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Validation of the age-adjusted shock index for pediatric casualties in Iraq and Afghanistan

Military Medical Research 2021年第1期8卷 17-24页

作者： Camaren M.Cuenca Matthew A.Borgman Michael D.April Andrew D.Fisher steven g.schauer JUS Army Institute of Surgical Research 3698 Chambers PassJBSA Fort Sam HoustonSan AntonioTX 78234-7767USA Brooke Army Medical Center JBSA Fort Sam HoustonSan AntonioTXUSA Uniformed Services University of the Heath Sciences BethesdaMDUSA Texas Army National guard AustinTXUSA Department of Surgery UNM School of MedicineAlbuquerqueNMUSA 59th Medical Wing JBSA LacklandSan AntonioTXUSA

Background: Pediatric casualties account for a notable proportion of encounters in the deployed setting based on the humanitarian medical care mission. Previously published data demonstrates that an age-adjust shock index may be a useful tool in predicting massive transfusion and death in children. We seek to determine if those previous findings are applicable to the deployed, combat trauma ***: We queried the Department of Defense Trauma Registry(DODTR) for all pediatric subjects admitted to US and Coalition fixed-facility hospitals in Iraq and Afghanistan from January 2007 to January 2016. This was a secondary analysis of casualties seeking to validate previously published data using the shock index, pediatric age adjusted. We then used previously published thresholds to determine patients outcome for validation by age grouping, 1–3 years(1.2), 4–6 years(1.2), 7–12 years(1.0), 13–17 years(0.9).Results: From January 2007 through January 2016 there were 3439 pediatric casualties of which 3145 had a documented heart rate and systolic pressure. Of those 502(16.0%) underwent massive transfusion and 226(7.2%) died prior to hospital discharge. Receiver operating characteristic(ROC) thresholds were inconsistent across age groups ranging from 1.0 to 1.9 with generally limited area under the curve(AUC) values for both massive transfusion and death prediction characteristics. Using the previously defined thresholds for validation, we reported sensitivity and specificity for the massive transfusion by age-group: 1–3(0.73, 0.35), 4–6(0.63, 0.60), 7–12(0.80, 0.57), 13–17(0.77, 0.62). For death, 1–3(0.75, 0.34), 4–6(0.66–0.59), 7–12(0.64, 0.52), 13–17(0.70, 0.57). However, negative predictive values(NPV) were generally high with all greater than ***: Within the combat setting, the age-adjusted pediatric shock index had moderate sensitivity and relatively poor specificity for predicting massive transfusion and death. Better scoring systems are needed to p

关键词： Pediatric Massive Transfusion Shock Index Age

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Oligodendroglial heterogeneity in health,disease,and recovery:deeper insights into myelin dynamics

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Neural Regeneration Research 2025年第11期20卷 3179-3192页

作者： Pieter-Jan Serneels Julie D.De Schutter Lies De groef Lieve Moons steven Bergmans KU Leuven Leuven Brain InstituteDepartment of BiologyAnimal Physiology and Neurobiology DivisionNeural Circuit Development&Regeneration Research GroupLeuvenBelgium KU Leuven Leuven Brain InstituteDepartment of BiologyAnimal Physiology and Neurobiology DivisionCellular Communication&Neurodegeneration Research GroupLeuvenBelgium

Decades of research asserted that the oligodendroglial lineage comprises two cell types:oligodendrocyte precursor cells and ***,recent studies employing single-cell RNA sequencing techniques have uncovered novel cell states,prompting a revision of the existing *** forward,the oligodendroglial lineage should be delineated into five distinct cell states:oligodendrocyte precursor cells,committed oligodendrocyte precursor cells,newly formed oligodendrocytes,myelin-forming oligodendrocytes,and mature *** new classification system enables a deeper understanding of the oligodendroglia in both physiological and pathological *** this uniform terminology will facilitate comparison and integration of data across ***,including the consolidation of findings from various demyelinating models,is essential to better understand the pathogenesis of demyelinating ***,comparing injury models across species with varying regenerative capacities can provide insights that may lead to new therapeutic strategies to overcome remyelination ***,by standardizing terminology and synthesizing data from diverse studies across different animal models,we can enhance our understanding of myelin pathology in central nervous system disorders such as multiple sclerosis,Alzheimer's disease,and amyotrophic lateral sclerosis,all of which involve oligodendroglial and myelin dysfunction.

