目的分析血清乙型肝炎病毒(hepatitis B virus,HBV)前S1蛋白(precursor S1 protein,preS1)与慢性乙型肝炎(chronic hepatitis B,CHB)肝纤维化及癌变进展的相关性。方法对2019年10月—2021年10月期间在青海红十字医院接受检查的228例乙...目的分析血清乙型肝炎病毒(hepatitis B virus,HBV)前S1蛋白(precursor S1 protein,preS1)与慢性乙型肝炎(chronic hepatitis B,CHB)肝纤维化及癌变进展的相关性。方法对2019年10月—2021年10月期间在青海红十字医院接受检查的228例乙肝表面抗原(hepatitis B surface antigen,HBsAg)阳性慢性HBV感染者进行回顾性分析,其中CHB患者75例、肝硬化(liver cirrhosis,LC)患者93例(LC组)、肝细胞癌(hepatocellular carcinoma,HCC)患者60例(HCC组)。根据LC和HCC组肝组织活检分析肝脏炎症活动及肝纤维化程度。结果HCC组血清preS1水平[496.32(457.63,988.0)ng/mL]和LC组[338.72(247.93,554.61)ng/mL]血清preS1水平均显著高于CHB组[113.69(87.09,177.40)ng/mL],且差异具有统计学意义(P均<0.05)。HCC组血清preS1水平亦高于LC组(P=0.002)。经受试者工作特征曲线分析,血清preS1水平鉴别诊断CHB与LC的曲线下面积(area under the curve,AUC)是0.881(95%CI:0.830~0.932),鉴别诊断CHB/LC与HCC的AUC是0.861(95%CI:0.815~0.908)。3组患者的血清preS1水平与HBsAg(rs=0.799,P<0.001)呈强正相关和Log HBV DNA(rs=0.262,P<0.001)呈弱正相关。此外LC组和HCC组血清preS1水平与肝脏炎症活动分级(rs=0.201,P=0.009)及肝纤维化分期也呈弱正相关性(rs=0.295,P<0.001)。结论血清preS1水平与血清HBsAg、HBV DNA水平和肝脏炎症和纤维化进展呈正相关,有可能成为鉴别诊断HBV相关慢性肝病肝硬化或癌变的候选标志物。展开更多
Increased hazards threatening the United Nations Educational,Scientific and Cultural Organization(UNESCO)-designated sites and endangering cultural heritage and community well-being require attention and action.Con-si...Increased hazards threatening the United Nations Educational,Scientific and Cultural Organization(UNESCO)-designated sites and endangering cultural heritage and community well-being require attention and action.Con-sidering the pivotal role of UNESCO sites in conservation and development,this study assessed their levels of disaster preparedness.The absence of studies assessing disaster awareness,risk perception,and preparedness among UNESCO site actors,as well as the pivotal place of preparedness within the Disaster Risk Management(DRM)cycle justifies this research.Applying the tenets of the Person-Relative-to-Event framework,we hypothe-sized that a strong positive correlation exists between perceived risks,resources,and disaster preparedness.To collect pertinent data,we employed an embedded mixed-method design and conducted an online questionnaire survey yielding 141 responses from 59 countries.From the results of relevant analyses,wildfires,floods,and droughts are top hazards occurring frequently in UNESCO sites,with significant concerns about pollution and habitat loss during future events.Smartphones emerged as the most available crucial DRM resource,with higher availability of DRM resources correlating positively and significantly with sites’preparedness.Our findings con-tribute valuable insights to address missing links for disaster-ready and resilient UNESCO sites,promoting their preservation for future generations.展开更多
Context: Pre-eclampsia and placental malaria, are two diseases that share pathophysiological similarities, such as placental ischemia, endothelial dysfunction and production of pro-inflammatory cytokines. Objective: T...Context: Pre-eclampsia and placental malaria, are two diseases that share pathophysiological similarities, such as placental ischemia, endothelial dysfunction and production of pro-inflammatory cytokines. Objective: The objective of our study was to investigate the association between placental malaria lesions and severe pre-eclampsia. Methodology: We conducted a prospective analytical cross-sectional study in two University Hospitals in the city of Yaounde (Yaounde Central Hospital and the Gynaecological Obstetrics and Paediatrics Hospital), and in the laboratory of the Centre Pasteur in Yaounde over an eight-month period (1st January 2021 – 1st September 2021). All patients with pre-eclampsia diagnosed according to the criteria of the International Society for the Study of Hypertension (ISSHP) and free of chronic metabolic or infectious pathology were included in this study. The patients were divided into two groups: group 1 (mild pre-eclampsia) and group 2: severe pre-eclampsia. Socio-demographic, clinical and histopathological characteristics specific to pre-eclampsia and placental malaria were investigated. Statistical analysis was performed with SPSS 23.0 software, Chi 2 was used to compare categorical variables, Student t-test was used to compare means, and logistic regression was used to assess the association between placental malaria lesions and PES. Results: The mean age of our study population was 29.93 ± 7.36 years versus 28.28 ± 7.18 years in patients with mild and severe pre-eclampsia respectively. Pre-eclampsia placental lesions (accelerated villous maturation, infarction) were significantly greater in patients with severe pre-eclampsia (p Conclusion: Placental malaria lesions were significantly associated with severe pre-eclampsia and increased the risk of developing severe pre-eclampsia placental lesions by a factor of 10.展开更多
Introduction: Pre-eclampsia is a complication of pregnancy that generally occurs in the third trimester. It is associated with a maternal and foetal mortality rate of around 27%. In view of the grim picture painted by...Introduction: Pre-eclampsia is a complication of pregnancy that generally occurs in the third trimester. It is associated with a maternal and foetal mortality rate of around 27%. In view of the grim picture painted by this condition for both mother and newborn, studies have been carried out into the early detection of patients at risk of developing pre-eclampsia. These make it possible to introduce pregnancy-specific monitoring and preventive strategies to reduce the incidence of the condition. Objective: To establish the link between placental ultrasound characteristics and the onset of pre-eclampsia. Methodology: A multicentre prospective cohort study was conducted in two hospitals in Yaoundé, namely the Yaoundé Gynaecological Obstetrics and Paediatrics Hospital and the Nkolndongo Health and Social Animation Centre, in the gynaecology and radiology departments over a period of 11 months, from October 2022 to August 2023. It included pregnant women who had undergone obstetric ultrasound between 12 and 18 weeks’ gestation. In addition to routine obstetric ultrasound, we performed obstetric Doppler measurements in these patients. The resistance index of the left and right uterine arteries, the umbilical artery and the placental volume were the characteristics sought. At the end of this examination, two groups were formed: cases (pathological Doppler group) and controls (normal Doppler group). Blood pressure and urine dipstick were taken at each antenatal visit until delivery, then during the immediate postpartum period and finally at 7 days, 21 days and 42 days after delivery. Results: Sixty-seven (67) patients were included. Of these, 35 (47.8%) had pathological Dopplers. Sixteen patients had arterial hypertension associated with proteinuria and were therefore labelled as pre-eclampsia (PE). This gives a prevalence of 23.9%. Fifteen (42.8%) of these patients belonged to the exposed group and one to the unexposed group. The mean IR of the pre-eclampsia patients was significantly higher than that of the patients without pre-eclampsia;respectively 0.74 ± 0.096 and 0.49 ± 0.097 for the right uterine arteries and 0.71 ± 0.13 and 0.52 ± 0.089 for the left uterine arteries. We found that an increase in the uterine artery resistance index was significantly associated with the onset of pre-eclampsia, with a relative risk of 13.7 and a p value Conclusion: Abnormal Doppler ultrasound between 12 and 18 weeks of amenorrhoea had good overall sensitivity for predicting pre-eclampsia. Among the Doppler indices, the uterine artery resistance index was the only one significantly associated with pre-eclampsia.展开更多
Introduction: Pre-eclampsia is a major cause of maternal and prenatal morbidity and mortality, that complicates 2% to 8% of pregnancies worldwide. The aim of this study was to determine the predictive factors for pre-...Introduction: Pre-eclampsia is a major cause of maternal and prenatal morbidity and mortality, that complicates 2% to 8% of pregnancies worldwide. The aim of this study was to determine the predictive factors for pre-eclampsia in two hospitals in the city of Yaoundé. Methods: A case-control study was conducted at the Gynaecology & Obstetrics department of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital (YGOPH) and the Main Maternity of the Yaoundé Central Hospital (MM-YCH) from February 1 to July 30, 2022. The cases were all pregnant women presenting with pre-eclampsia. The control group included pregnant women without pre-eclampsia. Descriptive statistics followed by logistic regression analyses were conducted with level of significance set at p-value Results: Included in the study were 33 cases and 132 controls, giving a total of 165 participants. The predictive factors for pre-eclampsia after multivariate analysis were: primiparity (aOR = 51.86, 95% CI: 3.01 - 1230.96, p = 0.045), duration of exposure to partner’s sperm Conclusion: The odds of pre-eclampsia increased with primiparity, duration of exposure to partner’s sperm < 3 months, personal history of pre-eclampsia and maternal history of pre-eclampsia. Recognition of these predictor factors would improve the ability to diagnose and monitor women likely to develop pre-eclampsia before the onset of disease for timely interventions.展开更多
Background: In Sub-Saharan Africa, pre-eclampsia remains a major health problem contributing to high rates of maternal mortality. Despite this condition having adverse effects on maternal and child health, its prevale...Background: In Sub-Saharan Africa, pre-eclampsia remains a major health problem contributing to high rates of maternal mortality. Despite this condition having adverse effects on maternal and child health, its prevalence and associated risk factors are still significant, especially in developing countries including Ghana. This study aimed to assess the prevalence and demographic distributions associated with pre-eclampsia among pregnant women at the Ho Teaching Hospital. Methods: A facility-based retrospective study was conducted by reviewing available data or hospital records of pregnant mothers admitted to the labor and maternity wards from January 2018 to December 2020. All pregnant women who were diagnosed with pre-eclampsia within this period were included in the study. The data were collected using a structured checklist. Results: 5609 data on pregnant women from 2018 to 2020 were recorded. Out of the 5609 data recorded, 314 pre-eclampsia cases were recorded giving an overall prevalence of 5.6%. The yearly prevalence for 2018, 2019, and 2020 were 4.6%, 5.6%, and 6.6%, respectively. The most recorded pre-eclampsia cases were seen among women within the age group of 18 - 24 years. The data showed that 112 (35.7%) of the pregnant women who had pre-eclampsia were nulliparous. Pre-eclampsia-associated maternal and fetal complications were;preterm delivery 221 (70.4%), intrauterine fetal death 62 (19.7%), eclampsia 9 (2.9%), HELLP syndrome 5 (1.6%) and maternal death 17 (5.4%). Associated factors of pre-eclampsia were parity, level of education, and occupation (p ≤ 0.05). Conclusion: The findings of this study showed a rising trend in the incidence of pre-eclampsia over the years at the Ho Teaching Hospital. Parity, level of education, and occupation were found to be associated with developing pre-eclampsia.展开更多
Research Background: Pre-eclampsia is one of main causes of materno-foetal mortality and morbidity worldwide, with a prevalence of 3% - 7%. Although considered a primiparous condition, it can nevertheless recur. Sever...Research Background: Pre-eclampsia is one of main causes of materno-foetal mortality and morbidity worldwide, with a prevalence of 3% - 7%. Although considered a primiparous condition, it can nevertheless recur. Several factors appear to be associated with risk of recurrence of pre-eclampsia, such as the term of delivery of previous pregnancy, severity of disease, the existence of co-morbidities and the inter-genital space. Purpose: The aim of our study will be to analyse and identify in a population of pregnant women with a history of preeclampsia risk factors associated with occurrence of recurrent preeclampsia at University clinics of Kinshasa (Democratic Republic of Congo) and at Victor Dupouy Hospital Center (France). Methods: In this study, pregnant women with an history of preeclampsia who will give birth between November 2018 and October 2024 at University Clinics of Kinshasa (UCK) and Victor Dupouy Hospital Center (VDHC) will be included. This will be a cross-sectional analytical study, data from previous and subsequent pregnancies will be studied. Expected Result: The prevalence of recurrent preeclampsia in the study population will be determined. And we will highlight the factors that will determine the recurrence of preeclampsia by analysing the risk factors. Conclusion: Knowledge of the factors associated with recurrent preeclampsia could be an excellent tool for predicting and preventing the disease.展开更多
