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When evidence is lacking:a mixed-methods approach for the development of practice guidance in liver transplantation

Gastroenterology Report 2021年第1期9卷 22-30,I0001页

作者： Lisa B.VanWagner Blessing Aghaulor Tasmeen Hussain Megan Kosirog Patrick Campbell Stewart Pine Amna Daud daniel j.finn josh Levitsky Donald M.Lloyd-jones jane L.Holl Division of Gastroenterology and Hepatology Department of MedicineNorthwestern University Feinberg School of MedicineChicagoILUSA Department of Preventive Medicine Northwestern University Feinberg School of MedicineChicagoILUSA Comprehensive Transplant Center Northwestern University Feinberg School of MedicineChicagoILUSA Division of Cardiology Department of MedicineNorthwestern University Feinberg School of MedicineChicagoILUSA Department of Pediatrics Northwestern University Feinberg School of MedicineChicagoILUSA Center for Healthcare Delivery Science and Innovation and Department of Neurology Biological Sciences DivisionUniversity of ChicagoChicagoILUSA

Background Most interventions for conditions with a small cohort size,such as transplantation,are unlikely to be part of a clinical *** condition-specific evidence is lacking,expert consensus can offer more precise guidance to improve *** of cardiovascular risk in liver-transplant recipients is one example for which clinicians have,to date,adapted evidence-based guidelines from studies in the general ***,even when consensus is achieved,implementation of practice guidance is often inadequate and *** report on a novel mixed-methods approach,the Northwestern MethodVC,for the development of clinical-practice guidance when condition-specific evidence is *** illustrate the method through the development of practice guidance for managing cardiovascular risk in liver-transplant *** The Northwestern MethodVC consists of(i)adaptation of relevant,existing,evidence-based clinical-practice guidelines for the target population;(ii)consensus by experts of the proposed practice guidance;(iii)identification of barriers to guidance adherence in current practice;and(iv)recommendation for implementation and dissemination of the practice *** method is based on an iterative,user-centered approach in which the needs,wants,and limitations of all end users,including patients,are attended to at each stage of the design and development *** The Northwestern MethodVC for clinical-practice-guidance development uses a mixed-methods approach to bring together broad representation from multiple disciplines and practice settings to develop consensus considering the unique needs and preferences of patients,caregivers,and practitioners who are directly impacted by clinical-practice-guidance *** hypothesize that a priori involvement of end users in the guidance-development process will lead to sustainable implementation of guidance statements into clinical practice.

关键词： liver transplantation practice guideline consensus methodology

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Real-world cost-effectiveness of targeted temperature management in out-of-hospital cardiac arrest survivors: results from an academic medical center

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World journal of Emergency Medicine 2025年第1期16卷 28-34页

作者： Wachira Wongtanasarasin daniel K.Nishijima Wanrudee Isaranuwatchai jeff rey S.Hoch Department of Emergency Medicine Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand Department of Emergency Medicine University of California Davis School of MedicineSacramento 95817USA Health Intervention and Technology Assessment Program Ministry of Public HealthBangkok 11000Thailand Institute of Health Policy Management and EvaluationUniversity of TorontoToronto M5T 3M6Canada Division of Health Policy and Management Department of Public Health SciencesUniversity of California Davis School of MedicineSacramento 95817USA Center for Healthcare Policy and Research University of California Davis School of MedicineSacramento 95817USA

BACKGROUND: Targeted temperature management(TTM) is a common therapeutic intervention, yet its cost-effectiveness remains uncertain. This study aimed to evaluate the real-world cost-effectiveness of TTM compared with that of conventional care in adult out-of-hospital cardiac arrest(OHCA) survivors using clinical patient-level ***: We conducted a retrospective cohort study at an academic medical center in the USA to assess the cost-effectiveness of TTM in adult non-traumatic OHCA survivors between 1 january, 2019 and 30 june, 2023. The primary outcome was survival to hospital discharge. Incremental cost-effectiveness ratios(ICERs) were calculated and compared with various decision makers' willingness to pay. Cost-effectiveness acceptability curves were utilized to evaluate the economic attractiveness of TTM. Uncertainty about the incremental cost and effect was explored with a 95% confidence ***: Among 925 non-traumatic OHCA survivors, only 30(3%) received TTM. After adjusting for potential confounders, the TTM group did not demonstrate a significantly lower cost(delta cost-$5,141, 95% confidence interval [95% CI]: $-35,347 to $25,065, P=0.79) and higher survival to hospital discharge(delta effect 6%, 95% CI:-11% to 23%, P=0.41). Additionally, a 95% confidence ellipse indicated uncertainty reflected by evidence that the true value of the ICER could be in any of the quadrants of the cost-effectiveness ***: Although TTM did not demonstrate a clear survival benefit in this study, its potential cost-effectiveness warrants further investigation with larger sample sizes. These findings highlight the need for additional research to optimize TTM use in OHCA care and inform resource allocation decisions.

