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Implementation of a Pediatric Emergency Triage System in Xiamen, China

Chinese Medical Journal 2016年第20期129卷 2416-2421页

作者： Gang-Xi Lin Yin-Ling Yang Denise Kudirka Colleen Church Collin K K Yong fiona reilly Qi-Yi Zeng Department of Pediatrics Southern Medical UniversityGuangzhouGuangdong 510515China Department of Emergency Medicine First Affiliated Hospital of Xiamen UniversityXiamenFujian 361003China Department of Emergency Medicine First Affiliated Hospital of Xiamen University Xiamen Fujian 361003 China Department of Emergency Medicine Montreal Children's HospitalTupper V5L 2N1Canada Department of Emergency Medicine British-Columbia Children's HospitalVancouverBC V5L 2N1Canada Department of Emergency Medicine Mater Children's HospitalPaddingtonQueensland 4101Australia

Background：Pediatric emergency rooms （PERs） in Chinese hospitals are perpetually full of sick and injured children because of the lack of sufficiently developed community hospitals and low access to family *** aim of this study was to evaluate the clinical value of a new five-level Chinese pediatric emergency triage system （CPETS）,modeled after the Canadian Triage System and Acuity ***：In this study,we compared CPETS outcomes in our PER relative to those of the prior two-level *** who visited our PER before （January 2013-June 2013） and after （January 2014-June 2014） the CPETS was implemented served as the control and experimental group,*** flow,triage rates,triage accuracy,wait times （overall and for severe patients）,and patient/family satisfaction were compared between the two ***：Relative to the performance of the former system experienced by the control group,the CPETS experienced by the experimental group was associated with a reduced patient flow through the PER （Cox-Stuart test,t =0,P 〈 0.05）,a higher triage rate （93.40% vs.90.75%;χ^2 =801.546,P 〈 0.001）,better triage accuracy （96.32% vs.85.09%;χ^2 =710.904,P 〈 0.001）,shorter overall wait times （37.30 ± 13.80 min vs.41.60 ± 15.40 min;t =11.27,P 〈 0.001）,markedly shorter wait times for severe patients （2.07 [0.65,4.11] min vs.3.23 [1.90,4.36] min;z =-2.057,P =0.040）,and higher family satisfaction rates （94.23% vs.92.21%;x2 =321.528,P 〈 0.001）.Conclusions：Implementing the CPETS improved nurses＇ abilities to triage severe patients and,thus,to deliver the urgent treatments more *** system shunted nonurgent patients to outpatient care effectively,resulting in improved efficiency of PER health-care delivery.

关键词： Clinical Application Emergency Care Patient Satisfaction Wait Time

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Optimizing artificial intelligence in sepsis management: Opportunities in the present and looking closely to the future

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Journal of Intensive Medicine 2024年第1期4卷 34-45页

作者： Darragh O’reilly Jennifer McGrath Ignacio Martin-Loeches Department of Intensive Care Medicine Multidisciplinary Intensive Care Research Organization(MICRO)St James’HospitalDublinIreland Department of Respiratory Intensive care Hospital ClinicUniversitat de BarcelonaIDIBAPSCIBERESBarcelonaSpain

Sepsis remains a major challenge internationally for healthcare *** incidence is rising due to poor public awareness and delays in its recognition and subsequent *** sepsis,mortality increases with every hour left *** intelligence(AI)is transforming worldwide healthcare delivery at *** review has outlined how AI can augment strategies to address this global disease *** and machine learning(ML)algorithms can analyze vast quantities of increasingly complex clinical datasets from electronic medical records to assist clinicians in diagnosing and treating sepsis earlier than traditional *** review highlights how these models can predict the risk of sepsis and organ failure even before it *** gives providers additional time to plan and execute treatment plans,thereby avoiding increasing complications associated with delayed diagnosis of *** potential for cost savings with AI implementation is also discussed,including improving workflow efficiencies,reducing administrative costs,and improving healthcare *** these advantages,clinicians have been slow to adopt AI into clinical *** of the limitations posed by AI solutions include the lack of diverse data sets for model building so that they are widely applicable for routine clinical ***,the subsequent algorithms are often based on complex mathematics leading to clinician hesitancy to embrace such ***,we highlight the need for robust political and regulatory frameworks in this area to achieve the trust and approval of clinicians and patients to implement this transformational technology。

