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Factors associated with time to laparoscopic cholecystectomy for acute cholecystitis

World Journal of Gastroenterology 2008年第7期14卷 1084-1090页

作者： Chris N Daniak David Peretz jonathan M fine Yun Wang Alan K Meinke William B Hale Section of Gastroenterology Norwalk Hospital Norwalk CT United States Department of Internal Medicine Norwalk Hospital Norwalk CT United States Center for Outcomes Research and Evaluation Yale University/Yale New Haven Health System New Haven CT United States Department of Surgery Norwalk Hospital Norwalk CT United States

AIM: To determine patient and process of care factors associated with performance of timely laparoscopic cholecystectomy for acute cholecystitis. METHODS: A retrospective medical record review of 88 consecutive patients with acute cholecystitis was conducted. Data collected included demographic data, co-morbidities, symptoms and physical findings at presentation, laboratory and radiological investigations, length of stay, complications, and admission service (medical or surgical). Patients not undergoing cholecystectomy during this hospitalization were excluded from analysis. Hierarchical generalized linear models were constructed to assess the association of pre-operative diagnostic procedures, presenting signs, and admitting service with time to ***: Seventy cases met inclusion and exclusion criteria, among which 12 were admitted to the medical service and 58 to the surgical service. Mean ± SD time to surgery was 39.3 ± 43 h, with 87% of operations performed within 72 h of hospital arrival. In the adjusted models, longer time to surgery was associated with number of diagnostic studies and endoscopic retrograde cholangio-pancreatography (ERCP, P = 0.01) as well with admission to medical service without adjustment for ERCP (P < 0.05). Patients undergoing both magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT) scans experienced the longest waits for surgery. Patients admitted to the surgical versus medical service underwent surgery earlier (30.4 ± 34.9 vs 82.7 ± 55.1 h, P < 0.01), had less post-operative complications (12% vs 58%, P < 0.01), and shorter length of stay (4.3 ± 3.4 vs 8.1 ± 5.2 d, P < 0.01).CONCLUSION: Admission to the medical service and performance of numerous diagnostic procedures, ERCP, or MRCP combined with CT scan were associated with longer time to surgery. Expeditious performance of ERCP and MRCP and admission of medically stable patients with suspected cholecystitis to the surgical service to speed up ti

关键词： Acute cholecystitis Laparoscopic cholecystectomy Endoscopic retrograde cholangiopancreatography Post-operative complications

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射流电流计

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仪表技术与传感器 1972年第4期 45-48页

作者： jonathan E.fine 美国哈利.戴蒙德实验室

用一种射流电流计系统可测量电流在非绝缘导线上的流动情况。其敏感元件是一个射流振荡器,它的输出频率与电流所产生的热量成函数关系。这样的装置能做得十分灵敏,例如正在发展用来检测由周围射频辐射在测量电桥导线上所感应的电流。在... 详细信息

用一种射流电流计系统可测量电流在非绝缘导线上的流动情况。其敏感元件是一个射流振荡器,它的输出频率与电流所产生的热量成函数关系。这样的装置能做得十分灵敏,例如正在发展用来检测由周围射频辐射在测量电桥导线上所感应的电流。在这种情况下,其特点是:测量讯号介质是流体,因此这不会引入更多的电磁干扰。系统的叙述气源的气体进入振荡器,并冲击分流器(图1),从而形成了以公式1所给出的频率来激励空腔的边棱音。表1表示了各种术语。f=KT……………………(1)

关键词：电流计导线基准振荡器传送线生产线

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Conscious or unconscious:The impact of sedation choice on colon adenoma detection

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World Journal of Gastroenterology 2011年第34期17卷 3912-3915页

作者： Mark Metwally Nicholas Agresti William B Hale Victor Ciofoaia Ryan O＇Connor Michael B Wallace jonathan fine Yun Wang Seth A Gross Department of Gastroenterology Norwalk Hospital 34 Stevens St. Norwalk CT 06850 United States Department of Gastroenterology Mayo Clinic 4500 San Pablo Road FL 32224 United States Department of Statistics Yale University 333 Cedar Street New Haven CT 06510 USA 34 Stevens St. Norwalk CT 06850 United States

