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Burns in the elderly:a nationwide study on management and clinical outcomes

Burns & Trauma 2020年第1期8卷 71-81页

作者： Harold Goei margriet e.van baar Jan Dokter J Vloemans Gerard I.J.M.Beerthuizen esther Middelkoop Kees H.van der Vlies the Dutch Burn Repository group Association of Dutch Burn Centres Burn CentreMaasstad HospitalRotterdamthe Netherlands Department of Plastic Reconstructive and Hand SurgeryAmsterdam Movement SciencesVU University Medical CentreAmsterdamthe Netherlands Burn Centre Maasstad Hospital Rotterdamthe Netherlands Burn Centre Red Cross Hospital Beverwijkthe Netherlands Burn Centre Martini HospitalGroningenthe Netherlands Association of Dutch Burn Centres Burn Centre Red Cross HospitalBeverwijkthe Netherlands Department of Public Health Erasmus Medical CentreRotterdamthe Netherlands 不详

Background:In modern-day burn care,advanced age remains an important predictor for mortality among burn *** this study,we compared the complete treatment trajectory(including prehospital and surgical treatment)and the outcomes between an elderly burn population and a younger adult burn ***:In this nationwide study,data from the Dutch Burn Repository were *** is a uniform national registration for Dutch specialized burn *** adult patients that were admitted to one of the three Dutch burn centres from the period 2009 to 2015 were included in the *** patients were considered as elderly when≥65 years of age,and were then further subdivided into three age categories:65–74,75–85 and 85+*** adults in the age category 18–64 years were used as the reference *** managementwas studied comprehensively and included timing of surgery,the number of procedures and details on the surgical technique,especially the technique used for debridement and the grafting technique that was *** the comparison of clinical outcome,the following parameters were included:mortality,wound infections,length of stay/TBSA(total body surface area)burned,discharge disposition and secondary ***:During the study period,3155 adult patients were included(elderly,n=505).Burn severity,reflected by the median TBSA,varied between 3.2–4.0%and was comparable,but aetiology and pre-hospital care were different between elderly and the younger adult reference *** treatment was initiated significantly faster in elderly burn patients(pess selective techniques for surgical debridement were used in the elderly burns patients(hydrosurgery,42.0%vs 23.5–22.6%),and on the other hand more avulsion(5.3%vs 7.3–17.6%)and primary wound closure(6.7%vs 24.5%).The most frequently used grafting technique was meshed skin grafts(79.2–88.6%);this was not related to *** increased rapidly with a higher age and showed a h

关键词： Burns Nationwide study elderly Surgical management Clinical outcomes

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Follow-up in patients with a burn-related emergency department visit:a feasibility study

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Burns & Trauma 2017年第4期5卷 260-267页

作者： H. Goei B. F. M. Wijnen S. Mans M. A. C. de Jongh C. H. van der Vlies S. Polinder N. e. e. van Loey M. e. van baar Association of Dutch Burn Centres Burn Centre Maasstad Hospital PO Box 9100 3007 AC Rotterdam the Netherlands Department of Plastic Reconstructive and Hand Surgery MOVE Research Institute VU University Medical Centre Amsterdam the Netherlands Association of Dutch Burn Centres Burn Centre Maasstad Hospital PO Box 9100 3007 AC Rotterdam the Netherlands Department of Health Services Research CAPHRI School of Public Health and Primary Care Maastricht University 6200 MD Maastricht the Netherlands Trauma Centre Brabant Elisabeth-TweeSteden Hospital Tilburg the Netherlands Burn Centre Maasstad Hospital Rotterdam the Netherlands Department of Public Health Erasmus Medical Centre Rotterdam the Netherlands Association of Dutch Burn Centres Red Cross Hospital Beverwijk the Netherlands Association of Dutch Burn Centres Burn Centre Maasstad Hospital PO Box 9100 3007 AC Rotterdam the Netherlands Department of Public Health Erasmus Medical Centre Rotterdam the Netherlands

