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Critical care practices in the world:Results of the global intensive care unit need assessment survey 2020

World Journal of Critical Care Medicine 2022年第3期11卷 169-177页

作者： Faisal A Nawaz Neha Deo Salim Surani William Maynard Martin L Gibbs rahul Kashyap College of Medicine Mohammed Bin Rashid University of Medicine and Health SciencesDubai 505055United Arab Emirates Department of Medicine Mayo Clinic Alix School of MedicineRochesterMN 55905United States Critical Care Medicine Mayo ClinicRochesterMN 55905United States Texas A&M University College StationTX 77843United States Internal Medicine TriStar Centennial Medical CenterHCA HealthcareNashvilleTN 37203United States Pulmonary and Critical Care Tulane University School of MedicineNew OrleansLA 70112United States

BACKGROUND There is variability in intensive care unit(ICU)resources and staffing *** may reflect variation in practice and outcomes across all health *** To improve research and quality improvement measures administrative leaders can create long-term strategies by understanding the nature of ICU practices on a global *** The Global ICU Needs Assessment Research Group was formed on the basis of diversified skill *** aimed to survey sites regarding ICU type,availability of staffing,and adherence to critical care *** international survey‘Global ICU Needs Assessment’was created using Google Forms,and this was distributed from February 17^(th),2020 till September 23^(rd),*** survey was shared with ICU providers in 34 *** approaches to motivating healthcare providers were implemented in securing submissions,including use of emails,phone calls,social media applications,and WhatsApp^(TM).By completing this survey,providers gave their consent for research *** study was deemed eligible for category-2 Institutional Review Board exempt *** There were a total 121 adult/adult-pediatrics ICU responses from 34 countries in 76 cities.A majority of the ICUs were mixed medical-surgical[92(76%)].108(89%)were adult-only *** 36 respondents(29.8%)were 31-40 years of age,with 79(65%)male and 41(35%)female participants.89 were consultants(74%).A total of 71(59%)respondents reported having a 24-h inhouse intensivist.A total of 87(72%)ICUs were reported to have either a 2:1 or≥2:1 patient/nurse *** 44%of the ICUs were open and 76%were mixed type(medical-surgical).Protocols followed regularly by the ICUs included sepsis care(82%),ventilator-associated pneumonia(79%);nutrition(76%),deep vein thrombosis prophylaxis(84%),stress ulcer prophylaxis(84%),and glycemic control(89%).CONCLUSION Based on the findings of this international,multi-dimensional,needs-assessment survey,there is a need for increased

关键词： Intensive care unit Critical care Global Survey Intensive care unit survey Intensive care unit needs

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东非大坝引争议

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科技纵览 2022年第5期 8-9,3页

作者： rahul Rao 不详

在埃塞俄比亚政府眼中,未来是一座145米高的丰碑:其由混凝土和法式水轮机组成,横跨青尼罗河,距离苏丹边境很近。2022年2月20日,这一未来愿景变成现实,埃塞俄比亚总理阿比·艾哈迈德按下虚拟键,开启了埃塞俄比亚复兴大坝(GERD)项目,这也... 详细信息

在埃塞俄比亚政府眼中,未来是一座145米高的丰碑:其由混凝土和法式水轮机组成,横跨青尼罗河,距离苏丹边境很近。2022年2月20日,这一未来愿景变成现实,埃塞俄比亚总理阿比·艾哈迈德按下虚拟键,开启了埃塞俄比亚复兴大坝(GERD)项目,这也是到目前为止非洲最大的水电项目。

关键词：埃塞俄比亚艾哈迈德水电项目 GERD 未来愿景

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小型反应堆取得大进展

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科技纵览 2023年第3期 5-7页

作者： rahul Rao 不详

在中国南部的海南岛,在一个由混凝土和金属制造的紧凑迷宫中,正塑造着核能的未来.2022年7月,一台起重机将反应堆厂房钢制安全壳上部筒体吊装成功;与此同时,工人们正缓慢而稳定地组装一个微型核反应堆.

