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Clonidine use during dexmedetomidine weaning:A systematic review

World journal of Critical Care Medicine 2023年第1期12卷 18-28页

作者： Sanu Rajendraprasad Molly Wheeler Erin Wieruszewski joseph Gottwald Lindsey A.Wallace Danielle Gerberi Patrick M Wieruszewski nathan j Smischney Department of Pulmonary&Critical Care Mayo ClinicRochesterMN 55905United States Department of Pharmacy Mayo ClinicRochesterMN 55905United States Department of Anesthesiology&Perioperative Medicine Mayo ClinicRochesterMN 55905United States Critical Care Medicine Independent Multidisciplinary Program Mayo ClinicRochesterMN 55905United States Mayo Medical Libraries Mayo ClinicRochesterMN 55905United States

BACKGROUND Dexmedetomidine is a centrally acting alpha-2A adrenergic agonist that is commonly used as a sedative and anxiolytic in the intensive care unit(ICU),with prolonged use increasing risk of withdrawal symptoms upon sudden *** clonidine is an enterally available alpha-2A adrenergic agonist,it may be a suitable agent to taper off dexmedetomidine and reduce withdrawal *** appropriate dosing and conversion strategies for using enteral clonidine in this context are not *** objective of this systematic review is to summarize the evidence of enteral clonidine application during dexmedetomidine weaning for prevention of withdrawal *** To systematically review the practice,dosing schema,and outcomes of enteral clonidine use during dexmedetomidine weaning in critically ill *** This was a systematic review of enteral clonidine used during dexmedetomidine weaning in critically ill adults(≥18 years).Randomized controlled trials,prospective cohorts,and retrospective cohorts evaluating the use of clonidine to wean patients from dexmedetomidine in the critically ill were *** primary outcomes of interest were dosing and titration schema of enteral clonidine and dexmedetomidine and risk factors for dexmedetomidine *** secondary outcomes included prevalence of adverse events associated with enteral clonidine use,re-initiation of dexmedetomidine,duration of mechanical ventilation,and ICU length of *** A total of 3427 studies were screened for inclusion with three meeting inclusion criteria with a total of 88 *** three studies were observational,two being prospective and one *** all included studies,the choice to start enteral clonidine to wean off dexmedetomidine was made at the discretion of the *** time ranged from 13 to 167 h on *** clonidine was started in the prospective studies in a similar protocolized method,with 0.3 mg every 6 *** starti

关键词： Clonidine Dexmedetomidine Intensive care unit Withdrawal Weaning

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Effect of Varying Temperature and Oxygen on Particulate Matter Formation in Oxy-Biomass Combustion

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Energy Engineering 2022年第3期119卷 863-881页

作者： Chen Wang Cicilia Kemunto Mesa Samuel Bimenyimana nathan Bogonko George Adwek Yiyi Mo Godwin Norense Osarumwense Asemota Changfu Yuan Yaowen Chen Changtai Li Etienne Ntagwirumugara Aphrodis Nduwamungu Fujian Provincial Higher–Educational Engineering Research Centre of Intelligence and Automation in Construction College of Civil EngineeringHuaqiao UniversityXiamenChina Kenya Industrial Research and Development Institute NairobiKenya Hello Renewables Ltd.KigaliRwanda Mount Kenya University ThikaKenya African Centre of Excellence in Energy for Sustainable Development University of RwandaKigaliRwanda Morayo College NairobiKenya Fujian Baichuan Construction Technology Co. Ltd.XiamenChina Haoqi(Xiamen)Construction Technology Co. Ltd.XiamenChina University of Rwanda College of Science and TechnologyKigaliRwanda

