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Evaluation of hand infections in the emergency department using point-of-care ultrasound

World Journal of Emergency medicine 2024年第4期15卷 283-288页

作者： David Ahmad Haidar David mintz Brandon m Wubben Omar Rizvi Srikar Adhikari Department of Emergency medicine Michigan MedicineAnn Arbor 48109-1382USA University of Arizona College of medicine Tucson 85724USA Department of Emergency medicine University of IowaIowa City 52242-1009USA Department of Surgery University of Arizona College of MedicineTucson 85724USA Department of Emergency medicine University of Arizona College of MedicineTucson 85724USA

BACKGROUND:We aimed to evaluate the utility of point-of-care ultrasound(POCUS)in the assessment of hand infections that present to the emergency department(ed)and its impact on medical decision making and patient ***:We conducted a retrospective review of patients who presented to two urban academic eds with clinical presentations concerning for skin and soft tissue infections(SSTI)of the hand between December 2015 and December *** trained POCUS fellowship physicians reviewed an ed POCUS database for POCUS examinations of the *** then reviewed patients’electronic health records(EHR)for demographic characteristics,history,physical examination findings,ed course,additional imaging studies,consultations,impact of POCUS on patient care and final ***:We included a total of 50 cases(28 male,22 female)in the final *** most common presenting symptoms and exam findings were pain(100%),swelling(90%),and erythema(74%).The most common sonographic findings were edema(76%),soft tissue swelling(78%),and fluid surrounding the tendon(57%).POCUS was used in medical decision making 68%of the time(n=34),with the use of POCUS leading to changes in management 38%of the time(n=19).POCUS use led to early antibiotic use(11/19),early consultation(10/19),and led to the performance of a required procedure(8/19).The POCUS diagnosis was consistent with the discharge diagnosis of flexor tenosynovitis 8/12 times,abscess 12/16 times,and cellulitis 14/20 ***:POCUS is beneficial for evaluating of hand infections that present to the ed and can be used as an important part of medical decision making to expedite patient care.

关键词： Ultrasound Point-of-care ultrasound Cellulitis Abscess Flexor tenosynovitis

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A novel approach to study generalized coupled cubic Schrödinger-Korteweg-de Vries equations

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Journal of Ocean Engineering and Science 2024年第1期9卷 13-24页

作者： Lanre Akinyemi P.Veeresha m.T.Darvishi Hadi Rezazadeh mehmet Senol Udoh Akpan Department of mathematics Lafayette CollegeEastonPAUSA Department of mathematics Christ Deemed to be UniversityBengaluru 560029India Department of mathematics Razi UniversityKermanshah 67149Iran Faculty of Engineering Technology Amol University of Special Modern TechnologiesAmolIran Department of mathematics Nev¸s ehir HacıBekta¸s Veli UniversityNev¸s ehirTurkey Drexel University Department of MathematicsPhiladelphiaPAUSA

The Kortewegde Vries(KdV)equation represents the propagation of long waves in dispersive media,whereas the cubic nonlinear Schrödinger(CNLS)equation depicts the dynamics of narrow-bandwidth wave packets consisting of short dispersive waves.A model that couples these two equations seems in-triguing for simulating the interaction of long and short waves,which is important in many domains of applied sciences and engineering,and such a system has been investigated in recent *** work uses a modified Sardar sub-equation procedure to secure the soliton-type solutions of the generalized cubic nonlinear Schrödinger-Korteweg-de Vries system of *** various selections of arbitrary parameters in these solutions,the dynamic properties of some acquired solutions are represented graph-ically and *** particular,the dynamics of the bright solitons,dark solitons,mixed bright-dark solitons,W-shaped solitons,m-shaped solitons,periodic waves,and other soliton-type *** re-sults demonstrated that the proposed technique is highly efficient and effective for the aforementioned problems,as well as other nonlinear problems that may arise in the fields of mathematical physics and engineering.

