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World Journal of Hepatology 2014年第10期6卷 696-703页

作者： Banwari Agarwal andrew davenport Intensive Care Unit The Royal Free HospitalNW32QG LondonUnited Kingdom UCL Centre for Nephrology The Royal Free HospitalNW32QG LondonUnited Kingdom

Renal function in patients with advanced cirrhosis is an important prognostic factor for survival both prior to and following liver transplantation. The importance of renal function is reflected by the introduction of the model for end stage liver disease(MELD) score, which includes serum creatinine. The MELD score has been shown to predict the short term risk of death for transplant wait listed patients and is currently used by many countries to allocate liver transplants on the basis of severity of underlying illness. Changes in serum creatinine are also used to stage acute kidney injury. However prior to liver transplantation the serum creatinine typically over estimates underlying renal function, particularly when a colorimetric Jaffe based assay is used, and paradoxically then under estimates renal function post liver transplantation, particularly when immunophyllins are started early as part of transplant immunosuppression. As acute kidney injury is defined by changes in serum creatinine, this potentially leads to over estimation of the incidence and severity of acute kidney injury in the immediate post-operative period.

关键词： Serum creatinine Acute kidney injury Liver transplantation

Human albumin solution for patients with cirrhosis and acute on chronic liver failure: Beyond simple volume expansion

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World Journal of Hepatology 2016年第7期8卷 345-354页

作者： Christopher Valerio Eleni Theocharidou andrew davenport Banwari Agarwal Intensive Care Unit Royal Free Hospital Royal Free Hampstead NHS Trust University College London the Royal Free Sheila Sherlock Liver Centre Royal Free Hospital Royal Free Hampstead NHS Trust and Institute of Liver and Digestive Health University College London UCL Centre for Nephrology Royal Free Hospital

To provide an overview of the properties of human serum albumin(HSA), and to review the evidence for the use of human albumin solution(HAS) in critical illness, sepsis and cirrhosis. A MEDLINE search was performed using the terms "human albumin", "critical illness", "sepsis" and "cirrhosis". The references of retrieved articles were reviewed manually. Studies published between 1980 and 2014 were selected based on quality criteria. Data extraction was performed by all authors. HSA is the main plasma protein contributing greatly to its oncotic pressure. HSA demonstrates important binding properties for endogenous and exogenous toxins, drugs and drug metabolites that account for its anti-oxidant and anti-inflammatory properties. In disease states, hypoalbuminaemia is secondary to decreased HSA production, increased loss or transcapillary leakage into the interstitial space. HSA function can be also altered in disease with reduced albumin binding capacity and increased production of modified isoforms. HAS has been used as volume expander in critical illness, but received criticism due to cost and concerns regarding safety. More recent studies confirmed the safety of HAS, but failed to show any survival benefit compared to the cheaper crystalloid fluids, therefore limiting its use. On the contrary, in cirrhosis there is robust data to support the efficacy of HAS for the prevention of circulatory dysfunction post-large volume paracentesis and in the context of spontaneous bacterial peritonitis, and for the treatment of hepato-renal syndrome and hypervolaemic hyponatraemia. It is likely that not only the oncotic properties of HAS are beneficial in cirrhosis, but also its functional properties, as HAS replaces the dysfunctional HSA. The role of HAS as the resuscitation fluid of choice in critically ill patients with cirrhosis, beyond the established indications for HAS use, should be addressed in future studies.

关键词： Human serum albumin Human albumin solution Critical illness Cirrhosis Resuscitation fluid Large-volume paracentesis Hepatorenal syndrome Spontaneous bacterial peritonitis

Can non-invasive measurements aid clinical assessment of volume in patients with cirrhosis?

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World Journal of Hepatology 2013年第8期5卷 433-438页

作者： andrew davenport Banwari Argawal Gavin Wright Konstantinos Mantzoukis Rumyana Dimitrova Joseph Davar Panayota Vasianopoulou andrew K Burroughs UCL Center for Nephrology Royal Free Hospital Intensive care Unit Royal Free Hospital Sheila Sherlock centre for hepatic diseases Royal Free Hospital Department of Cardiology Royal Free Hospital

AIM:To evaluate the non-invasive assessments of volume status in patients with ***:Echocardiography and multifrequency bioimpedance analysis measurements and short synacthen tests were made in 20 stable and 25 acutely decompensated patients with ***:Both groups had similar clinical assessments,cortisol response and total body water(TBW),however the ratio of extracellular water(ECW)/TBW was significantly greater in the trunk(0.420±0.004 vs0.404±0.005),and limbs(R leg 0.41±0.003 vs 0.398±0.003,P<0.05,and L leg 0.412±0.003 vs 0.399±0.003)with decompensated cirrhosis compared to stable cirrhotics,P<0.05).Echocardiogram derived right atrial and ventricular filling and end diastolic pressures and presence of increased left ventricular end diastolic volume and diastolic dysfunction were similar in both *** decompensated group had lower systemic blood pressure,mean systolic 101.8±4.3 vs122.4±5.3 and diastolic 58.4±4.1 mmHg vs 68.8±3.1 mmHg respectively,P<0.01,and serum albumin30(27-33)vs 32(31-40.5)g/L,P<***:Decompensated cirrhotics had greater leg and truncal ECW expansion with lower serum albumin levels consistent with intravascular volume depletion and increased vascular permeability.

