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Combat lifesaver-trained, first-responder application of junctional tourniquets: A prospective, randomized,crossover trial

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Military Medical research 2019年第2期6卷 105-110页

作者： Ismael Flecha jason FNaylor steven Gschauer ryan ACurtis Cord WCunningham 21st Combat support Hospital Fort HoodKilleen76544TXUSA Madigan Army Medical Center JBLM Fort LewisLakewood98431USA san Antonio Military Medical Center JBSA Fort Sam HoustonSan Antonio78234TXUSA Us Army Institute of surgical research JBSA Fort Sam HoustonSan Antonio78234TXUSA 59th MedicalWing JBSA LacklandSan Antonio78234TXUSA

Background:Junctional hemorrhage surpassed extremity hemorrhage as the leading cause of preventable death after the resurgence of limb tourniquets during the recent conflicts in Afghanistan and *** tourniquets(JTQs)were developed in response to this injury *** data for JTQ efficacy are limited and do not incorporate nonmedical,military first *** compared the time for effective placement and scores for device satisfaction between two different JTQs,stratified by combat lifesaver(CLs)and combat ***:We performed a prospective,randomized,crossover trial utilizing the sAM ’ Medical Junctional Tourniquet(sJT)and Junctional Emergency Treatment Tool(JETTTM).Investigators simple randomized CLs and combat medics to sJT or JETT for their first JTQ application on mannequins with penetrating inguinal ***,participants immediately placed the other JTQ on another casualty with the same *** primary outcome measured was time of successful applicatio *** was defined as proper JTQ placement and a pressu re reading of at least 180 *** compared outcomes between CLs and combat *** JTQ applications were excluded from the comparative ***:From June 2015 to August 2015,a total of 227 personnel(133 CLs and 94 combat medics)at Fort Hood,Texas,UsA volunteered to participate in the ***-eight percent(38 of 133)of CLs and 40%(38 of 94)of combat medics placed both JTQs successfully,for a total of 152 applications(76 sJTs and 76 JETTs).We found a significant difference between applications of the JETT between the CLs and combat medics(92.0±37.7 s versus70.5±20.5 s,P=0.004).No other subg roup analyses,whether by device or user,demonstrated a sig nifica nt difference in application *** groups preferred the sJT over the *** disagreed with combat medics that the JETT could be easily applied by one person(median 3.0[2.0,4.0]versus median 4.0[3.0,5.0];P=0.006).Conclusions:Overall,succe

关键词： Junctional Tourniquet Hemorrhage Combat Battlefield

The gardener's companion to medicinal plants

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Cyber risk at the edge:current and future trends on cyber risk analytics and artificial intelligence in the industrial internet of things and industry 4.0 supply chains

作者： simmonds Monique s. J. Howes Melanie-Jayne Irving jason

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Cybersecurity 2018年第1期1卷 767-787页

作者： Petar radanliev David De roure Kevin Page jason r.C.Nurse rafael Mantilla Montalvo Omar santos La’Treall Maddox Pete Burnap Oxford e-research Centre Engineering Sciences DepartmentUniversity of OxfordOxfordEngland school of Computing University of KentKentEnglandUK Cisco research Centre Research Triangle ParkDurhamNorth CarolinaUSA school of Computer science and Informatics Cardiff UniversityCardiffWalesUK

Digital technologies have changed the way supply chain operations are *** this article,we conduct systematic syntheses of literature on the impact of new technologies on supply chains and the related cyber risks.A taxonomic/cladistic approach is used for the evaluations of progress in the area of supply chain integration in the Industrial Internet of Things and Industry 4.0,with a specific focus on the mitigation of cyber *** analytical framework is presented,based on a critical assessment with respect to issues related to new types of cyber risk and the integration of supply chains with new *** paper identifies a dynamic and self-adapting supply chain system supported with Artificial Intelligence and Machine Learning(AI/ML)and real-time intelligence for predictive cyber risk *** system is integrated into a cognition engine that enables predictive cyber risk analytics with real-time intelligence from IoT networks at the *** enhances capacities and assist in the creation of a comprehensive understanding of the opportunities and threats that arise when edge computing nodes are deployed,and when AI/ML technologies are migrated to the periphery of IoT networks.

