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Driving pressure in mechanical ventilation:A review

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World Journal of Critical Care Medicine 2024年第1期13卷 15-27页

作者： Syeda Farheen Zaidi Asim Shaikh Daniyal aziz Khan Salim Surani Iqbal Ratnani Department of Medicine Queen Mary UniversityLondon E14NSUnited Kingdom Department of Medicine Aga Khan UniversitySindhKarachi 74500Pakistan Department of Medicine Jinnah Postgraduate Medical CenterSindhKarachi 75510Pakistan Department of Medicine and Pharmacology Texas A and M UniversityCollege StationTX 77843United States Department of Anesthesiology and Critical Care Houston Methodist HospitalHoustonTX 77030United States

Driving pressure(ΔP)is a core therapeutic component of mechanical ventilation(MV).Varying levels ofΔP have been employed during MV depending on the type of underlying pathology and severity of ***,ΔP levels have also been shown to closely impact hard endpoints such as *** this,conducting an in-depth review ofΔP as a unique,outcome-impacting therapeutic modality is extremely *** is a need to understand the subtleties involved in making sureΔP levels are optimized to enhance outcomes and minimize *** performed this narrative review to further explore the various uses ofΔP,the different parameters that can affect its use,and how outcomes vary in different patient populations at different pressure *** better utilizeΔP in MV-requiring patients,additional large-scale clinical studies are needed.

关键词： Driving pressure Acute respiratory distress syndrome Mortality Positive end-expiratory pressure Ventilator induced lung injury Mechanical ventilation

Exploring the Latest Trends in AI Technologies: A Study on Current State, Application and Individual Impacts

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Journal of Computer and Communications 2024年第8期12卷 21-36页

作者： Md Ahsan Ullah Imran Mustakim Bin aziz Anamika Tiwari Sanchita Saha Ashok Ghimire Department of Business Administration Westcliff University 17877 Von Karman Ave 4th Floor Irvine CA 92614 United States

Artificial Intelligence (AI) offers immediate insights to penetrate the overwhelming volume of everyday security warnings. The current body of research mostly examines the use of AI in the field of cyber security, but it does not adequately address the visual inspection of AI applications. The advent of AI has led to noticeable structural changes in the field of cyber security. This study facilitates the advancement of theory about artificial intelligence (AI) across several fields. It assists researchers in determining research paths and serves as a resource for corporations and governments to strategize the use of AI in areas such as cyber security, education, healthcare, and work-life balance. Numerous nations, organizations, and writers are intricately linked via cooperation and citation networks. Artificial intelligence is an academic discipline focused on the research and advancement of computer systems, robots, and other creations that possess human-like intelligence, which is defined by cognitive powers, learning capabilities, and adaptability. This research aimed to evaluate the present trajectory and influence of Artificial Intelligence (AI) on education, healthcare, cybersecurity, and work-life balance. Based on an initial examination, this research focused on evaluating the use and impact of AI in many domains, using a specific narrative and framework. The findings of this study will enable researchers to comprehend the prevailing pattern and the influence of people on the integration of AI into daily life.

关键词： Artificial Intelligence Cybersecurity Healthcare AI on Education Work-Life Balance

Artificial Intelligence ChatGPT’s Perspective on Implementation of Augmented Intelligence within Orthopaedic Practice—A Comparative Narrative Synthesis?

