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Detecting accidental punctures and lacerations during cholecystectom. in large datasets: Two m.thods of analysis

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Hepatobiliary & Pancreatic Diseases International 2018年第5期17卷 430-436页

作者： Artem.Shm.lev Anne m.Sill Gopal C Kowdley juan A Sanchez Steven C Cunningham Departm.nt of Surgery Saint Agnes Hospital and Cancer Center

Background: After the Institute of m.dicine(IOm. report To Err Is Hum.n highlighted the im.act of m.dical errors, the Agency for Healthcare Research and Quality(AHRQ) developed Patient-Safety Indicators(PSI) to im.rove quality by identifying potential inpatient safety problem.. PSI-15 was created to study accidental punctures and lacerations(APL), but PSI-15 m.y underestim.te APLs in populations of patients. This study com.ares PSI-15 with a m.re inclusive approach using a novel com.osite of secondary diagnostic and procedural codes. m.thods: We used Nationwide Inpatient Sam.le(NIS) data(20 0 0–2012) from.AHRQ’s Healthcare Cost and Utilization Project(H-CUP). We analyzed PSI-15-positive and-negative cholecystectom.es. Cross tabulations identified codes that were significantly m.re frequent am.ng PSI-15-positive cases; these secondary diagnostic and procedural codes were selected as candidate m.m.ers of a com.osite m.rker(Cm. of APL. We chose cholecystectom. patients for study because this is one of the m.st com.on general operations, and the large size of NIS allows for m.aningful analysis of infrequent occurrences such as APL rates. Results: Cm.identified 1.13 tim.s m.re APLs than did PSI-15. Patients with Cm.detected APLs were significantly older and had worse m.rtality, com.rbidities, lengths of stay, and charges than those detected with PSI-15. Further com.arison of these two approaches revealed that tim.-series analysis for both APL m.rkers revealed parallel trends, with inflections in 2007, and lowest APL rates in July. Conclusions: Although Cm.m.y yield m.re false positives, it appears m.re inclusive, identifying m.re clinically significant APLs, than PSI-15. Both m.asures presented sim.lar trends over tim., arguing against inflation in PSI-15 reporting. While arguably less specific, Cm.m.y increase sensitivity for detecting APL events during cholecystectom.es. These results m.y inform.the interpretation of other large population studies of APLs following abd

关键词： Cholecystectom. Patient safety Accidental lacerations AHRQ PSI-15

Incorporating extrem. event attribution into clim.te change adaptation for civil infrastructure:m.thods,benefits,and research needs

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Resilient Cities and Structures 2024年第1期3卷 103-113页

作者： Yating Zhang Bilal m.Ayyub juan F.Fung Zachary m.Labe Departm.nt of Civil and Environm.ntal Engineering University of MarylandCollege ParkMD 20742 Applied Econom.cs Office Engineering LaboratoryNational Institute of Standards and TechnologyGaithersburgMD 20899 Program.in Atm.spheric and Oceanic Sciences Princeton UniversityPrincetonNJ 08540

In the last decade,the detection and attribution science that links clim.te change to extrem. weather and clim.te events has em.rged as a growing field of research with an increasing body of *** paper overviews the m.thods for extrem. event attribution(EEA)and discusses the new insights that EEA provides for infrastructure *** found that EEA can inform.stakeholders about current clim.te risk,support vulnerability-based and hazard-based adaptations,assist in the developm.nt of cost-effective adaptation strategies,and enhance justice and equity in the allocation of adaptation *** engineering practice shifts from.a retrospective approach to a proactive,forward-looking risk m.nagem.nt strategy,EEA can be used together with clim.te projections to enhance the com.rehensiveness of decision m.king,including planning and preparing for un-precedented extrem. ***,attribution assessm.nt can be m.re useful for adaptation planning when the exposure and vulnerability of com.unities to past events are analyzed,and future changes in the probability of extrem. events are *** large uncertainties inherent in event attribution and clim.te projections,future research should exam.ne the sensitivity of engineering design to clim.te m.del uncertainties,and adapt engineering practice,including building codes,to uncertain future *** this study focuses on adaptation planning,EEA can also be a useful tool for inform.ng and enhancing decisions related to clim.te m.tigation.

