Bullous pemphigoid associated with acquired hemophilia A: A case report

BACKGROUND Acquired hemophilia A (AHA) is a rare and potentially severe bleeding disordercaused by circulating autoantibodies against factor Ⅷ (FⅧ). In approximately50% of the patients, the condition is associated with autoimmune diseases,cancers, medication use, pregnancy, and the post-partum period. Bullous pemphigoid(BP) is a chronic autoimmune subepidermal blistering disease associatedwith tissue-bound and circulating autoantibodies against BP antigens 180 (BP180)and 230 (BP230). AHA-associated BP has a high mortality rate;hence, the understandingof this disease must improve.CASE SUMMARY A 69-year-old man presented with erythema, blisters, blood blisters, and crustsaccompanied by severe pruritus for more than 20 days, and ecchymosis andswelling on his left upper arm for 3 days. Pathological examination revealed asubepidermal blister that contained eosinophils. Laboratory tests showed that theBP180 autoantibody levels had increased, isolated activated partial thromboplastintime was notably prolonged (115.6 s), and coagulation FⅧ activity wasextremely low (< 1.0%). Furthermore, the FⅧ inhibitor titer had greatlyincreased (59.2 Bethesda units). Therefore, the patient was diagnosed as having BP associated with AHA, prescribed 0.05% topical halometasone cream, and transferred to a higher-level hospitalfor effective treatment;however, he died after 2 days.CONCLUSION AHA associated BP is rare, dangerous, and has a high mortality rate. Therefore, its timely diagnosis and effectivetreatment are necessary.

高职资源勘查类专业Auto CAD课程产学融合教学模式探索与构建

以资源勘查类专业的Auto CAD课程教学为例,探讨如何有效地进行教学管理和完成教学设计,以适应产学融合、培养高质量的技术型人才的需求。通过针对性的课程设计,融入资源勘查类专业的知识点并引导学生运用知识点,能在一定程度上提高学生的学习兴趣,有利于实现以需求为导向的教学目标,使产学互动无缝衔接。

Acquired aplastic anemia:Is bystander insult to autologous hematopoiesis driven by immune surveillance against malignant cells?

We previously reported a serendipitous finding from a patient with refractory severe aplastic anemia who had gotten an unexpected hematological response to treatment with gut-cleansing preparations(GCPs).This patient experienced three recurrences over the ensuing one year of intermittent GCP treatments,with each recurrence occurring 7-8 wk from a GCP.After his third recurrence,he was prescribed successive treatment with rifampicin,berberine,and monthly administered GCP for 4 mo,and he developed an erythroid proliferative neoplasma and an overwhelming enteropathy,and eventually died of septic shock.Laboratory investigations had validated the resolution of myelosuppression and the appearance of malignant clonal hematopoiesis.From the treatment process and laboratory investigations,it is reasonably inferred that the engagement of gut inflammation is critically required in sustaining the overall pathophysiology of acquired aplastic anemia probably by creating a chronic inflammatory state.Incorporation of rifampicin,berberine,and monthly GCP into cyclosporine can enhance the immunosuppressive effect.In a subgroup of acquired aplastic anemia patients whose pathogenesis is associated with genotoxic exposure,the suppressed normal hematopoiesis may result from the bystander insult that is mediated by the soluble inflammatory cytokines generated in response to the immunogenic products of damaged hematopoietic cells in the context of chronic inflammatory state and may offer a protective antineoplastic mechanism against malignant proliferation.

Digital CEOs in Digital Enterprises:Automating,Augmenting,and Parallel in Metaverse/CPSS/TAOs

BIG models or foundation models are rapidly emerging as a key force in advancing intelligent societies[1]–[3]Their significance stems not only from their exceptional ability to process complex data and simulate advanced cognitive functions,but also from their potential to drive innovation across various industries.

ACQUIRING AND PATTERN RECOGNITION OF SPECTRUM INFORMATION OF WELDING METAL TRANSFER

In order to recognize various metal transfer modes, by the creation of apattern recognition system for metal transfer mode, five kinds of spectrum signal in gas metal arcwelding (MIG, MAG and CO_2) are collected and taken as training samples. These samples arepretreated by computer. Several key characteristic parameters of the spectrum signal are creativelyextracted, and a corresponding recognition function and a minimum-distance-classifier areconstructed. The results show that using this method, the pattern recognition of several kinds ofmetal transfer mode for the metal gas arc welding can be done successfully. It has good accuracy andrecognition precision, basis for controlling the metal gas arc welding metal transferautomatically, and relative important parameters in welding process, such as the frequency ofdroplet transfer and the approximate diameter of each droplet, can also be obtained.

