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Call for action:Increased healthcare utilization with growing use of percutaneous cholecystectomy tube over initial cholecystectomy in cirrhotics

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Hepatobiliary & Pancreatic Diseases International 2022年第1期21卷 56-62页

作者： Srikanth Vedachalam Sajid Jalil Somashaker g Krishna Kyle Porter Na Li Sean g kelly Lanla Conteh Khalid Mumtaz Department of Internal Medicine The Ohio State University Wexner Medical CenterColumbusOH 43210USA Division of gastroenterology Hepatology and NutritionThe Ohio State University Wexner Medical CenterColumbusOH 43210USA Center for Biostatistics Department of Biomedical InformaticsThe Ohio State University Wexner Medical CenterColumbusOH 43210USA

Background:Acute calculous cholecystitis(ACC)is frequently seen in cirrhotics,with some being poor candidates for initial ***,these patients may undergo percutaneous cholecystostomy tube(PCT)*** studied the healthcare utilization and predictors of cholecystectomy and PCT in patients with ***:The National Database was queried to study all cirrhotics and non-cirrhotics with ACC between 2010-2014 who underwent initial PCT(with or without follow-up cholecystectomy)or *** patients were divided into compensated and decompensated *** predictors and outcomes of initial PCT and failure to undergo subsequent cholecystectomy were ***:Out of 919189 patients with ACC,13283(1.4%)had *** cirrhotics,cholecystec-tomy was performed in 12790(96.3%)and PCT in the remaining 493(3.7%).PCT was more frequent in cirrhotics(3.7%)than in non-cirrhotics(1.4%).Multivariate analyses showed increased early readmis-sions[odds ratio(OR)=2.12,95%confidence interval(CI):1.43-3.13,Pgth of stay(effect ratio=1.39,95%CI:1.20-1.61,Pgoing initial PCT compared to *** cirrhosis(OR=2.25,95%CI:1.67-3.03,Pghest odds of getting initial ***,regardless of compensated(OR=0.56,95%CI:0.34-0.90,P=0.020)or decompensated(OR=0.28,95%CI:0.14-0.59,Pgetting a subsequent ***:Cirrhotic patients undergo fewer cholecystectomy incurring initial PCT ***,the rates of follow-up cholecystectomy are lower in *** healthcare utilization is seen with initial PCT amongst cirrhotic *** situation reflects suboptimal management of ACC in cirrhotics and a call for action.

关键词： National Healthcare Cholecystectomy Percutaneous cholecystostomy Cirrhosis Decompensated cirrhosis

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INVESTIgATION OF THE ATRP OF n-BUTYL METHACRYLATE USINg THE Cu(I)/N,N,N',N",N"-PENTAMETHYLDIETHYLENETRIAMINE CATALYST SYSTEM

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Chinese Journal of Polymer Science 2004年第2期22卷 195-204页

作者： kelly A. Davis Krzysztof Matyjaszewski Center for Macromolecular Engineering Department of Chemistry Carnegie Mellon University 4400 Fifth Ave.Pittsburgh Pennsylvania 15213 USACenter for Macromolecular Engineering Department of Chemistry Carnegie Mellon University 4400 Fifth Ave.Pittsburgh Pennsylvania 15213 USA

The polymerization of n-butyl methacrylate was investigated using the Atom Transfer Radical Polymerization technique with CuBr and CuCl/N,N,N',N',N'-pentamethyldiethylenetriamine catalytic systems. Various combinations of catalyst systems and initiators were utilized in order to optimize the polymerization conditions and to obtain well-defined polymers (i.e. controlled molecular weights and low polydispersities). It has been found that the optimal initiator for this system is a chlorine-based initiator, when the catalyst used is a salt in conjunction with the N,N,N',N',N'- pentamethyldiethylenetriamine ligand. Bromine-based initiators tend to result in large amounts of initial termination, leading to polymers with less than ideal chain end functionality, even if CuCl is used as the species to invoke the halogen exchange. Additionally, the effects of the polymerization temperature, species and the initiator structure were determined.

