Pathological and Etiological Aspects of Nephrotic Syndrome at the Niamey General Reference Hospital

Introduction: Studies have been conducted on nephrotic syndrome in Niger. The study aimed to determine the histological and etiological aspects of nephrotic syndrome. Patients and Method: This was a retrospective study from February 1st, 2018 to January 31st, 2024. All patients with nephrotic syndrome who underwent renal biopsy were included. Samples were analyzed at the anatomy-cytology pathology laboratory of the Faculty of Medicine in Dakar (Senegal). The variables studied included clinical, biological, histological and etiological characteristics. Data were analyzed using Excel 2013 and Epi-info 7.2.0 software. Results: The study included 119 patients with nephrotic syndrome. Prevalence of nephrotic syndrome was 11.24%. The male-to-female ratio was 2.25:1. The mean age at diagnosis was between 34.5 ± 18.84 years. Edema was the reason for admission in 40.34% of cases. The nephrotic syndrome was impure in 63.86% of cases. Nine histological lesions were identified. Focal and segmental glomerulosclerosis (40.09%), minimal change disease (23.53%), membranous nephropathy (13.45%), diabetic nephropathy (10.92%), membranous proliferative glomerulonephritis (3.36%), acute glomerulonephritis (3.36%), glomerular thrombotic microangiopathy (2.52%), non-IgA mesengial proliferative glomerulonephritis (1.68%) and amyloidosis (0.84%). Nephrotic syndrome was primary in 57.98% of cases. Secondary etiologies were dominated by diabetes (11.76%), followed by hepatitis B virus (9.24%), lupus, lymphoma, malaria, syphilis, cryoglobulinemia, sickle cell disease and HIV. Conclusion: Future studies should investigate the causes of glomerulopathy secondary to chronic tubulointerstitial lesions.

Management Measures for Preventing Postoperative Incision Infections in General Surgery at Primary Hospitals

Objective:To analyze the management measures and effects of preventing postoperative incision infections in the general surgery department of primary hospitals.Methods:Forty-nine surgical patients with 11 healthcare workers who were admitted to the general surgery department of the primary hospital between August 2021 and August 2022 were selected as the routine group for routine incision infection management.Forty-nine surgical patients with 11 healthcare workers admitted to the same department between September 2022 and September 2023 were selected as the prevention group for prophylactic management of postoperative incision infections.The incision infection rate,knowledge,attitude,and practice(KAP)scores,and management satisfaction of the patients as well as the management skill scores of healthcare workers were compared between the two groups.Results:The rate of postoperative incision infection in the prevention group was lower than that in the routine group;after implementing management measures,patients in the prevention group had higher KAP scores than those in the routine group;patients in the prevention group were more satisfied with the management than those in the routine group;and healthcare workers in the prevention group had higher scores than those in the routine group,with P<0.05 for the comparison between the groups.Conclusion:The implementation of preventive management for general surgery patients in primary hospitals can reduce the incidence of postoperative incision infection and improve the KAP of patients,with higher management satisfaction.It can also enhance the management skills of healthcare workers,thus improving their overall management level.

A Comparative Analysis of the Control Effect of Medical Expenses between General Hospitals and Traditional Chinese Medicine Hospitals from 2012 to 2021

Objective To analyze the changing trend of average medical expenses and structure in general hospitals and traditional Chinese medicine(TCM)hospitals and the effects and differences achieved by the two kinds of hospitals through controlling unreasonable growth of medical expenses,so as to provide reference for controlling the rapid rise of medical cost in public hospitals and optimizing the cost structure.Methods Based on the changes of related indicators of medical expense control from 2012 to 2021,the overall characteristics,changes of cost structure and trends of medical expenses in general hospitals and TCM hospitals were investigated.Results and Conclusion From 2012 to 2021,the increase of medical expenses in general hospitals and traditional Chinese medicine hospitals had slowed down,the proportion of drug revenue to medical income began to decline,and the medical service income increased.However,the proportion of inspection,test and sanitary materials income has increased instead of decreasing,but the management cost has decreased.The two kinds of hospitals have achieved certain cost control results,the structure of medical cost has changed greatly,and the technical service and labor value of medical personnel have been reflected to a certain extent.However,it is still necessary to explore a more scientific and reasonable cost control mechanism to promote the further optimization of medical cost structure.

