On the role of diagnosis of prostate diseases at the outpatient appointment of a therapist

Злокачественные заболевания остаются важной проблемой медицины, при этом ее решение зависит от эффективности выявления ранних стадий онкозаболеваний на амбулаторном этапе, включая терапевтическое звено оказания медицинской помощи. Существующие в настоящее время подходы к пропаганде основ здорового образа жизни преимущественно направлены лишь на профилактику поведенческих факторов риска: табакокурения, нерационального питания, недостаточной физической активности и пагубного употребления алкоголя. При этом, по оценкам экспертов, даже воздействие только на них позволит предотвратить по меньшей мере 40% случаев развития злокачественных новообразований. В России организована 3-уровневая система оказания медицинской помощи. Именно первый уровень оказания первичной медико-санитарной помощи и должен обеспечивать профилактическую направленность здравоохранения: грамотная диспансеризация способна обеспечить существенный, до 30%, вклад в снижение общей смертности населения, в том числе и смертности от злокачественных новообразований. Первым звеном диагностики онкологического заболевания являются терапевты, к которым пациенты обращаются с жалобами общего характера (утомляемость, субфебрилитет, боли в суставах, дизурия и т. д.). Наиболее актуальными задачами в работе терапевта являются своевременное обнаружение опухолевого заболевания и направление больного на лечение к онкологу. Статья рассматривает возможности скрининговых мероприятий с участием терапевтов, врачей общей практики, предлагает специально разработанные алгоритмы диагностики доброкачественных и злокачественных новообразований предстательной железы. Формирование навыков онкологической настороженности у врача первичного амбулаторного звена необходимо для раннего выявления и снижения частоты продвинутых стадий опухолей и более раннего начала специализированного лечения. Выявление симптоматики, подозрительной на злокачественные новообразования, с помощью алгоритмизированных подходов и последующая консультация пациента урологом или онкологом должны улучшить результаты лечения. Malignant diseases remain an important problem in medicine, while its solution depends on the effectiveness of detecting the early stages of cancer at the outpatient stage, including the therapeutic link in the provision of medical care. Currently existing approaches to the promotion of the foundations of a healthy lifestyle are mainly aimed only at the prevention of behavioral risk factors: tobacco smoking, unhealthy diet, insufficient physical activity and harmful use of alcohol. At the same time, according to experts, even exposure only to them will prevent at least 40% of cases of the development of malignant ovariances. A 3-tier system of medical care has been organized in Russia. It is the first level of primary health care that should ensure the prophylactic focus of health care: competent clinical examination is able to provide a significant, up to 30%, contribution to reducing the overall mortality of the population, including mortality from malignant neoplasms. The first stage in the diagnosis of oncological disease are therapists, to whom patients come with general complaints (fatigue, low-grade fever, joint pain, dysuria, etc.). The most urgent task in the work of a general practitioner is the timely detection of a tumor disease and referral of a patient for treatment to an oncologist. The article considers the possibilities of screening measures with the participation of therapists, general practitioners, and offers specially developed algorithms for the diagnosis of benign and malignant neoplasms of the prostate gland. The formation of oncological alertness skills in a primary outpatient care physician is necessary for early detection and reduction of the incidence of advanced stages of tumors and earlier initiation of specialized treatment. Identification of symptoms suspicious of malignant neoplasms using algorithmic approaches and subsequent consultation with the patient by a specialist urologist or oncologist should improve treatment outcomes.

Research and Implementation of Mobile Internet Management Optimization and Intelligent Information System Based on Smart Decision

The way by which artificial intelligence is implemented is similar to the thinking process of the human brain. People obtain information about external conditions through five senses, namely, vision, hearing, smell, taste, and touch, and, through the further processing of the brain, it forms meaningful decision-making elements. Then, through the process of analysis and reasoning, further decisions are made. In the information age, the application of intelligent management information systems in various fields has promoted the modernization and intelligence of social development. From the perspective of intelligent decision-making, this paper analyzes the requirements of intelligent information systems and designs an intelligent information system based on mobile Internet management optimization, including system management optimization, and proposes an environment-based layer, network transport layer, and the three-tier system architecture of the smart service application layer. Finally, this paper considers the problem of data fusion after system expansion. According to the existing fuzzy fusion algorithm, a weight-based fuzzy fusion algorithm is proposed. The simulation analysis shows that the algorithm can be effectively applied in intelligent information systems.