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Intelligent Information Management 2024年第1期16卷 10-20页

作者： Neil Capes Hiran Patel Islam Sarhan Gur-aziz S. Sidhu Neil Ashwood Andrew Dekker Department of Trauma & Orthopaedics University Hospitals Derby and Burton Derby United Kingdom Department of Trauma & Orthopaedics University Hospital Lewisham London United Kingdom Research Institute University of Wolverhampton Wolverhampton United Kingdom

ChatGPT has obvious benefits in the way it can interrogate vast amounts of reference information and utilise metadata generation to answer questions posed to it and is freely available having been developed through human feedback. Already there are ethical and practical implications on its impact on learning and research. Artificial Intelligence (AI) has been seen as a way of improving healthcare provision by delivering more robust outcomes but measuring these and implementing AI within this setting is at present limited and disjointed. Methods: ChatGPT was interrogated to see what it felt were the barriers to its implementation within healthcare and in particular orthopaedic practice. The evidence for this determination was then examined for validity and applicability for a practical roll out at a Trust, Regional or National level. Results: AI can synthesise a vast amount of information to help it answer specific questions. The context and structure of any question will determine the usefulness of the answer which can then be used to develop practical solutions based on experience and resource limitations. Conclusions: AI has a role in service development and can quickly focus a working group to areas to consider when practically implementing change.

关键词： Artificial Intelligence ChatGPT

Alternative Phenotypic Profile for B-Cell Abnormality in a Case at Zinder National Hospital

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Open Journal of Blood Diseases 2024年第1期14卷 8-16页

作者： Brah Moustapha Maman Amadou Djibrilla-Almoustapha Moustapha Elhadji-Chefou Abdoul-aziz Garba Badé Malam-Abdou Department of Medicine Université André Salifou de Zinder Zinder Niger Department of Medicine H&#244pital National de Zinder Zinder Niger Department of Medicine Université Abdou Moumouni de Niamey Niamey Niger Department of Medicine Université Dan Dicko Dan Koulodo de Maradi Maradi Niger

Introduction: Since it is impossible to establish a diagnosis in the presence of hyperlymphocytosis not secondary to lymphocytic hyperactivation, we considered a B-lymphoid hematopathy with a non-specific phenotypic profile. We report one case of this. Observation: This is a forty-eight (48) year old patient with hyperlymphocytosis at 139,000 elements per cubic millimeter, heterogeneous splenomegaly at 25.6 cm in diameter on abdominal ultrasound without detectable deep or peripheral lymphadenopathy. Peripheral blood cytology shows lymphocyte cell proliferation suggestive of the circulating phase of chronic lymphoproliferative B syndrome. The expression profile of cell membrane markers did not allow for the definition of a specific phenotypic profile. Faced with this immunophenotyping result, we considered a B-lymphoid hemopathy with a non-specific phenotypic profile. After three courses, the MINICHOP treatment was used to achieve partial remission with wasting of more than 80% of the evaluable masses. Conclusion: Despite the contribution of immunophenotyping in the diagnosis of lymphoproliferative syndromes, it is possible to consider the diagnosis of a B-lymphoid hemopathy with a phenotypic non-specific profile of CD45+, monotypic kappa, CD19+, FMC7+, CD22+, CD5−, CD79b−, CD23−, CD43−, CD38−, CD200−.

关键词： Hyperlymphocytosis CLL Immunophenotyping MINICHOP

Predicting short-term thromboembolic risk following Roux-en-Y gastric bypass using supervised machine learning

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World Journal of Gastrointestinal Surgery 2024年第4期16卷 1097-1108页

作者： Hassam Ali Faisal Inayat Vishali Moond Ahtshamullah Chaudhry Arslan Afzal Zauraiz Anjum Hamza Tahir Muhammad Sajeel Anwar Dushyant Singh Dahiya Muhammad Sohaib Afzal Gul Nawaz Amir H Sohail Muhammad aziz Department of Gastroenterology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of Internal Medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan Department of Internal Medicine Saint Peter's University Hospital and Robert Wood Johnson Medical SchoolNew BrunswickNJ 08901United States Department of Internal Medicine St.Dominic's HospitalJacksonMS 39216United States Department of Internal Medicine Rochester General HospitalRochesterNY 14621United States Department of Internal Medicine Jefferson Einstein HospitalPhiladelphiaPA 19141United States Department of Internal Medicine UHS Wilson Medical CenterJohnsonNY 13790United States Division of Gastroenterology Hepatology and MotilityThe University of Kansas School of MedicineKansasKS 66160United States Department of Internal Medicine Louisiana State University HealthShreveportLA 71103United States Department of Surgery University of New Mexico School of MedicineAlbuquerqueNM 87106United States Department of Gastroenterology and Hepatology The University of ToledoToledoOH 43606United States

