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Surgical management of the diabetic foot:The current evidence

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World Journal of Orthopedics 2024年第5期15卷 404-417页

作者： Richard Henry Randall Roberts Gareth rhys Davies-jones James Brock Vaishnav Satheesh Greg AJ Robertson Department of Trauma and Orthopaedics Wrexham Maelor HospitalWrexham LL137TDUnited Kingdom Department of Trauma and Orthopaedics The Robert Jones and Agnes Hunt Orthopaedic HospitalOswestry SY107AGUnited Kingdom

The prevalence of diabetes mellitus and its associated complications,particularly diabetic foot pathologies,poses significant healthcare challenges and economic burdens *** review synthesises current evidence on the surgical management of the diabetic foot,focusing on the interplay between neuropathy,ischemia,and infection that commonly culminates in ulcers,infections,and,in severe cases,*** escalating incidence of diabetes mellitus underscores the urgency for effective management strategies,as diabetic foot complications are a leading cause of hospital admissions among diabetic patients,significantly impacting morbidity and mortality *** review explores the pathophysiological mechanisms underlying diabetic foot complications and further examines diabetic foot ulcers,infections,and skeletal pathologies such as Charcot arthropathy,emphasising the critical role of early diagnosis,comprehensive management strategies,and interdisciplinary care in mitigating adverse *** addressing surgical interventions,this review evaluates conservative surgeries,amputations,and reconstructive procedures,highlighting the importance of tailored approaches based on individual patient profiles and the specific characteristics of foot *** integration of advanced diagnostic tools,novel surgical techniques,and postoperative care,including offloading and infection control,are discussed in the context of optimising healing and preserving limb function.

关键词： Diabetes Diabetic foot Charcot Osteomyelitis Amputation Diabetic foot attack Conservative surgery

Severe acute pancreatitis： pathogenesis, diagnosis and surgical management

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Hepatobiliary & Pancreatic Diseases International 2017年第2期16卷 155-159页

作者： Mark Portelli christopher David jones Department of General Surgery University Hospital Ayr Ayr KA6 6DX UK

BACKGROUND： Severe acute pancreatitis is a subtype of acute pancreatitis, associated with multiple organ failure and systemic inflammatory response syndrome. In this qualitative review we looked at the principles of pathogenesis, classification and surgical management of severe acute pancreatitis. We also looked at the current shift in paradigm in the management of severe acute pancreatitis since the guideline developed by the British Society of *** SOURCES： Studies published between 1st January 1991 and 31st December 2015 were identified with Pub Med, MEDLINE, EMBASE and Google Scholar online search engines using the following Medical Subject Headings： “acute pancreatitis, necrosis, mortality, pathogenesis, incidence” and the terms “open necrosectomy and minimally invasive necrosectomy”.The National Institute of Clinical Excellence（NICE） Guidelines were also included in our study. Inclusion criteria for our clinical review included established guidelines, randomized controlled trials and non-randomized controlled trials with a follow-up duration of more than 6 ***： The incidence of severe acute pancreatitis within the UK is significantly rising and pathogenetic theories are still controversial. In developed countries, the most common cause is biliary calculi. The British Society of Gastroenterology,acknowledges the Revised Atlanta criteria for prediction of severity. A newer Determinant-based system has been *** principle of surgical management of acute necrotizing pancreatitis requires intensive care management, identifying infection and if indicated, debridement of any infected necrotic area. The current procedures opted for include standard surgical open necrosectomy, endoscopic necrosectomy and minimally invasive necrosectomy. The current paradigm is shifting towards a step-up ***： Severe acute pancreatitis is still a subject of grey areas in its surgical management even though new studies have been recorde

关键词： severe acute pancreatitis acute pancreatitis necrosis mortality pathogenesis incidence open necrosectomy and minimally invasive necrosectomy

Urban heat mitigation by green and blue infrastructure:Drivers,effectiveness,and future needs

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The Innovation 2024年第2期5卷 145-166页