Characterization of Class 1 Integron Gene Cassettes among Clinical Bacteria Isolated from One Large Hospital in Northern China

The class 1 integron and complex gene cassettes among different species of clinical isolates in northern China were characterized in this study. 383 clinical isolates were obtained from northern China, and class 1 integrons containing gene cassettes widely distributed among gram negative clinical isolates was observed. We find that the class 1 integron showed positive correlation with multidrug resistance phenotype of gram negative bacteria. In addition, we find that isolates belonged to one species harbored different types of gene cassette arrays, while same types of gene cassette arrays were observed in different species of isolates. The diversity of gene cassette arrays among the isolates indicated the complexity of multidrug resistance in clinical isolates in northern China.

Risk Management of Clinical Reference Dosimetry of a Large Hospital Network Using Statistical Process Control

Managing TG-51 reference dosimetry in a large hospital network can be a challenging task. The objectives of this study are to investigate the effectiveness of using Statistical Process Control (SPC) to manage TG-51 workflow in such a network. All the sites in the network performed the annual reference dosimetry in water according to TG-51. These data were used to cross-calibrate the same ion chambers in plastic phantoms for monthly QA output measurements. An energy-specific dimensionless beam quality cross-calibration factor, , was derived to monitor the process across multiple sites. The SPC analysis was then performed to obtain the mean, , standard deviation, σk, the Upper Control Limit (UCL) and Lower Control Limit (LCL) in each beam. This process was first applied to 15 years of historical data at the main campus to assess the effectiveness of the process. A two-year prospective study including all 30 linear accelerators spread over the main campus and seven satellites in the network followed. The ranges of the control limits (±3σ) were found to be in the range of 1.7% - 2.6% and 3.3% - 4.2% for the main campus and the satellite sites respectively. The wider range in the satellite sites was attributed to variations in the workflow. Standardization of workflow was also found to be effective in narrowing the control limits. The SPC is effective in identifying variations in the workflow and was shown to be an effective tool in managing large network reference dosimetry.

A qualitative study on nurses'reactions to inpatient suicide in a general hospital

Aims:To explore the impact of inpatient suicides on nurses working in front-line,the patterns of regulation and their needs for support.Methods:Data were collected through purposive sampling by conducting semi-structured and individual in-depth interviews in a tertiary referral hospital in China.Colaizzi's sevenstep phenomenological method was simultaneously used by two interviewers.Results:Reactions to inpatient suicides revealed three central themes:(1)inpatients were highly likely to commit suicide,(2)inpatient suicide was difficult to prevent,and(3)nurses lacked the necessary suicide prevention skills.Psychological responses mainly included shock and panic,self-accusation or guilt,sense of fear,and frustration.The impacts on practice were stress,excessive vigilance,and burnout.Avoidance and sharing of feelings played key roles in the regulation patterns of nurses.Conclusions:Nurses who experienced inpatient suicide became stressed.Effective interventions must be implemented to improve the coping mechanisms of nurses against the negative consequences of inpatient suicide.The findings of this study will allow administrators to gain insight into the impacts of inpatient suicides on nurses in general hospitals.Such information can be used to develop effective strategies and provide individual support and ongoing education.Consequently,nurses will acquire suicide prevention skills and help patients achieve swift recovery.

Health personnel-targeted education interventions on inpatient suicide prevention in general hospitals:A scoping review

