Profile of Full-Term Births in Maternity Wards of Public Hospitals in Douala Cameroon

Introduction: Pregnancy as much as childbirth constitutes a risky situation, potentially fraught with sometimes dramatic complications: maternal death. Objective: We conducted this study with the aim of establishing the profile of those giving birth in our context with the aim to anticipate operationally in the future on morbidity but more on maternal deaths. Methodology: We conducted, using a structured questionnaire, a prospective descriptive study in representative maternity wards in the city of Douala;the study variables were socio-economic, anthropometric, obstetrical and clinical. Statistical analyses were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables and the percentages. Results: We recruited 305 births for our study. The average age of our births was 28.7 years ± 6.1 with an average height of 161.6 cm ± 5.06;an average body mass index at the start of pregnancy of 28.0 kilograms/square meter and 31.3 kilograms/square meter at delivery;the average weight gain was 8.4 g ± 5.37;an average gestation of 2.84±1.90;an average parity of 2.2 ± 2.1 with an average birth interval of 27.7 months ± 23.7. The average gestational age was 39.2 weeks ± 1.21 with pregnancy pathology dominated by malaria;85.9% began their prenatal follow-up before the 14th week of amenorrhea. Conclusion: The profile of childbirth in urban Cameroon does not seem potentially dystocic compared to that of the same regional and racial area.

A Comparison between Late Preterm and Term Infants with Respiratory Distress Syndrome, Early-Onset Sepsis, and Neonatal Jaundice in Ecuadorian Newborns

Background: To examine the differences in prevalence of respiratory distress syndrome, early-onset sepsis and jaundice, between late preterm infants versus term infants in Ecuadorian newborns. Methods: Study design: Epidemiological, observational, and cross-sectional, with two cohorts of patients. Settings: IESS Quito Sur Hospital at Quito, Ecuador, from February to April of 2020. Participants: This study included 204 newborns, 102 preterm infants, 102 term infants. Results: There are significant differences between late preterm infants and term infants, with a p-value of 0.000 in the prevalence of early sepsis, 70.59% vs. 35.29%. In respiratory distress syndrome between late and term premature infants, significant differences were observed with a p-value of 0.000, the proportion being 55.58% vs. 24.51% respectively. The prevalence of jaundice is higher in term infants with a p value of 0.002, 72.55%, versus 51.96% in late preterm infants, and the mean value of bilirubins in mg/dL was higher in term infants 14.32 versus 12.33 in late preterm infants;this difference is statistically significant with a p value of 0.004. Admission to the NICU is more frequent in late preterm infants with a p-value of 0.000, being 42.16% for late preterm infants vs. 7.84% in term infants;the mean of the hospital days with p-value 0.005, was higher in late preterm infants 4.97 days vs. 3.55 days for term newborns. Conclusion: Due to the conditions of their immaturity, late preterm infants are 2.86 times more likely to present early sepsis than full-term newborns. It is shown that late preterm infants are 2.69 times more likely to have respiratory distress syndrome compared to term infants, therefore, late preterm infants have a longer hospital stay of 4.97 days versus 3.55 days in term infants. Jaundice and mean bilirubin levels are higher in term infants due to blood group incompatibility and insufficient breastfeeding.

Long-term assessment of collagenase treatment for Dupuytren’s contracture:A 10-year follow-up study

BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.AIM To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with DC.METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic reevaluation.The study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years post-surgery.RESULTS Thirty-seven patients completed the 10-year follow-up.At 10 years,patients treated at the PIP joint exhibited a 100%recurrence.However,patients treated at the MCP joint only showed a 50%recurrence.Patient satisfaction varied,with a lower satisfaction reported in PIP joint cases.Recurrence exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained efficacy.Significant differences were noted between outcomes at the 7-year and 10-year intervals.CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint.However,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction.Re-intervention is needed within a decade of treatment.

