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The value of prognostic markers for pediatric trauma patients

World Journal of Emergency Medicine 2023年第6期14卷 448-453页

作者： Cansu Durak Ebru Guney Sahin Yasar Yusuf Can Alican Sarisaltik Kubra Boydag Guvenc Department of Pediatric intensive care Sancaktepe Sehit Prof.Dr.IlhanVarank Training and Research HospitalHealth Science UniversityIstanbul 34785Turkiye Republic of Turkiye Ministry of Health Cayirova District Health DirectorateKocaeli 41420Turkiye

BACKGROUND: Despite the rapid development of pediatric intensive care medicine, there are still limited data in the literature regarding the follow-up of pediatric trauma patients in pediatric intensive care units(PICUs). In this study, we aim to evaluate our experience with children admitted and followed up with the diagnosis of trauma at our ***: We evaluated the retrospective data of 77 pediatric trauma patients who were admitted to the PICU at Sancaktepe Sehit Prof. Dr. IlhanVarank Training and Research Hospital from August 2020 to December 2022. The demographic data, clinical parameters and laboratory results were recorded. The primary outcome was the mortality in PICU. The performances of markers in predicting mortality were evaluated with receiver operating characteristic(ROC) ***: The median age of the patients was 70(33–157) months, and the median duration of hospitalization in the PICU was 6(2–11) d. Of the 77 patients, 9 died due to trauma(11,1%). Among the clinical parameters, Pediatric Risk of Mortality III(PRISM III) Score, inotrope requirement, extracorporeal treatment requirement, and mechanical ventilator requirement were significantly higher in non-survivors than in survivors. Among the laboratory parameters, procalcitonin(PCT), lactate/albumin ratio(LAR), neutrophil/lymphocyte ratio(NLR), and transfusion requirement were significantly higher in non-survivors than in ***: In pediatric trauma patients, baseline PCT, LAR, and NLR values can be used to identify patients at risk for mortality.

关键词： Critical care Pediatric Lactate Procalcitonin Trauma

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Implementation of a nurse-led protocol for early extubation after cardiac surgery: A pilot study

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World Journal of Critical care Medicine 2019年第3期8卷 28-35页

作者： Giovanni Serena Carlos Corredor Nick Fletcher Filippo Sanfilippo Cardiothoracic intensive care unit Intensive Care Directorate-St Georges Healthcare NHS Foundation Trust

BACKGROUND Protocols for nurse-led extubation are as safe as a physician-guided weaning in general intensive care unit(ICU).Early extubation is a cornerstone of fast-track cardiac surgery,and it has been mainly implemented in post-anaesthesia care *** a nurse-led extubation protocol may lead to reduced extubation *** To investigate results of the implementation of a nurse-led protocol for early extubation after elective cardiac surgery,aiming at higher extubation rates by the third postoperative *** A single centre prospective study in an 18-bed,consultant-led Cardiothoracic ICU,with a 1:1 nurse-to-patient *** a 3-wk period,the protocol was implemented with:(1)Structured teaching sessions at nurse handover and at bed-space(all staff received teaching,over 90%were exposed at least twice;(2)Email;and(3)Laminated sheets at *** compared“standard practice”and“intervention”periods before and after the protocol implementation,measuring extubation rates at several time-points from the third until the 24th postoperative *** Of 122 cardiac surgery patients admitted to ICU,13 were excluded as early weaning was considered ***,109 patients were included,54 in the standard and 55 in the intervention *** of surgical interventions and baseline left ventricular function were similar between *** the third to the 12th post-operative hour,the intervention group displayed a higher proportion of patients extubated compared to the standard ***,results were significant only at the sixth hour(58%vs 37%,P=0.04),and not different at the third hour(13%vs 6%,P=0.33).From the 12th post-operative hour time-point onward,extubation rates became almost identical between groups(83%in standard vs 83%in intervention period).CONCLUSION The implementation of a nurse-led protocol for early extubation after cardiac surgery in ICU may gradually lead to higher rates of early extubation.

