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Abdominal aortic thrombosis as initial presentation of COViD-19 infection: A case report

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World Journal of Clinical infectious Diseases 2020年第3期10卷 42-46页

作者： William Zachary Webster Amrit Sraow karla Cruz Morel Department of internal Medicine University of South Carolina School of MedicineColumbiaSC 29203United States Department of Pulmonary and Critical Care Medicine University of South Carolina School of Medicine-Prisma HealthColumbiaSC 29203United States

BACKGROUND The hypercoagulable state associated with coronavirus disease 2019(COViD-19)has been shown to complicate the course of this viral illness with both venous and arterial *** presenting after hospitalization and known COViD-19 diagnosis,the etiology of thrombosis has been attributed to the hyperinflammatory state and endothelial dysfunction associated with *** report portrays a patient who experienced an aortic thrombosis resulting in back and leg pain with subsequent loss of motor function of his legs as his initial presentation of *** SUMMARY Patient is a 60-year-old Caucasian male with no medical history who presented with sudden onset pain in his lower back and lower *** went on to experience complete motor loss of the lower extremities two hours after *** pain and shortness of breath developed one day later but were not present at time of *** tomography angiography of the chest,abdomen,and pelvis revealed occlusion by thrombosis of the abdominal aorta in addition to multifocal pulmonary ground-glass opacities prompting COViD-19 PCR,which was *** was taken to surgery for attempted thrombectomy and the thrombus was retrieved starting from the right common femoral artery,but a second thrombus had immediately reformed in place of the prior thrombectomy site resulting in conclusion of the *** was continued on unfractionated heparin and received a dose of tocilizumab 400 mg,but rapidly developed hemodynamic compromise and expired from cardiac *** This presentation emphasizes the importance of evaluating patients for COViD-19 who experience unusual thromboses without superior explanation.

关键词： COViD-19 Aortic thrombosis Arterial thrombosis Atypical COViD-19 presentation COViD-19 complication Case report

Extreme Hyperferritinemia in a Filipino Male Patient with Adult Onset Still’s Disease: A Case Report

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Open Journal of Rheumatology and Autoimmune Diseases 2022年第4期12卷 119-127页

作者： Denise Joy Emmanuelle Lopez karla Sofia Reyes Aileen U. Agbanlog Section of Rheumatology Department of Medicine St. Luke’s Medical Center Quezon City Metro Manila Philippines

Background: Elevated serum ferritin is more commonly due to reactive causes such as infection, hepatic disorders, rheumatologic conditions, and malignancy than true iron overload. Extreme hyperferritinemia (>10,000 ng/mL), on the other hand, should prompt consideration of rare conditions such as adult-onset Still’s disease (AOSD) or hemophagocytic lymphohistiocytosis. This paper aims to present the case of the highest reported extreme hyperferritinemia (actual level 256,000 ng/mL) in a patient eventually diagnosed with adult onset Still’s Disease (AOSD). Case Presentation: A 55-year-old male, Filipino, was admitted due to acute onset fever and shortness of breath. He was initially assessed to have community-acquired pneumonia and a suspect for coronavirus disease 2019 (COViD-19), hence inflammatory markers were requested. Ferritin was notably elevated at 44,255 ng/mL. He eventually tested negative for COViD-19 RT-PCR. He was investigated for other causes of markedly elevated ferritin levels. His complete blood count (CBC) only showed leukocytosis with no peripheral blasts, iron level and liver function tests were normal, HiV immunoassay was negative, ANA was 1:80 speckled with normal complement level, rheumatoid factor negative, and positron emission tomography (PET) scan revealed presence of lymphadenopathies and did not show solid tumors. He was treated for urinary tract infection and pneumonia but still had intermittent fever and increasing ferritin trend, with the highest documented level at 256,000 ng/mL. Fulfilling the Yamaguchi criteria, he was managed as a case of severe AOSD and received tocilizumab. He had lysis of fever and decreasing trend of ferritin levels thereafter, with ferritin level of 34,184 ng/mL three weeks after tocilizumab infusion. He was discharged and improved with prednisone and methotrexate as home medications. Conclusion: To our knowledge, the highest level of extreme hyperferritinemia recorded in literature as of 2016 is 143,931 ng/mL,

