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Fetal Head Compr.ssion: Its Possible r.le in Neur.logic Inj.r.

Open j.ur.al of Obstetr.cs and Gynecology 2024年第1期14卷 124-143页

作者： Bar.y S. Schifr.n brian j. koos.wayne r. cohen Depar.ment of Obstetr.cs and Gynecology The Western University of Health Sciences Pomona USA The David Geffen School of Medicine at UCLA Los Angeles USA The Univer.ity of Ar.zona College of Medicine Tucson USA

It is widely assumed that fetal ischemic br.in inj.r. dur.ng labor.der.ves almost exclusively fr.m sever., systemic hypoxemia with mar.ed neonatal depr.ssion and acidemia. Sever. asphyxia, however. is one of sever.l causes of per.natal neur.logical inj.r. and may not be the most common;most neonates diagnosed with hypoxic-ischemic encephalopathy do not have evidence of sever. asphyxia. Sepsis, dir.ct br.in tr.uma, and dr.g or.toxin exposur. account for.some cases, while mechanical for.es of labor.and deliver. that incr.ase fetal intr.cr.nial pr.ssur. sufficiently to impair.br.in per.usion may also contr.bute. Because of bony compliance and mobile sutur. lines, the fetal skull changes shape and r.distr.butes cer.br.spinal fluid dur.ng labor.accor.ing to constr.ints imposed by contr.ctions, and bony and soft tissue elements of the bir.h canal as the head descends. These accommodations, including the incr.ase in intr.cr.nial pr.ssur., ar. adaptive and necessar. for.efficient descent of the head while safeguar.ing cer.br.l blood flow. Autonomic r.flexes mediated thr.ugh centr.l r.ceptor. nor.ally pr.vide ample pr.tection of the br.in fr.m the consider.ble pr.ssur. exer.ed on the skull. On occasion, those for.es, which ar. tr.nsmitted intr.cr.nially, may over.ome the var.ous adaptive anatomical, car.iovascular. metabolic, and neur.logical mechanisms that maintain cer.br.l per.usion and oxygen availability, r.sulting in ischemic br.in inj.r.. Accepting the notion of a potentially adver.e impact of fetal head compr.ssion suggests that avoidance of excessive uter.ne activity and of r.lentless pushing without steady pr.gr.ss in descent may offer.pr.tection for.the fetal br.in dur.ng par.ur.tion. Excessive head compr.ssion should be consider.d in the differ.ntial diagnosis of ischemic encephalopathy.

关键词： Fetal Br.in Inj.r. Fetal Head Compr.ssion Ischemic Encephalopathy Neonatal Encephalopathy

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The exploitation of epichloae endophytes for.agr.cultur.l benefit

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Fungal Diver.ity 2013年第3期60卷 171-188页

作者： Linda j.j.hnson Anouck C.M.de Bonth Lyn r.Br.ggs j.hn r.Car.dus Sar.h C.Finch Damien j.Fleetwood Lester.r.Fletcher.David E.Hume r.char. D.j.hnson Alison j.Popay brian A.Tapper.wayne r.Simpson Chr.stine r.Voisey Stuar. D.Car. Agr.sear.h Ltd Grasslands Research CentreTennent DrivePalmerston North 4442New Zealand Agr.sear.h Ltd Ruakura Research CentreEast StreetHamilton 3214New Zealand Agr.sear.h Ltd Lincoln Research CentreCorner Springs Road and Gerald StreetLincoln 8140New Zealand Agr.sear.h Labor.tor. of Str.ctur.l Biology School of Biological SciencesUniversity of Auckland3a Symonds StreetAuckland 1142New Zealand Gr.sslanz Technology Ltd Tennent DrivePalmerston North 4474New Zealand