关键词： Fast-track Extubation protocol intensive care Mechanical ventilation Implementation strategies

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Cervical Oesophagotomy and Removal of an Impacted Oesophageal Denture: Case Report and Literature Review

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Surgical Science 2020年第7期11卷 177-186页

作者： Isaac Okyere Sanjeev Singh Perditer Okyere Antwi Kusi Samuel Gyasi Brenu Cardiovascular and Thoracic Surgery unit Directorate of Surgery Komfo Anokye Teaching Hospital Kumasi Ghana School of Medicine and Dentistry College of Health Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana directorate of anaesthesia and intensive care Komfo Anokye Teaching Hospital Kumasi Ghana Renal unit Directorate of Medicine Komfo Anokye Teaching Hospital Kumasi Ghana

We present the case of a 46-year old man with a two-year history of losing his denture presenting with cachexia and a two-month history of dysphagia to both liquids and solids associated with odynophagia. Review at the ENT department where a diagnostic rigid oesophagoscopy was done under general anaesthesia showed a denture impacted to the wall of the oesophagus at 17 cm from the incisor. Attempts at retrieval were unsuccessful as the denture was deeply embedded in the oesophageal wall and bled easily on attempted removal. He subsequently underwent a 2-stage surgical management approach by the cardiothoracic surgical team. Patient first underwent nutritional rehabilitation for a month through a created feeding gastrostomy tube via a limited midline laparotomy. He then had a open cervical oesophagotomy and removal of the denture. Currently doing well six months after surgery and tolerating normal oral diet.

关键词： Impacted Oesophageal Denture Surgery Cervical Oesophagotomy Feeding Gastrostomy

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Forecasting of in situ electron energy loss spectroscopy

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npj Computational Materials 2022年第1期8卷 2400-2408页

作者： Nicholas R.Lewis Yicheng Jin Xiuyu Tang Vidit Shah Christina Doty Bethany E.Matthews Sarah Akers Steven R.Spurgeon Department of Chemical Engineering University of WashingtonSeattleWA98195USA National Security directorate Pacific Northwest National LaboratoryRichlandWA99352USA Energy and Environment directorate Pacific Northwest National LaboratoryRichlandWA99352USA Department of Physics University of WashingtonSeattleWA98195USA

Forecasting models are a central part of many control systems,where high-consequence decisions must be made on long latency control *** models are particularly relevant for emerging artificial intelligence(AI)-guided instrumentation,in which prescriptive knowledge is needed to guide autonomous *** we describe the implementation of a long short-term memory model(LSTM)for forecasting in situ electron energy loss spectroscopy(EELS)data,one of the richest analytical probes of materials and chemical *** describe key considerations for data collection,preprocessing,training,validation,and benchmarking,showing how this approach can yield powerful predictive insight into order-disorder phase ***,we comment on how such a model may integrate with emerging AI-guided instrumentation for powerful high-speed experimentation.

关键词： consequence autonomous transitions

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An Audit of Admissions to intensive care unit at Kamuzu Central Hospital in Malawi

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Open Journal of Nursing 2014年第8期4卷 583-589页

作者： Rodwell Gundo Edoly Shirley Lengu Alfred Maluwa Onias Mtalimanja Deliwe Chipeta Clement Kadyaudzu intensive care unit Kamuzu Central Hospital Lilongwe Malawi Medical-Surgical Nursing Department Kamuzu College of Nursing University of Malawi Lilongwe Malawi Research directorate Kamuzu College of Nursing University of Malawi Lilongwe Malawi

Results are presented of a retrospective audit of admissions to the intensive care unit (ICU) of Kamuzu Central Hospital in Lilongwe, Malawi, which is a tertiary referral facility. The audit was conducted for a period of one year spanning from January to December, 2012. The objectives of the audit were to: describe the profile of admissions and treatment outcomes of the admissions and identify main causes of mortality in ICU of the facility. The admission book and patients’ records were reviewed retrospectively guided by a data extraction form which was specifically designed for this study. The extracted data included age, sex, referring unit, diagnosis, treatment outcome and length of stay. The data were analyzed using STATA version 10.0. A total of 253 patients were admitted to the ICU over the one year period of study. About a third of the patients (33.6% n = 85) were admitted due to postoperative surgery. There were 154 deaths representing an overall mortality of 60.9%. Sepsis was the commonest cause of death and accounted for 39.6%, n = 61 of the deaths. Younger age of less than 40 years and increased patients’ length of stay in the unit were significantly and positively associated with mortality (P care service delivery in the country. There is therefore a need to strengthen critical care services to improve treatment outcomes for patients admitted to ICU of the facility.

