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precision of a parabolic Optimum Calculated from Noisy Biological Data, and Implications for Quantitative Optimization of Biventricular pacemakers (Cardiac Resynchronization Therapy)

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Applied Mathematics 2011年第12期2卷 1497-1506页

作者： darrel p. francis 不详

In patients with heart failure and disordered intracardiac conduction of activation, doctors implant a biven- tricular pacemaker (“cardiac resynchronization therapy”, CRT) to allow adjustment of the relative timings of activation of parts of the heart. The process of selecting the pacemaker timings that maximize cardiac function is called “optimization”. Although optimization—more than any other clinical assessment—needs to be precise, it is not yet conventional to report the standard error of the optimum alongside its value in clinical practice, nor even in research, because no method is available to calculate precision from one optimization dataset. Moreover, as long as the determinants of precision remain unknown, they will remain unconsidered, preventing candidate haemodynamic variables from being screened for suitability for use in optimization. This manuscript derives algebraically a clinically-applicable method to calculate the precision of the optimum value of x arising from fitting noisy biological measurements of y (such as blood flow or pressure) obtained at a series of known values of x (such as atrioventricular or interventricular delay) to a quadratic curve. A formula for uncertainty in the optimum value of x is obtained, in terms of the amount of scatter (irreproducibility) of y, the intensity of its curvature with respect to x, the width of the range and number of values of x tested, the number of replicate measurements made at each value of x, and the position of the optimum within the tested range. The ratio of scatter to curvature is found to be the overwhelming practical determinant of precision of the optimum. The new formulae have three uses. First, they are a basic science for anyone desiring time-efficient, reliable optimization protocols. Second, asking for the precision of every reported optimum may expose optimization methods whose precision is unacceptable. Third, evaluating precision quantitatively will help clinicians decide whether an

关键词： Cardiac pacemaker parabolic Haemodynamics

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这种肌肉疼痛是由他汀引起的吗？使用一个人多次试验的结果来获取可靠的个体患者数据

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英国医学杂志中文版 2018年第1期21卷 1-2页

作者：贾朝旭杜昕 Matthew J Shun-Shin darrel p francis 首都医科大学附属北京安贞医院心内科 International Centrefor CirculatoryHealth ImperialCollege London UK

常言道：治病不如防病。在实际生活中，迅速救治急性心肌梗死往往会得到患者的感谢和配合，而推荐他汀类药物预防心肌梗死，情况就不同了。为什么人们不愿意接受这种预防措施呢？

关键词：他汀肌肉疼痛保健知识个体患者

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Understanding the catalysis of chromium trioxide added magnesium hydride for hydrogen storage and Li ion battery applications

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Journal of Magnesium and Alloys 2024年第3期12卷 1117-1130页

作者： D.pukazhselvan IhsanÇaha Catarina de Lemos Sergey M.Mikhalev francis Leonard Deepak Duncan paul Fagg Department of Mechanical Engineering TEMA-Centre for Mechanical Technology and AutomationUniversity of AveiroAveiro 3810-193Portugal LASI-Intelligent Systems Associate Laboratory Guimarães 4800-058Portugal Nanostructured Materials Group International Iberian Nanotechnology Laboratory(INL)Avenida Mestre Jose VeigaBraga 4715-330Portugal

