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Computed tomography and patient risk:Facts,perceptions and uncertainties

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World Journal of Radiology 2016年第12期8卷 902-915页

作者： Stephen P Power Fiachra moloney maria Twomey Karl James Owen J O'connor michael m maher Department of Radiology Cork University Hospital

Since its introduction in the 1970s, computed tomography(CT) has revolutionized diagnostic decision-making. One of the major concerns associated with the widespread use of CT is the associated increased radiation exposure incurred by patients. The link between ionizing radiation and the subsequent development of neoplasia has been largely based on extrapolating data from studies of survivors of the atomic bombs dropped in Japan in 1945 and on assessments of the increased relative risk of neoplasia in those occupationally exposed to radiation within the nuclear industry. However, the association between exposure to low-dose radiation from diagnostic imaging examinations and oncogenesis remains unclear. With improved technology, significant advances have already been achieved with regards to radiation dose reduction. There are several dose optimization strategies available that may be readily employed including omitting unnecessary images at the ends of acquired series, minimizing the number of phases acquired, and the use of automated exposure control as opposed to fixed tube current techniques. In addition, new image reconstruction techniques that reduce radiation dose have been developed in recent years with promising results. These techniques use iterative reconstruction algorithms to attain diagnostic quality images with reduced image noise at lower radiation doses.

关键词： Computed tomography Radiation dose Iterative reconstruction Neoplasia Carcinogenesis

糖水缓解1～12月婴儿预防接种所致疼痛效果的系统评价

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中国当代儿科杂志 2016年第6期18卷 534-540页

作者：谌绍林 Harrison denise 黄瑞瑞张晴谢日华文师吾湖南医药学院护理学院湖南怀化418000 加拿大渥太华大学护理学院加拿大渥太华大学医学院加拿大渥太华大学医院研究所

目的评价口服糖水对缓解1~12月婴儿预防接种所致疼痛的效果,为临床实践提供依据。方法通过计算机检索数据库,纳入相关随机对照试验（RCTs）文献;评价其研究质量、提取资料;采用Revman 5.3软件行meta分析。结果共纳入20项RCTs（n=2 37... 详细信息

目的评价口服糖水对缓解1~12月婴儿预防接种所致疼痛的效果,为临床实践提供依据。方法通过计算机检索数据库,纳入相关随机对照试验（RCTs）文献;评价其研究质量、提取资料;采用Revman 5.3软件行meta分析。结果共纳入20项RCTs（n=2 376）,有6项质量评价为A级,14项为B级。meta分析显示,与无菌水相比,口服25%~75%糖水降低了婴儿啼哭时间[WmD=-21.16,95%CI（-39.66,-2.77）,P〈0.05]、啼哭时间比例（啼哭时间/注射开始后3 min）[WmD=-13.83,95%CI（-20.88,-6.78）,P〈0.01];而口服12%蔗糖水组与无干预组相比,婴儿啼哭持续时间无统计学差异。结论预防接种前2 min,口服25%~75%糖水2 m L可有效缓解1~12月婴儿预防接种所致疼痛。

关键词：糖水疼痛预防接种系统评价婴儿

Risk management of Cyanotoxins in Singapore

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Journal of Water Resource and Protection 2020年第6期12卷 512-525页

作者： mong Hoo Lim Hui Shi melissa Tay denise A. Devotta maxine A. D. mowe Simon m. mitrovic Water Quality Department Public Utilities Board (PUB) Singapore Freshwater and Invasion Biology Laboratory Department of Biological Science National University of Singapore (NUS) Singapore Freshwater and Estuarine Research Group School of Life Sciences University of Technology Sydney Sydney Australia

