Clinical, Therapeutic and Evolutionary Profiles of Hypertensive Emergencies in the Cardiology Department of the Ignace Deen National Hospital (Conakry)

Introduction: Hypertensive emergencies are a reality in the cardiology department of the Ignace Deen National Hospital. The aim of this study was to determine the clinical, therapeutic and evolutionary profile of hypertensive emergencies in the cardiology department of the Ignace Deen National Hospital. Methods: This was a longitudinal descriptive study of patients admitted to the cardiology department of the Ignace Deen National Hospital for hypertensive emergencies, over a period of six (6) months from 1 October 2020 to 31 March 2021. Results: Among the 638 patients admitted to the cardiology department during the study period, 102 cases of hypertensive emergencies were identified, representing a frequency of 15.99%. The mean age of the patients was 56.65 ± 13.33 years, with extremes of 23 and 90 years, and the sex ratio was 1.91 in favour of men. The associated cardiovascular risk factors were: age (76.47%), smoking (41.18%), sedentary lifestyle (31.37%), obesity (16.67%), dyslipidaemia (12.75%), diabetes (11.76%) and excessive alcohol consumption (11.76%). The various clinical pictures found were: acute pulmonary oedema 39 cases (38.23%), acute coronary syndrome 31 cases (30.39%), stroke 17 cases (16.67%), hypertensive encephalopathy 11 cases (10.78%), acute renal failure 3 cases (2.94%) and aortic dissection 1 case (0.98%). The drugs used on admission were calcium antagonists (Nicardipine 10mg) in 58 cases (56.86%), diuretics (Furosemide 20mg) in 44 cases (43.13%), nitrates (Risordan 20mg) in 39 cases (38.23%) and beta-blockers in 31 cases (30.39%). In terms of outcome, 88 (86.27%) patients had improved. However, 12 (11.76%) deaths were recorded. Conclusion: Hypertensive emergencies are a worrying condition with a high prevalence in the cardiology department of the Ignace Deen National Hospital.

Acute Fevers in the Medical Unit of the Medical-Surgical Emergency Department of the Donka National Hospital

Introduction: Fever is a high core temperature ≥ 37.5°C in the morning and 37.8°C in the evening. It is acute when it evolves from 0 to 20 days. Very common in clinical practice, the etiological diagnosis, particularly in developing and tropical countries, is often a challenge for clinicians due to their diversity and the limited availability of diagnostic tools. There is a wide spectrum of etiological diagnoses including infectious causes and non-infectious causes. The aim of this study was to investigate the etiology of fevers acute at the medical unit in the medico-surgical emergency department of the Donka National Hospital. Methods: This was a descriptive cross-sectional study lasting 03 months (January 01, 2022 to March 31, 2022). We included in this study all patients seen in the medical unit, whose age ≥ 18 years, without distinction of sex, from any origin, with an axillary temperature ≥ 37.5°C in the morning and 37.8°C in the evening, evolving from 0 to 20 days, hospitalized or followed on an outpatient basis, and having given verbal consent. Results: Of a total of 1087 patients seen, 466 had an acute fever. The mean age was 40.04 ± 18.91 years (18 and 96 years). The female sex (58.15%) was predominant with a sex ratio of 0.72. Malaria (50.86%) was the main diagnosis. The treatment consisted of compressed paracetamol (59.01%), arthemether + lumefantrine (50.85%). Conclusion: The incidence of acute fevers is high in the medical unit of the medico-surgical emergency department of the Donka National Hospital. Malaria was the main pathology. Treatment was etiological and symptomatic. This high incidence could be explained by the fact that Guinea is an endemic malaria zone. A study taking into account other etiological factors would be of great interest.

