. There were no statistically significant differences between the two groups regarding sex, age, body mass index, or operator satisfaction with the used devices. The success rates of the first attempt and the procedure time were statistically significant between the IO group and the CVC group(91.7% vs. 50.0%, P<0.001;52.0 seconds vs. 900.0 seconds, P<0.001). During the study, 32 patients were conscious. There was no statistically significant difference between the two groups regarding the pain score associated with insertion. There were statistically significant differences between the two groups regarding the pain score associated with IO or CVC infusion(1.5 vs. 0.0, P=0.044). Complications were not observed in the two groups.CONCLUSIONS: IO access is a safe, rapid, and effective technique for gaining vascular access in critically ill adults with inaccessible peripheral veins in the emergency departments.展开更多
文摘This critical review of the literature assembles and compares available data on breast cancer clinical stage, time intervals to care, and access barriers in different countries. It provides evidence that while more than 70% of breast cancer patients in most high-income countries are diagnosed in stages Ⅰ and Ⅱ, only 20%-50% patients in the majority of low- and middleincome countries are diagnosed in these earlier stages. Most studies in the developed world show an association between an advanced clinical stage of breast cancer and delays greater than three months between symptom discovery and treatment start. The evidence assembled in this review shows that the median of this interval is 30-48 d in high-income countries but 3-8 mo in low- and middle-income countries. The longest delays occur between the first medical consultation and the beginning of treatment, known as the provider interval. The little available evidence suggests that access barriers and quality deficiencies in cancer care are determinants of provider delay in low- and middle-income countries. Research on specific access barriers and deficiencies in quality of care for the early diagnosis and treatment of breast cancer is practically non-existentin these countries, where it is the most needed for the design of cost-effective public policies that strengthen health systems to tackle this expensive and deadly disease.
文摘网络技术的发展和多接入边缘计算的兴起使得计算和网络资源的部署逐渐靠近终端.随着服务数量的增多,为了向用户更好地推荐服务,如何在复杂、动态的边缘计算环境中实时、准确地预测服务质量(quality of service,QoS)成为一项挑战.本文提出一种基于服务负载实时预测QoS的深度神经模型(QPSL),它可以为边缘计算中的QoS预测提供缺少的负载状况感知和周期感知.首先,对服务的负载状况进行特征表示,并通过时序分解模块获取时序特征.其次,将CNN和BiLSTM结合,学习潜在的时序关系,生成不同时刻的状态向量.然后,基于Attention机制为历史时刻的状态向量分配权重,从而构造未来时刻的状态向量.最后,将上下文嵌入向量与状态向量送入感知层完成实时QoS预测.基于真实的融合数据集进行了大量的实验,结果表明QPSL在响应时间和吞吐量任务上的MAE分别平均提升了10.28%和10.87%,优于现有的时间感知QoS预测方法.
基金the National Social Science Foundation of China(No.22CTQ032).
文摘Purpose:Recently,global science has shown an increasing open trend,however,the characteristics of research integrity of open access(OA)publications have rarely been studied.The aim of this study is to compare the characteristics of retracted articles across different OA levels and discover whether OA level influences the characteristics of retracted articles.Design/methodology/approach:The research conducted an analysis of 6,005 retracted publications between 2001 and 2020 from the Web of Science and Retraction Watch databases.These publications were categorized based on their OA levels,including Gold OA,Green OA,and non-OA.The study explored retraction rates,time lags and reasons within these categories.Findings:The findings of this research revealed distinct patterns in retraction rates among different OA levels.Publications with Gold OA demonstrated the highest retraction rate,followed by Green OA and non-OA.A comparison of retraction reasons between Gold OA and non-OA categories indicated similar proportions,while Green OA exhibited a higher proportion due to falsification and manipulation issues,along with a lower occurrence of plagiarism and authorship issues.The retraction time lag was shortest for Gold OA,followed by non-OA,and longest for Green OA.The prolonged retraction time for Green OA could be attributed to an atypical distribution of retraction reasons.A comparative study on characteristics of retracted publications across different open access levels Research limitations:There is no exploration of a wider range of OA levels,such as Hybrid OA and Bronze OA.Practical implications:The outcomes of this study suggest the need for increased attention to research integrity within the OA publications.The occurrences offalsification,manipulation,and ethical concerns within Green OA publications warrant attention from the scientific community.Originality/value:This study contributes to the understanding of research integrity in the realm of OA publications,shedding light on retraction patterns and reasons a
基金supported by the Capital Clinical Characteristic Applied Research Project(z151100004015118)the Fostering and Exploring Project of Key Clinical Projects in the Peking University Third Hospital(BYSY2014006)the Health Science Promotion Project of Beijing(TG-2017-83)。
文摘BACKGROUND: It is challenging to establish peripheral intravenous access in adult critically patients. This study aims to compare the success rate of the first attempt, procedure time, operator satisfaction with the used devices, pain score, and complications between intraosseous(IO) access and central venous catheterization(CVC) in critically ill Chinese patients.METHODS: In this prospective clustered randomized controlled trial, eight hospitals were randomly divided into either the IO group or the CVC group. Patients who needed emergency vascular access were included. From April 1, 2017 to December 31, 2018, each center included 12 patients. We recorded the data mentioned above.RESULTS: A total of 96 patients were enrolled in the study. There were no statistically significant differences between the two groups regarding sex, age, body mass index, or operator satisfaction with the used devices. The success rates of the first attempt and the procedure time were statistically significant between the IO group and the CVC group(91.7% vs. 50.0%, P<0.001;52.0 seconds vs. 900.0 seconds, P<0.001). During the study, 32 patients were conscious. There was no statistically significant difference between the two groups regarding the pain score associated with insertion. There were statistically significant differences between the two groups regarding the pain score associated with IO or CVC infusion(1.5 vs. 0.0, P=0.044). Complications were not observed in the two groups.CONCLUSIONS: IO access is a safe, rapid, and effective technique for gaining vascular access in critically ill adults with inaccessible peripheral veins in the emergency departments.