关键词： Still’s Disease Hyperferritinemia Autoimmune Tocilizumab Case Report

Organizational Environment and Work Satisfaction of the Employees of Hitachi Chemical Montemorelos Nuevo Leon México

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Journal of Modern Accounting and Auditing 2017年第6期13卷 272-280页

作者： Omar A. Flores Laguna Sandy M. Veláquez Hemández karla S. Basurto Gutiérrez karla L. Haro-Zea University of Montemorelos Mexico Meritorious Autonomous University of Puebla Mexico

This study seeks to answer one question： The quality level of organizational environment. is it an indicator of the workplace satisfaction level, according to the perception of Hitachi Chemical employees in Montemorelos, Nuevo León, México？ This study＇s design is both explanatory and cross-sectional. The sample size was composed of 143 Hitachi Chemical employees of Montemorelos, Nuevo León, México. For the data collection, two instruments were used： the first instrument was used to measure the quality of organizational climate and the second was focused on measuring the workplace satisfaction level. As a result, the level of organizational climate quality is in fact a predictor of workplace satisfaction of Hitachi Chemical employees. After the regression analysis, it was found that the variable, level of organizational climate, explained a 71.4% variance in the dependent variable, work satisfaction. it was determined that organizational climate is a strong predictor of work satisfaction perceived by employees of Hitachi Chemicals, Montemorelos, Nuevo León, México. it can be established that the greater the levels of organizational climate experienced by the employees, the greater the level of work satisfaction will be.

关键词： organizational climate work satisfaction employees' satisfaction organizational environment performance job management

Rationalizing the Use of Water in industry—Part 1: Summary of the instruments Developed by the Clean Technology Network in the State of Bahia and Main Results Obtained

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Journal of Environmental Protection 2013年第5期4卷 486-496页

作者： Asher Kiperstok karla Esquerre Ricardo Kalid Emerson Sales Geiza Oliveira Clean Technology Network of Bahia (TECLiM) Industrial Engineering Program (PEI) Federal University of Bahia (UFBA) Rua Aristides Novis Salvador Brazil

Based on cleaner production concepts, a method for water use minimization has been developed by the Clean Technology Network of Bahia (TECLiM) at one of the largest industrial complexes in Latin America located in the State of Bahia, Brazil. This method is concerned with an area of secondary interest to the productive sector: the use of water. Based on the best cleaner production principles (CP), nine instruments have been developed during cooperative projects with chemical, petrochemical and copper metallurgical industries. These instruments are described in Part 2 of this paper [1]. The main benefits derived from partnership schemes include: a reduction in water consumption and effluent generation;the development of a techno-operational culture to increase eco-efficiency;and the introduction of conceptual projects to ensure the continuity of the activities in the company after the projects have been completed. The specific consumption of water was reduced by 20% as a consequence of the application of this method in Company A;a specific reduction in the generation of effluents of more than 40% was observed in Company B;a 42% fall in fresh water consumption in Company C;and a 20% decrease in the cost of effluent treatment in Company D. Among the difficulties encountered were the limited time availability of the operators and engineers for the project, the lack of measurement and calibration of available flow meters and the lack of detailed technical data.

关键词： Water Effluent Rationalization industry Cleaner Production Clean Technology Network (TECLiM)

Healthcare staff as promoters of parental presence at anesthetic induction:Net Promoter Score survey

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World Journal of Clinical Pediatrics 2021年第6期10卷 159-167页

作者： María Velayos karla Estefanía María Alvarez María C Sarmiento Lucas Moratilla Pascual Sanabria Francisco Hernández Manuel V López Santamaría Servicio de Cirugía Pediátrica Hospital Universitario La PazMadrid 28046Spain Servicio de Anestesia y Reanimación infantil Hospital Universitario La PazMadrid 28046Spain

