Predictive Factors for Pre-Eclampsia: A Case-Control Study in Two Hospitals in Yaounde

Introduction: Pre-eclampsia is a major cause of maternal and prenatal morbidity and mortality, that complicates 2% to 8% of pregnancies worldwide. The aim of this study was to determine the predictive factors for pre-eclampsia in two hospitals in the city of Yaoundé. Methods: A case-control study was conducted at the Gynaecology & Obstetrics department of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital (YGOPH) and the Main Maternity of the Yaoundé Central Hospital (MM-YCH) from February 1 to July 30, 2022. The cases were all pregnant women presenting with pre-eclampsia. The control group included pregnant women without pre-eclampsia. Descriptive statistics followed by logistic regression analyses were conducted with level of significance set at p-value Results: Included in the study were 33 cases and 132 controls, giving a total of 165 participants. The predictive factors for pre-eclampsia after multivariate analysis were: primiparity (aOR = 51.86, 95% CI: 3.01 - 1230.96, p = 0.045), duration of exposure to partner’s sperm Conclusion: The odds of pre-eclampsia increased with primiparity, duration of exposure to partner’s sperm < 3 months, personal history of pre-eclampsia and maternal history of pre-eclampsia. Recognition of these predictor factors would improve the ability to diagnose and monitor women likely to develop pre-eclampsia before the onset of disease for timely interventions.

Effect of Uncertainty of the Pre-Exponential Factor on Kinetic Parameters of Hydrocarbon Generation from Organic Matter and its Geological Applications

The source rock sample of the Shahejie Formation （upper Es4） in Jiyang Sag was pyrolyzed under open system with the Rock-Eval-lI apparatus, and then kinetic model parameters were calibrated for investigating the effect of uncertainty of pre-exponential factors on kinetic parameters and geological applications, where the parallel first-order reaction rate model with an average pre- exponential factor and discrete distribution activity energies was used. The results indicate that when the pre-exponential factor changes from low to high, an extreme value for residual errors occurs. And with the increasing pre-exponential factor, the distribution shape of activation energies are nearly the same, but the values of activation energies move higher integrally, and the average activation energy increases about 12 kJ/mol for every 10-fold of the pre-exponential factors. Extrapolating the geological heating rate of 3.3 ~C/Ma, the results show that with the increases in pre-exponential factor, the geological temperature corresponding to TRo.5 （transforming ratio of hydrocarbon generation is 50%） increases gradually, and the additional temperature gradually decreases. Combined with geochemical data of source rock, the kinetic parameters with different pre-exponentia[ factors are used to calculate the transformation ratio of hydrocarbon generation, and the result indicates that kinetic parameters corresponding to the better optimized pre-exponential factor are more suitable. It is suggested that the risk assessment of hydrocarbon generation kinetic parameters should be enhanced when using the kinetic method to appraise the oil-gas resources. Meantime, the application result of different kinetic parameters should be verified with geological and geochemical data of source rock in the target area; therefore, the most suitable kinetic parameters for target can be obtained.

Rationale of a Cross Sectional Analytic Study on Determinants of Recurrent Preeclampsia at University Clinics of Kinshasa (Democratic Republic of Congo) and at Victor Dupouy Hospital Center (France)

Research Background: Pre-eclampsia is one of main causes of materno-foetal mortality and morbidity worldwide, with a prevalence of 3% - 7%. Although considered a primiparous condition, it can nevertheless recur. Several factors appear to be associated with risk of recurrence of pre-eclampsia, such as the term of delivery of previous pregnancy, severity of disease, the existence of co-morbidities and the inter-genital space. Purpose: The aim of our study will be to analyse and identify in a population of pregnant women with a history of preeclampsia risk factors associated with occurrence of recurrent preeclampsia at University clinics of Kinshasa (Democratic Republic of Congo) and at Victor Dupouy Hospital Center (France). Methods: In this study, pregnant women with an history of preeclampsia who will give birth between November 2018 and October 2024 at University Clinics of Kinshasa (UCK) and Victor Dupouy Hospital Center (VDHC) will be included. This will be a cross-sectional analytical study, data from previous and subsequent pregnancies will be studied. Expected Result: The prevalence of recurrent preeclampsia in the study population will be determined. And we will highlight the factors that will determine the recurrence of preeclampsia by analysing the risk factors. Conclusion: Knowledge of the factors associated with recurrent preeclampsia could be an excellent tool for predicting and preventing the disease.

