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Ali Pourmand Jen Liao Jesse M. Pines Maryann Mazer-Amirshahi 《The Journal of emergency medicine》2018,54(5):630-635
Background
The Segway® Personal Transporter? (SPT) is used widely as a means of transport for city sightseeing tours, law enforcement, and professionals working in large facilities and factories.Methods
We conducted a systematic review of the literature to assess SPT-related injuries. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, we queried PubMed from 1990 to 2017. The search terms Segway, personal transporter, and injury were used. Only English-language studies were included. Data were extracted from each article, specifically the sample size, study setting, and design, as well as the prevalence of specific injuries.Results
A total of six articles were included that included data on 135 patients. Sample size per study varied from 1 to 41 patients. Studies occurred in both the emergency department and inpatient settings, including medical-surgical wards, and intensive care units. The most commonly reported injuries were orthopedic cases (n = 45), maxillofacial cases (n = 13), neurologic cases (n = 8), and thoracic cases (n = 10).Conclusions
The SPT is an innovative transportation method; however, its use is associated with a wide range of injuries. Many of these injuries require hospital admission and surgical intervention, incurring significant morbidity and high costs. 相似文献64.
Samuel Mullinax Christen E. Chalmers Jesse Brennan Gary M. Vilke Kimberly Nordstrom Michael P. Wilson 《The American journal of emergency medicine》2018,36(10):1779-1783
Background
Suicide screening scales have been advocated for use in the ED setting. However, it is currently unknown whether patients classified as low-risk on these scales can be safely discharged from the emergency department. This study evaluated the utility of three commonly-used suicide screening tools in the emergency department to predict ED disposition, with special interest in discharge among low-risk patients.Methods
This prospective observational study enrolled a convenience sample of patients who answered “yes” to a triage suicidal ideation question in an urban academic emergency department. Patients were administered the weighted modified SADPERSONS Scale, Suicide Assessment Five-step Evaluation and Triage, and Columbia-Suicide Severity Rating Scale. Patients who subsequently received a psychiatric evaluation were included, and the utility of these screening tools to predict disposition was evaluated.Results
276 subjects completed all three suicide screening tools and were included in data analyses. Eighty-two patients (30%) were admitted or transferred. Three patients (1%) died by suicide within one year of enrollment; one was hospitalized at the end of his or her enrollment visit, dying by suicide seven months later and the other two were discharged, dying by suicide nine and ten months later, respectively. The screening tools exhibited modest negative predictive values (range: 0.66–0.73).Conclusion
Three suicide screening tools displayed modest ability to predict the disposition of patients who presented to an emergency department with suicidal ideation. This study supports the current ACEP clinical policy on psychiatric patients which states that screening tools should not be used in isolation to guide disposition decisions of suicidal patients from the ED. 相似文献65.
Chigozie Jesse Uneke Abel Ebeh Ezeoha Henry Uro-Chukwu Chinonyelum Thecla Ezeonu Ogbonnaya Ogbu Friday Onwe Chima Edoga 《Online Journal of Public Health Informatics》2015,7(2)
Background
In Nigeria, one of the major challenges associated with evidence-to-policy link in the control of infectious diseases of poverty (IDP), is deficient information literacy knowledge and skill among policymakers. There is need for policymakers to acquire the skill to discover relevant information, accurately evaluate retrieved information and to apply it correctly.Objectives
To use information literacy tool of International Network for Availability of Scientific Publications (INASP) to enhance policymakers'' knowledge and skill for policymaking on control of IDP in Nigeria.Methods
Modified "before and after" intervention study design was used in which outcomes were measured on target participants both before the intervention is implemented and after. This study was conducted in Ebonyi State, south-eastern Nigeria and participants were career health policy makers. A two-day health-policy information literacy training workshop was organized to enhance participants" information literacy capacity. Topics covered included: introduction to information literacy; defining information problem; searching for information online; evaluating information; science information; knowledge sharing interviews; and training skills.Results
A total of 52 policymakers attended the workshop. The pre-workshop mean rating (MNR) of knowledge and capacity for information literacy ranged from 2.15-2.97, while the post-workshop MNR ranged from 3.34-3.64 on 4-point scale. The percentage increase in MNR of knowledge and capacity at the end of the workshop ranged from 22.6%-55.3%.Conclusion
The results of this study suggest that through information literacy training workshop policy makers can acquire the knowledge and skill to identify, capture and share the right kind of information in the right contexts to influence relevant action or a policy decision. 相似文献66.
