检索结果-南通市图书馆

A Case Report: Emergency Management of a Pregnant Trauma Patient—An Anesthesiologist’s Perspective and Role

Open Journal of Anesthesiology 2024年第2期14卷 25-39页

作者： Kalpana Tyagaraj candice Ibarra Kimberly Moy Nina Luksanapol Gianna Torre Raymond Powers Anuj Bapodra Maimonides Medical Center New York USA

Trauma is the leading cause of death for all women of childbearing age. Motor vehicle accidents account for almost two-thirds of all maternal non-obstetric, trauma-related deaths, while falls and domestic violence comprise a large percentage of the rest. The leading causes of obstetric trauma are motor vehicle accidents, falls, assaults, and gunshots, and ensuing injuries are classified as blunt abdominal trauma, pelvic fractures, or penetrating trauma . The causes are different with different life styles and different socio-economic and cultural background. Pregnant trauma victims tend to be younger, less severely injured, and more likely African American or of Hispanic descent compared with nonpregnant victims of trauma. Drugs and alcohol are a factor in about 20 percent of maternal trauma. With pregnancy comes the challenge and responsibility of caring for two patients at once, the mother and the fetus. In general, providing optimal maternal care is the best strategy to optimize fetal survival. Decision-making including the condition of the mother, gestational age, status of the fetus, and interventions are based on these key factors. Many providers are involved in the care of the pregnant patient: at the trauma scene, in the emergency department, and in the operating room. The anesthesiologist plays a key role in the care and management of the pregnant trauma patient. All anesthesiologists have ample training in obstetric anesthesia during their residency and frequently cover obstetric units in hospitals where pregnant patients are cared for. On the other hand, most nonobstetric physicians have little obstetric exposure and may be uncomfortable caring for the pregnant patient because of unfamiliarity with the physiologic changes of pregnancy or the evaluation of fetal well-being. This is not only a source of stress for other trauma providers, but can put maternal well-being at risk. Non-obstetric physicians may hesitate to order necessary diagnostic and therapeu

关键词： Obstetric Anesthesiology Ob Trauma Maternal and Fetal Resuscitation

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

Evaluation of Clinician Training in Autism Screening, Care Management, and Patient Education

引用

Open Journal of Pediatrics 2024年第3期14卷 488-513页

作者： Belinda O’Hagan Julie White Ilana Hardesty Rachel Amgott candice Bangham Xinyang Liu Alyson Codner Amy Ursitti Alana Chandler Sarah Foster Marilyn Augustyn Jacey Greece Division of Developmental and Behavioral Pediatrics Department of Pediatrics Boston Medical Center Boston United States of America Boston University Chobanian & Avedisian School of Medicine Boston United States of America Department of Community Health Sciences Boston University School of Public Health Boston United States of America

Objective: The demand for pediatric developmental evaluations has far exceeded the workforce available to perform them, which creates long significant wait times for services. A year-long clinician training using the Extension for Community Healthcare Outcomes (ECHO®) model with monthly meetings was conducted and evaluated for its impact on primary care clinicians’ self-reported self-efficacy, ability to administer autism screening and counsel families, professional fulfillment, and burnout. Methods: Participants represented six community health centers and a hospital-based practice. Data collection was informed by participant feedback and the Normalization Process Theory via online surveys and focus groups/interviews. Twelve virtual monthly trainings were delivered between November 2020 and October 2021. Results: 30 clinicians participated in data collection. Matched analyses (n = 9) indicated statistically significant increase in self-rated ability to counsel families about autism (Pre-test Mean = 3.00, Post-test Mean = 3.89, p = 0.0313), manage autistic patients’ care (Pre-test Mean = 2.56, Post-test Mean = 4.11, p = 0.0078), empathy toward patients (Pre-test Mean = 2.11, Post-test Mean = 1.22, p = 0.0156) and colleagues (Pre-test Mean = 2.33, Post-test Mean = 1.22, respectively, p = 0.0391). Unmatched analysis revealed increases in participants confident about educating patients about autism (70.59%, post-test n = 12 vs. 3.33%, pre-test n = 1, p = 0.0019). Focus groups found increased confidence in using the term “autism”. Conclusion: Participants reported increases in ability and confidence to care for autistic patients, as well as empathy toward patients and colleagues. Future research should explore long-term outcomes in participants’ knowledge retention, confidence in practice, and improvements to autism evaluations and care.

