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Age as a predictor of clinical outcomes and determinant of therapeutic measures for emergency medical services treated cardiogenic shock

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Journal of Geriatric Cardiology 2023年第1期20卷 1-10页

作者： Xiaoman Xiao jason e Bloom emily Andrew Luke P Dawson Ziad Nehme Michael Stephenson David Anderson Himawan Fernando Samer Noaman Shelley Cox William Chan David M Kaye Karen Smith Dion Stub Department of Cardiology Alfred Health55 Commercial RoadMelbourneAustralia Baker Heart and Diabetes Institute 75 Commercial RoadMelbourneAustralia Department of Cardiology Western HealthFurlong RoadSt AlbansAustralia Ambulance Victoria 31 Joseph StreetBlackburnAustralia School of Public Health and Preventive Medicine Monash University553 St Kilda RoadMelbourneAustralia Department of Paramedicine Monash UniversityMcMahons RoadFrankstonAustralia

BACKGROUND The impact of age on outcomes in cardiogenic shock(CS)is poorly described in the pre-hospital *** assessed the impact of age on outcomes of patients treated by emergency medical services(eMS).MeTHODS This population-based cohort study included consecutive adult patients with CS transported to hospital by *** linked patients were stratified into tertiles by age(18-63,64-77,and>77 years).Predictors of 30-day mortality were assessed through regression *** primary outcome was 30-day all-cause *** A total of 3523 patients with CS were successfully linked to state health *** average age was 68±16 years and 1398(40%)were *** patients were more likely to have comorbidities including pre-existing coronary artery disease,hypertension,dyslipidemia,diabetes mellitus,and cerebrovascular *** incidence of CS was significantly greater with increasing age(incidence rate per 100,000 person years 6.47[95%CI:6.1-6.8]in age 18-63 years,34.34[32.4-36.4]in age 64-77 years,74.87[70.6-79.3]in age>77 years,Pere was a step-wise increase in the rate of 30-day mortality with increasing age *** adjustment,compared to the lowest age tertile,patients aged>77 years had increased risk of 30-day mortality(adjusted hazard ratio=2.26[95%CI:1.96-2.60]).Older patients were less likely to receive inpatient coronary *** Older patients with eMS-treated CS have significantly higher rates of short-term *** reduced rates of invasive interventions in older patients underscore the need for further development of systems of care to improve outcomes for this patient group.

关键词： assessed services shock

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Machine Learning-enabled Communication Approach for the Internet of Medical Things

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Computers, Materials & Continua 2023年第8期76卷 1569-1584页

作者： Rahim Khan Abdullah Ghani Samia Allaoua Chelloug Mohammed Amin Aamir Saeed jason Teo Faculty of Computing and Informatics University Malaysia SabahKota KinabaluSabah88400Malaysia Department of Information Technology College of Computer and Information SciencesPrincess Nourah bint Abdulrahman UniversityP.O.Box84428Riyadh11671Saudi Arabia Department of Computer Science Abdul Wali Khan UniversityMardan23200Pakistan College of Computer Sciences and Information Technology King Faisal UniversityAl-Ahsa31982Saudi Arabia Department of Computer Science and IT UET PeshawarJalozai CampusJalozai24240Pakistan

The Internet ofMedical Things(IoMT)is mainly concernedwith the efficient utilisation of wearable devices in the healthcare domain to manage various processes automatically,whereas machine learning approaches enable these smart systems to make informed ***,broadcasting is used for the transmission of frames,whereas congestion,energy efficiency,and excessive load are among the common issues associated with existing *** this paper,a machine learning-enabled shortest path identification scheme is presented to ensure reliable transmission of frames,especially with the minimum possible communication overheads in the IoMT *** this purpose,the proposed scheme utilises a well-known technique,i.e.,Kruskal’s algorithm,to find an optimal path from source to destination wearable ***,other evaluation metrics are used to find a reliable and shortest possible communication path between the two interested *** from that,every device is bound to hold a supplementary path,preferably a second optimised path,for situations where the current communication path is no longer available,either due to device failure or heavy ***,the machine learning approach helps enable these devices to update their routing tables simultaneously,and an optimal path could be replaced if a better one is *** proposed mechanism has been tested using a smart environment developed for the healthcare domain using IoMT *** results show that the proposed machine learning-oriented approach performs better than existing approaches where the proposed scheme has achieved the minimum possible ratios,i.e.,17%and 23%,in terms of end to end delay and packet losses,***,the proposed scheme has achieved an approximately 21%improvement in the average throughput compared to the existing schemes.