关键词： Artificial intelligence Data science Machine learning Intensive care unit(ICU) Critical care Sepsis

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Mutations of voltage-gated sodium channel contribute to pyrethroid resistance in Panonychus citri

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Insect Science 2024年第3期31卷 803-816页

作者： Deng Pan Qiu-Juan Luo Andrias O.O'reilly Guo-Rui Yuan Jin-Jun Wang Wei Dou Key Laboratory of Entomology and Pest Control Engineering College of Plant ProtectionAcademy of Agricultural SciencesSouthwest UniversityChongqingChina Key Laboratory of Agricultural Biosafety and Green Production of Upper Yangtze River(Ministry of Education) Academy of Agricultural SciencesSouthwest UniversityChongqingChina School of Biological and Environmental Sciences Liverpool John Moores UniversityLiverpoolUK

Insecticide resistance in Panonychus citri is a major obstacle to mite control in citrus *** insecticides are continually used to control mites in China,although resistance to pyrethroids has evolved in some ***,the resistance to the pyrethroid fenpropathrin was investigated and 7 out of 8 field-collected populations of P citri exhibited a high level of resistance,ranging from 171-fold to 15391-fold higher than the susceptible(SS)comparison *** voltage-gated sodium channel(VGSC)mutations were identified in the tested populations:L1031V,F1747L,and *** sequencing was used to evaluate the frequency of these mutations in the 19 field populations.L1031V and F1751I were present in all populations at frequencies of 11.6%-82.1%and 0.5%-31.8%,respectively,whereas the F1747L mutation was only present in 12 populations from Chongqing,Sichuan,Guangxi,and Yunnan *** of these mutations singly or in combination into transgenic flies significantly increased their resistance to fenpropathrin and these flies also exhibited reduced mortality after exposure to the pyrethroids permethrin andβ-*** citri VGSC homology modeling and ligand docking indicate that F1747 and F1751 form direct binding contacts with pyrethroids,which are lost with mutation,whereas L1031 mutation may diminish pyrethroid effects through an allosteric ***,the results provide molecular markers for monitoring pest resistance to pyrethroids and offer new insights into the basis of pyrethroid actions on sodium channels.

关键词： amplicon sequencing kdr mutation molecular docking Panonychus citri pyrethroid resistance transgenic flies

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What's the Biggest Thing in the Universe?

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英语世界 2024年第7期 127-128页

作者： John O'reilly

What's the biggest thing in the universe? It sounds like a child's question but scientists have been searching for an answer for over thirty years. Now a team led by Dr Roger Clowes from the University of Central Lancashire believe they have found it. The largest thing in the universe may be a group of seventy-three quasars.

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Assisted-Living Home

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英语世界 2024年第6期 127-128页

作者： John O'reilly

In the future those who are taking care of old or sick people may get help from the house *** the last few years, new technology, such as the Internet, Wi-Fi and flat TV screens, has changed our homes and the way we live. Now, another technology revolution is happening. A new project at the University of Hertfordshire wants to create a home that supervises people living in it who are weak or elderly.

