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Patterns,procedures,and indications for pediatric surgery in a Tanzanian Refugee Camp:a 20-year experience

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World journal of Pediatric Surgery 2023年第3期6卷 161-167页

作者： Sarah Rapaport Zachary Obinna Enumah Hilary Ngude Daniel S Rhee Mohamed Abbas Amber Lekey Peter j Winch joseph V Sakran Kent A Stevens Center for Global Surgery Johns Hopkins MedicineBaltimoreMarylandUSA Department of International Health Johns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA Tanzania Red Cross Society Dar es SalaamTanzania Department of Pediatric Surgery Johns Hopkins MedicineBaltimoreMarylandUSA Department of Surgery Tulane University School of MedicineNew OrleansLouisianaUSA Satcher Health Leadership Institute Morehouse School of MedicineAtlantaGeorgiaUSA

Background There are 103 million displaced people worldwide,41%of whom are *** on the provision of surgery in humanitarian settings are *** scarcer is literature on pediatric surgery performed in humanitarian settings,particularly protracted humanitarian *** We reviewed patterns,procedures,and indications for pediatric surgery among children in Nyarugusu Refugee Camp using a 20-year retrospective *** A total of 1221 pediatric surgical procedures were performed over the study *** between the ages of 12 and 17 years were the most common age group undergoing surgery(n=991;81%).A quarter of the procedures were performed on local Tanzanian children seeking care in the camp(n=301;25%).The most common procedures performed were cesarean sections(n=858;70%),herniorrhaphies(n=197;16%),and exploratory laparotomies(n=55;5%).Refugees were more likely to undergo exploratory laparotomy(n=47;5%)than Tanzanian children(n=7;2%;p=0.032).The most common indications for exploratory laparotomy were acute abdomen(n=24;44%),intestinal obstruction(n=10;18%),and peritonitis(n=9;16%).Conclusions There is a significant volume of basic pediatric general surgery performed in the Nyarugusu *** are used by both refugees and local *** hope this research will inspire further advocacy and research on pediatric surgical services in humanitarian settings worldwide and illuminate the need for including pediatric refugee surgery within the growing global surgery movement.

关键词： surgery pediatric seeking

Computational discovery of ultra-strong, stable, and lightweight refractory multi-principal element alloys. Part II: comprehensive ternary design and validation

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npj Computational Materials 2023年第1期9卷 1469-1481页

作者： Kate L.M.Elder joel Berry Aurélien Perron Brandon Bocklund jibril Shittu Connor j.Rietema Hunter B.Henderson Scott K.McCall joseph T.McKeown Materials Science Division Lawrence Livermore National LaboratoryLivermoreCA 94550USA.✉

Here the discovery of refractory multi-principal element alloys(MPEAs)with high-temperature strength and stability is pursued within a constrained and application-relevant design space.A comprehensive approach is developed and applied to explore all 165 ternary systems in the Al-Ce-Fe-Hf-Mo-Nb-Ta-Ti-V-W-Zr family.A subset of ternary systems that contain large areas in composition–temperature space with high strength and robust BCC phase stability is *** sets of high-performing alloys are identified,each set optimized for one combination of phase constraint,optimization target,and temperature *** mechanical tests support the viability of the *** work highlights the importance of considering phase stability,exploring non-equiatomic regions of composition space,and applying application-relevant *** I and II provide three down-selection techniques for identifying high-performing BCC refractory MPEAs,design guidelines,and many candidates predicted to have BCC phase stability and strengths 2–3 times higher than any reported to date.

关键词： alloys element ternary

Social media growth of orthopaedic surgery residency programs in response to the COVID-19 pandemic

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World journal of Orthopedics 2022年第8期13卷 693-702页

作者： joseph S Geller Dustin H Massel Michael G Rizzo Ean Schwartz jacob Eric Milner Chester j Donnally III Department of Orthopaedic Surgery University of Miami Miller School of MedicineMiamiFL 33136United States Department of Orthopedics University of Miami Miller School of MedicineMiamiFL 33136United States University of Miami Leonard M.Miller School of Medicine University of Miami Miller School of MedicineMiamiFL 33136United States Miller School of Medicine University of MiamiMiamiFL 33136United States Texas Spine Consultants Texas Spine ConsultantsAddisonTX 75001United States

