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TIC-Tox: A preliminary discussion on identifying the forcing agents of DBP-mediated toxicity of disinfected water

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Journal of Environmental Sciences 2017年第8期29卷 208-216页

作者： Michael J.Plewa elizabeth D.Wagner Susan D.Richardson Safe Global Water Institute and the Department of Crop Sciences University of Illinois at Urbana-Champaign Department of Chemistry and Biochemistry University of South Carolina

The disinfection of drinking water is a major public health achievement; however, an unintended consequence of disinfection is the generation of disinfection by-products（DBPs）. Many of the identified DBPs exhibit in vitro and in vivo toxicity, generate a diversity of adverse biological effects, and may be hazards to the public health and the *** a few DBPs are regulated by several national and international agencies and it is not clear if these regulated DBPs are the forcing agents that drive the observed toxicity and their associated health effects. In this study, we combine analytical chemical and biological data to resolve the forcing agents associated with mammalian cell cytotoxicity of drinking water samples from three cities. These data suggest that the trihalomethanes（THMs） and haloacetic acids may be a small component of the overall cytotoxicity of the organic material isolated from disinfected drinking water. Chemical classes of nitrogen-containing DBPs, such as the haloacetonitriles and haloacetamides, appear to be the major forcing agents of toxicity in these samples. These findings may have important implications for the design of epidemiological studies that primarily rely on the levels of THMs to define DBP exposure among populations. The TIC-Tox approach constitutes a beginning step in the process of identifying the forcing agents of toxicity in disinfected water.

关键词： DBPs CHO cell cytotoxicity Toxicity Additivity

Delayed assessment and eager adoption of laparoscopic cholecystectomy:Implications for developing surgical technologies

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World Journal of Gastroenterology 2010年第33期16卷 4115-4122页

作者： Alexander C Allori I Michael Leitman elizabeth Heitman Department of Surgery Beth Israel Medical Center Center for Biomedical Ethics and Society Vanderbilt University Medical Center

Despite the prevailing emphasis in the medical literature on establishing evidence,many changes in the practice of surgery have not been achieved using proper evidence-based *** paper examines the adoption of laparoscopic cholecystectomy(LC)into regular use for the treatment of cholecystitis and the process of its acceptance,focusing on the limited role of technology assessment in its appraisal.A review of the published medical literature concerning LC was *** 3000 studies of LC have been conducted since 1985,and there have been nearly 8500 publications to *** LC was adopted enthusiastically into practice,the results of outcome studies generally showed that it compared favorably with the traditional,open cholecystectomy with regard to mortality,complications,and length of hospital ***,despite the rapid general agreement on surgical technique,efficacy,and appropriateness,there remained lingering doubts about safety,outcomes,and cost of the procedure that suggested that essential research questions were ignored even as the procedure became *** LC as a case study,there are important lessons to be learned about the need for important guidelines for surgical innovation and the adoption of minimally invasive surgical techniques into current clinical and surgical *** highlight one recent example,natural orifice transluminal endoscopic surgery and how necessary it is to properly evaluate this new technology before it is accepted as a safe and effective surgical option.

关键词： Laparoscopy Endoscopy Minimally invasive surgery Cholecystectomy Natural orifice transluminal endoscopic surgery Evidence-based medicine Technol- ogy assessment Comparative effectiveness research

Cardiovascular dysfunction following spinal cord injury

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Neural Regeneration Research 2016年第2期11卷 189-194页

作者： elizabeth Partida Eugene Mironets Shaoping Hou Veronica J.Tom Spinal Cord Research Center Department of Neurobiology & Anatomy Drexel University College of Medicine

Both sensorimotor and autonomic dysfunctions often occur after spinal cord injury（SCI）. Particularly, a high thoracic or cervical SCI interrupts supraspinal vasomotor pathways and results in disordered hemodynamics due to deregulated sympathetic outflow. As a result of the reduced sympathetic activity, patients with SCI may experience hypotension, cardiac dysrhythmias, and hypothermia post-injury. In the chronic phase, changes within the CNS and blood vessels lead to orthostatic hypotension and life-threatening autonomic dysreflexia（AD）. AD is characterized by an episodic, massive sympathetic discharge that causes severe hypertension associated with bradycardia. The syndrome is often triggered by unpleasant visceral or sensory stimuli below the injury level. Currently the only treatments are palliative - once a stimulus elicits AD, pharmacological vasodilators are administered to help reduce the spike in arterial blood pressure. However, a more effective means would be to mitigate AD development by attenuating contributing mechanisms, such as the reorganization of intraspinal circuits below the level of injury. A better understanding of the neuropathophysiology underlying cardiovascular dysfunction after SCI is essential to better develop novel therapeutic approaches to restore hemodynamic performance.

