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Validation of the VitalPAC Early Warning Score at the intermediate Care Unit

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World Journal of Critical Care Medicine 2018年第3期7卷 39-45页

作者： Joost DJ Plate Linda M Peelen Luke PH Leenen Falco Hietbrink Division of Surgery University Medical Centre Utrecht Utrecht University Julius Center for Health Sciences University Medical Center Utrecht Utrecht University Departments of Anaesthesiology and Intensive Care Medicine University Medical Center Utrecht Utrecht University

AIM To assess the performance and clinical relevance of the Early Warning Scoring(EWS)system at the intermediate Care Unit(IMCU).METHODS This cohort study used all the Vital PAC EWS(Vi EWS)scores collected during each nursing shift from 2014through 2016 at the mixed surgical IMCU of an academic teaching *** deterioration defined as transfer to the Intensive Care Unit(ICU)or mortality within 24 h was the primary outcome of *** A total of 9113 aggregated Vi EWS scores were obtained from 2113 *** incidence of the combined outcome was 272(3.0%).The area under the curve of the Vi EWS was 0.72(CI:0.69-0.75).Using a threshold value of six,the sensitivity was 68%with a positive predictive value of 5%and a number needed to trigger(e.g.,false alarms)of 19%.CONCLUSION The Vi EWS at the IMCU has a discriminative performance that is considerably lower than at the hospital *** number of false alarms is high,which may result in alarm ***,use of the Vi EWS in its current form at the IMCU should be reconsidered.

关键词： intermediate Care Unit High-dependency unit Clinical deterioration Vital signs Early Warning Scoring

Acute Myocardial Infarction (AMI) and intermediate Coronary Syndrome (ICS)

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Health 2010年第2期2卷 131-136页

作者： E. Stoupel A. Tamoshiunas R. Radishauskas G. Bernotiene E. Abramson J. Sulkes P. Israelevich 不详

In recent studies it was shown that blood co-agulation and inflammation markers are raising at high geomagnetic activity;acute myocardial infarction and all his subtypes, mostly related to atheromatous plaque disruption with higher Cosmic Ray (Neutron) activity. The aim of this study was to explore AMI and ICS differences by concomitant physical conditions, accompany-ing each of these acute coronary syndromes. The data was a part of MONICA international study in Kaunas, Lithuania in years 2000-2005 (72 consecutive months). 4633 patients with AMI (2461 men) and 961 with ICS (654 men), (age up to 65) were studied. For comparison four indices of Solar (SA), three of Geomagnetic (GMA), Cosmic Ray (CRA) measured by Neutron activity imp/min. were used. Cosmophysical data were from space science institutions in the USA and Russia. Pearson correlation coefficients and their probabilities were *** num-ber of AMI and ICS shows different links with the physical parameters: AMI were significantly in-verse related to SA (r=-0.4, p=0.0021) and direct to CRA (Neutron) activity (r=0.23, p=0.048). ICS was not correlated with these two parameters, but show significant links to GMA (r=0.25, p=0.037). Gender differences were evident, men more close related to changes in the mentioned physical ***: 1. Monthly nu- mber of AMI and ICS is different related to fluc-tuations of environmental physical parameters. 2. The described connections can affect differ-ences in the pathogenesis of these forms of Acute Coronary Insufficiency.

关键词： Acute Myocardial Infarction intermediate Coronary Syndrome Geomagnetic

Necessity and proper way of intermediate kissing balloon dilation for culotte stenting: further insights from bench testing

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Journal of Interventional Medicine 2018年第4期1卷 212-220页

作者： Wei Cai Lianglong Chen Linlin Zhang Zhixiong Wei Sheng Tu Lin Fan Department of Cardiology Fujian Medical University Union Hospital Fujian Medical Heart Center Provincial Institute of Coronary Artery Disease

