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Overprescription of opioid analgesia is common following ambulatory Otolaryngology—Head and Neck surgery procedures: A multicenter study

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第2期8卷 145-151页

作者： Amr F.Hamour Frederick Laliberte Jordan Levy Jason Xu Edward Park Vincent Lin john de almeida Julie Strychowsky Antoine Eskander Eric Monteiro department of Otolaryngology-Head and Neck Surgery University of TorontoTorontoOntarioCanada department of Otolaryngology-Head and Neck Surgery London Health Sciences CentreLondonOntarioCanada department of Otolaryngology-Head and Neck Surgery Mount Sinai HospitalTorontoOntarioCanada

Background: The rise in the use of prescription opioids for postoperative analgesia within surgery has mirrored an increased trend of opioid-related morbidity within Canada and the United States. This study prospectively studied daily pain levels and medication requirements postoperatively in patients undergoing elective Otolaryngology—Head and Neck surgery ***: Patients were asked to prospectively document their pain level and medication use daily for 7 days postoperatively. A final survey was used to quantify unused medication left at home and clarify each patient's disposal plan. We included patients undergoing elective outpatient or short stay surgeries from three tertiary care centers in Toronto, Ontario from September 2016 to September 2017. Previous opioids users or patients suffering from chronic pain were ***: A final cohort of 56 eligible adult patients were included in the study. The most common procedures were thyroidectomy (n = 19), endoscopic sinus surgery (n= 10), tympanoplasty/ossiculoplasty (n= 7), and cochlear implant (n = 5). Most patients received a prescription for acetaminophen/codeine (n = 29, 51.8%) or acetaminophen/oxycodone (n = 22, 39.3%) and used on average 29% of their initial prescription. Patients most commonly opted to keep their unused narcotics at home (n = 23, 41%). A total of 710 tablets of narcotics were overprescribed in our study population, 351 of which were kept in patients'' home for future ***: There is a clear tendency to overestimate postoperative pain resulting in significant overprescription of opioids among Otolaryngologists.

关键词： analgesia health policy opioid quality improvement quality of life

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Optimizing prediction models for pancreatic fistula after pancreatectomy:Current status and future perspectives

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World Journal of Gastroenterology 2024年第10期30卷 1329-1345页

作者： Feng Yang john A Windsor de-Liang Fu department of Pancreatic Surgery Huashan HospitalShanghai Medical CollegeFudan UniversityShanghai 200040China Surgical and Translational Research Centre Faculty of Medical and Health SciencesUniversity of AucklandAuckland 1142New Zealand

Postoperative pancreatic fistula(POPF)is a frequent complication after pancre-atectomy,leading to increased morbidity and *** prediction models for POPF has emerged as a critical focus in surgical *** over sixty models following pancreaticoduodenectomy,predominantly reliant on a variety of clinical,surgical,and radiological parameters,have been documented,their predictive accuracy remains suboptimal in external validation and across diverse *** models after distal pancreatectomy continue to be pro-gressively reported,their external validation is eagerly ***,POPF prediction after central pancreatectomy is in its nascent stage,warranting urgent need for further development and *** potential of machine learning and big data analytics offers promising prospects for enhancing the accuracy of prediction models by incorporating an extensive array of variables and optimizing algorithm ***,there is potential for the development of personalized prediction models based on patient-or pancreas-specific factors and postoperative serum or drain fluid biomarkers to improve accuracy in identifying individuals at risk of *** the future,prospective multicenter studies and the integration of novel imaging technologies,such as artificial intelligence-based radiomics,may further refine predictive *** these issues is anticipated to revolutionize risk stratification,clinical decision-making,and postoperative management in patients undergoing pancre-atectomy.

关键词： Pancreatic fistula Pancreaticoduodenectomy Distal pancreatectomy Central pancreatectomy Prediction model Machine learning Artificial intelligence

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development and characterization of 3D-printed electroconductive pHEMA-co-MAA NP-laden hydrogels for tissue engineering

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Bio-design and Manufacturing 2024年第3期7卷 262-276页

作者： Sara de Nitto Aleksandra Serafin Alexandra Karadimou Achim Schmalenberger john J.EMulvihill Maurice N.Collins DIBRIS Polytechnic Inter-School Section University of Genoa16126 GenoaItaly School of Engineering Bernal InstituteUniversity of LimerickLimerick V94 T9PXIreland School of Natural Sciences Department of Biological SciencesUniversity of LimerickLimerick V94 T9PXIreland Health Research Institute University of LimerickLimerick V94 T9PXIreland AMBER University of LimerickLimerick V94 T9PXIreland

