Transjugular intrahepatic portosystemic shunt:A promising therapy for recompensation in cirrhotic patients

This is a retrospective study focused on recompensation after transjugular intrahepatic portosystemic shunt(TIPS)procedure.The authors confirmed TIPS could be a treatment for recompensation of patients with cirrhosis according to Baveno VII.The paper identified age and post-TIPS portal pressure gradient as independent predictors of recompensation in patients with decompensated cirrhosis after TIPS.These results need to be validated in a larger prospective cohort.

The effectiveness of physical activity interventions on blood pressure in children and adolescents:A systematic review and network meta-analysis

Background:High blood pressure(BP)is a major contributor to mortality and cardiovascular diseases.Despite the known benefits of exercise for reducing BP,it is crucial to identify the most effective physical activity(PA)intervention.This systematic review and network meta-analysis(NMA)aimed to evaluate the available evidence on the effectiveness of various PA interventions for reducing BP and to determine their hierarchy based on their impact on BP.Methods:A search of PubMed,SPORTDiscus,PsycINFO,Web of Science,CINAHL,Cochrane,and Eric databases was conducted up to December 2022 for this systematic review and NMA.Randomized controlled trials and quasi-experimental studies targeting healthy children and adolescents aged 6-12 years old were included in this study.Only studies that compared controlled and intervention groups using PA or exercise as the major influence were included.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines.Three independent investigators performed the literature screening,data extraction,and risk of bias assessment.We used Bayesian arm-based NMA to synthesize the data.The primary outcomes were systolic BP and diastolic BP.We calculated the mean differences(MDs)in systolic BP and diastolic BP before and after treatment.Mean treatment differences were estimated using NMA and random-effect models.Results:We synthesized 27 studies involving 15,220 children and adolescents.PA combined with nutrition and behavior change was the most effective intervention for reducing both systolic BP and diastolic BP(MD=-8.64,95%credible interval(95%CI):-11.44 to-5.84;MD=-6.75,95%CI:-10.44 to-3.11),followed by interventions with multiple components(MD=-1.39,95%CI:-1.94 to-0.84;MD=-2.54,95%CI:-4.89 to-0.29).Conclusion:Our findings suggest that PA interventions incorporating nutrition and behavior change,followed by interventions with multiple components,are most effective for reducing both systolic BP and diastolic BP in children and adolescents.

Evaluation of frictional pressure drop correlations for air-water and air-oil two-phase flow in pipeline-riser system

Accurate prediction of the frictional pressure drop is important for the design and operation of subsea oil and gas transporting system considering the length of the pipeline. The applicability of the correlations to pipeline-riser flow needs evaluation since the flow condition in pipeline-riser is quite different from the original data where they were derived from. In the present study, a comprehensive evaluation of 24prevailing correlation in predicting frictional pressure drop is carried out based on experimentally measured data of air-water and air-oil two-phase flows in pipeline-riser. Experiments are performed in a system having different configuration of pipeline-riser with the inclination of the downcomer varied from-2°to-5°to investigated the effect of the elbow on the frictional pressure drop in the riser. The inlet gas velocity ranges from 0.03 to 6.2 m/s, and liquid velocity varies from 0.02 to 1.3 m/s. A total of885 experimental data points including 782 on air-water flows and 103 on air-oil flows are obtained and used to access the prediction ability of the correlations. Comparison of the predicted results with the measured data indicate that a majority of the investigated correlations under-predict the pressure drop on severe slugging. The result of this study highlights the requirement of new method considering the effect of pipe layout on the frictional pressure drop.

Control system design for a pressure-tube-type supercritical water-cooled nuclear reactor via a higher order sliding mode method

Nuclear power plants exhibit non-linear and time-variable dynamics.Therefore,designing a control system that sets the reactor power and forces it to follow the desired load is complicated.A supercritical water reactor(SCWR)is a fourth-generation conceptual reactor.In an SCWR,the non-linear dynamics of the reactor require a controller capable of control-ling the nonlinearities.In this study,a pressure-tube-type SCWR was controlled during reactor power maneuvering with a higher order sliding mode,and the reactor outgoing steam temperature and pressure were controlled simultaneously.In an SCWR,the temperature,pressure,and power must be maintained at a setpoint(desired value)during power maneuvering.Reactor point kinetics equations with three groups of delayed neutrons were used in the simulation.Higher-order and classic sliding mode controllers were separately manufactured to control the plant and were compared with the PI controllers speci-fied in previous studies.The controlled parameters were reactor power,steam temperature,and pressure.Notably,for these parameters,the PI controller had certain instabilities in the presence of disturbances.The classic sliding mode controller had a higher accuracy and stability;however its main drawback was the chattering phenomenon.HOSMC was highly accurate and stable and had a small computational cost.In reality,it followed the desired values without oscillations and chattering.

