Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Heart Failure in the Medical Department at Gao Regional Hospital

Introduction: Heart failure is a major public health pandemic, particularly in Africa, where its prevalence continues to increase. In northern Mali, few data exist, hence the interest of this study with the objective of studying the epidemiological, clinical and therapeutic and evolutionary aspects of Heart failure at the regional hospital of Gao. Patients and Methods: This was a cross-sectional, descriptive study that took place from July 2022 to June 2023 in the medical department at Gao Hospital. Results: The hospital prevalence of heart failure was 44.1%. The mean age was 47.30 ± 20 years (range: 16-88). Hypertension was the most common with 46.1%, followed by a sedentary lifestyle, and diabetes with 18.2% and 8.3% respectively;NYHA stage III-IV dyspnea was found in 83.9%. Reduced EF heart failure was present in 110 patients (76.9%), seventeen cases with moderately reduced EF (11.9%) and sixteen patients had preserved EF (11.2%). Global heart failure was the dominant (91.6%). The main etiologies of heart failure were dominated by hypertensive heart disease in 46 patients (32.2%), followed by postpartum cardiomyopathy with 43 cases (30.1%), primary dilated cardiomyopathy in 18 patients (12.6%), ischemic heart disease in 16 patients with 11.2%. Seven cases of valvular heart disease, or 4.9%. The evolution was favorable under treatment in 104 patients or 72.7%. In-hospital mortality was 14.7%. Conclusion: Heart failure is a common condition in sub-Saharan Africa, particularly in our country.

Dialectical Thermodynamics’Solution to the Conceptual Imbroglio That Is the Reversible Path

According to the second law of thermodynamics, as currently understood, any given transit of a system along the reversible path proceeds with a total entropy change equal to zero. The fact that this condition is also the identifier of thermodynamic equilibrium, makes each and every point along the reversible path a state of equilibrium, and the reversible path, as expressed by a noted thermodynamic author, “a dense succession of equilibrium states”. The difficulties with these notions are plural. The fact, for example, that systems need to be forced out of equilibrium via the expenditure of work, would make any spontaneous reversible process a consumer of work, this in opposition to common thermodynamic wisdom that makes spontaneous reversible processes the most efficient transformers of work-producing-potential into actual work. The solution to this and other related impasses is provided by Dialectical Thermodynamics via its previously proved notion assigning a negative entropy change to the energy upgrading process represented by the transformation of heat into work. The said solution is here exemplified with the ideal-gas phase isomerization of butane into isobutane.

Reevaluation of dialect boundaries in the Yellowhammer(Emberiza citrinella)based on citizen science data:Should we split or lump?

Dialects are a specific form of geographic variation of birdsong with relatively sharp boundaries between distinct song characteristics,which provide opportunities for focused studies of processes underlying the emergence of spatial patterns in vocalization.Several songbird species that exhibit dialects became models for such research,and for some of them large-scale datasets were assembled that included recordings provided by the public.Among them,the Yellowhammer(Emberiza citrinella,Emberizidae) is particularly prominent,as it has been recently a subject of dedicated citizen science projects focusing on its dialect distribution.The most successful,in terms of public participation as well as the number and density of obtained recordings,was the Dialects of Czech Yellowhammers(DCY) project,which assembled detailed data at the whole-country level.A mosaic of almost all common song variants known across Europe was observed in Czechia,but the results indicated that some of the traditionally recognized Yellowhammer dialects may not represent geographically clustered song variants,at least not in Central Europe.We quantitatively analysed variation(frequency and temporal characteristics and modulation) of the terminal song element in three dialects defined by arbitrary frequency thresholds in DCY.Multivariate analyses indicated that pooling these to two distinct groups reflects the variation in the songs,as well as their spatial distribution,better than retaining the current classification to three dialects or their finer splitting to even more categories.We provide simple measures that may be used for classification of these Yellowhammer song variants in Central Europe.However,we warn from indiscriminate transposing of results from one region to another,as that may lead to substantial biases.Future studies of birdsong variation will benefit from big data assembled by citizen scientists,but to maximise their usefulness for further dialect research,careful delineation of dialect boundaries is essential.

