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Impact of initial fluid resuscitation volume on clinical outcomes in patientswith heart failure and septic shock

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Journal of Intensive Medicine 2023年第3期3卷 254-260页

作者： Adam L.Wiss Bruce A.Doepker brittany Hoyte Logan M.Olson Kathryn A.Disney Eric M.McLaughlin Vincent Esguerra Jessica L.Elefritz Department of Pharmacy Ascension Saint Thomas Hospital WestNashvilleTN 37205USA Department of Pharmacy The Ohio State University Wexner Medical CenterColumbusOH 43210USA Department of Pharmacy Corewell HealthGrand RapidsMI 49503USA Department of Pharmacy Nebraska MedicineOmahaNE 68105USA Department of Pharmacy Huntsman Cancer Institute at the University of UtahSalt Lake CityUT 84112USA Center for Biostatistics The Ohio State UniversityColumbusOH 43210USA Division of Pulmonary AllergyCritical Careand Sleep Medicine.The Ohio State University Wexner Medical CenterColumbusOH 43210USA

Background:Fluid resuscitation is a key treatment for sepsis,but limited data exists in patients with existing heartfailure(HF)and septic *** objective of this study was to determine the impact of initial fluid resuscitationvolume on outcomes in HF patients with reduced or mildly reduced left ventricular ejection fraction(LVEF)withseptic ***:This multicenter,retrospective,cohort study included patients with known HF(LVEF≤50%)presentingwith septic *** were divided into two groups based on the volume of fluid resuscitation in the first 6 h;<30 mL/kg or≥30 mL/*** primary outcome was a composite of in-hospital mortality or renal replacementtherapy(RRT)within 7 *** outcomes included acute kidney injury(AKI),initiation of mechanicalventilation,and length of stay(LOS).All related data were collected and compared between the two groups.A generalized logistic mixed model was used to assess the association between fluid groups and the primaryoutcome while adjusting for baseline LVEF,Acute Physiology and Chronic Health Evaluation(APACHE)II score,inappropriate empiric antibiotics,and receipt of ***:One hundred and fifty-four patients were included(93 patients in<30 mL/kg group and 61 patientsin≥30 mL/kg group).The median weight-based volume in the first 6 h was 17.7(12.2–23.0)mL/kg in the<30 mL/kg group vs.40.5(34.2–53.1)mL/kg in the≥30 mL/kg group(P<0.01).No statistical difference was detected in the composite of in-hospital mortality or RRT between the<30 mL/kg group compared to the≥30 mL/kggroup(55.9%vs.45.9%,P=0.25),***<30 mL/kg group had a higher incidence of AKI,mechanicalventilation,and longer hospital ***:In patients with known reduced or mildly reduced LVEF presenting with septic shock,no differencewas detected for in-hospital mortality or RRT in patients who received≥30 mL/kg of resuscitation fluid comparedto less fluid,although this study was underpowered to detect a ***

关键词： Sepsis Septic shock Heart failure Fluid resuscitation

Wastewater surveillance provides 10-days forecasting of COVID-19 hospitalizations superior to cases and test positivity:A prediction study

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Infectious Disease Modelling 2023年第4期8卷 1138-1150页

作者： Dustin T.Hill Mohammed A.Alazawi E.Joe Moran Lydia J.Bennett Ian Bradley Mary B.Collins Christopher J.Gobler Hyatt Green Tabassum Z.Insaf brittany Kmush Dana Neigel Shailla Raymond Mian Wang Yinyin Ye David A.Larsen Department of Public Health Syracuse UniversitySyracuseNY13244USA Center for Environmental Health New York State Department of HealthAlbanyNYUSA CDC Foundation AtlantaGAUSA Department of Civil Structural and Environmental EngineeringUniversity at BuffaloBuffaloNYUSA School of Marine and Atmospheric Sciences Sustainability Studies DivisionStony Brook UniversityStony BrookNYUSA Institute for Advanced Computational Science Stony Brook UniversityStony BrookNYUSA New York State Center for Clean Water Technology Stony Brook UniversityStony BrookNYUSA School of Marine and Atmospheric Sciences Stony Brook UniversityStony BrookNYUSA Department of Environmental Biology State University of New York College of Environmental Science and ForestrySyracuseNYUSA Department of Epidemiology and Biostatistics School of Public HealthUniversity at AlbanyRensselaerNYUSA Department of Civil Engineering College of Engineering and Applied SciencesStony Brook UniversityStony BrookNYUSA