Portal vein pulsatility:An important sonographic tool assessment of systemic congestion for critical ill patients

In this editorial we comment on the article by Kuwahara et al,published in the recent issue of the World Journal of Cardiology.In this interesting paper,the authors showed a correlation between portal vein pulsatility ratio,examined by bedside ultrasonography,and prognosis of hospitalized patients with acute heart failure.Systemic congestion is being notoriously underdetected in the acutely ill population with conventional methods like clinical examination,biomarkers,central venous pressure estimation and X-rays.However,congestion should be a key therapeutic target due to its deleterious effects to end organ function and subsequently patient prognosis.Doppler flow assessment of the abdominal veins is gaining popularity worldwide,as a valuable tool in estimating comprehensively congestion and giving a further insight into hemodynamics and patient management.

Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure

Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.

Experimental models of high-risk bowel anastomosis in rats:A systematic review

BACKGROUND Anastomotic leaks remain one of the most dreaded complications in gastrointestinal surgery causing significant morbidity,that negatively affect the patients’quality of life.Experimental studies play an important role in understanding the pathophysiological background of anastomotic healing and there are still many fields that require further investigation.Knowledge drawn from these studies can lead to interventions or techniques that can reduce the risk of anastomotic leak in patients with high-risk features.Despite the advances in experimental protocols and techniques,designing a high-quality study is still challenging for the investigators as there is a plethora of different models used.AIM To review current state of the art for experimental protocols in high-risk anastomosis in rats.METHODS This systematic review was performed according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.To identify eligible studies,a comprehensive literature search was performed in the electronic databases PubMed(MEDLINE)and Scopus,covering the period from conception until 18 October 2023.RESULTS From our search strategy 102 studies were included and were categorized based on the mechanism used to create a high-risk anastomosis.Methods of assessing anastomotic healing were extracted and were individually appraised.CONCLUSION Anastomotic healing studies have evolved over the last decades,but the findings are yet to be translated into human studies.There is a need for high-quality,well-designed studies that will help to the better understanding of the pathophysiology of anastomotic healing and the effects of various interventions.

Diamond growth in a high temperature and high pressure Fe–Ni–C–Si system:Effect of synthesis pressure

Pressure is one of the necessary conditions for diamond growth.Exploring the influence of pressure on growth changes in silicon-doped diamonds is of great value for the production of high-quality diamonds.This work reports the morphology,impurity content and crystal quality characteristics of silicon-doped diamond crystals synthesized under different pressures.Fourier transform infrared spectroscopy shows that with the increase of pressure,the nitrogen content in the C-center inside the diamond crystal decreases.X-ray photoelectron spectroscopy test results show the presence of silicon in the diamond crystals synthesized by adding silicon powder.Raman spectroscopy data shows that the increase in pressure in the Fe-Ni-C-Si system shifts the Raman peak of diamonds from 1331.18 cm^(-1)to 1331.25 cm^(-1),resulting in a decrease in internal stress in the crystal.The half-peak width decreased from 5.41 cm^(-1)to 5.26 cm^(-1),and the crystallinity of the silicon-doped diamond crystals improved,resulting in improved quality.This work provides valuable data that can provide a reference for the synthesis of high-quality silicon-doped diamonds.

Management of sepsis in a cirrhotic patient admitted to the intensive care unit:A systematic literature review