Background: Schwannomas are generally benign neoplasms arising from the nerve sheath. Presacral schwannomas are very rare entities and difficult to diagnose, representing less than 15% of all retrorectal space tumors....Background: Schwannomas are generally benign neoplasms arising from the nerve sheath. Presacral schwannomas are very rare entities and difficult to diagnose, representing less than 15% of all retrorectal space tumors. Benign schwannoma sometimes displays degenerative changes, such as cyst formation, calcification, hemorrhage, and hyalinization. Usually these degenerations are partially seen in the tumors. Objective: To point out that presacral schwannoma can display markedly multilocular cystic degeneration. Case Report: We present this unique case of a 24-year-old man diagnosed with an unusually large pure multilocular cystic schwannoma, which is revealed by digestive, urinary, and nonspecific neurological symptoms. The patient was successfully treated with radical surgery via an anterior approach leading to the recovery of symptoms. Discussion and Conclusion: This tumor was unusual in its totally multicystic appearance and its resemblance to a wide spectrum of lesions that can occur in the pre-sacral space, such as hydatid and developmental cysts. Preoperative diagnosis is essential to prevent major neurological deficits during surgical intervention.展开更多
Background: The size of Hamstring autograft of less than 8.0 mm in ACL re-construction is one of the key factors that may contribute to the failure of the graft. In this study, we are going to assess the correlation o...Background: The size of Hamstring autograft of less than 8.0 mm in ACL re-construction is one of the key factors that may contribute to the failure of the graft. In this study, we are going to assess the correlation of pre-operative MRI measurement of Hamstring tendons with the intra-operative ACL graft. Thus, it may help surgeons to anticipate the needs for graft augmentation should the final graft size be smaller than expected. Methods: We retrospectively re-viewed 41 cases of ACL reconstructions in which MRI were done pre-operatively, in Hospital Pakar Sultanah Fatimah (HPSF), Muar between January 2019 until December 2022. MRI measurements of Hamstring tendon (semitendinosus: ST, and gracilis) were done by a radiologist, and the in-tra-operative notes were reviewed for the final graft size. Pearson’s correlation coefficients were calculated to determine the relationship between graft size and tendon cross-sectional area. The intraclass correlation (ICC) by using two-way mixed model with type consistency, the reliability based on average measure was 0.41 (95% CI: ?0.10, 0.69). A p-value < 0.05 was considered sig-nificant. Results: Of 105 patients with primary ACL reconstruction done be-tween January 2019 to December 2022, only 41 patients were included in this study. There was fair correlation (p = 0.048) between pre-operative MRI measurement and the graft diameter intra-operatively. The mean of 17.0 mm of combined diameter of ST and gracilis tendon in MRI may results in graft diameter of 8.3 mm. There was also positive correlation between patients’ height and the intra-operative graft size. Conclusion: These results showed good correlation between pre-operative MRI measurement of Hamstring ten-don size with the intra-operative graft size, hence it is a reliable tool to predict the Hamstring autograft size in ACL reconstruction.展开更多
BACKGROUND: Permanent tooth avulsion is one of the severe forms of dental traumatic injuries. The immediate action taken at the site of the accident is crucial to the prognosis of the tooth. Replantation is considered...BACKGROUND: Permanent tooth avulsion is one of the severe forms of dental traumatic injuries. The immediate action taken at the site of the accident is crucial to the prognosis of the tooth. Replantation is considered as the treatment of choice. OBJECTIVE: The study was undertaken to assess the knowledge of parents who accompany their children to the pediatric dental clinic, KATH on the pre-hospital management of avulsed permanent tooth in children. METHODS: A researcher administered structured questionnaire was used to collect data on the knowledge of pre-hospital management of avulsed permanent tooth from 83 parents who accompanied their wards to the pediatric dental clinic at KATH. RESULTS: A total of 83 parents were involved in the study. 30 (36%) were males while 53 (64%) were females. The majority of the parents (57%) were either university trained or had attended college of education. Only 32 parents (39%) were aware of the possibility of replantation. Majority of the parents chose non-physiologic media as the transport media of choice and only 10% would attempt self-replantation before seeking professional help. 76 parents (92%) had no previous education on pre-hospital management of avulsed tooth. CONCLUSION: The results obtained from this study indicate that parental knowledge on pre-hospital management of avulsed permanent tooth is low hence the need for massive public educational campaigns.展开更多
Objective: To investigate the occurrence of PTSD in pre-hospital emergency nurses and its related factors, and to compare the differences of neurotransmitter and immune-related factors between pre-hospital emergency n...Objective: To investigate the occurrence of PTSD in pre-hospital emergency nurses and its related factors, and to compare the differences of neurotransmitter and immune-related factors between pre-hospital emergency nurses who experienced traumatic events and those who did not develop PTSD and healthy people. How: Post-traumatic Stress Disorder Self-Rating Scale (PCL-C) tests were performed on pre-hospital emergency nurses in PTSD group, non-PTSD group and healthy control group, and the plasma monoamine neurotransmitters and serum cytokines were determined by double-antibody sandwich ABC-ELISA assay using enzyme-linked adsorption kit provided by Shanghai Xitang Biotechnology Co., Ltd. Results: 1) There were statistically significant differences in PCL-C scores between PTSD group, non-PTSD group and healthy group (p α between PTSD group, non-PTSD group and healthy group (p Conclusion: Pre-hospital emergency nurses should have early psychological intervention and guidance to reduce the occurrence of PTSD in emergency and emergency nurses.展开更多
