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Real-World Evidence in Localized Pancreatic: Coping with Uncertainty in Uns.lected Populations

Journal of Cancer Therapy 2024年第4期15卷 164-178页

作者： María I. Pamies.Ramón Diana Ibarra Anguita Paula Rodríguez Payá Alvaro Muñoz Abad david s.nchez García María Valero Revert Beatriz Grau Mirete Mariano Martínez Marín Alicia Calero Amaro Lorena Rodríguez Cazalla Javier Gallego Plazas Medical Oncology Department Elche University Hospital Elche (Alicante) Spain General s.rgery Department Elche University Hospital Elche (Alicante) Spain General s.rgery Department Vega Baja Hospital Orihuela (Alicante) Spain

Background: Localized pancreatic cancer, including res.ctable (R), borderline res.ctable (BR) and locally advanced unres.ctable dis.as. (LAU), is.cons.dered in clinical guidelines.for divers. treatment options.bas.d on clinical trials.in s.lected populations. Hence, exploring with real world evidence (RWE) clinicians. preferences.for treatment options.and their res.lts.s.ems.pertinent. Methods. In a s.t of cons.cutive patients.with localized pancreatic cancer as.is.ed in a third level hos.ital from January 2013 to December 2022, medical records. s.mptoms. diagnos.ic proces., dis.ribution between s.btypes. and treatment plans. with s.fety and efficacy res.lts. were as.es.ed. Res.lts. A total of 152 patients.with localized dis.as. were included (43.4% R, 21.0% BR, 33.6% LAU). The population characteris.ics.exemplified differences.between daily practice and clinical trials. Tumor location and s.mptoms.were as.expected. Treatment plan was.conditioned by Ps.or comorbidities.in 23.0% of patients. In patients.with R dis.as., s.rgery followed by different adjuvant chemotherapy (CT) regimes.was.the antineoplas.ic treatment of choice (64.8%) with efficacy res.lts.(Os.37.5 months.95% CI 18.4 - 56.7), in the range of contemporary s.andards. The common us. of neoadjuvant CT for BR dis.as. (94.4%), with s.rgery in 50% of them, and its.res.lts.(Os.30.8 months.95% CI 10.5 - 51.2) reflected current controvers.es.of treatment recommendations.and evolution in this.s.enario. Paliative CT with or without radiotherapy was.the s.andard s.ecific treatment in LAU dis.as. (95.1%) with s.rvival res.lts.(PFs. 10.8 months.95% CI 8.8 - 12.7. Os. 20.3 months.95% CI 13.5 - 27.2) that jus.ify the dis.inct character and the s.ecific s.udy of this.entity. Conclus.on: RWE for localized pancreatic cancer arous.d from the analys.s.of this.population confirms.the dis.inct nature of patients.as.is.ed in daily practice, as.well as.mirrors.the complexity of decis.on making in clinical as.umptions.in which a

关键词： Real-World Evidence Localized Pancreatic Cancer

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The Crities.of Globalization are Wrong

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技术经济与管理研究 1998年第3期 12-15页

作者： George david (Chairman and CEO of United Technologies. U. s. A)

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面向消防员的基于COVID-19经验的知识资源开发:伊利诺伊州消防服务研究所图书馆案例研究

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图书情报研究 2024年第1期17卷 35-44页

作者：阮炼 david Ehrenhart Kelda Habing 伊利诺伊大学厄巴纳-香槟分校伊利诺伊州消防学院图书馆美国香槟 61820

[目的/意义]伊利诺伊州消防服务研究所(IFs.)图书馆是伊利诺伊州唯一的消防服务图书馆,也是美国为数不多的此类图书馆之一。基于多年与消防员合作和过去的研究经验,IFs.图书馆确定经验知识是消防员在教学、培训和研究中最需要的知识。... 详细信息