BACKGROUND Sepsis is a severe medical condition that occurs when the body's immune system overreacts to an infection,leading to life-threatening organ dysfunction.The"Third international consensus definitions for sepsis and septic shock(Sepsis-3)"defines sepsis as an increase in sequential organ failure assessment score of 2 points or more,with a mortality rate above 10%.Sepsis is a leading cause of intensive care unit(ICU)admissions,and patients with underlying conditions such as cirrhosis have a higher risk of poor outcomes.Therefore,it is critical to recognize and manage sepsis promptly by administering fluids,vasopressors,steroids,and antibiotics,and identifying and treating the source of infection.AIM To conduct a systematic review and meta-analysis of existing literature on the management of sepsis in cirrhotic patients admitted to the ICU and compare the management of sepsis between cirrhotic and non-cirrhotic patients in the ICU.METHODS This study is a systematic literature review that followed the PRISMA statement's standardized search method.The search for relevant studies was conducted across multiple databases,including PubMed,Embase,Base,and Cochrane,using predefined search terms.One reviewer conducted the initial search,and the eligibility criteria were applied to the titles and abstracts of the retrieved articles.The selected articles were then evaluated based on the research objectives to ensure relevance to the study's aims.RESULTS The study findings indicate that cirrhotic patients are more susceptible to infections,resulting in higher mortality rates ranging from 18%to 60%.Early identification of the infection source followed by timely administration of antibiotics,vasopressors,and corticosteroids has been shown to improve patient outcomes.Procalcitonin is a useful biomarker for diagnosing infections in cirrhotic patients.Moreover,presepsin and resistin have been found to be reliable markers of bacterial infection in patients with decompensated liver cirrhosis,with similar diagnostic performance compared to procalcitonin.CONCLUSION This review highlights the importance of early detection and management of infections in cirrhosis patients to reduce mortality.Therefore,early detection of infection using procalcitonin test and other biomarker as presepsin and resistin,associated with early management with antibiotics,fluids,vasopressors and low dose corticosteroids might reduce the mortality associated with sepsis in cirrhotic patients.

An Analysis of the Static and Dynamic Behavior of the Hydraulic Compensation System of a Multichannel Valve

Electro-hydraulic proportional valve is the core control valve in many hydraulic systems used in agricultural and engineering machinery.To address the problem related to the large throttling losses and poor stability typically associated with these valves,here,the beneficial effects of a triangular groove structure on the related hydraulic response are studied.A mathematical model of the pressure compensation system based on the power-bond graph method is introduced,and the AMESim software is used to simulate its response.The results show that the triangular groove structure increases the jet angle and effectively compensates for the hydrodynamic force.The steady-state differential pressure at the valve port of the new pressure compensation structure was 0.65 MPa.Furthermore,experimental results show that the pressure difference at the main valve port is 0.73 MPa,and that the response time is less than 0.2 s.It is concluded that the new compensation structure has good pressure compensation response characteristics.

An ultrafast spectroscopy system for studying dynamic properties of superconductors under high pressure and low temperature conditions

An ultrafast pump-probe spectroscopy system combined with a cryogenic diamond anvil cell(DAC) instrument is developed to investigate the photo-excitation dynamic properties of condensed materials under low temperature and high pressure(LTHP) conditions.The ultrafast dynamics study is performed on Bi_(2)Sr_(2)CaCu_(2)O_(8+δ)(Bi-2212) thin film under LTHP conditions.The superconducting(SC) phase transition has been observed by analyzing the ultrafast dynamics of Bi-2212 as a function of pressure and temperature.Our results suggest that the pump-probe spectroscopy system combined with a cryogenic DAC instrument is an effective method to study the physical mechanism of condensed matter physics at extreme conditions,especially for the SC phase transition.

Pressure-induced stable structures and physical properties of Sr–Ge system

We have systematically investigated the structures of Sr-Ge system under pressures up to 200 GPa and found six stable stoichiometric structures,they being Sr_(3)Ge,Sr_(2)Ge,SrGe,SrGe_(2),SrGe_(3),and SrGe_(4).We demonstrate the interesting structure evolution behaviors in Sr-Ge system with the increase of germanium content,Ge atoms arranging into isolated anions in Sr_(3)Ge,chains in Sr_(2) Ge,square units in SrGe,trigonal units and hexahedrons in SrGe_(2),cages in SrGe_(3),hexagons and Geg rings in SrGe_(4).The structural diversity produces various manifestations of electronic structures,which is of benefit to electrical transportation.Among them,these novel phases with metallic structures show superconductivity(maximum T_(c)~8.94 K for Pmmn Sr_(3)Ge).Notably,the n-type semiconducting Pnma SrGe_(2) structure exhibits high Seebeck coefficient and excellent electrical conductivity along the y direction,leading to a high ZT value up to 1.55 at 500 K,which can be potential candidates as high-performance thermoelectrics.Our results will enable the development of fundamental science in condensed matter physics and potential applications in novel electronics or thermoelectric materials.