Tissue engineering(TE)continues to be widely explored as a potential solution to meet critical clinical needs for diseased tissue replacement and tissue *** this study,we developed a poly(2-hydroxyethyl methacrylate-co-methacrylic acid)(pHEMA-co-MAA)based hydrogel loaded with newly synthesized conductive poly(3,4-ethylene-dioxythiophene)(PEDOT)and polypyrrole(PPy)nanoparticles(NPs),and subsequently processed these hydrogels into tissue engineered constructs via three-dimensional(3D)*** presence of the NPs was critical as they altered the rheological properties during ***,all samples exhibited suitable shear thinning properties,allowing for the development of an optimized processing window for 3D *** were 3D printed into pre-determined disk-shaped configurations of 2 and 10 mm in height and diameter,*** observed that the NPs disrupted the gel crosslinking efficiencies,leading to shorter degradation times and compressive mechanical properties ranging between 450 and 550 *** conductivity of the printed hydrogels increased along with the NP concentration to(5.10±0.37)×10^(−7)S/*** vitro studies with cortical astrocyte cell cultures demonstrated that exposure to the pHEMA-co-MAA NP hydrogels yielded high cellular viability and proliferation ***,hydrogel antimicrobial studies with staphylococcus epidermidis bacteria revealed that the developed hydrogels affected bacterial *** together,these materials show promise for various TE strategies.

关键词： Conductive nanoparticles Hydroxyethyl methacrylate(HEMA) Ultraviolet(UV)polymerization 3D printing

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Review of Networked Microgrid Protection:Architectures,Challenges,Solutions,and Future Trends

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CSEE Journal of Power and Energy Systems 2024年第2期10卷 448-467页

作者： Jorge de la Cruz Ying Wu john E.Candelo-Becerra Juan C.Vasquez Josep M.Guerrero Center for Research on Microgrids(CROM) Department of Energy TechnologyAalborg University9220 AalborgDenmark Facultad de Minas Departamento de Energia Eléctrica y AutomaticaUniversidad Nacional de ColombiaSede MedellinCarrera 80 No.65-223RobledoMedellin 050041Colombia. Center for Research on Microgrids at UPC(UPC CROM) Department of Electronic EngineeringTechnical University of Catalonia(UPC)08019 Barcelona Spain ICREA Pg.Lluis Companys 2308010 BarcelonaSpain Center for Research on Microgrids at AAU(AAU CROM) AAU EnergyAalborg University(AAU)9220 Aalborg EastDenmark

design and selection of advanced protection schemes have become essential for reliable and secure operation of networked *** protection schemes that allow correct operation of microgrids have been proposed for individual systems in different topologies and ***,protection schemes for networked microgrids are still in devel-opment,and further research is required to design and operate advanced protection in interconnected *** of these microgrids in different nodes with various intercon-nection technologies increases fault occurrence and complicates protection *** paper aims to point out challenges in developing protection for networked microgrids,potential solutions,and research areas that need to be addressed for their ***,this article presents a systematic analysis of different microgrid clusters proposed since 2016,including several architectures of networked microgrids,operation modes,components,and utilization of renewable sources,which have not been widely explored in previous review ***,the paper presents a discussion on protection systems currently available for microgrid clusters,current challenges,and solutions that have been proposed for these ***,it discusses the trend of protection schemes in networked microgrids and presents some conclusions related to ***—Adaptive eprotection,microgrid cluster,microgrid,multiple microgrid,networked microgrid,real-time simulation,smart grid.

关键词： Adaptive eprotection microgrid cluster microgrid multiple microgrid networked microgrid real-time simulation smart grid

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Does photobiomodulation require glucose to work effectively?

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Neural Regeneration Research 2024年第5期19卷 945-946页

作者： Jaimie Hoh Kam john Mitrofanis UniversitéGrenoble Alpes Fonds de Dotation ClinatecGrenobleFrance University College London Institute of OphthalmologyUK

A main requirement for cells to function normally is the availability of ***,available either direct from circulation or storage,is converted to the essential energy that cells need to drive critical intrinsic *** cells are deprived of glucose,they become dysfunctional and suffer ***,the use of specific wavelengths of light on body tissues,has been shown to promote,through small organelles called mitochondria,the metabolism of glucose to make energy for cells;this energy can be used to improve cell function and *** this perspective,we hypothesize that the availability of glucose is central to the core mechanism of photobiomodulation;that photobiomodulation is at its most efficient in stimulating mitochondrial activity and improving cell function when there is glucose readily available.

