BACKGROUND:Chlorfenapyr is used to kill insects that are resistant to organophosphorus insecticides.Chlorfenapyr poisoning has a high mortality rate and is difficult to treat.This article aims to review the mechanisms...BACKGROUND:Chlorfenapyr is used to kill insects that are resistant to organophosphorus insecticides.Chlorfenapyr poisoning has a high mortality rate and is difficult to treat.This article aims to review the mechanisms,clinical presentations,and treatment strategies for chlorfenapyr poisoning.DATA RESOURCES:We conducted a review of the literature using PubMed,Web of Science,and SpringerLink from their beginnings to the end of October 2023.The inclusion criteria were systematic reviews,clinical guidelines,retrospective studies,and case reports on chlorfenapyr poisoning that focused on its mechanisms,clinical presentations,and treatment strategies.The references in the included studies were also examined to identify additional sources.RESULTS:We included 57 studies in this review.Chlorfenapyr can be degraded into tralopyril,which is more toxic and reduces energy production by inhibiting the conversion of adenosine diphosphate to adenosine triphosphate.High fever and altered mental status are characteristic clinical presentations of chlorfenapyr poisoning.Once it occurs,respiratory failure occurs immediately,ultimately leading to cardiac arrest and death.Chlorfenapyr poisoning is diflcult to treat,and there is no specific antidote.CONCLUSION:Chlorfenapyr is a new pyrrole pesticide.Although it has been identified as a moderately toxic pesticide by the World Health Organization(WHO),the mortality rate of poisoned patients is extremely high.There is no specific antidote for chlorfenapyr poisoning.Therefore,based on the literature review,future efforts to explore rapid and effective detoxification methods,reconstitute intracellular oxidative phosphorylation couplings,identify early biomarkers of chlorfenapyr poisoning,and block the conversion of chlorfenapyr to tralopyril may be helpful for emergency physicians in the diagnosis and treatment of this disease.展开更多
Moyamoya disease (MMD) is a condition characterized by the gradual narrowing and blockage of blood vessels in the brain, specifically those in the circle of Willis and the arteries that supply it. This results in redu...Moyamoya disease (MMD) is a condition characterized by the gradual narrowing and blockage of blood vessels in the brain, specifically those in the circle of Willis and the arteries that supply it. This results in reduced blood flow and oxygen to the brain, leading to progressive symptoms and potential complications. The underlying pathophysiological mechanism remains elucidated. However, recent studies have highlighted numerous etiologic factors: abnormal immune complex responses, susceptibility genes, branched-chain amino acids, antibodies, heritable diseases, and acquired diseases, which may be the great potential triggers for the development of moyamoya disease. Its clinical presentation has varying degrees from transient asymptomatic events to significant neurological deficits. Moyamoya disease (MMD) shows different patterns in children and adults. Children with MMD are more susceptible to ischemic events due to decreased blood flow to the brain. Conversely, adults with MMD are more prone to hemorrhagic events involving brain bleeding. Children with MMD may experience a range of symptoms including motor impairments, sensory issues, seizures, headaches, dizziness, cognitive delays, or ongoing neurological problems. Although adults may present with similar clinical symptoms as children, they are more prone to experiencing sudden onset intraventricular, subarachnoid, or intracerebral hemorrhages. One of the challenges in moyamoya disease is the potential for misdiagnosis or delayed diagnosis, particularly when physicians fail to consider MMD as a possible cause in stroke patients. This review aims to provide a comprehensive overview of recent global studies on the pathophysiology of MMD, along with advancements in its management. Additionally, the review will delve into various surgical treatment options for MMD, as well as its rare occurrence alongside atrioventricular malformations. Exciting prospects include the use of autologous bone marrow transplant and the potential role of Connexin 43 protein treatment in the development of moyamoya disease.展开更多
A comprehensive differential diagnosis is essential in the emergency department, even when patient presentations are atypical. Timely recognition of life-threatening conditions, such as aortic dissection, hinges on th...A comprehensive differential diagnosis is essential in the emergency department, even when patient presentations are atypical. Timely recognition of life-threatening conditions, such as aortic dissection, hinges on this critical diagnostic approach.展开更多
In the new era when demands for flexible intellectual skills are increasing,strengthening the cultivation of critical thinking ability of students has become one of the key purposes of higher education.This paper inte...In the new era when demands for flexible intellectual skills are increasing,strengthening the cultivation of critical thinking ability of students has become one of the key purposes of higher education.This paper intends to discuss how to cultivate students’critical thinking ability through English classroom presentations.It points out that during the whole process,teachers’guidance plays an indispensable role.Only when both teachers and students are aware that classroom presentations are a golden opportunity for the cultivation of students’critical thinking ability and carry this awareness into their English classes,can English presentations be brought into full play.展开更多
