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Assessing Healthcare Facilities Preparedness for Mass Fatalities Incident

International Journal of Clinical Medicine 2013年第12期4卷 525-531页

作者： Marisol Pena-Orellana Ralph Rivera-Gutierrez Juan AGonzalez-Sanchez nilsa padilla-elias Heriberto Marin Centeno Hector Alonso-Serra Liza Millan-Perez Patricia Monserrate-Vazquez Center for Public Health Preparedness Graduate School of Public HealthMedical Sciences CampusUniversity of Puerto RicoSan JuanPuerto Rico Department of Health Services Administration Graduate School of Public HealthMedical Sciences CampusUniversity of Puerto RicoSan JuanPuerto Rico Department of Emergency Medicine School of MedicineMedical Sciences CampusUniversity of Puerto RicoSan JuanPuerto Rico

Background: Any healthcare facility must be prepared to handle a dramatic increase in deaths that can be produced by a catastrophic disaster. A mass fatality incident (MFI) will significantly increase the usual number of deaths that hospitals or forensic science services can manage on a daily basis. A survey was conducted to assess the hospital emergency department level of preparedness to deal with an MFI. Objective: To examine healthcare facilities level of preparedness for an MFI and morgue capacity. Methods: A total of 39 out of a sample of 44 hospitals participated in the study. Seven questionnaires were administered to explore: hospital general characteristics;emergency plans;equipment and infrastructure;collaborative agreements;personnel trainings;emergency communications;laboratory facilities;treatment protocols;security;and, epidemiologic surveillance. Results: Three-fourths (79.5%) of the healthcare facilities reported having a morgue, their average storage capacity was of three bodies. More than two-thirds (66.7%) of the institutions stated that they could not increase their morgue’s capacity. Most installations without a morgue do not possess an agreement with any other institution for the management of bodies. Hospitals have a very limited number of body bags utilized for the handling and transport of bodies. Conclusion: Most of healthcare facilities have morgues, but there are limitations with the current capacity and the lack of resources to increase their capacity in case of a disaster. Management of an MFI must be part of every hospital’s emergency plan, and must include collaborative agreements with forensic authorities, emergency management and public health agencies, and the community.

关键词： Hospitals Morgues Mass Casualties Mass Fatalities Puerto Rico

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Diversity of Emergency Codes in Hospitals

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International Journal of Clinical Medicine 2013年第11期4卷 499-503页

作者： nilsa padilla-elias Marisol Pena-Orellana Ralph Rivera-Gutierrez Juan AGonzalez-Sanchez Heriberto AMarin Centeno Hector Alonso-Serra Liza Millan-Perez Patricia Monserrrate-Vazquez (Center for Public Health Preparedness)Graduate School of Public Health Medical Sciences CampusUniversity of Puerto RicoSan JuanPuerto Rico (School of Medicine)Department of Emergency Medicine Medical Sciences CampusUniversity of Puerto RicoSan JuanPuerto Rico Department of Health Services Administration Graduate School of Public HealthMedical Sciences CampusUniversity of Puerto RicoSan JuanPuerto Rico

Background: Hospitals must be prepared to deal efficiently and effectively with different emergencies. To accomplish this, several countries have standardized their hospital emergency codes to improve their response capability. This is particularly important in Puerto Rico given that many health professionals, particularly physicians and nurses, provide services in more than one hospital. This study examined the emergency codes and alerts utilized in Puerto Rican hospitals. Objective: To assess hospitals’ level of emergency preparedness and response capability related to the variability of emergency codes and alerts utilized to respond to a situation in Puerto Rico. Method: A survey was conducted to characterize hospital emergency department level of preparedness and response to a mass fatality incident. A total of 39 out of a sample of 44 hospitals participated in the study. Semi-structured questionnaires were administered by the research team to members of each hospital’s administrative staff to explore the following: general hospital characteristics, emergency plans, emergency department capacity, collaborative agreements, personnel training, emergency communications, laboratory facilities, treatment protocols, security, epidemiologic surveillance, equipment and infrastructure. Results: Some hospitals in Puerto Rico use color coded emergency alerts, while others use key words or codes. Single color emergency codes can have different meanings in different hospitals. Conclusions: The findings clearly show that there is a lack of uniformity and clarity in the emergency codes utilized by hospitals in Puerto Rico. Single color codes have diverse meanings in different hospitals. This could adversely affect hospitals’ efficient and effective emergency response.

