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国际医学放射学杂志 2021年第6期 732-733页

作者： S.R.Teixeira J.Elias Jr C.M.Coutinho M.C.Z.Zotin A.Y.Yamamoto S.F.B.de Moura Negrini 朱冬勇

就纳入标准和实验室检查结果而言,将神经影像学结果作为先天性寨卡病毒感染的主要结果的研究存在差异。目的研究产前接触寨卡病毒婴儿的颅内超声征象,并描

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Conservative management of cholestasis with and without fever in acute biliary pancreatitis

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World journal of Gastrointestinal Surgery 2012年第3期4卷 55-61页

作者： joséSebastio Santos Rafael Kemp joséCelso Ardengh jorge elias jr Division of Digestive Surgery Department of Surgery and AnatomyFaculty of Medicine of Ribeiro PretoUniversity of So Paulo Department of Internal Medicine Faculty of Medicine of Ribeiro PretoUniversity of So Paulo

The presence of cholestasis in both mild and severe forms of acute biliary pancreatitis(ABP)does not justify,of itself,early endoscopic retrograde cholangiography(ERC)or endoscopic sphincterotomy(ES).Clinical support treatment of acute pancreatitis for one to two weeks is usually accompanied by regression of pancreatic edema,of cholestasis and by stone migration to the duodenum in 60%-88%of cases.On the other hand,in cases with both cholestasis and fever,a condition usually characterized as ABP associated with cholangitis,early ES is normally indicated.However,in daily clinical practice,it is practically impossible to guarantee the coexistence of cholangitis and mild or severe acute pancreatitis.Pain,fever and cholestasis,as well as mental confusion and hypotension,may be attributed to inflammatory and necrotic events related to ABP. Under these circumstances,evaluation of the bile duct by endo-ultrasonography(EUS)or magnetic resonance cholangiography(MRC)before performing ERC and ES seems reasonable.Thus,it is necessary to assess the effects of the association between early and opportune access to the treatment of local and systemic inflammatory/infectious effects of ABP with cholestasis and fever, and to characterize the possible scenarios and the subsequent approaches to the common bile duct,directed by less invasive examinations such as MRC or EUS.

关键词： Biliary pancreatitis Cholestasis Endoscopic sphincterotomy Cholangitis Mortality Magnetic resonance cholangiopancreatography Endoscopic retrograde cholangiography Endoscopic ultrasonography Intensive care Health system regulation

联合肝脏的小肠移植可减少免疫排斥但会增加感染

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Gastroenterology Report 2018年第1期6卷 29-37,I0001,I0002页

作者： Guosheng Wu Ruy j.Cruz jr Department of Gastrointestinal Surgery Xijing Hospital of Digestive DiseasesThe Fourth Military Medical UniversityXi’anShannxiChina Thomas E.Starzl Transplantation Institute University of Pittsburgh Medical CenterPittsburghPAUSA

背景:联合肝移植被认为可以减轻其他移植器官的免疫排斥损伤,但联合肝移植对移植小肠的影响目前尚无详细的研究数据。本研究旨在比较联合肝脏的小肠移植(LITx)与不联合肝脏的小肠移植(LETx)免疫排斥情况、移植失败的原因及临床结局。方... 详细信息

背景:联合肝移植被认为可以减轻其他移植器官的免疫排斥损伤,但联合肝移植对移植小肠的影响目前尚无详细的研究数据。本研究旨在比较联合肝脏的小肠移植(LITx)与不联合肝脏的小肠移植(LETx)免疫排斥情况、移植失败的原因及临床结局。方法:2000年5月至2010年5月间,212例成人小肠移植患者纳入研究,其中接受LITx者76例,接受LETx者136例。LITx包括肝肠联合移植和含肝脏在内的多器官联合移植,LETx则包括单独小肠移植和不含肝脏的改良多器官联合移植。结果:在(44.9631.4)月的术后随访期间,LITx组患者1、3、5年移植小肠存活率分别为96.9%、93.2%和89.9%,LETx分别为91.4%、69.3%和60.0%,两组差异有统计学意义(P<0.0001)。由于免疫排斥导致移植失败的比例LETx组高于LITx组(30.9%vs 6.6%,P<0.0001),而由于感染导致移植失败的比例LITx组则相对较高(25.0%vs 5.1%,P<0.0001)。按免疫排斥的类型进行分析,尽管两组急性细胞排斥反应的总体情况相当,但LITx组发生频率(平均0.87 vs 1.42,P=0.02)和严重程度(重度比例7.9%vs 21.3%,P=0.01)显著优于LETx组;急性抗体介导的排斥反应发生率(3.6%vs 25.1%,P=0.03)和慢性排斥反应发生率(3.9%vs 24.3%,P=0.0002)LITx组亦明显低于LETx组。结论:联合肝脏的小肠移植似乎可以减轻术后免疫排斥,但同时也增加了感染的风险。我们的研究结果提示,LITx有其独特的免疫特征和临床进程,对于行LITx的患者,应降低免疫抑制治疗的强度以减少感染的发生风险。

