Clinical characteristics of acute non-varicose upper gastrointestinal bleeding and the effect of endoscopic hemostasis

BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)constitutes a prevalent emergency within Gastroenterology,encompassing 80%-90%of all gastrointestinal hemorrhage incidents.This condition is distinguished by its abrupt onset,swift progression,and notably elevated mortality rate.AIM To gather clinical data from patients with ANVUGIB at our hospital in order to elucidate the clinical characteristics specific to our institution and analyze the therapeutic effectiveness of endoscopic hemostasis.METHODS We retrospectively retrieved the records of 532 patients diagnosed with ANVUGIB by endoscopy at our hospital between March 2021 and March 2023,utilizing our medical record system.Data pertaining to general patient information,etiological factors,disease outcomes,and other relevant variables were meticulously collected and analyzed.RESULTS Among the 532 patients diagnosed with ANVUGIB,the male-to-female ratio was 2.91:1,with a higher prevalence among males.Notably,43.6%of patients presented with black stool as their primary complaint,while 27.4%had hematemesis as their initial symptom.Upon admission,17%of patients exhibited both hematemesis and black stool,while most ANVUGIB patients primarily complained of overt gastrointestinal bleeding.Urgent routine blood examinations at admission revealed that 75.8%of patients had anemia,with 63.4%experiencing moderate to severe anemia,and 1.5%having extremely severe anemia(hemoglobin<30 g/L).With regard to etiology,53.2%of patients experienced bleeding without a definitive trigger,24.2%had a history of using gastric mucosa-irritating medications,24.2%developed bleeding after alcohol consumption,2.8%attributed it to improper diet,1.7%to emotional excitement,and 2.3%to fatigue preceding the bleeding episode.Drug-induced ANVUGIB was more prevalent in the elderly than middle-aged and young individuals,while bleeding due to alcohol consumption showed the opposite trend.Additionally,diet-related bleeding was more common among the young age group compared to the middle-aged group.Gastrointestinal endoscopy identified peptic ulcers as the most frequent cause of ANVUGIB(73.3%),followed by gastrointestinal malignancies(10.9%),acute gastric mucous lesions(9.8%),and androgenic upper gastrointestinal bleeding(1.5%)among inpatients with ANVUGIB.Of the 532 patients with gastrointestinal bleeding,68 underwent endoscopic hemostasis,resulting in an endoscopic treatment rate of 12.8%,with a high immediate hemostasis success rate of 94.1%.

Survival and risk analysis of patients with COVID-19 in Iran

Objective:To evaluate the risk factors of death caused by COVID-19 in Iran.Methods:This study was a retrospective cohort study from February 20,2020,to August 22,2022,in the hospitals in Isfahan,Iran.The data were collected through a researcher-made checklist.To determine the risk factors of the death,logistic regression and Cox regression models were used.For each variable,the odds ratio and 95%confidence interval were also reported.Results:1885 Patients were included.The age of deceased persons was significantly higher than that of the surviving persons.The risk of death for the age group above 60 years was about 14 times higher than that of people aged 19-35 years[95%CI:14.41(2.02-102.99),P<0.01].Hypertension[95%CI:1.92(1.47-2.5),P<0.01],diabetes[95%CI:1.62(1.23-2.13),P<0.001],and chronic obstructive pulmonary disease[95%CI:1.92(1.47-2.50),P<0.01]were also risk factors of mortality.Conclusions:This study reveals that the mortality rate due to COVID-19 is associated with old age,longer hospitalization in the ICU,increased length of stay,and comorbidities of high blood pressure,diabetes,and chronic pulmonary disease.

Etitiological Relationship between Hyperlipidemia and Acute Pancreatitis

Hyperlipidemia is a kind of pancreatitis caused by high triglyceride levels in the blood. The morbidity and mortality of this disease continue to increase worldwide, and it has become one of the most common gastrointestinal diseases in developed countries worldwide. Although many studies have been conducted, the pathogenesis still cannot be defined. Many studies have shown that this may be related to the triglyceride decomposition products free fatty acids are the main toxic substances, which can directly damage pancreatic acinar cells and vascular endothelial cells, causing tissue ischemia and acidic environment. Therefore, this paper focuses on the correlation of triglycerides and their decomposition products in plasma and provides evidence on the pathogenesis of AP and the disease progression of AP. Finally, the future potential to prevent and treat acute pancreatitis by some new drugs to reduce plasma triglycerides is summarized.

