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Airway management of a patient with linear immunoglobulin A bullous dermatosis:A case report

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World Journal of Clinical Cases 2024年第13期12卷 2263-2268页

作者： Olga C Nin Robert Hutnik neil N Chheda David Hutchinson Department of Anesthesiology University of Florida College of MedicineGainesvilleFL 32610United States Department of Otolaryngology University of Florida College of MedicineGainesvilleFL 32610United States

BACKGROUND There is limited literature on managing the airway of patients with linear immunoglobulin A(IgA)bullous dermatosis,a rare mucocutaneous disorder that leads to the development of friable *** clinical decision making is necessary when there is a risk of bleeding into the airway,and a multidisciplinary team approach may lead to decreased patient morbidity during these high-risk scenarios,especially when confronted with an unusual cause for *** SUMMARY A 45-year-old African American female presented to our ambulatory surgical center for right corneal transplantation due to corneal perforation after blunt trauma in the setting of cicatricial conjunctivitis and diffuse corneal neovascularization from linear IgA bullous *** diagnosis of IgA dermatosis was recent,and the patient had been lost to *** severity of the disease and extent of airway involvement was unknown at the time of the *** airway bleeding was noticed upon intubation and the otorhinolaryngology team had to be called to the operating *** patient required transfer to the intensive care unit where a multidisciplinary team was involved in her *** patient was extubated on postoperative day *** A multidisciplinary approach to treating this disease is the best course of action before a surgical *** our case,key communication between the surgery,anesthesia,and dermatology teams led to the quick and safe treatment of our patient’s *** surgery should not be considered for these cases unless they are in full remission and there is no mucous membrane involvement.

关键词： Airway management Bleeding risk Linear immunoglobulin A bullous dermatosis Multidisciplinary approach Outpatient procedure Case report

Advancements in assessing soil health through functional traits and energy flow analysis of soil

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Soil Ecology Letters 2024年第2期6卷 21-30页

作者： Jingnan Zhang Shiyu Li Elly Morrien neil B.McLaughlin Shixiu Zhang School of Life Sciences Zhengzhou UniversityZhengzhou 450001China State Key Laboratory of Black Soils Conservation and Utilization Northeast Institute of Geography and AgroecologyChineseAcademy of SciencesChangchun 130012China Key Laboratory of Mollisols Agroecology Northeast Institute of Geography and AgroecologyChinese Academy of SciencesChangchun 130012China Institute of Biodiversity and Ecosystem Dynamics(IBED-ELD) Department of Ecosystem and Landscape DynamicsUniversity of AmsterdamScience Park 9041098 XHA msterdamThe Netherlands Ottawa Research and Development Centre Agriculture and Agri-Food CanadaOttawa K1AoC6Canada University of Chinese Academy of Sciences Bejing 100049China

We examined the development of soil nematodes ecological indices from the perspective off *** found that soil nematode energy flow analyses based on multiple functional traits quantify the dynamics of energy flow across multipletrophic levels to provide a more comprehensive *** conducted comparative analyses of the sensitivities of NMF and energy flow to verify that the energy flow analyses are more sensitive and have greater potential to reveal soil health and ecosystem *** in-depth studies of functional traits and energy flow analysis can help us achieve informed soil management practices,sustainable agriculture,*** Tess CT Nematode ecological index based on functional traits:MI El,S,BI,C1 NMF Bongen.1990 Ferrisetal,2001 Ferris,2010 energs low analysis of soil nematodes Compare thecological index(NMf)and Bacterivores(Ba)Functional traits Energy flux Fungihores(Fn)rahn Soilnematodes latitude Lindicator Plant-parasites(PP)PF Energflus Soilhealth Omnivores-predators(oP)latitude Energy flow analysis of soil nematodes:By quantifying energy fux among trophic groups Barbes et al.,2014,2018 This paper examines the development of ecological indices for soil nematodes from the perspective of functional *** emphasizes the increasing significance of integrating multiple functional traits to achieve a more accurate assessment of soil *** indices based on life history strategies,feeding habits,and body size provide useful tools for assessing soil ***,these indices do not fully capture the dynamics ofenergyflow across multiple-trophic levels inthesoil foodweb,which is critical fora deeperunderstanding of the intrinsic properties of soil *** combining functional traits such as functional group,body size,feeding preference and metabolic rate,nematode energy flow analyses provide a more comprehensive *** approach establishes a direct correlation between changes