Outcome prediction value of National Early Warning Score in septic patients with community-acquired pneumonia in emergency department: A single-center retrospective cohort study

BACKGROUND:To evaluate the accuracy of National Early Warning Score(NEWS)in predicting clinical outcomes(28-day mortality,intensive care unit[ICU]admission,and mechanical ventilation use)for septic patients with community-acquired pneumonia(CAP)compared with other commonly used severity scores(CURB65,Pneumonia Severity Index[PSI],Sequential Organ Failure Assessment[SOFA],quick SOFA[qSOFA],and Mortality in Emergency Department Sepsis[MEDS])and admission lactate level.METHODS:Adult patients diagnosed with CAP admitted between January 2017 and May 2019 with admission SOFA≥2 from baseline were enrolled.Demographic characteristics were collected.The primary outcome was the 28-day mortality after admission,and the secondary outcome included ICU admission and mechanical ventilation use.Outcome prediction value of parameters above was compared using receiver operating characteristics(ROC)curves.Cox regression analyses were carried out to determine the risk factors for the 28-day mortality.Kaplan-Meier survival curves were plotted and compared using optimal cut-off values of qSOFA and NEWS.RESULTS:Among the 340 enrolled patients,90 patients were dead after a 28-day follow-up,62 patients were admitted to ICU,and 84 patients underwent mechanical ventilation.Among single predictors,NEWS achieved the largest area under the receiver operating characteristic(AUROC)curve in predicting the 28-day mortality(0.861),ICU admission(0.895),and use of mechanical ventilation(0.873).NEWS+lactate,similar to MEDS+lactate,outperformed other combinations of severity score and admission lactate in predicting the 28-day mortality(AUROC 0.866)and ICU admission(AUROC 0.905),while NEWS+lactate did not outperform other combinations in predicting mechanical ventilation(AUROC 0.886).Admission lactate only improved the predicting performance of CURB65 and qSOFA in predicting the 28-day mortality and ICU admission.CONCLUSIONS:NEWS could be a valuable predictor in septic patients with CAP in emergency departments.Admission lactate did not predict well the outcomes or improve the severity scores.A qSOFA≥2 and a NEWS≥9 were strongly associated with the 28-day mortality,ICU admission,and mechanical ventilation of septic patients with CAP in the emergency departments.

Epidemiology of shoulder dislocations presenting to United States emergency departments:An updated ten-year study

BACKGROUND Glenohumeral dislocation is a common injury that may predispose patients to chronic pain and instability.However,there is a paucity of current data available regarding the epidemiological trends of this injury.AIM To provide an updated,comparative assessment of the epidemiology of shoulder dislocations presenting to emergency departments in the United States.We also sought to analyze patient demographic risk factors and consumer products associated with dislocation events.METHODS Data were obtained from the national electronic injury surveillance system database for glenohumeral dislocations between 2012 and 2021.Incidence,age,sex,and injury characteristics were analyzed using weighted population statistics as well as incidence rates and 95%confidence intervals(CI).RESULTS In total,an estimated 773039 shoulder dislocations(CI:640598-905481)presented to emergency rooms across the United States during the study period.The annual incidence rate was 23.96 per 100000 persons and the average patient age at the time of injury was 37.1 years.Significantly more male patients sustained dislocations than female patients(537189,69.5%,vs 235834,30.5%,P<0.001).With regard to associated consumer products,sports and recreation equipment were involved in the highest proportion of incidents(44.31%),followed by home structures and construction materials(21.22%),and home furnishings,fixtures,and accessories(21.21%).Regarding product sub-groups,stairs,ramps,landings,floors was cited in the greatest number of cases(131745).CONCLUSION The national annual incidence rate of glenohumeral dislocations throughout the study period was approximately 23.92 per 100000 persons.Male adolescents sustained the highest proportion of dislocations,with a peak incidence in age group 15-20 years,predominantly secondary to participation in sporting and recreational activities.Conversely,women experienced a relatively consistent incidence of dislocation throughout their lifespan.After age 63,the incidence rate of dislocations in females was found to surpass that observed in males.

