Two-Staged Method for Ice Channel Identification Based on Image Segmentation and Corner Point Regression

Identification of the ice channel is the basic technology for developing intelligent ships in ice-covered waters,which is important to ensure the safety and economy of navigation.In the Arctic,merchant ships with low ice class often navigate in channels opened up by icebreakers.Navigation in the ice channel often depends on good maneuverability skills and abundant experience from the captain to a large extent.The ship may get stuck if steered into ice fields off the channel.Under this circumstance,it is very important to study how to identify the boundary lines of ice channels with a reliable method.In this paper,a two-staged ice channel identification method is developed based on image segmentation and corner point regression.The first stage employs the image segmentation method to extract channel regions.In the second stage,an intelligent corner regression network is proposed to extract the channel boundary lines from the channel region.A non-intelligent angle-based filtering and clustering method is proposed and compared with corner point regression network.The training and evaluation of the segmentation method and corner regression network are carried out on the synthetic and real ice channel dataset.The evaluation results show that the accuracy of the method using the corner point regression network in the second stage is achieved as high as 73.33%on the synthetic ice channel dataset and 70.66%on the real ice channel dataset,and the processing speed can reach up to 14.58frames per second.

AGK2 pre-treatment protects against thioacetamide-induced acute liver failure via regulating the MFN2-PERK axis and ferroptosis signaling pathway

Background:Acute liver failure(ALF)is an unpredictable and life-threatening critical illness.The pathological characteristic of ALF is massive necrosis of hepatocytes and lots of inflammatory cells infiltration which may lead to multiple organ failure.Methods:Animals were divided into 3 groups,normal,thioacetamide(TAA,ALF model)and TAA+AGK2.Cultured L02 cells were divided into 5 groups,normal,TAA,TAA+mitofusin 2(MFN2)-siRNA,TAA+AGK2,and TAA+AGK2+MFN2-siRNA groups.The liver histology was evaluated with hematoxylin and eosin staining,inositol-requiring enzyme 1(IRE1),activating transcription factor 6β(ATF6β),protein kinase R(PKR)-like endoplasmic reticulum kinase(PERK)and phosphorylated-PERK(p-PERK).C/EBP homologous protein(CHOP),reactive oxygen species(ROS),MFN2 and glutathione peroxidase 4(GPX4)were measured with Western blotting,and cell viability and liver chemistry were also measured.Mitochondriaassociated endoplasmic reticulum membranes(MAMs)were measured by immunofluorescence.Results:The liver tissue in the ALF group had massive inflammatory cell infiltration and hepatocytes necrosis,which were reduced by AGK2 pre-treatment.In comparison to the normal group,apoptosis rate and levels of IRE1,ATF6β,p-PERK,CHOP,ROS and Fe2+in the TAA-induced ALF model group were significantly increased,which were decreased by AGK2 pre-treatment.The levels of MFN2 and GPX4 were decreased in TAA-induced mice compared with the normal group,which were enhanced by AGK2 pretreatment.Compared with the TAA-induced L02 cell,apoptosis rate and levels of IRE1,ATF6β,p-PERK,CHOP,ROS and Fe2+were further increased and levels of MFN2 and GPX4 were decreased in the MFN2-siRNA group.AGK2 pre-treatment decreased the apoptosis rate and levels of IRE1,ATF6β,p-PERK,CHOP,ROS and Fe2+and enhanced the protein expression of MFN2 and GPX4 in MFN2-siRNA treated L02 cell.Immunofluorescence observation showed that level of MAMs was promoted in the AGK2 pre-treatment group when compared with the TAA-induced group in both mice and L02 cells.Conclusions:The data suggested that AGK2 pre-treatment had hepatoprotective role in TAA-induced ALF via upregulating the expression of MFN2 and then inhibiting PERK and ferroptosis pathway in ALF.

