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Laparoscopic Surgery of Incisional Hernia: Technique and Short-Term Results in Three Surgical Units in Cameroon

Surgical Science 2024年第4期15卷 232-243页

作者： Guy Aristide Bang Eric Patrick Savom Achille Aimé Bekolo Otiti Fred Dikongue Dikongue Mahamat Yannick Ekani Boukar richard II Mbele Cédric Paterson Atangana Daniel Biwole Biwole Arthur Essomba Yaoundé Teaching Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I Yaound&#233 Cameroon Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the University of Dschang Dschang Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Yaoundé Central Hospital Yaound&#233 Cameroon

Introduction: Incisional hernia is a common medical situation and its treatment has always been a challenge for general surgeons. If laparoscopic repair has become a gold standard elsewhere, it is increasingly done in our milieu, but no data has been found. The aim of this study was to review this surgery done in our country so far, to describe the operative technique and to evaluate the postoperative outcomes. Patients and Methods: We conducted an observational descriptive study with retrospective collection of data from the 1st of July 2018 to 30th of June 2022, in three hospitals in Cameroon. Data on socio-demographic and clinical characteristics, surgical technique and postoperative outcomes of patients who had a laparoscopic repair of their incisional hernia were collected. Results: We reviewed 20 files. There were 14 women with an average age of 54.6 years. The average BMI was 32.8 kg/m2. Thirteen patients had a moderate size hernia and the hernia was localized at the midline in 18 cases. Only composite biface meshes were used with dimensions chosen to obtain at least 5 cm overlap. Spiral tacks were the only fixation means used. We registered 3 complications. One case of generalized peritonitis secondary to missed digestive perforation, one case of seroma and one case of postoperative ileus. We registered no death. Conclusion: Laparoscopic repair of incisional hernias is feasible in a resource-limited setting like ours. Compliance with the operative technique and recommendations is important to obtain short-term results closed to that put forward by literature.

关键词： Incisional Hernia Laparoscopy Repair Composite Biface Mesh Postoperative Outcomes

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richard MILLE 追求极致再上层楼

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钟表·最时间 2024年第2期 24页

作者： Chaos richard MILLE Jili

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Surgical Management of Perforated Colon Tumours in Yaoundé: A Multicentre Retrospective Review of 30-Day Postoperative Outcome

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Surgical Science 2024年第5期15卷 330-341页

作者： Eric Patrick Savom richard II Mbele Colman Tamboh Tankou Mahamat Yannick Ekani Boukar Cédric Paterson Atangana Fred Dikongue Dikongue Daniel Biwole Biwole Guy Aristide Bang Arthur Essomba Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&#233 I Yaound&#233 Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Dschang Dschang Cameroon Yaoundé Central Hospital Yaound&#233 Cameroon Yaoundé University Teaching Hospital Yaound&#233 Cameroon

Introduction: Colon cancer is often diagnosed late in our context and there is a high prevalence of complicated forms, this including perforation. The optimal surgical treatment remains controversial. The aim of this study was to improve the short-term postoperative outcomes of patients operated upon for perforated colon cancer, by identifying factors associated with complications occurring within 30 days after surgery. Patients and methods: We carried out an analytical observational study, with a retrospective collection of data from the files of patients operated upon for an in situ tumoral colon perforation. This was done in four referral hospitals in the city of Yaoundé. The period was from the 1st of January, 2012 to the 31st of December, 2021. Cox regression identified the factors associated with postoperative morbidity and mortality. Results: We collected files of 46 patients. The mean age was 54.7 ± 19.9 years with a sex ratio of 1.4. The clinical presentation on admission was dominated by the presence of signs of peritoneal irritation (91.3%) and bowel obstruction (28.3%). The diagnosis was made preoperatively in 16 cases (34.8%). The surgical procedures consisted of colectomy with anastomosis in 28 cases (60.9%) and without anastomosis in 14 cases (30.4%). Postoperative morbidity was 60.9% dominated by surgical site infection (37%). Postoperative mortality was 39.1%. The existence of generalized peritonitis was associated with the occurrence of postoperative complications (p = 0.019). The main factors associated with postoperative mortality were resection with primary anastomosis (p = 0.027), enterocutaneous fistula (p = 0.005). Conclusion: Colic resection with primary anastomosis or ideal colectomy is associated with an increased risk of mortality and should therefore not be performed in this setting.