BACKGROUND In the Spring of 2020,residency programs across the country experienced rapid and drastic changes to their application process as a result of the coronavirus disease 2019(COVID-19)*** response,residency programs shifted to virtual events and began harnessing social media to communicate with *** To analyze the changes in social media usage by orthopaedic surgery programs in response to the COVID-19 *** Based on the 2019 residency and fellowship electronic database,accredited US orthopaedic surgery programs were reviewed for social media presence on Instagram and *** 47000 tweets from 2011-2021 were extracted through the Twitter application programming *** extracted:Total number of followers,accounts following,tweets,likes,date of account creation,hashtags,and *** language processing was utilized for tweet sentiment analysis and classified as positive,neutral,or *** data was collected and deemed current as of August 11,*** account foundation date analysis was based on the date recognized as the start of the COVID-19 outbreak in the United States,before or after March 1,*** A total of 85(42.3%)orthopaedic surgery residency program Twitter handles were ***-five(41.2%)programs joined Twitter in the nine months after the 2020 covid *** 2020,there was a 126.6%increase in volume of tweets by orthopaedic surgery residency accounts as compared to *** median number of followers was 474.5(interquartile range 205.0-796.5).The account with the highest number of tweets was Hospital for Special Surgery(@HSpecialSurgery)with 13776 tweets followed by University of Virginia(@UVA_Ortho)with 5063 and Yale(@OrthoAtYale)with *** analysis before 2020 revealed 30.4%positive,60.8%neutral,and 8.8%negative sentiments across ***,the positive sentiment percentage increased in 2020 from 30.4%to 34.5%.Of the 201 ACGME-accredited ortho

关键词： Social media COVID-19 Orthopaedic surgery Residency

Knowledge of radiation exposure associated with common trauma imaging modalities among orthopaedic surgeons,emergency medicine physicians,and general surgeons in the United States

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World journal of Emergency Medicine 2023年第4期14卷 294-301页

作者： Fady Y.Hijji Andrew D.Schneider Matthew D.Thomas joseph G.Lyons Daniel D.Bohl jennifer L.jerele Michael j.Prayson Department of Orthopaedic Surgery Wright State University Boonshoft School of MedicineDayton OH 45409USA Department of Orthopaedic Surgery Rush University Medical CenterChicago IL 60612USA

BACKGROUND:Few contemporary studies have assessed physicians’knowledge of radiation exposure associated with common imaging studies,especially in trauma *** purpose of this study was to assess the knowledge of physicians involved in caring for trauma patients regarding the effective radiation doses of musculoskeletal(MSK)imaging studies routinely utilized in the trauma ***:An electronic survey was distributed to United States orthopaedic surgery,general surgery,and emergency medicine(EM)residency *** were asked to estimate the radiation dose for common imaging modalities of the pelvis,lumbar spine,and lower extremity,in terms of chest X-ray(CXR)*** estimates were compared to the true effective radiation ***,participants were asked to report the frequency of discussing radiation risk with ***:A total of 218 physicians completed the survey;102(46.8%)were EM physicians,88(40.4%)wereorthopaedicsurgeons,and28(12.8%)*** underestimated the effective radiation doses of nearly all imaging modalities,most notably for pelvic computed tomaography(CT)(median 50 CXR estimation vs.162 CXR actual)and lumbar CT(median 50 CXR estimation vs.638 CXR actual).There was no difference between physician specialties regarding estimation accuracy(P=0.133).Physicians who regularly discussed radiation risks with patients more accurately estimated radiation exposure(P=0.007).CONCLUSION:The knowledge among orthopaedic and general surgeons and EM physicians regarding the radiation exposure associated with common MSK trauma imaging is *** investigation with larger scale studies is warranted,and additional education in this area may improve care.

关键词： Radiation dosage Radiation exposure Radiation protection X-ray Emergency department

Assessing the Effectiveness of Strategies in US Birth Cohort Screening for Hepatitis C Infection

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journal of Clinical and Translational Hepatology 2020年第1期8卷 25-41页

作者： Cynthia j.Tsay joseph K.Lim Department of Internal Medicine Yale University School of MedicineNew HavenCTUSA Yale Liver Center Section of Digestive DiseasesYale University School of MedicineNew HavenCTUSA

