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Acute mesenteric ischemia after cardio-pulmonary bypass surgery

World Journal of Gastroenterology 2008年第35期14卷 5361-5370页

作者： Bassam Abboud ronald Daher Joe Boujaoude Department of General Surgery Hotel Dieu de France HospitalFaculty of MedicineSaint-Joseph UniversityBeirut 16-6830Lebanon Department of Gastroenterology Hotel Dieu de France HospitalFaculty of MedicineSaint-Joseph UniversityBeirut 16-6830Lebanon

Acute mesenteric ischemia (AMI) is a highly-lethal surgical emergency. Several pathophysiologic events (arterial obstruction, venous thrombosis and diffuse vasospasm) lead to a sudden decrease in mesenteric blood flow. Ischemia/reperfusion syndrome of the intestine is responsible for systemic abnormalities, leading to multi-organ failure and death. Early diagnosis is difficult because the clinical presentation is subtle, and the biological and radiological diagnostic tools lack sensitivity and specificity. Therapeutic options vary from conservative resuscitation, medical treatment, endovascular techniques and surgical resection and revascularization. A high index of suspicion is required for diagnosis, and prompt treatment is the only hope of reducing the mortality rate. Studies are in progress to provide more accurate diagnostic tools for early diagnosis. AMI can complicate the post-operative course of patients following cardio-pulmonary bypass (CPB). Several factors contribute to the systemic hypo-perfusion state, which is the most frequent pathophysiologic event. In this particular setting, the clinical presentation of AMI can be misleading, while the laboratory and radiological diagnostic tests often produce inconclusive results. The management strategies are controversial, but early treatment is critical for saving lives. Based on the experience of our team, we consider prompt exploratory laparotomy, irrespective of the results of the diagnostic tests, isthe only way to provide objective assessment and adequate treatment, leading to dramatic reduction in the mortality rate.

关键词： Acute mesenteric ischemia Non-occlusive Cardio-pulmonary bypass Laparotomy Prognosis Mortality

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Algebraic manipulation detection codes

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Science China Mathematics 2013年第7期56卷 1349-1358页

作者： CRAMER ronald FEHR Serge PADRó Carles Centrum voor Wiskunde en Informatica (CWI) Mathematical Institute Leiden University Division of Mathematical Sciences School of Physical and Mathematical Sciences Nanyang Technological University

Algebraic manipulation detection codes are a cryptographic primitive that was introduced by Cramer et al. (Eurocrypt 2008). It encompasses several methods that were previously used in cheater detection in secret sharing. Since its introduction, a number of additional applications have been found. This paper contains a detailed exposition of the known results about algebraic manipulation detection codes as well as some new results.

关键词： cryptography keyless message authentication algebraic manipulation

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New trends in colorectal surgery: Single port and natural orifice techniques

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World Journal of Gastroenterology 2014年第48期20卷 18104-18120页

作者： ronald Daher Elie Chouillard Yves Panis Department of General and Digestive Surgery Poissy/Saint-Germain Medical Center 78300Poissy France Department of Colorectal Surgery Beaujon Hospital Assistance Publique Hopitaux de Paris University Denis Diderot (Paris VII) 75013 Clichy France

Single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) have rapidly gained pace worldwide, potentially replacing conventional laparoscopic surgery (CLS) as the preferred colorectal surgery technique. Currently available data mainly consist of retrospective series analyzed in four meta-analyses. Despite conflicting results and lack of an objective comparison, SILS appears to offer cosmetic advantages over CLS. However, due to conflicting results and marked heterogeneity, present data fail to show significant differences in terms of operative time, postoperative morbidity profiles, port-site complications rates, oncological appropriateness, duration of hospitalization or cost when comparing SILS with conventional laparoscopy for colorectal procedures. The application of “pure” NOTES in humans remains limited to case reports because of unresolved issues concerning the ideal access site, distant organ reach, spatial orientation and viscera closure. Alternatively, minilaparoscopy-assisted natural orifice surgery techniques are being developed. The transanal “down-to-up” total mesorectum excision has been derived for transanal endoscopic microsurgery (TEM) and represents the most encouraging NOTES-derived technique. Preliminary experiences demonstrate good oncological and functional short-term outcomes. Large-scale randomized controlled trials are now mandatory to confirm the long-term SILS results and validate transanal TEM for the application of NOTES in humans.