关键词： Perforated Colon Cancer Postoperative Morbidity and Mortality Colectomy Acute Generalized Peritonitis

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Combining scanning tunneling microscope (STM) imaging and local manipulation to probe the high dose oxidation structure of the Si(111)-7×7 surface

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Nano Research 2020年第1期13卷 145-150页

作者： Dogan Kaya richard J.Cobley richard E.Palmer Department of Electronics and Automation Vocational School of AdanaCukurova University01160CukurovaAdanaTurkey Nanoscale Physics Research Laboratory School of Physics and AstronomyUniversity of BirminghamEdgbastonBirminghamB152TTUK College of Engineering Swansea UniversityBay CampusFabian WaySwanseaSA18ENUK

Understanding the atomistic formation of oxide layers on semiconductors is important for thin film fabrication,scaling down conventional devices and for the integration of emerging research ***,the initial oxidation of Si(111)is studied using the scanning tunneling *** to the complete saturation of the silicon surface with oxygen,we are able to probe the atomic nature of the oxide layer *** establish the threshold for local manipulation of inserted oxygen sites to be+3.8 *** by combining imaging with local atomic manipulation are we able to determine whether inserted oxygen exists beneath surface-bonded oxygen sites and differentiate between sites that have one and more than one oxygen atom inserted beneath the *** to the creation of the thin oxide film we observe a flip in the manipulation rates of inserted oxygen sites consistent with more oxygen inserting beneath the silicon surface.

关键词： scanning tunneling microscopy(STM) local manipulation Si(111) oxidation

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Soundscapes and the sense of hearing of fishes

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Integrative Zoology 2009年第1期4卷 26-32页

作者： richard FAY Parmly Hearing Institute Loyola University ChicagoChicagoUSA

Underwater soundscapes have probably played an important role in the adaptation of ears and auditory systems of fishes throughout evolutionary time,and for all *** sounds probably contain important information about the environment and about most objects and events that confront the receiving fish so that appropriate be-havior is *** example,the sounds from reefs appear to be used by at least some fishes for their orientation and *** sorts of environmental sounds should be considered much like“acoustic daylight,”that continuously bathes all environments and contain information that all organisms can potentially use to form a sort of image of the *** present,however,we are generally ignorant of the nature of ambient sound fields impinging on fishes,and the adaptive value of processing these fields to resolve the multiple sources of *** field has focused almost exclusively on the adaptive value of processing species-specific communication sounds,and has not considered the informational value of ambient“noise.”Since all fishes can detect and process acoustic particle motion,including the directional characteristics of this motion,underwater sound fields are potentially more complex and information-rich than terrestrial acoustic *** capacities of one fish species(goldfish)to receive and make use of such sound source information have been demonstrated(sound source seg-regation and auditory scene analysis),and it is suggested that all vertebrate species have this capacity.A call is made to better understand underwater soundscapes,and the associated behaviors they determine in fishes.

关键词： acoustic daylight auditory scene analysis soundscape sound source segregation.

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Optimal orientations of discrete global grids and the Poles of Inaccessibility

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International Journal of Digital Earth 2020年第7期13卷 803-816页

作者： richard Barnes Energy&Resources Group BerkeleyUSA Electrical Engineering&Comptuer Science BerkeleyUSA

Spatial analyses involving binning often require that every bin have the same area,but this is impossible using a rectangular grid laid over the Earth or over any projection of the *** global grids use hexagons,triangles,and diamonds to overcome this issue,overlaying the Earth with equally-sized *** discrete global grids are formed by tiling the faces of a ***,the orientations of these polyhedra have been chosen to satisfy only simple criteria such as equatorial symmetry or minimizing the number of vertices intersecting ***,projection distortion and singularities in discrete global grids mean that such simple orientations may not be sufficient for all use ***,I present an algorithm for finding suitable orientations;this involves solving a nonconvex optimization *** a side-effect of this study I show that Fuller’s Dymaxion map corresponds closely to one of the optimal orientations I find.I also give new high-accuracy calculations of the Poles of Inaccessibility,which show that Point Nemo,the Oceanic Pole of Inaccessibility,is 15 km farther from land than previously recognized.

