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Long-Term Outcomes Comparing Minimally Invasive Mitral Valve Repair versus Conventional Mitral Valve Surgery

World Journal of.Cardiovascular Surgery 2018年第8期8卷 127-139页

作者： Matthew Jackson Manraj S. Sandhu Chao Dong Bilal Bawamia Muhammad Qureshi Khalid Khan Andrew Goodwin Simon Kendall Steven Hunter Richard Graham Jeetendra Thambyrajah enoch f. akowuah Cardiothoracic Surgery The James Cook University Hospital Middlesbrough UK Cardiology The Freeman Hospital Newcastle UK

Objectives: To compare the long term outcomes between minimally invasive mitral valve repair (MiMVR) and conventional surgery. Current retrospective comparisons between the techniques f.equently report echocardiographical (echo) outcomes early af.er surgery and rarely report them later. Methods: Patients were selected f.r MiMVR by the surgical multi-disciplinary meeting f.om June 2008-March 2013. Patients included had at least two transthoracic post-operative echocardiograms. Echocardiographic parameters including lef. ventricular size and systolic f.nction, degree of.mitral regurgitation (MR) and mean mitral valve gradient were recorded. Clinical outcomes including all-cause mortality, re-operation, recurrence of.at least moderate MR and elevated mean mitral valve gradients > 5 mmHg were recorded and compared using Kaplan-Meier survival analysis. Results: 223 patients were screened, 96 (43%) met the criteria and were included. Thirty-seven patients underwent conventional surgery and 59 underwent MiMVR. Mean clinical f.llow-up was 6.3 years and echo f.llow up was 3.2 years. There was a signif.cantly higher recurrence of.moderate MR in the conventional group (38% (n = 19) versus 17% (n = 10)). The mean LV end-diastolic diameter was 4.8 cm (conventional) versus 5.0 cm (MiMVR). The incidence of.elevated PG was 26% (n = 13, conventional) and 23% (n = 14, MiMVR). There was no signif.cant dif.erence in incidence in re-operation (conventional 12% (n = 6), MiMVR 8.3% (n = 5)). Long-term mortality was higher in the conventional group (1.7% vs. 18% p = 0.004) although the logistic Euroscore was signif.cantly higher 6.8% ± 5.4 vs. 3.6% ± 1.6. Conclusions: Minimally invasive mitral valve surgery is saf. and f.asible in selected patients with good medium and long-term echocardiographic f.llow-up.

关键词： Mitral Valve Surgery Minimally Invasive Surgery Echocardiogram Clinical Outcomes

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Navigating ref.ux disease af.er achalasia treatments:Balancing risks and benef.ts

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World Journal of.Gastroenterology 2024年第21期30卷 2740-2743页

作者： Ewen A Grif.iths enoch Wong Department of.Upper Gastrointestinal Surgery University Hospitals Birmingham NHS Foundation TrustBirmingham B152GWWest MidlandsUnited Kingdom Department of.Immunology and Immunotherapy University of BirminghamBirmingham B152TTWest MidlandsUnited Kingdom

The peroral endoscopic myotomy(POEM)procedure has revolutionized the management of.achalasia in many centres around the world as it of.ers patients a minimally invasive endoscopic solution to their dysphagia caused by *** its success in alleviating dysphagia,concerns regarding postoperative gastroesophageal ref.ux disease have emerged as a pertinent issue which are not f.lly *** this study,Nabi et al have comprehensively reviewed the topic of.the prediction,prevention and management of.gastroesophageal ref.ux af.er *** is a purely endoscopic procedure which is usually perf.rmed without any anti-ref.ux *** patients may be better served by a laparoscopic Heller’s myotomy and f.ndoplication and it is important that gastroenterologists and surgeons provide comprehensive risks and benef.ts of.each achalasia treatment option so that patients can decide what treatment is best f.r *** article by Nabi et al provides a comprehensive review of.the current status of.this issue to allow these discussions to occur.

