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LIV-4:A novel model for predicting transplant-free survival in critically ill cirrhotics

World Journal of Hepatology 2020年第6期12卷 298-311页

作者： Christina C Lindenmeyer Gianina Flocco Vedha Sanghi rocio Lopez Ahyoung J Kim Fadi Niyazi Neal A Mehta Aanchal Kapoor William D Carey Eduardo Mireles-Cabodevila Carlos Romero-Marrero Department of Gastroenterology Hepatology and NutritionCleveland ClinicClevelandOH 44195United States Department of Internal Medicine Cleveland ClinicClevelandOH 44195United States Department of Quantitative Health Sciences Cleveland ClinicClevelandOH 44106United States Department of Critical Care Medicine Cleveland ClinicClevelandOH 44195United States

BACKGROUND Critically ill patients with cirrhosis,particularly those with acute decompensation,have higher mortality rates in the intensive care unit(ICU)than patients without chronic liver *** of short-term mortality is important in order to identify patients at highest risk of *** of the currently available prognostic models have been widely accepted for use in cirrhotic patients in the ICU,perhaps due to complexity of calculation,or lack of universal variables readily available for these *** believe a survival model meeting these requirements can be developed,to guide therapeutic decision-making and contribute to cost-effective healthcare resource *** To identify markers that best identify likelihood of survival and to determine the performance of existing survival *** Consecutive cirrhotic patients admitted to a United States quaternary care center ICU between 2008-2014 were included and comprised the training *** data and clinical laboratory test collected on admission to ICU were *** under the curve receiver operator characteristics(AUROC)analysis was performed to assess the value of various scores in predicting inhospital mortality.A new predictive model,the LIV-4 score,was developed using logistic regression analysis and validated in a cohort of patients admitted to the same institution between *** Of 436 patients,119(27.3%)died in the *** multivariate analysis,a combination of the natural logarithm of the bilirubin,prothrombin time,white blood cell count,and mean arterial pressure was found to most accurately predict in-hospital *** from the regression coefficients of the independent variables,a novel model to predict inpatient mortality was developed(the LIV-4 score)and performed with an AUROC of 0.86,compared to the Model for End-Stage Liver Disease,Chronic Liver Failure-Sequential Organ Failure Assessment,and Royal Free Hospital Score,wh

关键词： Risk stratification Resource allocation Intensive care unit Acute-on-chronic liver failure Modeling Mortality

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Novel device for monitoring respiratory rate during endoscopy-A thermodynamic sensor

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2019年第3期10卷 57-66页

作者： Vaibhav Wadhwa Adalberto J Gonzalez Kristen Selema Ronen Feldman rocio Lopez John J Vargo Department of Gastroenterology and Hepatology Cleveland Clinic FloridaWestonFL 33324United States Department of Internal Medicine Cleveland Clinic FloridaWestonFL 33331United States Department of Technology Artep IncorporatedElliot CityMD 21042United States Department of Quantitative Health Sciences Cleveland ClinicClevelandOH 44195United States Department of Gastroenterology and Hepatology Digestive Disease and Surgery InstituteCleveland ClinicClevelandOH 44195United States

BACKGROUND Monitoring ventilation accurately is an indispensable aspect of patient care in procedural *** current gold standard method of monitoring ventilation is by measuring exhaled carbon dioxide concentration,known as capnography.A new device utilizing thermodynamic measurement,the Linshom Respiratory Monitoring Device(LRMD),has been designed to measure respiratory rate(RR)by using the temperature of exhaled *** hypothesized that the temperature sensor is at least equivalent in accuracy to capnography in monitoring *** To determine if the temperature sensor is equivalent to capnography in monitoring procedural *** In this prospective study,participants were individually fitted with a face mask monitored by both LRMD and *** following data were collected:gender,age,body mass index,type of procedure,and doses of *** each patient,we report the mean RR for each device as well as the mean *** analyses were performed using SAS,and a P<0.05 was considered statistically *** Twelve consecutive patients undergoing endoscopic procedures at our institution were *** patients were excluded due to incomplete data,inadequate data,patient cooperation,and capnography ***,we found that LRMD RR highly correlated to capnography RR(P<0.001);the average capnography RR increases by 0.66 breaths for every one additional breath measured by the *** addition,apnea rates were 7.4%for the capnography and 6.4%for the LRMD(95%confidence interval:0.92-1.10).CONCLUSION The LRMD correlated with the gold standard capnography with respect to respiratory rate detection and apnea *** LRMD could be used as an alternative to capnography for measuring respiration in endoscopy.

