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| 1 | 影响卒中死亡率下降的因素美国心脏协会/美国卒中协会的科学声明显示文摘背景和目的 美国的卒中死亡率自20世纪初以来一直呈下降趋势,尽管这种“下降”很受欢迎,但其原因尚不完全清楚.由于近年来卒中死亡率呈现出更为显著的加速下降趋势,卒中已从美国的第3位死亡原因下降至第4位.这促使人们对影响卒中发病风险和死亡率变化的相关因素进行详细评估.这份声明对有关卒中死亡率下降趋势的促进因素的研究证据进行回顾,并讨论了将来如何利用这些因素在卒中这一重大公共卫生问题的干预研究中发挥作用.方法 写作组成员由委员会主席和副主席根据其以前在相关领域的研究成果提名,并通过美国心脏协会(American Heart Association,AHA)卒中委员会的科学声明监督委员会和美国心脏协会手稿监督委员会批准.作者利用系统文献综述,参考公开发表的临床和流行病学研究、发病率和死亡率报告、临床与公共卫生指南、权威声明、个人文件以及专家意见,对相关证据进行总结并指出与当前知识水平的差距.所有写作组成员均有机会评论这份声明并批准其最终版本.这份声明经过AHA内部的广泛同行评议以及卒中委员会领导阶层和科学声明监督委员会的审查,然后获得AHA科学顾问与协调委员会的批准.结果 过去数十年间,在不同性别、所有种族/民族以及各个年龄组人群中都观察到卒中死亡率的下降,这体现出人群健康的重大进展.除了卒中对于总体寿命损失的影响减少外,在65岁以下人群中观察到的卒中死亡率显著下降体现了其所致潜在寿命损失年的减少.卒中死亡率的下降要归功于卒中发病率和病死率的降低.这些卒中转归的显著改善与心血管危险因素的控制和干预相一致.虽然很难计算出具体的归因危险度估计值,但始于20世纪70年代的血压控制措施似乎已对卒中死亡率的加速下降产生了最实质性的影响.尽管实施较晚,但糖尿病和血脂异常控制以及戒烟计划,特别是联合降压治疗,似乎同样促进了卒中死亡率的下降.远程医疗和卒中医疗体系也似乎具有强烈的潜在作用,但尚需足够长的时间来证明其对卒中死亡率下降的影响.其他因素也可能产生影响,但需要更多的研究来确定它们的作用.结论 卒中死亡率的下降是真实存在的,代表着公共卫生以及临床医学的巨大成功.卒中从第3位死亡原因下降至第4位是死亡率真实下降的结果,而并非由于慢性肺病死亡率上升所致,后者是目前在美国是第3位的死亡原因.有强烈的证据表明,卒中死亡率的下降可归功于以科学发现为基础、旨在降低卒中风险而执行的联合干预措施和项目,其中最有可能的是对高血压控制的改善.因此,对正在开展的干预项目进行的研究及其成果的应用已改善了人群健康.对一些积极的循证公共卫生项目以及临床干预措施的持续应用预期会进一步降低卒中死亡率. | Daniel T.Lackland Edward J.Roccella Anne F.Deutsch Myriam Fornage Mary G.George George Howard Brett M.Kissela Steven J.Kittner Judith H.Lichtman Lynda D. Lisabeth Lee H. Schwamm Eric E. Smith 高一鹭 陈政弘 王文志 | 2014 | 国际脑血管病杂志2014，22，5： | 41 |
| 2 | Methylation-dependent loss of RIP3 expression in cancer represses programmed necrosis in response to chemotherapeutics显示文摘交往受体的蛋白质 kinase-3 (RIP3 或 RIPK3 ) 是执行 “ 的细胞的机械的必要部分; programmed”或 “ regulated”坏死。这里,我们证明那规划坏死响应许多化学疗法的代理人被激活并且贡献导致化疗的房间死亡。然而,我们证明那 RIP3 表情经常在化学疗法的死亡期间由于它的 transcriptional 开始地点, MLKL 的这样 RIP3 依赖的激活和下游地规划的坏死附近的 genomic methylation 是在癌症房间的 silenced 大部分被镇压。不过,有 hypomethylating 代理人的治疗恢复 RIP3 表示,并且从而以一种 RIP3 依赖的方式把敏感提升到 chemotherapeutics。RIP3 表示在 85% 乳癌病人与正常织物相比在肿瘤被减少,建议那 RIP3 缺乏断然在肿瘤生长 / 发展期间被选择。因为 hypomethylating 代理人在病人是相当容忍得好的,我们建议病人们可以从收到 hypomethylating 代理人与常规 chemotherapeutics 在治疗以前导致 RIP3 表示有益于的那 RIP3 缺乏的癌症。 | Gi-Bang Koo Michael J Morgan Da-Gyum Lee Woo-Jung Kim Jung-Ho Yoon Ja Seung Koo Seung I1 Kim Soo Jung Kim Mi Kwon Son Soon Still Hong Jean M Mulcahy Levy Daniel A Pollyea Craig T Jordan Pearlly Yan David Frankhouser Deedra Nicolet Kati Maharry Guido Marcucci Kyeong Sook Choi Hyeseong Cho ndrew Thorbum You-Sun Kim | 2015 | Cell Research2015，25，6： | 20 |