Background: Globally, PRAKI is among the leading causes of death in pregnant women. The prevalence, causes and outcome of this condition vary among countries due to differences in environmental, socioeconomic, and hea...Background: Globally, PRAKI is among the leading causes of death in pregnant women. The prevalence, causes and outcome of this condition vary among countries due to differences in environmental, socioeconomic, and health delivery systems. The common causes that have been reported in several studies are PIH, Haemorrhages and Sepsis while the outcomes may be either complete renal recovery, progression to CKD and hence dialysis dependency or death. This study aimed at determining clinical presentation and treatment outcomes of Pregnancy-Related Acute Kidney Injury in Pregnant women admitted at the Benjamin Mkapa Hospital, Dodoma, Tanzania. Results: Out of 4007 pregnant women who were admitted to the maternity ward 51 pregnant women were found to have PRAKI. Of those with PRAKI, 74.5% were between 21 to 25 years. The leading causes of PRAKI were PPH 12 (23.53%), Eclampsia 12 (23.53%), and pre-eclampsia 12 (23.5%). Hemodialysis therapy was provided to 22 (43.1%) patients, 15 (29.4%) individuals recovered spontaneously with medical management and 14 (27.5%) missed haemodialysis therapy due to various reasons. The mortality due to PRAKI was 17 (33.3%). Conclusion and Recommendation: Pre-eclampsia/eclampsia and post-partum haemorrhage were found to be the main causes of PRAKI. The mortality related to PRAKI is high and Hemodialysis therapy is vital help to prevent deaths for pregnant women with PRAKI. Pregnant women who develop acute kidney injury should be followed closely and a nephrologist should be consulted early. Early referral should be done by the lower level facilities for all at-risk pregnant women to a specialized multidisciplinary health facility.展开更多
In the age of new media,short videos play an increasingly important role in international cultural exchange.However,German learners often encounter challenges when producing and sharing short videos due to factors suc...In the age of new media,short videos play an increasingly important role in international cultural exchange.However,German learners often encounter challenges when producing and sharing short videos due to factors such as technology and language proficiency.Such challenges can affect the professionalism and attractiveness of the videos.This study focuses on German learners at the University of Shanghai for Science and Technology.The aim of this study is to investigate students’experiences in producing short videos,identify issues through surveys and interviews,and concentrate on editing skills,language proficiency,and intercultural communication abilities.It proposes strategies for developing these skills and aims to provide insights for German and other foreign language learners in telling Chinese stories using short videos.展开更多
Background: Fournier’s gangrene is a fulminant infection of the genitourinary tract characterized by progressive necrosis of the skin and subcutaneous tissue of the external genitalia. Initially mainly seen involving...Background: Fournier’s gangrene is a fulminant infection of the genitourinary tract characterized by progressive necrosis of the skin and subcutaneous tissue of the external genitalia. Initially mainly seen involving the scrotum of elderly men with different moods of occurrence each unpleasantly lethal. With varying types of presentation only one thing has remained constant;the poor prognosis of this condition. Purpose/Aim: Thus, it’s important to study the trends of the presentation of this condition laying emphasis on the challenges in the management of these patients;both the negative and positive prognostic factors. Materials and Methods: Urology ward record books, clinic record books and operating theater records were used to identify patients managed for Fournier gangrene in ATBUTH Bauchi. A retrospective study of the medical files of all the patients managed from January 2011 to January 2024 was done. Data was analyzed using SPSS version 29. Results: Data from 47 patients seen during the period of study were carefully collected and analyzed. The age range is 2 weeks to 97 years. There were two neonates, one at 2nd week of life and the other at 3rd week. Mortality rate is 36%. The average time duration before presentation for patients that died was two weeks, a minimum of 9 days prior to presentation and a maximum of 21 days, about 10 of which came in septic shock and the remaining presented with fever and very extensive necrotizing fasciitis of the perineum. All the patients that died had diabetes mellitus as a comorbidity except the neonate. All the patients that survived were much younger, all were below 60 years of age (2 weeks - 53 years). Conclusion: Here, we share our experience managing patients with Fournier’s gangrene in our facility in the past 13-year period from January 2011 to January 2024. .展开更多