关键词： Out-of-hospital cardiac arrest Targeted temperature management Cost-effectiveness Survival Real-world data

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Vaccines for prevention of non-viral cancers

Vaccines for prevention of non-viral cancers

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第十二届全国免疫学学术大会

作者： Olivera j.finn Department of Immunology University of Pittsburgh School of Medicine

Discovery almost three decades ago of the first few human tumor antigens,targets of human antibodies and T cells,started a new field of therapeutic cancer *** of molecules that were found to be differentially expressed on tumors versus normal cells were incorporated in various forms into vaccines to be administered to patients in hope of boosting preexisting immunity or eliciting new immune responses to control tumor *** such antigen was the epithelial mucin MUCl that is overexpressed and hypoglycosylated on tumor

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An illustrated guide to:Distributed and integrated fibreoptic sensing in seismology

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Earthquake Science 2025年第1期38卷 67-77页

作者： Andreas Fichtner Fabian Walter Patrick Paitz Sara Klaasen daniel C.Bowden Sebastian Noe Nils Müller Dominik Husmann jacques Morel Department of Earth Sciences ETH ZürichZürich 8049Switzerland Swiss Federal Institute for Forest Snow and Landscape ResearchBirmensdorf 8903Switzerland Swiss Federal Institute of Metrology METAS Bern 3003Switzerland

The properties of laser signals are affected by deformation of the optical fibre through which they are *** this deformation dependence is undesirable in telecommunication,it can be exploited for the construction of novel seismic sensors that fill a niche in data acquisition where traditional seismometer arrays would be difficult to *** includes densely populated urban centers,the oceans,volcanoes and the Earth’s polar *** notes complement a presentation on recent methodological developments and applications in fibre-optic *** first part is focused on the use of distributed fibreoptic sensing in cryosphere research,and specifically the investigation of the internal structure and seismicity of glaciers and ice *** second part is dedicated to recent advances in integrated fibre-optic sensing,with emphasis on novel measurement principles and sensitivity.

关键词： seismology fibre-optics cryosphere earthquakes

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A Rare Case of Concordant Atrioventricular Connection to L-Looped Ventricles in Situs Solitus:4-Dimensional Magnetic Resonance Imaging and 3D Printing

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Congenital Heart Disease 2022年第4期17卷 387-392页

作者： Gregory Perens Takegawa Yoshida j.Paul finn UCLA Mattel Children’s Hospital Children’s Heart CenterLos AngelesCAUSA Diagnostic Cardiovascular Imaging Laboratory Department of Radiology12222 David Geffen School of Medicine at UCLALos AngelesCAUSA

An infant male presented with the rare anatomy consisting of situs solitus,concordant atrioventricular connections to L-looped ventricles,double outlet right ventricle(DORV),and hypoplastic aortic arch.6 months after neonatal aortic arch repair,the morphologic right ventricle function deteriorated,and surgical evaluation was undertaken to determine if either biventricular repair with a systemic morphologic left ventricle or right ventricular exclusion was *** initial echocardiography,magnetic resonance imaging(MRI)was used to create detailed axial and 4-dimensional(4D)images and 3-dimensional(3D)printed *** detailed anatomy of this rare,complex case and its use in pre-surgical planning is presented.

关键词： Magnetic resonance imaging cardiac segments 3D printing

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Mating system and genetic diversity of a rare desert legume Ammopiptanthus nanus (Leguminosae)

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journal of Systematics and Evolution 2009年第1期47卷 57-66页

作者： daniel j CRAWFORD Department of Ecology and Evolutionary Biology and the Natural History Museum and Biodiversity Research CenterThe University of Kansas

Ammopiptanthus nanus is an endangered evergreen shrub endemic to the deserts of central Asia and plays an important role in delaying further desertification. We examined allozyme variation and AFLP diversity in A. nanus populations and investigated the mating system of this species using progeny arrays assayed for poly-morphic allozyme loci. Mating system analysis in the Keyi’eryongke’er population showed low levels of out-crossing, and strong inbreeding depression. Low levels of genetic variation were detected at both population (allozyme, Pp=14.0%, A=1.14, He=0.031; AFLP, Pp=14.5%, Shannon’s information index I=0.063) and species (allozyme, Pp=21.1%, A=1.21, He=0.040; AFLP, Pp=20.9%, I=0.083) levels; while moderate genetic differentiation existed among populations, as indicated by allozymes (GST=0.081) and AFLP (GST=0.151-0.193). Founder effect, bottlenecks in evolutionary history, the mixed mating system and co-ancestry may have influenced the level of genetic diversity in A. nanus. Markers of both types provide new insights for conservation management, indicating that the Biao’ertuokuoyi and Keyi’eryongke’er populations should be given priority for in situ conservation and regarded as seed sources for ex situ conservation.