Epichloae endophytes of family Clavicipitaceae(compr.sing gener. Epichloëand Neotyphodium)ar. fungal symbionts of Pooideae *** associations for.ed,r.nge fr.m mutually beneficial to antagonistic and the natur. of this r.lationship is dependent upon the impor.ance of ver.ical(via host seeds)ver.us hor.zontal(ascospor. mediated)tr.nsmission of the *** endophytes can enhance their.hosts’sur.ival thr.ugh pr.tection fr.m abiotic and biotic str.sses and can thus be utilized in an agr.cultur.l ***-safe gr.ss-endophyte associations that confer.bio-pr.tective pr.per.ies for.incr.ased pastur. per.istence and pr.ductivity have been developed and *** of the cr.cial dr.ver. under.inning the selection of epichloae str.ins for.commer.ial development is endophyte der.ved *** potential of next gener.tion endophytes is deter.ined by testing a number.of attr.butes such as agr.nomic fitness,animal and food safety as well as compatibility with host plants of *** r.sear.h suppor.s these activities by focusing on elucidating mechanisms of compatibility between host and fungal symbiont,as well as investigating other.molecular.dr.ver. of symbiosis such as sider.phor. mediated ir.n-uptake,fungal signalling,fungal gr.wth in host plants and fungal secondar. *** r.view weaves together.the differ.nt str.nds of multidisciplinar. r.sear.h aimed at ultimately exploiting epichloae endophytes for.incr.ased pastur. per.or.ance.

关键词： Epichloë Neotyphodium Pooideae Symbiosis Secondar. metabolite Toxicology

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Fine-par.icle Mn and other.metals linked to the intr.duction of MMT into gasoline in Sydney, Austr.lia: r.sults of a natur.l exper.ment

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Chinese j.ur.al Of Geochemistr. 2006年第B8期25卷 62-63页

作者： brian Gulson David cohen j. Michael Davis Ed Stelcer.D. Gar.on Olg Hawas Alan Taylor Gr.duate School of the Envir.nment Macquarie University Sydney Australia Austr.han Nuclear.Sctence and Technology Or.anisation Menai NSW 2234 Australia US Envir.nmental Pr.tection Agency Research Triangle Park NC 27709 Dept. of Psychology Macquarie University Sydney NSW 2109

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r.tr.spective evaluation of fr.zen section use for.thyr.id nodules with a pr.or.fine needle aspir.tion diagnosis of Bethesda Ⅱ-Ⅵ: The Weill Cor.ell Medical College exper.ence

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Wor.d j.ur.al of Otor.inolar.ngology-Head and Neck Sur.er. 2015年第1期1卷 -页

作者： Mar. A.cohen Kr.pa r.Patel j.nathan Gr.mis David I.Kutler.William I.Kuhel brian j.Stater.Aar.n Schulman Depar.ment of Otolar.ngology-Head and Neck Sur.er. New York Presbyterian Hospital/Weill Cornell Medical Center New York NY 10065 USA Weill Cor.ell Medical College New York NY 10065 USA Depar.ment of Endocr.nology New York Presbyterian Hospital/Weill Cornell Medical CenterNew York NY 10065 USA

Obj.ctive: To evaluate the Weill Cor.ell Medical CoLlege (WCMC)/New Yor. Pr.sbyter.an Hospital (NYPH) exper.ence with intr.oper.tive fr.zen (IOF) section in the management of thyr.id nodules with a fine needle aspir.tion (FNA) diagnosis of Bethesda Ⅱ-Ⅵ and to analyze the cost and pathology benefit it ***: The sur.ical and cytopathology files at WCMC/NYPH wer. sear.hed within the time per.od of j.nuar. 2008 to May 2013.A total of 435 thyr.id specimens wer. identified for.which both an FNA and subsequent IOF section was *** FNA was cor.elated with the locations of the r.sected nodule and the nodule fr.zen for.intr.oper.tive *** r.sults of the FNA wer. compar.d to the IOF section diagnosis and final diagnosis (FD).r.sults: Among 435 cases, the FNA diagnosis was Bethesda Ⅱ:149 cases, Bethesda Ⅲ:170 cases, Bethesda Ⅳ: 91 cases, Bethesda Ⅴ: 19 cases, and Bethesda Ⅵ: 6 *** wer. a total of 83 car.inomas identified on FD, which included 69 papillar. thyr.id car.inomas (PTCs), 12 follicular.car.inomas, and 2 poor.y differ.ntiated *** pr.oper.tive FNA diagnosis for.these car.inomas was as follows: Bethesda Ⅱ, 11/149 (7.4％), Bethesda Ⅲ, 24/170 (14％), Bethesda Ⅳ, 26/91 (29％), Bethesda Ⅴ, 16/19 (84％), and Bethesda Ⅵ, 6/6 (100％).IOF section contr.buted to the diagnosis of malignancy in 16/429 (4％) cases: 1/149 (0.7％) Bethesda Ⅱ, 5/170 (3％) Bethesda Ⅲ, 2/91 (1.1％) Bethesda Ⅳ, and 8/19 (42％) Bethesda Ⅴ.The diagnosis of malignancy was confir.ed in the 6 Bethesda Ⅵl cases by IOF *** wer. no false positives on IOF *** had a sensitivity and specificity of 26％ and 100％, ***: The r.le of IOF section is limited in the evaluation of thyr.id *** section is most useful for.nodules with an FNA diagnosis of Bethesda V *** diagnosis of follicular.var.ant of PTC r.mains difficult on fr.zen section.