Rural electrification remains a critical challenge in achieving equitable access to electricity, a cornerstone for poverty alleviation, economic growth, and improved living standards. Capacitor Coupled Substations (CC...Rural electrification remains a critical challenge in achieving equitable access to electricity, a cornerstone for poverty alleviation, economic growth, and improved living standards. Capacitor Coupled Substations (CCS) offer a promising solution for delivering cost-effective electricity to these underserved areas. However, the integration of multiple CCS units along a transmission network introduces complex interactions that can significantly impact voltage, current, and power flow. This study presents a detailed mathematical model to analyze the effects of varying distances and configurations of multiple CCS units on a transmission network, with a focus on voltage stability, power quality, and reactive power fluctuations. Furthermore, the research addresses the phenomenon of ferroresonance, a critical issue in networks with multiple CCS units, by developing and validating suppression strategies to ensure stable operation. Through simulation and practical testing, the study provides insights into optimizing CCS deployment, ultimately contributing to more reliable and efficient rural electrification solutions.展开更多
A heterogeneous information network,which is composed of various types of nodes and edges,has a complex structure and rich information content,and is widely used in social networks,academic networks,e-commerce,and oth...A heterogeneous information network,which is composed of various types of nodes and edges,has a complex structure and rich information content,and is widely used in social networks,academic networks,e-commerce,and other fields.Link prediction,as a key task to reveal the unobserved relationships in the network,is of great significance in heterogeneous information networks.This paper reviews the application of presentation-based learning methods in link prediction of heterogeneous information networks.This paper introduces the basic concepts of heterogeneous information networks,and the theoretical basis of representation learning,and discusses the specific application of the deep learning model in node embedding learning and link prediction in detail.The effectiveness and superiority of these methods on multiple real data sets are demonstrated by experimental verification.展开更多
Angiotensin Receptor Blockers (ARB) are used as an alternative of Angiotensin Converting Enzyme Inhibitors (ACEI) in patients where ACEIs cannot be used because of their known adverse effects, cough and angioedema. Th...Angiotensin Receptor Blockers (ARB) are used as an alternative of Angiotensin Converting Enzyme Inhibitors (ACEI) in patients where ACEIs cannot be used because of their known adverse effects, cough and angioedema. Thus ARB induced angioedema is considered to be a rare phenomenon and it is continued to be used as an alternatives of ACEIs. In this case report, we reported a case of 78-year-old gentleman who presented to emergency department with losartan, an ARB induced angioedema, who did not have history of any previous use of ACEIs. He was given steroids and antihistamine as a treatment. His angioedema resolved rapidly and he was discharged after six hours of emergency department (ED) observation with stable hemodynamically. We, the authors by reporting this case, wants to make clinicians aware ARB, however rarely, can cause angioedema, which can be life threatening if clinicians are not aware of it and diagnose and stop the offending drug promptly and treat it early.展开更多
This work presents a flexible/unified hardware architecture of Elliptic-curve Cryptography(ECC)and PRESENT for cryptographic applications.The features of the proposed work are(i)computation of only the point multiplic...This work presents a flexible/unified hardware architecture of Elliptic-curve Cryptography(ECC)and PRESENT for cryptographic applications.The features of the proposed work are(i)computation of only the point multiplication operation of ECC over GF(2163)for a 163-bit key generation,(ii)execution of only the variant of an 80-bit PRESENT block cipher for data encryption&decryption and(iii)execution of point multiplication operation(ECC algorithm)along with the data encryption and decryption(PRESENT algorithm).To establish an area overhead for the flexible design,dedicated hardware architectures of ECC and PRESENT are implemented in the first step,and a sum of their hardware area is computed.Then,the implementation of the proposed flexible architecture for ECC and PRESENT algorithms is presented.Implementation results regarding the area,clock cycles,latency,clock frequency,and power after the place-and-route level on Xilinx Virtex-5,Virtex-6,and Virtex-7 FPGA devices are presented.Hence,the implementation results and comparisons show that the proposed architecture suits applications demanding flexible implementation of cryptographic applications.展开更多
