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基于一个大型随机试验预测稳定性心绞痛队列患者死亡、心肌梗死和卒中的危险评分

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英国医学杂志中文版 2006年第1期9卷 16-19页

作者： tim c clayton Stuart J Pocock Jacobus Lubsen Zoltán Vokó Bridget-Anne Kirwan Keith A A Fox Philip A Poole-Wilson Department ofEpidemiology andPopulation Health London School of Hygiene andTropical MedicineLondon Department of Epidemiology and Biostatistics Erasmus Medical Centre 3000 DR Rotterdam Netherlandsprofessor School of Public Health University of Debrecen H-4028 Debrecen Hungary assistant professor SOcAR Research SA PO Box 2564 CH-1260 Nyon 2 Switzerland director cardiovascular Research Unit EdinburghUniversityEdinburghEH16 4SBprofessor cardiovascularSciences NationalHeart and LungInstitute ImperialCollege LondonLondon SW3 6LYprofessor

目的对需要抗心绞痛治疗并且左心室功能代偿症状稳定的心绞痛患者建立预测全因死亡、心肌梗死和导致致残性卒中的复合危险评分。设计大型多中心临床试验数据的多变量cox回归分析。背景西欧、以色列、加拿大、澳大利亚和新西兰的心脏专... 详细信息

目的对需要抗心绞痛治疗并且左心室功能代偿症状稳定的心绞痛患者建立预测全因死亡、心肌梗死和导致致残性卒中的复合危险评分。设计大型多中心临床试验数据的多变量cox回归分析。背景西欧、以色列、加拿大、澳大利亚和新西兰的心脏专科门诊患者。入选者7311例具有全部需要资料的患者被入选。主要结局的测量指标平均随访4.9年时间内所有原因的死亡、心肌梗死或者致残性卒中。结果1063例患者发生任何原因死亡或者持久性心肌梗死或者致残性卒中。这些复合终点的5年危险性在危险性最低的十分位患者为4%,而在危险性最高的十分位患者为35%。危险评分结合16项临床常规变量的降序排序是:年龄、左心室射血分数、吸烟、白细胞计数、糖尿病、随机血糖浓度、肌酐浓度、既往卒中病史、1周至少1次心绞痛发作、冠状动脉造影发现(如果能够获得)、降脂治疗、QT间期、收缩期血压≥150mmHg、抗心绞痛药物数量、陈旧性心肌梗死以及性别。把这个模型分别应用于任何原因所致的死亡、心肌梗死和卒中进行预测评估,所得的结果相似。危险评分似乎不能预测事件性质(39%的死亡、46%心肌梗死以及15%致残性卒中)或者冠状动脉造影或血管重建率(占29%的患者)。结论该危险评分对客观地决定稳定性心绞痛患者进一步治疗措施以减少重要预后事件发生是有帮助的。该危险评分同样可以用于将来的计划性试验。

关键词：陈旧性心肌梗死心绞痛患者稳定性心绞痛冠状动脉造影危险评分随机试验血管重建治疗措施卒中预测

Open Scrotal Trauma complicated by Testicular Evisceration: An Unusual Injury after a Brawl in 2 cases

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Open Journal of Urology 2024年第5期14卷 282-289页

作者： Atangana cédric Paterson Savom Eric Patrick tim Fabrice Dikongue Diwondi Audrey Ngapanya Youssofa Etobe cécile Akoa Manga Ismael Fodoung Wamba Danny Bang Guy Aristide Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaound&#233 Cameroon Department of Surgery General Hospital Yaounde Yaounde Cameroon Department of Visceral Surgery Yaound&#233 Central Hospital Yaounde Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Department of Surgery Yaound&#233 University Hospital Yaounde Cameroon

Background: Scrotal trauma is a rare injury, and can compromise reproductive function. If in closed trauma, a morphological assessment of the lesion is usually necessary before treatment, in open trauma otherwise, namely in the case of testicular evisceration, surgical exploration is the rule. Objective: To present the management of open scrotal trauma. case Presentation: These were two adults aged 42 and 63, admitted for post-traumatic testicular evisceration. One of the patients presented with signs of infection due to a diagnosis delay. Management consisted on surgical exploration, with scrotal debridement and testicular reintegration. The evolution was favourable. conclusion: Open scrotal trauma is a rare lesion that can cause testicular evisceration. It requires surgical exploration, which should be systematic.