This study explores how the chemical interaction between magnesium hydride(MgH_(2))and the additive CrO_(3) influences the hydrogen/lithium storage characteristics of MgH_(2).We have observed that a 5 wt.%CrO_(3) additive reduces the dehydrogenation activation energy of MgH_(2) by 68 kJ/mol and lowers the required dehydrogenation temperature by 80℃.CrO_(3) added MgH_(2) was also tested as an anode in an Li ion battery,and it is possible to deliver over 90%of the total theoretical capacity(2038 mAh/g).Evidence for improved reversibility in the battery reaction is found only after the incorporation of additives with MgH_(2).In depth characterization study by X-ray diffraction(XRD)technique provides convincing evidence that the CrO_(3) additive interacts with MgH_(2) and produces Cr/MgO *** free energy analyses confirm the thermodynamic feasibility of conversion from MgH_(2)/CrO_(3) to MgO/Cr,which is well supported by the identification of Cr(0)in the powder by X ray photoelectron spectroscopy(XpS)*** high resolution transmission electron microscopy(HRTEM)and energy dispersive spectroscopy(EDS)we found evidence for the presence of 5 nm size Cr nanocrystals on the surface of MgO rock salt *** is also convincing ground to consider that MgO rock salt accommodates Cr in the *** observations support the argument that creation of active metal–metal dissolved rock salt oxide interface may be vital for improving the reactivity of MgH_(2),both for the improved storage of hydrogen and lithium.

关键词： Hydrogen storage Rechargeable batteries Binary hydrides Metal oxides Catalytic mechanism.

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Fuzzy Difference Equations in Diagnoses of Glaucoma from Retinal Images Using Deep Learning

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Computer Modeling in Engineering & Sciences 2024年第4期139卷 801-816页

作者： D.Dorathy prema Kavitha L.francis Raj Sandeep Kautish Abdulaziz S.Almazyad Karam M.Sallam Ali Wagdy Mohamed Department of Mathematics Voorhees CollegeVelloreTamil NaduIndia Chandigarh Group of Colleges JhanjeriMohaliPunjabIndia Department of Computer Engineering College of Computer and Information SciencesKing Saud UniversityP.O.Box 51178Riyadh11543Saudi Arabia Faculty of Science and Technology School of IT and SystemsUniversity of CanberraCanberraAustralia Operations Research Department Faculty of Graduate Studies for Statistical ResearchCairo UniversityGiza12613Egypt Applied Science Research Center Applied Science Private UniversityAmman11937Jordan

The intuitive fuzzy set has found important application in decision-making and machine *** enrich and utilize the intuitive fuzzy set,this study designed and developed a deep neural network-based glaucoma eye detection using fuzzy difference equations in the domain where the retinal images *** image detections are categorized as normal eye recognition,suspected glaucomatous eye recognition,and glaucomatous eye *** degrees associated with weighted values are calculated to determine the level of concentration between the fuzzy partition and the retinal *** proposed model was used to diagnose glaucoma using retinal images and involved utilizing the Convolutional Neural Network(CNN)and deep learning to identify the fuzzy weighted regularization between *** methodology was used to clarify the input images and make them adequate for the process of glaucoma *** objective of this study was to propose a novel approach to the early diagnosis of glaucoma using the Fuzzy Expert System(FES)and Fuzzy differential equation(FDE).The intensities of the different regions in the images and their respective peak levels were *** the peak regions were identified,the recurrence relationships among those peaks were then *** partitioning was done due to varying degrees of similar and dissimilar concentrations in the *** and dissimilar concentration levels and spatial frequency generated a threshold image from the combined fuzzy matrix and *** distinguished between a normal and abnormal eye condition,thus detecting patients with glaucomatous eyes.

关键词： Convolutional Neural Network(CNN) glaucomatous eyes fuzzy difference equation intuitive fuzzy sets image segmentation retinal images

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Dynamics of self-hybridized exciton–polaritons in 2D halide perovskites

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Light(Science & Applications) 2024年第1期13卷 13-22页

作者： Surendra B.Anantharaman Jason Lynch Christopher E.Stevens Christopher Munley Chentao Li Jin Hou Hao Zhang Andrew Torma Thomas Darlington francis Coen Kevin Li Arka Majumdar pJames Schuck Aditya Mohite Hayk Harutyunyan Joshua R.Hendrickson Deep Jariwala Department of Electrical and Systems Engineering University of PennsylvaniaPhiladelphiaPA19104USA KBR Inc. BeavercreekOH45431USA Air Force Research Laboratory Sensors DirectorateWright-Patterson Air Force BaseOH45433USA Department of physics University of WashingtonSeattleWA98195USA Department of physics Emory UniversityAtlantaGA30322USA Department of Chemical and Biomolecular Engineering Rice UniversityHoustonTX77005USA Department of Materials Science and Nanoengineering Rice UniversityHoustonTX77005USA Applied physics program Smalley‐Curl InstituteRice UniversityHoustonTX77005USA Department of Mechanical Engineering Columbia UniversityNew YorkNY10027USA Department of Electrical and Computer Engineering University of WashingtonSeattleWA98195USA