Information Management in Disaster and Humanitarian Response: A Case in United Nations Office for the Coordination of Humanitarian Affairs

To guarantee a unified response to disasters, humanitarian organizations work together via the United Nations Office for the Coordination of Humanitarian Affairs (OCHA). Although the OCHA has made great strides to improve its information management and increase the availability of accurate, real-time data for disaster and humanitarian response teams, significant gaps persist. There are inefficiencies in the emergency management of data at every stage of its lifecycle: collection, processing, analysis, distribution, storage, and retrieval. Disaster risk reduction and disaster risk management are the two main tenets of the United Nations’ worldwide plan for disaster management. Information systems are crucial because of the crucial roles they play in capturing, processing, and transmitting data. The management of information is seldom discussed in published works. The goal of this study is to employ qualitative research methods to provide insight by facilitating an expanded comprehension of relevant contexts, phenomena, and individual experiences. Humanitarian workers and OCHA staffers will take part in the research. The study subjects will be chosen using a random selection procedure. Online surveys with both closed- and open-ended questions will be used to compile the data. UN OCHA offers a structure for the handling of information via which all humanitarian actors may contribute to the overall response. This research will enable the UN Office for OCHA better gather, process, analyze, disseminate, store, and retrieve data in the event of a catastrophe or humanitarian crisis.

“双一流”背景下资源勘查工程一流专业建设与探索

随着深入实施科教兴国战略、人才强国战略、创新驱动发展战略,高等教育必然要担当起新的使命和时代重任,而专业建设是高等教育体系的重要支柱,是人才培养的基础平台,资源勘查工程专业关系着我国能源资源安全,为此,在充分分析河南理工大学资源勘查工程专业建设基础上,查找目前存在的问题,对标“一流专业”和“新工科”建设要求,结合河南理工大学特色优势,探索“双一流”背景下资源勘查工程专业的建设路径,总结取得的一些成效,以期进一步促进资源勘查工程专业内涵式发展,同时为我国其他兄弟院校相关专业建设提供借鉴,为实现地球科学强国目标贡献科技和人才力量。

中国能源应急管理体系演进、问题及政策建议

能源应急管理体系的构成与演变决定了一个国家应对能源突发事件的能力和效率。新中国成立后,中国能源应急管理体系经历了单灾种专项应急管理体系(1949—2003年)、以“一案三制”为核心的应急管理体系(2003—2012年)、以总体国家安全观为统领的应急管理体系(2012年至今)3个发展阶段。总体来看,中国现阶段能源应急管理体系建设还存在大安全大应急理念有待加强、能源综合应急管理体制需要模式重构、应急法制体系亟待完善、全流程应急管理机制和应急保障能力急需提高等一系列问题。建议推进能源战略安全理念,贯彻大安全大应急新思想;完善集中统一、高效权威的能源综合应急管理体制;加强能源应急管理机制建设;健全能源应急管理法制与标准体系;强化能源应急保障体系。

老龄化对新兴国家出境旅游需求的影响——基于跨国样本的实证

人口老龄化是二战以来世界人口变化的最大特征之一,对经济和社会领域的影响深远,对旅游业的发展既是机遇又是挑战。文章以1995—2019年20个新兴国家的数据为样本,采用双向固定效应模型,实证研究老龄化对出境旅游需求的影响及其异质性特征,并探究了国家文化价值观的调节效应。研究发现:1)老龄化对出境旅游需求有正向影响;2)不同年龄阶段的老年人对出境旅游的影响存在异质性,不同老龄化程度的新兴国家对出境旅游需求的影响存在异质性;3)国家文化价值观对老年人出境旅游需求有显著的调节作用。其中,不确定性规避程度、个人主义削弱了老龄化对出境旅游需求的正向作用;高权力距离、男性主义、长期主义加强了老龄化对出境旅游需求正向作用。该研究结果将为推进新兴国家银发旅游市场的开发、完善配套政策提供参考依据。