作者： Prashant Kumar Sisay E.Debele Soheila Khalili Christos H.Halios Jeetendra Sahani Nasrin Aghamohammadi Maria de Fatima Andrade Maria Athanassiadou Kamaldeep Bhui Nerea Calvillo Shi-Jie Cao Frederic Coulon Jill L.Edmondson David Fletcher Edmilson Dias de Freitas Hai Guo Matthew C.Hort Madhusudan Katti Thomas Rodding Kjeldsen Steffen Lehmann Giuliano Maselli Locosselli Shelagh K.Malham Lidia Morawska Rajan Parajuli christopher D.F.Rogers Runming Yao Fang Wang Jannis Wenk Laurence jones Global Centre for Clean Air Research(GCARE) School of SustainabilityCivil and Environmental EngineeringFaculty of Engineering and Physical SciencesUniversity of SurreyGuildford GU27XHUK Institute for Sustainability University of SurreyGuildford GU27XHSurreyUK School of Built Environment University of ReadingWhiteknightsReading RG66BUUK School Design and the Built Environment Curtin University Sustainability Policy InstituteKent StBentley 6102Western Australia Harry Butler Institute Murdoch UniversityMurdoch 6150Western Australia Atmospheric Sciences Department Institute of AstronomyGeophysics and Atmospheric SciencesUniversity of Sao PauloSao Paulo 05508-090Brazil Met Office FitzRoy RoadExeter EX13PBUK Department of Psychiatry and Nuffield Department of Primary Care Health Sciences Wadham CollegeUniversity of OxfordOxfordUK Centre for Interdisciplinary Methodologies University of WarwickWarwickUK School of Architecture Southeast University2 SipailouNanjing 210096China Cranfield University School of WaterEnvironment and EnergyCranfield MK430ALUK Plants PhotosynthesisSoil ClusterSchool of BiosciencesUniversity of SheffieldSheffield S102TNUK UK Centre for Ecology&Hydrology Environment Centre WalesDeiniol RoadBangor LL572UWUK Air Quality Studies Department of Civil and Environmental EngineeringThe Hong Kong Polytechnic UniversityHong KongChina Department of Forestry and Environmental Resources Faculty Excellence Program for Leadership in Public ScienceNorth Carolina State UniversityChancellorRaleighNC 27695USA Departments of Architecture&Civil Engineering and Chemical EngineeringUniversity of BathBath BA27AYUK School of Architecture University of NevadaLas VegasNV 89154USA Department of Tropical Ecosystems Functioning Center of Nuclear Energy in AgricultureUniversity of São PauloPiracicaba 13416-000Sao PauloBrazil School of Ocean Sciences Bangor UniversityMenai BridgeAnglesey LL595 ABUK International Laboratory for Air Quality and Health Science and Engine

The combination of urbanization and global warming leads to urban overheating and compounds the frequency and intensity of extreme heat events due to climate ***,the risk of urban overheating can be mitigated by urban green-blue-grey infrastructure(GBGI),such as parks,wetlands,and engineered greening,which have the potential to effectively reduce summer air *** many reviews,the evidence bases on quantified GBGI cooling benefits remains partial and the practical recommendations for implementation are *** systematic literature review synthesizes the evidence base for heat mitigation and related co-benefits,identifies knowledge gaps,and proposes recommendations for their implementation to maximize their *** screening 27,486 papers,202 were reviewed,based on 51 GBGI types categorized under 10 main *** GBGI(green walls,parks,street trees)have been well researched for their urban cooling ***,several other GBGI have received negligible(zoological garden,golf course,estuary)or minimal(private garden,allotment)*** most efficient air cooling was observed in botanical gardens(5.0±3.5℃),wetlands(4.9±3.2℃),green walls(4.1±4.2℃),street trees(3.8±3.1℃),and vegetated balconies(3.8±2.7℃).Under changing climate conditions(2070–2100)with consideration of RCP8.5,there is a shift in climate subtypes,either within the same climate zone(e.g.,Dfa to Dfb and Cfb to Cfa)or across other climate zones(e.g.,Dfb[continental warm-summer humid]to BSk[dry,cold semi-arid]and Cwa[temperate]to Am[tropical]).These shifts may result in lower efficiency for the current GBGI in the *** the importance of multiple services,it is crucial to balance their functionality,cooling performance,and other related co-benefits when planning for the future *** global GBGI heat mitigation inventory can assist policymakers and urban planners in prioritizing effective interventions to reduce the risk of urban overheating,fi

关键词： estuary walls extreme

NDI of Rail Squats and Estimating Defect Size and Location Using Lock-In Thermography

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Engineering（科研） 2013年第1期5卷 29-38页

作者： Daren Peng rhys jones Department of Mechanical and Aerospace Engineering Monash University Melbourne Australia

Rail squats are a form of near surface rolling contact fatigue damage found in rail heads. Currently, the most popular method to detect the rail squats is utilizing ultrasonic techniques to determine their presence and measure their depths. This technique needs to be direct contact between the probe and the rail head, with a coupling fluid in at the interface. Other weaknesses of these ultrasonic techniques include false detections as well as missed detections. Infrared thermography is a relatively new non-destructive inspection technique used for a wide range of applications but is not used for rail squat detection. Lock-in thermography is a non-destructive inspection technique that can be used for the detection of near surface defects. It utilizes an infrared camera to detect the thermal waves and then produces a thermal image, which displays the local thermal wave variation in phase or amplitude. In inhomogeneous materials, the amplitude and phase of the thermal wave carries information related to both the local thermal properties and the nature of the structure being inspected. This comparison is then used to determine the phase angle difference (Δf) between the input and the thermal response of the object. The aim of this paper is to determine whether lock-in thermography can be used to firstly locate squats in rails, and secondly measure their depths. It has demonstrated the feasibility for using such a technique in generating thermal responses that could be adequately utilized for the purpose of defect characterization.

关键词： Lock-In Thermography Phase Contrast Infrared Camera Squat Non-Destructive Inspection

Finite Element Method Study on the Squats Growth Simulation

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Applied Mathematics 2013年第5期4卷 29-38页

作者： Daren Peng rhys jones Department of Mechanical and Aerospace Engineering Monash University Victoria Australia

A simplified finite element analysis on the squats growth simulation and the effect different contact stresses has been presented. This analysis is based on the element removal study to simulate squat growth in a rail track under cyclic loading. The major principal stress (maximum principal stress failure theory) has been used as failure criteria. Evolution strategies are derived from the biological process of evolution, to find squats growth path solution to a complex rail/ wheel contact problem.