Prevalence and Demographic Distributions of Pre-Eclampsia among Pregnant Women at Ho Teaching Hospital

Background: In Sub-Saharan Africa, pre-eclampsia remains a major health problem contributing to high rates of maternal mortality. Despite this condition having adverse effects on maternal and child health, its prevalence and associated risk factors are still significant, especially in developing countries including Ghana. This study aimed to assess the prevalence and demographic distributions associated with pre-eclampsia among pregnant women at the Ho Teaching Hospital. Methods: A facility-based retrospective study was conducted by reviewing available data or hospital records of pregnant mothers admitted to the labor and maternity wards from January 2018 to December 2020. All pregnant women who were diagnosed with pre-eclampsia within this period were included in the study. The data were collected using a structured checklist. Results: 5609 data on pregnant women from 2018 to 2020 were recorded. Out of the 5609 data recorded, 314 pre-eclampsia cases were recorded giving an overall prevalence of 5.6%. The yearly prevalence for 2018, 2019, and 2020 were 4.6%, 5.6%, and 6.6%, respectively. The most recorded pre-eclampsia cases were seen among women within the age group of 18 - 24 years. The data showed that 112 (35.7%) of the pregnant women who had pre-eclampsia were nulliparous. Pre-eclampsia-associated maternal and fetal complications were;preterm delivery 221 (70.4%), intrauterine fetal death 62 (19.7%), eclampsia 9 (2.9%), HELLP syndrome 5 (1.6%) and maternal death 17 (5.4%). Associated factors of pre-eclampsia were parity, level of education, and occupation (p ≤ 0.05). Conclusion: The findings of this study showed a rising trend in the incidence of pre-eclampsia over the years at the Ho Teaching Hospital. Parity, level of education, and occupation were found to be associated with developing pre-eclampsia.

Pre-operative factors that can predict neoplastic polypoid lesions of the gallbladder

AIM:To investigate the preoperative factors that can predict neoplastic polypoid lesions of the gallbladder(PLGs) as well as malignant PLGs.METHODS:A retrospective analysis was conducted on the 210 consecutively enrolled patients who underwent cholecystectomy due to a PLG larger than 10 mm,as was determined by preoperative trans-abdominal ultrasonography or endoscopic ultrasonography.We ana-lyzed the medical,laboratory,radiologic data and the pathologic results.RESULTS:In 210 cases,146 had non-neoplastic polyps(69.5%) and 64 cases were neoplastic polyps(30.5%).An older age(≥ 65 years),the presence of diabetes mellitus(DM) and the size of polyp(≥ 15 mm) were revealed to be independent predictive variables for neoplastic polyps with odd ratios(OR) of 2.27(P = 0.044),2.64(P = 0.021) and 4.94(P < 0.01),respectively.Among the neoplastic PLGs,an older age(≥ 65 years),the presence of DM and polyp size(≥ 15 mm) were associated with malignancy with ORs of 4.97(P = 0.005),6.13(P = 0.001) and 20.55(P < 0.001),respectively.CONCLUSION:Among patients with PLGs larger than 10 mm in size,higher risk groups such as elderly patients more than 65 years old,those with DM or a large polyp size(≥ 15 mm) should be managed by cholecystectomy.