关键词： Cirrhosis Bioimpedance Echocardiography Extracellular water Ascites Cortisol

肾功能和疾病规范命名:改善全球肾脏病预后(KDIGO)会议共识

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临床儿科杂志 2022年第8期40卷 627-633页

作者：王忍高春林夏正坤张沛(译) 东部战区总医院儿科江苏南京210002

为规范描述肾功能和疾病的专业术语,2019年6月改善全球肾脏病预后组织(KDIGO)召开共识会议,对肾脏功能和疾病、肾衰竭、急性肾脏病和急性肾损伤、慢性肾脏病及肾脏评估共5个部分的内容制定了相应的术语表,并就以下建议达成共识。①对于... 详细信息

为规范描述肾功能和疾病的专业术语,2019年6月改善全球肾脏病预后组织(KDIGO)召开共识会议,对肾脏功能和疾病、肾衰竭、急性肾脏病和急性肾损伤、慢性肾脏病及肾脏评估共5个部分的内容制定了相应的术语表,并就以下建议达成共识。①对于肾脏功能和疾病的一般描述,使用术语“kidney”,而不使用“renal”或前缀“nephro-”;②使用“肾衰竭(kidney failure)”并适当描述是否存在相应症状、体征和治疗,而不是“终末期肾脏疾病(end-stage kidney disease)”;③使用KDIGO对急性肾脏病(AKD)和急性肾损伤(AKI)进行定义和分类;④使用KDIGO对慢性肾脏病(CKD)进行定义和分类;⑤使用特定的肾脏检测指标,例如蛋白尿或肾小球滤过率(GFR)降低,而不是肾功能“异常(abnormal)”或“降低(reduced)”来描述肾脏结构和功能的改变。文章简要总结会议的主要讨论。

关键词：肾脏功能肾脏疾病术语

Lipopolysaccharide inhibits or accelerates biomedical titanium corrosion depending on environmental acidity

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International Journal of Oral Science 2015年第3期7卷 179-186页

作者： Fei Yu Owen Addison Stephen J Baker Alison J davenport School of Metallurgy and Materials University of Birmingham Biomaterials Unit College of Medical and Dental Sciences University of Birmingham School of Geography Earth and Environmental Sciences University of Birmingham

Titanium and its alloys are routinely used as biomedical implants and are usually considered to be corrosion resistant under physiological conditions. However, during inflammation, chemical modifications of the peri-implant environment including acidification occur. In addition certain biomolecules including lipopolysaccharide（LPS）, a component of Gram-negative bacterial cell walls and driver of inflammation have been shown to interact strongly with Ti and modify its corrosion resistance. Gram-negative microbes are abundant in biofilms which form on dental implants. The objective was to investigate the influence of LPS on the corrosion properties of relevant biomedical Ti substrates as a function of environmental acidity. Inductively coupled plasma mass spectrometry was used to quantify Ti dissolution following immersion testing in physiological saline for three common biomedical grades of Ti（ASTM Grade 2, Grade 4 and Grade 5）. Complementary electrochemical tests including anodic and cathodic polarisation experiments and potentiostatic measurements were also conducted. All three Ti alloys were observed to behave similarly and ion release was sensitive to p H of the immersion solution. However, LPS significantly inhibited Ti release under the most acidic conditions（p H 2）, which may develop in localized corrosion sites, but promoted dissolution at p H 4–7, which would be more commonly encountered *** observed pattern of sensitivity to environmental acidity of the effect of LPS on Ti corrosion has not previously been reported. LPS is found extensively on the surfaces of skin and mucosal penetrating Ti implants and the findings are therefore relevant when considering the chemical stability of Ti implant surfaces in vivo.

关键词： corrosion electrochemistry inductively coupled plasma mass spectrometry lipopolysaccharide titanium

Using physiological conditions to assess current and future habitat use of a Subarctic frog

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Integrative Zoology 2023年第1期18卷 2-14页

作者： Thomas P.HASTINGS Blake R.HOSSACK LeeAnn FISHBACK Jon M.davenport Department of Biology Appalachian State UniversityBooneNorth CarolinaUSA U.S.Geological Survey Northern Rocky Mountain Science Centerand Wildlife Biology ProgramW.A.Franke College of Forestry&ConservationUniversity of MontanaMissoulaMontanaUSA Churchill Northern Studies Centre ChurchillManitobaCanada