Cyanotoxins produced by cyanobacteria pose significant challenges to water resource management due to the potential impacts they have on human health. Cylindrospermopsin (CYN) and microcystins (mC) are the more commonly detected cyanotoxins in Singapore’s reservoirs. Among the mC congeners monitored locally, the most frequently detected variants are mC-RR (37.6%), followed by mC-LR (25.6%). mC-LA and mC-YR are the least frequently detected variants (7.1%). No cyanotoxins have been detected in Singapore’s treated drinking water. Singapore’s National Water Agency (PUB) and the National Environment Agency (NEA) developed recreational water quality guidelines using Chl m>am> concentrations of 50 μg/L. In local surface waters, long-term data showed that at 50 μg/L of Chl m>am>, mC-LR concentrations ranged from m>am> concentrations, m>microcystism> cell counts in reservoir water have also been used to manage cyanotoxin risk in drinking water. Specifically, routinely monitored data from all 17 Singapore reservoirs indicated that to keep mC-LR concentrations below the WHO provisional guideline of 1 μg/L in drinking water, m>microcystism> cell counts needed to be ml. Culture experiments using local m>microcystism> isolates showed m. m>aeruginosam> produced the most mC compared to m>mm>. m>ichthyoblabem>, m>m.m> m>flos-aquaem>, and m>mm>. m>viridism>. Based on the maximum toxin cell quota equivalent to the WHO provisional guideline for mC-LR of 1 μg/L in drinking water, a 5000 cells/ml cell count guideline was derived for m>mm>. m>aeruginosam>. This cell count has also been incorporated into Singapore’s cyanotoxin risk management framework for reservoirs.

关键词： Chlorophyll-a Cyanobacteria Cyanotoxins Nutrients Tropical

Observation of robust edge superconductivity in Fe(Se,Te) under strong magnetic perturbation

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Science Bulletin 2021年第5期66卷 425-432,M0003页

作者： Da Jiang Yinping Pan Shiyuan Wang Yishi Lin connor m.Holland John R.Kirtley Xianhui Chen Jun Zhao Lei Chen Shaoyu Yin Yihua Wang Shanghai Institute of microsystem and Information Technology Shanghai 200050China State Key Laboratory of Surface Physics and Department of Physics Fudan UniversityShanghai 200433China Department of Physics Stanford UniversityStanfordCA 94305USA Department of Physics University of Science and Technology of ChinaHefei 230026China Institute for Theoretical Physics and Cosmology Zhejiang University of TechnologyHangzhou 310023China Shanghai Research Center for Quantum Sciences Shanghai 201315China

The iron-chalcogenide high temperature superconductor Fe(Se,Te)(FST) has been reported to exhibit complex magnetic ordering and nontrivial band topology which may lead to novel superconducting phenomena. However, the recent studies have so far been largely concentrated on its band and spin structures while its mesoscopic electronic and magnetic response, crucial for future device applications, has not been explored experimentally. Here, we used scanning superconducting quantum interference device microscopy for its sensitivity to both local diamagnetic susceptibility and current distribution in order to image the superfluid density and supercurrent in FST. We found that in FST with 10% interstitial Fe,whose magnetic structure was heavily disrupted, bulk superconductivity was significantly suppressed whereas edge still preserved strong superconducting diamagnetism. The edge dominantly carried supercurrent despite of a very long magnetic penetration depth. The temperature dependences of the superfluid density and supercurrent distribution were distinctively different between the edge and the *** Heisenberg modeling showed that magnetic dopants stabilize anti-ferromagnetic spin correlation along the edge, which may contribute towards its robust superconductivity. Our observations hold implication for FST as potential platforms for topological quantum computation and superconducting spintronics.

关键词： Edge superconductivity magnetic perturbation Anti-ferromagnetic spin correlation Iron-chalcogenide superconductors Scanning SQUID microscopy

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汉语精读课本预科

Clinical Experiences of mEBT/mEBO in Wound management in New Zealand

丛书名：外国学生汉语言专业本科系列教材

2006年

作者：马燕华（英）connor Walsh翻译

本书是依照相关教学大纲及外国留学生学习汉语的特点而编写的。书中的文章既适合外国留学生学习汉语基础知识、掌握基本技能, 也能使其通过课文的学习了解中国国情。本书每篇课文后还附有大量练习及正确答案, 便于学生课外练习等, 是一... 详细信息

ISBN: (纸本)7500454619

本书是依照相关教学大纲及外国留学生学习汉语的特点而编写的。书中的文章既适合外国留学生学习汉语基础知识、掌握基本技能, 也能使其通过课文的学习了解中国国情。本书每篇课文后还附有大量练习及正确答案, 便于学生课外练习等, 是一部有很强实用价值的教科书。

关键词：对外汉语教学汉语

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Clinical Experiences of MEBT/MEBO in Wound Management in New...

