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Clinical characteristics and in-hospital outcomes of patients receiving contemporary intensive cardiac care:retrospective study from a large centre in China

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Journal of Geriatric Cardiology 2021年第2期18卷 94-103页

作者： Fei CHEN Yi-Ming LI Qi LIU Bao-Tao HUANG Fang-Yang HUANG Yong PENG Mao CHEN Department of Cardiology West China HospitalSichuan UniversityChengduChina West China School of Medicine Sichuan UniversityChengduChina

BACKGROUND Few studies from developed countries have quantitatively characterized the clinical characteristics and outcomes of patients receiving contemporary intensive cardiac *** sought to investigate these data in patients admitted to a Chinese intensive cardiac care unit(ICCU).METHODS We conducted a retrospective study using data from 2,337 consecutive admissions to the ICCU at a large centre in China from June 2016 to May *** were captured after systematic inspection of individual medical records regarding current demographics,primary diagnosis,comorbidities,illnesses severity,and in-hospital *** The mean age was 65.6±14.2 years,and females accounted for 32.0%of *** Charlson Comorbidity Index and Oxford Acute Severity of Illness Score were 2.4±1.8 and 22.5±10.4,*** top reason for admission was ST-segment elevation myocardial infarction(32.0%),and nonischaemic heart diseases accounted for 31.2%of all primary *** diseases were prevalent in the ICCU population,including chronic illnesses and acute noncardiovascular critical illnesses(ANCIs);in particular,21.7%of patients were marked by acute respiratory failure(14.6%),acute kidney injury(13.7%),sepsis(4.2%),or gastrointestinal bleeding(3.3%).The median length of stay in the ICCU and hospital were 1.1 days[interquartile range(IQR):0.8–2.6 days]and 6.3 days(IQR:3.8−10.9 days),*** overall incidence of in-hospital death or discharge against medical advice under extremely critical conditions was 7.6%(n=177).Multivariate logistic regression analysis showed that the complexity of chronic illnesses and incident ANCIs were strong independent determinants for in-hospital *** Remarkable patient diversity and breadth of critical illnesses were observed in a Chinese ICCU ***,noncardiovascular diseases were prevalent and associated with adverse *** of organization and staffing practices may be

关键词： patients admitted centre

The near centre of Doi-Hopf module category _AM (H)~C

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Science China Mathematics 1999年第5期42卷 496-509页

作者：阚海斌许永华 1. Institute of Mathematics Fudan University 200433 Shanghai China

It is known that any strict tensor category (C?I) determines a braided tensor categoryZ(C), the centre ofC. WhenA is a finite dimension Hopf algebra, Drinfel’d has proved thatZ(A M) is equivalent to D(A) M as a braided tensor category, whereA M is the left A-module category andD(A) is the Drinfel’d double ofA. For a braided tensor category, the braidC U,v is a natural isomorphism for any pair of object (U,V) in. If weakening the natural isomorphism of the braidC U,V to a natural transformation, thenC U,V is a prebraid and the category with a prebraid is called a prebraided tensor category. Similarly it can be proved that any strict tensor category determines a prebraided tensor category Z～ (C), the near centre of. An interesting prebraided tensor structure of the Yetter-Drinfel’d category C*A YD C*A given, whereC # A is the smash product bialgebra ofC andA. And it is proved that the near centre of Doi-Hopf module A M(H) C is equivalent to the Yetter-Drinfel’ d C*A YD C*A as prebraided tensor categories. As corollaries, the prebraided tensor structures of the Yetter-Drinfel’d category A YD A , the centres of module category and comodule category are given.

关键词： Doi-Hopf module centre category prebraided tensor.