Local and range-wide distribution of song types suggest Ovenbirds(Seiurus aurocapilla)have song neighborhoods but not macro-dialects

The song systems of oscine passerines(songbirds)are complex and diverse.Because songs are used for both mate attraction and territory defense and are therefore important signals for survival and reproduction,comprehensive knowledge of within and among species song structure and distribution is informative for understanding the evolution of song repertoires and vocal behaviour.In this study,we explored variation in the song structure of the Ovenbird(Seiurus aurocapilla),a widespread warbler(Family Parulidae)found in North American forests.We analyzed recordings from the 2021 breeding season to assess song type variation at a local(n=158 birds;Sault Ste.Marie,ON)and breeding range scale(n=512 birds;eBird).We characterized the local song types and tested whether Ovenbirds share song types with their neighbors more often than expected by chance.We then characterized song types of Ovenbirds across the breeding range to determine whether any geographic pattern of song clustering exists(i.e.,macro-dialects).We found 10 distinct song types and some evidence for song type clustering at the local study site(i.e.,song neighborhoods).We found 7 of those 10 song types throughout the breeding range and identified an additional 24 types that were not recorded in our local population.We found no evidence for song dialects across the Ovenbird breeding range.This study contributes to our understanding of Ovenbird song while simultaneously adding to our understanding of geographic structuring of warbler repertoires.Our work contributes to delineating a more comprehensive understanding of factors affecting dialect development for this diverse group of songbirds.

GAO疫情跟踪审计框架:目标、举措及评价

GAO对美国联邦政府应对新型冠状病毒肺炎(COVID-19)而使用的专项拨款情况进行了跟踪审计,并发布审计报告。文章围绕GAO发布的9份报告,分析了GAO应对新型冠状病毒肺炎(COVID-19)确定的原则、目标及审计内容,重点梳理了审计重点及其效果。GAO发表的前7份审计报告共提出72项建议和4项需要美国国会审议的事项。研究发现,GAO审查重点是拨付资金使用的合规性、联邦政府机构各部门之间的协调合作、疫苗研制与使用、信息透明度以及数据的完整性等方面内容。GAO跟踪审计在资金使用的合规性审查、远程办公、绩效审计以及推动国内外审计机构更好开展疫情审计等方面取得了明显成效,但在审计方向、重点方面存在不当,未对疫情防控所出台的法案及政策本身发表评价意见;同时,GAO提出的建议落实率不高,影响了审计效果。

On the Phonology Characteristics of Leizhou Dialect in Malaysia

Based on first-hand materials obtained from field investigations in Malaysia, the results show that: firstly, there are 17 initials in the Leizhou dialect of Malaysia, including the implosives initial and the [f] initial. The pronunciation of Leizhou dialect in China is already rare, some of which are retained in the Leizhou dialect of Malaysia. Its initial consonant is borrowed from local Hua Yu or other Chinese dialects. Secondly, the Leizhou dialect of Malaysia has 46 finals. The pronunciation and timbre of some of its vowels are similar to the Yue dialect of Malaysia [&#592] main vowel. Thirdly, there are 8 monosyllabic tones in the Leizhou dialect of Malaysia. The pronunciation and tone of some of its characters are similar to the Xia Yin entering tone of Yue dialect of Malaysia.

Artificial Intelligence Model to Detect and Classify Arabic Dialects

The Arabic Dialect (AD) detection method involves analyzing the matching sound wave for various characteristics that identify the speaker’s dialect. Among these features are accent, intonation, stress, vowel length, vowel type, and other acoustic characteristics. Data from different speakers of different dialects is usually used in training machine learning algorithms. Based on this data, an algorithm is created to accurately identify the speaker’s dialect. Arabic dialects can be detected and classified using several models and techniques available in literature. Various models have been proposed from different perspectives. Therefore, this paper discussed different studies about AD for building an understanding of conceptual deep learning model to detect and classify Arabic dialects. The model captured the semantic, syntactic, and phonological characteristics of these dialects using Convolutional Neural Networks (CNNs) and Recurrent Neural Networks (RNNs). The proposed model consists of six stages: Natural Language Processing (NLP) stage, feature engineering techniques, neural networks, language models, optimization techniques, and evaluation techniques. Each stage of the proposed model has several techniques that can be used to detect and classify AD. The accuracy and capability of the proposed model will be performed in the future work.

