General anesthetic agents can impact brain function through interactions with neurons and their effects on glial cells.Oligodendrocytes perform essential roles in the central nervous system,including myelin sheath for...General anesthetic agents can impact brain function through interactions with neurons and their effects on glial cells.Oligodendrocytes perform essential roles in the central nervous system,including myelin sheath formation,axonal metabolism,and neuroplasticity regulation.They are particularly vulnerable to the effects of general anesthetic agents resulting in impaired proliferation,differentiation,and apoptosis.Neurologists are increasingly interested in the effects of general anesthetic agents on oligodendrocytes.These agents not only act on the surface receptors of oligodendrocytes to elicit neuroinflammation through modulation of signaling pathways,but also disrupt metabolic processes and alter the expression of genes involved in oligodendrocyte development and function.In this review,we summarize the effects of general anesthetic agents on oligodendrocytes.We anticipate that future research will continue to explore these effects and develop strategies to decrease the incidence of adverse reactions associated with the use of general anesthetic agents.展开更多
The traditional standard wet sieving method uses steel sieves with aperture?0.063 mm and can only determine the particle size distribution(PSD)of gravel and sand in general soil.This paper extends the traditional meth...The traditional standard wet sieving method uses steel sieves with aperture?0.063 mm and can only determine the particle size distribution(PSD)of gravel and sand in general soil.This paper extends the traditional method and presents an extended wet sieving method.The extended method uses both the steel sieves and the nylon filter cloth sieves.The apertures of the cloth sieves are smaller than 0.063 mm and equal 0.048 mm,0.038 mm,0.014 mm,0.012 mm,0.0063 mm,0.004 mm,0.003 mm,0.002 mm,and 0.001 mm,respectively.The extended method uses five steps to separate the general soil into many material sub-groups of gravel,sand,silt and clay with known particle size ranges.The complete PSD of the general soil is then calculated from the dry masses of the individual material sub-groups.The extended method is demonstrated with a general soil of completely decomposed granite(CDG)in Hong Kong,China.The silt and clay materials with different particle size ranges are further examined,checked and verified using stereomicroscopic observation,physical and chemical property tests.The results further confirm the correctness of the extended wet sieving method.展开更多
Neuroscientists have recognized the importance of astrocytes in regulating neurological function and their influence on the release of glial transmitters.Few studies,however,have focused on the effects of general anes...Neuroscientists have recognized the importance of astrocytes in regulating neurological function and their influence on the release of glial transmitters.Few studies,however,have focused on the effects of general anesthetic agents on neuroglia or astrocytes.Astrocytes can also be an important target of general anesthetic agents as they exert not only sedative,analgesic,and amnesic effects but also mediate general anesthetic-induced neurotoxicity and postoperative cognitive dysfunction.Here,we analyzed recent advances in understanding the mechanism of general anesthetic agents on astrocytes,and found that exposure to general anesthetic agents will destroy the morphology and proliferation of astrocytes,in addition to acting on the receptors on their surface,which not only affect Ca^(2+)signaling,inhibit the release of brain-derived neurotrophic factor and lactate from astrocytes,but are even involved in the regulation of the pro-and anti-inflammatory processes of astrocytes.These would obviously affect the communication between astrocytes as well as between astrocytes and neighboring neurons,other neuroglia,and vascular cells.In this review,we summarize how general anesthetic agents act on neurons via astrocytes,and explore potential mechanisms of action of general anesthetic agents on the nervous system.We hope that this review will provide a new direction for mitigating the neurotoxicity of general anesthetic agents.展开更多
Introduction: Gastroesophageal reflux disease (GERD) is a benign and chronic disease that can impair the quality of life. Objective: To study the epidemiological, clinical aspects and factors associated with typical G...Introduction: Gastroesophageal reflux disease (GERD) is a benign and chronic disease that can impair the quality of life. Objective: To study the epidemiological, clinical aspects and factors associated with typical GERD in the general population of Parakou in the Republic of Benin. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection which took place from May 1, 2019 to June 30, 2019. The study population consisted of any subject aged at least 15 years and living in Parakou. Subjects aged at least 15 years, present on the day of the survey and having given their free and informed verbal consent were included. The Short form of QRS®(Reflux-Qual Short form) questionnaire and the “Hospital Anxiety and Depression” score were used to assess the quality of life and anxiety/depression, respectively. The sampling was probabilistic through a 2-stage cluster sampling. The variable of interest was the presence of GERD. Results: Out of 390 subjects surveyed, 28 had symptoms of typical GERD, representing a prevalence of 7.18%. The average age of these subjects was 27.11 ± 7.88 years. Fifteen subjects (53.57%) were male, giving a sex ratio of 1.15. Fourteen (50%) had a secondary level of education, 12 (42.86%) were pupils/students, 18 (64.29%) were single. The monthly income of 22 subjects (78.57%) was lower than the guaranteed interprofessional minimum wage (40,000 FCFA). The average duration of progression of symptoms was 15.89 ± 4.97 months. Symptoms occurred less than twice a week in 22 subjects (78.57%). The clinical manifestations were both diurnal and nocturnal in 12 subjects (42.86%). None of the 28 subjects with GERD had clinical warning signs. Asthma, diabetes, consumption of high fat or spice foods, carbonated drinks, non-steroidal anti-inflammatory drugs, alcoholic beverages and tobacco were statistically associated with the occurrence of GERD. Each of the 28 subjects had at least one associated factor. A significant impair in quality of life was observed in 27 patients (96.43%). Conclusion: Typical GERD is relatively common in the general population of Parakou in the Republic of Benin. It often affects young males. Among the risk factors identified, the most common are carbonated drinks, spicy meals and diabetes. GERD significantly impairs quality of life. Raising awareness about the disease and its associated factors is necessary among the general population.展开更多
Arbuscular mycorrhizae(AM)fungi form symbiotic associations with plant roots,providing nutritional benefits and promoting plant growth and defenses against various stresses.Metabolic changes in the roots during AM fun...Arbuscular mycorrhizae(AM)fungi form symbiotic associations with plant roots,providing nutritional benefits and promoting plant growth and defenses against various stresses.Metabolic changes in the roots during AM fungal colonization are key to understanding the development and maintenance of these symbioses.Here,we investigated metabolic changes in the roots of peanut(Arachis hypogaea L.)plants during the colonization and development of AM symbiosis,and compared them to uncolonized roots.The primary changes during the initial stage of AM colonization were in the contents and compositions of phenylpropanoid and flavonoid compounds.These compounds function in signaling pathways that regulate recognition,interactions,and pre-colonization between roots and AM fungi.Flavonoid compounds decreased by 25%when the symbiosis was fully established compared to the initial colonization stage.After AM symbiosis was established,general metabolism strongly shifted toward the formation of lipids,amino acids,carboxylic acids,and carbohydrates.Lipid compounds increased by 8.5%from the pre-symbiotic stage to well-established symbiosis.Lyso-phosphatidylcholines,which are signaling compounds,were only present in AM roots,and decreased in content after the symbiosis was established.In the initial stage of AM establishment,the content of salicylic acid increased two-fold,whereas jasmonic acid and abscisic acid decreased compared to uncolonized roots.The jasmonic acid content decreased in roots after the symbiosis was well established.AM symbiosis was associated with high levels of calcium,magnesium,and D-(+)-mannose,which stimulated seedling growth.Overall,specific metabolites that favor the establishment of AM symbiosis were common in the roots,primarily during early colonization,whereas general metabolism was strongly altered when AM symbiosis was well-established.In conclusion,specialized metabolites function as signaling compounds to establish AM symbiosis.These compounds are no longer produced after the symbiosis between the roots and AM becomes fully established.展开更多