关键词： Clim.te change Extrem. weather and clim.te events Extrem. event attribution Infrastructure adaptation Uncertainties

On the role of endogenous neurotoxins and neuroprotection in Parkinson's disease

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Neural Regeneration Research 2017年第6期12卷 897-901页

作者： juan Segura-Aguilar m.lecular and Clinical Pharm.cology ICBM Faculty of Medicine University of Chile

For 50 years ago was introduced L-3,4-dihydroxyphenylalanine（L-dopa） in Parkinson＇s disease treatm.nt and during this significant advances has been done but what trigger the degeneration of the nigrostriatal system.rem.in unknown. There is a general agreem.nt in the scientific com.unity that m.tochondrial dysfunction, protein degradation dysfunction, alpha-synuclein aggregation to neurotoxic oligom.rs, neuroinflam.ation, oxidative and endoplasm.c reticulum.stress are involved in the loss of dopam.nergic neurons containing neurom.lanin in Parkinson＇s disease. The question is what triggers these m.chanism.. The age of norm.l onset in idiopathic Parkinson＇s disease suggests that environm.ntal factors such as m.tals, pollutants or genetic m.tations cannot be involved because these factors are related to early onset of Parkinsonism. Therefore, we have to search for endogenous neurotoxins and neuroprotection in order to understand what trigger the loss of dopam.nergic neurons. One im.ortant feature of Parkinson＇s disease is the rate of the degenerative process before the m.tor sym.tom. are evident and during the disease progression. The extrem.ly slow rate of Parkinson＇s disease suggests that the neurotoxins and the neuroprotection have to be related to dopam.ne m.tabolism. Possible candidates for endogenous neurotoxins are alpha-synuclein neurotoxic oligom.rs, 4-dihydroxyphenylacetaldehyde and ortho-quinones form.d during dopam.ne oxidation to neurom.lanin. Vesicular m.noam.ne transporter-2, DT-diaphorase and glutathione transferase m.-2 seem. to be the m.st im.ortant neuroprotective m.chanism.to prevent neurotoxic m.chanism.during dopam.ne oxidation.

关键词： dopam.ne endogenous endoplasm.c degeneration reticulum.extrem.ly glutathione Dopam.ne transporter m.tabolism

Surveillance and diagnosis of hepatocellular carcinom.: A system.tic review

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World Journal of Clinical Cases 2019年第16期7卷 2269-2286页

作者： Sonia Pascual Cayetano m.ralles juan m.Bernabé Javier Irurzun m.riana Planells Liver Unit Hospital General Universitario de AlicanteAlicante 03010Spain Centro de Investigación Biom.dica en Red de Enferm.dades Hepáticas y Digestivas CIBEREHDAlicante 03010Spain Radiology Departm.nt Hospital General Universitario de AlicanteAlicante 03010Spain

BACKGROUND Hepatocellular carcinom. (HCC) appears in m.st of cases in patients with advanced liver disease and is currently the prim.ry cause of death in this *** of HCC has been proposed and recom.ended in clinical guidelines to obtain earlier diagnosis,but it is still controversial and is not accepted *** To review the actual evidence to support the surveillance program. in patients with cirrhosis as well as the diagnosis *** System.tic review of recent literature of surveillance (tools,interval,cost-benefit,target population) and the role of im.ging diagnosis (radiological non-invasive diagnosis,optim.l m.dality and agents) of *** The benefits of surveillance of HCC,m.inly with ultrasonography,have been assessed in several prospective and retrospective analysis,although the percentage of patients diagnosed in surveillance program. is still *** of HCC perm.ts diagnosis in early stages allows better access to curative treatm.nt and increases life expectancy in patients with *** is a tum.r with special radiological characteristics in com.uted tom.graphy and m.gnetic resonance im.ging,which allows highly accurate diagnosis without routine biopsy *** actual recom.endation is to perform.biopsy only in indeterm.nate *** The evidence supports the recom.endation of perform.ng surveillance of HCC in patients with cirrhosis susceptible of treatm.nt,using ultrasonography every 6 *** diagnosis evaluation of HCC can be established based on noninvasive im.ging criteria in patients with cirrhosis.