Investigation on the Integration of “Gao” in Hong Kong Chinese and Mainland Mandarin

From the diachronic dimension,this paper makes a two-way interactive investigation on the integration of Hong Kong Chinese and Mainland Mandarin.“Gao”is a delexical verb in contemporary Chinese.In different words and expressions related to“gao”character,there are mutual absorptions between Chinese mainland and Hong Kong,which is characterized by starting from nothing to something and from less to more.

Hegel and the Antidialectic

This work,using the case study of the Haitian Revolution,positions Paul C.Mocombe’s theory of antidialectic within Hegel’s dialectical reasoning.Mocombe posits that the antidialectical position in Hegel’s dialectic is the position of each self-consciousness when they initially encounter each other at the onset of the master/slave dialectic.Whereas,the master seeks to move to the dialectical position in order to dominate and eliminate the original(antidialectical)position of the slave,the slave remains in this antidialectical position so long as they seek to fight against their enslavement for the purpose of maintaining and reproducing their original,antidialectical,position,which is social,political,economic,and ideological.In any other instances,they(the slaves)are either in the dialectical,seeking to maintain the status quo,or negative dialectical,seeking to integrate the status quo on equal footing with the master,positions.

Relationship between the Three Laws of Dialectics of Nature and Agricultural Development

Based on the three laws of dialectics of nature-the law of unity of opposites, the law of mutual change of quality and the law of negation of negation, this paper analyzes the relationship between the three laws and agricultural development, and proposes making good use of the three laws to promote the better development of agriculture and realize agricultural modernization.

美GAO发布《网络安全高风险系统报告》

日前,美国政府问责局(GAO)发布《网络安全高风险系统报告:建立综合网络安全战略和执行有效监管的挑战》(以下简称《报告》)。《报告》指出,政府机构在信息安全、关键网络基础设施保护、个人可识别信息隐私等高风险领域存在风险,且相关安全建议未被采纳和实施。

老年初治肺结核中医证型与细胞因子及免疫表达的相关性分析

目的 观察老年初治肺结核患者血清中细胞因子及TB淋巴细胞亚群的表达水平,探究中医证型与细胞因子、TB淋巴细胞表达之间的关系。方法 纳入2016年5月至2021年12月解放军总医院第八医学中心结核医学部收治的初治老年肺结核病患者322例作为研究对象,根据辨证分型分为肺阴亏虚组78例、阴虚火旺组83例、气阴两虚组79例、阴阳两虚组82例。采用酶联免疫吸附试验检测血清中γ干扰素(IFN-γ)、肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、IL-5、IL-2、IL-6、IL-8、IL-17、IL-4、IL-10等细胞因子的表达水平,流式细胞仪测定TB淋巴细胞亚群中CD3^(+)、CD4^(+)、CD8^(+)、B细胞、NK细胞的绝对数及CD4^(+)/CD8^(+)T细胞比值,并将测定结果进行统计学分析。结果 四组肺结核患者IL-β、IL-5、IL-2、IL-17、IL-4、IL-10水平差异无统计学意义(P>0.05)。气阴两虚组IFN-γ水平显著高于其他三组(P<0.05);阴阳两虚组TNF-α水平显著高于其他三组(P<0.05);阴阳两虚组、气阴两虚组、阴虚火旺组、肺阴亏虚组的IL-6水平依次降低(P<0.05);阴阳两虚组IL-8水平显著高于其他三组,气阴两虚组高于肺阴亏虚组、阴虚火旺组(P<0.05)。CD3^(+)、CD4^(+)、CD8^(+)、B细胞、NK细胞绝对数在阴阳两虚组、气阴两虚组、阴虚火旺组、肺阴亏虚组依次降低,差异均有统计学意义(P<0.05)。阴阳两虚组CD4^(+)/CD8^(+)T细胞比值显著高于其他三组,肺阴亏虚组、阴虚火旺组、气阴两虚组组间比较差异无统计学意义(P>0.05)。结论 不同证型的老年肺结核病患者细胞因子及免疫细胞表达存在差异性,可作为中医辨证论治的客观参考标准之一,为临床辨证治疗提供一定参考。

