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A novel predictor of unsustained return of spontaneous circulation in cardiac arrest patients through a combination of capnography and pulse oximetry: a multicenter observational study

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World Journal of Emergency Medicine 2024年第1期15卷 16-22页

作者： Jing Yang Hanqi Tang Shihuan Shao Feng Xu Yangyang Fu Shengyong Xu Chen Li Yan Li Yang Liu joseph harold walline Huadong Zhu Yuguo Chen Xuezhong Yu Jun Xu Emergency Department State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China Emergency Department Peking University People’s HospitalBeijing 100044China Department of Emergency and Chest Pain Center Shandong Provincial Clinical Research Center for Emergency and Critical Care MedicineKey Laboratory of Emergency and Critical Care Medicine of Shandong ProvinceQilu Hospital of Shandong UniversityJinan 250012China Emergency Department Beijing Jishuitan HospitalBeijing 100035China Emergency Department Tianjin Medical University General HospitalTianjin 300052China Department of Emergency Medicine Penn State Health Milton S.Hershey Medical Center and Penn State College of MedicineHershey 17033USA

BACKGROUND:Unsustained return of spontaneous circulation(ROSC)is a critical barrier to survival in cardiac arrest patients.This study examined whether end-tidal carbon dioxide(ETCO_(2))and pulse oximetry photoplethysmogram(POP)parameters can be used to identify unsustained ROSC.METHODS:We conducted a multicenter observational prospective cohort study of consecutive patients with cardiac arrest from 2013 to 2014.Patients’general information,ETCO_(2),and POP parameters were collected and statistically analyzed.RESULTS:The included 105 ROSC episodes(from 80 cardiac arrest patients)comprised 51 sustained ROSC episodes and 54 unsustained ROSC episodes.The 24-hour survival rate was significantly higher in the sustained ROSC group than in the unsustained ROSC group(29.2%vs.9.4%,P<0.05).The logistic regression analysis showed that the difference between after and before ROSC in ETCO_(2)(ΔETCO_(2))and the difference between after and before ROCS in area under the curve of POP(ΔAUCp)were independently associated with sustained ROSC(odds ratio[OR]=0.931,95%confi dence interval[95%CI]0.881-0.984,P=0.011 and OR=0.998,95%CI 0.997-0.999,P<0.001).The area under the receiver operating characteristic curve ofΔETCO_(2),ΔAUCp,and the combination of both to predict unsustained ROSC were 0.752(95%CI 0.660-0.844),0.883(95%CI 0.818-0.948),and 0.902(95%CI 0.842-0.962),respectively.CONCLUSION:Patients with unsustained ROSC have a poor prognosis.The combination ofΔETCO_(2) andΔAUCp showed signifi cant predictive value for unsustained ROSC.

关键词： Return of spontaneous circulation Pulse oximetry photoplethysmogram End-tidal carbon dioxide Cardiac arrest Cardiopulmonary resuscitation

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Treatment of hyperkalemic emergencies

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World Journal of Emergency Medicine 2022年第3期13卷 232-236页

作者： Yao Wu Yang-yang Fu Hua-dong Zhu Jun Xu joseph harold walline Emergency Department State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China Centre for the Humanities and Medicine the University of Hong KongHong KongChina

Hyperkalemic emergency(HE)refers to life-threatening hyperkalemia consisting of a high serum potassium level with severe complications(e.g.,dysrhythmias,cardiac arrest,or myopathy).^([1])Hyperkalemic emergencies(HEs)a... 详细信息

关键词： cardiac potassium arrest

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Is rosuvastatin protective against sepsis-associated encephalopathy? A secondary analysis of the SAILS trial

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World Journal of Emergency Medicine 2022年第5期13卷 367-372页

作者： Shi-yuan Yu Zeng-zheng Ge Jun Xiang Yan-xia Gao Xin Lu joseph harold walline Mu-bing Qin Hua-dong Zhu Yi Li Emergency Department State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China General Medicine Department of Jingnan Medical Center General Hospital of PLABeijing 100039China Emergency Department the First Affi liated Hospital of Zhengzhou UniversityZhengzhou 450052China Department of Emergency Medicine Penn State HealthMilton S.Hershey Medical CenterHershey 17033USA