Background:Inpatient suicide is an important part of patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by health personnel mastering inpatient suicide prevention strategy.To enhance health personnel’s inpatient suicide prevention strategy,education intervention is a common method.Educational interventions in the researches varied in contents,duration and outcome measurements.However,there has been not synthesis of education interventions targeting health personnel on inpatient suicide prevention.Objective:Prevention of inpatient suicide is a critical priority in patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by effective strategies mastered by health personnel through education interventions.Educational interventions in researches varied in contents,duration and outcome measurements.We aimed to review education interventions targeting health personnel on inpatient suicide prevention.Methods:A scoping review was used to analyze existing researches on education interventions targeting health personnel focusing on inpatient suicide prevention in general hospitals.Cochrane Library,PubMed,Embase,CINAHL,China National Knowledge Infrastructure,WanFang,and Chinese Scientific Journal Database were searched in Oct 2019.According to the inclusion and exclusion criteria,the searched studies were screened by two reviewers.And then,two researchers conducted the data extraction independently by using a table format,including the first author,year of publication,study design,participants,education intervention,etc.Results:Twelve studies were included in this scoping review.The contents of education interventions on inpatient suicide prevention included three aspects:suicide knowledge,suicide assessment,and skills for coping with suicide.The duration of education interventions ranged from 1.5-h to 32.0-h.The effects of education interventions were mainly focused on participants’knowledge,attitudes and skills of suicide prevention.Conclusion:The evidence showed that education interventions on inpatient suicide prevention had positive impact on health personnel’s knowledge,attitude and skills about inpatient suicide prevention in general hospitals.However,the best health personnel-targeted education intervention on inpatient suicide prevention in general hospitals was yet to be determined.In the future,it is necessary to combine evidence in this review and the actual condition in clinical practice.

Application of refined management in prevention and control of the coronavirus disease 2019 epidemic in non-isolated areas of a general hospital

Objective:This article summarizes the experience in the prevention and control of coronavirus disease 2019(COVID-19)epidemic in non-isolated areas in a general hospital.Methods:Based on refined management theory,we professionally developed the standards for prevention and control of COVID-19 in non-isolated areas,systematically implemented various prevention and control measures,performed gridding audits,effectively communicated among teams and between medical staff and patients assisted by information techniques,and reported results for quality improvement.Results:There was no hospital-acquired COVID-19 infections among staff in the hospital.The rates of mask-wearing,epidemiological history screening,and the medical supplies disinfection were all 100%in the hospital.The accuracy rate of mask-wearing of patients and their families was 73.79%and the compliance rate of their hand hygiene was 40.78%.Conclusion:Refined management strategies for the prevention and control of COVID-19 infection in non-isolated areas of the general hospital are effective.The accuracy rate of mask-wearing and hand hygiene compliance of patients and their families need to be further improved.

Gated Neural Network-Based Unsteady Aerodynamic Modeling for Large Angles of Attack

Modeling of unsteady aerodynamic loads at high angles of attack using a small amount of experimental or simulation data to construct predictive models for unknown states can greatly improve the efficiency of aircraft unsteady aerodynamic design and flight dynamics analysis.In this paper,aiming at the problems of poor generalization of traditional aerodynamic models and intelligent models,an intelligent aerodynamic modeling method based on gated neural units is proposed.The time memory characteristics of the gated neural unit is fully utilized,thus the nonlinear flow field characterization ability of the learning and training process is enhanced,and the generalization ability of the whole prediction model is improved.The prediction and verification of the model are carried out under the maneuvering flight condition of NACA0015 airfoil.The results show that the model has good adaptability.In the interpolation prediction,the maximum prediction error of the lift and drag coefficients and the moment coefficient does not exceed 10%,which can basically represent the variation characteristics of the entire flow field.In the construction of extrapolation models,the training model based on the strong nonlinear data has good accuracy for weak nonlinear prediction.Furthermore,the error is larger,even exceeding 20%,which indicates that the extrapolation and generalization capabilities need to be further optimized by integrating physical models.Compared with the conventional state space equation model,the proposed method can improve the extrapolation accuracy and efficiency by 78%and 60%,respectively,which demonstrates the applied potential of this method in aerodynamic modeling.

Fever Outpatient Service of General Hospital Applies “1 + 3 + 3” Emergency Management Mode to Deal with COVID-19 Pandemic

Purpose: To discuss the effect of “1 + 3 + 3” emergency management mode to deal with COVID-19 pandemic in fever outpatient service of general hospitals. Method: This paper analyzes and summarizes the problems encountered by fever outpatient service in dealing with the COVID-19 pandemic from three aspects of “One Team”, “Three-Key” Control and “Three Mosts”. Results: The application of “1 + 3 + 3” emergency management mode can effectively boost the orderliness and efficiency of fever outpatient service in dealing with COVID-19 pandemic. Conclusion: The “1 + 3 + 3” emergency management mode provides a new management mode and idea for dealing with COVID-19 pandemic, so the fever outpatient service of general hospitals can better improve the national overall anti-pandemic situation.

