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Surgical management of the diabetic foot:The current evidence

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

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The effect of EMG magnitude on the masseter vestibular evoked myogenic potential(mVEMP)

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Journal of Otology 2022年第4期17卷 203-210页

作者： Daniel J.Romero Gary P.Jacobson richard A.roberts Department of Hearing and Speech Sciences Division of Vestibular SciencesVanderbilt University Medical Center121521st Ave.South6308 Medical Center EastNashvilleTN37232-8718USA

Introduction:The masseter vestibular evoked myogenic potential(mVEMP)is a bilaterally generated,electromyographically(EMG)-mediated response innervated by the trigeminal *** purpose of the present investigation was to 1)determine whether subjects could accurately achieve and maintain a range of EMG target levels,2)to examine the effects of varied EMG levels on the latencies and amplitudes of the mVEMP,and 3)to investigate the degree of side-to-side asymmetry and any effects of EMG ***:Subjects were nine neurologically and otologically normal young adults.A high-intensity tone burst was presented monaurally while subjects were seated upright and asked to match a range of EMG target levels by clenching their *** were made from the ipsilateral and contralateral masseter muscles referenced to the ear being monaurally ***:We found that the tonic EMG target had no effect on mVEMP ***,although mVEMP amplitudes“scaled”to the EMG target,there was a tendency for the subjects’EMG level to“undershoot”the EMG target levels greater than 50 *** some individuals did generate differences in EMG activation between sides,there were no significant differences on average EMG activation between ***,while average corrected amplitude asymmetry was similar across EMG targets,some individuals demonstrated large,corrected amplitude asymmetry ***:The results of this investigation suggest that,as with cVEMP recordings,the underlying EMG activation may vary between subjects and could impact mVEMP amplitudes,yet could be mitigated by amplitude correction *** it is important to be aware that even young normal subjects have difficulty maintaining large,tonic EMG activity during the mVEMP recording.

关键词： Vestibular evoked myogenic potentials (VEMPs) Masseter VEMPs Electromyography(EMG) Vestibulomasseteric reflex(VMR) EMG target Level

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Optimal and interactive keyframe selection for motion capture

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Computational Visual Media 2019年第2期5卷 171-191页

作者： richard roberts J.P.Lewis Ken Anjyo Jaewoo Seo Yeongho Seol Victoria University of Wellington WellingtonNew Zealand SEED Electronic ArtsLos AngelesUnited States OLM Digital TokyoJapan Pinscreen Los AngelesUnited States Weta Digital WellingtonNew Zealand

Motion capture is increasingly used in games and movies, but often requires editing before it can be used, for many reasons. The motion may need to be adjusted to correctly interact with virtual objects or to fix problems that result from mapping the motion to a character of a different size or, beyond such technical requirements, directors can request stylistic ***, editing is laborious because of the lowlevel representation of the data. While existing motion editing methods accomplish modest changes, larger edits can require the artist to "re-animate" the motion by manually selecting a subset of the frames as *** this paper, we automatically find sets of frames to serve as keyframes for editing the motion. We formulate the problem of selecting an optimal set of keyframes as a shortest-path problem, and solve it efficiently using dynamic programming. We create a new simplified animation by interpolating the found keyframes using a naive curve fitting technique. Our algorithm can simplify motion capture to around 10% of the original number of frames while retaining most of its detail. By simplifying animation with our algorithm, we realize a new approach to motion editing and stylization founded on the timetested keyframe interface. We present results that show our algorithm outperforms both research algorithms and a leading commercial tool.

关键词： motion capture motion editing keyframe animation dynamic programming

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A factor analytic assessment of the English translation of the neuropsychological vertigo inventory(NVI)

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Journal of Otology 2020年第2期15卷 45-49页

作者： Gary P.Jacobson Erin G.Piker Kelsey Hatton richard A.roberts Vanderbilt University Medical Center NashvilleTNUSA James Madison University HarrisonburgVAUSA