关键词： Surgery Colon Rectum Cancer Laparoscopy Single-port Natural orifice transluminal endoscopic surgery

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Nonlinear Evolution of Non-axisymmetric Dynamical Instability in a Slender Accretion Torus

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Science China Mathematics 1994年第1期37卷 99-111页

作者：王德焴 ronald E. Taam 吴丁 Purple Mountain Observatory Academia Sinica Nanjing 210008 PRC Department of Physics and Astronomy Northwestern University Evanston Illinois 52021 USA

The nonlinear evolution of non-axisymmetric dynamical instability has been interpreted here wuhin the framework of soliton *** dispersion relation of a two-dimensional slender accretion torus in the long wavelength incompressible limit is similar to that of the linearized KdV *** argue that the ’planet-like’ solutions of nonlinear dynamical instability in the numerical simulations should he the soliton solutions of KdV *** also find that the vorticity of accretion disk is a non-conservation quantity due to the variation of density and entropy in the nonlinear evolution of dynamical instability It is the cause of the redistribution of angular momentum during the instability.

关键词： accretion disk theory nonlinear dynamical instability KdVequation

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Inter-Regional Comparisons on the Quaternary Large Mammalian Faunas between China and Sub-Saharan Africa

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Acta Geologica Sinica(English Edition) 2011年第1期85卷 91-106页

作者： TONG Haowen HU Nan LIU Jinyi ronald CLARKE Key Laboratory of Evolutionary Systematics of Vertebrates Institute of Vertebrate Paleontology and Paleoanthropology Chinese Academy of Sciences Beijing 100044 China Graduate University of Chinese Academy of Sciences Beijing 100049 China Institute for Human Evolution University of the Witwatersrand Johannesburg 2193 South Africa

The current and dominant theory about the origin of modern humans is the out-of-Africa hypothesis, which asserts that populations of Homo sapiens left Africa 100,000 years ago and replaced indigenous populations of humans in Eurasia. Many scholars equated the out-of-Africa dispersal of humans with paleoenvironmental changes. However, until now, few have paid special attention to the faunal data and whether or not faunal patterns are supportive of the popular theory. Recent comparative study of the Chinese fauna shows that the communication of faunas between Africa and East Asia could have occurred during the Neogene, but it was very limited during the Pleistocene. In the Chinese Quaternary fauna, only 16% of the genera are also present in the sub-Saharan African fauna. There is also no element among the dominant taxa of the Chinese Quaternary fauna which can be related to the African fauna. There is no reliable proof for the existence of Hippopotamus and Giraffa, as well as Panthera leo, during the Quaternary in China. Two controversial taxa are Acinonyx and Crocuta, about which there is still argument concerning their species identification in Eurasia. It is possible that both of the genera have co-specific taxa in Africa and Eurasia. Although the two genera are confined to Africa today, they did have a long evolutionary history in China. For the Out of Africa hypothesis for Homo sapiens, the implications of the limited faunal interchanges between China and Africa are not completely clear yet.

关键词： large mammals faunal comparisons Quaternary out of Africa theory Sub-SaharanAfrica China

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Type 2 Diabetes, Pre-Diabetes, and the Metabolic Syndrome (Current Clinical Practice) 1

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丛书名： Current Clinical Practice

2005年

作者： ronald A. Codario

ISBN: (数字)9781592599325

ISBN: (纸本)1588294714

Well-known and highly respected diabetes authority ronald A. Codario, MD, details for busy primary care practitioners the state of the art in diagnosing and managing diabetes, as well as in reducing patient risk factors. Using an evidence-based approach, Dr. Codario explains, in simple clinical terms that avoid the complexity of much larger textbooks, our latest understanding of the pathophysiology of diabetes, its treatment with insulin and oral agents, and the management of its risk factors. The author also extensively reviews such major topics as the metabolic syndrome, the role of exercise and nutrition, and the key issues associated with the use of herbs and nutraceuticals. Also included are continuing medical education (CME) questions that provide the opportunity to acquire up to a maximum of 10 AMA/PRA category 1 CME credits. For the past 15 years, the author has given CME lectures on diabetes throughout the country

关键词： Diabetes Mellitus Type 2.

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Modelling behavioural interactions of drivers' in mixed traffic conditions

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Journal of Traffic and Transportation Engineering(English Edition) 2018年第4期5卷 284-295页

作者： Caleb ronald Munigety Centre for Infrastructure Sustainable Transportation and Urban Planning Indian Institute of Science