BACKGROUND Roux-en-Y gastric bypass(RYGB)is a widely recognized bariatric procedure that is particularly beneficial for patients with class III *** aids in significant weight loss and improves obesity-related medical *** its effectiveness,postoperative care still has *** evidence shows that venous thromboembolism(VTE)is a leading cause of 30-d morbidity and mortality after ***,a clear unmet need exists for a tailored risk assessment tool for VTE in RYGB *** To develop and internally validate a scoring system determining the individualized risk of 30-d VTE in patients undergoing *** Using the 2016–2021 Metabolic and Bariatric Surgery Accreditation Quality Improvement Program,data from 6526 patients(body mass index≥40 kg/m^(2))who underwent RYGB were analyzed.A backward elimination multivariate analysis identified predictors of VTE characterized by pulmonary embolism and/or deep venous thrombosis within 30 d of *** resultant risk scores were derived from the coefficients of statistically significant *** performance of the model was evaluated using receiver operating curves through 5-fold *** Of the 26 initial variables,six predictors were *** included a history of chronic obstructive pulmonary disease with a regression coefficient(Coef)of 2.54(P7%(Coef 1.19,P<0.001),venous stasis history(Coef 1.43,P<0.001),and preoperative anticoagulation use(Coef 1.24,P<0.001).These variables were weighted according to their regression coefficients in an algorithm that was generated for the model predicting 30-d VTE risk *** risk model's area under the curve(AUC)was 0.79[95%confidence interval(CI):0.63-0.81],showing good discriminatory power,achieving a sensitivity of 0.60 and a specificity of *** training,the same model performed satisfactorily

关键词： Roux-en-Y gastric bypass Venous thromboembolism Machine learning Bariatric surgery Predictive modeling

Local Criteria Used by Farmers to Evaluate the Agronomic Performance and the Fertilizing Capacity of Cowpea Varieties: Diversity, Variability and Proximal Relation with Agronomic Measurements in Contrasted Sahelian Locations

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Agricultural Sciences 2024年第1期15卷 114-131页

作者： Nouhou Salifou Jangorzo Abdoul-aziz Saïdou Abou-Soufianou Sadda Abdoulaye Moussa Mamoudou Hassane Bil-Assanou Issoufou Département des Sciences du Sol et Télédétection Université Dan Dicko Dankoulodo de Maradi Maradi Niger. Unité Mixte de Recherche “Diversité et Adaptation des Plantes” (UMR DAP) Université Dan Dicko Dankoulodo de Maradi Maradi Niger Centre Imaan de Support en Recherche Transdisciplinaire (Imaan Research) Niamey Niger Institut de Recherche pour le Développement Niamey Niger Université Boubacar BA de Tillabéri Tillabéri Niger Département des Sciences et Techniques de Productions Végétales Université Dan Dicko Dankoulodo de Maradi Maradi Niger

When contributing to participatory research, farmers usually appreciate the performance of cowpea varieties using qualitative scores. The score they attribute to each variety are based on local knowledge. The specific criteria they individually use to attribute a score are not well described. The objectives of this work were to: 1) identify and describe exhaustively the local criteria used by farmers to measure the agronomic performance of cowpea;2) assess the variability and statistical structure of these farmer criteria across local contexts;3) and analyze the association between these farmer criteria and the classical agronomic measurement. To achieve these objectives, an augmented block design was implemented across fifteen locations in the regions of Maradi, Dosso and Tillabéri, representing a diversity of local contexts. From a set of 36 cowpea varieties, fifteen varieties were sown per location, including five varieties (controls) common to all locations. In each location, two replicates were sown in randomized Fisher’s blocks. After agronomic measurement and participatory evaluation (scoring of varieties by farmers), a group survey (focus group) was conducted in each location to identify the criteria considered by farmers to found their discretional scoring of varieties during the participatory evaluation. The analysis of the data identified, across locations, thirteen criteria defined by farmers to characterize the agronomic performance of cowpea. Some of these criteria were different according to location. Farmers ranked the three varieties with the best performance for each agronomical trait (Top 3 varieties). A comparison of the farmer ranking with the ranking based on agronomic measurements revealed similarity and complementary between both methods. This study highlighted the importance of considering both local and scientific knowledge in local varietal evaluations.

