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2023年美国麻醉医师学会神经肌肉阻滞监测与拮抗实践指南:美国麻醉医师学会工作组关于神经肌肉阻滞的报告

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中华麻醉学杂志 2024年第5期44卷 518-542页

作者： Stephan R.Thilen Wade A.Weigel Michael M.Todd richard P.dutton Cynthia A.Lien Stuart A.Grant Joseph W.Szokol Lars I.Eriksson Myron Yaster Mark d.Grant Madhulika Agarkar Anne M.Marbella Jaime F.Blanck Karen B.domino 西雅图华盛顿州明尼阿波里斯明尼苏达州达拉斯得克萨斯州密尔沃基威斯康星州教堂山北卡罗来纳州洛杉矶加利福尼亚州斯德哥尔摩瑞典丹佛科罗拉多州绍姆堡伊利诺斯州巴尔的摩马里兰州

本实践指南基于证据提供了全身麻醉期间及术后神经肌肉功能监测与阻滞拮抗的管理推荐。主要关注神经肌肉功能监测的类型与部位及阻滞拮抗的过程,以减少肌肉松弛药残留阻滞。

关键词：神经肌肉阻滞肌肉松弛药神经肌肉功能监测舒更葡糖钠新斯的明

Epidemiological, diagnostic, Therapeutic, and Prognostic Profile of Non-Tuberculous Community-Acquired Purulent Pleurisy in Children at the Bouaké University Hospital Center, 2017-2021

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Advances in Infectious diseases 2024年第1期14卷 220-232页

作者： Yapo Thomas Aba Christian Yao Pacôme Monemo richard Azagoh-Kouadio Iburaima Akandji Noelle Gonné Jean-Marie Karidioula Vincent Achi Vincent Kouadio Asse department of Infectious and Tropical diseases University Hospital of Bouaké Bouaké Ivory Coast University Alassane Ouattara of Bouake Bouake Ivory Coast department of Pediatrics University Hospital of Bouaké Bouaké Ivory Coast department of Bacteriology & Virology University Hospital of Bouake Bouaké Ivory Coast department of Pediatrics University Hospital of Angré Abidjan Ivory Coast department of Pneumology University Hospital of Bouake Bouaké Ivory Coast

Introduction: In Côte d’Ivoire, there is a scarcity of data on children’s purulent pleurisies. Objective: This study aims to elucidate the epidemiological, diagnostic, therapeutic, and evolutionary facets of non-tuberculous purulent pleurisies in pediatric patients. Methods: A retrospective analysis was conducted using the medical records of children aged one month to fifteen years with purulent pleurisies at Bouaké University Hospital Center from January 2017 to december 2021. Results: The study identified 124 cases of purulent pleurisies, constituting 18% of lower respiratory tract infections and 0.8% of all hospitalizations. The majority of these cases (69%) were in children between 1 and 24 months of age. Prominent symptoms included dyspnea (85.5%), O2 saturation below 95% in room air (76.6%), respiratory distress (68.5%), cutaneous-mucosal pallor (63.7%), and fever (43.5%). Radiological findings predominantly showed right-sided pleurisy (62.1%). The pleurisy was often extensive (78.2%), accompanied by pneumothorax (37.1%), alveolo-interstitial opacities (8.1% of cases), and abscess formations (1.6%). Pleural fluid cultures were positive in 46.9% of cases, with Staphylococcus aureus (75%, methi-S) identified among 32 bacteria. Initial antibiotic treatment was empirical, favoring oxacillin (53.2%) or amoxicillin-clavulanic acid (53.2%) in dual (42%) or triple therapy (33%) with gentamicin (64.1%) and/or metronidazole (21.8%). Treatments also included pleural drainage (68.5%) or repeated evacuation punctures (33.1%), and blood transfusion (39%). The mortality rate was 18.8%. Conclusion: Non-tuberculous purulent pleurisy remains a significant concern in pediatric hospitalizations at the CHU of Bouaké, marked by high mortality rates.

关键词： Community-Acquired Purulent Pleurisies Children Mortality Bouaké

Acceptance of COVId-19 vaccine and its related determinants in Nigeria:An online survey

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World Journal of Virology 2024年第4期13卷 89-110页