Chronic hepatitis C infection in the USA is a highly morbid condition and current guidelines recommend one-time screening among the birth cohort(1945-1965).Understand-ing strategies to optimize screening can help inform future hepatitis C virus(HCV)screening guidelines.A focused literature search was performed using PubMed and manual abstract review from major hepatology conferences over the past 2 *** search strategy involved using Medical Subject Headings terms for hepatitis C,screening,birth cohort,baby boomers,and *** review was limited to data from the USA.A total of 327 articles were identified and 36 abstracts were included,with studies published between *** including clinician education,electronic medical record alerts,reflex HCV RNA testing,point-of-care testing,multisite(outpatient,inpatient,emergency department,endoscopy suite)initiatives,direct patient solicitation,and utilization of non-physician providers have increased HCV screening ***,broad imple-mentation remains less than *** include lack of patient acceptance to screening and engagement in the HCV care *** Veterans Affairs Healthcare System has achieved higher birth cohort screening rates through an integrated approach requiring high-level engagement by leadership and institutional *** strategies for increasing birth cohort screening have been successful,but overall rates of HCV screening remain *** strat-egies can inform public health efforts to implement emerging national recommendations for expansion of HCV screening to all *** age 18 or older.

关键词： Hepatitis C Epidemiology HCV antibody Screening Birth cohort Baby boomers Care cascade Electronic medical records

Complications associated with energy-based devices during thyroidectomy from 2010–2020

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World journal of Otorhinolaryngology-Head and Neck Surgery 2023年第1期9卷 35-44页

作者： Esther Lee jane Y.Tong Luke j.Pasick Daniel A.Benito Arjun joshi Punam G.Thakkar joseph F.Goodman Division of Otolaryngology-Head and Neck Surgery George Washington University School of Medicine&amp Health SciencesWashingtonDCUSA Western University of Health Sciences PomonaCAUSA Department of Otolaryngology-Head and Neck Surgery Drexel University College of MedicinePhiladelphiaPAUSA Department of Otolaryngology-Head and Neck Surgery University of Miami Miller School of MedicineMiamiFLUSA

Objective:Harmonic Focus(Ethicon,johnson and johnson,Cincinnati,OH,USA),LigaSure Small jaw(Medtronic,Covidien Products,Minneapolis,MN,USA),and Thunderbeat Open Fine jaw(Olympus,japan)are electrosurgical instruments used widely in head and neck *** study aims to compare device malfunctions,adverse events to patients,operative injuries,and interventions related to Harmonic,LigaSure,and Thunderbeat use during ***:The US Food and Drug Administration's Manufacture and User Facility Device Experience(MAUDE)database was queried for adverse events associated with Harmonic,LigaSure,and Thunderbeat from january 2005 to August *** were extracted from reports pertaining to ***:Of the 620 adverse events extracted,394(63.5%)involved Harmonic,134(21.6%)LigaSure,and 92(14.8%)*** reported device malfunctions most frequently associated with Harmonic was damage to the blade(110(27.9%)),LigaSure was inappropriate function(47(43.1%)),Thunderbeat was damage to the tissue or Teflon pad(27(30.7%)),*** injury and incomplete hemostasis were the most commonly reported adverse *** operative injury reported most frequently when using Harmonic and LigaSure was burn *** operator injuries were reported with Thunderbeat ***:The most frequently reported device malfunctions were damage to the blade,inappropriate function,and damage to the tissue or Teflon *** most frequently reported adverse events to patients was a burn injury and incomplete *** aimed at improving physician education may help reduce adverse events attributed to improper use.

关键词： Adverse events Harmonic LigaSure Manufacture and User Facility Device Experience Patient safety Quality Thunderbeat Thyroidectomy

Rhizosphere microbiomes can regulate plant drought tolerance

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Pedosphere 2022年第1期32卷 61-74页

作者： Mehtab Muhammad ASLAM Eyalira jOKAL Aisha Lawan IDRIS Zhang QIAN Weifeng XU joseph K.KARANjA Shabir HWANI Wei YUAN College of Agriculture Yangzhou UniversityYangzhou 225009China joint International Research Laboratory of Water and Nutrient in Crops and College of Life Sciences Center for Plant Water-Use and Nutrition Regulation and College of Resources and EnvironmentFujian Agriculture and Forestry UniversityFuzhou 350002China juncao Research Center College of Life SciencesFujian Agriculture and Forestry UniversityFuzhou 350002China State Key Laboratory of Ecological Pest Control for Fujian and Taiwan Crops&Key Laboratory of Biopesticide and Chemical Biology of Ministry of Education College of Life SciencesFujian Agriculture and Forestry UniversityFuzhou 350002China Mountain Research Centre for Field Crops Khudwani Sher-e-Kashmir University of Agricultural Sciences and TechnologyKashmir 192102India

Beneficial root-associated rhizospheric microbes play a key role in maintaining host plant growth and can potentially allow drought-resilient crop production. The complex interaction of root-associated microbes mainly depends on soil type, plant genotype, and soil moisture. However, drought is the most devastating environmental stress that strongly reduces soil biota and can restrict plant growth and yield. In this review, we discussed our mechanistic understanding of drought and microbial response traits. Additionally, we highlighted the role of beneficial microbes and plant-derived metabolites in alleviating drought stress and improving crop growth. We proposed that future research might focus on evaluating the dynamics of root-beneficial microbes under field drought conditions. The integrative use of ecology, microbial, and molecular approaches may serve as a promising strategy to produce more drought-resilient and sustainable crops.