关键词： ATRP Atom transfer radical polymerization Controlled/living radical polymerization Butyl methacrylate Pentamethyldiethylenetriamine

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Speed of Thought and Speed of Feet:Examining Perceptual-Cognitive Expertise and Physical Performance in an English Football Academy

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Journal of Science in Sport and Exercise 2021年第1期3卷 88-97页

作者： adam L.kelly Mark R.Wilson Daniel T.Jackson Jennifer Turnnidge Craig A.Williams Faculty of Health Education and Life SciencesBirmingham City UniversityBirminghamWest MidlandsUK Children’s Health and Exercise Research Centre and the College of Life and Environmental Sciences University of ExeterSt Luke’s CampusHeavitree RoadExeter EX12LUDevonUK Exeter City Football Club ExeterDevonUK School of Kinesiology and Health Studies Queen’s UniversityKingstonONCanada

The world's greatest professional football players are able to execute effective tactical decisions as well as fulfil various physical ***,the degree to which both are associated with greater potential in a football academy is ***,the aim of this study was to investigate decision-making skill and physical performance as contributing factors to coach potential rankings in an English football ***-eight outfield academy players(Foundation Development Phase[FDP]under-9 to under-11 n=40;Youth Development Phase[YDP]under-12 to under-16 n=58)participated in the *** engaged in 45 film-based simulations at two occlusion phases(e.g.,the visual display is cut-off at a precise time during an action),firstly"during"and secondly"post"execution,to examine decision-making *** also completed four fitness tests to examine physical performance.A classification of"higher-potentials"(top third)and"lower-potentials"(bottom third)were applied through coach *** t-tests compared the decision-making and physical performance ***-potentials made significantly more accurate decisions within the"post"phase within the FDP(Pg"phase within the YDP(Pgher-potentials were significantly faster for the 0-30 m sprint in both the FDP and YDP(Pgher-potentials within the YDP also significantly faster in the 0-10 m sprint(Pgnificantly higher in the countermovement jump(Pgs indicated that greater football potential may be associated with superior perceptual-cognitive expertise and quicker sprint ability in both academy age phases,with a greater discriminatory function within the older cohort.

关键词： Decision-making Sprint ability Fitness testing Academy football Talent identification Talent development

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Update on endoscopic ultrasound-guided liver biopsy

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World Journal of gastroenterology 2022年第28期28卷 3586-3594页

作者： Shiva Rangwani Devarshi R Ardeshna Khalid Mumtaz Sean g kelly Samuel Y Han Somashekar g Krishna Division of gastroenterology Hepatologyand NutritionDepartment of Internal MedicineOhio State University Wexner Medical CenterColumbusOH 43210United States

Endoscopic ultrasound guided liver biopsy(EUS-LB)has emerged as a minimally-invasive alternative to the traditional(percutaneous or transjugular)liver biopsy techniques for the diagnosis of liver parenchymal ***,EUS-LB combines the advantages of percutaneous and transjugular liver biopsy in addressing focused sampling in addition to measuring portal ***,EUS-LB facilitates access to both the lobes of the liver which is not considered with the traditional percutaneous liver *** studies have compared EUS-LB with conventional liver biopsy and reported comparable diagnostic yield,increased acquisition of complete portal tracts,and longer specimen length as compared to the traditional ***-LB is associated with lesser post-procedural pain and shorter recovery time,while providing lower risk of complications when compared to traditional liver *** in needle types,needle sizes and suction techniques have aimed at further optimizing the EUS-LB *** review article updates current literature with focus on the variations in the technique and equipment used for EUS-LB,and compares EUS-LB with traditional methods of liver biopsy.

