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Reducing unnecessary crossmatching for hip fracture patients by accounting for preoperative hemoglobin concentration

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World Journal of Orthopedics 2021年第5期12卷 292-300页

作者： Raj m Amin Varun Puvanesarajah Yash P Chaudhry matthew J Best Sandesh S Rao Steven m Frank erik A Hasenboehler Department of Orthopaedic Surgery Stanford University Medical CenterStanfordCA 94305United States Department of Orthopaedic Surgery Johns Hopkins School of MedicineBaltimoreMD 21205United States Department of Orthopaedic Surgery Philadelphia College of Osteopathic MedicinePhiladelphiaPA 19122United States Department of Orthopaedic Surgery Massachusetts General HospitalBostonMD 02114United States Department of Anesthesiology Critical Care MedicineBaltimoreMD 21205United States Department of Orthopaedics Johns Hopkins School of MedicineBaltimoreMD 21205United States

BACKGROUND maximum surgical blood order schedules were designed to eliminate unnecessary preoperative crossmatching prior to surgery in order to conserve blood bank *** protocols recommend type and cross of 2 red blood cell(RBC)units for patients undergoing surgery for treatment of hip *** hemoglobin has been identified as the strongest predictor of inpatient transfusion,but current maximum surgical blood order schedules do not consider preoperative hemoglobin values to determine the number of RBC units to prepare prior to *** To determine the preoperative hemoglobin level resulting in the optimal 2:1 crossmatch-to-transfusion(C:T)ratio in hip fracture surgery *** In 2015 a patient blood management(PBm)program was implemented at our institution mandating a single unit-per-occurrence transfusion policy and a restrictive transfusion threshold ofmoglobin in asymptomatic patients andmptomatic anemia or history of coronary artery *** identified all hip fracture patients between 2013 and 2017 and compared the preoperative hemoglobin which would predict a 2:1 C:T ratio in the pre PBm and post PBm *** profiling and sensitivity analysis were performed with statistical significance set at Pm *** requirements in the post PBm cohort were lower(51%vs 33%,Pm *** mean RBC units transfused per patient was 1.15 in the pre PBm cohort,compared to 0.66 in the post PBm cohort(Pmoglobin of 12.3 g/dL[area under the curve(AUC)0.78(95%confidence interval(CI),0.72-0.83),Sensitivity 0.66]in the pre PBm cohort and 10.7 g/dL[AUC 0.78(95%CI,0.73-0.83),Sensitivity 0.88]in the post PBm cohort.A

关键词： Hip fracture Transfusion Blood conservation Hemoglobin Type and cross maximum surgical blood order schedule

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Quantities of comorbidities affects physical, but not mental health related quality of life in type 1 diabetes with confirmed polyneuropathy

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World Journal of Diabetes 2019年第2期10卷 87-95页

作者： Anne-marie L Wegeberg Theresa meldgaard Sofie Hyldahl Poul erik Jakobsen Asbjφrn m Drewes Birgitte Brock Christina Brock mech-Sense Department of Gastroenterology and HepatologyAalborg University Hospital and Clinical InstituteAalborg UniversityAalborg 9000Denmark Steno Diabetes Center North Judland Region NordjyllandAalborg 9000Denmark Steno Diabetes Center Copenhagen Region HovedstadenGentofte 2820Denmark

BACKGROUND A large number of adults with long-term type 1 diabetes are affected by symmetrical peripheral *** complications increase socioeconomic expenses and diminish the individual quality of *** 36-Item Short Form Health Survey(SF-36)is a generic patient reported questionnaire,measuring mental and physical health related quality of *** hypothesized that diabetic neuropathy would decrease physical and mental quality of life measured with SF-36,and that clinical appearance may be associated with the *** To investigate if diabetic neuropathy would decrease physical and mental quality of life measured with SF-36,and if clinical appearance may be associated with the *** Forty-eight adults[age 50±9 years,10 females,disease duration 32(14-51)years]with verified diabetic symmetrical peripheral neuropathy and 21 healthy participants(age 51±6 years,6 females)underwent standardised nerve conduction testing and completed the SF-36 ***,disease duration,number of comorbidities,both diabetes related and nondiabetes related,vibration perception threshold,number of hypoglycaemic events,HbA1c and administration way of insulin was *** In comparison to healthy subjects,patients’mental composite score was not significantly diminished(51.9±8.9 vs 53.1±5.5,P=0.558),while the physical composite score was(46.3±11.7 vs 54.6±3.3,P=0.002).As expected,the overall physical health related symptoms in patients were associated to total number of comorbidities(Pmorbidities relation to diabetes(P=0.0002)and HbA1c(P=0.005)as well as comorbidities not related to diabetes(P=0.0006).CONCLUSION The finding of this study emphasises the importance of focusing on quality of life in adults with diabetes and especially in those with multiple comorbidities as well as the possibility of HbA1c as a biomarker for severe complication.

