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.

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.

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.

Mathematical Modeling and Control Algorithm Development for Bidirectional Power Flow in CCS-CNT System

As the demand for more efficient and adaptable power distribution systems intensifies, especially in rural areas, innovative solutions like the Capacitor-Coupled Substation with a Controllable Network Transformer (CCS-CNT) are becoming increasingly critical. Traditional power distribution networks, often limited by unidirectional flow capabilities and inflexibility, struggle to meet the complex demands of modern energy systems. The CCS-CNT system offers a transformative approach by enabling bidirectional power flow between high-voltage transmission lines and local distribution networks, a feature that is essential for integrating renewable energy sources and ensuring reliable electrification in underserved regions. This paper presents a detailed mathematical representation of power flow within the CCS-CNT system, emphasizing the control of both active and reactive power through the adjustment of voltage levels and phase angles. A control algorithm is developed to dynamically manage power flow, ensuring optimal performance by minimizing losses and maintaining voltage stability across the network. The proposed CCS-CNT system demonstrates significant potential in enhancing the efficiency and reliability of power distribution, making it particularly suited for rural electrification and other applications where traditional methods fall short. The findings underscore the system's capability to adapt to varying operational conditions, offering a robust solution for modern power distribution challenges.

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.

Neurotrophic factor therapy for Parkinson's disease: past, present and future

One of the greatest unmet needs in the treatment of Parkinson’s disease（PD）is a disease-modifying therapy,which can halt the ongoing degeneration of dopaminergic neurons that is characteristic of this disorder.Current therapies focus on managing symptoms,rather than on addressing their cause.Promising candidates for disease-modifying therapies are the dopaminergic neurotrophic factors（NTFs）.

Narrating the Past in Different Contexts:C-BI Approach to the Present Perfect and Past Simple

Concept-based instruction(C-BI)has proven to be effective in improving students’command of grammar items used out of context by offering the students revision lessons,but its effect in teaching newly-introduced grammar items in a complex context of a specific genre remains unclear.To probe C-BI’s effect on students’use of the past simple and present perfect tenses out of context and in the context of a narrative by its description of the grammar concept in its materialization,that is,the Schemas of a Complete Orienting Basis of an Action(SCOBAs),we taught the two tenses to 40 eighth-graders in a Chinese middle school in our three-week teaching experiment.The qualitative and quantitative analysis of the results shows that i)in both out-ofcontext use and in-context use,accuracy of using the target tenses is higher after C-BI intervention;ii)by improving their conceptual knowledge through C-BI,the students are helped to pin down reference time and are hence more certain in using the target tenses.Moreover,they are encouraged to use the newly-introduced tenses in the complex context of the narrative genre;iii)both in simple contexts or complex contexts,the SCOBAs are effective in helping students navigate the learning task and determine their intended meaning by establishing temporal reference in the context.

Take Presentations into the EFL Classroom

Presentations are activities in which people show,describe,or explain something to a group of people.They are often used in American school classrooms.On the base of the author’s referring to literature,observing classes and co-teaching practice,presentations are suggested to be applied to EFL classrooms to help students improve their speaking levels and integrate their language skills efficiently.In point of ways of organizing,presentations can be divided into three types:controlled,guided and free ones.While in point of ways of applying,they can be divided into five types:interactive,role-plays,interview,note-taking,and discourse analysis ones.Thus different types of presentations should be adopted according to EFL students’different levels and different communication purposes.Topics relating to EFL students’study,life and interest are practical for presentations.Important aspects of presentations include:posture and presence,eye contact with the audience,volume and voice projection,rate of speech,use of audiovisual aids,vitality,adherence to the topic,keeping track of time,natural delivery,fluency and accuracy,the quantity of information presented,the way the topic was handled and how the questions are handled in the post-presentation session and so on.Presentation evaluations can be done by the teacher or together with student peers.

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...

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,

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.

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.

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.

《The Present》的功能文体学赏析

运用功能文体学的理论,通过对三大元功能的介绍和应用对《The Present》一文加以分析,旨在引导学生以客观的标准分析文章,以达到对文章的深层理解和欣赏。