关键词： Agronomic Performance Participatory Research Cowpea Farmers’ Criteria

Seasonal Performance of Solar Power Plants in the Sahel Region: A Study in Senegal, West Africa

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Smart Grid and Renewable Energy 2024年第2期15卷 79-97页

作者： Serigne Abdoul aziz Niang Mamadou Simina Drame Astou Sarr Mame Diarra Toure Ahmed Gueye Seydina Oumar Ndiaye Kharouna Talla FST D&#233partement de Physique Universit&#233 Cheikh Anta Diop de Dakar Dakar S&#233n&#233gal Laboratoire de Physique de l’Atmosphère et de l’Océan Siméon Fongang Université Cheikh Anta Diop Dakar Sénégal

The main objective of this study is to evaluate the seasonal performance of 20 MW solar power plants in Senegal. The analysis revealed notable seasonal variations in the performance of all stations. The most significant yields are recorded in spring, autumn and winter, with values ranging from 5 to 7.51 kWh/kWp/day for the reference yield and 4.02 to 7.58 kWh/kWp/day for the final yield. These fluctuations are associated with intense solar activity during the dry season and clear skies, indicating peak production. Conversely, minimum values are recorded during the rainy season from June to September, with a final yield of 3.86 kWh/kW/day due to dust, clouds and high temperatures. The performance ratio analysis shows seasonal dynamics throughout the year with rates ranging from 77.40% to 95.79%, reinforcing reliability and optimal utilization of installed capacity. The results of the capacity factor vary significantly, with March, April, May, and sometimes October standing out as periods of optimal performance, with 16% for Kahone, 16% for Bokhol, 18% for Malicounda and 23% for Sakal. Total losses from solar power plants show similar seasonal trends standing out for high loss levels from June to July, reaching up to 3.35 kWh/kWp/day in June. However, using solar trackers at Sakal has increased production by up to 25%, demonstrating the operational stability of this innovative technology compared with the plants fixed panel. Finally, comparing these results with international studies confirms the outstanding efficiency of Senegalese solar power plants, other installations around the world.

关键词： Performance Study Photovoltaic Power Plant Season Variations Senegal

Modeling the Spatio-Temporal Dynamics of Local Context for a Contextualized Diffusion of Agroecological Intensification Options in Niger

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International Journal of Geosciences 2024年第3期15卷 270-301页

作者： Nouhou Salifou Jangorzo Maud Loireau Abou-Souﬁanou Sadda Ousmane Sami Mari Abdoul-aziz Saïdou Hassane Bil-Assanou Issoufou Département des Sciences du Sol et Télédétection Université Dan Dicko Dankoulodo de Maradi UMR DAP Maradi Niger Unité mixte de Recherche Diversité et Adaptation des Plantes (UMR DAP) Université Dan Dicko Dankoulodo de Maradi Maradi Niger Institut de Recherche pour le Développement UMR Espace-DEV Université de Perpignan Via Domitia (UPVD) Perpignan France Institut de Recherche pour le Développement Représentation Niamey Niger Centre Imaan de Support en Recherche Transdisciplinaire UMR DAP/UDDM Niamey Niger Département des Sciences et Techniques de Productions Végétales Université Dan Dicko Dankoulodo de Maradi UMR DAP Maradi Niger