关键词： soil nematodes soil health nematodefoodweb functional traits energyflux

Hydromechanical characterization of gas transport amidst uncertainty for underground nuclear explosion detection

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Journal of Rock Mechanics and Geotechnical Engineering 2024年第6期16卷 2019-2032页

作者： Wenfeng Li Chelsea W.neil J William Carey Meng Meng Luke P.Frash Philip H.Stauffer Earth and Environmental Sciences Los Alamos National LaboratoryLos AlamosNM87544USA Department of Mineral Engineering New Mexico TechSocorroNM87801USA

Given the challenge of definitively discriminating between chemical and nuclear explosions using seismic methods alone,surface detection of signature noble gas radioisotopes is considered a positive identification of underground nuclear explosions(UNEs).However,the migration of signature radionuclide gases between the nuclear cavity and surface is not well understood because complex processes are involved,including the generation of complex fracture networks,reactivation of natural fractures and faults,and thermo-hydro-mechanical-chemical(THMC)coupling of radionuclide gas transport in the *** this study,we provide an experimental investigation of hydro-mechanical(HM)coupling among gas flow,stress states,rock deformation,and rock damage using a unique multi-physics triaxial direct shear rock testing *** testing system also features redundant gas pressure and flow rate measurements,well suited for parameter uncertainty *** porous tuff and tight granite samples that are relevant to historic UNE tests,we measured the Biot effective stress coefficient,rock matrix gas permeability,and fracture gas permeability at a range of pore pressure and stress *** Biot effective stress coefficient varies from 0.69 to 1 for the tuff,whose porosity averages 35.3%±0.7%,while this coefficient varies from 0.51 to 0.78 for the tight granite(porosity<1%,perhaps an underestimate).Matrix gas permeability is strongly correlated to effective stress for the granite,but not for the porous *** experiments reveal the following key engineering implications on transport of radionuclide gases post a UNE event:(1)The porous tuff shows apparent fracture dilation or compression upon stress changes,which does not necessarily change the gas permeability;(2)The granite fracture permeability shows strong stress sensitivity and is positively related to shear displacement;and(3)Hydromechanical coupling among stress states,rock damage,and gas flow appears to be

关键词： Underground nuclear explosion uncertainty quantification Radionuclide transport Biot effective stress coefficient Fracture permeability Matrix permeability

An acoustofluidic device for the automated separation of platelet-reduced plasma from whole blood

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Microsystems & Nanoengineering 2024年第3期10卷 293-303页

作者： Zhehan Ma Jianping Xia neil Upreti Emeraghi David Joseph Rufo Yuyang Gu Kaichun Yang Shujie Yang Xiangchen Xu Jean Kwun Eileen Chambers Tony Jun Huang Thomas Lord Department of Mechanical Engineering and Materials Science Duke UniversityDurhamNCUSA Department of Biomedical Engineering Duke UniversityDurhamNCUSA Department of Pediatrics Duke UniversityDurhamNCUSA Duke Transplant Center Department of SurgeryDuke University School of MedicineDurhamNCUSA

Separating plasma from whole blood is an important sample processing technique required for fundamental biomedical research,medical diagnostics,and therapeutic *** protocols for plasma isolation require multiple centrifugation steps or multiunit microfluidic processing to sequentially remove large red blood cells(RBCs)and white blood cells(WBCs),followed by the removal of small ***,we present an acoustofluidic platform capable of efficiently removing RBCs,WBCs,and platelets from whole blood in a single *** leveraging differences in the acoustic impedances of fluids,our device generates significantly greater forces on suspended particles than conventional microfluidic approaches,enabling the removal of both large blood cells and smaller platelets in a single *** a result,undiluted human whole blood can be processed by our device to remove both blood cells and platelets(>90%)at low voltages(25 Vpp).The ability to successfully remove blood cells and platelets from plasma without altering the properties of the proteins and antibodies present creates numerous potential applications for our platform in biomedical research,as well as plasma-based diagnostics and ***,the microfluidic nature of our device offers advantages such as portability,cost efficiency,and the ability to process small-volume samples.