Offsetting particulate matter emissions has become a critical global aim as there are concerted efforts to deal with environmental and energy poverty *** study consists of investigations of computing emissions of particulate matter from biomass fuels in various atmospheres and *** laboratory setup included a fixed bed electric reactor and a particulate matter(PM)measuring machine interfaced with the flue gas from the fixed bed reactor combustion *** experiments were conducted at seven different temperatures(600℃-1200℃)and six incremental oxygen concentrations(21%-100%).Five biomass types were studied;A-cornstalk,B-wood,C-wheat straw,D-Rice husk,E-Peanut shell,each pulverized to a size of approximately 75 *** study shows that PM emitted during char combustion is consistently higher than that emitted during the *** de-volatilization,increase in temperature leads to linear decrease in PM emission between atmospheres of 21%O_(2)to 50%O_(2),thereafter,between 70%O_(2)to 100%O_(2);increase in temperature leads to a rise in PM *** average PM formation from all the five considered biomass is relatively comparable however,with differing atmospheres and temperatures,the fibrous and low-density biomass forms more *** char combustion,the study shows that at oxygen levels of 21%,70%,90%and 100%,increase in temperature leads to increased PM *** increase in oxygen concentration and temperature increases the rate of combustion hence diminishing the time of combustion.

关键词： Oxy-fuel combustion particulate matter(PM) volatiles char combustion

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Human Smuggling and the International Sex Trade： An Evaluation of the Trafficking Victims Protection Act

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Sociology Study 2013年第1期3卷 23-39页

作者： Ben Atkins nathan R. Moran Robert D. Hanser Midwestern State University US University of Louisiana at Monroe US

The United States Congress set a benchmark in US anti-human trafficking policy with the Trafficking Victims Protection Act of 2000 （TVPA 2000j. The TVPA 2000 and its subsequent reauthorizations in 2003, 2005, and 2008 were put forth to increase the scope, focus, and effectiveness of US efforts to combat human trafficking. In-depth analyses of each reauthorization provide an understanding of the aims of the TVPA. The evolution of the TVPA reauthorizations dearly demonstrates that the US is committed to thwarting human trafficking both domestically and internationally. The analyses examine strengths and weaknesses of the legislation and provide insight as to how the TVPA reached its current state as the William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008 （TVPRA 2008）. Drawing from the evolution of TVPA legislation, the future of the human trafficking phenomenon and legislation is discussed.

关键词： Human trafficking human slavery organized crime

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父与子全集口袋书白金版

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2016年

作者：耿小辉（美）nathan Ching （美）joseph Ching

本书用漫画的形式体现了约200个生动幽默的父子小故事。主要内容包括：爸爸的“帮助”、晚饭时间、汽车故障、免票、粗暴的游戏、克隆爸爸、打靶练习、完美照片、致命的错误等。

ISBN: (纸本)9787500143635

关键词：英语漫画

来源：畅想之星图书光盘版（南... 评论

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Mastabol induced acute cholestasis: A case report

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World journal of Hepatology 2013年第3期5卷 133-136页

作者： Brett M Hymel David W Victor Luis Alvarez nathan j Shores Luis A Balart Department of Gastroenterology Louisiana State University School of Medicine Department of Gastroenterology and Hepatology Tulane University School of Medicine

A 26-year-old male presented with three weeks of jaundice after the self-initiation of the injectable anabolic steroid, Mastabol [Dromastanolone Di-Propionate (17 beta-Hydroxy-2alpha-methyl-5alpha-androstan-3one propionate)]. He reported dark urine, light stools, and pruritus. He denied abdominal pain, intravenous drug use, intranasal cocaine, blood transfusions, newly placed tattoos, or sexually transmitted diseases. He used alcohol sparingly. Physical exam revealed jaundice with deep scleral icterus. The liver was palpable 2 cm below the right costal margin with no ascites. The peak bilirubin was 23.6 mg/dL, alkaline phosphatase was 441 units/L, and aspartate aminotransferase/alanine aminotransferase were 70 units/L and 117 units/L respectively. A working diagnosis of acute intrahepatic cholestasis was made. Liver biopsy revealed a centrilobular insult with neutrophilic infiltrates and Ito cell hyperplasia consistent with acute drug induced cholestasis. The patient' s clinical symptoms resolved and his liver enzymes, bilirubin, and alkaline phosphatase normalized. Anabolic steroids with 17 alpha carbon substitutions have been associated with a bland variety of cholestatic injury with little hepatocellular injury. Cholestasis, under these circumstances, may be secondary to the binding of drugs to canalicular membrane transporters, accumulation of toxic bile acids from canalicular pump failure, or genetic defects in canalicular transport proteins. Mastabol is an injectable, 17 beta hydroxyl compound with no alpha alkyl groups at the 17 carbon position. As such, it has been reported to have little potential toxic effects on the liver. This is the first known reported case of Mastabolinduced cholestatic liver injury. It highlights the need for physicians to consider such widely available substances when faced with hepatic injury of unclear etiology.

