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Isolated sacral injuries: Postoperative length of stay, complications, and readmission

World Journal of Orthopedics 2015年第8期6卷 629-635页

作者： Vasanth Sathiyakumar Hanyuan Shi Rachel V Thakore Young M Lee david joyce Jesse Ehrenfeld William T Obremskey Manish K Sethi the Vanderbilt Orthopaedic Institute Center for Health Policy Medical Center East

AIM: To investigate inpatient length of stay(LOS), complication rates, and readmission rates for sacral fracture patients based on operative ***: All patients who presented to a large tertiary care center with isolated sacral fractures in an 11-year period were included in a retrospective chart review. Operative approach(open reduction internal fixation vs percutaneous) was noted, as well as age, gender, race, and American Society of Anesthesiologists' score. Complications included infection, nonunion and malunion, deep venous thrombosis, and hardware problems; 90-d readmissions were broken down into infection, surgical revision of the sacral fracture, and medical complications. LOS was collected for the initial admission and readmission visits if applicable. Fisher's exact and non-parametric t-tests(Mann-Whitney U tests) were employed to compare LOS, complications, and readmissions between open and percutaneous ***: Ninety-four patients with isolated sacral fractures were identified: 31(30.4%) who underwentopen reduction and internal fixation(ORIF) vs 63(67.0%) who underwent percutaneous fixation. There was a significant difference in LOS based on operative approach: 9.1 d for ORIF patients vs 6.1 d for percutaneous patients(P = 0.043), amounting to a difference in cost of $13590. Ten patients in the study developed complications, with no significant difference in complication rates or reasons for complications between the two groups(19.4% for ORIF patients vs 6.3% for percutaneous patients). Eight patients were readmitted, with no significant difference in readmission rates or reasons for readmission between the two groups(9.5% percutaneous vs 6.5% ORIF).CONCLUSION: There is a significant difference in LOS based on operative approach for sacral fracture patients. Given similar complications and readmission rates, we recommend a percutaneous approach.

关键词： Sacral fractures Open reduction and internal fixation Percutaneous complications Readmissions Length of stay

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T cells from induced and spontaneous models of SLE recognize a common T cell epitope on β2-glycoprotein Ⅰ

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Cellular & Molecular Immunology 2019年第8期16卷 685-693页

作者： david Salem Rebecca Subang Masataka Kuwana Jerrold S.Levine joyce Rauch Division of Rheumatology Department of MedicineResearch Institute of the McGill University Health CentreMontrealQCCanada Department of Allergy and Rheumatology Nippon Medical SchoolGraduate School of MedicineTokyoJapan Section of Nephrology Department of MedicineUniversity of Illinois at ChicagoChicagoILUSA Section of Nephrology Department of MedicineJesse Brown Veterans Affairs Medical CenterChicago IL USA

Systemic lupus erythematosus is a prototypic model for B-cell epitope spread in *** to numerous molecularly distinct self-antigens emerge in a sequential manner over several years,leading to disease *** the earliest autoantibodies to appear are those targeting phospholipid-binding proteins,particularlyβ2-glycoprotein Ⅰ.Notably,mice immunized with β2-glycoprotein Ⅰ and lipopolysaccharide develop a strong T cell response to β2-glycoprotein Ⅰ that is associated with autoantibody production and renal disease,similar to that seen in human *** we hypothesized that mice with murine systemic lupus erythematosus,whether induced or spontaneous,should have T cells that recognizeβ2-glycoprotein *** evaluated the response of splenic T cells from mice with induced(C57BL/6 and C3H/HeN)and spontaneous(MRL/lpr)systemic lupus erythematosus to peptides spanning the entire sequence of humanβ*** found that mice with induced and spontaneous systemic lupus erythematosus recognize a common T cell epitope(peptide 31;LYRDTAVFECLPQHAMFG)in domain Ⅲ ofβ2-glycoprotein I.β2GPI-reactive CD4^(+)T cells from the two models differed primarily in cytokine production:T cells from mice with induced SLE expressed IFN-γ,while T cells from MRL/lpr mice expressed both IL-17 and IFN-γ,indicating that IL-17-expressing T cells are not necessary for generating aβ2GPI-reactive T cell *** data suggest that the generation of aβ2-glycoprotein Ireactive T cell response is shared by both induced and spontaneous models of systemic lupus erythematosus and that this T cell response may mediate epitope spread to autoantibodies in both models.

