Clinical Presentation and Treatment Outcomes of Pregnancy-Related Acute Kidney Injury among Pregnant Women Admitted at the Benjamin Mkapa Hospital in Tanzania

Background: Globally, PRAKI is among the leading causes of death in pregnant women. The prevalence, causes and outcome of this condition vary among countries due to differences in environmental, socioeconomic, and health delivery systems. The common causes that have been reported in several studies are PIH, Haemorrhages and Sepsis while the outcomes may be either complete renal recovery, progression to CKD and hence dialysis dependency or death. This study aimed at determining clinical presentation and treatment outcomes of Pregnancy-Related Acute Kidney Injury in Pregnant women admitted at the Benjamin Mkapa Hospital, Dodoma, Tanzania. Results: Out of 4007 pregnant women who were admitted to the maternity ward 51 pregnant women were found to have PRAKI. Of those with PRAKI, 74.5% were between 21 to 25 years. The leading causes of PRAKI were PPH 12 (23.53%), Eclampsia 12 (23.53%), and pre-eclampsia 12 (23.5%). Hemodialysis therapy was provided to 22 (43.1%) patients, 15 (29.4%) individuals recovered spontaneously with medical management and 14 (27.5%) missed haemodialysis therapy due to various reasons. The mortality due to PRAKI was 17 (33.3%). Conclusion and Recommendation: Pre-eclampsia/eclampsia and post-partum haemorrhage were found to be the main causes of PRAKI. The mortality related to PRAKI is high and Hemodialysis therapy is vital help to prevent deaths for pregnant women with PRAKI. Pregnant women who develop acute kidney injury should be followed closely and a nephrologist should be consulted early. Early referral should be done by the lower level facilities for all at-risk pregnant women to a specialized multidisciplinary health facility.

Thinking on Improving Presentation Teaching-Based on the Empirical Analysis of Presentation in College English Classes of Junior Non-English Majors in Universities of Science and Engineering

Based on the empirical investigation of presentation in college English classes for junior non-English majors in science and engineering universities,the author explains her own thinking on how to improve presentation teaching from four aspects:setting teaching objectives,selecting teaching contents,using teaching methods,and evaluating and implementing methods.

Losartan Induced Angioedema, a Rare Case Report and the Dilemma of Using Angiotensin II Receptor Blockers in Patients with Previous Angioedema with Angiotensin Converting Enzyme Inhibitors

Angiotensin Receptor Blockers (ARB) are used as an alternative of Angiotensin Converting Enzyme Inhibitors (ACEI) in patients where ACEIs cannot be used because of their known adverse effects, cough and angioedema. Thus ARB induced angioedema is considered to be a rare phenomenon and it is continued to be used as an alternatives of ACEIs. In this case report, we reported a case of 78-year-old gentleman who presented to emergency department with losartan, an ARB induced angioedema, who did not have history of any previous use of ACEIs. He was given steroids and antihistamine as a treatment. His angioedema resolved rapidly and he was discharged after six hours of emergency department (ED) observation with stable hemodynamically. We, the authors by reporting this case, wants to make clinicians aware ARB, however rarely, can cause angioedema, which can be life threatening if clinicians are not aware of it and diagnose and stop the offending drug promptly and treat it early.

Research on Strategies for Enhancing the Ability of Chinese German Learners to Tell Chinese Stories Through Short Videos

In the age of new media,short videos play an increasingly important role in international cultural exchange.However,German learners often encounter challenges when producing and sharing short videos due to factors such as technology and language proficiency.Such challenges can affect the professionalism and attractiveness of the videos.This study focuses on German learners at the University of Shanghai for Science and Technology.The aim of this study is to investigate students’experiences in producing short videos,identify issues through surveys and interviews,and concentrate on editing skills,language proficiency,and intercultural communication abilities.It proposes strategies for developing these skills and aims to provide insights for German and other foreign language learners in telling Chinese stories using short videos.

Clinical Presentation, Management and Materno-Fetal Outcome of Patients with HELLP Syndrome at the Yaoundé Gyneco-Obstetrics and Pediatric Hospital