关键词： Quality of life 36-Item Short Form Health Survey(SF-36) Diabetes mellitus,Type 1 Diabetic neuropathies Comorbidity

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maximizing recovery time between knock-out races improves sprint cross-country skiing performance

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Journal of Sport and Health Science 2022年第1期11卷 21-29页

作者： Kerry mcGawley Coline Van Waerbeke Karl-Johan Westberg erik P.Andersson Swedish Winter Sports Research Centre Department of Health SciencesMid Sweden UniversityOstersund 83125Sweden

Background:In a sprint cross-country(XC)ski competition,the difference in recovery times separating the first and the second semi-final(SF)heats from the final(F)may affect *** aim of the current study was to compare the effects of longer *** recovery periods prescribed between the 3 knock-out races of a simulated sprint XC ski competition involving a prologue(P),quarter-final(QF),SF,and ***:Eleven well-trained XC ski athletes completed 2 simulated sprint XC ski competitions on a treadmill involving 4×883-m roller-ski bouts at a 4°incline using the gear 3 ski-skating *** first 3 bouts were completed at a fixed speed(PFIX,QFFIX,and SFFIX)corresponding to~96%of each individual’s previously determined maximal *** final bout was performed as a self-paced sprint time trial(FSTT).Test conditions differed by the time durations prescribed between the QFFIX,SFFIX,and FSTT,which simulated real-world XC ski competition conditions using maximum(mAX-REC)or minimum(mIN-REC)recovery ***:The FSTT was completed 5.4±5.5 s faster(p=0.009)during mAX-REC(179.2±18.1 s)compared to mIN-REC(184.6±20.0 s),and this was linked to a significantly higher power output(p=0.010)and total metabolic rate(p=0.009).The pre FSTT blood lactate(BLa)concentration was significantly lower during mAX-REC compared to mIN-REC(2.5±0.8 mmol/L vs.3.6±1.6 mmol/L,respectively;p=0.027),and the pre-to-post FSTT increase in BLa was greater(8.8±2.1 mmol/L vs.7.1±2.3 mmol/L,respectively;p=0.024).No other differences for mAX-REC ***-REC reached significance(p>0.05).Conclusion:Performance in a group of well-trained XC skiers is negatively affected when recovery times between sprint heats are minimized which,in competition conditions,would occur when selecting the last QF *** result is combined with a higher pre-race BLa concentration and a reduced rise in BLa concentration under shorter recovery *** findings may help inform decision making when

关键词： Energetics Repeated sprints Roller skiing Simulated competition Tactics

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Artificial intelligence for characterization of diminutive colorectal polyps:A feasibility study comparing two computer-aided diagnosis systems

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Artificial Intelligence in Gastrointestinal Endoscopy 2024年第1期5卷 11-22页

作者： Quirine Eunice Wennie van der Zander Ramon m Schreuder Ayla Thijssen Carolus H J Kusters Nikoo Dehghani Thom Scheeve Bjorn Winkens mirjam C m van der Ende-van Loon Peter H N de With Fons van der Sommen Ad A m masclee erik J Schoon Department of Gastroenterology and Hepatology Maastricht University Medical CenterMaastricht 6202 AZNetherlands GROW School for Oncology and ReproductionMaastricht UniversityMaastricht 6200 MDNetherlands Division of Gastroenterology and Hepatology Catharina Hospital EindhovenEindhoven 5602 ZANetherlands Department of Electrical Engineering Eindhoven University of TechnologyEindhoven 5600 MBNetherlands Department of methodology and Statistics Maastricht UniversityPostbus 6166200 MD MaastrichtNetherlands School for Public Health and Primary Care Maastricht UniversityMaastricht 6200 MDNetherlands