A survey on 564 cases of inpatients with anxiety and depression in general hospitals in 2015

Objective: To understand the prevalence of anxiety and depression in medical patients in general hospitals and find out main influencing factors. Methods: According to the inclusion criteria, a total of 564 inpatients from the Third Affiliated Hospital of Inner Mongolia Medical University were selected during January to June of 2015. Patients were assessed for anxiety and/or depression by use of Hospital Anxiety and Depression Scale (HADS), Hamilton Anxiety Scale (HAMAS) and Hamilton Depression Scale (HAMDS). Meanwhile, final diagnosis was made on the basis of diagnostic criteria listed in Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV). Results: In different departments, the positive rate (HADS ≥ 8) was the highest in Department of Oncology (45.42%), and the lowest in Department of Gastroenterology (16.05%). After assessment with the help of HAMD and HAMA, the prevalence of anxiety/depression was the highest in Department of Oncology (46.43%), and the lowest in Department of Gastroenterology (16.05%). There was no statistical significance in diagnostic results acquired from HAMD and HAMA (p = .071). Two types of diagnostic methods were highly consistent (κ = 0.852, p = .000). Inpatients aged from 40 to 59 years, with junior high school education or below, very tiring work, poor marital status (separated, divorced, widowed), unharmonious family, low personal income, completely self-paying and family history of anxiety and depression, currently unable to take care of themselves were more prone to anxiety and depression (p < .05). Conclusions: The prevalence of anxiety and depression in medical patients in general hospitals is high due to many influencing factors. It is necessary to establish an effective diagnosis and treatment system for anxiety and depression, in order to make patients easy to receive an early and comprehensive treatment and improve their life quality.

Study of Sound Environment Influenced by the Crowd in Waiting Areas in General Hospitals

In this study,the crowd has been investigated and analyzed in waiting areas in large general hospitals in China in order to find the rules the variations of sound environment with the change of crowd. The field investigation,questionnaire,field-testing and computer simulation have been adopted. The results show that: the social /demographic characteristics of staff and patients are not significantly related to the satisfaction evaluation of sound environment; there is a significant correlation between the population density and LAeq of the background noise in waiting areas; when population density is 0,the LAeq of background noise is not 0 in waiting areas; the loudspeaker should be set in the waiting areas. Loudspeaker arrangements should be integrated into the ceiling lamp or construct facilities along the depth direction of the layout,and the two adjacent speakers recommended distance should be controlled at about 4 m. If the population density is controlled in the reasonable range,and sound absorption,noise reduction processing and electronic queuing system are adopted,sound environment of waiting areas will be built with noise interference relatively small in different population densities.

Characteristics of and management strategies for 54 suicidal inpatients in a general hospital

Objective： The aim of this study was to explore the characteristics of and preventive management strategies for suicidal inpatients in a general hospital.Methods： A total of 54 suicide victims were drawn from a patient safety adverse event network reporting system during hospitalization in a general hospital from November 2008 to January 2017.Results： Subjects who committed suicide in the general hospital were women and those who suffered from malignant neoplasms during general hospital treatment. Furthermore, most of the patients who committed suicide used more violent suicide methods. The most common and lethal means was jumping from heights at the windowsill.Conclusions： It is concluded that management straties for suicide prevention can be provided from the aspects of patients, medical staff and the hospital environment. It is not only urgent but also feasible to reduce the suicide rate of inpatients and further improve hospital safety management.

Interactive Generalization on Large-Scale Topographical Map Supported by a Database Platform

This paper makes astudy on the interactive digital gener-alization, where map generalizationcan be divided into intellective reason-ing procedure and operational proce-dure, which are done by human andcomputer, respectively. And an inter-active map generalization environmentfor large scale topographic map is thendesigned and realized. This researchfocuses on: ① the significance of re-searching an interactive map generali-zation environment, ② the features oflarge scale topographic map and inter-active map generalization, ③ the con-struction of map generalization-orien-ted database platform.

