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空中英语教室（高级版．彭蒙惠英语） 2024年第3期 24-26,45,46页

作者： marcel Schwantes 不详

发现领导者,过去十年,商界经历了严重的领导力短缺,许多公司都措手不及,公司内部没有培训好足够的领导者来满足职场的需求。决策者应该掌握那些既能建立良好工作关系,又能带来出色业务成果的特定素质和技能。

关键词：业务成果领导力素质和技能决策者有方

Risk Factors for mortality in Acute Kidney Injury in Intensive Care Units in Togo

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Open Journal of Nephrology 2024年第1期14卷 37-47页

作者： Eyram makafui Yoan Yawo Amekoudi Kossi Akomola Sabi marcel David Keoula Badomta Dolaama Sarakawabalo Assenouwe Tabana mouzou Department of Nephrology Kara University Hospital University of Kara Kara Togo Department of Nephrology and Haemodialysis Sylvanus Olympio University Hospital University of Lome Lomé Togo Department of Anaesthesia and Intensive Care University Hospital of Kara University of Kara Kara Togo

Context: Acute kidney injury (AKI) in intensive care unit (ICU) is common and associated with very high mortality. In Togo, a tropical country with limited resources and only one nephrology department in the north, acute kidney injury seems to be a real tragedy with high mortality. Aims: to determine risk factors for mortality in acute kidney injury in the intensive care units. methods and material: We made a multicentric cross sectional study during 6 months in the four referral centers in northern Togo. Univariate and multivariate logistic regression was used to identify factors associated with mortality. Data were analyzed using RStudio 2023.04.1. Results: A total of 12.6% of patients admitted to intensive care had presented with AKI. The mean age was 49.6 ± 17.9. The sex ratio (m/F) was 2.1. Community-acquired AKI was in the majority (67.7%). Oligo anuria was the most frequent functional sign (38.4%). In our series, 81.6% of patients were in KDIGO stages 2 to 3. AKI was organic in 56.2% of cases. mortality was 44.3%. In multivariate analysis, the main factors predictive of death were: respiratory distress (OR = 2.36;p Conclusions: Acute kidney injury in intensive care is common in northern Togo, and mortality is high. Identification of associated factors should help anticipate prognosis.

关键词： AKI Intensive Care Unit Dialysis Epidemiology Togo

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

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

Intermediate Hip Arthroplasty in Gabon: Blood Loss and Risk Factor for Transfusion

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Open Journal of Anesthesiology 2024年第4期14卷 109-117页

作者： Ghislain Edjo Nkilly Pascal Christian Nze Obiang Raphael Okoue Ondo Arthur matsanga Stéphane Oliveira Léandre Nguiabanda Jean-marcel mandji-Lawson Department of Anaesthesia and Intensive Care Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon Department of Anaesthesia and Intensive Care Jeanne Ebori Fondation Libreville Gabon Department of Anaesthesia and Intensive Care Owendo University Hospital (CHUO) Libreville Gabon Department of Anaesthesia and Intensive Care Akanda Army Training Hospital Libreville Gabon Orthopedic Surgery Service Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon

Background: Hip arthroplasty is a surgery with a high risk of bleeding. The main objective of this study was to research risk factors for bleeding and transfusion in patients undergoing hip hemiarthroplasty in Gabon. method: It was a retrospective, monocentric, descriptive and analytical study carried out from June 2011 to June 2021 at the Omar Bongo Ondimba army training hospital. The variables studied were demographic characteristics, biological variables, transfusion and intraoperative data. The primary outcome was intraoperative transfusion. A univariate and multivariate analysis was conducted to identify the factors associated with the occurrence of a transfusion. Results: Of the 97 patients included, the average age was 74.2 years ± 10, male predominance was 73.2%, the average ASA score was 1.9 ± 0.5, and transfusion incidence was 38.1%. The average number of RBCs transfused was 1.2 ± 0.6. Tranexamic acid was used in 11.3% of patients. The average bleeding was 450 ± 453 ml. Preoperative anemia was predictor of transfusion to be significant. Conclusion: The incidence of transfusion is law compared to total hip arthroplasty. The implementation of a patient blood management protocol is difficult given the urgency of bone repair. However, a better use of tranexamic acid could reduce this transfusion incidence.

