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Resection of complex pancreatic injuries: Benchmarking postoperative complications using the Accordion classification

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World Journal of Gastrointestinal Surgery 2017年第3期9卷 82-91页

作者： jake e krige eduard Jonas Sandie R Thomson Urda K Kotze Mashiko Setshedi Pradeep H Navsaria Andrew J Nicol Surgical Gastroenterology Unit Department of Surgery University of Cape Town Health Sciences Faculty Observatory Groote Schuur Hospital Observatory Department of Medicine University of Cape Town Health Sciences Faculty Department of Surgery Trauma Centre University of Cape Town Health Sciences Faculty Observatory

AIM To benchmark severity of complications using the Accordion Severity Grading System(ASGS) in patients undergoing operation for severe pancreatic injuries. MeTHODS A prospective institutional database of 461 patients with pancreatic injuries treated from 1990 to 2015 was reviewed. One hundred and thirty patients with AAST grade 3, 4 or 5 pancreatic injuries underwent resection(pancreatoduodenectomy, n = 20, distal pancreatectomy, n = 110), including 30 who had an initial damage controllaparotomy(DCL) and later definitive surgery. AAST injury grades, type of pancreatic resection, need for DCL and incidence and ASGS severity of complications were assessed. Uni-and multivariate logistic regression analysis was applied. ReSULTS Overall 238 complications occurred in 95(73%) patients of which 73% were ASGS grades 3-6. Nineteen patients(14.6%) died. Patients more likely to have complications after pancreatic resection were older, had a revised trauma score(RTS) ere shocked on admission, had grade 5 injuries of the head and neck of the pancreas with associated vascular and duodenal injuries, required a DCL, received a larger blood transfusion, had a pancreatoduodenectomy(PD) and repeat laparotomies. Applying univariate logistic regression analysis, mechanism of injury, RTS easing AAST grade and type of pancreatic resection were significant variables for complications. Multivariate logistic regression analysis however showed that only age and type of pancreatic resection(PD) were significant. CONCLUSION This ASGS-based study benchmarked postoperative morbidity after pancreatic resection for trauma. The detailed outcome analysis provided may serve as a reference for future institutional comparisons.

关键词：胰损害复杂并发症手风琴分类

epidemiologic investigation of pediatric distal humerus fractures: An American insurance claims database study

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World Journal of Orthopedics 2024年第1期15卷 52-60页

作者： Kyle Jay Klahs jake e Dertinger Grant T Mello Kevin Thapa Alexis B Sandler e'Stephan J Jesus Garcia Nata Parnes Department of Orthopaedic Surgery Texas Tech University Health Sciences-El PasoEl PasoTX 79905United States Medical School California Health Sciences University College of Osteopathic MedicineClovisCA 93611United States Undergraduate School Binghampton UniversityVestalNY 13902United States Department of Orthopaedic Surgery William Beaumont Army Medical CenterFort BlissTX 79918United States Department of Orthopaedic Surgery Carthage Area HospitalCarthageNY 13619United States

BACKGROUND Distal humerus elbow fractures are one of the most common traumatic fractures seen in pediatric patients and present as three main types:Supracondylar(SC),lateral condyle(LC),and medial epicondyle(Me)*** To evaluate the epidemiology of pediatric distal humerus fractures(SC,LC,and Me)from an American insurance claims *** A retrospective review was performed on patients 17 years and younger with the ICD 9 and 10 codes for SC,LC and Me fractures based on the IBM Truven MarketScan®Commercial and IBM Truven MarketScan Medicare Supplemental *** from 2015 to 2020 were queried for treatments,patient age,sex,length of hospitalization,and *** A total of 1133 SC,154 LC,and 124 Me fractures were *** fractures had the highest percentage of operation at 83%,followed by LC(78%)and Me fractures(41%).Male patients were,on average,older than female patients for both SC and Me *** In the insurance claims databases used,SC fractures were the most reported,followed by LC fractures,and finally Me *** was identified to be a factor for how a pediatric distal humerus fractures,with patients with SC and LC fractures being younger than those with Me *** peak age per injury per sex was similar to reported historic central tendencies,despite reported trends for younger physiologic development.