Integrated Assessment of Natural Hazards, Including Climate Change’s Influences, for Cultural Heritage Sites: The Case of the Historic centre of Rethymno in Greece

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International Journal of Disaster Risk Science 2019年第3期10卷 343-361页

作者： Mohammad Ravankhah Rosmarie de Wit Athanasios V.Argyriou Angelos Chliaoutakis Maria Joao Revez Joern Birkmann Maja Zuvela-Aloise Apostolos Sarris Anastasia Tzigounaki Kostas Giapitsoglou Institute of Spatial and Regional Planning(IREUS-Institut fur Raumordnung und Entwicklungsplanung) University of Stuttgart70174 StuttgartGermany Central Institution for Meteorology and Geodynamics(ZAMG-Zentralanstalt fur Meteorologie und Geodynamik) 1190 ViennaAustria GeoSat ReSeArch Lab IMS-ORTH(Geophysical-SatelliteRemote Sensing and Archaeoenvironment LabInstitute for Mediterranean Studies-Foundation for Research and TechnologyHellas)74100 RethymnoGreece Nova Conservacao S.A.1200-872LisbonPortugal The Archaeological Research Unit Department of Historyand ArchaeologyUniversity of Cyprus1678 NicosiaCyprus Ephorate of Antiquities of Rethymno 74100 RethymnoGreece

Within the framework of disaster risk management, this article proposes an interdisciplinary method for the analysis of multiple natural hazards, including climate change’s influences, in the context of cultural heritage. A taxonomy of natural hazards applicable to cultural heritage was developed based on the existing theoretical and conceptual frameworks. Sudden-onset hazards, such as earthquakes and floods, and slow-onset hazards, such as wetting–drying cycles and biological contamination, were incorporated into the hazard assessment procedure. Future alteration of conditions due to climate change, such as change in heat waves’ duration, was also taken into account. The proposed hazard assessment framework was applied to the case of the Historic centre of Rethymno, a city on the northern coast of the island of Crete in Greece,to identify, analyze, and prioritize the hazards that have the potential to cause damage to the center’s historic structures. The assessment procedure includes climate model projections, GIS spatial modeling and mapping, and finally a hazard analysis matrix to enable the sharing of a better understanding of multiple hazards with the *** results can facilitate decision making by providing the vulnerability and risk analysis with the nature and spatial distribution of the significant hazards within the study area and its setting.

关键词： Climate change analysis Crete Cultural heritage protection Greece Hazard assessment Historic centre of Rethymno Risk assessment

centre for Precision Manufacturing

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Nanomanufacturing and Metrology 2020年第3期3卷 236-237页

作者： Xichun Luo University of Strathclyde GlasgowUK

The centre for Precision Manufacturing(CPM)is an internationally leading research centre for advanced *** centre researches and develops materials,processes,tools,machinery,and numerical modelling techniques for improving economic and technical performance of materi-als and manufacturing processes with advaneed precision,micro-and nano-manufacturing *** is one of the most successful centres in Europe in attracting external funding(over￡40 million)to con duct industry-relevant *** centre led the EU FP6什agship integrated project MASMICRO,one of the largest-ever funded EU projects in the EU NMP theme(€21.4 million budget and 36 partners from 13 EU countries)which led to a series of new design and manufacturing solutions in dealing with materials,size effects.

关键词： centre attracting dealing

An innovative 5-Step Patient Interview approach for integrating mental healthcare into primary care centre services:a validation study

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General Psychiatry 2022年第4期35卷 249-256页

作者： Abdullah Dukhail AlKhathami Primary Mental Health Care Program Saudi Arabia Ministry of HealthRiyadhSaudi Arabia

