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Water balloon-induced orbital fracture in an aviator

Military medical Research 2020年第2期7卷 245-248页

作者： Timothy E.Holland David M.Smith Guy N.Gibson Jared G.Brinkerhoff flight and operational medical clinic 78th Medical Group655 Seventh StreetRobins Air Force BaseRobinsGA 31098USA Department of Radiology Ehrling Bergquist Clinic2501 Capehart RdOffutt AFBNEOffutt 68113-2160USA flight and operational medical clinic 5th Medical Group194 Missilie AveMinot AFBNDMinot 58705USA

Background:Orbital fractures are common injuries found in facial *** etiologies of orbital fractures include motor vehicle collisions and *** report the case of a 32-year-old male who suffered an orbital fracture from a water ***,we describe the aeromedical complications that may result from this ***,we attempt to answer the question of when a patient may return to flying after sustaining such an injury through review of the *** presentation:A 32-year-old male pilot with the United States Air Force was at an outdoor event with his unit when he was struck with a water balloon launched from a sling shot into his left *** afterwards,he had an onset of subcutaneous emphysema and was escorted to a nearby Emergency *** tomography identified an orbital fracture with associated orbital and subcutaneous *** patient was evaluated by a plastic surgeon and was determined not to be a surgical *** weeks later,he returned to flying ***:Water balloons are thought to be safe and harmless ***,when coupled with sling shots,water balloons can become formidable projectiles capable of significant orbital injury including orbital *** injuries are concerning to aviators,as the most common sites for fractures of the orbit are the thin ethmoid and maxillary bones adjacent to the *** altitude,gases in the sinuses may expand and enter the orbit through these fractures,which may suddenly incapacitate the *** is important for flight surgeons to identify and assess these individuals to determine suitability for flying.

关键词： Boyle’s law Orbital emphysema Facial fracture

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Epidemiological characteristics of childhood migraine syndrome in Serbia

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Neural Regeneration Research 2011年第9期6卷 692-698页

作者： Marija Knezevi-Poganev Neboja Jovi Vesna Iveti Danka Filipovi Dragan Katani Institute of Child and Youth Health Care of Vojvodina clinic of Neurology and Psychiatry for Children and Youth medical Faculty of Novi Sad Institute for PhysiologyDepartment for Neurophysiology

This study investigated childhood migraine, examining the clinical characteristics of different childhood migraine types, predisposing factors, and possible medical treatments in a sample of children in Serbia. This was the first epidemiological study in Serbia using the operational diagnostic criteria of the International Headache Society. The present study examined 30 636 children between 1988 and 2006, including 15 434 （50.38%） males and 15 202 （49.62%） females, in nine towns in Vojvodina, a northern province in Serbia. Migraine was reported in 2 644 （8.63%） children aged 3 to 7 years, consisting of 1 189 （8.0%） males and 1 455 （9.6%） females. Migraine with aura accounted for 25.55%, migraine without aura for 67.21% and other migraine syndromes for 7.23% of reported migraine sufferers. The mean age of first migraine attack across groups was 5 years and 1.8 months. Migraine with aura was associated with an earlier onset than migraine without aura Migraine was more frequent among younger groups of children who were breastfed for a shorter period of time. Child healthcare in Vojvodina has a high level of specialization, with more than half of the children reporting migraine diagnosed and treated by neuropediatricians. Socioeconomic status, duration of breastfeeding, birth order, and age of entering full-day nursery care were found to be important factors for childhood migraine. These findings suggest that healthcare providers should educate parents about these predisposing factors, so they can be identified and avoided early.

关键词： children migraine epidemiology health care Serbia

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Predictors of disease severity in ulcerative colitis patients from Southwestern Ontario

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World Journal of Gastroenterology 2010年第2期16卷 232-236页

作者： Lee S Roth Nilesh Chande Terry Ponich Maya L Roth James Gregor Division of Gastroenterology London Health Sciences Centre Victoria Hospital800 Commissioner’s Road EastLondon OntarioN6A 5W9Canada operational Stress Injury clinic Parkwood HospitalLondonOntarioN6C 5J1Canada

