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Perspectives on perioperative management of children’s surgical conditions during the COVID-19 pandemic in low-income and middle-income countries:a global survey

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World Journal of Pediatric Surgery 2020年第3期3卷 29-36页

作者： Paul Truche Alexis Bowder Amber Trujillo Lalla Robert Crum Fabio Botelho Henry Elliot Rice Bellisa Caldas Lopes Sarah Greenberg Faye Evans John Gerard Meara Emmanuel Adoyi Ameh David Patrick Mooney Program in Global Surgery and Social Change Harvard Medical SchoolBostonMassachusettsUSA Department of Surgery Boston Children's HospitalBostonMassachusettsUSA University of New Mexico School of Medicine AlbuquerqueNew MexicoUSA Hospital das Clinicas da Universidade Federal de Minas Gerais Belo HorizonteMinas GeraisBrazil Division of Pediatric General Surgery Duke Children's Hospital and Health CenterDurhamNorth CarolinaUSA Department of Pediatric Surgery Instituto de Medicina Integral Prof.Fernando FigueiraRecifeBrazil Department of Surgery University of WashingtonSeattleWashingtonUSA Division of Pediatric General&Thoracic Surgery Seattle Children’s HospitalSeattleWashingtonUSA Department of Anesthesiology Critical Care and Pain MedicineBoston Children's HospitalBostonMassachusettsUSA Department of Plastic and Oral Surgery Boston Children's HospitalBostonMassachusettsUSA Division of Paediatric Surgery Department of SurgeryNational HospitalAbujaNigeria

Background Many organizations have issued recommendations to limit elective surgery during the coronavirus disease 2019(COVID-19)*** surveyed providers of children’s surgical care working in low-income and middle-income countries(LMICs)to understand their perspectives on surgical management in the wake of the COVID-19 pandemic and how they were subsequently modifying their surgical care *** A survey of children’s surgery providers in LMICs was *** reported how their perioperative practice had changed in response to *** were also presented with 26 specific procedures and asked which of these procedures they were allowed to perform and which they felt they should be allowed to *** in surgical practice reported by respondents were analyzed *** A total of 132 responses were obtained from 120 unique institutions across 30 LMICs.117/120 institutions(97.5%)had issued formal guidance on delaying or limiting elective children’s surgical *** in LICs were less likely to have issued guidance on elective surgery compared with middle-income facilities(82%in LICs vs 99%in lower middle-income countries and 100%in upper middle-income countries,p=0.036).Although 122(97%)providers believed cases should be limited during a global pandemic,there was no procedure where more than 61%of providers agreed cases should be delayed or *** There is little consensus on which procedures should be limited or delayed among LMIC *** of testing capacity and local,context-specific guidelines may be a better strategy than international consensus,given the disparities in availability of preoperative testing and the lack of consensus towards which procedures should be delayed.

关键词： income survey testing

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Newfound physiological function of FAIM protein offers hope of novel disease-modifying therapy for Alzheimer's disease

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Neural Regeneration Research 2023年第12期18卷 2677-2679页

作者： Allison RBalaj Hiroaki Kaku Department of Investigative Medicine Western Michigan University Homer Stryker M.D.School of MedicineKalamazooMIUSA

Introduction of Fas apoptosis inhibitory molecule(FAIM): FAIM was originally discovered in FASresistant mouse primary B lymphocytes in 1999, and was thought of as a FAS-apoptosis inhibitor based on overexpression studies(Schneider et al., 1999). FAIM is an approximately 20 k Da intracellular protein, but a subsequent study identified an alternatively spliced form.

关键词： al. Alzheimer lymphocytes

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Probabilistic Teleportation of the Three—Particle Entangled State by the Partial Three—Particle Entangled State and the Three—Particle Entangled W State

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Chinese Physics Letters 2003年第8期20卷 1196-1198页

作者：戴宏毅李承祖陈平形 CollegeofScience NationalUniversityofDefenseTechnologyChangsha410073

We present a scheme to teleport an unknown three-particle entangled state from a sender to either one of two receivers. The partial three-particle entangled state and the three-particle entangled W state are considered as the quantum channels. An unknown three-particle entangled state can be perfectly teleported probabilistically by performing two generalized Bell measurements and the Hadamard operation at the sender's side and introducing an appropriate unitary transformation in each receiver's laboratory conditioned on the simple measurement outcome of the other. All kinds of unitary transformations are given in details. This scheme can be directly generalized to teleport an unknown three-particle entangled state from a sender to any one of N receivers by the partial three-particle entangled state and the (N + 1)-particle entangled W state.