Excitons,bound electron–hole pairs,in two-dimensional hybrid organic inorganic perovskites(2D HOIps)are capable of forming hybrid light-matter states known as exciton-polaritons(E–ps)when the excitonic medium is confined in an optical *** the case of 2D HOIps,they can self-hybridize into E–ps at specific thicknesses of the HOIp crystals that form a resonant optical cavity with the ***,the fundamental properties of these self-hybridized E–ps in 2D HOIps,including their role in ultrafast energy and/or charge transfer at interfaces,remain ***,we demonstrate that>0.5µm thick 2D HOIp crystals on Au substrates are capable of supporting multiple-orders of self-hybridized E–p *** E–ps have high Q factors(>100)and modulate the optical dispersion for the crystal to enhance sub-gap absorption and *** varying excitation energy and ultrafast measurements,we also confirm energy transfer from higher energy E–ps to lower energy E–***,we also demonstrate that E–ps are capable of charge transport and transfer at *** findings provide new insights into charge and energy transfer in E–ps opening new opportunities towards their manipulation for polaritonic devices.

关键词： charge polar excitation

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Split Addition of Nitrogen-Rich Substrate at Thermophilic and Mesophilic Stages of Composting: Effect on Green House Gases Emission and Quality of Compost

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Open Journal of Soil Science 2024年第2期14卷 133-158页

作者： Boakye Acheampong Kodwo Miezah Enoch Bessah Benedicta Essel Ayamba francis Kemausour Department of Agricultural and Biosystems Engineering College of Engineering Kwame Nkrumah University of Science and Technology Kumasi Ghana Department of Environmental Science College of Science Kwame Nkrumah University of Science and Technology Kumasi Ghana Soil Fertility and plant Nutrition Division CSIR-Soil Research Institute Kumasi Ghana The Brew-Hammond Energy Center College of Engineering Kwame Nkrumah University of Science and Technology Kumasi Ghana

Composting as a solution to the increasing generation of municipal solid waste (MSW), also contribute to GHGs emission when not controlled and could lack some basic nutrients, especially nitrogen. This study assessed the split-additions of nitrogen-rich substrate to composting materials and their effect on GHGs emissions as well as the quality of the composts. Nitrogen-rich substrates formulated from pig and goat manure were co-composted with MSW for a 12-weeks period by split adding at mesophilic (˚C) and thermophilic (>50˚C) stages in five different treatments. Representative samples from the compost were taken from each treatment for physicochemical, heavy metals and bacteriological analysis. In-situ CH4, CO2, N2O gas emissions were also analyzed weekly during composting. It was observed that all the treatments showed significant organic matter decomposition, reaching thermophilic temperatures in the first week of composting. The absence affects the suitable agronomic properties. All nitrogen-rich substrate applied at thermophilic stage (Treatment two) recorded the highest N, p and K concentrations of 1.34%, 0.97% and 2.45%, respectively with highest nitrogen retention. In terms of GHG emissions, CO2 was highest at the thermophilic stage when N-rich substrate was added in all treatment, while CH4 was highest in the mesophilic stage with N-rich substrate addition. N2O showed no specific trend in the treatments. Split addition of the N-rich substrate for co-composting of MSW produced compost which is stable, has less nutrient loss and low GHG emissions. Split addition of a nitrogen-rich substrate could be an option for increasing the fertilizer value of MSW compost.