关键词： Supracondylar humerus fracture Lateral condyle fracture Medial epicondyle fracture Pediatric elbow Truven epidemiology

Applying refined pancreaticogastrostomy techniques in pancreatic trauma

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World Journal of Gastrointestinal Surgery 2022年第5期14卷 521-524页

作者： jake krige Marc Bernon eduard Jonas Department of Surgery University of Cape Town Health Sciences FacultyCape Town 7925South Africa

We comment on a study titled“Feasibility and safety of"bridging"pancreaticogastrostomy for pancreatic trauma in Landrace pigs”in which ten pigs were randomized to either experimental“bridging”pancreaticogastrostomy(PG)or a control group with a routine mucosa-to-mucosa *** six months anastomoses had strictured and closed in both *** authors concluded that“bridging”PG is feasible and safe in damage control surgery during the early stage of pancreatic *** this letter we comment on the study design,specifically leaving a 2 cm gap between the pancreatic stump and the stomach and highlight the complexity of performing pancreatic anastomoses following trauma pancreaticoduodenectomy as to our experience in a high volume trauma *** data emphasize that pancreatic anastomoses in trauma are complex procedures with significant postoperative morbidity and are best managed collaboratively by trauma and hepatopancreaticobiliary surgical teams with the required technical skills.

关键词： Pancreatic trauma Pancreatic anastomoses Pancreaticogastrostomy Complications

Novel CABIN score outperforms other prognostic models in predicting in-hospital mortality after salvage transjugular intrahepatic portosystemic shunting

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World Journal of Gastrointestinal Pathophysiology 2023年第2期14卷 34-45页

作者： jake krige eduard Jonas Chanel Robinson Steve Beningfield Urda Kotze Marc Bernon Sean Burmeister Christo Kloppers Department of Surgical Gastroenterology University of Cape Town Health Sciences FacultyCape Town 7925Western CapeSouth Africa Department of Radiology University of Cape Town Health Sciences FacultyCape Town 7925Western CapeSouth Africa Department of Surgical Gastroenterology University of Cape TownFaculty of Health SciencesCape Town 7925Western CapeSouth Africa

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is now established as the salvage procedure of choice in patients who have uncontrolled or severe recurrent variceal bleeding despite optimal medical and endoscopic *** To analysis compared the performance of eight risk scores to predict in-hospital mortality after salvage TIPS(sTIPS)placement in patients with uncontrolled variceal bleeding after failed medical treatment and endoscopic *** Baseline risk scores for the Acute Physiology and Chronic Health evaluation(APACHe)II,Bonn TIPS early mortality(BOTeM),Child-Pugh,emory,FIPS,model for end-stage liver disease(MeLD),MeLD-Na,and a novel 5 category CABIN score incorporating Creatinine,Albumin,Bilirubin,INR and Na,were calculated before ***(C)statistics for predictive accuracy of inhospital mortality of the eight scores were compared using area under the receiver operating characteristic curve(AUROC)*** Thirty-four patients(29 men,5 women),median age 52 years(range 31-80)received sTIPS for uncontrolled(11)or refractory(23)bleeding between August 1991 and November *** TIPS controlled bleeding in 32(94%)patients with recurrence in ***(29%)patients died in *** scoring systems had a significant association with in-hospital mortality(Pe *** on in-hospital survival AUROC,the CABIN(0.967),APACHe II(0.948)and emory(0.942)scores had the best capability predicting mortality compared to FIPS(0.892),BOTeM(0.877),MeLD Na(0.865),Child-Pugh(0.802)and MeLD(0.792).CONCLUSION The novel CABIN score had the best prediction capability with statistical superiority over seven other risk *** sTIPS,hospital mortality remains high and can be predicted by CABIN category B or C or CABIN scores>*** was 100%in CABIN A patients while mortality was 75%for CABIN B,87.5%for CABIN C,and 83%for CABIN scores>10.

