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Open Journal of Obstetrics and Gynecology 2022年第4期12卷 243-257页

作者： Glory Mangi Pendo Mlay Olola Oneko Werner Maokola patricia swai Department of Obstetrics and Gynecology Kilimanjaro Christian Medical Center Moshi Tanzania Department of Obstetrics and Gynaecology Kilimanjaro Christian Medical University College Moshi Tanzania Ministry of Health and Social Welfare Dodoma Tanzania

Introduction: Caesarean section (CS) causes some complications. We here attempted to determine the rate of CS complications, characterize their timing, and identify their risk factors among women delivered at Kilimanjaro Christian Medical Center (KCMC). Methods: Patients who underwent CS in KCMC were interviewed and analysed. Risk factors were expressed with Odds ratio (OR) and 95% CI. Results: Of 386 deliveries, 106 (27.5%) had one or more complications. Common early complications (24 - 72 hours after CS) were puerperal sepsis, anaesthesia-related complications, blood transfusion and ICU admission. Longer duration of surgery was significantly associated with all complications (aOR 2.90;95% CI: 1.02 - 8.50). Grand multiparity was significantly associated with blood transfusion (7.0;1.40 - 34.35) and PPH (6.4;1.5 - 24.24) while pre-operative anaemia was significantly associated with blood transfusion (4.34;1.90 - 9.45). Conclusion: Longer duration of surgery, grand multiparity and pre-operative anaemia are associated with complications. Physicians should be aware that these are risk factors for CS-complications.

关键词： Caesarean Section Complications Risk Factors

Abnormal Umbilical Doppler: Incidence and Neonatal Outcomes among Hypertensive Disorders in Pregnancy at KCMC: A Hospital-Based Prospective Cohort Study

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Open Journal of Obstetrics and Gynecology 2024年第8期14卷 1253-1266页

作者： Yusuph Mwidibo Pendo Mlay Adnan Sadiq Gosbert George Bariki Mchome Nasra Batchu Glory Mangi Raziya Gaffur Rafiki Mjema Eusebius Maro Tom Kakumbi Doris Rwenyagila Gileard Masenga patricia swai Department of Obstetrics and Gynecology Kilimanjaro Christian Medical Center (KCMC) Moshi Tanzania Department of Obstetrics and Gynecology Kilimanjaro Christian Medical University College (KCMUCo) Moshi Tanzania Department of Radiology Kilimanjaro Christian Medical Center (KCMC) Moshi Tanzania

Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9% from 1990 to 2019. Umbilical Doppler study in hypertensive disorders of pregnancy helps to predict neonatal outcomes and prevent neonatal and maternal morbidity and mortality. Objective: This study aims to determine the incidence of abnormal umbilical Doppler among hypertensive pregnant women, to identify the adverse neonatal outcomes associated with abnormal umbilical Doppler, and also to detect the diagnostic predictive values of umbilical Doppler to neonatal outcomes at KCMC. Material and methods: A hospital-based prospective cohort study included women with hypertensive disorders of pregnancy from the gestational age of 28 weeks and above, followed up to delivery during the study period from August 2022 to March 2023. Multivariate logistic regression analysis was used to determine the association between AUD and neonatal outcomes. Results: Out of 112 women with HDP, the incidence of abnormal umbilical Doppler was 38 (33.93%). Abnormal umbilical Doppler was associated with neonates with low birth weight aOR (95% of CI) of 4.52 (1.59 - 12.83) p = 0.005 and neonatal ICU admission 9.71 (2.90 - 32.43) p Conclusion: The incidence of abnormal umbilical Doppler is high in hypertensive disorders of pregnancy which is associated with an increase in neonatal low birth weight and neonatal ICU admissions, the sensitivity of abnormal umbilical Doppler in prediction of low birth weight and neonatal ICU admission is significant hence the routine use of umbilical Doppler assessment among hypertensive pregnant women is crucial.

关键词： Hypertensive Disorders in Pregnancy Umbilical Doppler Neonatal Outcomes KCMC

Postpartum Hemorrhage: Incidence, Causes and Maternal Outcomes at Muhimbili National Hospital, Tanzania—A Retrospective Descriptive Hospital-Based Study

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Open Journal of Obstetrics and Gynecology 2023年第7期13卷 1244-1258页

作者： Rafiki Nickson Mjema Amani Idris Kikula Furaha August Fadhlun Alwy Al-Beity Ali Said Phineas F. Sospeter Nasra Batchu Benjamin Shayo Damian Jeremiah Ponsian P. Kunambi John Somi patricia swai Department of Obstetrics and Gynecology Muhimbili University of Health and Allied Sciences MUHAS Dar es Salaam Tanzania Department of Reproductive Maternal and Child Health Ministry of Health Dodoma Tanzania Department of Obstetrics and Gynecology Kilimanjaro Christian Medical Centre Moshi Kilimanjaro Tanzania Department of Obstetrics and Gynecology Baylor’s College Lilongwe Malawi Kilimanjaro Christian Medical University College Moshi Kilimanjaro Tanzania