Autoimmune Diseases and Acquired Von Willebrand Disease in Two Cases of Progeria

Ammar A., a 23-year-old male patient, who lives in Babylon, Haswa District, and his mother describes symptoms of growth retardation, skin changes, hair changes early graying and alopecia. These manifestation started early during his childhood period. There is canseguanity between the patient’s mother & father also one of the patient’s sister has similar illness and one male brother died few months following his birth. We admit the patient to hospital due acute pulmonary infection in Jan 2009, which is controlled after a course of antibiotic and after 5 months he develops generalised mucocuteneous bullous eruption which shows partial response to oral prednisolone 2 mg/Kg. The patient has normal IQ and he is in the secondary school and he has normal blood picture and the only abnormal biochemical abnormalities is mild hyperlipidemia Serum cholestrol of 5.8 mmol/L and Serum Triglyceride of 260 mg/dl. Ammar’s Sister Qawthar A., who has a similar phenotypic manifestations, presented skin vitiligo and hepatosplenomegaly associated with sever anemia and jaundice and her presentation suggestive of autoimmune haemolytic anemia improved following blood transfusion, corticosteroid and azothioprim. In February 2014 Ammer presented with multiple and diffuse cuteneous ecchymymosis with markedly prolonged PTT and slightly proloned bleeding time highly consistent with acquired Von Willebrand’s disease. In conclusion premature aging is a predisposing factor for disturbed immunity and development of autoimmune diseases.

Magnetic resonance imaging of extraocular rectus muscles abnormalities in acute acquired concomitant esotropia

AIM:To investigate the difference of medial rectus(MR)and lateral rectus(LR)between acute acquired concomitant esotropia(AACE)and the healthy controls(HCs)detected by magnetic resonance imaging(MRI).METHODS:A case-control study.Eighteen subjects with AACE and eighteen HCs were enrolled.MRI scanning data were conducted in target-controlled central gaze with a 3-Tesla magnetic resonance scanner.Extraocular muscles(EOMs)were scanned in contiguous image planes 2-mm thick spanning the EOM origins to the globe equator.To form posterior partial volumes(PPVs),the LR and MR cross-sections in the image planes 8,10,12,and 14 mm posterior to the globe were summed and multiplied by the 2-mm slice thickness.The data were classified according to the right eye,left eye,dominant eye,and non-dominant eye,and the differences in mean cross-sectional area,maximum cross-sectional area,and PPVs of the MR and LR muscle in the AACE group and HCs group were compared under the above classifications respectively.RESULTS:There were no significant differences between the two groups of demographic characteristics.The mean cross-sectional area of the LR muscle was significantly greater in the AACE group than that in the HCs group in the non-dominant eyes(P=0.028).The maximum cross-sectional area of the LR muscle both in the dominant and non-dominant eye of the AACE group was significantly greater than the HCs group(P=0.009,P=0.016).For the dominant eye,the PPVs of the LR muscle were significantly greater in the AACE than that in the HCs group(P=0.013),but not in the MR muscle(P=0.698).CONCLUSION:The size and volume of muscles dominant eyes of AACE subjects change significantly to overcome binocular diplopia.The LR muscle become larger to compensate for the enhanced convergence in the AACE.

Exploration of the Facilitative Effects of Music Acquiring Device on Language Acquisition

Music Acquiring Device （or MAD, for short） is proposed to identify the origin and acquisition of human language, and is regarded as preceded Chomsky＇s LAD （Language Acquisition Device）. This paper tries to find the answers to two questions. Firstly, what are the main similarities between music and language？ Secondly, in what aspects can music facilitate language similarities （sound, rhythm, and acquisiti structure on？ By literature reviewing, comparison and contrast, three main ） between music and language are discussed, and then three facilitative effects of MAD on language acquisition are illustrated. They are： （1） MAD lays a foundation for language pronunciation acquisition; （2） MAD accelerates the mastery of language rhythm; and （3） MAD promotes language syntax acquisition. This paper will help teachers who like to use music-assistant language teaching method understand more about the positive effects of music on language teaching and acquisition.

Mabel's Love Pursuing and Acquiring from the Perspective of Politeness Theory

The Horse Dealer's Daughter gradually acquires her love in a tough and unbearable situation after a long dialogue with Doctor Fergusson.By analyzing the linguistic features between Doctor Fergusson and Mabel'dialogues from the perspective of politeness principle,one conception of which is that politeness is a social behavior in the contact of human beings,the strategies of Mabel's love pursuing and acquiring are gradually revealed.