Background:Wernicke encephalopathy(WE)is an acute neurological disease resulting from vitamin B1 deficiency,and there are only very few case reports of WE after liver transplantation.The present study aimed to investi...Background:Wernicke encephalopathy(WE)is an acute neurological disease resulting from vitamin B1 deficiency,and there are only very few case reports of WE after liver transplantation.The present study aimed to investigate the clinical characteristics,etiology,magnetic resonance imaging(MRI)features,treatment and prognosis of patients with WE after liver transplantation.Methods:Twenty-three patients with WE after liver transplantation from the First Affiliated Hospital,Zhejiang University School of Medicine and Jiangxi Provincial People’s Hospital between January 2011 and December 2021 were retrospectively analyzed.Results:Among the 23 patients diagnosed with WE after liver transplantation,6(26%)had a classic triad of impaired consciousness,oculomotor palsy and ataxia,and 17(74%)had two features.The misdiagno-sis rate was 65%.After treatment with high-dose vitamin B1,19(83%)patients showed improvement,whereas 4(17%)showed no improvement,including 3 with residual short-term memory impairments and 1 with residual spatial and temporal disorientation and ataxia.Conclusions:The misdiagnosis rate is high in the early stage of WE,and the prognosis is closely asso-ciated with whether WE is diagnosed early and treated timely.High-dose glucose or glucocorticoids can trigger WE and cannot be administered before vitamin B1 treatment.Vitamin B1 is suggested to be used as a prophylactic treatment for patients with WE after liver transplantation.展开更多
In the 21st century,a new round of scientifi c and technological revolution represented by digitalization,networking and intelligence has caused a change in the scientific research paradigm,and the research of complex...In the 21st century,a new round of scientifi c and technological revolution represented by digitalization,networking and intelligence has caused a change in the scientific research paradigm,and the research of complex systems has become the main driving force for the change of the scientific research paradigm.展开更多
BACKGROUND Incidence of cholangiocarcinoma(CCA)is rising,with overall prognosis remaining very poor.Reasons for the high mortality of CCA include its late presentation in most patients,when curative options are no lon...BACKGROUND Incidence of cholangiocarcinoma(CCA)is rising,with overall prognosis remaining very poor.Reasons for the high mortality of CCA include its late presentation in most patients,when curative options are no longer feasible,and poor response to systemic therapies for advanced disease.Late presentation presents a large barrier to improving outcomes and is often associated with diagnosis via mergency presentation(EP).Earlier diagnoses may be made by Two Week Wait(TWW)referrals through General practitioner(GP).We hypothesise that TWW referrals and EP routes to diagnosis differ across regions in England.AIM To investigate routes to diagnosis of CCA over time,regional variation and influencing factors.METHODS We linked patient records from the National Cancer Registration Dataset to Hospital Episode Statistics,Cancer Waiting Times and Cancer Screening Programme datasets to define routes to diagnosis and certain patient characteristics for patients diagnosed 2006-2017 in England.We used linear probability models to investigate geographic variation by assessing the proportions of patients diagnosed via TWW referral or EP across Cancer Alliances in England,adjusting for potential confounders.Correlation between the proportion of people diagnosed by TWW referral and EP was investigated with Spearman’s correlation coefficient.RESULTS Of 23632 patients diagnosed between 2006-2017 in England,the most common route to diagnosis was EP(49.6%).Non-TWW GP referrals accounted for 20.5%of diagnosis routes,13.8%were diagnosed by TWW referral,and the remainder 16.2%were diagnosed via an‘other’or Unknown route.The proportion diagnosed via a TWW referral doubled between 2006-2017 rising from 9.9%to 19.8%,conversely EP diagnosis route declined,falling from 51.3%to 46.0%.Statistically significant variation in both the TWW referral and EP proportions was found across Cancer Alliances.Age,presence of comorbidity and underlying liver disease were independently associated with both a lower proportion of patients diagnosed via TWW referral,and a higher proportion diagnosed by EP after adjusting for other potential confounders.CONCLUSION There is significant geographic and socio-demographic variation in routes to diagnosis of CCA in England.Knowledge sharing of best practice may improve diagnostic pathways and reduce unwarranted variation.展开更多
The Advanced Machining Technology Team of the National Research Council Canada The team,with its focus on the research and development of advanced machining technology,was formed in 2003 within the Aerospace Manufactu...The Advanced Machining Technology Team of the National Research Council Canada The team,with its focus on the research and development of advanced machining technology,was formed in 2003 within the Aerospace Manufacturing Technology Centre,one of the national labs of the National Research Council Canada,which is the largest research&development organization of the Federal Government of Canada.Six research officers all having doctorate degrees lead research work presently in different areas.展开更多
