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Comparative utility of vestibular function tests in patients with peripheral and central vestibular dysfunction

Journal of Otology 2024年第1期19卷 5-9页

作者： Cameron B.Fattahi Christopher Zaro Janice J.Chung richard F.lewis Divya A.Chari Department of Otolaryngology-Head and Neck Surgery UMASS Memorial Medical CenterUniversity of Massachusetts Chan Medical SchoolWorcesterMAUSA Jenks Vestibular Physiology Laboratory Massachusetts Eye and EarBostonMAUSA Department of Otolaryngology-Head and Neck Surgery Massachusetts Eye and EarHarvard Medical SchoolBostonMAUSA Department of Neurology Harvard Medical SchoolBostonMAUSA

Background: Bithermal caloric irrigation, video head impulse test(vHIT), and rotational testing are commonly used to assess peripheral vestibular function, but the relative clinical utility of each test in differentiating patients with peripheral vestibulopathy is ***: To determine whether(1) the combination of two or more vestibular tests enhances diagnostic utility over a single test;(2) abnormal test results on vestibular tests correlate with one ***: Retrospective analysis of data collected from multidisciplinary vestibular clinics at two academic medical centers from 2016 to ***: 150 patients(54.10 ± 15.09 years, 88 females) were included. No individual test was significantly better at predicting the presence of peripheral vestibular damage(p > 0.05). vHIT test results improved significantly when combined with either the caloric test(p = 0.007) or rotary chair test(p = 0.039). Caloric and rotational testing had high sensitivity(74.65% and 76.06%, respectively) and specificity(83.54% and 78.48%, respectively). vHIT demonstrated excellent specificity(89.87%) but poor sensitivity(47.89%). Caloric, vHIT, and rotary chair tests results did not correlate with one another(p > 0.05).Conclusions: Vestibular function tests have comparable diagnostic utility, yet each offers unique advantages. Caloric and rotational testing may be best suited for screening peripheral damage and vHIT may function ideally as a confirmatory test.

关键词： vestibular patients specificity

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Current review of Excimer laser Trabeculostomy

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Eye and Vision 2020年第1期7卷 232-240页

作者： Georges M.Durr Marc Töteberg-Harms richard lewis Antonio Fea Paola Marolo Iqbal Ike K.Ahmed Department of Ophthalmology Universitéde MontréalMontrealQuebecCanada Department of Ophthalmology Centre Hospitalier Universitaire de Montréal(CHUM)1051 Rue SanguinetMontreal H2X 3E4QuebecCanada Department of Ophthalmology University Hospital ZurichZurichSwitzerland Sacramento Eye Consultants SacramentoCaliforniaUSA Struttura Complessa Oculistica Cittàdella Salute e della Scienza di TorinoDipartimento di Scienze ChirurgicheUniversitàdegli Studi di TorinoTorinoItaly Department of Ophthalmology&Vision Sciences University of TorontoTorontoOntarioCanada

Background:Excimer laser trabeculostomy(ELT)is a microinvasive glaucoma surgery(MIGS)that creates multiple laser channels through the trabecular meshwork using a cold laser system,which minimizes tissue fibrosis and aids in bypassing the main area of resistance to aqueous *** purpose of this review is to evaluate the current body of evidence surrounding ELT in terms of efficacy and review the safety profile of the *** text:Studies screened had to show clear inclusion and exclusion criteria as well as well-defined outcome ***,MEDLINE,EMBASE and the Cochrane Controlled Trial Database were *** Reporting Items of Systematic Reviews(PRISMA)guidelines were used to assess for study quality and for any ***-four articles were initially identified with 18 meeting preliminary screening ***,8 studies met inclusion criteria and 2 additional non-referenced publications were also included:1 randomized control trial,4 prospective case series and 5 retrospective *** studies showed moderate intraocular pressure(IOP)lowering of between 20%and 40%from baseline without medication washout and mostly a decrease in glaucoma medications with few ***:Current literature shows a significant IOP-lowering effect of ELT with a favorable safety-profile in standalone cases or combined with cataract *** to these studies are the lack of controls and washout ***,ELT is an attractive MIGS option that does not require any residual device remaining in the angle.