关键词： blood pressure heart rate autonomic dysreflexia hypertension bradycardia spinal cord lesion sprouting plasticity bladder distension relay sympathetic activity

Automatic Segmentation of Liver from Abdominal Computed Tomography Images Using Energy Feature

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Computers, Materials & Continua 2021年第4期67卷 709-722页

作者： Prabakaran Rajamanickam Shiloah elizabeth Darmanayagam Sunil Retmin Raj Cyril Raj University Department of Computer Science Engineering Anna UniversityChennai600025India University Department of Information Technology MIT CampusChennai600044India

Liver Segmentation is one of the challenging tasks in detecting and classifying liver tumors from Computed Tomography(CT)*** segmentation of hepatic organ is more intricate task,owing to the fact that it possesses a sizeable quantum of *** paper proposes an algorithm for automatic seed point selection using energy feature for use in level set algorithm for segmentation of liver region in CT *** effectiveness of the method can be determined when used in a model to classify the liver CT images as tumorous or *** involves segmentation of the region of interest(ROI)from the segmented liver,extraction of the shape and texture features from the segmented ROI and classification of the ROIs as tumorous or not by using a classifier based on the extracted *** this work,the proposed seed point selection technique has been used in level set algorithm for segmentation of liver region in CT scans and the ROIs have been extracted using Fuzzy C Means clustering(FCM)which is one of the algorithms to segment the *** dataset used in this method has been collected from various repositories and scan *** outcome of this proposed segmentation model has reduced the area overlap error that could offer the intended accuracy and *** gives better results when compared with other existing *** execution in short span of time is another advantage of this method which in turns helps the radiologist to ascertain the abnormalities instantly.

关键词： Liver segmentation automatic seed point tumor segmentation classification fuzzy C means clustering

China’s Changing Strategies and Motivations in the Middle East:The Cases of Israel and Syria

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China’s Changing Strategies and Motivations in the Middle E...

作者： elizabeth Forman 华东师范大学

学位级别：硕士

This paper explores the way China’s Middle East policy and strategies are changing,using the cases of Israel and *** paper examines what strategies are changing and how,and asks the question of what is motivating these change while using a realist theoretical framework coupled with creative involvement *** paper also seeks to find areas where academic literature leaves gaps in the narrative of China’s changing *** methods used include data analysis from policy papers and news sources as well as interviews with scholars to help fill in the gaps in the *** these interviews and the data analysis,the author expects to find that based on a realist perspective,it is important to consider the protection of the security of China’s economic assets,the protection of its domestic security from the threat of Islamist extremism,and its rise toward becoming a great power on the world stage as part of China’s motivations for its changes in the Middle *** expected finding is that the One Belt One Road Initiative is playing a large role in China’s economic and political ambitions.

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Is early patent ductus arteriosus ligation helpful in premature neonates? A 10-year retrospective study

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World Journal of Pediatrics 2022年第5期18卷 350-357页

作者： Anip Garg Naveen Athiraman elizabeth Jenkins David Crossland Prakash Kannan Loganathan Neonatal Unit Royal Victoria InfirmaryNewcastleUK Paediatric Cardiology Freeman HospitalNewcastleUK Neonatal Unit James Cook University HospitalMarton RoadMiddlesbrough TS43BWUK

Background To compare short and long outcomes between early(≤28 days)(EL)and late ligation(LL)*** explore factors predicting early extubation(≤7 days)after patent ductus arteriosus(PDA)*** We conducted a single center,retrospective cohort study of preterm infants<32 weeks who underwent surgical ligation over a 10-year period(2009-2019).Results A total of 133 infants underwent PDA ligation,in the study *** groups had similar short-term outcome such as bronchopulmonary dysplasia(BPD)or death(96%vs.98%,P=0.64)and long-term clinical outcomes including Bayley's assessment at 2 years corrected *** infants in the EL group developed severe BPD(63%vs.81%,P=0.02).Age at ligation had adjusted odds ratio of 1.04 with over lapping confidence interval(95%CI 1.0-1.1,P=0.02)for severe BPD/*** was no difference in day of extubation between the EL and LL group(8 days vs.7 days,P=0.85).Left atrium/aortic root ratio of ≥1.75 would give sensitivity of 41% and 80% specificity for early extubation(area under the curve of 0.61).There was marginal reduction of hospital stay in the EL group[113(105-121)days vs.115(107-123)days;log rank P=0.026].Conclusion EL can be delivered safely with a clinically important lower incidenee of severe BPD and shorter duration of hospital stay compared to LL.