作者： Eyiuche d Ezigbo Seyi S Enitan Esther N Adejumo Abiodun E durosinmi richard Y Akele Michael O dada Grace E Itodo Abah M Idoko Okeoghene M Edafetanure-Ibeh Edwin N Okafor Adedeji A Abdulsalam Oyekan I Oyedoyin Polit U Yelpoji Ogunwola O Opeyemi Ogbuji S Nmesomachi Adesola O Oyekale Chisom B Onyeji Haemostasis and Thrombosis Unit Department of Medical Laboratory SciencesUniversity of NigeriaEnugu CampusEnuguEN 400241Nigeria department of Medical Laboratory Science School of Public and Allied HealthBabcock UniversityIlishan-RemoOG 121109Nigeria department of Medical Laboratory Science State HospitalIjebu-OdeOG 120221Nigeria department of Biomedical Science School of Applied ScienceUniversity of BrightonBrightonES BN24ATUnited Kingdom department of Microbiology Federal Teaching Hospital LokojaLokojaKO 260006Nigeria department of Hematology and Blood Group Serology Federal College of Veterinary and Medical Laboratory TechnologyVomPL 930101Nigeria department of Environmental and Occupational Health Texas A and M University School of Public HealthGarlandTX 75049United States division of Chemical Pathology Department of Medical Laboratory SciencesUniversity of NigeriaEnugu CampusEnuguEN 400102Nigeria School of Molecular Bioscience Sciences College of MedicalVeterinary and Life SciencesUniversity of GlasgowGlasgowSCO G128QQUnited Kingdom department of Medical Laboratory Science State Hospital Ijebu-OdeIjebu-OdeOG 360101Nigeria department of Medical Laboratory Science Faculty of Health Sciences and TechnologyUniversity of JosJosPL 930103Nigeria department of Medical Laboratory Science Bola Tinubu Health and Diagnostic CenterLagosLA 100102Nigeria department of Pathology 68 Nigerian Army Reference HospitalYabaLA 1211001Nigeria department of Medical Laboratory Science Ladoke Akintola University of TechnologyOgbomosoOS 2111105Nigeria

BACKGROUNd Vaccine hesitancy is a major challenge in the fight against the coronavirus disease 2019(COVId-19)*** the sociodemographic factors associated with vaccine acceptance among Nigerians is crucial for improving vaccine *** To assess the acceptance rate of COVId-19 vaccine and its related determinants among *** An online cross-sectional survey(observational study)was conducted between February 2021 and May 2021,using a questionnaire hosted on *** invitation to take part in the poll was sent out to participants through social networking platforms.A logistic regression was used to determine which sociodemographic factors were associated with vaccine acceptance *** A total of 1800 persons responded to the survey,a larger proportion of whom were males(53.9%)and within the age group of 21-30 years(29.4%)and earned an average income of less than$500 per month(43.3%).Only 0.56%of participants had a high perceived risk of COVId-19 infection,while only 1.11%had a perceived risk of dying from *** perception rate of the COVId-19 vaccine among participants was 51.1%,while the acceptance rate was 63.9%.There was no significant association between the COVId-19 vaccine acceptance rate and related determinants assessed,particularly age(χ²=3.049,P=0.550),sex(χ²=0.102,P=0.749),average income(χ²=3.802,P=0.875),and religion(χ²=2.819,P=0.420).Participants with chronic conditions demonstrated a higher acceptance rate compared to the general *** despite the positive perception observed and substantial vaccine acceptance rate among the study participants,more public health interventions are still needed to enhance vaccine acceptability in Nigeria.

关键词： Acceptance COVId-19 determinants Hesitancy Nigerians Online survey Vaccine

Monte Carlo sampling for error propagation in linear regression and applications in isochron geochronology

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Science Bulletin 2019年第3期64卷 189-197页

作者： Yang Li Shuang Zhang richard Hobbs Camila Caiado Adam d.Sproson david Selby Alan d.Rooney State Key Laboratory of Lithospheric Evolution Institute of Geology and Geophysics Chinese Academy of Sciences department of Earth Sciences Durham University department of Geology and Geophysics Yale University department of Mathematical Sciences Durham University Atmosphere and Ocean Research Institute The University of Tokyo

Geochronology is essential for understanding Earth's history. The availability of precise and accurate isotopic data is increasing; hence it is crucial to develop transparent and accessible data reduction techniques and tools to transform raw mass spectrometry data into robust chronological data. Here we present a Monte Carlo sampling approach to fully propagate uncertainties from linear regressions for isochron dating. Our new approach makes no prior assumption about the causes of variability in the derived chronological results and propagates uncertainties from both experimental measurements(analytical uncertainties) and underlying assumptions(model uncertainties) into the final age *** synthetic examples, we find that although the estimates of the slope and y-intercept(hence age and initial isotopic ratios) are comparable between the Monte Carlo method and the benchmark‘‘Isoplot" algorithm, uncertainties from the later could be underestimated by up to 60%, which are likely due to an incomplete propagation of model uncertainties. An additional advantage of the new method is its ability to integrate with geological information to yield refined chronological constraints. The new method presented here is specifically designed to fully propagate errors in geochronological applications involves linear regressions such as Rb-Sr, Sm-Nd, Re-Os, Pt-Os, Lu-Hf, U-Pb(with discordant points),Pb-Pb and Ar-Ar.

