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Noninvasive Respiratory Strategies in Patients with Acute Hypoxemic Respiratory failure and COVID-19 in Gabon: A Prospective Observational Study

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Open Journal of Emergency Medicine 2024年第1期12卷 18-27页

作者： Ghislain Edjo Nkilly Raphael Okoue Ondo fernande Manga Stéphane Oliveira Jean Marcel Mandji-lawson Romain Tchoua Department of Emergency Anesthesia Resuscitation Omar Bongo Ondimba Army Training Hospital Libreville Gabon Department of Anesthesia and Resuscitation Libreville University Hospital Center Libreville Gabon Department of Anesthesia and Resuscitation Akanda Army Training Hospital Libreville Gabon

Importance: The best respiratory support technique to reduce intubation and mortality in patients with respiratory failure due to COVID-19 is controversial. Objective: To determine the respiratory support technique that could reduce the need for tracheal intubation and mortality in patients with respiratory failure due to COVID-19 admitted to intensive care units (ICUs) of Military’s Hospital (HIAOBO) in Gabon. Design, Setting, and Participants-Methodology: Prospective observational study over 10 months (January 2021-October 2021). We included patients admitted to intensive care for SARS Cov2 pneumonia who had benefited from available ventilatory support: high concentration face mask, High flow Nasal cannula (HfNC), NIV (Non Invasive Ventilation), Continuous Positive Airway Pressure (CPAP). The choice was guided by the clinical condition, and the choice of the prescribing physicians. Recourse to mechanical ventilation was decided when faced with a Glasgow score of less than 13, an SpO2/fiO2 ratio ≤ 300, a fR ≥ 35/min, the impossibility of drainage of secretions. Main Outcomes and Measures: The primary outcome was the proportion of patients requiring intubation. The secondary outcomes were mortality in ICU. Results: The sample included 97 patients, the average age was55.6 years, hypertension was the main comorbidity (51.1%). Mean respiratory rate (RR) was 30.8 cycles/min, admission SpO2 was 83%, respiratory alkalosis was present in 63% of patients, mean CT involvement was 51%.Respiratory support was NIV (56.7%), CPAP (21.65%), high concentration face mask (18.55%). Sixteen percent (16%) of patients were intubated, 93% of them following failure of NIV. Mortality was 30%, mechanical ventilation was an independent risk factor for mortality. Conclusions: Non Invasive Ventilation, CPAP, and high-concentration face mask were frequently used in patients with COVID-related acute respiratory failure. The CPAP has reduced the need for intubation. Mechanic

关键词： Respiratory failure COVID 19-Intensive Care Units Military Hospital Gabon

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Understanding the neighborhoods’in-between spaces on spatial perception,social interaction,and security

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frontiers of Architectural Research 2024年第1期13卷 21-36页

作者： Lizeth félix Mariel Organista Autonomous University of Baja California Ensenada 22860Mexico

This study reflects on the impact that the neighborhoods’in-between spaces have on:spatial perception,social interaction,and *** sites,characterized by their abandonment and deterioration,can also be seen as crucial spaces of opportunity for cities,in the architectural,urban and landscape *** paper aims to analyze the sociospatial relationships in the neighborhoods’in-between spaces and examine the impact of inbetween space configuration on urban *** investigation draws on a survey of perception to residents about the requirements for a suitable social interaction in these *** study was developed in a neighborhood in the city periphery,characterized by their social dynamics and location in a nature conservation *** findings indicate that the appropriation process,activities,and collective practices are dependent on the spatial legibility,in this case when this increases,gives rise to improve the habitability and the rehabilitation of the in-between ***,the lack of design on in-between spaces substantially affects the use of these spaces and the social interaction among residents.

关键词： In-between spaces Socio-spatial relationships Habitability Neighborhoods Security

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The Ca^(2+)-sensing receptor and the pocketome:comparing nature's complexity with human intervention in receptor modulation

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Signal Transduction and Targeted Therapy 2024年第8期9卷 3153-3154页

作者： Edda S.f.Matthees Carsten Hoffmann Institut fur Molekulare Zellbiologie CMB-Center for Molecular BiomedicineUniversitatsklinikum JenaHans-Knoll StraBe 2D-07745 JenaGermany friedrich-Schiller-Universitat Jena Hans-KnollStraBe2D-07745 JenaGermany