A Comparative Study on the Post-Buckling Behavior of Reinforced Thermoplastic Pipes(RTPs)Under External Pressure Considering Progressive Failure

The collapse pressure is a key parameter when RTPs are applied in harsh deep-water environments.To investigate the collapse of RTPs,numerical simulations and hydrostatic pressure tests are conducted.For the numerical simulations,the eigenvalue analysis and Riks analysis are combined,in which the Hashin failure criterion and fracture energy stiffness degradation model are used to simulate the progressive failure of composites,and the“infinite”boundary conditions are applied to eliminate the boundary effects.As for the hydrostatic pressure tests,RTP specimens were placed in a hydrostatic chamber after filled with water.It has been observed that the cross-section of the middle part collapses when it reaches the maximum pressure.The collapse pressure obtained from the numerical simulations agrees well with that in the experiment.Meanwhile,the applicability of NASA SP-8007 formula on the collapse pressure prediction was also discussed.It has a relatively greater difference because of the ignorance of the progressive failure of composites.For the parametric study,it is found that RTPs have much higher first-ply-failure pressure when the winding angles are between 50°and 70°.Besides,the effect of debonding and initial ovality,and the contribution of the liner and coating are also discussed.

Identification of High-Risk Scenarios for Cascading Failures in New Energy Power Grids Based on Deep Embedding Clustering Algorithms

At present,the proportion of new energy in the power grid is increasing,and the random fluctuations in power output increase the risk of cascading failures in the power grid.In this paper,we propose a method for identifying high-risk scenarios of interlocking faults in new energy power grids based on a deep embedding clustering(DEC)algorithm and apply it in a risk assessment of cascading failures in different operating scenarios for new energy power grids.First,considering the real-time operation status and system structure of new energy power grids,the scenario cascading failure risk indicator is established.Based on this indicator,the risk of cascading failure is calculated for the scenario set,the scenarios are clustered based on the DEC algorithm,and the scenarios with the highest indicators are selected as the significant risk scenario set.The results of simulations with an example power grid show that our method can effectively identify scenarios with a high risk of cascading failures from a large number of scenarios.

Left bundle branch pacing vs biventricular pacing in heart failure patients with left bundle branch block:A systematic review and meta-analysis

BACKGROUND Left bundle branch pacing(LBBP)is a novel pacing modality of cardiac resynchronization therapy(CRT)that achieves more physiologic native ventricular activation than biventricular pacing(BiVP).AIM To explore the validity of electromechanical resynchronization,clinical and echocardiographic response of LBBP-CRT.METHODS Systematic review and Meta-analysis were conducted in accordance with the standard guidelines as mentioned in detail in the methodology section.RESULTS In our analysis,the success rate of LBBP-CRT was determined to be 91.1%.LBBP CRT significantly shortened QRS duration,with significant improvement in echocardiographic parameters,including left ventricular ejection fraction,left ventricular end-diastolic diameter and left ventricular end-systolic diameter in comparison with BiVP-CRT.CONCLUSION A significant reduction in New York Heart Association class and B-type natriuretic peptide levels was also observed in the LBBP-CRT group vs BiVP-CRT group.Lastly,the LBBP-CRT cohort had a reduced pacing threshold at follow-up as compared to BiVP-CRT.

Pollution source identification methods and remediation technologies of groundwater: A review

Groundwater is an important source of drinking water.Groundwater pollution severely endangers drinking water safety and sustainable social development.In the case of groundwater pollution,the top priority is to identify pollution sources,and accurate information on pollution sources is the premise of efficient remediation.Then,an appropriate pollution remediation scheme should be developed according to information on pollution sources,site conditions,and economic costs.The methods for identifying pollution sources mainly include geophysical exploration,geochemistry,isotopic tracing,and numerical modeling.Among these identification methods,only the numerical modeling can recognize various information on pollution sources,while other methods can only identify a certain aspect of pollution sources.The remediation technologies of groundwater can be divided into in-situ and ex-situ remediation technologies according to the remediation location.The in-situ remediation technologies enjoy low costs and a wide remediation range,but their remediation performance is prone to be affected by environmental conditions and cause secondary pollution.The ex-situ remediation technologies boast high remediation efficiency,high processing capacity,and high treatment concentration but suffer high costs.Different methods for pollution source identification and remediation technologies are applicable to different conditions.To achieve the expected identification and remediation results,it is feasible to combine several methods and technologies according to the actual hydrogeological conditions of contaminated sites and the nature of pollutants.Additionally,detailed knowledge about the hydrogeological conditions and stratigraphic structure of the contaminated site is the basis of all work regardless of the adopted identification methods or remediation technologies.

