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Controversies in fluid therapy: Type, dose and toxicity

世界重症医学杂志 2014年第1期3卷 24-33页

作者： Robert C mcDermid Karthik Raghunathan Adam Romanovsky Andrew D Shaw sean m bagshaw Division of Critical Care medicine Faculty of Medicine and Dentistry University of Alberta Edmonton AB T6G2B7 Canada Department of Anesthesiology Duke University Medical Center/Durham VAMC Durham NC 90484 United States Department of Critical Care medicine Duke University Medical Center/Durham VAMC Durham NC 90484 United States

Fluid therapy is perhaps the most common intervention received by acutely ill hospitalized patients; however, a number of critical questions on the efficacy and safety of the type and dose remain. In this review, recent insights derived from randomized trials in terms of fluid type, dose and toxicity are discussed. We contend that the prescription of fluid therapy is context-specific and that any fluid can be harmful if administered inappropriately. When contrasting ‘‘crystalloid vs colloid'', differences in efficacy are modest but differences in safety are significant. Differences in chloride load and strong ion difference across solutions appear to be clinically important. Phases of fluid therapy in acutely ill patients are recognized, including acute resuscitation, maintaining homeostasis, and recovery phases. Quantitative toxicity(fluid overload) is associated with adverse outcomes and can be mitigated when fluid therapy basedon functional hemodynamic parameters that predict volume responsiveness and minimization of non-essential fluid. Qualitative toxicity(fluid type), in particular for iatrogenic acute kidney injury and metabolic acidosis, remain a concern for synthetic colloids and isotonic saline, respectively. Physiologically balanced crystalloids may be the ‘‘default'' fluid for acutely ill patients and the role for colloids, in particular hydroxyethyl starch, is increasingly unclear. We contend the prescription of fluid therapy is analogous to the prescription of any drug used in critically ill patients.

关键词： Fluid therapy Resuscitation Critical illness Peri-operative Toxicity Saline Crystalloid Colloid

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Cannabinoids and endocannabinoids as therapeutics for nervous system disorders:preclinical models and clinical studies

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Neural Regeneration Research 2024年第4期19卷 788-799页

作者： R.Scott Duncan sean m.Riordan matthew C.Gernon Peter Koulen Department of Ophthalmology School of MedicineUniversity of Missouri Department of Biomedical Sciences School of MedicineUniversity of Missouri

Cannabinoids are lipophilic substances derived from Cannabis sativa that can exert a variety of effects in the human *** have been studied in cellular and animal models as well as in human clinical trials for their therapeutic benefits in several human *** of these include central nervous system(CNS)diseases and dysfunctions such as forms of epilepsy,multiple sclerosis,Parkinson’s disease,pain and neuropsychiatric *** addition,the endogenously produced cannabinoid lipids,endocannabinoids,are critical for normal CNS function,and if controlled or modified,may represent an additional therapeutic avenue for CNS *** review discusses in vitro cellular,ex vivo tissue and in vivo animal model studies on cannabinoids and their utility as therapeutics in multiple CNS *** addition,the review provides an overview on the use of cannabinoids in human clinical trials for a variety of CNS *** and endocannabinoids hold promise for use as disease modifiers and therapeutic agents for the prevention or treatment of neurodegenerative diseases and neurological disorders.

关键词： anandamide cannabidiol cannabinoid endocannabinoid epilepsy multiple sclerosis neurodegeneration neuroprotection tetrahydrocannabinol

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High-entropy catalysts for electrochemical water-electrolysis of hydrogen evolution and oxygen evolution reactions

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Frontiers in Energy 2024年第3期18卷 265-290页

作者： Simiao SHA Riyue GE Ying LI Julie m.CAIRNEY Rongkun ZHENG sean LI Bin LIU Jiujun ZHANG Wenxian LI School of materials Science and Engineering Shanghai UniversityShanghai 200444China School of Chemical and Environmental Engineering Anhui Polytechnic UniversityWuhu 241000China Australian Centre for microscopy and microanalysis School of AerospaceMechanical and Mechatronic EngineeringThe University of SydneySydney NSW 2006Australia School of Physics The University of SydneySydney NSW 2006Australia School of materials Science and Engineering UNSW Materials&Manufacturing Futures InstituteUniversity of New South WalesSydney NSW 2052Australia College of materials Science and Engineering Fuzhou UniversityFuzhou 350108China