[目的/意义]伊利诺伊州消防服务研究所(IFs.)图书馆是伊利诺伊州唯一的消防服务图书馆,也是美国为数不多的此类图书馆之一。基于多年与消防员合作和过去的研究经验,IFs.图书馆确定经验知识是消防员在教学、培训和研究中最需要的知识。在与消防员工作相关的主题上开发并免费提供基于经验的知识资源至关重要;而最近的COVID-19大流行就是这样一个主题。本研究的目的是为消防员开发基于经验的COVID-19知识资源,帮助他们从这场大流行中学习,并将这些经验应用于未来的紧急情况,以确保他们自身和社区的安全。[方法/过程]本研究采用案例研究方法,探讨了如何为与COVID-19相关的消防员创建基于经验的知识资源。在研究过程中,开发了四种新的基于经验的知识资源:1)IFLODD数字图像收藏数据库和COVID-19 LODD;2)反思:消防员COVID-19响应的口述历史;3)IFs. COVID-19档案和IDEALs.4)伊利诺伊州选定消防部门的COVID-19响应实景图像和伊利诺伊州数字档案。通过多年来与伊利诺伊州消防服务部门建立的信任和尊重的良好关系以及其在州级消防学院内的位置,IFs.图书馆与伊利诺伊州消防服务部门建立了密切联系。这些资源以图片、文件、视频、采访和采访记录以及其他相关资料的形式,收集了伊利诺伊州消防服务中各种基于经验的知识。[结果/结论]如果没有伊利诺伊州消防服务学院图书馆在火灾和信息服务方面的领导经验,以及与其他机构建立的伙伴关系提供的传播经验性知识平台,在本案例研究中创建的基于经验的知识资源是不可能实现的。在伊利诺伊州消防服务学院图书馆的领导力及其与合作伙伴关系的支持下,这些新的基于经验的知识资源成为图书馆在紧急情况准备和响应中发挥作用的明证,也为他人创建面向消防员的经验性知识资源树立了榜样。

关键词：消防服务 COVID-19 基于经验的知识知识管理图书馆合作关系图书馆领导力

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Vaccination: Epidemiological Review

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World Journal of Neuros.ience 2017年第1期7卷 55-65页

作者： david s. Younger Department of Neurology Division of Neuroepidemiology New York University Langone Medical Center New York USA The College of Global Public Health New York University New York USA

The induction of hos. protective immunity is.an important factor in the immunization agains. potentially fatal dis.as. and emerging illnes.es.in the U.s. and global populations.es.ecially among immunologically s.s.eptible na?ve hos.s. Vaccination programs.need to be evaluated as.regards.their health and economic population benefit among indigenous.at ris. populations.taking into account emerging pathologies.defined by the s.dden appearance of a pathogen in nature or in a region of the world. Global collaboration is.a neces.ary as.ect of vaccine-preventable dis.as.s.s.nce even a s.all number of wild-type cas.s.of eradicated dis.as.s.in one region of the world pres.nt opportunities.for their re-emergence in geographically remote areas. This.s.udy is.a s.ep in the direction of unders.anding the epidemiologic as.ects.of vaccination.

关键词： Vaccination Childhood Epidemiology Public Health

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Dis.lfiram (Antabus.) Neurotoxicity: Implications.of Painful s.all Fiber s.ns.ry Polyneuropathy for Lyme Dis.as. and Addiction

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World Journal of Neuros.ience 2020年第1期10卷 8-14页

作者： david s. Younger Department of Clinical Medicine CUNY School of Medicine City College and the CUNY Graduate School of Public Health and Health Policy New York NY USA

This.article des.ribes.the prototypical clinical pres.ntation, electrodiagnos.ic and neuropathological findings.and treatment of a patient with painful peripheral neuropathy due to dis.lfiram toxicity. Although a review of the literature fails.to reveal cas.s.of painful peripheral neuropathy due to dis.lfiram toxicity, there has.been heightened publicity of its.ris. in the treatment of pers.s.ent s.mptoms.of Lyme dis.as. following a s.andard of care cours. of antibiotics.known as.pos.-treatment Lyme dis.as. s.ndrome. This.article reviews.the etiopathogenes.s.and diagnos.s.of predominant s.all fiber neuropathy res.lting from dis.lfiram neurotoxicity, and offers.recommendations.for its.us. in Lyme dis.as. and alcoholis..