Background: Preeclampsia is reported to complicate 2% - 8% of pregnancies globally and is an important cause of maternal and perinatal morbidity and mortality. The aetiology and pathogenesis are still poorly understoo...Background: Preeclampsia is reported to complicate 2% - 8% of pregnancies globally and is an important cause of maternal and perinatal morbidity and mortality. The aetiology and pathogenesis are still poorly understood and substantial improvement has not been made in the prediction, prevention and treatment of the disease. Objective: To compare the frequency of activated protein C resistance (APC-R) in patients with pre-eclampsia to that of normotensive pregnant women and to determine the correlation between activated protein ratio (APC-ratio) and the severity of pre-eclampsia. Methodology: A cross-sectional study was carried out in 100 pre-eclamptic patients and 100 normotensive pregnant controls. The APC-ratio was determined using the modified activated partial thromboplastin time. Study participants with APC-ratio of less than 2.0 were defined as having APC-R. Data was analyzed using SPSS version 22.0. Results: Mean APC-ratio was significantly lower in pre-eclamptics (2.89 ± 1.70) compared to normotensive pregnant women (3.57 ± 1.06) (p = 0.0008) and the levels were also higher in mild (2.95 ± 1.15) compared to severe pre-eclamptics (2.62 ± 1.14). The frequency of APC-R was 26% among women with pre-eclampsia compared to 4% among normotensive controls (p = 0.000). Among 100 pre-eclamptic women 7 (21.2%) out of 33 with mild pre–eclampsia had APC-R, while 19 (28.4%) out of 67 with severe pre-eclampsia had APC-R. APC-ratio had a significant negative correlation with mean arterial blood pressure (r = −0.324;p = 0.000) and proteinuria (r = −0.379;p = 0.000) among study participants. Conclusion: The frequency of activated protein c resistance is significantly higher in pre-eclamptics compared to normotensive pregnant women and this is more pronounced in those with severe pre-eclampsia compared with those with mild disease. APC-R may therefore be used as a marker of severity in the disease.展开更多
Introduction: Hypertensive disorder in pregnancy affects 4 to 6 percent of all pregnancies and carries risks for the both baby and the mother. Only a few groups of women who are at high-risk pregnancies are received p...Introduction: Hypertensive disorder in pregnancy affects 4 to 6 percent of all pregnancies and carries risks for the both baby and the mother. Only a few groups of women who are at high-risk pregnancies are received prophylaxis Aspirin, more than 15 percent of women develop pre-eclampsia with a single minor risk factor. Methods: This descriptive cross-sectional study was conducted to compare the 1<sup>st</sup> trimester NLR value of normotensive, pregnancy induced hypertensive and pre-eclamptic pregnant women. The study was conducted with a sample of 416, antenatal patients who were admitted to ward 25, at Colombo North Teaching Hospital Ragama. Data was collected as separated three groups. NLR value was calculated separately and ANOVA test was used to analyze the 3 categorical data. Post HOC test was done to assess the multiple comparison. Results: The prevalence rates of pregnancy induced hypertension and pre-eclampsia among the pregnant women were 8.6% and 5.7%. The mean NLR values of normotensive group was 2.708, pregnancy induced hypertensive group was 2.650 and pre eclamptic group was 3.789. There was a significant difference in NLR value between pre eclamptic group and other two groups with P value of Conclusion: The 1<sup>st</sup> trimester NLR value of pre eclamptic patients significantly increased compared to normotensive women.展开更多
Background: Orthodontics is a dental specialty focusing on correcting dental irregularities and malocclusion. Knowledge and attitudes towards orthodontic treatment are crucial for promoting oral health and overall wel...Background: Orthodontics is a dental specialty focusing on correcting dental irregularities and malocclusion. Knowledge and attitudes towards orthodontic treatment are crucial for promoting oral health and overall well-being. Education and awareness play a vital role in ensuring optimal treatment outcomes and improving quality of life. Aim: This study aims to determine the knowledge and attitudes of Kwame Nkrumah University of Science and Technology (KNUST) pre-clinical dentistry students concerning orthodontic therapy. Methodology: This research is a quantitative descriptive cross-sectional study. The research used a non-random convenience sampling method to form the desired sample. For data collection, an interview-administered questionnaire was used over one month. The study set its sights on pre-clinical dental students in KNUST. A total of 150 questionnaires were printed to meet the sample size. Results: The results of the research showed that the knowledge level of KNUST pre-clinical students on orthodontic treatment and its nuances is quite limited. They however had a fair level of knowledge on the disease or ailment that orthodontic treatments solved (especially malocclusion). Their interest in orthodontic treatments on the other hand was quite significant, with a large number having interest in it. Conclusion: To conclude, KNUST pre-clinical students in Ghana although having a limited level of knowledge on orthodontic treatments have a keen interest in undergoing them regardless of the discomforts or the length of time.展开更多