Background: HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome is a common complication of severe preeclampsia, with a high maternal and perinatal mortality rate. Data on HELLP syndrome is scanty in our setting. We sought to study the clinical presentation, management, and materno-fetal outcome of patients with HELLP syndrome at the Yaoundé Gyneco-Obstetrics and Pediatric Hospital (YGOPH). Methods: This was a cross-sectional, analytical study with a retrospective data collection of patients, diagnosed with HELLP syndrome at the YGOPH between 1st January 2020 and 31st July 2021. Data were analyzed using the software R version 4.0.2. Results are presented as mean ± standard deviation, frequencies and percentages. P values < 0.05 were considered statistically significant. Results: Of 254 cases of severe preeclampsia, 17 developed HELLP syndrome, giving us a frequency of 6.7%. One patient who presented with hepatitis B was excluded. The mean age was 27.19 ± 6.44 years. Most patients (56.3%) had poor follow up during antenatal contacts. The most common symptom was headache (93.8%). Most cases (56.3%) were diagnosed during post-partum, prepartum (25.0%), and per partum (18.8%). Obstetrical management was done by cesarean section (62.5%) and vaginal delivery (37.5%). Post-partum management of HELLP syndrome consisted of antihypertensive medication, anticonvulsants, sedatives, transfusion of blood and blood products, and fluid resuscitation. Of the 50% of patients who presented with acute kidney injury, only 12.5% (1) were referred for dialysis. Over 50% of our study participants presented severe complications after delivery, but 43.8% recovered, while 56.2% finally died. The fetal outcome was: still birth (31.2%), intra-uterine growth restriction/low birth weight (12.5%), term delivery (≥37 weeks) (31.3%), and preterm deliveries (<37 weeks) (68.7%). Three (18.8%) of the neonates delivered alive presented with a poor Apgar score at the 5th minute. Conclusion: Although rare, HELLP syndrome exists in our setting. Proper management in appropriate centers is key to improving maternal and fetal outcomes.

What to do when it is breech? A state-of-the-art review on management of breech presentation

Any non-cephalic presentation in a fetus is regarded as malpresentation.The most common malpresentation,breech,contributes to 3%-5%of term pregnancies and is a leading indication for cesarean delivery.Identification of risk factors and a proper physical examination are beneficial;however,ultrasound is the gold standard for the diagnosis of malpresentations.External cephalic version(ECV)refers to a procedure aimed to convert a non-cephalic presenting fetus to cephalic presentation.This procedure is performed manually through the mother’s abdomen by a trained health care provider,to reduce the likelihood of a cesarean section.Studies have reported a version success rate of above 50%by ECV.The main objective of this review is to present a broad perspective on fetal malpresentation,ECV,and delivery of a breech fetus.The focus is to elaborate all clinical scenarios of breech and to provide an evidence-based clinical approach for them.After discussing breech prevalence,risk factors,diagnosis,and management,an updated review of ECV is presented.Moreover,ECV indications/contraindications,alternatives,clinical techniques on how to perform ECV and breech vaginal delivery,and obstetrical considerations for the delivery of malpresentations are thoroughly discussed.

DYNAMIC CHARACTERISTICS OF PRESENT PRODUCTIVITY FOR CULTIVATED LAND IN THE FARNMING-PASTORAL ZONE OF INNER MONGOLIA

In this article, the distribution of cultivated land, the changes ofcultivated land productivity, and regional differentiation of the Change forpresent productivity in the Farming-Pastoral Zone, Inner Mongolia arediscussed. Then, the close relationship between dynamic characterlsticsdivision and atmospheric circulation systems is revealed. Finally, based ondynamic characteristics, four regions are divided, including thenortheastem area, the eastern area, the western area, and the middle area.

The Prevention of Blindness-Past, Present and Future

Prevention of blindness is the most important aim of ophthalmology. Prevention of blindness is related to many factors. It is related to many factors, such as science and technology, economy and social behavior. There are worldwide activities by WHO, NGOs and other functions to promote the prevention of blindness in the world. More than 90% of blind population lives in developing world. Cataract is the top causes of blindness which is curable. Onchocerciasis is an endemic disease in west Africa and cent...

Changes of the Transcriptional Levels of Molecules Associated with Endogenous Antigen Processing and Presentation in Porcine Skin-derived Dendritic Cells Infected with PCV2 in vivo

[Objective] This study aimed to investigate the changes of the transcriptional levels of molecules associated with endogenous antigen processing and presenta- tion in porcine skin-derived dendritic cells infected with PCV2 in vivo. [Method] Healthy 40-day-old Landrace piglets were infected with porcine circovirus type 2 （PCV2） and euthanized on the 34, 7rd, 14th, 21st and 35th d post inoculation （DPI）. The porcine skin-derived dendritic cells （DCs） were collected to analyze the transcrip- tional levels of molecules （LMP7, UBP, MHC-I, calreticulin） associated with endogenous antigen processing and presentation by using real-time fluorescent quantitative PCR （real-time FQ-PCR）. [Result] The results showed that the level of LMP7 mR- NAs was reduced significantly on the 3DPI （P〈0.05）; the level of UBP mRNAs was consistently up-regulated, which increased significantly on the 21DPI and 35DPI （P〈 0.05）; the level of MHC-I mRNAs was significantly down-regulated on the 7DPI （P〈 0.05）; the level of calreticulin mRNAs was up-regulated slightly without significant dif- ference. [Conclusion] PCV2 can inhibit the endogenous antigen processing and presentation ability of porcine skin-derived DCs at early stages of infection.