AIM: To determine if anesthesiologist-monitored useof propofol results in improved detection of adenomaswhen compared with routine conscious sedation. METHODS: This retrospective study was conductedat two separate hospital-based endoscopy units whereapproximately 12 000 endoscopic procedures are permed annually, with one endoscopy unit exclusivelyusing anesthesiologist-monitored propofol. Three thousand two hundred and fifty-two patients underwent initial screening or surveillance colonoscopies. Our primaryend point was the adenoma detection rate, def ined asthe number of patients in whom at least one adenomawas found, associated with the type of sedation. RESULTS: Three thousand two hundred and fi ftytwooutpatient colonoscopies were performed by fi ve selected endoscopists. At least one adenoma was detected in 27.6% of patients (95% CI = 26.0-29.1) with no difference in the detection rate between the anesthes-ologist propofol and group and the gastroenterologist-midazolam/fentanyl group (28.1% vs 27.1%, P = 0.53). CONCLUSION: The type of sedation used during colonoscopy does not affect the number of patients in whom adenomatous polyps are detected.

关键词： Sedation Colonoscopy Adenoma

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Infectious Disease Modelling 2018年第1期3卷 1-12页

作者： Mauricio Santillana Ashleigh Tuite Tahmina Nasserie Paul fine David Champredon Leonid Chindelevitch jonathan Dushoff David Fisman Computation Health Informatics Program Boston Children's HospitalBostonMAUSA Department of Pediatrics Harvard Medical SchoolBontonMAUSA Dalla Lana School of Public Health University of TorontoTorontoOntarioCanada BlueDot TorontoOntarioCanada Department of Infectious Disease Epidemiology London School of Hygiene and Tropical MedicineLondonUK Agent-Based Modelling Laboratory York UniversityTorontoOntarioCanada School of Computing Science Simon Fraser UniversityBurnabyBritish ColumbiaCanada Department of Theoretical Biology McMaster UniversityHamiltonOntarioCanada Department of Medicine Faculty of MedicineUniversity of TorontoTorontoOntarioCanada

Mathematical models are often regarded as recent innovations in the description and analysis of infectious disease outbreaks and epidemics,but simple mathematical expressions have been in use for projection of epidemic trajectories for more than a *** recently introduced a single equation model(the incidence decay with exponential adjustment,or IDEA model)that can be used for short-term epidemiological *** the mid-19th century,*** Farr made the observation that epidemic events rise and fall in a roughly symmetrical pattern that can be approximated by a bell-shaped *** noticed that this time-evolution behavior could be captured by a single mathematical formula(“Farr's law”)that could be used for epidemic *** show here that the IDEA model follows Farr's law,and show that for intuitive assumptions,Farr's Law can be derived from the IDEA ***,we show that both mathematical approaches,Farr's Law and the IDEA model,resemble solutions of a susceptible-infectious-removed(SIR)compartmental differential-equation model in an asymptotic limit,where the changes of disease transmission respond to control measures,and not only to the depletion of susceptible *** suggests that the concept of the reproduction number eR 0T was implicitly captured in Farr's(pre-microbial era)work,and also suggests that control of epidemics,whether via behavior change or intervention,is as integral to the natural history of epidemics as is the dynamics of disease transmission.

关键词： equation exponential decay

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Understanding urban structures and crowd dynamics leveraging large-scale vehicle mobility data

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Frontiers of Computer Science 2020年第5期14卷 77-88页

作者： Zhihan Jiang Yan Liu Xiaoliang Fan Cheng Wang jonathan Li Longbiao Chen Fujian Key Laboratory of Sensing and Computing for Smart Cities School of Information Science and EngineeringXiamen UniversityXiamen361005China

A comprehensive understanding of city structures and urban dynamics can greatly improve the efficiency and quality of urban planning and management,while the traditional approaches of which,such as manual surveys,usually incur substantial labor and *** this paper,we propose a data-driven framework to sense urban structures and dynamics from large-scale vehicle mobility ***,we divide the city into fine-grained grids,and cluster the grids with similar mobility features into structured urban areas with a proposed distance-constrained clustering algorithm(DCCA).Second,we detect irregular mobility traffic patterns in each area leveraging an ARIMA-based anomaly detection algorithm(ADAM),and correlate them to the urban social and emergency ***,we build a visualization system to demonstrate the urban structures and crowd *** evaluate our framework using real-world datasets collected from Xiamen city,China,and the results show that the proposed framework can sense urban structures and crowd comprehensively and effectively.