关键词： Scrotal Trauma Testicular Evisceration Infection Surgical Exploration

The Dallas Donation after circulatory Death Transplantation Summit:expanding donation after circulatory death procedures through process improvement,broader utilization,and innovation

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Hepatobiliary Surgery and Nutrition 2024年第5期13卷 824-836,I0009页

作者： Michele Finotti Anji Wall Anthony D’Alessandro Gary Schwartz chris Sonnenday David Goldberg Ashish Shah Peter Friend Jeff P.Orlowski Greg McKenna Steve Newton Brad Adams William c.chapman Amit Mathur Marwan Abouljoud tim Pruett Amelia Hessheimer James F.Trotter Sumeet K.Asrani Giuliano Testa Simmons Transplant Institute Baylor University Medical CenterDallasTXUSA Hepatobiliary and General Surgery Unit Regional Hospital TrevisoDISCOGUniversity of PaduaPaduaItaly Division of Transplantation Department of SurgeryUniversity of Wisconsin School of Medicine and Public HealthMadisonWIUSA Department of Thoracic Surgery and Lung Transplantation Baylor University Medical CenterCenter for Advanced Heart and Lung DiseaseDallasTXUSA Department of Surgery University of MichiganAnn ArborMIUSA Division of Digestive Health and Liver Diseases Department of MedicineUniversity of Miami Miller School of MedicineMiamiFLUSA Department of cardio-Thoracic Surgery Vanderbilt University Medical CenterNashvilleTNUSA Nuffield Department of Surgical Sciences University of OxfordOxfordUK LifeShare Transplant Donor Services of Oklahoma Oklahoma CityOKUSA Administration Baylor University Medical CenterDallasTXUSA Southwest Transplant Alliance DallasTXUSA Department of Surgery/Transplantation Washington UniversitySt.LouisMOUSA Division of Transplant Surgery Department of SurgeryMayo Clinic ArizonaAlix School of MedicinePhoenixAZUSA Divisions of Transplant and Hepatobiliary Surgery Henry Ford HospitalDetroitMIUSA Department of Surgery University of MinnesotaMinneapolisMNUSA General and Digestive Surgery Hospital Universitario La PazIdiPAZMadridSpain

Despite a significant increase in utilization over the past decade,the number of donation after circulatory death(DcD)organs that are procured and transplanted in the United States(US)remains well below its *** is still room for expansion,as utilizing DcD organs to the fullest extent is currently the most viable solution to the persistent mismatch between supply and demand in *** convened a multidisciplinary transplantation summit to examine various aspects of DcD,with faculty members from around the world with clinical and academic interest in DcD donation and transplantation,including abdominal and cardiothoracic surgeons,organ procurement organization directors,hepatologists,and *** conference focused on identifying barriers to DcD organ utilization and strategies to overcome these *** divide the barriers to DcD utilization into three mains categories:(Ⅰ)policy and process variation;(II)logistical and transportation challenges;and(Ⅲ)higher risk perceptions related to DcD *** each barrier,we proposed a variety of solutions,providing an overview of the status of DcD donation in the US and suggestions on how to increase the use of *** is a specific focus on ex situ machine perfusion,normothermic regional perfusion,and other opportunities to expand DcD utilization without negatively impacting recipient outcomes.

关键词： Donation after circulatory death donation(DcD donation) marginal graft donor pool machine perfusion(MP)

A framework for the extended evaluation of ABAc policies

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cybersecurity 2019年第1期2卷 117-137页

作者： charles Morisset tim A.c.Willemse Nicola Zannone Newcastle University NewcastleTyneUK Eindhoven University of Technology P.O.Box 5135600 MBEindhovenNetherlands

A main challenge of attribute-based access control(ABAc)is the handling of missing *** studies have shown that the way standard ABAc mechanisms,*** on XAcML,handle missing information is flawed,making ABAc policies vulnerable to attribute-hiding *** work has addressed the problem of missing information in ABAc by introducing the notion of extended evaluation,where the evaluation of a query considers all queries that can be obtained by extending the initial *** method counters attribute-hiding attacks,but a na飗e implementation is intractable,as it requires an evaluation of the whole query *** this paper,we present a framework for the extended evaluation of ABAc *** framework relies on Binary Decision Diagram(BDDs)data structures for the efficient computation of the extended evaluation of ABAc *** also introduce the notion of query constraints and attribute value power to avoid evaluating queries that do not represent a valid state of the system and to identify which attribute values should be considered in the computation of the extended evaluation,*** illustrate our framework using three real-world policies,which would be intractable with the original method but which are analyzed in seconds using our framework.

