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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

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光电极表面态的静态结构与时间分辨动力学和频光谱研究

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Chinese Journal of Chemical Physics 2024年第2期37卷 376-397,I0105页

作者：张彤 Jesse B.Brown Haley fisher Mallory Liebes 皇甫至超钱余亲饶毅美国犹他州立大学化学与生物化学系犹他州洛根84322

在光催化或光电催化反应过程中,光电极的表面态扮演着重要的角色,影响着电荷的产生、分离和利用过程,从而很大程度上决定了光电极的催化性能,通常用于研究光电极表面态以改进其性能的方法是间接的、非表面特异性的以及需要超高真空条件... 详细信息

在光催化或光电催化反应过程中,光电极的表面态扮演着重要的角色,影响着电荷的产生、分离和利用过程,从而很大程度上决定了光电极的催化性能,通常用于研究光电极表面态以改进其性能的方法是间接的、非表面特异性的以及需要超高真空条件下进行的方法,无法获得真实条件下的表面态信息。电子和频光谱和电子二次谐波等非线性光学方法具有表面特异性,可以在各种条件下实现表界面系统的原位研究.本研究介绍了表面态的重要性及其与催化性能的密切关系,概述研究半导体表面态、电场和载流子动力学的方法,并重点介绍了界面特异性光谱方法在该领域的最新贡献.包括通过相位信息提取带电表面态的宽带外插法电子二次谐波技术,提供表面态动力学信息的时间分辨电子和频光谱技术和探索表面态耦合的二维电子和频光谱技术,这些非线性光学方法的进一步发展将实现对光电极表面态和界面电子特性的多角度原位表征,提供对表面态及表面电荷转移过程更深层次的理解,以启发未来光催化和光电催化材料的研究和改进.

关键词：表面态电子和频光谱光催化光电催化

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雷电对航天飞行器作业的影响

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气象科技 1991年第6期19卷 55-62页

作者： Bruce d.fisher 郭昌明美国国家航空航天局兰利研究中心

传统上,飞机受雷击并不是飞行安全的主要问题。然而,由于合成材料使用不断增加和在飞行关键系统中使用数字航空电子系统,就要求在这类飞行器的设计中含有更专门的防雷措施以保证现有运输机比较好的雷电安全记录。另外,最近发生的一些不... 详细信息

传统上,飞机受雷击并不是飞行安全的主要问题。然而,由于合成材料使用不断增加和在飞行关键系统中使用数字航空电子系统,就要求在这类飞行器的设计中含有更专门的防雷措施以保证现有运输机比较好的雷电安全记录。另外,最近发生的一些不幸事故,其中最引人注目的是1987年3月在佛罗里达州卡纳维拉尔角空军基地大力神-半人马座A/C67飞行器的损失,表明飞机和运载火箭是十分容易遭受飞行器触发雷电现象的。本文评述美国航空航天局风暴危害计划(SHP)中在与飞机遭到雷击有关的大气现象方面得到的一些新发现。把这些资料与近期业务飞行飞机的雷击结果作了比较。最后,总括给出了NASA和美国国防部正在使用的新的触发闪电的“升空保障准则”(LCC)(下面称升空准则)。NASA的研究资料说明在雷暴中直接雷击飞行器的最大几率发生在环境温度约为—40℃左右。在这种环境中,相对降水和扰动强度可以忽略或比较弱。然而,业务飞行资料说明在日常作业中,大多数飞机雷击发生在温度在冻结层附近的非积雨云中。迄今非雷暴环境还不曾是空中飞行专门的闪电研究对象。

关键词：航天飞行器卡纳维拉尔角航空航天局航空电子系统飞行安全冻结层雷电现象美国国防部大气现象日常作业

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Azoospermia:vasal agenesis

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Asian Journal of Andrology 2022年第1期24卷 1-4页

作者： J Sam fisher Edward d Kim department of Urology University of TennesseeKnoxvilleTN 37920USA

SPECIFIC GENETIC TESTS(CFTR ANd INTRON 8 SPLICE VARIANT TESTING)ANd THEIR SIGNIFICANCE Congenital bilateral absence of the vas deferens(CBAVd)and cystic fibrosis(CF)began as separate entities with an apparent clinical *** occurs in 1%–2%of men presenting with infertility at urological departments and has an incidence of 1:1000–1:2000 in Caucasian *** example of this anatomic variant is shown in Figure 1.