A Chinese Multi-Specialty Delphi Consensus to Optimize RAASi Usage and Hyperkalaemia Management in Patients with Chronic Kidney Disease and Heart Failure

Objective Variations are present in common clinical practices regarding best practice in managing hyperkalaemia(HK),there is therefore a need to establish a multi-specialty approach to optimal renin angiotension-aldosterone system inhibitors(RAASi)usage and HK management in patients with chronic kidney disease(CKD)&heart failure(HF).This study aimed to establish a multi-speciality approach to the optimal use of RAASi and the management of HK in patients with CKD and HF.Methods A steering expert group of cardiology and nephrology experts across China were convened to discuss challenges to HK management through a nominal group technique.The group then created a list of 41 statements for a consensus questionnaire,which was distributed for a further survey in extended panel group of cardiologists and nephrologists across China.Consensus was assessed using a modified Delphi technique,with agreement defined as"strong"(≥75%and<90%)and"very strong"(≥90%).The steering group,data collection,and analysis were aided by an independent facilitator.Results A total of 150 responses from 21 provinces across China were recruited in the survey.Respondents were comprised of an even split(n=75,50%)between cardiologists and nephrologists.All 41 statements achieved the 75%consensus agreement threshold,of which 27 statements attained very strong consensus(≥90%agreement)and 14 attained strong consensus(agreement between 75%and 90%).Conclusion Based on the agreement levels from respondents,the steering group agreed a set of recommendations intended to improve patient outcomes in the use of RAASi therapy and HK management in China.

Three-dimensional limit variation analysis on the ultimate pullout capacity of the anchor cables based on the Hoek-Brown failure criterion

Only simplified two-dimensional model and a single failure mode are adopted to calculate the ultimate pullout capacity(UPC)of anchor cables in most previous research.This study focuses on a more comprehensive combination failure mode that consists of bond failure of an anchorage body and failure of an anchored rock mass.The three-dimensional ultimate pullout capacity of the anchor cables is calculated based on the Hoek-Brown failure criterion and variation analysis method.The numerical solution for the curvilinear function in fracture plane is obtained based on the finite difference theory,which more accurately reflects the failure state of the anchor cable,as opposed to that being assumed in advance.The results reveal that relying solely on a single failure mode for UPC calculations has limitations,as changes in parameter values not only directly impact the UPC value but also can alter the failure model and thus the calculation method.

Iron and Heart Failure: Current Concepts and Emerging Pharmacological Paradigms

Background: Emerging evidence has recognized that anemia and iron deficiency are recurrent comorbidities in chronic heart failure (HF) and several trials have established that iron administration improves myocardial asset and clinical scenario in HF. Purpose: Recent acquisitions suggest that iron deficiency represents a concrete bias in the pathogenetic mechanism of chronic HF, so we have investigated the putative role of the hepcidin/ferroportin axis in the cardiovascular setting to advocate novel pharmacological and clinical approaches. Methods: Here, after an excursus on iron metabolism, we first reviewed the ongoing studies on novel iron targeted compounds. Then, we summarize large clinical interventional studies conducted on patient suffering from iron deficiency and HF which have tested the effects of drugging iron regard QoL, hospitalizations and cardiovascular death. Results: Novel compounds such as hepcidin agonist (PTG 300), synthetic human hepcidin (LJPC-401) and anti FPN (Vamifeport) are ongoing in iron overloaded patients, while the hepcidin blocker (PRS-080) is under investigation in anemic patients. Noteworthy, novel insights could arise from the results of a Phase IV interventional study regarding the modification of hepcidin pathway in a large cohort of HF patients (n = 1992) by sodium glucose cotransporter 2 inhibitors. To date, several studies highlight the beneficial effect of iron administration in cardiovascular setting and latest evidences consider hepcidin level as a novel biomarker of cardiac injury and atherosclerosis. Conclusions: We advocate that data from ongoing studies will suggest novel iron targeted therapies for diagnosis, prognosis and therapy transferable in selected heart failed patients.