Fast-scale border collision bifurcation in SEPIC power factor pre-regulators

In this paper we report a kind of fast-scale instability occurring in the single-ended primary inductance converter （SEPIC） power factor pre-regulator, which is designed to operate in discontinuous conduction mode. Main results are given by exact cycle-by-cycle computer simulations as well as theoretical analysis. It is found that the instability phenomenon manifests itself as a fast-scale bifurcation at the switching period, which implies the occurrence of border collision bifurcation, or is related to the transition of the regular operating mode of the SEPIC. According to the theoretical analysis and simulation results, the effects of parameters on system stability, and the locations of the bifurcation points are confirmed. Moreover, the effects of such an instability on power factor and switching stress are also discussed. Finally, the occurrence of the asymmetric bifurcation locations is investigated. The results show that this work provides a convenient means of predicting stability boundaries which can facilitate the selection of the practical parameters.

Interaction between the Wilms tumour factor-1 element in the promoter of Amh and a downstream enhancer is required for a strong expression of the gene in pre-pubertal sertoli cells

Amh (anti-Müllerian hormone) is a single copy gene which is expressed strongly in Sertoli cells in the foetal testis and participates in the onset of sexual differentiation. Its promoter driving the expression of a reporter gene (d2EGFP) has been used to analyse the role of certain defined putative elements and a downstream enhancer element in gene expression. These experiments were carried out in vitro using a line of pre-pubertal mouse Sertoli cells, transienly transfected with circular DNA constructs with variously mutated promoter elements. A downstream enhancer element, situated immediately 3’ of the polyadenylation (PA) signal for Amh, has been inserted in an equivalent position in the d2EGFP construct. When the Amh promoter is unmodified, the downstream enhancer (DE) is positively associated with a large increase in EGFP expression. This is at least partly the consequence of an increased rate of expression by individual cells. Experiments using variously truncated Amh promoters indicate that an upstream region (-214 to -336) may play a minor role in facilitating enhancement. However mutation of the Wilms tumour factor-1 element, situated between the tata box and the start of translation, results in an almost complete suppression of enhancement.

The Transcription Factors GATA-1 and GATA-4 Have Opposite Effects on DNA Expression Driven by an Amh Promoter

An Amh promoter driving expression of a reporter gene (d2EGFP) has been used to analyze the role of two specific promoter transcription factor binding elements. In addition a downstream (3’) enhancer (DE) was also investigated. The transcription factors GATA-1 and GATA-4 had opposite effects, the former being incremental and the latter decremental. The quantitative balance between these two factors may provide a degree of control over the level of gene expression.

子痫前期患者循环PLGF水平对预测病情及评估母婴结局的价值初探

目的探讨循环胎盘生长因子(PLGF)水平与子痫前期(PE)病情程度及母婴结局、胎盘病理学改变的相关性。方法选取PE患者159例为研究对象,根据终止妊娠孕周分为:PE_(1)组(62例,<34周终止妊娠的PE患者)和PE_(2)组(97例,≥34周终止妊娠的PE患者);选取同期分娩的107例非PE患者作为对照,根据终止妊娠孕周分为:非PE_(1)组(41例,<34周终止妊娠的非PE患者),非PE_(2)组(66例,≥34周终止妊娠的非PE患者)。收集各组孕妇一般资料:年龄、体质量指数(BMI)、入院收缩压、舒张压,24 h尿蛋白定量、孕产次、是否存在胎儿生长受限(FGR)、胎儿宫内窘迫。新生儿一般资料:术中记录是否有羊水粪染、新生儿窒息,新生儿入住新生儿重症监护病房(NICU)天数;检测分娩当日孕妇静脉血PIGF;将患者胎盘行病理检测并评分;胎儿娩出后行脐动脉血气分析并记录酸碱度(p H)、碱剩余(BE)、乳酸(LAC)。结果PE_(1)组和PE_(2)组与相应孕周非PE_(1)和非PE_(2)组年龄、孕次、产次差异无统计学意义;PE_(1)组与PE_(2)组BMI分别高于非PE_(1)、非PE_(2)组,PLGF分别低于非PE_(1)、非PE_(2)组,且PE_(1)组PLGF低于PE_(2)组(P<0.05)。PE_(1)组患者24 h尿蛋白定量、收缩压、舒张压、胎盘异常病理改变评分高于PE_(2)组(P<0.05)。PE_(1)组与PE_(2)组产时羊水粪染、胎儿宫内窘迫情况、脐动脉血p H值差异无统计学意义,与PE_(2)组比较,PE_(1)组新生儿窒息及FGR比例、脐动脉血LAC升高,BE值降低,入住NICU时间延长(P<0.05)。结论PE患者循环PLGF水平降低,PLGF水平在PE病情评估、预测不良妊娠结局方面有一定价值。