Worldwide obstetric hemorrhage remains the leading cause of maternal mortality, accounting for over one quarter of maternal deaths. Over half of these deaths occur in Sub-Saharan Africa with mortality rates of 500 - 1000 per 100,000 births, compared to approximately 5 - 10 in developed countries. Over decades in Sub Saharan Africa preventive measures and treatment protocols have been made to reduce maternal mortality caused by PPH. While rates of postpartum hemorrhage have continued to rise, there is a need to evaluate if its etiology and patterns have changed over time. Broad Objective: This study aims at describing trends in incidence, causes and maternal outcomes of Postpartum Hemorrhage at Muhimbili National Hospital for a period of 7 years. Methodology: This is a retrospective descriptive hospital-based study that has included all cases of postpartum hemorrhage at Muhimbili National Hospital, a tertiary hospital in Tanzania from 2014 to 2020. The data was analyzed using SPSS Version 26 and presented using frequency tables, figures and percentages. The trends of postpartum hemorrhage over time were determined using chi-square test and P-value where less than 0.05 was considered statistically significant. Results: Overall, the incidence of postpartum hemorrhage has been fluctuating over the years with minimum of 1.78% and maximum of 2.87% with no statistical significance. Out of 1113 enrolled cases of PPH, 422 (37.9%) were attributed to genital tears followed by uterine atony 285 (25.6%). A statistically significant increase in linear trend was observed in the postpartum hemorrhage cases due to uterine atony, uterine rupture and sub analysis on genital tears (cervical tear). Overall, there was a statistically significant change in trend of maternal outcomes throughout the years, with a P-value < 0.001 and likelihood of complications increasing over time. Conclusion: The trend in the incidence of postpartum hemorrhage has been fluctuating over the years during the

关键词： Postpartum Hemorrhage Incidence Causes Maternal Outcomes and Tanzania

D-Dimer: Predictor of Postpartum Hemorrhage among Pre-Eclampsia at Kilimanjaro Christian Medical Centre

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Open Journal of Obstetrics and Gynecology 2024年第6期14卷 923-937页

作者： Husna Silim Ally Nyasatu G. Chamba Raziya Gaffur Nasra Batchu Glory Mangi Pendo S. Mlay Bariki Mchome Mtoro J. Mtoro Thomas J. Kakumbi Rafiki N. Mjema Doris Rwenyagila Eusebius Maro Fredrick Mbise Gilleard Masenga patricia S. swai Department of Obstetrics and Gynaecology KCMC Hospital Moshi Tanzania Department of Obstetrics and Gynaecology Kilimanjaro Christian Medical University College (KCMUCo) Moshi Tanzania

Background: Postpartum hemorrhage (PPH) is the major contributor to maternal mortality and morbidity worldwide as well as in Tanzania. Studies have shown Pre-eclampsia as a risk indicator for Postpartum hemorrhage and D-dimer tends to rise in women with pre-eclampsia. Few studies that have shown the association between D-dimer and PPH have been controversial and differ according to ethnicity and lifestyle. Hence there is no suitable reference interval for D-dimer in predicting Postpartum hemorrhage among women with pre-eclampsia. Broad Objective: This study aimed to assess the association, sensitivity, and specificity of D-dimer as a laboratory predictor of postpartum hemorrhage among women with pre-eclampsia at KCMC hospital. Methodology: This was a hospital-based analytical cross-sectional study conducted at KCMC Hospital in Northern Tanzania from September 2022 to March 2023. A total of 195 women with pre-eclampsia were included in this study. Plasma D-dimer levels were taken from women with pre-eclampsia pre-delivery. Haematocrit was compared before and after delivery, and a fall of 10% was considered as Postpartum hemorrhage together with clinical assessment of the patient. Participants were divided among those who had severe features and those who did not have severe features and were further categorized into those who had PPH and those who did not have PPH. Logistic regression was used to determine the association between D-dimer and PPH adjusting for other factors. The Receiver Operating Curve (ROC) was used to evaluate the predictive value. Results: Higher median D-dimer levels were seen among women who had PPH compared to those who had no PPH. D-dimer was seen to be associated with PPH, thus for every unit increase of µg/ml of D-dimer among women who had pre-eclampsia without severe features there was a 14% significant increase in the odds of having postpartum hemorrhage and a 45% significant increase of having postpartum hemorrhage among those who had pre