Development of a pressure coring system for the investigation of deep underground exploration

To provide a more accurate evaluation of the scale of deep underground resources,a new pressure coring system was carefully developed and its strength and safety of the engineering were verified by theoretical analyses and numerical simulation.The designed pressure coring system can obtain cores with length of 3 m and diameter of 50 mm at 70 MPa.The results of the ball-drop operation experiment demonstrate that differential motion assembly can effectively cut a safety pin by applying a tensile force of 4852 N,and it can lift the core tube through the center pole to complete a series of mechanical actions to seal the pressure.Additionally,by maintaining pressures at 70 MPa for 30 min,the pressure sealing capacity of the system was proven.Furthermore,a core sample with a diameter of 50 mm was obtained through a core drilling experiment and the coring performance of the pressure coring system was verified.This study can not only enrich the existing onshore coring technology but also provide a theoretical guide and design criteria for the development of similar pressure coring systems to meet the demand for deeper underground exploration.

Non-Contact Physiological Measurement System for Wearing Masks During the Epidemic

Physiological signals indicate a person’s physical and mental state at any given time.Accordingly,many studies extract physiological signals from the human body with non-contact methods,and most of them require facial feature points.However,under COVID-19,wearing a mask has become a must in many places,so how non-contact physiological information measurements can still be performed correctly even when a mask covers the facial information has become a focus of research.In this study,RGB and thermal infrared cameras were used to execute non-contact physiological information measurement systems for heart rate,blood pressure,respiratory rate,and forehead temperature for peoplewearing masks due to the pandemic.Using the green(G)minus red(R)signal in the RGB image,the region of interest(ROI)is established in the forehead and nose bridge regions.The photoplethysmography(PPG)waveforms of the two regions are obtained after the acquired PPG signal is subjected to the optical flow method,baseline drift calibration,normalization,and bandpass filtering.The relevant parameters in Deep Neural Networks(DNN)for the regression model can correctly predict the heartbeat and blood pressure.In addition,the temperature change in the ROI of the mask after thermal image processing and filtering can be used to correctly determine the number of breaths.Meanwhile,the thermal image can be used to read the temperature average of the ROI of the forehead,and the forehead temperature can be obtained smoothly.The experimental results show that the above-mentioned physiological signals of a subject can be obtained in 6-s images with the error for both heart rate and blood pressure within 2%∼3%and the error of forehead temperature within±0.5°C.

Hemodynamic Profiling Using a Cardiac Index–Systemic Vascular Resistance Plot in Patients with Fontan Circulation

Background: Elevated Fontan pressure (FP) alone cannot fully predict clinical outcomes. We hypothesized thathemodynamic profiling using a cardiac index (CI)-systemic vascular resistance (SVR) plot could characterize clinicalfeatures and predict the prognosis of post-Fontan patients. Methods: We included post-Fontan patients whounderwent cardiac catheterization at age < 10 years. Patients were classified into four categories: A, CI ≥ 3, SVRindex (SVRI) ≥ 20;B, CI < 3, SVRI ≥ 20;C, CI ≥ 3, SVRI < 20;and D, CI < 3, SVRI < 20. The primary outcome wasfreedom from the combined endpoint: new onset of protein-losing enteropathy or plastic bronchitis, heart transplant,and death. Clinical and hemodynamic variables and freedom from the endpoint were compared betweenthe hemodynamic categories and outcome predictors were evaluated. Results: Eighty-three patients wereincluded. Median follow-up was 5.3 years. Category A/B/C/D consisted of 4/15/53/11 patients, respectively. Allthe patients in category A were New York Heart Association I/II and had a significantly lower pulmonary vascularresistance index (PVRI). Patients in category C had lower pulmonary/systemic blood flow. Patients in category Dhad a higher PVRI and had the poorest freedom from the endpoint (44% at 5 years). Elevated FP and category Dwere outcome predictors. Conclusions: CI-SVR plots was a novel adjunctive method for Fontan hemodynamicprofiling.