Biologically,because of the impact of reproduction period and nonlocal dispersal of HIV-infected cells,time delay and spatial heterogeneity should be considered.In this paper,we establish an HIV infection model with n...Biologically,because of the impact of reproduction period and nonlocal dispersal of HIV-infected cells,time delay and spatial heterogeneity should be considered.In this paper,we establish an HIV infection model with nonlocal dispersal and infection age.Moreover,applying the theory of Fourier transformation and von Foerster rule,we transform the model to an integrodifferential equation with nonlocal time delay and dispersal.The well-posedness,positivity,and boundedness of the solution for the model are studied.展开更多
In the present paper,we prove the existence,non-existence and multiplicity of positive normalized solutions(λ_(c),u_(c))∈ℝ×H^(1)(ℝ^(N))to the general Kirchhoff problem-M\left(\int_{\mathbb{R}^N}\vert\nabla u\ve...In the present paper,we prove the existence,non-existence and multiplicity of positive normalized solutions(λ_(c),u_(c))∈ℝ×H^(1)(ℝ^(N))to the general Kirchhoff problem-M\left(\int_{\mathbb{R}^N}\vert\nabla u\vert^2{\rm d}x\right)\Delta u+\lambda u=g(u)~\hbox{in}~\mathbb{R}^N,u\in H^1(\mathbb{R}^N),N\geq 1,satisfying the normalization constraint\int_{\mathbb{R}^N}u^2{\rm d}x=c,where M∈C([0,∞))is a given function satisfying some suitable assumptions.Our argument is not by the classical variational method,but by a global branch approach developed by Jeanjean et al.[J Math Pures Appl,2024,183:44–75]and a direct correspondence,so we can handle in a unified way the nonlinearities g(s),which are either mass subcritical,mass critical or mass supercritical.展开更多
A new steganographic method by pixel-value differencing(PVD)using general quantization ranges of pixel pairs’difference values is proposed.The objective of this method is to provide a data embedding technique with a ...A new steganographic method by pixel-value differencing(PVD)using general quantization ranges of pixel pairs’difference values is proposed.The objective of this method is to provide a data embedding technique with a range table with range widths not limited to powers of 2,extending PVD-based methods to enhance their flexibility and data-embedding rates without changing their capabilities to resist security attacks.Specifically,the conventional PVD technique partitions a grayscale image into 1×2 non-overlapping blocks.The entire range[0,255]of all possible absolute values of the pixel pairs’grayscale differences in the blocks is divided into multiple quantization ranges.The width of each quantization range is a power of two to facilitate the direct embedding of the bit information with high embedding rates.Without using power-of-two range widths,the embedding rates can drop using conventional embedding techniques.In contrast,the proposed method uses general quantization range widths,and a multiple-based number conversion mechanism is employed skillfully to implement the use of nonpower-of-two range widths,with each pixel pair being employed to embed a digit in the multiple-based number.All the message bits are converted into a big multiple-based number whose digits can be embedded into the pixel pairs with a higher embedding rate.Good experimental results showed the feasibility of the proposed method and its resistance to security attacks.In addition,implementation examples are provided,where the proposed method adopts non-power-of-two range widths and employsmultiple-based number conversion to expand the data-hiding and steganalysis-resisting capabilities of other PVD methods.展开更多
In this paper,Let M_(n)denote the maximum of logarithmic general error distribution with parameter v≥1.Higher-order expansions for distributions of powered extremes M_(n)^(p)are derived under an optimal choice of nor...In this paper,Let M_(n)denote the maximum of logarithmic general error distribution with parameter v≥1.Higher-order expansions for distributions of powered extremes M_(n)^(p)are derived under an optimal choice of normalizing constants.It is shown that M_(n)^(p),when v=1,converges to the Frechet extreme value distribution at the rate of 1/n,and if v>1 then M_(n)^(p)converges to the Gumbel extreme value distribution at the rate of(loglogn)^(2)=(log n)^(1-1/v).展开更多
This paper aims to formalize a general definition of intelligence beyond human intelligence. We accomplish this by re-imagining the concept of equality as a fundamental abstraction for relation. We discover that the c...This paper aims to formalize a general definition of intelligence beyond human intelligence. We accomplish this by re-imagining the concept of equality as a fundamental abstraction for relation. We discover that the concept of equality = limits the sensitivity of our mathematics to abstract relationships. We propose a new relation principle that does not rely on the concept of equality but is consistent with existing mathematical abstractions. In essence, this paper proposes a conceptual framework for general interaction and argues that this framework is also an abstraction that satisfies the definition of Intelligence. Hence, we define intelligence as a formalization of generality, represented by the abstraction ∆∞Ο, where each symbol represents the concepts infinitesimal, infinite, and finite respectively. In essence, this paper proposes a General Language Model (GLM), where the abstraction ∆∞Ο represents the foundational relationship of the model. This relation is colloquially termed “The theory of everything”.展开更多
Biodiversity,large trees,and environmental conditions such as climate and soil have important effects on forest carbon stocks.However,recent studies in temperate forests suggest that the relative importance of these f...Biodiversity,large trees,and environmental conditions such as climate and soil have important effects on forest carbon stocks.However,recent studies in temperate forests suggest that the relative importance of these factors depends on tree mycorrhizal associations,whereby large-tree effects may be driven by ectomycorrhizal(EM)trees,diversity effects may be driven by arbuscular mycorrhizal(AM)trees,and environment effects may depend on differential climate and soil preferences of AM and EM trees.To test this hypothesis,we used forest-inventory data consisting of over 80,000 trees from 631 temperate-forest plots(30 m×30 m)across Northeast China to examine how biodiversity(species diversity and ecological uniqueness),large trees(top 1%of tree diameters),and environmental factors(climate and soil nutrients)differently regulate aboveground carbon stocks of AM trees,EM trees,and AM and EM trees combined(i.e.total aboveground carbon stock).We found that large trees had a positive effect on both AM and EM tree carbon stocks.However,biodiversity and environmental factors had opposite effects on AM vs.EM tree carbon stocks.Specifically,the two components of biodiversity had positive effects on AM tree carbon stocks,but negative effects on EM tree carbon stocks.Environmental heterogeneity(mean annual temperature and soil nutrients)also exhibited contrasting effects on AM and EM tree carbon stocks.Consequently,for the total carbon stock,the positive large-tree effect far surpasses the diversity and environment effect.This is mainly because when integrating AM and EM tree carbon stock into total carbon stock,the opposite diversity-effect(also environment-effect)on AM vs.EM tree carbon stock counteracts each other while the consistent positive large-tree effect on AM and EM tree carbon stock is amplified.In summary,this study emphasized a mycorrhizal viewpoint to better understand the determinants of overarching aboveground carbon profile across regional forests.展开更多