BACKGROUND Artificial intelligence(AI)has potential in the optical diagnosis of colorectal *** To evaluate the feasibility of the real-time use of the computer-aided diagnosis system(CADx)AI for ColoRectal Polyps(AI4CRP)for the optical diagnosis of diminutive colorectal polyps and to compare the performance with CAD EYE^(Tm)(Fujifilm,Tokyo,Japan).CADx influence on the optical diagnosis of an expert endoscopist was also *** AI4CRP was developed in-house and CAD EYE was proprietary software provided by *** CADxsystems exploit convolutional neural *** polyps were characterized as benign or premalignant and histopathology was used as gold ***4CRP provided an objective assessment of its characterization by presenting a calibrated confidence characterization value(range 0.0-1.0).A predefined cut-off value of 0.6 was set with valuesmalignant colorectal *** confidence characterizations were defined as values 40%around the cut-off value of 0.6(0.76).Self-critical AI4CRP’s diagnostic performances excluded low confidence *** AI4CRP use was feasible and performed on 30 patients with 51 colorectal ***-critical AI4CRP,excluding 14 low confidence characterizations[27.5%(14/51)],had a diagnostic accuracy of 89.2%,sensitivity of 89.7%,and specificity of 87.5%,which was higher compared to *** EYE had a 83.7%diagnostic accuracy,74.2%sensitivity,and 100.0%*** performances of the endoscopist alone(before AI)increased nonsignificantly after reviewing the CADx characterizations of both AI4CRP and CAD EYE(AI-assisted endoscopist).Diagnostic performances of the AI-assisted endoscopist were higher compared to both CADx-systems,except for specificity for which CAD EYE performed *** Real-time use of AI4CRP was *** confidence values provided by a CADx is novel and self-critical AI4CRP sho

关键词： Artificial intelligence Colorectal polyp characterization Computer aided diagnosis Diminutive colorectal polyps Optical diagnosis Self-critical artificial intelligence

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A new approach for determining GND and SSD densities based on indentation size effect:An application to additive-manufactured Hastelloy X

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Journal of materials Science & Technology 2022年第1期96卷 295-307页

作者： Luqing Cui Cheng-Han Yu Shuang Jiang Xiaoyu Sun Ru Lin Peng Jan-erik Lundgren Johan moverare Division of Engineering materials Department of Management and EngineeringLinköping UniversityLinköping SE-58183Sweden Siemens Energy AB Finspång SE-61231Sweden

Dislocation plays a crucial role in controlling the strength and plasticity of bulk ***,determining the densities of geometrically necessary dislocations(GNDs)and statistically stored dislocations(SSDs)is one of the classical problems in material research for several ***,we proposed a new approach based on indentation size effect(ISE)and strengthening *** approach was performed on a laser powder bed fused(L-PBF)Hastelloy X(HX),and the results were verified by the Hough-based EBSD and modified Williamson-Hall(m-WH)***,to better understand the new approach and essential mechanisms,an in-depth investigation of the microstructure was *** distribution of dislocations shows a clear grain orientation-dependent:low density in largepreferentially orientated grains while high density in fineorientated *** increment of strengthening in L-PBF HX is attributed to a huge amount of *** slip is the main operative deformation mechanism during indentation tests,and the slip step patterns depend mostly on grain orientations and stacking fault *** study provides quantitative results of GND and SSD density for L-PBF HX,which constructs a firm basis for future quantitative work on other metals with different crystal structures.

关键词： microstructure characterization Indentation size effect Hastelloy X Geometrically necessary dislocation Statistically stored dislocation

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Thermal evolution of an ancient subduction interface revealed by Lue Hf garnet geochronology, Halilba■? Complex(Anatolia)

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Geoscience Frontiers 2019年第1期10卷 127-148页

作者： Amaury Pourteau erik E.Scherer Simon Schorn Rebecca Bast Alexander Schmidt Lisa Ebert Institut für Erd- und Umweltwissenschaften Universit?t Potsdam Earth Dynamics Research Group ARC Centre of Excellence for Core to Crust Fluid Systems (CCFS) The Institute for Geoscience Research (TIGeR) School of Earth and Planetary Sciences Curtin University münster Isotope Research Centre Institut für Mineralogie Westf?lische Wilhelms-Universit?t Münster Department of Geological Sciences University of Cape Town Institut für Geologie und mineralogie Universit?t zu K?ln