关键词： animal models demyelination fish mammals multiple sclerosis myelin neurodegeneration oligodendrocytes oligodendroglial lineage remyelination

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A Field Observation and Significant Range Extension of Manouria impressa in Myanmar

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Asian Herpetological Research 2016年第4期7卷 295-297页

作者： Saw HTUN steven g. PLATT Wildlife Conservation Society Myanmar Program Office Block C- 1 Aye Yeik Mon 1st Street Hlaing Township YangonMyanmar

Few records of the impressed tortoise （Manouria impressa） are available from Myanmar and most are based on historic accounts, old museum specimens, and shells obtained from villagers and wildlife traffickers. We herein report the observation of a living M. impressa in the Hukaung Valley Wildlife Sanctuary of northern Myanmar. Our observation extends the known distribution of M. impressa in Myanmar approximately 850 km northwards from previously reported populations in the Rakhine Hills of Magway Region.

关键词： conservation Hukaung Valley Wildlife Sanctuary impressed tortoise Myanmar

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High Strength Low Alloy (HSLA) Steels in Building Construction

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Journal of Iron and Steel Research International 2011年第S1期18卷 773-778页

作者： Sivakumaran Ken Siva Jansto steven g Department of Civil Engineering McMaster UniversityHamilton Reference Metals Company-CBMM 1000 Old Pond RoadBridgevillePA 15017USA

Majority of the buildings,including industrial buildings,are constructed using either structural steel (plates and structural shapes) or deformed bar steel reinforced *** buildings,however,must be designed to be safe and serviceable during construction and during use and *** objectives can be easily achieved by the use of steels having superior mechanical properties,ductility,weldability,fire resistance,*** the years,the steel industry has made improvements in steel making technologies resulting in high strength low alloy (HSLA) steels with superior steel properties well suited for building *** part of this paper presents the structural design considerations,and the constructional considerations associated with the building structures in general,and steel structures in *** second part of the paper looks at the acceptance criteria for HSLA steels for North American building codes and *** third part of the paper presents the structural properties of currently available HSLA steels for building *** discussion focuses on hot-rolled structural steel shapes as well as deformed steel bars for concrete *** paper argues that Niobium microalloying is the key to achieving superior properties in such steels.

关键词： HSLA steels building construction structural shapes deformed bars structural performance niobium

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Nitrogen-doped biochars as adsorbents for mitigation of heavy metals and organics from water:a review

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Biochar 2022年第1期4卷 906-935页

作者： Nitesh Kasera Praveen Kolar steven g.Hall Department of Biological and Agricultural Engineering North Carolina State UniversityRaleighNCUSA

Mitigation of toxic contaminants from wastewater is crucial to the safety and sustainability of the aquatic ecosystem and human *** is a pressing need to find economical and efficient technologies for municipal,agricultural,aquacultural,and industrial wastewater ***-doped biochar,which is synthesized from waste biomass,is shown to exhibit good adsorptive performance towards harmful aqueous contaminants,including heavy metals and organic ***-porating nitrogen into the biochar matrix changes the overall electronic structure of biochar,which favors the interaction of N-doped biochar with *** this review,we start the discussion with the preparation techniques and raw materials used for the production of N-doped biochar,along with its structural ***,the adsorption of heavy metals and organic pollutants on N-doped biochars is systematically *** adsorption mechanisms of contaminant removal by N-doped biochar are also clearly ***,mathematical analyses of adsorption,crucial to the quantification of adsorption,process design,and understanding of the mechanics of the process,are ***,the influence of environmental parameters on the adsorption process and the reusability of N-doped biochars are critically ***,future research trends for the design and development of application-specific preparation of N-doped biochars for wastewater treatment are suggested.

