检索结果-南通市图书馆

世界核心医学期刊文摘（儿科学分册） 2006年第9期2卷 38-39页

作者： Nwomeh B.C. Georges A.j. groner j.i. 刘凯 Department of Pediatric Surgery Children's HospitalColumbusOH 43205United States

Background:Limitation of resident work hours has created the need to explore alternatives to surgeon presence during initial assessment and resuscitation for selected life-threat-ening injuries in children. We recently eliminated the requirement for surgeon presence during Level ii alerts. The purpose of this study was to evaluate the impact of this change on patient care. Methods:A retrospective analysis of trauma alert activity was performed using data from our trauma registry. in March 2003,responsibility for level ii alerts was transferred from the pediatric surgeons (PSs) to the Emergency Department (ED)-physicians. We compared the activity in the 18-month period before this change (period 1; n=627) to that afterward (period 2; n=587). Outcome measures included injury severity score,emergency department length of stay,missed injuries,abdominal computed tomography use,and mortality. Data were analyzed using log-rank statistic,χ 2,or t test,where appropriate,with significance level at P ing the entire study period,1499 patientsmet the trauma alert activation criteria of which 1214 (81% ) were level ii alerts. The mean injury severity score for period 1 (8.5 ± 7.3 SD) was similar to period 2 (9.0 ± 7.1 SD). When ED physicians replaced PS for Level ii alerts,ED length of stay increased from 135 minutes to 165 minutes (P in addition,the use of abdominal computed tomography was significantly decreased (53.6% vs 42.6% ; P issed injuries and no significant differences in the rate of mortality. Conclusions:When ED physicians replaced PS for Level ii alerts,trauma room length of stay was increased,but use of abdominal imaging was decreased with no differences in rate of missed injury or mortality. Emergency Department physicians can safely replace PS during Level ii alerts. These findings may be useful to institutions experiencing surgical workforce limitations for trauma alerts.

关键词：医疗理念 ii 创伤反应创伤严重度评分急诊科漏诊率创伤急救漏诊情况工作时间停留时间

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Unexpectedly low δ^(13)C in leaves,branches,stems and roots of three acacia species growing in hyper-arid environments

引用

journal of Plant Ecology 2021年第1期14卷 117-131页

作者： Daphna Uni Elli groner Elaine Soloway Amgad Hjazin Spencer johnswick Gidon Winters Efrat Sheffer ido Rog Yael Wagner Tamir Klein Department of Plant and Environmental Sciences Weizmann Institute of ScienceRehovotIsrael The Dead Sea-Arava Science Center Tamar Regional CouncilNeve Zohar 86910Israel institute of Plant Sciences and Genetic in Agriculture The Robert H.Smith Faculty of AgricultureFood and EnvironmentThe Hebrew University of JerusalemRehovotIsrael Arava institute for Environmental Studies Kibbutz KeturaIsrael

Aims in plant eco-physiology,less negative(enriched)carbon 13(^(13)C)in the leaves indicates conditions of reducing leaf gas exchange through stomata,*** *** addition,^(13)C is expected to be less negative in non-photosynthetic tissues as compared with ***,these relationships inδ^(13)C from leaves(photosynthetic organs)to branches,stems and roots(non-photosynthetic organs)are rarely tested across multiple closely related tree species,multiple compartments,or in trees growing under extreme heat and *** We measured leaf-to-root^(13)C in three closely related desert acacia species(Acacia tortilis,*** and ***).We measuredδ^(13)C in leaf tissues from mature trees in southern *** parallel,a 7-year irrigation experiment with 0.5,1.0 or 4.0 L day1 was conducted in an experimental *** the end of the experiment,growth parameters andδ^(13)C were measured in leaves,branches,stems and *** Findings Theδ^(13)C in leaf tissues sampled from mature trees was ca.-27‰,far more depleted than expected from a desert tree growing in one of the Earth's driest and hottest *** acacia species and compartments,δ^(13)C was not enriched at all irrigation levels(-28‰to ca.-27‰),confirming our measurements in the mature *** compartments,leafδ^(13)C was unexpectedly similar to branch and rootδ^(13)C,and surprisingly,even less negative than stemδ^(13)*** highly depleted leafδ^(13)C suggests that these trees have high stomatai gas exchange,despite growing in extremely dry *** lack ofδ^(13)C enrichment in nonphotosynthetic tissues might be related to the seasonal coupling of growth of leaves and heterotrophic tissues.

关键词： stable isotope δ^(13)C enrichment desert tree drought resistance Acacia raddiana Acacia tortilis

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

下肢损伤和学步期婴幼儿中儿童虐待的发生风险

引用

世界核心医学期刊文摘（儿科学分册） 2005年第6期1卷 43-44页

作者： Coffey C. Haley K. Hayes j. groner j. i. 宁亮 The Trauma Program Children’s Hospital Columbus OH 43205 United States

The aim of this study was to assess the risk of child abuse in children younger than 18 months admitted to a pediatric trauma service with lower extremity injuries. An institutional Review Board-approved retrospective case series of children admitted to a regional pediatric trauma center with lower extremity injuries from 1998 to 2002 (n = 5497) was performed. Factors analyzed included age, injuries, and injury mechanism. Among 5497 trauma patients, the incidence of abuse was 104 (2%) of 4942 children 18 months or older and 175(32%) of 555 children younger than 18 months (odds ratio [OR], 21.4±2.9, P ients with lower extremity injuries in the entire sample, and 66 of these were younger than 18 months. in the extremity trauma group, for patients 18 months or older, 16 (1%) of 1186 were abused compared with 44 (67%) of 66 patients younger than 18 months (OR, 146 ±53, P ients younger than 18 months, 41 of 55 lower extremity fractures were linked to abuse, whereas 134 of 500 other injuries were caused by abuse (OR, 8.0 ±2.6, P ibia fracture (14). Among children 18 months or older, abuse is an uncommon cause of lower extremity trauma. in children younger than 18 months, lower extremity injuries, particularly fractures, are highly associated with child abuse. Clinicians must thoroughly investigate lower extremity injuries in this age group.

关键词：下肢损伤学步期下肢骨折学术评论临床医生性创伤总样本

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：