Knowledge of Hospital Acquired Infections (HAIs) among Medical Students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria

Background: Hospital Acquired Infections (HAIs) remain a common cause of death, functional disability, emotional suffering and economic burden among hospitalized patients. Knowledge of HAIs is important in its prevention and control. This study seeks to assess the knowledge of Hospital Acquired Infections (HAIs) among medical students in a Tertiary Hospital in Jos North Local Government Area, Plateau State, Nigeria. Methods: This was a descriptive cross-sectional study done in October 2019 among clinical medical students using a Multistage sampling technique. Data was collected using a self-administered structured questionnaire and analyzed using the IBM SPSS 20 (Statistical Package for the Social Sciences). Ethical approval was granted by Bingham University Teaching Hospital, Ethics Committee, Jos, Plateau State. Results: A total of 219 students in the clinical arm of the College of Medicine and Health Sciences were selected. A higher proportion (97.7%) of respondents knew about Hospital Acquired Infections and 85.4% knew that Hospital Acquired infections occur in the hospital, and (86.3%) considered patients contagious with half (58.9%) considered patients as the most important source of HAIs, followed by care givers (13.2%), then doctors including medical students and interns (10.0%) and lastly nurses (8.7%). The majority of respondents (70.8%) considered Surgical Wound Infections to be the most commonly occurring HAI, followed by UTIs (69.9%), RTIs (61.2%), BSIs (37.0%) and others (0.9%). The clinical thermometer was the instrument that most commonly transmits HAIs (82.6%), then followed by stethoscope (62.1%), white coats (53.9%), and blood pressure cuff (51.1%). Most respondents knew the infectious substances, like blood (96.3%), nasal discharge (82.6%), saliva (85.3%), and faeces (79.4%) transmitted HAIs, 72.6% of the respondents said that they were aware of the recommended hand washing techniques by WHO. Conclusion: The majority of students 91.3% had good knowledge while 8.7% had poor knowledge of HAIs. Lower classes had more respondents with poor knowledge. This finding was statistically significant (p = 0.002, Chi-square 12.819). Students are encouraged to keep up the level of knowledge they have about HAIs. These students can help improve the knowledge of those whose knowledge level is low. Government and NGOs should support sponsorship for capacity-building events targeted at HAIs for healthcare workers and medical students.

基于智慧职教平台的混合式教学模式课程设计与教学实践研究——以Auto CAD绘图课程为例

传统Auto CAD绘图课程的教学模式是老师不断输出知识和操作演示,学生被动接受和模仿学习,学生未能真正将知识进行内化,也没有思考后的输出和应用。该方式教学内容与企业需求脱轨,学生只能完成课堂布置的练习及课后作业,缺乏学习探索的主动性。据此,将现代信息化教学手段与普通线下教学方式进行糅合,并在此基础上进行课程内容重构、教学过程设计和多元化评价体系等,以求达到更好的教学效果,培养出企业需要、社会满意的学生。

Botulinum toxin type A in treating early-stage patients with small-angle acute acquired comitant esotropia

AIM:To investigate botulinum toxin A(BTXA)efficacy on small-angle(≤25Δ)acute acquired concomitant esotropia(AACE)in early-stage patients.METHODS:The electronic medical record data of AACE patients during March 2019 and June 2023 were collected in this retrospective and hospital-based cohort study.A total of 72 small-angle AACE patients received BTXA extraocular muscle injection.Patients were grouped by onset-to-treatment time(Group A:≤6mo,Group B:>6mo).Deviation of esotropia,eye alignment and stereopsis were analyzed at the period of pre/post-injection(1wk,1,3,and 6mo).Orthophoria rate at 6mo(horizontal deviation<10Δand binocular single vision)were considered as outcome index.RESULTS:There were no significant baseline differences(P>0.05)between two groups except onset-to-treatment time(2mo vs 11mo,P<0.001).Higher orthophoria rates were in Group A at last follow-up(94.74%vs 73.53%,P=0.013).Post-BTXA deviations of two groups at 1mo showed no difference(P>0.05);while in 3 and 6mo Group A was significantly smaller than group B(all P<0.001).No statistically significant differences were observed among all post-BTXA deviations of near and distance in Group A.In Group B,deviation at 3mo(near:2Δvs 0,P<0.001;distance:4Δvs 0,P<0.001)and 6mo(near:6Δvs 0,P<0.001;distance:6Δvs 0,P<0.001)was significant increased compared to deviation at 1wk after treatment.Group A showed better stereopsis recovery in last follow-up compared to Group B(80″vs 200″,P=0.002).Both groups obtained improved stereopsis after treatment(Group A:80″vs 300″,P<0.001;Group B:200″vs 300″,P=0.037).CONCLUSION:BTXA is effective for AACE with small deviation(≤25Δ)in early stage.Delayed treatment(>6mo)may reduce BTXA efficacy.Early BTXA intervention benefits long-term eye alignment and stereopsis recovery.