关键词： Autism Spectrum Disorder Program Evaluation Case-Based Training Provider Burnout Continuing Medical Education

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

A novel role for tissue-nonspecific alkaline phosphatase at the blood-brain barrier during sepsis

引用

Neural Regeneration Research 2021年第1期16卷 99-100页

作者： Divine C.Nwafor candice M.Brown Department of Neuroscience West Virginia University Health Science CenterMorgantownWVUSA Department of Microbiology Immunologyand Cell BiologySchool of MedicineWest Virginia University Health Science CenterMorgantownWVUSA

Sepsis and the blood-brain barrier(BBB):Sepsis is a life threatening systemic inflammatory condition involving multi-organ *** World Health Organization estimates that about 30 million people are affected by sepsis every year,and at least 6 million people die from sepsis each *** of approximately 24 million sepsis survivors,it is estimated that 70%of these individuals will experience some form of long-term neurological impairment(Iwashyna et al.,2010).Thus,when combined with prevention,diagnosis,and therapeutic management strategies,a functional understanding of the mechanisms that promote sepsis-associated neurological impairment is necessary to address the clinical challenges and economic burdens faced when treating sepsis.

关键词： prevention diagnosis barrier

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

Dynamic Patterns of Gene Expression Additivity and Regulatory Variation throughout Maize Development

引用

Molecular Plant 2019年第3期12卷 410-425页

作者： Peng Zhou candice N.Hirsch Steven P.Briggs Nathan M.Springer Department of Plant and Microbial Biology University of MinnesotaSaint PaulMN 55108USA Department of Agronomy and Plant Genetics University of MinnesotaSaint PaulMN 55108USA Division of Biological Sciences University of CaliforniaSanDiegoLaJollaCA92093USA

Gene expression variation is a key component underlying phenotypic variation and heterosis. Transcriptome profiling was performed on 23 different tissues or developmental stages of two maize inbreds, B73 and Mo17, as well as their hybrid. The obtained large-scale datasets provided opportunities to monitor the developmental dynamics of differential expression, additivity for gene expression, and regulatory variation. The transcriptome can be divided into .30 000 genes that are expressed in at least one tissue of one in bred and an additional ~10 000 “silent” genes that are not expressed in any tissue of any genotype, 90% of which are non-syntenic relative to other grasses. Many (.74%) of the expressed genes exhibit differential expression in at least one tissue. However, the majority of genes with differential expression do not exhibit consistent differential expression in different tissues. These genes often exhibit tissue-specific differential expression with equivalent expression in other tissues, and in many cases they switch the directionality of differential expression in different tissues. This suggests widespread variation for tissue-specific regulation of gene expression between the two maize inbreds B73 and Mo17. Nearly 5000 genes are expressed in only one parent in at least one tissue (single parent expression) and 97% of these genes are expressed at mid-parent levels or higher in the hybrid, providing extensive opportunities for hybrid complementation in heterosis. In general, additive expression patterns are much more common than non-additive patterns, and this trend is more pronounced for genes with strong differential expression or single pare nt expressi on. There is relatively little evidence for non-additive expression patterns that are maintained in multiple tissues. The analysis of allele-specific expression allowed classification of cis. and trans-regulatory variation. Genes with c/s-regulatory variation often exhibit additive expression and tend

关键词： maize gene expression heterosis differential expression non-additive expression allele-specific expression

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

The role of radiation therapy in the management of primary thymic epithelial neoplasms

引用

Journal of Cancer Metastasis and Treatment 2022年第1期8卷 160-173页

作者： candice Johnstone Charles B.Simone 2nd Department of Radiation Oncology Medical College of WisconsinMilwaukeeWI 53211USA Department of Radiation Oncology New York Proton CenterNew YorkNY 10035USA

Therapeutic radiation plays an important role in the management of thymoma and thymic *** two tumor types differ substantially in their aggressiveness and *** most pressing issue in radiotherapy is which thymoma and thymic carcinoma patients need *** that these are rare cancers,few randomized trials have been *** remains regarding which patients benefit from adjuvant radiation *** literature spans patients treated over nearly 50 years,during which time radiation therapy has evolved from rudimentary 2-dimensional based planning to conformal 3-dimensional planning to yet more conformal dose painting techniques such as intensity-modulated radiation therapy and proton *** the effect of radiation is small and the natural history of a disease long,as is the case for stage I favorable histology thymoma,then differences in techniques and toxicities may have as much of an impact as whether radiation was given or not.