High entropy materials (HEms) have developed rapidly in the field of electrocatalytic water-electrolysis for oxygen evolution reaction (OER) and hydrogen evolution reaction (HER) due to their unique properties. In particular, HEm catalysts are composed of many elements. Therefore, they have rich active sites and enhanced entropy stability relative to single atoms. In this paper, the preparation strategies and applications of HEm catalysts in electrochemical water-electrolysis are reviewed to explore the stabilization of HEms and their catalytic mechanisms as well as their application in support green hydrogen production. First, the concept and four characteristics of HEms are introduced based on entropy and composition. Then, synthetic strategies of HEm catalysts are systematically reviewed in terms of the categories of bottom-up and top-down. The application of HEms as catalysts for electrochemical water-electrolysis in recent years is emphatically discussed, and the mechanisms of improving the performance of electrocatalysis is expounded by combining theoretical calculation technology and ex-situ/in situ characterization experiments. Finally, the application prospect of HEms is proposed to conquer the challenges in HEm catalyst fabrications and applications.

关键词： high-entropy electrocatalysis synthetic methods water-electrolysis hydrogen and oxygen evolutions

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World Journal of Critical Care medicine 2022年第4期11卷 236-245页

作者： Vincent Issac Lau Jeffrey A Johnson sean m bagshaw Oleksa G Rewa John Basmaji Kimberley A Lewis m Elizabeth Wilcox Kali Barrett Francois Lamontagne Francois Lauzier Niall D Ferguson Simon J W Oczkowski Kirsten m Fiest Daniel J Niven Henry T Stelfox Waleed Alhazzani margaret Herridge Robert Fowler Deborah J Cook Bram Rochwerg Feng Xie Department of Critical Care medicine University of AlbertaEdmonton T6G 2B7ABCanada School of Public Health Inst Hlth EconUniversity of AlbertaEdmonton T6G 2B7ABCanada Department of medicine Division of Critical CareWestern UniversityLondon N6A 5W9Canada Division of Critical Care McMaster UniversityHamilton L8N 4A6Canada Interdepartmental Division of Critical Care University of TorontoToronto M5T 2S8Canada Department of medicine University SherbrookeSherbrooke J1H 5N4Canada Departments of medicine and Anesthesiology University LavalLaval G1V 4G2Canada Department Critical Care medicine University of TorontoToronto M5G 2C4Canada Department of medicine McMaster ClinHamilton Gen HospMcMaster UniversityHamilton L8N 4A6Canada Department of Community Health Sciences&Institute for Public Health University of CalgaryCalgary T2N 2T9Canada Department of Critical Care medicine University CalgaryCalgary T2N 2T9Canada Department of Community Health Sciences University of CalgaryCalgary T2N 2T9Canada Department of medicine McMaster UniversityHamilton L8N 4A6Canada Indepartmental Division of Critical Care University Health NetworkToronto M5G 2C4Canada Departments of medicine and Critical Care medicine Sunnybrook Health Sciences CenterInstitute of Health Policy Management and EvaluationUniversity of TorontoToronto M4N 3M5Canada Health Research methods Evidence and ImpactMcMaster UniversityHamilton L8N 3Z5Canada

mortality is a well-established patient-important outcome in critical care *** contrast,morbidity is less uniformly reported(given the myriad of critical care illnesses and complications of each)but may have a common end-impact on a patient’s functional capacity and health-related quality-of-life(HRQoL).Survival with a poor quality-of-life may not be acceptable depending on individual patient values and ***,as mortality decreases within critical care,it becomes increasingly important to measure intensive care unit(ICU)survivor *** measurements with a preference-based scoring algorithm can be converted into health utilities on a scale anchored at 0(representing death)and 1(representing full health).They can be combined with survival to calculate quality-adjusted life-years(QALY),which are one of the most widely used methods of combining morbidity and mortality into a composite *** QALYs have been use for health-technology assessment decision-making,an emerging and novel role would be to inform clinical decision-making for patients,families and healthcare providers about what expected HRQoL may be during and after ICU *** care randomized control trials(RCTs)have not routinely measured or reported HRQoL(until more recently),likely due to incapacity of some patients to participate in patient-reported outcome *** differences in HRQoL measurement tools can lead to non-comparable *** this end,we propose the validation of a gold-standard HRQoL tool in critical care,specifically the *** combined health-utility and mortality(disaggregated)and QALYs(aggregated)can be reported,with disaggregation allowing for determination of which components are the main drivers of the QALY *** use of HRQoL,health-utility,and QALYs in critical care RCTs has the potential to:(1)Increase the likelihood of finding important effects if they exist;(2)improve research efficiency;and(3)help inform optimal m