基于大模型的知识生产与启蒙辩证法

人们在使用大模型的过程中,会存在某种程度的幻觉,即认为大模型无所不知和无所不能。正因为这种幻觉的存在,大模型可能会从启蒙的理性变成新的启蒙神话。启蒙的意义在于保持一种开放性,而启蒙的神话就表明了这种开放性的消失。大模型的发展无疑会加剧世界的数学化。在此背景之下,权证就构成了未来数字世界的基本通货。过度的数学化也酝酿了新的工具理性危险。作为新的技术,大模型全面展示了知识与权力的关系。大模型拥有巨大的整合力,正在实现新型的知识大一统。这种弥散化的超能力会进入知识生产的各个领域,没有个体可以逃脱这种超能力的捕捉。大模型会进一步加剧知识工业化,这将导致更为严重的意识形态问题。一方面,大模型本身有其意识形态。另一方面,大模型更加深刻的意识形态会隐含在其免费模式和消费模式之中,同时想象的知识共同体最终又会服务于知识霸权。面对知识工业化的风险,应该建立知识生产的“手工绿洲”,用荒谬、隐喻和修辞来对抗理性,让人类保有通过具身体验来创造知识的能力,并且要避免同一性和绝对正确的神话。

数字资本主义技术代码视域下功绩主体的自我剥削与自由悖论

数字技术作为数字资本主义的重要基点,既承载了数字生产力的纯粹要素方面,也维持和重塑着数字生产关系。数字资本主义的技术代码表征了数字技术生产力与生产关系、技术需求与社会需求的内聚统一,形塑了数字资本主义下崭新的功绩社会。功绩社会下,驯化主体被功绩主体所代替,功绩主体将传统的否定禁止和他者剥削翻转为肯定示好和自我剥削,自我剥削打着自我发展、自我实现、自我优化和自我完善的幌子,实际却是自我征服、自我促逼、自我耗散和自我毁灭,由此呈现出自由的功绩主体不自由的悖论景象。对此,我们需要求教和回归马克思历史唯物主义和技术批判的原则方法,透视和掌握数字资本主义的技术代码和技术本质,识破功绩主体自我剥削的不自由真相,分析其深层本质和致因逻辑,并在此基础上阐明一种真正自由的可能的未来方向。

马克思主义理论形态的历史演变及其辩证法基础

马克思主义是不断发展的、开放的理论,始终站在时代最前沿。从理论特质来看,马克思主义并非是一成不变、既成性的,而是与时俱进、生成性的。从理论形态来看,从19世纪到20世纪、再到21世纪,马克思主义的历史生成形态大致包括马克思主义的“经典形态”“发展形态”和“创新形态”。具体而言,马克思主义的“经典形态”即“原生形态”是由马克思、恩格斯共同创立的马克思主义的“欧洲形态”;马克思主义的“发展形态”即列宁主义是由列宁根据经济文化落后国家的具体实际创立的马克思主义的“俄国形态”;马克思主义的“创新形态”即马克思主义中国化的理论形态是由中国共产党人坚持、发展的马克思主义的“中国形态”。从辩证法基础来看,马克思主义的理论形态均贯穿着马克思主义哲学这一科学世界观和方法论,如果说马克思主义“经典形态”的基础是历史辩证法、马克思主义“发展形态”的基础是认识辩证法,那么,马克思主义“创新形态”的基础就是战略辩证法。