关键词： Quantum entanglement

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Current concepts in total femoral replacement

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World Journal of Orthopedics 2015年第11期6卷 919-926页

作者： Deepak Ramanathan Marcelo BP Siqueira Alison K Klika Carlos A Higuera Wael K Barsoum Michael J Joyce Department of Orthopaedic Surgery Cleveland Clinic Foundation

Total femoral replacement(TFR) is a salvage arthroplasty procedure used as an alternative to lower limb amputation. Since its initial description in the mid-20^(th) century, this procedure has been used in a variety of oncologic and non-oncologic indications. The most compelling advantage of TFR is the achievement of immediate fixation which permits early mobilization. It is anticipated that TFR will be increasingly performed as the rate of revision arthroplasty rises worldwide. The existing literature is mainly composed of a rather heterogeneous mix of retrospective case series and a wide assortment of case reports. Numerous TFR prostheses are currently available and the surgeon must understand the unique implications of each implant design. Long-term functional outcomes are dependent on adherence to proper technique and an appropriate physical therapy program for postoperative rehabilitation. Revision TFR is mainly performed for periprosthetic infection and the severe femoral bone loss associated with aseptic revisions. Depending on the likelihood of attaining infection clearance, it may sometimes be advisable to proceed directly to hip disarticulation without attempting salvage of the TFR. Other reported complications of TFR include hip joint instability, limb length discrepancy, device failure, component loosening, patellar maltracking and delayed wound healing. Further research is needed to better characterize the long-term functional outcomes and complications associated with this complex procedure.

关键词： Hip disarticulation Limb salvage Revision arthroplasty Total femur arthroplasty Total femoral arthroplasty Total femoral replacement Total femur replacement Salvage arthroplasty

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膝关节骨关节炎生物力学的研究进展

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中日友好医院学报 2014年第4期28卷 236-238页

作者：张启栋郭万首北京协和医学院研究生院北京100730 中日友好医院骨关节外科北京100029

骨关节炎（osteoarthritis,OA）是一种以软骨磨损为特点的退行性关节病,主要发生在中老年人,严重困扰人民健康,使至少10％的人丧失劳动能力.流行病学的研究估计,仅在美国大约有4300万人受影响,全世界大约有15％人口受到困扰.它不仅给社... 详细信息

骨关节炎（osteoarthritis,OA）是一种以软骨磨损为特点的退行性关节病,主要发生在中老年人,严重困扰人民健康,使至少10％的人丧失劳动能力.流行病学的研究估计,仅在美国大约有4300万人受影响,全世界大约有15％人口受到困扰.它不仅给社会,也给患者带来巨大的心理和经济负担[1].OA通常被认为是一个多因素导致的关节病,包括机械应力增加、力线异常、软骨退化、软骨下骨改变和肌肉软组织损伤.继发滑膜炎也在OA发生发展中扮演了重要的角色,尤其在早期阶段.生物力学在OA发生发展中的作用更是越来越受到人们重视.目前有研究指出,生物力学因素在OA发病中起到了瀑布效应[2].本文将主要对OA发生发展的不同生物力学因素进行讨论,现综述如下.

关键词：生物力学因素膝关节骨关节炎退行性关节病软骨磨损软组织损伤中老年人人民健康流行病学

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Economic factors in the future delivery of spinal healthcare

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World Journal of Orthopedics 2015年第5期6卷 409-412页

作者： Vincent J Rossi Junyoung Ahn Daniel D Bohl Ehsan Tabaraee Kern Singh Department of Orthopaedic Surgery Rush University Medical Center

The current trajectory of healthcare-related spending in the United States is unsustainable. Currently, the predominant form of reimbursement is the form of a fee-for-service system in which surgeons are reimbursed for each discrete unit of care provided. This system does factor the cost, quality, or outcomes of service provided. For the purposes of cost containment, the bundled episode reimbursement has gainedpopularity as a potential alternative to the current feefor-service system. In the newer model, the spinal surgeon will become increasingly responsible for controlling costs. The bundled payment system will initially offer financial incentives to initiate a meaning-ful national transition from the fee-for-service model. The difficulty will be ensuring- that the services of surg-eons continue to be valued past this initiation period. However, g-reater financial responsibilities will be placed upon the individual surgeon in this new system. Over time, the evolving interests of hospital systems could result in the devaluation of the surgeons' services. Significant cooperation on behalf of all involved healthcare providers will be necessary to ensure that quality of care does not suffer while efforts for cost containment continue.