关键词： ICU Admission Head Injuries Retrospective ICU Audit Sepsis Length of ICU Stay

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Management of Retroperitoneal Liposarcoma: A Case Report

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Surgical Science 2016年第8期7卷 361-367页

作者： Joseph Yorke Pius Agbenorku Roland Awoonor-Williams Michael Offoe Adinku Eseenam Anita Agbeko Joseph Yaw Manu Kodwo Aboagye Addae Papa Kwesi Sonsomir Fiifi Yankson Dorcas Ahulu Daniel Anning Gyawu Nana Esi Abeduwa Abaidoo Dennis Afful-Yorkee Department of Surgery School of Medical Sciences College of Health Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana directorate of anaesthesia and intensive care Komfo Anokye Teaching Hospital Kumasi Ghana Reconstructive Plastic Surgery & Burns unit Department of Surgery School of Medical Sciences College of Health Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana General Surgery unit Directorate of Surgery Komfo Anokye Teaching Hospital Kumasi Ghana School of Medical Sciences College of Health Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana

Retroperitoneal liposarcoma is a rare malignant tumour with an incidence of 2.5 per million people annually. It is the most common type of all the retroperitoneal malignant tumours. Early diagnosis of the tumour is difficult because of absence of specific clinical presentation. Symptoms would only occur if the tumour exhibits pressure on the surrounding organs. It usually occurs between the fourth to sixth decades of life affecting both genders equally. Histological subtypes include: well-differentiated, poorly differentiated, myxoid, round cell and pleomorphic. Radiological imaging useful in diagnosis include: ultrasonography, computed tomography and magnetic resonance imaging. Complete surgical resection of the tumour and the adjacent viscera involved or organs remained the mainstay of treatment. Radiotherapy plays a role in reducing the risk of recurrence but its effect on the overall survival of patients is not known. The case presented is a 48-year-old male patient with retroperitoneal liposarcoma, treated by complete surgical resection of the tumour and right hemicolectomy and currently on follow-up for possible recurrence.

关键词： Retroperitoneal Liposarcoma Surgical Resection Malignant Tumour

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Sentinel-1 In SAR observations and time-series analysis of co-and postseismic deformation mechanisms of the 2021 Mw 5.8 Bandar Ganaveh Earthquake,Southern Iran

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Journal of Mountain Science 2023年第4期20卷 911-927页

作者： Reza SABER Veysel ISIK Ayse CAGLAYAN Marjan TOURANI Department of Geological Engineering Tectonics Research GroupAnkara UniversityTR-06830AnkaraTürkiye Department of Geological Survey Ministry of Environment and UrbanisationGeneral Directorate of Spatial PlanningTR-06520AnkaraTürkiye

In the past two decades,because of the significant increase in the availability of differential interferometry from synthetic aperture radar and GPS data,spaceborne geodesy has been widely employed to determine the co-seismic displacement field of *** April 18,2021,a moderate earthquake(Mw 5.8)occurred east of Bandar Ganaveh,southern Iran,followed by intensive seismic activity and aftershocks of various *** use two-pass D-InSAR and Small Baseline Inversion techniques via the LiCSBAS suite to study the coseismic displacement and monitor the four-month post-seismic deformation of the Bandar Ganaveh earthquake,as well as constrain the fault geometry of the co-seismic faulting mechanism during the seismic *** show that the co-and postseismic deformation are distributed in relatively shallow depths along with an NW-SE striking and NE dipping complex reverse/thrust fault branches of the Zagros Mountain Front Fault,complying with the main trend of the Zagros *** average cumulative displacements were obtained from-137.5 to+113.3 mm/yr in the SW and NE blocks of the Mountain Front Fault,*** received maximum uplift amount is approximately consistent with the overall orogen-normal shortening component of the Arabian-Eurasian convergence in the Zagros *** surface ruptures were associated with the seismic source;therefore,we propose a shallow blind thrust/reverse fault(depth~10 km)connected to the deeper basal decollement fault within a complex tectonic zone,emphasizing the thin-skinned tectonics.

关键词： Sentinel‑1 InSAR time-series Neotectonic reactivation Seismogenic fault Bandar Ganaveh earthquakes Zagros Fold-Thrust Belt Arabian-Eurasian collision

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Survival following an impalement injury through the perineum in association with high voltage electrical burns: A case report

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Journal of Acute Disease 2017年第2期6卷 82-84页

作者： Joseph Yorke Pius Agbenorku Ronald Awoonor-Williams Kofi Baah Nyamekye George Amoah Offoe Michael Adinku Charles Appiah Amoah Edward Boateng Esinam Anita Agbeko Papa Kwesi Sonsomir Fiifi-Yankson Dorcas Ahulu Daniel Anning Gyawu Dennis Afful Yorke Department of Surgery School of Medical SciencesCollege of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana General Surgery unit Directorate of SurgeryKomfo Anokye Teaching HospitalKumasiGhana Reconstructive Plastic Surgery&Burns unit Department of SurgerySchool of Medical SciencesCollege of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana Urology unit Department of SurgeryKomfo Anokye Teaching HospitalKumasiGhana directorate of anaesthesia and intensive care unit Komfo Anokye Teaching HospitalKumasiGhana School of Medical Sciences College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana

We reported a case of a 30-year-old man who reportedly sustained electrical burns and fell from a high voltage electric pole about 50 meter high onto a metal that caused impalement injury. In addition, he sustained full-thickness burns of the right upper limb (7%), the right hemithorax, the perineum (sparing the penis), the anterior abdominal wall and the lateral aspect of both thighs. There was 43% burned surface area in total. Radiographic examination revealed a slender curved object extending from his perineum into the pelvis. The management of this case was a challenging one which was described in this article.

关键词： Impalement injury High voltage electrical burns Perineum Pelvis

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Rapid and flexible segmentation of electron microscopy data using few-shot machine learning

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npj Computational Materials 2021年第1期7卷 1733-1741页

作者： Sarah Akers Elizabeth Kautz Andrea Trevino-Gavito Matthew Olszta Bethany E.Matthews Le Wang Yingge Du Steven R.Spurgeon National Security directorate Pacific Northwest National LaboratoryRichlandWA 99352USA Energy and Environment directorate Pacific Northwest National LaboratoryRichlandWA 99352USA Department of Industrial Engineering and Management Sciences Northwestern UniversityEvanstonIL 60208USA Physical and Computational Sciences directorate Pacific Northwest National LaboratoryRichlandWA 99352USA

Automatic segmentation of key microstructural features in atomic-scale electron microscope images is critical to improved understanding of structure–property relationships in many important materials and chemical ***,the present paradigm involves time-intensive manual analysis that is inherently biased,error-prone,and unable to accommodate the large volumes of data produced by modern *** more automated approaches have been proposed,many are not robust to a high variety of data,and do not generalize well to diverse microstructural features and material ***,we present a flexible,semi-supervised few-shot machine learning approach for segmentation of scanning transmission electron microscopy images of three oxide material systems:(1)epitaxial heterostructures of SrTiO_(3)/Ge,(2)La_(0.8)Sr_(0.2)FeO_(3) thin films,and(3)MoO_(3) *** demonstrate that the few-shot learning method is more robust against noise,more reconfigurable,and requires less data than conventional image analysis *** approach can enable rapid image classification and microstructural feature mapping needed for emerging high-throughput characterization and autonomous microscope platforms.

关键词： systems image enable

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Big earth data analytics on Sentinel-1 and Landsat imagery in support to global human settlements mapping

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Big Earth Data 2017年第1期1卷 118-144页

作者： Christina Corbane Martino Pesaresi Panagiotis Politis Vasileios Syrris Aneta JFlorczyk Pierre Soille Luca Maffenini Armin Burger Veselin Vasilev Dario Rodriguez Filip Sabo Lewis Dijkstra Thomas Kemper European Commission Joint research Centre(JrC)Directorate for SpaceSecurity&Migrationispraitaly Arhs Developments S.a. rue Nicolas BovéLuxembourg European Commission Joint research Centre(JrC)Directorate for Competencesispraitaly GFt italia S.r.l. Milanoitaly Arhs Developments italia S.r.l. Milanoitaly European Commission Economic analysis Unit at European Commission Directorate general for regional and Urban PolicyBrusselsBelgium

Continuous global-scale mapping of human settlements in the service of international agreements calls for massive volume of multi-source,multi-temporal,and multi-scale earth observation *** this paper,the latest developments in terms of processing big earth observation data for the purpose of improving the Global Human Settlement Layer(GHSL)data are *** experiments with Sentinel-1 and Landsat data collections were run leveraging on the Joint Research Centre Earth Observation Data and Processing Platform.A comparative analysis of the results of built-up areas extraction from different remote sensing data and processing workflows shows how the information production supported by data-intensive computing infrastructure for optimization and multiple testing can improve the output information reliability and consistency within the GHSL *** paper presents the processing workflows and the results of the two main experiments,giving insights into the enhanced mapping capabilities gained by analyzing Sentinel-1 and Landsat data-sets,and the lessons learnt in terms of handling and processing big earth observation data.

关键词： Big data built-up surfaces global human settlement layer Sentinel-1 Landsat JrC earth observation and processing platform

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