Long-term outcomes of endoscopic submucosal dissection for undifferentiated type early gastric cancer over 2 cm with R0 resection

BACKGROUND Endoscopic submucosal dissection(ESD)for over 2 cm in size undifferentiated type(UD type)early gastric cancer(EGC)confined to the mucosa is not only challenging,but also long-term outcomes are not well known.AIM To evaluate the long-term outcomes of ESD done for UD type EGCs confined to the mucosa over 2 cm in size and compare the results with those where the lesions were less than 2 cm.METHODS 143 patients with UD type EGC confirmed on histology after ESD at a tertiary hospital were reviewed.Cases with synchronous and metachronous lesions and a case with emergency surgery after ESD were excluded.A total of 137 cases were enrolled.79 cases who underwent R0 resection were divided into 2 cm or less(group A)and over 2 cm(group B)in size.RESULTS Among 79 patients who underwent R0 resection,the number in group A and B were 51 and 28,respectively.The mean follow-up period(SD)was 79.71±45.42 months.There was a local recurrence in group A(1/51,2%)and group B(1/28,3.6%)respectively.This patient in group A underwent surgery while the patient in group B underwent repeated ESD with no further recurrences in both patients.There was no regional lymph node metastasis,distant metastasis,and deaths in both groups.With R0 resection strategy for ESD on lesions over 2 cm,20.4%(28/137)of patients were able to avoid surgery compared with expanded indication.CONCLUSION If R0 resection is achieved by ESD,UD type EGCs over 2 cm also showed good and similar clinical outcomes as compared to lesions less than 2 cm when followed for over 5 years.With R0 resection strategy,several patients can avoid surgery.

Draft of an Anthropometric Reference System for Full-Term Cameroonian Newborns: Prospective Study with Analytical Aim in the Maternity Wards of Douala

Introduction: Anthropometry applied to newborns is a reliable indicator of the quality of fetal growth. The latter is influenced by genetic, racial and nutritional factors varying from one population to another, explaining why a standard cannot be applied to all populations. Research question: should the Caucasian frame of reference be dogmatically applied in our African context? Multicenter studies are therefore necessary;hence the interest of this work, the main objective of which was to describe the anthropometric profile of full-term newborns in the city of Douala. Methodology: We carried out a cross-sectional study with an analytical aim and prospective data collection in the maternity wards of the Douala General Hospital, Laquintinie Hospital, District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given consent. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using structured and pre-tested survey sheets. The study variables were obstetric and anthropometric. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The average anthropometric parameters of the full-term newborn in the city of Douala were: average weight: 3305 grams, average height: 49.8 centimeters, average head circumference: 34.6 centimeters, average upper arm circumference: 11.3 centimeters, circumference average thoracic: 32.8 centimeters. The percentile distribution showed a 10th percentile at 2656 grams and a 90th percentile at 3966 grams for weight defining the limits for small-for-gestational-age neonates and macrosomes. Conclusion: The anthropometric data of the full-term newborn in the city of Douala were: an average weight of 3305.4 grams, an average height of 49.8 centimeters, an average head circumference of 34.2 centimeters, an average upper arm circumference of 11.3 centimeters, and an average thoracic circumference of 32.8 centimeters with higher valuesin male newborns.

Long-Term Mortality of Children with Congenital Heart Disease Admitted to the Departmental University Hospital of Borgou/Alibori from 2011 to 2022

Background: Congenital heart disease is a public health issue due to its incidence and mortality rate. The aim of this study was to investigate the long-term mortality of children with congenital heart disease admitted to the Departmental University Hospital of Borgou/Alibori (CHUD-B/A) from 2011 to 2022. Methods: This descriptive longitudinal study with analytical aims covered 11 years (April 1, 2011 to December 31, 2022). It consisted of a review of the records of children under 15 years of age with echocardiographically confirmed congenital heart disease. This was followed by an interview with the parents to assess the children’s current condition. Data were entered using Kobocollect software and analyzed using R Studio 4.2.2. software. Results: A total of 143 complete files were retained. The median age at diagnosis was 14 months (IIQ: Q1 = 4;Q3 = 60) with a range of 2 days and 175 months, and the sex-ratio (M/F) was 0.96. Left-to-right shunts were the most frequent cardiopathy group (62.9%). Only 35 children (24.5%) benefited from restorative treatment. The mortality rate was 31.5%. Median survival under the maximum bias assumption was 114 months and 216 months under the assumption of minimum bias. Survival was significantly better in children with right-to-left shunts (p = 0.0049) under the assumption of minimum bias. The death risk factors were: age at diagnosis less than 12 months (aHR = 7.58;95% CI = 3.36 - 17.24;p Conclusion: The long-term mortality of congenital heart disease is high and favoured by the absence of restorative treatment. Local correction of congenital heart disease and medical follow-up will help to reduce this mortality.