The thermal structure of subduction zones exerts a major influence on deep-seated mechanical and chemical processes controlling arc magmatism, seismicity, and global element cycles. Accretionary complexes exposed inland may comprise tectonic blocks with contrasting pressureetemperature(Pe T)histories, making it possible to investigate the dynamics and thermal evolution of former subduction interfaces. With this aim, we present new Lue Hf geochronological results for mafic rocks of the Halilbag?Complex(Anatolia) that evolved along different thermal gradients. Samples include a lawsoniteeepidote blueschist, a lawsoniteeepidote eclogite, and an epidote eclogite(all with counter-clockwise Pe T paths),a prograde lawsonite blueschist with a "hairpin"-type Pe T path, and a garnet amphibolite from the overlying sub-ophiolitic metamorphic sole. Equilibrium phase diagrams suggest that the garnet amphibolite formed at w0.6 -0.7 GPa and 800 -850℃, whereas the prograde lawsonite blueschist records burial from 2.1 GPa and 420℃ to 2.6 GPa and 520℃. Well-defined Lue Hf isochrons were obtained for the epidote eclogite(92.38 ± 0.22 ma) and the lawsoniteeepidote blueschist(90.19 ± 0.54 ma),suggesting rapid garnet growth. The lawsoniteeepidote eclogite(87.30 ± 0.39 ma) and the prograde lawsonite blueschist(ca. 86 ma) are younger, whereas the garnet amphibolite(104.5 ± 3.5 ma) is *** data reveal a consistent trend of progressively decreasing geothermal gradient from granulite-facies conditions at ~104 ma to the epidote-eclogite facies around 92 ma, and the lawsonite blueschist-facies between 90 ma and 86 ma. Three Lue Hf garnet dates(between 92 ma and 87 ma) weighted toward the growth of post-peak rims(as indicated by Lu distribution in garnet) suggest that the HP/LT rocks were exhumed continuously and not episodically. We infer that HP/LT metamorphic rocks within the Halilbag?Complex were subjected to continuous return flow, with "warm" rocks being exhumed during the tectonic bur

关键词： Subduction Lu/Hf dating of garnet metamorphic sole Eclogite Blueschist Lawsonite

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LoSI: Large Scale Location Inference Through Fm Signal Integration and Estimation

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Big Data mining and Analytics 2019年第4期2卷 319-348页

作者： Tathagata mukherjee Piyush Kumar Debdeep Pati erik Blasch Eduardo Pasiliao Liqin Xu Department of Computer Science University of Alabama in HuntsvilleHuntsvilleAL 35806USA CompGeom Inc. TallahasseeFL 32311USA Department of Statistics Texas A&M UniversityCollege StationTX 77843USA Air Force Research Laboratory RomeNY 13441USA Air Force Research Laboratory ShalimarFL 32579USA CompGeom Inc. TallahasseeFL 32579USA

In this paper we present a large scale, passive positioning system that can be used for approximate localization in Global Positioning System(GPS) denied/spoofed environments. This system can be used for detecting GPS spoofing as well as for initial position estimation for input to other GPS free positioning and navigation systems like Terrain Contour matching(TERCOm). Our Location inference through Frequency modulation(Fm)Signal Integration and estimation(LoSI) system is based on broadcast Fm radio signals and uses Received Signal Strength Indicator(RSSI) obtained using a Software Defined Radio(SDR). The RSSI thus obtained is used for indexing into an estimated model of expected Fm spectrum for the entire United States. We show that with the hardware for data acquisition, a single point resolution of around 3 miles and associated algorithms, we are capable of positioning with errors as low as a single pixel(more precisely around 0.12 mile). The algorithm uses a largescale model estimation phase that computes the expected Fm spectrum in small rectangular cells(realized using geohashes) across the Contiguous United States(CONUS). We define and use Dominant Channel Descriptor(DCD) features, which can be used for positioning using time varying models. Finally we use an algorithm based on Euclidean nearest neighbors in the DCD feature space for position estimation. The system first runs a DCD feature detector on the observed spectrum and then solves a subset query formulation to find Inference Candidates(IC).Finally, it uses a simple Euclidean nearest neighbor search on the ICs to localize the observation. We report results on 1500 points across Florida using data and model estimates from 2015 and 2017. We also provide a Bayesian decision theoretic justification for the nearest neighbor search.

关键词： Global Positioning System(GPS)-free positioning Frequency modulation(Fm) radio signals of opportunity nearest neighbor search

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Transcription factors specificity protein and nuclear receptor 4A1 in pancreatic cancer

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World Journal of Gastroenterology 2021年第38期27卷 6387-6398页

作者： Stephen Safe Rupesh Shrestha Kumaravel mohankumar marcell Howard erik Hedrick maen Abdelrahim Department of Veterinary Physiology and Pharmacology Texas A&M UniversityCollege StationTX 77845United States Department of Biochemistry and Biophysics Texas A&M UniversityCollege StationTX 77845United States Cancer Institute Cleveland ClinicClevelandOH 44195United States Department of medical Oncology Houston Methodist Hospital Cancer CenterHoustonTX 77030United States