关键词： Achalasia Gastro-esophageal ref.ux disease Laparoscopic heller’s myotomy Peroral endoscopic myotomy f.ndoplication

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Praseodymium metal nanorods as a 5-f.uorouracil carrier

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Journal of.Rare Earths 2024年第7期42卷 1328-1336,I0005页

作者： Varnitha Manikantan Govindaraj Sri Varalakshmi Ujma Ashapak Tamboli Archana Sumohan Pillai Aleyamma Alexander Anushka Lucas Bose Allben Akash Israel V.M.V.enoch Centre f.r Nanoscience and Genomics Karunya Institute of Technology and Sciences(Deemed University)Coimbatore641114Tamil NaduIndia Department of.Applied Chemistry Karunya Institute of Technology and Sciences(Deemed University)Coimbatore641114Tamil NaduIndia

Interest in metal nanoparticles as nanoscale drug-carrying vehicles has been *** such an aspect,lanthanide metal nanoparticles are particularly ***,we report praseodymium nanoparticles as a novel anticancer therapeutic transporting *** material was made as a composite with the supramolecular host polymer,poly-β-*** praseodymium nanorods were characterized using standard analytical techniques,including X-ray dif.raction(XRD),X-ray photoelectron spectroscopy(XPS),and thermogravimetric analysis(TGA).In addition,they were imaged using transmission electron *** nanostructures are a long rod-shaped material with 2.0±0.1μm in length and 230±10 nm in *** material shows a saturation magnetization value above 30 emu/g with a coercivity value of.130 *** nanocarrier is f.eighted with the drug 5-f.uorouracil,and the encapsulation ef.iciency is 76.09%.The drug release is continuous f.om the nanocarrier(polymer-containing praseodymium nanoparticles)and proceeds f.r above 250 *** in vitro cytotoxicities of.the blank nanocarrier and the 5-f.uorouracil-loaded one are deduced by testing them on MCf.7 and Vero(non-cancerous)cell *** cytotoxicity on the cancerous cell lines is observed,whereas the non-cancerous cells are *** IC_(50)values on the cell lines are reported.

关键词： Metal nanoparticles Praseodymium Poly-cyclodextrin Drug delivery Anticancer activity Rare earths

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Assessment of.groundwater quantity, quality, and associated health risk of.the Tano river basin, Ghana

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Acta Geochimica 2024年第2期43卷 325-353页

作者： Adwoba Kua-Manza Edjah Bruce Banoeng-Yakubo Anthony Ewusi enoch Sakyi-Yeboah David Saka Clara Turetta Giulio Cozzi David Atta-Peters Larry Pax Chegbeleh Water Resources Research Centre Ghana Atomic Energy CommissionAccraGhana Earth Science Department University of GhanaLegonAccraGhana Geological Engineering Department University of Mines and TechnologyTarkwaGhana Department of.Statistics University of GhanaAccraLegonGhana Institute of.Polar Sciences National Research Council of ItalyVeniceItaly

In the Tano River Basin,groundwater serves as a crucial resource;however,its quantity and quality with regard to trace elements and microbiological loadings remain poorly understood due to the lack of.groundwater logs and limited water *** study presents a comprehensive analysis of.the Tano River Basin,f.cusing on three key ***,it investigated the aquif.r hydraulic parameters and the results showed signiﬁcant spatial variations in borehole depths,yields,transmissivity,hydraulic conductivity,and speciﬁc *** boreholes were concentrated in the northeastern and southeastern zones,while geological f.rmations,particu-larly the Apollonian f.rmation,exhibit a strong inﬂuence on borehole *** study identiﬁed areas with high transmissivity and hydraulic conductivity in the southern and eastern regions,suggesting good groundwater avail-ability and suitability f.r sustainable water ***-ondly,the research investigated the groundwater quality and observed that the majority of.borehole samples f.ll within WHO(Guidelines f.r Drinking-water Quality,Environmental Health Criteria,Geneva,2011,***://***)***,some samples have pH levels below the standards,although the groundwater generally qualiﬁes as *** study f.rther explores hydrochemical f.cies and health risk assessment,highlighting the dominance of.Ca–HCO3 water *** element analysis reveals minimal health risks f.om most elements,with chromium(Cr)as the primary contributor to chronic health ***,this study has provided a key insights into the Tano River Basin’s hydrogeology and associated health *** outcome of.this research has contributed to the broader understanding of.hydrogeologi-cal dynamics and the importance of.managing groundwater resources sustainably in complex geological environments.