关键词： Communications Hospitals Health Health Communications Emergency Preparedness Preparedness Emergency Codes

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On Word Equations Originated from Discrete Dynamical Systems Related to Antisymmetric Cubic Maps with Some Applications

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Acta Mathematica Sinica,English Series 2018年第11期34卷 1663-1676页

作者： elias ABBOUD The Academic Arab Institute Faculty of EducationBeit Berl College

In this article, we solve some word equations originated from discrete dynamical systems related to antisymmetric cubic map. These equations emerge when we work with primitive and greatest words. In particular, we characterize all the cases for which （β1β1） = （β2β） where β1 and β2 are the greatest words in 〈〈β31〉〉 and 〈〈β32〉〉 of M（n）.

关键词： Word equation broken alternating word primitive word greatest word parity-lexicographic order

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Real-time calculation of fragment velocity for cylindrical warheads

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Defence Technology（防务技术） 2019年第3期15卷 264-271页

作者： David Felix Ian Colwill elias Stipidis Institution of Engineering and Technology Stevenage England Member of British Computer Society London Institute of Electrical and Electronics Engineers London

To simulate explosion fragments, it is necessary to predict many variables such as fragment velocity, size distribution and projection angle. For active protection systems these predictions need to be made very quickly, before the weapon hits the target. Fast predictions also need to be made in real time simulations when the impact of many different computer models need to be assessed. The research presented in this paper focuses on creating a fast and accurate estimate of one of these variables - the initial fragment velocity. The Gurney equation was the first equation to calculate initial fragment velocity. This equation, sometimes with modifications, is still used today where finite element analysis or complex mathematical approaches are considered too computationally expensive. This paper enhances and improves Breech’s two-dimensional Gurney equation using available empirical data and the principals of conservation of momentum and energy. The results are computationally quick, providing improved accuracy for estimating initial fragment velocity. This will allow the developed model to be available for real-time simulation and fast computation, with improved accuracy when compared to existing approaches.

关键词： Initial fragment velocity Real-time simulation Cylindrical explosion

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Young blood products:emerging treatment for Alzheimer's disease?

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Neural Regeneration Research 2018年第4期13卷 624-627页

作者： Rita Khoury elias Ghossoub Department of Psychiatry and Behavioral Neuroscience Saint Louis University

Alzheimer＇s disease is the most common neurodegenerative disorder and no disease-modifying treatment is currently *** has shown that while brain neurogenesis continues in adult life,it declines with *** parabiosis,plasma transfusions and direct administration of neural growth factors,animal studies have demonstrated the positive impact of exposure to young blood products on neurogenesis and synaptic plasticity in an aging *** hippocampus and the sub-ventricular zones were identified as the main regions *** findings have prompted researchers to experiment their effects in subjects with an established neurocognitive disorder,such as Alzheimer＇s *** argued that modification of brain vasculature,reactivation of adult neural stem cells,and remodeling of their synaptic activity/plasticity may lead to cognitive enhancement and increased *** pilot human study found that young donor plasma infusion protocols for adults with Alzheimer＇s disease were safe and feasible;however,no statistically significant improvements in cognition were *** is a need to conduct additional placebo-controlled human studies in larger *** studies should focus on identifying an “optimal age” at which an intervention in humans may yield significant cognitive enhancement,as well as determining the types of transfusions with the best efficacy and tolerability profiles.