关键词： D-Dimer Preeclampsia Postpartum Hemorrhage Tanzania

Treating amyotrophic lateral sclerosis with allogeneic Schwann cell-derived exosomal vesicles: a case report

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Neural Regeneration Research 2025年第4期20卷 1207-1216页

作者： Pascal J.Goldschmidt-Clermont Aisha Khan George Jimsheleishvili patricia Graham Adriana Brooks Risset Silvera Alexander J.P.Goldschmidt Damien D.Pearse W.Dalton Dietrich Allan D.Levi James D.Guest Miller School of Medicine University of MiamiMiamiFLUSA Stem Cell Institute Miller School of MedicineUniversity of MiamiMiamiFLUSA The Miami Project to Cure Paralysis Miller School of MedicineUniversity of MiamiMiamiFLUSA Alzady International LLC MiamiFLUSA Neurological Surgery Miller School of MedicineUniversity of MiamiMiamiFLUSA

Schwann cells are essential for the maintenance and function of motor neurons,axonal networks,and the neuromuscular *** amyotrophic lateral sclerosis,where motor neuron function is progressively lost,Schwann cell function may also be ***,important signaling and potential trophic activities of Schwann cell-derived exosomal vesicles have been *** case report describes the treatment of a patient with advanced amyotrophic lateral sclerosis using serial intravenous infusions of allogeneic Schwann cell-derived exosomal vesicles,marking,to our knowledge,the first instance of such *** 81-year-old male patient presented with a 1.5-year history of rapidly progressive amyotrophic lateral *** initial diagnosis,the patient underwent a combination of generic riluzole,sodium phenylbutyrate for the treatment of amyotrophic lateral sclerosis,and *** patient volunteered to participate in an FDA-approved single-patient expanded access treatment and received weekly intravenous infusions of allogeneic Schwann cell-derived exosomal vesicles to potentially restore impaired Schwann cell and motor neuron *** confirmed that cultured Schwann cells obtained from the amyotrophic lateral sclerosis patient via sural nerve biopsy appeared impaired(senescent)and that exposure of the patient’s Schwann cells to allogeneic Schwann cell-derived exosomal vesicles,cultured expanded from a cadaver donor improved their growth capacity in *** a period of observation lasting 10 weeks,during which amyotrophic lateral sclerosis Functional Rating Scale-Revised and pulmonary function were regularly monitored,the patient received weekly consecutive infusions of 1.54×1012(×2),and then consecutive infusions of 7.5×1012(×6)allogeneic Schwann cell-derived exosomal vesicles diluted in 40 mL of Dulbecco’s phosphate-buffered *** of the infusions were associated with adverse events such as infusion reactions(allergic or otherwise)or

关键词： allogeneic amyotrophic lateral sclerosis exosomes infusion neuromuscular junction Schwann cell

Tribological behavior of ammonium-based protic ionic liquid as lubricant additive

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Friction 2021年第1期9卷 169-178页

作者： Hong GUO patricia IGLESIAS Mechanical Engineering Department Rochester Institute of TechnologyNew York 14623-5603USA

In this study, the tribological behavior of an ammonium-based protic ionic liquid(PIL) as an additive in a base mineral oil(MO) is investigated on a steel–steel contact at room temperature and 100℃. Tri-[bis(2-hydroxyethylammonium)] citrate(DCi) was synthesized in a simple and low-cost way, and the ionic structure of DCi was confirmed by proton nuclear magnetic resonance(^(1)H NMR). The stability measurement of 1 wt% DCi to a MO was investigated, and the lubricating ability and anti-wear properties of DCi as an additive in MO were also examined using a custom-designed reciprocating ball-on-flat tribometer. Optical microscope and profilometry were used to obtain the worn morphology of the steel disks. Scanning electron microscopy(SEM) and energy dispersive X-ray spectroscopy(EDS) were carried out to investigate the wear mechanism and to analyze the surface interactions between the rubbing components. When 1 wt% DCi is added into the base MO, frictional performance is improved at both temperatures studied with a friction reduction of 29.0% and 35.5%, respectively. Moreover, the addition of 1 wt% DCi to MO reduced the wear volume 59.4% compared to the use of MO. An oxygen-richened tribolayer is confirmed by EDS on the disk surface when DCi was used as additive under 100℃.