关键词： CNLS equation modiﬁed Sardar sub-equation method KdV equation Solitons Long and short waves

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Association of Congenital Heart Defects (CHD) with Factors Related to maternal Health and Pregnancy in Newborns in Puerto Rico

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Congenital Heart Disease 2024年第1期19卷 19-31页

作者： Yamixa Delgado Caliani Gaytan Naydi Perez Eric miranda Bryan Colón morales mónica Santos Biochemistry&Pharmacology Department San Juan Bautista School of MedicineCaguas00726Puerto Rico Hispanic Alliance for Clinical and Translational Research University of Puerto Rico Medical Sciences CampusSan Juan00936Puerto Rico Department of Internal medicine University of Puerto Rico Medical Sciences CampusSan Juan00936Puerto Rico

Background:Given the pervasive issues of obesity and diabetes both in Puerto Rico and the broader United States,there is a compelling need to investigate the intricate interplay among body mass index(BmI),pregesta-tional,and gestational maternal diabetes,and their potential impact on the occurrence of congenital heart defects(CHD)during neonatal ***:Using the comprehensive System of Vigilance and Surveillance of Congenital Defects in Puerto Rico,we conducted a focused analysis on neonates diagnosed with CHD between 2016 and *** assessment encompassed a range of variables,including maternal age,gestational age,BmI,pregestational diabetes,gestational diabetes,hypertension,history of abortion,and presence of ***:A cohort of 673 patients was included in our *** average maternal age was 26 years,within a range of 22 to 32 *** mean gestational age measured 39 weeks,with a median span of 38 to 39 *** the 673 patients,274(41%)mothers gave birth to neonates diagnosed with *** this group,22 cases were linked to pre-gestational diabetes,while 202 were not;20 instances were associated with gestational diabetes,compared to 200 without;and 148 cases exhibited an overweight or obese BmI,whereas 126 displayed a normal ***:We identiﬁed a statistically signiﬁcant correlation between pre-gestational diabetes mellitus and the occurrence of ***,our analysis did not show a statistically signiﬁcant association between maternal BmI and the likelihood of *** results may aid in developing effective strategies to prevent and manage CHD in neonates.

关键词： Congenital heart defects(CHD) obesisty maternal health diabetes body mass index(BmI)

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Synthesis and applications of lanthanoid complexes of pentadentate and hexadentate N_(5) and N_(6) macrocycles:A review

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Journal of Rare Earths 2024年第1期42卷 1-15,I0001页

作者： Julio Corredoira-Vázquez Cristina González-Barreira Paula Oreiro-martínez Ana m.García-Deibe Jesús Sanmartín-matalobos matilde Fondo Departamento de Química Inorganica Facultade de QuímicaUniversidade de Santiago de CompostelaCampus Vida15782Santiago de CompostelaSpain Phantom-g CICECO-Aveiro Institute of MaterialsDepartment of PhysicsUniversity of Aveiro3810-193AveiroPortugal Institute of materials(imATUS) Universidade de Santiago de Compostela15782Santiago de CompostelaSpain

In this paper,the lanthanoid complexes of N_(5) and N_(6) macrocycle ligands,without pendant arms or additional heteroatoms,are *** review covers the period from 2015 to the current date,since in 2014 Schiff base macrocyclic ligands incorporating the pyridine moiety,and their complexes,were revised,and in 2015 the chemistry of pentaaza macrocycle ligands with rare earth metals was also *** and phthalocyanine ligands are not included in this review,which primarily focuses on complexes with Schiff bases and amines without pendant arms or any additional donor other than *** synthetic methods,structural characterization,based on single X-ray crystal data,and properties of the lanthanoid complexes,with special attention to magneto-structural correlations,are presented herein.