Old Geographical Materialities. Recover the Past and the Heritage in the Present of Pheripherical European Rural Spaces: A Research Proposal

The past has had a minor consideration in geographic studies the transformation of rural areas,usually dominated by socioeconomic analysis.Incorporating the old and in many cases,the materialities of the past through a reconsideration of heritage to the future of rural space requires an adequate conceptualization and reconsideration of rural materialities and especially of popular housing.In this way,it is intended to decentralize the human and functionalist point of view to give a life of their own to rural cultural and natural materialities in the context of more-than-human-geographies.The renewed study of heritage and the historical past acquires a notable value in the present and future of rural areas through:(1)the interpretation of dissymmetrical realities where the old confronts new activities;(2)for adequate and realistic management of rural heritage and the processes of selective recovery of heritage in certain historical places.

China Autos' Past, Present & Future—An Interview with Miao Yu, Deputy Director of the Automobile Industry Department, Ministry of Machine-building Industry

After the second world war, Japan and Korea realized their dream for automobiles. The development of the automobile industry has given an impetus to their whole national economy. When will the Chinese dream for automobiles come true? With this question in mind, our reporter interviewed Mr. Miao Yu. He briefed the reporter on the past,

Recent Advances for Global Perspectives on Etiology, Pathophysiology, Clinical Presentations, and Management of Moyamoya Disease

Moyamoya disease (MMD) is a condition characterized by the gradual narrowing and blockage of blood vessels in the brain, specifically those in the circle of Willis and the arteries that supply it. This results in reduced blood flow and oxygen to the brain, leading to progressive symptoms and potential complications. The underlying pathophysiological mechanism remains elucidated. However, recent studies have highlighted numerous etiologic factors: abnormal immune complex responses, susceptibility genes, branched-chain amino acids, antibodies, heritable diseases, and acquired diseases, which may be the great potential triggers for the development of moyamoya disease. Its clinical presentation has varying degrees from transient asymptomatic events to significant neurological deficits. Moyamoya disease (MMD) shows different patterns in children and adults. Children with MMD are more susceptible to ischemic events due to decreased blood flow to the brain. Conversely, adults with MMD are more prone to hemorrhagic events involving brain bleeding. Children with MMD may experience a range of symptoms including motor impairments, sensory issues, seizures, headaches, dizziness, cognitive delays, or ongoing neurological problems. Although adults may present with similar clinical symptoms as children, they are more prone to experiencing sudden onset intraventricular, subarachnoid, or intracerebral hemorrhages. One of the challenges in moyamoya disease is the potential for misdiagnosis or delayed diagnosis, particularly when physicians fail to consider MMD as a possible cause in stroke patients. This review aims to provide a comprehensive overview of recent global studies on the pathophysiology of MMD, along with advancements in its management. Additionally, the review will delve into various surgical treatment options for MMD, as well as its rare occurrence alongside atrioventricular malformations. Exciting prospects include the use of autologous bone marrow transplant and the potential role of Connexin 43 protein treatment in the development of moyamoya disease.

Nanluoguxiang Alley A Blend of the Past and Present

TOURISTS traveling to Beijing always have the Great Wall,Tiananmen Square and the Forbidden City on their must-see list.But what if you have already seen the sights?Then it’s time to explore the ancient capital’s hutongs.Featured this issue is Nanluoguxiang Alley,one of downtown Beijing’s best preserved hutongs.With its grey-walled courtyard homes,it offers a real taste of traditional city life. Located several kilometers north of the Forbidden City and east of Houhai Lake, Nanluoguxiang Alley is a 786-meter-long and 8-meter-wide lane.It stretches northsouth from Gulou East Street to Di’anmen East Street.

Beyond the Usual Suspects (Aortic Dissection in Patients with Chronic Kidney Disease)

A comprehensive differential diagnosis is essential in the emergency department, even when patient presentations are atypical. Timely recognition of life-threatening conditions, such as aortic dissection, hinges on this critical diagnostic approach.

The Present Situation of Chattel Guarantee System and Its Improvements—Taking the Angle of American Uniform Commercial Code(UCC)

Although there are appropriate stipulations for the chattel guarantees in the law of China, this guarantee system could not adapt to the request of economy's development because of the following reasons: the scope of chattel guarantees is narrow according to relevant stipulations; the transaction cost of the chattel is high; mortgage registration of chattel is in a mess; lack of efficiently executive guarantee system, etc. To counter the problems existing in the present Chinese chattel guarantee system, in this article, the author proposed some corresponding suggestions and countermeasures, hoping to perfect the chattel guarantee system in China.