关键词： Groundwater Unsupervised machine learning technique Hydrochemistry Aquif.r hydraulic parameter Health risk

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Split Addition of.Nitrogen-Rich Substrate at Thermophilic and Mesophilic Stages of.Composting: Ef.ect on Green House Gases Emission and Quality of.Compost

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Open Journal of.Soil Science 2024年第2期14卷 133-158页

作者： Boakye Acheampong Kodwo Miezah enoch Bessah Benedicta Essel Ayamba f.ancis Kemausour Department of.Agricultural and Biosystems Engineering College of Engineering Kwame Nkrumah University of Science and Technology Kumasi Ghana Department of.Environmental Science College of Science Kwame Nkrumah University of Science and Technology Kumasi Ghana Soil f.rtility and Plant Nutrition Division CSIR-Soil Research Institute Kumasi Ghana The Brew-Hammond Energy Center College of Engineering Kwame Nkrumah University of Science and Technology Kumasi Ghana

Composting as a solution to the increasing generation of.municipal solid waste (MSW), also contribute to GHGs emission when not controlled and could lack some basic nutrients, especially nitrogen. This study assessed the split-additions of.nitrogen-rich substrate to composting materials and their ef.ect on GHGs emissions as well as the quality of.the composts. Nitrogen-rich substrates f.rmulated f.om pig and goat manure were co-composted with MSW f.r a 12-weeks period by split adding at mesophilic (˚C) and thermophilic (>50˚C) stages in f.ve dif.erent treatments. Representative samples f.om the compost were taken f.om each treatment f.r physicochemical, heavy metals and bacteriological analysis. In-situ CH4, CO2, N2O gas emissions were also analyzed weekly during composting. It was observed that all the treatments showed signif.cant organic matter decomposition, reaching thermophilic temperatures in the f.rst week of.composting. The absence af.ects the suitable agronomic properties. All nitrogen-rich substrate applied at thermophilic stage (Treatment two) recorded the highest N, P and K concentrations of.1.34%, 0.97% and 2.45%, respectively with highest nitrogen retention. In terms of.GHG emissions, CO2 was highest at the thermophilic stage when N-rich substrate was added in all treatment, while CH4 was highest in the mesophilic stage with N-rich substrate addition. N2O showed no specif.c trend in the treatments. Split addition of.the N-rich substrate f.r co-composting of.MSW produced compost which is stable, has less nutrient loss and low GHG emissions. Split addition of.a nitrogen-rich substrate could be an option f.r increasing the f.rtilizer value of.MSW compost.

关键词： Compost Nitrogen-Rich Substrate Thermophilic Mesophilic Greenhouse Gas Emissions

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Epidemiological, Clinical and Paraclinical Prof.le of.Osteoarthritis of.the Lower Limbs in Obese Patients at the Cocody University Teaching Hospital

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Open Journal of.Rheumatology and Autoimmune Diseases 2024年第2期14卷 69-76页

作者： Nzima Brice Kollo Aboubakar Bamba¹ Aboubacar Sidiki Condé Nzima Hilary Ngon Kanbaye Medom Ada Nina Kpami Yaya Coulibaly Kan Joseph enoch Kof.i Ehaulier Soh Christian Louis Kouakou Mohamed Diomandé¹ Edmond Eti Rheumatology Department Cocody University Hospital Abidjan C&#244te d&#8217Ivoire Internal Medicine Department Yaounde University Hospital Yaounde Cameroon Rheumatology Department Bouake University Hospital Bouake C&#244te d&#8217Ivoire

