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Use of ketamine sedation for the management of displaced paediatric forearm fractures

World Journal of Orthopedics 2018年第3期9卷 50-57页

作者： Anatole Vilhelm Wiik Poonam Patel Joanna Bovis Adele Cowper Philip Socrates Pastides Alison Hulme stuart evans Charles Stewart Department of Surgery and Cancer Charing Cross Hospital Department of Paediatric Emergency Chelsea and Westminster Hospital Department of Trauma and Orthopaedics Chelsea Westminster Hospital

AIM To determine if ketamine sedation is a safe and cost effective way of treating displaced paediatric radial and ulna fractures in the emergency department. METHODS Following an agreed interdepartmental protocol, fractures of the radius and ulna(moderately to severely displaced) in children between the age of 2 and 16 years old, presenting within a specified 4 mo period, were manipulated in our paediatric emergency department. Verbal and written consent was obtained prior to procedural sedation to ensure parents were informed and satisfied to have ketamine. A single attempt at manipulation was performed. Pre and postmanipulation radiographs were requested and assessed to ensure adequacy of reduction. Parental satisfaction surveys were collected after the procedure to assess the perceived quality of treatment. After closed reduction and cast immobilisation, patients were then followed-up in the paediatric outpatient fracture clinic and functional outcomes measured prospectively. A cost analysis compared to more formal manipulation under a general anaesthetic was also *** During the 4 mo period of study, 10 closed, moderate to severely displaced fractures were identified and treated in the paediatric emergency department using our ketamine sedation protocol. These included fractures of the growth plate(3), fractures of both radius and ulna(6) and a single isolated proximal radius fracture. The mean time from administration of ketamine until completion of the moulded plaster was 20 min. The mean time interval from sedation to full recovery was 74 min. We had no cases of unacceptable fracture reduction and no patients required any further manipulation, either in fracture clinic or under a more formal general anaesthetic. There were no serious adverse events in relation to the use of ketamine. Parents, patients and clinicians reported extremely favourable outcomes using this technique. Furthermore, compared to using a manipulation under general anaesthes

关键词： Paediatrics Forearm fractures Displaced fractures Ketamine Salter Harris Procedural sedation

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In vitro investigation of the effect of dairy propionibacteria on rumen pH,lactic acid and volatile fatty acids

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Journal of Integrative Agriculture 2017年第7期16卷 1566-1575页

作者： Jianbiao Luo Chaminda Senaka Ranadheera stuart King Craig evans Surinder Baines School of Environmental&Life Sciences The University of NewcastleCallaghan NSW 2308Australia Advanced Food Systems Research Unit College of Health and BiomedicineVictoria UniversityMelbourne VIC 3030Australia School of Health Sciences The University of NewcastleCallaghan NSW 2308Australia

Ruminal acidosis is a prevalent disorder in ruminants such as dairy cows and feedlot beef cattle, caused primarily by the inclusion of a high percentage of readily fermentable concentrates in the diet. The disorder presents as an accumulation of lactic acid, a decrease of pH in the rumen and a subsequent imbalance of the rumen fermentation process with detrimental impacts on the animal＇s health and productivity. Dairy propionibacteria, a group of bacteria characterised by utilization of lactic acid as the favoured carbon source, with propionic acid produced as a by-product, were evaluated in this study as potential direct-fed microbials for use in controlling ruminal acidosis. Acidosis was simulated by introduction of high concentrations of lactic acid into rumen fluid samples and a multi-strain in vitro analysis was conducted, whereby changes in pH and lactic acid metabolism were compared in identical acidified rumen samples, following inoculation with various propionibacteria. This was followed by a study to evaluate the effect of bacterial inoculation dosage on acid metabolism. The results indicated that lactic acid levels in the rumen fluid were significantly reduced, and propionic acid and acetic acid concentrations both significantly increased, following addition of propionibacteria. Significant ＇between strains＇ differences were observed, with Propionibacterium acidopropionici 341, Propionibacterium freudenreichfi CSCC 2207, Propionibacterium jensenfi NCFB 572 and P. jensenii 702 each producing more rapid reduction of lactic acid concentration than P. freudenreich# CSCC 2206, P. acidopropionici ATCC 25562 and Propionibacterium thoenii ATCC 4874. Furthermore, the efficacy of this application was dosage related, with the rates of reduction in lactic acid levels and production of propionic acid, both significantly greater for the higher （10^10 cfu mL-1） compared with lower （10^5 cfu mL-1） dosage inoculation. The results confirmed that the introduction of propion