Background Mental health problems are prevalent among patients seeking primary ***,traditional patient interviews often fail to identify and manage these ***,an improved patient interview process is needed to assess and treat mental health problems in primary care *** To assess the validity,reliability,sensitivity and specificity of a 5-Step Patient Interview approach for the screening,diagnosis and treatment of mental health *** and setting This study compared a 5-Step Patient Interview approach(AlKhathami approach)with expert psychiatric interviews based on the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders,fifth edition,the Patient Health Questionnaire-9(PHQ-9)and the Generalised Anxiety Disorder-7(GAD-7)questionnaire from 1 January 2020 to 30 April 2020 in family practice or primary healthcare *** A total of 760 participants from five Saudi Arabian regions were selected using a multiclustered random sample of every third patient aged≥18 years,drawn from the clinics’patient *** A total of 732 patients agreed to participate,with a response rate of 96.3%;396(54.1%)were women;the mean(Standard Deviation)age was 41.28(14.30)years(ranging from 18 to 84 years).Mental health problems were suspected in 40%of the *** 5-Step Patient Interview approach was shown to be comparable to an expert interview by a ***,it was more accurate than the PHQ-9 and GAD-7 self-administered questionnaires in screening for stress and classifying it as mild,moderate to severe or ***,the 5-Step Patient Interview approach improved physician-patient communication by encouraging the exploration of patients’*** The 5-Step Patient Interview approach is a valid,reliable tool that can aid the integration of mental healthcare into primary healthcare and family *** studies should evaluate the implementation outco

关键词： centre interview integrating

Using an interprofessional team to provide refugee healthcare in an academic medical centre

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Family Medicine and Community Health 2019年第3期7卷 22-29页

作者： Catherine E Elmore Jeffrey M Tingen Kelly Fredgren Sarah N Dalrymple Rebekah M Compton Elizabeth L Carpenter Claudia W Allen Fern R Hauck Department of Family Medicine University of Virginia Health SystemCharlottesvilleVirginiaUSA Department of Pharmacy Services University of Virginia Health SystemCharlottesvilleVirginiaUSA Department of Social Work University of Virginia Health SystemCharlottesvilleVirginiaUSA Department of Public Health Sciences University of Virginia Health SystemCharlottesvilleVirginiaUSA

Introduction The International Family Medicine Clinic(IFMC)was established in 2002 by the University of Virginia Department of Family Medicine to provide comprehensive,timely,culturally sensitive and high-quality healthcare to the growing refugee and special immigrant population in Central Virginia,*** The purpose of this paper is to describe the IFMC,with a specific focus on interprofessional roles,interprofessional collaboration,community partnerships and the services and resources available to IFMC *** The clinic has served over 3100 refugees from 60 countries in its 16-year *** 2019,the clinic staff now includes 4 attending physicians,2 nurse practitioners and 14 residents who have dedicated clinic time to see refugees;a registered nurse care coordinator and a social worker dedicated to the IFMC refugee population;2 clinical psychologists and doctoral students in clinical psychology;and a clinical *** IFMC also provides onsite psychiatric care.A process flow map depicts the interconnectivity of interprofessional team members working together with other specialty care providers within the medical centre and with community partners on behalf of refugee patients through the resettlement *** Individuals who arrive in the USA as refugees are a particularly vulnerable patient group and often require an interprofessional team *** IFMC may serve as a model for other institutions interested in starting a similar interprofessional,refugee-centred medical home.

关键词： centre nurse professional

Epidemiology of foot burns in a Dutch burn centre

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Burns & Trauma 2015年第1期3卷 29-34页

作者： Tülay Kilic Pieta Krijnen Wim E Tuinebreijer Roelf S Breederveld Department of Surgery Leiden University Medical Center University Leiden2300 RC LeidenThe Netherlands Acute Burn Care&Trauma Surgery Department Surgery/Burn CentreRode Kruis ZiekenhuisVondellaan 131942 LE BeverwijkThe Netherlands

Background:Although the feet involve a small percentage of the total body surface area,they can have major effects in daily life,caused by prolonged bed rest,hospitalization and high risk of both early and late *** aim of this study was to define the aetiology,treatment and outcomes of foot burns,with special interest in paediatric patients,patients with diabetic disease and burns acquired at the ***:This is a retrospective cohort study of 82 patients who were admitted to one of the three burn centres in the Netherlands during the period 2004 to *** patients had a median age of 43.5 years(range 0.01–85.9),and included 14 children and 8 *** were collected from the hospital ***:Scalding was the most common cause of the *** all patients required surgical *** is notable that most of hospitalized patients(82%)were not admitted on the day of *** had a significantly shorter length of stay compared to adults(p=0.01).The eight patients with diabetes had a significantly longer length of hospital stay,more complications and more often residual defects compared to the non-diabetic *** 13 patients,the injury took place at *** of these burns were caused by scalding,and foot burns caused by chemicals at work were rare(two patients).Conclusions:Although the incidence of foot burns is low,there is a significant morbidity due to complications and long hospital *** following three points are *** referral to a burn centre is *** is important to educate diabetic patients on the risk of complications and adverse outcomes after burn *** measures at the workplace are worth considering.