关键词： Excimer laser trabeculostomy Trabeculotomy ELT Intraocular pressure Glaucoma MIGS Cataract

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Prognostic Factors to Reduce ICU Overtriage in Elderly Patients with Isolated Mild Traumatic Brain Injury

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Surgical Science 2023年第7期14卷 517-532页

作者： Tomas Jacome Chris LaBorde richard lewis Danielle Tatum Our Lady of the Lake Regional Medical Center Baton Rouge LA USA LSU Health-Baton Rouge Baton Rouge LA USA

Introduction: Elderly patients with mild traumatic brain injury (mTBI) are frequently admitted to an intensive care unit (ICU), which is potentially both harmful and unnecessary. It is not known which patients may be safely observed in a non-ICU setting, potentially improving ICU utilization. The purpose of this study was to identify factors that predict which geriatric patients with traumatic brain injury may be admitted to a level of care other than the ICU. Methods: Adults ≥65+ years admitted with positive radiologic study demonstrating isolated mTBI (defined as Glasgow Coma Scale (GCS) 13 - 15) that was initially managed nonoperatively between January 2011-December 2016 were identified. Primary outcomes evaluated included over triage and Glasgow Outcome Scale (GOS). Results: 207 were identified. Most patients presented with GCS 15 (77.8%) and were admitted to ICU (85.5%). 27% (n = 55) met overtriage criteria. The most common TBI was subdural hemorrhage (SDH) (48.8%) followed by subarachnoid hemorrhage (SAH) (22.2%). Hemorrhage progression developed in 8.7% of subjects, but there was no difference across TBI type. 21.7% of patients developed a ≥2 point decrease in GCS during their hospital stay. Upon discharge, 89.9% had a GOS ≥ 4 - 5. Presence/type of a single intracranial hemorrhage (ICH) was not significantly associated with outcome, but presence of bilateral or multiple lesions was significantly associated with poor outcome (p = 0.04). Conclusions: Overtriage of patients to an ICU is costly, resource intensive, and avoidable. Here, we suggest a conservative framework to assist the determination of which patients can be safely observed in non-ICU setting. Future studies should determine if this framework is generalizable to the entire geriatric population who present with mTBI.

关键词： Traumatic Brain Injury Geriatric Trauma Overtriage Intensive Care Unit Outcomes

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Perspectives on the Potential Migration of Fluids Associated with Hydraulic Fracturing in Southwest Florida

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Journal of Environmental Science and Engineering(A) 2018年第3期7卷 108-124页

作者： William C. Hutchings richard G. lewis Environmental Department GHD Services Inc. Fort Myers 33901 USA lewis Solutions Fort Myers 33907 USA

The variable-density flow model-SEAWAT Version 4, was used to evaluate the hydrogeological conditions associatedwith hydraulic fracturing （fracking） the limestone oil reservoir in the Lower Cretaceous Sunniland Formation of Southwest *** research contributes to the understanding of the controls on fluid and potential contaminant migration, following high pressurehydraulic fracturing. A hydraulic fracturing treatment used recently in this formation at the Collier-Hogan 20-3H well represents thebase case simulation. Multiple stage fracturing using typical stress periods, a modelled fracture zone radius, and various injectionrates were tested to evaluate the potential for horizontal and vertical fluid migration in and from the reservoir under dynamicconditions, with TDS used as a tracer. Hypothetical scenarios including preferential vertical pathways between the SunnilandFormation and the Lower Floridan aquifer Boulder Zone were also simulated. Results indicate that injected fluids do not migratesignificantly in the lateral and vertical directions beyond the design fractured zone, unless a preferential pathway exists within closeproximity to the fractured zone. In a worst-case scenario under the simulated conditions, vertical heads are approximately 580 metersgreater than static conditions and fluids associated with hydraulic fracturing vertically migrate approximately 500 meters; therefore,the quality of the deepest sources of drinking water is not compromised. Analytical results from a monitoring well installed in theimmediate vicinity of the Collier-Hogan 20-3H well and at the base of the deepest source of drinking water support the conclusionthat impacts from hydraulic fracturing fluids have not migrated into the deepest sources of drinking water.