BACKGROUND:Sepsis is a common cause of death in emergency departments and sepsis-associated encephalopathy(SAE)is a major complication.Rosuvastatin may play a neuroprotective role due to its protective effects on the vascular endothelium and its anti-inflammatory functions.Our study aimed to explore the potential protective function of rosuvastatin against SAE.METHODS:Sepsis patients without any neurological dysfunction on admission were prospectively enrolled in the“Rosuvastatin for Sepsis-Associated Acute Respiratory Distress Syndrome”study(SAILS trial,ClinicalTrials.gov number:NCT00979121).Patients were divided into rosuvastatin and placebo groups.This is a secondary analysis of the SAILS dataset.Baseline characteristics,therapy outcomes,and adverse drug events were compared between groups.RESULTS:A total of 86 patients were eligible for our study.Of these patients,51 were treated with rosuvastatin.There were significantly fewer cases of SAE in the rosuvastatin group than in the placebo group(32.1%vs.57.1%,P=0.028).However,creatine kinase levels were significantly higher in the rosuvastatin group than in the placebo group(233[22-689]U/L vs.79[12-206]U/L,P=0.034).CONCLUSION:Rosuvastatin appears to have a protective role against SAE but may result in a higher incidence of adverse events.

关键词： Rosuvastatin calcium Sepsis-associated encephalopathy Anti-infl ammatory agents Sepsis Adverse reactions

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Hemodynamic characteristics in preeclampsia women during cesarean delivery after spinal anesthesia with ropivacaine

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World Journal of Clinical Cases 2020年第8期8卷 1444-1453页

作者： Na Zhao Jin Xu Xiao-Guang Li joseph harold walline Yi-Chong Li Lin Wang Guo-Sheng Zhao Ming-Jun Xu Department of Anesthesiology Beijing Obstetrics and Gynecology HospitalCapital Medical UniversityBeijing 100026China Department of Emergency Medicine Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Accident and Emergency Medicine Academic Unit Prince of Wales HospitalThe Chinese University of Hong KongHong Kong 9990777China Department of Clinical Research and Epidemiology National Clinical Research Center for Cardiovascular DiseasesFuwai HospitalChinese Academy of Medical SciencesBeijing 100037China

BACKGROUND Very few studies have been published on the hemodynamic changes associated with spinal anesthesia induced with ropivacaine during cesarean deliveries in preeclamptic women.AIM To record and analyze hemodynamic data in women with preeclampsia undergoing cesarean delivery after spinal anesthesia induced with ropivacaine.METHODS Ten eligible women with preeclampsia were enrolled in this prospective observational study.Spinal anesthesia was performed with 2.4 mL of 0.5%ropivacaine.Hemodynamic changes were then analyzed at multiple time points.The hemodynamic responses to vasopressor interventions and uterotonic agents,as well as maternal and neonatal outcomes were also recorded.RESULTS Stable hemodynamic trends were observed in this study.Cardiac output(CO)and stroke volume increased mildly during surgery.In contrast,mean arterial pressure and systemic vascular resistance showed a moderate decrease from induction until the end of surgery.Central venous pressure dramatically increased after delivery.Oxytocin administration was associated with the most significant hemodynamic fluctuations during surgery,namely,an increase in CO and heart rate.Phenylephrine intervention was only required in three patients,and caused an increase in mean arterial pressure and systemic vascular resistance along with a decrease in heart rate,stroke volume,and CO.No maternal and neonatal complications were observed during this study,except transient episodes of hypotension.CONCLUSION Spinal anesthesia for caesarian delivery with ropivacaine in women with preeclampsia is linked to modest hemodynamic changes of no clinical significance in this study.Careful cardiovascular monitoring is still recommended,particularly after the delivery of the fetus or the use of oxytocin.

关键词： Preeclampsia Cesarean delivery Spinal anesthesia Cardiac output Hemodynamics

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Expert consensus on emergency diagnosis and treatment procedures for acute upper gastrointestinal bleeding

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Journal of Acute Disease 2020年第6期9卷 231-243页

作者：无 Jia-Yuan Dai Lu Yin Jun Xu joseph harold walline Chuan-Zhu Lv Xiao-Dong Zhao Xue-Zhong Yu Emergency Physician Branch Chinese Medical Doctor AssociationBeijingChina Emergency Medicine Branch Chinese Medical AssociationBeijingChina Emergency Medicine Professional Committee of the Whole Army BeijingChina Chinese Emergency Medicine Partnerships BeijingChina Beijing Emergency Medical Association BeijingChina Peking Union Medical College Hospital BeijingChina Hong Kong Prince of Wales Hospital HongkongChina Hainan Medical University Ha ikouChina the 4th Medical Center of the PLA General Hospital BeijingChina

