检索结果-南通市图书馆

Validation of the age-adjusted shock index for pediatric casualties in Iraq and Afghanistan

military medical Research 2021年第1期8卷 17-24页

作者： Camaren m.Cuenca matthew A.Borgman michael D.April andrew D.Fisher Steven G.Schauer JUS Army Institute of Surgical Research 3698 Chambers PassJBSA Fort Sam HoustonSan AntonioTX 78234-7767USA Brooke Army medical Center JBSA Fort Sam HoustonSan AntonioTXUSA Uniformed Services University of the Heath Sciences BethesdaMDUSA Texas Army National Guard AustinTXUSA Department of Surgery UNM School of MedicineAlbuquerqueNMUSA 59th medical Wing JBSA LacklandSan AntonioTXUSA

Background: Pediatric casualties account for a notable proportion of encounters in the deployed setting based on the humanitarian medical care mission. Previously published data demonstrates that an age-adjust shock index may be a useful tool in predicting massive transfusion and death in children. We seek to determine if those previous findings are applicable to the deployed, combat trauma ***: We queried the Department of Defense Trauma Registry(DODTR) for all pediatric subjects admitted to US and Coalition fixed-facility hospitals in Iraq and Afghanistan from January 2007 to January 2016. This was a secondary analysis of casualties seeking to validate previously published data using the shock index, pediatric age adjusted. We then used previously published thresholds to determine patients outcome for validation by age grouping, 1–3 years(1.2), 4–6 years(1.2), 7–12 years(1.0), 13–17 years(0.9).Results: From January 2007 through January 2016 there were 3439 pediatric casualties of which 3145 had a documented heart rate and systolic pressure. Of those 502(16.0%) underwent massive transfusion and 226(7.2%) died prior to hospital discharge. Receiver operating characteristic(ROC) thresholds were inconsistent across age groups ranging from 1.0 to 1.9 with generally limited area under the curve(AUC) values for both massive transfusion and death prediction characteristics. Using the previously defined thresholds for validation, we reported sensitivity and specificity for the massive transfusion by age-group: 1–3(0.73, 0.35), 4–6(0.63, 0.60), 7–12(0.80, 0.57), 13–17(0.77, 0.62). For death, 1–3(0.75, 0.34), 4–6(0.66–0.59), 7–12(0.64, 0.52), 13–17(0.70, 0.57). However, negative predictive values(NPV) were generally high with all greater than ***: Within the combat setting, the age-adjusted pediatric shock index had moderate sensitivity and relatively poor specificity for predicting massive transfusion and death. Better scoring systems are needed to p

关键词： Pediatric massive Transfusion Shock Index Age

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Radical Addition of Perfluorinated Alkyl Iodides to multi- Layered Graphene and Single-Walled Carbon Nanotubes

引用

Nano Research 2010年第2期3卷 138-145页

作者： Christopher E.Hamilton Jay R.Lomeda Zhengzong Sun James m.Tour andrew R.Barron Richard E.Smalley Institute for Nanoscale Science and Technology Department of Chemistry and Department of Mechanical Engineering and Materials ScienceRice UniversityHoustonTexas 77005USA

A simple one-pot reaction that serves to functionalize graphite nanosheets(graphene)and single-walled carbon nanotubes(SWNTs)with perfluorinated alkyl groups is *** radical addition of 1-iodo-1H,1H,2H,2H-perfluorododecane to ortho-dichlorobenzene suspensions of the carbon nanomaterial is initiated by thermal decomposition of benzoyl ***,UV photolysis of 1-iodo-perfluorodecane serves to functionalize the carbon ***-SWNTs,perfluorododecyl-graphene,and perfluorodecyl-graphene are characterized by infrared(IR)and Raman spectroscopy,X-ray photoelectron spectroscopy(XPS),thermogravimetric analysis(TGA),and atomic force microscopy(AFm).The products show enhanced dispersability in CHCl3 as compared to unfunctionalized starting *** advantage of this one-pot functionalization procedure lies in the use of pristine graphite as starting material thereby avoiding the use of harsh oxidizing conditions.