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Nitrate reduction capacity of the oral microbiota is impaired in periodontitis:potential implications for systemic nitric oxide availability

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International Journal of Oral Science 2024年第1期16卷 52-61页

作者： Bob T.Rosier William Johnston Miguel Carda-Diéguez Annabel Simpson Elena Cabello-Yeves Krystyna Piela Robert reilly Alejandro Artacho Chris Easton Mia Burleigh Shauna Culshaw Alex Mira Department of Genomics and Health FISABIO FoundationCenter for Advanced Research in Public HealthValenciaSpain Department of Biological and Biomedical Sciences Glasgow Caledonian UniversityGlasgowUK Oral Sciences University of Glasgow Dental SchoolSchool of MedicineDentistry and NursingCollege of MedicalVeterinary and Life SciencesUniversity of GlasgowGlasgowUK Sport and Physical Activity Research Institute University of the West of ScotlandBlantyreScotland Instituto de Biomedicina de Valencia Consejo Superior de Investigaciones Científicas(IBV-CSIC)ValenciaSpain CIBER Center for Epidemiology and Public Health MadridSpain

The reduction of nitrate to nitrite by the oral microbiota has been proposed to be important for oral health and results in nitric oxide formation that can improve cardiometabolic conditions. Studies of bacterial composition in subgingival plaque suggest that nitrate-reducing bacteria are associated with periodontal health, but the impact of periodontitis on nitrate-reducing capacity(NRC)and, therefore, nitric oxide availability has not been evaluated. The current study aimed to evaluate how periodontitis affects the NRC of the oral microbiota. First, 16S rRNA sequencing data from five different countries were analyzed, revealing that nitratereducing bacteria were significantly lower in subgingival plaque of periodontitis patients compared with healthy individuals(P < 0.05 in all five datasets with n = 20–82 samples per dataset). Secondly, subgingival plaque, saliva, and plasma samples were obtained from 42 periodontitis patients before and after periodontal treatment. The oral NRC was determined in vitro by incubating saliva with 8 mmol/L nitrate(a concentration found in saliva after nitrate-rich vegetable intake) and compared with the NRC of 15healthy individuals. Salivary NRC was found to be diminished in periodontal patients before treatment(P < 0.05) but recovered to healthy levels 90 days post-treatment. Additionally, the subgingival levels of nitrate-reducing bacteria increased after treatment and correlated negatively with periodontitis-associated bacteria(P < 0.01). No significant effect of periodontal treatment on the baseline saliva and plasma nitrate and nitrite levels was found, indicating that differences in the NRC may only be revealed after nitrate intake. Our results suggest that an impaired NRC in periodontitis could limit dietary nitrate-derived nitric oxide levels, and the effect on systemic health should be explored in future studies.

关键词： impaired intake nitrate

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Toxicity of a seafood toxin， domoic acid， in the retina via modulation of the NRF2 and NF-κB pathways

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Food Science and Human Wellness 2024年

作者： Gabriel Mbuta Tchivelekete Yanqun Cao Mohammad Almarhoun Xinzhi Zhou Agostinho Francisco Cachapa Sebasti?o Tumitangua James reilly Patricia E.Martin Xinhua Shu Department of Biological and Biomedical Sciences， Glasgow Caledonian University Department of Marine Biology， Faculty of Natural Science， University of Namibe Puai Medical School， Shaoyang University Department of Vision Science， Glasgow Caledonian University

Domoic acid (DA)， a biotoxin， is produced by several species of marine dinoflagellate and diatom during harmful algal bloom events. DA is a neurotoxin， in humans and non-human primates， oral exposure to DA results in gastrointestinal effects， while DA at higher doses leads to neurological symptoms， seizures and memory deficiency. Exposure of humans to DA occurs mainly through consumption of contaminated seafoods containing an accumulation of the toxin. Previously， it was unclear if DA can have toxic effects on the retina. We assessed the toxicity of DA in human retinal cells (ARPE-19) and in zebrafish embryos. DA significantly lowered ARPE-19 cell viability dose-dependently， and decreased anti-oxidative capacity， increased inflammation， and promoted cell death， possibly through modulating the NRF2 and NF-κB signalling pathways. Zebrafish embryos exposed to DA for four days from one day post fertilization (dpf) had an increase in mortality and a decrease in both hatching and heartbeat rate and exhibited morphological abnormalities. DA treatment also significantly downregulated expression of antioxidant genes and upregulated expression of inflammation mediators， as well as causing photoreceptor death in zebrafish embryos. The results demonstrate that consuming seafood containing DA will have potential toxic effects in human retinas.