Spatio-temporal variability and dynamics in Sahelian agro-pastoral zones make each local situation a special case. These specificities must be considered to guide the dissemination of agricultural options with a view to sustainable development. The territorial scale of municipalities is not sufficient for this necessary contextualization;the scale of the “village terroir” seems to be a better option. This is the hypothesis we put forward in the framework of the Global Collaboration for Resilient Food Systems program (CRFS), i.e. local context is spatially defined by village terroir. The study is based on data collected through participatory mapping and surveys in “village terroirs” in three regions of Niger (Maradi, Dosso and Tillabéri). Then the links between farm managers and their cultivated land, as well as the spatio-temporal dynamics of local context are analyzed. This study provides evidence of the existence and functional usefulness of the village terroir for farmers, their land management and their activities. It demonstrates the usefulness of contextualizing agricultural options at this scale. Their analysis elucidates the links between “terroirs village” and the specific functioning of the agrosocio-ecosystems acting on each of them, thus laying the systemic and geographical foundations for a model of the spatio- temporal dynamics of “village terroirs”. This initial work has opened up new perspectives in modeling and sustainable development.

关键词： Niger Option by Context Local Condition Complex System Multiscale Conceptual Modeling

Late Diagnosis of Turner Syndrome in Adulthood;a Case Study from the Endocrinology-Diabetology Nutrition Department of the National Hospital of Pikine Senegal

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Open Journal of Endocrine and Metabolic Diseases 2024年第5期14卷 115-122页

作者： Nafy Ndiaye Yakham Mohamed Leye Ngone Diaba Diack Mamadou Ba Bibatou Abdoulaye Leye Abdou aziz Diouf Alassane Diouf Jean Pascal Demba Diop Internal Medicine/Endocrinology-Diabetology Department Teaching Hospital of Pikine Cheikh Anta Diop University Dakar Senegal Department of Gynaecology-Obstetric Teaching Hospital of Pikine Cheikh Anta Diop University Dakar Senegal Department of Human Genetic Faculty of Medicine Pharmacy and Odontology Cheikh Anta Diop University Dakar Senegal

Introduction: Turner syndrome is a rare genetic disorder characterised by the presence of one X chromosome and the absence of part or all of an X or Y chromosome and patients may experience delayed puberty and infertility. Our study aimed to evaluate the diagnostic delay in our practice and analyze the impact of this diagnostic delay on the effectiveness of patient management. Patients and Methods: Turner syndrome patients were identified from the endocrinology-diabetology nutrition department Database We examined the records of patients in whom the karyotype analysis favoured Turner syndrome. Results: We have selected 5 patients’ records of female patients with Turner syndrome. The mean age was 25, ranging from 19 to 29 years. Primary amenorrhea and characteristic dysmorphic features were observed in all patients. One married patient, who sought consultation for infertility, expressed a desire for pregnancy. Short stature was identified in 3 patients. Primary hypothyroidism and hypertension were respectively found in 1 and 2 patients. Gonadal dysgenesis was noted in 100% of cases. Karyotype analysis revealed monosomy X in 2 patients and mosaic patterns in others. All patients received estrogen-progestin treatment. Antihypertensive therapy was initiated for 2 patients. One patient is on L-thyroxine. In the short term, treatment led to the onset of menstruation after the initial months. Evaluation of treatment efficacy on internal genital organs is yet to be performed. Due to uncertain benefits at this age, growth hormone therapy was not considered for our patients. We provided counseling on assisted reproductive options for couples desiring to conceive. In our study, all patients were placed on estrogen-progestin therapy, and the response appeared favorable. Conclusion: In our practice, the diagnosis of Turner syndrome occurs very late in adulthood, at an age when growth hormone treatment is nearly ineffective. Treatment typically revolves around estrogen-progestin

关键词： Turner Syndrome Primary Amenorrhea Adult Pikine