This literature review primarily aims to explore and synthesise the previous studies in simulation education research conducted over the past five years related to the effects of simulation training on the self-effica...This literature review primarily aims to explore and synthesise the previous studies in simulation education research conducted over the past five years related to the effects of simulation training on the self-efficacy of undergraduate pre-registration nursing students. The second aim of this study is to explore additional outcome variables that were examined in the previous studies. Five electronic databases were searched systematically. These databases were MEDLINE, CINAHL Plus, Scopus, Embase and PsycINFO. The PICO model was employed to identify the search terms, with a thesaurus being used to provide synonyms. Reference lists of relevant articles were examined and hand searches of journals were also undertaken. The quality of each study was assessed using the Simulation Research Rubric (SRR). A total of 11 studies were included. All studies explored the impact of simulation education on undergraduate pre-registration nursing. Six studies explored nursing students’ competence and performance and two papers examined their critical thinking. Problem solving, learning motivation, communication skills and knowledge acquisition were examined once. The majority of studies indicated that simulation training has a positive impact on pre-registration nursing students’ self-efficacy and other outcome variables. Furthermore, the study results indicate that simulation training is more dependable than traditional training, and students were extremely satisfied with the simulation training. However, most of the studies included in this review had several gaps, including study design, sample size and dissimilarities between the scales used. Further research with large samples, reliable and valid instruments, and outcomes measures (such as critical thinking and transferability of skills) is required to provide better insight into the effectiveness of simulation in undergraduate nursing education. .展开更多
A function which is reflexive is called by pre-mean, a more generalized definition of a mean. In this paper, we define a new pre-mean and study its properties, and then using the given invariant curve we consider the ...A function which is reflexive is called by pre-mean, a more generalized definition of a mean. In this paper, we define a new pre-mean and study its properties, and then using the given invariant curve we consider the problem of convergence of Gauss iteration of a kind of pre-mean type mappings generated by the exponential and logarithmic functions.展开更多
文摘目的分析血清乙型肝炎病毒(hepatitis B virus,HBV)前S1蛋白(precursor S1 protein,preS1)与慢性乙型肝炎(chronic hepatitis B,CHB)肝纤维化及癌变进展的相关性。方法对2019年10月—2021年10月期间在青海红十字医院接受检查的228例乙肝表面抗原(hepatitis B surface antigen,HBsAg)阳性慢性HBV感染者进行回顾性分析,其中CHB患者75例、肝硬化(liver cirrhosis,LC)患者93例(LC组)、肝细胞癌(hepatocellular carcinoma,HCC)患者60例(HCC组)。根据LC和HCC组肝组织活检分析肝脏炎症活动及肝纤维化程度。结果HCC组血清preS1水平[496.32(457.63,988.0)ng/mL]和LC组[338.72(247.93,554.61)ng/mL]血清preS1水平均显著高于CHB组[113.69(87.09,177.40)ng/mL],且差异具有统计学意义(P均<0.05)。HCC组血清preS1水平亦高于LC组(P=0.002)。经受试者工作特征曲线分析,血清preS1水平鉴别诊断CHB与LC的曲线下面积(area under the curve,AUC)是0.881(95%CI:0.830~0.932),鉴别诊断CHB/LC与HCC的AUC是0.861(95%CI:0.815~0.908)。3组患者的血清preS1水平与HBsAg(rs=0.799,P<0.001)呈强正相关和Log HBV DNA(rs=0.262,P<0.001)呈弱正相关。此外LC组和HCC组血清preS1水平与肝脏炎症活动分级(rs=0.201,P=0.009)及肝纤维化分期也呈弱正相关性(rs=0.295,P<0.001)。结论血清preS1水平与血清HBsAg、HBV DNA水平和肝脏炎症和纤维化进展呈正相关,有可能成为鉴别诊断HBV相关慢性肝病肝硬化或癌变的候选标志物。
文摘Increased hazards threatening the United Nations Educational,Scientific and Cultural Organization(UNESCO)-designated sites and endangering cultural heritage and community well-being require attention and action.Con-sidering the pivotal role of UNESCO sites in conservation and development,this study assessed their levels of disaster preparedness.The absence of studies assessing disaster awareness,risk perception,and preparedness among UNESCO site actors,as well as the pivotal place of preparedness within the Disaster Risk Management(DRM)cycle justifies this research.Applying the tenets of the Person-Relative-to-Event framework,we hypothe-sized that a strong positive correlation exists between perceived risks,resources,and disaster preparedness.To collect pertinent data,we employed an embedded mixed-method design and conducted an online questionnaire survey yielding 141 responses from 59 countries.From the results of relevant analyses,wildfires,floods,and droughts are top hazards occurring frequently in UNESCO sites,with significant concerns about pollution and habitat loss during future events.Smartphones emerged as the most available crucial DRM resource,with higher availability of DRM resources correlating positively and significantly with sites’preparedness.Our findings con-tribute valuable insights to address missing links for disaster-ready and resilient UNESCO sites,promoting their preservation for future generations.
文摘Context: Pre-eclampsia and placental malaria, are two diseases that share pathophysiological similarities, such as placental ischemia, endothelial dysfunction and production of pro-inflammatory cytokines. Objective: The objective of our study was to investigate the association between placental malaria lesions and severe pre-eclampsia. Methodology: We conducted a prospective analytical cross-sectional study in two University Hospitals in the city of Yaounde (Yaounde Central Hospital and the Gynaecological Obstetrics and Paediatrics Hospital), and in the laboratory of the Centre Pasteur in Yaounde over an eight-month period (1st January 2021 – 1st September 2021). All patients with pre-eclampsia diagnosed according to the criteria of the International Society for the Study of Hypertension (ISSHP) and free of chronic metabolic or infectious pathology were included in this study. The patients were divided into two groups: group 1 (mild pre-eclampsia) and group 2: severe pre-eclampsia. Socio-demographic, clinical and histopathological characteristics specific to pre-eclampsia and placental malaria were investigated. Statistical analysis was performed with SPSS 23.0 software, Chi 2 was used to compare categorical variables, Student t-test was used to compare means, and logistic regression was used to assess the association between placental malaria lesions and PES. Results: The mean age of our study population was 29.93 ± 7.36 years versus 28.28 ± 7.18 years in patients with mild and severe pre-eclampsia respectively. Pre-eclampsia placental lesions (accelerated villous maturation, infarction) were significantly greater in patients with severe pre-eclampsia (p Conclusion: Placental malaria lesions were significantly associated with severe pre-eclampsia and increased the risk of developing severe pre-eclampsia placental lesions by a factor of 10.