AIM:To understand the demographic characteristics of patients in Southwestern Ontario,Canada with ulcerative colitis(UC)in order to predict disease severity. METHODS:Records from 1996 to 2001 were exam- ined to create a database of UC patients seen in the London Health Sciences Centre South Street Hospital Inflammatory Bowel Disease *** be included, patients'charts were required to have information of their disease presentation and a minimum of 5 years of *** were reviewed using standardized data collection *** severity was generated during the chart review process,and non-endoscopic Mayo Score criteria were collected into a composite. RESULTS:One hundred and two consecutive patients'data were entered into the *** analyses revealed that 51%of the patients were male, the mean age at diagnosis was 39 years,13.7%had a first degree relative with inflammatory bowel disease (IBD),61.8%were nonsmokers and 24.5%were *** 22.5%of patients the disease was limited to the rectum,in 21.6%disease was limited to the sigmoid colon,in 22.5%disease was limited to the left colon,and 32.4%of patients had pancolitis. Standard multiple regression analysis which regressed a composite of physician global assessment of disease severity,average number of bowel movements,and average amount of blood in bowel movements on year of diagnosis and age at time of diagnosis was significant,R 2=0.306,F(7,74)=4.66,P<0.01. Delay from symptoms to diagnosis of UC,gender, family history of IBD,smoking status and disease severity at the time of diagnosis didnot significantly predict the composite measure. CONCLUSION:UC severity is associated with younger age at diagnosis and year of diagnosis in a longitudinal cohort of UC patients,and may identify prognostic UC indicators.

关键词： Demographic Disease severity Prognosis Ulcerative colitis

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Task sharing: situation analysis about capacity and resources for management of diabetic retinopathy in Pakistan

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International Journal of Ophthalmology(English edition) 2019年第5期12卷 809-814页

作者： Mufarriq Shah Ayesha Noor C Alex Harper Jill Elizabeth Keeffe Pakistan Institute of Community Ophthalmology Hayatabad Medical Complex Vision and Dental Care clinic Centre for Eye Research Australia Department of OphthalmologyUniversity of Melbourneand Royal Victorian Eye and Ear Hospital LV Prasad Eye Institute

AIM: To assess the capacity and resources of eye care facilities, using the WHO Health Systems Framework, to manage diabetic retinopathy(DR) through task ***: Using purposive sampling, four participants(administrators) from four selected hospitals in two provinces in Pakistan were recruited for this cross-sectional study. A survey, to assess the capacity and resources of the selected eye care facilities for the feasibility to adopt task sharing in management of DR to prevent vision loss, was emailed to participants who were asked to complete. Responses to open-ended questions were entered into a Microsoft Excel spread sheet and inductive approach was applied for ***: All the surveyed eye care facilities offer eye care services for people with diabetes and DR. All surveyed eye care facilities have a shortage in the number of human resources across all cadres. Optometrists and mid-level eye care workers did not have active roles in DR screening and management in all four hospitals. All the hospitals surveyed did not have a computerized record management system for patients who visit ophthalmologists for eye examinations. Equipment for detection and management of DR were short in number and main users were ophthalmologists. There was no policy for population-based screening program for detection of DR in any of the surveyed ***: A system-based approach to manage DR is needed. The capacity of eye care facilities and the potential to improve access of people with diabetes to eyecare services can be enhanced through implementation of task sharing.

关键词： task sharing capacity diabetes diabetic retinopathy Pakistan

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History and present status of pulmonary metastasectomy in colorectal cancer

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World Journal of Gastroenterology 2014年第40期20卷 14517-14526页

作者： Tom Treasure Miel Miloevi Francesca Fiorentino Joachim Pfannschmidt clinical operational Research Unit University College London London WC1E 6BT United Kingdom clinic for Thoracic Surgery Institute for Pul-monary Diseases of Vojvodina University of Novi Sad Novi Sad 402920 Serbia Department of Cardiothoracic Surgery National Heart and Lung Institute Imperial College London W12 0NN United Kingdom HELIOS Klinikum Emil von Behring Lungenklinik Heckeshorn 14165 Berlin Germany

clinical practice with respect to metastatic colorectal cancer differs from the other two most common cancers,breast and lung,in that routine surveillance is recommended with the specific intent of detecting liver and lung metastases and undertaking liver and lung resections for their *** trace the history of this approach to colorectal cancer by reviewing evidence for effectiveness from the 1950s to the present *** sources included published citation network analyses,the documented proposal for randomised trials,large systematic reviews,and meta-analysis of observational *** present consensus position has been adopted on the basis of a large number of observational studies but the randomised trials proposed in the 1980s and 1990s were either not done,or having been done,were not *** opinion is the mainstay of current practice but in the absence of randomised trials there remains a possibility of selection *** controlled trials(RCTs)are now routine before adoption of a new practice but RCTs are harder to run in evaluation of already established *** such trial is recruiting and shows that controlled trial are possible.