Purpose:Vestibular impairments have been associated with a variety of cognitive deficits,most notably deficits in visuo-spatial *** Neuropsychological Vertigo Inventory(NVI)was developed to measure self-reported cognitive deficits in patients with dizziness and/or *** original French language version of the NVI includes 28 items and 7 *** purpose of the present investigation was to determine whether the statistical assessment of an English language version supported the presence of the same cognitive constructs as the French version of the ***:The English language adaptation of the NVI(referred to here as the NVIe)was administered to an unselected sample of 280 patie nts that were being evaluated for dizziness and/or vertigo in a tertiary care dizziness *** individual item scores from the NVIe were subjected to an exploratory factor analysis(EFA).Results:The results of the data analysis supported a 22-item NVIe consisting of 4 constructs:affective state,temporal memory,spatial memory,visual spatial ***:The NVIe is a new tool for screening cognitive constructs that may be affected by vestibular *** to clinical implementation of the NVIe,additional studies of reliability and convergent validity are needed.

关键词： Cognition Vestibular Construct validity

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RecBERT:Semantic recommendation engine with large language model enhanced query segmentation for k-nearest neighbors ranking retrieval

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Intelligent and Converged Networks 2024年第1期5卷 42-52页

作者： richard Wu the Dublin Unified School District and the SF Artificial Intelligence Club DublinCA 94568USA

The increasing amount of user traffic on Internet discussion forums has led to a huge amount of unstructured natural language data in the form of user *** modern recommendation systems rely on manual tagging,relying on administrators to label the features of a class,or story,which a user comment corresponds *** common approach is to use pre-trained word embeddings to compare class descriptions for textual similarity,then use a distance metric such as cosine similarity or Euclidean distance to find top k ***,neither approach is able to fully utilize this user-generated unstructured natural language data,reducing the scope of these recommendation *** paper studies the application of domain adaptation on a transformer for the set of user comments to be indexed,and the use of simple contrastive learning for the sentence transformer fine-tuning process to generate meaningful semantic embeddings for the various user comments that apply to each *** order to match a query containing content from multiple user comments belonging to the same class,the construction of a subquery channel for computing class-level similarity is *** channel uses query segmentation of the aggregate query into subqueries,performing k-nearest neighbors(KNN)search on each individual *** achieves state-of-the-art performance,outperforming other state-of-the-art models in accuracy,precision,recall,and F1 score for classifying comments between four and eight classes,*** outperforms the most precise state-of-the-art model(distilRoBERTa)in precision by 6.97%for matching comments between eight classes.

关键词： sentence transformer simple contrastive learning large language models query segmentation k-nearest neighbors

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Bound and Resonating Multiquark Configurations

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Chinese Physics Letters 2024年第8期41卷 8-12页

作者： Jean-Marc richard Institut de Physique des 2 Infinis de Lyon Universit′e Claude Bernard(Lyon 1) CNRS-IN2P34 rue Enrico Fermi69622 VilleurbanneFrance

We review the predictions of quark models for multiquark configurations that are bound or resonant states,and compare different methods for estimating the properties of resonances.

关键词： quark Configuration resonant

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一路平安

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中国全科医学 2013年第19期16卷 2191-2192页

作者： richard roberts roberts 邵钧(翻译) 美国威斯康辛州 Wisconsin大学医学和公共卫生学院家庭医学系中国全科医学杂志社

我不善于说＂拜拜＂.在担任WONCA主席的三年里,我无数次地对我的家人、患者、诊所同事、工作中视察的家庭医生说＂拜拜＂.这从来不是一件容易的事.每当我走进当地机场的停机楼,离开家人的忧伤就席卷我的全身.每次和患者、诊所同事谈起... 详细信息

我不善于说＂拜拜＂.在担任WONCA主席的三年里,我无数次地对我的家人、患者、诊所同事、工作中视察的家庭医生说＂拜拜＂.这从来不是一件容易的事.每当我走进当地机场的停机楼,离开家人的忧伤就席卷我的全身.每次和患者、诊所同事谈起我下一次的旅行,我就深感内疚.我担心我不在的时候会发生什么我不该错过或本该预料到的事.