A Prospective Study on Evaluating the Long-Term Effects of Childhood Vaccination from Birth to 13 Years Old in Kuwait

Background: To prevent infectious diseases and deaths of children, vaccinations play a crucial role in public health strategies in Kuwait. However, it remained uncertain to demonstrate the potential long-term health outcomes of vaccination, including neurodevelopmental disorders (NDD) and autism. This study aimed to evaluate the long-term health outcomes of vaccination among Kuwait children from birth to thirteen years old. Objectives: This study included the significant objectives: (1) to compare long-term health effects, including chronic and acute conditions for unvaccinated, partially vaccinated, and vaccinated children, and (2) to evaluate the association of vaccination with the neurodevelopmental disorders (NDD) and autism, and the preventable illnesses. Methods: This prospective study involved a sample of 976 children from Kuwait based on mothers’ reporting. Data collection about the vaccination status of children and various health outcomes relevant to chronic and acute illnesses was performed based on structured questionnaires through an online survey. However, participants were classified into unvaccinated (n = 40), partially vaccinated (n = 222), and fully vaccinated (n = 714). Statistical analyses, including the chi-square test, Odds Ratios (OR), 95% Confidence Interval (CI), and logistic regression, were performed using SAS (Version 9.4) to determine the associations between vaccination status and health outcomes among children. Results: The study disclosed that vaccinated children showed an increased diagnosis of chronic (allergic rhinitis, allergies, autism spectrum, eczema, neuro-developmental disorders, learning disability, ADHD, and any chronic condition) and acute (whooping cough, pneumonia, rubella, hepatitis A or B, measles, mumps, meningitis, influenza, rotavirus, cancer, chronic fatigue, Crohn’s disease, inflammatory bowel disease, conduct disorder, diabetes type 1 or 2, rheumatoid arthritis, obesity, seizures, hearing loss, polio, diphtheria, tetanus, and depression) illnesses than unvaccinated children. The fully vaccinated children showed an increased prevalence of influenza diagnosis, while partially vaccinated children were more likely to be diagnosed with rheumatoid arthritis than unvaccinated children. In contrast, unvaccinated were more likely to have been diagnosed with chickenpox and encephalopathy than fully and partially vaccinated. Males with chronic and acute conditions had a lower incidence of allergies and pneumonia, respectively, whereas females had a reduced prevalence of acute illnesses, such as whooping cough, inflammatory bowel disease, and hepatitis A or B among vaccinated (n = 936;combination of partially vaccinated and fully vaccinated) children. Regarding medication use and health service applications, vaccinated children were more likely to use medications for fever, antibiotics, and allergies. In addition, they showed an increased rate of sick visits and emergency visits in the past twelve months. On the other hand, factors like age (2 - 5 years, 6 - 9 years, and 10 - 13 years), birth type (cesarian), and mother suffering during pregnancy (gestational diabetes) were significantly associated with NDD (learning disability, autism spectrum, and attention deficient hyperactivity disorder) in the adjusted analysis. In the interaction model of age and birth type, age (6 - 9 years;OR 5.3, 95% CI: 1.1, 25.3) and mother suffering (gestational diabetes;OR 2.5, 95% CI: 1.2, 5.2) during pregnancy were associated with NDD. Conclusion: The findings of this study showed that there are some cases where the infection rate is higher among the vaccinated compared to unvaccinated children, or there are no significant differences between the two groups in Kuwait. Upon controlling the factors in the interaction model, the age of 6 to 9 years and gestational diabetic mothers during pregnancy were associated with the synergistic increment of odds with NDD. These data findings are recommended to verify a larger and diverse group of samples to optimize the vaccination on health outcomes in Kuwait children.