BACKGROUND Limited knowledge exists regarding the casual associations linking blood metabolites and the risk of developing colorectal cancer.AIM To investigate causal associations between blood metabolites and colon c...BACKGROUND Limited knowledge exists regarding the casual associations linking blood metabolites and the risk of developing colorectal cancer.AIM To investigate causal associations between blood metabolites and colon cancer.METHODS The study utilized a two-sample Mendelian randomization(MR)analysis to investigate the causal impact of 486 blood metabolites on colorectal cancer.The primary method of analysis used was the inverse variance weighted model.To further validate the results several sensitivity analyses were performed,including Cochran's Q test,MR-Egger intercept test,and MR robust adjusted profile score.These additional analyses were conducted to ensure the reliability and robustness of the findings.RESULTS After rigorous selection for genetic variation,486 blood metabolites were included in the MR analysis.We found Mannose[odds ratio(OR)=2.09(1.10-3.97),P=0.024],N-acetylglycine[OR=3.14(1.78-5.53),P=7.54×10^(-8)],X-11593-O-methylascorbate[OR=1.68(1.04-2.72),P=0.034],1-arachidonoylglycerophosphocholine[OR=4.23(2.51-7.12),P=6.35×10^(-8)]and 1-arachidonoylglycerophosphoethanolamine 4[OR=3.99(1.17-13.54),P=0.027]were positively causally associated with colorectal cancer,and we also found a negative causal relationship between Tyrosine[OR=0.08(0.01-0.63),P=0.014],Urate[OR=0.25(0.10-0.62),P=0.003],N-acetylglycine[0.73(0.54-0.98),P=0.033],X-12092[OR=0.89(0.81-0.99),P=0.028],Succinylcarnitine[OR=0.48(0.27-0.84),P=0.09]with colorectal cancer.A series of sensitivity analyses were performed to confirm the rigidity of the results.CONCLUSION This study showed a causal relationship between 10 blood metabolites and colorectal cancer,of which 5 blood metabolites were found to be causal for the development of colorectal cancer and were confirmed as risk factors.The other five blood metabolites are protective factors.展开更多
Discrete feedback control was designed to stabilize an unstable hybrid neutral stochastic differential delay system(HNSDDS) under a highly nonlinear constraint in the H_∞ and exponential forms.Nevertheless,the existi...Discrete feedback control was designed to stabilize an unstable hybrid neutral stochastic differential delay system(HNSDDS) under a highly nonlinear constraint in the H_∞ and exponential forms.Nevertheless,the existing work just adapted to autonomous cases,and the obtained results were mainly on exponential stabilization.In comparison with autonomous cases,non-autonomous systems are of great interest and represent an important challenge.Accordingly,discrete feedback control has here been adjusted with a time factor to stabilize an unstable non-autonomous HNSDDS,in which new Lyapunov-Krasovskii functionals and some novel technologies are adopted.It should be noted,in particular,that the stabilization can be achieved not only in the routine H_∞ and exponential forms,but also the polynomial form and even a general form.展开更多
During the 1980s, as part of a policy of liberalization, following budgetary cuts linked to the implementation of structural adjustment programs, management responsibilities for AHAs were transferred from ONAHA to coo...During the 1980s, as part of a policy of liberalization, following budgetary cuts linked to the implementation of structural adjustment programs, management responsibilities for AHAs were transferred from ONAHA to cooperatives concerned. Due to lack of financial resources, but also because of poor management, everywhere in Niger we are witnessing an accelerated deterioration of the irrigation infrastructure of hydro-agricultural developments. Institutional studies carried out on this situation led the State of Niger to initiate a reform of the governance of hydro-agricultural developments, by streng-thening the status of ONAHA, by creating an Association of Irrigation Water Users (AUEI) and by restructuring the old cooperatives. Indeed, this research aims to analyze the creation of functional and sustainable Irrigation Water User Associations (AUEI) in Niger in a context of reform of the irrigation sector, and based on the experience of the Konni AHA. It is based on a methodological approach which takes into account documentary research and the collection of data from 115 farmers, selected by reasoned choice and directly concerned by the management of the irrigated area. The data collected was analyzed and the results were analyzed using the systemic approach and the diagnostic process. The results show that the main mission of the AUEI is to ensure better management of water, hydraulic equipment and infrastructure on the hydro-agricultural developments of Konni. The creation of the Konni AUEI was possible thanks to massive support from the populations and authorities in the implementation process. After its establishment, the AUEI experienced a certain lethargy for some time due to the rehabilitation work of the AHA but currently it is functional and operational in terms of associative life and governance. Thus, the constraints linked to the legal system, the delay in the completion of the work, the uncertainties of access to irrigation water but also the problems linked to the change in mentality of certain ONAHA agents constitute the challenges that must be resolved in the short term for the operationalization of the Konni AUEI.展开更多
Background:Shared decision-making(SDM)implementation is a priority for Australian health systems,including general practices but it remains complex for specific groups like older rural Australians.We initiated a quali...Background:Shared decision-making(SDM)implementation is a priority for Australian health systems,including general practices but it remains complex for specific groups like older rural Australians.We initiated a qualitative study with older rural Australians to explore barriers to and facilitators of SDM in local general practices.Methods:We conducted a patient-oriented research,partnering with older rural Australians,families,and health service providers in research design.Participants who visited general practices were purposively sampled from five small rural towns in South Australia.A semi-structured interview guide was used for interviews and reflexive thematic coding was conducted.Results:Telephone interviews were held with 27 participants.Four themes were identified around older rural adults’involvement in SDM:(1)Understanding of"patient involvement";(2)Positive and negative outcomes;(3)Barriers to SDM;and(4)Facilitators to SDM.Understanding of patient involvement in SDM considerably varied among participants,with some reporting their involvement was contingent on the“opportunity to ask questions”and the“treatment choices”offered to them.Alongside the opportunity for involvement,barriers such as avoidance of cultural care and a lack of continuity of care are new findings.Challenges encountered in SDM implementation also included resource constraints and time limitations in general practices.Rural knowledge of general practitioners and technology integration in consultations were viewed as potential enablers..Conclusion:Adequate resources and well-defined guidelines about the process should accompany the implementation of SDM in rural general practices of South Australia.Innovative strategies by general practitioners promoting health literacy and culturally-tailored communication approaches could increase older rural Australians'involvement in general.展开更多