关键词： vehicle mobility big data spatial clustering event detection urban computing ubiquitous computing

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Group dynamics and relocation decisions of a trap-building predator are differentially affected by biotic and abiotic factors

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Current Zoology 2017年第6期63卷 647-655页

作者： Noa KATZ Roni SHAVIT jonathan N. PRUITT Inon SCHARF Department of Zoology Faculty of Life Sciences Tel Aviv University Tel Aviv 69978 Israel Department of Ecology Evolution and Marine Biology University of California Santa Barbara CA 93106-9610 USA

Most habitats in nature are heterogeneous, incorporating favorable and unfavorable microhabitats for different animals, based on their ecological niche. Unsuitable microhabitats have negative consequences for individual growth and survival. Animals, therefore, should fine-tune their location within the habitat by dispersing away from such microhabitats. We studied the suitability of different constant microhabitat conditions for wormlion larvae, a trap-building predator, tested in groups under laboratory conditions. Wormlions construct pit-traps in loose soil and capture small arthropod prey. As wormlions occur in high densities in nature, testing in groups is thus more indicative of their natural behavior than testing individuals. Wormlions responded strongly to biotic conditions--high conspecific density, starvation, and large body mass of conspecifics--by either increasing pit-relocation events or moving away from the microhabitat center to the periphery of the arena, probably opting for a way out. In other instances, individuals increased their distance to the nearest neighbor, thereby changing the spatial pattern toward a more regular pattern, potentially indicating interference competition. The only abiotic condition apparently perceived by wormlions as unsuitable was shallow sand, which led to frequent relocations. The two other abiotic factors--illumination and sand particle size--had no observable effect on behavior, although wormlions in nature always occur under shade in fine sand, and prefer both shade and fine sand particle size under laboratory conditions when given a choice. Under the fine spatial scale of the present experiment, biotic factors appear to be more influential than abiotic ones.

关键词： antlions dispersal relocation spatial pattern wormlions.

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Venous vascular malformation of the parotid gland

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世界耳鼻咽喉头颈外科杂志英文版 2024年第4期10卷 350-352页

作者： Hakimi Amir A. Wu Eric L. Giurintano jonathan Department of Otolaryngology-Head and Neck Surgery Medstar Georgetown University Hospital Washington District of Columbia USA

Venous vascular malformations of the parotid gland are very rare vascular tumors, especially among adults. This case report discusses the presentation and challenges of diagnosing a venous vascular malformation of the parotid gland in a patient with previous oncologic history. Our patient is a 45-year-old female with a history of breast cancer, meningioma, and secreting pituitary adenoma who presented with a malformation on magnetic resonance imaging, incidentally demonstrating a T2 intense mass in the superficial lobe of the right parotid gland. She was otherwise asymptomatic. Ultrasound-guided fine needle aspiration was nondiagnostic. She underwent a right inferior superficial parotidectomy. Histologic section analysis demonstrated a well-delineated vascular tumor made of large vascular spaces with thin walls surrounded by a parotid tissue consistent with a venous vascular malformation of the parotid gland. Venous vascular malformations are exceedingly rare, especially among adults. Ultrasound-guided fine needle aspiration can be of limited value. Parotidectomy may be electively considered for diagnostic and therapeutic purposes.

关键词： parotidectomy salivary gland tumor vascular malformation

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Tunneled biopsy is an underutilised,simple,safe and efficient method for tissue acquisition from subepithelial tumours

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World Journal of Clinical Cases 2021年第21期9卷 5822-5829页

作者： Andreas Koutsoumpas Ruwan Perera Adele Melton jonathan Kuker Tilak Ghosh Barbara Braden Translational Gastroenterology Unit Oxford University Hospitals NHS Foundation TrustOxford OX39DUUnited Kingdom Senior School Magdalen College SchoolOxford OX40DZUnited Kingdom Translational Gastroenterology Unit Oxford University Hospital NHS Foundation TrustOxford OX39DUUnited Kingdom

BACKGROUND Tissue acquisition from subepithelial lesions is often attempted by endoscopic ultrasound(EUS)-sampling as conventional endoscopic biopsy usually fails to reach deeper layers of the gastrointestinal *** To investigate the utilisation,safety and diagnostic yield of an intensified“biteon-bite”tunnel biopsy *** In this retrospective cohort study,all patients presenting with subepithelial masses in the upper gastrointestinal tract from March 2013 to July 2019 were *** were analysed for size and location of the subepithelial mass,use of intensified tunnel biopsy protocol(more than 10 double bite-on-bite biopsies)or superficial conventional biopsies,histology and imaging results,occurrence of readmission and adverse events after *** Two hundred and twenty-nine patients with subepithelial lesions were *** conventional biopsies were taken in 117 patients and were diagnostic only in one lipoma(0.9%).Tunnel biopsies taken in 112/229(48.9%)patients were significantly more likely to provide histological diagnosis(53.6%;P<0.001).For lesions≥10mm the diagnostic yield of tunnel biopsies further increased to 41/67(61.2%).No immediate or delayed complications were *** 8 of the 51 endoscopists(15.7%)regularly attempted tunnel *** Tunnel biopsy is a simple,safe and efficient but underutilised diagnostic modality for tissue acquisition in subepithelial *** should be routinely attempted at the initial endoscopy.