关键词： Discrete grid geographic information system(GIS) geoinformatics supercomputer projections spatial statistics

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Design of low-energy on-chip electro-optical 1 × M wavelength-selective switches

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Photonics Research 2017年第4期5卷 340-345页

作者： richard SOREF Department of Engineering The University of Massachusetts at Boston

A theoretical design is presented for a 1 × M wavelength-selective switch(WSS) that routes any one of N incoming wavelength signals to any one of M output ports. This planar on-chip device comprises of a 1 × N demultiplexer, a group of N switching "trees" actuated by electro-optical or thermo-optical means, and an M-fold set of N × 1multiplexers. Trees utilize 1 × 2 switches. The WSS insertion loss is proportional to [log_2(M+N +1)]. Along with cross talk from trees, cross talk is present at each cross-illuminated waveguide intersection within the WSS, and there are at most N-1 such crossings per path. These loss and cross talk properties will likely place a practical limit of N=M=16 upon the WSS size. By constraining the 1 × 2 switching energy to^1 f J∕bit, we find that resonant, narrowband 1 × 2 switches are required. The 1 × 2 devices proposed here are nanobeam Mach–Zehnders and asymmetric contra-directional couplers with grating assistance.

关键词： Design of low-energy on-chip electro-optical 1 M wavelength-selective switches WSS

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Prevalence of Gender-Based Violence among Sex Workers in Bangui, Central African Republic (CAR)

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Advances in Sexual Medicine 2024年第2期14卷 13-20页

作者： D. Mossoro-Kpinde Hermione S. C. Diemer Henri R. Tende Nzengou richard S. Siki Francis J. D. D. Tekpa Bertrand Ministry of Labor Employment Social Protection and Vocational Training Bangui Central African Republic Department of Public Health Faculty of Health Sciences University of Bangui Bangui Central African Republic Community of the Tree of Life Bangui Central African Republic Traumatology Department The Central African Republic RCA Community Hospital Bangui Central African Republic

Background: Violence against women has become an international public health and human rights issue in recent decades. The violence suffered by sex workers is of little interest for research, yet it constitutes a major health and safety problem. We propose to assess the extent of the phenomenon of gender-based violence (GBV) among sex workers (SWs) in the city of Bangui in the CAR. Methodology: This is a descriptive cross-sectional epidemiological study covering the period from July to October 2021 carried out among SWs in Bangui, the capital of the CAR. Given that the SWs association had only 159 members in Bangui, an exhaustive sampling was retained. Were included in the study, any SW present during the data collection period and having given their written consent. The parameters studied were socio-demographic characteristics: age, sex, residence, level of education, marital status, and characteristics linked to violence: the notion of violence during their professional activity, the type of violence, the declaration and the declaration if necessary, the response and management of this violence. The data collected was analyzed using Epi info version 7 software. Results: Of the 159 SWs that counted the association, 108 had been included. The average age was 27.0 years with extremes of 14 and 46 years. The age groups of 25 to 34 years were the most represented (43.5%). Fifty-six SWs (51.9%) had reached the secondary level. Unemployed SWs were in the majority at 74.1%;Sixty-six (66) SWs in our sample (61.1%) had already been victims of violence during the exercise of their activity Sexual violence was the most represented (28.5%) followed by verbal violence (22.4%). Sixty-eight (62.9%) wanted to stop the professional activity of SWs and 93.1% would accept another income-generating activity in place of sex work. Conclusion: It is necessary to supervise SWs and protect them within the framework of respect for human rights, rather than criminalizing them and the exploit

关键词： Female Sex Workers Gender-Based Violence Central African Republic

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Effect of Different Rates and Mixtures of Solid Household Waste and Faecal Sludge-Based Composts on Soil Fertility and Productivity of Sunflower (Helianthus annuus L.) in Dschang, West Cameroon

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Open Journal of Soil Science 2024年第7期14卷 448-470页