BACKGROUND General anesthesia is commonly used in the surgical management of gastrointestinal tumors;however,it can lead to emergence agitation(EA).EA is a common complication associated with general anesthesia,often ...BACKGROUND General anesthesia is commonly used in the surgical management of gastrointestinal tumors;however,it can lead to emergence agitation(EA).EA is a common complication associated with general anesthesia,often characterized by behaviors,such as crying,struggling,and involuntary limb movements in patients.If treatment is delayed,there is a risk of incision cracking and bleeding,which can significantly affect surgical outcomes.Therefore,having a proper understanding of the factors influencing the occurrence of EA and implementing early preventive measures may reduce the incidence of agitation during the recovery phase from general anesthesia,which is beneficial for improving patient prognosis.AIM To analyze influencing factors and develop a risk prediction model for EA occurrence following general anesthesia for primary liver cancer.METHODS Retrospective analysis of clinical data from 200 patients who underwent hepatoma resection under general anesthesia at Wenzhou Central Hospital(January 2020 to December 2023)was conducted.Post-surgery,the Richmond Agitation-Sedation Scale was used to evaluate EA presence,noting EA incidence after general anesthesia.Patients were categorized by EA presence postoperatively,and the influencing factors were analyzed using logistic regression.A nomogram-based risk prediction model was constructed and evaluated for differentiation and fit using receiver operating characteristics and calibration curves.RESULTS EA occurred in 51(25.5%)patients.Multivariate analysis identified advanced age,American Society of Anesthesiologists(ASA)grade Ⅲ,indwelling catheter use,and postoperative pain as risk factors for EA(P<0.05).Conversely,postoperative analgesia was a protective factor against EA(P<0.05).The area under the curve of the nomogram was 0.972[95%confidence interval(CI):0.947-0.997]for the training set and 0.979(95%CI:0.951-1.000)for the test set.Hosmer-Lemeshow test showed a good fit(χ^(2)=5.483,P=0.705),and calibration curves showed agreement between predicted and actual EA incidence.CONCLUSION Age,ASA grade,catheter use,postoperative pain,and analgesia significantly influence EA occurrence.A nomogram constructed using these factors demonstrates strong predictive accuracy.展开更多
Background: Flow FL-100 is a transcranial direct current stimulation (tDCS) device self-administered by a patient at home in combination with a software application delivered wellbeing behaviour therapy training. tDCS...Background: Flow FL-100 is a transcranial direct current stimulation (tDCS) device self-administered by a patient at home in combination with a software application delivered wellbeing behaviour therapy training. tDCS has evidence of effectiveness in treating symptoms of depression. Purpose/Aim: This post marketing study evaluated the effect of Flow on depression for primary care general practice patients with depression symptoms. Methods: Open-label patient cohort design with no control group. Inclusion criteria were aged 18 years or over and reporting depression symptoms. Participants self-administered five 30 minute tDCS sessions per week for the first three weeks, and then 3 sessions per week following this. Three, six and ten week assessment with participant self-report measure: Montgomery- Åsberg Depression Rating Scale (MADRS-S). Results: MADRS-S remission rates were between 29% - 30% at three weeks, 33% - 34% at six-weeks and 50% at 10-weeks treatment. There was a significant improvement in MADRS-S with large effect sizes at all time points. Conclusions: Flow tDCS can be delivered through a primary healthcare general practice service and patients will choose to use. Flow tDCS provides an effective depression treatment in addition and as an alternative to antidepressants and psychotherapy. tDCS has evidence as an effective depression treatment, and the widespread availability of tDCS in primary care general practice should be considered.展开更多
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 stud...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.展开更多
Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anest...Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anesthesia is required. The objective of the study was to evaluate the analgesic effectiveness of 4 analgesic techniques performed during cesarean section under general anesthesia in two centers with different anesthetic practices (North Franche Comté Hospital and Omar Bongo Ondimba Army Training Hospital). Method: This is a retrospective and descriptive study over 2 years, from January 1, 2019 to December 31, 2020. It involved evaluating the analgesic effectiveness and tolerance of morphine in the epidural catheter, wound infiltration, intravenous analgesia and Transversus Abdominous Plane block (TAP block) from the post-anesthesia care unit (PACU) until the 4<sup>th</sup> post-operative day. Results: Of the 354 cesarean sections performed, 84 (11.14%) received general anesthesia. The average age was 32.27 years. Acute fetal distress was the first indication for cesarean section (45.2%), followed by hemorrhagic placenta previa (10.7%) and prolapse of the cord (8.33%). Morphine in the epidural catheter was the most used (47.6%) followed by parietal infiltration (36.9%), intravenous analgesia (13.1%) and TAP block (2.38%). The analgesic effectiveness was comparable between the techniques from postoperative day 0 to day 4. No difference in side effects. Postoperative morphine consumption was significantly reduced (p = 0.011) in the infiltration (9 mg) and TAP block (9mg) groups compared to the epidural catheter (16 mg) and intravenous analgesia (17 mg). No difference in 02 rehabilitation criteria (ambulation, first bowel movement). No difference in the occurrence of chronic pain. Conclusion: In the event of a cesarean section under general anesthesia, there are effective and well-tolerated alternatives to neuraxial anesthesia, particularly regional anesthesia techniques (nerve blocks), particularly in countries with low availability of morphine.展开更多
Planck scale plays a vital role in describing fundamental forces. Space time describes strength of fundamental force. In this paper, Einstein’s general relativity equation has been described in terms of contraction a...Planck scale plays a vital role in describing fundamental forces. Space time describes strength of fundamental force. In this paper, Einstein’s general relativity equation has been described in terms of contraction and expansion forces of space time. According to this, the space time with Planck diameter is a flat space time. This is the only diameter of space time that can be used as signal transformation in special relativity. This space time diameter defines the fundamental force which belongs to that space time. In quantum mechanics, this space time diameter is only the quantum of space which belongs to that particular fundamental force. Einstein’s general relativity equation and Planck parameters of quantum mechanics have been written in terms of equations containing a constant “K”, thus found a new equation for transformation of general relativity space time in to quantum space time. In this process of synchronization, there is a possibility of a new fundamental force between electromagnetic and gravitational forces with Planck length as its space time diameter. It is proposed that dark matter is that fundamental force carrying particle. By grand unification equation with space-time diameter, we found a coupling constant as per standard model “α<sub>s</sub>” for that fundamental force is 1.08 × 10<sup>-23</sup>. Its energy calculated as 113 MeV. A group of experimental scientists reported the energy of dark matter particle as 17 MeV. Thorough review may advance science further.展开更多
基金supported by the Natural Science Foundation of Zhejiang Province(LZ22H090002,2014C33170)National Natural Science Foundation of China(82171260,81641042,81471240)。
文摘General anesthetic agents can impact brain function through interactions with neurons and their effects on glial cells.Oligodendrocytes perform essential roles in the central nervous system,including myelin sheath formation,axonal metabolism,and neuroplasticity regulation.They are particularly vulnerable to the effects of general anesthetic agents resulting in impaired proliferation,differentiation,and apoptosis.Neurologists are increasingly interested in the effects of general anesthetic agents on oligodendrocytes.These agents not only act on the surface receptors of oligodendrocytes to elicit neuroinflammation through modulation of signaling pathways,but also disrupt metabolic processes and alter the expression of genes involved in oligodendrocyte development and function.In this review,we summarize the effects of general anesthetic agents on oligodendrocytes.We anticipate that future research will continue to explore these effects and develop strategies to decrease the incidence of adverse reactions associated with the use of general anesthetic agents.