Chronic pancreatitis:A diagnostic dilemma

第十届全国烧伤创疡学术会议

作者： J.E.O’connor R.G.O.N.N.Z.I.m.Cert.Sup.management Post Grad.Dip.Health Science-End.Gerontology Cert.Nursing Practice-End.Wound management N.C.A.E. Cert.Adult Literacy Study & Clinical Experience mEBT/mEBO-China

Objective:The objective is to outline the overall health scene as it is in New Zealand and to demonstrate that there is tremendous potential for the increased use of moist Exposed Burn Therapy(mEBT)across a wide variety of health care facilities within New ***:The presentation allows me to share with you evidence from clini- cal based practice and examples of how and where mEBT and the product moist Exposed Burn Ointment(mEBO)has been used within New Zealand’ s health *** will include evidence from other nursing colleagues who work in the Aged Care sector or in the New Zealand ***:my experiences in the clinical field have enabled me to see that there is much that can be done through education for nurses by professional nurse educators. Currently there is little or no funding available to Nurse Educators for them to be able to provide the required education and training,or to be able to introduce the correct clini- cal techniques of mEBT into our heahhcare profession. Patients who require wound management and have been treated using the mEBT method are provided with sustained wound healing,improved outcomes and consequently an improved quality of life. New Zealand health providers are beginning to realize that use of mEBT and mEBO is a cost effective form of *** only in monetary terms but in ethical and physiolog- ical terms as *** this point in time however,there is evidence that nurses will experi- ment with products such as mEBO but revert back to techniques and products they know and are comfortable with in day to day nursing situations. It can therefore be concluded that New Zealand nurses do not have adequate knowl- edge or understanding of the clinical application of mEBT/mEBO to achieve the optimum results for their patients. Ongoing education is essential to ensure that nurses,who are using mEBT,under- stand the principals of mEBT and follow the correct clinical application. There has been evidence,during my cl

关键词： Wound management Nurse Education mEBT/mEBO

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World Journal of Gastroenterology 2016年第7期22卷 2304-2313页

作者： Sinead N Duggan Hazel m NíChonchubhair Oladapo Lawal Donal B O’connor Kevin C Conlon Department of Surgery Trinity College DublinCentre for Pancreatico-Biliary DiseasesTrinity Centre for Health SciencesTallaght Hospital24 DublinIreland

Typical clinical symptoms of chronic pancreatitis are vague and non-specific and therefore diagnostic tests are required, none of which provide absolute diagnostic certainly, especially in the early stages of disease. Recently-published guidelines bring much needed structure to the diagnostic work-up of patients with suspected chronic pancreatitis. In addition, novel diagnostic modalities bring promise for the future. The assessment and diagnosis of pancreatic exocrine insufficiency remains challenging and this review contests the accepted perspective that steatorrhea only occurs with > 90% destruction of the gland.

关键词： Pancreatitis, chronic Diagnosis Exocrinepancreatic insufficiency Pancreatic enzyme replacementtherapy malabsorption

A simple scoring system to estimate perioperative mortality following liver resection for primary liver malignancy-the Hepatectomy Risk Score(HeRS)

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Hepatobiliary Surgery and Nutrition 2021年第3期10卷 315-324,I0001,I0002页

作者： Dimitrios moris Brian I.Shaw Cecilia Ong Ashton connor mariya L.Samoylova Samuel J.Kesseli Nader Abraham Jared Gloria Robin Schmitz Zachary W.Fitch Bryan m.Clary Andrew S.Barbas Department of Surgery Duke University Medical CenterDurhamNCUSA

