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The Effect on physician Interpretation after Ultrasound Video Transmission

Open Journal of Emergency Medicine 2017年第2期5卷 25-36页

作者： Eric Zevallos Joseph Coppiano Ann Marie Kuchinski Taylor Mueller bradley White patrick Loeffler Zachary Farmer patricia Hall Matt Lyon Emergency Medicine and Hospitalist Services Department Medical College of Georgia Augusta Georgia USA

Title: The Effect on physician Interpretation After Ultrasound Video Transmis-sion. Objective: There is a limited amount of qualified sonographers, which is problematic to rural, and prehospital settings that require clinical ultrasound. One solution is the use of telemedicine to transmit ultrasound videos to a distant expert. Our objective was to determine the effect of video image transfer using Skype on physician image interpretation. Methods: Three emergency medicine physicians of varied ultrasound proficiency were given 72 pairs of transmitted and non-transmitted ultrasound video clips in random order. Raters were instructed to determine whether ultrasound clips were positive or negative for pathology. Same interpretations between video pairs were categorized as homodiagnostic while different interpretations were categorized as heterodiagnostic. Raters were also asked to rate the image resolution, image detail, and total image quality using a 10-point Likert scale. For the diagnostic results, rater agreement, accuracy, sensitivity, and specificity were calculated. Results: The raters collectively demonstrated high agreement (92.1%), sensitivity (96.3%), specificity (92.8%), and accuracy (94.1%). Raters 1 (95.8%, κ = 0.912) and 3 (97.2%, κ = 0.942) had near perfect agreement, while rater 2 (83.3%, κ = 0.666) had substantial agreement. Only raters 1 and 3 detected a decrease in image resolution, image detail, and total image quality (p Conclusions: This study demonstrates that transmission via Skype has minimal effect on a physician’s interpretation of an ultrasound video. The implications of these results are that ultrasound video transmission can be used to improve access to specialists without compromising accuracy which will ultimately increase patients’ quality of care.

关键词： Ultrasound Telemedicine Emergency Medicine Transmission Skype

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p2z受体在介导慢性淋巴细胞白血病细胞凋亡中的作用

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中华血液学杂志 1998年第8期19卷 398-401页

作者：彭黎明 CJ bradley JS Wiley 华西医科大学第一附属医院澳大利亚墨尔本大学医学院ＡＵＳＴＩＮ医院血液科

目的：研究嘌呤能Ｐ２ｚ受体在介导慢性淋巴细胞白血病（ＣＬＬ）细胞凋亡中的作用。方法：将表达Ｐ２ｚ受体［Ｐ２ｚ（＋）］与不含Ｐ２ｚ受体［Ｐ２ｚ（－）］的两组ＣＬＬ细胞分别同１．０ｍｍｏｌ／Ｌ三磷酸腺苷（ＡＴＰ）体外培养... 详细信息

目的：研究嘌呤能Ｐ２ｚ受体在介导慢性淋巴细胞白血病（ＣＬＬ）细胞凋亡中的作用。方法：将表达Ｐ２ｚ受体［Ｐ２ｚ（＋）］与不含Ｐ２ｚ受体［Ｐ２ｚ（－）］的两组ＣＬＬ细胞分别同１．０ｍｍｏｌ／Ｌ三磷酸腺苷（ＡＴＰ）体外培养８小时，以电镜、ＤＮＡ凝胶电泳和定量ＤＮＡ３′端ＴｄＴ法检测细胞凋亡；并对ＡＴＰ、苯甲酰苯甲酸ＡＴＰ（ＢｚＡＴＰ）、２甲基硫ＡＴＰ（２ＭｅＳＡＴＰ）、γ硫代ＡＴＰ（ＡＴＰγＳ）及其它核苷的诱导效应和氧化型ＡＴＰ（ＯｘＡＴＰ）、１［Ｎ，Ｏ二（５异喹啉碘酰基）Ｎ甲基Ｌ酪氨酰］４苯哌嗪（ＫＮ６２）的抑制效应做定量研究。结果：①Ｐ２ｚ＋细胞能在ＡＴＰ诱导下呈现典型的细胞凋亡形态和ＤＮＡ梯形条带；②不同的Ｐ２ｚ受体激活剂可通过Ｐ２ｚ受体诱导细胞凋亡并产生不同量的ＤＮＡ降解片段，诱导能力的强弱顺序是ＢｚＡＴＰ＞ＡＴＰ＞２ＭｅＳＡＴＰ，而ＡＴＰγＳ或其它核苷几乎无诱导能力；③ＯｘＡＴＰ和ＫＮ６２可完全阻止诱导剂诱导的细胞凋亡。