基金The work described in this paper was partially supported by grants from the Research Grant Council of the Hong Kong Special Administrative Region,China(Project Nos.HKU 17207518 and R5037-18).
文摘The traditional standard wet sieving method uses steel sieves with aperture?0.063 mm and can only determine the particle size distribution(PSD)of gravel and sand in general soil.This paper extends the traditional method and presents an extended wet sieving method.The extended method uses both the steel sieves and the nylon filter cloth sieves.The apertures of the cloth sieves are smaller than 0.063 mm and equal 0.048 mm,0.038 mm,0.014 mm,0.012 mm,0.0063 mm,0.004 mm,0.003 mm,0.002 mm,and 0.001 mm,respectively.The extended method uses five steps to separate the general soil into many material sub-groups of gravel,sand,silt and clay with known particle size ranges.The complete PSD of the general soil is then calculated from the dry masses of the individual material sub-groups.The extended method is demonstrated with a general soil of completely decomposed granite(CDG)in Hong Kong,China.The silt and clay materials with different particle size ranges are further examined,checked and verified using stereomicroscopic observation,physical and chemical property tests.The results further confirm the correctness of the extended wet sieving method.
基金supported by the National Natural Science Foundation of China,Nos.82171260,81641042,81471240the Natural Science Foundation of Zhejiang Province,Nos.LZ22H090002 and 2014C33170(all to ZH)。
文摘Neuroscientists have recognized the importance of astrocytes in regulating neurological function and their influence on the release of glial transmitters.Few studies,however,have focused on the effects of general anesthetic agents on neuroglia or astrocytes.Astrocytes can also be an important target of general anesthetic agents as they exert not only sedative,analgesic,and amnesic effects but also mediate general anesthetic-induced neurotoxicity and postoperative cognitive dysfunction.Here,we analyzed recent advances in understanding the mechanism of general anesthetic agents on astrocytes,and found that exposure to general anesthetic agents will destroy the morphology and proliferation of astrocytes,in addition to acting on the receptors on their surface,which not only affect Ca^(2+)signaling,inhibit the release of brain-derived neurotrophic factor and lactate from astrocytes,but are even involved in the regulation of the pro-and anti-inflammatory processes of astrocytes.These would obviously affect the communication between astrocytes as well as between astrocytes and neighboring neurons,other neuroglia,and vascular cells.In this review,we summarize how general anesthetic agents act on neurons via astrocytes,and explore potential mechanisms of action of general anesthetic agents on the nervous system.We hope that this review will provide a new direction for mitigating the neurotoxicity of general anesthetic agents.
文摘Introduction: Gastroesophageal reflux disease (GERD) is a benign and chronic disease that can impair the quality of life. Objective: To study the epidemiological, clinical aspects and factors associated with typical GERD in the general population of Parakou in the Republic of Benin. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection which took place from May 1, 2019 to June 30, 2019. The study population consisted of any subject aged at least 15 years and living in Parakou. Subjects aged at least 15 years, present on the day of the survey and having given their free and informed verbal consent were included. The Short form of QRS®(Reflux-Qual Short form) questionnaire and the “Hospital Anxiety and Depression” score were used to assess the quality of life and anxiety/depression, respectively. The sampling was probabilistic through a 2-stage cluster sampling. The variable of interest was the presence of GERD. Results: Out of 390 subjects surveyed, 28 had symptoms of typical GERD, representing a prevalence of 7.18%. The average age of these subjects was 27.11 ± 7.88 years. Fifteen subjects (53.57%) were male, giving a sex ratio of 1.15. Fourteen (50%) had a secondary level of education, 12 (42.86%) were pupils/students, 18 (64.29%) were single. The monthly income of 22 subjects (78.57%) was lower than the guaranteed interprofessional minimum wage (40,000 FCFA). The average duration of progression of symptoms was 15.89 ± 4.97 months. Symptoms occurred less than twice a week in 22 subjects (78.57%). The clinical manifestations were both diurnal and nocturnal in 12 subjects (42.86%). None of the 28 subjects with GERD had clinical warning signs. Asthma, diabetes, consumption of high fat or spice foods, carbonated drinks, non-steroidal anti-inflammatory drugs, alcoholic beverages and tobacco were statistically associated with the occurrence of GERD. Each of the 28 subjects had at least one associated factor. A significant impair in quality of life was observed in 27 patients (96.43%). Conclusion: Typical GERD is relatively common in the general population of Parakou in the Republic of Benin. It often affects young males. Among the risk factors identified, the most common are carbonated drinks, spicy meals and diabetes. GERD significantly impairs quality of life. Raising awareness about the disease and its associated factors is necessary among the general population.