In a recent paper published in Nature,the relatively understudied Ca^(2+)-sensing,receptor(CasR)within the Gprotein-coupled receptor(GPCR)family C,gained attention due to pioneering research led by Georgios Skiniotis ... 详细信息

关键词： Stanford gained Skin

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Morphological traits explain the individual position within resource-consumer networks of a Neotropical marsupial

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Current Zoology 2024年第4期70卷 453-464页

作者： Nicholas f.de Camargo Hernani f.M.de Oliveira Juliana f.Ribeiro Amabilio J.A.de Camargo Emerson M.Vieira Laboratorio de Ecologia de Vertebrados Departamento de EcologiaInstituto de Ciencias BiologicasUniversidade de BrasiliaCP 04457BrasiliaDF70910-900Brazil Departamento de Zoologia Setor de Ciencias BiologicasUniversidade Federal do ParanaAvenida Coronel Francisco Heraclito dos Santos100CuritibaPR81531980Brazil Embrapa Cerrados Rodovia BR020km 18CP 08223PlanaltinaDE73310-970Brazil

Knowledge regarding the influence of individual traits on interaction patterns in nature can help understand the topological role of individuals within a network of intrapopulation *** tested hypotheses on the relationships between individuals'positions within networks(specialization and centrality)of 4 populations of the mouse opossum Gracilinanus agilis and their traits(i.e.,body length,body condition,tail length relative to body length,sex,reproductive condition,and botfly parasitism)and also seasonal effects in the Brazilian *** with lower body length,better body condition,and relatively shorter tail were more specialized(i.e.,less connected within the network).Individuals were also more specialized and less connected during the warm-wet *** relationship between individuals'position in the network and body traits,however,was independent of *** propose that specialization may arise not only as a result of preferred feed-ing strategies by more capable individuals(i.e.,those with better body condition and potentially prone to defend and access high-quality food resources)but alsobecause of morphological ***/younger individuals(consequently with less experience in foraging)and short-tailed individuals(less skilled to explore the vertical strata of the vegetation)would feed only on a subset of the available food resources and consequently become more ***,individuals are more specialized during the warm-wet season because of high competition(population-dense period)and higher ecological opportunities(resource-rich period).Therefore,our study reveals the relevance of individual traits inshaping interactionpatternsandspecialization inpopulations.

关键词： bodytraits centrality Cerrado Gracilinanus agilis seasonality specialization.

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Radiative capture of proton through the ^(14)N(p,γ)^(15)O reaction at low energy

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Chinese Physics C 2024年第4期48卷 183-192页

作者： B.f.Irgaziev Abdul Kabir Jameel-Un Nabi National University of Uzbekistan Tashkent 100174Uzbekistan Space and Astrophysics Research lab National Centre of GIS and Space ApplicationsDepartment of Space ScienceInstitute of Space TechnologyIslamabad 44000Pakistan University of Wah Quaid AvenueWah Cantt 47040PunjabPakistan

The CNO cycle is the main source of energy in stars more massive than our *** process defines the energy production,the duration of which can be used to determine the lifetime of massive *** cycle is an important tool for determining the age of globular *** proton capture via p+^(14)N→^(15)O+γ,at energies of astrophysical interest,is an important process in the CNO *** this project,we apply a potential model to describe both non-resonant and resonant reactions in the channels where radiative capture occurs through electric E1 *** employed the R-matrix method to describe the ongoing reactions via M1 resonant transitions,when it was not possible to correctly reproduce the experimental data using the potential *** partial components of the astrophysical S-factor are calculated for all possible electric and magnetic dipole transitions in ^(15)*** linear extrapolated S-factor at zero energy(S(0))agrees well with earlier reported values for all transition types considered in this *** on the value of the total astrophysical S-factor,depending on the collision energy,we calculate the nuclear reaction rates for p+^(14)N→^(15)O+γ.The computed rates agree well with the results reported in the NACRE II Collaboration and most recent existing measurements.

关键词： CNO cycle potential model R-matrix method cross-section astrophysical S-factor nuclear rates.