Background:The public health response to COVID-19 has shifted to reducing deaths and hospitalizations to prevent overwhelming health *** amount of SARS-CoV-2 RNA fragments in wastewater are known to correlate with clinical data including cases and hospital admissions for *** developed and tested a predictive model for incident COVID-19 hospital admissions in New York State using wastewater ***:Using county-level COVID-19 hospital admissions and wastewater surveillance covering 13.8 million people across 56 counties,we fit a generalized linear mixed model predicting new hospital admissions from wastewater concentrations of SARS-CoV-2 RNA from April 29,2020 to June 30,*** included covariates such as COVID-19 vaccine coverage in the county,comorbidities,demographic variables,and holiday ***:Wastewater concentrations of SARS-CoV-2 RNA correlated with new hospital admissions per 100,000 up to ten days prior to *** that included wastewater had higher predictive power than models that included clinical cases only,increasing the accuracy of the model by 15%.Predicted hospital admissions correlated highly with observed admissions(r¼0.77)with an average difference of 0.013 hospitalizations per 100,000(95%CI¼[0.002,0.025])Interpretation:Using wastewater to predict future hospital admissions from COVID-19 is accurate and effective with superior results to using case data *** lead time of ten days could alert the public to take precautions and improve resource allocation for seasonal surges.

关键词： COVID-19 hospitalizations Wastewater-based epidemiology Forecasting Prediction SARS-CoV-2

Extremely low-volume, high-intensity interval training improves exercise capacity and increases mitochondrial protein content in human skeletal muscle

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Open Journal of Molecular and Integrative Physiology 2013年第4期3卷 202-210页

作者： Jasmin K. Ma Trisha D. Scribbans brittany A. Edgett J. Colin Boyd Craig A. Simpson Jonathan P. Little Brendon J. Gurd Department of Emergency Medicine Kingston General Hospital Kingston Canada Department of Health and Social Development University of British Columbia Okanagan Kelowna Canada Department of Kinesiology Queen’s University Kingston Canada

Purpose: The purpose of the present study was to evaluate whole-muscle content of several proteins involved in the regulation of skeletal muscle mitochondrial protein content and anaerobic capacity following 4 weeks of extremely low-volume high-intensity interval training (HIT). Methods: Young, healthy, recreationally active adult males (n = 8) trained 4 times a week for 4 weeks on a cycle ergometer. Each session involved 4 min of total exercise comprised of eight 20 s intervals at ~170% of peak aerobic power separated by 10 s rest. Muscle biopsies were taken prior to (pre) and ~72 hrs post-training (post). Par- ticipants completed an incremental peak oxygen up- take (VO2peak) test and a Wingate test pre-, mid-, and post-training. Results: VO2peak was elevated (p p < 0.05) and post-training (pre: 40.5 ± 3.8 ml·kg-1·min-1, mid: 43.4 ± 2.5 ml·kg-1·min-1, post-: 47.2 ± 2.9 ml·kg-1·min-1). Wingate mean power also increased with training (pre-: 701.0 ± 73.0 W, mid-: 745.5 ± 73.3 W, post-: 786.8 ± 80.0 W). While maximal citrate synthase activity was unchanged, protein expression of the mitochondrial protein cytochrome c oxidase (COX) subunit I (+27%;p p p = 0.08) increased. Increases (p α (+19%), and nuclear PGC-1α (+46%) were also observed after 4 weeks of HIT. No changes were observed in the whole-muscle contents of PDHe1a, PDK4, SIRT1, mTOR, S6K1, MCT1, or PFK protein. Conclusions: These results demonstrate that several mitochondrial protein (but not citrate synthase activity), PGC-1α protein content, and exercise capacity can be improved in only 4 min of total training time per day, 4 days per wk using HIT cycle training.