基金supported by the National Key R&D Program of China(2022YFD1000105)the Key R&D Program of Shandong Province,China(2021CXGC010804)+5 种基金the Taishan Scholars Project,China(202211275)the Youth Found of Shandong Natural Science Foundation,China(ZR2021QC163)the Natural Science Foundation of Shandong Province,China(ZR2020MC094)the Strategic Academic Leadership Program“Priority 2030”of the Kazan Federal University,Russiathe RUDN University Strategic Academic Leadership Program,Chinathe 2022 High-level Talent Innovation and Entrepreneurship(Platform)Project of Linyi,China。
文摘Arbuscular mycorrhizae(AM)fungi form symbiotic associations with plant roots,providing nutritional benefits and promoting plant growth and defenses against various stresses.Metabolic changes in the roots during AM fungal colonization are key to understanding the development and maintenance of these symbioses.Here,we investigated metabolic changes in the roots of peanut(Arachis hypogaea L.)plants during the colonization and development of AM symbiosis,and compared them to uncolonized roots.The primary changes during the initial stage of AM colonization were in the contents and compositions of phenylpropanoid and flavonoid compounds.These compounds function in signaling pathways that regulate recognition,interactions,and pre-colonization between roots and AM fungi.Flavonoid compounds decreased by 25%when the symbiosis was fully established compared to the initial colonization stage.After AM symbiosis was established,general metabolism strongly shifted toward the formation of lipids,amino acids,carboxylic acids,and carbohydrates.Lipid compounds increased by 8.5%from the pre-symbiotic stage to well-established symbiosis.Lyso-phosphatidylcholines,which are signaling compounds,were only present in AM roots,and decreased in content after the symbiosis was established.In the initial stage of AM establishment,the content of salicylic acid increased two-fold,whereas jasmonic acid and abscisic acid decreased compared to uncolonized roots.The jasmonic acid content decreased in roots after the symbiosis was well established.AM symbiosis was associated with high levels of calcium,magnesium,and D-(+)-mannose,which stimulated seedling growth.Overall,specific metabolites that favor the establishment of AM symbiosis were common in the roots,primarily during early colonization,whereas general metabolism was strongly altered when AM symbiosis was well-established.In conclusion,specialized metabolites function as signaling compounds to establish AM symbiosis.These compounds are no longer produced after the symbiosis between the roots and AM becomes fully established.
基金Supported by Funding for the National Natural Science Foundation of China(12201557,12001483,61807006)。
文摘Biologically,because of the impact of reproduction period and nonlocal dispersal of HIV-infected cells,time delay and spatial heterogeneity should be considered.In this paper,we establish an HIV infection model with nonlocal dispersal and infection age.Moreover,applying the theory of Fourier transformation and von Foerster rule,we transform the model to an integrodifferential equation with nonlocal time delay and dispersal.The well-posedness,positivity,and boundedness of the solution for the model are studied.
基金supported by the NSFC(12271184)the Guangzhou Basic and Applied Basic Research Foundation(2024A04J10001).
文摘In the present paper,we prove the existence,non-existence and multiplicity of positive normalized solutions(λ_(c),u_(c))∈ℝ×H^(1)(ℝ^(N))to the general Kirchhoff problem-M\left(\int_{\mathbb{R}^N}\vert\nabla u\vert^2{\rm d}x\right)\Delta u+\lambda u=g(u)~\hbox{in}~\mathbb{R}^N,u\in H^1(\mathbb{R}^N),N\geq 1,satisfying the normalization constraint\int_{\mathbb{R}^N}u^2{\rm d}x=c,where M∈C([0,∞))is a given function satisfying some suitable assumptions.Our argument is not by the classical variational method,but by a global branch approach developed by Jeanjean et al.[J Math Pures Appl,2024,183:44–75]and a direct correspondence,so we can handle in a unified way the nonlinearities g(s),which are either mass subcritical,mass critical or mass supercritical.
文摘A new steganographic method by pixel-value differencing(PVD)using general quantization ranges of pixel pairs’difference values is proposed.The objective of this method is to provide a data embedding technique with a range table with range widths not limited to powers of 2,extending PVD-based methods to enhance their flexibility and data-embedding rates without changing their capabilities to resist security attacks.Specifically,the conventional PVD technique partitions a grayscale image into 1×2 non-overlapping blocks.The entire range[0,255]of all possible absolute values of the pixel pairs’grayscale differences in the blocks is divided into multiple quantization ranges.The width of each quantization range is a power of two to facilitate the direct embedding of the bit information with high embedding rates.Without using power-of-two range widths,the embedding rates can drop using conventional embedding techniques.In contrast,the proposed method uses general quantization range widths,and a multiple-based number conversion mechanism is employed skillfully to implement the use of nonpower-of-two range widths,with each pixel pair being employed to embed a digit in the multiple-based number.All the message bits are converted into a big multiple-based number whose digits can be embedded into the pixel pairs with a higher embedding rate.Good experimental results showed the feasibility of the proposed method and its resistance to security attacks.In addition,implementation examples are provided,where the proposed method adopts non-power-of-two range widths and employsmultiple-based number conversion to expand the data-hiding and steganalysis-resisting capabilities of other PVD methods.
文摘In this paper,Let M_(n)denote the maximum of logarithmic general error distribution with parameter v≥1.Higher-order expansions for distributions of powered extremes M_(n)^(p)are derived under an optimal choice of normalizing constants.It is shown that M_(n)^(p),when v=1,converges to the Frechet extreme value distribution at the rate of 1/n,and if v>1 then M_(n)^(p)converges to the Gumbel extreme value distribution at the rate of(loglogn)^(2)=(log n)^(1-1/v).
文摘This paper aims to formalize a general definition of intelligence beyond human intelligence. We accomplish this by re-imagining the concept of equality as a fundamental abstraction for relation. We discover that the concept of equality = limits the sensitivity of our mathematics to abstract relationships. We propose a new relation principle that does not rely on the concept of equality but is consistent with existing mathematical abstractions. In essence, this paper proposes a conceptual framework for general interaction and argues that this framework is also an abstraction that satisfies the definition of Intelligence. Hence, we define intelligence as a formalization of generality, represented by the abstraction ∆∞Ο, where each symbol represents the concepts infinitesimal, infinite, and finite respectively. In essence, this paper proposes a General Language Model (GLM), where the abstraction ∆∞Ο represents the foundational relationship of the model. This relation is colloquially termed “The theory of everything”.