The Role of the California Tier System in Controlling Population Mobility During the COVID-19 Pandemic

Policies to restrict population mobility are a commonly used strategy to limit the transmission of contagious diseases. Among measures implemented during the COVID-19 pandemic were dynamic stay-at-home orders informed by real-time, regional-level data. California was the only state in the U.S. to implement this novel approach; however, the effectiveness of California’s four-tier system on population mobility has not been quantified. Utilizing data from mobile devices and county-level demographic data, we evaluated the impact of policy changes on population mobility and explored whether demographic characteristics explained variability in responsiveness to policy changes. For each Californian county, we calculated the proportion of people staying home and the average number of daily trips taken per 100 persons, across different trip distances and compared this to pre-COVID-19 levels. We found that overall mobility decreased when counties moved to a more restrictive tier and increased when moving to a less restrictive tier, as the policy intended. When placed in a more restrictive tier, the greatest decrease in mobility was observed for shorter and medium-range trips, while there was an unexpected increase in the longer trips. The mobility response varied by geographic region, as well as county-level median income, gross domestic product, the prevalence of farms, and recent election results. This analysis provides evidence of the effectiveness of the tier-based system in decreasing overall population mobility to ultimately reduce COVID-19 transmission. Results demonstrate that economic and political indicators drive important variability in such patterns across counties.

Pandemic, Primary Health Workers and work trajectories: A Memoing Representational Study

More than 65 per cent of the population in India lives in rural areas with the highest overall burden of disease. The Indian rural health care system is composed of the three-tier system comprising Sub-Centres, Primary Health Centres, and Community Health Centres with a considerable shortfall in health facilities at different levels - 18 per cent at Sub centre level, 22 per cent at PHC level and 30 per cent at CHC level. The real facts and figures of the epidemic in rural areas are not known yet except for broad distribution patterns. The course of events with respect to preventive strategies to control COVID-19 especially the experiences in states like Kerala which has comparatively well-developed health infrastructure are important as a lesson for managing future emergencies. In the present study, the responses and experiences of the frontline health workers including ASHA workers toward the pandemic are documented. We followed a Memoing approach largely similar to in-depth interviews- based on conversations with primary level health workers including ASHA workers and Junior Health Staff. The conversations which lasted for about one hour and in some cases more were presented by the respondents as experiential representations and memoranda on which reflective notes were prepared by the authors who conversed with the staff. The conversations mainly echoed the complaints, concerns and criticisms of the staff regarding the program and the severe limitations that they faced in COVID control. Based on the narratives as well as representations, we could identify interlinked dominant and minor specific-context related issues which are important for equity-based universal health coverage. Firstly, training of primary health workers in Primary Emergency Health care is important in order to counter unpleasant human interactions and also for maintaining security. The training is also important to counter misinformation which is hampering positive health actions. Secondly, it is important to reinvigorate the medical loop and preventive protocols in health programs to strengthen the health service system at the grassroots level especially enhance the trust between the workers and the people. COVID 19 pandemic is an opportunity to recognize and reinforce the role of primary care workers and formulate gender-sensitive and effective control strategies.

Modelling Wireless Robots for Urban Search and Rescue in Artificial Rubble

<p>Using robots to assist rescue personnel in USAR (Urban Search and Rescue) missions is an active area of research. Researchers are developing robots to penetrate into rubble to gather information about the environment and to search for victims. The School of Engineering and Computer Science of Victoria University of Wellington is developing a team of robots, the "robot family" to help at disasters. The robot family is a three-tier system. The first tier the "grandmother" which carries second tier "mother robots" to the rubble. The mother robot each launches a group of the third tier "daughter robots" that will penetrate the rubble surface. The daughter robots will burrow deep into the disaster site. They will be equipped with sensors to search for and locate trapped persons. They are designed to be small, battery operated, low cost and disposable. The team of robots is hierarchically structured and to be remotely monitored by rescue personnel at a safe distance from the rubble via a wireless communication link. This thesis describes the successful implementation of a wireless communication platform for the team of robots. This was verified using a simulated rubble site. A suitable ZigBee wireless module was selected by comparing a list of target brands to form the wireless network. A group of simulated wireless daughter robot models were developed by attaching wireless modules to microcontrollers. An automatic routing wireless network was implemented between the robots. They were deployed into artificial rubble and the communication system was characterised. Proof of concept experiments were carried out and demonstrated that rescue personnel using a computer at a safe distance outside the rubble could successfully establish reliable communication to monitor or control all robots inside the artificial rubble environment.</p>

