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Higher cost of arthroplasty for hip fractures in patients transferred from outside hospitals vs primary emergency department presentation

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World journal of Orthopedics 2022年第8期13卷 725-732页

作者： Emanuel C Haug Hakan Pehlivan j Ryan Macdonell Wendy Novicoff james Browne thomas Brown Quanjun Cui Department of Orthopedic Surgery University of VirginiaCharlottesvilleVA 22908United States Department of Orthopedic Surgery Preferred Pediatric Orthopedic SurgeryRidgewoodNJ 07450United States Department of Orthopedic Surgery Asheville Orthopedic AssociatesAshevilleNC 28801United States

BACKGROUND In 2016 Centers for Medicare and Medicaid Services proposed bundled payments for hip fractures to improve the quality and decrease costs of *** transferred from other facilities may be imposing a financial risk on the hospitals that accept these *** To determine the costs associated with patients that either presented to the emergency department or were transferred from another hospital or skilled nursing facility(SNF)with the diagnosis of a hip fracture requiring operative *** A retrospective single institution review was conducted for all arthroplasty patients from 2010 to *** criteria included a total or partial hip replacement for a hip *** criteria included pathologic,periprosthetic,and fracture *** was collected to compare total observed costs for patients from the emergency department,patients from skilled nursing facilities,and patients from an outside *** A total of 223 patients met the inclusion criteria.135(60.54%)of these patients presented primarily to the emergency department,58 patients(26.01%)were transferred from an outside hospital,and 30 patients(13.43%)were transferred from a *** data analysis showed that outside hospital patients demonstrated significantly greater total cost for their hospitalization($43302)compared to emergency department patients($28875,P=0.000)and SNF patients($28282,P=0.000).CONCLUSION Patients transferred from an outside hospital incurred greater costs for their hospitalization than patients presenting from an emergency department or *** is a strong argument for riskadjustment models when bundling payments for the care of hip fracture patients.

关键词： Total hip arthroplasty Cost Transfer Outside hospital Hip fracture

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A-posteriori error estimation for second order mechanical systems

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Acta Mechanica Sinica 2012年第3期28卷 854-862页

作者： thomas Ruiner jrg Fehr Bernard Haasdonk Peter Eberhard Institute of Engineering and Computational Mechanics University of StuttgartPfaffenwaldring 970569 StuttgartGermany Institute of Applied Analysis and Numerical Simulation University of StuttgartPfaffenwaldring 5770569 StuttgartGermany

One important issue for the simulation of flexible multibody systems is the reduction of the flexible bodies de- grees of freedom. As far as safety questions are concerned knowledge about the error introduced by the reduction of the flexible degrees of freedom is helpful and very important. In this work, an a-posteriori error estimator for linear first order systems is extended for error estimation of me- chanical second order systems. Due to the special second order structure of mechanical systems, an improvement of the a-posteriori error estimator is achieved. A major advan- tage of the a-posteriori error estimator is that the estimator is independent of the used reduction technique. Therefore, it can be used for moment-matching based, Gramian matrices based or modal based model reduction techniques. The capability of the proposed technique is demon- strated by the a-posteriori error estimation of a mechanical system, and a sensitivity analysis of the parameters involved in the error estimation process is conducted.

关键词： A-posteriori error estimator. Flexible multibodysystems Model reduction

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Transjugular intrahepatic portosystemic shunt vs conservative treatment for recurrent ascites:A propensity score matched comparison

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World journal of Gastroenterology 2022年第41期28卷 5944-5956页

作者： Martin Philipp Theresia Blattmann jörn Bienert Kristian Fischer Luisa Hausberg jens-Christian Kröger thomas Heller Marc-AndréWeber Georg Lamprecht Department of Medicine Division of Gastroenterology and EndocrinologyRostock University Medical CenterRostock 18057Germany Institute of Diagnostic and Interventional Radiology Pediatric Radiology and NeuroradiologyRostock University Medical CentreRostock 18057Germany