关键词： Hip Arthroplasty Risk Factors Patients Hemiarthroplasty Gabon

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新民族学博物馆,布达佩斯,匈牙利

世界建筑 2024年第5期 70-75页

作者：无 marcel Ferencz molnár József(摄影) 王单单(译) NAPUR建筑设计事务所不详

新民族学博物馆位于布达佩斯市中心的城市公园内,其使命是向匈牙利文化的千年传统致敬,并加强在空间层面上不断发展的民族认同。这种使命具有原创性、不可复制性和不可复原性,通过探索其空间性向来自世界各地的人们传递信息。这座建筑... 详细信息

新民族学博物馆位于布达佩斯市中心的城市公园内,其使命是向匈牙利文化的千年传统致敬,并加强在空间层面上不断发展的民族认同。这种使命具有原创性、不可复制性和不可复原性,通过探索其空间性向来自世界各地的人们传递信息。这座建筑的设计动感而简洁,既与公园的自然环境相协调,又与周围的城市肌理相联系。柔和的曲线使建筑成为连接城市和公园的门户与通道。该建筑有近60%的面积位于地面以下。按照现代博物馆的科学建议,世界级的展览空间不应受自然光照的影响。此外,因景观屋顶和地面部分的透明度,新博物馆在规模上也与周围环境相适应。

关键词：现代博物馆不可复制性周围环境自然光照复原性展览空间城市肌理城市公园

Urea breath test for Helicobacter pylori infection in adult dyspeptic patients: A meta-analysis of diagnostic test accuracy

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World Journal of Gastroenterology 2024年第6期30卷 579-598页

作者： Fabian Fellipe Bueno Lemos Caroline Tianeze de Castro marcel Silva Luz Gabriel Reis Rocha Gabriel Lima Correa Santos Luís Guilherme de Oliveira Silva mariana Santos Calmon Cláudio Lima Souza Ana Carla Zarpelon-Schutz Kádima Nayara Teixeira Dulciene maria de magalhães Queiroz Fabrício Freire de melo Instituto multidisciplinar em Saúde Universidade Federal da BahiaVitória da Conquista 45029-094BahiaBrazil Instituto de Saúde Coletiva Universidade Federal da BahiaSalvador 40110040BahiaBrazil Campus Toledo Universidade Federal do ParanáToledo 85919-899ParanáBrazil Laboratory of Research in Bacteriology UFMGBelo Horizonte 30130-100Minas GeraisBrazil

BACKGROUND Helicobacter pylori(***)infection has been well-established as a significant risk factor for several gastrointestinal *** urea breath test(UBT)has emerged as a leading non-invasive method for detecting *** numerous studies confirming its substantial accuracy,the reliability of UBT results is often compromised by inherent *** findings underscore the need for a rigorous statistical synthesis to clarify and reconcile the diagnostic accuracy of the UBT for the diagnosis of *** *** To determine and compare the diagnostic accuracy of 13C-UBT and 14C-UBT for *** infection in adult patients with *** We conducted an independent search of the Pubmed/mEDLINE,EmBASE,and Cochrane Central databases until April *** search included diagnostic accuracy studies that evaluated at least one of the index tests(^(13)C-UBT or ^(14)C-UBT)against a reference *** used the QUADAS-2 tool to assess the methodo-logical quality of the *** utilized the bivariate random-effects model to calculate sensitivity,specificity,positive and negative test likelihood ratios(LR+and LR-),as well as the diagnostic odds ratio(DOR),and their 95%confidence *** conducted subgroup analyses based on urea dosing,time after urea administration,and assessment *** investigate a possible threshold effect,we conducted Spearman correlation analysis,and we generated summary receiver operating characteristic(SROC)curves to assess ***,we visually inspected a funnel plot and used Egger’s test to evaluate publication *** both as reliable diagnostic tools in clinical *** In summary,our study has demonstrated that ^(13)C-UBT has been found to outperform the ^(14)C-UBT,making it the preferred diagnostic ***,our results emphasize the significance of carefully considering urea dosage,assessment timing,and measurement techniques for both tests to enh

关键词： Helicobacter pylori Urea breath test Diagnosis Diagnostic test accuracy meta-analysis

Broad Hormonal Responses Induced by Aluminum in Roots of Dwarf Transgenics of Solanum lycopersicum L. cv “micro-Tom”

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American Journal of Plant Sciences 2024年第5期15卷 349-358页

作者： Arthur B. Rates Daniela Boanares Daniele S. G. Pianetti Felipe Della-Torre Joni E. Lima marcel G. C. França Department of Botany and Plant Physiology Laboratory Federal University of Minas Gerais Belo Horizonte Brazil

The spatial pattern distribution of plant hormones in response to aluminum (Al) toxicity in roots remains to be shown. This study was performed to assess the root hormonal accumulation and gene expression in response to Al toxicity in five transgenic miniature dwarf tomatoes cv. micro-Tom (mT). mT and mT transgenics to acid indole acetic, cytokinin, gibberellin, abscisic acid and ethylene were cultivated in nutrient solutions containing different Al concentrations. Root growth elongation was measured and cellular damage was visualized by staining Evans’s blue. The GUS reporter gene staining technique was used to visualize hormonal changes in mT apex root tissues. Data indicated that the mT is sensitive to Al that induced significant growth inhibition and cellular damage. Al concentration of 27 μm was significantly toxic, inducing root apex darkening and inhibition of root development. The qualitative evaluation of GUS reporter gene expression showed intense crosstalk among all hormones studied, underscoring the complexity of signaling induced by Al in apex roots. Results point out to a major understanding of the hormonal signaling in response to Al toxicity, which may induce a change of root growth and architecture with growth inhibition and cell constraints modulated by all different hormones evaluated.