关键词： Transjugular intrahepatic portosystemic shunt Risk score Portal hypertension Variceal bleeding Mortality

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Hybrid Identities

Chinese Annals of History of Science and Technology 2018年第2期2卷 11-18页

作者： John krige School of History and Sociology Georgia Institute of TechnologyAtlantaUS

This paper analyzes the permanent exhibition on the life of Qian Xuesen on the campus of Jiao Tong University in *** highlights the emphasis placed in the exhibition on the transnational movement of Qian Xuesen,who spent about fifteen years in the United States,first as a student,then as a brilliant scientist and *** exhibit also presents Qian Xuesen as a national hero,as a man for whom the sojourn abroad was merely a detour in a long journey of a devoted and patriotic Chinese citizen who loved his country,and who was inspired by Marxism-Leninism and by the *** national emphasis is only to be expected in an exhibit that is directed to the general *** it excludes aspects of Qian Xuesen that do not fit into a purely nationalist narrative(*** application for American citizenship,the technical help he got from the Soviet Union in the late 1950s).The paper stresses that Qian Xuesen had a hybrid identity that enabled him to draw on resources from different countries,including his *** argues that such hybridity contributed to his brilliant career,and is a quality to be valued for the role it played in“bringing newness into the world.”

关键词： Jiao Tong University nationalism newness science exhibition Soviet Union transnational history United States

Recent advancements in noninvasive brain modulation for individuals with autism spectrum disorder

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Neural Regeneration Research 2023年第6期18卷 1191-1195页

作者： Jessica R.Griff jake Langlie Nathalie B.Bencie Zachary J.Cromar Jeenu Mittal Idil Memis Steven Wallace Alexander e.Marcillo Rahul Mittal Adrien A.eshraghi Hearing Research and Communication Disorders Laboratory Department of OtolaryngologyNeurotology DivisionUniversity of Miami Miller School of MedicineMiamiFLUSA Department of Neurological Surgery University of Miami Miller School of MedicineMiamiFLUSA Department of Biomedical engineering University of MiamiCoral GablesFLUSA Department of Pediatrics University of Miami Miller School of MedicineMiamiFLUSA

Autism spectrum disorder is classified as a spectrum of neurodevelopmental disorders with an unknown definitive *** with autism spectrum disorder show deficits in a variety of areas including cognition,memory,attention,emotion recognition,and social *** no definitive treatment or cure,the main interventions for individuals with autism spectrum disorder are based on behavioral ***,noninvasive brain modulation techniques including repetitive transcranial magnetic stimulation,intermittent theta burst stimulation,continuous theta burst stimulation,and transcranial direct current stimulation have been studied for their therapeutic properties of modifying neuroplasticity,particularly in individuals with autism spectrum *** evidence from small cohort studies,pilot studies,and clinical trials suggests that the various noninvasive brain stimulation techniques have therapeutic benefits for treating both behavioral and cognitive manifestations of autism spectrum ***,little data is available for quantifying the clinical significance of these findings as well as the long-term outcomes of individuals with autism spectrum disorder who underwent transcranial *** objective of this review is to highlight the most recent advancements in the application of noninvasive brain modulation technology in individuals with autism spectrum disorder.

关键词： autism spectrum disorder behavior cognition neurostimulation interventions noninvasive brain modulation theta burst stimulation transcranial direct current stimulation transcranial magnetic stimulation

Investigation into precision engineering design and development of the next-generation brake discs using Al/SiC metal matrix composites

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Nanotechnology and Precision engineering 2021年第4期4卷 24-36页

作者： jake Haley Kai Cheng Department of Mechanical and Aerospace engineering College of EngineeringDesign and Physical SciencesBrunel University LondonUxbridge UB83PHUnited Kingdom

Substantially lightweight brake discs with high wear resistance are highly desirable in the automotive *** paper presents an investigation of the precision-engineering design and development of automotive brake discs using nonhomogeneous Al/SiC metal-matrixcomposite *** design and development are based on modeling and analysis following stringent precision-engineering principles,i.e.,brake-disc systems that operate repeatably and stably over time as enabled by precision-engineering *** design and development are further supported by tribological experimental testing and finite-element *** results show the industrial feasibility of the innovative design approach and the application merits of using advanced metal-matrix-composite materials for next-generation automotive and electric vehicles.