我国财政安全的内涵、挑战和实现路径:基于总体国家安全观视角

财政安全是经济安全的最后一道防线。本文试图在总体国家安全观视角下厘清财政安全的内涵和要求,甄别我国财政安全目前面临的主要挑战,并给出实现财政安全的政策路径。本文提出,财政安全是指一国的财政收支短期平稳运行,中长期实现跨年度、跨周期平衡,并储备一定的财政空间和财政资源,应对各种自然、政治、经济、社会重大冲击,以维持国家政治稳定和经济社会长期可持续发展的状态。当前,我国财政安全主要面临来自财政收支压力、地方政府性债务风险、人口老龄化、数字经济、自然灾害和复杂国际形势等方面的挑战。实现财政安全,未来政策取向可以考虑从强化中期财政规划管理、构建政府债务管理长效机制、深化养老保险制度改革、建立与数字经济适配的数字税收体系和建立高效的财政应急管理机制等方面着手,以财政安全推动高质量发展和高水平安全之间的良性互动。

北约新兴与颠覆性技术趋势评估及启示——基于北约《2023—2043科技趋势》报告的分析

[研究目的]基于对北约《2023—2043科技趋势》报告的剖析,总结归纳北约国防科技情报工作的显著特点和有益经验,为进一步增强我国国防科技情报工作的时代性、针对性、有效性提供参考建议。[研究方法]采用内容分析、文献研究等方法,对报告文本进行深入剖析,从环境背景、逻辑架构、组合影响、驱动因素等层面进行梳理提炼,并据此提出优化我国国防科技情报工作的启示建议。[研究结论]应尝试建立国防科技情报工作的统筹协调机制,前沿科技预测更加注意安全环境变化的影响,用融合式思维指导技术预见工作,进一步增强情报工作的决策支持功能,主动对接技术发展与未来应用,更好促进我国国防科技情报工作转型发展。

贯彻总体国家安全观构建中国特色国家安全学术体系

总体国家安全观是我们党历史上第一个被确立为国家安全工作指导思想的重大战略思想,是习近平新时代中国特色社会主义思想的重要组成部分,是当代中国对世界的重要思想和理论贡献。总体国家安全观根植于中国特色社会主义新时代的新实践。面对百年变局、世纪疫情、复兴跨越,我国国家安全形势发生了重大变化。推进国家安全体系和能力现代化,消除和解决长期积累的体制性障碍、结构性矛盾、政策性问题,筑牢全面建设社会主义现代化国家安全屏障,任务艰巨而繁重。为全面贯彻落实总体国家安全观,服务国家安全战略需要,西南政法大学于2018年5月22日在全国普通高校中首个挂牌成立国家安全学院,探索国家安全学学科建设、加强国家安全学基础理论研究、培养国家急需专业人才的新路径。学校坚持发挥法学学科基础和传统优势,立足“两个一百年”奋斗目标和历史方位,运用总体国家安全观所蕴含的认识论和方法论,密切关注中国式现代化进程中国家安全理论问题与实践要求,注重将科学研究与国家安全战略需求紧密结合,不断探索适应新时代国家安全工作新格局的新理念、新思维、新方法,不断强化中国特色国家安全理论的体系化、科学化与实战化建设,为推进国家安全体系和能力现代化提供有力学科支撑和智力保障。

拜登政府国防科技战略评析

[研究目的]科学分析拜登政府出台的国防科技战略,为我国国防科技发展提供参考。[研究方法]采用文本分析等方法,对拜登政府国防科技战略进行深入考察,分析其战略动因、主要内容、显著特点、潜在影响和现实挑战,并据此提出应对之策。[研究结论]拜登政府出台国防科技战略,旨在通过聚焦联合任务、加快创新转化、夯实研发基础等战略手段,塑造美国在国防科技领域的新一轮优势,捍卫美国军事霸权。这一战略有着“重竞争、全政府、非对称”的鲜明特点,将恶化国际安全环境,在实行过程中仍面临国内动员、国际协调、人才吸引等多方面挑战。对此,我们要从加快推进高水平科技自立自强和强化国际合作两方面做好应对。