Mixed traffic conditions are often prevalent in developing economies such as India, China, Bangladesh, etc. and are characterised by the presence of multiple vehicle types. The presence of multiple vehicle types with varying dynamic and static characteristics results in vehicle-type dependent driving behaviours. For instance, drivers of small sized vehicles such as motorbikes accelerate and decelerate at will, maintain shorter safe gaps with the lead vehicles, and accept smaller lateral clearances to make lateral movements within and across lanes breaking the lane discipline. On the other hand, drivers of heavy vehicles such as trucks have less flexibility in performing the acceleration/deceleration and lateral movement operations. Thus, the representation of mixed traffic systems requires model- ling vehicle-type dependent driving behaviours. This paper first establishes the effect of vehicle type on the longitudinal and lateral movement behaviours of drivers using the trajectory data collected in India and subsequently presents the proposed vehicle-type dependent driver behavioural models based on the same dataset. The efficiency of the proposed models is tested by implementing them in a simulation framework compatible with non-lane-based movements of vehicles and cross validating with the field data. The results indicate better predictability of the driver behaviour and thus more realistic rep- resentation in the mixed traffic systems. Moreover, the simulator hinged upon the pro- posed behavioural models will be useful in evaluating alternate traffic improvement initiatives and help the transport planners to design the transport systems of developing countries in an efficient and sustainable manner.

关键词： Mixed traffic Vehicle type Lane discipline Driving behaviour Simulation

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Large-Scale Assessments,Personalized Learning,and Creativity:Paradoxes and Possibilities

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ECNU Review of Education 2019年第3期2卷 311-327页

作者： ronald A.Beghetto University of Connecticut

Purpose:This article,based on an invited talk,aims to explore the relationship among large-scale assessments,creativity and personalized ***/Approach/Methods:Starting with the working definition of large-scale assessments,creativity,and personalized learning,this article identified the paradox of combining these three components *** a consequence,a logic mode of large-scale assessment and creativity expressions is illustrated,along with an exploration of new ***:Smarter design of large-scale assessments is ***,we need to assess creative learning at the individual level,so complex tasks with high uncertainty should be presented to ***,additional process and experiential data while students are working on problems need to be ***,the human-artificial intelligence(AI)augmented scoring should be explored,developed,and ***/Value:This article addresses the drawbacks of current large-scale assessments and explores possibilities for combining assessment with creativity and personalized learning.A logic model illustrating variations necessary for creative learning and considerations and cautions for designing large-scale assessments are also provided.

关键词： Creative expression creative learning creativity large-scale assessments personalized learning

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Finite Complements in English

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外国语 2008年第1期31卷 2-35页

作者： ronald W. Langacker University of California San Diego USA

This paper explores the conceptual basis of finite complementation in English. It first considers the distinguishing property of a finite clause,namely grounding,effected by tense and the modals. Notions crucial for clausal grounding—including a reality conception and the striving for control at the effective and epistemic levels—also figure in the semantic import of complementation. An essential feature of complement constructions is the involvement of multiple conceptualizers,each with their own conception of reality. The different types of complement and their grammatical markings can be characterized on this basis. Finite complements differ from other types by virtue of expressing an autonomous proposition capable of being apprehended by multiple conceptualizers,each from their own vantage point. A cognitive model representing phases in the striving for epistemic control provides a partial basis for the semantic description of predicates taking finite complements. The same model supports the description of both personal and impersonal complement constructions.

关键词：英语认知文法补语谓词限定从句

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Access,Activation,and Overlap:Focusing on the Differential

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外国语 2012年第1期35卷 2-25页

作者： ronald W.Langacker University of California San DiegoU.S.A.

As a long term goal,Cognitive Grammar envisages a unified account of linguistic structure,processing,and discourse.A key requirement is that it properly reflect the dynamicity of language,in all its aspects(including grammar).Consisting as it does in patterns of activity,language is something that happens: it unfolds through time,and how it does so is essential for its *** structure involves the complex interplay of serial and hierarchical *** theory has generally overemphasized the latter,as witnessed by the predominant role of grammatical constituency based on the metaphor of composition("building" a complex structure out of smaller "pieces").More promising for a unified treatment of structure,processing,and discourse is an alternative metaphor,in which a "moving window" of attention allows serial access to complex conceptions that are mostly already in *** processing proceeds concurrently on different time scales,in windows of different *** provides a dynamic basis for hierarchical *** arises when conceptions accessed in windows on one time scale figure in a distinct and more elaborate conception(with its own,emergent properties) accessed in a single window on a larger time *** on the alternative metaphor,an approach is outlined that features serial access,windows of attention,levels of activation,and conceptual *** is then applied,in exploratory fashion,to a number of grammatical *** "access-and-activation" approach directly accommodates reference point relationships,the basis for possessive and topic *** lends itself quite well to the characterization of informational focus,marked in English by unreduced *** requisite descriptive notions are then extended and adapted for ellipsis,which has rather different *** same notions prove useful for handling problematic aspects of coordinate ***,they provide a straig

关键词： attention conceptual overlap discourse dynamicity seriality vs.hierarchy

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