关键词：小肠移植免疫抑制排斥感染

Integrity and resilience in the face of multiple crises:commentary from Puerto Rico

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Forensic Sciences Research 2021年第3期6卷 316-319页

作者： Richard j.Noel jr jose A.Torres-Ruiz Department of Basic Sciences School of MedicinePonce Health Sciences UniversityPoncePRUSA Office of the Chancellor Ponce Health Sciences UniversityPoncePRUSA

Since 2010,the population of Puerto Rico has declined by 11.8%and is currently 3.3 million peo-ple[1].This worrisome trend is a result of a pleth-ora of island-wide challenges spanning financial difficulties,natural disasters,and epidemics.Following over a decade of economic hardship and debt,incapacitating hurricanes,Irma and Maria,destroyed large swaths of the island in 2017.While still recovering from that disaster,a magnitude 6.4 earthquake centered about 5 miles off the south-western coast on january 7,2020,destroying build-ings and roads in southwestern Puerto Rico.This event,and subsequent aftershocks that continue until today,further aggravate an already stressed popula-tion.In the mix,viral epidemics have brought fur-ther economic,social,and health-related suffering.Puerto Rico was the centre of the 2016-2017 Zika virus infections,representing over 85%of the US infections in 2016[2].

关键词： island disaster southwestern

Alternative expressions for stand diameter in complex forests

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Forest Ecosystems 2023年第3期10卷 328-336页

作者： Mark j.Ducey john A.Kershaw jr. Department of Natural Resources and the Environment University of New HampshireDurhamNHUSA Faculty of Forestry and Environmental Management University of New BrunswickFrederictonNBCanada

Quadratic mean diameter is the most frequently reported descriptor of the diameter distribution of forests.As such,it is often used as an indicator of forest stand structure,developmental stage,and ecological and economic potential.However,quadratic mean diameter can be heavily influenced by the presence or absence of large numbers of small stems in lower canopy strata,and it is also sensitive to left-truncation of the diameter distribution,making its interpretation across inventories with different protocols challenging.Here,we examine three alternative expressions of stand diameter:the arithmetic and quadratic mean diameter of the thickest 100 trees per hectare,and the basal area-weighted mean diameter.Using data from the United States Forest Inventory and Analysis program for New York and New England,these alternative expressions showed closer correlation with multiple stand structural variables than did quadratic mean diameter,including merchantable cubic and board foot volume per hectare,aboveground live tree carbon per hectare,and total number of live and dead standing trees greater than 40 cm diameter at breast height per hectare(previously proposed as an index of old-growth structure).Arithmetic and quadratic mean diameter of the thickest 100 trees per hectare showed nearly identical performance,and the strongest correlations across the board.We develop closed-form expressions for these variables when the diameter distribution is a Weibull,and illustrate their behavior relative to quadratic mean diameter for that situation.While the reasons for prevalence of quadratic mean diameter as an indicator remain valid,we suggest that these alternative measures should be more widely reported and analyzed to give a more informative depiction of stand structure and development in complex forests.