关键词： Hydraulic fracturing Sunniland Formation fluid migration

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Sax's Dangerous Properties of Industrial Materials 11th;editon

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2004年

作者： richard J. lewis Sr.

ISBN: (数字)9780471701347

ISBN: (纸本)9780471476627

Since its inception in the early 1950's, Sax's Dangerous Properties of Industrial Materials has become the primary source for those who need to evaluate the hazardous potential of substances used in commerce. Sax's is the only reference that combines data on toxicology, flammability, reactivity, explosive potential, and regularity information for over 28,000 substances. Each entry includes the following data (where available): DPIM code Hazard rating Entry name CAS number DOT number Molecular formula Line structural formula Description of the material and physical properties of the chemical Synonyms Toxicology data with references for reports of primary skin and eye irritation, mutation, reproductive, carcinogenic, and acute toxic dose data Reviews of Sax's Dangerous Properties of Industrial Materials: "This publication is a tour de force in its field: the presentation and structuring of both the hardback and electronic versions are first class. It is highly recommended as the best reference work for anyone wishing to access comprehensive information on the dangerous properties of industrial materials in the workplace." -- Bioseparation "...any practicing chemical engineer would be grateful for access..." -- Process Safety & Environmental Protection "...no other source can match the breadth and depth found in this title." -- Fire "This very handy reference guide provides health and safety data, regulatory standards, toxicity and carcinogenicity information, and physical property profiles for over 26,000 potentially hazardous chemical substances..." -- Journal of the American Chemical Society "Sax's remains the authoritative text for those who need to evaluate hazards of substances used in industry...a worthwhile resource for libraries, colleges, and union regional and national offices..." -- Hazards

关键词： Hazardous substancesHandbooks manuals etc.

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Screening and Purification of Natural Products from Actinomycetes that Induce a“Rounded”Morphological Phenotype in Fission Yeast

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Natural Products and Bioprospecting 2021年第4期11卷 431-445页

作者： richard Alexander lewis Jenileima Devi Katherine Green Juanjuan Li Adam Hopkins Jacqueline Hayles Paul Nurse Jeff Errington Nicholas Edward Ellis Allenby Demuris Ltd The BiosphereDraymans WayNewcastle HelixNewcastle upon Tyne NE45BXUK University of Southampton University RoadSouthampton SO171BJUK Cell Cycle Laboratory The Francis Crick Institute1 Midland RoadLondon NW11ATUK

This study was designed to identify and investigate bioactive natural product compounds that alter the cellular shape of the fission yeast Schizosaccharomyces pombe and induce a“rounded”or“small”cellular morphological *** using a range of antifungal agents against a multidrug-sensitive fission yeast strain,SAK950 showed that many induced a“rounded”*** then investigated whether 46 of the actinomycete strains identified in our previous study as inducing a similar phenotype produced antifungal agents of similar *** show that five of the strains produced streptothricin and that 26 strains produced polyenes,including fungichromin,filipin and candicidin,the last of which was produced by 24 strains.A taxonomic study of the strains indicated that the majority of the candicidin only producers were Streptomyces hydrogenans and *** whilst those that additionally produced streptothricin were related to ***.A follow-up study to investigate the natural products made by related strains indicated that they followed a similar *** identification of several compounds from the actinomycete strains similar to the antifungal agents initially tested confirm the validity of an approach using the *** morphological phenotype and actinomycete taxonomy as a predictive tool for natural product identification.

关键词： Actinomycetes Schizosaccharomyces pombe Morphology Phenotype Antifungal Polyene

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Absolut Sequel: : . . , , /

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2005年

作者： richard W. lewis

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Stoichiometry and activation of the STIM-Orai CRAC channel complex

Stoichiometry and activation of the STIM-Orai CRAC channel c...

