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Disparities in employment outcomes among critical care graduates with different training backgrounds

Emergency and Critical Care Medicine 2023年第4期3卷 163-170页

作者： greg j.eisinger Patrick j.Sylvester Dheeraj Duggineni David P.Way jing Peng jiang Ma jennifer W.McCallister Matthew C.Exline Division of Pulmonary Critical Care and Sleep Medicine Department of Internal MedicineThe Ohio State University Wexner Medical CenterColumbusOHUSA Team Health KnoxvilleTNUSA Department of Emergency Medicine The Ohio State University Wexner Medical CenterColumbusOHUSA Department of Biomedical Informatics The Ohio State UniversityColumbusOHUSA

Background:We sought to characterize the impact of critical care training pathways on subsequent employment ***:A survey assessing the postfellowship work environment and barriers to employment in a preferred setting was electronically distributed on September 16,2019,to program directors and coordinators at all US adult critical care fellowships with instructions to for-ward it to the prior year’s ***:Data collection was interrupted by the coronavirus disease 2019 ***-nine participants were included,reflecting a low rate of *** worked in urban areas(76.6%)at academic hospitals(81.7%).Graduates of internal medicine critical care(IMCC)were more likely than pulmonary critical care(PCC)to report their fellowship as a barrier to employment(50%vs 0%;P<0.05).Emergency medicine graduates were more likely than internal medicine to report their residency as a barrier to employment(83.3%vs 4.6%;P<0.05).Inability to find a desired position at an academic center(50%vs 5.9%;P<0.05)and in the preferred metropolitan setting(37.5%vs 0%;P<0.05)were more common among IMCC than ***:In this survey of critical care graduates,residency in emergency medicine and fellowship in IMCC were associated with in-creased barriers to finding desired employment.

关键词： Bias Critical care Critical care workforce Employment medicine Employment barriers Employment opportunities Fellowship training job market Residency training

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Roles of SO_2 oxidation in new particle formation events

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journal of Environmental Sciences 2015年第4期27卷 90-101页

作者： He Meng Yujiao Zhu greg j.Evans Cheol-Heon jeong Xiaohong Yao Key Lab of Marine Environmental Science and Ecology Ministry of Education Ocean University of China Southern Ontario Centre for Atmospheric Aerosol Research University of Toronto

The oxidation of SO2 is commonly regarded as a major driver for new particle formation（NPF） in the atmosphere. In this study, we explored the connection between measured mixing ratio of SO2 and observed long-term（duration 〉 3 hr） and short-term（duration〈 1.5 hr） NPF events at a semi-urban site in Toronto. Apparent NPF rates（j30） showed a moderate correlation with the concentration of sulfuric acid（[H2SO4]） calculated from the measured mixing ratio of SO2 in long-term NPF events and some short-term NPF events（Category I）（R^2= 0.66）. The exponent in the fitting line of j30~ [H2SO4]nin these events was1.6. It was also found that SO2 mixing ratios varied a lot during long-term NPF events,leading to a significant variation of new particle counts. In the SO2-unexplained short-term NPF events（Category II）, analysis showed that new particles were formed aloft and then mixed down to the ground level. Further calculation results showed that sulfuric acid oxidized from SO2 probably made a negligible contribution to the growth of 〉 10 nm new particles.

关键词： Nucleation Particle growth Sulfuric acid Photochemical oxidation SO2

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Seasonal resource selection of an arboreal habitatspecialist in a human-dominated landscape: A case studyusing red panda

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Current Zoology 2023年第1期69卷 1-11页

作者： Damber Bista greg S.Baxter Nicholas j.Hudson Peter j.Murray School of Agriculture and Food Sciences(Wildlife Science Unit) The University of QueenslandGattonQLD 4343Australia School of Agriculture and Environmental Science University of Southern QueenslandDarling HeightsQLD 4350Australia

Human-dominated landscapes provide heterogeneous wildlife habitat. Conservation of habitat specialists, like red pandas Ailurus fulgens, inhabiting such landscapes is challenging. Therefore, information on resource use across spatial and temporal scales could enable informed-decisionmaking with better conservation outcomes. We aimed to examine the effect of geo-physical, vegetation, and disturbance variables on fine-scalehabitat selection of red pandas in one such landscape. We equipped 10 red pandas with GPS collars in eastern Nepal in 2019 and monitoredthem for 1 year. Our analysis was based on a generalized-linear-mixed model. We found the combined effect of geo-physical, vegetation, anddisturbance variables resulted in differences in resource selection of red pandas and that the degree of response to these variables variedacross seasons. Human disturbances, especially road and cattle herding activities, affected habitat utilization throughout the year whereas othervariables were important only during restricted periods. For instance, geo-physical variables were influential in the premating and cub-rearingseasons while vegetation variables were important in all seasons other than premating. Red pandas selected steeper slopes with high solarinsolation in the premating season while they occupied elevated areas and preferred specific aspects in the cub-rearing season. Furthermore,the utilized areas had tall bamboo in the birthing and cub-rearing seasons while they also preferred diverse tree species and high shrub coverin the latter. Our study demonstrates the significance of season-specific management, suggests the importance of specific types of vegetationduring biologically crucial periods, and emphasizes the necessity to minimize disturbances throughout the year.