关键词： Forest structure Diameter at breast height Weibull distribution

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Paleoecological Response of Corals to the End-Triassic Mass Extinction： An Integrational Analysis

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journal of Earth Science 2018年第4期29卷 879-885页

作者： George D Stanley jr Hannah M E Shepherd Autumn j Robinson University of Montana Paleontology Center Missoula MT 59812 USA

The end-Triassic （also Triassic-jurassic） mass extinction severely affected life on planet Earth 200 million years ago. Paleoclimate change triggered by the volcanic eruptions of the Central Atlantic Magmatic Province （CAMP） caused a great loss of marine biodiversity, among which 96% coral genera were get lost. However, there is precious little detail on the paleoecology and growth forms lost between the latest Triassic extinction and the Early jurassic recovery. Here a new pilot study was conducted by analyzing corallite integration levels among corals from the latest Triassic and Early jurassic times. Integration levels in corals from the Late Triassic and Early jurassic were determined through both the Paleobiology Database as well as from a comprehensive museum collection of fossil corals. Results suggest that in addition to a major loss of diversity following the end-Triassic mass extinction, there also was a significant loss of highly integrated corals as clearly evidenced by the coral data from the Early jurassic. This confirms our hypothesis of paleoecological selectivity for corals following the end-Triassic mass extinction. This study highlights the importance of assigning sim- ple to advanced paleoecological characters with integration levels, which opens a useful approach to understanding of mass extinction and the dynamics of the recovery.

关键词： coral loss integration level end-Triassic mass extinction paleoecology

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Up-regulation of Long Non-coding RNA TUG1 in Hibernating Thirteen-lined Ground Squirrels

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Genomics, Proteomics & Bioinformatics 2016年第2期14卷 113-118页

作者： jacques j.Frigault Daneck Lang-Ouellette Pier Morin jr. Department of Chemistry and Biochemistry Faculty of Sciences Universite'de Moncton

Mammalian hibernation is associated with multiple physiological, biochemical, and molecular changes that allow animals to endure colder temperatures. We hypothesize that long non-coding RNAs（lnc RNAs）, a group of non-coding transcripts with diverse functions, are differentially expressed during hibernation. In this study, expression levels of lncRNAs H19 and TUG1 were assessed via qRT-PCR in liver, heart, and skeletal muscle tissues of the hibernating thirteen-lined ground squirrels（Ictidomys tridecemlineatus）. TUG1 transcript levels were significantly elevated 1.94-fold in skeletal muscle of hibernating animals when compared with euthermic animals. Furthermore, transcript levels of HSF2 also increased 2.44-fold in the skeletal muscle in hibernating animals. HSF2 encodes a transcription factor that can be negatively regulated by TUG1 levels and that influences heat shock protein expression. Thus, these observations support the differential expression of the TUG1-HSF2 axis during hibernation. To our knowledge, this study provides the first evidence for differential expression of lnc RNAs in torpid ground squirrels, adding lnc RNAs as another group of transcripts modulated in this mammalian species during hibernation.

关键词： Hibernation Hypometabolism Cold adaptation Non-codiag RNAs lncRNAs

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Intramedullary bone pedestal formation contributing to femoral shaft fracture nonunion:A case report and review of the literature

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World journal of Orthopedics 2022年第5期13卷 528-537页

作者： Charles B Pasque Alexander j Pappas Chad A Cole jr Department of Orthopaedic Surgery and Rehabilitation University of Oklahoma College of MedicineOklahoma CityOK 73104United States University of Colorado School of Medicine AuroraCO 80045United States

BACKGROUND Femoral shaft fracture is a commonly encountered orthopedic injury that can be treated operatively with a low overall delayed/nonunion rate.In the case of delayed union after antegrade or retrograde intramedullary nail fixation,fracture dynamization is often attempted first.Nonunion after dynamization has been shown to occur due to infection and other aseptic etiologies.We present a unique case of diaphyseal femoral shaft fracture nonunion after dynamization due to intramedullary cortical bone pedestal formation at the distal tip of the nail.CASE SUMMARY A 37-year-old male experienced a high-energy trauma to his left thigh after coming down hard during a motocross jump.Evaluation was consistent with an isolated,closed,left mid-shaft femur fracture.He was initially managed with reamed antegrade intramedullary nail fixation but had continued thigh pain.Radiographs at four months demonstrated no evidence of fracture union and failure of the distal locking screw,and dynamization by distal locking screw removal was performed.The patient continued to have pain eight months after the initial procedure and 4 mo after dynamization with serial radiographs continuing to demonstrate no evidence of fracture healing.The decision was made to proceed with exchange nailing for aseptic fracture nonunion.During the exchange procedure,an obstruction was encountered at the distal tip of the failed nail and was confirmed on magnified fluoroscopy to be a pedestal of cortical bone in the canal.The obstruction required further distal reaming.A longer and larger diameter exchange nail was placed without difficulty and without a distal locking screw to allow for dynamization at the fracture site.Post-operative radiographs showed proper fracture and hardware alignment.There was subsequently radiographic evidence of callus formation at one year with subsequent fracture consolidation and resolution of thigh pain at eighteen months.CONCLUSION The risk of fracture nonunion caused by intramedullary bone pedestal formation can be mitig

