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Patterns of Ketorolac dosing by emergency physicians

World Journal of Emergency Medicine 2017年第1期8卷 43-46页

作者： emil Soleyman-Zomalan Sergey Motov Antonios Likourezos Victor Cohen Illya Pushkar Christian Fromm Department of Emergency Medicine Texas Health Arlington Memorial HospitalArlingtonTX76012USA Department of Emergency Medicine Maimonides Medical CenterBrooklynNY 11219USA Corporate Clinical Director of Pharmacy services New York City Health+HospitalsNYNY 10013USA

BACKGROUND: Ketorolac tromethamine is a non-steroidal anti-inflammatory drug(NSAIDs) that is widely used in the emergency department(ED) for the treatment of moderate-to-severe pain. Ketorolac, like other NSAIDs, exhibits an analgesic ceiling effect and previous research suggests that 10 mg is possibly the ceiling dose. Do the patterns of ketorolac dosing by emergency physicians follow its analgesic ceiling dose?METHODS: This was a single center retrospective, descriptive study to characterize patterns of ketorolac administration in ED patients. Data for all patients who received ketorolac during the ten year study period from January 1, 2003 to January 1, 2013 were collected from the electronic medical record of an urban community ED with an annual volume of 116 935 ***: There were 49 605 ketorolac administrations during the study period; 38 687(78%) were given intravenously, 9 916(20%) intramuscularly, and 1 002(2%) orally. Through the intravenous route, 5 288(13.7%) were 15 mg, 32 715(84.6%) were 30 mg, 15(0.03%) were 60 mg, and 669(1.7%) were other varying doses. Through the intramuscular route, 102(1.0%) were 15 mg, 4 916(49.6%) were 30 mg, 4 553(45.9%) were 60 mg, and 345(3.5%) were other varying doses. The most common diagnoses at discharge were renal colic(21%), low back pain(17%) and abdominal pain(11%).CONCLUSION: The data show that ketorolac was prescribed above its ceiling dose of 10 mg in 97% of patients who received intravenous doses and in 96% of patients receiving intramuscular doses.

关键词： Ketorolac NSAID Analgesic ceiling Acute pain Prescription pattern

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Introducing Stakeholder-Based Frameworks for Post-merger Integration （PMI） Success

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Journal of Modern Accounting and Auditing 2013年第10期9卷 1376-1381页

作者： emil Martirosyan Teimuraz Vashakmadze Russian Presidential Academy of National Economy and Public Administration Moscow Russia

The importance of stakeholder relationship management for successful integration in post-merger management is not doubted. The establishment of a new powerful trend in investments produces strategic shifts in strategic management. Shareholder wealth maximization way of thinking is changing to stakeholder wealth maximization where a company＇s value management system is based not only on economic profit maximization, but also on environmental, social, and governance （ESG） maximization. There is especially a high need for a management system that can be used by mergers and acquisitions （M＆A） practitioners during integration process. There is a critical need for metrics which can trace the interests of all stakeholders, because to achieve success in integration, it is no longer acceptable for management to focus solely on the needs of one or two stakeholder groups. In this article, the authors have introduced two frameworks： sun cube and stakeholder relationship matrix. These tools can be useful in mergers and acquisitions （M＆A） process for conducting a stakeholder analysis.

关键词： stakeholders mergers and acquisitions (M&A) post-merger integration (PMI) environmental social and governance (ESG)

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Shipbuilding—An Analysis from the Perspective of Enterprise Resources Planning System

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World Journal of Engineering and Technology 2023年第1期11卷 81-112页

作者： Mihaela-Greti Manea emil Manea “Mircea celBǎtrîn” Naval Academy Constanta Romania Greece Representative Office of Constanta Shipyard Romania Kallithea Athens Greece

