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Thrombocytopenia in cirrhosis:Impact of fibrinogen on bleeding risk

World Journal of Hepatology 2017年第6期9卷 318-325页

作者： Sonali V Thakrar Susan V Mallett Royal Free Perioperative Research Group Department of AnaesthesiaRoyal Free LondonLondon NW3 2QGUnited Kingdom

AIMTo investigate the relationship between baseline platelet count, clauss fibrinogen, maximum amplitude (MA) on thromboelastography, and blood loss in orthotopic liver transplantation (OLT). METHODSA retrospective analysis of our OLT Database (2006-2015) was performed. Baseline haematological indices and intraoperative blood transfusion requirements, as a combination of cell salvage return and estimation of 300 mls/unit of allogenic blood, was noted as a surrogate for intraoperative bleeding. Two groups: Excessive transfusion (> 1200 mL returned) and No excessive transfusion ( RESULTSOf 322 OLT patients, 77 were excluded due to fulminant disease; redo transplant or baseline haemoglobin (Hb) of P ≤ 0.001), platelet count (P = 0.005), clauss fibrinogen (P = 0.004) and heparinase MA (P = 0.001) were all statistically significantly different. Univariate logistic regression with a cut-off of platelets 9/L as the predictor and Haemorrhage as the outcome showed an odds ratio of 1.393 (95%CI: 0.758-2.563; P = 0.286). Review of receiver operating characteristic curves showed an area under the curve (AUC) for platelet count of 0.604 (95%CI: 0.534-0.675; P = 0.005) as compared with AUC for fibrinogen level, 0.678 (95%CI: 0.612-0.744; P ≤ 0.001). A multivariate logistic regression shows united Kingdom model for End Stage Liver Disease (P = 0.006), Hb (P = 0.022) and Fibrinogen (P = 0.026) to be statistically significant, whereas Platelet count was not statistically significant. CONCLUSIONPlatelet count alone does not predict excessive transfusion. Additional investigations, e.g., clauss fibrinogen and viscoelastic tests, provide more robust assessment of bleeding-risk in thrombocytopenia and cirrhosis.

关键词： Thrombocytopenia Cirrhosis Haemostasis Fibrinogen Liver transplantation

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DYNAMIC ENERGY ABSORPTION OF STRUCTURES

DYNAMIC ENERGY ABSORPTION OF STRUCTURES

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The 7th International Conference on Shock and Impact Loads on Structures

作者： Norman Jones University of Liverpool United Kingdom

＜正＞This article focuses on the energy absorption of structural systems subjected to extreme Ioadings which can arise from impact,explosion and various other dynamic *** dynamic properties of high strength steels are discussed briefly because they have been proposed for energy-absorbing systems in place of the more common mild steel and aluminium *** energy-absorbing effectiveness factor is proposed which compares the dynamic energy absorbed in a device with the energy consumed up to rupture in a uniaxial tensile test specimen,which is made from the same volume of the *** dimensionless factor is examined for the axial impact loading of thin-walled tubes having several cross-sections and made from different *** transpires that the aluminium alloys are more effective than the mild and high strength steels and that circular cylindrical shells are more effective than square tubes and thin-walled tubes having other cross-sections.

关键词： energy-absorption impact energy-absorbing effectiveness factor thin-walled tubes high strength steel strain rate sensitivity.

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A Mathematical Model of Breast Cancer and Mediated Immune System Interactions

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Journal of Mathematics and System Science 2012年第7期2卷 430-446页

作者： Kodwo Annan Mickayla Nagel Hannibel A. Brock Department of Mathematics & Computer Science Minot State University Minot 58707 United States Department of Science Minot State University Minot 58707 United States

Mathematical model that describes breast cancer and immune interactions were presented using system of differential equations to provide analytic and nnmeric framework of cancer-immune dynamics. Four types of immune cells-CTLs （cytotoxic T lymphocytes）, macrophages, NK （natural killer） and helper T cells-known to play the most significant roles in developing breast cancer immunity were modeled using differential equations. The model was then applied to different cancer growth rates and simulated using MATLAB software tool. The parameters of the model were based on experimental and clinical results from published articles. Results supported clinical studies that maximal breast cancer immunity depends mostly on each of the four immune cell types chosen. It was observed that for a given breast cancer growth rate, there was an optimal activation that maximized the response of the immune system. The effectiveness of the immune system resulted in the decrease in breast cancer killing rates. These results highlighted the importance of immune system activations in breast cancer development and treatment. Therefore, the model and its simulation provided a robust framework to better understand breast cancer progression and response to the immune system.

