Chlorfenapyr poisoning:mechanisms,clinical presentations,and treatment strategies

BACKGROUND:Chlorfenapyr is used to kill insects that are resistant to organophosphorus insecticides.Chlorfenapyr poisoning has a high mortality rate and is difficult to treat.This article aims to review the mechanisms,clinical presentations,and treatment strategies for chlorfenapyr poisoning.DATA RESOURCES:We conducted a review of the literature using PubMed,Web of Science,and SpringerLink from their beginnings to the end of October 2023.The inclusion criteria were systematic reviews,clinical guidelines,retrospective studies,and case reports on chlorfenapyr poisoning that focused on its mechanisms,clinical presentations,and treatment strategies.The references in the included studies were also examined to identify additional sources.RESULTS:We included 57 studies in this review.Chlorfenapyr can be degraded into tralopyril,which is more toxic and reduces energy production by inhibiting the conversion of adenosine diphosphate to adenosine triphosphate.High fever and altered mental status are characteristic clinical presentations of chlorfenapyr poisoning.Once it occurs,respiratory failure occurs immediately,ultimately leading to cardiac arrest and death.Chlorfenapyr poisoning is diflcult to treat,and there is no specific antidote.CONCLUSION:Chlorfenapyr is a new pyrrole pesticide.Although it has been identified as a moderately toxic pesticide by the World Health Organization(WHO),the mortality rate of poisoned patients is extremely high.There is no specific antidote for chlorfenapyr poisoning.Therefore,based on the literature review,future efforts to explore rapid and effective detoxification methods,reconstitute intracellular oxidative phosphorylation couplings,identify early biomarkers of chlorfenapyr poisoning,and block the conversion of chlorfenapyr to tralopyril may be helpful for emergency physicians in the diagnosis and treatment of this disease.

Recent Advances for Global Perspectives on Etiology, Pathophysiology, Clinical Presentations, and Management of Moyamoya Disease

Moyamoya disease (MMD) is a condition characterized by the gradual narrowing and blockage of blood vessels in the brain, specifically those in the circle of Willis and the arteries that supply it. This results in reduced blood flow and oxygen to the brain, leading to progressive symptoms and potential complications. The underlying pathophysiological mechanism remains elucidated. However, recent studies have highlighted numerous etiologic factors: abnormal immune complex responses, susceptibility genes, branched-chain amino acids, antibodies, heritable diseases, and acquired diseases, which may be the great potential triggers for the development of moyamoya disease. Its clinical presentation has varying degrees from transient asymptomatic events to significant neurological deficits. Moyamoya disease (MMD) shows different patterns in children and adults. Children with MMD are more susceptible to ischemic events due to decreased blood flow to the brain. Conversely, adults with MMD are more prone to hemorrhagic events involving brain bleeding. Children with MMD may experience a range of symptoms including motor impairments, sensory issues, seizures, headaches, dizziness, cognitive delays, or ongoing neurological problems. Although adults may present with similar clinical symptoms as children, they are more prone to experiencing sudden onset intraventricular, subarachnoid, or intracerebral hemorrhages. One of the challenges in moyamoya disease is the potential for misdiagnosis or delayed diagnosis, particularly when physicians fail to consider MMD as a possible cause in stroke patients. This review aims to provide a comprehensive overview of recent global studies on the pathophysiology of MMD, along with advancements in its management. Additionally, the review will delve into various surgical treatment options for MMD, as well as its rare occurrence alongside atrioventricular malformations. Exciting prospects include the use of autologous bone marrow transplant and the potential role of Connexin 43 protein treatment in the development of moyamoya disease.

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.

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.

Cultivate Critical Thinking Ability via Students’ Presentations in College English Classes

In the new era when demands for flexible intellectual skills are increasing,strengthening the cultivation of critical thinking ability of students has become one of the key purposes of higher education.This paper intends to discuss how to cultivate students’critical thinking ability through English classroom presentations.It points out that during the whole process,teachers’guidance plays an indispensable role.Only when both teachers and students are aware that classroom presentations are a golden opportunity for the cultivation of students’critical thinking ability and carry this awareness into their English classes,can English presentations be brought into full play.

Research on Heterogeneous Information Network Link Prediction Based on Representation Learning

A heterogeneous information network,which is composed of various types of nodes and edges,has a complex structure and rich information content,and is widely used in social networks,academic networks,e-commerce,and other fields.Link prediction,as a key task to reveal the unobserved relationships in the network,is of great significance in heterogeneous information networks.This paper reviews the application of presentation-based learning methods in link prediction of heterogeneous information networks.This paper introduces the basic concepts of heterogeneous information networks,and the theoretical basis of representation learning,and discusses the specific application of the deep learning model in node embedding learning and link prediction in detail.The effectiveness and superiority of these methods on multiple real data sets are demonstrated by experimental verification.