A Theory of Evolving Natural Constants Based on the Unification of General Theory of Relativity and Dirac’s Large Number Hypothesis

Talcing Dirac's large number hypothesis as true, we have shown [Commun.Theor. Phys. (Beijing, China) 42 (2004) 703] the inconsistency of applying Einstein's theory ofgeneral relativity with fixed gravitation constant G to cosmology, and a modified theory for varyingG is found, which reduces to Einstein's theory outside the gravitating body for phenomena of shortduration in small distances, thereby agrees with all the crucial tests formerly supportingEinstein's theory. The modified theory, when applied to the usual homogeneous cosmological model,gives rise to a variable cosmological tensor term determined by the derivatives of G, in place ofthe cosmological constant term usually introduced ad hoc. Without any free parameter thetheoretical Hubble's relation obtained from the modified theory seems not in contradiction toobservations, as Dr. Wang's preliminary analysis of the recent data indicates [Commun. Theor. Phys.(Beijing, China) 42 (2004) 703]. As a complement to Commun. Theor. Phys. (Beijing, China) 42 (2004)703 we shall study in this paper the modification of electromagnetism due to Dirac's large numberhypothesis in more detail to show that the approximation of geometric optics still leads to nullgeodesies for the path of light, and that the general relation between the luminosity distance andthe proper geometric distance is still valid in our theory as in Einstein's theory, and give theequations for homogeneous cosmological model involving matter plus electromagnetic radiation.Finally we consider the impact of the modification to quantum mechanics and statistical mechanics,and arrive at a systematic theory of evolving natural constants including Planck's h as well asBoltzmann's k_B by finding out their cosmologically combined counterparts with factors ofappropriate powers of G that may remain truly constant to cosmologically long time.

Prof. Peter Wiedemann,President of ICO/General Advisor of IJO,visited IJO Press and Xijing Hospital in Xi’an,China on 19th Nov. 2019

Warmly welcome Prof.Peter Wiedemann(middle),President of ICO/General Advisor of IJO to visit IJO Press Prof.Peter Wiedemann gave some guidance to IJO,recognized that it is a high-quality academic journal,and expected that it will make a greater contribution to the world ophthalmology.

Mediating effect of work engagement between job characteristics and nursing performance among general hospital nurses

Objective:This study aimed to determine the effects of job characteristics and work engagement on the nursing performance of nurses working in general hospitals.Methods:Data were collected from 169 nurses who are working in a general hospital in South Korea by using a cross-sectional descriptive survey design.Results:Nurses’job characteristics and work engagement showed positive effects on nursing performance.This effect was magnified when work engagement was used as a mediating variable.Conclusions:The findings elucidate the factors influencing job performance and provide managers with important information for developing programs to improve the job skills and work engagement of nurses.

Magnetic Resonance Imaging of Osteo-Articular System at the Douala General Hospital