BACKGROUND Surgical intervention is usually a traumatic event that causes stress and anxiety in the pediatric patient and the family *** reduce the harmful effects of presurgical anxiety,parental presence during induction of anesthesia(PPiA)is one of the more notable interventions used in medical ***,data on this measure are difficult to evaluate and often face resistance from healthcare *** To analyze the perception of the healthcare workers after the implementation of a PPiA *** A survey was developed and sent by email to all the healthcare staff working in the children’s area of a tertiary *** consisted of 14 items divided into positive aspects of PPiA and negative aspects of PPiA evaluated with the use of a Likert scale(1 to 5).The demographics of the respondents were included in the data *** answers to the questions were interpreted through the Net Promoter Score(NPS).The statistical analysis compared the differences in the responses to each question of the survey made by the different groups of health personnel *** A total of 141 surveys were sent out,with a response rate of 69%.Of the total number of responses,68%were from women and 32%from *** average age of the participants was 42.3±10.6 *** for the positive questions about the PPiA,83%had an NPS>50,and only one had a score between 0 and 50,which means that the quality of the service was rated as excellent or good by 100%of the *** the other hand,100%of the negative questions about the PPiA had a negative *** to the question“PPiA increases patient safety”were significantly different(P=0.037),with a lower percentage of pediatric surgeons(70%)thinking that PPiA increased patient safety,compared with anesthesiologists(90%),nursing(92%),and other medical personnel(96%).CONCLUSiON The personnel who participated in the PPiA program at our center were in favor of *** were no validated arguments to

关键词： Parental presence Survey Anesthesia induction Patient-centered care Anxiety Surgery

Rationalizing the Use of Water in industry—Part 2: instruments Developed by the Clean Technology Network in the State of Bahia

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Journal of Environmental Protection 2013年第5期4卷 497-507页

作者： Asher Kiperstok karla Esquerre Ricardo Kalid Emerson Sales Geiza Oliveira Federal University of Bahia (UFBA) Clean Technology Network of Bahia (TECLIM) Industrial Engineering Program (PEI) Rua Aristides Novis Salvador Brazil

The instruments developed by the Clean Technology Network of Bahia (TECLiM) at the Federal University of Bahia (UFBA) (cited in Part 1 of this paper) are presented. Factors regarding water management in industry were examined, on the basis of experience acquired over the period of a decade in cooperative research projects with large industrial process plants located mostly in the Camacari Petrochemical Complex, Bahia State, Brazil. The main results consist of training about 1700 industry professionals in CP, the identification of about 500 ideas for the rationalization of water use, the presentation and publication of 90 articles in journals, conferences and other academic events, identification of ideas with potential water savings estimated at around 1400 t·h–1 and the reduction of at least 500 t·h–1 in effluents. Other sectors that make use of water, for example public buildings, commercial buildings, homes, shopping centers and airports can adapt and use the TECLiM method as will be exemplified.

关键词： Water Effluent Rationalization industry Cleaner Production Clean Technology Network (TECLiM)

Geochemistry and mineralogy of beach sediments in the northern Gulf of Mexico,Tamaulipas state,Mexico:implication for provenance

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Journal of Palaeogeography 2024年第3期13卷 375-400页

作者： Mayank Shukla Sanjeet K.Verma Mayla A.Ramos-Vázquez John S.Armstrong-Altrin karla R.Hernández-Martínez Sumit Mishra Vivek P.Malviya Héctor Hernández-Mendoza Posgrado de la Division de Geociencias Aplicadas Instituto Potosino de Investigacion Científica y Tecnologica(IPICYT)Camino a la Presa San José2055San Luis Potosí78216Mexico Division de Geociencias Aplicadas Instituto Potosino de Investigación Científica y Tecnologica(IPICYT)Camino a la Presa San Jose 2055San Luis Potosí78216Mexico Universidad Nacional Autonoma de México Instituto de Ciencias del Mar y LimnologíaUnidad de ProcesosOceanicos y CosterosCiudad UniversitariaCiudad de México 04510Mexico Department of Marine Sciences Bharathidasan UniversityTiruchirappalli620024Tamil NaduIndia instituto de Geociencias Universidad Nacional Autonoma de MéxicoBoulevard Juriquilla 300176230JuriquillaQueretaroMexico Department of Applied Geology Dr.Harisingh Gour Central UniversitySagar470002Madhya PradeshIndia instituto de investigacion de Zonas Desérticas Universidad Autònoma de San Luis PotosíAltair 200CP 78377San LuisS.L.P.Mexico Universidad del Centro de Mexico Capitán Caldera 75CP 78250San LuisS.L.P.Mexico

