检索结果-南通市图书馆

Ten misconceptions regarding decision-making in critical care

在线全文

学校读者我要写书评

暂无评论

World Journal of Critical care Medicine 2024年第2期13卷 72-82页

作者： Tara Ramaswamy Jamie l Sparling Marvin G Chang Edward A Bittner Department of Anesthesiology Perioperative and Pain MedicineStanford University School of MedicineStanfordCA 94305United States Department of Anesthesia Critical Care and Pain MedicineMassachusetts General HospitalHarvard Medical SchoolBostonMA 02114United States

Diagnostic errors are prevalent in critical care practice and are associated with patient harm and costs for providers and the healthcare *** complexity,illness severity,and the urgency in initiating proper treatment all contribute to decision-making ***-related factors such as fatigue,cognitive overload,and inexperience further interfere with effective *** science has provided insight into the clinical decision-making process that can be used to reduce *** evidence-based review discusses ten common misconceptions regarding critical care *** understanding how practitioners make clinical decisions and examining how errors occur,strategies may be developed and implemented to decrease errors in Decision-making and improve patient outcomes.

关键词： Clinical reasoning Cognitive bias Critical care Debiasing strategies decision making Diagnostic reasoning Diagnostic error Heuristics Medical knowledge Patient safety

Slowed driving-reaction time following concussion-symptom resolution

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

Journal of Sport and Health Science 2021年第2期10卷 145-153页

作者： landon B.lempke Robert C.lynall Nicole l.Hoffman Hannes Devos Julianne D.schmidt UGA Concussion Research laboratory Department of KinesiologyUniversity of GeorgiaAthensGA 30602USA School of Kinesiology and Recreation Illinois State UniversityNormalIL 61790USA laboratory for Advanced Rehabilitation Research in Simulation Department of Physical Therapy and Rehabilitation ScienceUniversity of Kansas Medical CenterKansas CityKS 66160USA

Background:Concussed patients have impaired reaction time(RT)and cognition following injury that may linger and impair driving *** research has used direct methods to assess driving-RT *** study compared driving RT during simulated scenarios between concussed and control individuals and examined driving-RT’s relationship with traditional computerized neurocognitive testing(CNT)***:We employed a cross-sectional study among 14 concussed(15.9±9.8 days post-concussion,mean±SD)individuals and 14 healthy controls matched for age,sex,and driving *** completed a driving simulator and CNT(CNS Vital Signs)assessment within 48 h of symptom resolution.A driving-RT composite(ms)was derived from 3 simulated driving scenarios:stoplight(green to yellow),evasion(avoiding approaching vehicle),and pedestrian(person running in front of vehicle).The CNT domains included verbal and visual memory;CNT-RT(simple-,complex-,Stroop-RT individually);simple and complex attention;motor,psychomotor,and processing speed;executive function;and cognitive *** t tests and Hedge d effect sizes assessed driving-RT differences between groups,Pearson correlations(r)examined driving RT and CNT domain relationships among cohorts separately,and p values were controlled for false discovery rate via Benjamini-Hochberg procedures(a=0.05).Results:Concussed participants demonstrated slower driving-RT composite scores than controls(mean difference=292.86 ms;95%confidence interval(95%CI):70.18515.54;p=0.023;d=0.992).Evasion-RT(p=0.054;d=0.806),pedestrian-RT(p=0.258;d=0.312),and stoplight-RT(p=0.292;d=0.585)outcomes were not statistica.ly significant after false-discovery rate corrections but demonstrated medium to large effect sizes for concussed *** concussed individuals,driving-RT outcomes did not significantly correlate with CNT domains(r-range:0.51 to 0.55;p>0.05).No correlations existed between driving-RT outcomes a

关键词： Mild traumatic brain injury Motor vehicle Neurocognitive function Response time Return to driving

Environmental Occurrence of Selenium in Waters and Related Health Significance

在线全文

学校读者我要写书评

暂无评论

Biomedical and Environmental Sciences 1997年第2期10卷 292-299页

作者： JANE l. VAlENTINE(School of Public Health, University of calIfornia at los Angeles, los Angeles, ca 90024, USA) School of Public Health University of California at Los Angeles 90024 USA.