关键词： Affordable care act Spine surgery Economics Future Access Payments Reimbursement

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Complications associated with prone positioning in elective spinal surgery

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World Journal of Orthopedics 2015年第3期6卷 351-359页

作者： J Mason De Passe Mark A Palumbo Maahir Haque Craig P Eberson Alan H Daniels Department of Orthopaedics Warren Alpert Medical School of Brown University

Complications associated with prone surgical positioning during elective spine surgery have the potential to cause serious patient *** many ofthese complications remain uncommon,the range of possible morbidities is wide and includes multiple organ *** visual loss(POVL)is a well described,but uncommon complication that may occur due to ischemia to the optic nerve,retina,or cerebral ***-angle glaucoma and amaurosis have been reported as additional etiologies for vision loss following spinal *** nerve injuries,such as those caused by prolonged traction to the brachial plexus,are more commonly encountered postoperative *** complications including pressure ulcers and compartment syndrome may also occur after prone positioning,albeit *** uncommon positioning complications such as tongue swelling resulting in airway compromise,femoral artery ischemia,and avascular necrosis of the femoral head have also been *** of these are well-understood and largely avoidable through thoughtful attention to *** complications,such as POVL,remain incompletely understood and thus more difficult to predict or ***,the current literature on the complications of prone positioning for spine surgery is reviewed to increase awareness of the spectrum of potential complications and to inform spine surgeons of strategies to minimize the risk of prone patient morbidity.

关键词： Spine Patient positioning Prone position Complications Prevention and control

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Are you suffering from a large arterial occlusion?Please raise your arm!

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Stroke & Vascular Neurology 2018年第4期3卷 215-221页

作者： Charith Cooray Michael V Mazya Matteo Bottai Jan F Scheitz Azmil H Abdul-Rahim Tiago Prazeres Moreira Robert Mikulik Antonin Krajina Miroslava Nevsimalova Danilo Toni Nils Wahlgren Niaz Ahmed Department of Clinical Neurosciences Karolinska InstitutetStockholmSweden Department of Neurology Karolinska University HospitalStockholmSweden Unit of Biostatistics Institute of Environmental MedicineKarolinska InstitutetStockholmSweden Center for Stroke Research Berlin and Department of Neurology Charité-Universitätsmedizin BerlinBerlinGermany Stroke Research Institute of Cardiovascular and Medical SciencesUniversity of GlasgowGlasgowUK International Clinical Research Center and Neurology Department St.Anne's University Hospital in Brno and Masaryk UniversityBrnoCzech Republic Department of Radiology University HospitalHradec KraloveCzech Republic Comprehensive Cerebrovascular Center HospitalČeskéBudějoviceCeske BudejoviceCzech Republic Emergency Department Stroke Unit Department of Neurology and PsychiatryHospital Policlinico Umberto I'Sapienza'UniversityRomeItaly

Background and purpose Triage tools to identify candidates for thrombectomy are of utmost importance in acute *** prognostic tool has yet gained any widespread *** compared the predictive value of various models based on National Institutes of Health Stroke Scale(NIHSS)subitems,ranging from simple to more complex models,for predicting large artery occlusion(LAO)in anterior circulation *** Patients registered in the SITS international Stroke Register with available NIHSS and radiological arterial occlusion data were *** compared 2042 patients harbouring an LAO with 2881 patients having no/distal *** binary logistic regression,we developed models ranging from simple 1 NIHSS-subitem to full NIHSS-subitems *** and specificities of the models for predicting LAO were *** The model with highest predictive value included all NIHSS subitems for predicting LAO(area under the curve(AUC)0.77),yielding a sensitivity and specificity of 69%and 76%,*** second most predictive model(AUC 0.76)included 4-NIHSS-subitems(level of consciousness commands,gaze,facial and arm motor function)yielding a sensitivity and specificity of 67%and 75%,*** simplest model included only deficits in arm motor-function(AUC 0.72)for predicting LAO,yielding a sensitivity and specificity of 67%and 72%,*** Although increasingly more complex models yield a higher discriminative performance for predicting LAO,differences between models are not *** grade of arm dysfunction along with an established stroke-diagnosis model may serve as a surrogate measure of arterial occlusion-status,thereby assisting in triage decisions.

关键词： occlusion specificity diagnosis

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Antimicrobial technology in orthopedic and spinal implants

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World Journal of Orthopedics 2016年第6期7卷 361-369页

作者： Adam EM Eltorai Jack Haglin Sudheesha Perera Bielinsky A Brea Roy Ruttiman Dioscaris R Garcia Christopher T Born Alan H Daniels Warren Alpert Medical School Brown University Department of Biology Brown University Center for Biomedical Engineering Brown University Department of Orthopaedic Surgery Warren Alpert Medical School Brown University

Infections can hinder orthopedic implant function and *** implant-based antimicrobial strategies largely utilize coating-based approaches in order to reduce biofilm formation and bacterial *** emerging antimicrobial technologies that integrate a multidisciplinary combination of drug delivery systems,material science,immunology,and polymer chemistry are in development and early clinical *** review outlines orthopedic implant antimicrobial technology,its current applications and supporting evidence,and clinically promising future directions.

关键词： Antimicrobial Coated implants Antibiotic Antiseptic Nano-silver Photoactive

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