基金supported by the Key Research Program of Frontier Sciences,Chinese Academy of Sciences(Grant ZDBS-LY-DQC019)the National Key Research and Development Program of China(2023YFE0124300)+4 种基金the National Natural Science Foundation of China(32301344)Major Program of Institute of Applied EcologyChinese Academy of Sciences(IAEMP202201)supported by grants from the U.S.National Science Foundation(DEB 2240431)the Seeding Projects for Enabling Excellence and Distinction(SPEED)Program at Washington University in St.Louis。
文摘Biodiversity,large trees,and environmental conditions such as climate and soil have important effects on forest carbon stocks.However,recent studies in temperate forests suggest that the relative importance of these factors depends on tree mycorrhizal associations,whereby large-tree effects may be driven by ectomycorrhizal(EM)trees,diversity effects may be driven by arbuscular mycorrhizal(AM)trees,and environment effects may depend on differential climate and soil preferences of AM and EM trees.To test this hypothesis,we used forest-inventory data consisting of over 80,000 trees from 631 temperate-forest plots(30 m×30 m)across Northeast China to examine how biodiversity(species diversity and ecological uniqueness),large trees(top 1%of tree diameters),and environmental factors(climate and soil nutrients)differently regulate aboveground carbon stocks of AM trees,EM trees,and AM and EM trees combined(i.e.total aboveground carbon stock).We found that large trees had a positive effect on both AM and EM tree carbon stocks.However,biodiversity and environmental factors had opposite effects on AM vs.EM tree carbon stocks.Specifically,the two components of biodiversity had positive effects on AM tree carbon stocks,but negative effects on EM tree carbon stocks.Environmental heterogeneity(mean annual temperature and soil nutrients)also exhibited contrasting effects on AM and EM tree carbon stocks.Consequently,for the total carbon stock,the positive large-tree effect far surpasses the diversity and environment effect.This is mainly because when integrating AM and EM tree carbon stock into total carbon stock,the opposite diversity-effect(also environment-effect)on AM vs.EM tree carbon stock counteracts each other while the consistent positive large-tree effect on AM and EM tree carbon stock is amplified.In summary,this study emphasized a mycorrhizal viewpoint to better understand the determinants of overarching aboveground carbon profile across regional forests.
基金Supported by the General Project of Medical and Health Technology Plan of Zhejiang Province,No.2020KY845.
文摘BACKGROUND Limited knowledge exists regarding the casual associations linking blood metabolites and the risk of developing colorectal cancer.AIM To investigate causal associations between blood metabolites and colon cancer.METHODS The study utilized a two-sample Mendelian randomization(MR)analysis to investigate the causal impact of 486 blood metabolites on colorectal cancer.The primary method of analysis used was the inverse variance weighted model.To further validate the results several sensitivity analyses were performed,including Cochran's Q test,MR-Egger intercept test,and MR robust adjusted profile score.These additional analyses were conducted to ensure the reliability and robustness of the findings.RESULTS After rigorous selection for genetic variation,486 blood metabolites were included in the MR analysis.We found Mannose[odds ratio(OR)=2.09(1.10-3.97),P=0.024],N-acetylglycine[OR=3.14(1.78-5.53),P=7.54×10^(-8)],X-11593-O-methylascorbate[OR=1.68(1.04-2.72),P=0.034],1-arachidonoylglycerophosphocholine[OR=4.23(2.51-7.12),P=6.35×10^(-8)]and 1-arachidonoylglycerophosphoethanolamine 4[OR=3.99(1.17-13.54),P=0.027]were positively causally associated with colorectal cancer,and we also found a negative causal relationship between Tyrosine[OR=0.08(0.01-0.63),P=0.014],Urate[OR=0.25(0.10-0.62),P=0.003],N-acetylglycine[0.73(0.54-0.98),P=0.033],X-12092[OR=0.89(0.81-0.99),P=0.028],Succinylcarnitine[OR=0.48(0.27-0.84),P=0.09]with colorectal cancer.A series of sensitivity analyses were performed to confirm the rigidity of the results.CONCLUSION This study showed a causal relationship between 10 blood metabolites and colorectal cancer,of which 5 blood metabolites were found to be causal for the development of colorectal cancer and were confirmed as risk factors.The other five blood metabolites are protective factors.
基金supported by the National Natural Science Foundation of China(61833005)the Humanities and Social Science Fund of Ministry of Education of China(23YJAZH031)+1 种基金the Natural Science Foundation of Hebei Province of China(A2023209002,A2019209005)the Tangshan Science and Technology Bureau Program of Hebei Province of China(19130222g)。
文摘Discrete feedback control was designed to stabilize an unstable hybrid neutral stochastic differential delay system(HNSDDS) under a highly nonlinear constraint in the H_∞ and exponential forms.Nevertheless,the existing work just adapted to autonomous cases,and the obtained results were mainly on exponential stabilization.In comparison with autonomous cases,non-autonomous systems are of great interest and represent an important challenge.Accordingly,discrete feedback control has here been adjusted with a time factor to stabilize an unstable non-autonomous HNSDDS,in which new Lyapunov-Krasovskii functionals and some novel technologies are adopted.It should be noted,in particular,that the stabilization can be achieved not only in the routine H_∞ and exponential forms,but also the polynomial form and even a general form.
文摘During the 1980s, as part of a policy of liberalization, following budgetary cuts linked to the implementation of structural adjustment programs, management responsibilities for AHAs were transferred from ONAHA to cooperatives concerned. Due to lack of financial resources, but also because of poor management, everywhere in Niger we are witnessing an accelerated deterioration of the irrigation infrastructure of hydro-agricultural developments. Institutional studies carried out on this situation led the State of Niger to initiate a reform of the governance of hydro-agricultural developments, by streng-thening the status of ONAHA, by creating an Association of Irrigation Water Users (AUEI) and by restructuring the old cooperatives. Indeed, this research aims to analyze the creation of functional and sustainable Irrigation Water User Associations (AUEI) in Niger in a context of reform of the irrigation sector, and based on the experience of the Konni AHA. It is based on a methodological approach which takes into account documentary research and the collection of data from 115 farmers, selected by reasoned choice and directly concerned by the management of the irrigated area. The data collected was analyzed and the results were analyzed using the systemic approach and the diagnostic process. The results show that the main mission of the AUEI is to ensure better management of water, hydraulic equipment and infrastructure on the hydro-agricultural developments of Konni. The creation of the Konni AUEI was possible thanks to massive support from the populations and authorities in the implementation process. After its establishment, the AUEI experienced a certain lethargy for some time due to the rehabilitation work of the AHA but currently it is functional and operational in terms of associative life and governance. Thus, the constraints linked to the legal system, the delay in the completion of the work, the uncertainties of access to irrigation water but also the problems linked to the change in mentality of certain ONAHA agents constitute the challenges that must be resolved in the short term for the operationalization of the Konni AUEI.
基金financed by the Flinders University College of Business,Government and Law Large Project Grant(Grant number:100031.21).
