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Dilemmas in end-stage heart failure

2000年

作者： carol Yacht.

来源：畅想之星图书光盘版（南... 评论

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Journal of Geriatric Cardiology 2015年第1期12卷 57-65页

作者： carol Chen-Scarabelli Louis Saravolatz Benjamin Hirsh Pratik Agrawal Tiziano M. Scarabelli Veterans Affairs Healthcare System Ann Arbor 2215 Fuller Rd. Ann Arbor M148105 USA St. John Hospital and Medical Center~Wayne State University 22101 Moross Rd. Detroit M148236 USA Zena and Michael A. Wiener Cardiovascular Institute Mount Sinai Medical Center One Gustave L. Levy Place Box 1030 New York NY 10029-6574 USA

Heart failure （HF）, a complex clinical syndrome due to structural or functional disorder of the heart, is a major global health issue, with a prevalence of over 5.8 million in the USA alone, and over 23 million worldwide. As a leading cause of hospitalizations among patients aged 65 years or older, HF is a major consumer of healthcare resources, creating a substantial strain on the healthcare system. This paper discusses the epidemiology of HF, financial impact, and multifaceted predicaments in end-stage HF care. A search was conducted on the U.S National Library of Medicine website （***） using keywords such as end-stage heart failure, palliative care, ethical dilemmas. Despite the poor prognosis of HF （worse than that for many cancers）, many HF patients, caregivers, and clinicians are unaware of the poor prognosis. In addition, the unpredictable clinical trajectory of HF complicates the planning of end-of-life care, such as palliative care and hospice, leading to underutilization of such resources. In conclusion, ethical dilemmas in end-stage HF are numerous, embroiling not only the patient, but also the caregiver, healthcare team, and society.

关键词： Ethical dilemmas Heart failure Palliative care

Single-layer graphene as a highly selective barrier for vanadium crossover with high proton selectivity

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Journal of Energy Chemistry 2021年第8期30卷 419-430,I0009页

作者： Saheed Bukola Zhaodong Li Jason Zack Christopher Antunes carol Korzeniewski Glenn Teeter Jeffrey Blackburn Bryan Pivovar National Renewable Energy Laboratory(NREL) 80401 GoldenUnited States Department of Chemistry Texas Tech University79409 LubbockUnited States*Corresponding author(email:Saheed.Bukola@nrel.gov

We report near-zero crossover for vanadium cross-permeation through single-layer graphene immobilized at the interface of two Nafion?polymer electrolyte *** ion diffusion and migration,including proton mobility through membrane composites,were studied with and without graphene under diffusion and migration ***-layer graphene was found to effectively inhibit vanadium ion diffusion and migration under specific *** single-layer graphene composites also enabled remarkable ion transmission selectivity improvements over pure Nafion membranes,with proton transport being four orders of magnitude faster than vanadium ion *** values of 0.02±0.005Ωcm^(2) for proton and 223±4Ωcm^(2) for vanadium ion through single atomic layer graphene are *** high selectivity may have significant impact on flow battery applications or for other electrochemical devices where proton conductivity is required,and transport of other species is *** results emphasize that crossover may be essentially completely eliminated in some cases,enabling for greatly improved operational viability.

关键词： Ion selectivity Polymer electrolyte membrane Redox flow battery Single-layer graphene Vanadium crossover 2D nanomaterial

Gement improved highly weathered phyllite for highway subgrades:A case study in Shaanxi province

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Journal of Traffic and Transportation Engineering(English Edition) 2017年第4期4卷 403-411页

作者： Xuesong Mao carol Jean Miller Longqi Liu School of Highway Chang'on Uniuersity Xi'an 710064 China Department of Civil and Environmental Engineering Wayne State University Detroit MI 48105 USA

In a cost-saving move, the soft rocks composed of highly-weathered phyllites available on- site were used to fill the subgrade in the eastern Ankang section of the expressway of Shiyan to Tianshui, China. Cement admixture was used to improve the performance of the weathered phyllites. In order to determine the best mix ratio, values corresponding to compaction performance, unconfined compressive strength, and the California bearing ratio （CBR） were analyzed for variable cement content weight percentages （3%, 4%, 5%, and 6%） using test subgrade plots in the field. Field measurements of resilience modulus and deflection confirmed that the strength of the subgrade increased as the cement ratio increased. In order to further evaluate the cement/phyllite mixture, the performance of the 3% cement ratio sample was evaluated under saturated conditions （with various levels of moisture addition and soaking time） using both the wetting deformation and resilient modulus values. Results suggest that moisture added and soaking time are key factors that affect the seepage depth, water content, and resilient modulus. The recommend values for the cement addition and for the water content are given out. This study can aid in pre- vention of highway damage by improving the foundation capacity and lengthening the lifecycle of the highway in phyllite distributed region at home and abroad.