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An Automated,Highly Selective Reaction Monitoring Instrument Using Molecular Rotational Resonance Spectroscopy

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Precision Chemistry 2024年第2期2卷 57-62页

作者： Ann Adele Byars Khushi R.Kompally Emily Mechnick reilly E.Sonstrom Alexander Mikhonin Justin L.Neill Ruth Boetzel James MacGregor Courtney Talicska Jian Li Yizhou Liu BrightSpec Inc.CharlottesvilleVirginia 22903United States Pfizer R&D UK Limited Sandwich CT139NJUnited Kingdom Analytical Research and Development Pfizer Research and DevelopmentGrotonConnecticut 06340United States

Online monitoring of chemical reactions by using analytical chemistry tools is a powerful way to maximize control over these *** this paper,we demonstrate the use of molecular rotational resonance,an emerging and extraordinarily selective spectroscopic technique,to perform automated reaction monitoring *** interface using a six-port valve with a calibrated sample loop,coupled to a temperature controlled inlet for analyte volatilization,was developed and *** reactions were chosen for initial characterization:an amine-aldehyde condensation reaction to form an imine product and an isotopic exchange reaction of aβ-ketoester with keto-enol *** spectrometer was able to provide kinetic information about the reaction and determine reaction *** the future,this system can be extended to detect and quantify impurities and characterize reaction selectivity,in addition to the reaction progress.

关键词： molecular rotational resonance spectroscopy reaction monitoring reaction kinetics isotopes process analytical technology

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Post-discharge follow-up of patients with spine trauma in the National Spinal Cord Injury Registry of Iran during the COVID-19 pandemic:Challenges and lessons learned

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Chinese Journal of Traumatology 2024年第3期27卷 173-179页

作者： Zahra Azadmanjir Moein Khormali Mohsen Sadeghi-Naini Vali Baigi Habibollah Pirnejad Mohammad Dashtkoohi Zahra Ghodsi Seyed Behnam Jazayeri Aidin Shakeri Mahdi Mohammadzadeh Laleh Bagheri Mohammad-Sajad Lotfi Salman Daliri Amir Azarhomayoun Homayoun Sadeghi-Bazargani Gerard O'reilly Vafa Rahimi-Movaghai Health Information Management Department School of Allied Medical SciencesTehran University of Medical SciencesTehranIran Sina Trauma and Surgery Research Center Tehran University of Medical SciencesTehranIran Department of Neurosurgery Lorestan University of Medical SciencesKhoram-AbadIran Department of Epidemiology and Biostatistics School of Public HealthTehran University of Medical SciencesTehranIran Patient Safety Research Center Clinical Rsearch Institute Urma Universty of Medical SciencesUrmaIran Erasmus School of Health Policy&Management(ESHPM) Erasmus University RotterdamRoterdamthe Netherlands Brain and Spinal Cord Injury Research Center Neuroscience InstituteTehran University of Medical SciencesTehranIran Students Scientifc Research Center(SSRC) Tehran University of Medical SciencesTehranIran Department of Neurosurgery Arak University of Medical SciencesArakIran Trauma Research Center Kashan University of Medical SciencesKashanIran Shahid Rahnemoun Hospital Shahid Sadoughi University of Medical SciencesYazdIran Trauma Nuring Rearch entre Faculty of Nursing and Midwifry Kahan Universty of Medical Sciences Kahan Iran Clinical Research Development Unit Imam Hossein HospitalShahroud University of Medical SciencesShahroudIran Research Center for Evidence Based Medicine Faculty of MedicineTabriz University of Medical SciencesTabrizIran Road Trafic Injury Research Center Tabriz University of Medical SciencesTabrizIran School of Public Health and Preventive Medicine Monash UniversityMelbourneAustralia National Trauma Research Institute The AlfredMelbourneAustralia Department of Neurosurgery Shariati HospitalTehran University of Medical SciencesTehranIran Universal Scientific Education and Research Network(USERN) TehranIran Institute of Biochemistry and Biophysics University of TehranTehranIran