Geochemical and mineralogical studies were performed in the La Pesca(LP)and Tesoro Altamira(TA)beach sediments,located in the Tamaulipas state,northern Gulf of *** main aim of this study is to infer the weathering history and provenance and to discriminate the tectonic environment of the beach *** sediments are composed of quartz with small amounts of accessory minerals such as plagioclase,calcite,orthoclase,microcline,and *** beach sediments are classified as fine-grained and very well sorted,however LP has coarse skewed and leptokurtic sediments,whereas TA has fine-skewed and very leptokurtic *** chemical index of weathering(CiW’)indicates intense weathering in the source *** quartz grain microtextures in the LP and TA are classified into mechanical,chemical,and mechanical/chemical *** features such as fractures,pits,percussion marks,abrasion fatigue,and V-shaped marks favor high-energy littoral,fluvial,subaqueous-marine,and aeolian *** chemical features indicate solution pits and crystalline overgrowth,which suggests a silica saturated marine *** mechanical/chemical features display adhering particles and elongated depressions suggest formation in a sub-aqueous nearshore marine *** and trace elements-based provenance discrimination diagrams indicate a felsic source derived from the Mesa Central(MC),Sierra Madre Oriental(SMOr)and Oaxaquia *** major and trace element concentrations imply a passive margin setting for the northern Gulf of Mexico,which is consistent with the general geology.

关键词： Beach sediments Geochemistry Mineralogy Provenance Tamaulipas Tectonic setting

Therapies for patients with coexisting heart failure with reduced ejection fraction and non-alcoholic fatty liver disease

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World Journal of Cardiology 2023年第7期15卷 328-341页

作者： Jose Arriola-Montenegro Renato Beas Renato Cerna-Viacava Andres Chaponan-Lavalle karla Hernandez Randich Diego Chambergo-Michilot Herson Flores Sanga Pornthira Mutirangura Department of internal Medicine University of MinnesotaMinneapolisMN 55455United States Department of Medicine Indiana University School of MedicineIndianaIN 46202United States Department of Medicine Henry Ford HospitalDetroitMI 48202United States Escuela de Medicina Universidad Peruana de Ciencias AplicadasLima 15067Peru Universidad Científica del Sur LimaPeru Department of Telemedicine CardiologyHospital Nacional Carlos Alberto Seguin EscobedoArequipa 8610Peru Department of Medicine University of MinnesotaMinneapolisMN 55415United States

Heart failure with reduced ejection fraction(HFrEF)and nonalcoholic fatty liver disease(NAFLD)are two common comorbidities that share similar pathophysiological *** is a growing interest in the potential of targeted therapies to improve outcomes in patients with coexisting HFrEF and *** manuscript reviews current and potential therapies for patients with coexisting HFrEF and *** therapies,including angiotensinconverting enzyme inhibitors/angiotensin receptor blockers,mineralocorticoids receptor antagonist,and sodium-glucose cotransporter-2 inhibitors,have been shown to reduce fibrosis and fat deposits in the ***,there are currently no data showing the beneficial effects of sacubitril/valsartan,ivabradine,hydralazine,isosorbide nitrates,digoxin,or beta blockers on NAFLD in patients with *** study highlights the importance of considering HFrEF and NAFLD when developing treatment plans for patients with these *** research is needed in patients with coexisting HFrEF and NAFLD,with an emphasis on novel therapies and the importance of a multidisciplinary approach for managing these complex comorbidities.

关键词： Non-alcoholic fatty liver disease Heart Failure Heart failure reduced ejection fraction Novel therapies Cardiovascular disease

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汤姆·汉克斯:还记得当年的阿甘吗?

新世纪智能 2020年第20期 37-40页

作者： karla 不详

汤姆·汉克斯(Tom Hanks)是非常受美国人热爱的。一般来说,无论多大牌的明星,黑粉总是有的。但奇怪的是,他似乎赢得了所有人的喜爱。尤其是从几年前开始,美国媒体开始一窝蜂地称他为“国民老爸”。

关键词：汤姆所有人美国