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Timing of percutaneous endoscopic gastrostomy tube placement in post-stroke patients does not impact mortality, complications, or outcomes

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2022年第5期13卷 77-87页

作者： Kavya M Reddy preston lee Parul J Gor Antonio Cheesman Noor Al-Hammadi David John Westrich Jason Taylor Vatche and Tamar Manoukian Division of Digestive Diseases David Geffen School of Medicine at University of California Los AngelesLos AngelesCA 90095United States Department of Internal Medicine Santa Clara Valley Medical CenterSan JoseCA 95128United States Division of Gastroenterology and Hepatology Mercy HospitalSaint LouisMO 63141United States David John Westrich Jason TaylorDivision of Gastroenterology and HepatologySaint Louis University School of MedicineSaint LouisMO 63104United States Saint Louis University Center for Health Outcomes Research Saint Louis UniversitySaint LouisMO 63104United States

BACKGROUND Percutaneous Endoscopic Gastrostomy(PEG)tubes are often placed for dysphagia following a stroke in order to maintain sufficient caloric *** 2011 ASGE guidelines recommend delaying PEG tube placement for two weeks,as half of patients with dysphagia improve within 2 *** are few studies comparing outcomes based on timing of PEG tube placement,and there is increasing demand for early PEG tube placement to meet requirements for timely discharge to rehab and skilled nursing *** To assess the safety of early(≤7 d post stroke)vs late(>7 d post stroke)PEG tube placement and evaluate whether pre-procedural risk factors could predict mortality or *** We performed a retrospective study of patients undergoing PEG tube placement for dysphagia following a stroke at two hospitals in Saint Louis,MO between January 2011 and December *** were identified by keyword search of endoscopy ***,peri-procedural complication rates,and post-procedural complication rates were compared in both *** of morbidity and mortality such as protein-calorie malnutrition,presence of an independent cardiovascular risk equivalent,and presence of Systemic inflammatory response syndrome(SIRS)criteria or documented infection were evaluated by multivariate logistic *** 154 patients had a PEG tube placed for dysphagia following a stroke,92 in the late group and 62 in the early *** were 32 observed deaths,with 8 occurring within 30 d of the *** was an increase in peri-procedural and post-procedural complications with delayed PEG placement which was not statistically *** length of stay was significantly less in patients with early PEG tube placement(12.9 vs 22.34 d,P<0.001).Protein calorie malnutrition,presence of SIRS criteria and/or documented infection prior to procedure or having a cardiovascular disease risk equivalent did not significantly predict mortality or complicati

关键词： Percutaneous endoscopic gastrostomy tube Dysphagia Stroke Enteral nutrition Gastrostomy/adverse effect

Microfluidic single cell analysis shows porcine induced pluripotent stem cell-derived endothelial cells improve myocardial function by paracrine activation

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中国病理生理杂志 2012年第11期 2086-2087页

作者： Patricia NGUYEN Divya NAG preston D.LAVINGHOUSEZ Jordan R.PLEW Andrew S.lee Bruno C.HUBER Won Hee lee Patricia E.de ALMEIDA Jennfier LYONS Fumi IKENO Robert C.ROBBINS Michael T.LONGAKER Joseph C.WU Department of Medicine Division of Cardiovascular MedicineStanford University School of MedicineStanfordCA 94305-5101USA Department of Pediatrics Stanford University School of MedicineStanfordCA 94305-5101USA Department of Radiology Molecular Imaging ProgramStanford University School of MedicineStanfordCA 94305-5101USA Department of Cardiothoracic Surgery Stanford University School of MedicineStanfordCA 94305-5101USA Department of Plastic Surgery Stanford University School of MedicineStanfordCA 94305-5101USA

AIM:Induced pluripotent stem cells(iPSCs)hold great promise for the development of patient-specific therapies for cardiovascular ***,clinical translation will require preclinical optimization and validation of large a... 详细信息

关键词： iPSC cell Microfluidic single cell analysis shows porcine induced pluripotent stem cell-derived endothelial cells improve myocardial function by paracrine activation stem

The Phenomenon of High Hardness Values on the S-Phase Layer of Austenitic Stainless Steel via Screen Plasma Nitriding Process

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Advances in Materials Physics and Chemistry 2018年第6期8卷 257-268页

作者： Sang-Gweon Kim Kook-Hyun Yeo Yong-Ki Cho Jae-Hoon lee Masahiro Okumiya Heat Treatment R&D Group Korea Institute of Industrial Technology (KITECH) Siheung Republic of Korea Toyota Technological Institute Nagoya Japan

The purpose of this study is to improve the surface properties of austenitic stainless steel using the double-folded electrode screen plasma nitriding (SPN) process. In general, the S-phase is well-known for its excellent properties such as improved hardness and wear resistance along with sustained corrosion resistance. The concentrated nitrogen via SPN process was injected to form S-phase with time at 713 K. This study was carried out under the conditions of 44 at% of nitrogen injection, which was higher than 25 at% known as the condition of no precipitation of S-phase formed by the SPN process, and 20 K higher than the maximum temperature without precipitation phase. The hardness analysis of stainless steel sample treated by the SPN process at 713 K showed a much higher value than the typical nitriding hardness at a depth of lower nitrogen than the maximum nitrogen concentration. The SPN 20 hr treated specimen showed the average value of 2339 HV while 40 hr showed the average value of 2215 HV. The result is attributed to the concentrated nitrogen formed in the SPN process reacting with the alloying elements contained in the base material to form fine precipitates, thus producing a synergy effect of the extreme hardening effect;that is, the movement of precipitates and dislocations due to the GP-zone (Guinier-preston zone).