Purpose:The purpose of the National Spinal Cord Injury Registry of Iran(NSCIR-IR)is to create an infrastructure to assess the quality of care for spine trauma and in this study,we aim to investigate whether the NSCIR-IR successfully provides necessary post-discharge follow-up data for these ***:An observational prospective study was conducted from April 11,2021 to April 22,2022 in 8 centers enrolled in NSCIR-IR,respectively Arak,Rasht,Urmia,Shahroud,Yazd,Kashan,Tabriz,and *** were classified into 3 groups based on their need for care resources,respectively:(1)non-spinal cord injury(SCI)patients without surgery(group 1),(2)non-SCI patients with surgery(group 2),and(3)SCI patients(group 3).The assessment tool was a self-designed questionnaire to evaluate the care quality in 3 phases:pre-hospital,in-hospital,and *** data from the first 2 phases were collected through the *** post-hospital data were collected by conducting follow-up *** follow-ups were conducted for groups 1 and 2(non-SCI patients),while group 3(SCI patients)had a face-to-face *** study took place during the COVID-19 *** on age and time interval from injury to follow-up were expressed as mean±standard deviation(SD)and response rate and follow-up loss as a ***:Altogether 1538 telephone follow-up records related to 1292 patients were registered in the *** the total calls,918(71.05%)were related to successful follow-ups,but 38 cases died and thus were excluded from data *** the end,post-hospital data from 880 patients alive were *** success rate of follow-ups by telephone for groups 1 and 2 was 73.38%and 67.05%respectively,compared to 66.67%by face-to-face visits for group 3,which was very hard during the COVID-19 *** data completion rate after discharge ranged from 48%-100%,22%-100%and 29%-100%for groups ***:To improve patient accessibility,NSCIR-IR should take me

关键词： Follow-up studies Spinal injuries Spinal cord injuries COVID-19 NSCIR-IR

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Element diffusion ability in metasomatic agents and its effect on chemical characteristics of metasomatized peridotites

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Science China Earth Sciences 2006年第9期49卷 926-937页

作者： Y S O’reilly GEMOC ARC National Key Centre Department of Earth and Planetary Sciences Macquarie University Sydney N.S.W. 2109 Australia

Detailed in situ LM-ICPMS researches on the composite xenoliths from Yingfengling volcano of Leizhou Peninsula, South China, indicate that most incompatible trace elements of clino- pyroxenes in composite xenoliths decrease spatially from pyroxenites to distal lherzolites, and com- patible elements and HREE increase steeply. The increasing and decreasing rate is distinct for dif- ferent trace elements, which give rise to element chromatographic fractionation within metasomatized lherzolites. The element chromatographic fractionation result actually from the difference in element diffusive rate in melts or fluids percolating through wall-rock lherzolites. Based on element variation profiles in composite xenoliths this study indicates that Sr, Nb, La and Ce have the highest diffusive mobility, MREE-HREE are moderate, and Zr, Hf, Ti, Ga and Sc are very low in most cases. Higher diffusive rates of LREE than HREE would enlarge the REE fractionation of metasomatized peridotites, and lower diffusive rate of Zr, Hf and Ti relative to neighbor REEs with similar incompatibility would cause the relative depletion of these elements in metasomatized peridotites. Trace elements com- monly have a higher diffusive rate in fluid-rich infiltrating melt, which will weaken element chroma- tographic fractionation during the metasomatism. The range of mantle metasomatism caused by sili- cate melt intrusion is very limited, generally within tens of centimeters wide. The width of metasoma- tized wall-rock peridotites near the pyroxenite or horblendite veins was strictly controlled by both melt volume and chemical characteristics.

关键词： composite xenolith, metasomatism, chromatographic fractionation, diffusive rate, Leizhou Peninsula.

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