关键词： Cholestatic Mastabol Hepatic Anabolic Steroids

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Low Phase Noise CMOS Voltage-controlled Oscillators

Low Phase Noise CMOS Voltage-controlled Oscillators

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2007 7th International Conference on ASIC Electronic Version(ASICON 2007)

作者： David j.Allstot Sankaran Aniruddhan nathan M.Neihart Dicle Ozis Sudip Shekhar jeffrey S.Walling Dept.of Electrical Engineering Univ.of WashingtonSeattle WA 98195 Now with Telegent Systems Inc.SunnyvaleCA 94085

Design considerations and performance comparisons for several low phase noise CMOS voltagecontrolled oscillator（VCO） topologies are presented including the Hartley,quadrature Colpitts,Clapp,and tuned-input tunedoutput *** indirect approach for high-frequency signal generation using a VCO coupled with a 2X passive frequency multiplier is also *** of the structures are attractive alternatives to the conventional LC tank VCO.

关键词： Voltage-controlled oscillator,Hartley oscillator Colpitts oscillator Clapp oscillator dual-tank oscillator,tuned-input tuned-output oscillator phase noise transformer.

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2型糖尿病高血糖的治疗:反复失败的终结?

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英国医学杂志中文版 2007年第3期10卷 156-161页

作者： R j Heine M Diamant j-C Mbanya D M nathan 谢超（译） Diabetes Centre Department of Endocrinology VU University Medical Centre Amsterdam De Boelelaan 1117 Netherlands Diabetes and Endocrine Unit Department of Internal Medicine and Specialities University of Yaounde Cameroon Diabetes Center Massachusetts General Hospital Harvard Medical School Boston MA USA 不详

2型糖尿病的流行给全世界的卫生保健工作带来了13益增长的巨大负担。估计到2025年，全世界2型糖尿病患者的数量将从2000年的1．51亿增加到3亿。严格控制血糖能够降低微血管并发症这一认识使得有效治疗高血糖成为优先考虑的因素。最近，... 详细信息

2型糖尿病的流行给全世界的卫生保健工作带来了13益增长的巨大负担。估计到2025年，全世界2型糖尿病患者的数量将从2000年的1．51亿增加到3亿。严格控制血糖能够降低微血管并发症这一认识使得有效治疗高血糖成为优先考虑的因素。最近，控制糖尿病及其并发症试验（DCCT）显示，以血糖正常为目标的强化治疗对1型糖尿病患者的心血管疾病有益。对于2型糖尿病，来自英国糖尿病前瞻性研究（UKPDS）的流行病学资料表明降低血糖能减少心血管疾病的风险。

关键词： 2型糖尿病有效治疗高血糖英国糖尿病前瞻性研究微血管并发症心血管疾病反复卫生保健工作

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Sinonasal Schwannoma: A Case Report and Updated Review of the Literature

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Open journal of Medical Imaging 2015年第2期5卷 66-70页

作者： Edwin A. Takahashi nathan C. Hull Christopher j. Stevens joseph M. Hoxworth Steven M. Weindling Christopher P. Wood Department of Radiology Mayo Clinic Rochester USA Department of Radiology Mayo Clinic Scottsdale USA Department of Radiology Mayo Clinic Jacksonville USA

Sinonasal schwannomas are rare, benign and slow-growing peripheral nerve sheath tumors without age, race, or gender predilection. We present the unusual case of a 59-year-old female who pre-sented with right-sided retro-orbital pressure and rhinorrhea. Radiographic imaging revealed a mass centered in the right superior nasal cavity with extension through the cribriform plate into the right more than the left subfrontal region. Biopsy confirmed the diagnosis of a sinonasal schwannoma, which was resected via nasal endoscopic surgery and ethmoidectomy. These tumors, albeit rare, should be considered in the differential diagnosis for patients presenting with a para-nasal sinus mass to ensure inclusion of this benign lesion and avoid unnecessary aggressive in-tervention.