关键词： Ailurus fulgens anthropogenic disturbances habitat specialists habitat utilization resource use spatio-temporal variation vegetation

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Lower limb stress fractures in sport:Optimising their management and outcome

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World journal of Orthopedics 2017年第3期8卷 242-255页

作者： greg A j Robertson Alexander M Wood Edinburgh Orthopaedic Trauma Unit Royal Infirmary of Edinburgh Edinburgh Department of Orthopaedic Leeds General Infirmary

Stress fractures in sport are becoming increasing more common,comprising up to 10%of all of sporting *** 90%of such injuries are located in the lower *** articles aims to define the optimal management of lower limb stress fractures in the athlete,with a view to maximise return rates and minimise return times to *** planning of this condition is specific to the location of the ***,there remains a clear division of stress fractures by"high"and"low"risk."Low risk"stress fractures are those with a low probability of fracture propagation,delayed union,or non-union,and so can be managed reliably with rest and exercise *** include stress fractures of the PosteroMedial Tibial Diaphysis,Metatarsal Shafts,Distal Fibula,Medial Femoral Neck,Femoral Shaft and Calcaneus."High risk"stress fractures,in contrast,have increased rates of fracture propagation,displacement,delayed and non-union,and so require immediate cessation of activity,with orthopaedic referral,to assess the need for surgical *** include stress fractures of the Anterior Tibial Diaphysis,Fifth Metatarsal Base,Medial Malleolus,Lateral Femoral Neck,Tarsal Navicular and Great Toe *** order to establish the optimal methods for managing these injuries,we present and review the current evidence which guides the treatment of stress fractures in *** this,we note an increased role for surgical management of certain high risk stress fractures to improve return times and rates to *** this,key recommendations are provided for the management of the common stress fracture types seen in the *** case reports are also presented to illustrate the application of sportfocussed lower limb stress fracture treatment in the clinical setting.

关键词： Fractures Lower Limb Sport Management Stress

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A GLOBAL VIEW OF THE RELATIONSHIP BETWEEN ENSO AND TROPICAL CYCLONE FREQUENCIES

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Acta meteorologica Sinica 1994年第1期8卷 19-29页

作者：董克勤 greg j.Holland Chinese Academy of Meteorological Sciences Beijing 100081 Bureau of Meteorology Research Centre MelbourneAustralia

The relationship between tropical cyclone activity and ENSO is examined for the major cyclone regions using cross correlations,spectral analysis and composite analysis of eastern equatorial Pacific sea surface temperature,the normalised monthly Southern Oscillation Index(SOI),and tropical cyclone *** closest relationship between the 3—4 year ENSO period and tropical cyclone activity was found in the western North Pacific west of 160°E and there seems to be significant potential for seasonal forecasting in this region based on ENSO parameters *** significant relationships were found for the North Indian Ocean,and the remainder of the basins were dominated by oscillations near the quasi-biennial *** explanations and forecasting of the seasonal variations in tropical cyclone num- bers in these regions will need to account for the QBO as well as the 3—4 year ENSO connections.

关键词： tropical cyclone El Nino Southern Oscillation

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Return to sport following tibial plateau fractures: A systematic review

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World journal of Orthopedics 2017年第7期8卷 574-587页

作者： greg A j Robertson Seng j Wong Alexander M Wood Edinburgh Orthopaedic Trauma Unit Royal Infirmary of Edinburgh Orthopaedic Department Leeds General Infirmary