关键词： Nanotube single-walled carbon nanotube graphene radical addition

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Prognostic model of survival outcomes in non-small cell lung cancer patients initiated on afatinib: pooled analysis of clinical trial data

引用

Cancer Biology & medicine 2019年第2期16卷 341-349页

作者： Ashley m. Hopkins Adel Shahnam Sasha Zhang Chris S. Karapetis andrew Rowland michael J. Sorich Flinders Centre for Innovation in Cancer Department of Clinical Pharmacology College of Medicine and Public Health Flinders University Adelaide 5042 Australia The Canberra Hospital Garran 2605 Australia

Objective: Several predictors of survival have been identified in EGFR-positive non-small cell lung cancer(NSCLC) patients treated with first generation EGFR inhibitors. Prognostic models of survival outcomes with afatinib have not been ***: A prognostic tool for overall survival(OS)/progression free survival(PFS) based on pre-treatment clinicopathological factors was developed for EGFR-positive advanced NSCLC patients treated with first-line afatinib using penalised regression of individual-participant data from LUX-Lung 3 and 6(n = 468). Favourable, intermediate and poor risk groups were identified and externally validated using LUX-Lung 1(n = 390) and LUX-Lung 2(n = 129) trials that initiated afatinib following previous chemotherapy or EGFR inhibitor ***: Discriminative performance was good in the development and validation cohorts. For patients treated with first-line afatinib, the median OS for the favourable, intermediate and poor risk groups were > 47.7, 29.3 and 16.4 months, respectively, and the median PFS were 17.3, 13.2 and 8.3 months, respectively. The improvement in median OS with afatinib use compared to chemotherapy was > 12.4 months for the favourable risk group, whereas no OS benefit was apparent for the poor risk group. The improvement in median PFS with afatinib use compared to chemotherapy was 10.2 months for the favourable risk group and 3.2 months for the poor risk ***: A prognostic tool was developed and validated to identify favourable, intermediate and poor risk groups for OS/PFS in EGFR-positive advanced NSCLC patients treated with afatinib. The prognostic groups can inform the likely absolute OS/PFS benefit expected from afatinib compared to chemotherapy in first-line treatment.

关键词： Afatinib non-small cell lung cancer prognostic model

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Calculation of reservoir capacity loss due to sediment deposition in the muela reservoir,Northern Lesotho

引用

International Soil and Water Conservation Research 2017年第2期5卷 130-140页

作者： Liphapang Khaba James andrew Griffiths Water and Environmental Engineering School of the Built EnvironmentLerotholi PolytechnicMoshoeshoe RoadP.O.Box 16Maseru 100Lesotho Department of Geographical Sciences University of Nottingham Ningbo China199 Taikang East RoadNingbo 315100ZhejiangChina

Bathymetry survey records of the muela Reservoir in norther Lesotho were obtained from the Lesotho Highlands Development Authority(LHDA)with the aim of identifying reservoir storage apacity loss due to sediment deposition,between 1985 and *** this purpose,data from eight surveys completed between 1985 and January 2015 were analyzed to quantify bathymetric change between each *** interpolation methods(inverse distance weighting Kriging,natural neighbor,and spline),were used to create digital terrain models from each survey *** addition,a triangulated irregular network(TIN)surface was created from each *** average reservoir storage capacity loss of 15,400 m^(3)/year was determined across the whole per iod between 1985 and early 2015,based on *** the results indicate high inter-annual variability in the rate of reservoir capacity reduction,consideration of errors in the surveying and reservoir volumetric calculation methods suggest that rates of reservoir volume reduction can vary between 11,400 m/year and 18,200 m/year.