Neuropsychological Profile of a Patient with Acquired Brain Damage Following Vascular Lesion of the Left Anterior Cingulate Cortex

Stroke is a physiological alteration associated with changes in blood flow that can result in sudden-onset cognitive impairment. It has a heterogenous clinical presentation with varying degrees of severity correlated with specific central nervous system zones or areas, and its prognosis is uncertain. This case study describes a 62-year-old male patient with acquired brain damage of the anterior cingulate cortex as a result of an ischemic event in the territory of the left anterior cerebral artery. Cognitive function was assessed using the neuropsychological executive function and frontal lobe test battery (BANFE-2) as well as other neuropsychological tests. The results show a profile of higher mental functions characterized by the presence of dysexecutive syndrome with marked behavioral alteration and diencephalic amnesia. .

Risk factors for intensive-care-unit-acquired weakness

Wang et al reported 1063 cases from the initial 14 d of intensive care unit(ICU)stay,and analyzed relevant data such as age,comorbidities,recent dosages,vapor pressure dosages,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,which are closely related to ICU-acquired weakness(ICUAW).It is suggested that the length of ICU stay and the duration of mechanical ventilation are the main factors.ICU-AW is the most common neuromuscular injury in the ICU,which affects clinical progression and outcomes of patients.This manuscript helps to improve the early recognition of ICU-AW,thereby reducing mortality and improving prognosis.

Study of the Effectiveness of Papaver Sp. Alkaloids as Future Therapeutic Alternatives against Enterococcus Sp. Causing Hospital-Acquired Septicemic Infections

Background and Objective: In recent years, control of Enterococcus sp. It has been proven in the local medical environment to be a cause of acquired septicemia in various age groups, and medical instruments are considered an effective means of transmitting enterococcal septicemia, and catheters are at the forefront in terms of danger. Based on this risk, this study aimed to monitor the spread of Enterococcus sp., which causes blood poisoning acquired from catheters, and to compare its response to antibiotics with that of those isolated from clinical samples in children, as a first study locally. The effectiveness of alkaloids of different types of Papaver sp. In Syrian plants, they were tested against infection with this bacteria. Materials and Methods: The study dealt with two parts: The first part included collecting clinical samples from the University Children’s Hospital in Damascus/bacterial diagnostic laboratories/then isolating and diagnosing the bacteria by following a set of tests to identify the most prevalent genera and species and comparing their prevalence rate with Enterococcus. The second part;It included collecting plant samples, confirming the species taxonomically, then extracting alkaloids from plant parts (fruit, stem, Flowers), then comparing the extent of resistance of bacterial strains to antibiotics compared to the Enterococcus sp., and then confirming the antibacterial activity of the Papaver sp. alkaloids against Enterococcus sp. Result:In its first part, the study confirmed the significant contribution of the Enterococcus sp. to infections acquired from various sources, largely in catheter tip infections (9.09%) and to a lesser extent in other sources (3.7%), The second part was to confirm the effective-ness of the alkaloid extract of the Papaver sp., especially the two species Papaver syriacum, and Papaver dubium, against Enterococcus sp. with areole diameters that ranged between (15 - 26 mm) for the fruit extract and at a minimum inhibitory concentration (3.12 - 6.25 mml) and then the stem (5 - 20 mm). And the effectiveness of the Flowers extract is very weak to almost non-existent. Conclusions: The catheter and medical sources surrounding the patient constitute a dangerous source of multi-resistant Enterococcus sp., which poses a real threat to the lives of children, with new mechanisms represented by colonization of the skin and the ability to form biofilms Surfaces of medical instruments, with are resistant to a wide range of antibiotics. As an alternative and effective modern source to limit its spread in the future, the alkaloid extract of the fruits and stems of the wild Papaver sp. has proven a strong antibiotic effect, especially the two types: Papaver syriacum and Papaver dubium.