关键词： Endoscopic ultrasound guided liver biopsy Liver biopsy Percutaneous liver biopsy Transjugular liver biopsy Liver parenchymal disease Portal pressure gradient

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Optimization designed large-stroke MEMS micromirror for adaptive optics

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Chinese Optics Letters 2010年第12期8卷 1163-1166页

作者：孙全 kelly He Edmond Cretu College of Optoelectronics Science and Engineering National University of Defense Technology Department of Electrical and Computer Engineering University of British Columbia

A novel micromirror based on the PolyMUMPs process is designed and presented. The hexagonal micromirror with a diameter of 450 μm consists of three supporting bilayer cantilevers and a mirror plate. The bilayer cantilevers, formed with a polysilicon layer and a gold layer, elevate the mirror plate according to residual stress-induced bending. Both analytical and finite element analysis （FEA） models are built to calculate the elevated height of the free end of the cantilever. The analytical solution is in accordance with the FEA simulation results, with longitudinal stresses applied only. Results of a three-dimensional （3D） simulation with two direction stresses applied also show the elevated height to be proportional to the width of the cantilever and the length of the gold layer. Due to the torque of the joint, the elevated heights of the two kinds of cantilevers assembled with the mirror plates are much smaller than those of the free end of the cantilevers. Both micromirrors with different cantilevers are fabricated. The elevated heights of the fabricated micromirrors are measured using Veeco optical profiler, which show good coincidence with simulation results.

关键词： Finite element method Microelectromechanical devices Mirrors Polysilicon Three dimensional Three dimensional computer graphics

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Antibiotic use in early childhood and risk of obesity: longitudinal analysis of a national cohort

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World Journal of Pediatrics 2019年第4期15卷 390-397页

作者： Dervla kelly Alan kelly Tom O'Dowd Catherine B.Hayes Department of Public Health and Primary Care Trinity College DublinRussell CenterTallaght CrossDublin 24Ireland

Background Taking oral antibiotics during childhood has been linked with an increased risk of childhood *** study assessed any potential association in number of courses of antibiotics taken between 2-3 and 4-5 years of age and body mass trajectory up to age *** The study was a secondary analysis of 8186 children and their parents from the infant cohort of the Irish National Longitudinal Study of *** use was measured by parental recall between ages 2-3 and *** models described the relationship between antibiotic exposure and body mass index (BMI) standard deviation scores andbinary outcomes,and examined interactions between covariates,which included socioeconomic status,diet assessed by food frequency questionnaires and maternal *** Any antibiotic usage between 2 and 3 years did not predict risk of overweight or obesity at age *** or more courses of antibiotics between 2 and 3 years were independently associated with obesity at age 5 (odds ratio 1.6,95% confidence interval 1.11-2.31).Effect size was modest (coefficient + 0.09 body mass SD units,standard error 0.04,P =0.037).Maternal BMI modified the relationship:≥ 4 courses of antibiotics between 2 and 3 years were associated with a + 0.12 body mass SD units increase in weight at age 5 among children of normal-weight mothers (P=0.035),but not in children of overweight *** Number of antibiotic courses,rather than antibiotic use,may be an important factor in any link between early antibiotic exposure and subsequent childhood *** is needed to confirm differential effects on babies of normal versus overweight/obese mothers independent of socioeconomic factors.

关键词： Antibiotics Body mass index Early childhood Infants Obesity

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The impact of increased flooding caused by climate change on heritage in England and North Wales, and possible preventative measures: what could/should be done?

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Built Heritage 2023年第1期7卷 44-58页

作者： kelly Anderson Independent Consultant ManchesterEngland

Despite 30 years of discussion,adaptation work is not routinely being carried out at heritage sites to minimise future impacts of climate change,particularly increased flooding *** understand barriers to essential work being carried out,interviews were carried out with six heritage sites that have already experienced river flooding to understand levels of preparation both before and after the flooding *** results prove that despite funding,or lack of,being an important contributor,it is not the sole barrier to *** flooded sites still do not have a flood plan in place,outside agencies are preventing work being carried out,measures which have been put in place through listing status are prohibiting necessary work and delays in decision making about what is acceptable are all delaying adaptation while allowing more damage to be caused from weather *** responsibility for adaptation lies locally this situation will not improve;responsibility needs to lie more *** the principle of replacing like for like is a sound one with the best of intentions behind it,this is also contributing to losses in heritage and must be reconsidered when big decisions are finally made about what will be acceptable if impacts to heritage from future climate change are to be minimised.