AIM To systemically review all studies reporting return to sport following tibial plateau fracture, in order to provide information on return rates and times to sport, and to assess variations in sporting outcome for different treatment *** A systematic search of CINAHAL, Cochrane, EMBASE, Google Scholar, MEDLINE, PEDro, Scopus, SPORTDiscus and Web of Science was performed in january 2017 using the keywords "tibial", "plateau", "fractures", "knee", "athletes", "sports", "non-operative", "conservative", "operative", "return to sport". All studies which recorded return rates and times to sport following tibial plateau fractures were included. RESULTS Twenty-seven studies were included: 1 was a randomised controlled trial, 7 were prospective cohort studies, 16 were retrospective cohort studies, 3 were case series. One study reported on the outcome of conservative management(n = 3); 27 reported on the outcome of surgical management(n = 917). Nine studies reported on Open Reduction Internal Fixation(ORIF)(n = 193), 11 on Arthroscopic-Assisted Reduction Internal Fixation(ARIF)(n = 253) and 7 on Frame-Assisted Fixation(FRAME)(n = 262). All studies recorded "return to sport"rates. Only one study recorded a "return to sport" time. The return rate to sport for the total cohort was 70%. For the conservatively-managed fractures, the return rate was 100%. For the surgically-managed fractures, the return rate was 70%. For fractures managed with ORIF, the return rate was 60%. For fractures managed with ARIF, the return rate was 83%. For fractures managed with FRAME was 52%. The return rate for ARIF was found to be significantly greater than that for ORIF(OR 3.22, 95%CI: 2.09-4.97, P < 0.001) and for FRAME(OR 4.33, 95%CI: 2.89-6.50, P < 0.001). No difference was found between the return rates for ORIF and FRAME(OR 1.35, 95%CI: 0.92-1.96, P = 0.122). The recorded return time was 6.9 mo(median), from a study reporting on *** Return rates to sport for tibial pl

关键词： Tibial Plateau Fracture Knee Return Sport Rate Time

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Stable isotope paleohydrology and chemostratigraphy of the Albian Wayan Formation from the wedge-top depozone,North American Western Interior Basin

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Science China Earth Sciences 2017年第1期60卷 44-57页

作者： jeffrey B.ROSS greg A.LUDVIGSON Andreas MOLLER Luis A.GONZALEZ j.D.WALKER Department of Geology University of Kansas Kansas Geological Survey University of Kansas

Understanding of the role of atmospheric moisture and heat transport in the climate system of the Cretaceous greenhouse world represents a major challenge in Earth system science. Stable isotopic paleohydrologic data from mid-Cretaceous paleosols in North America, from paleoequatorial to paleoArctic latitudes, have been used to constrain the oxygen isotope mass balance of the Albian hydrologic cycle. Over the range from 40°-50°N paleolatitude, sideritic paleosols predominate, indicating paleoenvironments with positive precipitation-evaporation （P-E） balances. Local exceptions occur on leeward side of the Sevier Orogen, where calcic paleosols in the wedge-top depozone record paleoenvironments with negative P-E balances in the orographic rain shadow. Stratigraphic sections in the Wayan Formation of Idaho （WF） were sampled from the wedge-top depozone. The units consist of stacked m-scale mudstone paleosols separated by m-scale sandstone-siltstone beds. Sections were sampled for organic carbon isotope profiles, and B-horizons from 6 well-developed paleosols were sampled for detrital zircons to determine maximum depositional ages. The first of these from the WF has produced a U-Pb concordia age of 101.0±1.1 Ma. This same WF section has produced a stratigraphic trend of upwardly decreasing δ18C values ranging from -24‰ upwards to -27‰ VPDB, suggesting correlation to the late Albian C15 C-isotope segment. Pedogenic carbonates from the WF principally consist of micritic calcite, with carbon-oxygen isotope values that array along meteoric calcite lines （MCLs） with δ18O values that range from -9.47‰ up to -8.39‰ VPDB. At approximately 42°N paleolatitude, these MCL values produce calculated paleoprecipitation values of-8.12‰ to -7.04‰ VSMOW, a range that is consistent with the estimates produced from other proxies at the same paleolatitudes across North America. These results indicate that despite the orographic rain shadow effect, the processes of meridional atmospheric moist

关键词： Cretaceous Paleoclimate Wayan Formation Pedogenic carbonates Geochronology

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ACOUSTIC MEASUREMENTS BUBBLES IN BIOLOGICAL TIESSURE

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journal of Hydrodynamics 2009年第1期21卷 47-64页

作者： CHAHINE Georges L. TANGUAY Michel LORAINE greg DYNAFLOW INC. 10621-J Iron Bridge Road Jessup Maryland 20794 USA

An acoustic based instrument, the ABS Acoustic Bubble Spectrometer@@（ABS）, was investigated for the detection and quantification of bubbles in biological media. These include viscoelastic media （blood）, materials of varying density （bone in tissue）, non-homogenous distribution of bubbles （intravenous bubbly flow）, and bubbles migrating in tissue （decompression sickness, DCS）. The performance of the ABS was demonstrated in a series of laboratory experiments. Validation of the code was performed using a viscoelastic polymer solution, Polyox, in which the bubble size distribution and void fraction were determined by ABS measurements and with image analysis of high speed videos. These tests showed that the accuracy of the ABS was not significantly affected by viscoelasticity for bubbles smaller than 200 microns. The ABS detection and measurement of non-homogenous bubble distributions was demonstrated using a bubbly flow through a simulated vein surrounded by tissue. The scatter of acoustic signals due to bones in the acoustic pathway was also investigated. These in-vitro experiments were done using meat （beef） as a tissue simulant. Decompression experiments were done using beef meat which was held underwater at high pressure （9.9 atm） then rapidly decompressed. Bubble size distributions and void fraction calculations in these experiments were then validated using image analysis of high speed video. In addition, preliminary experiments were performed with the US Navy Medical Research Center, demonstrating the utility of the modified ABS system in detecting the evolution of bubbles in swine undergoing decompression sickness （DCS）. These results indicate that the ABS may be used to detect and quantify the evolution of bubbles in-vivo and aid in the monitoring of DCS.