Objective: To describe the epidemiological, clinical and paraclinical characteristics of.osteoarthritis of.the lower limbs in obese patients at the Cocody University Teaching Hospital. Methodology: This was an analytical cross-sectional study carried out in the rheumatology department of.the Cocody UTH in Abidjan (Ivory Coast) f.om March 1 to April 30 2023. Patients who came f.r rheumatology consultation presenting with mechanical arthralgia of.the lower limbs, who were obese, had radiographic images were included. All patients without radiographic images were excluded. Obesity was def.ned as a body mass index (BMI) greater than or equal to 30 kg/m. The Chi2 test was used to compare proportions and determine the existence of.associations between osteoarthristis and obesity, obesity severity and radiographic stage of.osteoarthritis as well as the f.nctional impact. A p-value below a predef.ned threshold (p = 0,05) indicates a signif.cant relationship between the variables. Result: Out of.185 patients received f.r osteoarthritis of.the lower limbs during the study period, 136 were obese (74%). There were 115 women (84.6%) with an average age of.56.03 with a standard deviation of.12.72 years (extremes: 22 and 84 years). The main socio-prof.ssional category was the inf.rmal sector (30%). The majority of.patients had a low socio-economic level (80.2%) and lived in urban areas (92.6%). The most common past medical history was hypertension (33.08%) f.llowed by peptic ulcer disease (16.91%). Patients had a body mass index class 1 (81.6%), class 2 (15.40%) and class 3 (2.90%). The average duration of.symptom progression until diagnosis was 11 months. Genu varum was the main static disorder (56.10%) and the knee joint was the dominant topography (90.4%) with a bilateral localization (80%). The average Lequesne index was greater than 8 (59.5%). The Kellgren and Lawrence radiographic stages were stage 1 (9.20%), stage 2 (46.90%), stage 3 (29.20%) and stage 4 (6.90%).

关键词： Osteoarthritis Lower Limbs Obesity Abidjan

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Assessing Saf.ty of.CABG in the Era Post Primary PCI, an Outcome Analysis of.STEMI Population

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World Journal of.Cardiovascular Surgery 2013年第1期3卷 15-22页

作者： Saqib H. Qureshi Mark de Belder enoch akowuah Bristol Heart Institute Bristol Royal Infirmary Bristol UK Cardiothoracic Division The James Cook University Hospital Middlesbrough UK

Background: Primary PCI (PPCI) has replaced thrombolysis as the treatment of.choice f.r STEMI. The ef.ect of.this change on outcomes of.patients ref.rred f.r subsequent CABG is unknown. Methods: All STEMI patients having thrombolysis or PPCI between 2000 and 2010 were identif.ed. Of.these, patients subsequently ref.rred f.r isolated f.rst time CABG f.rm the cohort f.r this study. Results: 83 of.2476 (3.4%) patients f.om the PPCI cohort (median f.llow-up [f.] 3 years [range 6 m - 7.8 y]) and 49 of.528 (9.2%) f.om the thrombolysis cohort (median f. 9 y [range 1.5 - 10 y] were ref.rred f.r subsequent CABG. In this ref.rred group, initial reperf.sion success (as def.ned) was: PPCI = 86%, lysis = 84%, p = 0.69. Surgical waiters with prior PPCI had less post inf.rct angina (1.2% vs. 25%, p 0.01) and late re-inf.rction (6% vs. 20%, p = 0.034) prior to surgery. Timing of.CABG was: 6 m (PPCI 82%, lysis 73%), 6 m-1 y (PPCI 8.4%, lysis: 9%), >1 y (PPCI 9.6%, lysis 18%).Other than an increased prevalence of.diabetes in the thrombolysis group, there were no dif.erences in demographic details or risk prof.le. There were no post-operative deaths, MIs or CVAs. There were no signif.cant dif.erences in post-op Af.(28% vs. 22% p = 0.5), respiratory f.ilure (8% vs. 18%, p = 0.08), renal f.ilure (5% vs. 6%, p = 0.5) or re-openings (0% vs. 6%, p = 0.8). Mortality at 3 years was 2.4% in the PPCI cohort and 4% in the thrombolysis cohort. Overall mortality during f.llow-up f.r the PPCI group was 3.6% (n = 3) (median f. 3 years), and f.r the lysis group was 24.5% (n = 12) (median f. 9 years). Conclusions: In patients awaiting CABG af.er STEMI, PPCI reduces the risk of.post-inf.rct angina and re-inf.rction prior to surgery, but early surgical results were equally f.vorable in both groups. Additional f.llow-up is needed in the PPCI cohort to determine whether there are any signif.cantly dif.erent longer-term outcomes.