关键词： PGC-1α Mitochondrial Biogenesis High-Intensity Interval Training SIRT1 Aerobic Fitness

An Unsteady Two-Dimensional Complex Variable Boundary Element Method

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Applied Mathematics 2017年第6期8卷 878-891页

作者： Bryce D. Wilkins Joshua Greenberg brittany Redmond Alan Baily Nicholas Flowerday Adam Kratch Theodore V. Hromadka Randy Boucher Howard D. McInvale Steve Horton Department of Mathematics United States Military Academy West Point NY USA

The Complex Variable Boundary Element Method (CVBEM) procedure is extended to modeling applications of the two-dimensional linear diffusion partial differential equation (PDE) on a rectangular domain. The methodology in this work is suitable for modeling diffusion problems with Dirichlet boundary conditions and an initial condition that is equal on the boundary to the boundary conditions. The underpinning of the modeling approach is to decompose the global initial-boundary value problem into a steady-state component and a transient component. The steady-state component is governed by the Laplace PDE and is modeled using the Complex Variable Boundary Element Method. The transient component is governed by the linear diffusion PDE and is modeled by a linear combination of basis functions that are the products of a two-dimensional Fourier sine series and an exponential function. The global approximation function is the sum of the approximate solutions from the two components. The boundary conditions of the steady-state problem are specified to match the boundary conditions from the global problem so that the CVBEM approximation function satisfies the global boundary conditions. Consequently, the boundary conditions of the transient problem are specified to be continuously zero. The initial condition of the transient component is specified as the difference between the initial condition of the global initial-boundary value problem and the CVBEM approximation of the steady-state solution. Therefore, when the approximate solutions from the two components are summed, the resulting global approximation function approximately satisfies the global initial condition. In this work, it will be demonstrated that the coupled global approximation function satisfies the governing diffusion PDE. Lastly, a procedure for developing streamlines at arbitrary model time is discussed.

关键词： Complex Variables Diffusion Equation Laplace Equation Complex Variable Boundary Element Method (CVBEM) Numerical Techniques for Partial Differential Equations

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If I Were a Boy

英语沙龙（高中） 2014年第3期 1-1页

作者： brittany Jean Carlson toby Gad

三月，为了迎接the International Women’s Day，特意献上这首歌曲。碧昂斯在歌中用女性的视角诠释了心目中的男神标准。但歌词中大量出现的虚拟语气体现了谈淡的忧伤，难道这样温柔体贴的男子世间罕见，女生们只能期待来自星星的他？

关键词：英语学习学习方法阅读知识阅读材料

Surgical palliation of gastric outlet obstruction in advanced malignancy

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World Journal of Gastrointestinal Surgery 2016年第8期8卷 545-555页

作者： brittany A Potz Thomas J Miner Department of Surgical Oncology Warren Alpert Medical School Brown University

Gastric outlet obstruction(GOO) is a common problem associated with advanced malignancies of the upper gastrointestinal *** treatment of patients' symptoms who present with GOO is an important aspect of their *** palliation of malignancy is defined as a procedure performed with the intention of relieving symptoms caused by an advanced malignancy or improving quality of *** treatment for GOO includes operative(open and laparoscopic gastrojejunostomy) and non-operative(endoscopic stenting) *** performance status and medical condition of the patient,the extent of the cancer,the patients prognosis,the availability of a curative procedure,the natural history of symptoms of the disease(primary and secondary),the durability of the procedure,and the quality of life and life expectancy of the patient should always be considered when choosing treatment for any patient with advanced *** appears to be associated with better long term symptom relief while stenting appears to be associated with lower immediate procedure related morbidity.

关键词： Surgical palliation Gastric outlet obstruction Advanced malignancy Gastrojejunostomy Endoscopic stenting

科技创新与价值创造——炼油工艺催化剂及石化技术新进展

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世界石油工业 2015年第3期22卷 32-37页

作者： David C. Aldous Sara George brittany Mcginley John J. Murphy Rosann Schiller Rive技术公司CEO 壳牌CRI/Criterion公司催化剂术副总哉 TCG公司总裁 TCGR公司总裁 Grace催化剂技术公司市场部经理

油品需求结构的变化和更为严格的产品规范是推动炼油技术创新以及新技术应用的原动力。为了适应更加严格的排放法规和产品标准要求，满足市场对清洁油品的需求，燃料清洁化已经成为一种不可逆转的世界性潮流。