关键词： Lanthanoid N_(5),N_(6)macrocycle Coordination chemistry Chirality Biological activity molecule magnet

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Geochemistry of island arc assemblage in the Eastern Desert of Egypt and the role of Pan-African magmatism in crustal growth of the Arabian–Nubian Shield:A review

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Acta Geochimica 2024年第3期43卷 588-622页

作者： Abdel-Aal mAbdel-Karim mohamed mHamdy Adel A.Surour Geology Department Faculty of ScienceZagazig UniversityZagazig 44519Egypt Geology Department Faculty of ScienceTanta UniversityTanta 31527Egypt Department of Geological Sciences Faculty of ScienceNew Galala City 43511Egypt Geology Department Faculty of ScienceCairo UniversityGiza 12613Egypt

Neoproterozoic island arc assemblage of the Arabian–Nubian Shield(ANS)in the Eastern Desert(ed)of Egypt comprises juvenile suites of metavolcanics(mV),large amounts of meta-sedimentary rocks(mS),and voluminous metagabbros-diorites(mGD)and syn-tectonic intrusions of older granitoids(OG).We report here the updates of these four rock units in terms of classification,distribution,chemical characteristics,geodynamic evolution,metamorphism,and *** addition,we discuss these integrated data to elucidate a reasonable and reliable model for crustal evolution in the *** main features of these rock units indicate their relation to each other and the geodynamic environment dominated by early immature oceanic island arcs to primitive continental *** information of the island arc metavolcanic and plutonic rocks(gabbros,diorites,tonalites,and granodiorites)furnish evidence of the genetic *** include proximity and a coeval nature in the field;all protolith magmas are subalkaline in nature following calc-alkaline series with minor tholeiitic affinities;common geochemical signature of the arc rocks and subduction-related magmatism;their similar enrichment in LREEs;and similar major element compositions with mafic melts derived from metasomatized mantle *** volcano-sedimentary and the OG rocks underwent multiphase deformation events whereas the mGD complexes deformed *** on the magmatic,sedimentological,and metamorphic evolutions constrained by geochronological data as well as the progressive evolutionary trend from extensional to compressional regimes,a possible gradual decrease in the subducted slab dip angle is the most infl uential in any geodynamic model for arc assemblage in the ed of Egypt.

关键词： Island arc assemblage magmatism Crustal growth Neoproterozoic Arabian–Nubian Shield Eastern Desert Egypt

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A multi-shot target wheel assembly for high-repetition-rate, laser-driven proton acceleration

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High Power Laser Science and Engineering 2024年第2期12卷 87-94页

作者： J.Penas A.Bembibre D.Cortina-Gil L.martin A.Reija C.Ruiz m.Seimetz A.Alejo J.Benlliure Instituto Galego de Fisica de Altas Enerxias Universidade de Santiago de CompostelaSantiago de CompostelaSpain Laboratorio Laser de Aceleracion y Aplicaciones RIAIDTUniversidade de Santiago de CompostelaSantiago de CompostelaSpain Instituto Universitario de Física Fundamental y matematicas y Dpto.de Didactica de la matematica y de las Ciencias Experimentales Universidad de SalamancaSalamancaSpain Instituto de Instrumentación para Imagen molecular(I3m) CSIC-Universitat Politecnica de ValenciaValenciaSpain

A multi-shot target assembly and automatic alignment procedure for laser–plasma proton acceleration at high repetition rate are *** assembly is based on a multi-target rotating wheel capable of hosting more than 5000 targets,mounted on a 3D motorized stage to allow rapid replenishment and alignment of the target material between laser *** automatic alignment procedure consists of a detailed mapping of the impact positions at the target surface prior to the irradiation that ensures stable operation of the target,which alongside the purpose-built design of the target wheel,enables operation at rates up to 10 *** and continuous laser-driven proton acceleration at 10 Hz is demonstrated,with observed cut-off energy stability about 15%.

关键词： high repetition rate laser-plasma acceleration multi-shot operation proton source target assembly

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Performance Evaluation ofmulti-Agent Reinforcement Learning Algorithms

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Intelligent Automation & Soft Computing 2024年第2期39卷 337-352页