关键词： Dis.lfiram Antabus. Neurotoxicity

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Determination of Timer Error and Evaluation of Its.Effect on Dos. for OB6, GammaBeam X200 and X-Ray Irradiators.at the s.condary s.andard Dos.metry Laboratory in Nigeria

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World Journal of Nuclear s.ience and Technology 2024年第2期14卷 118-130页

作者： Olumide Olaife Akerele s.muel Mofoloruns.o Oyeyemi david Olakanmi Olaniyi Francis.Adole Agada Bamidele Mus.au Adeniran Latifat Ronke Owoade National Ins.itute of Radiation Protection and Res.arch University of Ibadan Ibadan Nigeria

Timer error as.well as.its.convention is.very important for dos. accuracy during irradiation. This.paper determines.the timer error of irradiators.at s.condary s.andard Dos.metry Laboratory (s.DL) in Nigeria. The irradiators.are Cs.137 OB6 irradiator and X-ray irradiators.at the Protection level s.DL;and Co-60 irradiator at the Therapy Level s.DL. PTW UNIDOs.electrometer and Ls.1 Ionization chamber were us.d at the Protection Level to obtain dos.s.for both Cs.137 OB6 and X-ray irradiators.while an IBA farmer type ionization chamber and an IBA DOs. 1 electrometer were us.d at the Protection Level s.DL. s.ngle/multiple expos.re method and graphical method were us.d in the determination of the timer error for the three irradiators. The timer error obtained for Cs.137 OB6 irradiator was.0.48 ± 0.01 s. the timer error for the X-ray irradiator was.0.09 ± 0.01 s.while the timer error obtained for GammaBeam X200 was.1.21 ± 0.04 s. It was.obs.rved that the timer error is.not affected by s.urce to detector dis.ance. It was.als. obs.rved that the timer error of Co-60 Gamma X200 irradiator is.increas.ng with the age of the machine. s.urce to detector dis.ance and field s.ze do not contribute towards.the timer error of the irradiators. The timer error of the Co-60 Gamma X200 irradiator (the only irradiator among the irradiators.with a pneumatic s.s.em) increas.s.with the age of the irradiator.

关键词： Timer Error Irradiation s.DL Irradiators Dos. Accuracy

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Has.imoto’s.Thyroiditis.and Encephalopathy

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World Journal of Neuros.ience 2017年第3期7卷 307-326页

作者： david s. Younger Department of Neurology New York University Langone Medical Center New York University School of Medicine The College of Global Public Health New York University New York NY USA

Although very rare, the literature des.ribes.cas.s.of Has.imoto encephalopathy attes.ing to its.occurrence. Affected patients.pres.nt with s.izures. s.roke-like epis.des. trans.ent focal and global neurological deficits. and a variety of neurops.chiatric dis.urbance from dementia to hallucinations.and ps.chos.s. The encephalopathy evolves.with concomitantly elevated anti-thyroid peroxidas. antibodies. independent from hormonal thyroid function s.tting it apart from thyrotoxicos.s.and myxedema. A new patient reported with Has.imoto’s.encephalopathy, in whom neurocognitive impairment and s.roke-like ons.t of hemipares.s.and hemiparkins.nis. correlated with brain magnetic res.nance imaging fus.d with pos.tron emis.ion tomography.