Appreciable amounts of selenium in spring and well waters can be found due to geological occurrence. Concentrations of as much as 400 9000 μg/l have been reported in U. S. *** levels are 8 to 180 times the current EPA drinking water standard and approximate dietary exposures of 4900μg in selenosis regions of China. Reviews of health significance of the elevated drinking water exposures to U. S. populations revealed elevated concentrations of selenium in urine and blood. A decrease in glutathione peroxidase activity in such instances was noted. However noticeable symptoms and signs seem absent in studies reviewed. A comparison of intake levels (diet or drinking water) to urinary excretion for residents of China and the U. S. produced a correlation coefficient, r = 0. 82 (P lable

关键词： In Am Environmental Occurrence of Selenium in Waters and Related Health Significance

Himalayas as a global hot spot of springtime stratospheric intrusions:Insight from isotopic signatures in sulfate aerosols

在线全文

学校读者我要写书评

暂无评论

Research in Cold and Arid Regions 2024年第1期16卷 5-13页

作者： Kun Wang ShiChang Kang Mang lin PengFei Chen Chaoliu li XiuFeng Yin Shohei Hattori Teresa l.Jackson JunHua Yang YiXi liu Naohiro Yoshida Mark HThiemens State Key laboratory of Cryospheric Science Northwest Institute of Eco-Environment and ResourcesChinese Academy of Sciences(CAS)LanzhouGansu 730000China State Key laboratory of Isotope Geochemistry Guangzhou Institute of GeochemistryCASGuangzhouGuangdong 510640China University of Chinese Academy of Sciences Beijing 100049China International Center for Isotope Effects Research(ICIER) School of Earth Sciences and EngineeringNanjing UniversityNanjingJiangsu 210023China Frontiers Science Center for Critical Earth Material Cycling State Key Laboratory for Mineral Deposits ResearchSchool of Earth Sciences and EngineeringNanjing UniversityNanjingJiangsu 210023China Department of Chemical Science and Engineering School of Materials and Chemical TechnologyTokyo Institute of Technology4259 Nagatsuta-choMidori-kuYokohamaKanagawa 226-8502Japan Department of Chemistry and Biochemistry University of California San DiegoLa JollaCA 92093-0021USA Earth-life Science Institute Tokyo Institute of TechnologyMeguro-kuTokyo 152-8551Japan National Institute of Information and Communications Technology KoganeiTokyo 184-8795Japan

Downward transport of stratospheric air into the troposphere(identified as stratospheric intrusions)could potentially modify the radiation budget and chemical of the Earth's surface *** the highest and largest plateau on earth,the Tibetan Plateau including the Himalayas couples to global climate,and has attracted widespread attention due to rapid warming and cryospheric *** studies recognized strong stratospheric intrusions in the Himalayas but are poorly understood due to limited direct evidences and the complexity of the meteorological dynamics of the third ***^(35)S is a radioactive isotope predominately produced in the lower stratosphere and has been demonstrated as a sensitive chemical tracer to detect stratospherica.ly sourced air mass in the planetary boundary ***,we report 6-month(April–September 2018)observation of^(35)S in atmospheric sulfate aerosols(^(35)SO_(4)^(2-))collected from a remote site in the Himalayas to reveal the stratospheric intrusion phenomenon as well as its potential impacts in this *** the sampling campaign,the^(35)SO_(4)^(2-)concentrations show an average of 1,070±980 atoms/m^(3).In springtime,the average is 1,620±730 atoms/m^(3),significantly higher than the global existing data measured so *** significant enrichments of^(35)SO_(4)^(2-)measured in this study verified the hypothesis that the Himalayas is a global hot spot of stratospheric intrusions,especially during the springtime as a consequence of its unique geology and atmospheric *** combined with the ancillary evidences,e.g.,oxygen-17 anomaly in sulfate and modeling results,we found that the stratospheric intrusions have a profound impact on the surface ozone concentrations over the study region,and potentially have the ability to constrain how the mechanisms of sulfate oxidation are affected by a change in plateau atmospheric properties and *** study provides new observational constraints on stra

关键词： Himalayas Stratospheric intrusions Cosmogenic^(35)SO_(4)^(2-) Ozone Atmospheric oxidation

Quantifying the effect of persistent dryer climates on forest productivity and implications for forest planning:a case study in northern Germany

在线全文

学校读者我要写书评

暂无评论

Forest Ecosystems 2018年第4期5卷 451-471页

作者： Matthias Albert Ralf-Volker Nagel Johannes Sutmoller Matthias schmidt Department of Forest Growth Northwest German Forest Research Institute GottingenGermany Department of Environmental Control Northwest German Forest Research InstituteGottingenGermany.