关键词： Brake disc design Metal matrix composite Precision engineering design Tribological testing Automotive braking system Finite element analysis(FeA)and simulation

Aggressive behavioural interactions between swans(Cygnus spp.)and other waterbirds during winter:a webcam-based study

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Avian Research 2020年第3期11卷 310-325页

作者： Kevin A.Wood Phoebe Ham jake Scales eleanor Wyeth Paul e.Rose Wildfowl&Wetlands Trust Slimbridge Wetland CentreSlimbridgeGloucestershire GL27BTUK Centre for Research in Animal Behaviour PsychologyWashington SingerUniversity of ExeterPerry RoadExeterDevon EX44QGUK University Centre Sparsholt College SparsholtHampshire SO212NFUK

Background:Our understanding of any impacts of swans on other waterbirds(including other swans),and potential effects on waterbird community structure,remain limited by a paucity of fundamental behavioural and ecological data,including which species swans interact aggressively with and how frequently such interactions ***:Behavioural observations of aggression by swans and other waterbirds in winters 2018/2019 and 2019/2020,were carried out via live-streaming webcams at two wintering sites in the *** occurrence sampling was used to identify all aggressive interactions between conspecific or heterospecifics individuals,whilst focal observations were used to record the total time spent by swans on aggressive interactions with other *** tests were then used to assess whether the proportion of intraspecific aggressive interactions of each species differed from 0.5(which would indicate equal numbers of intraspecific and interspecific interactions).Zero-inflated generalized linear mixed effects models(ZIGLMMs)were used to assess between-individual variation in the total time spent by swans on aggressive interactions with other ***:All three swan species were most frequently aggressive towards,and received most aggression from,their *** 10-min focal observations showed that Whooper(Cygnus cygnus)and Bewick’s Swans(*** bewickii)spent 13.8±4.7 s(means±95%CI)and 1.4±0.3 s,respectively,on aggression with other *** durations were equivalent to 2.3%and 0.2%of the Whooper and Bewick’s Swan time-activity budgets,*** selection indicated that the time spent in aggressive interactions with other swans was best-explained by the number of other swans present for Whooper Swans,and an interactive effect of time of day and winter of observation for Bewick’s ***,the relationship between swan numbers and Whooper Swan aggression times was not strong(R2=19.3%).Conclusions:Whilst swans do exhibit some agg

关键词： Aggression Agonistic behaviour Bewick’s Swans Intraspecific versus interspecific competition Remote data collection Waterfowl Whooper Swans

Multimodal alarm behavior in urban and rural gray squirrels studied by means of observation and a mechanical robot

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Current Zoology 2010年第3期56卷 313-326页

作者： Sarah R.PARTAN Andrew G FULMeR Maya A.M.GOUNARD jake e.ReDMOND Hampshire College School of Cognitive Science

Urbanization of animal habitats has the potential to affect the natural communication systems of any species able tosurvive in the changed environment. Urban animals such as squirrels use multiple signal channels to communicate, but it is unknownhow urbanization has affected these behaviors. Multimodal communication, involving more than one sensory modality,can be studied by use of biomimetic mechanical animal models that are designed to simulate the multimodal signals and be presentedto animal subjects in the field. In this way the responses to the various signal components can be compared and contrastedto determine whether the multimodal signal is made up of redundant or nonredundant components. In this study, we presentedwild gray squirrels in relatively urban and relatively rural habitats in Western Massachusetts with a biomimetic squirrel modelthat produced tail flags and alarm barks in a variety of combinations. We found that the squirrels responded to each unimodalcomponent on its own, the bark and tail flag, but they responded most to the complete multimodal signal, containing both theacoustic and the moving visual components, providing evidence that in this context the signal components are redundant and thattheir combination elicits multimodal enhancement. We expanded on the results of Partan et al. (2009) by providing data on signalingbehavior in the presence and absence of conspecifics, suggesting that alarm signaling is more likely if conspecifics arepresent. We found that the squirrels were more active in the urban habitats and that they responded more to tail flagging in theurban habitats as compared to the rural ones, suggesting the interesting possibility of a multimodal shift from reliance on audio tovisual signals in noisier more crowded urban habitats [Current Zoology 56 (3): 313-326, 2010].

关键词：观测手段多式联运机器人行为报警机械灰色农村