关键词： Industry 4.0 supply chain design Transformational design roadmap IIoT supply chain model Decision support for information management artificial intelligence and machine learning(AI/ML) dynamic self-adapting system cognition engine predictive cyber risk analytics

Antiphospholipid syndrome:a clinical perspective

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Chinese Medical Journal 2020年第8期133卷 929-940页

作者： Yu Zuo Hui shi Chun Li jason s.Knight Division of rheumatology Department of Internal MedicineUniversity of MichiganAnn ArborMIUSA Department of rheumatology and Immunology Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China Department of rheumatology and Immunology Peking University People’s HospitalBeijing 100044China

Antiphospholipid syndrome (APs) is a thromboinflammatory disease with a variety of clinical phenotypes. Primary thrombosis prophylaxis should take an individualized risk stratification approach. Moderate-intensity vitamin K antagonist such as warfarin remains the primary strategy for secondary thrombosis prophylaxis among APs patients, especially for patients with predominantly venous disease. For now, direct oral anti-coagulants should be avoided in most APs patients, especially those with history of arterial manifestations. Obstetric APs management should be tailored based on an individual patient’s antiphospholipid antibody profile, and obstetric and thrombotic history. Pharmacological agents beyond anticoagulants may be considered for the management of microthrombotic and nonthrombotic manifestations of APs, although more data are needed. A relatively recent discovery in the area of APs pathogenesis is the implication of neutrophil extracellular traps in thrombin generation and initiation of inflammatory cascades. APs is a complex thromboinflammatory disease with a broad clinical spectrum. Personalized therapy according to an individual’s unique thrombosis and obstetric risk should be advocated.

关键词： Antiphospholipid syndrome Antiphospholipid antibodies Treatment

Understanding acute burn injury as a chronic disease

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Burns & Trauma 2019年第1期7卷 213-221页

作者： Lucy W.Barrett Vanessa s.Fear jason C.Waithman Fiona M.Wood Mark W.Fear Telethon Kids Institute University of Western AustraliaNorthern EntrancePerth Children’s Hospital15 Hospital AveNedlandsWA 6009Australia Institute for respiratory Health Ground FloorE Block Sir Charles Gairdner HospitalHospital AvenueNedlandsWA 6009Australia Fiona Wood Foundation Fiona Stanley HospitalMNH(B)Main HospitalCD 15Level 4Burns Unit102-118 Murdoch DriveMurdochWA 6150Australia Burns service of Western Australia WA Department of HealthNedlandsWA 6009Australia Burn injury research unit School of Biomedical SciencesUniversity of Western AustraliaCrawleyWA 6009Australia

While treatment for burn injury has improved significantly over the past few decades,reducing mortality and improving patient outcomes,recent evidence has revealed that burn injury is associated with a number of secondary pathologies,many of which arise long after the initial injury has *** studies have linked burn injury with increased risk of cancer,cardiovascular disease,nervous system disorders,diabetes,musculoskeletal disorders,gastrointestinal disease,infections,anxiety and *** wide range of secondary pathologies indicates that burn can cause sustained disruption of homeostasis,presenting new challenges for post-burn *** burn injury as a chronic disease will improve patient care,providing evidence for better long-term support and monitoring of *** focused research into the mechanisms underpinning long-term dysfunction,a better understanding of burn injury pathology may help with the development of preventative treatments to improve long-term health *** review will outline evidence of long-term health effects,possible mechanisms linking burn injury to long-term health and current research into burns as a chronic disease.

关键词： Burns Immune system Endocrine system Homeostasis Patient care Chronic disease

Using Universal Line Model (ULM) for representing Three-phase Lines

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Energy and Power Engineering 2013年第4期5卷 1159-1164页

作者： Anderson ricardo Justo de Araújo rodrigo Cléber da silva sérgio Kurokawa Department of Electrical Engineering Universidade Estadual Paulista Ilha Solteira Brazil

The second-order differential equations that describe the transmission line are difficult to solve due to the mutual coupling among phases and the fact that the parameters are distributed along their length. A method for the analysis of polyphase systems is the technique that decouples their phases. Thus, a system that has n phases coupled can be represented by n decoupled single-phase systems which are mathematically identical to the original system. Once obtained the n-phase circuit, it’s possible to calculate the voltages and currents at any point on the line using computational methods. The Universal Line Model (ULM) transforms the differential equations in the time domain to algebraic equations in the frequency domain, solve them and obtain the solution in the frequency domain using the inverse Laplace transform. This work will analyze the method of modal decomposition in a three-phase transmission line for the calculation of voltages and currents of the line during the energizing process.