关键词：微型核反应堆小型反应堆反应堆厂房金属制造筒体吊装钢制安全壳起重机混凝土

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Treatment of severe frontobasilar fractures in growing patients： a case series evaluation

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Chinese Journal of Traumatology 2013年第4期16卷 199-203页

作者： Alan S Herford rahul Tandon Luca Pivetti Marco Cicci Department of Oral & Maxillofacial Surgery Loma LindaUniversity Loma Linda California 92350 United States Boyne Geistlich Research Fellow Loma LindaUniversity Loma Linda California 92350 United States Department of Implant Dentistry Ospedale MaggiorePoliclinico University of Milan Milan Italy Department of Human Pathology School of DentistryUniversity of Messina Messina Italy

frontobasilar 破裂的 ObjectiveThe 治疗是 craniofacial 破裂管理的一个费力的方面。不适当或不适当的破裂管理的一本续集导致很困难改正的化妆、功能的问题。这张手稿的目的是检查为 frontobasilar 破裂对待的一组成长病人并且提供... 详细信息

frontobasilar 破裂的 ObjectiveThe 治疗是 craniofacial 破裂管理的一个费力的方面。不适当或不适当的破裂管理的一本续集导致很困难改正的化妆、功能的问题。这张手稿的目的是检查为 frontobasilar 破裂对待的一组成长病人并且提供临床医生为这些挑战性的 *** 的治疗的一种可能的治疗学的选择这调查，不到为对 frontobasilar 区域的严重损害对待的 16 年岁的 12 个病人被包括。他们的记录被考察评估临床的诊断，外科手术前的调查结果，医院功课，手术后的结果，和长期的后续。外科手术前、手术后的 CT 扫描在对待的所有孩子被执行。手术后的复杂并发症详细被考察。外科的过程为固定的类型和地点被评估。所有复杂并发症和治疗是与脑髓的液体(CSF ) 介绍的病人的 *** 漏缝和要求的 pericranial 拍动。仅仅 3 个病人在剩余的病人在生长上在 1 个病人，在 1 个病人的松开的硬件，和有限骚乱由于明显性经历了盘子和螺丝钉的移动。七个病人与联合与可再吞的盘子，有钛盘子的 4 个病人，和 1 个病人经历了开的减小和内部固定。后续从 6 个月到 5 年。有一条外科手术前的 CSF 漏缝的病人都没开发 *** 的任何复发到基本 craniofacial 原则，减少并且稳定破裂应该重建前面的头部的底。然而，儿科学的 maxillofacial 损伤的治疗要求几个因素的评估。一个孩子的面部骨骼常常正在演变，它的生长取决于基础骨头和软纸巾的平衡。

关键词：治疗患者骨折评测病例脑脊液概率问题临床医生

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Safety and performance of the EverProTM everolimus-eluting coronary stent system with biodegradable polymer in a real-world scenario

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World Journal of Cardiology 2020年第12期12卷 615-625页

作者： rahul Trimukhe Preeti Vani Arvind Patel Vikas Salgotra Department of Cardiology Atma Malik HospitalAhmednagar 423601MaharashtraIndia SLTL Medical Division SLTL(Sahajanand Laser Technology Ltd.)Gandhinagar 382016GujaratIndia SLTL Group SLTL(Sahajanand Laser Technology Ltd.)Gandhinagar 382016GujaratIndia