关键词：白血病 CLL 细胞凋亡 p2z受体嘌呤能受体

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Modified rives-stoppa repair for abdominal incisional hernias

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Health 2010年第2期2卷 162-169页

作者： peter Nau Clancy J. Clark Mason Fisher Gregory Walker bradley J. Needleman E. Christopher Ellison peter Muscarella 不详

Incisional hernias are a prevalent problem in abdominal surgery and occur in 11% of patients who undergo laparotomy. primary suture clo-sure of incisional hernias results in a 31%-58% chance of recurrence. The addition of a pros-thetic mesh implant decreases recurrence rates to 8%-10%. popularized in Europe by Rives and Stoppa, the sublay technique has proven to be very effective, with low recurrence rates (0%-23%) and minimal complications. The pur-pose of the study was to evaluate the experi-ence of a single surgeon at a large tertiary care center performing a modified Rives-Stoppa re-pair for abdominal incisional hernias. To do this, the records of all patients undergoing a modi-fied Rives-Stoppa incisional hernia repair be-tween January 2000 and August 2003 were ret-rospectively reviewed. Outpatient clinic notes, discharge summaries, operative reports, and laboratory data were reviewed for patient demographics, surgical data and postoperative complications. Univariate analysis was per-formed in order to identify predictors for recur-rence. During the study period, 83 patients un-derwent a modified Rives-Stoppa incisional hernia repair. Nineteen patients were excluded due to incomplete medical records. No patients required postoperative exploration for an in-tra-abdominal catastrophe. Twenty-five percent (n=16) of patients had a complication as a result of the hernia repair. Only two patients (3.1%) developed recurrent incisional hernias. History of diabetes (p=0.007) and benign prostatic hy-perplasia (p=0.000) were the only significant predictors for recurrence. The results presented here confirm that the modified Rives-Stoppa retromuscular repair is an effective method for the repair of incisional hernias. The complica-tion and recurrence rates compare favorably to results for currently popular alternative tech-niques.

关键词： Incisional Hernia Repair Mesh Rives-Stoppa Repair Abdominal Wall Defects

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先天性腭裂儿童中枢性听觉处理能力的行为测听研究

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广东牙病防治 2015年第9期23卷 476-479页

作者：杨峰束煌丁桂聪 bradley Mcpherson 深圳市儿童医院口腔科广东深圳518000 香港大学言语及听觉科学系

目的研究先天性腭裂儿童的中枢性听觉处理能力是否存在障碍。方法对34例先天性腭裂儿童进行中枢听觉处理能力测验并与对照组30名正常儿童比较,测验采用噪音下语言感知测试(hearing in noise test,HINT)、音调花样序列测试(pitch pattern... 详细信息