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第十一届全国钙信号和细胞功能研讨会

作者： richard S.lewis Michelle Yen Department of Molecular & Cellular Physiology Stanford University School of Medicine

Following Ca store depletion, the ER Ca sensor STIM1 accumulates at ER-plasma membrane junctions,where it traps and activates CRAC channels through direct binding of its CAD/SOAR domain to the cytoplasmic C termini of Orai1. To understand the activation process at a molecular level, several fundamental issues regarding the stoichiometry of the STIM-Orai complex need to be resolved. Current evidence is divided on whether the CRAC channel functions as a tetramer or a hexamer of Orai1 subunits, and both the stoichiometry of the CAD-Orai1 interaction and how it drives channel opening are unclear. We have addressed these questions by applying electrophysiological and FRET techniques to study concatenated Orai1 proteins. We find that hexameric concatemers of Orai1 behave like native CRAC channels in terms of activation and inactivation properties, ion selectivity, Ca binding affinity of the pore, single-channel conductance and open probability. Because ion permeation is highly sensitive to pore geometry, we conclude that the native CRAC channel functions as a hexamer of Orai1. By manipulating individual STIM1 binding sites on Orai1 concatemers we show that CAD dimers can interact with single Orai1 C termini but preferentially engage pairs of C termini, and that this bimolecular binding mode contributes to channel activation. Orai1 mutations that reduce STIM1 binding inhibit channel opening in a nonlinear way, consistent with a model in which each binding event is independent and contributes an equal amount of energy to open the activation gate. Our modeling results suggest that STIM1 binding activates the CRAC channel by controlling modal transitions between long-lived silent and highly active states.

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Guaranteed Cost Attitude Tracking Control for Uncertain Quadrotor Unmanned Aerial Vehicle Under Safety Constraints

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IEEE/CAA Journal of Automatica Sinica 2024年第6期11卷 1447-1457页

作者： Qian Ma Peng Jin Frank L.lewis School of Automation Nanjing University of Science and TechnologyNanjing 210094China UTA Research Institute University of Texas at ArlingtonFort WorthTexas 76118 USA IEEE

In this paper,guaranteed cost attitude tracking con-trol for uncertain quadrotor unmanned aerial vehicle(QUAV)under safety constraints is ***,an augmented system is constructed by the tracking error system and reference *** transformation aims to convert the tracking control prob-lem into a stabilization control ***,control barrier function and disturbance attenuation function are designed to characterize the violations of safety constraints and tolerance of uncertain disturbances,and they are incorporated into the reward function as penalty *** on the modified reward function,the problem is simplified as the optimal regulation problem of the nominal augmented system,and a new Hamilton-Jacobi-Bellman equation is ***,critic-only rein-forcement learning algorithm with a concurrent learning tech-nique is employed to solve the Hamilton-Jacobi-Bellman equa-tion and obtain the optimal *** proposed algorithm can not only ensure the reward function within an upper bound in the presence of uncertain disturbances,but also enforce safety *** performance of the algorithm is evaluated by the numerical simulation.

关键词： Attitude tracking control quadrotor unmanned aerial vehicle(QUAV) reinforcement learning safety constraints uncertain disturbances.

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副轴工件夹持方案

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现代制造 2015年第34期 48-50页

作者： richard lewis Hardinge公司

单次装卡完成整个部件的加工，一直以来都是绝大多数大型和小型制造公司所追求的目标。这种方式通常不仅意味着较高的生产量，而且意味着更精确的成品部件。对于车削作业来说，这种方式要求机床配备一个副轴，用于从主轴处接取部件，并... 详细信息

单次装卡完成整个部件的加工，一直以来都是绝大多数大型和小型制造公司所追求的目标。这种方式通常不仅意味着较高的生产量，而且意味着更精确的成品部件。对于车削作业来说，这种方式要求机床配备一个副轴，用于从主轴处接取部件，并在副轴上完成背侧精加工，即典型的op．10／op．20工艺。在这个工艺当中，也许最为关键且经常最容易被忽视的步骤就是选择正确的工件夹持装置。如果想要达到成功的结果，这项因素就会变成一项重要的决策。

关键词：夹持装置副轴工件精加工部件生产量工艺 op

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