前维生素D相对校正因子的研究及测定

目的:测定前维生素D相对校正因子,简化维生素D含量测定的计算方法。方法:通过对各国药品标准中维生素D含量计算方法的研究,采用HPLC法测定前维生素D相对校正因子,并对测定的影响因素进行了考察。结果:统计了国内7家实验室的前维生素D相对校正因子的测定结果,确定了254 nm和265 nm 2个波长下的前维生素D相对校正因子。结论:采用前维生素D相对校正因子法计算维生素D的总量,简化了实验步骤,避免了随机操作误差。该方法快速、准确,为进一步提高维生素D制剂标准奠定了基础。

绵阳市男男性行为者对HIV暴露前预防的使用意愿及影响因素

目的 了解绵阳市男男性行为者(MSM)对人类免疫缺陷病毒(HIV)暴露前预防(PrEP)的使用意愿,分析影响因素。方法 2022年1—12月,用滚雪球抽样法进行MSM的PrEP使用意愿等问卷调查,使用χ2检验和logistics回归模型分析PrEP使用意愿的影响因素。结果 有效问卷共981份,如药品不免费和免费MSM的PrEP使用意愿分别为19.6%(192人)和48.1%(472人)。期望获得PrEP服务的途径为医院为23.3%(229人)、疾控中心和社会组织均为43.4%(426人)、诊所为95.3%(935人)。PrEP药品不免费时,职业为学生(OR=2.660,95%CI:3.676~5.128)、月收入>5 000元(OR=2.471,95%CI:1.308~4.666),PrEP知晓(OR=6.804,95%CI:4.314~10.730),社区朋友对PrEP使用持支持态度(OR=2.323,95%CI:1.503~3.591)者PrEP的使用意愿较高,艾滋病知识全正确(OR=0.417,95%CI:0.237~0.733)、害怕感染HIV(OR=0.423,95%CI:0.258~0.895)、有预防HIV感染的能力(OR=0.426,95%CI:0.252~0.722)、性角色被插入方(OR=0.566,95%CI:0.347~0.924)和均可(OR=0.504,95%CI:0.309~0.821)者PrEP的使用意愿较低。结论 绵阳市MSM PrEP使用意愿较低,其使用意愿受多种因素影响,经济状况和社区支持不佳、对HIV感染的恐惧心理和预防感染能力的盲目自信或制约其PrEP的使用意愿,要针对性开展PrEP宣传促进。

基于5G专网的院前急救运作模式、体系对创伤失血性休克患者凝血功能及炎性因子的影响研究

目的研究基于5G专网的院前急救运作模式、体系对创伤失血性休克患者凝血功能及炎性因子的影响。方法应用医学研究随机数字表法,选取我院2020年8月—2023年8月收治的创伤失血性休克患者100例,按照治疗路径不同分为对照组和观察组,对照组给予常规救治模式治疗,观察组给予基于5G专网的院前急救运作模式、体系治疗,比较两组凝血功能、炎性因子以及抢救总有效率。结果观察组PT、APTT、TT、FIB指标水平均低于对照组,PLT水平高于对照组(均P<0.05);观察组TNF-α、IL-1、IL-6、CRP等炎性因子指标水平以及抢救总有效率均低于对照组(均P<0.05)。结论基于5G专网的院前急救运作模式、体系对创伤失血性休克能明显改善患者的凝血功能,降低炎性因子指标水平,升高抢救有效率。