BACKGROUND The late presentation of dural tears(LPDT)has a low incidence rate and hidden symptoms and is easily ignored in clinical practice.If the disease is not treated in time,a series of complications may occur,in...BACKGROUND The late presentation of dural tears(LPDT)has a low incidence rate and hidden symptoms and is easily ignored in clinical practice.If the disease is not treated in time,a series of complications may occur,including low intracranial pressure headache,infection,pseudodural cyst formation,and sinus formation.Here,we describe two cases of LPDT.CASE SUMMARY Two patients had sudden fever 1 wk after lumbar surgery.Physical examination showed obvious tenderness in the operation area.The patients were confirmed as having LPDT by lumbar magnetic resonance imaging and surgical exploration.One case was caused by continuous negative pressure suction and malnutrition,and the other was caused by decreased dural ductility and low postoperative nutritional status.The first symptom of both patients was fever,with occasional headache.Both patients underwent secondary surgery to treat the LPDT.Dural defects were observed and dural sealants were used to seal the dural defects,then drainage tubes were retained for drainage.After the operation,the patients were treated with antibiotics and the patients’surgical incisions healed well,without fever or incision tenderness.Both recovered and were discharged 1 wk after the operation.CONCLUSION LPDT is a rare complication of spinal surgery or neurosurgery that has hidden symptoms and can easily be overlooked.Since it may cause a series of complic-ations,LPDT needs to be actively addressed in clinical practice.展开更多
基金supported by the Research Foundation of Ningbo No.2 Hospital (2023HMKY49)Ningbo Key Support Medical Discipline (2022-F16)。
文摘BACKGROUND:Chlorfenapyr is used to kill insects that are resistant to organophosphorus insecticides.Chlorfenapyr poisoning has a high mortality rate and is difficult to treat.This article aims to review the mechanisms,clinical presentations,and treatment strategies for chlorfenapyr poisoning.DATA RESOURCES:We conducted a review of the literature using PubMed,Web of Science,and SpringerLink from their beginnings to the end of October 2023.The inclusion criteria were systematic reviews,clinical guidelines,retrospective studies,and case reports on chlorfenapyr poisoning that focused on its mechanisms,clinical presentations,and treatment strategies.The references in the included studies were also examined to identify additional sources.RESULTS:We included 57 studies in this review.Chlorfenapyr can be degraded into tralopyril,which is more toxic and reduces energy production by inhibiting the conversion of adenosine diphosphate to adenosine triphosphate.High fever and altered mental status are characteristic clinical presentations of chlorfenapyr poisoning.Once it occurs,respiratory failure occurs immediately,ultimately leading to cardiac arrest and death.Chlorfenapyr poisoning is diflcult to treat,and there is no specific antidote.CONCLUSION:Chlorfenapyr is a new pyrrole pesticide.Although it has been identified as a moderately toxic pesticide by the World Health Organization(WHO),the mortality rate of poisoned patients is extremely high.There is no specific antidote for chlorfenapyr poisoning.Therefore,based on the literature review,future efforts to explore rapid and effective detoxification methods,reconstitute intracellular oxidative phosphorylation couplings,identify early biomarkers of chlorfenapyr poisoning,and block the conversion of chlorfenapyr to tralopyril may be helpful for emergency physicians in the diagnosis and treatment of this disease.
文摘Moyamoya disease (MMD) is a condition characterized by the gradual narrowing and blockage of blood vessels in the brain, specifically those in the circle of Willis and the arteries that supply it. This results in reduced blood flow and oxygen to the brain, leading to progressive symptoms and potential complications. The underlying pathophysiological mechanism remains elucidated. However, recent studies have highlighted numerous etiologic factors: abnormal immune complex responses, susceptibility genes, branched-chain amino acids, antibodies, heritable diseases, and acquired diseases, which may be the great potential triggers for the development of moyamoya disease. Its clinical presentation has varying degrees from transient asymptomatic events to significant neurological deficits. Moyamoya disease (MMD) shows different patterns in children and adults. Children with MMD are more susceptible to ischemic events due to decreased blood flow to the brain. Conversely, adults with MMD are more prone to hemorrhagic events involving brain bleeding. Children with MMD may experience a range of symptoms including motor impairments, sensory issues, seizures, headaches, dizziness, cognitive delays, or ongoing neurological problems. Although adults may present with similar clinical symptoms as children, they are more prone to experiencing sudden onset intraventricular, subarachnoid, or intracerebral hemorrhages. One of the challenges in moyamoya disease is the potential for misdiagnosis or delayed diagnosis, particularly when physicians fail to consider MMD as a possible cause in stroke patients. This review aims to provide a comprehensive overview of recent global studies on the pathophysiology of MMD, along with advancements in its management. Additionally, the review will delve into various surgical treatment options for MMD, as well as its rare occurrence alongside atrioventricular malformations. Exciting prospects include the use of autologous bone marrow transplant and the potential role of Connexin 43 protein treatment in the development of moyamoya disease.