Moral Perspective as Depicted in the Archetypes on Divine-Human Perspective of Dianshizhai Pictorial

This article examines the archetypes related to the divine-human perspective in the Dianshizhai Pictorial and uses the basic theory of“Myth-Archetype Criticism”to analyze the concepts of moral perspective and the view of cause and effect reflected in the text.It summarizes the interactive modes and various archetypes of cause and effect in three contexts:gods to humans,humans to gods,and humans to humans,explores the social reality and the relevant views of moral perspective and causality reflected in the illustrated magazine,and reveals the archetype foundation of the narrative of moral perspective retribution in Dianshizhai Pictorial in the three dimensions of psychology,literature,and society.

Investigating the Correlation between Patient Education on Web-Based Portal Functionality and the Reduction in 30-Day Hospital Readmission Rates

Background: The growing use of web-based patient portals offers patients valuable tools for accessing health information, communicating with healthcare providers, and engaging in self-management. However, the influence of educating patients on these portals’ functionality on clinical outcomes, such as all-cause readmission rates, remains underexplored. Objective: This research proposal tested the hypothesis that educating a subset of patients with Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF), on how to effectively access and utilize the functionality of web-based patient portals can reduce all-cause readmission rates. Methods: We performed a prospective, quasi-experimental study at Bon Secours St. Mary’s Hospital in Richmond, Virginia, USA;dividing participants into an intervention group, receiving education about accessing and navigating “My Chart”, the Bon Secours Web based portal, and a control group, receiving standard care. We then compared 30-day readmission rates, patient engagement, and self-management behaviors between the groups. Data was analyzed using statistical tests to assess the intervention’s impact. Results: We projected that educated patients will exhibit lower readmission rates, improved engagement, and better self-management. The results of the study showed that there was a significant decrease in 30-day readmissions in the intervention group in comparison with the control group (22.7% and 40.9%, respectively). This reduction of 18. 2% of readmissions evaluated here for a trial of meaningful clinical effect is statistically insignificant (p = 0. 184). The practical significance of the intervention is considered small-to-moderate (Cramer V = 0. 20) suggesting that the observed difference has a potential clinical importance even though the difference was not statistically significant. Conclusion: These results imply that the proposed educational intervention might have a positive impact on readmissions;nonetheless, the patient’s characteristics that make him or her capable of readmission cannot be changed and are assessed by the RoR (Risk of Readmission) score. The potential impact of the intervention may be offset, in part, by these baseline risk factors. The study’s power may be limited by sample size, potentially affecting the detection of significant differences. Future studies with larger, multi-center samples and longer follow-up periods are recommended to confirm these findings.

Analysis of the Factors That Cause Environmental Degradation of Lake Santa Maria Tasi Tolu Dili Timor-Leste

This research aims to understand more closely the damage to the lake environment and the factors that cause pollution in Lake Santa Maria are the first factor of increasing urbanization, the use of the land around the lake as a place to live, the absence of maximum control from the local government this case, the Dili municipal authority. Types of solid waste consist of iron from car accidents, motorcycles, used building materials, plastic, used drink bottles and clothes, mosquito nets, food scraps from household waste, as well as old fishing nets from residents. In addition, household waste such as bath and bath, dishwashing, detergents, and waste from tempeh and tofu factories, including burnt oil from cars and motorcycles, are thrown into the lake. Municipal waste management is based on environmental standards to determine the quality of waste management in Dili Municipality. It is possible to identify the composition of waste and waste, as well as predict its environmental impact. Human (Anthropic) factors Domestic Liquid Waste, Domestic Solid Waste: Composed of organic and inorganic waste. Synthetic Waste, Disposal of Used Oil, Disposal of Domestic Animal Waste, Shallow Drains and Septic Tanks, Mountain Garbage, Garbage Thrown by Visitors, Natural Factors, Climate change, Prolonged drought, Low rainfall, El Niño and La Niña factors, Wind speed, Heat (high daily temperature pressure), Greater water evaporation, Dry wind. The occurrence of contamination necessarily implies an ecological imbalance. The impact introduced by residual compounds and waste that may be associated with the toxicity.

Analysis and Response of Steel Stacking Accidents in Hot Rolling Coilers

Through long-term production and maintenance practice,various types of stacking steel in the 2250mm hot rolling coiler of Ma Steel were tracked and analyzed,and the causes of stacking steel were summarized.Cor-responding measures were formulated to effectively reduce the probability of stacking steel.