关键词： protic ionic liquid(PIL) tri-[bis(2-hydroxyethylammonium)]citrate(DCi) steel–steel friction wear

Alcoholic liver injury:Influence of gender and hormones

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World Journal of Gastroenterology 2010年第11期16卷 1377-1384页

作者： patricia K Eagon Department of Medicine Division of Gastroenterology Hepatology and Nutrition University of Pittsburgh School of Medicine

This article discusses several subjects pertinent to a consideration of the role of gender and hormones in alcoholic liver injury (ALI). Beginning with an overview of factors involved in the pathogenesis of ALI, we review changes in sex hormone metabolism resulting from alcohol ingestion, summarize research that points to estrogen as a cofactor in ALI, consider evidence that gut injury is linked to liver injury in the setting of alcohol, and briefly review the limited evidence regarding sex hormones and gut barrier function. In both women and female animals, most studies reveal a propensity toward greater alcohol-induced liver injury due to female gender, although exact hormonal influences are not yet understood. Thus, women and their physicians should be alert to the dangers of excess alcohol consumption and the increased potential for liver injury in females.

关键词： Alcohol Liver injury Female Estrogen Oxidative injury

Adsorption desalination:Advances in porous adsorbents

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Chinese Journal of Chemical Engineering 2022年第2期35卷 151-169页

作者： Boya Qiu patricia Gorgojo Xiaolei Fan Department of Chemical Engineering and Analytical Science School of EngineeringThe University of ManchesterOxford RoadManchester M139PLUnited Kingdom Nanoscience and Materials Institute of Aragón(INMA)CSIC-Universidad de Zaragoza Mariano Esquillor50018 ZaragozaSpain Chemical and Environmental Engineering Department Universidad de ZaragozaPedro Cerbuna 1250009 ZaragozaSpain

With the continuous growth of the world population,the demand for fresh water is ever *** desalination is a means of producing fresh water from saline water,and one of the proposed solutions in the scientific community for solving the current global freshwater *** is foreseen as a promising technology for desalination due to its relatively low energy requirements,low environmental impact,low cost and high salt removal *** importantly,chemicals are not required in adsorption *** carbons,zeolites,carbon nanostructures,graphene and coordination framework materials are amongst the most investigated adsorbents for adsorption desalination,which show different performances regarding adsorption rate,adsorption capacity,stability and *** this review,the latest adsorbent materials with their features are assessed(using metrics)and commented critically,and the current trend for their development is *** adsorption mode is also reviewed,which can provide guidance for the design of adsorbents from the engineering application point of view.

关键词： Adsorption desalination Adsorbents Porous materials Operation modes

Synchronous waving in fiddler crabs: a review

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Current Zoology 2019年第1期65卷 83-88页

作者： patricia Ruth Yvonne Backwell Research School of Biology The Australian National University Canberra ACT 2601 Australia

Many animals that use acoustic communication synchronize their mate attract!on signals: individuals precisely time their calls to overlap those of their neighbors. In contrast, synchrony in the mate attraction displays of species with visual/motion-based signals is rare. It has only been documented in five species of fiddler crabs. In all of them, small groups of males wave their single large claw in close synchrony. Here, I review what we know about synchrony in fiddler crabs, comparing the five species with each other to determine whether similar mechanisms and functions are comm on to all. I also propose future research questions that, if answered, would shed light on synchronous behavior in both visual and acoustic signallers.

关键词： fiddler crab synchrony waving mate choice wave timing visual signal

Orbit orientation in didelphid marsupials （Didelphimorphia： Didelphidae）

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Current Zoology 2017年第4期63卷 403-415页

作者： patricia PILATTI Diego ASTUA Laboratorio de Mastozoologia Departamento de Zoologia Universidade Federal de Pernambuco. Av. Prof. Moraes Rego S/N Cidade Universitaria Recife PE 50670-901 Brazil

Usually considered a morphologically conservative group, didelphid marsupials present consider- able variation in ecology and body size, some of which were shown to relate to morphological structures. Thus, changes on orbit morphology are likely and could be related to that variation. We calculated orbit orientation in 873 specimens of 16 Didelphidae genera yielding estimates of orbits convergence （their position relative to midsagittal line） and verticality （their position relative to frontal plane）. We then compared similarities in these variables across taxa to ecological, morpho- logical and phylogenetic data to evaluate the influencing factors on orbit orientation in didelphids. We found an inverse relation between convergence and verticality. Didelphids orbits have low ver- ticality but are highly convergent, yet orbit orientation differs significantly between taxa, and that variation is related to morphological aspects of the cranium. Rostral variables are the only morpho- logical features correlated with orbit orientation： increasing snout length yields more convergent orbits, whereas increase on snout breadth imply in more vertical orbits. Size and encephalization quotients are uncorrelated with orbit orientation. Among ecological data, diet showed significant correlation whereas locomotion is the factor that less affects the position of orbits. Phylogeny is uncorrelated to any orbital parameters measured. Ecological factors seemingly play a more import- ant role on orbit orientation than previously expected, and differentiation on orbit orientation seems to be more functional than inherited. Thus, despite the apparent homogeneity on didelphid morphology, there is subtle morphological variability that may be directly related to feeding behavior.

关键词： convergence Didelphidae frontation orbit orientation verticality.