关键词： Coronary Artery Bypass Graf.ing (CABG) Primary Percutaneous Coronary Intervention (PPCI) Inf.rct Related Artery (IRA) Intra Aortic Balloon Counterpulsation (IABP) ST-Elevation Myocardial Inf.rction (STEMI) Thrombolysis

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History, current status, and prospects of.soybean production and research in sub-Saharan Af.ica

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The Crop Journal 2018年第3期6卷 226-235页

作者： Dalia Mohamedkheir Khojely Seif.ldin Elrayah Ibrahim enoch Sapey Tianf. Han MOA Key Lab of.Soybean Biology (Beijing) Institute of Crop SciencesChinese Academy of Agricultural Sciences Gezira Research Station Agricultural Research Corporation (ARC) Oil Palm Breeding and Genetics CSIR-Oil Palm Research Institute

Soybean(Glycine max(L.) Merr.) is a non-native and non-staple crop in sub-Saharan Af.ica(SSA) with potential to be a commercial crop owing to its wide range of.uses as f.od, f.ed,and industrial raw material. Soybean was f.rst introduced to SSA by Chinese traders in the19 th century and was cultivated as an economic crop as early as 1903 in South Af.ica. In the past f.ur decades, soybean cultivation area and production in SSA has increased exponentially, f.om about 20,000 ha and 13,000 t in the early 1970 s to 1,500,000 ha and2,300,000 t in 2016. Soybean yield has been stagnant in SSA f.r decades at about 1.1 t ha^(-1),much lower than the world average, representing one of.the most challenging issues in the soybean industry in SSA. The low soybean yield in SSA can be attributed to the use of.poorperf.rming varieties and to the limited application of.f.rtilizers and rhizobial inoculants in soils with no history of.soybean production. South Af.ica, Nigeria, Zambia, and Uganda are the leading soybean producers in SSA. Soybean research in SSA is conducted by international and national research institutions, including IITA, national soybean improvement programs, universities, and the private sector. Between 1970 and 2011, 195 soybean varieties were released by IITA, private breeders, and national soybean improvement programs in SSA. This paper reviews the history and current state of.soybean production and of.the utilization and adoption of.tropical varieties in SSA, addresses the major soybean yield-limiting f.ctors across the region, and discusses the potential of.the soybean industry in SSA. It also highlights soybean improvement ef.orts and lessons learned f.om previous soybean improvement ef.orts and the current progress of.some national soybean improvement programs in SSA. Opportunities f.r scaling up tropical soybean as a major crop across SSA countries are promising.