文摘Introduction: Pre-eclampsia is a complication of pregnancy that generally occurs in the third trimester. It is associated with a maternal and foetal mortality rate of around 27%. In view of the grim picture painted by this condition for both mother and newborn, studies have been carried out into the early detection of patients at risk of developing pre-eclampsia. These make it possible to introduce pregnancy-specific monitoring and preventive strategies to reduce the incidence of the condition. Objective: To establish the link between placental ultrasound characteristics and the onset of pre-eclampsia. Methodology: A multicentre prospective cohort study was conducted in two hospitals in Yaoundé, namely the Yaoundé Gynaecological Obstetrics and Paediatrics Hospital and the Nkolndongo Health and Social Animation Centre, in the gynaecology and radiology departments over a period of 11 months, from October 2022 to August 2023. It included pregnant women who had undergone obstetric ultrasound between 12 and 18 weeks’ gestation. In addition to routine obstetric ultrasound, we performed obstetric Doppler measurements in these patients. The resistance index of the left and right uterine arteries, the umbilical artery and the placental volume were the characteristics sought. At the end of this examination, two groups were formed: cases (pathological Doppler group) and controls (normal Doppler group). Blood pressure and urine dipstick were taken at each antenatal visit until delivery, then during the immediate postpartum period and finally at 7 days, 21 days and 42 days after delivery. Results: Sixty-seven (67) patients were included. Of these, 35 (47.8%) had pathological Dopplers. Sixteen patients had arterial hypertension associated with proteinuria and were therefore labelled as pre-eclampsia (PE). This gives a prevalence of 23.9%. Fifteen (42.8%) of these patients belonged to the exposed group and one to the unexposed group. The mean IR of the pre-eclampsia patients was significantly higher than that of the patients without pre-eclampsia;respectively 0.74 ± 0.096 and 0.49 ± 0.097 for the right uterine arteries and 0.71 ± 0.13 and 0.52 ± 0.089 for the left uterine arteries. We found that an increase in the uterine artery resistance index was significantly associated with the onset of pre-eclampsia, with a relative risk of 13.7 and a p value Conclusion: Abnormal Doppler ultrasound between 12 and 18 weeks of amenorrhoea had good overall sensitivity for predicting pre-eclampsia. Among the Doppler indices, the uterine artery resistance index was the only one significantly associated with pre-eclampsia.
文摘Introduction: Pre-eclampsia is a major cause of maternal and prenatal morbidity and mortality, that complicates 2% to 8% of pregnancies worldwide. The aim of this study was to determine the predictive factors for pre-eclampsia in two hospitals in the city of Yaoundé. Methods: A case-control study was conducted at the Gynaecology & Obstetrics department of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital (YGOPH) and the Main Maternity of the Yaoundé Central Hospital (MM-YCH) from February 1 to July 30, 2022. The cases were all pregnant women presenting with pre-eclampsia. The control group included pregnant women without pre-eclampsia. Descriptive statistics followed by logistic regression analyses were conducted with level of significance set at p-value Results: Included in the study were 33 cases and 132 controls, giving a total of 165 participants. The predictive factors for pre-eclampsia after multivariate analysis were: primiparity (aOR = 51.86, 95% CI: 3.01 - 1230.96, p = 0.045), duration of exposure to partner’s sperm Conclusion: The odds of pre-eclampsia increased with primiparity, duration of exposure to partner’s sperm < 3 months, personal history of pre-eclampsia and maternal history of pre-eclampsia. Recognition of these predictor factors would improve the ability to diagnose and monitor women likely to develop pre-eclampsia before the onset of disease for timely interventions.
文摘Background: In Sub-Saharan Africa, pre-eclampsia remains a major health problem contributing to high rates of maternal mortality. Despite this condition having adverse effects on maternal and child health, its prevalence and associated risk factors are still significant, especially in developing countries including Ghana. This study aimed to assess the prevalence and demographic distributions associated with pre-eclampsia among pregnant women at the Ho Teaching Hospital. Methods: A facility-based retrospective study was conducted by reviewing available data or hospital records of pregnant mothers admitted to the labor and maternity wards from January 2018 to December 2020. All pregnant women who were diagnosed with pre-eclampsia within this period were included in the study. The data were collected using a structured checklist. Results: 5609 data on pregnant women from 2018 to 2020 were recorded. Out of the 5609 data recorded, 314 pre-eclampsia cases were recorded giving an overall prevalence of 5.6%. The yearly prevalence for 2018, 2019, and 2020 were 4.6%, 5.6%, and 6.6%, respectively. The most recorded pre-eclampsia cases were seen among women within the age group of 18 - 24 years. The data showed that 112 (35.7%) of the pregnant women who had pre-eclampsia were nulliparous. Pre-eclampsia-associated maternal and fetal complications were;preterm delivery 221 (70.4%), intrauterine fetal death 62 (19.7%), eclampsia 9 (2.9%), HELLP syndrome 5 (1.6%) and maternal death 17 (5.4%). Associated factors of pre-eclampsia were parity, level of education, and occupation (p ≤ 0.05). Conclusion: The findings of this study showed a rising trend in the incidence of pre-eclampsia over the years at the Ho Teaching Hospital. Parity, level of education, and occupation were found to be associated with developing pre-eclampsia.