关键词： burns admitted centre

Putting health workers at the centre of health system investments in COVID-19 and beyond

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Family Medicine and Community Health 2022年第2期10卷 52-58页

作者： Rachel Deussom Arush Lal Diana Frymus Kimberly Cole Mary Ruth S Politico Kelly Saldaña Vamsi Vasireddy Glenda Khangamwa Wanda Jaskiewicz Global Health Division Chemonics InternationalWashingtonDCUSA ACT-Accelerator Health Systems Connector CSO Platform WashingtonDCUSA Department of Health Policy London School of EconomicsLondonUK Office of HIV/AIDS US Agency for International DevelopmentWashingtonDCUSA US Agency for International Development LilongweMalawi Republic of the Philippines Department of Health ManilaPhilippines Office of Health Systems US Agency for International DevelopmentWashingtonDCUSA United States Department of Defense KampalaUganda Civil Service Commission LilongweMalawi

The COVID-19 pandemic highlights the implications of chronic underinvestment in health workforce development,particularly in resource-constrained health *** health workforce diversity,insufficient training and remuneration,and limited support and protection reduce health system capacity to equitably maintain health service delivery while meeting urgent health emergency *** the Health Worker Life Cycle Approach provides a useful conceptual framework that adapts a health labour market approach to outline key areas and recommendations for health workforce investment-building,managing and optimising-to systematically meet the needs of health workers and the systems they *** also emphasises the importance of protecting the workforce as a cross-cutting investment,which is especially important in a health crisis like *** the global pandemic has spurred intermittent health workforce investments required to immediately respond to COVID-19,applying this‘lifecycle approach’to guide policy implementation and financing interventions is critical to centering health workers as stewards of health systems,thus strengthening resilience to public health threats,sustainably responding to community needs and providing more equitable,patient-centred care.

关键词： centre workers system

Integrated model of primary and mental healthcare for the refugee population served by an academic medical centre

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Family Medicine and Community Health 2023年第2期11卷 25-31页

作者： Katharine E Daniel Sarah R Blackstone Joseph S Tan Richard L Merkel Fern R Hauck Claudia W Allen Department of Psychology University of VirginiaCharlottesvilleVirginiaUSA Department of Family Medicine University of Virginia Health SystemCharlottesvilleVirginiaUSA Department of Psychiatry University of Virginia Health SystemCharlottesvilleVirginiaUSA

Refugees are at increased risk for developing mental health concerns due to high rates of trauma exposure and postmigration ***,barriers to accessing mental health services result in ongoing suffering within this *** care-which combines primary healthcare and mental healthcare into one cohesive,collaborative setting-may improve refugees’access to comprehensive physical and mental health services to ultimately better support this uniquely vulnerable *** integrated care models can increase access to care by colocating multidisciplinary services,establishing an effective integrated care model brings unique logistic(eg,managing office space,delineating roles between multiple providers,establishing open communication practices between specialty roles)and financial(eg,coordinating across department-specific billing procedures)*** therefore describe the model of integrated primary and mental healthcare used in the International Family Medicine Clinic at the University of Virginia,which includes family medicine providers,behavioural health specialists and ***,based on our 20-year history of providing these integrated services to refugees within an academic medical centre,we offer potential solutions for addressing common challenges(eg,granting specialty providers necessary privileges to access visit notes entered by other specialty providers,creating a culture where communication between providers is the norm,establishing a standard that all providers ought to be CC’ed on most visit notes).We hope that our model and the lessons we have learned along the way can help other institutions that are interested in developing similar integrated care systems to support refugees’mental and physical health.

关键词： services establishing centre