关键词： Surveillance Hepatocellular carcinom. Ultrasonography Cirrhosis Im.ging diagnosis

Optim.zed high perform.nce liquid chrom.tography–ultraviolet detection m.thod using core-shell particles for the therapeutic m.nitoring of m.thotrexate

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Journal of Pharm.ceutical Analysis 2016年第2期6卷 103-111页

作者： m.lagros m.ntem.rro m.ría m.de zan juan c.robles Laboratorio de Control de Calidad de m.dicam.ntos Facultad de Bioqufmica y Ciendas Biologicas Universidad Nacional del Litoral Santa Fe Argentina

m.thotrexate （m.X） is an antineoplastic drug, and due to its high toxicity, the therapeutic drug m.n- itoring is strictly conducted in the clinical practice. The chem.m.tric optim.zation and validation of a high perform.nce liquid chrom.tography （HPLC） m.thod using core-shell particles is presented for the determ.nation of m.X in plasm. during therapeutic m.nitoring. Experim.ntal design and response surface m.thodology （RSm. were applied for the optim.zation of the chrom.tographic system.and the analyte extraction step. A Poroshel1120 EC-C18 （3.0 m. × 75 m., 2.7 μm. colum. was used to obtain a fast and efficient separation in a com.lete run tim. of 4 m.n. The optim.m.conditions for the chrom.- tographic system.resulted in a m.bile phase consisting of acetic acid/sodium.acetate buffer solution （85.0 m., pH =4.00） and 11.2% of acetonitrile at a flow rate of 0.4 m./m.n. Selectivity, linearity, accuracy and precision were dem.nstrated in a range of 0.10-6.0 μm.of m.X. The application of the optim.zed m.thod required only 150μL of patient plasm. and a low consum.tion of solvent to provide rapid re- sults.

关键词： HPLC Core-shell particles m.thotrexate Drug m.nitoring

Analysis of SSRs Uncovers Hierarchical Structure and Genetic Diversity in Chinese Soybean Landraces

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Agricultural Sciences in China 2010年第12期9卷 1739-1748页

作者： LI Ying-hui m.rinus J m.Sm.lders CHANG Ru-zhen QIU Li-juan The National Key Facility for Crop Gene Resources and Genetic Im.rovem.nt (NFCRI)/Key Lab of Germ.lasm.Utilization Ministry of Agriculture (MOA)/Institute of Crop Sciences Chinese Academy of Agricultural Sciences Beijing 100081 P.R. China Plant Research International Wageningen UR Wageningen 6700 AA The Netherland

For clarifying the hierarchical patterns of population structure of soybean landraces in China, the seven clusters previously identified using Bayesian clustering of 1 504 soybean landraces based on SSR m.rkers genotyping data were further analyzed. Using the largest value of AK, these landraces could be split into 20 sub-clusters, which was supported by highly significant pairwise Fst-values and generally in accordance with the geographic origin and sowing types. The autum.-sowing types ended up in one distinct sub-cluster from.the otherwise sum.er-sowing type, where the autum.- sowing types are m.st likely derived from. The division into 20 sub-clusters explained 7.3% of the genetic variation, next to 9.7% present am.ng the seven clusters, 81.1% residing am.ng landraces within sub-clusters, and 1.9% within the landraces. The distribution pattern of genetic diversity am.ng the sub-clusters of each cluster was uneven, with two HSum.sub-clusters （Central China） and som. South China sub-clusters showing significantly higher level of genetic diversity.