关键词： AFLP allozyme Ammopiptanthus conservation endangered plant genetic structure outcrossing rate

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Investigations on the aging behavior of transparent bioplastics for optical applications

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InfoMat 2020年第2期2卷 424-433页

作者： jana Baltscheit Nico Schmidt finn Schröder jörg Meyer Photonics and Materials Science Hamm-Lippstadt University of Applied ScienceLippstadtGermany Department of Natural Science Paderborn UniversityPaderbornGermany

In this study,the optical properties of transparent bioplastics have been *** long-term technological goal is to establish biopolymers in a new market segment for demanding optical applications and to contribute to a more sustainable economy.A collection of transparent bioplastics has been tested with respect to the long-term stability and the possibility of an application in optical components for LED *** focus of materials testing was on the influence of short wavelength visible radiation as well as thermal *** results show,that some materials may be candidates for subsequent feasibility *** the best of our knowledge,the application of such polymers in complex technical products and in particular in luminaires has not yet been *** use of bio-based plastics for optical components therefore represents a novelty and has a high development potential.

关键词： (blue)LED irradiance (photo)degradation biobased plastics renewable materials transparent optics

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Laser cut hole matrices in novel armour plate steel for appliqué battlefield vehicle protection

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Defence Technology（防务技术） 2016年第5期12卷 351-359页

作者： daniel j. THOMAS Engineering Manufacturing Centre College of Engineering Swansea University Swansea UK

During this research, experimental rolled homogeneous armour steel was cast, annealed and laser cut to form an appliqué plate. This Martensitic–Bainitic microstructure steel grade was used to test a novel means of engineering lightweight armour. It was determined that a laser cutting speed of 1200 mm/min produced optimum hole formations with limited distortion. The array of holes acts as a double-edged solution, in that they provide weight saving of 45%, providing a protective advantage and increasing the surface area. Data collected were used to generate laser cut-edge hole projections in order to identify the optimum cutting speed, edge condition, cost and deformation performance. These parameters resulted in the generation of a surface, with less stress raising features. This can result in a distribution of stress across the wider surface. Provided that appropriate process parameters are used to generate laser cut edges, then the hardness properties of the surface can be controlled. This is due to compressive residual stresses produced in the near edge region as a result of metallurgical transformations. This way the traverse cutting speed parameter can be adjusted to alter critical surface characteristics and microstructural properties in close proximity to the cut-edge. A relationship was identified between the width of the laser HAZ and the hardness of the cut edge. It is the thickness of the HAZ that is affected by the laser process parameters which can be manipulated with adjusting the traverse cutting speed.

关键词： Armour steels Defence systems Steel processing Armour engineering

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The PACTUM model:Product analysis of cost and time using mathematics

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International journal of Modeling, Simulation, and Scientific Computing 2014年第S1期5卷 51-70页

作者： daniel j.Easters Department of Fashion Marketing Management&Communication School of Art&Design Nottingham Trent University Nottingham NG14BUUK

Establishing a mathematical supply-chain model is a proposition that has received attention due to its inherent benefits of evolving global supply-chain *** paper discusses the prevailing relationships found within apparel supply-chain environments,and contemplates the complex issues indicated for constituting a mathematical *** results identified within the data suggest,that the multifarious nature of global supply-chain activities require a degree of simplification in order to fully dilate the necessary factors which affect,each subsection of the ***,the research findings allowed the division of supply-chain components into subsections,which amassed a coherent method of product development ***,the supply-chain model was found to allow systematic mathematical formulae analysis,of cost and time,within the multiple contexts of each subsection *** paper indicates the supplychain model structure,the mathematics,and considers how product analysis of cost and time can improve the comprehension of product lifecycle management.

关键词： Fashion supply-chain mathematics

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Recent advances in the targeted fluorescent probes for the detection of metastatic bone cancer

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Science China Chemistry 2021年第8期64卷 1283-1296页

作者： Peng Wu daniel j.Siegwart Hu Xiong Research Center for Analytical Sciences Tianjin Key Laboratory of Biosensing and Molecular RecognitionCollege of ChemistryNankai UniversityTianjin300071China Department of Biochemistry Simmons Comprehensive Cancer CenterThe University of Texas Southwestern Medical CenterDallasTexas75390USA

Tumors of the breast,prostate,and lung are most likely to metastasize to the bone and typically indicates a poor cure and survival rate in cancer *** of metastatic bone cancer in early stage would save many lives and greatly improve patients’quality of ***,bone scintigraphy is often utilized to visualize bone metastases due to its relatively low cost and high ***,a growth number of analytical researches aimed at developing targeted fluorescent probes to noninvasively image bone metastases with improved spatial resolution and specificity has been *** this review,we will summarize and discuss the recent published fluorescent probes on the accurate detection of metastatic bone ***,the design principles of various targeted probes for imaging bone metastases will be presented,highlighting the signal moieties,targeting ligands,and physicochemical properties of the bone-specific ***,the up-to-date bone-targeting fluorescent probes will be summarized and ***,future perspectives and challenges confronting the researchers in this field will be *** believe this review will encourage novel ideas to develop smart targeted molecular probes for bone metastasis imaging,image-guided surgery,and therapeutic imaging materials.

关键词： bone metastasis targeted probes fluorescence imaging smart design bone-targeting moieties

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