关键词： Compost Nitrogen-Rich Substrate Thermophilic Mesophilic Greenhouse Gas Emissions

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Rescue from complications after pancreaticoduodenectomies at a low-volume Caribbean center:Value of tailored peri-pancreatectomy protocols

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 681-688页

作者： Shamir O Cawich Elijah Dixon parul J Shukla Shailesh V Shrikhande Rahul R Deshpande Fawwaz Mohammed Neil W pearce Wesley francis Shaneeta Johnson Johann Bujhawan Department of Surgery University of the West IndiesSt Augustine 000000Trinidad and Tobago Department of Surgery Faculty of MedicineUniversity of CalgaryCalgaryAlberta T2N2T9Canada Department of Surgery Weill Cornell Medical CollegeNew YorkNY 10065United States Department of Surgical Oncology Tata Memorial CenterHomi Bhabha National UniversityMumbai 400012India Department of Surgery Manchester Royal InfirmaryManchester M139WLUnited Kingdom University Surgical Unit Southampton General HospitalSouthampton SO166YDUnited Kingdom Department of Surgery University of the West IndiesNassau N-1184Bahamas Department of Surgery Morehouse School of MedicineAtlantaGA 30310United States Department of Surgery General Hospital in Port of SpainPort of Spain 000000Trinidad and Tobago

BACKGROUND pancreaticoduodenectomy(pD)is a technically complex operation,with a re-latively high risk for *** ability to rescue patients from post-pD complications is as a recognized quality *** protocols were instituted at our low volume facility in the year *** To document the rate of rescue from post-pD complications with tailored protocols in place as a measure of *** A retrospective audit was performed to collect data from patients who experienced major post-pD complications at a low volume pancreatic surgery unit in Trinidad and Tobago between January 1,2013 and June 30,***-dardized definitions from the International Study Group of pancreatic Surgery were used to define post-pD complications,and the modified Clavien-Dindo classification was used to classify post-pD *** Over the study period,113 patients at a mean age of 57.5 years(standard deviation[SD]±9.23;range:30-90;median:56)underwent pDs at this *** complications were recorded in 33(29.2%)patients at a mean age of 53.8 years(SD:±7.9).Twenty-nine(87.9%)patients who experienced major morbidity were salvaged after aggre-ssive treatment of their ***(3.5%)died from bleeding pseudoaneurysm(1),septic shock secondary to a bile leak(1),anastomotic leak(1),and myocardial infarction(1).There was a significantly greater salvage rate in patients with American Society of Anesthesiologists scores≤2(93.3%vs 25%;p=0.0024).CONCLUSION This paper adds to the growing body of evidence that volume alone should not be used as a marker of quality for patients requiring *** low volumes at our facility,we demonstrated that 87.9%of patients were rescued from major *** attributed this to several factors including development of rescue protocols,the competence of the pancreatic surgery teams and continuous,and adaptive learning by the entire institution,cul-minating in the development of tailored peri-pancreatectomy protoc

关键词： pancreas Complication Rescue Failure Morbidity Mortality pancreaticoduodenectomy

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Socio-Demographic and Clinical Characteristics of patients presenting with Lower Urinary Tract Symptoms Secondary to BpH, in a Tertiary Hospital

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Open Journal of Urology 2024年第8期14卷 447-457页

作者： Abdul-Jalilu Mohammed Muntaka Edwin Mwintiereh Ta-Ang Yenli francis Atindaana Abantanga Department of Surgery School of Medicine University for Development Studies Tamale Ghana Department of Surgery Tamale Teaching Hospital Tamale Ghana

Background: Benign prostatic hyperplasia (BpH) is the proliferation of the stromal and epithelial cells of the prostate gland, resulting in an increase in its size. This may result in obstruction of the lower urinary tract causing storage and voiding symptoms. Methods: This was a prospective cross-sectional study from August 2020 to July 2021, to evaluate the characteristic of patients presenting to the Tamale Teaching Hospital with lower urinary tract symptoms secondary to BpH. Results: The median age at presentation with LUTS secondary to BpH is 68.88 ± 11.10 years with an average prostate volume of 70 g. The average time of presentation to the hospital is 5 months, mostly with moderate to severe symptoms. Correlation between prostate volume (pV) and age yielded a positive relationship;however, this was not statistically significant, (r = 0.028, p-value = 0.747). There was a significant positive relationship between pV and the IpSS score, (r = 0.334, p-value Conclusion: Our patients with symptomatic BpH present at age 60 years and above, with nearly all of them presenting with moderate to severe LUTS.