关键词： Linear regression Isochron Geochronology Uncertainty propagation Monte Carlo Isoplot

Epidemiological, Clinical Progress Aspects of Congenital Heart disease with Neonatal Revelation at the Mother-Child Hospital of Bingerville (HME) Concerning 98 Cases from January 2021 to december 2022 (Côte d’Ivoire)

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Open Journal of Pediatrics 2024年第1期14卷 89-100页

作者： Adja Evelyne Akaffou-Gbery richard Azagoh-Kouadio Anne-Lise Laetitia Mobio Jean-Jacques Yao Atteby Serenah Marie Janice N’vrah Anoh Kouassi Raoul Yao department of Paediatrics and Neonatology H&#244pital Mère-Enfant de Bingerville (HME) Bingerville C&#244te d’Ivoire department of Medical Pediatrics and Specialties CHU de Angré Abidjan C&#244te d’Ivoire

Introduction The distribution of congenital heart disease (CHd) in sub-Saharan Africa is highly imprecise and varies from one region to another due to the inequality of diagnostic facilities. The aim of this study was to determine the in-hospital prevalence of congenital heart disease in children at the Mother-Child hospital of Bingerville (HME) by specifying the diagnostic, therapeutic and evolutionary aspects. Materials and methods We conducted a retrospective, descriptive, cross-sectional study at HME of Bingerville from January 2021 to december 2022. All newborns with congenital heart disease confirmed by echocardiography were included in the study. Results Of 656 admissions to the neonatology department over the study period, congenital heart disease accounted for 14.9% (98/656) of cases. In our series, 76.7% were diagnosed before the 1st week of life, with a mean chronological age of 5.18 days and extremes of 0 and 46 days. There were as many male patients (50%) as female (50%), i.e. a sex ratio of 1. These newborns were premature in 60.2% of cases, with a mean and median gestational age of 34 weeks’ amenorrhea. Most were left-right shunts (90.8%). Persistent ductus arteriosus (PdA) (48.9%) predominated, followed by atrial septal defect (38.7%), ventricular septal defect (13.3%), common trunk artery (CTA) (3.1%) and open septal pulmonary atresia (OSPA) (1%) as the primary cyanogenic heart disease. Pulmonary arterial hypertension (PAH) (50%) was primary in 38.8% and secondary (61.2%). The mortality rate was 30.6%, and all CTA patients died (100%), with a significant statistical relationship (p = 0.027). Progression under treatment was marked by clinical stabilization (68/98) in 69.4% of cases. Conclusion: Congenital heart disease is relatively common at the Bingerville HME. Access to echocardiography should be facilitated in neonatology departments for rapid diagnosis and optimal management of congenital heart disease in newborns.

关键词： Newborn Congenital Heart disease Côte d’Ivoire

Wafer-scale quasi-layered tungstate-doped polypyrrole film with high volumetric capacitance

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Nano Research 2023年第4期16卷 4895-4900页

作者： Huabo Liu Jiaxing Liang John Watt richard d.Tilley Rose Amal da-Wei Wang School of Chemical Engineering University of New South WalesSydneyNSW 2052Australia 2 Center for Integrated NanotechnologiesLos Alamos National LaboratoryLos AlamosNW 87545USA 3 School of ChemistryUniversity of New South WalesSydneyNSW 2052Australia

Layered materials are particularly attractive for supercapacitors because of their unique physical,electrical and chemical ***,we demonstrate a facile and scalable electrochemical deposition method for wafer-scale synthesis of quasilayered tungstate-doped polypyrrole films(named TALPy)with controllable thickness and *** as-prepared TALPy film exhibits a high gravimetric density and excellent volumetric capacitance,exceeding many high-performing carbon-and polymerbased film *** on combined results of ex-situ X-ray diffraction(XRd),Raman and X-ray photoelectron spectroscopy(XPS),it is determined that TALPy stores charge through an ion intercalation process accompanied by change in oxidation states of polypyrrole backbone,which is referred as intercalation *** these results suggest the great promise of electrochemical deposition as a scalable and controllable bottom-up approach for synthesizing quasi-layered conductive organic-inorganic hybrid films for electrochemical energy storage applications with high volumetric performance.