Stability analysis of intermittently jointed rock slopes based on the stepped failure mode

In practical engineering,due to the noncontinuity characteristics of joints in rock slopes,in addition to plane failure,stepped sliding failure may occur for intermittently jointed rock slopes.Especially for intermittently bedding jointed rock slopes,the correlation and difference in strength parameters between joints and rock bridges,along with the various failure modes and intermittency of rock bridges,contribute to the complexity of stepped failure modes and the unpredictability of failure regions.Based on the upper-bound limit analysis method and multi-sliders step-path failure mode,considering the shear and tensile failure of rock bridges and the weakened relationship between the strength parameters of rock bridges and jointed surfaces,by introducing the modified M-C failure criterion and the formula for calculating the energy consumption of tensile failure of rock bridges,two failure mechanisms are constructed to obtain the safety factor(F_(s))of intermittently jointed rock slopes.The sequential quadratic programming method is used to obtain the optimal upper-bound solution for F_(s).The influence of multiple key parameters(slope height H,horizontal distance L,Slope angleβ,shear strength parameters of the rock bridgeφr and cr,Dimensionless parameter u,weakening coefficients of the internal friction angle and cohesion between the rock bridges and joint surfaces Kφand Kc)on the stability analysis of intermittently jointed rock slopes under the shear failure mode of rock bridges as well as under the tensile failure mode is also explored.The reliability of the failure mechanisms is verified by comparative analysis with theoretical results,numerical results,and landslide cases,and the variation rules of F_(s)with each key parameter are obtained.The results show that F_(s) varies linearly withφr and cr of the rock bridge and with K_(φ)and K_(c),whereas F_(s)changes nonlinearly with H and L.In particular,with the increase in Kφand Kc,Fs increases by approximately 52.78%and 171.02%on average,respectively.For rock bridge tensile failure,F_(s) shows a nonlinearly positive correlation withφr,cr,Kφand Kc.In particular,with the increase in Kφand Kc,Fs increases by approximately 13%and 61.69%on average,respectively.Fs decreases rapidly with increasing slope gradientβand decreasing dimensionless parameterμ.When Kφand Kc are both less than 1.0,the stepped sliding surface occurs more easily than the plane failure surface,especially in the case of tensile failure of the rock bridge.In addition,rock slopes with higher strength parameters,taller heights,and greater weakening coefficients are prone to rock bridge tension failure with lower Fs,and more attention should be given to the occurrence of such accidents in actual engineering.

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.

Quaternion-Based Adaptive Trajectory Tracking Control of a Rotor-Missile with Unknown Parameters Identification

This paper investigates the adaptive trajectory tracking control problem and the unknown parameter identification problem of a class of rotor-missiles with parametric system uncertainties.First,considering the uncertainty of structural and aerodynamic parameters,the six-degree-of-freedom(6Do F) nonlinear equations describing the position and attitude dynamics of the rotor-missile are established,respectively,in the inertial and body-fixed reference frames.Next,a hierarchical adaptive trajectory tracking controller that can guarantee closed-loop stability is proposed according to the cascade characteristics of the 6Do F dynamics.Then,a memory-augmented update rule of unknown parameters is proposed by integrating all historical data of the regression matrix.As long as the finitely excited condition is satisfied,the precise identification of unknown parameters can be achieved.Finally,the validity of the proposed trajectory tracking controller and the parameter identification method is proved through Lyapunov stability theory and numerical simulations.