关键词： Machine learning Internet of Medical Things healthcare load balancing communication

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Deformation correlations,stress field switches and evolution of an orogenic intersection:The Pan-African Kaoko-Damara orogenic junction,Namibia

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Geoscience Frontiers 2017年第6期8卷 1187-1232页

作者： Ben Goscombe David A.Foster David Gray Ben Wade Antonios Marsellos jason Titus Integrated Terrane Analysis Research(ITAR) 18 Cambridge RdAldgate5154SAAustralia Department of Geological Sciences University of FloridaGainesvilleFL32611USA School of earth Sciences University of TasmaniaHobartTASAustralia Adelaide Microscopy University of AdelaideAdelaide5005SAAustralia Hofstra University HempsteadNYUSA

Age calibrated deformation histories established by detailed mapping and dating of key magmatic time markers are correlated across all tectono-metamorphic provinces in the Damara Orogenic *** across structural belts result in an internally consistent deformation framework with evidence of stress field rotations with similar timing,and switches between different deformation *** principle compressive stress rotated clockwise ~180°in total during Kaoko Belt evolution,and^135° during Damara Belt *** most stages,stress field variation is progressive and can be attributed to events within the Damara Orogenic System,caused by changes in relative trajectories of the interacting Rio De La Plata,Congo,and Kalahari *** orogenesis occurred earliest and evolved from collision and obduction at ~590 Ma,involving e-W directed shortening,progressing through different transpressional states with ~45° rotation of the stress field to strike-slip shear under NW-Se shortening at ~550-530 *** orogenesis evolved from collision at ~555-550 Ma with NW-Se directed shortening in common with the Kaoko Belt,and subsequently evolved through ~90°rotation of the stress field to Ne-SW shortening at ~512-508 *** Kaoko and Damara orogenic fronts were operating at the same time,with all three cratons being coaxially convergent during the 550-530 Ma period;Rio De La Plata directed Se against the Congo Craton margin,and both together over-riding the Kalahari Craton margin also towards the *** stress field rotation was punctuated by rapid and significant switches at ~530-525 Ma,~508 Ma and ~505 *** three events included:(1)Culmination of main phase orogenesis in the Damara Belt,coinciding with maximum burial and peak metamorphism at 530-525 *** occurred at the same time as termination of transpression and initiation of transtensional reactivation of shear zones in the Kaoko *** compressive stress switched from NW-

关键词： Damara Orogen Stress fields Orogeny Assembly of Gondwana event geochronology Deformation correlations

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Innovations in otorhinolaryngology in the age of COVID-19: A systematic literature review

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第3期8卷 224-238页

作者： e.Berryhill McCarty Liuba Soldatova jason A.Brant jason G.Newman Perelman School of Medicine at the Universityof Pennsylvania PhiladelphiaPAUSA Department of Otorhinolaryngology-Head and Neck Surgery Universityof Pennsylvania Health SystemPhiladelphiaPennsylvaniaPAUSA

Objective: Otolaryngologists are at increased occupational risk of Coronavirus Disease 2019 (COVID-19) infection due to exposure from respiratory droplets and aerosols generated during otologic, nasal, and oropharyngeal examinations and procedures. There have been a variety of guidelines and precautions developed to help mitigate this risk. While many reviews have focused on the personal protective equipment (PPe) and preparation guidelines for surgery in the COVID-19 era, none have focused on the more creative and unusual solutions designed to limit viral transmission. This review aims to fill that *** Sources: PubMed, Ovid/Medline, and ScopusMethods: A comprehensive review of literature was performed on September 28, 2020 using PubMed, Ovid/Medline, and Scopus databases. All english-language studies were included if they proposed or assessed novel interventions developed for Otolaryngology practice during the COVID-19 pandemic. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were ***: A total of 41 papers met inclusion criteria and were organized into 5 categories ("General Recommendations for Otolaryngologic Surgery’, "equipment Shortage Solutions’, "Airway Procedures’, "Nasal endoscopy and Skull Base Procedures’, and "Otologic Procedures’). Articles were summarized, highlighting the innovations created and evaluated during the COVID-19 pandemic. Creative solutions such as application of topical viricidal agents, make-shift mask filters, three-dimensional (3-D) printable adapters for headlights, aerosol containing separation boxes, and a variety of new draping techniques have been developed to limit the risk of COVID-19 ***: Persistent risk of COVID-19 exposure remains high. Thus, there is an increased need for solutions that mitigate the risk of viral transmission during office procedures and surgeries, especially given that most COVID-19 positive patients present asymptomatically