Designed as a tool for business intelligence, resource planning is used to manage the essentials of a business by integrating processes into a single system. Enterprise Resource Planning (ERP) solutions ensure all the organizational, operational, and procedural structures interconnection, which can be both an advantage and a disadvantage, knowing that inefficiency within one structure will lead to inefficiency in others. The originality of the approach consists in the unitary analysis of all processes which shipbuilding involves (design;evaluation of ship construction possibilities;contracting of works;contracting of supply of materials and equipment;presentation of inspections for the completed works reception;delivery of the ship into operation). The systemic approach is a notable contribution by highlighting the input and output quantities for the analyzed processes. Also, where it was found relevant, the diagrams highlight the owners of the process and show the interconnectivity of the functional departments within a shipyard. Although it is obviously the expression of in-depth knowledge of the peculiarities of Romanian shipyards, the authors hope that the work can support any shipyard that may be interested in knowing these structures (as a logical scheme mandatory to design a custom ERP software system).

关键词： Shipbuilding Shipyard Production Structures Enterprise Resource Planning Processes Flow

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Experiments with Forming Coated Sheets with Plasma-Chemical Pretreatment of the Surface

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Journal of Surface Engineered Materials and Advanced Technology 2016年第3期6卷 118-124页

作者： emil Schwarzer Milan Dvořák BUT Faculty of Mechanical Engineering IMT Brno Czech Republic

The article used new experimental equipment for effective testing of adhesion coatings on the sheets. Testing was performed in jig by bending roller with selected radius. In the context of experiments a multi-jet system was used. The aim of my previous publications and even this article is to achieve that by using of multi-jet plasma system, samples were achieved that will not be damaged coating after the bending. Specific coats on the sheets have been optimized composition of the plasma so that its result was the maximum adhesion of the coating to the steel base of samples. Results of experiments are presented in article. The article focuses on the tensile test and the result of the tensile test. All important values of tensile tests are published in this article. For example: elongation A50, Ag, tensile strength Rm, and yield strength Rp0.2. Results with values of tensile tests are also presented in this article. Selected coated steel samples were photographed in the clamped in jig on the tension device. Group selected samples were divided by the applied coating. First, the basecoat, the final coat and coat were treated with a multi-jet plasma system. From a previous publication graphs show the dependence of the strength on elongation of a sample. Further research will be focused on selected coated samples, where samples are etched onto the surface of a network and are bent in a special jig in range bending radius R11 to R35. After bending, the samples are examined at a special optical device and are evaluated deformation circles in straight and bent part of the samples.

关键词： Nozzles Bending Multi-Jet Plasma System Flow Tensile Tests Coating

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Endoscopic or percutaneous biliary drainage in hilar cholangiocarcinoma:When and how?

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World Journal of Gastrointestinal Oncology 2021年第12期13卷 2050-2063页

作者： Tudor Mocan Adelina Horhat emil Mois Florin Graur Cristian Tefas Rares Craciun Iuliana Nenu Mihaela Spârchez Zeno Sparchez Third Medical Department "Iuliu Hatieganu"University of Medicine and PharmacyCluj-Napoca 400162Romania Institute for Gastroenterology and Hepatology Cluj-Napoca 400162Romania Second Pediatric Department University of Medicine and Pharmacy"Iuliu Hatieganu"Cluj-Napoca 400162Romania

Hilar cholangiocarcinoma (hCCA) is a primary liver tumor associated with a dimprognosis. The role of preoperative and palliative biliary drainage has long beendebated. The most common techniques are endoscopic retrograde cholangiopancreatography(ERCP) and percutaneous transhepatic biliary drainage (PTBD);however, recently developed endoscopic ultrasound-assisted methods are gainingmore atention. Selecting the best available method in any specific scenario iscrucial, yet sometimes challenging. Thus, this review aimed to discuss theavailable techniques, indications, perks, pitfalls, and timing-related issues in themanagement of hCCA. In a preoperative setting, PTBD appears to have someadvantages: low risk of postprocedural complications (namely cholangitis) andbetter priming for surgery. For palliative purposes, we propose ERCP/PTBDdepending on the experience of the operators, but also on other factors: the levelof bilirubin (if very high, rather PTBD), length of the stenosis and the presence ofcholangitis (PTBD), ERCP failure, or altered biliary anatomy.