Celebrating the 70th Anniversary--National University of Defense Technology,1953-2023 Special Section on Complex Systems Theory and Practice

In the 21st century,a new round of scientifi c and technological revolution represented by digitalization,networking and intelligence has caused a change in the scientific research paradigm,and the research of complex systems has become the main driving force for the change of the scientific research paradigm.

Cancer screening and management in the transgender population:Review of literature and special considerations for gender affirmation surgery

BACKGROUND Literature focused on cancer screening and management is lacking in the transgender population.AIM To action to increase contributions to the scientific literature that drives the creation of cancer screening and management protocols for transgender and gender nonconforming(TGNC)patients.METHODS We performed a systematic search of PubMed on January 5th,2022,with the following terms:“TGNC”,OR“transgender”,OR“gender non-conforming”,OR“gender nonbinary”AND“cancer screening”,AND“breast cancer”,AND“cervical cancer”,AND“uterine cancer”,AND“ovarian cancer”,AND“prostate cancer”,AND“testicular cancer”,AND“surveillance”,AND“follow-up”,AND“management”.70 unique publications were used.The findings are discussed under“Screening”and“Management”categories.RESULTS Screening:Current cancer screening recommendations default to cis-gender protocols.However,long-term genderaffirming hormone therapy and loss to follow-up from the gender-specific specialties contribute to a higher risk for cancer development and possible delayed detection.The only known screening guidelines made specifically for this population are from the American College of Radiology for breast cancer.Management:Prior to undergoing Gender Affirmation Surgery(GAS),discussion should address cancer screening and management in the organs remaining in situ.Cancer treatment in this population requires consideration for chemotherapy,radiation,surgery and/or reconstruction.Modification of hormone therapy is decided on a case-by-case basis.The use of prophylactic vs aesthetic techniques in surgery is still debated.CONCLUSION When assessing transgender individuals for GAS,a discussion on the future oncologic risk of the sex-specific organs remaining in situ is essential.Cancer management in this population requires a multidisciplinary approach while the care should be highly individualized with considerations to social,medical,surgical and gender affirming surgery related specifications.Special considerations have to be made during planning for GAS as surgery will alter the anatomy and may render the organ difficult to sample for screening purposes.A discussion with the patient regarding the oncologic risk of remaining organs is imperative prior to GAS.Other special considerations to screening such as the conscious or unconscious will to unassociated with their remaining organs is also a key point to address.We currently lack high quality studies pertinent to the cancer topic in the gender affirmation literature.Further research is required to ensure more comprehensive and individualized care for this population.

Present Geothermal Fields of the Dongpu Sag in the Bohai Bay Basin

The Dongpu sag is located in the south of the Bohai Bay basin,China,and has abundant oil and gas reserves.To date,there has been no systematic documentation of its geothermal fields.This study measured the rock thermal conductivity of 324 cores from 47 wells,and calculated rock thermal conductivity for different formations.The geothermal gradient and terrestrial heat flow were calculated for 192 wells on basis of 892 formation-testing data from 523 wells.The results show that the Dongpu sag is characterized by a medium-temperature geothermal field between stable and active tectonic areas,with an average geothermal gradient of 32.0℃/km and terrestrial heat flow of 65.6 mW/m2.The geothermal fields in the Dongpu sag is significantly controlled by the Changyuan,Yellow River,and Lanliao basement faults.They developed in the Paleogene and the Dongying movement occurred at the Dongying Formation depositional period.The geothermal fields distribution has a similar characteristic to the tectonic framework of the Dongpu sag,namely two subsags,one uplift,one steep slope and one gentle slope.The oil and gas distribution is closely associated with the present geothermal fields.The work may provide constraints for reconstructing the thermal history and modeling source rock maturation evolution in the Dongpu sag.

Residual Film Pollution in the Eighth Division of the Xinjiang Production and Construction Corps

This study investigated the residual film content and distribution at different soil depths in the Eighth Division of the Xinjiang Production and Construction Corps.Before spring plowing in 2019,representative fields in four areas(Anjihai,Shihezi suburbs,Mosuowan and Xiayedi)were selected for residual film collection.The average content of residual film in the Eighth Division was 104 kg/ha.The residual film content in the four areas decreased in the order Anjihai>Shihezi suburbs>Mosuowan>Xiayedi.The average amount of residual film collected from cotton fields was greater than that from corn fields.Residual film content in the cotton field at soil depths of 0~10 and 10~30 cm was higher than that in the corn field,whereas the residual film content at a 30–50 cm soil depth in the corn field was higher than that in the cotton field.The results showed that farmers do not consider the long-term benefits,the high cost and short time of recycling,and the easy recycling of surface residual film.The shallow that the higher content of residual film,the less water in the soil of cotton.The same time,the results showed that the quantity of residual film in cotton field had greater influence on cotton quality.