目的研究先天性腭裂儿童的中枢性听觉处理能力是否存在障碍。方法对34例先天性腭裂儿童进行中枢听觉处理能力测验并与对照组30名正常儿童比较,测验采用噪音下语言感知测试(hearing in noise test,HINT)、音调花样序列测试(pitch pattern sequence test,ppST)以及双耳数字分听测试(dichotic digits test,DDT),观察各项测验结果差异是否具有统计学意义。结果 HINT测试(安静条件)腭裂组与对照组结果分别为(10.48±2.12)分贝及(9.82±2.27)分贝,两组间差异无统计学意义(Z=-0.93,p=0.360);而噪音条件下的HINT测试结果为腭裂组(-5.61±1.80)分贝,对照组(-9.01±1.49)分贝,腭裂组弱于对照组(Z=-5.31,p=0.005);ppST测试结果为腭裂组(94.23±2.81)分(左耳)、(93.13±3.42)分(右耳),对照组(97.65±2.88)分(左耳)、(96.97±3.45)分(右耳),腭裂组得分均低于对照组(左耳Z=-2.18,p=0.019;右耳Z=-4.41,p=0.026);DDT测试结果为腭裂组(90.54±2.22)分,对照组(96.89±2.04)分,腭裂组得分较低(Z=-3.63,p=0.011)。结论先天性腭裂儿童在噪音下的听觉感知能力降低,对高低频音调分辨能力不足,对复杂声音信息的整合能力较差,可能存在中枢性听觉障碍。

关键词：先天性腭裂听力障碍中枢性听觉处理障碍

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Impact of a pharmacist Implemented protocol on Overall Use of Alvimopan （Entereg） and Length of Stay in Laparoscopic Colorectal Surgeries

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Journal of pharmacy and pharmacology 2016年第10期4卷 521-525页

作者： Halle M. Orlinski Rachana R. patel bradley J. Champagne Joseph A. Trunzo Karen L. Kier University Hospitals St. John Medical Center Westlake Ohio 44145 USA

The primary objective of this study is to assess the impact of a pharmacist-implemented protocol on number of post-operative alvimopan doses. The secondary objective of this study is to assess LOS （length of stay）, in days, before and after protocol implementation. A retrospective chart review was conducted from October 2015 through March 2016 for all laparoscopic colorectal surgeries. Number of post-operative alvimopan doses received and LOS was recorded for each patient that received at least one dose of alvimopan. Comparative data, before protocol implementation, from November 2014 through June 2015 were analyzed against the study data. Number of post-operative alvimopan doses and LOS were recorded. The mean number of doses was 6.41 in the comparator group and 4.25 in the study group （probability size p 〈 0.001）, which did meet statistical significance. Although the secondary objective was not statistically significant, LOS slightly decreased as the mean LOS was 5.01 days in the comparator group versus 4.49 days in the study group （p = 0.256）. At the current price of $120 per capsule, close to $30,000 was saved during the study period, projecting an annual cost savings of approximately $68,000. Results from this study show that pharmacists can play a vital role in cost savings and ensuring appropriate use of certain high-risk medications, like alvimopan, without increasing overall length of stay.

关键词： Alvimopan pharmacist-implemented colorectal cost savings.

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Nucleoside reverse transcriptase inhibitors and Kamuvudines inhibit amyloid-βinduced retinal pigmented epithelium degeneration

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Signal Transduction and Targeted Therapy 2021年第5期6卷 1526-1534页

作者： Siddharth Narendran Felipe pereira praveen Yerramothu Ivana Apicella Shao-bin Wang Kameshwari Ambati Shuichiro Hirahara Younghee Kim Meenakshi Ambati Vidya L.Ambati peirong Huang Akhil Varshney Yosuke Nagasaka Shinichi Fukuda Kirstie L.Baker Kenneth M.Marion Jan M.Deussing Srinivas R.Sadda bradley D.Gelfand Jayakrishna Ambati Center for Advanced Vision Science University of Virginia School of MedicineCharlottesvilleVAUSA Department of Ophthalmology University of Virginia School of MedicineCharlottesvilleVAUSA Aravind Eye Care System MaduraiIndia Departamento de Oftalmologia e Ciências Visuais Escola Paulista de MedicinaUniversidade Federal de São PauloSão PauloBrazil Center for Digital Image Evaluation CharlottesvilleVAUSA Doheny Eye Institute Los AngelesLos AngelesCAUSA Molecular Neurogenetics Department of Stress Neurobiology and NeurogeneticsMax Planck Institute of PsychiatryMunichGermany Department of Ophthalmology David Geffen School of MedicineUniversity of California–Los AngelesLos AngelesCAUSA Department of Biomedical Engineering University of Virginia School of MedicineCharlottesvilleVAUSA Department of pathology University of Virginia School of MedicineCharlottesvilleVAUSA Department of Microbiology Immunologyand Cancer BiologyUniversity of Virginia School of MedicineCharlottesvilleVAUSA