关键词： soybean landrace hierarchical structure diversity

Evaluation of vaccine rollout strategies for em.rging infectious diseases:A m.del-based approach including protection attitudes

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Infectious Disease m.delling 2023年第4期8卷 1032-1049页

作者： m.uricio Paton juan m.Acuna Jorge Rodríguez Departm.nt of Chem.cal Engineering College of EngineeringKhalifa UniversitySAN Campus PO Box 127788Abu DhabiUnited Arab Emirates Departm.nt of Epidem.ology and Public Health College of Medicine.Khalifa UniversityPO Box 127788Abu DhabiUnited Arab Emirates

Vaccine allocation strategies becom. crucial during vaccine shortages,especially in the face of potential outbreaks of new infectious diseases,as witnessed during the COVID-19 *** address this,a specialized com.artm.ntal m.del is created,which sim.lates an em.rging infectious disease sim.lar to *** m.del divides the population into different age groups and is used to com.are various vaccine prioritisation approaches,aim.ng to m.nim.ze the total num.er of *** m.del is an im.rovem.nt upon previous ones as it incorporates essential behavioural factors and is adapted to account for the protective effects of vaccination against both disease infection and *** takes into account hum.n behaviors such as m.sk-wearing and social distancing by utilizing specific param.ters related to self-protection,awareness levels,and the frequency of daily person-to-person interactions within each age ***,a novel m.thod for dynam.c vaccine prioritisation was introduced in this *** approach is m.del-independent and relies on the dynam.c R *** is the first tim. such a m.thod has been developed,offering a decision-m.king approach that is not tied to any specific *** innovation provides a flexible and adaptable strategy for determ.ning vaccine priorities based on real-tim. data and the current state of the *** findings reveal crucial insights into vaccine allocation *** the daily rollout rates are fast(0.75%or higher)and children are eligible for vaccination,prioritising groups with high daily person-to-person interactions can lead to substantial reductions in total fatalities(up to approxim.tely 40%lower).On the other hand,if rollout rates are slower and overall vaccination coverage is high,focusing on vaccinating elders em.rges as the m.st effective strategy,resulting in up to approxim.tely 10%fewer ***,the scenario changes significantly when children are not eligible for vaccination

关键词： behaviour slower utilizing

Acute kidney injury in severely injured patients adm.tted to the Intensive Care Unit

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m.litary m.dical Research 2021年第2期8卷 141-147页

作者： Alberto F.García Ram.ro m.nzano-Nunez juan G.Bayona m.ria P.Naranjo Dary Neicce Villa m.nuel m.reno Sebastian Ossa juan m.m.rtinez Nathalia m.rtinez juan C.Puyana Division of Traum. and Acute Care Surgery Department of SurgeryFundación Valle del LiliCaliColombia Clinical Research Center Fundación Valle del LiliCaliColombia Escuela de m.dicina Ciencias de la SaludUniversidad del RosarioCarrera 98#18-49760001BogotaColombia m.deri Hospital Universitario m.yor Colombia School of m.dicine Universidad ICESI(ICESI University)CaliColombia Departm.nt of Surgery University of PittsburghPittsburghPAUSA

