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A rare case of single right coronary artery arising from the right sinus of Valsalva with severe three-vessel disease

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Journal of Geriatric Cardiology 2017年第3期14卷 218-221页

作者： Saif Ibrahim nachiket patel Sayf Said Bashar Al-Turk DO Melissa Dakak DO Farah Al-Saffar Department of Cardiology University of Florida Jacksonville FL USA Providence Hospital Washington DC USA Department of Internal Medicine University of Florida Jacksonville FL USA Department of Cardiology University of Arizona Tucson AZ USA Department of Cardiology Mayo Clinic Scottsdale AZ USA

A 63-year-old man was admitted to our observation unit with atypical angina found to be non-adherent with his an- ti-hypertensive medication regimen for one month. His medical history was notable for hypertension for ten years and current tobacco smoking. He was hypertensive with otherwise, stable vital signs. Cardiac auscultation revealed normal S1 and $2 without a murmur.

关键词： Coronary artery anomalies Coronary artery disease Sinus of Valsalva

A soft gripper of fast speed and low energy consumption

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Science China(Technological Sciences) 2019年第1期62卷 31-38页

作者： WANG YuZhe GUPTA Ujjaval PARULEKAR nachiket ZHU Jian Department of Mechanical Engineering National University of Singapore School of Mechanical Sciences Indian Institute of Technology Bhubaneswar

Grasping of complicated objects is an active research area which is developing fast throughout the years. Soft grippers can be an effective solution, since they are capable of holding workpieces of various shapes and interacting with unstructured environments effectively. Soft grippers generally consist of soft, flexible and compliant materials, which are able to conform to the shape of the object so that the gripper will not deform or bruise the soft object. Fast grasping of objects with various sizes and shapes remains a challenging task for soft grippers. In the present article, a soft gripper based on bi-stable dielectric elastomer actuator(DEA) inspired by the insect-catching ability of the Venus flytrap, is designed. This soft gripper can achieve good performances in grasping various objects by a simple actuation system. The gripper can switch from one stable state to another when subject to an impulse voltage of 0.04 s. The time duration for each grasping action is 0.17 s, and no continuous voltage is required for holding the gripped object. Thus, energy consumption can be achieved as low as 0.1386 J per grasping action. The mechanism of achieving bi-stable states is related to the duration of impulse voltage applied and the resonant frequency of the structure. The present study demonstrates that bi-stable dielectric elastomer actuators are capable of achieving fast speed for grasping with very low energy consumption, which is significant in the applications to soft grippers and biomimetic robots.

关键词： soft gripper dielectric elastomer fast speed bi-stable low energy consumption

Validation of Vesical Imaging Reporting and Data System score for the diagnosis of muscle-invasive bladder cancer: A prospective cross-sectional study

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Asian Journal of Urology 2022年第4期9卷 467-472页

作者： Kumawat Ghanshyam Vyas nachiket Sharma Govind Priyadarshi Shivam Gupta Bhagwan Sahay Singla Mohit Kumar Ashok Department of Urology Sawai Man Singh Medical College and HospitalJaipurRajasthanIndia

Objective:Vesical Imaging Reporting and Data System(VIRADS)score was developed to standardize the reporting and staging of bladder tumors on pre-operative multiparametric magnetic resonance *** helps in avoiding unnecessary repeat transurethral resection of bladder tumor in high-risk non-muscle-invasive bladder cancer *** study was done to determine the validity of VIRADS score prospectively for the diagnosis of muscleinvasive bladder ***:This study was conducted from March 2019 to March 2020 at Sawai Man Singh Medical College and Hospital,Jaipur,Rajasthan,*** admitted with the provisional diagnosis of bladder tumor were included as *** these patients underwent a 3 Tesla mpMRI to obtain a VIRADS score before they underwent transurethral resection of bladder tumor and these data were analyzed to evaluate the correlation of pre-operative VIRADS score with mus-cle invasiveness of the tumor in final biopsy ***:A cut-off of VIRADS≥4 for prediction of detrusor muscle invasion yielded a sensitivity of 79.4%,specificity of 94.2%,positive predictive value of 90.0%,negative predictive value of 87.5%,and diagnostic accuracy of 86.4%.A cut off of VIRADS≥3 for prediction of detrusor muscle invasion yielded a sensitivity of 91.2%,specificity of 78.8%,positive predictive value of 73.8%,negative predictive value of 93.2%,and accuracy of 83.7%.The receiver operating curve showed the area under the curve to be 0.922(95%confidence interval:0.862e0.983).Conclusion:VIRADS score appears to be an excellent and effective pre-operative radiological tool for the prediction of detrusor muscle invasion in bladder cancer.

关键词： Vesical Imaging Reporting and Data System Bladder tumor Multiparametric magnetic resonance imaging Detrusor invasion

Patient Demographics and Characteristics of Infection with Carbapenem-Resistant <i>Acinetobacter baumannii</i>in a Teaching Hospital from the United States

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Advances in Infectious Diseases 2013年第1期3卷 10-16页

作者： nachiket D. Vaze Christopher L. Emery Richard J. Hamilton Ari D. Brooks Suresh G. Joshi Surgical & Nosocomial Infection Research and Bacterial Pathogenesis Program Drexel University College of Medicine Hahnemann University Hospital Philadelphia USA

A characterization of the clinical demographic features of patients with infection caused Acinetobacter baumannii, and the antibiotyping of the isolates recovered from these patients was undertaken, with a special reference to carbapenem-resistant variants, and their risk factors. This study was conducted retrospectively from January 2010 to March 2011 at a 616-bed tertiary care university hospital. Sixty-four patients were identified. Clinical and microbiological data were analyzed for risk factors and demographic features to derive relative risk and odds ratio. We identified 100 A. baumannii from 64 patients during 15 months period. Significant risk factors were working age (18 - 60 years), male gender, hospital stay (>1 week but Pseudomonas aeruginosa, and Klebsiella pneumoniae were the significant co-infecting agents. The antibiogram demonstrated multidrug resistance in a majority of the isolates. Relative risk associated with ventilator, diabetes, and surgery was higher in repeat isolates than in first isolates and were multidrug resistant. Repeat isolates were more resistant that the first isolates to most anti-acinetobacter agents, but the overall crude mortality was not significant during this study period, and couldn’t correlated to the choice of treatment. In conclusion, a resistance against all clinically used carbapenems, and colistin is rapidly increasing in repeat isolates of A. baumannii;leaves narrow therapeutic options to treat multidrug-resistant and pandrug-resistant A. baumannii infection. For the first time we report rising incidence of colistin resistance by 20 percent in repeat isolates, and is worrisome for healthcare centers. A combination therapy should be adopted to treat such infection to avoid the emergence of colistin-resistant phenotypes in the United States.

关键词： Acinetobacter baumannii Carbapenem Resistance Colistin Imipenem Meropenem Multidrug Resistance Risk Factor