| 3 | Analysis of Autopilot Disengagements Occurring During Autonomous Vehicle Testing显示文摘In present-day highly-automated vehicles, there are occasions when the driving system disengages and the human driver is required to take-over. This is of great importance to a vehicle's safety and ride comfort. In the U.S state of California, the Autonomous Vehicle Testing Regulations require every manufacturer testing autonomous vehicles on public roads to submit an annual report summarizing the disengagements of the technology experienced during testing. On 1 January 2016,seven manufacturers submitted their first disengagement reports:Bosch, Delphi, Google, Nissan, Mercedes-Benz, Volkswagen, and Tesla Motors. This work analyses the data from these disengagement reports with the aim of gaining abetter understanding of the situations in which a driver is required to takeover, as this is potentially useful in improving the Society of Automotive Engineers(SAE) Level 2 and Level 3 automation technologies.Disengagement events from testing are classified into different groups based on attributes and the causes of disengagement are investigated and compared in detail. The mechanisms and time taken for take-over transition occurred in disengagements are studied. Finally, recommendations for OEMs, manufacturers, and government organizations are also discussed. | Chen Lv Dongpu Cao Yifan Zhao Daniel J. Auger Mark Sullman Huaji Wang Laura Millen Dutka Lee Skrypchuk Alexandros Mouzakitis | 2018 | IEEE/CAA Journal of Automatica Sinica2018，5，1： | 15 |
| 4 | Switchgrass as a bioenergy crop in the Loess Plateau, China:Potential lignocellulosic feedstock production and environmental conservation显示文摘A large portion of the Loess Plateau of China is characterized as 'marginal' with serious land degradation and desertification problems. Consequently, two policies, Grain for Green and Western Development Action were established by the Chinese government in response to the demand for ecological protection and economic development in the Loess Plateau. These policies are designed to increase forest cover, expand farmlands, and enhance soil and water conservation, while creating sustainable vegetation restoration. Perennial grasses have gained attention as bioenergy feedstocks due to their high biomass yields, low inputs, and greater ecosystem services compared to annual crops. Moreover, perennial grasses limit nutrient runoff and reduce greenhouse gas emissions and soil losses while sequestering carbon. Additionally, perennial grasses can generate economic returns for local farmers through producing bioenergy feedstock or forage on marginal lands. Here, we suggest a United States model energy crop, switchgrass(Panicum virgatum L.) as a model crop to minimize land degradation and desertification and to generate biomass for energy on the Loess Plateau. | Danielle Cooney Hyemi Kim Lauren Quinn Moon-Sub Lee Jia Guo CHEN Shao-lin XU Bing-cheng D.K.Lee | 2017 | Journal of Integrative Agriculture2017，16，6： | 12 |