关键词： Highly-weathered phyllite Cement admixtureSoaking time Wetting deformation Resilient modulus

Anthropogenic impacts to the sediment budget of São Francisco River navigation channel using SWAT

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International Journal of Agricultural and Biological Engineering 2015年第3期8卷 140-157页

作者： Calvin T.Creech Rafael Brito Siqueira James P.Selegean carol Miller Wayne State University DetroitMichigan 48202United States Com panhia de Desenvolvimento dos Vales do São Francisco e do Parnaíba(CODEVASF) Brasília 70830Brazil United States Army Corps of Engineers Detroit DistrictDetroitMichigan 48226United States United States Army Corps of Engineers Mobile Di strictMobile 36628AlabamaUnited States

The São Francisco River Basin,located in eastern Brazil,has undergone a significant amount of anthropogenic changes in the last several decades,such as agricultural expansion,irrigation activities,mining,and the construction of large ***,these changes have altered the historic sediment budget and have led to an aggradation of sediments in the navigation channel,impacting the ability to efficiently ship agricultural commodities to regional *** an effort to aid decision makers in future waterway navigation planning,an international partnership between the Brazilian government agency CODEVASF and the US Army Corps of Engineers(USACE)was *** this partnership a SWAT model of the 630000 km2 São Francisco River basin was developed to better understand both the historic and current sediment budget within the navigation *** SWAT model of the São Francisco River Basin was calibrated for hydrology and sediment *** discharges were calibrated at 17 Agência Nacional deÁguas(ANA)gages,with Nash-Sutcliffe efficiency(NSE)values ranging from 0.42 to 0.75 for an eleven year *** loads were calibrated to an ANA sediment gage located in the Middle São Francisco River Navigation Channel,with a PBIAS(Percent Bias)of *** on model results,the aggradation rate of sediment in the São Francisco River and major tributaries has increased by approximately 20 Mt since Pre-European settlement of the basin(from approximately 7 Mt/a to 27 Mt/a).This increase has contributed to an impaired navigation channel due to shoaling of sandy sediments in the navigation channel.

关键词： sediment budget aggradation rate São Francisco River anthropogenic impact SWAT

Nursing education in China:Meeting the global demand for quality healthcare

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International Journal of Nursing Sciences 2016年第1期3卷 131-136页

作者： carol Chunfeng Wang Lisa Whitehead Sara Bayes School of Nursing and Midwifery Edith Cowan UniversityPerth WA 6027Australia

With a predicted global nursing shortage,ensuring the provision of quality healthcare has become a pressing *** China,these concerns include the need to produce nurses trained to a level to support advancing nursing practice and a healthcare system that supports the growth and retention of nurses in *** paper argues that the standard of nursing education in China plays a crucial role in preparing graduates to meet the health demands of China's growing population and the role that China can play into the future in the global progression of *** between nursing authorities,educators,and legislators is required to support the progression of nursing worldwide.

关键词： China Nursing education Globalisation Global healthcare Transcultural nursing

The power of story:Narrative inquiry as a methodology in nursing research

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International Journal of Nursing Sciences 2015年第2期2卷 195-198页

作者： carol Chunfeng Wang Sara Kathleen Geale School of Nursing and Midwifery Edith Cowan UniversityPerthWA 6027Australia

The aim of this paper is to explore the essential elements and value of narrative inquiry in nursing *** propose that understanding a previous experience allows the nurse researcher an“insider view”and hence a deeper understanding of the issues that arise in the relationship between participant and *** suggest that narrative inquiry in nursing research offers a particular way of caring about how knowledge is *** science would benefit from the understanding that health and nursing practices are dynamic processes characterized by the continuous interaction of human thought and behaviour that continuously‘pumps’into personal,social and material *** inquiry as a methodology in nursing research is exceptionally useful to uncover nuance and detail of previous experiences.

关键词： Narrative inquiry Subjectivity Nursing research

Utility of high-resolution anterior segment optical coherence tomography in the diagnosis and management of sub-clinical ocular surface squamous neoplasia

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Eye and Vision 2019年第1期6卷 229-235页

作者： Ann Q.Tran Nandini Venkateswaran Anat Galor carol L.Karp Department of Ophthalmology Bascom Palmer Eye InstituteUniversity of Miami Miller School of Medicine900 NW 17th StMiamiFL 33136USA