Heat Recovery from Automotive Exhaust Using Heat Pipes with Limited Fluid Charge

Experiments were conducted in this study to examine the thermal performance of a thermosyphon,made from Inconel alloy 625,could recover waste heat from automobile exhaust using a limited amount of fluid.The thermosyphon has an outer diameter of 27 mm,a thickness of 2.6 mm,and an overall length of 483 mm.The study involved directing exhaust gas onto the evaporator.This length includes a 180-mm evaporator,a 70-mm adiabatic section,a 223-mm condenser,and a 97-mm finned exchanger.The study examined the thermal performance of the thermosyphon under exhaust flow rates ranging from 0–10 g/sec and temperatures varying from 300℃–900℃.The influence of three parameters—inclination angle(5°–45°),water mass(2–5.3 g),and the quantity of non-condensable gas Argon(0–0.6 g)—was investigated to assess their impacts on the thermosyphon’s thermal efficiency.The experimental findings revealed that with 3 g of water and 0.0564 g of argon in the thermosyphon,the condenser reached its highest temperature at around 200℃.The ideal fuel loading rate for the thermosyphon falls between 0.2 and 0.7 g/s.Moreover,as inclination angles rise,outer wall temperatures of the thermosyphon increase.This is attributed to the explicit expansion of the effective heating area within the evaporation section,coupled with an amplified gravitational component of the water flux.Additionally,an upsurge in the quantity of non-condensable gas(NCG)can mitigate temperature gradients on the outer wall,resulting in a decline in the thermosyphon’s performance.The insulation applied to the adiabatic section demonstrated efficacy in augmenting temperature gradients on the outer wall,thereby improving the overall performance of the thermosyphon.As the water charge within the thermosyphon increases,there is a corresponding rise in heat transfer rates both from the exhaust to the thermosyphon and from the thermosyphon to the fuel.

Automated Actuarial Data Analytics-Based Inflation Adjusted Frequency Severity Loss Reserving Model

In this paper, the Automated Actuarial Loss Reserving Model is developed and extended using machine learning. The traditional actuarial reserving techniques are no longer compatible with the increase in technological advancement currently at hand. As a result, the development of the alternative Artificial Intelligence Based Automated Actuarial Loss Reserving Methodology which captures diverse risk profiles for various policyholders through augmenting the Micro Finance services, Auto Insurance Services and Both Services lines of business on the same platform through the computation of the Comprehensive Automated Actuarial Loss Reserves (CAALR) has been implemented in this paper. The introduction of the four further types of actuarial loss reserves to those existing in the actuarial literature seems to significantly reduce lapse rates, reduce the reinsurance costs as well as expenses and outgo. As a matter of consequence, this helps to bring together a combination of new and existing policyholders in the insurance company. The frequency severity models have been extended in this paper using ten machine learning algorithms which ultimately leads to the derivation of the proposed machine learning-based actuarial loss reserving model which remarkably performed well when compared to the traditional chain ladder actuarial reserving method using simulated data.

A Tale of Two Continents-An Autobiography

On 14th September 2023,we were gathered in a Beijing conference hall to exchange views with the leaders of the Chinese Association for International Understanding.We had been introduced about the Association by researcher Zhang Yaowu during our field trips.However,when we met Ai Ping,I had no idea that we were talking with the author of"A Tale of Two Continents:An Autobiography".In receiving his signed book,I realized that the speaker was the current Vice-President of the Chinese Association for International Understanding and a Deputy Minister and an Ambassador Extraordinary and Plenipotentiary of China to Ethiopia.

新工科背景下化工制图与Auto CAD的过程性教学改革

化工制图与Auto CAD化学工程与工艺专业的一门核心课程,具有较强的理论性和实践性,通过讲授工程制图的基本知识、化工设备图样、化工工艺图样,让学生掌握识图、阅图及绘图的基本能力,课程的教学质量将会直接影响到后续专业课学习、毕业设计质量及化工设计大赛的完成情况等。笔者结合多年的教学积累和教学反思,介绍了化工制图与Auto CAD在教学过程中存在的一些问题,阐述在教学中过程性改革的具体措施。通过改进教学模式,优化过程性评价,培养学生独立思考能力和动手实践能力,为化工企业输送应用型人才。

Auto CAD二次开发在幕墙设计中的应用

随着建筑幕墙行业的快速发展,幕墙设计工作也越来越复杂.幕墙设计不仅在招投标阶段发挥重要作用,更在工程施工过程中给予大量的技术支持,导致幕墙设计人员肩上的担子越来越重.本文通过研究Auto CAD二次开发来解决复杂幕墙设计问题,减少重复机械操作,提高幕墙设计人员的工作效率.