Objective: The aim of this study was to investigate whether intermediate kissing balloon dilation(IKBD) is necessary during mini-culotte stenting(MCS) and how it can be properly conducted. Methods: MCS was emulated in a bifurcation model with a branch diameter difference(BDD) in three-step sizes of 0.50, 0.75 and 1.00 mm, and with intermediate balloon dilation(IBD) in three treatments of routine intermediate solo balloon dilation(rISBD), concurrent IKBD(cIKBD) or sequential IKBD. Microcomputed tomography was performed to assess stent under-expansion(SUE) around the polygon of confluence(POC), residual ostial stenosis(ROS) at the ostial side-branch(SB) and main-branch(MB) and stent cell distortion(SCD) in the bifurcation segments. Results: There were both main and interactive effects of IBD and BDD on ROS at the ostial SB and SCD in the ostial SB, but there were only main effects of IBD or BDD on SUE around the POC, ROS at the ostial MB and SCD in the ostial MB. Analysis of the main effects showed that SUE around the POC or ROS at the ostial SB was significantly different between sI KBD and rISBD and between cI KBD and rISBD. There was also a significant difference in SCD in the ostial SB between sI KBD and rI SBD and between sI KBD and cIKBD. Analysis of the interactive effects showed that ROS at the ostial SB or SCD in the ostial SB was affected by all IBD treatments in all BDD step-sizes. Moreover, increasing the BDD step-sizes significantly increased ROS at the ostial SB as treated by rISBD and SCD in the ostial SB as treated by rISBD or cIKBD. Conclusions: SIKBD was shown to be essential and superior to rISBD or cIKBD, resulting in better bifurcated stent expansion and coverage when using MCS.

关键词： coronary bifurcation culotte stenting intermediate kissing dilation

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Freeze-out Time Scale for Reaction^(40)Ar+^(58)Niat intermediate Energies

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IMP & HIRFL Annual Report 1997年 18-19页

Schistosomiasis Mansoni in the Amazon Region:Malacological Surveys of intermediate Hosts for the Identification of Disease Transmission Areas in Belem,Para,Brazil

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Journal of Pharmacy and Pharmacology 2019年第2期7卷 51-60页

作者： Christiane de Oliveira Goveia Ricardo Jose de Paula Souza e Guimaraes Marcio Roberto Teixeira Nunes Isabelle Helena Lima Dias Martin Johannes Enk Instituto Evandro Chagas Secretaria de Vigilancia em SaudeMinisterio da Saude-IEC/SVS/MS-Secao de ParasitologiaLaboratario de Parasitoses IntestinaisEsquistossomose e MalacologiaAnanindeuaParaBrasil Programa de Pos-Graduacao em Biologia Parasitaria na Amazonia Universidade do Estado do Para-UEPABelemParaBrasil Instituto Evandro Chagas Secretaria de Vigilancia em SaudeMinisterio da SaudeLaboratorio de Geoprocessamento-LABGEO/IEC/SVS/MSAnanindeuaParaBrasil Instituto Evandro Chagas Secretaria de Vigilancia em SaudeMinisterio da SaudeCentro de Inovacoes Tecnologicas-CIT/IEC/SVS/MSAnanindeuaParaBrasil

In Brazil,schistosomiasis occurrence is related to the presence of the etiological agent Schistosoma *** presence of mollusks for Biomphalaria genus is a necessary condition for development of the parasite *** Parástate,the species ***,***,*** and *** have already been identified,with reports of the last two occurring in Belé*** aim of this study was to determine the spatial distribution of Biomphalaria species in Belém,Pará,Brazil,identifying risk areas for schistosomiasis *** malacological surveys were carried out between September 2013 and October 2017 in 35 neighborhoods of Belé*** collection points were georeferenced using a Global Positioning System(GPS)receiver and the Kernel Density Estimation(KDE)was used to the spatial *** mollusks,after measurement,were exposed to light to verify the presence of *** ***,mollusks were sacrificed and fixed for dissection and morphological identification of *** surveys resulted in a total of 10,803 mollusks collected,of which 9,367(86.70%)specimens were *** the analyzed mollusks,5,820(62.14%)were identified as *** and 3,547(37.86%)as *** presence of the parasite was observed in 208(2.22%)specimens,all *** mollusks were found in six neighborhoods:Guamá(51 mollusks/24.5%),Sacramenta(47 mollusks/22.6%),Telégrafo(47 mollusks/22.6%),Terra Firme(36 mollusks/17.3%),Condor(20 mollusks/9.6%)and Barreiro(7 mollusks/3.4%).This study confirms that *** species actively participates as intermediate host in the disease maintenance in Belé*** KDE allowed to analyze the spatial distribution of collection sites and consequently to determine possible risk areas of schistosomiasis transmission in *** development of maps identifying sites with schistosomiasis positive snails may support efforts of this municipality by directing activities related to endemic disease control.