文摘A comprehensive differential diagnosis is essential in the emergency department, even when patient presentations are atypical. Timely recognition of life-threatening conditions, such as aortic dissection, hinges on this critical diagnostic approach.
文摘In the new era when demands for flexible intellectual skills are increasing,strengthening the cultivation of critical thinking ability of students has become one of the key purposes of higher education.This paper intends to discuss how to cultivate students’critical thinking ability through English classroom presentations.It points out that during the whole process,teachers’guidance plays an indispensable role.Only when both teachers and students are aware that classroom presentations are a golden opportunity for the cultivation of students’critical thinking ability and carry this awareness into their English classes,can English presentations be brought into full play.
文摘Background: Globally, PRAKI is among the leading causes of death in pregnant women. The prevalence, causes and outcome of this condition vary among countries due to differences in environmental, socioeconomic, and health delivery systems. The common causes that have been reported in several studies are PIH, Haemorrhages and Sepsis while the outcomes may be either complete renal recovery, progression to CKD and hence dialysis dependency or death. This study aimed at determining clinical presentation and treatment outcomes of Pregnancy-Related Acute Kidney Injury in Pregnant women admitted at the Benjamin Mkapa Hospital, Dodoma, Tanzania. Results: Out of 4007 pregnant women who were admitted to the maternity ward 51 pregnant women were found to have PRAKI. Of those with PRAKI, 74.5% were between 21 to 25 years. The leading causes of PRAKI were PPH 12 (23.53%), Eclampsia 12 (23.53%), and pre-eclampsia 12 (23.5%). Hemodialysis therapy was provided to 22 (43.1%) patients, 15 (29.4%) individuals recovered spontaneously with medical management and 14 (27.5%) missed haemodialysis therapy due to various reasons. The mortality due to PRAKI was 17 (33.3%). Conclusion and Recommendation: Pre-eclampsia/eclampsia and post-partum haemorrhage were found to be the main causes of PRAKI. The mortality related to PRAKI is high and Hemodialysis therapy is vital help to prevent deaths for pregnant women with PRAKI. Pregnant women who develop acute kidney injury should be followed closely and a nephrologist should be consulted early. Early referral should be done by the lower level facilities for all at-risk pregnant women to a specialized multidisciplinary health facility.
基金the“Undergraduate Innovation and Entrepreneurship Training Program”Project of Shanghai University of Technology(Project No.XJ2023263)the Ministry of Education’s Industry-University Cooperation and Collaborative Education Project(Project No.220903230275503).
文摘In the age of new media,short videos play an increasingly important role in international cultural exchange.However,German learners often encounter challenges when producing and sharing short videos due to factors such as technology and language proficiency.Such challenges can affect the professionalism and attractiveness of the videos.This study focuses on German learners at the University of Shanghai for Science and Technology.The aim of this study is to investigate students’experiences in producing short videos,identify issues through surveys and interviews,and concentrate on editing skills,language proficiency,and intercultural communication abilities.It proposes strategies for developing these skills and aims to provide insights for German and other foreign language learners in telling Chinese stories using short videos.
文摘Background: Fournier’s gangrene is a fulminant infection of the genitourinary tract characterized by progressive necrosis of the skin and subcutaneous tissue of the external genitalia. Initially mainly seen involving the scrotum of elderly men with different moods of occurrence each unpleasantly lethal. With varying types of presentation only one thing has remained constant;the poor prognosis of this condition. Purpose/Aim: Thus, it’s important to study the trends of the presentation of this condition laying emphasis on the challenges in the management of these patients;both the negative and positive prognostic factors. Materials and Methods: Urology ward record books, clinic record books and operating theater records were used to identify patients managed for Fournier gangrene in ATBUTH Bauchi. A retrospective study of the medical files of all the patients managed from January 2011 to January 2024 was done. Data was analyzed using SPSS version 29. Results: Data from 47 patients seen during the period of study were carefully collected and analyzed. The age range is 2 weeks to 97 years. There were two neonates, one at 2nd week of life and the other at 3rd week. Mortality rate is 36%. The average time duration before presentation for patients that died was two weeks, a minimum of 9 days prior to presentation and a maximum of 21 days, about 10 of which came in septic shock and the remaining presented with fever and very extensive necrotizing fasciitis of the perineum. All the patients that died had diabetes mellitus as a comorbidity except the neonate. All the patients that survived were much younger, all were below 60 years of age (2 weeks - 53 years). Conclusion: Here, we share our experience managing patients with Fournier’s gangrene in our facility in the past 13-year period from January 2011 to January 2024. .