Nonfibrillar amyloid-βoligomers(AβOs)are a major component of drusen,the sub-retinal pigmented epithelium(RpE)extracellular deposits characteristic of age-related macular degeneration(AMD),a common cause of global *** report that AβOs induce RpE degeneration,a clinical hallmark of geographic atrophy(GA),a vision-threatening late stage of AMD that is currently *** demonstrate that AβOs induce activation of the NLRp3 inflammasome in the mouse RpE in vivo and that RpE expression of the purinergic ATp receptor p2RX7,an upstream mediator of NLRp3 inflammasome activation,is required for AβO-induced RpE *** classes of small molecule inflammasome inhibitors—nucleoside reverse transcriptase inhibitors(NRTIs)and their antiretrovirally inert modified analog Kamuvudines—both inhibit AβOs-induced RpE *** findings crystallize the importance of p2RX7 and NLRp3 in a disease-relevant model of AMD and identify inflammasome inhibitors as potential treatments for GA.

关键词： degeneration activation upstream

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Use of Three Dimensional Conformal Radiation Therapy for Node positive Breast Cancer Does Not Result in Excess Lung and Heart Irradiation

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International Journal of Medical physics, Clinical Engineering and Radiation Oncology 2017年第1期6卷 1-9页

作者： phillip prior Irina Sparks J. Frank Wilson Joseph Bovi Adam Currey Julie bradley Tracy Kelly X. Allen Li Julia R White Department of Radiation Oncology Medical College of Wisconsin Milwaukee WI USA Department of Radiation Oncology Ohio State University Columbus OH USA

purpose: This work evaluates the use of target and organs at risk (OAR) dose-volume goals in 3D conformal radiotherapy (3DCRT) planning for node positive breast cancer (NpBC) patients undergoing regional nodal irradiation after lumpectomy/mastectomy. Methods: Dosimetric data for 262 NpBC patients receiving regional nodal and whole breast/chest wall (WB/CW) irradiation from 2000-2009 were analyzed. In all cases, target & OAR volumes were delineated on treatment CT scans for field generation and dose-volume histograms (DVHs) were generated. Cases were analyzed to identify how frequently they met treatment planning institutional dose-volume goals (“institutional guidelines” & standardized in 2005) and how this would affect OAR doses. Results: The incidence of cases from 2000-2009 meeting current institutional guidelines improved over the study period. Target coverage improved from 2005-2009, when guidelines were followed as a part of the plan approval. Those cases from 2000-2004 meeting acceptable target goals were found to be significantly different from those cases from 2005-2009 (p plans from 2000-2004 versus 2005-2009 was found. Conclusions: The use of institutional guidelines in 3DCRT for WB/CW and regional nodal irradiation for NpBC patients improved target coverage without a statistically significant increase in heart and lung doses.

关键词： Node positive Breast Cancer Dose-Volume Goals Target Coverage CT Based planning

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VERNAUZATION1 Modulates Root System Architecture in Wheat and Barley

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Molecular plant 2018年第1期11卷 226-229页