Off-Pump Coronary Artery Bypass Grafting in Patients with Left Ventricular Dysfunction: Short-Term Results from a Single Center in Bangladesh

Background: Off-pump coronary artery bypass grafting (OPCAB) is considered a safer alternative to on-pump surgery, especially in patients with left ventricular dysfunction (LVD). Objectives: This study assessed short-term outcomes and functional improvements in LVD patients post-OPCAB. Methods: The study included 200 coronary artery disease patients who underwent isolated off-pump coronary artery bypass grafting (OPCAB) at the National Heart Foundation Hospital and Research Institute between January 2019 and June 2020. Patients were categorized into Group 1, with a left ventricular ejection fraction (LVEF) of 30% - 39%, and Group 2, with an LVEF of 40% or higher. Echocardiographic assessments of left ventricular dimensions and ejection fraction were performed preoperatively, at discharge, and one month postoperatively. Results: In Group 1, preoperative left ventricular internal dimensions during diastole (LVIDd) and systole (LVIDs) were 53.48 ± 4.40 mm and 44.23 ± 3.93 mm, respectively, with a left ventricular ejection fraction (LVEF) of 35.28% ± 2.26%. At discharge, these values improved to 51.58 ± 4.04 mm (LVIDd), 41.23 ± 5.30 mm (LVIDs), and 39.25% ± 3.75% (LVEF). One month postoperatively, further improvements were observed: 46.29 ± 3.76 mm (LVIDd), 37.45 ± 3.68 mm (LVIDs), and 43.22% ± 4.67% (LVEF). Group 2 showed similar positive outcomes, with preoperative values of 47.09 ± 5.06 mm (LVIDd), 35.11 ± 5.25 mm (LVIDs), and 50.13% ± 7.25% (LVEF), improving to 42.37 ± 4.18 mm (LVIDd), 31.05 ± 4.19 mm (LVIDs), and 55.33% ± 7.05% (LVEF) at one month postoperatively. Both groups demonstrated significant improvements in left ventricular function and NYHA class, with most patients moving from class III/IV to I/II. Complications were minimal, and no mortality was observed. Conclusion: OPCAB is safe and effective for patients with LVEF 30% - 39% and LVEF ≥ 40%, providing significant short-term functional improvements without increased risk.

A Trajectory Privacy Protection Method to Resist Long-Term Observation Attacks

Users face the threat of trajectory privacy leakage when using location-based service applications, especially when their behavior is collected and stored for a long period of time. This accumulated information is exploited by opponents, greatly increasing the risk of trajectory privacy leakage. This attack method is called a long-term observation attack. On the premise of ensuring lower time overhead and higher cache contribution rate, the existing methods cannot utilize cache to answer subsequent queries while also resisting long-term observation attacks. So this article proposes a trajectory privacy protection method to resist long-term observation attacks. This method combines caching technology and improves the existing differential privacy mechanism, while incorporating randomization factors that are difficult for attackers to recognize after long-term observation to enhance privacy. Search for locations in the cache of both the mobile client and edge server that can replace the user’s actual location. If there are replacement users in the cache, the query results can be obtained more quickly. Simultaneously obfuscating the spatiotemporal correlation of actual trajectories by generating confusion regions. If it does not exist, the obfuscated location generation method that resists long-term observation attacks is executed to generate the real anonymous area and send it to the service provider. The above steps can comprehensively protect the user’s trajectory privacy. The experimental results show that this method can protect user trajectories from long-term observation attacks while ensuring low time overhead and a high cache contribution rate.

