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Impact of pre- and peri-operative risk factors on length of stay and hospital readmission following minimally-invasive partial nephrectomy

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Asian Journal of Urology 2024年第1期11卷 72-79页

作者： Vanessa A.Lukas Rahul dutta Ashok K.Hemal Matvey Tsivian Timothy E.Craven Nicholas A.deebel david d.thiel Ram Anil Pathak Brigham and Women's Hospital Division of UrologyDepartment of Surgery75 Francis StreetBostonMAUSA Atrium Health Wake Forest Baptist Medical Center Department of Urology1 Medical Center BlvdWinston-SalemNCUSA Mayo Clinic Florida Department of Urology4500 San Pablo RoadJacksonvilleFLUSA

Objective:We conducted an analysis of the American College of Surgeons National Surgical Quality Improvement Program database for minimally-invasive partial nephrectomy cases reported with the goal to identify pre-and peri-operative variables associated with length of stay(LOS)greater than 3 days and readmission within 30 ***:Records from 2008 to 2018 for“laparoscopy,surgical;partial nephrectomy”for prolonged LOS and readmission cohorts were *** analysis with Chi-square,t-tests,and multivariable logistic regression analysis with odds ratios(ORs),p-values,and 95%confidence intervals assessed statistical ***:Totally,20306 records for LOS greater than 3 days and 15854 for readmission within 30 days were *** and multivariable analysis exhibited similar *** LOS greater than 3 days,undergoing non-elective surgery(OR=5.247),transfusion of greater than four units within 72 h prior to surgery(OR=5.072),pre-operative renal failure or dialysis(OR=2.941),and poor pre-operative functional status(OR=2.540)exhibited the strongest statistically significant *** hospital readmission within 30 days,loss in body weight greater than 10%in 6 months prior to surgery(OR=2.227)and bleeding disorders(OR=2.081)exhibited strongest statistically significant ***:Multiple pre-and peri-operative risk factors are independently associated with prolonged LOS and hospital readmission within 30 days of surgery using the American College of Surgeons National Surgical Quality Improvement Program *** the risks factors that can potentially be improved prior to minimally-invasive partial nephrectomy is crucial to informing patient selection,optimization strategies,and patient education.

关键词： Minimally-invasive partial nephrectomy The American College of Surgeons National Surgical Quality Improvement Program Lengthof stay Hospital readmission

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Making bridges between preclinical and clinical insights into age-related cognitive decline

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Neural Regeneration Research 2025年第8期20卷 2321-2322页

作者： david VC Brito Clévio Nóbrega Algarve Biomedical Center-Research Institute(ABC-RI) Campus GambelasFaroPortugal Algarve Biomedical Center-(ABC) Campus GambelasFaroPortugal Faculty of Medicine and Biomedical Sciences(FMCB) University of AlgarveGambelas CampusFaroPortugal

With people living longer,the societal impact of age-related cognitive decline is becoming more pronounced(Crimmins,2015).Thus,it is increasingly important to comprehend the cognitive shifts linked to aging-whether th... 详细信息

关键词： bridges becoming insight

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Women in visual neural regeneration research

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Neural Regeneration Research 2025年第2期20卷 489-490页

作者： Tonia S.Rex david J.Calkins Vanderbilt Eye Institute Vanderbilt University Medical CenterNashvilleTNUSA

The year 2024 marks the 60^(th)anniversary of Title IX and 25 years since the New York Times revealed bias against female faculty members at the Massachusetts Institute of *** take an opportunity here to examine the state of gender bias in a relatively new yet already prominent field,neural regeneration in the visual system,for which there is a well-defined context useful for this *** National Eye Institute(NEI)provided the first round of research funding for its Audacious Goals Initiative(AGI)on visual neural regeneration in 2013 and the last round in ***,we focus on this *** sources included PubMed,the National Science Foundation(NSF),the NEI,the Blue Ridge Institute for Medical Research and data from the major professional organization for eye and vision research,the Association for Research in Vision and Ophthalmology(ARVO).