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS) placement is an effective intervention for recurrent tense ascites. Some studies show an increased risk of acute on chronic liver failure(ACLF) associated with TIPS placement. It is not clear whether ACLF in this context is a consequence of TIPS or of the pre-existing liver *** To better understand the risks of TIPS in this challenging setting and to compare them with those of conservative *** Two hundred and fourteen patients undergoing their first TIPS placement for recurrent tense ascites at our tertiary-care center between 2007 and 2017 were identified(TIPS group). Three hundred and ninety-eight patients of the same time interval with liver cirrhosis and recurrent tense ascites not undergoing TIPS placement(No TIPS group) were analyzed as a control group. TIPS indication,diagnosis of recurrent ascites, further diagnoses and clinical findings were obtained from a database search and patient records. The in-hospital mortality and ACLF incidence of both groups were compared using 1:1 propensity score matching and multivariate logistic *** After propensity score matching, the TIPS and No TIPS groups were comparable in terms of laboratory values and ACLF incidence at hospital admission. There was no detectable difference in mortality(TIPS: 11/214, No TIPS 13/214). During the hospital stay, ACLF occurred more frequently in the TIPS group than in the No TIPS group(TIPS: 70/214, No TIPS: 57/214, P = 0.04). This effect was confined to patients with severely impaired liver function at hospital admission as indicated by a significant interaction term of Child score and TIPS placement in multivariate logistic regression. The TIPS group had a lower ACLF incidence at Child scores < 8 points and a higher ACLF incidence at ≥ 11 points. No significant difference was found between groups in patients with Child scores of 8 to 10 *** TIPS placement for recurrent tense as

关键词： Liver cirrhosis Ascites Transjugular intrahepatic portosystemic shunt Acute on chronic liver failure Mortality Propensity score

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Cathepsin D overexpression in the nervous system rescues lethality and Aβ42 accumulation of cathepsin D systemic knockout in vivo

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Acta Pharmaceutica Sinica B 2023年第10期13卷 4172-4184页

作者： Xiaosen Ouyang Willayat Y.Wani Gloria A.Benavides Matthew j.Redmann Hai Vo thomas van Groen Victor M.Darley-Usmar jianhua Zhang Department of Pathology University of Alabama at BirminghamBirminghamAL 35294USA Department of Cell Developmental and Integrative BiologyUniversity of Alabama at BirminghamBirminghamAL 35294USA Birmingham VA Medical Center University of Alabama at BirminghamBirminghamAL 35294USA

The lysosome is responsible for protein and organelle degradation and homeostasis and the cathepsins play a key role in maintaining protein quality *** D(CTSD),is one such lysosomal protease,which when deficient in humans lead to neurolipofuscinosis(NCL)and is important in removing toxic protein *** studies demonstrated that CTSD germ-line knockout-CtsdKO(CDKO)resulted in accumulation of protein aggregates,decreased proteasomal activities,and postnatal lethality on Day 26±*** of wildtype CTSD,but not cathepsin B,L or mutant CTSD,decreased a-synuclein toxicity in worms and mammalian *** this study we generated a mouse line expressing human CTSD with a floxed STOP cassette between the ubiquitous CAG promoter and the *** crossing with Nestin-cre,the STOP cassette is deleted in NESTIN+cells to allow CTSD overexpression-CTSDtg(CDtg).The CDtg mice exhibited normal behavior and similar sensitivity to subchronic 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)induced *** breeding CDtg mice with CDKO mice,we found that over-expression of CTSD extended the lifespan of the CDKO mice,partially rescued proteasomal deficits and the accumulation of Aβ42 in the *** new transgenic mouse provides supports for the key role of CTSD in protecting against proteotoxicity and offers a new model to study the role of CTSD enhancement in vivo.