文摘Rural electrification remains a critical challenge in achieving equitable access to electricity, a cornerstone for poverty alleviation, economic growth, and improved living standards. Capacitor Coupled Substations (CCS) offer a promising solution for delivering cost-effective electricity to these underserved areas. However, the integration of multiple CCS units along a transmission network introduces complex interactions that can significantly impact voltage, current, and power flow. This study presents a detailed mathematical model to analyze the effects of varying distances and configurations of multiple CCS units on a transmission network, with a focus on voltage stability, power quality, and reactive power fluctuations. Furthermore, the research addresses the phenomenon of ferroresonance, a critical issue in networks with multiple CCS units, by developing and validating suppression strategies to ensure stable operation. Through simulation and practical testing, the study provides insights into optimizing CCS deployment, ultimately contributing to more reliable and efficient rural electrification solutions.
基金Science and Technology Research Project of Jiangxi Provincial Department of Education(Project No.GJJ211348,GJJ211347 and GJJ2201056)。
文摘A heterogeneous information network,which is composed of various types of nodes and edges,has a complex structure and rich information content,and is widely used in social networks,academic networks,e-commerce,and other fields.Link prediction,as a key task to reveal the unobserved relationships in the network,is of great significance in heterogeneous information networks.This paper reviews the application of presentation-based learning methods in link prediction of heterogeneous information networks.This paper introduces the basic concepts of heterogeneous information networks,and the theoretical basis of representation learning,and discusses the specific application of the deep learning model in node embedding learning and link prediction in detail.The effectiveness and superiority of these methods on multiple real data sets are demonstrated by experimental verification.
文摘Angiotensin Receptor Blockers (ARB) are used as an alternative of Angiotensin Converting Enzyme Inhibitors (ACEI) in patients where ACEIs cannot be used because of their known adverse effects, cough and angioedema. Thus ARB induced angioedema is considered to be a rare phenomenon and it is continued to be used as an alternatives of ACEIs. In this case report, we reported a case of 78-year-old gentleman who presented to emergency department with losartan, an ARB induced angioedema, who did not have history of any previous use of ACEIs. He was given steroids and antihistamine as a treatment. His angioedema resolved rapidly and he was discharged after six hours of emergency department (ED) observation with stable hemodynamically. We, the authors by reporting this case, wants to make clinicians aware ARB, however rarely, can cause angioedema, which can be life threatening if clinicians are not aware of it and diagnose and stop the offending drug promptly and treat it early.
基金The authors would like to thank the Deanship of Scientific Research at Umm Al-Qura University for supporting this work by Grant Code:(22UQU4320020DSR01).
文摘This work presents a flexible/unified hardware architecture of Elliptic-curve Cryptography(ECC)and PRESENT for cryptographic applications.The features of the proposed work are(i)computation of only the point multiplication operation of ECC over GF(2163)for a 163-bit key generation,(ii)execution of only the variant of an 80-bit PRESENT block cipher for data encryption&decryption and(iii)execution of point multiplication operation(ECC algorithm)along with the data encryption and decryption(PRESENT algorithm).To establish an area overhead for the flexible design,dedicated hardware architectures of ECC and PRESENT are implemented in the first step,and a sum of their hardware area is computed.Then,the implementation of the proposed flexible architecture for ECC and PRESENT algorithms is presented.Implementation results regarding the area,clock cycles,latency,clock frequency,and power after the place-and-route level on Xilinx Virtex-5,Virtex-6,and Virtex-7 FPGA devices are presented.Hence,the implementation results and comparisons show that the proposed architecture suits applications demanding flexible implementation of cryptographic applications.
基金approved by Jiangxi Provincial People’s Hospital and First Affiliated Hospital,Zhejiang University School of Medicine(2022068 and 2022370).Written informed consent was obtained from all participants.
文摘Background:Wernicke encephalopathy(WE)is an acute neurological disease resulting from vitamin B1 deficiency,and there are only very few case reports of WE after liver transplantation.The present study aimed to investigate the clinical characteristics,etiology,magnetic resonance imaging(MRI)features,treatment and prognosis of patients with WE after liver transplantation.Methods:Twenty-three patients with WE after liver transplantation from the First Affiliated Hospital,Zhejiang University School of Medicine and Jiangxi Provincial People’s Hospital between January 2011 and December 2021 were retrospectively analyzed.Results:Among the 23 patients diagnosed with WE after liver transplantation,6(26%)had a classic triad of impaired consciousness,oculomotor palsy and ataxia,and 17(74%)had two features.The misdiagno-sis rate was 65%.After treatment with high-dose vitamin B1,19(83%)patients showed improvement,whereas 4(17%)showed no improvement,including 3 with residual short-term memory impairments and 1 with residual spatial and temporal disorientation and ataxia.Conclusions:The misdiagnosis rate is high in the early stage of WE,and the prognosis is closely asso-ciated with whether WE is diagnosed early and treated timely.High-dose glucose or glucocorticoids can trigger WE and cannot be administered before vitamin B1 treatment.Vitamin B1 is suggested to be used as a prophylactic treatment for patients with WE after liver transplantation.