Analysis of Traffic Accidents in Vietnam

Understanding the causes and solutions of road traffic accidents is important for developing road and action plans in a country. In Vietnam, awareness of traffic participants is the main cause of serious traffic accidents. In recent years, the number of road traffic accidents in Tuyen Quang province with deaths has decreased, but the number of accidents has increased significantly. The article uses data on traffic accidents in Tuyen Quang over the (2016-2023) has been analytically reviewed. From there, analyze accident characteristics and causes of traffic accidents in Tuyen Quang province, and propose solutions to improve traffic safety in Tuyen Quang, Vietnam. The findings can be information for managers and researchers interested in studying the province of Tuyen Quang, Vietnam road traffic safety. Additionally, the findings have led the government to achieve national targets in reducing the number of accidents and serious injuries.

Multiple Indicators&Multiple Cause of Public Administration of Zoos in the Sustainable Development Goals

Zoo management has been approached from its financial guidelines in accordance with the SDGs,but without considering its adjustment to the SDGs.Therefore,the objective of this work was to compare the theoretical structure reported in the literature with respect to the observations of this work.A cross-sectional and retrospective study was carried out with a sample of administrative managers linked to zoos committed to the implementation of the SDGs.The results suggest that age and gender determine the financial factor.In relation to the state of the art where dimensions related to learning financial administration are reported,this work suggests that age is a determinant of social responsibility.

Age-specific causes of upper gastrointestinal bleeding in children

The etiology of upper gastrointestinal bleeding(UGIB)varies by age,from newborns to adolescents,with some of the causes overlapping between age groups.While particular causes such as vitamin K deficiency and cow’s milk protein allergy are limited to specific age groups,occurring only in neonates and infants,others such as erosive esophagitis and gastritis may be identified at all ages.Furthermore,the incidence of UGIB is variable throughout the world and in different hospital settings.In North America and Europe,most UGIBs are nonvariceal,associated with erosive esophagitis,gastritis,and gastric and duodenal ulcers.In recent years,the most common causes in some Middle Eastern and Far Eastern countries are becoming similar to those in Western countries.However,variceal bleeding still predominates in certain parts of the world,especially in South Asia.The most severe hemorrhage arises from variceal bleeding,peptic ulceration,and disseminated intravascular coagulation.Hematemesis is a credible indicator of a UGI source of bleeding in the majority of patients.Being familiar with the most likely UGIB causes in specific ages and geographic areas is especially important for adequate orientation in clinical settings,the use of proper diagnostic tests, and rapid initiation of the therapy. The fundamental approach to the management of UGIBincludes an immediate assessment of severity, detecting possible causes, and providing hemodynamic stability,followed by early endoscopy. Unusual UGIB causes must always be considered when establishing a diagnosis inthe pediatric population because some of them are unique to children. Endoscopic techniques are of significantdiagnostic value, and combined with medicaments, may be used for the management of acute bleeding. Finally,surgical treatment is reserved for the most severe bleeding.

Omadacycline for the treatment of Legionella pneumophila pneumonia caused by drowning:a case report

Drowning is a major cause of preventable death and pathology worldwide.Every year,more than 295,000people die from accidental drowning.Ninety percent of accidental drowning deaths occur in low-and middleincome countries,and nearly half occur in people under the age of 25.

Knowledge-enriched joint-learning model for implicit emotion cause extraction

Emotion cause extraction(ECE)task that aims at extracting potential trigger events of certain emotions has attracted extensive attention recently.However,current work neglects the implicit emotion expressed without any explicit emotional keywords,which appears more frequently in application scenarios.The lack of explicit emotion information makes it extremely hard to extract emotion causes only with the local context.Moreover,an entire event is usually across multiple clauses,while existing work merely extracts cause events at clause level and cannot effectively capture complete cause event information.To address these issues,the events are first redefined at the tuple level and a span-based tuple-level algorithm is proposed to extract events from different clauses.Based on it,a corpus for implicit emotion cause extraction that tries to extract causes of implicit emotions is constructed.The authors propose a knowledge-enriched jointlearning model of implicit emotion recognition and implicit emotion cause extraction tasks(KJ-IECE),which leverages commonsense knowledge from ConceptNet and NRC_VAD to better capture connections between emotion and corresponding cause events.Experiments on both implicit and explicit emotion cause extraction datasets demonstrate the effectiveness of the proposed model.