关键词： Cathepsin D transgenic mouse Mitochondrial bioenergetics Apoptosis Cathepsin D knockout mice Dopamine Autophagy Lysosome Life expectancy Behavior

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nNPipe: a neural network pipeline for automated analysis of morphologically diverse catalyst systems

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npj Computational Materials 2023年第1期9卷 2176-2187页

作者： Kevin P.Treder Chen Huang Cameron G.Bell thomas j.A.Slater Manfred E.Schuster DoğanÖzkaya judy S.Kim Angus I.Kirkland Department of Materials University of OxfordParks RoadOX13PH OxfordOxfordshireUnited Kingdom Rosalind Franklin Institute Harwell Research CampusOX110FA DidcotOxfordshireUnited Kingdom School of Chemistry The University of EdinburghEH93FJ EdinburghUnited Kingdom School of Chemistry Cardiff UniversityPark PlaceCF103AT CardiffUnited Kingdom Electron Physical Sciences Imaging Centre Diamond Light SourceOxfordshire OX110DEUnited Kingdom johnson Matthey Technology Centre Blount’s CourtSonning CommonReading RG49NHUnited Kingdom

We describe nNPipe for the automated analysis of morphologically diverse catalyst materials. Automated imaging routines anddirect-electron detectors have enabled the collection of large data stacks over a wide range of sample positions at high temporalresolution. Simultaneously, traditional image analysis approaches are slow and hence unsuitable for large data stacks andconsequently, researchers have progressively turned towards machine learning and deep learning approaches. Previous studiesoften detail work on morphologically uniform material systems with clearly discernible features, limited workable image sizes andtraining data that may be biased due to manual labelling. The nNPipe data-processing method consists of two standaloneconvolutional neural networks that were exclusively trained on multislice image simulations and enables fast analysis of2048 × 2048 pixel images. Inference performance compared between idealised and real industrial catalytic samples and insightsderived from subsequent data analysis are placed into the context of an automated imaging scenario.

关键词： catalyst hence subsequent

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Pyogenic liver abscess:An audit of 10 years’experience

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World journal of Gastroenterology 2011年第12期17卷 1622-1630页

作者： Tony CY Pang thomas Fung jaswinder Samra thomas j Hugh Ross C Smith Upper Gastrointestinal Surgical Unit Royal North Shore HospitalUniversity of SydneySt Leonards NSW 2065Australia

AIM:To describe our own experience with pyogenic liver abscesses over the past 10 years and investigate the risk factors associated with failure of initial percutaneous ***:A retrospective study of records of 63 PLA patients presenting between 1998 and 2008 to Australian tertiary referral centre,were *** and hydatid abscesses were ***,clinical,radiological,and microbiological characteristics,as well as surgical/radiological interventions,were ***:Sixty-three patients(42 males,21 females) aged 65(±14) years[mean±(SD) ]had prodromal symptoms for a median(interquartile range;IQR) of 7(5-14) *** 59%of patients were febrile at presentation;however,the serum C-reactive protein was elevated in all 47 in whom it was *** function tests were non-specifically abnormal.67%of patients had a solitary abscess,while 32%had>3 abscesses with a median(IQR) diameter of 6.3(4-9) *** organisms were:Streptococcus milleri 25%,Klebsiella pneumoniae 21%,and Escherichia coli 16%.A presumptive cryptogenic cause was most common (34%).Four patients died in this series:one from sepsis,two from advanced cancer,and one from acute myocardial *** initial procedure was radiological aspiration±drainage in 54 and surgery in two patients.17%underwent surgical management during their *** hypoalbuminaemia[mean (95%CI) :32(29-35) g/L vs 28(25-31) g/L,P=0.045] on presentation was found to be the only factor related to failure of initial percutaneous therapy on univariate ***:PLA is a diagnostic challenge,because the presentation of this condition is *** antibiotics and radiological drainage in the first instance allows resolution of most PLAs;However,a small proportion of patients still require surgical drainage.