BACKGROUND The EverProTM(Sahajanand Laser Technology Ltd.,India)everolimus-eluting coronary stent system(EES)is a second-generation drug-eluting stent with a biodegradable *** To determine the safety and performance of the EverProTM EES in patients with coronary artery disease(CAD)during a 1-year clinical *** This observational,retrospective,single-center study enrolled patients who had been implanted with the EverProTM stent between June 1,2018 and January 31,2019,and had completed a 1-year follow-up period after the index *** primary clinical endpoint was major adverse cardiac events(MACE)at 6 mo defined as the composite of cardiac death,myocardial infarction(MI),and target lesion revascularization(TLR).Secondary endpoints were the incidence of TLR at 1,6 and 12 mo follow-up,MACE at 1 and 12 mo follow-up,and stent thrombosis up to 1 year after the index *** The study population comprised 77 patients(98 lesions).A total of 37(48.1%)patients had comorbid *** total,26(33.8%)patients presented with ST segment elevation MI and 10.4%patients with non-ST segment elevation *** lesions were located mainly in the left anterior descending artery(49%)followed by the right coronary artery(29.6%),left circumflex(12.2%)and obtuse marginal(9.2%)*** majority of patients were with single-vessel disease(79%),22.2%of lesions had a mild to severe thrombus load,and 94.9%were American College of Cardiology/American Heart Association type B or *** novo stenting was performed in 96.9%of patients and 3%were treated for in-stent *** success was attained in all ***-hospital or followup MACE and stent thrombosis were not reported during the 1-year follow-up *** These findings suggest that the EverProTM EES is a safe and effective treatment option with no MACE or stent thrombosis reported during the 1-year study period in patients with CAD.

关键词： Coronary artery disease Everolimus Major adverse cardiac event Retrospective,EverPro^(TM),Myocardial infarction

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Advanced machine learning decision policies for diameter control of carbon nanotubes

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npj Computational Materials 2021年第1期7卷 1454-1462页

作者： rahul Rao Jennifer Carpena-Núñez Pavel Nikolaev Michael A.Susner Kristofer G.Reyes Benji Maruyama Materials and Manufacturing Directorate Air Force Research LaboratoryWPAFBDaytonOH 45433USA UES Inc.DaytonOH 45423USA Department of Materials Design and Innovation University at BuffaloBuffaloNY 14260USA

The diameters of single-walled carbon nanotubes(SWCNTs)are directly related to their electronic properties,making diameter control highly desirable for a number of *** we utilized a machine learning planner based on the Expected Improvement decision policy that mapped regions where growth was feasible *** feasible and further optimized synthesis conditions to selectively grow SWCNTs within a narrow diameter *** maximized two ranges corresponding to Raman radial breathing mode frequencies around 265 and 225 cm^(−1)(SWCNT diameters around 0.92 and 1.06 nm,respectively),and our planner found optimal synthesis conditions within a hundred *** post-growth characterization showed high selectivity in the optimized growth experiments compared to the unoptimized growth ***,our planner revealed significantly different synthesis conditions for maximizing the two diameter ranges in spite of their relative *** study shows the promise for machine learning-driven diameter optimization and paves the way towards chirality-controlled SWCNT growth.

关键词： synthesis carbon diameters

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Tracheostomy manipulations: Impact on tracheostomy safety

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Pediatric Investigation 2019年第3期3卷 141-145页

作者： Alexandra G Espinel Kelly Scriven rahul K Shah Division of Otolaryngology Children's National Medical CenterWashington DCUSA