Molecular Identification of Mycobacterium Strains Responsible of Bovine Tuberculosis Cases in Bobo-Dioulasso Slaughterhouse, Burkina Faso

Bovine tuberculosis (bTB) is an endemic zoonosis significantly affects animal health in Burkina Faso. The primary causative agent is Mycobacterium tuberculosis (M. tuberculosis) complex, mainly M. bovis. Cattle are considered as natural reservoir of M. bovis. However, in Burkina Faso, the circulation of these strains remains poorly understood and documented. This study aimed to identify and characterize Mycobacterium strains from suspected carcasses during routine meat inspection at Bobo-Dioulasso refrigerated slaughterhouse. A prospective cross-sectional study was conducted from January 2021 to December 2022 on cases of seizures linked to suspected bovine tuberculosis. Microbiological and molecular analyzes were used for mycobacterial strain isolation and characterization. Out of 50 samples, 24% tested positive by microscopy and 12% by culture. Molecular analysis identified 6 strains of Mycobacteria, exclusively Mycobacterium bovis specifically the subspecies bovis (Mycobacterium bovis subsp bovis). In conclusion, M. bovis subsp bovis is the primary agent responsible for bovine tuberculosis in Bobo-Dioulasso. Continuous monitoring of mycobacterial strains is therefore necessary for the effective control of this pathology in the local cattle population.

Heart Failure-Like Reaction Is Likely Involved in the Feeding Behaviour of Blood-Sucking Leeches

Medicinal leeches have been utilized in therapy for thousands of years. However, the adaptation physiology between leeches and hosts is not fully understand. To disclose the molecular mechanisms of adaptation between leech and host, the body transcriptomes of hunger and fed blood-sucking Poecilobdella javanica, Haemadipsa cavatuses, and Hirudo nipponia leeches were obtained by RNA sequencing, after comparison, a stratified unigenes group was obtained, which closely correlated to body distension. In the group, Rfamide receptor decreased significantly (P < 0.05) while serotonin receptor increased significantly (P < 0.05). Moreover, four KEGG (Kyoto Encyclopedia of Genes and Genomes) pathways, including cardiac muscle contraction, complement and coagulation cascades, renin-angiotensin system, and hypertrophic cardiomyopathy were significantly enriched. The unigenes annotation, neuroregulators correlation analysis and induced function of the KEGG pathways, were consistently supported the same result as: vasoconstriction and systole reaction enhance in hunger leeches and vice versa vasodilation and diastole increase in fed leeches, meanwhile, Interspecific comparison and correlative analyses of physiological function showed that the strongest reaction of induced heart failure from four KEGG occur in strongest reaction of systole in hungry P. javanica and in strongest reaction of diastole in fed H. nipponia. Overall, heart failure is likely a physiological function involved in feeding behaviour.

Research on Risk Identification and Industrial Governance of Digital Education Products Based on Data Annotation Technology

The social transformation brought aboutby digital technology is deeply impacting various industries.Digital education products, with core technologiessuch as 5G, AI, IoT (Internet of Things),etc., are continuously penetrating areas such as teaching,management, and evaluation. Apps, miniprograms,and emerging large-scale models are providingexcellent knowledge performance and flexiblecross-media output. However, they also exposerisks such as content discrimination and algorithmcommercialization. This paper conducts anevidence-based analysis of digital education productrisks from four dimensions: “digital resourcesinformationdissemination-algorithm design-cognitiveassessment”. It breaks through corresponding identificationtechnologies and, relying on the diverse characteristicsof governance systems, explores governancestrategies for digital education products from the threedomains of “regulators-developers-users”.