关键词： β2-glycoprotein I T cells systemic lupus erythematosus autoantibodies MHC class II haplotypes

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Climatic zoning for energy efficiency applications in buildings based on multivariate statistics:The case of the Brazilian semiarid region

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Frontiers of Architectural Research 2022年第1期11卷 161-177页

作者： Mariana Navarro Benevides david Bruno de Sousa Teixeira joyce Correna Carlo Department of Architecture and Urban Planning Federal University of ViçosaViçosaMG36570-900Brazil Department of Agricultural Engineering Federal University of ViçosaViçosaMG36570-900Brazil

This study aimed to propose climatic zones in the Brazilian semiarid region using multivariate statistical techniques and to characterize these zones for energy efficiency applications in *** component analysis(PCA)was used to select the variables with the greatest practical *** this selection,hierarchical cluster analysis(HCA)was used to spatially define climatically homogeneous *** each defined zone,the most feasible constructive thermal conditioning strategies were defined,and the thermal indexes of heat and degree-hours of cooling and heating were *** result,PCA reduced the dimensionality of the initial database from 104 to 48 variables,among which the climatic and bioclimatic variables related to temperature stood *** the HCA,three climatic zones were defined for the Brazilian semiarid *** all zones,there was a high demand for constructive conditioning strategies,which have to be adopted in more than half of the total annual *** proposed zoning is adapted to the climatic aspects of the Brazilian semiarid and has significant potential for applications in construction planning in this ***,the methodology presented can be applied for establishing climatic zones in other regions,which can contribute to increasing the energy efficiency of buildings.

关键词： Principal component analysis Hierarchical cluster analysis Psychrometric chart Heat index Degree-hours

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Positive autoantibodies in living liver donors

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World Journal of Hepatology 2022年第9期14卷 1757-1766页

作者： joyce Loh Koji Hashimoto Choon Hyuck david Kwon Masato Fujiki Jamak Modaresi Esfeh Department of Internal Medicine Cleveland Clinic FoundationClevelandOH 44195United States Digestive Diseases Institute Cleveland Clinic FoundationClevelandOH 44195United States Digestive Disease and Surgery Institute Cleveland Clinic FoundationClevelandOH 44195United States

BACKGROUND There is a nationwide shortage of organs available for liver *** donors help meet this growing *** uncommonly,donors will have positive ***,it is unclear whether donor positive autoantibodies are correlated with worse outcomes following living liver donor *** To analyze the significance of positive autoantibodies in donors on post-transplant outcomes in *** We performed a retrospective review of living liver donors who had undergone liver transplantation between January 1,2012 and August 31,*** characteristics and pre-transplant data including antinuclear antibodies(ANA)and anti-smooth muscle antibody titers were collected in *** of interest were post-transplantation complications including mortality,biliary strictures,biliary leaks,infection,and *** recipients and donors without measured pre-transplant autoantibody serologies were excluded from this *** 172 living donor liver transplantations were performed during the study period,of which 115 patients met inclusion criteria.37(32%)living donors were autoantibody-positive with a median ANA titer of 1:160(range 1:80 to 1:1280)and median anti-SMA titer of 1:40(range 1:20 to 1:160).There were no significant differences in baseline demographics between the autoantibody positive and negative ***-transplantation rates of death(P value=1),infections(P value=0.66),and overall rates of complications(P value=0.52)were similar between the autoantibody positive and negative *** incidences of anastomotic strictures and rejection were observed in the autoantibody positive group;however,these differences were not statistically significant(P value=0.07 and P value=0.30 respectively).CONCLUSION Isolated pre-transplant autoantibody positivity is not correlated to worse post-transplant outcomes in living liver donor transplants.

关键词： Antinuclear antibodies Anti-smooth muscle antibody Liver transplantation Treatment outcome Transplant donors

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家用食物铁强化剂Spr inkles的应用(英文)

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营养学报 2004年第3期26卷 161-166页

作者： joyce Yap Caraline Cheng david L.Yenng 中国亨氏公司广州美国亨氏公司美国宾夕法尼亚州匹兹堡

铁缺乏与缺铁贫血(IDA)仍是世界上盛行的营养问题。在婴幼儿中,IDA对生长发育能产生不良反应。Sprinkles含有延胡索酸铁及其他微量营养素,涂以大豆脂类。Sprinkles包装成小袋,可加入即食的家庭制备的辅食中,每日一次。在中国5个城市中对... 详细信息

铁缺乏与缺铁贫血(IDA)仍是世界上盛行的营养问题。在婴幼儿中,IDA对生长发育能产生不良反应。Sprinkles含有延胡索酸铁及其他微量营养素,涂以大豆脂类。Sprinkles包装成小袋,可加入即食的家庭制备的辅食中,每日一次。在中国5个城市中对6～12个月龄婴儿和2～5岁幼儿进行连续4w供给Sprinkles以了解他们的接受程度,实验期间进行4次随访。结果表明,婴幼儿对添加Sprinkles的食物能很好的接受,母亲们很愿意购买上市产品。

关键词： Sprinkles 强化铁缺铁性贫血

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Conservative management of small bowel perforation in Ehlers-Danlos syndrome type Ⅳ

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World Journal of Gastrointestinal Endoscopy 2013年第8期5卷 398-401页