Acute upper gastrointestinal bleeding is one of the most common life-threatening diseases.Standardized diagnosis and treatment of acute upper gastrointestinal bleeding are of great importance for improving the prognosis.In 2015,the Emergency Physician Branch of the Chinese Medical Doctor Association updated an expert consensus statement on the emergency diagnosis and treatment procedures for acute upper gastrointestinal bleeding.Based on the 2015 consensus statement,members of the expert panel decided to reconvene and draw up a 2020 update on the advancements in the clinical care for acute upper gastrointestinal bleeding.The 2020 expert consensus statement is summarized in 10 sections:emergency assessment,diagnosis,stratified treatment,emergency treatment,comprehensive assessment,medication management,endoscopy,interventional radiology,multidisciplinary treatment,and evaluation of prognosis.The consensus statement is based on experts'opinions combined with the latest relevant medical evidence.

关键词： diagnosis treatment statement

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100 case studies in pathophysiology

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2009年

作者： Bruyere harold joseph 1947-

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High-throughput prediction of the ground-state collinear magnetic order of inorganic materials using Density Functional Theory

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npj Computational Materials 2019年第1期5卷 588-598页

作者： Matthew Kristofer Horton joseph harold Montoya Miao Liu Kristin Aslaug Persson Energy Technologies Area Lawrence Berkeley National LaboratoryBerkeleyCAUSA Institute of Physics Chinese Academy of SciencesBeijingChina Department of Materials Science University of California BerkeleyBerkeleyCA 94720USA

We present a robust,automatic high-throughput workflow for the calculation of magnetic ground state of solid-state inorganic crystals,whether ferromagnetic,antiferromagnetic or ferrimagnetic,and their associated magnetic moments within the framework of collinear spin-polarized Density Functional Theory.This is done through a computationally efficient scheme whereby plausible magnetic orderings are first enumerated and prioritized based on symmetry,and then relaxed and their energies determined through conventional DFT+U calculations.This automated workflow is formalized using the atomate code for reliable,systematic use at a scale appropriate for thousands of materials and is fully customizable.The performance of the workflow is evaluated against a benchmark of 64 experimentally known mostly ionic magnetic materials of non-trivial magnetic order and by the calculation of over 500 distinct magnetic orderings.A non-ferromagnetic ground state is correctly predicted in 95% of the benchmark materials,with the experimentally determined ground state ordering found exactly in over 60% of cases.Knowledge of the ground state magnetic order at scale opens up the possibility of high-throughput screening studies based on magnetic properties,thereby accelerating discovery and understanding of new functional materials.

关键词： state ground ferromagnetic

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FISH ASSEMBLAGE RESPONSES TO DIFFERENT SECONDARY CHANNEL DESIGNS IN THE LOWER MISSISSIPPI RIVER,U.S.A.:A TEMPLATE FOR RIVER RESTORATION

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水生生物学报 2018年第6期42卷 1089-1106页

作者： KAISER joseph E. SMITH Shannon C.F. SCHRAMM Jr.,harold L. EGGLETON Michael A. Department of Aquaculture and Fisheries University of Arkansas at Pine Bluff1200 N.UniversityMail Slot 4912Pine BluffArkansas 71601U.S.A U.S.Geological Survey Mississippi Cooperative Fish and Wildlife Research UnitMississippi State University

The lower Mississippi River(LMR) has been heavily modified for multiple human purposes such as navigation, flood control, and bank stabilization. However, the LMR simultaneously supports a diverse fish fauna that includes recreational and commercial fisheries. Due to river training and diversion structures constructed during the past 80 years, the historic characteristics of the LMR have been drastically altered and have likely influenced fishes and fisheries in the system. One common restoration measure used throughout the LMR has been to "notch" wing-dike structures that close secondary(side) river channels. Dike notching allows year-round flows through secondary channels, which enhances habitat diversity and promotes biological productivity at the ecosystem scale. Although notching is presumed good for LMR fishes and other biota, few studies have examined its effects on fish assemblages. In this study, fish assemblages were sampled at seven LMR secondary channels spanning from river kilometer(rkm) 628(Louisiana-Mississippi, U.S.A.) upstream to rkm 1504(Missouri-Kentucky, U.S.A.). Four secondary channels were termed "permanent"(i.e.,with notched dikes) while three secondary channels were termed "temporary"(i.e., without notched dikes).Fishes were sampled by boat-mounted electrofishing conducted during falling and low stages from1995—1997. Fish assemblages differed between permanent and temporary secondary channels, and varied somewhat between falling and low stages. Gizzard shad(Dorosoma cepedianum), threadfin shad(D. petenense), and white bass(Morone chrysops) demonstrated consistent preferences for low-current conditions associated with temporary secondary channels. Conversely, blue catfish(Ictalurus furcatus), flathead catfish(Pylodictis olivaris), and freshwater drum(Aplodinotus grunniens) were more associated with permanent secondary channels. Future restoration strategies in the LMR should consider dike notching and resultant maintenance of permanent secondary channels in selected river reaches. However,