关键词： Gastrointestinal stromal tumour fine needle biopsy Lipoma Immunohistology Neuroendocrine tumours fine needle biopsy

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下方玻璃体腔注射后眼内炎高发病率研究（英文）

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国际眼科杂志 2015年第5期15卷 750-754页

作者： Gowtham Jonna Daniel B. Roth Howard F. fine H. Matthew Wheatley jonathan L. Prenner Arvin Kheterpal Suzanne Cohen William J. Feuer 罗格斯大学Robert Wood Johnson医学院眼科美国新泽西州08901 迈阿密大学Miller医学院、Bascom Palmer眼科研究所美国佛罗里达州

目的:探讨下方玻璃体腔注射比上方注射出现注射后眼内炎的几率是否更高。下方小梁切除术滤过泡眼内炎的发病率高于上方小梁切除术滤过泡,有可能是因为细菌聚集在下方的泪湖。方法:经过广泛实践过的眼内炎病例数据库验证,发现在2a的研究... 详细信息

目的:探讨下方玻璃体腔注射比上方注射出现注射后眼内炎的几率是否更高。下方小梁切除术滤过泡眼内炎的发病率高于上方小梁切除术滤过泡,有可能是因为细菌聚集在下方的泪湖。方法:经过广泛实践过的眼内炎病例数据库验证,发现在2a的研究期间内,有5例眼内炎病例。同时,为了评估注射部位对发病率的影响,对治疗过的909例1 121眼共计8672次注射进行了回顾性调查。结果:5眼出现感染性眼内炎,80%的眼内炎病例均是下方注射,尽管所选病例中84.6%是位于上方注射。与感染有关的下方注射部位的危险比是(OR)22.1(P=0.006)。结论:玻璃体腔注射后感染眼内炎的几率很小,仅为0.025%。避免在偏下象限进行玻璃体腔注射可能会进一步减小眼内炎的发病率。

关键词：玻璃体内注射部位抗血管生长因子疗法眼内炎

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Disturbance history,species diversity,and structural complexity of a temperate deciduous forest

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Journal of Forestry Research 2020年第2期31卷 397-414页

作者： jonathan D.Goode Carson R.Barefoot Justin L.Hart Daniel C.Dey Department of Geography University of AlabamaTuscaloosaAL 35487USA Northern Research Station USDA Forest ServiceColumbiaMO 65211USA

Stand structural complexity enhancement is an increasingly popular management objective,especially on public *** stand structures are hypothesized to support a relatively high degree of native forest diversity and be more resistant and resilient to *** structures are characterized by the presence of deadwood and heterogeneity of tree-size classes and tree *** little is known about how discrete disturbance events affect structural complexity and compositional diversity in Quercus-dominated stands at fine spatial scales(***).We established 200.05 ha fixed-radius plots on the Sipsey Wilderness of William *** National Forest in northern Alabama to quantify woody plant species composition and *** were mapped on each plot to quantify overstory structural complexity and compositional *** extracted two cores from all canopy Quercus spp.C 5 cm diameter at breast height to quantify age,recruitment pulses,and reconstruct canopy disturbance *** species diversity in the sampled area was 1.75 for trees,2.08 for saplings,and 1.69 for *** alba had the greatest basal area,and Ostrya virginiana had the highest *** stand exhibited a reverse J-shaped distribution with a q-factor of *** oldest Quercus dated to 1795,and the largest recruitment pulse occurred in the *** mean return interval for intermediateseverity disturbance was 38 *** we documented no relationships between disturbance frequency and compositional diversity at the neighborhood scale(0.05 ha),less frequent disturbance was associated with higher structural complexity(r^2=0.258,p=0.026)at the neighborhood *** suggest that localized disturbance increases species diversity and structural complexity,but these processes are manifest at the stand level and not at the neighborhood *** conclude that the spatial variability(***,shape,orientation,microsite conditions)is likel

关键词： Canopy gap Quercus(oak) Stand development Succession

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