展望美国银行业危机:原因、后果和前景

The successive failures of Silicon Valley Bank and two other United States(US) banks triggered a wave of market panic. This study argues that this case should be viewed as a systemic crisis, highlighting the fragility of the US banking system. Although the turmoil in the banking sector gradually subsided owing to the strong intervention of the US government, it has not ended. Instead, the banking turmoil has transformed into a long-lasting “slow crisis,” which can be characterized as “boiling a frog in warm water,” presenting a comprehensive socio–economic crisis. From a historical and global perspective, the current banking crisis in the US has developed against the backdrop of the once-in-a-century changes that shape the world. Furthermore, its evolutionary path will be different from that of previous ones.

Prediction of high-speed train delay propagation based on causal text information

The delay-causing text data contain valuable information such as the specific reasons for the delay,location and time of the disturbance,which can provide an efficient support for the prediction of train delays and improve the guidance of train control efficiency.Based on the train operation data and delay-causing data of the Wuhan-Guangzhou high-speed railway,the relevant algorithms in the natural language processing field are used to process the delay-causing text data.It also integrates the train operatingenvironment information and delay-causing text information so as to develop a cause-based train delay propagation prediction model.The Word2vec model is first used to vectorize the delay-causing text description after word segmentation.The mean model or the term frequency-inverse document frequency-weighted model is then used to generate the delay-causing sentence vector based on the original word vector.Afterward,the train operating-environment features and delay-causing sentence vector are input into the extreme gradient boosting(XGBoost)regression algorithm to develop a delay propagation prediction model.In this work,4 text feature processing methods and 8 regression algorithms are considered.The results demonstrate that the XGBoost regression algorithm has the highest prediction accuracy using the test features processed by the continuous bag of words and the mean models.Compared with the prediction model that only considers the train-operating-environment features,the results show that the prediction accuracy of the model is significantly improved with multi-ple regression algorithms after integrating the delay-causing feature.

Reflections on the Toxicity and Safety of Traditional Chinese Medicine Combined with the Cases of Nephrotoxicity and Hepatotoxicity

This paper analyzes the relationship between toxicity and safety of traditional Chinese medicine(TCM)based on the cases of current nephrotoxicity and hepatotoxicity,and summarizes the literature on hepatotoxicity and nephrotoxicity.It is found that the main reasons for the toxic reaction of TCM are own factors of drugs,irregular administration of medicine and individual difference.However,as long as the"quality"and"quantity"of TCM are guaranteed,the toxicity of TCM can be controlled within the safety range.

Unified Understanding of Cosmological Energy Fields: Exploring Gravitation, Repulsion, and More

First, we develop a unitary process that can explain all four physical activations: electromagnetic wave, electromagnetic force, repulsion, and attraction. Second, it is clarified that cosmological and physical entities relate to different levels of existence in the universe and, hence, cannot be considered under the same paradigm. We know that biological entities use physical substances as executants;analogously, physical entities use cosmological substances as executants. Therefore, we have introduced new terms for the cosmological substances used as executants in physical activities. Third, this study introduces the primary elements of the cosmological world, such as visibility, forcibility, fullness, and hollowness, and defines them according to their attributes. This study explains how different combinations and placements of primary elements create different cosmological fields. These fields are used in all physical activations. Finally, we explain the entity model and how all physical activations occur. This study concludes that all physical activations use primary elements and follow the same universal law. Therefore, this study addresses the untouched subject of the creation of repulsion and attraction (gravitation). Furthermore, it addresses several cosmic mysteries that are yet to be resolved.

The Cause and Prevention of Major Earthquakes in the World

On February 6, 2023, a series of severe earthquakes occurred in eastern Turkey and neighboring areas of Syria. It was the largest earthquake in the world in more than a year, and the largest earthquake in the history of Turkey. Living under the fear of earthquakes, the people in Turkey and other earthquake zones have hoped again and again to change their fate, but they have to resign themselves to fate. Thus, the author analyzed the causes of large earthquakes such as Turkey earthquake, and found that some of the world’s potential seismic zones have been eroded by sea water or river water for a long time to create a series of surface faults. When the moon gets close to these faults, it will have a huge gravitational pull on them, and even cause the fault to move, resulting in strong earthquakes. Especially in some seismic zones, earthquakes are occurring more and more frequently and their intensity is getting bigger and bigger. The main reason is that the opening of the Arctic shipping route and the exploration and exploitation of oil and gas have caused the melting of the Arctic ice sheet and the loss of glaciers, which has led to the weakening of the Arctic vortex and the reduction of the compression ability of the polar vortices to the clouds, thus slowing down the rotation of the Earth and thus the revolution of the moon. So the moon gradually moves in a spiral toward the Earth;as the moon orbit close to the Earth, the moon’s gravity on the surface faults will gradually strengthen, so it is easy to cause the surface fault dislocations, resulting in frequent earthquakes or strong earthquakes. So the author puts forward some measures to prevent frequent and strong earthquakes.