作者： Romary Ngnipa Tchinda Rodrigue Emmanuel Kenne Primus Azinwi Tamfuh Jovanie Gladys Kenfack Doris Temgoua Zombou Désiré Évariste Moundjeu Tsafack richard Tanwi Ghogomu Emile Temgoua Dieudonné Bitom Oyono Department of Environmental Sciences of the Higher Institute of Agriculture Wood Water and the Environment of the University of Bertoua Blabo Cameroon Department of Soil Science Soil Analysis and Environmental Chemistry Research Unit Faculty of Agronomy and Agricultural Sciences University of Dschang Dschang Cameroon Department of Mining and Mineral Engineering National Higher Polytechnic Institute University of Bamenda Bambili Cameroon Department of Animal Biology Faculty of Sciences University of Dschang Dschang Cameroon Department of Earth Sciences University of Yaounde 1 Yaounde Cameroon

The unbalanced and inadequate use of fertilizers is one of the causes of soil degradation. Combined with the ever-increasing population, it is necessary to find sustainable agricultural production alternatives. The present work aims to determine the effect of different rates and mixtutes of organic amendments on soil fertility and the performance of Sunflower (Helianthus annuus L.). In the field, treatments consisted of solid household waste and faecal sludge in the ratios of 3/5 (V1), and a mixture of faecal sludge and household waste in the ratio of 3/5 with 900 worms (V2). At the end of the composting process, V1, V2 composts and the poultry manure (PM) were applied at rates of 4, 5 and 6 t∙ha−1 in a randomized complete block design with three replications. Soil samples were collected before and after the experiment and analyzed. The main results revealed that at the end of the composting process, there was a progressive improvement in the physico-chemical properties of V1 and V2 composts. In particular, the C/N ratio, phosphorus (P) and total nitrogen (TN) initially at 16.49 ± 0.42 (V1, V2), 21.06 ± 0.07 mg∙kg−1 (V1, V2), 0.76% ± 0.08% (V1, V2) respectively, increased after 60 days to 12.40 ± 0.41 (V1), 9.74 ± 0.28 (V2) for C/N, 21.94 ± 0.63 mg∙kg−1 (V1) and 22.04 ± 0.04 mg∙kg−1 (V2) for P, 0.96% ± 0.0% (V1) and 1.22 ± 0.04 (V2) for TN. The application of 6 t∙ha−1of PM had the greatest influence on the diameter and weight of the flower heads (27.16 ± 4.01 t∙ha−1 and 230.83 ± 2.64 t∙ha−1), while 4 t∙ha−1 of V2 gave the tallest sunflower plants (110.07 ± 73.28 cm) as well as the diameter at the crown (19.30 ± 9.07 cm). However, CEC was most influenced by 4 t∙ha−1 of V1, while 4 t∙ha−1 of PM had the greatest effect on organic carbon and phosphorus. However, 5 t∙ha−1 of PM showed the highest sunflower production and yield (1.67 ± 0.21 t∙ha−1). The combination with 900 earthworms is recommended for composting and 5 t∙ha−1 of PM is recommended to obtain a better sunfl

关键词： Sunflower Faecal Sludge Household Waste Compost Soil Fertility

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Mid-infrared 2×2 electro-optical switching by silicon and germanium three-waveguide and four-waveguide directional couplers using free-carrier injection

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Photonics Research 2014年第5期2卷 102-110页

作者： richard Soref The Engineering Program University of Massachusetts at Boston100 Morrissey Blvd.BostonMassachusetts 02125USA

New designs are proposed for 2×2 electro-optical switching in the 1.3–12μm wavelength *** couplers are analyzed using a two-dimensional effective-index *** is shown that three or four side-coupled Si or Ge channel waveguides can provide complete crossbar broad-spectrum switching when the central waveguides are injected with electrons and holes to modify the waveguides’core index by an amountΔn+iΔ*** four-waveguide device is found to have a required active length L that is 50%shorter than L for the three-waveguide switch.A rule ofΔβL>28 for 3w andΔβL>14 for 4w is deduced to promise insertion loss<1.5 dB and crosstalk<−15 dB at the bar *** an injection ofΔNe=ΔNh=5×10^(17)cm^(−3),the predicted L decreased from∼2 to∼0.5 mm asλincreased from 1.32 to 12μ*** of Ge’s largeΔk,the Ge bar loss is high in 4w but is acceptable in 3w.

关键词： waveguide optical injection

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