关键词：家庭医学家庭医生医生病人关系

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英国全科医学的起伏

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中国全科医学 2013年第7期16卷 715-716页

作者： richard roberts 李月威斯康辛大学医学和公共卫生学院家庭医学系美国威斯康辛州53715 中国全科医学杂志社

从1828年英国诞生第一家免费医疗诊所开始,到1948年二战结束后由英国政府支持的国民卫生服务体系(NHS)正式确立,直到今天,英国的免费国民医疗保健已经走过了一个半世纪的道路。NHS以提供"所有人都能享受的、以需要而非支付能力为基础的... 详细信息

从1828年英国诞生第一家免费医疗诊所开始,到1948年二战结束后由英国政府支持的国民卫生服务体系(NHS)正式确立,直到今天,英国的免费国民医疗保健已经走过了一个半世纪的道路。NHS以提供"所有人都能享受的、以需要而非支付能力为基础的免费全面服务"为准则,是全球最早、最廉价和最公平的国民医疗卫生保障体系。为了削减初级卫生保健信托机构(此类机构长期负责管理并给社区诊所拨付医疗经费)数量,英国政府对NHS实行改革,将国民保健服务预算的75%,即健康资金预算权都交给全科医生直接管理,并允许全科医生向私人医疗服务机构购买服务,新组成一个委员会负责监管全科医生。卫生政策专家警告新的改革幅度太大,且存在私人医疗机构通过贿赂全科医生引起资金外流等制度设计缺陷。NHS改革引起了专业人士和普通民众的关注。本文由Wonca主席richard roberts撰写,对英国全科医学及NHS的改革等问题进行了探讨,以期帮助读者更深入地了解NHS和英国全科医学的发展形势。

关键词：英国全科医学英国国民卫生服务体系改革

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整体大于部分之和

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中国全科医学 2013年第16期16卷 1819-1820页

作者： richard roberts 邵钧 Wisconsin大学医学和公共卫生学院家庭医学系世界家庭医生组织中国全科医学杂志社

有些真理常常需要通过不同的表达方式来重复，直到我们更好地理解。最近的一次计划开展家庭医生共病工作坊的会议使我再次想到了这句话。会议由糖尿病和抑郁症小组（DDD）组织，规划会议在根特大学召开，由JandeMacseneer教授主持。DDD... 详细信息

有些真理常常需要通过不同的表达方式来重复，直到我们更好地理解。最近的一次计划开展家庭医生共病工作坊的会议使我再次想到了这句话。会议由糖尿病和抑郁症小组（DDD）组织，规划会议在根特大学召开，由JandeMacseneer教授主持。DDD是在2007年发起的一个多学科小组，旨在改善糖尿病和抑郁症共病患者的照顾和结局。世界家庭医生组织（WONCA）是DDD的创始成员之一。DDD计划为全世界的糖尿病医生、家庭医生、初级保健工作者、护士、精神卫生工作者提供一系列糖尿病和抑郁症共病工作坊。

关键词：家庭医学家庭医生家庭医生工作坊共病

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Liver transplantation as an alternative for the treatment of non-resectable liver colorectal cancer: Advancing the therapeutic algorithm

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Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 154-159页

作者： Badi Rawashdeh richard Bell Abdul Hakeem Raj Prasad Division of Transplant Surgery Department of General SurgeryMedical College of WisconsinMilwaukeeWI53226USA Leeds Teaching Hospital LeedsUK

Colorectal cancer is a leading cause of cancerrelated mortality,with nearly half of the affected patients developing liver *** three decades,liver resection(LR)has been the primary curative strategy,yet its applicability is limited to about 20%of *** transplantation(LT)for unresectable metastases was attempted unsuccessfully in the 1990s,with high rates of perioperative death and *** is now more interest in this strategy due to improvements in systemic therapies and surgical techniques.A significant study conducted by the Oslo group showed that patients receiving liver transplants had a 60%chance of survival after five *** better results have been achieved by using advanced imaging for risk stratification and further refining selection criteria,especially in the Norvegian SECA *** review carefully charts the development and history of LT as a treatment option for colorectal cancer liver *** revolutionary path from the early days of exploratory surgery to the current situation of cautious optimism is traced,highlighting the critical clinical developments and improved patient selection standards that have made LT a potentially curative treatment for such challenging very well selected cases.

关键词： Liver transplantation Colorectal cancer liver metastases Non-resectable liver metastases

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