关键词： Critical care health-related quality of life Quality-adjusted life-years Health-utility mortality morbidity Kaplan-meier curves

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The component-activity interrelationship of cobalt-based bifunctional electrocatalysts for overall water splitting:Strategies and performance

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Journal of Energy Chemistry 2024年第4期91卷 453-474页

作者： mingjie Sun Riyue Ge sean Li Liming Dai Yiran Li Bin Liu Wenxian Li School of materials Science and Engineering Shanghai UniversityShanghai 200444China Institute of Textiles and Clothing The Hong Kong Polytechnic UniversityHong Kong SAR 999077China School of materials Science and Engineering University of New South WalesSydneyNew South Wales 2052Australia UNSW materials&manufacturing Futures Institute UNSW SydneyNew South Wales 2052Australia School of Chemical Engineering University of New South WalesSydneyNew South Wales 2052Australia

Cobalt-based electrocatalysts take advantage of potentially harmonizable microstructure and flexible coupling effects compared to commercial noble metal-based catalytic ***,conventional water electrolysis systems based on cobalt-based monofunctional hydrogen evolution reaction(HER)or oxygen evolution reaction(OER)catalysts have certain shortcomings in terms of resource utilization and *** contrast,cobalt-based bifunctional catalysts(CBCs)have attracted much attention in recent years for overall water splitting systems because of their practicality and reduced preparation cost of *** review aims to address the latest development in CBCs for total *** main modification strategies of CBCs are systematically classified in water electrolysis to provide an overview of how to regulate their morphology and electronic ***,the catalytic performance of CBCs in total-hydrolysis is summarized according to the types of cobalt-based phosphides,sulfides and oxides,and the mechanism of strengthened electrocatalytic ability is emphasized through combining experiments and theoretical *** efforts are finally suggested to focus on exploring the dynamic conversion of reaction intermediates and building near-industrial CBCs,designing advanced CBC materials through micro-modulation,and addressing commercial applications.

关键词： Cobalt Bifunctional electrocatalysis Water splitting modification strategies Electrocatalytic performances

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Network analyses:Inhibition of androgen receptor signaling reduces inflammation in the lung through AR-mAF-IL6 signaling axes

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Genes & Diseases 2024年第3期11卷 140-143页

作者： Albert R.Wang Andrew m.Baschnagel Zijian Ni sean R.Brennan Hypatia K.Newton Darya Buehler Christina Kendziorski Randall J.Kimple Gopal lyer Department of Human Oncology University of Wisconsin School of Medicine and Public HealthUniversity of WisconsinMadisonWI 53705USA Department of Biomedical Engineering University of Wisconsin-MadisonMadisonWI 53705USA University of Wisconsin Carbone Cancer Center MadisonWI 53705USA Department of Biostatistics and medical Informatics University of Wisconsin-MadisonMadisonWI 53706USA Department of Biology Tufts UniversityMedfordMA 02155USA Department of Pathology and Laboratory medicine University of Wisconsin School of Medicine and Public HealthUniversity of WisconsinMadisonWI 53705USA

Androgen receptor(AR)is a major transcription factor that plays a role in inflammatory response including interleukin-6(IL6)signaling.1 While AR regulation through paracrine loop signaling in prostate tissue is well-studied,its impact through an IL6 autocrine loop in the lung has not been wellstudied despite the organ's response to respiratory viral *** inhibition and RNA knockdown of AR identified a bZIP transcription factor mAF to be a common target of inflammation using these perturbations in lung cells.