| 5 | Advances in surgical management for locally recurrent rectal cancer: How far have we come?显示文摘Locally recurrent rectal cancer(LRRC) is a complex disease with far-reaching implications for the patient. Until recently, research was limited regarding surgical techniques that can increase the ability to perform an en bloc resection with negative margins. This has changed in recent years and therefore outcomes for these patients have improved. Novel radical techniques and adjuncts allow for more radical resections thereby improving the chance of negative resection margins and outcomes. In the past contraindications to surgery included anterior involvement of the pubic bone, sacral invasions above the level of S2/S3 and lateral pelvic wall involvement. However, current data suggests that previously unresectable cases may now be feasible with novel techniques, surgical approaches and reconstructive surgery. The publications to date have only reported small patient pools with the research conducted by highly specialised units. Moreover, the short and long-term oncological outcomes are currently under review. Therefore although surgical options for LRRC have expanded significantly, one should balance the treatment choices available against the morbidity associated with the procedure and select the right patient for it. | Daniel Jin-Keat Lee Peter M Sagar Gaitri Sadadcharam Kok-Yang Tan | 2017 | World Journal of Gastroenterology2017，23，23： | 12 |
| 6 | Ubiquitylation of p62/sequestosome1 activates its autophagy receptor function and controls selective autophagy upon ubiquitin stress显示文摘在细胞的 ubiquitin (Ub ) 的改变动态平衡,作为 Ub 知道强调,展示并且影响处于多重条件的细胞的回答,然而,内在的机制不完全地被理解。这里,我们报导 autophagy 受体 p62/sequestosome-1 与结合酶, UBE2D2 和 UBE2D3 的 E2 Ub 交往。内长的 p62 在 Ub 动态平衡的 upregulation 期间经历 E2 依赖的 ubiquitylation,一个条件作为 Ub + 应力称为,那对由 bortezomib 的 Ub overexpression,热吃惊或延长 proteasomal 抑制内在,化学疗法的药。p62 的 Ubiquitylation 破坏 p62 的 UBA 领域的 dimerization,解放它的能力认出为选择 autophagy 的 polyubiquitylated 货物。我们进一步证明这机制可能为在 Ub + 压力条件之上的 autophagy 激活是批评的。机制的描述和在察觉到 Ub 应力并且控制选择 autophagy 的 p62 的规章的角色能帮助理解并且调制细胞的回答到许多内长、环境的挑战,潜在地对 autophagy 相关的病为治疗学的策略的发展打开一条新大街。 | Hong Peng Jiao Yang Guangyi Li Qing You Wen Han Tianrang Li Darning Gao Xiaoduo Xie Byung-Hoon Lee Juan Du Jian Hou Tao Zhang Hai Rao Ying Huang Qinrun Li Rong Zeng Lijian Hui Hongyan Wang Qin Xia Xuemin Zhang Yongning He Masaaki Komatsu Ivan Dikic Daniel Finley Ronggui Hu | 2017 | Cell Research2017，27，5： | 9 |