Background:Selection of the optimal treatment modality for primary liver cancers remains complex,balancing patient condition,liver function,and extent of *** individuals with preserved liver function,liver resection remains the primary approach for treatment with curative intent but may be associated with significant *** purpose of this study was to establish a simple scoring system based on model for End-stage Liver Disease(mELD)and extent of resection to guide risk assessment for liver ***:The 2005-2015 NSQIP database was queried for patients undergoing liver resection for primary liver *** first developed a model that incorporated the extent of resection(1 point for major hepatectomy)and a mELD-Na score category of low(mELD-Na=6,1 point),medium(mELD-Na=7-10,2 points)or high(mELD-Na>10,3 points)with a score range of 1-4,called the Hepatic Resection Risk Score(HeRS).We tested the predictive value of this model on the dataset using logistic *** next developed an optimal multivariable model using backwards sequential selection of variables under logistic *** performed K-fold cross validation on both *** operating characteristics were plotted and the optimal sensitivity and specificity for each model were calculated to obtain positive and negative predictive ***:A total of 4,510 patients were *** was associated with increased odds of 30-day mortality[HeRS=2:OR=3.23(1.16-8.99),P=0.025;HeRS=3:OR=6.54(2.39-17.90),Pmodel was *** AUC for the optimal multivariable model was higher at *** K-fold cross validation,the positive predictive value(PPV)and negative predictive value(NPV)of these two models were similar at PPV=6.4%and NPV=97.7%for the HeRS only model and PPV=8.4%and NPV=98.1%for the optimal multivariable ***:The HeRS offers a simple heuristic for estimating 30-day mortality after resectio

关键词： Hepatocellular carcinoma(HCC) cholangiocarcinoma liver resection model for End-stage Liver Disease(mELD) outcomes

meta-analysis and trial sequential analysis of randomized evidence comparing general anesthesia vs regional anesthesia for laparoscopic cholecystectomy

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World Journal of Gastrointestinal Endoscopy 2021年第5期13卷 137-154页

作者： Peter Asaad Adam O’connor Shahab Hajibandeh Shahin Hajibandeh Department of General and Colorectal Surgery Wythenshawe HospitalManchester M239LTUnited Kingdom Department of General Surgery Royal Blackburn HospitalBlackburn BB23HHUnited Kingdom Department of General Surgery Glan Clwyd HospitalRhyl LL185UJUnited Kingdom Department of General Surgery Wye Valley NHS TrustHereford HR12ERUnited Kingdom

BACKGROUND In an effort to further reduce the morbidity and mortality profile of laparoscopic cholecystectomy,the outcomes of such procedure under regional anesthesia(RA)have been *** the context of cholecystectomy,combining a minimally invasive surgical procedure with a minimally invasive anesthetic technique can potentially be associated with less postoperative pain and earlier *** To evaluate comparative outcomes of RA and general anesthesia(GA)in patients undergoing laparoscopic *** A comprehensive systematic review of randomized controlled trials with subsequent meta-analysis and trial sequential analysis of outcomes were conducted in line with Preferred Reporting Items for Systematic Reviews and meta-Analyses statement *** Thirteen randomized controlled trials enrolling 1111 patients were *** study populations in the RA and GA groups were of comparable age(P=0.41),gender(P=0.98)and body mass index(P=0.24).The conversion rate from RA to GA was 2.3%.RA was associated with significantly less postoperative pain at 4 h[mean difference(mD):-2.22,PmD:-1.53,P=0.0006),12 h(mD:-2.08,PmD:-0.90,Pmpared to ***,it was associated with significantly lower rate of nausea and vomiting[risk ratio(RR):0.40,Pmonstrated that the meta-analysis was conclusive for most outcomes,with the exception of a risk of type 1 error for headache and urinary retention and a risk of type 2 error for total procedure *** Our findings indicate that RA may be an attractive anesthetic modality for daycase laparoscopic cholecystectomy considering its associated lower postoperative pain and nausea and vomiting compared to ***,its associated risk of urinary retention and headache and lack of knowledge on its impact on proc

关键词： Laparoscopic cholecystectomy Regional anesthesia General anesthesia Laparoscopy Level 1 evidence meta-analysis