关键词： COVID-19 Innovations Inventions Literature Review Otolaryngology

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No evidence for enzootic plague within black-tailed prairie dog(Cynomys ludovicianus)populations

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Integrative Zoology 2021年第6期16卷 834-851页

作者： Rebecca e.COLMAN R.Jory BRINKeRHOFF Joseph D.BUSCH Chris RAY Adina DOYLe jason W.SAHL Paul KeIM Sharon K.COLLINGe David M.WAGNeR Pathogen and Microbiome Institute Northern Arizona UniversityFlagstaffArizonaUSA environmental Studies Program University of Colorado at BoulderBoulderColoradoUSA

Yersinia pestis,causative agent of plague,occurs throughout the western United States in rodent populations and periodically causes epizootics in susceptible species,including black-tailed prairie dogs(Cynomys ludovicianus).How *** persists long-term in the environment between these epizootics is poorly understood but multiple mechanisms have been proposed,including,among others,a separate enzootic transmission cycle that maintains *** without involvement of epizootic hosts and persistence of *** within epizootic host populations without causing high mortality within those *** live-trapped and collected fleas from black-tailed prairie dogs and other mammal species from sites with and without black-tailed prairie dogs in 2004 and 2005 and tested all fleas for presence of *** was not detected in 2126 fleas collected in 2004 but was detected in 294 fleas collected from multiple sites in 2005,before and during a widespread epizootic that drastically reduced black-tailed prairie dog populations in the affected *** and spatial patterns of *** occurrence in fleas and genotyping of *** present in some infected fleas suggest *** was introduced multiple times from sources outside the study area and once introduced,was dispersed between several *** conclude *** likely was not present in these black-tailed prairie dog colonies prior to epizootic activity in these *** we did not identify likely enzootic hosts,we found evidence that deer mice(Peromyscus maniculatus)may serve as bridging hosts for *** between unknown enzootic hosts and black-tailed prairie dogs.

关键词： black-tailed prairie dog Cynomys ludovicianus plague prairie dogs Yersinia pestis

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紫杉醇局部治疗抑制猪静脉桥新生内膜形成和增厚的实验研究

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中国循环杂志 2003年第6期18卷 465-467页

作者：吴隐雄 Martin H Chamberlain Thomas johnson jason L johnson Andrew C Newby Gianni D Angelin Martin Oberhoff Karl K Karsch 广西壮族自治区医院心脏科广西壮族自治区南宁市530021 Bristol Heart Institute University of Bristol

目的 :局部药物治疗是一个很好的防治静脉桥病变的策略。本研究用抗细胞增殖药物紫杉醇处理大隐静脉桥后植入猪的颈动脉 ,以观察紫杉醇的抗细胞增殖作用在抑制静脉桥内膜平滑肌细胞增殖、迁移导致内膜形成和增厚的效果。方法 :将 10头猪... 详细信息

目的 :局部药物治疗是一个很好的防治静脉桥病变的策略。本研究用抗细胞增殖药物紫杉醇处理大隐静脉桥后植入猪的颈动脉 ,以观察紫杉醇的抗细胞增殖作用在抑制静脉桥内膜平滑肌细胞增殖、迁移导致内膜形成和增厚的效果。方法 :将 10头猪的 2 0只大隐静脉桥分为两组。治疗组 :将大隐静脉桥 10只置于含有 10 μmol/L浓度的紫杉醇溶液中 (先用该溶液灌洗 )浸泡 1h后植入猪的颈动脉 ,紫杉醇是溶解在 2 5 μl/L的无水酒精中 ,对照组 10只大隐静脉桥置于单纯的酒精中浸泡。 4周后取开放的静脉桥进行组织学分析。结果 :①治疗组静脉桥新生内膜面积 (1 5 9± 0 95 )mm2 ,对照组新生内膜面积高达 (2 43± 1 3 5 )mm2 ,治疗组显著低于对照组 ,两组比较有非常显著的差异 ,P <0 0 1;②治疗组内膜平滑肌细胞密度均值为 (3 681± 193 5 ) /mm2 ,对照组为 (4 60 7± 1993 ) /mm2 ,两组比较有显著性差异 ,P <0 0 5 ;中膜平滑肌细胞密度均值治疗组 (2 13 9± 73 4) /mm2 ,对照组(3 62 9± 3 2 0 7) /mm2 ,两组比较有显著性的差异 ,P <0 0 5。结论 :紫杉醇可显著抑制静脉桥内膜、中膜平滑肌细胞的增殖 ,抑制新生内膜的形成 ,证明紫杉醇可在防治静脉桥闭塞方面发挥独特作用。