文摘Background:Shared decision-making(SDM)implementation is a priority for Australian health systems,including general practices but it remains complex for specific groups like older rural Australians.We initiated a qualitative study with older rural Australians to explore barriers to and facilitators of SDM in local general practices.Methods:We conducted a patient-oriented research,partnering with older rural Australians,families,and health service providers in research design.Participants who visited general practices were purposively sampled from five small rural towns in South Australia.A semi-structured interview guide was used for interviews and reflexive thematic coding was conducted.Results:Telephone interviews were held with 27 participants.Four themes were identified around older rural adults’involvement in SDM:(1)Understanding of"patient involvement";(2)Positive and negative outcomes;(3)Barriers to SDM;and(4)Facilitators to SDM.Understanding of patient involvement in SDM considerably varied among participants,with some reporting their involvement was contingent on the“opportunity to ask questions”and the“treatment choices”offered to them.Alongside the opportunity for involvement,barriers such as avoidance of cultural care and a lack of continuity of care are new findings.Challenges encountered in SDM implementation also included resource constraints and time limitations in general practices.Rural knowledge of general practitioners and technology integration in consultations were viewed as potential enablers..Conclusion:Adequate resources and well-defined guidelines about the process should accompany the implementation of SDM in rural general practices of South Australia.Innovative strategies by general practitioners promoting health literacy and culturally-tailored communication approaches could increase older rural Australians'involvement in general.
文摘BACKGROUND General anesthesia is commonly used in the surgical management of gastrointestinal tumors;however,it can lead to emergence agitation(EA).EA is a common complication associated with general anesthesia,often characterized by behaviors,such as crying,struggling,and involuntary limb movements in patients.If treatment is delayed,there is a risk of incision cracking and bleeding,which can significantly affect surgical outcomes.Therefore,having a proper understanding of the factors influencing the occurrence of EA and implementing early preventive measures may reduce the incidence of agitation during the recovery phase from general anesthesia,which is beneficial for improving patient prognosis.AIM To analyze influencing factors and develop a risk prediction model for EA occurrence following general anesthesia for primary liver cancer.METHODS Retrospective analysis of clinical data from 200 patients who underwent hepatoma resection under general anesthesia at Wenzhou Central Hospital(January 2020 to December 2023)was conducted.Post-surgery,the Richmond Agitation-Sedation Scale was used to evaluate EA presence,noting EA incidence after general anesthesia.Patients were categorized by EA presence postoperatively,and the influencing factors were analyzed using logistic regression.A nomogram-based risk prediction model was constructed and evaluated for differentiation and fit using receiver operating characteristics and calibration curves.RESULTS EA occurred in 51(25.5%)patients.Multivariate analysis identified advanced age,American Society of Anesthesiologists(ASA)grade Ⅲ,indwelling catheter use,and postoperative pain as risk factors for EA(P<0.05).Conversely,postoperative analgesia was a protective factor against EA(P<0.05).The area under the curve of the nomogram was 0.972[95%confidence interval(CI):0.947-0.997]for the training set and 0.979(95%CI:0.951-1.000)for the test set.Hosmer-Lemeshow test showed a good fit(χ^(2)=5.483,P=0.705),and calibration curves showed agreement between predicted and actual EA incidence.CONCLUSION Age,ASA grade,catheter use,postoperative pain,and analgesia significantly influence EA occurrence.A nomogram constructed using these factors demonstrates strong predictive accuracy.
文摘Background: Flow FL-100 is a transcranial direct current stimulation (tDCS) device self-administered by a patient at home in combination with a software application delivered wellbeing behaviour therapy training. tDCS has evidence of effectiveness in treating symptoms of depression. Purpose/Aim: This post marketing study evaluated the effect of Flow on depression for primary care general practice patients with depression symptoms. Methods: Open-label patient cohort design with no control group. Inclusion criteria were aged 18 years or over and reporting depression symptoms. Participants self-administered five 30 minute tDCS sessions per week for the first three weeks, and then 3 sessions per week following this. Three, six and ten week assessment with participant self-report measure: Montgomery- Åsberg Depression Rating Scale (MADRS-S). Results: MADRS-S remission rates were between 29% - 30% at three weeks, 33% - 34% at six-weeks and 50% at 10-weeks treatment. There was a significant improvement in MADRS-S with large effect sizes at all time points. Conclusions: Flow tDCS can be delivered through a primary healthcare general practice service and patients will choose to use. Flow tDCS provides an effective depression treatment in addition and as an alternative to antidepressants and psychotherapy. tDCS has evidence as an effective depression treatment, and the widespread availability of tDCS in primary care general practice should be considered.
文摘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.
文摘Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anesthesia is required. The objective of the study was to evaluate the analgesic effectiveness of 4 analgesic techniques performed during cesarean section under general anesthesia in two centers with different anesthetic practices (North Franche Comté Hospital and Omar Bongo Ondimba Army Training Hospital). Method: This is a retrospective and descriptive study over 2 years, from January 1, 2019 to December 31, 2020. It involved evaluating the analgesic effectiveness and tolerance of morphine in the epidural catheter, wound infiltration, intravenous analgesia and Transversus Abdominous Plane block (TAP block) from the post-anesthesia care unit (PACU) until the 4<sup>th</sup> post-operative day. Results: Of the 354 cesarean sections performed, 84 (11.14%) received general anesthesia. The average age was 32.27 years. Acute fetal distress was the first indication for cesarean section (45.2%), followed by hemorrhagic placenta previa (10.7%) and prolapse of the cord (8.33%). Morphine in the epidural catheter was the most used (47.6%) followed by parietal infiltration (36.9%), intravenous analgesia (13.1%) and TAP block (2.38%). The analgesic effectiveness was comparable between the techniques from postoperative day 0 to day 4. No difference in side effects. Postoperative morphine consumption was significantly reduced (p = 0.011) in the infiltration (9 mg) and TAP block (9mg) groups compared to the epidural catheter (16 mg) and intravenous analgesia (17 mg). No difference in 02 rehabilitation criteria (ambulation, first bowel movement). No difference in the occurrence of chronic pain. Conclusion: In the event of a cesarean section under general anesthesia, there are effective and well-tolerated alternatives to neuraxial anesthesia, particularly regional anesthesia techniques (nerve blocks), particularly in countries with low availability of morphine.
文摘Planck scale plays a vital role in describing fundamental forces. Space time describes strength of fundamental force. In this paper, Einstein’s general relativity equation has been described in terms of contraction and expansion forces of space time. According to this, the space time with Planck diameter is a flat space time. This is the only diameter of space time that can be used as signal transformation in special relativity. This space time diameter defines the fundamental force which belongs to that space time. In quantum mechanics, this space time diameter is only the quantum of space which belongs to that particular fundamental force. Einstein’s general relativity equation and Planck parameters of quantum mechanics have been written in terms of equations containing a constant “K”, thus found a new equation for transformation of general relativity space time in to quantum space time. In this process of synchronization, there is a possibility of a new fundamental force between electromagnetic and gravitational forces with Planck length as its space time diameter. It is proposed that dark matter is that fundamental force carrying particle. By grand unification equation with space-time diameter, we found a coupling constant as per standard model “α<sub>s</sub>” for that fundamental force is 1.08 × 10<sup>-23</sup>. Its energy calculated as 113 MeV. A group of experimental scientists reported the energy of dark matter particle as 17 MeV. Thorough review may advance science further.