关键词： Hilar cholangiocarcinoma Endoscopic biliary drainage Percutaneous biliary drainage Endoscopic ultrasound biliary drainage Surgical oncology

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Hepatoprotective and proapoptotic effect of Ecballium elaterium on CCl_4-induced hepatotoxicity in rats

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Asian Pacific Journal of Tropical Medicine 2015年第7期8卷 524-529页

作者： El Moataz Bellah El Naggar Marta Chalupova Gabriela Pra anov a Tom a Par ak emil vajdlenka Milan emlika Pavel Such Department of Pharmacognosy Faculty of Pharmacy Damanhur UniversityEgypt Department of Human Pharmacology and Toxicology Faculty of Pharmacy University of Veterinary and Pharmaceutical SciencesBrnoCzech Republic Department of Natural Drugs Faculty of Pharmacy University of Veterinary and Pharmaceutical SciencesBrnomCzech Republic

Objective: To investigate the effects of perorally administered juice on tetrachloromethane(CCl4)-induced hepatotoxicity model in rats. Methods: Male Wistar rats were tubeadministrated silymarin, Ecballium juice at 0.2 mL/kg and 0.7 mL/kg daily for 3 consequent days, ie. 3.28 μg and 11.48 μg of cucurbitacin B per kg of body weight respectively. On the third day, liver damage was induced by intraperitoneal application of CCl4. On the fourth day, abdominal cavity was macroscopically examined and liver samples were taken for histopathological and immunochemical evaluation. HPLC was used to determine the content of the active substance cucurbitacin B. Results: The experiment revealed that 0.7 ml/kg juice concentration expressed the highest pro-apoptotic activity, but with prevailing negative effects. Compared with the lower concentration, there was an observable vasodilatation with consequent interstitial hemorrhages and a larger scope of inflammatory damage, which suppressed the hepatoprotective effect. In the 0.2 mL/kg concentration, there was a smaller pro-apoptotic activity but other parameters had better results, and the liver parenchyma damage was reversible. Conclusions: No reactions confirming the potentially allergic effect on laboratory rats were observed; its hepatoprotective and anti-inflammatory effect was confirmed on a model of acute liver damage.

关键词： Ecballium elaterium Rats Tetrachloromethane Hepatotoxicity Apoptosis

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Microscopic theory of light-induced ultrafast skyrmion excitation in transition metal films

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npj Computational Materials 2022年第1期8卷 598-604页

作者： emil Viñas Boström Angel Rubio Claudio Verdozzi Max Planck Institute for the Structure and Dynamics of Matter Luruper Chaussee 14922761HamburgGermany Center for Computational Quantum Physics(CCQ) The Flatiron Institute162 Fifth AvenueNew YorkNY10010USA Division of Mathematical Physics and ETSF Lund UniversityPO Box 11822100LundSweden

Magnetic skyrmions are topological excitations of great promise for compact and efficient memory ***,to interface skyrmionics with electronic devices requires efficient and reliable ways of creating and destroying such *** this work,we unravel the microscopic mechanism behind ultrafast skyrmion generation by femtosecond laser pulses in transition metal thin *** employ a theoretical approach based on a two-band electronic model,and show that by exciting the itinerant electronic subsystem with a femtosecond laser ultrafast skyrmion nucleation can occur on a 100 fs *** combining numerical simulations with an analytical treatment of the strong s–d exchange limit,we identify the coupling between electronic currents and the localized d-orbital spins,mediated via Rashba spin–orbit interactions among the itinerant electrons,as the microscopic and central mechanism leading to ultrafast skyrmion *** results show that an explicit treatment of itinerant electron dynamics is crucial to understand optical skyrmion generation.