关键词： N-doped Nitrogen-enriched Adsorption Wastewater Mechanism

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Neutropenic enterocolitis

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World Journal of gastroenterology 2017年第1期23卷 42-47页

作者： Fabio g Rodrigues giovanna Dasilva steven D Wexner Department of Colorectal Surgery Cleveland Clinic FloridaWestonFL 33331United States

Neutropenic colitis is a severe condition usually affecting immunocompromised patients. Its exact pathogenesis is not completely understood. The main elements in disease onset appear to be intestinal mucosal injury together with neutropenia and the weakened immune system of the afflicted patients. These initial conditions lead to intestinal edema, engorged vessels, and a disrupted mucosal surface, which becomes more vulnerable to bacterial intramural invasion. Chemotherapeutic agents can cause direct mucosal injury (mucositis) or can predispose to distension and necrosis, thereby altering intestinal motility. This article aims to review current concepts regarding neutropenic colitis’ pathogenesis, diagnosis, and management.

关键词： Neutropenic enterocolitis Neutropenic colitis Immunocompromise Intestinal mucosal injury Neutropenia Intestinal edema Intramural invasion Pathogenesis

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A Fusion Steganographic Algorithm Based on Faster R-CNN

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Computers, Materials & Continua 2018年第4期55卷 1-16页

作者： Ruohan Meng steven g.Rice Jin Wang Xingming Sun School of Computer and Software Nanjing University of Information Science and TechnologyNing Liu RoadNo.219Nanjing210044China Jiangsu Engineering Centre of Network Monitoring Ning Liu RoadNo.219Nanjing210044China Department of Mathematics and Computer Science Northeastern State University TahlequahOK 74464USA School of Computer&Communication Engineering Changsha University of Science&TechnologyChangsha410114China

The aim of information hiding is to embed the secret message in a normal cover media such as image,video,voice or text,and then the secret message is transmitted through the transmission of the cover *** secret message should not be damaged on the process of the cover *** order to ensure the invisibility of secret message,complex texture objects should be chosen for embedding *** this paper,an approach which corresponds multiple steganographic algorithms to complex texture objects was presented for hiding secret ***,complex texture regions are selected based on a kind of objects detection ***,three different steganographic methods were used to hide secret message into the selected block *** results show that the approach enhances the security and robustness.

关键词： Faster R-CNN fusion steganography object detection CNNs information hiding.

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An investigation of roof runoff during rain events at the Royal Military College of Canada and potential discharge to Lake Ontario

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Journal of Environmental Sciences 2011年第7期23卷 1072-1078页

作者： David g. Kelly Ron D. Weir steven D. White Analytical Sciences group & SLOWPOKE-2 Facility at RMC Department of Chemistry and Chemical Engineering Royal Military College of Canada 11 General Crerar Crescent

The Royal Military College of Canada, located on the north eastern shore of Lake Ontario, possesses an abundance of copper roofs and lacks surface water treatment prior to discharge into Lake Ontario. Rainwater, roof runoff and soil samples were collected and analyzed for copper and other parameters. Copper was consistently detected in runoff samples with average concentrations of 3200 ± 2100 μg/L. Multivariable linear regression analysis for a dependant copper runoff concentration yielded an adjusted R 2 value of 0.611, based on an independent variable model using minimum temperature, maximum temperature, total precipitation, and wind speed. Lake water samples taken in the vicinity of storm water outfalls draining areas with copper roofs ranged from 2.0 to 40 μg/L copper. Such data exceed the 2.0 μg/L Canadian Water Quality guidelines for the Protection of Aquatic Life as outlined by the Canadian Council of Ministers of the Environment （CCME）. Analysis of raw, filtered and digested forms suggested that the majority of copper present in runoff and lake water samples was in a dissolved form. The majority of soils taken in this study displayed copper concentrations below the 63 μg/g CCME residential/parkland land use limits. These findings suggested that ion exchange processes between runoff water and soil do not occur to a sufficient extent to elevate copper levels in soil. It may therefore be concluded that the eventual fate of copper, which is not discharged via storm water outfalls, is lost to the water table and Lake Ontario through the sub-soil.