关键词： Electromagnetic Transients Transmission Lines Modal Decomposition Distributed Parameters

A decision support model for supplier portfolio selection in the retail industry

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Journal of Management Analytics 2021年第3期8卷 486-501页

作者： stanislaus solomon William A.Ellegood Gertrude Pannirselvam jason riley Management and Marketing Department Southern Illinois University EdwardsvilleEdwardsvilleILUSA Management Marketingand Information Systems DepartmentSam Houston State UniversityHuntsvilleTXUSA

In this paper we propose and test a staged knapsack model to create a supplier portfolio for *** first two stages in the model use judgement criteria related to supplier characteristics and supplier fit,gathered from managers to create a portfolio that optimizes supplier rank and fit *** the third stage we optimize cost by considering landed costs for each supplier in the portfolio to arrive at the final set of *** results indicate that the criteria used,and the staged refinement of the supplier pool resulted in a better fit than just considering the landed costs of the final pool of suppliers without rank and fit score *** proposed method will enable purchasing managers to strategically create a supplier portfolio that will suit the retailer’s needs more effectively.

关键词： supplier selection retail decision support supplier portfolio knapsack problem

Unintended targeting of Dmp1-Cre reveals a critical role for Bmpr1a signaling in the gastrointestinal mesenchyme of adult mice

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Bone research 2017年第1期5卷 41-48页

作者： Joohyun Lim Joseph Burclaff Guangxu He jason C Mills Fanxin Long Department of Orthopaedic surgery Washington University School of MedicineSt.LouisMOUSA Division of Gastroenterology Departments of Medicine and Pathology and ImmunologyWashington University School of MedicineSt.LouisMOUSA Department of Orthopedics The Second Xiangya HospitalCentral South UniversityHunan 410011China Department of Developmental Biology Washington University School of MedicineSt.LouisMOUSA

Cre/loxP technology has been widely used to study cell type-specific functions of genes. Proper interpretation of such data critically depends on a clear understanding of the tissue specificity of Cre expression. The Dmpl- Cre mouse, expressing Cre from a 14-kb DNA fragment of the mouse Dmpl gene, has become a common tool for studying gene function in osteocytes, but the presumed cell specificity is yet to be fully established. By using the Ai9 reporter line that expresses a red fluorescent protein upon Cre recombination, we find that in 2-month-old mice, Dmpl-Cre targets not only osteocytes within the bone matrix but also osteoblasts on the bone surface and preosteoblasts at the metaphyseal chondro-osseous junction. In the bone marrow, Cre activity is evident in certain stromal cells adjacent to the blood vessels, but not in adipocytes. Outside the skeleton, Dmpl-Cre marks not only the skeletal muscle fibers, certain cells in the cerebellum and the hindbrain but also gastric and intestinal mesenchymal cells that express Pdgfra. Confirming the utility of Dmpl-Cre in the gastrointestinal mesenchyme, deletion of Bmprla with Dmpl-Cre causes numerous large polyps along the gastrointestinal tract, consistent with prior work involving inhibition of BMP signaling. Thus, caution needs to be exercised when using Dmpl-Cre because it targets not only the osteoblast lineage at an earlier stage than previously appreciated, but also a number of non-skeletal cell types.

关键词： gene cell bone Unintended targeting of Dmp1-Cre reveals a critical role for Bmpr1a signaling in the gastrointestinal mesenchyme of adult mice Figure

Gastrointestinal manifestations of systemic mastocytosis

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World Journal of Gastroenterology 2008年第45期14卷 7005-7008页

作者： jason K Lee scott J Whittaker robert A Enns Peter Zetler Internal Medicine University of British Columbia st. Paul's Hospital Division of Gastroenterology University of British Columbia st. Paul's Hospital Division of Pathology University of British Columbia

systemic mastocytosis (sM) is a rare disease with abnormal proliferation and infiltration of mast cells in the skin, bone marrow, and viscera including the mucosal surfaces of the digestive tract. Gastrointestinal (GI) symptoms occur in 14%-85% of patients with systemic mastocytosis. The GI symptoms may be as frequent as the better known pruritis, urticaria pigmentosa, and flushing. In fact most recent studies show that the GI symptoms are especially important clinically due to the severity and chronicity of the effects that they produce. GI symptoms may include abdominal pain, diarrhea, nausea, vomiting, and bloating. A case of predominantly GI systemic mastocytosis with unique endoscopic images and pathologic confirmation is herein presented, as well as a current review of the GI manifestations of this disease including endoscopic appearances. Issues such as treatment and prognosis will not be discussed for the purposes of this paper.

关键词： systemic mastocytosis Idiopathic diarrhea Gastrointestinal manifestations