关键词： Neurilemmoma Paranasal Sinus Sinonasal Tract Schwannoma

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全球边疆:美国对外关系中的比较史与边疆研究路径

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民族学刊 2019年第2期10卷 27-40,102-104页

作者：内森.j.西蒂诺袁剑刘玺鸿美国莱斯大学历史系中央民族大学民族学与社会学学院

长期以来,美国对外关系研究的新路径并没有对例外论者的假设构成挑战,同时也无法对全球范围内的美国经验提供一个比较视角。最近开展的边地(borderland)和边疆(frontier)研究则为历史学家提供了一个深入到文化遭遇、文化认同转变以及国... 详细信息

长期以来,美国对外关系研究的新路径并没有对例外论者的假设构成挑战,同时也无法对全球范围内的美国经验提供一个比较视角。最近开展的边地(borderland)和边疆(frontier)研究则为历史学家提供了一个深入到文化遭遇、文化认同转变以及国家政治边缘的富有价值的视角,并可以对周边地区的人力和自然资源如何整合到更大的经济交换体系这一过程进行分析。在对边疆研究的域外经验与实践进行系统梳理之后,本文指出,有必要将边疆路径引入美国对外关系研究的领域,这样不仅有助于相关研究的推进,而且能够突破特纳理论的局限,进而更全面地看待包括当代跨国市场等在内的美国的内部发展与海外扩张历程。

关键词：美国全球边疆对外关系

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Secreted frizzled related-protein 2(Sfrp2)deficiency decreases adult skeletal stem cell function in mice

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Bone Research 2021年第4期9卷 606-617页

作者： Luis Fernandez de Castro Brian丄Sworder Byron Mui Kathryn Futrega Agnes Berendsen Matthew D.Phillips nathan j.Burbach Natasha Cherman Sergei Kuznetsov Yankel Gabet Kenn Holmbeck Pamela G.Robey Skeletal Biology Section National Institute of Dental and Craniofacial ResearchNational Institutes of HealthDepartment of Health and Human ServicesNational Institutes of HealthBethesdaMDUSA Department of Molecular Medicine Boston UniversityBostonMAUSA School of Dentistry University of Minnesota-Twin CitiesMinneapolisMNUSA Department of Anatomy and Anthropology Sackler Faculty of MedicineTel Aviv UniversityTel Aviv-YafoIsrael

In a previous transcriptomic study of human bone marrow stromal cells(BMSCs,also known as bone marrow-derived^mesenchymal stem cells#,)/SFRP2 was highly over-represented in a subset of multipotent BMSCs(skeletal stem cells,SSCs),which recreate a bone/marrow organ in an in vivo ectopic bone formation *** modulate WNT signaling,which is essential to maintain skeletal homeostasis,but the specific role of SFRP2 in BMSCs/SSCs is ***,we evaluated Sfrp2 deficiency on BMSC/SSC function in models of skeletal organogenesis and *** skeleton of Sfrp2-def\c\ent(KO)mice is overtly normal;but their BMSCs/SSCs exhibit reduced colony-forming efficiency,reflecting low SSC self-renewal/***2 KO BMSCs/SSCs formed less trabecular bone than those from WT littermates in the ectopic bone formation ***,regeneration of a cortical drilled hole defect was dramatically impaired in Sfrp2 KO ***2-deficient BMSCs/SSCs exhibited poor in vitro osteogenic differentiation as measured by Runx2 and Osterix expression and calcium ***,activation of the Wnt co-receptor;Lrp6,and expression of Wnt target genes,Axin2,C-myc and Cyclin Dl,were reduced in Sfrp2-deficient BMSCs/*** of recombinant Sfrp2 restored most of these activities,suggesting that Sfrp2 acts as a Wnt *** demonstrate that Sfrp2 plays a role in self-renewal of SSCs and in the recruitment and differentiation of adult SSCs during bone ***2 is also a useful marker of BMSC/SSC multipotency,and a factor to potentially improve the quality of ex vivo expanded BMSC/SSC products.

关键词： skeletal impaired healing

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