关键词： Thymoma thymic carcinoma post-operative radiation therapy

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

The Legends of Four Seasons

引用

新高考（高一语文、数学、英语） 2010年第2期 45-46页

作者： candice

春天，万物复苏，微风拂面；夏季，绿树成荫，阳光灿烂；秋天，北雁南飞，落叶蹁跹；冬日，银装素裹，苍茫纯洁。四个季节，四种心情。我们享受春目的喜悦，感受夏日的激情，分享秋季的收获，体验冬季的高远。

关键词：高中英语课外阅读阅读材料

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

The Legends of Four Seasons

引用

新高考(语文备考) 2010年第2期 45-46页

作者： candice

春天,万物复苏,微风拂面;夏季,绿树成荫,阳光灿烂;秋天,北雁南飞,落叶蹁跹;冬日,银装素裹,苍茫纯洁。四个季节,四种心情。我们享受春日的喜悦,感受夏日的激情,分享秋季的收获,体验冬季的高远。四季,总是被赋予着浪漫的气息。现在,就让... 详细信息

春天,万物复苏,微风拂面;夏季,绿树成荫,阳光灿烂;秋天,北雁南飞,落叶蹁跹;冬日,银装素裹,苍茫纯洁。四个季节,四种心情。我们享受春日的喜悦,感受夏日的激情,分享秋季的收获,体验冬季的高远。四季,总是被赋予着浪漫的气息。现在,就让我们一同去看看东西方文化都有哪些关于四季不同的传奇故事吧!

关键词：情态动词 The Legends of Four Seasons

来源：

同方期刊数据库评论

在线全文

同方期刊数据库

学校读者我要写书评

暂无评论

Immanant positivity for Catalan-Stieltjes matrices

引用

Frontiers of Mathematics in China 2022年第5期17卷 887-903页

作者： Ethan Y.H.LI Grace M.X.LI Arthur L.B.YANG candice X.T.ZHANG Center for Combinatorics LPMCNankai UniversityTianjin 300071China

We give some sufficient conditions for the nonnegativity of immanants of square submatrices of Catalan-Stieltjes matrices and their corresponding Hankel *** obtain these sufficient conditions,we construct new planar networks with a recursive nature for Catalan-Stieltjes *** applications,we provide a unified way to produce inequalities for many combinatorial polynomials,such as the Eulerian polynomials,Schröder polynomials,and Narayana polynomials.

关键词： Immanant character Catalan-Stieltjes matrices Hankel matrices planar network

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

Lactate reloaded–reevaluation of the importance of lactate monitoring in the management of adult sepsis in the emergency department

引用

BIOCELL 2021年第3期45卷 445-449页

作者： GABOR XANTUS BALINT KISS GYULA MOLNAR candice MATHESON V.A NNA GYARMATHY PETER L.KANIZSAI Cardiff University CardiffCF103ATUK Semmelweis University Budapest1085Hungary Dalhuis University Halifax HalifaxNS B3H 4R2Canada EpiConsult Biomedical Consulting and Medical Communications Agency DoverDE 19901USA Pecs University Clinical CentrePecs7626Hungary

For about a quarter of a century,monitoring lactate levels and/or lactate clearance has been an unquestionable cornerstone in sepsis *** elevated lactate level appeared to be an independent predictor of mortality,and the consequent metabolic acidosis was thought to explain a number of pathophysiological changes seen in septic *** physiological and clinical findings seem to challenge the adverse role of lactic acidosis in *** suggests that lactate levels are not necessarily directly proportional to either tissue or cellular hypoxia,and conversely,despite high lactate levels,increased peripheral tissue oxygen pressure can be measured in adult patients with septic *** to the most recent understanding of in vitro and in vivo evidence,the elevated lactate level in sepsis might be a normal reaction due to adrenergic stress with potential beneficial/protective physiological effects,as *** the one hand,burning lactic may help fuel the body during critical illness,but on the other hand,with a slight drop in pH,the body may counteract certain deleterious changes during the dysregulated host response;reduce the chances of reperfusion myocardial injury,and improve tissue oxygenation by shifting the haemoglobin dissociation curve to the *** the pathophysiological process in sepsis resulting in elevated lactate levels may aid management in an emergency,medicine,and intensive care *** more in-depth physiological knowledge,physicians may inevitably surpass normalisation heuristics and deliver personalized rather than protocolised sepsis resuscitation.

关键词： Reevaluation Lactate Sepsis Resuscitation

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

Evaluation of Clinician Training in Autism Screening, Care Management,and Patient Education

引用

Open Journal of Pediatrics（儿科学期刊） 2024年第3期 488页

作者： Belinda O’Hagan Julie White Ilana Hardesty Rachel Amgott candice Bangham Xinyang Liu Alyson Codner Amy Ursitti Alana Chandler Sarah Foster Marilyn Augustyn Jacey Greece

来源：博看期刊评论

在线全文

博看期刊

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：