Background:Data on epidemiology, costs, and outcomes of burn-related injuries presenting at emergency departments (eDs) are scarce. To obtain such information, a questionnaire study with an adequate response rate is imperative. There is evidence that optimized strategies can increase patient participation. However, it is unclear whether this applies to burn patients in an eD setting. The objective of this feasibility study was to optimize and evaluate patient recruitment strategy and follow-up methods in patients with burn injuries presenting at eDs. Methods:In a prospective cohort study with a 6-month follow-up, patients with burn-related injuries attending two large eDs during a 3-month study period were included. eligible patients were quasi-randomly allocated to a standard or optimized recruitment strategy by week of the eD visit. The standard recruitment strategy consisted of an invitation letter to participate, an informed consent form, a questionnaire, and a franked return envelope. The optimized recruitment strategy was complemented by a stamped returned envelope, monetary incentive, sending a second copy of the questionnaire, and a reminder by telephone in non-responders. Response rates were calculated, and questionnaires were used to assess treatment, costs, and health-related quality of life. Results:A total of 87 patients were included of which 85 were eligible for the follow-up study. There was a higher response rate at 2 months in the optimized versus the standard recruitment strategy (43.6%vs. 20.0%;OR=3.1 (95%CI 1.1–8.8)), although overall response is low. Non-response analyses showed no significant differences in patient, burn injury or treatment characteristics between responders versus non-responders. Conclusions:This study demonstrated that response rates can be increased with an optimized, but more labor-intensive recruitment strategy, although further optimization of recruitment and follow-up is needed. It is feasible to assess epidemiology, tr

关键词： Burns emergency department Recruitment strategy Response rate Health care survey methods

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Little effect of climate change on body size of herbivorous beetles

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Insect Science 2018年第2期25卷 309-316页

作者： Yuval baar Ariel Leib Leonid Friedman Shai Meiri Inon Scharf Department of Zoology Faculty of Life Sciences ＆ Steinhardt Museum of Natural History and National Research Center Tel Aviv University Tel Aviv Israe

Ongoing climate change affects various aspects of an animal＇s life, with impor- tant effects on distribution range and phenology. The relationship between global warming and body size changes in mammals and birds has been widely studied, with most find- ings indicating a decline in body size over time. Nevertheless, little data exist on similar size change patterns of invertebrates in general and insects in particular, and it is unclear whether insects should decrease in size or not with climate warming. We measured over 4000 beetle specimens, belonging to 29 beetle species in 8 families, collected in Israel during the last 100 years. The sampled species are all herbivorous. We examined whether beetle body size had changed over the years, while also investigating the relationships between body size and annual temperature, precipitation, net primary productivity （NPP） at the collection site and collection month. None of the environmental variables, including the collection year, was correlated with the size of most of the studied beetle species, while there were strong interactions of all variables with species. Our results, though mostly neg- ative, suggest that the effect of climate change on insect body size is species-specific and by no means a general macro-ecological rule. They also suggest that the intrapopulation variance in body size of insects collected as adults in the field is large enough to conceal intersite environmental effects on body size, such as the effect of temperature and NPe

关键词： Coleoptera museum collections rain temperature-size rule thermal ecol-ogy

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基于喷油策略和eGR耦合控制的单缸共轨柴油机燃用DMC/柴油调和燃料的研究

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内燃机工程 2013年第5期34卷 7-12页

作者：梅德清任华王忠 Roland baar 江苏大学汽车与交通工程学院镇江2120131 柏林工业大学机械与交通工程系德国柏林10587

在柴油中掺入10%碳酸二甲酯(10%DMC,简称为D10),进行了D10燃料的燃烧与排放特性的研究。试验结果表明:在特定负荷下,对于3种燃油(D10无喷油调整、D10有喷油调整和柴油)供给状态下,发动机的着火几乎出现在同一时刻;发动机燃用D10时,其瞬... 详细信息