Background: Forest management decisions are based on expectations of future developments. For sound decisions it is essential to accurately predict the expected values in future developments and to account for their inherent uncertainty,for example the impact of climate change on forests. Changing climatic conditions affect forest productivity and alter the risk profile of forests and forest enterprises. Intensifying drought stress is seen as one major risk factor threatening forest management in the north German lowlands. Drought stress reduces tree growth and vitality and might even trigger mortality. But so far, it is not possible to quantify effects of a persistent dryer climate on forest productivity at a level suitable for forest ***: We apply a well-established single-tree forest growth simulator to quantify the effect of persistent dryer climates on future forest productivity. We analyse the growth of Scots pine(Pinus sylvestris l.), European beech(Fagus sylvatico l.) and oak(Quercus robur l. and Quercus petraea(Matt.) liebl.) in two forest regions in the north German lowlands for a time interval of 60 years until 2070. The growth response under three different climate projections is compared to a baseline ***: The results show clear differences in volume increment to persistent dryer climates between tree species. The findings exhibit regional differences and temporal trends. While mean annual increment at biological rotation age of Scots pine and oak predominantly benefits from the projected climate conditions until 2070, beech might suffer losses of up to 3 m^3·ha^(-1)yr^(-1) depending on climate scenario and region. However, in the projection period2051 to 2070 the uncertainty ranges comprise positive as well as negative climatic effects for all ***: The projected changes in forest growth serve as quantitative contributions to provide decision support in the evaluation of, for example, species future site suita

关键词： Climate change Forest growth Forest productivity Persistent dryer climate simulation study Uncertainty

Optimization of phenol degradation by candida tropicalis Z-04 using Plackett-Burman design and response surface methodology

在线全文

学校读者我要写书评

暂无评论

Journal of Environmental Sciences 2011年第1期23卷 22-30页

作者： Jiangya Zhou Xiaojuan Yu Cong Ding Zhiping Wang Qianqian Zhou Hao Pao Weimin ca School of Environmental Science and Engineering Shanghai Jiaotong University Dongchuan Road 800 Shanghai 200240 China.

Statistical experimental designs were used to optimize the process of phenol degradation by candida tropicalis Z-04, isolated from phenol-degrading aerobic granules. The most important factors influencing phenol degradation （p 〈 0.05）, as identified by a two-level Plackett-Burman design with 11 variables, were yeast extract, phenol, inoculum size, and temperature. Steepest ascent method was undertaken to determine the optimal regions of these four significant factors. Central composite design （CCD） and response surface analysis were adopted to further investigate the mutual interactions between these variables and to identify their optimal values that would generate maximum phenol degradation. The analysis results indicated that interactions between yeast extract and temperature, phenol and temperature, inocuhim size and temperature affected the response variable （phenol degradation） significantly. The predicted results showed that the maximum removal efficiency of phenol （99.10%） could be obtained under the optimum conditions of yeast extract 0.41 g/l, phenol 1.03 g/l, inoculum size 1.43% （V/V） and temperature 30.04℃. These predicted values were further verified by validation experiments. The excellent correlation between predicted and experimental values confirmed the validity and practicability of this statistical optimum strategy. This study indicated the excellent ability of C. tropicalis Z-04 in degrading high-strength phenol. Optimal conditions obtained in this experiment laid a solid foundation for further use of this microorganism in the treatment of highstrength phenol effluents.

关键词： phenol degradation candida tropicalis Z-04 optimization Plackett-Burman design response surface methodology

载体金属催化剂的氧化-还原处理及其微结构和催化性能——烷烃在Ru,Rh,Ir,Ni,Pt禾Pd/SiO_2上的氢解

在线全文

学校读者我要写书评

暂无评论

Chinese Journal of catalysis 1989年第3期10卷 221-228页

作者：高森泉 schmidt l.D. 美国明尼苏达大学化学工程和材料科学系

SiO_2负载的过渡金属催化剂经低温还原对烷烃氢解均呈活性状态,但不同金属彼此相差极大,Ru,Rh较Pt,Pd高5个数最级。高温烧结导致催化能力不同程度的下降,Ru,Rh下降达1000倍,而Ni仅降为原来的一半。透射电镜研究表明载体上各金属在烧结... 详细信息