关键词： Reservoir Bathymetry Sedimentation Lesotho

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Spontaneous emergence of overgrown molar teeth in a colony of Prairie voles(microtus ochrogaster)

引用

International Journal of Oral Science 2015年第1期7卷 23-26页

作者： andrew H Jheon michaela Prochazkova michael Sherman Devanand S manoli Nirao m Shah Lawrence Carbone Ophir Klein Department of Orofacial Sciences and Program in Craniofacial and mesenchymal Biology University of California San Francisco (UCSF) Department of Anthropology and Human Genetics Faculty of Science Charles University in Prague Laboratory Animal Resource Center UCSF Department of Psychiatry UCSF Department of Anatomy UCSF

Continuously growing incisors are common to all rodents, which include the microtus genus of voles. However, unlike many rodents, voles also possess continuously growing molars. Here, we report spontaneous molar defects in a population of Prairie voles （microtus ochrogaster）. We identified bilateral protuberances on the ventral surface of the mandible in several voles in our colony. In some cases, the protuberances broke through the cortical bone. The mandibular molars became exposed and infected, and the maxillary molars entered the cranial vault. Visualisation upon soft tissue removal and microcomputed tomography （microCT） analyses confirmed that the protuberances were caused by the overgrowth of the apical ends of the molar teeth. We speculate that the unrestricted growth of the molars was due to the misregulation of the molar dental stem cell niche. Further study of this molar phenotype may yield additional insight into stem cell regulation and the evolution and development of continuously growing teeth.

关键词： continuously growing teeth molar phenotype mutation stem cell regulation voles

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

A matched-pair analysis of laparoscopic versus open pancreaticoduodenectomy: oncological outcomes using Leeds Pathology Protocol

引用

Hepatobiliary & Pancreatic Diseases International 2014年第4期13卷 435-441页

作者： Abdul R Hakeem Caroline S Verbeke Alison Cairns Amer Aldouri andrew m Smith Krishna V menon Department of HPB and Transplant Surgery St James's University Hospital NHS TrustLeeds Teaching Hospitals Beckett street Leeds LS9 7TF United Kingdom Division of Pathology Department of Laboratory Medicine Karolinska Institutet Stockholm Sweden Department of Histopathology St James's University Hospital NHS TrustLeeds Teaching Hospitals Beckett street Leeds LS9 7TF United Kingdom

BACKGROUND： Laparoscopic pancreaticoduodenectomy（LPD）is a safe procedure. Oncological safety of LPD is still a matter for debate. This study aimed to compare the oncological outcomes,in terms of adequacy of resection and recurrence rate following LPD and open pancreaticoduodenectomy（OPD）.mETHODS： Between November 2005 and April 2009, 12LPDs（9 ampullary and 3 distal common bile duct tumors）were performed. A cohort of 12 OPDs were matched for age,gender, body mass index（BmI） and American Society of Anesthesiologists（ASA） score and tumor ***： mean tumor size LPD vs OPD（19.8 vs 19.2 mm,P=0.870）. R0 resection was achieved in 9 LPD vs 8 OPD（P=1.000）. The mean number of metastatic lymph nodes and total number resected for LPD vs OPD were 1.1 vs 2.1（P=0.140）and 20.7 vs 18.5（P=0.534） respectively. Clavien complications grade I/II（5 vs 8）, III/IV（2 vs 6） and pancreatic leak（2 vs 1）were statistically not significant（LPD vs OPD）. The mean high dependency unit（HDU） stay was longer in OPD（3.7 vs 1.4 days,P〈0.001）. There were 2 recurrences each in LPD and OPD（logrank,P=0.983）. Overall mortality for LPD vs OPD was 3 vs 6（log-rank, P=0.283） and recurrence-related mortality was 2 vs *** was one death within 30 days in the OPD group secondary to severe sepsis and none in the LPD ***： Compared to open procedure, LPD achieved a similar rate of R0 resection, lymph node harvest and longterm recurrence for tumors less than 2 cm. Though technically challenging, LPD is safe and does not compromise oncological outcome.