Importance: Tracheotomy is one of the riskiest procedures for composite morbidity within pediatric otolaryngology. During the postoperative period, each time the tracheostomy tube is manipulated, there is opportunity for morbidity (e.g. a patient is vulnerable to accidental decannulation and airway loss). Objective: To identify areas of improvement in caring for 'fresh tracheostomy' patients by determining the number of times a tracheostomy tube is manipulated from placement until discharge. The hypothesis is that the more a tracheostomy is manipulated, the higher probability of morbidity. Methods: A quality improvement initiative was conducted to map the care of patients who underwent tracheostomy placement over 12 months. Tracheostomy care and manipulation by all providers were reviewed. Complications, wound care, and respiratory treatments were also evaluated. Results: Patients were hospitalized for an average of 39 days (7–140) following tracheostomy. The first tracheostomy tube change occurred on average 6 days (5–10) following placement. Tracheostomy tubes were manipulated an average of 6 (2.5–11.9) times a day to amount to 216 (51–1091) times between placement and discharge. Bedside nurses and respiratory therapists were responsible for 95% of these actions;physicians accounted for 4%. There were 6 tracheostomy related complications. Three were accidental decannulations resulting in cardiopulmonary arrest. One of these caused long term patient morbidity. Patients with more than 4 manipulations per day during the 2 weeks following tracheostomy tube placement, were more likely to have a tracheostomy related complication than those with less than 4 (OR: 12.5;95% CI: 1.2–130.6;P = 0.0349). Interpretation: While uncommon, complications related to tracheostomy can have serious long term effects and at best prolongs length of stay for patients. Reducing the number of tracheostomy manipulations may provide safer postoperative care ultimately reducing morbidity and po

关键词： Complications Management Pediatric tracheostomy Safety

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Real-time estimation and prediction of the mortality caused due to COVID-19 using particle swarm optimization and finding the most influential parameter

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Infectious Disease Modelling 2020年第1期5卷 772-782页

作者： rahul G.Makade Siddharth Chakrabarti Basharat Jamil Mechanical Engineering Department O.P.Jindal UniversityRaigarh496109ChhattisgarhIndia Aerospace Engineering Department MIT ADT UniversityPune412201MaharashtraIndia Mechanical Engineering Department ZHCETAligarh Muslim UniversityAligarh202002Uttar PradeshIndia

On March 11,2020,the World Health Organization has declared the outbreak of COVID-19 as Pandemic,which is the massive challenges faced *** studies have indicated that the meteorological parameters can play a vital role in transmissibility and *** the present work,the influence of Comorbidity and meteorological parameters are investigated for Mortality caused due to *** this,the most affected city by COVID-19 is considered,i.e.,Mumbai,India,as a case *** was found that Comorbidity is the most influential parameter on the Mortality of *** Spearman correlation coefficient for meteorological parameters lies between 0.386 and 0.553,whereas for Comorbidity was found as 0.964.A regression model is developed using particle swarm optimization to predict the mortality cases for Mumbai,***,the developed model is validated for the COVID-19 cases of Delhi,India,to emphasize the utility of the developed model for other *** measured and predicted curve shows a good fit with a mean percentage error of 0.00957%and a coefficient of determination of ***,particle swarm optimization techniques demonstrate very high potential for the prediction of Mortality caused due to *** is insisted that by providing constant health monitoring and adequate care for the comorbidity patients,the Mortality can be suppressed *** present work can serve as an input to the policymakers to overcome the COVID-19 pandemic in India as well as other parts of the world.

关键词： COVID-19 Meteorological Mortality Comorbidity PSO

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Novel non-invasive score to predict cirrhosis in the era of hepatitis C elimination: A population study of ex-substance users in Singapore

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Hepatobiliary & Pancreatic Diseases International 2019年第2期18卷 143-148页

作者： Yue Zhao Prem Harichander Thurairajah rahul Kumar Jessica Tan Eng Kiong Teo John Chen Hsiang Department of Gastroenterology and Hepatology Changi General Hospital