Evolution model and failure mechanisms of rainfall-induced cracked red clay slopes:insights from Xinshao County,China

Red clay landslides are widely distributed worldwide,resulting in severe loss of life and property.Although rainfall-induced red clay slopes have received extensive attention,the role of cracks in the evolutionary process of red clay slopes and their connection to failure mechanisms is still poorly understood.A comprehensive approach integrating field investigation,laboratory tests,and numerical simulations was conducted to study the 168 red clay landslides in Xinshao County,China.The results show that red clay is prone to forming cracks at high moisture content due to its low swelling and high shrinkage properties.The failure mode of red clay slopes can be summarized in three stages:crack generation,slope excavation,and slope failure.Furthermore,the retrospective analysis and numerical simulations of the typical landslide in Guanchong indicated that intense rainfall primarily impacts the shallow layer of soil within approximately 0.5 m on the intact slope.However,cracks change the pattern of rainfall infiltration in the slope.Rainwater infiltrates rapidly through the preferential channels induced by the cracks rather than uniformly and slowly from the slope surface.This results in a significant increase in both the depth of infiltration and the saturated zone area of the cracked slope,reaching 3.8 m and 36.2 m^(2),respectively.Consequently,the factor of safety of the slope decreases by 13.4%compared to the intact slope,ultimately triggering landslides.This study can provide valuable insights into understanding the failure mechanisms of red clay slopes in China and other regions with similar geological settings.

A real-time intelligent lithology identification method based on a dynamic felling strategy weighted random forest algorithm

Real-time intelligent lithology identification while drilling is vital to realizing downhole closed-loop drilling. The complex and changeable geological environment in the drilling makes lithology identification face many challenges. This paper studies the problems of difficult feature information extraction,low precision of thin-layer identification and limited applicability of the model in intelligent lithologic identification. The author tries to improve the comprehensive performance of the lithology identification model from three aspects: data feature extraction, class balance, and model design. A new real-time intelligent lithology identification model of dynamic felling strategy weighted random forest algorithm(DFW-RF) is proposed. According to the feature selection results, gamma ray and 2 MHz phase resistivity are the logging while drilling(LWD) parameters that significantly influence lithology identification. The comprehensive performance of the DFW-RF lithology identification model has been verified in the application of 3 wells in different areas. By comparing the prediction results of five typical lithology identification algorithms, the DFW-RF model has a higher lithology identification accuracy rate and F1 score. This model improves the identification accuracy of thin-layer lithology and is effective and feasible in different geological environments. The DFW-RF model plays a truly efficient role in the realtime intelligent identification of lithologic information in closed-loop drilling and has greater applicability, which is worthy of being widely used in logging interpretation.

To Analyze the Sensitivity of RT-PCR Assays Employing S Gene Target Failure with Whole Genome Sequencing Data during Third Wave by SARS-CoV-2 Omicron Variant

Introduction: Omicron is a highly divergent variant of concern (VOCs) of a severe acute respiratory syndrome SARS-CoV-2. It carries a high number of mutations in its spike protein hence;it is more transmissible in the community by immune evasion mechanisms. Due to mutation within S gene, most Omicron variants have reported S gene target failure (SGTF) with some commercially available PCR kits. Such diagnostic features can be used as markers to screen Omicron. However, Whole Genome Sequencing (WGS) is the only gold standard approach to confirm novel microorganisms at genetically level as similar mutations can also be found in other variants that are circulating at low frequencies worldwide. This Retrospective study is aimed to assess RT-PCR sensitivity in the detection of S gene target failure in comparison with whole genome sequencing to detect variants of Omicron. Methods: We have analysed retrospective data of SARS-CoV-2 positive RT-PCR samples for S gene target failure (SGTF) with TaqPath COVID-19 RT-PCR Combo Kit (ThermoFisher) and combined with sequencing technologies to study the emerged pattern of SARS-CoV-2 variants during third wave at the tertiary care centre, Surat. Results: From the first day of December 2021 till the end of February 2022, a total of 321,803 diagnostic RT-PCR tests for SARS-CoV-2 were performed, of which 20,566 positive cases were reported at our tertiary care centre with an average cumulative positivity of 6.39% over a period of three months. In the month of December 21 samples characterized by the SGTF (70/129) were suggestive of being infected by the Omicron variant and identified as Omicron (B.1.1.529 lineage) when sequence. In the month of January, we analysed a subset of samples (n = 618) with SGTF (24%) and without SGTF (76%) with Ct values Conclusions: During the COVID-19 pandemic, it took almost more than 15 days to diagnose infection and identify pathogen by sequencing technology. In contrast to that molecular assay provided quick identification with the help of SGTF phenomenon within 5 hours of duration. This strategy helps scientists and health policymakers for the quick isolation and identification of clusters. That ultimately results in a decreased transmission of pathogen among the community.