关键词： pancreaticoduodenectomy minimally invasive laparoscopic open oncological outcomes resection margins pathology

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Refractory very early-onset inflammatory bowel disease associated with cytosolic isoleucyl-tRNA synthetase deficiency:A case report

引用

World Journal of Gastroenterology 2020年第15期26卷 1841-1846页

作者： andrew Fagbemi William G Newman Stuart G Tangye Stephen m Hughes Edmund Cheesman Peter D Arkwright Department of Paediatric Gastroenterology Royal Manchester Children’s HospitalManchester M199WLUnited Kingdom Department of medical Genetics Manchester University NHS Foundation TrustManchester M139WLUnited Kingdom Evolution and Genomic Sciences University of ManchesterManchester M139WLUnited Kingdom Garvan Institute of medical Research DarlinghurstNSW 2010Australia St Vincent’s Clinical School Faculty of MedicineUNSW AustraliaSydneyNSW 2010Australia Department of Paediatric Allergy and Immunology Royal Manchester Children’s HospitalManchester M139WLUnited Kingdom Department of Paediatric Histopathology St Mary’s HospitalManchester M139WLUnited Kingdom Lydia Becker Institute of Immunology and Inflammation University of ManchesterManchester M139WLUnited Kingdom

BACKGROUND Aminoacyl tRNA synthetases/ligases(ARSs)are highly conserved enzymes involved in attaching amino acids to tRNA promoting protein *** deficiencies of ARSs localized to the mitochondria classically present with neuropathology,the clinical features of cytosolic ARS deficiencies are more *** have previously been associated with neonatal hepatitis,but never with early-onset inflammatory bowel *** SUmmARY A nine-year-old Bangladeshi boy presented with neonatal liver failure and deranged clotting,transaminitis and *** parents were first *** older brothers and a sister were *** patient suffered from loose stools from early infancy which became more troublesome and persistent from five years old with ten bloody motions a *** endoscopies showed persistent pancolitis,which was refractory to mesalazine,corticosteroids,azathioprine,sirolimus and anti-TNF(adalimumab)therapy,but has improved recently with subcutaneous *** Genome Sequencing revealed a novel pathogenic missense variant(c.290A>G)in the cytosolic isoleucyl-tRNA synthetase gene,leading to an amino acid substitution(***97Gly).Pathogenic variants in other genes associated with inflammatory bowel disease(IBD)(ADAm17,EGFR,FOXP3,IL10RA,IL10RB,IL21R,NCF4,STAT3)were *** assays demonstrated markedly elevated IL-2,IL-5,IL-13,IL-9 and IL-10 by the patient’s CD4+T-cells,while IL-17A,IL-17F,IFNβwere lower,and TNFαnot significantly different when compared to healthy *** This case report provides evidence that recessive mutations in cytosolic isoleucyltRNA synthetase are a novel monogenic cause of IBD,which should be considered,particularly in infants and children with a history of neonatal hepatitis and very early-onset IBD poorly responsive to treatment.

关键词： Inflammatory bowel disease Hepatitis Gene Cytosolic isoleucine tRNA synthase

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

On the Fully Implicit Solution of a Phase-Field model for Binary Alloy Solidification in Three Dimensions

引用

Advances in Applied mathematics and mechanics 2012年第6期4卷 665-684页

作者： Christopher E.Goodyer Peter K.Jimack andrew m.mullis Hongbiao Dong Yu Xie School of Computing University of LeedsWoodhouse LaneLeedsLS29JTUK School of Process Environmental and Materials EngineeringUniversity of LeedsWoodhouse LaneLeedsLS29JTUK Department of Engineering University of LeicesterUniversity RoadLeicesterLE17RHUK

A fully implicit numerical method,based upon a combination of adaptively refined hierarchical meshes and geometric multigrid,is presented for the simulation of binary alloy solidification in three space *** computational techniques are presented for a particular mathematical model,based upon the phase-field approach,however their applicability is of greater generality than for the specific phase-field model used *** particular,an implicit second order time discretization is combined with the use of second order spatial differences to yield a large nonlinear system of algebraic equations as each time *** is demonstrated that these equations may be solved reliably and efficiently through the use of a nonlinear multigrid scheme for locally refined *** effect this paper presents an extension of earlier research in two space dimensions(***.,225(2007),pp.1271–1287)to fully three-dimensional *** extension is validated against earlier two-dimensional results and against some of the limited results available in three dimensions,obtained using an explicit *** efficiency of the implicit approach and the multigrid solver are then demonstrated and some sample computational results for the simulation of the growth of dendrite structures are presented.