作者： Kai p. Voss-Fels Hannah Robinson Stephen R. Mudge Cecile Richard Saul Newman Benjamin Wittkop Andreas Stahl Wolfgang Friedt Matthias Frisch lulian Gabur Anika Miller-Cooper bradley C. Campbell Alison Kelly Glen Fox Jack Christopher Mandy Christopher Karine Chenu Jerome Franckowiak Emma S. Mace Andrew K. Borrell Howard Eagles David R. Jordan Jose R. Botella Graeme Hammer lan D. Godwin Ben Trevaskis Rod J. Snowdon Lee T. Hickey Department of plant Breeding IFZ Research Centre for Biosystems Land Use and Nutrition Justus Uebig University Heinrich-Buff-Ring 26-32 35392 Giessen Germany Queensland Alliance for Agriculture and Food Innovation The University of Queensland St Lucia QLD 4072 Australia School of Agriculture and Food Sciences The University of Queensland Brisbane QLD 4072 Australia CSIRO Agriculture Canberra ACT 2601 Australia Department of Biometry and population Genetics IFZ Research Centre for Biosystems Land Use and Nutrition Justus Liebig University Heinrich-Buff-Ring 26-32 35392 Giessen Germany Department of Agriculture and Fisheries Leslie Research FacilRy Toowoomba QLD 4350 Australia Queensland Alliance for Agriculture and Food Innovation The University of Queensland roowoomba QLD 4350 Australia Department of Agronomy and plant Genetics University of Minnesota St Paul MN USA Department of Agriculture and Fisheries Hermitage Research Facility Warwick QLD 4370 Australia Queensland Alliance for Agriculture and Food Innovation Hermitage Research Facility The University of Queensland Warwick QLD 4370 Australia These authors contributed equally to this article.

Dear Editor Roots play a key role in plant growth regulation. It is well described that the below-ground plant architecture has a significant impact on plant performance under abiotic constraints and maintains stabili... 详细信息

关键词： TRAITS RESpONDS

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Nurse Mentor Training program to Improve Quality of Maternal and Newborn Care at primary Health Centres: process Evaluation

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Open Journal of Nursing 2016年第6期6卷 458-469页

作者： Maryann Washington Krishnamurthy Jayanna Swarnarekha Bhat Annamma Thomas Suman Rao Gayathiri perumal Troy Cunningham Janet bradley Lisa Avery Elisabeth Fischer prem K. Mony St. John’s Research Institute St. John’s National Academy of Health Sciences (SJNAHS) Bangalore India Karnataka Health promotion Trust Bangalore India Department of Community Health Sciences University of Manitoba Winnipeg Canada St. John’s Research Institute St. John’s National Academy of Health Sciences (SJNAHS) Bangalore India St. John’s Medical College Hospital SJNAHS Bangalore India St. John’s College of Nursing SJNAHS Bangalore India Intrahealth Chapel Hill USA

Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form the frontline of health care workforce have limited access to enhancing their clinical knowledge and competencies. To address this gap, a new cadre of nurse mentors (NMs) for the public health system were trained by specialists from a teaching hospital in a special 5-week training course. This included 54 hours of theory and 110 hours of practical in clinical obstetric and newborn care, apart from mentoring, quality improvement and health systems issues. The nurse mentors were assigned to support staff nurses in the primary health care centres (pHCs) in eight northern Karnataka districts. Each NM covered 6-8 pHCs monthly for 2 - 3 days and thus a total of 385 pHCs were reached. They received support in the field through supportive supervision visits done by the specialists who had trained them, as well as by refresher training and clinical postings to the district hospitals. This paper presents impact of the training program on change in immediate and long term knowledge and competency scores of nurse mentors. Their baseline knowledge scores changed from 44.3 ± 12.7 to 72.1 ± 13.8 immediately after the training in obstetric and from 18.2 ± 19.1 to 66.4 ± 14.9 in newborn (p p p > 0.05). Skills score soon after training increased from 62.2 ± 13.2 to 69.6 ± 12.5 in obstetric after a 1 year period and from 52.6 ± 9.3;63.5 ± 14.4 in newborn (p pectively. These findings have implications for those interested in improving quality of maternal and child care through nurse-dependent health delivery systems.

关键词： Nurse Mentors Skilled Birth Attendance Training program Basic Newborn Care Maternal Care primary Health Centers Quality Improvement India

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逻辑原理上第1版

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1959年

作者：（英）布拉德雷（bradley F.H.）庆泽彭译

据1922年英文版译出:书名原文:The principles of logic.

ISBN: (纸本)2017·36

据1922年英文版译出:书名原文:The principles of logic.

关键词：逻辑学科:理论

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