关键词： Biomphalaria spp. Schistosoma mansoni intermediate hosts schistosomiasis spatial analysis

Expending the Paradigm: Active Surveillance for intermediate Risk Prostate Cancer

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Open Journal of Urology 2018年第8期8卷 248-256页

作者： Mohamed Jalloh Mamadou Tieoule Traore Thierno Amadou Diallo Issa Labou Lamine Niang Serigne Magueye Gueye Service d’Urologie Hopital General de Grand Yoff Dakar Senegal Centre Hospitalier Universitaire de Ouahigouya Ouahigouya Burkina Faso

Prostate cancer is the leading male cancer worldwide. There remains a controversy as to which patients have indolent disease and which patients present an aggressive disease needing treatment with intent to cure. Because of quality of life impairment associated with treatment by radiation or surgery, active surveillance (AS) is a valid management option to avoid or differ aggressive treatment. Traditionally, AS was reserved for men with low risk prostate cancer, however intermediate risk patients are more and more found in AS cohorts. The aim of this review is to describe the place of AS in intermediate risk patients and the perspectives offered by such a treatment modality.

关键词： Prostate Cancer Active Surveillance intermediate Risk

Clinical Utility of N-13 Ammonia Cardiac PET Perfusion Imaging in the Assessment of Epicardial Coronary Lesions of intermediate Range

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Open Journal of Medical Imaging 2012年第2期2卷 41-46页

作者： Maddury Jyotsna Ghanta Somasekhar Vatturi Venkata Satya Prabhaker Rao RNV Kumar E. Jyotsna Cardiology Department Nizam’s Institute of Medical Sciences Hyderabad India Nuclear Medicine Department Nizam’s Institute of Medical Sciences Hyderabad India

Objective: To identify the high risk myocardial perfusion defects which prognosticate the future ischemic cardiac events, on Positron emission tomography (PET) myocardial perfusion imaging (MPI) of intermediate coronary stenosis (ICS) on coronary angiogram (CAG) with negative single photon emission computed tomography (SPECT) MPI in chronic stable angina (CSA) patients. Methods: For this study non-infarcted CSA patients of single vessel disease (SVD) on CAG with ICS and normal LV function were selected. In all patients with negative stress SPECT MPI, stress PET MPI was done. In both scans, extent score (ES), severity score (SS), total severity/extent score ratio (TS-ES R) and Left ventricular dilatation (LVD) were noted. Patients with Positive PET MPI were closely followed for 2yrs and PCI was performed depending on symptoms. Results: Out of 47 study group patients, during 2yr follow up period, 11 out of 15 patients with ischemia positive PET MPI underwent percutaneous coronary intervention (PCI). Indication for PCI was rest or persistence or recurrence of angina. Four of 15 patients remained asymptomatic. In medically managed vs. PCI done patients, mean of ES was 1.2 ± 0.5 vs. 2.3 ± 1, SS was 1.2 ± 0.5 vs. 5.3 ± 1.9, TS-ESR was 1 vs. 2.5 ± 0.5 which was statistically significant (p = 0.01). Conclusion: It was inferred that subgroup of PET MPI positive ICS patients with basal PET MPI showing SS > 5 and TS-ES R > 1.5 with LVD during stress required close follow up as they are likely require PCI subsequently. Condensed Abstract: As negative for inducible ischemia by single photon emission computed tomography myocardial perfusion imaging (SPECT MPI) is associated with low cardiac event rate, even though positive imaging by Positron emission tomography myocardial perfusion imaging (PET MPI), in patients with intermediate Coronary stenosis (ICS) may not require immediate percutaneous coronary intervention (PCI). We fol-lowed these patients for two 2yrs and identified tha

关键词： PET MPI SPECT MPI intermediate Coronary Stenosis Percutaneous Coronary Intervention

Sinopec Jiujiang Conducts intermediate Handing over Gasoline Hydrogenation Unit

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China Chemical Reporter 2010年第4期21卷 11-11页

Sinopec Jiujiang Petrochemical Co.,*** intermediate handing overthe 900 000 t/a gasoline hydrogenation facility on January *** RMB167 million project is to meet the national Ⅲ gasoline *** on the project was started ... 详细信息

关键词： gasoline facility intermediate hydrogenation

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Investigation of I MF Multiplicityin intermediate Energy HeavyIon Collision

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IMP & HIRFL Annual Report 1997年 17-18页