关键词： neural visual Times

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Chemically derived graphene quantum dots for high-strain sensing

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Journal of Materials Science & Technology 2023年第10期141卷 110-115页

作者： Shujun Wang Francesco Lenzini dechao Chen Philip Tanner Jisheng Han david.thiel Mirko Lobino Qin Li Queensland Miro-and Nanotechnology Centre Griffith UniversityNathan CampusBrisbane QLD 4111Australia School of Engineering and Built Environment Griffith UniversityNathan CampusBrisbane QLD 4111Australia Centre for Quantum dynamics Griffith UniversityNathan CampusBrisbane QLD 4111Australia department of Industrial Engineering University of Trento38122Italy

Graphene quantum dots(GQds)refer to graphene fragments with a lateral dimension typically less than 100 nm,which possess unique electrical and optical properties due to the quantum confinement *** this study,we demonstrate that chemically derived graphene quantum dots show great potential for making highly stretchable and cost-effective strain sensors via an electron tunneling ***-able strain sensors are critical devices for the field of flexible or wearable electronics which are expected to maintain function up to high strain values(>30%).However,strain sensors based on conventional materials(*** or semiconductors)or metal nanoparticles(*** or silver nanoparticles)only work within a small range of strain(*** former have a working ranged the latterdy,by simply dropcasting solution-processed GQds between the interdigitated electrodes on polydimethylsiloxane,we obtained devices that can function in the range from 0.06%to over 50%ten-sile strain with both the sensitivity and working range conveniently adjustable by the concentration of GQds *** study provides a new concept for practical applications of GQds,revealing the poten-tial of this material for smart applications such as artificial skin,human-machine interfaces,and health monitoring.

关键词： Graphene quantum dots Graphene Strain Sensor Electron tunneling

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Cirrhotic ascites review: Pathophysiology, diagnosis and management

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World Journal of Hepatology 2013年第5期5卷 251-263页

作者： Christopher M Moore david H Van thiel Section of Hepatology Department of MedicineRush University Medical CenterChicagoIL 60612United States

Ascites is a pathologic accumulation of peritoneal fluidcommonly observed in decompensated cirrhotic states. Its causes are multi-factorial, but principally involve significant volume and hormonal dysregulation in the setting of portal hypertension. The diagnosis of ascites is considered in cirrhotic patients given a constellation of clinical and laboratory findings, and ultimately confirmed, with insight into etiology, by imaging and paracentesis procedures. Treatment for ascites is multimodal including dietary sodium restriction, pharmacologic therapies, diagnostic and therapeutic paracentesis, and in certain cases transjugular intra-hepatic portosystemic shunt. Ascites is associated with numerous complications including spontaneous bacterial peritonitis, hepato-hydrothorax and hepatorenal syndrome. Given the complex nature of ascites and associatedcomplications, it is not surprising that it heralds increased morbidity and mortality in cirrhotic patients and increased cost-utilization upon the health-care system. This review will detail the pathophysiology of cirrhotic ascites, common complications derived from it, and pertinent treatment modalities.

关键词： Ascites Cirrhosis Hepato-hydrothorax Hepatorenal syndrome Spontaneous bacterial peritonitis

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disease dependent qualitative and quantitative differences in the inflammatory response to ascites occurring in cirrhotics

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World Journal of Hepatology 2014年第2期6卷 85-91页

作者： Bashar M Attar Magdalena George Nicolae Ion-Nedelcu Guilliano Ramadori david H Van thiel division of Gastroenterology and Hepatology John H Stroger Hospital of Cook County Rush University Medical Center Victor Babes Infectious and Tropical disease Clinic department of Gastroenterology and Endocrinology August Georg University

AIM:To assess differing patterns and levels of ascitic fluid cyctokine and growth factors exist between those with a high risk and low risk of spontaneous bacterial peritonitis(SBP). METHOdS: A total of 57 consecutive patients with ascites requiring a large volume paracentesis were studied. Their age, gender, specific underlying disease conditions were recorded after a review of their clinical records. Each underwent a routine assessment prior to their paracentesis consisting of a complete blood count, complete metabolic profile and prothrombin time/international normalized ratio(INR) determination. The ascitic fluid was cultured and a complete cellcount and albumin determination was obtained on the fluid. In addition, blood and ascitic fluid was assessed for the levels of interleukin interleukin(IL)-1A, IL-1B, IL-2, IL-4, IL-8, IL-10, monocyte chemotactic protein(MCP)-1, tumor necrosis factor(TNF)-α, interferon(IFN)-γ, vascular endothelial growth factor(VEGF) and epidermal growth factor(EGF) utilizing the Randox Biochip platforms(Boston, MA). A serum-ascites gradient, for each cytokine and growth factor was calculated. The results are reported as mean ± SEM between disease groups with statistical analysis consisting of the student t-test(two tailed) with a P value of 0.05 defining significance. RESULTS: No clinically important demographic or biochemical differences between the 4 groups studied were evident. In contrast, marked difference in the cytokine and growth factors levels and pattern were evident between the 4 disease groups. Individuals with alcoholic cirrhosis had the highest levels of IL-1A, IL-1B, IL-4, IFNγ. Those with malignant disease had the highest levels of IL-2. Those with hepatitis C virus(HCV) associated cirrhosis had the highest value for IL-6, IL-8, IL-10, MCP-1 and VEGF. Those with cardiac disease had the highest level of TNF-α and EGF. The calculated serum- ascites gradients for the cardiac and malignant disease groups had a greater frequenc