关键词：紫杉醇药物治疗猪新生内膜实验静脉桥闭塞冠状动脉搭桥术冠心病

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Resolving the Mortierellaceae phylogeny through synthesis of multi-gene phylogenetics and phylogenomics

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Fungal Diversity 2020年第5期104卷 267-289页

作者： Natalie Vandepol Julian Liber Alessandro Desirò Hyunsoo Na Megan Kennedy Kerrie Barry Igor V.Grigoriev Andrew N.Miller Kerry O’Donnell jason e.Stajich Gregory Bonito Department of Microbiology and Molecular Genetics Michigan State UniversityEast LansingMI 48824USA Department of Plant Biology Michigan State UniversityEast LansingMI 48824USA Department of Plant Soil and Microbial Sciences Michigan State UniversityEast LansingMI 48824USA Joint Genome Institute BerkeleyCA 94720USA Illinois Natural History Survey University of Illinois Urbana-ChampaignChampaignIL 61820USA United States Department of Agriculture Agricultural Research ServicePeoriaIL 61604USA Department of Microbiology and Plant Pathology&Institute for Integrative Genome Biology University of California-RiversideRiversideCA 92521USA

early efforts to classify Mortierellaceae were based on macro-and micromorphology,but sequencing and phylogenetic studies with ribosomal DNA(rDNA)markers have demonstrated conflicting taxonomic groupings and polyphyletic *** some taxonomic confusion in the family has been clarified,rDNA data alone is unable to resolve higher level phylogenetic relationships within *** this study,we applied two parallel approaches to resolve the Mortierel-laceae phylogeny:low coverage genome(LCG)sequencing and high-throughput,multiplexed targeted amplicon sequenc-ing to generate sequence data for multi-gene *** then combined our datasets to provide a well-supported genome-based phylogeny having broad sampling depth from the amplicon *** the Mortierellaceae phylogeny into monophyletic genera resulted in 13 genera,7 of which are newly ***-coverage genome sequencing proved to be a relatively cost-effective means of generating a high-confidence *** multi-gene phylogenetics approach enabled much greater sampling depth and breadth than the LCG approach,but has limitations *** present this work to resolve some of the taxonomic confusion and provide a genus-level framework to empower future studies on Mortierellaceae diversity and evolution.

关键词： Mortierellaceae Phylogenomics Molecular systematics Taxonomy Multi-locus sequence typing

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Hospitalizations and healthcare costs associated with serious, non-lethal firearm-related violence and injuries in the United States, 1998-2011

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Family Medicine and Community Health 2015年第2期3卷 8-19页

作者： jason L.Salemi Vikas Jindal Roneée.Wilson Mulubrhan F.Mogos Muktar H.Aliyu Hamisu M.Salihu Department of Family and Community Medicine Baylor College of MedicineHoustonTexasUSA Department of Occupational Health Kaiser PermanenteLancasterCaliforniaUSA Department of epidemiology and Biostatistics College of Public HealthUniversity of South FloridaTampaFloridaUSA Department of Community Health Systems School of NursingIndiana UniversityIndianapolisIndianaUSA Vanderbilt Institute for Global Health Vanderbilt UniversityNashvilleTennesseeUSA

Objective:To describe the prevalence,trends,correlates,and short-term outcomes of inpa-tient hospitalizations for firearm-related injuries(FRIs)in the United States between 1998 and ***:We conducted a retrospective,cross-sectional analysis of inpatient hospitalizations using data from the Nationwide Inpatient *** addition to generating national prevalence estimates,we used survey logistic regression to calculate odds ratios(ORs)and 95%confidence intervals(CIs)for the association between FRIs and patient/hospital-level ***-ral trends were estimated and characterized using joinpoint ***:There were 10.5 FRIs(95%CI:9.2-11.8)per 10,000 non-maternal/neonatal inpatient hospitalizations,with assault accounting for 60.1%of FRIs,followed by unintentional/accidental(23.0%)and intentional/self-inflicted FRIs(8.2%).The highest odds of FRIs,particularly FRIs associated with an assault,was observed among patients 18-24 years of age,patients 14-17 years of age,patients with no insurance/self-pay,and non-Hispanic *** mean inpatient length of stay for FRIs was 6.9 days;however,4.7%of patients remained in the hospital over 24 days and 1 in 12 patients(8.2%)died before *** mean cost of an inpatient hospitalization for a FRI was$22,149,which was estimated to be$679 million annually;approximately two-thirds of the annual cost(64.7%)was for assault($439 million).Conclusion:FRIs are a preventable public health issue which disproportionately impacts younger generations,while imposing significant economic and societal burdens,even in the ab-sence of *** of FRIs should be considered a priority in this era of healthcare cost containment.