Pre-transjugular-intrahepatic-portosystemic-shunt measurement of hepatic venous pressure gradient and its clinical application: A comparison study

BACKGROUND It is controversial whether transjugular intrahepatic portosystemic shunt(TIPS)placement can improve long-term survival.AIM To assess whether TIPS placement improves survival in patients with hepaticvenous-pressure-gradient(HVPG)≥16 mmHg,based on HVPG-related risk stratification.METHODS Consecutive variceal bleeding patients treated with endoscopic therapy+nonselectiveβ-blockers(NSBBs)or covered TIPS placement were retrospectively enrolled between January 2013 and December 2019.HVPG measurements were performed before therapy.The primary outcome was transplant-free survival;secondary endpoints were rebleeding and overt hepatic ence-phalopathy(OHE).RESULTS A total of 184 patients were analyzed(mean age,55.27 years±13.86,107 males;102 in the EVL+NSBB group,82 in the covered TIPS group).Based on the HVPG guided risk stratification,70 patients had HVPG<16 mmHg,and 114 patients had HVPG≥16 mmHg.The median follow-up time of the cohort was 49.5 mo.There was no significant difference in transplant-free survival between the two treatment groups overall(hazard ratio[HR],0.61;95%confidence interval[CI]:0.35-1.05;P=0.07).In the high-HVPG tier,transplant-free survival was higher in the TIPS group(HR,0.44;95%CI:0.23-0.85;P=0.004).In the low-HVPG tier,transplantfree survival after the two treatments was similar(HR,0.86;95%CI:0.33-0.23;P=0.74).Covered TIPS placement decreased the rate of rebleeding independent of the HVPG tier(P<0.001).The difference in OHE between the two groups was not statistically significant(P=0.09;P=0.48).CONCLUSION TIPS placement can effectively improve transplant-free survival when the HVPG is greater than 16 mmHg.

Abnormal Systemic and Ocular Responses to the Valsalva Manoeuvre in Primary Open-Angle Glaucoma:A Case for Autonomic Failure?

Objective This study aimed to examine the association of primary open-angle glaucoma(POAG)with autonomic dysfunction by assessing the differences in systemic and ocular responses to an autonomic provocation test,the Valsalva manoeuvre(VM),between POAG patients and normal subjects.Methods Forty POAG and forty control subjects were subjected to the VM.Systemic and ocular parameters were measured at baseline,phase 2,and phase 4 of the VM(VM2 and VM4),where VM2 and VM4 are sympathetic and parasympathetic nervous activation states,respectively.Heart rate variability was used to assess the autonomic nervous activity,among which the high-frequency component(HF)and the low-frequency(LF)/HF ratio were used as indices of parasympathetic and sympathetic activation,respectively.Results POAG patients demonstrated higher sympathetic activation(LF/HF ratio median:2.17 vs.1.53,P=0.000)than controls at baseline and exhibited attenuated sympathetic and parasympathetic responses(a smaller change in LF/HF and HF values)during the VM than controls.During VM,the intraocular pressure(IOP),mean blood pressure(MAP),mean ocular perfusion pressure(MOPP),and the Schlemm’s canal area(SCAR)increased from baseline to VM2 and then decreased from VM2 to VM4 in both the POAG and control groups(all P<0.05).However,when we compared the changes above,the fluctuations in IOP,MAP,and MOPP were more pronounced in POAG than in controls(all P<0.05),while the changes in amplitudes of SCAR were smaller in POAG(P<0.05).Furthermore,from VM2 to VM4,the choroid thickness(ChT)in the POAG group was significantly decreased,while it was unchanged in normal subjects(P=0.258).A regression analysis showed a significant correlation of the baseline LF/HF with IOP change values(ΔIOP)from baseline to VM2 in POAG(R^(2)=0.147,P=0.014).Conclusion Patients with POAG showed more pronounced fluctuations in IOP,MAP,MOPP and ChT during the VM than controls.These reactions could be associated with autonomic dysfunction in POAG.

Carbon dioxide partial pressure and its diffusion flux in karst surface aquatic ecosystems:a review