关键词： Nonunion Femoral shaft fracture Diaphysis Fracture fixation Antegrade intramedullary nail Case report

Deformation‑Induced Strengthening Mechanism in a Newly Designed L‑40 Tool Steel Manufactured by Laser Powder Bed Fusion

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Acta Metallurgica Sinica(English Letters) 2023年第1期36卷 21-34页

作者： Yuan Tian Kanwal Chadha Clodualdo Aranas jr Voestalpine Additive Manufacturing Centre Ltd MississaugaON L5N 7Y3Canada Department of Mechanical Engineering University of New BrunswickFrederictonNB E3B 5A3Canada Planetary and Space Science Centre University of New BrunswickFrederictonNB E3B 5A3Canada

The microstructural and mechanical properties of a newly designed tool steel(L-40),specifcally designed to be employed in the laser powder bed fusion(LPBF)technique,were examined.Melt pool boundaries with submicron dendritic structures and about 14%retained austenite phase were evident after printing.The grain orientation after high cooling rate solidifcation is mostlyα∥building direction(BD).Then,the heat treatment converted the microstructure into a conventional martensitic phase,reduced the retained austenite to about 1.5%,and increasedα∥BD texture.The heat-treated sample exhibits higher tensile strength(1720±14 MPa)compared to the as-printed sample(1540±26 MPa)along the building direction,mainly due to hardening caused by a lower volume fraction of retained austenite phase and precipitation of carbides.As a consequence of the strength-to-ductility trade-of,the heat-treated sample showed lower elongation(10%±2%)than that of the as-printed sample(18%±2%).It was observed that transformation-induced plasticity(TRIP)occurs in both the as-printed and heat-treated samples during tensile testing,which dynamically transforms the retained austenite into martensite,leading to improved ductility.The minimum driving force to initiate the displacive phase transformation is about 6000 j/mol,which was achieved during tensile testing.The strength and ductility of LPBF-produced L-40 were compared with the other LPBF-produced tool steels in literature;the data indicate that heat-treated L-40 has an excellent combination of strength and ductility complemented with high printability.

关键词： Additive manufacturing Laser powder bed fusion L-40 tool steel Phase transformation

IDEALIZED SIMULATIONS OF THE INNER CORE BOUNDARY LAYER STRUCTURE IN A LANDFALLING TROPICAL CYCLONE. PART Ⅰ: KINEMATIC STRUCTURE

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Tropical Cyclone Research and Review 2019年第2期8卷 53-73页

作者： GABRIEL j.WILLIAMS jr. Department of Physics and Astronomy College of Charleston

The effects of coastal topography and coastal location in the distribution of boundary layer winds in the inner core of mature tropical cyclones are examined using a high-resolution multi-level model. In these numerical simulations, the evolution of the tropical cyclone boundary layer(TCBL) is studied in storm-relative coordinates, and in lieu of an actual steering current moving the model vortex, the position of the land-sea interface was shifted through the grid domain at a constant speed with separate surface boundary conditions specified over the land and ocean areas. It is shown that the presence of a coastal boundary produces land-induced asymmetries(along with an internal boundary layer) due to the asymmetric structure of surface drag. This land-induced asymmetry is found in both the azimuthal and radial wind field at landfall. For a moving storm, nonlinear advective interactions between storm-induced asymmetries and land-induced asymmetries can generate a lowlevel vorticity band ahead of the hurricane. When the storm motion vector has a component that is perpendicular to the coastal boundary, the interaction between this band and the mean vortex leads to a temporary weakening and re-intensification cycle. Furthermore, it is shown that the relative magnitude of the land-induced asymmetry depends upon the terrain slope and the terrain height such that the land-induced asymmetry dominates over the motion-induced asymmetry for elevated terrain. These results underscore the specific differences in boundary layer evolution and intensity evolution for hurricanes interacting with complex topographical features.

关键词： hurricane tropical cyclone landfalling hurricane tropical cyclone boundary layer