关键词： ABS Acoustic Bubble Spectrometer@@ (ABS) biological tissue decompression sickness (DCS)

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Return to sport following toe phalanx fractures:A systematic review

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World journal of Orthopedics 2023年第6期14卷 471-484页

作者： greg A j Robertson Amit Sinha Thomas Hodkinson Togay Koç Department of Orthopaedic Surgery Queen Alexandra HospitalPortsmouth PO63LYUnited Kingdom Department of Trauma and Orthopaedic Surgery Wales DeaneryCardiff CF157QQUnited Kingdom Department of Orthopaedic Surgery Hull University Teaching Hospitals NHS TrustHull HU32JZUnited Kingdom Department of Trauma and Orthopaedic Surgery Southampton General HospitalSouthampton SO166YDUnited Kingdom

BACKGROUND Evidence-based guidance on return to sport following toe phalanx fractures is *** To systemically review all studies recording return to sport following toe phalanx fractures(both acute fractures and stress fractures),and to collate information on return rates to sport(RRS)and mean return times(RTS)to the *** A systematic search of PubMed,MEDLINE,EMBASE,CINAHL,Cochrane Library,Physiotherapy Evidence Database,and Google Scholar was performed in December 2022 using the keywords‘Toe’,‘Phalanx’,‘Fracture’,‘injury’,‘athletes’,‘sports’,‘non-operative’,‘conservative’,‘operative’,‘return to sport’.All studies which recorded RRS and RTS following toe phalanx fractures were *** Thirteen studies were included:one retrospective cohort study and twelve case *** studies reported on acute *** studies reported on stress *** the acute fractures(n=156),63 were treated with primary conservative management(PCM),6 with primary surgical management(PSM)(all displaced intra-articular(physeal)fractures of the great toe base of the proximal phalanx),1 with secondary surgical management(SSM)and 87 did not specify treatment *** the stress fractures(n=26),23 were treated with PCM,3 with PSM,and 6 with *** acute fractures,RRS with PCM ranged from 0 to 100%,and RTS with PCM ranged from 1.2 to 24 *** acute fractures,RRS with PSM were all 100%,and RTS with PSM ranged from 12 to 24 *** case of an undisplaced intra-articular(physeal)fracture treated conservatively required conversion to SSM on refracture with a return to *** stress fractures,RRS with PCM ranged from 0%to 100%,and RTS with PCM ranged from 5 to 10 *** stress fractures,RRS with PSM were all 100%,and RTS with surgical management ranged from 10 to 16 *** cases of conservatively-managed stress fractures required conversion to *** of these cases were associated with a prolonged delay to diagnosis(1 year,2 years)and four cases with an un

关键词： Acute Stress Fracture Toe Phalanx Return Sport Rate Time

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Immunostimulation in the era of the metagenome

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Cellular & Molecular Immunology 2011年第3期8卷 213-225页

作者： Amy D Proal Paul j Albert greg P Blaney Inge A Lindseth Chris Benediktsson Trevor G Marshall Murdoch University PerthWAAustralia Weill Cornell Medical College New YorkNYUSA Stillpoint Centre VancouverBCCanada 4M-Klinikken OsloNorway Autoimmunity Research Foundation Thousand OaksCAUSA

Microbes are increasingly being implicated in autoimmune *** calls for a re-evaluation of how these chronic inflammatory illnesses are routinely *** standard of care for autoimmune disease remains the use of medications that slow the immune response,while treatments aimed at eradicating microbes seek the exact opposite-stimulation of the innate immune *** is complicated by a cascade of sequelae,including exacerbated inflammation,which occurs in response to microbial *** the past 8 years,we have collaborated with American and international clinical professionals to research a model-based treatment for inflammatory *** intervention,designed to stimulate the innate immune response,has required a reevaluation of disease progression and *** is the inherent conflict between palliation and microbicidal *** microbicidal activity was experienced as immunopathology-a temporary worsening of *** studies are needed,but they will require careful planning to manage this immunopathology.

关键词： antimicrobial peptides autoimmune disease immune reconstitution inflammatory syndrome immunopathology innate immunity metagenomics

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