关键词： Benign prostate Hyperplasia Lower Urinary Tract Symptoms Sociodemographic Characteristics

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Beta-HCG Levels and Ovarian Ultrasonography Results among Non-pregnant Women of Reproductive Age in port Harcourt, Nigeria: A Cross-Sectional Study

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Journal of Biosciences and Medicines 2024年第5期12卷 233-241页

作者： Celine C. Agonsi francis Anacletus Joel Aluko Chinemerem Eleke Joy C. Samuel African Centre of public Health and Toxicological Research (ACE-pUTOR) University of Port Harcourt Choba Nigeria Department of Nursing Science University of Port Harcourt Choba Nigeria

Background: Certain ovarian cancers that were previously common in postmenopausal women are now increasingly observed in women of reproductive age. The research on using β-HCG as a diagnostic biomarker for ovarian cancer in women of reproductive age is ongoing. Aim: This study assessed the level of serum β-HCG in non-pregnant women of reproductive age and determined its potential association with suspicious ovarian ultrasonography results. Methods: The study was conducted in port Harcourt, Nigeria. This study adopted a cross-sectional design on a quota sample of 224 case notes of women aged 18 - 40 years obtained from eight diagnostic centres. A data extraction form was used for data collection. Data analysis employed descriptive statistics, Chi-square, Fisher’s exact test, and Odds Ratio at 95% confidence and 5% significance levels. Results: About 5.8% of the participants exhibited detectable levels of serum β-HCG above 5 IU/L (World Health Organization reference) at a mean concentration of 5.87 (±1.75) IU/L. About 4.0% of the participants had suspicious ovarian lesions identified through ultrasonography. participants with elevated serum β-HCG levels above the WHO reference were 59 times more likely to have suspicious ovarian lesions (Odds ratio: 59.4, 95%CI: 12.3 - 287.8, p β-HCG level and age (p = 0.041) as well as parity (p Conclusion: Serum β-HCG levels above the WHO reference in non-pregnant women were associated with suspicious ovarian lesions. More rigorous primary research, systematic reviews, and meta-analyses are needed to confirm the findings of this study.

关键词： Biomarkers Ovarian Cancer pregnancy Ultrasonography

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风热感冒临床表型组及药物表型组的构建与表型组学研究

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中药药理与临床 2024年第1期40卷 103-106页

作者：刘子渝高晨皓叶玲玉段大跃西南医科大学附属中医医院泸州646099 西南医科大学中医药表型组学研究中心泸州646000

随着中医药现代化的深入发展,新兴科学表型组学(phenomics)已成为传统中医药融合现代医学的新研究范式。本文提出以中医证候为框架,结合现代医学对证候相关临床表型特征的共识,构建风热感冒临床表型组,并根据方证相应原则,建立大型“病... 详细信息

随着中医药现代化的深入发展,新兴科学表型组学(phenomics)已成为传统中医药融合现代医学的新研究范式。本文提出以中医证候为框架,结合现代医学对证候相关临床表型特征的共识,构建风热感冒临床表型组,并根据方证相应原则,建立大型“病证方”相结合的风热感冒临床表型组及银翘散药物表型组队列,进行多组学集合的表型组学研究的理论和方法。为中医证候的量化诊断和治疗以及临床疗效评价提供客观科学依据,最终实现风热感冒的精准防治。

关键词：银翘散风热感冒表型组学中医药代谢组学精准医学

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