关键词： Soybean Sub-Saharan Af.ica(SSA) History Current status Prospects

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Ef.ects of.music and video on perceived exertion during high-intensity exercise

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Journal of.Sport and Health Science 2017年第1期6卷 81-88页

作者： enoch C.Chow Jennif.r L.Etnier Department of.Kinesiology University of North Carolina at GreensboroGreensboroNC 27412USA

Background: Dissociative attentional stimuli(e.g., music, video) are ef.ective in decreasing ratings of.perceived exertion(RPE) during low-tomoderate intensity exercise, but have inconsistent results during exercise at higher intensity. The purpose of.this study was to assess attentional f.cus and RPE during high-intensity exercise as a f.nction of.being exposed to music, video, both(music and video), or a no-treatment control ***: During the f.rst session, healthy men(n = 15) completed a maximal f.tness test to determine the workload necessary f.r high-intensity exercise(operationalized as 125% ventilatory threshold) to be perf.rmed during subsequent sessions. On 4 subsequent days, they completed 20 min of.high-intensity exercise in a no-treatment control condition or while listening to music, watching a video, or both. Attentional f.cus, RPE,heart rate, and distance covered were measured every 4 min during the ***: Music and video in combination resulted in signif.cantly lower RPE across time(partial η~2= 0.36) and the size of.the ef.ect increased over time(partial η~2= 0.14). Additionally, music and video in combination resulted in a signif.cantly more dissociative f.cus than the other conditions(partial η~2= 0.29).Conclusion: Music and video in combination may result in lower perceived exertion during high-intensity exercise when compared to music or video in isolation. f.ture research will be necessary to test if.reductions in perceived exertion in response to dissociative attentional stimuli have implications f.r exercise adherence.

关键词： Acute exercise Attentional f.cus Ef.ort Perceived exertion

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Impacts of.climate change on the yields of.leguminous crops in the Guinea Savanna agroecological zone of.Ghana

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Regional Sustainability 2023年第2期4卷 139-149页

作者： enoch YELELIERE Philip ANTWI-AGYEI f.ank BAf.OUR-ATA Department of.Environmental Science College of ScienceKwame Nkrumah University of Science and TechnologyKumasiGhana

The impacts of.climate change on crop yields are receiving renewed interest,with f.cus on cereals and staple crops at the regional and national ***,the impacts of.climate change on the yields of.leguminous crops in the local context has not been ***,an in-depth understanding of.climate change in the local context may support the design of.locally relevant adaptation responses to current and f.ture climate *** study examined the impacts of.climate variables(annual rainf.ll,annual average temperature,rainf.ll indices(rainf.ll onset,rainf.ll cessation,and the length of.rainy days),and the number of.dry days)on the yields of.leguminous crops(groundnuts,cowpeas,and soybeans)in the Guinea Savanna agroecological zone of.Ghana during the period of.*** data were analysed using Mann-Kendall’s trend,Sen’s slope test,correlation analysis,and Multiple Regression Analysis(MRA).The f.ndings revealed that annual rainf.ll,annual average temperature,rainf.ll onset,rainf.ll cessation,and the length of.rainy days,and the number of.dry days all showed varied impacts on the yields of.groundnuts,cowpeas,and *** trend analysis detected a marginal decrease in the amount of.rainf.ll,rainf.ll onset,and the number of.dry days f.om 1989 to 2020(P>0.050).Annual average temperature and the length of.rainy days substantially varied(Pf.om 1989 to 2020,showing an increasing *** f.ndings also showed a marked upward trend f.r the yields of.groundnuts,cowpeas,and soybeans during *** climate variables analysed above increased the yields of.groundnuts,cowpeas,and soybeans by 49.0%,55.0%,and 69.0%,*** yields of.groundnuts,cowpeas,and soybeans f.uctuated with the variability of.30.0%,28.0%,and 27.0%f.om 2005 to 2020,*** three leguminous crops under study demonstrated unpredictable yields due to the variations of.annual rainf.ll,annual average temperature,rainf.ll onset,rainf.ll cessation,the length of.rainy days,and

关键词： Climate change Leguminous crops(groundnuts,cowpeas,and soybeans) Guinea Savanna Annual average temperature Rainf.ll indices Number of.dry days

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