关键词： Phase-field simulations binary alloys mesh adaptivity implicit methods nonlinear multigrid

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Confidence estimation in the prediction of epithermal neutron resonance self-shielding factors in irradiation samples using an ensemble neural network

引用

能源与人工智能(英文) 2022年第1期7卷 101-119页

作者： Ian m.Wilkinson Ritwik R.Bhattacharjee Jenifer C.Shafer andrew G.Osborne Nuclear Science&Engineering The Colorado School of Mines101214th St.GoldenCO80401USA Department of Chemistry The Colorado School of Mines101214th St.GoldenCO80401USA Department of mechanical Engineering The Colorado School of Mines1610 Illinois St.GoldenCO80401USA

Large neutron absorption resonances in the nuclides present in irradiation samples reduce the irradiating neutron flux at energies close to a *** neutron activation analysis of optically thick samples with resonant isotopes,this self-shielding effect can be significant,and must be accounted for to ensure accurate *** we show that an ensemble artificial neural network can be used to accurately predict the epithermal selfshielding factors in wires composed of up to 57 ***,the neural network can account for resonance interference that affects the self-shielding in samples containing nuclides with large overlapping *** use monte Carlo simulations of sample wires irradiated in a thermal neutron spectrum to create the data for training the neural network and validate its predictions.A Gaussian negative log likelihood loss function is combined with the ensemble to estimate the confidence in the predicted self-shielding factors when ground-truth data are unavailable.

关键词： Neutron activation analysis Epithermal self-shielding Neural Networks

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

modified thin manual Descemet stripping endothelial keratoplasty with air-guided, non-pachymetric donor lenticule dissection: outcomes of graft thickness and complication rate

引用

International Journal of Ophthalmology(English edition) 2020年第2期13卷 342-345页

作者： Abdo Karim Tourkmani andrew m J Turnbull Parwez N Hossain Aristides Konstantopoulos David F Anderson Cornea and External Eye Disease Service Department of OphthalmologyUniversity Hospital SouthamptonSouthampton SO166YDUK.

●AIm:To describe a modified technique of donor lenticule dissection for thin manual Descemet stripping endothelial keratoplasty(Tm-DSEK).●mETHODS:Donor material was soaked in balanced salt solution(BSS)for 30 min,before being mounted on an artificial anterior chamber(AAC).Rather than BSS,the AAC was filled with filtered air,resulting in a visible reflection at the corneal endothelium-air *** reflection served as a landmark for the depth of the dissection,facilitating the creation of a thin lenticule with low risk of *** was commenced at a standardized depth of 500 microns,with no initial pachymetry *** 29 donor corneas were dissected by a novice Tm-DSEK *** time,central graft thickness at 2 mo and complications were analysed.●RESULTS:Results were similar to other endothelial keratoplasty techniques,despite the cases being performed by a novice DSEK *** dissection time was 7 min(range 6-10).One graft perforation occurred(3.45%),but the air tamponaded the break and enabled dissection to be restarted and completed from a different *** central graft thickness after at least two months follow-up was 106 microns(range 25-170).●CONCLUSION:A problem with manual DSEK is the risk of graft perforation by attempting to dissect too thin a lenticule,or creating a thick graft due to fear of *** modified air-guided technique addresses this problem,and is recommended for surgeons either embarking on the learning curve,or who wish to achieve more consistently thin grafts while reducing perforation rates.

关键词： Descemet stripping endothelial keratoplasty manual donor lenticule dissection graft thickness

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：