关键词： Colorectal cancer Metastasectomy Liver resection Pulmonary metastasectomy Oligometastatic state

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Gut Microbiota Community Shift with Severity of Coronary Artery Disease

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Engineering 2021年第12期7卷 1715-1724页

作者： Jia-Lu Hu Zhi-Feng Yao Min-Na Tang Chun Tang Xiao-Fan Zhao Xi Su Dan-Bo Lu Qiu-Rong Li Zhang-Sheng Wang Yan Yan Zeneng Wang Department of Cardiology Zhongshan HospitalFudan UniversityShanghai 200032China Research Institute of General Surgery Jinling HospitalMedical School of Nanjing UniversityNanjing 210002China Department of Laboratory Medicine Zhongshan HospitalFudan UniversityShanghai 200032China Department of Cardiology The Fifth People’s Hospital of ShanghaiFudan UniversityShanghai 200240China Department of Cardiovascular and Metabolic Sciences Lerner Research InstituteCleveland ClinicClevelandOH 44195USA

Gut microbiota community shift with coronary artery disease(CAD)has been reported in several limited cohorts during the past several ***,whether the enriched or decreased microbiota taxa with CAD can be reproducible deserves further investigation and *** this study,78 human subjects were *** these,19 were diagnosed without stenosis in coronary artery(control group,referred to herein as Ctrl),14 with stenosis less than 50%(LT50),and 45 with stenosis greater than 50%(GT50).Fecal samples were collected and DNA was extracted to perform 16S ribosomal RNA(rRNA)gene *** operational taxonomic units(OTUs)were analyzed to identify taxa specific to different groups;next,multivariate logistic regression was employed to test whether the defined taxa could independently predict CAD *** found that Deltaproteobacteria,Fusobacterium,Bilophila,Actinomyces,and Clostridium XIX were enriched in Ctrl;Prevotellaceae,Parabacteriodes,and Butyricicoccus were enriched in LT50;and Roseburia and Butyricimonas were enriched in *** analysis revealed that increased populations of Deltaproteobacteria,Fusobacterium,Bilophila,and Desulfovibrionaceae were associated with a 0.26-fold,0.21-fold,0.18-fold,and 0.26-fold decreased risk of CAD,respectively(p<0.05),and an increased Prevotellaceae population was associated with a 5.63-fold increased risk of CAD(p<0.01).A combination of the 20 microbial taxa achieved an area under the receiver operating characteristic(ROC)curve of higher than 0.88 for all discriminations between LT50 vs Ctrl,GT50 vs Ctrl,LT50+GT50 vs Ctrl,and GT50 vs Ctrl+***,the microbial taxa previously reported as enriched in CAD patients or healthy controls could not be observed in our cohort except for *** conclusion,CAD patients showed a different microbial taxa signature than the healthy ***,the non-reproducibility of the microbiota taxa enriched in CAD across different cohorts limits the use of this s

关键词： Gut microbiota Atherosclerosis Coronary artery disease

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Acute myocardial infarction in myeloproliferative neoplasms

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World Journal of Cardiology 2023年第11期15卷 571-581页

作者： Muhammad Romail Manan Vincent Kipkorir Iqra Nawaz Maryann Wanjiku Waithaka Bahadar Singh Srichawla Amelia Maria Găman Camelia Cristina Diaconu Mihnea-Alexandru Găman Services Institute of medical Sciences Lahore 54000Pakistan Department of Human Anatomy and Physiology University of NairobiNairobi 00100Kenya Quaid-e-Azam medical College Bahawalpur 63100Pakistan Department of Neurology University of Massachusetts Chan Medical SchoolWorcesterMA 01655United States Department of Pathophysiology University of Medicine and Pharmacy of CraiovaCraiova 200143Romania clinic of Hematology Filantropia City HospitalCraiova 200143Romania Department of Internal Medicine Faculty of Medicine“Carol Davila”University of Medicine and PharmacyBucharest 050474Romania Internal Medicine clinic Clinical Emergency Hospital of BucharestBucharest 105402Romania Faculty of Medicine “Carol Davila”University of Medicine and PharmacyBucharest 050474Romania Department of Hematology Center of Hematology and Bone Marrow TransplantationFundeni Clinical InstituteBucharest 022328Romania Department of Cellular and Molecular Pathology Stefan S.Nicolau Institute of VirologyRomanian AcademyBucharest 030304Romania