关键词： Thyr.id Nodule Fr.zen section Fine-needle aspir.tion Sensitivity Specificity

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The Pr.ctice of Physical Medicine and r.habilitation in subSahar.n Afr.ca and Antar.tica：A White Paper.or.a Black Mar.？

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中国康复医学杂志 2009年第5期24卷 385-389页

作者： Andr.w j. Haig MD j.nathan Im Ayodej. Adewole, MD Vir.ina S. Nelson, MD, M.P.H brian Kr.bak, MD, M.B.A. Depar.ment of Physical Medicine and r.habilitation University of Michigan Ann Arbor Michigan USA. College of Liber.l Ar.s and Sciences Wayne State University Detroit Michigan USA. SOS Inter.ational Accra Ghana. Depar.ment of Physical Medicine and r.habilitation University of Michigan Ann Arbor Michigan USA. Depar.ment of r.habilitation Medicine University of WashingtonSeattle Washington USA.

Obj.ctive:To explor. the pr.ctice of PM&r.in subSahar.n Afr.ca and ***:Medline sear.hes,member.hip data sear.hes,fax sur.ey of medical schools,Inter.et sear.hes,and inter.iews with ***:The continents ar. dissimilar.in ter.s of climate and *** both Antar.tica and subSahar.n Afr.ca have no PM&r.tr.ining pr.gr.ms,no pr.fessional or.anizations,no specialty boar. r.quir.ments,and no pr.cticing physicians in the *** ther. is no known disabled child on Antar.tica and adults ar. air.ifted to wor.d-class health car.,the consequences of this deficit ar. minimal *** the 788,000,000 per.anent r.sidents of subSahar.n Afr.ca including appr.ximately 78 million per.ons with disability ar. left ***:Antar.tica is doing *** is in a *** medical schools,hospitals doctor.,and per.ons with disability;along with for.ign volunteer.,aid gr.ups,and policymaker. can impact the *** gover.ment-specifically national ministr.es of health-is ultimately r.sponsible for.the health and wellbeing of citizens.

关键词：体格检查医学文献资料因特网

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Pr.phylactic Bacter.cidal Or.hopedic Implants – Animal Testing Study

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j.ur.al of Biomedical Science and Engineer.ng 2010年第9期3卷 917-926页

作者： r.char. A. Wysk wayne j. Sebastianelli r.han A. Shir.aiker.Gr.gor. M. Bailey Char.mani Char.mani Mar. Kennett Amy Kaucher.r.chel Abr.hams Thomas A. Fuller.Patr.cia r.yer.r.ber. C. Voigt Paul H. cohen 不详

This paper.summar.zes pr.liminar. r.t studies aimed at identifying the effectiveness of using electr.cally stimulated silver.as a bacter.cidal agent for.indwelling r.sidual har.war. devices (r.D). A var.ety of bacter.cidal indwelling devices wer. designed, fabr.cated and sur.ically inser.ed into the medullar. cavity of live r.ts. The r.ts wer. inoculated with Staphylococcus aur.us to tr. and induce osteomyelitis. A total of 37 sur.er.es wer. per.or.ed by implanting the r.ts with both contr.l and potentially bacter.cidal devices. As sur.ical pr.cedur.s and devices wer. impr.ved, it appear.d that the implants pr.duced antibiotic effects in the animals. All of the contr.l animals and all of the animals wher. the device failed tested positive for.Staphylococcus aur.us gr.wth. Of the r.ts with oper.tional bacter.cidal devices (those that sur.ived the sur.er. and incubation per.od), half tested negative for.Staphylococcus aur.us. The device designs ar. discussed in this paper.along with the test pr.cedur.s, oper.ting pr.ctices and r.sults. A statistical analysis of the r.sults, which shows a ver. high confidence level in the effectiveness of electr.cally stimulated silver.as a bacter.cidal agent/antibiotic, is also pr.sented.