关键词： probiotics ruminal acidosis lactic acid propionic acid dairy Propionibacterium

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Electrophysiological assessment of primary cortical neurons genetically engineered using iron oxide nanoparticles

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Nano Research 2017年第8期10卷 2881-2890页

作者： Michael G. evans Arwa Al-Shakli stuart I. Jenkins Divya M. Chari School of Life Sciences Keele University Keele Staffordshire ST5 5BG UK Institute for Science and Technology in Medicine Keele University Keele Staffordshire ST5 5BG UK

The development of safe technologies to genetically modify neurons is of great interest in regenerative neurology, for both translational and basic science applications. Such approaches have conventionally been heavily reliant on viral transduction methods, which have safety and production limitations. Magnetofection （magnet-assisted gene transfer using iron oxide nanoparticles as vectors） has emerged as a highly promising non-viral alternative for safe and reproducible genetic modification of neurons. Despite the high potential of this technology, there is an important gap in our knowledge of the safety of this approach, namely, whether it alters neuronal function in adverse ways, such as by altering neuronal excitability and signaling. We have investigated the effects of magnetofection in primary cortical neurons by examining neuronal excitability using the whole cell patch clamp technique. We found no evidence that magnetofection alters the voltage-dependent sodium and potassium ionic currents that underpin excitability. Our study provides important new data supporting magnetofection as a safe technology for bioengineering of neuronal cell populations.

关键词： transfection magnetic nanoparticle green fluorescent protein (GFP) whole-cell patch clamp fluorescence microscopy

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Polychlorinated biphenyls (PCBs), hexabromocyclododecanes (HBCDDs) and degradation products in topsoil from Australia and the United Kingdom

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Emerging Contaminants 2016年第1期2卷 37-41页

作者： Jennifer Desborough Timothy evans Jochen Müller stuart Harrad School of Geography Earthand Environmental SciencesUniversity of BirminghamBirmingham B152TTUnited Kingdom National Research Centre for Environmental Toxicology(Entox) The University of Queensland39 Kessels RoadBrisbaneQueensland 4108Australia

Hexabromocyclododecane(HBCDD)is listed under the Stockholm Convention on persistent organic pollutants,yet very few data are available on HBCDD concentrations in *** concentrations of total hexabromocyclododecanes(SHBCDDs)from soils from the UK(n=24)were 0.73 ng g^-1 dry weight(range0.05)from those of HBCDDs;thereby underlining the extent to which HBCDDs have migrated into the UK ***,PCB concentrations in this study are not markedly lower than those recorded in UK soils sampled in the mid-1980s indicating that the initial rapid decline in UK contamination with PCBs following bans on their manufacture and use,has not been *** products of HBCDD:pentabromocyclododecenes(PBCDs)and tetrabromocyclododecadienes(TBCDs)were detected in some UK soil samples with semi-quantitative concentrations ranging between 0.01 and 7.3 ng g^-1 for SPBCDs and 0.01e1.3 ng g^-1 for *** Australian soils only STBCDs were detected at concentrations ranging from 0.0023 to 0.45 ng g^-*** signatures of HBCDDs were racemic or non-racemic in all samples indicating minimal edaphic enantioselective degradation.A horizontal transect at the most contaminated UK location(a suburban garden)revealed a marked decrease in concentrations of HBCDDs with increasing distance from buildings.