关键词： Sedation Capnography Linshom Thermodynamic sensor Endoscopy

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Association of procedure length on outcomes and adverse events of endoscopic retrograde cholangiopancreatography

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Gastroenterology Report 2014年第2期2卷 140-144页

作者： Paresh P.Mehta Madhusudhan R.Sanaka Mansour A.Parsi Mazen J.Albeldawi John A.Dumot rocio Lopez Gregory Zuccaro John J.Vargo Digestive Disease Institute Department of Gastroenterology and HepatologyCleveland ClinicCleveland OHUSA Department of Quantitative Health Sciences Cleveland ClinicClevelandOHUSA

Objective:The aims of this study were to determine the effects of length of procedure on endoscopic retrograde cholangiopancreatography(ERCP)outcomes and adverse ***:All ERCP procedures,performed by experienced advanced endoscopists,in patients without prior papillary intervention from 2006 to 2008 were *** were arbitrarily divided into two groups:shorter procedures(SP),with a duration shorter than the overall mean procedure length,and longer procedures(LP),with a duration longer than overall mean procedure *** of procedure was defined as the time from endoscope insertion to endoscope ***:Two hundred and ninety-five procedures were included in the *** procedure length was 45.630.1 *** hundred and seventy-seven procedures(60%)were SP and 118(40%)were *** were no differences between the groups with regard to patients’ages,genders,race,or trainee *** cases were more likely to be biliary vs pancreatic or bi-ductal evaluations(P=0.03).LP had significantly higher complexity scores(34%with>3 vs 13%;P=0.046)and were more likely to require pre-cut papillotomy(39%vs 15%;P<0.001).There was no significant difference between the groups in overall completion rates(91.5%LP vs 96%SP;P=0.10)or adverse events(10.2%LP vs 6.2%SP;P=0.21).However,LP cases were associated with higher rates of post-ERCP bleeding(4.2%vs 0.6%;P=0.029).Conclusion:There was no significant difference in outcomes or overall adverse events between shorter and longer ERCP ***,longer procedures were associated with higher procedure complexity,higher utilization of pre-cut technique,and increased risk of bleeding.

关键词： endoscopic retrograde cholangiopancreatography(ERCP) duration of procedure adverse events pancreatitis

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Assessment of Malignancy Risk in Thyroid Nodules Using a Practical Ultrasound Predictor Model: “Alpha Score”

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Open Journal of Radiology 2018年第4期8卷 191-202页

作者： Mena Glenn Benavides Raul Villagomez rocio Muñ oz Marco Mena Bucheli Santiago Mosquera Mariela Guerrero Rosa ALPHA Image Radiology and Interventionism Institute Quito Ecuador Axxis Pathology Laboratory Quito Ecuador

Objective: The aim of this study was to develop a simple predictor model to diagnose malignancy by using ultrasound features of thyroid nodules and the association with cytopathological diagnosis obtained by fine needle aspiration. Materials and Methods: The likelihood of malignancy from ultrasound features was assessed in thyroid nodules obtained by fine-needle aspiration biopsy (FNAB) according to cytopathological findings reported using Bethesda System. A score was developed depending on the presence of each ultrasound feature evaluated. Results: 429 nodules were assessed, 103 (24%) were malignant. The following ultrasound features were associated with malignancy, according to the logistic regression analysis and were assigned a score of 0, +1, +2 depending on the presence or absence of each one: hypoechogenicity, solid appearance, irregular margins, microcalcifications, absence of a halo, diameter of ≥10 mm and intranodular vascular flow. The area under the curve of the proposed model was 0.900, demonstrating its predictive capacity. 4 risk categories were stablished based on the score obtained. Malignant nodules scored higher than the benign nodules (7.24 ±1.87 vs. 3.74 ±1.83). Conclusions: The proposed predictive model demonstrated to be useful and easy to apply when stratifying thyroid nodule risk of malignancy using presented US features and applying the proposed risk categories to increase the accuracy at selecting nodules that need to be studied with FNA.