关键词： Breast cancer immune system mathematical model.

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Impact of SIPS performance on Power Systems Integrity

Impact of SIPS performance on Power Systems Integrity

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2011 International Conference on Advanced Power System Automation and Protection(APAP 2011)

作者： Mathaios Panteli Peter Crossley The University of Manchester United Kingdom

ISBN: (纸本)9781424496228

An increasing number of utilities are using System Integrity Protection Schemes （SIPS） to minimize the probability of large disturbances and to enhance power system reliability. This trend leads to the use of an increased number of SIPS resulting in additional risks to system security. This paper proposes a procedure based on Markov Modeling for assessing the risk of a SIPS failure or misoperation. The proposed method takes into consideration failures in the three stages of SIPS operation: arming, activation and implementation. This method is illustrated using an example of a Generation Rejection Scheme （GRS） for preventing cascading outages that may lead to load shedding. In addition, system operators tend to have the SIPS always armed to prevent a failure to operate when required. However, this can result in increased probability of SIPS misoperation （operation when not needed）. Therefore, the risk introduced to the system by having the SIPS always armed and ready to initiate actions is examined and compared with the risk of automatic or manual arming of SIPS only when required. Sensitivity analysis is also performed to determine how different factors can affect the ability of the SIPS to operate in a dependable and secure manner.

关键词： System Integrity Protection Schemes risk assessment Markov Modeling sensitivity analysis

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When It Strikes,Are We Ready?Lessons Identified at the 7th Planetary Defense Conference in Preparing for a Near-Earth Object Impact Scenario

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International Journal of Disaster Risk Science 2022年第1期13卷 151-159页

作者： Shirish Ravan Tom De Groeve Lara Mani Einar Bjorgo Richard Moissl Jose Miguel Roncero Katherine Rowan David Schuld Leviticus A.Lewis Romana Kofler united Nations Office for Outer Space Affairs(UNOOSA) United Nations1220 ViennaAustria European Commission Joint Research Centre 21027 IspraItaly Centre for the Study of Existential Risk University of CambridgeCambridge CB21SBUK Division for Satellite Analysis United Nations Institute for Training and Research(UNITAR)1202 GenevaSwitzerland European Space Agency/European Space Research and Technology Centre(ESA/ESTEC) 2201 AZ NoordwijkThe Netherlands Security and Situational Awareness Unit European Commission's Directorate-General for European Civil Protection and Humanitarian Aid Operations1049 BrusselsBelgium Department of Communication George Mason UniversityFairfaxVA 22030USA Hagerty Consulting EvanstonIL 60201USA Response Operations Division Federal Emergency Management AgencyWashingtonDC 20024USA

Near-Earth object(NEO)impact is one of the examples of high impact and low probability(HILP)event,same as the Covid-19 pandemic the world faces since the beginning of *** 7 th Planetary Defense Conference held by the International Academy of Astronautics(IAA)in April 2021 included an exercise on a hypothetical NEO impact event,allowing the planetary defense community to discuss potential *** the span of the 4-day conference this exercise connected disaster response and management professionals to participate in a series of panels,providing feedback and perspective on the unfolding crisis *** hypothetical but realistic asteroid threat scenario illustrated how such a short-warning threat might *** scenario utilized during the conference indicates a need to prepare now for what might come in the future,because even with advance notice,preparation time might be *** scenario chose Europe for the impact,which may likely cope with such a disaster,through the Union Civil Protection Mechanism(UCPM)and other solidarity and support mechanisms within the European Union(EU),as well as with potential support from international *** short article raises concern about other areas in the world on how they may access NEO impact information and cope with such *** also provides an idea on vast scale of such disaster vis-a-vis the current capacity of response systems to cope with a larger event in Europe or *** scenario showed that planetary defense is a global *** engagement of the planetary defense and disaster response communities is essential in order to keep the world safe from potential disasters caused by NEO impacts.