Photoelectric State with Long-Term Relaxation in CdTe:(Ag, Cu, Cd) and Sb2Se3:Se Photovoltaic Films

The results of an experimental study of long-term relaxation of the photoelectret state of polycrystalline CdTe:(Ag, Cu, Cd) and Sb2Se3:Se films with an anomalous photovoltaic property are presented. In such films, the residual photovoltage is caused by the separation of photocarriers by the built-in electrostatic field of the near-surface region of space charges and their asymmetric capture by deep levels of impurities or complexes, including impurity atoms and intrinsic defects, both in the bulk and on the surface of crystal grains. It has been shown that in activated films, a two-step exponential temporary relaxation of the initial photovoltage of the order of VAPV ≈ (500-600) V is detected, and only 10% of it experiences long-term relaxation (t ≈ 100-120 min).

Protocol for the management of oral surgery patients on warfarin utilizing a Point-of-Care In-Office international normalized ratio monitoring device

Purpose: This study was performed to assess the utility and safety of an In-Office INR Monitoring Device and present a safe and efficient protocol for the management of patients on oral anticoagulants and/or antithrombolytics requiring routine office oral and maxillofacial surgery. Patients and Methods: Sixty-one patients requiring “minor” oral and maxillofacial surgery being treated chronically with oral anticoagulation (warfarin) were entered into the study and compared in 2 groups. The control group (n = 29) was managed by discontinuing warfarin and any anti-platelet medication(s) prior to surgery. In the study group (n = 30), the decision to continue or withhold warfarin was determined by a protocol in which patients are 1) stratified based on risk for thromboembolism, and 2) classified as requiring “major” or “minor” surgery. Procedures categorized as “minor” surgery included dental extraction(s), dental implants, soft tissue and bone biopsies, and preprosthetic bone surgery, and incision and drainage. Warfarin and antiplatelet medication were not withheld in these patients, and a Point-of-Care In-Office INR Monitoring Device was used to obtain INR levels on the day of consultation and surgery. Local measures including removal of granulation tissue, packing, suturing, etc. were utilized for hemostasis. Results: The 30 patients in the study group maintained on warfarin readily achieved hemostasis using intraoperative local measures. The mean INR measured by the In-Office INR Monitoring Device was 2.36 with a range from 1.3 to 3.2. Study group patients underwent a total of 131 separate procedures including 108 dental extractions (impactions), placement of dental implants, preprosthetic bony surgery, bone cyst removal, soft tissue biopsies, facial skin cancer repair, and incision and drainage. One patient (3%) required “minor” intervention with removal of a “liver clot” on postop day 2 with repacking and suturing. The 29 patients in the control group discontinued off of war farin underwent a total of 99 procedures. One patient (3%) also required a “minor” intervention (repacking of extraction site). There were no “major” complications in either group. Conclusions: This study supports previous studies that minor oral surgery procedures can be safely performed while maintaining patients on warfarin minimizing the risk of a potentially devastating thromboembolic event. When deciding whether or not to withhold warfarin, this study supports the use of the proposed protocol based on 1) risk stratification for thromboembolism, 2) the need for “minor” versus “major” surgery, 3) and utilization of an In-Office INR Monitoring Device. An In-Office Point-of-Care INR measuring device can be a very effective tool to safely simplify and make the perioperative management of the anticoagulated patient more efficient for the patient and oral and maxillo facial surgeon.

Main factors influencing long-term outcomes of liver transplantation in 2022

Liver transplant(LT)outcomes have markedly improved in the recent decades,even if long-term morbidity and mortality are still considerable.Most of late deaths are independent from graft function and different comorbidities,including complications of metabolic syndrome and de novo neoplasms,seem to play a key role in determining long-term outcomes in LT recipients.This review discusses the main factors associated with late mortality and suggests possible strategies to improve long-term management and follow-up after liver transplantation.In particular,the reduction of drug toxicity,the use of tools to identify high-risk patients,and setting up a multidisciplinary team also for long-term management of LT recipients may further improve survival after liver transplantation.