关键词： young blood rejuvenation cognition Alzheimer's disease plasma transfusion aging neurogenesis

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Selective serotonin reuptake inhibitors and Alzheimer’s disease

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Neural Regeneration Research 2020年第1期15卷 41-46页

作者： Bernadette Mdawar elias Ghossoub Rita Khoury Department of Psychiatry American University of Beirut Medical CenterBeirutLebanon Department of Psychiatry and Behavioral Neuroscience Saint Louis University School of MedicineSt.LouisMOUSA

Given the failure to develop disease-modifying therapies for Alzheimer’s disease(AD),strategies aiming at preventing or delaying the onset of the disease are being *** the debate regarding whether depression is an etiological risk factor or a prodrome of AD rages on,a key determining factor may be the timing of depression onset in older *** is increasing evidence that untreated early-onset depression is a risk factor and that late-onset depression may be a catalyst of cognitive *** from animal studies have shown a beneficial impact of selective serotonin reuptake inhibitors on pathophysiological biomarkers of AD including amyloid burden,tau deposits and *** humans,studies focusing on subjects with a prior history of depression also showed a delay in the onset of AD in those treated with most selective serotonin reuptake ***,which has strong anticholinergic properties,was associated with increased mortality and mixed effects on amyloid and tau deposits in mice,as well as increased odds of developing AD in *** most of the data regarding selective serotonin reuptake inhibitors is promising,findings should be interpreted cautiously because of notable methodological heterogeneity between *** is thus a need to conduct large scale randomized controlled trials with long follow up periods to clarify the dose-effect relationship of specific serotonergic antidepressants on AD prevention.

关键词： Alzheimer’s disease amyloidogenesis animal models antidepressant depression onset delay prevention selective serotonin reuptake inhibitor SSRI

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Intestinal microbiota and its interaction to intestinal health in nursery pigs

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Animal Nutrition 2022年第1期8卷 169-184页

作者： Marcos elias Duarte Sung Woo Kim Department of Animal Science North Carolina State UniversityRaleighNC27695United States

The intestinal microbiota has gained increased attention from researchers within the swine industry due to its role in promoting intestinal maturation,immune system modulation,and consequently the enhancement of the health and growth performance of the *** review aimed to provide updated scientific information on the interaction among intestinal microbiota,dietary components,and intestinal health of *** small intestine is a key site to evaluate the interaction of the microbiota,diet,and host because it is the main site for digestion and absorption of nutrients and plays an important role within the immune *** diet and its associated components such as feed additives are the main factors affecting the microbial composition and is central in stimulating a beneficial population of *** microbiotaehost interaction modulates the immune system,and,concurrently,the immune system helps to modulate the microbiota *** direct interaction between the microbiota and the host is an indication that the mucosa-associated microbiota can be more effective in evaluating its effect on health *** was demonstrated that the mucosa-associated microbiota should be evaluated when analyzing the interaction among diets,microbiota,and *** addition,supplementation of feed additives aimed to promote the intestinal health of pigs should consider their roles in the modulation of mucosa-associated microbiota as biomarkers to predict the response of growth performance to dietary interventions.

关键词： Intestinal health Mucosa-associated microbiota Nursery pig

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Effect of TiO_2 nanoparticles on hydrogen evolution reaction activity of Ni coatings

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International Journal of Minerals,Metallurgy and Materials 2018年第4期25卷 472-479页

作者： Revanna Kullaiah Liju elias Ampar Chitharanjan Hegde Electrochemistry Research Lab Department of Chemistry National Institute of Technology Karnataka