基于对抗训练的事件要素识别方法

针对目前大多数事件要素识别模型未考虑词级别的语义信息,及模型鲁棒性不高的问题,提出一种融合词信息和对抗训练的事件要素识别方法。将Bert(bidirectional encode representations from transformers)预训练语言模型生成的字向量与分词信息进行融合,在得到的融合向量中添加扰动因子产生对抗样本,将对抗样本与融合向量表示作为编码层的输入;采用BiGRU(bidirectional gating recurrent unit)网络对输入的文本进行编码,丰富文本的上下文语义信息;采用CRF(conditional random field)函数计算完成事件要素的识别任务。在CEC(Chinese emergency corpus)中文突发事件语料库上的实验结果表明,该方法能够取得较好的效果。

VA-ECMO患者院内死亡风险预测模型的构建及验证:一项多中心、回顾性、病例对照研究

目的 分析静脉-动脉体外膜肺氧合技术(VA-ECMO)患者死亡危险因素,构建并验证VA-ECMO患者院内死亡风险预测模型。方法 采用便利抽样,选取2015年1月~2022年1月广东省3家三甲综合医院ICU的302例VA-ECMO患者作为研究对象,随机分为建模组201例,验证组101例。运用单因素及多因素Logistic回归分析VA-ECMO患者死亡危险因素,构建VAECMO患者死亡风险预测模型并以列线图形式呈现。使用受试者工作特征曲线(ROC曲线)、校准曲线和临床决策曲线评价模型区分度、一致性及临床有效性。结果 预测VA-ECMO患者院内死亡风险的最终模型包括了高血压(OR=3.694,95%CI 1.582-8.621)、连续性肾脏替代治疗(OR=9.661,95%CI 4.103-22.745)、钠离子(OR=1.048,95%CI 1.003-1.095)、血红蛋白(OR=0.987,95%CI 0.977-0.998)。建模组预测模型的受试者工作特征曲线下面积AUC=0.829(95%CI 0.770-0.889),高于4个单独危险因素(AUC<0.800)、APACHE II评分[AUC=0.777(95%CI 0.714-0.840)]、SOFA评分的[AUC=0.721(95%CI 0.647-0.796)]。内部验证结果显示模型的受试者工作特征曲线下面积AUC为0.774(95%CI 0.679-0.869),拟合优度检验结果χ2=4.629,P>0.05。结论构建的VA-ECMO患者院内死亡风险预测模型区分度、校准度及临床有效性均较好,优于常用疾病严重程度评分系统,对评估重症患者疾病的严重程度及预后的风险水平有重要意义。

上海市35岁以上人群糖尿病前期现状分析

目的:了解上海市35岁以上人群糖尿病前期流行现状,分析相关影响因素。方法:采用上海市慢性病及其危险因素监测数据,收集调查问卷、身体测量和实验室检测等相关数据,最终以14940名35岁以上符合纳入标准的居民作为研究对象。结果:上海市35岁以上人群糖尿病前期患病率为23.19%(标化率为20.03%),其中空腹血糖调节受损(IFG)患病率为6.43%(标化率为6.19%),糖耐量降低(IGT)的患病率为16.76%(标化率为13.84%)。非条件Logistic回归分析得出年龄、居住地为城乡结合和农村、有高血压病史、超重肥胖、中心性肥胖和总胆固醇异常为糖尿病前期的危险因素。结论:上海市35岁及以上居民糖尿病前期患病率处于高水平,应依据相关危险因素做好防控工作。