Carbon sequestration rate,nitrogen use efficiency and rice yield responses to long-term substitution of chemical fertilizer by organic manure in a rice–rice cropping system

Combined application of chemical fertilizers with organic amendments was recommended as a strategy for improving yield,soil carbon storage,and nutrient use efficiency.However,how the long-term substitution of chemical fertilizer with organic manure affects rice yield,carbon sequestration rate(CSR),and nitrogen use efficiency(NUE)while ensuring environmental safety remains unclear.This study assessed the long-term effect of substituting chemical fertilizer with organic manure on rice yield,CSR,and NUE.It also determined the optimum substitution ratio in the acidic soil of southern China.The treatments were:(i)NPK0,unfertilized control;(ii)NPK1,100%chemical nitrogen,phosphorus,and potassium fertilizer;(iii)NPKM1,70%chemical NPK fertilizer and 30%organic manure;(iv)NPKM2,50%chemical NPK fertilizer and 50%organic manure;and(v)NPKM3,30%chemical NPK fertilizer and 70%organic manure.Milk vetch and pig manure were sources of manure for early and late rice seasons,respectively.The result showed that SOC content was higher in NPKM1,NPKM2,and NPKM3 treatments than in NPK0 and NPK1 treatments.The carbon sequestration rate increased by 140,160,and 280%under NPKM1,NPKM2,and NPKM3 treatments,respectively,compared to NPK1 treatment.Grain yield was 86.1,93.1,93.6,and 96.5%higher under NPK1,NPKM1,NPKM2,and NPKM3 treatments,respectively,compared to NPK0 treatment.The NUE in NPKM1,NPKM2,and NPKM3 treatments was higher as compared to NPK1 treatment for both rice seasons.Redundancy analysis revealed close positive relationships of CSR with C input,total N,soil C:N ratio,catalase,and humic acids,whereas NUE was closely related to grain yield,grain N content,and phenol oxidase.Furthermore,CSR and NUE negatively correlated with humin acid and soil C:P and N:P ratios.The technique for order of preference by similarity to ideal solution(TOPSIS)showed that NPKM3 treatment was the optimum strategy for improving CSR and NUE.Therefore,substituting 70%of chemical fertilizer with organic manure could be the best management option for increasing CSR and NUE in the paddy fields of southern China.

Impact of anastomotic leakage on long-term prognosis after colorectal cancer surgery

Colorectal cancer(CRC)is one of the most common malignancies in the world.Despite significant improvements in surgical technique,postoperative complications still occur in a fair percentage of patients undergoing colorectal surgery.The most feared complication is anastomotic leakage.It negatively affects shortterm prognosis,with increased post-operative morbidity and mortality,higher hospitalization time and costs.Moreover,it may require further surgery with the creation of a permanent or temporary stoma.While there is no doubt about the negative impact of anastomotic dehiscence on the short-term prognosis of patients operated on for CRC,still under discussion is its impact on the long-term prognosis.Some authors have described an association between leakage and reduced overall survival,disease-free survival,and increased recurrence,while other Authors have found no real impact of dehiscence on long term prognosis.The purpose of this paper is to review all the literature about the impact of anastomotic dehiscence on long-term prognosis after CRC surgery.The main risk factors of leakage and early detection markers are also summarized.

Etiology analysis for term newborns with severe hyperbilirubinemia in eastern Guangdong of China