关键词： correlation. clinical Figure

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Electric scooter injuries:Incidence and injury patterns at a level I trauma center

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Chinese Journal of Traumatology 2023年第6期26卷 334-338页

作者： Nina d.fisher Ekenedilichukwu Nwakoby Hunter Hernandez Toni M.McLaurin department of Orthopedic Surgery Langone Orthopedic HospitalNew York UniversityNew YorkUnited States department of Orthopedic Surgery HealthþHospitals/Bellevue New York CityNew YorkUnited States

Purpose:Electric scooters(e-scooters)have become an increasingly popular mode of public transportation in recent *** the incidence of related injuries rises,it is important to understand specific fracture patterns unique to e-scooters and electric bikes(e-bikes)to help guide *** purpose of this study was to review the prevalence and describe specific fracture patterns of e-scooter and ebike related injuries at the busiest level 1 trauma center in the borough of ***:Chart review to determine mechanism of injury was performed on all patients for whom an orthopedic consult was requested from 1/1/2021 to 12/31/*** patients whose injuries were sustained due to an e-scooter or e-bike were further reviewed for demographics,injury characteristics including fracture pattern,and definitive injury *** patients who had an orthopedic consult placed for a reason other than an acute injury were *** statistics are reported as frequency(percentage)for categorical variables and means for continuous ***:Of the 1815 orthopedic consults requested,1357(74.8%)were for acute injury *** those with acute injuries,119(8.8%)sustained 136 e-scooter or e-bike related *** were 92(77.3%)males at an average age of(33.8±15.7)*** one-fifth of all patients presented in June 2021(26,21.8%).There was a 9.2%rate of open *** 136 injuries were evenly split between the upper and lower extremities,with 57(47.9%)upper extremity,57(47.9%)lower extremity injuries,and 5(4.2%)concomitant upper and lower extremity *** most common fracture patterns were ankle fractures(16,11.7%),followed by tibial shaft(14,10.2%),tibial plateau(13,9.5%),and radial head fractures(11,8.0%).There was a 33.3%incidence of associated posterior malleolar fractures in the spiral tibial shaft fractures,31.0%of posterior malleolar involvement and 18.8%of isolated vertical medial malleolar fractures in the ankle

关键词： Electric scooter Electric bike Tibial shaft Ankle fractures Tibial plateau fractures

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Manipulation of the intestinal microbiome-a slow journey to primetime

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World Journal of Clinical Cases 2023年第21期11卷 4975-4988页

作者： Ofra Kriger-Sharabi Stephen d H Malnick david.fisher Institute of Gastroenterology Assuta Medical CenterAshdod 7747629Israel department of Internal Medicine Kaplan Medical CenterRehovot 76100Israel department of Endocrinology Soroka Medical CenterBeer Sheva POB 151Israel

The gut microbiota has important functions in the regulation of normal body *** of the microbiota are being increasingly linked to various disease *** microbiome has been manipulated via the administration of stool from animals or humans,for more than 1000 ***,fecal microbiota transplantation can be performed via endoscopic administration of fecal matter to the duodenum or colon or via capsules of lyophilized *** recently fecal microbial transplantation has been shown to be very effective for recurrent Clostridoides difficile infection(CdI).In addition there is some evidence of efficacy in the metabolic syndrome and its hepatic manifestation,metabolic associated fatty liver disease(MAFLd),irritable bowel syndrome(IBS)and inflammatory bowel disease(IBd).We review the current literature regarding the microbiome and the pathogenesis and treatment of CdI,MAFLd,IBS and IBd.

关键词： Gut microbiota Fecal microbiota transplantation Clostridoides difficile Metabolic associated fatty liver disease Irritable bowel syndrome Inflammatory bowel disease

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An AMR Capable Finite Element diffusion Solver for ALE Hydrocodes

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Plasma Science and Technology 2015年第2期17卷 109-116页

作者： A.C.fisher d.S.BAILEY T.B.KAISER d.C.EdER B.T.N.GUNNEY N.d.MASTERS A.E.KONIGES R.W.ANdERSON Lawrence Livermore National Laboratory Lawrence Berkeley National Laboratory

We present a novel method for the solution of the diffusion equation on a composite AMR mesh. This approach is suitable for including diffusion based physics modules to hydrocodes that support ALE and AMR capabilities. To illustrate, we proffer our implementations of diffu- sion based radiation transport and heat conduction in a hydrocode called ALE-AMR. Numerical experiments conducted with the diffusion solver and associated physics packages yield 2nd order convergence in the L2 norm.

关键词： hydrodynamic simulation heat conduction thermal radiation adaptive meshrefinement finite element method

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Spectroscopic and calorimetric studies of congo red dye-amyloid peptide complexes

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Journal of Biophysical Chemistry 2010年第3期1卷 153-163页

作者： Kazushige Yokoyama andrew d. fisher Amanda R. Amori daniel R. Welchons Ruel E. McKnight 不详