关键词： remove separation removing

Artificial Intelligence ChatGPT’s Perspective on Implementation of Augmented Intelligence within Orthopaedic Practice—A Comparative Narrative Synthesis?

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Intelligent Information Management 2024年第1期16卷 10-20页

作者： neil Capes Hiran Patel Islam Sarhan Gur-Aziz S. Sidhu neil Ashwood Andrew Dekker Department of Trauma & Orthopaedics University Hospitals Derby and Burton Derby United Kingdom Department of Trauma & Orthopaedics University Hospital Lewisham London United Kingdom Research Institute University of Wolverhampton Wolverhampton United Kingdom

ChatGPT has obvious benefits in the way it can interrogate vast amounts of reference information and utilise metadata generation to answer questions posed to it and is freely available having been developed through human feedback. Already there are ethical and practical implications on its impact on learning and research. Artificial Intelligence (AI) has been seen as a way of improving healthcare provision by delivering more robust outcomes but measuring these and implementing AI within this setting is at present limited and disjointed. Methods: ChatGPT was interrogated to see what it felt were the barriers to its implementation within healthcare and in particular orthopaedic practice. The evidence for this determination was then examined for validity and applicability for a practical roll out at a Trust, Regional or National level. Results: AI can synthesise a vast amount of information to help it answer specific questions. The context and structure of any question will determine the usefulness of the answer which can then be used to develop practical solutions based on experience and resource limitations. Conclusions: AI has a role in service development and can quickly focus a working group to areas to consider when practically implementing change.

关键词： Artificial Intelligence ChatGPT

Twenty-nine million intrinsic Q-factor monolithic microresonators on thin-film lithium niobate

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Photonics Research 2024年第8期12卷 I0001-I0006页

作者： XINRUI ZHU YAOWEN HU SHENGYUAN LU HANA KWARNER XUDONG LI YUNXIANG SONG LETÍCIA MAGALHÃES AMIRHASSAN SHAMS-ANSARI ANDREA CORDARO neil SINCLAIR MARKO LONČAR John A.Paulson School for Engineering and Applied Sciences Harvard UniversityCambridgeMassachusetts 02138USA State Key Laboratory for Mesoscopic Physics and Frontiers Science Center for Nano-optoelectronics School of PhysicsPeking UniversityBeijing 100871China DRS Daylight Solutions San DiegoCalifornia 92127USA

The recent emergence of thin-film lithium niobate(TFLN)has extended the landscape of integrated *** has been enabled by the commercialization of TFLN wafers and advanced nanofabrication of TFLN such as high-quality dry ***,fabrication imperfections still limit the propagation loss to a few dB/m,restricting the impact of this ***,we demonstrate TFLN microresonators with a record-high intrinsic quality(Q)factor of twenty-nine million,corresponding to an ultra-low propagation loss of 1.3 dB/*** present spectral analysis and the statistical distribution of Q factors across different resonator *** work pushes the fabrication limits of TFLN photonics to achieve a Q factor within 1 order of magnitude of the material limit.