在柴油中掺入10%碳酸二甲酯(10%DMC,简称为D10),进行了D10燃料的燃烧与排放特性的研究。试验结果表明:在特定负荷下,对于3种燃油(D10无喷油调整、D10有喷油调整和柴油)供给状态下,发动机的着火几乎出现在同一时刻;发动机燃用D10时,其瞬时放热率在初始阶段比柴油高,指示热效率明显得到提高;HC和CO排放下降明显,但这两者遵循不同的机理,其中CO在高负荷下对较低的过量空气系数更敏感,而HC则更多地与着火延迟期长短有关;NOx排放因含氧燃料DMC的加入而增加,同时燃料中的氧对PM排放的降低起到了重要作用。PM排放的降幅和NOx排放的升幅为后续调节这两者排放提供了较大空间。

关键词：内燃机含氧燃料碳酸二甲酯燃烧排放

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DMC/柴油混合燃料共轨柴油机燃烧循环变动研究

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农业机械学报 2014年第8期45卷 14-18,65页

作者：梅德清任华姜士阳 baar Roland 江苏大学汽车与交通工程学院镇江212013 柏林工业大学机械与交通工程系柏林10587

研究了不同条件下DMC/柴油混合燃料共轨发动机的燃烧循环变动,以及COHR和eGR率对燃烧循环变动的影响。结果表明:共轨发动机燃用不同燃料时的燃烧循环变动率都较小;D10燃料燃烧的循环变动率大于纯柴油;发动机大负荷时的循环变动率相对较... 详细信息

研究了不同条件下DMC/柴油混合燃料共轨发动机的燃烧循环变动,以及COHR和eGR率对燃烧循环变动的影响。结果表明:共轨发动机燃用不同燃料时的燃烧循环变动率都较小;D10燃料燃烧的循环变动率大于纯柴油;发动机大负荷时的循环变动率相对较小;随着COHR的增加,以pmi为表征参数的循环变动系数变化不明显;以pmax为表征参数的循环变动系数略有增大,而以θd为表征参数的循环变动系数明显增长;D10燃料的循环变动系数随eGR率的增加呈缓慢增长,柴油则相对平稳;高的平均指示压力对应着短的火焰发展期。

关键词：碳酸二甲酯高压共轨柴油机燃烧循环变动

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多段燃油喷射对碳酸二甲酯-柴油混合燃料燃烧过程的影响

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农业工程学报 2014年第8期30卷 74-80页

作者：梅德清任华姜士阳王忠 Roland baar 江苏大学汽车与交通工程学院镇江212013 柏林工业大学机械与交通工程系柏林10587

柴油机多段燃油喷射可用来优化缸内燃烧以实现排放净化的目标。该文采用两段预喷和一段主喷组合的多段燃油喷射进行混合燃料D10(90%柴油+10%碳酸二甲酯)燃烧过程的研究。通过预喷相位可调但3段喷油之间相位间隔恒定、主喷持续时间可调但... 详细信息

柴油机多段燃油喷射可用来优化缸内燃烧以实现排放净化的目标。该文采用两段预喷和一段主喷组合的多段燃油喷射进行混合燃料D10(90%柴油+10%碳酸二甲酯)燃烧过程的研究。通过预喷相位可调但3段喷油之间相位间隔恒定、主喷持续时间可调但第1、2段预喷持续时间固定的喷油策略,实现在目标工况下精确的放热中心COHR(center of heat release)。当调整多段燃油喷射策略实现目标COHR以等步长推移时,柴油机的燃烧过程呈现如下特点:各工况的着火时刻均处于第2段预喷和主喷之间;从喷油时刻至着火时刻所经历的曲轴转角越来越小;着火时刻至放热中心所占用的曲轴转角则越来越大;缸内燃烧压力峰值出现位置与放热中心位置较为接近,相对缸内峰值压力出现位置,COHR不断后移且相距更远。与柴油相比,D10的滞燃期更长,其最大压升率也更高。由于易汽化的碳酸二甲酯促进了燃料混合及后续燃烧,从着火时刻到10%放热率及90%放热率对应时刻所占用曲轴转角均变小,说明碳酸二甲酯的加入有助燃烧的迅速进行。基于COHR为表征的燃烧特性分析,为碳酸二甲酯/柴油混合燃料的应用、多段燃油喷射调控燃烧过程及排放控制理论提供指导。