Background: Chronic hepatitis C infection is common among people with history of substance use. Liver fibrosis assessment is a barrier to linkage to care, particularly among those with history of substance users. The use of non-invasive scores can be helpful in predicting liver cirrhosis in the era of HCV elimination, especially in countries where transient elastography(TE) is not available. We compared the commonly used non-invasive scores with a novel non-invasive score in predicting liver cirrhosis in this population. Methods: HCV patients with history of substance use between 2011 and 2016 were analyzed. All patients had TE for liver fibrosis assessment. Clinical performance of established non-invasive scores for fibrosis assessment and novel score were compared. Youden's index was used to determine optimal cut-off of the novel score. Results: A total of 579 patients were included. In multivariate logistic regression, cirrhosis on TE was associated with age( P = 0.002), aspartate aminotransferase(AST)( P = 0.004), and platelet count( P < 0.001), but not alanine aminotransferase(ALT)( P = 0.896). These form the components of modified AST-toplatelet ratio index(APRI) score. Modified APRI was superior to APRI in predicting cirrhosis(AUROC, 0.796 vs. 0.770, P = 0.007), but not fibrosis-4 score(FIB-4)( P = 1.00). Modified APRI at cut-off of 4 has sensitivity, specificity and negative predictive value(NPV) of 94.4%, 26.9% and 92.6%, respectively, and at 19, has sensitivity, specificity and positive predictive value(PPV) of 33.3%, 96.2% and 77.1%, respectively. FIB-4 has a NPV and PPV of 88.6%, 41.8% and 78.5%, 77.6%, at cut-off of 1.45 and 3.25, respectively. Using the cut-off of 4 and 14 for modified APRI, 32.5% of patients can be correctly classified and misses out only 5.6% of cirrhosis patients. Conclusions: Modified APRI score is superior in predicting cirrhosis in HCV population, with 32.5% of the population being correctly classified using cut-off of 4 and 14.

关键词： Hepatitis C Cirrhosis Fibrosis assessment AST-to-platelet ratio index Modified APRI Fibrosis-4 score

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Effects of light availability on leaf attributes and seedling growth of four tree species in tropical dry forest

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Ecological Processes 2020年第1期9卷 17-32页

作者： Sachchidanand Tripathi rahul Bhadouria Pratap Srivastava Rajkumari S.Devi Ravikant Chaturvedi A.S.Raghubanshi Ecosystems Analysis Laboratory Department of BotanyInstitute of ScienceBanaras Hindu UniversityVaranasi 221005India Department of Botany Deen Dayal Upadhyaya CollegeUniversity of DelhiNew Delhi 110078India Natural Resource Management Laboratory Department of BotanyUniversity of DelhiNew Delhi 110007India Shyama Prasad Mukherjee Post-graduate College University of AllahabadAllahabad 211013India Xishuangbanna Tropical Botanical Garden Chinese Academy of SciencesYunnan 666303China Institute of Environment and Sustainable Development(IESD) Banaras Hindu UniversityVaranasi 221005India

Background:In tropical dry forests,variation in understory light availability due to season and canopy tree density could be a governing factor in establishment and growth of tree *** with varying life history traits are expected to respond differentially to such *** investigated the response of seedlings of four tree species in a tropical day forest in relation to spatiotemporal variability of *** attempt to explore the role of leaf attributes in explaining intra-and inter-specific variations in relative growth *** study sites,each with three contrasting canopy conditions,were selected along a soil moisture *** of four tree species(viz.,Acacia catechu,Bridelia retusa,Lagerstroemia parviflora,and Shorea robusta),varying in life history traits,were monitored for seasonal variations in growth traits across canopy condition and sites for 2 ***:We observed a larger variation in leaf attributes for pioneer *** showed highest mean values for leaf dry matter content,leaf nitrogen concentration,leaf phosphorus concentration,net stomatal conductance,net photosynthetic rate,and relative growth rate in high light *** and *** demonstrated highest mean values for all the leaf attributes(except leaf dry matter content)in low light ***,intermediate values for leaf attributes were observed in *** which preferred moderate light ***:Seasonal variations in light availability at the forest floor appear to play an important role in the establishment and growth of tree seedlings in seasonal dry *** attributes can be used to explain intra-and inter-specific variation in response to light *** attributes in combinations can be used to predict relative growth rate of tree species in tropical dry environment,which apart from soil moisture is also determined by light availability due to seasonal changes and canopy tree density.

关键词： Tropical dry forest Tree seedlings Light intensity Leaf attributes Pioneer species Shade tolerance

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