关键词： Mississippi River Secondary channels Dikes Fish assemblages River restoration River rehabilitation

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Ecology, Distribution and Risk of Transmission of Viral Haemorrhagic Fevers by Aedes Mosquitoes around the Port Areas of Tema in Southern Ghana

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Advances in Entomology 2022年第2期10卷 135-148页

作者： Kenechukwu C. Ojukwu joseph Chabi Kwadwo Frempong Delphina A. Adabie-Gomez joseph harold Nyarko Osei Andy Asafu-Adjaye Sellase Pi-Bansa Michelle Adimazoya Kojo Y. Sakyi Kwaku O. Akuoko Ruth Brenyah Maxwell A. Appawu Samuel Kweku Dadzie African Regional Postgraduate Programme in Insect Science University of Ghana Accra Ghana Parasitology Department Noguchi Memorial Institute of Medical Research University of Ghana Accra Ghana School of Veterinary Medicine University of Ghana Accra Ghana Department of Clinical Microbiology School of Medical Science Kwame Nkrumah University of Science and Technology Kumasi Ghana

Aedes-borne diseases remain a public health challenge for many countries globally. The extent of spread of invasive species of Aedes mosquitoes and risk of transmission of the diseases especially around the point of entry of goods such as ports is not well known in Ghana. This study investigated the ecology, distribution and risk of transmission of viral haemorrhagic fevers by Aedes mosquitoes around the port areas of Tema, Southern Ghana. The mosquitoes from this study were collected using human landing catches, ovitraps and larval collections for a period of six months. A total of 1092 containers were inspected in both seasons and of these, 237 (21.7%) were positive for mosquito larvae or pupae in rainy season while 181 (16.6%) were positive in dry season. A total of 6498 mosquitoes were collected and identified morphologically using taxonomic keys. 6038 (92.9%) were Aedes aegypti, 337 (5.2%) were Culex spp. and 123 (1.9%) were Anopheles gambiae. The Ae. aegypti larvae were found breeding in a series of water-holding containers which included disposed plastic containers, earthenware pots, car tyres, plastic barrels, plastic basins, buckets, metal drums, jerrycans and poly tank. A high proportion of Aedes aegypti eggs were found in the ovitraps during the rainy season than in the dry season in the study sites. Ae. aegypti was the most common mosquitoes biting mostly outdoors (65.6%) with more bites occurring in the rainy season (63.6%) in the two residential sites (Tema Community One and Tema New Town). The risk of transmission of viral haemorrhagic fever in the study sites was assessed using House Index, Container Index, Breteau Index and was found to be higher in Tema New town area with seasonal variations within the sites. The man-vector contact rates for the two residential sites were also found to be higher in rainy season than the dry season. These observations indicate that the risk of transmission of viral haemorrhagic fevers in the study areas is high especially in the rainy season. The implications of

关键词： Viral Haemorrhagic Fevers Tema Port Areas Aedes Risk of Transmission

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全新高效在线工具简化传感器信号路径设计流程

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电子设计应用 2009年第10期7卷 85-87页

作者： harold joseph 美国国家半导体

高性能的传感应用通常利用分立模拟元件将传感器与微处理器或微控制器进行连接。了解传感器与模拟元件的交互作用,是开发高效模拟设计解决方案的关键因素。本文针对典型的压力传感器开发出了信号路径解决方案,这类传感器广泛用于工业、... 详细信息

高性能的传感应用通常利用分立模拟元件将传感器与微处理器或微控制器进行连接。了解传感器与模拟元件的交互作用,是开发高效模拟设计解决方案的关键因素。本文针对典型的压力传感器开发出了信号路径解决方案,这类传感器广泛用于工业、医疗和高端消费类应用领域。此外,本文讨论了ADC和运算放大器的关键参数,并介绍了新的在线网络工具—WEBENCH传感器设计工具如何使传感器与模拟元件匹配,以及如何帮助用户创建并轻松修改针对特定应用的传感器信号路径解决方案。

关键词：传感器信号路径设计 WEBENCH传感器设计工具

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