A Hand Gesture Based Interactive Presentation System Utilizing Heterogeneous Cameras

In this paper, a real-time system that utilizes hand gestures to interactively control the presentation is proposed. The system employs a thermal camera for robust human body segmentation to handle the complex background and varying illumination posed by the projector. A fast and robust hand localization al- gorithm is proposed, with which the head, torso, and arm are sequentially localized. Hand trajectories are segmented and recognized as gestures for interactions. A dual-step calibration algorithm is utilized to map the interaction regions between the thermal camera and the projected contents by integrating a Web cam- era. Experiments show that the system has a high recognition rate for hand gestures, and corresponding interactions can be performed correctly.

Clinical and pathological portraits of axillary presentation breast cancer and effects of preoperative systemic therapy

There is a lack of investigation into the biological characteristics and preoperative systemic therapy （PST） for occult breast cancer （OBC）. For this study, departmental records in Breast Disease Center of Peking University First Hospital from January 2008 to December 2015 were retrospectively reviewed to identify cases of OBC. Eleven cases were included, and all patients were female, with a median age of 56 （range： 29-75） years. The sensitivity of magnetic resonance imaging （MRD was I00%, and the false positive rate was 33.3%. Based on histologic analysis of the axillary node, 9 （81.8%） cases were grade 3, and 2 （18.2%） cases were grade 2; 4 （36.4%） cases were 〉10% estrogen receptor （ER） positive and 6 （54.5%） human epidermal growth receptor 2 （HER2） positive. Nine cases （81.8%） exhibited over 30% Ki67 expression. PST was performed in 5 of the 11 cases. The lymph node response rate was 100% （5/5）, but no complete remission was achieved. In conclusion, aggressive subtypes were predominant among the included cases, and PST should be considered for OBC treatment options.

Presentation on the Electronic Control System of Space Solar Telescope

This paper gives the brief view of the electronic control system of SPACE SOLAR TELESCOPE (SST), especially the On Board Data Handling unit (OBDH) on the SST which control the operation of the instrument, acquire data and make data analysis and storage. In OBDH, the Scientific Data Unit (SDU) is a special unit that requires high speed computer. In this paper gives a brief comparison of two possible choices and discuss selection of electronic parts in the space environment.

CAD/CAN APPLICATION IN DENTISTRY: A PRESENTATION OF THE DURET SYSTEM

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Late presentation of dural tears:Two case reports and review of literature

BACKGROUND The late presentation of dural tears(LPDT)has a low incidence rate and hidden symptoms and is easily ignored in clinical practice.If the disease is not treated in time,a series of complications may occur,including low intracranial pressure headache,infection,pseudodural cyst formation,and sinus formation.Here,we describe two cases of LPDT.CASE SUMMARY Two patients had sudden fever 1 wk after lumbar surgery.Physical examination showed obvious tenderness in the operation area.The patients were confirmed as having LPDT by lumbar magnetic resonance imaging and surgical exploration.One case was caused by continuous negative pressure suction and malnutrition,and the other was caused by decreased dural ductility and low postoperative nutritional status.The first symptom of both patients was fever,with occasional headache.Both patients underwent secondary surgery to treat the LPDT.Dural defects were observed and dural sealants were used to seal the dural defects,then drainage tubes were retained for drainage.After the operation,the patients were treated with antibiotics and the patients’surgical incisions healed well,without fever or incision tenderness.Both recovered and were discharged 1 wk after the operation.CONCLUSION LPDT is a rare complication of spinal surgery or neurosurgery that has hidden symptoms and can easily be overlooked.Since it may cause a series of complic-ations,LPDT needs to be actively addressed in clinical practice.

Celebrating the 70th Anniversary--National University of Defense Technology,1953-2023 Special Section on Complex Systems Theory and Practice

In the 21st century,a new round of scientifi c and technological revolution represented by digitalization,networking and intelligence has caused a change in the scientific research paradigm,and the research of complex systems has become the main driving force for the change of the scientific research paradigm.

Capacity Optimization Configuration of Hydrogen Production System for Offshore Surplus Wind Power

To solve the problem of residual wind power in offshore wind farms,a hydrogen production system with a reasonable capacity was configured to enhance the local load of wind farms and promote the local consumption of residual wind power.By studying the mathematical model of wind power output and calculating surplus wind power,as well as considering the hydrogen production/storage characteristics of the electrolyzer and hydrogen storage tank,an innovative capacity optimization allocation model was established.The objective of the model was to achieve the lowest total net present value over the entire life cycle.The model took into account the cost-benefit breakdown of equipment end-of-life cost,replacement cost,residual value gain,wind abandonment penalty,hydrogen transportation,and environmental value.The MATLAB-based platform invoked the CPLEX commercial solver to solve the model.Combined with the analysis of the annual average wind speed data from an offshore wind farm in Guangdong Province,the optimal capacity configuration results and the actual operation of the hydrogen production system were obtained.Under the calculation scenario,this hydrogen production system could consume 3,800 MWh of residual electricity from offshore wind power each year.It could achieve complete consumption of residual electricity from wind power without incurring the penalty cost of wind power.Additionally,it could produce 66,500 kg of green hydrogen from wind power,resulting in hydrogen sales revenue of 3.63 million RMB.It would also reduce pollutant emissions from coal-based hydrogen production by 1.5 tons and realize an environmental value of 4.83 million RMB.The annual net operating income exceeded 6 million RMB and the whole life cycle NPV income exceeded 50 million RMB.These results verified the feasibility and rationality of the established capacity optimization allocation model.The model could help advance power system planning and operation research and assist offshore wind farm operators in improving economic and environmental benefits.