作者： Abdulghani m.Abdulghani mokhles m.Abdulghani Wilbur L.Walters khalid H.Abed Department of Electrical&Computer Engineering and Computer Science Jackson State UniversityJacksonMS 39217USA

multi-Agent Reinforcement Learning(mARL)has proven to be successful in cooperative *** is used to investigate how autonomous agents with the same interests can connect and act in one *** cooperation scenarios are explored in recreational cooperative augmented reality environments,as well as realworld scenarios in *** this paper,we explore the realm of mARL and its potential applications in cooperative *** focus is on developing a multi-agent system that can collaborate to attack or defend against enemies and achieve victory withminimal *** accomplish this,we utilize the StarCraftmulti-Agent Challenge(SmAC)environment and train four mARL algorithms:Q-learning with mixtures of Experts(QmIX),Value-DecompositionNetwork(VDN),multi-agent Proximal PolicyOptimizer(mAPPO),andmulti-Agent Actor Attention Critic(mAA2C).These algorithms allow multiple agents to cooperate in a specific scenario to achieve the targeted *** results show that the QmIX algorithm outperforms the other three algorithms in the attacking scenario,while the VDN algorithm achieves the best results in the defending ***,the VDNalgorithmreaches the highest value of battle wonmean and the lowest value of dead *** research demonstrates the potential formARL algorithms to be used in real-world applications,such as controllingmultiple robots to provide helpful services or coordinating teams of agents to accomplish tasks that would be impossible for a human to *** SmAC environment provides a unique opportunity to test and evaluate mARL algorithms in a challenging and dynamic environment,and our results show that these algorithms can be used to achieve victory with minimal damage.

关键词： Reinforcement learning RL multi-agent mARL SmAC VDN QmIX mAPPO

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Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RIGHT- 2 randomised sham- controlled ambulance trial

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Stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： Jason Philip Appleton Lisa J Woodhouse Craig S Anderson Sandeep Ankolekar Lesley Cala mark Dixon Timothy J England Kailash Krishnan Grant mair Keith W muir John Potter Christopher I Price marc Randall Thompson G Robinson Christine Roffe Else C Sandset Jeffrey L Saver Angela Shone Aloysius Niroshan Siriwardena Joanna m Wardlaw Nikola Sprigg Philip m Bath Stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK Stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of medicine The George Institute for Global HealthSydneyNew South WalesAustralia The George Institute China at Peking University Health Science Center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia Department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and medical Sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East midlands Ambulance Service NHS Trust NottinghamUK Stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK Centre for Clinical Brain Sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK Institute of Neurology and Psychology University of GlasgowGlasgowUK Bob Champion Research and education Building University of East AngliaNorwichUK Institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK Department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre University of LeicesterLeicesterUK Stroke Research in Stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK Department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway Department of Neurology and Comprehensive Stroke Center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and Graduate Services University of NottinghamNottinghamUK Community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(GTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is ***,we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2(RIGHT-2).methods RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of *** primary outcome was a shift in scores on the modified Rankin scale(mRS)at day *** outcomes included death;a global analysis(Wei-Lachin test)containing Barthel Index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’*** were reported as n(%),mean(SD),median[IQR],adjusted common OR(acOR),mean difference or mann-Whitney difference(mWD)with 95%*** 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),Glasgow Coma Scale 14(2)and time from onset to randomisation 67[45,108]***‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,GTN did not influence the primary outcome(acOR for increased disability 1.15,95%CI 0.85 to 1.54),death or global analysis(mWD 0.00,95%CI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe *** In patients who had an ischaemic stroke,ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital *** IS ALREADY KNOWN ON THIS TOPIC⇒Transdermal glyceryl trinitrate(GTN)was associat-ed with less death and dependency in those w

关键词： Glasgow nitrate random

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Tumor necrosis factor-alpha, transforming growth factor-beta, degree of lower urinary tract symptoms as predictors of erectile dysfunction in benign prostatic hyperplasia patients

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Asian Journal of Urology 2024年第2期11卷 280-285页

作者： Gede W.K.Duarsa Yeremia G.Kusumah Ronald Sugianto Pande m.W.Tirtayasa Tjokorda G.B.mahadewa Department of Urology Faculty of MedicineUniversitas UdayanaProf.Dr.I.G.N.G Ngoerah General HospitalBaliIndonesia Department of General Surgery Faculty of MedicineUniversitas UdayanaProf.Dr.I.G.N.G Ngoerah General HospitalBaliIndonesia medical Doctor Study Program Faculty of MedicineUniversitas UdayanaBaliIndonesia Department of Urology Faculty of MedicineUniversitas UdayanaUniversitas Udayana Teaching HospitalBaliIndonesia Department of Neurosurgery Faculty of MedicineUniversitas UdayanaProf.Dr.I.G.N.G Ngoerah General HospitalBaliIndonesia