关键词： resonator lithium film

How completely are randomized controlled trials of non-pharmacological interventions following concussion reported? A systematic review

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Journal of Sport and Health Science 2024年第4期13卷 537-547页

作者： Jacqueline Josee van Ierssel Olivia Galea Kirsten Holte Caroline Luszawski Elizabeth Jenkins Jennifer O’neil Carolyn A Emery Rebekah Mannix Kathryn Schneider Keith Owen Yeates Roger Zemek Children’s Hospital of Eastern Ontario Research Institute OttawaON K1H 8L1Canada The Centre for Health Activity and Rehabilitation ResearchUniversity of OtagoDunedin 9016New Zealand Sport Injury Prevention Research Centre Faculty of KinesiologyUniversity of CalgaryCalgaryAB T2N 1N4Canada Alberta Children’s Hospital Research Institute University of Calgary CalgaryAB T2N 1N4Canada Hotchkiss Brain Institute University of CalgaryCalgaryAB T2N 4N1Canada Department of Psychology University of CalgaryCalgaryAB T2N 1N4Canada g Faculty of MedicineUniversity of OttawaOttawaON K1H 8M5Canada School of Rehabilitation Sciences University of OttawaOttawaON K1H 8M5Canada Bruyere Research Institute OttawaON K1N 5C8Canada Departments of Pediatrics and Emergency Medicine Harvard Medical SchoolBostonMA 02115USA Departments of Pediatrics and Emergency Medicine University of OttawaOttawaON K1H 8M5Canada

Purpose:The study aimed to examine the reporting completeness of randomized controlled trials(RCTs)of non-pharmacological interventions following ***:We searched MEDLINE,Embase,PsycInfo,CINAHL,and Web of Science up to May *** reviewers independently screened studies and assessed reporting completeness using the Template for Intervention Description and Replication(TIDieR),Consensus on Exercise Reporting Template(CERT),and international Consensus on Therapeutic Exercise aNd Training(i-CONTENT)*** information was sought my study authors where reporting was *** of bias(ROB)was assessed with the Cochrane ROB-2 *** examining non-pharmacological interventions following ***:We included 89 RCTs(n=53 high ROB)examining 11 different interventions for concussion:sub-symptom threshold aerobic exercise,cervicovestibular therapy,physical/cognitive rest,vision therapy,education,psychotherapy,hyperbaric oxygen therapy,transcranial magnetic stimulation,blue light therapy,osteopathic manipulation,and head/neck *** scores were:TIDieR 9/12(75%;interquartile range(IQR)=5;range:5-12),CERT 17/19(89%;IQR=2;range:10-19),and i-CONTENT 6/7(86%;IQR=1;range:5-7).Percentage of studies completely reporting all items was TIDieR 35%(31/89),CERT 24%(5/21),and i-CONTENT 10%(2/21).Studies were more completely reported after publication of TIDieR(t_(87)=2.08;p=0.04)and CERT(t_(19)=2.72;p=0.01).Reporting completeness was not strongly associated with journal impact factor(TIDieR:rs=0.27;p=0.01;CERT:r_(s)=-0.44;p=0.06;i-CONTENT:r_(s)=-0.17;p=0.48)or ROB(TIDieR:rs=0.11;p=0.31;CERT:rs=0.04;p=0.86;i-CONTENT:rs=0.12;p=0.60).Conclusion:RCTs of non-pharmacological interventions following concussion demonstrate moderate to good reporting completeness,but are often missing key components,particularly modifications,motivational strategies,and qualified *** completeness improved after TIDieR and CERT publication,but p

关键词： Concussion Intervention Randomized controlled trial Systematic review

A midgut transcriptional regulatory loop favors an insect host to withstand a bacterial pathogen

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The Innovation 2024年第5期5卷 36-45,35页

作者： Zhaojiang Guo Liuhong Zhu Zhouqiang Cheng Lina Dong Le Guo Yang Bai Qingjun Wu Shaoli Wang Xin Yang Wen Xie neil Crickmore Xuguo Zhou RenéLafont Youjun Zhang State Key Laboratory of Vegetable Biobreeding Department of Plant ProtectionInstitute of Vegetables and FlowersChinese Academy of Agricultural SciencesBeijing 100081China School of Life Sciences University of SussexBrighton BN19QEUK Department of Entomology School of Integrative BiologyCollege of Liberal Arts&SciencesUniversity of Illinois Urbana-ChampaignUrbanaIL 61801-3795USA Sorbonne Université CNRS-IBPS(BIOSIPE)75005 ParisFrance