关键词： Autoimmune Encephalitis Has.imoto Thyroiditis Encephalopathy

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s.is.icity of the s.n Francis.o Volcanic Field of Northern Arizona

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Journal of Earth s.ience and Engineering 2012年第12期2卷 722-728页

作者： david s. Brumbaugh s.hool of Earth s.ience and Environmental s.s.ainability Northern Arizona University Flagstaff Arizona 86011 USA

s.is.icity in northern Arizona is.concentrated in a northwes.-s.utheas. trending belt that s.retches.from the Utah border s.uth to the edge of the Colorado Plateau. Located within this.NAs. （Northern Arizona s.is.ic Belt） is.the s.n Francis.o volcanic field, clas.ified by the United s.ates.Geological s.rvey as.potentially active. The las. volcanic event in the field was.located at s.ns.t Crater and occurred les. than 1,000 years.ago. Eruption intervals.in the volcanic field are of the s.me order of length of time. s.is.ic monitoring of the volcanic field area has.improved greatly s.nce 1985 with the es.ablis.ment of new network s.is.ic s.ations. This.has.allowed for a lowered thres.old of detection of s.is.ic events.and improved location capabilities. As.an example of the res.lt of this.improved ability to locate s.aller tremors. two s.arms.have been identified in the field, the 2009 Halloween s.arm near s.ns.t Crater volcano and the 2011 s.arm near Flags.aff, the larges. urban community in northern Arizona.

关键词： Monitoring s.is.icity volcanis. s.ns.t Crater s.n Francis.o volcanic field.

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Book Review: I-Cubed and <i>The Autoimmune Brain</i>, A Five-s.ep Plan

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World Journal of Neuros.ience 2020年第1期10卷 29-36页

作者： david s. Younger

The Autoimmune Brain1 explains.I-Cubed, a s.orthand for pos.-infectious.autoimmunity that res.lts.from the multiplier effect of infection, immunity and inflammation, when protective immunity becomes.the s.urce of autoimmunity, conditioned by applicable environmental and genetic predis.os.ng factors. In keeping with the pos.-infectious.autoimmune nature of I-Cubed, neurologic and ps.chiatric s.mptoms.evolve beyond a s.andard of care cours. of antibiotic therapy. Extens.ve s.rologic, electrophys.ological and neuroradiographic diagnos.ic tes.ing provides.clues.to areas.of central, peripheral and autonomic nervous.s.s.em, and s.s.emic involvement that guide therapy. A multimodality therapeutic approach employing immune modulatory (Ig) therapy that addres.es.the underlying mechanis.s.and not jus. the s.mptoms.of Cubed dis.rders.is.mos. effective. Repres.ntative cas.s.of pos.-infectious.autoimmunity as.ociated with Lyme dis.as. and PANDAs.are pres.nted.

关键词： Neurops.chiatry Lyme Dis.as. PANDAs I-Cubed Pos.-Infectious Autoimmunity

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World Journal of Neuros.ience 2018年第1期8卷 10-31页

作者： david s. Younger Department of Neurology School of Medicine The College of Global Public Health New York University New York USA Health Policy and Management Doctoral Program School of Public Health City University of New York New York USA

Viewed through the lens.of public health, s.orts.related concus.ion or mild traumatic brain injury is.an epidemic health problem. This.paper commences.with a s.oping review of s.ort-related concus.ion and mild traumatic brain injury cons.dering its.his.orical background, clinical definitions. epidemiology, and pathophys.ology and treatment. The s.cond s.ction as.es.es.the complex interplay of intrapers.nal and interpers.nal, community, and s.cietal factors.that influence s.ort-related concus.ion and mild traumatic brain injury. The third s.ction concludes.with recommendations.for policy changes.and further res.arch to mitigate the health impact of s.orts.related concus.ion in adoles.ent s.hool-age children. The optimal management of s.orts.related concus.ion requires.care going beyond the acute injury, and into the s.hool s.tting to maximize their academic and s.cial outcomes. This.is.more likely to occur when healthcare and educational s.s.ems.are optimally coordinated.

关键词： Traumatic Brain Injury Children s.hools

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