关键词： Thyroid Nodules Thyroid Cancer Ultrasound Fine-Needle Biopsy

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Robotic4all project:Results of a hands-on robotic surgery training program

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Laparoscopic, Endoscopic and Robotic Surgery 2023年第1期6卷 1-8页

作者： Mario Rui Gonçalves Jose Novo de Matos Antonio Oliveira Ricardo Marinho Irene Cadime Palmira Carlos Alves Salvador morales-Conde Miguel Castelo-Branco Faculty of Health Sciences University of Beira InteriorCovilha 6200-506Portugal Centro Hospitalar Universitario Lisboa Central Hospital de Sao JoseLisboa 1150-199Portugal Centro Hospitalar de Tras-os-Montes e Alto Douro Vila Real 5000-508Portugal Centro Hospitalar de Leiria Hospital de Santo AndreLeiria 2410-197Portugal Centro de Investigaçao em Psicologia Escola de Psicologia-Universidade do MinhoBraga 4710-057Portugal Departamento de Estudos Curriculares e Tecnologia Educativa Instituto de Educaçao-Universidade do MinhoCampus de GualtarBraga 4710-093Portugal Unit of Innovation in Minimally Invasive Surgery University Hospital Virgen del RocioUniversity of SevillaSeville 41013Spain

Objective Although robotic surgery adoption and its indications are growing worldwide,for multiple factors,including costs,there is a lack of training and *** aim was to study the impact of a robotic introduction training program on gesture performance,such as suturing,in robot-naive *** Using the DaVinci robot,a 2-hour program was based on virtual reality and anatomical model *** participants performed 3 repetitions of virtual reality exercises on the virtual simulator,and then performed and were assessed on 2 tests,ie robot and laparoscopic training *** the course,the participants were surveyed for this training *** Twenty-seven residents and surgeons were enrolled in the training *** only 2 hours of training,all of the participants were able to complete the training program,thus learning generic and specific skills in robotic *** virtual reality exercise,the scores of the 3 exercises increased significantly with every repetition(p<0.001)and the size of the increase was *** completion time on the robot platform was 2.6 times faster(169.33±28.28 s vs.447.96±156.55 s,p<0.001)than that in the laparoscopic box,and the difference between both types of tests was large(pη2=0.797).The centralization and passage of the needle were significantly better on the robot platform(5 vs.3,p<0.001,r=0.47;5 vs.4,p<0.001,r=0.59)than in the laparoscopic *** the intracorporeal stitch+knot test,every participant was able to perform the exercise on the robot but only 85.2%(23/27)in the laparoscopic ***-one participants answered the survey,and 13(61.9%)of them considered robotic performance independent of laparoscopic *** Surgeons are interested and seek training in robotic *** implemented the first hands-on robotic surgery training program in Portugal and participants considered it was important and adequate for its *** participants,even without robotic experience,lear

关键词： Simulation Education Laparoscopic suture Laparoscopy Robotic surgery

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疯狂马德里

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空中英语教室（高级版．彭蒙惠英语） 2015年第3期 11-13,39,40页

作者： rocio Labrador 陈信宏

5拿铁的杯碟撞击声、马蹄踏在鹅卵石上的踢踏声，还有穿着格子衫、被派去流动面包车购买法棍面包的儿童发出的咯咯笑声；这些声音刻画着马德里正迎接又一个艳阳高照的日子。期盼在为期两周的欧洲之旅当中尽可能看到更多景点的游客们，... 详细信息