关键词： climate change adaptation barriers heritage flooding site interviews

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重症监护室护士限制治疗努力的能力:整合性综述

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International Journal of Nursing Sciences 2024年第1期11卷 143-154,I0003页

作者： Elvia R.Lopez-Panza Vanessa C.Pacheco-Roys kelly J.Fernandez-Ahumada Diana C.Díaz-Mass María Y.Exposito-Concepcion Elizabeth Villarreal-Cantillo Cesar I.Aviles gonzalez Nursing Department Universidad del NorteBarranquillaColombia Nursing Program Faculty of Health SciencesUniversidad Popular del CesarValleduparColombia Clínica Valledupar ValleduparColombia Hospital Universidad del Norte SoledadColombia Department of Medical Sciences and Public Health University of CagliariCittadella Universitaria di MonserratoCagliariItaly

目的在重症监护病房(IntensiveCareUnit,ICU),护土难免会遇到需要限制治疗努力(limiting therapeutie efort,LTE)的患者,尽管多数护士还缺乏为这些临终患者及其家庭提供支持的准备。本综述旨在描述ICU护士在LTE中需要具备的能力。方法对... 详细信息

目的在重症监护病房(IntensiveCareUnit,ICU),护土难免会遇到需要限制治疗努力(limiting therapeutie efort,LTE)的患者,尽管多数护士还缺乏为这些临终患者及其家庭提供支持的准备。本综述旨在描述ICU护士在LTE中需要具备的能力。方法对2010年--2023年发表的文献进行综述。系统检索了5个数据库:Medline、Wiley Online Library、SciELO、ScienceDirect和Web of Science。使用关键评估项目工具西班牙语版(Critical Appraisal Skills Programme in Spanish,CASPe)作为评判性阅读工具。使用牛津循证医学中心(Center for Evidence-Based Medicine.,CEBM)评估工具确定证据级别和推荐强度。结果共纳入25篇文献。ICU护士LTE护理的能力包括对患者的直接护理、以家庭为中心的护理以及护士在团队中的作用。该综述确定了3个类别的能力:作为患者、家庭与跨学科团队之间维护者的能力,在LTE方面的决策能力,在患者生命末期治疗和护理干预的能力。结论ICU护士在LTE方面需要具备相应的能力,这对患者的生活质量死亡尊严以及患者家庭应对悲伤的全面支持至关重要。

关键词：重症监护家庭支持重症监护病房护士的作用安宁疗护专业能力

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Multilayer network analyses as a toolkit for measuring social structure

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Current Zoology 2021年第1期67卷 81-99页

作者： kelly R.FINN Neukom Institute Dartmouth CollegeHanoverNH 03755USA

The formalization of multilayer networks allows for new ways to measure sociality in complex social systems,including groups of *** same mathematical representation and methods are widely applicable across fields and study systems,and a network can represent drastically different types of *** such,in order to apply analyses and interpret the results in a meaningful way the researcher must have a deep understanding of what their network is representing and what parts of it are being measured by a given *** social networks can represent social structure with more detail than is often present in single layer networks,including multiple"types"of individuals,interactions,or relationships,and the extent to which these types are *** networks can also encompass a wider range of social scales,which can help overcome complications that are inherent to measuring *** this paper,I dissect multilayer networks into the parts that correspond to different components of social structures.I then discuss common pitfalls to avoid across different stages of multilayer network analyses-some novel and some that always exist in social network analysis but are magnified in multi-layer *** paper serves as a primer for building a customized toolkit of multilayer network analyses,to probe components of social structure in animal social systems.

关键词： animal behavior multilayer networks relationships sociality social networks social structure subgroups

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Double aortic arch and nasogastric tubes: A fatal combination

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World Journal of gastroenterology 2008年第16期14卷 2590-2592页

作者： Julia Massaad kelly Crawford Emory University School of Medicine Division of Digestive Diseases

Double aortic arch is a common form of complete vascular ring that encircles both the trachea and the esophagus, and presents with various respiratory and esophageal symptoms, usually in the pediatric population. We present a case of double aortic arch in an adult patient that manifested as massive upper gastrointestinal bleeding after prolonged nasogastric intubation.

关键词： Nasogastric tubes Aortoesophageal fistula gastrointestinal bleeding Double aortic arch Vasculardngs

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