Thermodynamic properties of complexes of Con ?go Red (CR) dye with amyloid ? (A?) peptides were studied by both absorption spectroscopy and isothermal titration calorimetry (ITC). Based on the absorption spectrum for the formation of CRAβ complexes in phosphate buffered saline solution (pH 7.4), van’t Hoff plots over a temperature range of 10oC to 70oC were created for CRAβ140, Aβ1228, and Aβ142. The plot for CR Aβ1228 complex showed a relatively linear feature within the given temperature range with ?H = –10.1 ?0.6 kJ/mol and ?S = + 0.128 ? 0.002 kJ/(mol K). However, the plot for CRAβ140 and CRAβ142 complexes exhibited two distinct linear regions with opposite slopes centered at a specific temperature, Ts, which was 54.7 ? 0.2℃ and 34.8 ? 0.2℃, respectively. The ITC experiments conducted at 25℃in water exhibited quite a different situation from the above mentioned spectroscopic approach. The ITC studies yielded a ?H of –85.3 ? 0.2 kJ/mol for the CRAβ1228 complex with negative entropy change –0.152 kJ/mol K). For CRAβ140, the ITC studies indicated the presence of two binding sites with ?H1 = –81.8 ? 0.3 kJ/mol and ?H2 = –119.5 ? 0.2 kJ/mol with K1 = 5.5 ? 0.7 ? 106 M1 and K2 = 6.9 ? 2.4 ? 108 M1, respectively. These binding constants are consistent with the model suggested by several studies. Both binding sites showed negative entropy changes suggesting that the formation of the complex is enthalpically driven. The disagreement in thermochemical values between two different methods confirmed that the enthalpy and entropy are heavily dependent on temperature and buffer/salt environment, and may involve inherently different reaction paths.

关键词： Amyloid Beta Congo Red dye-Protein Interaction Van’t Hoff Plot Isothermal Titration Calorimetry Binding Site Temperature

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Reservoir stress path and induced seismic anisotropy： results from linking coupled fluid-flow/geomechanical simulation with seismic modelling

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Petroleum Science 2016年第4期13卷 669-684页

作者： d.A.Angus Q.J.fisher J.M.Segura J.P.Verdon J.-M.Kendall M.dutko A.J.L.Crook School of Earth and Environment University of LeedsLeeds UK Formerly School of Earth and Environment University of Leeds Leeds UK department of Earth Sciences University of Bristol BristolUK Rockfield Software Ltd. Swansea UK Three Cliffs Geomechanics Swansea UK Repsol Madrid Spain ESG Solutions Kingston Canada

We present a workflow linking coupled fluid-flow and geomechanical simulation with seismic modelling to predict seismic anisotropy induced by non-hydrostatic stress changes. We generate seismic models from coupled simulations to examine the relationship between reservoir geometry, stress path and seismic anisotropy. The results indicate that geometry influences the evolution of stress,which leads to stress-induced seismic anisotropy. Although stress anisotropy is high for the small reservoir, the effect of stress arching and the ability of the side-burden to support the excess load limit the overall change in effective stress and hence seismic anisotropy. For the extensive reservoir, stress anisotropy and induced seismic anisotropy are high. The extensive and elongate reservoirs experience significant compaction, where the inefficiency of the developed stress arching in the side-burden cannot support the excess *** elongate reservoir displays significant stress asymmetry,with seismic anisotropy developing predominantly along the long-edge of the reservoir. We show that the link betweenstress path parameters and seismic anisotropy is complex,where the anisotropic symmetry is controlled not only by model geometry but also the nonlinear rock physics model used. Nevertheless, a workflow has been developed to model seismic anisotropy induced by non-hydrostatic stress changes, allowing field observations of anisotropy to be linked with geomechanical models.

关键词： Coupled fluid-flow/geomechanics Reservoir characterization Seismic anisotropy Stress path

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Multi-Material ALE with AMR for Modeling Hot Plasmas and Cold Fragmenting Materials

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Plasma Science and Technology 2015年第2期17卷 117-128页

作者： Alice KONIGES Nathan MASTERS Aaron fisher david EdER Wangyi LIU Robert ANdERSON david BENSON Andrea BERTOZZI Lawrence Berkeley National Laboratory Lawrence Livermore National Laboratory Jacobs School of Engineering 9500 Gilman Dr.UCSDLa JollaCA 92093USA department of Mathematics 520 Portola PlazaUCLALos AngelesCA 90095USA

We have developed a new 3d multi-physics multi-material code, ALE-AMR, which combines Arbitrary Lagrangian Eulerian （ALE） hydrodynamics with Adaptive Mesh Refinement （AMR） to connect the continuum to the microstructural regimes. The code is unique in its ability to model hot radiating plasmas and cold fragmenting solids. New numerical techniques were developed for many of the physics packages to work efficiently on a dynamically moving and adapting mesh. We use interface reconstruction based on volume fractions of the material components within mixed zones and reconstruct interfaces as needed. This interface reconstruction model is also used for void coalescence and fragmentation. A flexible strength/failure framework allows for pluggable material models, which may require material history arrays to determine the level of accumulated damage or the evolving yield stress in J2 plasticity models. For some applications laser rays are propagating through a virtual composite mesh consisting of the finest resolution representation of the modeled space. A new 2nd order accurate diffusion solver has been implemented for the thermal conduction and radiation transport packages. One application area is the modeling of laser/target effects including debris/shrapnel generation. Other application areas include warm dense matter, EUV lithography, and material wall interactions for fusion devices.

关键词： multi-physics simulations arbitrary lagrangian eulerian hydrodynamics,adaptive mesh refinement fragmentation laser ray tracing NIF

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