Species with especially close dependence on the environment to meet physiological requirements,such as ectotherms,are highly susceptible to the impacts of climate *** change is occurring rapidly in the Subarctic and Arctic,but there is limited knowledge on ectotherm physiology in these *** investigated how environmental conditions and habitat characteristics inﬂuence the physiological conditions and habitat use of wood frogs(Rana sylvatica)in a Subarctic landscape near Churchill,Manitoba(Canada).We used plaster models to estimate water loss rates and surface body temperatures among different habitat types and at speciﬁc locations used by radio-tracked *** loss(R2=0.67)and surface temperature(R2=0.80)of plaster models was similar to that of live ***-based water loss rates were greater in tundra habitat than in boreal forest and ecotone *** use of wood frogs was strongly tied with available surface moisture and decreased water loss rates that were observed with plaster *** conditions,such as wind speed and ground tem-perature,explained 58%and 91%of the variation in water balance and temperature of plaster *** physiological conditions may be challenging for semi-aquatic ectotherms in environments vulnerable to future cli-mate *** ability to predict physiological conditions based on environmental conditions,as demonstrated in our study,can help understand how wildlife will respond to climatic changes.

关键词： Arctic climate change landscape physiology water balance wood frog

Evaluating the environmental impact of selected chemical de-icers

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Transportation Safety and Environment 2019年第3期1卷 220-229页

作者： Xiang Li Benoit Van Aken Erica Mckenzie Huichun Zhang Bechara Abboud William davenport Civil&Environmental Engineering Department Temple UniversityPhiladelphiaPAUSA Advanced Research Institute of Multidisciplinary Science Beijing Institute of TechnologyBeijingChina Department of Civil Engineering Case Western Reserve UniversityClevelandOHUSA Department of Transportation PhiladelphiaPAUSA

In this study,the environmental impacts of six commercial chloride-based de-icer products,including Rock Salt and Salt Brine,were *** nutrients,oxygen demand,heavy metal concentration,corrosion and toxicity of all six de-icers were *** an assumed 500-fold dilution,the test results were compared to the public water-quality *** results show that the selected chemical de-icers have little chance of severely damaging the environment and ecosystem under a normal dilution ***,attention needs to be paid to small water bodies and sensitive receiving water.

关键词： chemical de-icer environmental impact corrosion test toxicity

Development of necrotizing enterocolitis after blood transfusion in very premature neonates

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World Journal of Pediatrics 2023年第1期19卷 68-75页

作者： Travis L.Odom Jessica Eubanks Nusiebeh Redpath Erica davenport Dmitry Tumin Uduak S.Akpan Department of Pediatrics University of Texas Health Sciences Campus7703 Floyd Curl DriveSan AntonioTX 78229-3900USA Department of Pediatrics Brody School of Medicine at EastCarolina UniversityGreenvilleNCUSA ECU Health Medical Center GreenvilleNCUSA

Background Prior studies report conflicting evidence on the association between packed red blood cell(PRBC)transfu-sions and necrotizing enterocolitis(NEC),especially in early weeks of life where transfusions are frequent and spontaneous intestinal perforation can mimic *** primary objective of this study was to evaluate the association between PRBC transfusions and NEC after day of life(DOL)14 in very premature *** A retrospective cohort analysis of very premature neonates was conducted to investigate association between PRBC transfusions and NEC after DOL *** endpoints were PRBC transfusions after DOL 14 until the date of NEC diagnosis,discharge,or *** ranked-sum and Fisher's exact tests,Cox proportional hazards regression,and Kaplan-Meier curves were used to analyze *** Of 549 premature neonates,186(34%)received transfusions after DOL 14 and nine(2%)developed NEC(median DOL=38;interquartile range=32-46).Of the nine with NEC after DOL 14,all were previously transfused(P<0.001);therefore,hazard of NEC could not be *** hoc analysis of patients from DOL 10 onward included five additional patients who developed NEC between DOL 10 and DOL 14,and the hazard of NEC increased by a factor of nearly six after PRBC transfusion(hazard ratio=5.76,95%confidence interval=1.02-32.7;P=0.048).Conclusions Transfusions were strongly associated with NEC after DOL *** studies are needed to determine if restrictive transfusion practices can decrease incidence of NEC after DOL 14.

关键词： Necrotizing enterocolitis Packed red blood cells Transfusions Very low birth weight infants

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如何靠产品而非销售实现增长

商业评论 2024年第7期 114-119页

作者：巴里·利伯特托马斯·达文波特徐广彤 AlMatters公司百森学院牛津大学赛德商学院麻省理工学院

不久以前,所有类型的公司都还把注意力主要放在和客户打交道时由人工完成的任务上.它们密切关注着反馈建议、无缝接单、交叉销售和追加销售这类流程.然而,如今许多软件公司已经开始将这些流程内嵌到软件中,在销售、营销和服务等业务活...

不久以前,所有类型的公司都还把注意力主要放在和客户打交道时由人工完成的任务上.它们密切关注着反馈建议、无缝接单、交叉销售和追加销售这类流程.然而,如今许多软件公司已经开始将这些流程内嵌到软件中,在销售、营销和服务等业务活动上尽可能减少对人工接触客户的依赖.这类云组织全凭软件功能满足客户需求,努力实现快速扩张,而不增加接触客户的员工.

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