SiO_2负载的过渡金属催化剂经低温还原对烷烃氢解均呈活性状态,但不同金属彼此相差极大,Ru,Rh较Pt,Pd高5个数最级。高温烧结导致催化能力不同程度的下降,Ru,Rh下降达1000倍,而Ni仅降为原来的一半。透射电镜研究表明载体上各金属在烧结态均呈规则的多面体大颗粒状。该颗粒经充分氧化并低温还原后分裂成众多的无规则小晶粒的簇团。具有更低配位数和更高自由能的表面原子是氢解反应活性中心,溶于金属体内的氢则对氢解反应起抑制作用。

关键词：过渡金属负栽催化剂烷烃氢解

Assessing risks and uncertainties in forest dynamics under different management scenarios and climate change

在线全文

学校读者我要写书评

暂无评论

Forest Ecosystems 2015年第3期2卷 169-189页

作者： Matthias Albert Jan Hansen Jürgen Nagel Matthias schmidt Hermann Spellmann Northwest German Forest Research Station

Background: Forest management faces a climate induced shift in growth potential and increasing current and emerging new risks. Vulnerability analysis provides decision support based on projections of natural resources taking risks and uncertainties into account. In this paper we(1) characterize differences in forest dynamics under three management scenarios,(2) analyse the effects of the three scenarios on two risk factors, windthrow and drought stress, and(3) quantify the effects and the amount of uncertainty arising from climate projections on height increment and drought ***: In four regions in northern Germany, we apply three contrasting management scenarios and project forest development under climate change until 2070. Three climate runs(minimum, median, maximum) based on the emission scenario RCP 8.5 control the site-sensitive forest growth functions. The minimum and maximum climate run define the range of prospective climate ***: The projections of different management regimes until 2070 show the diverging medium-term effects of thinnings and harvests and long-term effects of species conversion on a regional scale. Examples of windthrow vulnerability and drought stress reveal how adaptation measures depend on the applied management path and the decision-maker’s risk attitude. Uncertainty analysis shows the increasing variability of drought risk projections with time. The effect of climate projections on height growth are quantified and uncertainty analysis reveals that height growth of young trees is dominated by the age-trend whereas the climate signal in height increment of older trees is ***: Drought risk is a serious issue in the eastern regions independent of the applied silvicultural scenario,but adaptation measures are limited as the proportion of the most drought tolerant species Scots pine is already high. Windthrow risk is no serious overall threat in any region, but adequate counter-measures such as spec

关键词： Climate change Silvicultural management strategies

具有Ruddlesden-Popper结构的杂化非本征铁电体(ca_(1-x)Sm_(x))_(3)Ti_(2)O_(7)陶瓷的制备及其物理性能

在线全文

学校读者我要写书评

暂无评论

天津师范大学学报（自然科学版） 2024年第2期44卷 19-25页

作者： MARCO Antonio lópez-Aguila 柳志旭王守宇黄聪刘卫芳天津大学理学院天津300350 天津师范大学物理与材料科学学院天津300387

为探究稀土离子掺杂对ca_(3)Ti_(2)O_(7)物理性能的调控,采用固相反应法制备了Sm^(3+)掺杂的(ca_(1-x)Sm_(x))_(3)Ti_(2)O_(7)(x=0,0.02,0.04)陶瓷样品,通过XRD、XPS、紫外-可见光吸收光谱以及第一性原理计算等方法对样品的晶体结构、... 详细信息

为探究稀土离子掺杂对ca_(3)Ti_(2)O_(7)物理性能的调控,采用固相反应法制备了Sm^(3+)掺杂的(ca_(1-x)Sm_(x))_(3)Ti_(2)O_(7)(x=0,0.02,0.04)陶瓷样品,通过XRD、XPS、紫外-可见光吸收光谱以及第一性原理计算等方法对样品的晶体结构、光学性能、电学性能和磁学性能进行分析.结果表明:随着Sm^(3+)含量的增加,(ca_(1-x)Sm_(x))_(3)Ti_(2)O_(7)的晶胞参数逐渐增大.Sm^(3+)掺杂导致氧空位减少,因此样品的漏电流随着Sm^(3+)掺杂量的增加而减小.同时,随着Sm^(3+)掺杂量的增加,样品的光学带隙呈现增大趋势.此外,第一性原理研究表明,Sm^(3+)掺杂可在体系中诱导出磁性能,进一步丰富了该材料的物理性能.

关键词： (ca_(1-x)Sm_(x))_(3)Ti_(2)O_(7)陶瓷铁电性氧空位光学带隙第一性原理