文摘Research Background: Pre-eclampsia is one of main causes of materno-foetal mortality and morbidity worldwide, with a prevalence of 3% - 7%. Although considered a primiparous condition, it can nevertheless recur. Several factors appear to be associated with risk of recurrence of pre-eclampsia, such as the term of delivery of previous pregnancy, severity of disease, the existence of co-morbidities and the inter-genital space. Purpose: The aim of our study will be to analyse and identify in a population of pregnant women with a history of preeclampsia risk factors associated with occurrence of recurrent preeclampsia at University clinics of Kinshasa (Democratic Republic of Congo) and at Victor Dupouy Hospital Center (France). Methods: In this study, pregnant women with an history of preeclampsia who will give birth between November 2018 and October 2024 at University Clinics of Kinshasa (UCK) and Victor Dupouy Hospital Center (VDHC) will be included. This will be a cross-sectional analytical study, data from previous and subsequent pregnancies will be studied. Expected Result: The prevalence of recurrent preeclampsia in the study population will be determined. And we will highlight the factors that will determine the recurrence of preeclampsia by analysing the risk factors. Conclusion: Knowledge of the factors associated with recurrent preeclampsia could be an excellent tool for predicting and preventing the disease.
文摘Background: Schwannomas are generally benign neoplasms arising from the nerve sheath. Presacral schwannomas are very rare entities and difficult to diagnose, representing less than 15% of all retrorectal space tumors. Benign schwannoma sometimes displays degenerative changes, such as cyst formation, calcification, hemorrhage, and hyalinization. Usually these degenerations are partially seen in the tumors. Objective: To point out that presacral schwannoma can display markedly multilocular cystic degeneration. Case Report: We present this unique case of a 24-year-old man diagnosed with an unusually large pure multilocular cystic schwannoma, which is revealed by digestive, urinary, and nonspecific neurological symptoms. The patient was successfully treated with radical surgery via an anterior approach leading to the recovery of symptoms. Discussion and Conclusion: This tumor was unusual in its totally multicystic appearance and its resemblance to a wide spectrum of lesions that can occur in the pre-sacral space, such as hydatid and developmental cysts. Preoperative diagnosis is essential to prevent major neurological deficits during surgical intervention.
文摘Background: The size of Hamstring autograft of less than 8.0 mm in ACL re-construction is one of the key factors that may contribute to the failure of the graft. In this study, we are going to assess the correlation of pre-operative MRI measurement of Hamstring tendons with the intra-operative ACL graft. Thus, it may help surgeons to anticipate the needs for graft augmentation should the final graft size be smaller than expected. Methods: We retrospectively re-viewed 41 cases of ACL reconstructions in which MRI were done pre-operatively, in Hospital Pakar Sultanah Fatimah (HPSF), Muar between January 2019 until December 2022. MRI measurements of Hamstring tendon (semitendinosus: ST, and gracilis) were done by a radiologist, and the in-tra-operative notes were reviewed for the final graft size. Pearson’s correlation coefficients were calculated to determine the relationship between graft size and tendon cross-sectional area. The intraclass correlation (ICC) by using two-way mixed model with type consistency, the reliability based on average measure was 0.41 (95% CI: ?0.10, 0.69). A p-value < 0.05 was considered sig-nificant. Results: Of 105 patients with primary ACL reconstruction done be-tween January 2019 to December 2022, only 41 patients were included in this study. There was fair correlation (p = 0.048) between pre-operative MRI measurement and the graft diameter intra-operatively. The mean of 17.0 mm of combined diameter of ST and gracilis tendon in MRI may results in graft diameter of 8.3 mm. There was also positive correlation between patients’ height and the intra-operative graft size. Conclusion: These results showed good correlation between pre-operative MRI measurement of Hamstring ten-don size with the intra-operative graft size, hence it is a reliable tool to predict the Hamstring autograft size in ACL reconstruction.
文摘BACKGROUND: Permanent tooth avulsion is one of the severe forms of dental traumatic injuries. The immediate action taken at the site of the accident is crucial to the prognosis of the tooth. Replantation is considered as the treatment of choice. OBJECTIVE: The study was undertaken to assess the knowledge of parents who accompany their children to the pediatric dental clinic, KATH on the pre-hospital management of avulsed permanent tooth in children. METHODS: A researcher administered structured questionnaire was used to collect data on the knowledge of pre-hospital management of avulsed permanent tooth from 83 parents who accompanied their wards to the pediatric dental clinic at KATH. RESULTS: A total of 83 parents were involved in the study. 30 (36%) were males while 53 (64%) were females. The majority of the parents (57%) were either university trained or had attended college of education. Only 32 parents (39%) were aware of the possibility of replantation. Majority of the parents chose non-physiologic media as the transport media of choice and only 10% would attempt self-replantation before seeking professional help. 76 parents (92%) had no previous education on pre-hospital management of avulsed tooth. CONCLUSION: The results obtained from this study indicate that parental knowledge on pre-hospital management of avulsed permanent tooth is low hence the need for massive public educational campaigns.
文摘Objective: To investigate the occurrence of PTSD in pre-hospital emergency nurses and its related factors, and to compare the differences of neurotransmitter and immune-related factors between pre-hospital emergency nurses who experienced traumatic events and those who did not develop PTSD and healthy people. How: Post-traumatic Stress Disorder Self-Rating Scale (PCL-C) tests were performed on pre-hospital emergency nurses in PTSD group, non-PTSD group and healthy control group, and the plasma monoamine neurotransmitters and serum cytokines were determined by double-antibody sandwich ABC-ELISA assay using enzyme-linked adsorption kit provided by Shanghai Xitang Biotechnology Co., Ltd. Results: 1) There were statistically significant differences in PCL-C scores between PTSD group, non-PTSD group and healthy group (p α between PTSD group, non-PTSD group and healthy group (p Conclusion: Pre-hospital emergency nurses should have early psychological intervention and guidance to reduce the occurrence of PTSD in emergency and emergency nurses.