Background:To evaluate the frequency and characteristics of sub-clinical ocular surface squamous neoplasia(OSSN)detected by high-resolution anterior segment tomography(HR-OCT)in patients with clinically unapparent disease following topical ***:A retrospective chart review of patients with OSSN identified through a pharmacy database at the Bascom Palmer Eye Institute from January 2013 to December 2018 was *** undergoing primary therapy with topical 5-fluorouracil 1%(5-FU)(4 times a day for 7 days with a 21-day break)or interferon-alpha-2b(IFN)(4 times a day)were *** were separated into two *** 1 included individuals whose clinical resolution of OSSN aligned with complete resolution on *** 2(sub-clinical OSSN group)included individuals with clinical OSSN resolution but with features of persistent disease on *** excluded included those treated at an outside institution and those who used topical therapy as a surgical ***:A total of 95 patients(95 eyes)were ***-clinical OSSN was detected at a frequency of 17%in our study patients(n=16 patients,9 treated with 5-FU and 7 treated with IFN).In the 16 individuals,the mean time to clinical resolution was 3.6±1.0 cycles for 5-FU and 4.0±0.0 months for *** additional 2.1±0.8 cycles for 5-FU and 1.2±0.4 months for IFN were needed to achieve HR-OCT resolution of *** in Group 1 was noted in 10 patients(12%)while no recurrences occurred in Group 2,the cohort with subclinical disease that received the extended medical *** mean follow-up was 24.0±17.9 ***:We found that at least 17%of individuals with apparent clinical resolution of OSSN have sub-clinical disease detected on *** information can be used to optimize treatment and extend therapy past the point of clinical resolution.

关键词： Ocular surface squamous neoplasia,High-resolution optical coherence tomography,Sub-clinical ocular surface squamous neoplasia,Ocular surface imaging ocular surface lesions

Update on Diagnosis and Management of Conjunctival Papilloma

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Eye and Vision 2019年第1期6卷 131-147页

作者： Despoina Theotoka Melina I.Morkin Anat Galor carol L.Karp Department of Ophthalmology Bascom Palmer Eye InstituteUniversity of Miami Miller School of Medicine900 NW 17th StreetMiamiFL 33136USA Miami Veterans Administration Medical Center 1201 NW 16th StreetMiami 33125FLUSA

Conjunctival papilloma is an acquired benign squamous cell tumor that can present at any age,but most frequently in the third and fourth decades of *** have been associated with human papilloma virus(HPV)infection,usually types 6 and *** histopathological diagnosis remains the gold standard,the advent of newer non-invasive imaging modalities such as optical coherence tomography(OCT)is transforming the way we diagnose and treat ocular surface tumors,including conjunctival *** of these lesions can prove a challenge to the treating physician since not all lesions respond to medical and/or surgical therapy and in fact may worsen after surgical *** this review,the epidemiology,pathophysiology,clinical characteristics,and diagnosis of conjunctival papilloma including the use of OCT are ***,efficacy,and side effects of currently available management options are also reviewed to guide the selection of the best treatment approach.

关键词： Conjunctival papilloma Squamous cell papilloma Optical coherence tomography Treatment Interferon Mitomycin Surgery Cryotherapy Human papilloma virus

Comparison of water resources management between China and the United States

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Geography and Sustainability 2020年第2期1卷 98-108页

作者： Chansheng He carol P.Harden Yanxu Liu Department of Geography Western Michigan UniversityKalamazooMI 49008United States Department of Geography University of TennesseeKnoxvilleTN 37996United States State Key Laboratory of Earth Surface Processes and Resource Ecology Faculty of Geographical ScienceBeijing Normal UniversityBeijing 100875China

As the world’s top two economies,the United States(U.S.)and China face a number of similar water resources ***,few studies have been done to systematically compare policies and approaches on water resources management between China and the *** study compares water resources policies of China and the *** the areas of national authority,water supply,water quality,and ecosystem use of the water to draw lessons learned and shed light on water resources management in China,the U.S.,and the rest of the *** lessons learned from the comparison include six aspects.1)New paradigms of people-water harmony and a water-saving society are urgently needed to address the pressing water crisis and achieve the United Nations Sustainable Development Goals(UN SDGs).2)A comprehensive,consistent,forward-looking national policy is necessary to achieve sustainable use of water resources.3)Empowerment of river basin commissions with comprehensive authority over the integrative management of air,land,water,and biological resources in the river basin could significantly enhance the benefits and effectiveness of economic development and environmental protection.4)Expansion of water exchange through market mechanisms among water users promotes efficient and beneficial water uses.5)Use of water for ecosystem services should be an integral part of water resources *** has set up a national blueprint for achieving ecological civilization;maintaining appropriate amounts of flow in rivers and lakes for maintenance of wildlife and fisheries and ecosystems should be institutionalized as part of this national strategy as well.6)By sharing their rich experiences and lessons in water resources management,economic development,and ecological protection with other countries,China and the *** help the world to achieve global human-water harmony and the UN SDGs.

关键词： Water resources management Comparative analysis China The United States