文摘In the 21st century,a new round of scientifi c and technological revolution represented by digitalization,networking and intelligence has caused a change in the scientific research paradigm,and the research of complex systems has become the main driving force for the change of the scientific research paradigm.
文摘BACKGROUND Incidence of cholangiocarcinoma(CCA)is rising,with overall prognosis remaining very poor.Reasons for the high mortality of CCA include its late presentation in most patients,when curative options are no longer feasible,and poor response to systemic therapies for advanced disease.Late presentation presents a large barrier to improving outcomes and is often associated with diagnosis via mergency presentation(EP).Earlier diagnoses may be made by Two Week Wait(TWW)referrals through General practitioner(GP).We hypothesise that TWW referrals and EP routes to diagnosis differ across regions in England.AIM To investigate routes to diagnosis of CCA over time,regional variation and influencing factors.METHODS We linked patient records from the National Cancer Registration Dataset to Hospital Episode Statistics,Cancer Waiting Times and Cancer Screening Programme datasets to define routes to diagnosis and certain patient characteristics for patients diagnosed 2006-2017 in England.We used linear probability models to investigate geographic variation by assessing the proportions of patients diagnosed via TWW referral or EP across Cancer Alliances in England,adjusting for potential confounders.Correlation between the proportion of people diagnosed by TWW referral and EP was investigated with Spearman’s correlation coefficient.RESULTS Of 23632 patients diagnosed between 2006-2017 in England,the most common route to diagnosis was EP(49.6%).Non-TWW GP referrals accounted for 20.5%of diagnosis routes,13.8%were diagnosed by TWW referral,and the remainder 16.2%were diagnosed via an‘other’or Unknown route.The proportion diagnosed via a TWW referral doubled between 2006-2017 rising from 9.9%to 19.8%,conversely EP diagnosis route declined,falling from 51.3%to 46.0%.Statistically significant variation in both the TWW referral and EP proportions was found across Cancer Alliances.Age,presence of comorbidity and underlying liver disease were independently associated with both a lower proportion of patients diagnosed via TWW referral,and a higher proportion diagnosed by EP after adjusting for other potential confounders.CONCLUSION There is significant geographic and socio-demographic variation in routes to diagnosis of CCA in England.Knowledge sharing of best practice may improve diagnostic pathways and reduce unwarranted variation.
文摘The Advanced Machining Technology Team of the National Research Council Canada The team,with its focus on the research and development of advanced machining technology,was formed in 2003 within the Aerospace Manufacturing Technology Centre,one of the national labs of the National Research Council Canada,which is the largest research&development organization of the Federal Government of Canada.Six research officers all having doctorate degrees lead research work presently in different areas.
基金Supported by Jilin Health Science and Technology Capability Improvement Project,No.2022C107.
文摘BACKGROUND The late presentation of dural tears(LPDT)has a low incidence rate and hidden symptoms and is easily ignored in clinical practice.If the disease is not treated in time,a series of complications may occur,including low intracranial pressure headache,infection,pseudodural cyst formation,and sinus formation.Here,we describe two cases of LPDT.CASE SUMMARY Two patients had sudden fever 1 wk after lumbar surgery.Physical examination showed obvious tenderness in the operation area.The patients were confirmed as having LPDT by lumbar magnetic resonance imaging and surgical exploration.One case was caused by continuous negative pressure suction and malnutrition,and the other was caused by decreased dural ductility and low postoperative nutritional status.The first symptom of both patients was fever,with occasional headache.Both patients underwent secondary surgery to treat the LPDT.Dural defects were observed and dural sealants were used to seal the dural defects,then drainage tubes were retained for drainage.After the operation,the patients were treated with antibiotics and the patients’surgical incisions healed well,without fever or incision tenderness.Both recovered and were discharged 1 wk after the operation.CONCLUSION LPDT is a rare complication of spinal surgery or neurosurgery that has hidden symptoms and can easily be overlooked.Since it may cause a series of complic-ations,LPDT needs to be actively addressed in clinical practice.