文摘Background: Preeclampsia is reported to complicate 2% - 8% of pregnancies globally and is an important cause of maternal and perinatal morbidity and mortality. The aetiology and pathogenesis are still poorly understood and substantial improvement has not been made in the prediction, prevention and treatment of the disease. Objective: To compare the frequency of activated protein C resistance (APC-R) in patients with pre-eclampsia to that of normotensive pregnant women and to determine the correlation between activated protein ratio (APC-ratio) and the severity of pre-eclampsia. Methodology: A cross-sectional study was carried out in 100 pre-eclamptic patients and 100 normotensive pregnant controls. The APC-ratio was determined using the modified activated partial thromboplastin time. Study participants with APC-ratio of less than 2.0 were defined as having APC-R. Data was analyzed using SPSS version 22.0. Results: Mean APC-ratio was significantly lower in pre-eclamptics (2.89 ± 1.70) compared to normotensive pregnant women (3.57 ± 1.06) (p = 0.0008) and the levels were also higher in mild (2.95 ± 1.15) compared to severe pre-eclamptics (2.62 ± 1.14). The frequency of APC-R was 26% among women with pre-eclampsia compared to 4% among normotensive controls (p = 0.000). Among 100 pre-eclamptic women 7 (21.2%) out of 33 with mild pre–eclampsia had APC-R, while 19 (28.4%) out of 67 with severe pre-eclampsia had APC-R. APC-ratio had a significant negative correlation with mean arterial blood pressure (r = −0.324;p = 0.000) and proteinuria (r = −0.379;p = 0.000) among study participants. Conclusion: The frequency of activated protein c resistance is significantly higher in pre-eclamptics compared to normotensive pregnant women and this is more pronounced in those with severe pre-eclampsia compared with those with mild disease. APC-R may therefore be used as a marker of severity in the disease.
文摘Introduction: Hypertensive disorder in pregnancy affects 4 to 6 percent of all pregnancies and carries risks for the both baby and the mother. Only a few groups of women who are at high-risk pregnancies are received prophylaxis Aspirin, more than 15 percent of women develop pre-eclampsia with a single minor risk factor. Methods: This descriptive cross-sectional study was conducted to compare the 1<sup>st</sup> trimester NLR value of normotensive, pregnancy induced hypertensive and pre-eclamptic pregnant women. The study was conducted with a sample of 416, antenatal patients who were admitted to ward 25, at Colombo North Teaching Hospital Ragama. Data was collected as separated three groups. NLR value was calculated separately and ANOVA test was used to analyze the 3 categorical data. Post HOC test was done to assess the multiple comparison. Results: The prevalence rates of pregnancy induced hypertension and pre-eclampsia among the pregnant women were 8.6% and 5.7%. The mean NLR values of normotensive group was 2.708, pregnancy induced hypertensive group was 2.650 and pre eclamptic group was 3.789. There was a significant difference in NLR value between pre eclamptic group and other two groups with P value of Conclusion: The 1<sup>st</sup> trimester NLR value of pre eclamptic patients significantly increased compared to normotensive women.
文摘Background: Orthodontics is a dental specialty focusing on correcting dental irregularities and malocclusion. Knowledge and attitudes towards orthodontic treatment are crucial for promoting oral health and overall well-being. Education and awareness play a vital role in ensuring optimal treatment outcomes and improving quality of life. Aim: This study aims to determine the knowledge and attitudes of Kwame Nkrumah University of Science and Technology (KNUST) pre-clinical dentistry students concerning orthodontic therapy. Methodology: This research is a quantitative descriptive cross-sectional study. The research used a non-random convenience sampling method to form the desired sample. For data collection, an interview-administered questionnaire was used over one month. The study set its sights on pre-clinical dental students in KNUST. A total of 150 questionnaires were printed to meet the sample size. Results: The results of the research showed that the knowledge level of KNUST pre-clinical students on orthodontic treatment and its nuances is quite limited. They however had a fair level of knowledge on the disease or ailment that orthodontic treatments solved (especially malocclusion). Their interest in orthodontic treatments on the other hand was quite significant, with a large number having interest in it. Conclusion: To conclude, KNUST pre-clinical students in Ghana although having a limited level of knowledge on orthodontic treatments have a keen interest in undergoing them regardless of the discomforts or the length of time.
文摘This literature review primarily aims to explore and synthesise the previous studies in simulation education research conducted over the past five years related to the effects of simulation training on the self-efficacy of undergraduate pre-registration nursing students. The second aim of this study is to explore additional outcome variables that were examined in the previous studies. Five electronic databases were searched systematically. These databases were MEDLINE, CINAHL Plus, Scopus, Embase and PsycINFO. The PICO model was employed to identify the search terms, with a thesaurus being used to provide synonyms. Reference lists of relevant articles were examined and hand searches of journals were also undertaken. The quality of each study was assessed using the Simulation Research Rubric (SRR). A total of 11 studies were included. All studies explored the impact of simulation education on undergraduate pre-registration nursing. Six studies explored nursing students’ competence and performance and two papers examined their critical thinking. Problem solving, learning motivation, communication skills and knowledge acquisition were examined once. The majority of studies indicated that simulation training has a positive impact on pre-registration nursing students’ self-efficacy and other outcome variables. Furthermore, the study results indicate that simulation training is more dependable than traditional training, and students were extremely satisfied with the simulation training. However, most of the studies included in this review had several gaps, including study design, sample size and dissimilarities between the scales used. Further research with large samples, reliable and valid instruments, and outcomes measures (such as critical thinking and transferability of skills) is required to provide better insight into the effectiveness of simulation in undergraduate nursing education. .
文摘A function which is reflexive is called by pre-mean, a more generalized definition of a mean. In this paper, we define a new pre-mean and study its properties, and then using the given invariant curve we consider the problem of convergence of Gauss iteration of a kind of pre-mean type mappings generated by the exponential and logarithmic functions.