BACKGROUND Neonatal hyperbilirubinemia is one of the common diseases of newborns that typically presents with yellow staining of skin,resulting in sequelaes such as hearing loss,motor and intellectual development disorders,and even death.The pathogenic factors of neonatal hyperbilirubinemia are complex.Different cases of hyperbilirubinemia may have a single or mixed etiology.AIM To explore the etiological characteristics of severe hyperbilirubinemia in term newborns of eastern Guangdong of China.METHODS Term newborns with severe hyperbilirubinemia in one hospital from January 2012 to December 2021 were retrospectively analyzed.The etiology was determined according to the laboratory results and clinical manifestations.RESULTS Among 1602 term newborns with hyperbilirubinemia in eastern Guangdong of China,32.20%(580/1602)was severe hyperbilirubinemia.Among the causes of severe hyperbilirubinemia,neonatal hemolysis accounted for 15.17%,breast milk jaundice accounted for 12.09%,infection accounted for 10.17%,glucose-6-phosphate dehydrogenase(G6PD)deficiency accounted for 9.14%,and the coexistence of multiple etiologies accounted for 6.55%,unknown etiology accounted for 41.72%.ABO hemolysis and G6PD deficiency were the most common causes in the 20 cases with bilirubin encephalopathy.94 severe hyperbilirubinemia newborns were tested for uridine diphosphate glucuronosyl transferase 1A1(UGT1A1)*6 variant(rs4148323,c.211G>A,p.Arg71Gly),9 cases were 211 G to A homozygous variant,37 cases were 211 G to A heterozygous variant,and 48 cases were wild genotypes.CONCLUSION The main cause for severe hyperbilirubinemia and bilirubin encephalopathy in eastern Guangdong of China were the hemolytic disease of the newborns,G6PD deficiency and infection.UGT1A1 gene variant was also a high-risk factor for neonatal hyperbilirubinemia.Targeted prevention and treatment according to the etiology may reduce the occurrence of bilirubin encephalopathy and kernicterus.

Short Term Traffic Flow Prediction Using Hybrid Deep Learning

Traffic flow prediction in urban areas is essential in the IntelligentTransportation System (ITS). Short Term Traffic Flow (STTF) predictionimpacts traffic flow series, where an estimation of the number of vehicleswill appear during the next instance of time per hour. Precise STTF iscritical in Intelligent Transportation System. Various extinct systems aim forshort-term traffic forecasts, ensuring a good precision outcome which was asignificant task over the past few years. The main objective of this paper is topropose a new model to predict STTF for every hour of a day. In this paper,we have proposed a novel hybrid algorithm utilizing Principal ComponentAnalysis (PCA), Stacked Auto-Encoder (SAE), Long Short Term Memory(LSTM), and K-Nearest Neighbors (KNN) named PALKNN. Firstly, PCAremoves unwanted information from the dataset and selects essential features.Secondly, SAE is used to reduce the dimension of input data using onehotencoding so the model can be trained with better speed. Thirdly, LSTMtakes the input from SAE, where the data is sorted in ascending orderbased on the important features and generates the derived value. Finally,KNN Regressor takes information from LSTM to predict traffic flow. Theforecasting performance of the PALKNN model is investigated with OpenRoad Traffic Statistics dataset, Great Britain, UK. This paper enhanced thetraffic flow prediction for every hour of a day with a minimal error value.An extensive experimental analysis was performed on the benchmark dataset.The evaluated results indicate the significant improvement of the proposedPALKNN model over the recent approaches such as KNN, SARIMA, LogisticRegression, RNN, and LSTM in terms of root mean square error (RMSE)of 2.07%, mean square error (MSE) of 4.1%, and mean absolute error (MAE)of 2.04%.

Research on inversion method for complex source-term distributions based on deep neural networks

This study proposes a source distribution inversion convolutional neural network (SDICNN), which is deep neural network model for the inversion of complex source distributions, to solve inversion problems involving fixed-source distributions. A function is developed to obtain the distribution information of complex source terms from radiation parameters at individual sampling points in space. The SDICNN comprises two components:a fully connected network and a convolutional neural network. The fully connected network mainly extracts the parameter measurement information from the sampling points,whereas the convolutional neural network mainly completes the fine inversion of the source-term distribution. Finally, the SDICNN obtains a high-resolution source-term distribution image. In this study, the proposed source-term inversion method is evaluated based on typical geometric scenarios. The results show that, unlike the conventional fully connected neural network, the SDICNN model can extract the two-dimensional distribution features of the source terms, and its inversion results are better. In addition, the effects of the shielding mechanism and number of sampling points on the inversion process are examined. In summary, the result of this study can facilitate the accurate assessment of dose distributions in nuclear facilities.

