检索结果-南通市图书馆

Factors associated with refractory pain in emergency patients admitted to emergency general surgery

World Journal of Emergency Medicine 2021年第1期12卷 12-17页

作者： william gilliam Jackson FBarr Brandon Bruns Brandon Cave Jordan Mitchell Tina Nguyen Jamie Palmer Mark Rose Safura Tanveer Chris Yum Quincy K.Tran Johns Hopkins University Baltimore 21218USA Research Associate Program in Emergency Medicine and Critical Care Department of Emergency MedicineUniversity of Maryland School of MedicineBaltimore 21201USA R Adams Cowley Shock Trauma Center University of Maryland School of MedicineBaltimore 21201USA Department of Surgery University of Maryland School of MedicineBaltimore 21201USA Louisiana State University Louisiana 70803USA University of Maryland School of Medicine Baltimore 21201USA Department of Emergency Medicine University of Maryland School of MedicineBaltimore 21201USA

BACKGROUND: Oligoanalgesia in emergency departments (EDs) is multifactorial. A previousstudy reported that emergency providers did not adequately manage patients with severe paindespite objective findings for surgical pathologies. Our study aims to investigate clinical andlaboratory factors, in addition to providers’ interventions, that might have been associated witholigoanalgesia in a group of ED patients with moderate and severe pains due to surgical ***: We conducted a retrospective study of adult patients who were transferred directlyfrom referring EDs to the emergency general surgery (EGS) service at a quaternary academic centerbetween January 2014 and December 2016. Patients who were intubated, did not have adequaterecords, or had mild pain were excluded. The primary outcome was refractory pain, which wasdefi ned as pain reduction <2 units on the 0–10 pain scale between triage and ED ***: We analyzed 200 patients, and 58 (29%) had refractory pain. Patients with refractory painhad signifi cantly higher disease severity, serum lactate (3.4±2.0 mg/dL vs. 1.4±0.9 mg/dL, P=0.001), and lessfrequent pain medication administration (median [interquartile range], 3 [3–5] vs. 4 [3–7], P=0.001), whencompared to patients with no refractory pain. Multivariable logistic regression showed that the number of painmedication administration (odds ratio [OR] 0.80, 95% confi dence interval [95% CI] 0.68–0.98) and ED serumlactate levels (OR 3.80, 95% CI 2.10–6.80) were signifi cantly associated with the likelihood of refractory ***: In ED patients transferring to EGS service, elevated serum lactate levelswere associated with a higher likelihood of refractory pain.

关键词： Serum lactate Refractory pain Emergency general surgery Emergency department

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Simulated N and S deposition affected soil chemistry and understory plant communities in a boreal forest in western Canada

引用

Journal of Plant Ecology 2018年第4期11卷 511-523页

作者： Kangho Jung Jin-Hyeob Kwak Frank S.gilliam Scott X.Chang Department of Renewable Resources University of Alberta442 Earth Sciences BuildingEdmontonAlberta T6G 2E3Canada Divsion of Soil and Fertilizer Department of Agricultural EnvironmentNational Academy of Agricultural ScienceWansan-guJeonju-siJeollabuk-do 54875Republic of Korea Department of Biological Sciences Marshall UniversityHuntingtonWest Virginia 25755-2510USA

Aims We conducted a simulated nitrogen(N)and sulfur(S)deposition experi-ment from 2006 to 2012 to answer the following questions:(i)does chronic N and S deposition decrease cation concentrations in the soil and foliage of understory plant species,and(ii)does chronic N and S deposition decrease plant diversity and alter species composition of the understory plant community in a boreal forest in western Canada where intensifying industrial activities are increasing N and S deposition?Methods Our field site was a mixedwood boreal forest stand located~100 km southeast of Fort McMurray,Alberta,*** experiment involved a 2×2 factorial design,with two levels each of N(0 and 30 kg N ha−1 yr−1;applied as NH4NO3)and S addition(0 and 30 kg S ha−1 yr−1;applied as Na2SO4).Four blocks were established in July 2006,each with four plots of 20×20 m randomly assigned to the *** and understory vegetation were sampled and cover(%)of individual species of herb(height≤0.5 m)and shrub(height 0.5-1 m)layers was determined in August *** Findings Seven years after the treatments began,N addition increased dissolved organic carbon and N in the mineral soil(P<0.05),whereas S add-ition decreased exchangeable cations(P<0.05)in the forest *** the shrub layer,species evenness,and overall diversity were decreased by N addition(P<0.05)due to increases in abundance of nitrophil-ous species and S addition(P<0.01)due to decreased cation con-centrations in *** shrub cover decreased with S addition(P<0.10).Nitrogen and S addition affected neither species richness nor evenness in the herb ***,permutational multivariate ana-lysis of variance and non-metric multidimensional scaling analyses(based on plant cover)indicated that the effect of N and S addition on understory plant species composition in the both shrub and herb layers was *** of N decreased foliar phosphorus and potassium concentrations in some species,suggesting potential

关键词： species diversity nutrient imbalance cation leaching understory foliar chemistry acid deposition soil acidification

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Approaches to antiretroviral therapy in China

引用

Cell Research 2005年第Z1期15卷 895-902页

作者： Bruce L gilliam Robert R REDFIELD Division of Clinical Care and Research Institute of Human Virology University of Maryland Baltimore MD 21201 USA