作者： Satya Allaparthi Himanshu Verma david L Burns Ann M joyce Department of Medicine Saint Vincent Hospital Department of Gastroenterology Lahey Clinic

Ehlers-Danlos syndrome (EDS) is a group of inherited connective tissue disorders caused by collagen synthesis defects. EDS type Ⅳ, or vascular EDS, is caused by loss-of-function mutations in the type Ⅲ pro-collagen gene (COL3A1 ). Common complications of EDS type IV include gastrointestinal bleeding and bowel perforations, posing diagnostic and therapeutic dilemmas for both surgeons and gastroenterologists. Here, we describe a complicated case of EDS type Ⅳ in a 35-year-old caucasian female who presented with overt gastro-intestinal bleeding. The patient had a prior history of spontaneous colonic perforation, and an uncomplicated upper endoscopy was performed. A careful ileoscopy was terminated early due to tachycardia and severe ab-dominal pain, and a subsequent computed tomography scan confirmed the diagnosis of ileal perforation. The patient was managed conservatively, and demonstrated daily improvement. At the time of hospital discharge, no further episodes of gastrointestinal blood loss had occurred. This case highlights the benefit of conservative management for EDS patients with gastrointestinal hemorrhage. It is recommended that surgical treatmentshould be reserved for patients who fail conservative treatment or in cases of hemodynamic instability. Finally, this case demonstrates the necessity for a higher threshold of operative or endoscopic interventions in EDS type Ⅳ patients.

关键词： Type-Ⅳ Ehlers-Danlos syndrome Gastro-intestinal hemorrhage Bowel perforation Conservative management Non-operative COL3A1 Connective tissue disorder

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A Microwave-Irradiated StreptococcusagalactiaeVaccine Provides Partial Protection against Experimental Challenge in Nile Tilapia, Oreochromisniloticus

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World Journal of Vaccines 2014年第4期4卷 184-189页

作者： david J. Pasnik joyce J. Evans Phillip H. Klesius Aquatic Animal Health Research Laboratory United States Department of Agriculture Agricultural Research Service USA Warm Water Aquaculture Research Unit United States Department of Agriculture Agricultural Research Service Stoneville USA

Microwave irradiation, as opposed to formalin exposure, has not routinely been used in the preparation of killed vaccines despite the advantages of decreased chemical toxicity, ability to kill cells quickly, ease of completion requiring only a standard microwave, and potential increased protein conservation during irradiation. We evaluated the potential of microwave irradiation versus formalin fixation of bacteria to improve Streptococcus agalactiae vaccine efficacy in 5 gr fish by intraperitoneal (IP) injection and bath immersion (BI). There was no significant difference in the cumulative percent mortality (CPM) post-challenge between fish administered microwave-killed cells (MKC) or formalin killed cells (FKC) within the BI (p S. agalactiae antibody activity. Thirty days after vaccination and just prior to challenge, the optical density (OD) levels of the FKC and MKC groups in the IP trials were significantly higher (p < 0.0001) than that of the TSB group. None of the groups in the BI trial exhibited significantly different OD levels post vaccination. Fourteen days after the challenge, the OD levels of all groups in both trials increased significantly above their pre-challenge levels. Both the FKC and MKC IP groups (p < 0.0001) and only the FKC BI group (p < 0.0351) had significantly increased OD level above that of the corresponding post-challenge TSB group. These results indicate that the FKC vaccine provides marginally greater protection and increased antibody concentrations than the MKC vaccine by BI and the MKC vaccine may become a non-chemical alternative to FKC in vaccination.

关键词： Vaccine Streptococcus agalactiae Microwave

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The potential development of drug resistance in rheumatoid arthritis patients identified with p53 mutations

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Genes & Diseases 2023年第6期10卷 2252-2255页

作者： Congling Qiu joyce Tsz Wai Chan david Wei Zhang Io Nam Wong Yaling Zeng Betty Yuen Kwan Law Simon Wing Fai Mok Ivo Ricardo De Seabra Rodrigues Dias Wenfeng Liu Liang Liu Vincent Kam Wai Wong Dr.Neher's Biophysics Laboratory for Innovative Drug Discovery State Key Laboratory of Quality Research in Chinese MedicineMacao University of Science and TechnologyMacao SAR 999078China Department of Public Health and Preventive Medicine School of MedicineJinan UniversityGuangzhouGuangdong 510000China Faculty of Medicine Macao University of Science and TechnologyMacao SAR 999078China School of Biotechnology and Health Sciences Wuyi UniversityJiangmenGuangdong 529000China