关键词： electrochemical deposition conductive polymer polypyrrole organic-inorganic hybrid supercapacitor intercalation pseudocapacitance

Molecular targets in the treatment of alcoholic hepatitis

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World Journal of Gastroenterology 2012年第39期18卷 5504-5513页

作者： Ashwin d dhanda richard WL Lee Peter L Collins C Anne McCune department of Liver Medicine University Hospitals Bristol NHS Foundation TrustBS2 8HW BristolUnited Kingdom department of Cellular and Molecular Medicine School of Clinical SciencesUniversity of BristolBS9 1TD BristolUnited Kingdom

Alcohol related costs to health and society are high. One of the most serious complications of alcohol misuse to the individual is the development of alcoholic hepatitis (AH), a clinical syndrome of jaundice and progressive inflammatory liver injury in patients with a history of recent heavy alcohol use. It has a poor outcome and few existing successful therapies. The use of glucocorticoids in patients with severe AH is still controversial and there remains a group of patients with glucocorticoid-resistant disease. However, as our understanding of the pathogenesis of the condition improves there are opportunities to develop new targeted therapies with specific actions to control liver inflammation without having a detrimental effect on the immune system as a whole. In this article we review the molecular mechanisms of AH concentrating on the activation of the innate and adaptive immune response. We consider existing treatments including glucocorticoids, anti-tumor necrosis factor therapy and pentoxifylline and their limitations. Using our knowledge of the disease pathogenesis we discuss possible novel therapeutic approaches. New targets include pro-inflammatory cytokines such as interleukin (IL)-17, chemokines and their receptors (for example IL-8, CXCL9 and CXCR3) and augmentation of anti-inflam- matory molecules such as IL-10 and IL-22. And there is also future potential to consider combination therapy to selectively modulate the immune response and gain control of disease.

关键词： Alcoholic hepatitis Tumour necrosis factor-m Pentoxifylline Interleukins Chemokine receptors

Explicit and Parameterized Episodes of Warm-Season Precipitation over the Continental United States

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Advances in Atmospheric Sciences 2006年第1期23卷 91-105页

作者： Mitchell W. MONCRIEFF John d. TUTTLE richard E. CARBONE National Center for Atmospheric Research BoulderColorado 80307-3000U. S. A.

This paper describes explicit and parameterized simulations of midsummer precipitation over the continental United States for two distinct episodes： moderate large-scale forcing and weak forcing. The objective is to demonstrate the capability of explicit convection at currently affordable grid-resolution and compare it with parameterized realizations. Under moderate forcing, 3-kin grid-resolution explicit simulations represent rainfall coherence remarkably well. The observed daily convective generation near the Continental divide and the subsequent organization and propagation are reproduced qualitatively. The propagation speed, zonal extent and duration of the rainfall streaks compare favorably with their observed counterparts, although the streak frequency is underestimated. The simulations at -10-km grid-resolution applying conventional convective parameterization schemes also replicate reasonably well the diurnal convective regeneration in moderate forcing. The performance of the 3-km grid-resolution model demonstrates the potential of -1-km-resolution explicit cloud-resolving models for the prediction of warm season precipitation for moderately forced environments. In weak forcing conditions, however, predictions of precipitation coherence and diurnal variability are much poorer. This suggests that an even finer resolution explicit model is required to adequately treat convective initiation and upscale organization typical of the warm season over the continental U.S.

关键词： warm-season precipitation explicit simulation convective parameterization

Adults have more male-biased sex ratios than first-winter juveniles in wintering duck populations

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Avian Research 2021年第4期12卷 623-637页

作者： Kevin A.Wood Kane Brides Maurice E.durham richard d.Hearn Wildfowl&Wetlands Trust SlimbridgeGloucestershire GL27BTUK

Background:The long-term monitoring of demographic changes in waterbird populations remains limited,but such information can be valuable for conservationists and waterbird *** sex ratios can indicate differences in survival rates between *** particular,differences in the sex ratios of fledged juveniles and adults can provide insight into the development of male bias among ***:In this study,we used data from individual birds captured over a 57-year period to assess the extent,and temporal variability in male bias in nine populations of ducks wintering in the United Kingdom:Gadwall(Mareca strepera),Northern Mallard(Anas platyrhynchos),Northern Pintail(Anas acuta),Common Pochard(Aythya ferina),Common Shelduck(Tadorna tadorna),Northern Shoveler(Spatula clypeata),Eurasian Teal(Anas crecca),Tufted duck(Aythya fuligula),and Eurasian Wigeon(Mareca penelope).Results:Overall,eight of these populations were significantly male-biased and adults were more male-biased than first-winter juveniles for all nine *** increased male bias among adults is consistent with the hypothesis that factors such as higher mortality of reproductive-age females during the breeding season is a major cause of male bias in duck ***,such predation cannot explain the male bias detected in first-winter juveniles in four of the *** temporal trends in male bias differed between adults and first-winter juveniles in Northern Mallard,Northern Pintail,Common Pochard,Common Shelduck,Eurasian Teal,Tufted duck,and Eurasian *** the study period we found increased male bias among adult Northern Mallard,Northern Pintail,Common Pochard,Common Shelduck,and Tufted duck as well as both adult and first-winter juvenile Northern ***:We provide evidence that among wintering duck populations,sex ratios are typically male-biased,with adults exhibiting stronger male-biased sex ratios than first-winter *** monitoring

关键词： Anseriformes Bird ringing demography Population structure Sex ratio Waterfowl