关键词： biota drought stress metabolites phytohormone plant growth root-microbe association

Mortality and health care burden of Budd Chiari syndrome in the United States:A nationwide analysis(1998-2017)

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World journal of Hepatology 2021年第6期13卷 686-698页

作者： joseph j Alukal Talan Zhang Paul joseph Thuluvath Institute of Digestive Health and Liver Diseases Mercy Medical CenterBaltimoreMD 21202United States Department of Medicine University of Maryland School of MedicineBaltimoreMD 21202United States

The Budd Chiari syndrome(BCS)is a rare and potentially fatal disease,but there is a paucity of data on the in-hospital mortality as well its economic burden on the health care *** To evaluate trends in mortality,length of hospital stays and resource utilization among inpatients with *** Data on all adult patients with a diagnosis of BCS were extracted from the National Inpatient Sample(NIS)from 1998 to *** make inferences regarding the national estimates for the total number of BCS discharges across the study period,sample weights were applied to each admission per recommendations from the *** During the study period,there were 3591(8.73%)in-patient *** overall inhospital mortality rates among BCS patients decreased from 18%in 1998 to 8%in 2017;the mortality decreased by 4.41%(Pjury,acute respiratory failure,hepatic encephalopathy,hepatorenal syndrome,inferior vena cava thrombosis,intestinal infarct,sepsis/septic shock and cancer were associated increased risk of *** average of length of stay was 8.8 d and it consistently decreased by 2.04%(95%CI:-2.67%,-1.41%,Pjusted for Medical Care Consumers Price Index to 2017 dollars during the time period was$94440 and the annual percentage change increased by 1.15%(95%CI:0.35%,1.96%,P=0.005)from$95515 in 1998 to$103850 in *** The in-hospital mortality rate for patients admitted with BCS in the United States has reduced between 1998 and 2017 and this may a reflection of better management of these patients.

关键词： National Inpatient Sample Budd Chiari syndrome Mortality Length of stay Total charges

Influence of Heavy Fuel Oil on the Thermo-Physical and Erodibility Properties of Earthen Materials

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journal of Minerals and Materials Characterization and Engineering 2024年第1期12卷 37-48页

作者： Ohindemi G. Yameogo Donzala D. Some Souleymane Ouedraogo Philbert Nshimiyimana Sié Kam Dieudonné j. Bathiebo Laboratoire d’Energies Thermiques Renouvelables (L.E.T.RE) Unité de Formation et de Recherche en Sciences Exactes et Appliquées (UFR-SEA) University Joseph Ki-Zerbo of Ouagadougou Ouagadougou Burkina Faso Ministry in Charge of Infrastructures Ouagadougou Burkina Faso Department of Civil Engineering and Architectural Design Graduate School of Science and Engineering Saga University Saga Japan Laboratoire Eco-Matériaux et Habitats Durables (LEMHaD) Institut International d’Ingénierie de l’Eau et de L’Environnement (Institut 2iE) Ouagadougou Burkina Faso

This study focuses on the use of heavy fuel oil in construction material in Burkina Faso. Its mixture with silty or clayey soil is used as a coating to reinforce the walls of raw earth constructions which are very sensitive to water. The interest of this study is to determine erodibility, water content, while highlighting the influence of the porosity accessible by water on thermal diffusion in construction material containing heavy fuel oil. The heavy fuel oil was mixed with a silty-clayey soil, in different proportions, and water to make bricks samples on which tests were carried out. At the end of the experimental tests, it appears that the water content increases gradually, but not significantly with the addition of heavy fuel oil, which causes a slight increase in the speed of heat propagation through the material with reduced porosity, particularly those containing higher quantities of heavy fuel oil. Conversely, we note a good performance of heavy fuel oil in terms of water resistance properties such as porosity accessible by water and erodibility. This allows us to conclude that the mixture of heavy fuel oil and silty-clayey soil used as a coating material could greatly reduce water infiltration into the walls of housing constructions with raw earthen materials.

关键词： Porosity Accessible by Water Erodibility Water Content Thermal Diffusion