Objective: Erectile dysfunction (ed) is a condition of insufficient penile erection, consistently or recurrently, for sexual activity. Tumor necrosis factor-alpha (TNF-α) induces transforming growth factor-beta (TGF-β), which causes the transition of epithelial cells into mesenchymal cells that affect ed. This study aimed to evaluate the roles of TNF-α, TGF-β, degree of lower urinary tract symptoms, and prostatic volume for the presence of ed in benign prostatic hyperplasia (BPH) ***: Our study performed an analytic observational retrospective cohort study using secondary data from four hospitals in Bali, Indonesia, including medical records and other administrative data. The sample was BPH patients with several history ***: Our sample was 83 respondents, ranging from 50 years to 80 years, 61 respondents with ed and 22 with non-ed. The International Prostate Symptom Score showed a significant result, which indicates that ed is more common in patients with higher International Prostate Symptom Score (p=0.002). moreover, the TNF-α of ≥43.9 pg/mg and TGF-β of ≥175.8 pg/mL were significantly associated with the presence of ed in BPH patients (pme is not significant with ed (p=0.947).Conclusion: TNF-α, TGF-β, and lower urinary tract symptoms severity can predict the occurrence of ed in BPH, while prostatic volume was not significant.

关键词： Prostate enlargement Biomarker Erectiledysfunction Riskfactor

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Inflammatory myofibroblastic tumor from molecular diagnostics to current treatment

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Oncology Research 2024年第7期32卷 1141-1162页

作者： PAULINA CHmIEL ALEKSANDRA SŁOWIKOWSKA ŁUKASZ BANASZEK ANNA SZUmERA-CIEĆKIEWICZ BARTŁOmIEJ SZOSTAKOWSKI mATEUSZ J.SPAŁEK TOmASZŚWITAJ PIOTR RUTKOWSKI ANNA m.CZARNECKA Department of Soft Tissue/Bone Sarcoma and melanoma Maria Sklodowska-Curie National Research Institute of OncologyWarsaw02-781Poland Faculty of medicine Medical University of WarsawWarsaw02-091Poland Department of Pathology Maria Sklodowska Curie National Research Institute of OncologyWarsaw02-781Poland Department of Radiotherapy Maria Sklodowska-Curie National Research Institute of OncologyWarsaw02-781Poland

Inﬂammatory myoﬁbroblastic tumor(ImT)is a rare neoplasm with intermediate malignancy characterized by a propensity for recurrence but a low metastatic *** challenges arise from the diverse pathological presentation,variable symptomatology,and lack of different imaging ***,ImT is identiﬁed by the fusion of the anaplastic lymphoma kinase(ALK)gene,which is present in approximately 70%of cases,with various fusion partners,including ran-binding protein 2(RANBP2),which allows conﬁrmation of the *** surgery is the preferred approach for localized tumors,the optimal long-term treatment for advanced or metastatic disease is difﬁcult to deﬁ*** therapies are crucial for achieving sustained response to treatment within the context of genetic alteration in ***,an ALK tyrosine kinase inhibitor(TKI),was ofﬁcially approved by the US Food and Drug Administration(FDA)in 2020 to treat ImT with ALK ***,most patients face resistance and disease progression,requiring consideration of sequential *** radiotherapy with targeted therapy appears to be beneﬁcial in this *** promising results have also been achieved with immunotherapy,indicating potential for combined therapy ***,deﬁned recommendations are still *** review analyzes the available research on ImT,including genetic disorders and their impact on the course of the disease,data on the latest targeted therapy regimens and the possibility of developing immunotherapy in this indication,as well as summarizing general knowledge about prognostic and predictive factors,also in terms of resistance to systemic therapy.

关键词： Inﬂammatory myoﬁbroblastic tumor(ImT) Epithelioid inﬂammatory myoﬁbroblastic sarcoma Tyrosine kinase inhibitors(TKI) Anaplastic lymphoma kinase(ALK)

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