关键词： Soil BFRs POPs Chiral signatures Enantiomer fractions

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Rapid,high-resolution detection of environmental change over continental scales from satellite data–the Earth Observation Data Cube

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International Journal of Digital Earth 2016年第1期9卷 106-111页

作者： Adam Lewis Leo Lymburner Matthew B.J.Purss Brendan Brooke Ben evans Alex Ip Arnold G.Dekker James R.Irons stuart Minchin Norman Mueller Simon Oliver Dale Roberts Barbara Ryan Medhavy Thankappan Rob Woodcock Lesley Wyborn Geoscience Australia CanberraAustralia National Computational Infrastructure Australian National UniversityCanberraAustralia Commonwealth Scientific and Industrial Research Organisation CanberraAustralia NASA Goddard Space Flight Center GreenbeltMDUSA Research School of Finance Actuarial Studies and Applied StatisticsANUCanberraAustralia The Group on Earth Observations Secretariate GenevaSwitzerland

The effort and cost required to convert satellite Earth Observation(EO)data into meaningful geophysical variables has prevented the systematic analysis of all available *** overcome these problems,we utilise an integrated High Performance Computing and Data environment to rapidly process,restructure and analyse the Australian Landsat data *** this approach,the EO data are assigned to a common grid framework that spans the full geospatial and temporal extent of the observations–the EO Data *** approach is pixel-based and incorporates geometric and spectral calibration and quality assurance of each Earth surface reflectance *** demonstrate the utility of the approach with rapid time-series mapping of surface water across the entire Australian continent using 27 years of continuous,25 m resolution *** preliminary analysis of the Landsat archive shows how the EO Data Cube can effectively liberate high-resolution EO data from their complex sensor-specific data structures and revolutionise our ability to measure environmental change.

关键词： Earth Observation Data Cube HPD HPC surface water Landsat Australia

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好奇心、地方和幸福:鼓励特定地方的好奇心作为“促进幸福的方式”

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国际城市规划 2016年第1期 138-138页

作者： Richard Phillips Bethan evans stuart Muirhead 李志刚武汉大学城市设计学院

对幸福的科学研究近年不断增多,幸福的概念从单一的健康范畴拓展到广泛的综合范畴。影响幸福的各类物质、社会和精神资源均与城市和空间息息相关,对于幸福和地方关系的研究也在不断加强。2010年,英国利物浦开展了“10年健康和幸福”项目... 详细信息

对幸福的科学研究近年不断增多,幸福的概念从单一的健康范畴拓展到广泛的综合范畴。影响幸福的各类物质、社会和精神资源均与城市和空间息息相关,对于幸福和地方关系的研究也在不断加强。2010年,英国利物浦开展了“10年健康和幸福”项目,倡导居民对所在地方保持好奇心,将其视为促进幸福的方式。为了探究好奇心在幸福和地方关系中所起的作用,本文基于“10年健康和幸福”项目,采用深度采访、观察记录等质性研究方法,对

关键词：地方关系深度采访质性研究方法精神资源英国利物浦中所传统认知工业遗产老年痴呆症

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传染病的消灭:虚构还是现实

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国外医学(流行病学传染病学分册) 1986年第1期13卷 39-41页

作者： evans A S 汪培山

传染病的控制与消灭涉及许多学科,包括生物学和社会经济等方面。生物学控制水平有三个方面:第一,临床疾病的控制,如发病率、致残率和病死率;第二,感染本身的控制,包括临床的和无症状的感染;第三,环境中的致病因子及其传播的控制。在传... 详细信息

传染病的控制与消灭涉及许多学科,包括生物学和社会经济等方面。生物学控制水平有三个方面:第一,临床疾病的控制,如发病率、致残率和病死率;第二,感染本身的控制,包括临床的和无症状的感染;第三,环境中的致病因子及其传播的控制。在传染病可能消灭之前所有这三个水平均需在全球范围内完成。控制也有地理性等级,如局部、地区、一个国家、一个大陆及全球范围。stuart-Harris在他所下的定义中将这些概念概括为“一种感染的消灭是指这种感染在世界上所有国家消失,因为已永远阻断了这种病因因子的传播。”他用“消除”(elimination)这个词是指“传播从一定的区域内消失,一个国家或一个大陆不再有感

关键词：疾病报告致病因子疫苗接种无症状外环境 stuart 脊健灰质炎抗体应答免疫水平 elimination

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