关键词： Attribute-based access control Policy evaluation Missing attributes Attribute power Attribute-hiding attacks

The Flemish Performance-based Research Funding System: A Unique Variant of the Norwegian Model

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Journal of Data and Information Science 2018年第4期3卷 45-60页

作者： tim c.E.Engels Raf Guns centre for R&D Monitoring (EcOOM) Faculty of Social Science University of Antwerp

The BOF-key is the performance-based research funding system that is used in Flanders, Belgium. In this paper we describe the historical background of the system, its current design and organization, as well as its effects on the Flemish higher education landscape. The BOFkey in its current form relies on three bibliometric parameters: publications in Web of Science, citations in Web of Science, and publications in a comprehensive regional database for SSH publications. Taken together, the BOF-key forms a unique variant of the Norwegian model: while the system to a large extent relies on a commercial database, it avoids the problem of inadequate coverage of the SSH. Because the bibliometric parameters of the BOF-key are reused in other funding allocation schemes, their overall importance to the Flemish universities is substantial.

关键词： Performance-based research funding systems Flanders(Belgium) Norwegian model Web of Science VABB-SHW

Understorey species distinguish late successional and ancient forests after decades of minimum human intervention: A case study from Slovenia

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Forest Ecosystems 2023年第1期10卷 92-101页

作者： Mirjana Sipek tim Ravnjak Nina Sajna University of Maribor Faculty of Natural Sciences and MathematicsKoroska c.1602000MariborSlovenia

The main species composition drivers in temperate deciduous forests are environmental conditions, a stand?s age and the site history, e.g., the succession stage and past land use, as well as disturbance regime and current management. We compared plant species diversity and composition in late successional and ancient forests, cooccurring on the same small river island applying species accumulation curves and nonmetric multidimensional scaling, respectively. Given the island?s geomorphological characteristics, we expected these to be very similar before human intervention in the past. The forests experienced differing disturbance regimes in the past, while over the last 30 years, human intervention has been the same and reduced to a minimum. The ancient forest in this study had two major characteristics defining it as old, mature forest: continuity of presence for more than 200years and specific composition. The late successional forest experienced major disturbance in the 20th century and was allowed natural regeneration by bordering on the ancient forest, representing a potential species pool,and by decades of minimum human intervention. Our results showed that, even though there was no difference in species richness, we could still detect differences between the forests, particularly in the abundance and species composition of the understorey, among which geophytes had the most indicative importance. To make our results useful on a broader scale, we composed from the literature a species list of plants indicative for ancient forest and tested its application. These results are important for distinguishing between old and mature secondary stands and particularly for identifying old forest stands, which should be conserved and, in the case of fragmented landscapes, included in a network connecting forest fragments.

关键词： Forest community Successional forest Indicator plants Plant diversity Understorey Geophytes

Intestinal eosinophils:characterization of elusive granulocytes as anti-bacterial and immunomodulatory effector cells in colitis

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Signal Transduction and Targeted Therapy 2023年第9期8卷 3904-3906页

作者： tim Holland Jochen Mattner Mikrobiologisches Institut-Klinische Mikrobiologie Immunologie und HygieneUniversitätsklinikum Erlangen and Friedrich-Alexander-Universität(FAU)Erlangen-NürnbergErlangenGermany Medical Immunology campus Erlangen FAU Erlangen-NürnbergErlangenGermany

In a recent study published in Nature,Gurtner and colleagues identify active eosinophils(A-Eos)as eosinophil subset with anti-bacterial and immune regulatory functions during intestinal disease.1 Due to the combination of human singe cell transcip-tomics with pre-clinical experimental studies,the authors suggest eosinophils as promising targets for clinical intervention in inflammatory bowel disease(IBD).Eosinophils are known to exhibit versatile functions at mucosal ***,they can sustain the intestinal epithelial barrier as well as intestinal tissue architecture,communicate with other cell subsets and regulate local immune responses.2 However,despite having been associated with a panoply of different diseases including eosinophilic esophagitis or IBD,3 their role and plasticity in gastrointestinal disorders have not been well characterized.