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Thermo-kinetic characteristics on stabilizing hetero-phase interface of metal matrix composites by crystal plasticity finite element method

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Journal of Materials Science & Technology 2024年第2期169卷 53-67页

作者： Y.B.Zhang S.J.Song f.Liu State Key Laboratory of Solidification Processing Northwestern Polytechnical UniversityXi’an 710072China Analytical&Testing Center Northwestern Polytechnical UniversityXi’an 710072China

Using dislocation-based constitutive modeling in three-dimension crystal plasticity finite element(3D CPfE)simulations,co-deformation and instability of hetero-phase interface in different material systems were herein studied for polycrystalline metal matrix composites(MMCs).Local stress and strain fields in two types of 3layer MMCs such as fcc/fcc Cu-Ag and fcc/bcc Cu-Nb have been predicted under simple compressive ***,more severe strain-induced interface instability can be observed in the fcc/bcc systems than in the fcc/fcc systems upon refining to metallic nanolayered composites(MNCs).By detailed analysis of stress and strain localization,it has been demonstrated that the interface instability is always accompanied by high-stress concentration,i.e.,thermodynamic characteristics,or high strain prevention i.e.,kinetic characteristics,at the hetero-phase *** then follows that the thermodynamic driving forceG and the kinetic energy barrier Q during dislocation and shear banding can be adopted to classify the deformation modes,following the so-called thermo-kinetic *** by inserting a high density of high-energy interfaces into the Cu-Nb composites,such thermo-kinetic integration at the hetero-phase interface allows a successful establishment of MMCs with the high△G-high Q deformation mode,which ensures high hardening and uniform strain distri-bution,thus efficiently suppressing the shear band,stabilizing the hetero-phase interface,and obtaining an exceptional combination in strength and *** hetero-phase interface chosen by a couple of thermodynamics and kinetics can be defined as breaking the thermo-kinetic correlation and has been proposed for artificially designing MNCs.

关键词： Thermodynamics and kinetics Physics-based constitutive modeling Hetero-phase interface Crystal plasticity finite element

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On the analytical solution of transient friction in channel flows

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Applied Mathematics and Mechanics(English Edition) 2024年第8期45卷 1447-1466页

作者： f.J.GARCíA-GARCíA P.fARINAS-ALVARINO Department of Naval&Industrial Engineering Polytechnic School of EngineeringUniversity of A CorunaCampus Industrial de FerrolFerrol 15403A CorunaSpain Integraciones Técnicas de Seguridad S.A.Pol.Ind.Espiritu SantoC/Nobel15Cambre 15650A CorunaSpain

The transient friction in channel mean flows is the sum of two contributions,i.e.,the underlying laminar flow(ULf)and the purely turbulent component(PTC),and the contributions are analyzed separately by theoretical *** is found that,the transient friction may be higher or remarkably lower than that in equal-Reynolds number steady-state *** universal time constant for plane-parallel laminar flows is reported,and the role of the time constant in a turbulent mean flow is *** is shown that the time constant is related to the turbulence's frozen ***,a study of the logarithmic layer during the transient flow is accomplished,which shows that the logarithmic layer is destroyed.

关键词： transient friction transient flow unsteady channel flow

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Postoperative Analgesia and Cesarean Section under General Anesthesia: Multicenter Study

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Open Journal of Anesthesiology 2024年第1期14卷 1-12页

作者： Ghislain Edjo Nkilly Raphael Okoue Ondo Pascal Christian Nze Obiang Stéphane Oliveira Jean-Marcel Mandji-lawson Romain Tchoua Department of Anesthesia and Intensive Care Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon Department of Anesthesia and Intensive Care Jeanne Ebori Fondation Libreville Gabon Department of Anesthesia and Intensive Care Akanda Army Training Hospital Libreville Gabon

Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anesthesia is required. The objective of the study was to evaluate the analgesic effectiveness of 4 analgesic techniques performed during cesarean section under general anesthesia in two centers with different anesthetic practices (North franche Comté Hospital and Omar Bongo Ondimba Army Training Hospital). Method: This is a retrospective and descriptive study over 2 years, from January 1, 2019 to December 31, 2020. It involved evaluating the analgesic effectiveness and tolerance of morphine in the epidural catheter, wound infiltration, intravenous analgesia and Transversus Abdominous Plane block (TAP block) from the post-anesthesia care unit (PACU) until the 4th post-operative day. Results: Of the 354 cesarean sections performed, 84 (11.14%) received general anesthesia. The average age was 32.27 years. Acute fetal distress was the first indication for cesarean section (45.2%), followed by hemorrhagic placenta previa (10.7%) and prolapse of the cord (8.33%). Morphine in the epidural catheter was the most used (47.6%) followed by parietal infiltration (36.9%), intravenous analgesia (13.1%) and TAP block (2.38%). The analgesic effectiveness was comparable between the techniques from postoperative day 0 to day 4. No difference in side effects. Postoperative morphine consumption was significantly reduced (p = 0.011) in the infiltration (9 mg) and TAP block (9mg) groups compared to the epidural catheter (16 mg) and intravenous analgesia (17 mg). No difference in 02 rehabilitation criteria (ambulation, first bowel movement). No difference in the occurrence of chronic pain. Conclusion: In the event of a cesarean section under general anesthesia, there are effective and well-tolerated alternatives to neuraxial anesthesia, particularly regional anesthesia