关键词： Asteroid threats Disaster risk reduction Planetary defense Risk management and prevention

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Linking the effect of localised pitting corrosion with mechanical integrity of a rare earth magnesium alloy for implant use

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Bioactive Materials 2023年第3期21卷 32-43页

作者： Kerstin van Gaalen Conall Quinn Felix Benn Peter E.McHugh Alexander Kopp Ted J.Vaughan Biomechanics Research Centre(BioMEC) Biomedical EngineeringSchool of EngineeringNational University of Ireland GalwayGalwayIreland Meotec GmbH AachenGermany School of Mechanical and Aerospace Engineering Queen’s University BelfastBelfastUnited Kingdom

This study presents a computational framework that investigates the effect of localised surface-based corrosion on the mechanical performance of a magnesium-based alloy.A finite element-based phenomenological corrosion model was used to generate a wide range of corrosion profiles,with subsequent uniaxial tensile test simulations to predict the mechanical response to *** python-based detection framework PitScan provides detailed quantification of the spatial phenomenological features of corrosion,including a full geometric tracking of corroding *** this approach,this study is the first to quantitatively demonstrate that a surface-based non-uniform corrosion model can capture both the geometrical and mechanical features of a magne-sium alloy undergoing corrosion by comparing to experimental *** this verified corrosion modelling approach,a wide range of corrosion scenarios was evaluated and enabled quantitative relationships to be established between the mechanical integrity and key phenomenological corrosion *** particular,we demonstrated that the minimal cross-sectional area parameter was the strongest predictor of the remaining mechanical strength(R2=0.98),with this relationship being independent of the severity or spatial features of localised surface ***,our analysis demonstrated that parameters described in ASTM G46-94 showed weaker correlations to the mechanical integrity of corroding specimens,compared to parameters determined by *** study establishes new mechanistic insight into the performance of the magnesium-based materials undergoing corrosion.

关键词： Magnesium Localised corrosion Corrosion modelling Phenomenology FEM

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Increased proportion of alcohol-related trauma in a South London major trauma centre during lockdown:A cohort study

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Chinese Journal of Traumatology 2022年第5期25卷 277-282页

作者： Oliver S.Brown Toby O.Smith Andrew J.Gaukroger Prodromos Tsinaslanidis Caroline B.Hing St George's University Hospitals NHS Foundation Trust LondonUnited Kingdom Faculty of Medicine and Health Sciences University of East AngliaNonwvichUnited Kingdom

Purpose:Alcohol has been associated with 10%—35%trauma admissions and 40%trauma-related deaths *** response to the COVID-19 pandemic,the united Kingdom entered a state of"lockdown"on March 23,*** were most significantly eased on June 1,2020,when shops and schools *** purpose of this study was to quantify the effect of lockdown on alcohol-related trauma ***:All adult patients admitted as"trauma calls"to a London major trauma centre during April 2018 and April 2019(pre-lockdown,n=316),and 1st April—31st May 2020(lockdown,n=191)had electronic patient records analysed ***’blood alcohol level and records of intoxication were used to identify alcohol-related *** admissions from pre-lockdown and lockdown cohorts were compared using multiple regression ***:Alcohol-related trauma was present in a significantly higher proportion of adult trauma calls during lockdown(lockdown 60/191(31.4%),***-lockdown 62/316(19.6%);(odds ratio(OR):0.83,95%CI:0.38—1.28,p0.05).Conclusions:The united Kingdom lockdown was independently associated with an increased proportion of alcohol-related *** admissions were increased during the weekend when staffing levels are *** the possibility of further global"waves"of COVID-19,the long-term repercussions of dangerous alcohol-related behaviour to public health must be addressed.

关键词： Trauma Alcohol Lockdown COVID-19 Major trauma centre

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Thromboembolic events in metastatic testicular cancer treated with cisplatin-based chemotherapy

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World Journal of Clinical Oncology 2021年第3期12卷 183-194页

作者： Lisa B E Shields Michael W Daniels Nataliya Mar Arash Rezazadeh Kalebasty Norton Neuroscience Institute Norton HealthcareLouisvilleKY 40202United States Department of Bioinformatics and Biostatistics University of LouisvilleLouisvilleKY 40292United States Division of Hematology/Oncology Department of MedicineUCI Medical CenterOrangeCA 92868United States