Myeloproliferative neoplasms(MPNs)are a heterogeneous group of hematologic malignancies characterized by an abnormal proliferation of cells of the myeloid *** individuals are at increased risk for cardiovascular and thrombotic *** infarction(MI)may be one of the earliest clinical manifestations of MPNs or may be a thrombotic complication that develops during the natural course of the *** the present review,we examine the epidemiology,pathogenesis,clinical presentation,and management of MI in MPNs based on the available ***,we review potential biomarkers that could mediate the MI-MPNs crosstalk,from classical biochemical tests,e.g.,lactate dehydrogenase,creatine kinase and troponins,to pro-inflammatory cytokines,oxidative stress markers,and clonal hematopoiesis.

关键词： Myeloproliferative neoplasms Polycythemia vera Essential thrombocythemia Myelofibrosis Myocardial infarction Acute coronary syndrome Biomarker Clonal hematopoiesis

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Modeling minimum detectable activity as a function of detector speed

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Radiation Detection Technology and Methods 2019年第3期3卷 70-77页

作者： James Falkner Craig Marianno US Navy Naval Health Clinic Charleston110 NNPTC CircleGoose CreekSC 29445USA Texas A&M University 3473 TAMUCollege StationTX 77843USA

Purpose A radiation detector’s sensitivity is important when designing survey plans.A measure of sensitivity is minimum detectable activity(MDA)which is the lowest amount of activity required for a signal to be distinguished above *** has been known for some time that the efficiency of a moving detector can be improved by slowing the speed of *** Multi-Agency Radiation Survey and Site Investigation Manual describes but does not quantify this *** efficiency at higher speeds results in higher MDAs and thus less sensitive *** purpose of this research is to specifically define the relationship between detector MDA and *** Python was employed to calculate solid angle from equations developed by Masket and MCNP6.1 simulations were used to determine detection efficiency for a moving *** these results efficiency as a function of detector travel speed was fit to a modified four-parameter logistic function(M4PL).Results The result of this work is a well defined relationship that can be used to predict MDA as a function of *** relationship can also be used by operators to determine the optimum speed needed to meet a predefined *** Understanding this relationship between detector speed and efficiency will improve detector performance in remediation efforts and national security search *** M4PL function developed in this research allows optimizing remediation and wide-area radiation survey activities by setting maximum survey speed to meet a predetermined MDA.

关键词： Counting efficiency Detection limits Monte Carlo operational topics

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Prevalence of epilepsy in the onchocerciasis endemic middle belt of Ghana after 27 years of mass drug administration with ivermectin

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Infectious Diseases of Poverty 2023年第4期12卷 106-106页

作者： Kenneth Bentum Otabil Blessing Ankrah Emmanuel John Bart-Plange Emmanuel Sam Donkoh Fiona Amoabil Avarikame Fredrick Obeng Ofori-Appiah Theophilus Nti Babae Prince-Charles Kudzordzi Vera Achiaa Darko Joseph Ameyaw Joseph Gyekye Bamfo Raji Abdul Sakibu Daniel Antwi-Berko Joseph Nelson Siewe Fodjo María-Gloria Basáñez Henk D.F.H.Schallig Robert Colebunders NeTroDis Research Group Centre for Research in Applied Biology School of Sciences University of Energy and Natural Resources Sunyani Ghana Department of Biological Science School of Sciences University of Energy and Natural Resources Sunyani Ghana Global Health Institute University of Antwerp Antwerp Belgium Department of medical Laboratory Science School of Sciences University of Energy and Natural Resources Sunyani Ghana STU clinic Sunyani Technical University Sunyani Ghana Happy Family Hospital Nkoranza Ghana Tain District Hospital Nsawkaw Ghana Department of Infectious Disease Epidemiology MRC Centre for Global Infectious Disease Analysis (MRC GIDA) and London Centre for Neglected Tropical Disease Research School of Public Health Imperial College London London UK Department of medical Microbiology Experimental Parasitology Unit Amsterdam University Medical Centres Academic Medical Centre at the University of Amsterdam Amsterdam The Netherlands