Jeffrey
L. Moran Anton L. Cottrill Jesse D. Benck Pingwei Liu Zhe Yuan Michael S. Strano Jacopo Buongiorno 《RSC advances》2018,8(38):21389
Closed-cell foams are widely applied as insulation and essential for the thermal management of protective garments for extreme environments. In this work, we develop and demonstrate a strategy for drastically reducing the thermal conductivity of a flexible, closed-cell polychloroprene foam to 0.031 ± 0.002 W m−1 K−1, approaching values of an air gap (0.027 W m−1 K−1) for an extended period of time (>10 hours), within a material capable of textile processing. Ultra-insulating neoprene materials are synthesized using high-pressure processing at 243 kPa in a high-molecular-weight gas environment, such as Ar, Kr, or Xe. A Fickian diffusion model describes both the mass infusion and thermal conductivity reduction of the foam as a function of processing time, predicting a 24–72 hour required exposure time for full charging of a 6 mm thick 5 cm diameter neoprene sample. These results enable waterproof textile insulation that approximates a wearable air gap. We demonstrate a wetsuit made of ultra-low thermally conductive neoprene capable of potentially extending dive times to 2–3 hours in water below 10 °C, compared with <1 hour for the state-of-the-art. This work introduces the prospect of effectively wearing a flexible air gap for thermal protection in harsh environments.Herein, we develop, demonstrate, and model a repeatable process for synthesizing ultra-low-thermal-conductivity closed-cell neoprene garments by infusing high-molecular-weight noble gases. 相似文献
67.
Jay C. Buckey Abigail M. Fellows Odile H. Clavier Lindsay V. Allen Chris A. Brooks Jesse A. Norris Jiang Gui Deanna K. Meinke 《Noise & health》2015,17(78):263-272
Distortion product otoacoustic emission (DPOAE) level mapping provides a comprehensive picture of cochlear responses over a range of DP frequencies and f2/f1 ratios. We hypothesized that individuals exposed to high-level sound would show changes detectable by DPOAE mapping, but not apparent on a standard DP-gram. Thirteen normal hearing subjects were studied before and after attending music concerts. Pure-tone audiometry (500-8,000 Hz), DP-grams (0.3-10 kHz) at 1.22 ratio, and DPOAE level maps were collected prior to, as soon as possible after, and the day after the concerts. All maps covered the range of 2,000-6,000 Hz in DP frequency and from 1.3 to -1.3 in ratio using equi-level primary tone stimuli. Changes in the pure-tone audiogram were significant (P ≤ 0.01) immediately after the concert at 1,000 Hz, 4,000 Hz, and 6,000 Hz. The DP-gram showed significant differences only at f2 = 4,066 (P = 0.01) and f2 = 4,348 (P = 0.04). The postconcert changes were readily apparent both visually and statistically (P ≤ 0.01) on the mean DP level maps, and remained statistically significantly different from baseline the day after noise exposure although no significant changes from baseline were seen on the DP-gram or audiogram the day after exposure. Although both the DP-gram and audiogram showed recovery by the next day, the average DPOAE level maps remained significantly different from baseline. The mapping data showed changes in the cochlea that were not detected from the DP-gram obtained at a single ratio. DPOAE level mapping provides comprehensive information on subtle cochlear responses, which may offer advantages for studying and tracking noise-induced hearing loss (NIHL). 相似文献
68.
Rebecca E. Conway Camilo Rojas Jesse Alt Zora Nováková Spencer M. Richardson Tori C. Rodrick Julio L. Fuentes Noah H. Richardson Jonathan Attalla Samantha Stewart Beshoy Fahmy Cyril Barinka Mallika Ghosh Linda H. Shapiro Barbara S. Slusher 《Angiogenesis》2016,19(4):487-500
Prostate-specific membrane antigen (PSMA) is a membrane-bound glutamate carboxypeptidase expressed in a number of tissues. PSMA participates in various biological functions depending on the substrate available in the particular tissue; in the brain, PSMA cleaves the abundant neuropeptide N-acetyl-aspartyl-glutamate to regulate release of key neurotransmitters, while intestinal PSMA cleaves polyglutamated peptides to supply dietary folate. PSMA expression is also progressively upregulated in prostate cancer where it correlates with tumor progression as well as in tumor vasculature, where it regulates angiogenesis. The previous research determined that PSMA cleavage of small peptides generated via matrix metalloprotease-mediated proteolysis of the extracellular matrix protein laminin potently activated endothelial cells, integrin signaling and angiogenesis, although the specific peptide substrates were not identified. Herein, using enzymatic analyses and LC/MS, we unequivocally demonstrate that several laminin-derived peptides containing carboxy-terminal glutamate moieties (LQE, IEE, LNE) are bona fide substrates for PSMA. Subsequently, the peptide products were tested for their effects on angiogenesis in various models. We report that LQ, the dipeptide product of PSMA cleavage of LQE, efficiently activates endothelial cells in vitro and enhances angiogenesis in vivo. Importantly, LQE is not cleaved by an inactive PSMA enzyme containing an active site mutation (E424S). Endothelial cell activation by LQ was dependent on integrin beta-1-induced activation of focal adhesion kinase. These results characterize a novel PSMA substrate, provide a functional rationale for the upregulation of PSMA in cancer cells and tumor vasculature and suggest that inhibition of PSMA could lead to the development of new angiogenic therapies. 相似文献
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