关键词： Pyogenic liver abscess Image guided drainage Surgical drainage C-reactive protein Hypoalbuminaemia

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Smart Grid Wide-Area Transmission System Visualization

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Engineering 2015年第4期1卷 466-474页

作者： thomas j.Overbye james Weber University of Illinois at Urbana-Champaign PowerWorld Corporation

The installation of vast quantities of additional new sensing and communication equipment, in conjunction with building the computing infrastructure to store and manage data gathered by this equipment, has been the fi rst step in the creation of what is generically referred to as the "smart grid" for the electric transmission system. With this enormous capital investment in equipment having been made, attention is now focused on developing methods to analyze and visualize this large data set. The most direct use of this large set of new data will be in data visualization. This paper presents a survey of some visualization techniques that have been deployed by the electric power industry for visualizing data over the past several years. These techniques include pie charts, animation, contouring, time-varying graphs, geographic-based displays, image blending, and data aggregation techniques. The paper then emphasizes a newer concept of using word-sized graphics called sparklines as an extremely eff ective method of showing large amounts of timevarying data.

关键词：数据可视化电传动系统电网智能传输广域通信设备计算基础设施

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A Fast Accurate Boundary IntegralMethod for Potentials on Closely Packed Cells

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Communications in Computational Physics 2013年第9期14卷 1073-1093页

作者： Wenjun Ying j.thomas Beale Shanghai jiao Tong University Department of Mathematics and Institute of Natural SciencesMinhangShanghai 200240P.R.China Duke University Department of MathematicsDurhamNC 27708-0320USA

Boundary integral methods are naturally suited for the computation of harmonic functions on a region having inclusions or cells with different material ***,accuracy deteriorates when the cell boundaries are close to each *** present a boundary integralmethod in two dimensions which is specially designed tomaintain second order accuracy even if boundaries are arbitrarily *** uses a regularization of the integral kernel which admits analytically determined corrections to maintain *** boundaries with many components we use the fast multipolemethod for efficient *** compute electric potentials on a domain with cells whose conductivity differs from that of the surrounding *** first solve an integral equation for a source term on the cell interfaces and then find values of the potential near the interfaces via *** we use a Poisson solver to extend the potential to a regular grid covering the entire region.A number of examples are *** demonstrate that increased refinement is not needed to maintain accuracy as interfaces become very close.

关键词： Laplace equation boundary integral method fast multipole method

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Nearly Singular Integrals in 3D Stokes Flow

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Communications in Computational Physics 2013年第10期14卷 1207-1227页

作者： Svetlana Tlupova j.thomas Beale Department of Mathematics University of MichiganAnn ArborMI 48109-1043USA Department of Mathematics Duke UniversityDurhamNC 27708-0320USA

A straightforward method is presented for computing three-dimensional Stokes flow,due to forces on a surface,with high accuracy at points near the *** flowquantities arewritten as boundary integrals using the free-spaceGreen’s *** evaluate the integrals near the boundary,the singular kernels are regularized and a simple quadrature is applied in coordinate *** order accuracy is obtained by adding special corrections for the regularization and discretization errors,derived here using local asymptotic *** tests demonstrate the uniform convergence rates of the method.

关键词： Stokes equations boundary integral equation method nearly singular integrals

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Early developmental exposure to inorganic mercury does not alter affiliative behavior of adult prairie voles(Microtus ochrogaster)

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Integrative Zoology 2018年第6期13卷 761-768页

作者： Yue CHEN Robert LEWIS j.thomas CURTIS Department of Pharmacology and Physiology Oklahoma State University Center for Health SciencesTulsaOklahomaUK

Mercury chloride exposure through drinking water in adult male prairie voles(Microtus ochrogaster)has been shown to alter their social ***,we examined the potential disruption of adult social behavior in prairie voles that were exposed to 60 ppm mercury during early *** used a cross-fostering approach to test the effects of mercury exposure:(1)from conception until birth;(ii)from birth until weaning;and(iii)from conception until weaning,on adult affiliative *** and mercury-treated voles were given the option of remaining in an empty cage or affiliating with a same-sex conspecific in a 3-h choice *** found that early developmental mercury exposure had little if any effect on the reproductive success of breeder pairs or on affiliative behavior by either sex when subjects were tested as *** results suggest that,at least in the context of the behavior tested,the effects of early developmental exposure to mercury do not permanently alter adult prairie vole affiliative behavior,or do so in a way that is too subtle to be detected using the current testing paradigm.

关键词： behavioral testing metals toxicity social behavior prairie vole

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