关键词： Ascites Cirrhosis Growth factors Inflammation Procalcitonin

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ESTIMATING CROSS-TRAINING CALL CENTER CAPACITY THROUGH SIMULATION

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Journal of Systems Science and Systems Engineering 2016年第4期25卷 448-468页

作者： david A. Munoz Nathaniel d. Bastian department of Industrial and Manufacturing Engineering The Pennsylvania State University

Call centers have grown world-wide during the past decade. One of the most important aspects considered by call center managers is the optimization of its operators, which implies covering the highly variable demand and f＇mding an efficient way to assign people to certain shifts in order to achieve a desirable service level and abandonment rate. Another challenge is determining which system setup is appropriate for the specific call center. Should we have a single-skill call center or multi-skill call center？ If we do have the latter, how many multi-skill agents should we have on staff？. In this case study, we generate and analyze discrete-event systems simulation-optimization models to test the behavior of a real-world call center under the actual configuration and under different levels of cross-training. The model results help call center managers by： 1） determining the optimal number of operators needed for different staff configtmations in order to achieve the targets for service level and abandonment; 2） providing information about the trade-off between the key measurements in the call center; and 3） providing useful information about the number of operators needed and used for each hour of operation to estimate the number of four-hour shifts required to achieve the performance targets. Our experimental f＇mdings from this case study suggest that a bi-skill call center is economically better in the long-rtm compared to a full-skill or single-skill call center. This case study augments the call center body of knowledge by providing additional managerial insights for the operations management community.

关键词： Call centers cross-training discrete-event systems simulation simulation optimization service operations service systems

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An investigation of roof runoff during rain events at the Royal Military College of Canada and potential discharge to Lake Ontario

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Journal of Environmental Sciences 2011年第7期23卷 1072-1078页

作者： david G. Kelly Ron d. Weir Steven d. White Analytical Sciences Group & SLOWPOKE-2 Facility at RMC Department of Chemistry and Chemical Engineering Royal Military College of Canada 11 General Crerar Crescent

The Royal Military College of Canada, located on the north eastern shore of Lake Ontario, possesses an abundance of copper roofs and lacks surface water treatment prior to discharge into Lake Ontario. Rainwater, roof runoff and soil samples were collected and analyzed for copper and other parameters. Copper was consistently detected in runoff samples with average concentrations of 3200 ± 2100 μg/L. Multivariable linear regression analysis for a dependant copper runoff concentration yielded an adjusted R 2 value of 0.611, based on an independent variable model using minimum temperature, maximum temperature, total precipitation, and wind speed. Lake water samples taken in the vicinity of storm water outfalls draining areas with copper roofs ranged from 2.0 to 40 μg/L copper. Such data exceed the 2.0 μg/L Canadian Water Quality Guidelines for the Protection of Aquatic Life as outlined by the Canadian Council of Ministers of the Environment （CCME）. Analysis of raw, filtered and digested forms suggested that the majority of copper present in runoff and lake water samples was in a dissolved form. The majority of soils taken in this study displayed copper concentrations below the 63 μg/g CCME residential/parkland land use limits. These findings suggested that ion exchange processes between runoff water and soil do not occur to a sufficient extent to elevate copper levels in soil. It may therefore be concluded that the eventual fate of copper, which is not discharged via storm water outfalls, is lost to the water table and Lake Ontario through the sub-soil.

关键词： copper roof runoff Lake Ontario Canadian water quality guidelines for the protection of aquatic life

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Complement-dependent neuroinflammation in spinal cord injury:from pathology to therapeutic implications

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Neural Regeneration Research 2025年第5期20卷 1324-1335页

作者： Hassan Saad Bachar El Baba Ali Tfaily Firas Kobeissy Juanmarco Gutierrez Gonzalez daniel Refai Gerald R.Rodts Christian Mustroph david Gimbel Jonathan Grossberg daniel L.Barrow Matthew F.Gary Ali M.Alawieh department of Neurosurgery Emory University School of MedicineAtlantaGAUSA department of Neurology Yale UniversityNew HavenCTUSA Center for Neurotrauma Multiomics&Biomarkers(CNMB)Morehouse School of MedicineAtlantaGAUSA