关键词： metabolism distress stimulating

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What Knowledge is of Most Worth?Considering the Neo-Confucians in the Contemporary debate Between Moral and Intellectual Learning

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ECNU Review of Education 2024年第1期7卷 155-163页

作者： john Patrick Shekitka Manhattanville College

●The perennial debate regarding the relative usefulness of various forms of knowledge,especially between the theoretical and practical and the intellectual and moral,lies at the heart of education in both past and present times in both the West and China(de Bary,1988,2004,2005,2015).●Neo-Confucians remain relevant in the 21st century and can help us to understand and elucidate contemporary debates in education-specifically,to answer the question Spencer asked nearly a century and a half ago:"What knowledge is of most worth?".●Mencius,Zhu Xi,Wang Yangming,Xu Ai,and Kang Youwei advocated for a type of learning that would strongly resonate with john dewey(1938)and Paulo Freire(1970,1978).Foundational philosophies of education,particularly in the United States,have drawn heavily on 20th century European-American thinkers;this article attempts to correct this myopia and broaden perspectives.

关键词： Freire john dewey Neo-Confucian

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Oscillating Spacetime: The Foundation of the Universe

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Journal of Modern Physics 2024年第8期15卷 1097-1143页

作者： john A. Macken Santa Rosa California USA

In this article, spacetime is modeled as a quantum mechanical sonic medium consisting of Planck length oscillations at Planck frequency. Planck length-time oscillations give spacetime its physical constants of c, G and ħ. Oscillating spacetime is proposed to be the single universal field that generates and unifies everything in the universe. The 17 fields of quantum field theory are modeled as lower frequency resonances of oscillating spacetime. A model of an electron is proposed to be a rotating soliton wave in this medium. An electron appears to have wave-particle duality even though it is fundamentally a quantized wave. This soliton wave can momentarily be smaller than a proton in a high energy collision or can have a relatively large volume of an atom’s orbital wave function. Finding an electron causes it to undergo a superluminal collapse to a smaller wave size. This gives an electron its particle-like properties when detected. The proposed wave-based electron model is tested and shown to have an electron’s approximate energy, de Broglie wave properties and undetectable volume. Most important, this electron model is shown to also generate an electron’s electrostatic and gravitational forces. The gravitational properties are derived from the nonlinearity of this medium. When an electron’s gravitational and electrostatic forces are modeled as distortions of soliton waves, the equations become very simple, and a clear connection emerges between these forces. For example, the gravitational force between two Planck masses equals the electrostatic force between two Planck charges. Both force magnitudes equal ħc/r2.

关键词： Unification of Forces Electron Model Cosmological Constant Problem Foundation of Physics Aether

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Provenance and depositional setting of the Late MiocenePleistocene clastic sediments in the eastern Arabian Peninsula and western Iraq using rare earth elements geochemistry

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Acta Geochimica 2024年第2期43卷 399-410页

作者： Salih M.Awadh Zinah S.Al-Ankaz Mohanad R.A.Al-Owaidi john S.Armstrong-Altrin department of Geology College of ScienceUniversity of BaghdadBaghdadIraq department of Geology College of ScienceUniversity of WasitWasit 52011Iraq department of Applied Geology College of ScienceUniversity of BabylonBabylon 51001Iraq Unidad de Procesos Oceanicos y Costeros Instituto de Ciencias del Mar y LimnologíaUniversidad Nacional Autonoma de MexicoCiudad Universitaria04510 Mexico CityCDMXMexico department of Marine Sciences Bharathidasan UniversityTiruchirapalliTamil Nadu 620024India

The sandstones of the Late miocene–Pliocene Dibdibba Formation in the Najaf–Karbala Plateau and Basra were examined to determine their source rocks and origin. The rare earth elements(REE) and trace elements(Sc, Co, V, and Th) concentrations in these sandstones revealed that they likely derived from a single source. The steep light rare earth elements(LREE) and flat, heavy rare earth element(HREE) patterns, negative Eu anomaly, and high ΣREE contents in sandstones suggest its derivation from a suggests that a passive continental margin environment and originated from felsic source rocks. The average concentration of ΣREE is 93.5 ppm, which is lower than that of the average crustal compositions like Upper Continental Crust and Post Archean Australian Shale. The higher proportion of LREE compared to HREE implies that these sandstones were recycled and derived from a distal source. The Th/Co, Th/Sc, La/Sc, La/Co, Eu/Eu*and(La/Lu)cn elemental ratios indicated that these Late Miocene–Pliocene sandstones were derived from felsic rocks located in the marginal region of the Arabian Shield.