关键词： inflammation lung respiratory

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Smoking cessation prior to elective total joint arthroplasty results in sustained abstinence postoperatively

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World Journal of Orthopedics 2024年第7期15卷 627-634页

作者： Billy Insup Kim Jeffrey O'Donnell Colleen m Wixted Thorsten markus Seyler William A Jiranek michael Paul Bolognesi sean Patrick Ryan Department of Orthopedic Surgery Hospital for Special SurgeryNew YorkNY 10021United States Department of Orthopedic Surgery New York UniversityNew YorkNY 10003United States Department of Orthopedic Surgery Duke University HospitalDurhamNC 27560United States

BACKGROUND Tobacco use is a well-documented modifiable risk factor for perioperative *** To determine the tobacco abstinence rates of patients who made cessation efforts prior to a total joint arthroplasty(TJA)*** A retrospective evaluation was performed on 88 self-reported tobacco users who underwent TJA between 2014-2022 and had tobacco cessation dates within 3 mo of *** patients were contacted via phone survey to understand their tobacco use pattern,and patient reported outcomes.A total of 37 TJA patients *** Our cohort was on average 61-years-old,60%(n=22)women,with an average body mass index of 30 kg/m^(2).The average follow-up time was 2.9±1.9 years.A total of 73.0%(n=27)of patients endorsed complete abstinence from tobacco use prior to *** cessation methods were used perioperatively including prescription therapy(13.5%),over the counter nicotine replacement(18.9%),cessation programs(5.4%).At final follow up,43.2%(n=16)of prior tobacco smokers reported complete *** who were able to maintain cessation postoperatively had improved Patient-Reported Outcomes measurement Information System(PROmIS)-10 mental health scores(49 vs 58;P=0.01),and hip dysfunction and osteoarthritis outcome score for joint replacement(***)scores(63 vs 82;P=0.02).No patients in this cohort had a prosthetic joint infection or required revision *** We report a tobacco cessation rate of 43.2%in patients undergoing elective TJA nearly 3 years *** undergoing TJA who were able to remain abstinent had improved PROmIS-10 mental health scores and *** *** perioperative period provides clinicians a unique opportunity to assist active tobacco smokers with cessation efforts and improve postoperative outcomes.

关键词： Smoking cessation Total joint arthroplasty Outcomes Tobacco use Postoperative abstinence

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Gas-propelled nanomotors alleviate colitis through the regulation of intestinal immunoenvironment-hematopexis-microbiota circuits

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Acta Pharmaceutica Sinica B 2024年第6期14卷 2732-2747页

作者： Bo Xiao Yuqi Liang Ga Liu Lingshuang Wang Zhan Zhang Libin Qiu Haiting Xu sean Carr Xiaoxiao Shi Rui LReis Subhas CKundu Zhenghua Zhu Department of Gastroenterology the First Affiliated Hospital of Nanchang UniversityNanchang 330006China College of Sericulture Textileand Biomass SciencesSouthwest UniversityChongqing 400715China Department of Neurology School of MedicineEmory UniversityAtlantaGA 30322USA Atlanta Veterans Affairs medical Center DecaturGA 30033USA Department of Surgery School of MedicineEmory UniversityAtlantaGA 30322USA Bs Research Group I3Bs—Research Institute on BiomaterialsBiodegradables and BiomimeticsUniversity of MinhoHeadquarters of the European Institute of Excellence on Tissue Engineering and Regenerative MedicineAveParkBarcoGuimaraes 4805-017Portugal

The progression of ulcerative colitis(UC)is associated with immunologic derangement,intestinal hemorrhage,and microbiota *** traditional medications mainly focus on mitigating inflammation,it remains challenging to address multiple ***,a versatile gas-propelled nanomotor was constructed by mild fusion of post-ultrasonic CaO_(2) nanospheres with Cu_(2)O *** resulting CaO_(2)–Cu_(2)O possessed a desirable diameter(291.3 nm)and a uniform size *** could be efficiently internalized by colonic epithelial cells and macrophages,scavenge intracellular reactive oxygen/nitrogen species,and alleviate immune reactions by pro-polarizing macrophages to the anti-inflammatory m2 *** nanomotor was found to penetrate through the mucus barrier and accumulate in the colitis mucosa due to the driving force of the generated oxygen *** administration of CaO_(2)–Cu_(2)O could stanch the bleeding,repair the disrupted colonic epithelial layer,and reduce the inflammatory responses through its interaction with the genes relevant to blood coagulation,anti-oxidation,wound healing,and ***,it restored intestinal microbiota balance by elevating the proportions of beneficial bacteria(e.g.,Odoribacter and Bifidobacterium)and decreasing the abundances of harmful bacteria(e.g.,Prevotellaceae and Helicobacter).Our gas-driven CaO_(2)–Cu_(2)O offers a promising therapeutic platform for robust treatment of UC via the rectal route.