China has recognized the threat of HIV to its population and responded with a national antiretroviral treatment (ART) program. However, high ART failure rates and the spread of resistance within populations are important realities to consider when developing and managing ART programs in China and worldwide. Concepts which will define treatment success and local and national programmatic goals are 1) access to ART, 2) durability of ART at the patient level, 3) scalability of treatment modalities, and the 4) sustainability of the program at the community or national level. In the face of limited resources, China must also consider when to start ARV therapy, which agents to use, when to switch them, and how to treat highly experienced patients with drug resistance. The optimal ARV regimen to start with is changing frequently with the introduction of new agents and the presentation of new data. Currently, a regimen including tenofovir, emtricitabine or lamivudine and a nonnucleoside reverse transcriptase inhibitor appears to have optimal characteristics to treat HIV/AIDS in China. However, critical to all of these choices is the evaluation of programs implemented to insure wide scale success. China has wisely begun this process of evaluating the perfor- mance of local programs through systematic monitoring and evaluation of treatment outcomes. This will allow regi- mens and programs that work to be expanded, and programs with high failure rates to be eliminated. In the end, evidence based data supporting treatment strategies will allow China to successfully confront its AIDS epidemic early and prevent its tragic consequences

关键词： antiretroviral therapy scalability HIV/AIDS.

来源：

同方期刊数据库评论

在线全文

同方期刊数据库

学校读者我要写书评

暂无评论

Commentary on “Prevalence and evolution of drug resistance HIV-1 vari-ants in Henan, China”

引用

Cell Research 2005年第Z1期15卷 850-851页

作者： Bruce L gilliam Robert R REDFIELD Richard Y ZHAO Robert C GALLO Institute of Human Virology University of Maryland Baltimore MD 21201 USA Institute of Human Virology University of Maryland Baltimore MD 21201 USA Department of Microbiology-Immunology University of Maryland School of Medicine Baltimore MD 21201 USA Institute of Human Virology University of Maryland Baltimore MD 21201 USA .Department of Pathology University of Maryland School of Medicine Baltimore MD 21201 USA

Critical to the implementation and scale-up of successful antiretroviral therapy worldwide is an understanding of the effcacy, toxicitie and durability of antiretroviral regimens in the specific populations, which the... 详细信息

关键词： HIV Commentary on Prevalence and evolution of drug resistance HIV-1 vari-ants in Henan

来源：

同方期刊数据库评论

在线全文

同方期刊数据库

学校读者我要写书评

暂无评论

谷歌高调重启其数字图书馆计划——上千万图书被收录

引用

海外英语 2010年第1期 34-35页

作者： Jason gilliam 刘云溪不详安徽大学外语学院

近来谷歌网上图书馆与中国著作权人的纠纷引起多方关注．其实早在2004年．谷歌便已经开始了建设“世界上最大的数字图书馆”的计划。2005年．美国作家协会和一些美国出版商共同起诉谷歌．在两年多的争辩后．2008年10月最终以宣告谷歌与... 详细信息

近来谷歌网上图书馆与中国著作权人的纠纷引起多方关注．其实早在2004年．谷歌便已经开始了建设“世界上最大的数字图书馆”的计划。2005年．美国作家协会和一些美国出版商共同起诉谷歌．在两年多的争辩后．2008年10月最终以宣告谷歌与原告达成庭外和解收场。那么。此次谷歌数字图书馆计划究竟是在什么样的背景下获得英国出版界的支持．又将产生怎样的影响呢？

关键词：数字图书馆计划收录网上图书馆著作权人庭外和解作家协会出版商出版界

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

“Bradford”梨的嫩枝扦插繁殖

引用

国外农学（果树） 1989年第2期 13-16页

作者： gilliam C.H. 张运涛

引言 Bradford梨是近年来美国许多地区用实生繁殖供人们观赏的风景树。其幼树生长健壮,中等大小,紧凑,呈金字塔形,随树龄增大变成阔卵圆形,生产上一般用中国豆梨作基砧繁殖梨苗。嫩枝扦插繁殖有两方面的好处:一是‘Bradford’梨芽接具... 详细信息

引言 Bradford梨是近年来美国许多地区用实生繁殖供人们观赏的风景树。其幼树生长健壮,中等大小,紧凑,呈金字塔形,随树龄增大变成阔卵圆形,生产上一般用中国豆梨作基砧繁殖梨苗。嫩枝扦插繁殖有两方面的好处:一是‘Bradford’梨芽接具有不亲合性,此外,嫩枝扦插可以降低生产成本。

关键词： Bradford梨繁殖观尝树

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

大脑“垃圾”清理战

引用

小学教学研究 2017年第33期 53-53页

作者： gilliam

头昏脑涨、记忆力减退、烦躁易怒……这可能是因为你的大脑"垃圾"太多了。此时最好的做法就是清理大脑里的"垃圾",甚至给大脑"洗个澡"。侧卧有助于大脑自我清理经过一天的辛苦工作,人的大脑会产生各种废物,除了会严重影响大脑的正常运转... 详细信息

头昏脑涨、记忆力减退、烦躁易怒……这可能是因为你的大脑"垃圾"太多了。此时最好的做法就是清理大脑里的"垃圾",甚至给大脑"洗个澡"。侧卧有助于大脑自我清理经过一天的辛苦工作,人的大脑会产生各种废物,除了会严重影响大脑的正常运转外,还可能诱发阿尔茨海默症和其他重大精神疾病。而大脑内的类淋巴系统可以通过一系列的清理和溶解,确认并处理掉大脑里的废物。研究者运用核磁共振成像技术,研究不

关键词：淋巴系统脑脊液

来源：

同方期刊数据库评论

在线全文

同方期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：