Accident source term and radiological consequences of a small modular reactor

Considering the growing global demand for energy and the need for countries to achieve climate goals,there is an increasing global interest in small modular reactors(SMRs)and their applications.Accident source term and radiological consequence evaluations of SMRs are key components of nuclear and radiation safety reviews,which affect the site,exclusion area(EAB),and low population zone outer boundaries.Based on the design characteristics of the SMR and accident analysis results,a theoretical model of a whole-core fuel cladding damage accident was constructed to study the radioactivity released into the environment and its consequences.The accident source term and radiation dose calculation models were established to analyze the released amounts of radionuclides and the total effective dose affecting individuals at the site boundary.The results showed that the amount of radionuclides released into the environment after a whole-core fuel cladding damage accident reached 10^(14) Bq,among which the release amount of ^(133)Xe was the largest.The total effective dose at the site boundary 30 days after the accident was 8.65 mSv.The highest total effective dose affecting individuals occurred to the east-north-east.The results of the accident source term and radiological consequence provide technical support for site boundary dose assessments and reviews of SMRs.

Predictive Value of Amniotic Fluid Index in Term Small for Gestational Age with Normal Doppler Studies for Perinatal Outcomes

Background and Aim: Delivery of a fetus with SGA is associated with increased risk of perinatal morbidity and mortality. Evidence is limited for the accuracy of Oligohydramnios to predict substantive perinatal morbidity and mortality in non–anomalous SGA fetuses monitored with normal Doppler studies. The aim of this study is to determine the association between amniotic fluid index and adverse perinatal outcomes in term SGA fetuses with normal Doppler studies. Method: This is a prospective observational study carried out by 340 pregnant women who were admitted to obstetrics unit, Sri Jayewardenepura from January 2019 to January 2023. Singleton pregnancies at term who were diagnosed with SGA (EFW 10th centile or AC 10th centile) with normal umbilical artery and middle cerebral artery Doppler studies were included. AFI was assessed predelivery and data were collected according to demographic details, mode of delivery, time of delivery, intrapartum events, and neonatal outcomes. Results: A total of 340 term pregnant women were studied. Out of them, 44% were in AFI more than 10 groups and 37% and 19% were in AFI 5 - 10 and less than 5 groups respectively. More obstetrics interventions were reported in AFI 5 groupa in terms of induction of labor (P 0.04) and emergency caesarean sections (P 0.003). No significant deference in immediate neonatal outcome was detected between each group. (Meconium-stained liquor (P 0.634), 1 minute APGAR (P 0.575) and 5-minute APGAR P 0.165)). Neonatal unit admission (P 0.001) and long-term neonatal complications were

Optimization of sensor deployment sequences for hazardous gas leakage monitoring and source term estimation

Nowadays, chemical safety has attracted considerable attention, and chemical gas leakage monitoring and source term estimation(STE) have become hot spots. However, few studies have focused on sensor layouts in scenarios with multiple potential leakage sources and wind conditions, and studies on the risk information(RI) detection and prioritization order of sensors have not been performed. In this work, the monitoring area of a chemical factory is divided into multiple rectangles with a uniform mesh. The RI value of each grid node is calculated on the basis of the occurrence probability and normalized concentrations of each leakage scenario. A high RI value indicates that a sensor at a grid node has a high chance of detecting gas concentrations in different leakage scenarios. This situation is beneficial for leakage monitoring and STE. The methods of similarity redundancy detection and the maximization of sensor RI detection are applied to determine the sequence of sensor locations. This study reveals that the RI detection of the optimal sensor layout with eight sensors exceeds that of the typical layout with 12 sensors. In addition, STE with the optimized placement sequence of the sensor layout is numerically simulated. The statistical results of each scenario with various numbers of sensors reveal that STE is affected by sensor number and scenarios(leakage locations and winds). In most scenarios, appropriate STE results can be retained under the optimal sensor layout even with four sensors. Eight or more sensors are advised to improve the performance of STE in all scenarios. Moreover, the reliability of the STE results in each scenario can be known in advance with a specific number of sensors. Such information thus provides a reference for emergency rescue.