关键词：柴油机燃料燃烧碳酸二甲酯多段喷射

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放热中心对DMC-柴油燃料排放特性的影响

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长安大学学报（自然科学版） 2015年第3期35卷 143-150页

作者：梅德清姜士阳吴焓任华 Roland baar 江苏大学汽车与交通工程学院江苏镇江212013 柏林工业大学机械与交通工程系德国柏林10587

为提高柴油机的燃烧热效率及有效降低有害排放物,在1台高压共轨单缸柴油机上,运用2段预喷和1段主喷组合的多段燃油喷射,并耦合高eGR率以实现低温预混合燃烧。在不同放热中心及eGR率的条件下,对比研究柴油及D10燃料(在柴油中掺入10%碳酸... 详细信息

为提高柴油机的燃烧热效率及有效降低有害排放物,在1台高压共轨单缸柴油机上,运用2段预喷和1段主喷组合的多段燃油喷射,并耦合高eGR率以实现低温预混合燃烧。在不同放热中心及eGR率的条件下,对比研究柴油及D10燃料(在柴油中掺入10%碳酸二甲酯)的排放性能。研究结果表明:随着放热中心(crank angle 50,CA50)后移,NOx排放显著降低,HC及CO排放的变化则相对平缓,PM排放呈先增加后降低的趋势;通过调整燃油喷射系统参数调控CA50(燃油路径)及采用eGR率(气体路径)均可实现对NOx的控制,但对其他排放物的作用效果却各不相同;高eGR氛围耦合较晚的CA50,即燃油路径与气体路径二者良好的匹配使用,可实现NOx和PM这2个目标变量的兼顾控制;与柴油相比,使用含氧燃料D10后,HC和CO均略有下降,NOx排放略有上升,但在PM排放方面可以获得大幅度的降低,可为NOx与PM排放之间的再平衡提供更大的空间。

关键词：机械工程碳酸二甲酯多段喷射 eGR率放热中心排放

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基于低温PCCI的DMC-柴油的燃烧与排放特性研究

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内燃机工程 2016年第5期37卷 32-38页

作者：梅德清任华姜士阳吴焓 baar Roland 江苏大学汽车与交通工程学院镇江212013 柏林工业大学机械与交通工程系柏林10587

要在一台改造的高压共轨单缸柴油机上，以实现超低的NOx与颗粒（PM）排放和较高的热效率为目标，采用了高废气再循环（eGR）率、多段喷射和进气增压三者耦合来实现低温预混充量压燃（PCCI），分析碳酸二甲酯（DMC）-柴油混合燃料高预... 详细信息

要在一台改造的高压共轨单缸柴油机上，以实现超低的NOx与颗粒（PM）排放和较高的热效率为目标，采用了高废气再循环（eGR）率、多段喷射和进气增压三者耦合来实现低温预混充量压燃（PCCI），分析碳酸二甲酯（DMC）-柴油混合燃料高预混比例低温燃烧的详细特征及排放性能。研究结果表明：随着放热中心（center of heat release, COHR）推迟，缸内燃烧压力和温度渐次降低，最高燃烧温度均出现在COHR之后7°曲轴转角附近。当COHR从曲轴转角7°逐渐增加到19°时，由两段预喷油束燃烧形成的微弱放热峰放热比例仅占3.5%~6.7%，预喷策略和较高的eGR率联合控制主喷油束的蒸发速率及主燃期的燃烧速率，实现预混燃烧放热比例由65.3%增至76.2%。采用燃烧闭环控制后，基于平均指示压力的循环变动系数能维持在2.0%以内。D10和柴油两种燃料的指示热效率在COHR处于曲轴转角10°附近时达最大值。在较大预混比例低温燃烧PCCI模式下，可同时实现超低的NOx和PM排放。DMC的含氧特性使NOx排放增加，但同时也促进了氧化燃烧的完全程度，显著降低HC、CO和PM排放。