关键词：工艺催化剂石化技术科技创新炼油价值产品标准清洁油品技术创新

Essential Oils as an Alternative to Antibiotics to Reduce the Incidence and Severity of Necrotic Enteritis in Broiler Chickens: A Short Review

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Food and Nutrition Sciences 2023年第3期14卷 233-257页

作者： Makenly E. Coles brittany D. Graham Juan D. Latorre Victor M. Petrone-Garcia Xochitl Hernandez-Velasco Inkar Castellanos-Huerta Xiaolun Sun Billy M. Hargis Saeed El-Ashram Awad A. Shehata Guillermo Tellez-Isaias Department of Poultry Science University of Arkansas Agricultural Experiment Station Fayetteville USA Facultad de Estudios Superiores Cuautitlan Universidad Nacional Autonoma de Mexico (UNAM) Cuautitlan Izcalli Estado de Mexico Mexico Departamento de Medicina y Zootecnia de Aves Facultad de Medicina Veterinaria y Zootecnia (FMVZ) UNAM Cd. de Mexico Mexico Programa de Maestría y Doctorado en Ciencias de la Producción y de la Salud Animal FMVZ UNAM Cd. de Mexico Mexico College of Life Science and Engineering Foshan University Foshan China Prophy-Institute for Applied Prophylaxis Bönen Germany

Due to the removal of antibiotic growth promoters (AGPs) and consumer pressure for antibiotic-free (ABF) or no antibiotics ever (NAE) poultry production, there is a need for sustainable alternatives to prevent disease in commercial poultry operations. Without AGPs, there has been a rise in diseases that were traditionally controlled by subtherapeutic levels of antibiotics in the diet. This has impacted the health of commercial poultry and has been a significant cost to poultry producers. To mitigate this, the industry has started to investigate alternatives to antibiotics to treat these forthcoming health issues, such as necrotic enteritis (NE). NE is an enteric disease caused by an over proliferation of toxigenic Clostridium perfringens (CP) in the gastrointestinal tract. Although CP is a commensal in the avian intestinal tract, dysbiosis caused by inflammation and impaired intestinal integrity facilitates uncontrolled replication of CP. Infectious agents, such as Eimeria maxima, appear to be a predominant predisposing factor that promotes NE. However, non-infectious stressors, including dietary changes, have also been associated with NE to some degree. As a result of increased pressure to restrict the use of antibiotics, there is a need for research evaluating the efficacy of alternatives, such as plant-derived essential oils, as potential tools to mitigate NE in commercial poultry flocks. The aim of this study is to review the effects of essential oils as an alternative to antibiotics to reduce the incidence and severity of necrotic enteritis in broiler chickens.

关键词： Necrotic Enteritis Essential Oils Chickens Clostridium perfringens Alternatives to Antibiotics

Review of the initial treatment and avoidance of scald injuries

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World Journal of Dermatology 2017年第2期6卷 17-26页

作者： Ryan T Bourdon brittany B Nelson-Cheeseman John P Abraham Emergency Department Regions Hospital School of Engineering University of St.Thomas

Scald injuries,which describe burns to living tissue from hot liquids,are a very common injury that occur across geographical,social,economic,and national *** their ubiquitous nature,a complete understanding of the conditions which are required to cause scald burns is not yet *** addition,clear guidance to medical practitioners is available through various guidelines however in actual situations,the extent of the burn is not fully known and this lack of knowledge complicates ***,a comprehensive review is made of the available knowledge of temperatures and scald durations which lead to skin-burn *** range of volumes and liquid temperatures are typical of those found in heated consumer *** review can help medical practitioners design initial treatment protocols and can be used by manufacturers of hot-liquid products to avoid the most severe ***,within the context of this ability to quantify burn depths,a review of current burn treatment guidelines is *** in this review is a visual recognition of the extent of burns into the dermal layer as well as decision guidelines for selection of patients which would benefit from referral to a dedicated burn *** is hoped that by bringing together both the quantified burn-depth information and current treatment guidelines,this review can be used as a resource for persons in the medical,manufacturing,beverage service,and other industries to reduce the human impact of scald injuries.

关键词： Scald injury Skin burns Biological heating Hot beverages Burn depth