关键词： excitation transition topological

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New Methods Testing of Adhesion of the Coating to Sheet Metal by Bending

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Journal of Surface Engineered Materials and Advanced Technology 2012年第2期2卷 61-64页

作者： Milan Dvorak emil Schwarzer Faculty of Mechanical Engineering Brno University of TechnologyBrnoCzech Republic Fritzmeier Ltd. VyskovCzech Republic

The article is deals for new experimental equipment for effective test adhesion for selected coating STEEL, applied cold on the coated metal sheet with Al (aluminum). Explanation to the word STEEL: STEEL coating has significant anti- corrosive properties and he is resistant for main oxidizing agents such as acids, alkalis, salt vapors etc. Resists tem- peratures to 600?C and create an elastic film that is resistant to abrasion, as soon as it was to complete po-lymerization. It is very simple to applied to metallic and nonmetallic surfaces. Dries quickly and is dry to the touch after 90 to 120 seconds. STEEL is the best possible solution anywhere, if needs arises powerful local protection against atmospheric and corrosive agents or to elevated temperatures. STEEL is also useful as a method for protect of welds on stainless steels instead of traditional staining procedures. Broad application is in automotive industry to modify the surfaces of block vehicle, car-body repairs, welds needing protection, in heating industry for example boilers, in air condition with heat exchanger and in shipping industry. [1-3].In experiments with a new test equipment is showed that for bending radius of interval from range R11 to R35 there is a change deposited coating STEEL from original coating Al and this coating was part of test metal sheet of thickness 1.5 mm. In the next stage of solution was developed technological process, which allowed increase of adhesion coating STEEL for bending up to or maximum 180? (shape U). Result of new technology is documented in article. Experiments was implementing with cooperation of the Masaryk University in Brno.

关键词： Metal Sheet Aluminum Coating Adhesion Bending Plasma

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Modeling Municipal Solid Waste Management in Africa: Case Study of Matadi, the Democratic Republic of Congo

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Journal of Environmental Protection 2013年第5期4卷 435-445页

作者： Gregory Yom Din emil Cohen Independent Expert for Waste to Energy Projects Moshav Aniam Israel The Open University of Israel Raanana Israel Tel-Aviv University Tel-Aviv Israel

The purpose of this article is to present the key elements for best performance and profitability of Municipal Solid Waste (MSW) management in a low-income city. The research provides an overview of methods and models for integrated planning of a two-phase program: MSW collection and transportation, and MSW treatment. We present the case study of Matadi (the Democratic Republic of Congo) that has a low level of the MSW management compared to other African cities. We develop a spreadsheet model for collection and transportation of MSW which is relevant for low-income cities and enables determining the waste collection fee. A CDM decay model is used to predict the GHG emissions in disposal site. The MSW treatment plant in case of Matadi is evaluated. For the anaerobic digestion technology selected as appropriate for this plant, the key factors that ensure profitability of the plant are as follows: tipping fee from the municipality (19% of total revenue), amount of carbon credits which can sum up to 16% of the total revenue, expansion of waste collection range from 25 to 50 km. The methods of this study can be used for solving waste problem in other low-income cities where the budget for municipal services is scanty, particularly when starting from a very low level of MSW management.

关键词： Municipal Solid Waste Waste Treatment Emissions Trading Planning Economic Evaluation

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Natural Disaster in Tbilisi City (Riv. Vere Basin) in the Year 2015

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International Journal of Geosciences 2016年第9期7卷 1074-1087页

作者： George Gaprindashvili Merab Gaprindashvili emil Tsereteli LEPL National Environmental Agency Department of Geology Tbilisi Georgia

During 13-14 June 2015 heavy rainfall in the Riv. Vere basin area and its tributaries caused a drastic increase in the water level and triggered/activated large-scale landslide and debrisflow events. This put the Tskneti-Samadlo and Tsnketi-Akhal- daba motorways out of order. Residential buildings and miscellaneous infrastructural facilities, buildings and structures and Tbilisi Zoo located at the low elevations in the Riv. Vere Gorge were significantly damaged or/and totally destroyed. 23 persons died during the disaster. This study presents the results on an analysis of the landslides/ debrisflows in the riv. Vere catchment and discusses main triggering factors of natural disaster, statistics for the prior period, and geodynamic situation of Akhaldaba “big” landslide developed at the Tskneti-Samadlo road section. It is given recommendations for future activities to reduce landslide/debrisflow hazard in this catchment.

关键词： Georgia Tbilisi Landslide Debrisflow Natural Disaster

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