Specificity protein(Sp)transcription factors(TFs)Sp1,Sp3 and Sp4,and the orphan nuclear receptor 4A1(NR4A1)are highly expressed in pancreatic tumors and Sp1 is a negative prognostic factor for pancreatic cancer patient *** of knockdown and overexpression of Sp1,Sp3 and Sp4 in pancreatic and other cancer lines show that these TFs are individually pro-oncogenic factors and loss of one Sp TF is not compensated by other ***4A1 is also a prooncogenic factor and both NR4A1 and Sp TFs exhibit similar functions in pancreatic cancer cells and regulate cell growth,survival,migration and *** is also evidence that Sp TFs and NR4A1 regulate some of the same genes including survivin,epidermal growth factor receptor,PAX3-FOXO1,α5-andα6-integrins,β1-,β3-andβ4-integrins;this is due to NR4A1 acting as a cofactor and mediating NR4A1/Sp1/4-regulated gene expression through GC-rich gene promoter *** studies show that drugs targeting Sp downregulation or NR4A1 antagonists are highly effective inhibitors of Sp/NR4A1-regulated pathways and genes in pancreatic and other cancer cells,and the triterpenoid celastrol is a novel dual-acting agent that targets both Sp TFs and NR4A1.

关键词： Specificity protein Nuclear receptor 4A1 Pancreatic cancer Transcription factors Ligand inhibitors Nuclear receptor 4A antagonists

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Energy harvesting textiles for a rainy day:woven piezoelectrics based on melt-spun PVDF microfibres with a conducting core

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npj Flexible Electronics 2018年第1期2卷 67-75页

作者： Anja Lund Karin Rundqvist erik Nilsson Liyang Yu Bengt Hagstrom Christian muller Department of Chemistry and Chemical Engineering Chalmers University of TechnologyGöteborg 41296Sweden The Swedish School of Textiles University of BorasBoras 50190Sweden Department of materials Swerea IVFBox 104Mölndal 43122Sweden Department of Industrial and materials Science Chalmers University of TechnologyGoteborg 41296Sweden

Recent advances in ubiquitous low-power electronics call for the development of light-weight and flexible energy *** textile format is highly attractive for unobtrusive harvesting of energy from e.g.,biomechanical ***,we report the manufacture and characterisation of fully textile piezoelectric generators that can operate under wet *** use a weaving loom to realise textile bands with yarns of melt-spun piezoelectric microfibres,that consist of a conducting core surrounded byβ-phase poly(vinylidene fluoride)(PVDF),in the warp *** core-sheath constitution of the piezoelectric microfibres results in a—for electronic textiles—unique *** inner electrode is fully shielded from the outer electrode(made up of conducting yarns that are integrated in the weft direction)which prevents shorting under wet *** a result,and in contrast to other energy harvesting textiles,we are able to demonstrate piezoelectric fabrics that do not only continue to function when in contact with water,but show enhanced *** piezoelectric bands generate an output of several volts at strains below one *** show that integration into the shoulder strap of a laptop case permits the continuous generation of four microwatts of power during a brisk *** promising performance,combined with the fact that our solution uses scalable materials and well-established industrial manufacturing methods,opens up the possibility to develop wearable electronics that are powered by piezoelectric textiles.

关键词： piezoelectric harvesting electrode

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Syndromic craniosynostosis associated with microdeletion of chromosome 19p13.12-19p13.2

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Genes & Diseases 2015年第4期2卷 347-352页

作者： Sarah m.Lyon Darrel Waggoner Sara Halbach erik C.Thorland Leila Khorasani Russell R.Reid Pritzker School of medicine University of ChicagoUnited States Department of Human Genetics and Pediatrics University of Chicago5841 S.Maryland AveM/C 0077ChicagoIL 60637United States Lab medicine&Pathology 200 First St SWHilton 970RochesterMN 55905-0001United States Department of Surgery University of Chicago5841 S.Maryland AveM/C 0077ChicagoIL 60637United States

Craniosynostosis,a condition in which the cranial sutures prematurely fuse,can lead to elevated intracranial pressure and craniofacial abnormalities in young *** surgical intervention is the only therapeutic option for patients with this *** has been associated with a variety of different gene mutations and chromosome *** we describe three cases of partial deletion of chromosome *** of the cases present with syndromic craniosynostosis while one has metopic ridging.A review of the genes involved in the rearrangements between the three cases suggests several gene candidates for *** and DAND5,BmP regulators involved in osteoblast differentiation,and mORG1,a mediator of osteoclast dysregulation may play a role in abnormal cranial vault ***,CACNA1A,a gene that when mutated is associated with epilepsy and CC2D1A,a gene associated with non-syndromic mental retardation may contribute to additional phenotypic features seen in the patients we *** addition,these findings further support the need for genetic testing in cases of syndromic craniosynostosis.

关键词： Chromosome 19 Craniofacial syndrome Craniosynostosis microarray microdeletion

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