关键词：内燃机碳酸二甲酯低温预混充量压燃放热中心 eGR率排放

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CMO，与时间赛跑

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成功营销 2007年第2期 34-36页

作者： Aaron baar 刘鑫（编译）不详《成功营销》特约记者

眼下对于营销人士而言．可谓是艰难时世．尤其是对那些身居营销要职的人。仅仅在2007年首月．就有大众汽车的CMO（首席营销官）Kerri Martin在上任近20个月后．被辞退：美国百货公司运营商Sears的CMO Joan Chow上任19个月后也同样离职... 详细信息

眼下对于营销人士而言．可谓是艰难时世．尤其是对那些身居营销要职的人。仅仅在2007年首月．就有大众汽车的CMO（首席营销官）Kerri Martin在上任近20个月后．被辞退：美国百货公司运营商Sears的CMO Joan Chow上任19个月后也同样离职。此外，美国最大的服装零售商Gap营销副总裁Kyle Andrew于1月底离开．去”寻求其它机会“。不止于此．目前舆论纷纷的是沃尔玛CMO John Fleming．他不久也将离任。此外，还有包括可口可乐在内的一些大公司的CMO即将离职。

关键词： CMO 首席营销官服装零售商营销人大众汽车百货公司

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Unmasking lower gastrointestinal bleeding under administration of norepinephrine

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World Journal of Radiology 2022年第12期14卷 375-383页

作者： David John Werner Nicolai Wenzel Nael Abusalim Ralf Kiesslich Till baar Achim Tresch Johannes Wilhelm Rey Department of Radiology Helios Dr.Horst-Schmidt-ClinicWiesbaden 65199HessenGermany Radiologie Rhein-Nahe Krankenhaus St.MarienwörthBad Kreuznach 55543Rheinland-PfalzGermany Department of Diagnostic and Interventional Radiology Medical Center HanauHanau 63450HessenGermany Department of Internal Medicine II Helios Dr.Horst-Schmidt-ClinicWiesbaden 65199HessenGermany Institute for Medical Statistics and Computational Biology Faculty of MedicineUniversity of CologneCologne 50923Nordrhein-WestfalenGermany Department of Gastroenterology and endoscopy Medical Center OsnabrueckOsnabrueck 49076NiedersachsenGermany

BACKGROUND Bleeding in the gastrointestinal tract is common and transarterial embolization enables the clinician to control gastrointestinal *** extravasation is a prerequisite for successful *** angiography is helpful in the detection of elusive *** We performed a retrospective analysis of angiographic treatment in patients with lower gastrointestinal hemorrhage and initially negative angiographies,as well as the role of norepinephrine(Ne)in unmasking *** We analyzed 41 patients with lower gastrointestinal bleeding after angiography who had undergone treatment over a period of 10 *** patients had a positive shock index and needed intensive *** In three of four patients,angiography disclosed the site of bleeding when Ne was used during the procedure for hemodynamic *** We suggest that angiography performed after the administration of Ne in unstable patients with gastrointestinal bleeding and an initially negative angiography has the potential to unmask bleeding sites for successful ***,this statement must be confirmed in prospective studies.

关键词： Lower gastrointestinal bleeding endoscopy Provocative angiography Norepinephrine Radiology Gastrointestinal bleeding

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