关键词： Assault cost gunshot firearms hospitalization intentional injury

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Precore/basal core promoter mutants and hepatitis B viral DNA levels as predictors for liver deaths and hepatocellular carcinoma

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World Journal of Gastroenterology 2006年第41期12卷 6620-6626页

作者： Myron J Tong Lawrence M Blatt Jia-Horng Kao jason Tzuying Cheng William G Corey The Liver Center Huntington Medical Research InstitutesPasadenaCaliforniaUnited States The Pfleger Liver InstituteDavid Geffen Schoolof Medicine at the University of California in Los AngelesCaliforniaUnited States Intermune Inc.BrisbaneCaliforniaUnited States The Hepatitis Research Center National TaiwanUniversity HospitalTaipeiTaiwanChina The Liver Center Huntington Medical Research InstitutesPasadenaCaliforniaUnited States

AIM： To conduct a retrospective study in 400 chronic hepatitis B patients in order to identify hepatitis B viral factors associated with complications of liver disease or development of hepatocellular carcinoma. MeTHODS： The mean follow-up time was 83.6 ± 39.6 mo. Alpha-fetoprotein test and abdominal ultrasound were used for cancer surveillance. Hepatitis B basal core promoter mutants, precore mutants, genotypes, hepatitis B viral DNA （HBV DNA） level and hepatitis B e antigen （HBeAg） were measured. Univariate analysis and logistic regression were used to assess odds ratios for viral factors related to liver deaths and hepatocellular carcinoma development. ReSULTS： During follow-up, 38 patients had liver deaths not related to hepatocellular carcinoma. On multivariate analysis, older age [odds ratio： 95.74 （12.13-891.31）, P 〈 0.0001], male sex [odds ratio： 7.61 （2.20-47.95）; P = 0.006], and higher Iogzo HBV DNA [odds ratio： 4.69 （1.16-20.43）; P 〈 0.0001] were independently predictive for these liver related deaths. Also, 31 patients developed hepatocellular carcinoma. Multivariate analysis showed that older age [odds ratio： 26.51 （2.36-381.47）; P = 0.007], presence of precore mutants [odds ratio： 4.23 （1.53-19.58）, P = 0.02] and presence of basal core promoter mutants [odds ratio： 2.93 （1.24-7.57）; P = 0.02] were independent predictors for progression to hepatocellular carcinoma. CONCLUSION： Our results show that high levels of baseline serum HBV DNA are associated with non- hepatocellular carcinoma-related deaths of liver failure, while genetic mutations in the basal core promoter and precore regions are predictive for development of hepatocellular carcinoma.

关键词： Basal core promoter mutants Precore mutants Hepatitis B viral genotypes Hepatitis B viral DNA Hepatitis B e antigen Liver failure Hepatocellular carcinoma

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变泥质岩递进部分熔融作用的构造物理学效应

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地质通报 2008年第12期27卷 1992-2000页

作者：曾令森高利娥 jason B．Saleeby 中国地质科学院地质研究所大陆动力学实验室北京100037 美国加州理工学院地质与行星科学系加州帕萨迪纳91125

在南内华达岩基中,晚中生代花岗岩的侵位导致表壳岩广泛的变质及部分熔融,形成混合岩杂岩体。对伊萨贝拉湖南羊圈混合岩杂岩体构造的野外观测和应变测量表明:①变泥质混合岩和鹅卵石砾岩记录了类似强度的应变;②变泥质岩发生了递进部分... 详细信息

在南内华达岩基中,晚中生代花岗岩的侵位导致表壳岩广泛的变质及部分熔融,形成混合岩杂岩体。对伊萨贝拉湖南羊圈混合岩杂岩体构造的野外观测和应变测量表明:①变泥质混合岩和鹅卵石砾岩记录了类似强度的应变;②变泥质岩发生了递进部分熔融,表现为离羊圈花岗闪长岩岩体的距离越远,部分熔融程度越低;③随部分熔融程度的变化,变泥质岩的应变承载构造也逐渐从混合岩带的弱相承载构造(IWL)往强相承载构造(LBF)过渡;④在同岩浆构造作用中,浅色体的流变学性质与鹅卵石砾岩中泥质组分相当,为应变的主要承载体。该结果表明:在高级变质岩区中,部分熔融程度是否足够高及熔体能否形成互相链接的网络,是高级变质岩的流变学强度发生突降、深部岩石发生侧向流动的前提。

关键词：部分熔融应变分解混合岩内华达岩基

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