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.

Unusual Presentation of a Large Multi-Septated Cystic Hygroma: A Case Report and Comprehensive Literature Review

Background: Cystic hygromas are primarily found in the cervicofacial, thoracic, and abdominal regions, with limited occurrences in other areas. Despite existing literature on this condition, comprehensive descriptions and MRI findings of cystic hygromas in the extremities are rare. Aim: This case report aims to present a unique instance of a cystic hygroma in the left thigh. The objective is to provide detailed insights into the characteristics of this atypical presentation. Case Presentation: The case involves a 2-year-10 month-old girl with a cystic hygroma in her left thigh. The report includes a comprehensive description of the lesion’s clinical features and diagnostic evaluation, emphasizing the MRI findings to enhance understanding of this rare occurrence. Conclusion: This case report highlights the rarity of cystic hygromas outside the cervicofacial, thoracic, and abdominal regions, explicitly focusing on the occurrence in the left thigh. By presenting detailed insights into the clinical features, MRI findings, histopathological findings, and the surgical approach employed, this report contributes to the existing knowledge on this condition in atypical locations and informs future treatment strategies.

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.

An Incidental Finding and Unusual Presentation of Atypical Coccidioidomycosis in a 72-Year-Old Man: A Case Report

This case report presents an unusual and challenging diagnostic scenario involving a 72-year-old man who recently returned from a trip to Maui, Hawaii. While in Maui, the patient presented with a fever and fatigue that resolved spontaneously. However, he had an observable rash on his head and was given a steroid injection to resolve the rash. Later on his trip, the patient experienced a dry, nonproductive cough which resolved with a five-day course of prednisone. While visiting Michigan, the patient began to experience neck pain and visited Troy Beaumont Hospital for further treatment. Meningitis tests were negative. Vancomycin was given due to the detection of gram positive coccidioidomycosis in the culture, but this was later proven to be a contaminant. Coccidiomycosis does not initially have specific symptoms. Despite negative coccidioidomycosis antigen tests, the patient exhibited features more consistent with blastomycosis and cryptococcus, highlighting the complexities of diagnosing fungal infections with atypical presentations. The case emphasizes the importance of considering alternative fungal pathogens native to endemic regions and pursuing comprehensive diagnostic measures to establish an accurate diagnosis. Lastly, the discussion about recommendations for antifungal therapy and preventative measures for individuals at risk of respiratory fungal infections is critically important for the advancement of early detection of fungal infections.

“主题陈述+应用实践”模式在“社会学概论”课程教学中的运用——以H高校社会工作专业为例

文章通过对H高校“社会学概论”课程传统教学模式进行诊析,发现存在教学内容上重知识传授、轻立德树人;教学设计上重理论灌输、轻实践教学;教学方法上重教师主导、轻学生参与等问题。因此,课程教学团队以建构主义学习理论为指导,秉持“为学习者设计教学”的理念,创新性地提出以“主题陈述+应用实践”(Presentation+Practice)为核心的教学模式。该模式在理论教学部分增设“悦读经典”新环节,与学生共同选择高质量文献进行研讨,培养学生的研究能力与表达能力;在实践教学部分,创造性地移植并导入工科专业的“课程设计”环节,要求学生选择研究主题进行社会实践、撰写研究报告,帮助学生初步形成了运用专业理论知识和技术解决相关工作中实际问题的本领,提升了学生的能力。这一教学模式的创新契合“00后”大学生的学情特点,取得了显著的教学成效。

PRESENTATION在ESL课堂上的应用

PRESENTATION作为第二外语教学课堂交际活动的一种形式,已经得到越来越广泛地应用。本文作者论述了PRESENTATION应用于第二外语课堂教学的理论依据,介绍了它的优势,并且谈到了教师的策划及组织工作。对于PRESENTATION的准备及内容编排也做了较为详尽的阐述。

提高高校文科课堂教学效能的实证研究——基于Presentation教学法

以Presentation为主的互动教学法的实证探索,对提高课堂教学效能的实践效果,特别是对学生挑战权威意识、批判性阅读和批判性思维学术研究能力和发现、分析、解决问题、团队合作能力的提高进行质与量的分析,说明以Presentation为主的互动教学法是提高高校文科课堂效能的有效方法,并对其教学的效能的提高提供可操作的保障性建议。