关键词： REE Dibdibba formation Clastic sediments Passive continental margin

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Tree species identity and interaction determine vertical forest structure in young planted forests measured by terrestrial laser scanning

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Forest Ecosystems 2024年第3期11卷 266-275页

作者： Mengxi Wang Lander Baeten Frieke Van Coillie Kim Calders Kris Verheyen Quentin Ponette Haben Blondeel Bart Muys john Armston Hans Verbeeck Q-ForestLab Department of EnvironmentFaculty of Bioscience EngineeringGhent UniversityBelgium Forest&Nature Lab Department of EnvironmentFaculty of Bioscience EngineeringGhent UniversityBelgium Earth and Life Institute Université Catholique de Louvain(UCLouvain)Louvain-la-NeuveBelgium department of Earth&Environmental Sciences KU LeuvenBelgium department of Geographical Sciences University of MarylandCollege ParkMDUSA

Vertical forest structure is closely linked to multiple ecosystem characteristics,such as biodiversity,habitat,and *** tree species in planted forests has the potential to create diverse vertical forest structures due to the different physiological and morphological traits of the composing tree ***,the relative importance of species richness,species identity and species interactions for the variation in vertical forest structure remains unclear,mainly because traditional forest inventories do not observe vertical stand structure in *** laser scanning(TLS),however,allows to study vertical forest structure in an unprecedented ***,we used TLS single scan data from 126 plots across three experimental planted forests of a largescale tree diversity experiment in Belgium to study the drivers of vertical forest *** plots were 9–11years old young pure and mixed forests,characterized by four levels of tree species richness ranging from monocultures to four-species mixtures,across twenty composition *** generated vertical plant profiles from the TLS data and derived six stand structural *** mixed models were used to test the effect of species richness on structural *** a hierarchical diversity interaction modelling framework,we further assessed species identity effect and various species interaction effects on the six stand structural *** results showed that species richness did not significantly influence most of the stand structure variables,except for canopy height and foliage height *** identity on the other hand exhibited a significant impact on vertical forest structure across all *** interaction effects were observed to be site-dependent due to varying site conditions and species pools,and rapidly growing tree species tend to dominate these ***,our results highlighted the importance of considering both species identity an

关键词： TreeDivNet FORBIO Stand structural complexity Terrestrial laser scanning Vertical forest structure Tree diversity Planted forests

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Effects of a school-based karate intervention on academic achievement,psychosocial functioning,and physical fitness:A multi-country cluster randomized controlled trial

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Journal of Sport and Health Science 2024年第1期13卷 90-98页

作者： Tania Pinto-Escalona Erica Gobbi Pedro L.Valenzuela Simon J.Bennett Pierluigi Aschieri Manuel Martin-Loeches Antonio Paoli Oscar Martinez-de-Quel Faculty of Education Complutense University of MadridMadrid 28040Spain department of Biomolecular Sciences University of Urbino“Carlo Bo”Urbino 61029Italy department of Systems Biology University of AlcaláMadrid 28805Spain Research Institute for Sport and Exercise Sciences Faculty of ScienceLiverpool John Moores UniversityLiverpoolL33AFUK Italian Judo WrestlingKarate and Martial Arts FederationRome 00122Italy Psychobiology&Methods for the Behavioural Sciences department Complutense University of MadridMadrid 28040Spain department of Biomedical Sciences University of PaduaPadua 35122Italy

Purpose:To examine the effects of a school-based karate intervention on academic achievement,psychosocial functioning,and physical fitness in children aged 7-8 ***:Twenty schools in 5 different European countries(2 second-grade classrooms per school)participated in a cluster randomized controlled trial(Sport at School trial).Participants were assigned to either a control group,which continued with their habitual physical education lessons,or to an intervention group,which replaced these lessons with a 1-year karate intervention(Karate Mind and Movement program).A total of 721 children(344 girls and 377 boys,7.4±0.5 years old,mean±SD)completed the study,of which 333 and 388 were assigned to the control group and intervention group,*** included academic performance(average grade),psychosocial functioning(Strengths and Difficulties Questionnaire for parents),and different markers of physical fitness(cardiorespiratory fitness,balance,and flexibility).Results:The intervention provided small but significant benefits compared to the control group for academic achievement(d=0.16;p=0.003),conduct problems(d=-0.28;p=0.003),cardiorespiratory fitness(d=0.36;p0.05).Conclusion:A 1-year school-based karate intervention was effective in improving academic achievement,conduct problems,and physical fitness in primary school *** results support the inclusion of karate during physical education lessons.

关键词： Academic performance Cardiorespiratory fitness Conduct problems Karate Physical fitness

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