国家公园社区居民生计韧性测度及影响因素研究——以新冠疫情下的普达措国家公园为例

基于新冠疫情为突发公共卫生事件的典型案例,以普达措国家公园周边社区的调研数据,采用熵值法探讨居民疫情前后生计韧性时序变化规律;根据“压力-状态-响应”理论构建分析框架并选取生计韧性的影响因素,通过多元逐步回归分析,探寻居民生计恢复路径。结果表明:相较于疫情前的2019年,2022年居民生计韧性降低了1.94%;各类型居民生计韧性水平呈现差异:扩张型(0.2264)>更替型(0.2029)>升级型(0.1950)>维持型(0.1641);疫情常态化防控时期,居民健康状况、工作机会与稳定性是影响全体居民生计韧性的关键因素;各生计适应类型居民关键影响因素不同。政府部门可通过拓宽居民替代生计选择、完善社区基层治理机制、加强医疗卫生体系建设、精准帮扶不同类型居民等手段助力国家公园社区的可持续发展。

突发公共事件网络舆情风险的现代化协同治理机制:基于“事件—传播”的研究

随着现代风险社会及深度媒介化时代的到来,突发公共事件网络舆情风险往往由事件与传播双重逻辑耦合引发,常使国家陷入不确定性风险传播的被动响应中,因此需要建立突发公共事件网络舆情风险的现代化协同治理机制。在事件属性层面,应化解社会矛盾冲突、建立常态化社会治理机制,将数字技术作为提高舆情治理能力的基础设施,以社会治理现代化推动舆情风险治理的现代化;在媒介属性方面,要提高新型主流媒体突发公共事件舆论引导力,从舆情风险研判、预警及处置等层面进行全过程的舆情风险防范与治理。从整体性治理视角而言,建立网络舆情纵横协同应对,国家与社会、社会治理与传播治理的协同治理机制。通过现代化网络舆情风险协同治理机制的建立以提高国家应对突发公共事件网络舆情风险的韧性,适应中国式现代化国家治理的需要。

利益属性视角下国家紧急权力和个人权利的对立统一关系研究

在常规制度设计无法应对威胁国家生存的紧急危机时,为了最大程度地保障公共利益,以政府为代表的公权力主体权力范围扩大、个人权利相对克减,这本质上是国家进入紧急状态而行使国家紧急权力的逻辑结果。权力和权利是法理学研究的一对核心范畴,同时也是保障紧急危机治理在法治轨道上有序进行的本体支柱。国家紧急状态下与紧急危机治理有关的所有社会关系和社会问题实际上都是围绕权力和权利的关系展开的。从权力和权利的利益属性出发对国家紧急权力和个人权利的关系问题进行研究,不仅能够回应国家紧急状态下社会公众对公权力和私权利界限问题的关切,在法治原则和法治思维的基础上解决诸多社会问题,而且能够充实对该研究主题的整体性认识和精细化考量,为未来的相关研究提供明确而有效的创新思路。

集采常态化背景下仿制药质量安全应急管理能力评估指标体系构建

目的 构建我国仿制药质量安全应急管理能力评估指标体系,为评估并提高集采常态化背景下仿制药质量安全应急管理能力提供参考。方法 基于理论研究和文献分析初步拟定仿制药质量安全应急管理能力评估指标体系,采用德尔菲法和层次分析法确定评价指标体系并计算权重。结果 两轮咨询专家积极程度、权威系数与意见协调程度较好,最终构建了仿制药质量安全应急管理能力评估指标体系,包括一级指标4个(质量风险监测预警能力、应急准备能力、响应处置能力与应急恢复能力)、二级指标11个(如仿制药研发与生产过程质量风险监测预警能力、应急组织机制保障能力、应急响应处置能力等)、三级指标75个(如仿制药原料质量风险监测、仿制药质量和疗效一致性评价、仿制药利润空间风险隐患监测等)。其中,一级指标中质量风险监测预警能力的权重最大(0.392 4),二级指标中仿制药研发与生产过程质量风险监测预警能力的组合权重最大(0.146 0),三级指标中仿制药原料质量风险监测的组合权重最大(0.023 0)。结论 本研究构建的仿制药质量安全应急管理能力评估指标体系层次分明、权重合理,具有一定的可信度,可作为集采常态化背景下仿制药质量安全应急能力评估管理与决策的有效工具。

《美国政府关键和新兴技术国家标准战略》及其实施路线图特点浅析

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