Carbon dioxide(CO_(2))emissions from aquatic ecosystems are an important component of the karst carbon cycle process and also a key indicator for assessing the effect of karst carbon sinks.This paper reviewed the CO_(2)partial pressure(pCO_(2))and its diffusion flux(FCO_(2))in karst surface aquatic ecosystems,mainly rivers,lakes,and reservoirs,and their influencing factors summarized the methods for monitoring CO_(2)emissions in karst aquatic ecosystems and discussed their adaptation conditions in karst areas.The pCO_(2)and FCO_(2)decreased in the order of rivers>reservoirs>lakes,and the values in karst lakes were eventually significantly lower than those in global lakes.The pCO_(2)and FCO_(2)of karst aquatic ecosystems had patterns of variation with diurnal,seasonal,water depth and hydrological cycles,and spatial and temporal hetero-geneity.The sources of CO_(2)in karst waters are influenced by both internal and external sources,and the key spatial and temporal factors affecting the CO_(2)emissions from karst rivers,lakes,and reservoirs were determined in terms of physicochemical indicators,biological factors,and bio-genic elements;additionally,the process of human activity interference on CO_(2)emissions was discussed.Finally,a conceptual model illustrating the impacts of urban devel-opment,agriculture,mining,and dam construction on the CO_(2)emissions at the karst surface aquatic ecosystem is presented.Meanwhile,based on the disadvantages existing in current research,we proposed several important research fields related to CO_(2)emissions from karst surface aquatic ecosystems.

Systemic Capillary Leak Syndrome Secondary to COVID-19 Infection: Case Report

Introduction: Systemic capillary leak syndrome (SCLS) is an increasingly recognized rare syndrome. Its diagnosis is suggested by the occurrence of edema with arterial hypotension, hemoconcentration, and paradoxical hypoalbuminemia. SCLS can be idiopathic (Clarkson syndrome) or secondary. Secondary SCLS (SSCLS) is mainly triggered by infections (especially viruses), drugs (antitumor therapy), malignancies, and inflammatory diseases. We report a case of systemic capillary leak syndrome secondary to the COVID-19 infection. Observation: A 74-year-old chronic smoker with no particular history was initially admitted to the intensive care unit (ICU) with a picture of respiratory distress secondary to a COVID-19 infection with favorable evolution, hence his transfer to the emergency services. On Day 8 of hospitalization, following the installation of arterial hypotension, not responding to filling, associated with hypoalbuminemia, and generalized edematous syndrome, and in the absence of any other explanation for this clinical picture, a SCLS secondary to COVID-19 infection was suggested. On the balance sheet, after the discovery of acute renal failure, serum creatinine went from 7.9 mg/l to 16.6 mg/l with microalbuminuria at 420 mg/24h and leukocyturia at 20 elements/mm3 without germ-evoked tubulointerstitial nephritis (TIN) secondary to a viral infection with COVID-19. The evolution was marked by the spontaneous regression of the edema and the normalization of the blood pressure figures. Discussion: The classic triad combining hypotension, hemoconcentration, and hypoalbuminemia suggests the diagnosis of SCLS once all other causes of shock have been ruled out. Hemoconcentration is less constant in SSCLS than in ISCLS. This is the case with our patient. The exact pathophysiological process of SCLS is largely unknown. Viral infections are the most common infectious cause of SCLS. The kidneys are the second-most common organs affected by the SARS-Cov-2 coronavirus infection. The presence of nephritis can be used as an indicator of SCLS, which can be a predictor of serious complications such as fluid overload, respiratory failure, and the need for ICU admission. Conclusion: In the event of COVID-19 infection, the appearance of hypotension and hypoalbuminemia with the gradual onset of generalized edema should suggest SCLS. The establishment of close monitoring is mandatory, given the risk of fatal evolution. Fortunately, for our patient, the evolution was favorable.

Propagation Characteristics of Ultrasonic Guided Waves in Grouted Rockbolt Systems with Bond Defects under Different Confining Conditions

A rockbolt acting in the rock mass is subjected to the combined action of the pull-out load and confining pressure, and the bond quality of the rockbolt directly affects the stability of the roadway and cavern. Therefore, in this study, confining pressure and pull-out load are applied to grouted rockbolt systems with bond defects by a numerical simulation method, and the rockbolt is detected by ultrasonic guided waves to study the propagation law of ultrasonic guided waves in defective rockbolt systems and the bond quality of rockbolts under the combined action of pull-out load and confining pressure. The numerical simulation results show that the length and location of bond defects can be detected by ultrasonic guided waves under the combined action of pull-out load and confining pressure. Under no pull-out load, with increasing confining pressure, the low-frequency part of the guided wave frequency in the rockbolt increases, the high-frequency part decreases, the weakening effect of the confining pressure on the guided wave propagation law increases, and the bond quality of the rockbolt increases. The existence of defects cannot change the strengthening effect of the confining pressure on the guided wave propagation law under the same pull-out load or the weakening effect of the pull-out load on the guided wave propagation law under the same confining pressure.