Objectives: Osteoarticular pathology has benefited greatly from MRI. This modality was only recently introduced in our country and its implantation is still rare. The objective of this study was to evaluate the practice of MRI of osteoarticular system in Douala General Hospital. Method: It was a cross-sectional descriptive study during a five-month period from May to September 2017 involving all patients referred to the Imaging Department of the Douala General Hospital for osteoarticular MRI. All the patients were scanned using an open-sided mid-field MRI APERTO LUCENT (0.4 T) using axial, sagittal and coronal slices in T1-weighted, T2-weighted proton density. T1 gadolinium or water-fat saturation (WFS) slices were obtained after injection of a contrast agent (Dotarem). Collected data were analyzed using SPSS v20 and Microsoft Excel 2010 softwares. Results: 34 patients were enrolled in this study;osteoarticular MRI accounted for 12% of the activity behind MRI of the spine (40.4%) and the brain (42.5%). The mean age of patients was 37.6 ± 13.1 years with extremes between 6 and 61 years. There was male predominance with a sex ratio of 1.83. Trauma (44.2%) and pain (42.1%) were the most common indications. MRI of the lower limb (85.3%) and more particularly of the knee (68.9%) was more frequently performed than that of the upper limb (14.7%). Orthopedic surgeons (38.2%) and rheumatologists (26.5%) were the main referral physician. 73.5% of request’s forms did not conform to the eight compliance criteria according to the recommendations of French National Agency for Accreditation and Health Evaluation. Most of the examinations (94.1%) were performed without the injection of contrast agent (Dotarem). 97% of MRI was pathological. Traumatic pathologies (39.4%) were most frequent and concerned the knee (27.3%) and the ankle/feet (12.1%), followed by the degenerative pathologies (21.2%) which concerned the knee (18.2%) and hip joints (3%), inflammatory pathologies (12.1%) reaching the shoulder (9.1%) and wrist/hand (3%) while tumoral pathologies (6%) were reaching the knee (3%) and the leg (3%). Conclusion: The MRI of the osteoarticular system is quite common, ranking third after the MRI of the spine and the brain. This study showed that MRI has a significative impact on diagnosis of osteoarticular diseases whit a concordance of 97% with clinic.

Attitudes of General Hospital Staff towards Persons with Mental Illness: Associations between Place of Training, Ethnicity, and Type of Profession

Objective: Persons with mental illnesses (PMI) commonly report encountering discriminatory attitudes and behaviours by Health Care Professionals (HCPs) involved in their care. Such stigmatising attitudes and behaviours may affect recovery rates and erode quality of care provided by these HCPs. We assess attitudes of HCPs towards PMI in a tertiary general hospital in Singapore. Methods: An anonymised online questionnaire was sent to HCPs working in the hospital. Attitudes were assessed using the Opening Minds Stigma Scale for Healthcare Professionals (OMS-HC), with responses rated on a 3-point Likert scale. Results: Doctors and Chinese staff trained locally were significantly more likely to feel more comfortable treating persons with physical than psychiatric problems, whereas Indian staff were less likely to express such reservations. HCPs generally accepted physical complaints at face value, while nurses tended to adopt critical attitudes toward patients and negatively perceived the utility of psychiatric treatment. For instance, nurses were more likely to judge persons with mental illness as not trying hard enough to get better, while admitting to having difficulty feeling compassion for those with psychiatric problems. Staff who received undergraduate and postgraduate training overseas were more likely to develop favourable attitudes toward PMI. Conclusions: The study has uncovered gaps in the understanding of mental disorders and their treatment. These knowledge deficits should be rectified so as to reduce negative attitudes toward PMI.

Nurses Opinions Regarding Delirium Care in the Older General Hospital Population and in Older Cardiac Surgery Patients Specifically: A Multicentre Survey among Dutch Nurses

Background: Delirium is a high prevalent postoperative complication in older cardiac surgery patients and can have drastic consequence for the patient. Preventive interventions, diagnosis and treatment of delirium require specialized knowledge and skills. Objective: To gain insight in the current opinion and beliefs of nurses in hospitals concerning prevention, diagnosis and treatment of delirium in older hospital patients in general and specifically in older cardiac surgery patients. Methods: In a cross-sectional study from February to July 2010, we distributed a survey on beliefs on delirium care among 368 nurses in three hospitals in the Netherlands, in one hospital in all wards with older patients and in two hospitals in the cardiac surgery wards only. Results: Although in literature incidence rates up to 54.9% in cardiac surgery patients in hospitals are reported, with a response rate of 68% (250), half of the nurses believe that the incidence of delirium is not even 10%. Two thirds think that delirium in patients is preventable. Although, the Delirium Observation Scale is most often used for screening delirium, nearly all nurses do not routinely screen patients for delirium. Opinions on delirium of nurses working in cardiac surgery wards did not differ from nurses caring for older patients in other hospital wards. Conclusions: Nurses do have knowledge on delirium care, but there is a gap between the reported incidence in literature and the estimation of the occurrence of delirium by nurses. A two-way causal relationship emerges: because nurses underestimate the occurrence, they do not screen patients on a routine basis. And because they do not screen patients on a routine basis they underestimate the incidence.