Mounting evidence suggests that insect hormones associated with growth and development also participate in pathogen *** have discovered a previously undescribed midgut transcriptional control pathway that modulates the availability of 20-hydroxyecdysone(20E)in a worldwide insect pest(Plutella xylostella),allowing it to defeat the major virulence factor of an insect pathogen Bacillus thuringiensis(Bt).A reduction of the transcriptional inhibitor(PxDfd)increases the expression of a midgut microRNA(miR-8545),which in turn represses the expression of a newly identified ecdysteroid-degrading glucose dehydrogenase(PxGLD).Downregulation of PxGLD reduces 20E degradation to increase 20E titer and concurrently triggers a transcriptional negative feedback loop to mitigate 20E *** moderately elevated 20E titer in the midgut activates a MAPK signaling pathway to increase Bt tolerance/*** findings deepen our understanding of the functions attributed to these classical insect hormones and help inform potential future strategies that can be employed to control insect pests.

关键词： elevated transcriptional loop

Rescue from complications after pancreaticoduodenectomies at a low-volume Caribbean center:Value of tailored peri-pancreatectomy protocols

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 681-688页

作者： Shamir O Cawich Elijah Dixon Parul J Shukla Shailesh V Shrikhande Rahul R Deshpande Fawwaz Mohammed neil W Pearce Wesley Francis Shaneeta Johnson Johann Bujhawan Department of Surgery University of the West IndiesSt Augustine 000000Trinidad and Tobago Department of Surgery Faculty of MedicineUniversity of CalgaryCalgaryAlberta T2N2T9Canada Department of Surgery Weill Cornell Medical CollegeNew YorkNY 10065United States Department of Surgical Oncology Tata Memorial CenterHomi Bhabha National UniversityMumbai 400012India Department of Surgery Manchester Royal InfirmaryManchester M139WLUnited Kingdom University Surgical Unit Southampton General HospitalSouthampton SO166YDUnited Kingdom Department of Surgery University of the West IndiesNassau N-1184Bahamas Department of Surgery Morehouse School of MedicineAtlantaGA 30310United States Department of Surgery General Hospital in Port of SpainPort of Spain 000000Trinidad and Tobago

BACKGROUND Pancreaticoduodenectomy(PD)is a technically complex operation,with a re-latively high risk for *** ability to rescue patients from post-PD complications is as a recognized quality *** protocols were instituted at our low volume facility in the year *** To document the rate of rescue from post-PD complications with tailored protocols in place as a measure of *** A retrospective audit was performed to collect data from patients who experienced major post-PD complications at a low volume pancreatic surgery unit in Trinidad and Tobago between January 1,2013 and June 30,***-dardized definitions from the International Study Group of Pancreatic Surgery were used to define post-PD complications,and the modified Clavien-Dindo classification was used to classify post-PD *** Over the study period,113 patients at a mean age of 57.5 years(standard deviation[SD]±9.23;range:30-90;median:56)underwent PDs at this *** complications were recorded in 33(29.2%)patients at a mean age of 53.8 years(SD:±7.9).Twenty-nine(87.9%)patients who experienced major morbidity were salvaged after aggre-ssive treatment of their ***(3.5%)died from bleeding pseudoaneurysm(1),septic shock secondary to a bile leak(1),anastomotic leak(1),and myocardial infarction(1).There was a significantly greater salvage rate in patients with American Society of Anesthesiologists scores≤2(93.3%vs 25%;P=0.0024).CONCLUSION This paper adds to the growing body of evidence that volume alone should not be used as a marker of quality for patients requiring *** low volumes at our facility,we demonstrated that 87.9%of patients were rescued from major *** attributed this to several factors including development of rescue protocols,the competence of the pancreatic surgery teams and continuous,and adaptive learning by the entire institution,cul-minating in the development of tailored peri-pancreatectomy protoc

关键词： Pancreas Complication Rescue Failure Morbidity Mortality Pancreaticoduodenectomy