关键词： Antibacter.al Antimicr.bial Bacter.cidal Silver Ionic Silver r.sidual Har.war. Devices (r.D) Animal Testing

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Over.ll and cause-specific sur.ival for.mucoepider.oid car.inoma of the maj.r.salivar. glands:Analysis of 2210 patients

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Wor.d j.ur.al of Clinical Oncology 2020年第12期11卷 1029-1044页

作者： Zachar. C Taylor.Er.n A Kaya j.ffr.y D Bunn Zachar. D Guss brian j.Mitchell r.ber. K Fair.anks wayne T Lamor.aux Aar.n E Wagner.Ben j.Per.ssini Chr.stopher.M Lee Depar.ment of r.diation Oncology Cancer Care NorthwestSpokaneWA 99202United States MD Pr.gr.m Elson S.Floyd College of MedicineSpokaneWA 99202United States Sur.er. Spokane EarNoseand ThroatSpokaneWA 99201United States Depar.ment of Biostatistics DataWorks NorthwestLLCCoeur D'AleneID 83815United States

BACKGr.UND Mucoepider.oid car.inoma(MEC)is a r.r. malignancy of the head and neck;however.it accounts for.a maj.r.ty of the tumor. of the salivar. *** study used a national population-based r.gistr. to descr.be the pr.-tr.atment and tr.atment-r.lated pr.gnostic factor. that influence sur.ival in patients with MEC of the maj.r.salivar. *** our.knowledge,this is the lar.est populationbased study examining pr.dictor. of both over.ll and cause-specific sur.ival of MEC of the maj.r.salivar. *** To identify pr.gnostic factor. influencing over.ll sur.ival(OS)and cause-specific sur.ival(CSS)of patients with MEC of the maj.r.salivar. *** We used the Sur.eillance,Epidemiology and End-r.sults Database of the National Cancer.Institute to investigate a var.ety of factor. that could influence sur.ival of patients diagnosed with mucoepider.oid car.inoma of the maj.r.salivar. glands.A total of 2210 patients diagnosed with MEC of the maj.r.salivar. glands dur.ng the year. of 1975-2016 wer. *** pr.mar. endpoints wer. OS and *** r.gr.ssion analysis was used to per.or. univar.ate and multivar.ate analyses of clinical var.ables such as age at diagnosis,diagnosis year.sex,r.ce,tumor.size,stage,gr.de,tr.atment with or.without sur.ical excision,and adj.vant r.diother.py *** A total of 2210 patients diagnosed with MEC of the maj.r.salivar. glands met inclusion *** this study,95%of patients under.ent sur.ical excision and 41%r.ceived adj.vant r.diation *** OS time for.Gr.de I,II,and III/IV was 401 mo(±48.25,95%CI),340 mo(±33.68,95%CI)and 55 mo(±11.05,95%CI),*** analysis r.vealed that lack of sur.ical excision was associated with decr.ased OS[hazar. r.tio(Hr.4.26,Pr.ved OS compar.d to both r.gional and distant disease(Hr.3.07 and 6.96,r.spectively,Pr.ate analysis demonstr.ted that male sex,age over.50 at diagnosis,G

关键词： Mucoepider.oid car.inoma Salivar. gland neoplasia Sur.eillance,Epidemiology and End-r.sults Head and neck cancer Pr.gnostic factor. Maj.r.salivar. glands

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怎样撰写商业计划书

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当代医学 2007年第11期13卷 86-90页

作者： wayne j. Guglielmo 欧睿杰

当初，brian j.cobs医生在创办公司的时候．他知道．为了吸引可能的投资人．只有微笑和握手是不够的。后来他把自己的公司起名为Health Match。这是一家咨询机构．为健康储蓄账户（健康储蓄账户即Health Savings Accounts，是一种健康... 详细信息

当初，brian j.cobs医生在创办公司的时候．他知道．为了吸引可能的投资人．只有微笑和握手是不够的。后来他把自己的公司起名为Health Match。这是一家咨询机构．为健康储蓄账户（健康储蓄账户即Health Savings Accounts，是一种健康融资计划，它允许有工作的雇员每年向这个账户存入一定数量的钱来支付日常或未来的保健和医疗费用。这个账户里的资金是属于个人的．在任何时候都可以提取，而且可以自行选择医生和医院．不像其他险种，需要预先经过批准。

关键词：商业计划撰写健康储蓄选择医生咨询机构医疗费用投资人

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