关键词： Bronchopulmonary dysplasia Extubation Patent ductus arteriosus ligation

Retinal nerve fiber layer changes based on historic CD4 nadir among HIV positive patients undergoing glaucoma evaluation

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International Journal of Ophthalmology(English edition) 2019年第5期12卷 789-794页

作者： Sarah H.Van Tassel Paul Petrakos elizabeth Marlow elizabeth Mauer Harjot K.Singh Anna M.Demetriades Department of Ophthalmology Weill Cornell Medicine Division of Biostatistics and Epidemiology Department of Healthcare Policy & ResearchWeill Cornell Medicine Division of Infectious Disease New York-Presbyterian Hospital/Weill Cornell Medicine

AIM: To determine relationships between retinal nerve fiber layer(RNFL) thickness and nadir CD4 cell count in human immunodeficiency virus(HIV) positive patients evaluated for glaucoma ***: Data were reviewed for 329 HIV positive patients evaluated for glaucoma suspicion. High-definition optical coherence tomography(OCT) RNFL measurements were obtained at least 6 mo apart. Analyses were performed to identify relationships between nadir CD4 count and RNFL ***: Totally 110 eyes of 55 patients met inclusion criteria, of which 46 eyes were from subjects with nadir CD4<200 cells/mm^3 and 64 had nadir CD4≥200 cells/mm^3. Patients with nadir CD4<200 cells/mm^3 had significantly thicker superior(119.7±18.6 μm) and temporal(63.8±11.7 μm) quadrants at time of initial OCT compared to the superior(112.8±16.8 μm, P=0.048) and temporal(57.1±11.9 μm, P=0.004) quadrants of patients with higher nadir CD4. This trend toward thicker RNFL among subjects with lower nadir CD4 cell counts persisted at the time of follow up OCT where participants with nadir CD4<200 cells/mm^3 showed average RNFL thickness in the superior and temporal quadrants of 117.9±18.3 μm and 63.8±12.8 μm, respectively, compared to a superior thickness of 110.5±16.9 μm(P=0.034) and temporal thickness of 57.3±11.6 μm(P=0.007) among those with higher nadir CD4. CONCLUSION: Patients with lower nadir CD4 cell counts have thicker RNFL in the superior and temporal quadrants compared to those with higher nadir CD4 counts. RNFL thickness in HIV positive patients may be affected by historic HIV disease control and should be considered when evaluating HIV positive patients for glaucoma.

关键词： glaucoma glaucoma suspect human immunodeficiency virus retinal nerve fiber layer

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在发病前,拯教青少年抑郁

环球科学 2024年第3期 50-57页

作者：伊丽莎白·斯沃博达张胜楠(译) 不详中国科学院心理研究所

当埃丝特·奥拉德乔(Esther Oladejo)连续好几天都想不起来吃饭时,她意识到自已已经越过了一条无形的边界。作为一名颇有天赋的橄榄球运动员,忙碌的学校日程也不曾停下她成长的脚步。

关键词：橄榄球运动员青少年抑郁发病前

Assessing the accuracy of patient report of the 5As (ask,assess,advise,assist,and arrange) for smoking cessation counseling

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Family Medicine and Community Health 2017年第3期5卷 164-169页

作者： Susan A.Flocke elizabeth Antognoli Department of Family Medicine and Community Health Case Western Reserve Univer-sityClevelandOHUSA

Objective:The 5As framework(ask,advise,assess,assist,arrange)is a recommended strat-egy for smoking cessation counseling in primary *** study compares patient report with direct observation to assess the degree of recall bias for each of the ***:Primary care visits by 107 adult smokers and 16 physicians were *** 48 hours after the visit,patients completed a survey assessing whether or not smoking was discussed and items specific to each of the *** audio recordings were evaluated to assess the presence of each *** sensitivity,specificity,positive predictive value,and negative predictive value of patient report versus direct observation were ***:The frequency of the 5As based on evaluation of the audio recording ranged from 13% (arrange)to 98% (ask).The sensitivity and specificity of patient report were 92% and not applicable for ask,90% and 50% for assess,94% and 33% for advise,90% and 50% for assist,and 85% and 67% for arrange *** predictive values ranged from 28% to 98%;negative predictive values ranged from 0% to 97% .Conclusion:Compared with the gold standard of direct observation,patient report of each of the 5As is reasonably sensitive but not *** overreport the occurrence of each of the 5As.

关键词： 5As(ask,assess,advise,assist,arrange) smoking cessation primary care