关键词： Cesarean General Anesthesia Morphine Parietal Infiltration Epidural Catheter Transversus Abdominis Plane Block Intravenous Analgesia

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Are we ready to use new endoscopic scores for ulcerative colitis?

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World Journal of Gastroenterology 2024年第10期30卷 1466-1469页

作者： Rodrigo Quera Paulina Núñez f Universidad de los Andes Inflammatory Bowel Disease ProgramClinica Universidad de los AndesDigestive Disease CenterSantiago 7600976RMChile Digestive Disease Center Inflammatory Bowel Disease ProgramClínica Universidad de los AndesSantiago 7620157Chile Department of Gastroenterology Universidad de Chile-Hospital San Juan de DiosSantiago 770123Chile

for ulcerative colitis(UC),the variability in inflammatory activity along the colon poses a challenge in *** focus on achieving endoscopic healing in UC is evident,where the UC Endoscopic Index of Severity and Mayo Endoscopic Subscore are commonly used for ***,these indices primarily consider the most severely affected *** et al recent study validates the Toronto Inflammatory Bowel Disease Global Endoscopic Reporting(TIGER)score offering a comprehensive assessment of inflammatory activity across diverse segments of the colon and rectum and a reliable index correlating strongly with UC Endoscopic Index of Severity and moderately with Mayo Endoscopic Subscore(MES).Despite recommendation,certain aspects warrant further *** calprotectin,an intermediate target,correlates with TIGER and should be *** TIGER scores defining endoscopic remission and response,evaluating agreement with histological activity,and assessing inter-endoscopist agreement for TIGER require *** the correlation between TIGER and intestinal ultrasound,akin to MES,adds value.

关键词： Ulcerative colitis Sigmoidoscopy Colonoscopy Score index

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Two-Stream Approximation to the Radiative Transfer Equation:A New Improvement and Comparative Accuracy with Existing Methods

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Advances in Atmospheric Sciences 2024年第2期41卷 278-292页

作者： f.Momo TEMGOUA L.Akana NGUIMDO DNJOMO Environmental Energy Technologies Laboratory(EETL) Faculty of SciencesUniversity of YaoundéPO Box 812 YaoundéCameroon Department of Electrical and Electronic Engineering Faculty of Engineering and TechnologyUniversity of BueaPO Box 63 BueaCameroon

Mathematical modeling of the interaction between solar radiation and the Earth's atmosphere is formalized by the radiative transfer equation(RTE), whose resolution calls for two-stream approximations among other methods. This paper proposes a new two-stream approximation of the RTE with the development of the phase function and the intensity into a third-order series of Legendre polynomials. This new approach, which adds one more term in the expression of the intensity and the phase function, allows in the conditions of a plane parallel atmosphere a new mathematical formulation of γparameters. It is then compared to the Eddington, Hemispheric Constant, Quadrature, Combined Delta function and Modified Eddington, and second-order approximation methods with reference to the Discrete Ordinate(Disort) method(δ –128 streams), considered as the most precise. This work also determines the conversion function of the proposed New Method using the fundamental definition of two-stream approximation(f-TSA) developed in a previous work. Notably,New Method has generally better precision compared to the second-order approximation and Hemispheric Constant methods. Compared to the Quadrature and Eddington methods, New Method shows very good precision for wide domains of the zenith angle μ 0, but tends to deviate from the Disort method with the zenith angle, especially for high values of optical thickness. In spite of this divergence in reflectance for high values of optical thickness, very strong correlation with the Disort method(R ≈ 1) was obtained for most cases of optical thickness in this study. An analysis of the Legendre polynomial series for simple functions shows that the high precision is due to the fact that the approximated functions ameliorate the accuracy when the order of approximation increases, although it has been proven that there is a limit order depending on the function from which the precision is lost. This observation indicates that increasing the order of app

关键词： Radiative Transfer Equation two-stream method Legendre polynomial optical thickness moments of specific intensity conversion function transmittance reflectance

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