5拿铁的杯碟撞击声、马蹄踏在鹅卵石上的踢踏声，还有穿着格子衫、被派去流动面包车购买法棍面包的儿童发出的咯咯笑声；这些声音刻画着马德里正迎接又一个艳阳高照的日子。期盼在为期两周的欧洲之旅当中尽可能看到更多景点的游客们，通常会舍弃西班牙首都，而造访巴塞罗那装饰派艺术风格的街道或是太阳海岸的摩尔人省。

关键词：马德里疯狂艺术风格巴塞罗那面包车购买法西班牙游客

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Minimizing sperm oxidative stress using nanotechnology for breeding programs in rams

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Journal of Animal Science and Biotechnology 2023年第6期14卷 2395-2410页

作者： Alejandro Jurado‑Campos Pedro Javier Soria‑Meneses Maria Arenas‑Moreira Carlos Alonso‑Moreno Virginia Rodriguez‑Robledo Ana Josefa Soler Jose Julian Garde Maria del rocio Fernandez‑Santos SaBio IREC(CSIC-UCLM-JCCM) Campus UniversitarioS/N02071 AlbaceteSpain. Departamento de Quimica Inorganica Organica Y Bioquimica‑Centro de Innovacion en Quimica Avanzada(ORFEO‑CINQA)Facultad de FarmaciaUniversidad de Castilla-La Mancha02008 AlbaceteSpain. Centro Regional de Investigacion Biomedicas Unidad nanoDrugUniversidad de Castilla-La Mancha02008 AlbaceteSpain. Facultad de Farmacia Universidad de Castilla La Mancha02071 AlbaceteSpain.

Background Artificial insemination(AI)is a routine breeding technology in animal ***,the temperature-sensitive nature and short fertile lifespan of ram sperm samples hamper its use in *** this sense,nanotechnology is an interesting tool to improve sperm protection due to the development of nanomaterials for AI,which could be used as delivery *** this work,we explored the feasibility of vitamin E nanoemulsion(NE)for improving sperm quality during *** With the aim of evaluating this proposal,ejaculates of 7 mature rams of Manchega breed were collected by artificial vagina and extended to 60×10^(6)spz/mL in *** containing control and NE(12 mmol/L)with and without exogenous oxidative stress(100μmol/L Fe2+/ascorbate)were stored at 22 and 15℃and motility(CASA),viability(YO-PRO/PI),acrosomal integrity(PNA-FITC/PI),mitochondrial membrane potential(Mitotracker Deep Red 633),lipoperoxidation(C11 BODIPY 581/591),intracellular reactive oxygen species(ROS)production and DNA status(SCSAR)monitored during 96 *** results show that NE could be used to maintain ram spermatozoa during transport at 15 and 22℃for up to 96 h,with no appreciable loss of kinematic and physiological characteristics of freshly collected *** The storage of ram spermatozoa in liquid form for 2-5 d with vitamin E nanoemulsions may lead more flexibility to breeders in AI *** view of the potential and high versatility of these nanodevices,further studies are being carried out to assess the proposed sperm preservation medium on fertility after artificial insemination.

关键词： Breeding technology Nanoemulsions Nanotechnology Sperm oxidative stress Vitamin E

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拉丁美洲及加勒比海地区的民主化城市管理

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人类居住 2006年第1期 22-23页

作者： rocio Lombera 宗菁（译）墨西哥住房与人口执行中心的主任和主席不详

拉丁美洲及加勒比海地区的城市管理项目（UMP-LAC）已经成为在国家、地区、和城市之间建设新的大型工作网络的最佳范本。除此之外，城市管理项目最值得一提的是民众、社区和各类基层组织的主导作用，他们都在地方层面共同参与了解决他... 详细信息

拉丁美洲及加勒比海地区的城市管理项目（UMP-LAC）已经成为在国家、地区、和城市之间建设新的大型工作网络的最佳范本。除此之外，城市管理项目最值得一提的是民众、社区和各类基层组织的主导作用，他们都在地方层面共同参与了解决他们所面临的主要问题的努力。

关键词：加勒比海地区城市管理拉丁美洲民主化管理项目基层组织范本

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Optimization and Validation of a Method for Heavy Metals Quantification in Soil Samples by Inductively Coupled Plasma Sector Field Mass Spectrometry(ICP-SFMS)