关键词： Gene Reporter metal Plant Hormones Root Staining

狐狸界的“妲己” 赤狐近亲相残究竟为什么？

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环球人文地理 2024年第5期 74-81页

作者：鲨鲨张扬的小强滕洪亮 m.Leonard Photo marcel Rudolph-Gajda Kcapaldo mihiro＿wildlife Zyabich vladk213

因美丽而招致杀身之祸，为生存而近亲相残。狐狸界的妲己——赤狐，到底是祥瑞，还是祸水？从古至今，民间流传的神话传说、志怪传记都少不了狐狸们的身影。早在远古时期，华夏领袖大禹的妻子涂山九尾狐还是正面形象，可随后一个全然相...

因美丽而招致杀身之祸，为生存而近亲相残。狐狸界的妲己——赤狐，到底是祥瑞，还是祸水？从古至今，民间流传的神话传说、志怪传记都少不了狐狸们的身影。早在远古时期，华夏领袖大禹的妻子涂山九尾狐还是正面形象，可随后一个全然相反的狐狸形象诞生——妲己，她的知名度远远超过涂山氏，并在一定程度上定义了狐狸的妖媚概念。

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Correlation between Intestinal Health and Coccidiosis Prevalence in Broilers during Different Seasons of the Year in Brazil from 2012 to 2018

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Food and Nutrition Sciences 2024年第3期15卷 179-198页

作者： Fabio Luis Gazoni Gabriela miotto Galli marcel manente Boiago Lenita moura Stefani Aline Zampar marco A. Juárez-Estrada Guillermo Tellez-Isaias Aleksandro S. da Silva Animal Health and Reproduction Veterinary Medicine Graduate Program Federal University of Santa Maria (UFSM) Santa Maria Brazil Animal Science Graduate Program Federal University of Rio Grande do Sul (UFRGS) Porto Alegre Brazil Animal Science Graduate Program Santa Catarina State University (UDESC) Chapecó Brazil Departamento de medicina y Zootecnia de Aves Facultad de Medicina Veterinaria y Zootecnia Universidad Nacional Autonoma de Mexico Ciudad Universitaria Ciudad de Mexico Mexico Department of Poultry Science Division of Agriculture University of Arkansas Fayetteville AR USA

Coccidiosis is a disease caused by intracellular protozoan parasites, specifically belonging to the genus Eimeria. These parasites target the gastrointestinal tract in different types of hosts, causing sores in the intestinal lining. The presence of these lesions reduces the animal’s ability to digest and absorb nutrients, significantly impacting their overall performance. The current study aimed to explore the potential correlation between seasonal variations and the incidence of Eimeria spp-induced lesions in broiler chickens’ gastrointestinal tracts in Brazil from 2012 to 2018. A total of 8,607 broiler chickens, aged 14 to 42 days, were sampled from 103 poultry integrated companies in Brazil to conduct intestinal health examinations. The sampling process involved selecting 3 to 6 chickens from each poultry house for examination. The assessment included various abnormalities such as shedding of intestinal cells and excessive fluid and mucus presence, thickening and tension of the intestines, food movement, roughened mucosal surface resembling a Turkish towel in the small intestine, tissue death, duodenal inflammation, intestinal inflammation, gizzard erosion, presence of worms and bedding material, and ingestion of mealworms. During the seasons, winter exhibited the highest average occurrence of Eimeria maxima microorganisms at 52.83%, with E. acervulina following closely at 26.42% in second place. In spring, E. maxima had an occurrence of 11.31%, while in fall, E. tenella had the lowest occurrence at 6.74%. When analyzing the seasonal occurrence of Eimeria, it was observed that E. maxima micro was more common during winter compared to summer (P = 0.0491). However, no discernible variation was observed in the occurrence of the remaining species across different seasons. Research findings suggest that subclinical coccidiosis is most prevalent during the winter season in Brazil. Likewise, clinical disease caused by E. acervulina is also prevalent during this time. I

关键词： Eimeria Epidemiology Intestinal Pathology Broiler Chickens Brazil