Modelling Wireless Robots for Urban Search and Rescue in Artificial Rubble

<p>Using robots to assist rescue personnel in USAR (Urban Search and Rescue) missions is an active area of research. Researchers are developing robots to penetrate into rubble to gather information about the environment and to search for victims. The School of Engineering and Computer Science of Victoria University of Wellington is developing a team of robots, the "robot family" to help at disasters. The robot family is a three-tier system. The first tier the "grandmother" which carries second tier "mother robots" to the rubble. The mother robot each launches a group of the third tier "daughter robots" that will penetrate the rubble surface. The daughter robots will burrow deep into the disaster site. They will be equipped with sensors to search for and locate trapped persons. They are designed to be small, battery operated, low cost and disposable. The team of robots is hierarchically structured and to be remotely monitored by rescue personnel at a safe distance from the rubble via a wireless communication link. This thesis describes the successful implementation of a wireless communication platform for the team of robots. This was verified using a simulated rubble site. A suitable ZigBee wireless module was selected by comparing a list of target brands to form the wireless network. A group of simulated wireless daughter robot models were developed by attaching wireless modules to microcontrollers. An automatic routing wireless network was implemented between the robots. They were deployed into artificial rubble and the communication system was characterised. Proof of concept experiments were carried out and demonstrated that rescue personnel using a computer at a safe distance outside the rubble could successfully establish reliable communication to monitor or control all robots inside the artificial rubble environment.</p>

Pengaruh Faktor-Faktor Keuangan dan Board Of Directors Characteristics Terhadap Nilai Perusahaan

The purpose of this study was to examine the financial factors and board of directors characteristics on firm value. This research was conducted to obtain an overview of financial and non-financial factors influencing the value of the company during the Covid- 19 pandemic. The population of this study is Kompas 100 Index companies members for the 2019-2020 period, with a final sample of 72 companies. This study uses secondary data, and multiple linear regression analysis techniques. The results of this study show that Profitability and Board Meetings have a positive influence on firm value, while Company Size, Capital Structure, Board Independence, Board Size, and Gender Diversity have no effect on Firm Value and CEO Duality is only slightly present in Indonesia because Indonesia adheres to a two-tier system. Keywords: Firm Value, Financial Factors, and Non-financial Factors

The Socio-Cultural Impress on the Promotion of Self-Directed-Learning in Algerian Universities

The Algerian universities have witnessed significant changes since the establishment of the three-tier system composed of Licence, Master, and Doctorate (LMD). The latter necessitates many changes in the learning process as well as teaching methods. Yet, to achieve self-directed learning, the learner should first achieve autonomy at the personal level. Thus, this paper is mainly devoted to analyzing the impress of Algerian cultural and social traditions on the development of self-directed learning. This study addresses the following question: Do the Algerian cultural and social traditions enhance and facilitate self-directed learning or impede its implementation at university? The main aim of this paper is to investigate the aspects of the Algerian culture that hinder the promotion of self-directed learning. The research has been conducted in Saida University among Master students. To investigate the socio-cultural impact on the development of self-directedness, the researcher used a questionnaire and an interview that was related to Hofstede’s six-D Model. Discussing the Algerian culture through the lens of Hofstede’s six-D Model helped the researcher to diagnose the reasons behind the failure to promote self-directedness. The main finding of this research is that the collectivist nature of the Algerian culture retards the progress of self-directed learning. This paper also suggests that if the Algerian culture does not favor self-directed learning, educators should adopt new approaches and strategies that engage their learners in the learning experiences. Educators should counterbalance the parochial and paternalistic traditions with glocalization and multiple perspective curricula.

PRC History in Crisis and Clover

The history of the People's Republic of China is now an established discipline, with a built-in theoretical framework—aspirational socialism—and a first draft written by social scientists. The growth of the field of PRC history has been aided by an avalanche of unique grassroots sources. Grassroots documents, many of which are local archives discarded by the state, have prompted new research questions and uncovered hidden dimensions of the Mao years, but they remain inaccessible to the broader research community unless scholars go out of their way to digitize and share them. This solution, however, reveals a deeper crisis facing the field: even though new types of sources will continue to fuel the growth of PRC history, scholars farthest from Xi Jinping's organs of repression can share sources and write about them freely, while academics subject to authoritarian restrictions cannot. There is no easy fix to the two-tier system created by Document Nine's prohibition against evidence-based history research. Nonetheless, collaborative translation projects and vigorously pushing for a more diverse and inclusive field in and outside of China can help PRC history continue to flourish.