Review of Maternal Deaths in Two Health Regions of Togo: About 69 Cases (Epidemiological and Sociodemographic Aspects)

Introduction: Maternal mortality is a public health problem. It is common in hospitals in Togo. From 401 per 100,000 live births in 2013, in 2017 we are 396 per 100,000 live births. Despite several programs ranging from subsidized caesarean section (CARMA) yezou (assistance for pregnant women), the establishment of maternal death reviews in maternity wards to compensate for avoidable causes;we are seeing preventable maternal and fetal deaths in our hospitals. No study on these reviews has been done since its establishment. The objective of our study was to determine the frequency of reviews of maternal deaths, the epidemiological, sociodemographic aspects and the causes of these reviewed maternal deaths. Method: This was a descriptive and cross-sectional, multicenter study lasting four and a half years, from the 1st of January 2018 to the 30th of June 2022, relating to the review of maternal deaths in three reference hospitals of two health regions of south Togo. Any maternal death occurring in one of these hospitals during the study period was included in this survey. The data collected using a collection sheet were analyzed using Epi Info version 7 software. Results: During the study period, the maternal mortality ratio in the three hospitals was 722.3 per 100,000 live births. Only 12.2% of maternal deaths were reviewed in the three hospitals. The patients were young with an average age of 29.9 years, housewives (71%), uneducated (21.7%). The causes of maternal deaths were dominated by direct obstetric causes (89.7%). The main cause was hemorrhage (72.5%), the main cause being immediate postpartum hemorrhage (50.7%). Conclusion: This study shows that the maternal mortality ratio still remains high in our country with a low frequency of maternal death reviews. Young, poor, uneducated women are the most affected by these deaths, the main cause of which remains hemorrhage. Preventive measures deserve to be taken at all levels with a view to reducing maternal mortality.

The Effect of Coding Method on Cause-of-Death Rankings

Background: Cause-of-death rankings are often used for planning or evaluating health policy measures. In the European Union, some countries produce cause-of-death statistics by a manual coding of death certificates, while other countries use an automated coding system. The outcome of these two different methods in terms of the selected underlying cause of death for statistics may vary considerably. Therefore, this study explores the effect of coding method on the ranking of countries by major causes of death. Method: Age and sex standardized rates were extracted for 33 European (related) countries from the cause-of-death registry of the European Statistical Office (Eurostat). Wilcoxon’s rank sum test was applied to the ranking of countries by major causes of death. Results: Statistically significant differences due to coding method were identified for dementia, stroke and pneumonia. These differences could be explained by a different selection of dementia or pneumonia as underlying cause of death and by a different certification practice for stroke. Conclusion: Coding method should be taken into account when constructing or interpreting rankings of countries by cause of death.

Logging-based assessment of low-resistivity oil zones:A case study from Sudan

The reservoirs in the N oilfield in Sudan feature a complex sedimentary environment,which has led to a widespread development of low-resistivity oil zones,accounting for as high as 37%of the total oil zones.In this case,a large number of oil zones will be misinterpreted using conventional methods.Based on the analysis of the core data and logging curves of the study area,this study concludes that the lowresistivity oil zones are formed mainly due to the high irreducible water saturation caused by the high content of illite and smectite and complex pore structure,the additional electrical conductivity induced by clay minerals,and the difference in formation water salinity between the oil zones and water zones.Furthermore,four methods are proposed to qualitatively identify these oil zones and water zones,namely the relationship analysis of five reservoir properties,cross-plotting of sensitive parameters,analysis of pressure testing data,and multi-well correlation.Furthermore,the study quantitatively calculates the initial oil saturation using the capillary pressure data,thus avoiding the conventional empirical saturation formulas depending on electrical resistivity and solving the difficulty in calculating oil saturation of low-resistivity oil zones.Finally,precise logging processing and interpretation of 95 wells in the study area are conducted using the above-mentioned comprehensive assessment system for low-resistivity oil zones.As a result,59 oil zones are newly discovered in 43 wells.Moreover,it is recommended that 17 oil zones in 12 wells should be tested,of which 11 oil zones have been tested as recommended,all proven to be high production oil zones after perforation.The coincidence rate of logging interpretation increases from 75%to 94.3%,and the original oil in place(OOIP)increases by 57.42 million barrels.All these indicate that the assessment system proposed is suitable for low-resistivity zones.