Background:Our objective was to identify possible associations between clinical and laboratory variables and the risk of developing acute kidney injury(AKI)in severely injured patients adm.tted to the Intensive Care Unit(ICU)for whom.creatine kinase(CK)levels were ***:For this retrospective observational study,we analyzed adult traum. patients adm.tted to the ICU from.2011 to 2015 at Fundación Valle del Lili(FVL)University *** prim.ry outcom. was the incidence of *** regression analysis was used to assess risk factors for this ***:A total of 315 patients were *** traum. m.chanism. were blunt(n=130),penetrating(n=66)and blast(n=44)*** m.dian[interquartile range,(IQR)of injury severity score(ISS)was 21(16–29).AKI developed in 75 patients(23.8%).m.ltivariate regression analysis revealed that the thoracic abbreviated injury scale(AIS)value(m.dian(IQR)in the AKI group:3(0–4)],Acute Physiology and Chronic Health Evaluation(APACHE Ⅱ)score[m.dian(IQR)in the AKI group:18(10–27)],CK greater than 5000 U/L,lactic acid concentration at adm.ssion,and dobutam.ne adm.nistration were independently associated with ***:We found that age,APACHE Ⅱ score,thoracic traum.,lactic acidosis,and dobutam.ne adm.nistration were independently associated with *** surgeons need to be aware of the increased odds of AKI if one of these factors is identified during the evaluation and treatm.nt of injured patients.

关键词： Rhabdom.olysis Wounds and injuries Acute kidney injury Critical care Traum.

Short-term.effect of supplem.ntal yeast extract without or with feed enzym.s on growth perform.nce, im.une status and gut structure of weaned pigs challenged with Escherichia coli lipopolysaccharide

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Journal of Anim.l Science and Biotechnology 2017年第2期8卷 378-390页

作者： Sam.el m.Waititu Fugui Yin Rob Patterson juan C.Rodriguez-Lecom.te Charles m.Nyachoti Departm.nt of Anim.l Science University of Manitoba201-12 Dafoe RoadWinnipegM6 R3T 2N2Canada Canadian Bio-system. Inc. CalgaryAB T2C OJTCanada Atlantic Veterinary College University of Prince Edward IslandCharlottetownPE C1A 4P3Canada

Background： This study investigated the response of piglets receiving a yeast extract without or with a m.lti-enzym. m.xture com.ared with an antim.crobial growth prom.ter（AGP） on perform.nce, im.une status and gut structure after an E. coli lipopolysaccharide（LPS） challenge. Thirty-six pigs were allotted to six treatm.nts including： a non-challenged control（NCC）; LPS-challenged control（CC）; CC ＋ AGP; CC ＋ yeast extract; CC ＋ enzym.s; and CC ＋ enzym.s ＋ yeast extract. On d 7, pigs were bled and thereafter injected with LPS or sterile saline. Blood sam.les were collected at 6, 48, and 96 h post-challenge. After 96 h post-challenge, pigs were euthanized to obtain duodenal, jejunal and ileal ***： Overall（d 1 to 11）, com.ared with CC pigs, AGP attenuated the LPS-induced reduction in ADG（P = 0.004）,ADFI（P = 0.03） and gain/feed ratio（P = 0.01）. At 6 h post-challenge, AGP pigs had lower plasm. urea N（PUN; P = 0.02）and serum.TNF-α concentration（P = 0.07）, and higher platelet count（P = 0.04） and serum.IL-10 concentration（P = 0.02） than CC pigs. At 48 h post-challenge, AGP pigs had lower PUN（P = 0.02） than CC pigs, whereas enzym.s ＋ yeast extract interacted non-additively（P = 0.001） to reduce PUN. At 96 h post-challenge, AGP pigs had lower PUN（P = 0.02）and higher duodenal（P = 0.03）, jejunal（P = 0.01） and ileal（P = 0.07） villus height than CC pigs. In addition, enzym.s ＋yeast extract interacted additively and non-additively to reduce ileal IFN-γ（P 0.10） were observed between AGP and enzym.s ＋ yeast extract pigs on other m.asured param.ters except for the downregulation of ileal IFN-γ（P ＆lt; 0.0001） and TNF-α（P = 0.003） in enzym.s ＋ yeast extract pigs at 96 h ***： The LPS challenged piglets receiving enzym.s ＋ yeast extract showed beneficial responses in gut structure and im.unity com.ensurate with those receiving antibiotics, though the latter had better overall growth perform.nce.

关键词： Antim.crobial growth prom.ter Feed enzym.s Growth perform.nce Im.unity Nucleotides Piglets