BACKGROUND Testicular germ cell tumor(TGCT)is the most curable solid tumor and most common cancer among men 18-39 *** cisplatin-based chemotherapy has significantly lengthened the survival of patients with TGCT,it is associated with a high rate of thromboembolic events(TEE).AIM To summarize our single-center experience highlighting patients who were diagnosed with TGCT and received platinum-based chemotherapy,with special attention to those patients who suffered a *** A retrospective analysis of the medical records and imaging studies of 68 consecutive individuals who were diagnosed with TGCT and received platinumbased chemotherapy at our Institution in a metropolitan community between January 1,2014 and December 31,*** A total of 19(28%)patients experienced a TEE following orchiectomy which occurred during chemotherapy in 13(68%)of these *** with a higher pathologic stage(stage III)were significantly(P=0.023)more likely to experience a TEE compared to patients who had a lower ***,patients who were treated with 3 cycles of bleomycine,etoposide,and cisplatin and 1 cycle of etoposide and cisplatin or 4 cycles of etoposide and cisplatin were significantly 5(P=0.02)times more likely to experience a TEE compared to patients who were treated with only 3 cycles of bleomycine,etoposide,and *** Due to numerous factors that predispose to a TEE such as large retroperitoneal disease,higher clinical stage,greater number of chemotherapy cycle,central venous catheter,cigarette smoking,and possible cannabis use,high-risk ambulatory patients with TGCT treated with cisplatin-based chemotherapy may benefit from prophylactic *** studies to evaluate the safety and efficacy of prophylactic anticoagulants are warranted in this young patient population generally devoid of medical co-morbidities.

关键词： Oncology Testicular cancer Thromboembolic Cisplatin Pulmonary embolism Thromboprophylaxis

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Landform type mediates compositional change in a hurricane-disturbed subtropical forest

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Ecological Processes 2020年第1期9卷 292-304页

作者： Robert L.Spicer Ariel ELugo Nathan Ruhl Department of Biological Science Rowan UniversityGlassboroNJ 08028USA International Institute of Tropical Forestry United States Department of Agriculture Forest ServiceJardín Botánico SurRío PiedrasPRUSA

Background:Categorization of topographical features into landform type is a long-standing method for understanding physiographic patterns in the *** in forest composition between landform types are driven primarily by concurrent differences in soil composition and moisture,but also disturbance *** studies have focused on the interaction between fire disturbance,succession,and landforms,but the effects of hurricane disturbance on compositional differences between landforms are poorly *** the study presented here,we assess compositional and structural differences between landform types in the tree community of a young sub-tropical forest that is frequently subjected to ***,we ask whether the tree community(1)changed structurally over the study period,(2)experienced compositional change over the study period,(3)is compositionally different between landform types,and(4)exhibits compositional change mediated by landform ***:The tree community experienced significant structural change over the course of our study,but compositional change was only significant for some ***:Despite large-scale,intense,and frequent hurricane disturbance to our study system,compositional change in the tree community was localized and only significant for some landform types.

关键词： Hurricane Forest Community Composition Change Succession Landform

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Overview of the HiLASE project: high average power pulsed DPSSL systems for research and industry

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High Power Laser Science and Engineering 2014年第2期2卷 1-10页

作者： M.Divoky M.Smrz M.Chyla P.Sikocinski P.Severova O.Novak J.Huynh S.S.Nagisetty T.Miura J.Pila O.Slezak M.Sawicka V.Jambunathan J.Vanda A.Endo A.Lucianetti D.Rostohar P.D.Mason P.J.Phillips K.Ertel S.Banerjee C.Hernandez-Gomez J.L.Collier T.Mocek HiLASE Institute of Physics AS CR v.v.i. Na Slovance 2 182 21 Prague Czech Republic STFC Rutherford Appleton Laboratory Didcot OX11 0QX United Kingdom

An overview of the Czech national R&D project HiLASE(High average power pulsed laser) is presented. The project focuses on the development of advanced high repetition rate, diode pumped solid state laser(DPSSL) systems with energies in the range from mJ to 100 J and repetition rates in the range from 10 Hz to 100 kHz. Some applications of these lasers in research and hi-tech industry are also presented.

关键词： DPSSL Yb3+:YAG thin-disk multi-slab pulsed high average power laser

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