Rheumatoid arthritis(RA)is a chronic inflammatory disease characterized by cartilage and bone damage with the presence of pannus formation which causes uncontrollable proliferation and invasion of fibroblast-like synoviocytes(FLS).Since rheumatoid arthritis is a chronic disorder,the patients normally need to undergo prolonged antirheumatic treatment with the use of disease-modifying antirheumatic drugs(DMARDs),steroids,and nonsteroidal anti-inflammatory drugs(NSAIDs).The efficacy of such long-term pharmaceutical intervention can be significantly affected by the development of drug *** pathological relationship between rheumatoid arthritis and cancer hinted that some chemotherapeutic drugs,such as methotrexate(MTX),could be used for RA *** idea was reinforced by the analysis of mutations in p53 tumor suppressor *** 50%of p53 somatic mutations observed from various cancers are also identified in the synovium of RA patients1(Fig.1A).Of note,the hyperplastic synovium in RA with overexpressed p53 mutants contributed to the destruction of joints in patients with erosive RA.

关键词： patients drugs rheumatoid

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Social and Behavioral Determinants of Health in the Era of Artificial Intelligence with Electronic Health Records:A Scoping Review

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Health Data Science 2021年第1期2021卷 41-59页

作者： Anusha Bompelli Yanshan Wang Ruyuan Wan Esha Singh Yuqi Zhou Lin Xu david Oniani Bhavani Singh Agnikula Kshatriya joyce(Joy)E.Balls-Berry Rui Zhang Department of Pharmaceutical Care&Health Systems University of MinnesotaUSA Department of Health Information Management University of PittsburghUSA Department of Computer Science University of MinnesotaUSA Institute for Health Informatics and College of Pharmacy University of MinnesotaUSA Carlson School of Business University of MinnesotaUSA Department of Computer Science and Mathematics Luther CollegeUSA Center for Digital Health Mayo ClinicUSA Department of Neurology Washington University in St.LouisUSA Institute for Health Informatics Department of Pharmaceutical Care&Health SystemsUniversity of MinnesotaUSA

*** is growing evidence that social and behavioral determinants of health(SBDH)play a substantial effect in a wide range of health *** health records(EHRs)have been widely employed to conduct observational studies in the age of artificial intelligence(AI).However,there has been limited review into how to make the most of SBDH information from EHRs using AI ***.A systematic search was conducted in six databases to find relevant peer-reviewed publications that had recently been *** was determined by screening and evaluating the *** on selected relevant studies,a methodological analysis of AI algorithms leveraging SBDH information in EHR data was *** synthesis was driven by an analysis of SBDH categories,the relationship between SBDH and healthcare-related statuses,natural language processing(NLP)approaches for extracting SBDH from clinical notes,and predictive models using SBDH for health *** associations between SBDH and health outcomes are complicated and diverse;several pathways may be *** NLP technology to support the extraction of SBDH and other clinical ideas simplifies the identification and extraction of essential concepts from clinical data,efficiently unlocks unstructured data,and aids in the resolution of unstructured data-related *** known associations between SBDH and diseases,SBDH factors are rarely investigated as interventions to improve patient *** knowledge about SBDH and how SBDH data can be collected from EHRs using NLP approaches and predictive models improves the chances of influencing health policy change for patient wellness,ultimately promoting health and health equity.

关键词： spite policy publications

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Optimisation of accelerated solvent extraction for screening of the health benefits of plant food materials

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Health 2009年第3期1卷 220-230页

作者： Reginald Wibisono Jingli Zhang Zaid Saleh david E. Stevenson Nigel I. joyce The New Zealand Institute for Plant and Food Research Ltd

The development of a rapid, robust and reliable method for extracting plant food materials is important for screening a wide range of plant bioactives for their health benefits. In this study, extractions of bioactive polyphenolic com-pounds from fruits and vegetables were per-formed using a pressurised solvent extraction technique. Variables including solvent, extrac-tion temperature and time, and number of ex-traction cycles, were optimised to develop a rapid and efficient extraction protocol. The re-sulting extracts were then analysed for antioxi-dant capacity, total phenolic content and com-position. The optimal parameters found were 19:1 methanol/water (95% methanol) as solvent and three extraction cycles, of 10 minutes at 40oC or 2 minutes at 100oC. High performance liquid chromatography mass spectrometry did not detect any difference in extract composition between low and high temperatures. Extraction at 100°C generally gave a moderately higher yield of polyphenolics for some fruit and vege-table extracts but appeared to reduce the anti-oxidant activity particularly for turnip leaf, el-derberry and sour cherry extracts as measured by oxygen radical absorbance capacity assay. We found that all 40°C extracts were better at protecting cells from H2O2-induced cellular damage than their 100°C counterparts. The 40°C apple puree and elderberry extracts were about 2 fold and 1.7 fold more effective, respectively, than extracts prepared at 100°C. Our results demonstrated that pressurised solvent extrac-tion technique with careful parameter selection can be used as a quick method for screening the health benefits of plant food materials.

关键词： Antioxidant Accelerated Solvent Extraction Cytoprotection Polyphenolics

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