关键词： Nanomotor Anti-inflammation Blood coagulation Immune regulation Hematopexis microbiota rebalance Ulcerative colitis Rectal administration

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Why ecosystem characteristics predicted from remotely sensed data are unbiased and biased at the same time-and how this affects applications

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Forest Ecosystems 2024年第1期11卷 24-31页

作者： Goran Ståhl Terje Gobakken Svetlana Saarela Henrik J.Persson magnus Ekstrom sean P.Healey Zhiqiang Yang Johan Holmgren Eva Lindberg Kenneth Nystrom Emanuele Papucci Patrik Ulvdal Hans OleØrka Erik Næsset Zhengyang Hou Håkan Olsson Ronald E.mcRoberts Department of Forest Resource management Swedish University of Agricultural Sciences90183UmeåSweden Faculty of Environmental Sciences and Natural Resource management Norwegian University of Life SciencesÅsNorway USDA Forest Service Rocky Mountain Research StationOgdenUTUSA The Key Laboratory for Silviculture and Conservation of ministry of Education Beijing Forestry UniversityBeijing100083China Department of Forest Resources University of MinnesotaSt.PaulMNUSA

Remotely sensed data are frequently used for predicting and mapping ecosystem characteristics,and spatially explicit wall-to-wall information is sometimes proposed as the best possible source of information for ***,wall-to-wall information typically relies on model-based prediction,and several features of model-based prediction should be understood before extensively relying on this type of *** such feature is that model-based predictors can be considered both unbiased and biased at the same time,which has important implications in several areas of *** this discussion paper,we first describe the conventional model-unbiasedness paradigm that underpins most prediction techniques using remotely sensed(or other)auxiliary *** this point of view,model-based predictors are typically ***,we show that for specific domains,identified based on their true values,the same model-based predictors can be considered biased,and sometimes severely *** suggest distinguishing between conventional model-bias,defined in the statistical literature as the difference between the expected value of a predictor and the expected value of the quantity being predicted,and design-bias of model-based estimators,defined as the difference between the expected value of a model-based estimator and the true value of the quantity being *** show that model-based estimators(or predictors)are typically design-biased,and that there is a trend in the design-bias from overestimating small true values to underestimating large true ***,we give examples of applications where this is important to acknowledge and to potentially make adjustments to correct for the design-bias *** argue that relying entirely on conventional model-unbiasedness may lead to mistakes in several areas of application that use predictions from remotely sensed data.

关键词： Bias model-based inference Design-based inference

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management of stage Ⅳ rectal cancer: Palliative options

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World Journal of Gastroenterology 2011年第7期17卷 835-847页

作者： sean m Ronnekleiv-Kelly Gregory D Kennedy Department of Surgery Section of Colon and Rectal Surgery University of Wisconsin School of Medicine and Public Health 600 HighlandAvenue G4/701A CSC Madison WI 53792 United States

Approximately 30% of patients with rectal cancer present with metastatic disease. many of these patients have symptoms of bleeding or obstruction. Several treatment options are available to deal with the various complications that may afflict these patients. Endorectal stenting, laser ablation, and operative resection are a few of the options available to the patient with a malignant large bowel obstruction. A thorough understanding of treatment options will ensure the patient is offered the most effective therapy with the least amount of associated morbidity. In this review, we describe various options for palliation of symptoms in patients with metastatic rectal cancer. Additionally, we briefly discuss treatment for asymptomatic patients with metastatic disease.

关键词： Palliative therapy Rectal cancer malignant bleeding malignant obstruction Endorectal stenting Laser ablation

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