《泰山药物志》医学思想探析

《泰山药物志》是民国时期特色鲜明、影响较大的中医药学著作。全书共8卷(主干4卷),详载泰山药物500余味,附以单方验方及与泰山药物有关的轶事传闻,对研究民国时期医病特色、泰山药物的采集与使用具有较高的实用价值。结合书中所载处方及诊病记录,探析该书“治病先固本”“病理如事理”“天下物皆是药”“五海以和为贵”等医学药学思想,分析高宗岳医学思想的时代特征与思想渊源,对本书的历史价值与影响也作了初步探讨。

明代三边总督喻时生平著述考

喻时(1507—1571),明嘉靖十七年(1538)进士,历官嘉靖、隆庆两朝,前后三十余年间,曾任吴江县令、监察御史、山西巡抚、三边总督等职,官至兵部右侍郎。嘉靖后期,喻时临危受命,总督三边军务,功绩卓然,有力地维护了西北边地和平。其宦迹遍及南北,政绩斐然,声名远播,时有“喻青天”之美誉。喻时一生勤于著述,今有《吴皋先生文集》《海上老人别集》及其它散著存世。

宁波方言版数字三联音测试在听力筛查中的应用研究

目的 探究宁波方言版数字三联音测试(digit triplet test,DTT)在听力筛查中的敏感性和特异性,同时探索平均听阈、教育程度、年龄、认知能力等因素对宁波方言版DTT的影响。方法 选取2022年9月—2023年6月宁波卫生职业技术学院青年受试者23例为青年组、同期以宁波方言为母语的老年受试者33例为老年组。青年组完成宁波方言版DTT、普通话版DTT。老年组完成纯音测试、方言版DTT、中文版蒙特利尔认知评估基础量表测试,10例老年组同时完成普通话版DTT。结果 青年组普通话版DTT噪声下言语识别阈(speech reception threshold,SRT)与宁波方言版DTT比较,差异无统计学意义(P>0.05);老年组普通话版DTT的SRT与宁波方言版DTT比较,差异有统计学意义(P<0.05)。受试者教育程度、年龄均与宁波方言版DTT的SRT无相关。以25 dB HL作为宁波方言版测试的筛查目标时,SRT最佳截断分数-7.7分,筛查敏感性87.0%,特异性90.9%;以35 dB HL作为筛查目标时,SRT最佳截断分数为-7.7分,敏感性100.0%,特异性97.5%。结论 宁波地区老年人需要方言版的听力筛查工具,宁波方言版DTT具备实现宁波地区开展大范围的听力筛查的潜力,建议筛查目标设为35 dB HL。

人类文明形态演进的生命辩证法

马克思的世界观实现了相对于旧哲学世界观的革命性变革,这就是把价值论的维度引入世界观,从而不仅回答了“世界是什么”的本体论问题,而且回答了“世界向何处去”的价值论问题。按照马克思的世界观,人类文明形态的演进本质上是人类这一物种寻求永生的过程。于是,世界历史进程便表现为人类文明形态不断演进的过程。文明形态的演进遵循辩证法原理,而人类通过文明形态的演进,展现了人类独特的生命活动形式,即生命辩证法。共产主义社会文明形态实现了人类文明中“自然法则”和“理性法则”的辩证统一,使人类这一物种的永久生存成为可能。

陕西神木市北宋高世忠墓出土人骨研究

神木市地处陕、晋、蒙边界,素称要塞,其独特的地理位置决定了该地区是人群往来与交融的关键之地。神木市小庙M7是一座北宋时期双人合葬墓,埋葬方式为土葬与火葬并存。墓中出土一方碑石,显示墓主为北宋时期的爱国将领高世忠。本文对墓中的女性土葬个体进行了颅面部形态测量,结果表明该颅骨以东亚类型因素为主,同时包含部分北亚类型的因素。此外,对属于高世忠骨骼的火葬个体进行了形态观察。通过M7人骨的考察,结合碑石志文所蕴含的信息,折射出北宋边地汉人与党项人的交流、融合,共同创造多元一体的中华民族与中华文明的历史进程。