关键词： copper roof runoff Lake Ontario Canadian water quality guidelines for the protection of aquatic life

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ASSESSMENT OF OPTICAL CLEARINg AgENTS USINg REFLECTANCE-MODE CONFOCAL SCANNINg LASER MICROSCOPY

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Journal of Innovative Optical Health Sciences 2010年第3期3卷 183-188页

作者： RAVIKANT SAMATHAM KEVIN g.PHILLIPS steven L.JACQUES Departments of Dermatology and Biomedical Engineering Oregon Health and Science University 3303 SW Bond Avenue PortlandOR 97239USA

The mechanism of action of clearing agents to improve optical imaging of mouse skin during reflectance-mode confocal microscopy was *** dermal side of excised dorsal mouse skin was exposed for one hour to saline,glycerin,or 80% DMSO,then the clearing agent was removed and the dermis placed against a glass cover slip through which a confocal microscope measured reflectance at 488 nm *** untreated control was also *** axial attenuation of reflectance signal,R(z_(f))versus increasing depth of focus zf behaved as R=ρexp(−μz_(f) 2g),where ρ is tissue reflectivity and μ is attenuation[cm^(−1)].The factor 2g accounts for the in/out path of photons,and the numerical aperture of the *** ρ,μ data were mapped to values of scattering coefficient(μ_(s)[cm^(−1)])and anisotropy of scattering(g).Images showed that glycerin significantly increased the g of dermis from about 0.7 to about 0.99,with little change in the μ_(s) of dermis at about 300cm^(−1).DMSO and saline had only slight and inconsistent effects on g and μ_(s).

关键词： Optical properties skin anisotropy

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Reinforcement learning-driven local transactive energy market fordistributed energy resources

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Energy and AI 2022年第2期8卷 162-176页

作者： steven Zhang Daniel May Mustafa gül Petr Musilek Electrical and Computer Engineering University of AlbertaCanada Civil and Environmental Engineering University of AlbertaCanada

Local energy markets are emerging as a tool for coordinating generation, storage, and consumption of energyfrom distributed resources. In combination with automation, they promise to provide an effective energymanagement framework that is fair and brings system-level savings. The cooperative–competitive natureof energy markets calls for multi-agent based automation with learning energy trading agents. However,depending on the dynamics of the agent–environment interaction, this approach may yield unintended behaviorof market participants. Thus, the design of market mechanisms suitable for reinforcement learning agentsmust take into account this interplay. This article introduces autonomous local energy exchange (ALEX) asan experimental framework that combines multi-agent learning and double auction mechanism. Participantsdetermine their internal price signals and make energy management decisions through market interactions,rather than relying on predetermined external price signals. The main contribution of this article is examinationof compatibility between specific market elements and independent learning agents. Effects of different marketproperties are evaluated through simulation experiments, and the results are used for determine a suitablemarket design. The results show that market truthfulness maintains demand-response functionality, while weakbudget balancing provides a strong reinforcement signal for the learning agents. The resulting agent behavioris compared with two baselines: net billing and time-of-use rates. The ALEX-based pricing is more responsiveto fluctuations in the community net load compared to the time-of-use. The more accurate accounting ofrenewable energy usage reduced bills by a median 38.8% compared to net billing, confirming the ability tobetter facilitate demand response.

关键词： Transactive energy Demand response Distributed energy resources(DER) DER integration Local energy market Reinforcement learning

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