关键词： FEM Squats Complex Crack Growth Genetic Algorithm

Technical Design for Holistic Wireless Communication in Smart Buildings

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Transactions of Nanjing University of Aeronautics and Astronautics 2018年第S1期35卷 81-87页

作者： Sean rhys jones Mark Gillott Rabah Boukhanouf Gavin Walker David Tetlow Faculty of Engineering Department of Architecture and Built EnvironmentUniversity of Nottingham

This paper presents the design of a wireless building monitoring network implemented at the University of Nottingham's Creative Energy Homes test *** network is installed in seven smart buildings with the aim of holistically collecting energy *** will be used to inform a central control algorithm to optimise the energy flows between buildings,in turn promoting the smart cities *** and meters measuring temperature,humidity,CO_2,heat energy,power,and stratified tank temperature are ***,the communication protocols utilised are also discussed,which include wireless MBus and *** paper also covers the methods used for ensuring the reliability of data signals and the system controls.

关键词： smart cities smart buildings communication network building monitoring

Selective androgen receptor modulators for the treatment of late onset male hypogonadism

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Asian Journal of Andrology 2014年第2期16卷 256-261,I0009页

作者： christopher C Coss Amanda jones Michael L Hancock Mitchell S Steiner James T Dalton GTx Inc. Memphis Tennessee USA.

Several testosterone preparations are used in the treatment of hypogonadism in the ageing male. These therapies differ in their convenience, flexibility, regional availability and expense but share their pharmacokinetic basis of approval and dearth of long-term safety data. The brevity and relatively reduced cost of pharmacokinetic based registration trials provides little commercial incentive to develop improved novel therapies for the treatment of late onset male hypogonadism. Selective androgen receptor modulators （SARMs） have been shown to provide anabolic benefit in the absence of androgenic effects on prostate, hair and skin. Current clinical development for SARMs is focused on acute muscle wasting conditions with defined clinical endpoints of physical function and lean body mass. Similar regulatory clarity concerning clinical deficits in men with hypogonadism is required before the beneficial pharmacology and desirable pharmacokinetics of SARMs can be employed in the treatment of late onset male hypogonadism.

关键词： hypogonadism late onset hypogonadism selective androgen receptor modulators testosterone

Use of topical vancomycin powder in total joint arthroplasty:Why the current literature is inconsistent?

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世界骨科杂志:英文版 2023年第8期14卷 589-597页

作者： Fabio Mancino Piers J Yates Benjamin Clark christopher W jones Department of Orthopaedics Fiona Stanley HospitalPerth 6150Australia Department of Orthopaedics The Orthopaedic Research Foundation of Western AustraliaPerth 6010Australia Department of Orthopaedics University of Western AustraliaPerth 6009Australia Department of Infectious Diseases Fiona Stanley HospitalPerth 6150Australia Department of Orthopaedics Curtin UniversityPerth 6102Australia

Periprosthetic joint infection(PJI)is a rare but terrible complication in hip and knee arthroplasty,and the use of topical vancomycin powder(VP)has been investigated as a tool to potentially reduce its ***,there remains no consensus on its ***,the aim of this review is to provide an overview on the application of topical vancomycin in orthopaedic surgery focusing on the recent evidence and results in total joint *** systematic reviews and meta-analyses on topical VP in hip and knee arthroplasty have been recently published reporting sometimes conflicting *** from all being limited by the quality of the included studies(mostly level III and IV),confounding variables are often included potentially leading to biased *** taken into consideration the exclusive use of VP in isolation,the available data,although very limited,suggest that it does not reduce the infection rate in routine primary hip and knee ***,we still cannot advise for a routinary application.A properly powered randomized-controlled trial would be necessary to clarify the role of VP in hip and knee *** on the analysis of the current evidence,the use of topical VP appears to be safe when used locally in terms of systemic adverse reactions,hence,if proven to be effective,it could bring great benefits due to its low cost and accessibility.

关键词： Periprosthetic joint infection Vancomycin powder Total knee arthroplasty Total hip arthroplasty Infection antibiotic

Outcomes of Pringle maneuver in patients undergoing hepatic resection for colorectal liver metastases

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Hepatobiliary & Pancreatic Diseases International 2021年第6期20卷 588-591页

作者： Li Lian Kuan christopher P Neal Vaux Robertson Michael jones Ashley R Dennison Giuseppe Garcea Department of Hepatobiliary and Pancreatic Surgery Leicester General HospitalUniversity Hospitals of Leicester NHS TrustLeicester LE54PWUK Discipline of Surgery The Queen Elizabeth HospitalThe University of AdelaideAdelaideSouth AustraliaAustralia

To the Editor:The Pringle maneuver(PM)was initially described more than a century ago to control bleeding associated with hepatic trauma and it remains the most common method to block hepatic inflow and minimize blood... 详细信息

关键词： hepatic Pringle resection