关键词： Double-Folded Electrode Austenitic Stainless Steel (ASS) Screen Plasma Nitriding (SPN) Process S-Phase Corrosion Resistance High Hardness

No benefit of flat head positioning in early moderate-severe acute ischaemic stroke: a HeadPoST study subgroup analysis

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Stroke & Vascular Neurology 2020年第4期5卷 406-409页

作者： Alejandro M Brunser Menglu Ouyang Hisatomi Arima Pablo M Lavados Thompson Robinson Paula Munoz-Venturelli Veronica V Olavarria Laurent Billot Marre L Hackett Lili Song Sandy Middleton Octavio Pontes-Neto Tsong-Hai lee Caroline Watkins Craig S Anderson Department of General Emergency Clinica Alemana de SantiagoClinica Alemana Universidad del DesarrolloSantiagoChile Department of Neurology and Psychiatry Clinica Alemana de SantiagoFaculty of MedicineClinica Alemana Universidad del DesarrolloSantiagoChile The George Institute for Global Health University of New South WalesSidneyNew South WalesAustralia The George Institute in China Peking University Health Science CenterBeijingChina Department of Preventive Medicine and Public Health Fukuoka UniversityFukuokaJapan Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre University of LeicesterLeicesterUnited Kingdom Faculty of Health and Wellbeing University of Central LancashirePrestonLancashireUnited Kingdom Nursing Research Institute St Vincent's Health Network Sydney AustraliaAustralian Catholic UniversitySydneyNew South WalesAustralia Stroke Service-Neurology Division Department of Neuroscience and Behavioral SciencesRibeirao Preto Medical SchoolUniversity of Sao PauloSao PauloBrazil Stroke Center and Department of Neurology Linkou Chang Gung Memorial Hospital and College of MedicineChang Gung UniversityTaoyuanTaiwan

background Although the Head Positioning in acute Stroke Trial(HeadPoST)showed no effect of the flat head position(FP;vs sitting up head position(SUP))on functional outcome,we hypothesised that it could still offer benefits if commenced early in those with acute ischaemic stroke(AIS)of at least moderate *** Subgroup analysis of HeadPoST in participants with National Institutes of Health Stroke Scale(NIHSS)scores≥7,≥10 and≥14,randomised to FP or SUP<4.5 hours of AIS onset on functional outcomes defined by a shift in scores on the modified Rankin scale(mRS)and death/disability(mRS scores 3-6),and any cardiovascular serious adverse *** regression analyses were undertaken adjusted for study design and baseline risk *** There was no significant differential treatment effect in patient subgroups defined by increasing baseline NIHSS scores:adjusted OR and 95%CI for ordinal shift and binary(3-6)mRS scores:for NIHSS≥7(n=867)0.92(0.67 to 1.25)and 0.74(0.52 to 1.04);NIHSS≥10(n=606)0.80(0.58 to 1.10)and 0.77(0.49 to 1.19);NIHSS≥14(n=378)0.82(0.54 to 1.24)and 1.22(0.69 to 2.14).Conclusions Early FP had no significant effect in patients with moderate-severe AIS.

关键词： acute analysis effect

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弹性基体磨具的磨抛轨迹与表面加工质量研究

表面技术 2022年第12期51卷 255-268页

作者：郭磊明子航靳淇超王家庆李哲熙张新荣长安大学道路施工技术与装备教育部重点实验室西安710064 重庆大学机械传动国家重点实验室重庆400044 仁荷大学机械工学系仁川22212

目的解决以光学玻璃为代表的硬脆材料加工效率与表面质量难以同时得到保证的共性问题。方法以弹性基体工具磨削抛光技术为基础,分析弹性接触区域内有效工作磨粒的运动行为。基于preston方程材料去除模型,研究磨抛过程中磨抛接触区域的... 详细信息

目的解决以光学玻璃为代表的硬脆材料加工效率与表面质量难以同时得到保证的共性问题。方法以弹性基体工具磨削抛光技术为基础,分析弹性接触区域内有效工作磨粒的运动行为。基于preston方程材料去除模型,研究磨抛过程中磨抛接触区域的接触面积、速度分布、多颗磨粒的运动轨迹。基于运动学模型,探究磨抛过程中磨具的运动学参数、磨粒浓度及排布特征等因素对磨粒磨抛轨迹的影响,采用磨具与工件接触区域磨粒运动轨迹相对面积占比和变异系数表征磨粒运动轨迹分布的均匀性,并建立基于轨迹均匀性的加工表面质量评价方法,优化工艺参数。以石英玻璃为加工对象,以硅橡胶中混入金刚石磨粒为基体,通过正交实验研究不同参数对工件表面质量的影响。结果仿真结果表明,选取自转速度为300 r/min、进给速度为1 mm/s、磨抛进动角为15°,磨粒浓度及排布采用1 mm磨粒理论间距,此时获得的最大磨粒运动轨迹相对面积占比为96.46%,最小变异系数为0.375。通过实验,得到了选取磨抛工艺参数中的最佳参数组合,自转速度为1200 r/min,进给速度为1 mm/s,磨抛进动角为15°~20°,磨粒浓度及排布采用磨粒间距1 mm,该组合可将工件的表面粗糙度由1.078μm降至0.057μm,材料去除率为3.8×108μm^(3)/min。结论磨粒运动轨迹的密集程度与自转速度、磨粒浓度及排布呈正相关,与进给速度呈负相关,在考虑加工成本的前提下,采用高自转速度、高磨粒浓度、低进给速度及15°~20°的进动角可以获得密集且均匀的磨粒运动轨迹,提高了工件的表面质量和材料去除效率。

关键词：弹性磨削抛光磨粒轨迹表面质量轨迹均匀性表面形貌材料去除率