Spinal cord injury remains a major cause of disability in young adults,and beyond acute decompression and rehabilitation,there are no pharmacological treatments to limit the progression of injury and optimize recovery in this *** the thorough investigation of the complement system in triggering and propagating cerebral neuroinflammation,a similar role for complement in spinal neuroinflammation is a focus of ongoing *** this work,we survey the current literature investigating the role of complement in spinal cord injury including the sources of complement proteins,triggers of complement activation,and role of effector functions in the *** study relevant data demonstrating the different triggers of complement activation after spinal cord injury including direct binding to cellular debris,and or activation via antibody binding to damage-associated molecular *** effector functions of complement have been implicated in spinal cord injury,and we critically evaluate recent studies on the dual role of complement anaphylatoxins in spinal cord injury while emphasizing the lack of pathophysiological understanding of the role of opsonins in spinal cord *** this pathophysiological review,we systematically review the different translational approaches used in preclinical models of spinal cord injury and discuss the challenges for future translation into human *** review emphasizes the need for future studies to dissect the roles of different complement pathways in the pathology of spinal cord injury,to evaluate the phases of involvement of opsonins and anaphylatoxins,and to study the role of complement in white matter degeneration and regeneration using translational strategies to supplement genetic models.

关键词： complement neuroinflammation neuroplasticity regeneration spinal cord injury targeted therapy

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Silk-based nerve guidance conduits with macroscopic holes modulate the vascularization of regenerating rat sciatic nerve

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Neural Regeneration Research 2025年第6期20卷 1789-1800页

作者： Carina Hromada Patrick Heimel Markus Kerbl LászlóGál Sylvia Nürnberger Barbara Schaedl James Ferguson Nicole Swiadek Xavier Monforte Johannes C.Heinzel Antal Nógrádi Andreas H.Teuschl-Woller david Hercher department Life Science Engineering University of Applied Sciences Technikum WienViennaAustria Austrian Cluster for Tissue Regeneration ViennaAustria Ludwig Boltzmann Institute for Traumatology The Research Center in Cooperation with AUVAViennaAustria University Clinic of dentistry Medical University of ViennaViennaAustria department of Plastic Reconstructive and Aesthetic SurgeryLandesklinikum Wiener Neustadt2700 Wiener NeustadtAustria department of Anatomy Histology and EmbryologyAlbert Szent-Györgyi Medical SchoolUniversity of SzegedSzegedHungary Medical University of Vienna Department of Orthopedics and Trauma SurgeryDevision of Trauma SurgeryViennaAustria department of Hand- PlasticReconstructive and Burn SurgeryBG Unfallklinik TuebingenUniversity of TuebingenTuebingenGermany

Peripheral nerve injuries induce a severe motor and sensory deficit. Since the availability of autologous nerve transplants for nerve repair is very limited, alternative treatment strategies are sought, including the use of tubular nerve guidance conduits(tNGCs). However, the use of tNGCs results in poor functional recovery and central necrosis of the regenerating tissue, which limits their application to short nerve lesion defects(typically shorter than 3 cm). Given the importance of vascularization in nerve regeneration, we hypothesized that enabling the growth of blood vessels from the surrounding tissue into the regenerating nerve within the tNGC would help eliminate necrotic processes and lead to improved regeneration. In this study, we reported the application of macroscopic holes into the tubular walls of silk-based tNGCs and compared the various features of these improved silk^(+) tNGCs with the tubes without holes(silk^(–) tNGCs) and autologous nerve transplants in an 8-mm sciatic nerve defect in rats. Using a combination of micro-computed tomography and histological analyses, we were able to prove that the use of silk^(+) tNGCs induced the growth of blood vessels from the adjacent tissue to the intraluminal neovascular formation. A significantly higher number of blood vessels in the silk^(+) group was found compared with autologous nerve transplants and silk^(–), accompanied by improved axon regeneration at the distal coaptation point compared with the silk^(–) tNGCs at 7 weeks postoperatively. In the 15-mm(critical size) sciatic nerve defect model, we again observed a distinct ingrowth of blood vessels through the tubular walls of silk^(+) tNGCs, but without improved functional recovery at 12 weeks postoperatively. Our data proves that macroporous tNGCs increase the vascular supply of regenerating nerves and facilitate improved axonal regeneration in a short-defect model but not in a critical-size defect model. This study suggests that further optimizatio

关键词： axon regeneration blood vessel functional recovery macroporous nerve lesion peripheral nerve repair sciatic nerve silk-based nerve guidance conduit vascularization

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