Return to Dialysis after Kidney Graft Failure

Introduction: The transition period from renal transplantation to dialysis is associated with high morbidity and mortality. The aim of this study is to describe the clinical and paraclinical characteristics, therapeutic management and evolutionary profile of patients returning to dialysis after kidney graft failure. Material and Methods: This was a retrospective, descriptive study conducted in the Nephrology-Dialysis-Renal Transplant Department at university hospital IbnSina between January 1998 and December 2021. We included all renal transplant recipients who had experienced kidney graft dysfunction and returned to dialysis. Patients with a follow-up after return to dialysis of less than 1 year were excluded. Results: Among 166 renal transplant recipients, 20 returned to dialysis after a median renal graft life of 85.5 months [42 - 186], corresponding to a prevalence of 12%. The mean age of our patients was 38.7 ± 11.9 years, with a M/F sex ratio of 2.3. Dialysis was initiated urgently in 10 patients (50%). Hemodialysis was the most commonly used modality (75%). Central venous catheterization was used in 35% of cases, including tunneled catheters. General condition is impaired in all patients, with persistent hypertension in 70% of cases. Mean uremia was 2.35 ± 0.8 g/l, mean creatinine 116 ± 48.3 mg/l, giving a mean GFR of 5.1 ± 2.2 ml/min. Mean albuminemia was 32.9 ± 6 g/l and mean hemoglobinemia 8.6 ± 1.9 g/dl. During the first year of follow-up, none of the patients died. However, 13 patients required hospitalization, with a mean length of stay of 15 days. Eight patients were hospitalized for infections and 5 for renal graft intolerance syndrome. After a mean follow-up of 22 months, 6 patients were detransplanted following graft necrosis. Conclusion: Return to dialysis after RT is fraught with a high rate of complications. The management of these patients must be optimized to improve their vital prognosis and quality of life.

Assessment of the Level of Knowledge about Chronic Renal Failure in 271 Hypertensive Patients in Brazzaville

Background and Objectives: Chronic kidney disease (CKD) is now a global public health problem. In low- and middle-income countries such as the Congo, access to dialysis is low and inequitable. The prevention of CKD involves raising awareness among patients at risk, such as those suffering from arterial hypertension (AH), by improving their knowledge of CKD. The objectives of our work were to determine the level of knowledge about CKD among hypertensive patients and to identify the factors associated with a low level of knowledge. Methodology: We conducted a 3-month descriptive and analytical cross-sectional study from 1 August to 30 October 2023 in 3 large public hospitals in Brazzaville (capital of the Republic of Congo). We included: hypertensive patients aged 18 and over who had freely consented to participate in our study and were able to answer the questions on the survey form. Patients with known hypertension who had been followed for less than 3 years and those with known chronic renal failure were not included. Results: The mean age was 58.4 ± 14.4 years (29 - 88 years). There were 121 men and 150 women (sex ratio = 0.8). All the patients were educated;37.2% with a higher level of education and 13.6% with primary education. 24 patients (9%) had a good level of knowledge about CKD and 153 (56%) had poor knowledge. A good level of knowledge was associated with the duration of hypertension, intellectual level and the existence of associated heart disease. Conclusion: Our study reveals a significant lack of knowledge about chronic kidney disease among hypertensive patients in Brazzaville.