BackgroundIn onchocerciasis-endemic areas with high ongoing Onchocerca volvulus transmission,a high prevalence of epilepsy has been *** study aimed to determine the prevalence and clinical characteristics of epilepsy in the Bono Region of Ghana following 27 years of implementation of ivermectin mass drug administration(MDA).MethodsBetween October 2020 and August 2021,cross-sectional surveys were conducted in nine communities in the Tain District and Wenchi Municipality of the Bono Region of *** the first stage,a random door-to-door approach was used to screen the population for epilepsy using a pre-tested *** suspected of having epilepsy were invited for a second-stage neurological examination for case *** *** microfilarial infection status and Ov16 seropositivity were also ***-five confidence intervals(95%CI)for prevalence values were calculated using the Wilson Score *** the 971 participants,500(51.5%)were females,and the median age(interquartile range)was 26(15‒43)*** participants(1.4%,95%CI:1.0‒2.0)were diagnosed as having epilepsy with generalized seizures being the most frequent seizure type(85.7%,12/14).The overall microfilarial prevalence of *** was 10.3%(November 2020)and 9.9%(August 2021);the Ov16 seroprevalence was 22.2%(June 2021).Only 63.2%took ivermectin in the last round of MDA distribution in March *** 1.4%prevalence of epilepsy in the Bono region is similar to the median epilepsy prevalence in sub-Saharan ***,the persistent microfilarial prevalence and low ivermectin study coverage call for the Ghana Onchocerciasis Elimination Programme to step up its efforts to ensure that the gains achieved are consolidated and improved to achieve the elimination of onchocerciasis by 2030.

关键词： Onchocerca volvulus Microflaria Onchocerciasis-associated epilepsy Seizure Ivermectin Mass drug administration Coverage

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Roles of the eye care workforce for task sharing in management of diabetic retinopathy in Cambodia

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International Journal of Ophthalmology(English edition) 2018年第1期11卷 101-107页

作者： Mufarriq Shah Gail M.Ormsby Ayesha Noor Rahul Chakrabarti Manfred Morchen Fakir MAmirul Islam CAlex Harper Jill E Keeffe Pakistan Institute of Community Ophthalmology Hayatabad medical Complex Peshawar 25000Pakistan Centre for Eye Research Australia Department of Ophthal-mologyUniversity of MelbourneRoyal Victorian Eye and Ear HospitalMelbourneVIC 302Australia Faculty of Education Science and BusinessLifestyle Research CentreAvondale College of Higher EducationCooranbongNSW 2265Australia Vision and Dental Care clinic Peshawar 25000Pakistan CARITAS Takeo Eye Hospital Krong Doun Kaev 21151Cambodia Regional office Asia South East CBM International Unit 604 Alabang Business Tower 1216 Acacia AveMuntinlupa City 1799Philippines Statistics Data Science and EpidemiologySwinburne University of TechnologyHawthornVIC 3122Australia LV Prasad Eye Institute Hyderabad 500034India

AIM： To identify the current roles of eye and health care workers in eye care delivery and investigate their potential roles in screening and detection for management of diabetic retinopathy（DR） through task ***： Purposive sampling of 24 participants including health administrators, members from non-government organizations and all available eye care workers in Takeo province were recruited. This cross sectional mixed method study comprised a survey and in-depth interviews. Data were collected from medical records at Caritas Takeo Eye Hospital（CTEH） and Kiri Vong District Referral Hospital Vision Centre, and a survey and interviews with participants were done to explore the potential roles for task sharing in DR management. Qualitative data were transcribed into a text program and then entered into N-Vivo（version 10） software for data management and analysis. RESULTS： From 2009 to 2012, a total of 105 178 patients were examined and 14 030 eye surgeries were performed in CTEH by three ophthalmologists supported by ophthalmic nurses in operating and eye examination for patients. Between January 2011 and September 2012, 151 patients（72 males） with retinal pathology including 125（83%） with DR visited CTEH. In addition 170 patients with diabetes were referred to CTEH for eye examinations from Mo Po Tsyo screening programs for people with diabetes. Factors favouring task sharing included high demand for eye care services and scarcity of ***： Task sharing and team work for eye care services is functional. Participants favor the potential role of ophthalmic nurses in screening for DR through task sharing.

关键词： task sharing diabetes diabetic retinopathy human resources Cambodia

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