孕前及孕期相关因素对婴幼儿神经心理发育的影响研究

目的探讨孕前及孕期相关因素对婴幼儿神经心理发育的影响,为促进其神经心理发育提供依据。方法依托武汉妇儿健康宝贝出生队列项目,选取2016年7月至2018年9月在院建册和产检的孕妇,以招募获取的1019对母子作为研究对象。采用问卷形式收集孕妇孕前体质量指数(BMI)、怀孕年龄、孕次、职业、文化程度、分娩方式等信息;在婴幼儿2岁时采用贝利婴幼儿发展量表(中国城市修订版)(BSID-CR)测评其智力发展指数(MDI)和精神运动发展指数(PDI);将BSID-CR量表评分>79分归为正常组,≤79分归为异常组。采用广义线性模型和Logistic回归模型对影响婴幼儿神经心理发育的孕前及孕期相关因素进行分析。结果在1019名婴幼儿中,男童526名(51.6%)、女童493名(48.4%),MDI异常组86例(8.4%),PDI异常组21例(2.1%)。在MDI中,正常组与异常组母亲怀孕年龄、孕前BMI的分布比较差异均有统计学意义(χ2值分别为9.239、7.481,P<0.05)。广义线性模型分析结果显示,母亲怀孕年龄与子代MDI之间存在负向关联:相比于母亲怀孕年龄为24~35岁,母亲怀孕年龄≥35岁的子代MDI降低6.913分(95%CI:-10.177~-3.650,P=0.001);母亲孕前BMI与子代MDI之间存在负向关联:相比于母亲孕前BMI正常,母亲孕前BMI为超重或肥胖的子代MDI降低4.380分(95%CI:-8.004~-0.755,P=0.018);母亲分娩孕周与子代PDI之间存在负向关联:相比于母亲分娩孕周为37~42周,母亲分娩孕周<37周的子代PDI降低6.910分(95%CI:-12.766~-1.054,P=0.021)。多因素Logistic回归模型分析显示,母亲怀孕年龄≥35岁(OR=1.749,95%CI:1.041~2.939,P=0.035)和母亲孕前BMI为超重或肥胖(OR=1.765,95%CI:1.016~3.065,P=0.044)均明显增加子代MDI异常的发生风险。结论母亲高龄妊娠、孕前超重或肥胖及早产均可能是子代神经心理发育异常的高危因素,针对上述因素的及时干预有利于促进婴幼儿智力发育,提高人口素质。

职前小学科学教师身份认同现状及建议——基于621名职前小学科学教师的调查研究

教师队伍建设的关键之一是教师身份认同问题,而职前阶段恰恰是形成教师身份认同的重要时期,职前小学科学教师身份认同到底情况如何?影响因素又有哪些?本研究通过文献梳理、搭建框架、编制问卷、进行访谈等过程,调查了621名职前小学科学教师的身份认同现状,发现:(1)职前小学科学教师身份认同整体较好,各维度发展不均衡;(2)职前小学科学教师身份认同在专业类别、性别上具有差异(3)个人及环境两方面共同影响职前小学科学教师身份认同。基于研究现状和访谈结果进行归因并从教育部门、高等院校、师范生个体三个层面提出建议。

桥梁施工中钢抱箍滑移原因与防滑措施研究

为研究桥梁施工中钢抱箍滑移原因并提出针对性的应对措施,对钢抱箍受力进行理论分析。针对钢-混界面进水及螺栓施拧不足造成的滑移,进行钢-混界面摩擦系数和螺栓拧紧力矩系数测试及定量分析,根据测试结果并结合现场经验提出钢抱箍防滑措施。结果表明:实测干燥状态下钢-混界面的静摩擦系数为0.62,大于常用设计值(0.3~0.4),钢抱箍偏安全;界面润湿后,静摩擦系数有所降低,但仍高于常用设计值,说明钢-混界面进水会降低钢抱箍承载能力,但降低程度还不足以导致钢抱箍滑移。螺栓拧紧力矩系数取值不当是钢抱箍滑移的主要原因,拧紧力矩系数常用设计值仅为测试值的1/1.7~1/3.6,偏不安全;拧紧力矩系数取值跟螺栓轴线与承压板法线间的夹角有关,建议现场对其进行实测,以保证螺栓预紧力与设计相符。钢抱箍设计时,摩擦系数可偏安全地取0.45,螺栓拧紧力矩系数可在参考范围内取大值,并结合1.5~2.0的安全系数确定螺栓数量,以避免钢抱箍滑移。