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American Journal of Analytical Chemistry 2013年第10期4卷 9-15页

作者： Héctor Hernández-Mendoza Marcos Mejuto Ana Isabel Cardona Avelino García-Alvarez rocio Millán Abel Yllera Instituto Nacional de Investigaciones Nucleares Carretera México-TolucaLa Marquesa OcoyoacacMéxico Departamento de Medio Ambiente Centro de Investigaciones EnergéticasMedioambientales y Tecnológicas(CIEMAT)AvdaMadridEspana

In this work, a method for quantification of heavy metals Inductively Coupled Plasma Sector Field Mass Spectrometry (ICP-SFMS) in soil samples of El Bierzo district (Spain) has been optimized and validated. Optimization was carried out for elements: Cr, Mn, Co, Ni, Cu, Zn, Se, As, Cd, Hg, Pb and U. Validation of the method was performed with Certified and Standard Reference Materials (CRMs and SRMs);SRM2709, CRM020-051 and CRM050-051. Results obtained under optimized conditions can be summarized as follows: a) the Limits of Detection (LODs) were in the order of sub fg·g-1 for Cr, Mn, Cu, Co, As, Cd, Hg, Pb and U, and few fg·g-1for Ni, Zn and Se;b) precision measurement, in terms of relative standard deviation (RSD), was been below 5%;c) the average recovery of CRM was between 81.3% and 98%. In conclusion, the method offers several advantages: fast, good accuracy, very low values of Limits of Quantification (LOQs) and high sensitivity on measurement of heavy metal.

关键词： Soil Heavy Metal ICP-SFMS

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Simple anthropometric measurements to predict dyslipidemias in Mexican school-age children: a cross-sectional study

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Open Journal of Preventive Medicine 2011年第3期1卷 171-181页

作者： Maria del Carmen Caamano Olga Patricia Garcia Maria del rocio Arellano Karina de la Torre-Carbot Jorge LRosado School of Natural Sciences Universidad Autonoma de QueretaroQueretaroMexico Disease and Development Center for Chronic Diseases QueretaroMexico.

Objective: The purpose of this study was to identify the best predictors of dyslipidemias in Mexican obese children using different anthropometric and body composition measurements. Methods: In an observational, cross-sectional study, 905 children from 5 schools were measured for weight, height, waist and hip circumference, and triceps and subscapular skinfolds. A fasting blood sample was taken from a random sub-sample of 306 children to determine lipid profile. Abnormal total cholesterol, LDL, HDL, triglycerides, total cholesterol to HDL ratio, and LDL to HDL ratio, were determined. Logistic regressions and ROC analysis were carried out to determine the best anthropometric predictors of these risk factors. Results: Prevalence of elevated total cholesterol, triglycerides and LDL cholesterol was 14%, 56% and 58%, respectively. In logistic regressions, BMI and triceps skinfold had the highest odds ratios to predict elevated total cholesterol (1.05, 95%CI: 0.97 - 1.14;1.07, 1.01 - 1.13, respectively), triglycerides (1.19, 1.11 - 1.27;1.12, 1.08 - 1.17, respectively), LDL cholesterol (1.11, 1.04 - 1.18;1.09, 1.05 - 1.14, respectively), total cholesterol to HDL ratio (1.06, 1.00-1.14;1.07,1.03-1.12, respectively) and LDL to HDL ratio risk (1.08,1.01-1.15;1.07, 1.03-1.12, respectively). After BMI and triceps skinfold, subscapular skinfold also predicted dyslipidemias, except for low HDL;both skinfolds had a narrower odds ratio confidence interval than BMI. In ROC analysis, subscapular skinfold was the best predictor of elevated triglycerides with an AUC ≥ 0.7. Conclusion: Anthropometric measurements are not strongly associated with dyslipidemias in Mexican children. However, since triceps and subscapular skinfolds were better predictors than other anthropometry measures, they may be a simple way to predict dyslipidemias in Mexican children.

关键词： Cardiovascular Risk Dyslipidemia Lipids Anthropometry and Children

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