The electrocatalytic activity of electrodeposited Ni and Ni–TiO2 coatings with regard to the alkaline hydrogen evolution reaction（HER） was investigated. The Ni coatings were electrodeposited from an acid chloride bath at different current densities, and their HER activities were examined in a 1.0-mol·L^-1 KOH medium. The variations in the HER activity of the Ni coatings with changes in surface morphology and composition were examined via the electrochemical dissolution and incorporation of nanoparticles. Electrochemical analysis methods were used to monitor the HER activity of the test electrodes; this activity was confirmed via the quantification of gases that evolved during the analysis. The obtained results demonstrated that the Ni–TiO2 nanocomposite test electrode exhibited maximum activity toward the alkaline HER. The surface appearance, composition, and the phase structure of all developed coatings were analyzed using scanning electron microscopy（SEM）, energy dispersive spectroscopy（EDS）, and X-ray diffraction（XRD）, respectively. The improvement in the electrocatalytic activity of Ni–TiO2 nanocomposite coating toward HER was attributed to the variation in surface morphology and increased number of active sites.

关键词： coatings electrodeposition nanocomposite electrocatalysis

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Vitamin D:A new player in non-alcoholic fatty liver disease?

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World Journal of Gastroenterology 2015年第6期21卷 1718-1727页

作者： Myrto Eliades elias Spyrou Division of Endocrinology Diabetes and Nu-trition University of Maryland School of Medicine Department of Internal Medicine Medstar Washington Hospital Center

Vitamin D through its active form 1a-25-dihydroxyvtamin D[1,25(OH)2D]is a secosteroid hormone that plays a key role in mineral *** years have witnessed a significant scientific interest on vitamin D and expanded its actions to include immune modulation,cell differentiation and proliferation and inflammation *** our understanding of the many functions of vitamin D has grown,the presence of vitamin D deficiency has become one of the most prevalent micronutrient deficiencies ***,non-alcoholic fatty liver disease(NAFLD)has become the most common form of chronic liver disease in western *** and vitamin D deficiency often coexist and epidemiologic evidence has shown that both of these conditions share several cardiometabolic risk *** this article we provide an overview of the epidemiology and pathophysiology linking NAFLD and vitamin D deficiency,as well as the available evidence on the clinical utility of vitamin D supplementation in NAFLD.

关键词： Steatohepatitis Non-alcoholic fatty liver disease

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Experimental and finite element analysis on determining the fatigue life of pb-free solder joint(Sn-0.5Cu-3Bi-1Ag)used in electronic packages under harmonic loads

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International Journal of Modeling, Simulation, and Scientific Computing 2020年第3期11卷 60-67页

作者： Jayesh S Jacob elias Department of Mechanical Engineering School of Engineering Cochin University of Science and Technology KochiKerala-682022India

Electronic packages that are used these days are exposed to different types of vibration loadings in their usage *** vibration exposure can be categorized as harmonic and random *** reliability assessment of modern electronic systems is considered,vibration loading has an important role to *** of the biggest challenges facing today is the accurate and rapid assessment of fatigue life under the vibration *** solder joints were made of lead-tin *** to many environment legislations and rules,lead is prohibited as an ingredient in the solder *** reason for the prohibition of the usage of the lead is that it poisons the *** this study,Sn-0.5Cu-3Bi-1Ag is used as the lead-free solder *** life prediction of electronic package containing SAC405 is conducted with the aid of vibration testing and Finite element analysis under harmonic vibration loading.A specially designed Plastic Ball Grid Array Package(PBGA)component is mounted on Printed Circuit Board(PCB).It is taken as a test vehicle for the vibration *** test vehicle is excited by a sinusoidal *** frequency of this excitation equals the fundamental frequency of the test vehicle and it is continued till the component *** the solder balls are very small for direct measurement,Finite Element analysis(FEA)is used for noting down the *** stress versus failures cycles(S-N)curve is made by relating both the stresses on the solder balls obtained and the number of failure cycles from vibration *** fatigue life of the component can be estimated from the generated S-N *** is analyzed that the methodology is effective in predicting the component’s ***,the reliability of electronic package can be improved.

关键词： PCB lead free solder joint FEA PBGA S-N curve

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