关键词： eosinophils clinical diseases

Multi-scale drivers of soil resistance predict vulnerability of seasonally wet meadows to trampling by pack stock animals in the Sierra Nevada,USA

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Ecological Processes 2020年第1期9卷 364-377页

作者： Joy S.Baccei Mitchel P.Mcclaran tim J.Kuhn Stephen c.Hart Environmental Systems Graduate Group University of CaliforniaMercedCA 95343USA Uc Merced Vernal Pools and Grassland Reserve UC Merced Natural Reserve SystemMercedCA 95343USA School of Natural Resources and the Environment University of ArizonaTucsonAZ 85721USA Resources Management and Science Yosemite National ParkEl PortalCA 95318USA Department of Life&Environmental Sciences and Sierra Nevada Research Institute University of CaliforniaMercedCA 95343USA.

Background:Meadow ecosystems have important ecological functions and support socioeconomic services,yet are subject to multiple stressors that can lead to rapid *** the Sierra Nevada of the western USA,recreational pack stock(horses and mules)use in seasonally wet mountain meadows may lead to soil trampling and meadow degradation,especially when soil water content is high and vegetation is ***:In order to improve the ability to predict meadow vulnerability to soil disturbance from pack stock use,we measured soil resistance(SR),which is an index of vulnerability to trampling disturbance,at two spatial scales using a stratified-random sampling *** then compared SR to several soil and vegetation explanatory variables that were also measured at the two spatial scales:plant community type(local scale)and topographic gradient class(meadow scale).Results:We found that local-scale differences in drivers of SR were contingent on the meadow scale,which is important because multiple spatial scale evaluation of ecological metrics provides a broader understanding of the potential controls on ecological processes than assessments conducted at a single spatial *** also found two contrasting explanatory models for drivers of SR at the local scale:(1)soil gravimetric water content effects on soil disaggregation and(2)soil bulk density and root mass influence on soil *** resistance was insufficient to sustain pack stock use without incurring soil deformation in wet plant communities,even when plant cover was maximal during a major ***:Our study provides new information on seasonally wet meadow vulnerability to trampling by pack stock animals using multi-scale drivers of SR,including the contrasting roles of soil disaggregation,friction,and *** work aims to inform meadow management efforts in the Sierra Nevada and herbaceous ecosystems in similar regions that are subject to seasonal soil saturation and livestock u

关键词： Hydrogeomorphic classification Hydrologic regime Pack stock Plant communities Soil properties Soil strength

A Model of the Sea-Land Transition of the Mean Wind Profile in the Tropical cyclone Boundary Layer considering climate changes

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International Journal of Disaster Risk Science 2023年第3期14卷 413-427页

作者： Jiayao Wang tim K.T.Tse Sunwei Li Jimmy cHFung Department of civil and Environmental Engineering The Hong Kong University of Science and TechnologyHongKong999077China Shenzhen International Graduate School Tsinghua UniversityShenzhen518055China Department of Mathematics The Hong Kong University of Science and TechnologyHongKong 999077China

The tropical cyclone boundary layer(TcBL)connecting the underlying terrain and the upper atmosphere plays a crucial role in the overall dynamics of a tropical cyclone *** tropical cyclones approach the coastline,the wind field inside the TcBL makes a sea-land transition to impact both onshore and offshore *** better understanding of the wind field inside the TcBL in the sea-land transition zone is of great *** this end,a semiempirical model that integrates the sea-land transition model from the Engineering Sciences Data Unit(ESDU),Huang's refined TcBL wind field model,and the climate change scenarios from the coupled Model Intercomparison Project Phase 6(cMIP6)is used to investigate the influence of climate changes on the sea-land transition of the TcBL wind flow in Hong *** specifically,such a semiempirical method is employed in a series of Monte-carlo simulations to predict the wind profiles inside the TcBL across the coastline of Hong Kong under the impact of future climate *** wind profiles calculated based on the Monte-carlo simulation results reveal that,under the influences of the most severe climate change scenario,slightly higher and significantly lower wind speeds are found at altitudes above and below 400 m,respectively,compared to the wind speeds recommended in the Hong Kong Wind code of *** findings imply that the wind profile model currently adopted by the Hong Kong authorities in assessing the safety of low-to high-rise buildings may be unnecessarily over-conservative under the influence of climate *** the other hand,the coded wind loads on super-tall buildings slightly underestimate the typhoon impacts under the severe climate change conditions anticipated for coastal southern china.

关键词： climate change Hong Kong Sea-land transition Tropical cyclone boundary layer Wind speed profile