| 7 | Nano-Structured Carbide-Derived Carbon Films and Their Tribology显示文摘Carbide-derived carbon (CDC) is a form of carbon produced by reacting metal carbides, such as SiC or TiC, with halogens at temperatures high enough to produce fast kinetics, but too low to permit the re- arrangement of the carbon atoms into an equilibrium graphitic structure. The structure of CDC is derivative of the original carbide structure and contains nanoscale porosity and both sp2 and sp3 bonded carbon in a variety of nanoscale structures. CDC can be produced as a thin film on hard carbides to improve their tri- bological performance. CDC coatings are distinguished by their low friction coefficients and high wear resis- tance in many important industrial environments and by their resistance to spallation and delamination. The tribology of CDC coatings on SiC surfaces is described in detail. | Michael McNallan Daniel Ersoy Ranyi Zhu Allen Lee Christopher White Sascha Welz Yury Gogotsi Ali Erdemir Andriy Kovalchenko | 2005 | Tsinghua Science and Technology2005，10，6： | 6 |
| 8 | Targeted Blue Nanoparticles as Photoacoustic Contrast Agent for Brain Tumor Delineation显示文摘把一个肿瘤与非肿瘤的组织区分开来在癌症外科期间是一项挑战性的任务。几次尝试被做了使用可见或荧光灯的代理人在外科期间帮助一个肿瘤的可视化。我们描述一个新奇方法描出大脑肿瘤,用一种高度敏感的 photoacoustic 成像技术,那被用作一个对比代理人的指向肿瘤的蓝 nanoparticles 提高。幽灵并且在老鼠大脑上的实验,前 vivo,在描出表明 photoacoustic 成像的高敏感在集中包含对比代理人的肿瘤很比由肉眼为可视化需要降低。为 nanoparticles 的系统的察觉的限制是水(到 0.84 mol/L Coomassie 蓝染料的等价物) 里的大约 0.77 g/mL。当与强烈光的吸收对比代理人使用了时,现在的探索学习建议那 photoacoustic 成像,能由揭示肿瘤的分发和程度 intraoperatively 便于癌症外科。 | Aniruddha Ray Xueding Wang Yong-Eun Koo Lee Hoe Jin Hah Gwangseong Kim Thomas Chen Daniel A. Orringer Oren Sagher Xiaojun Liu Raoul Kopelman | 2011 | Nano Research2011，4，11： | 5 |
| 9 | 脑海绵状血管畸形临床诊疗指南概要:血管瘤联盟科学咨询委员会临床专家组基于系统文献评价的共识推荐显示文摘背景尽管脑海绵状血管畸形(cerebral cavernous malformation, CCM)的相关研究文献已相当丰富,但在诊断和治疗策略方面仍存在着争议。目的制订CCM诊疗指南。方法作为代表CCM患者和研究的患者支持团体,血管瘤联盟(www.angioma.org)召集了一个包括CCM临床专家在内的多学科写作组来帮助总结现有的CCM临床诊疗相关文献,重点关注5个主题:(1)流行病学和自然病程;(2)遗传检测和咨询;(3)诊断标准和影像学标准;(4)神经外科注意事项;(5)神经内科注意事项。写作组根据预定方案进行了文献回顾和证据评价,最终制定推荐意见,并且确立了共识、争议和知识空白。结果根据方法学标准从1983年1月1日至2014年9月31日期间公开发表的1 270篇文献中筛选出98篇,并确定了另外38篇近期或相关的文献。各主题作者利用这些文献总结了现有知识并形成了23项共识诊疗推荐,同时根据美国心脏协会/美国卒中协会标准进行了推荐强度(效应量)和证据水平(确定性估计)评级。其中,尚无A级证据(因为缺乏随机对照试验),B级证据11项(48%),C级证据12项(52%);Ⅰ级推荐8项(35%),Ⅱ级推荐10项(43%),Ⅲ级推荐5项(22%)。结论现有证据支持对CCM诊疗的推荐,但这些证据的级别和推荐强度普遍较低,因此需要进一步研究来帮助进行更好的临床实践并更新这些推荐。完整的推荐文档包括引用文献的纳入标准、关于各项推荐更详尽的评判标准以及各种争议和知识空白的总结,同样通过了同行评议并可在线获取(www.angioma.org/CCMGuidelines)。 | Amy Akers Rustam Al-Shahi Salman Issam A. Awad Kristen Dahlem Kelly Flemming Blaine Hart Helen Kim Ignacio Jusue-Torres Douglas Kondziolka Cornelia Lee Leslie Morrison Daniele Rigamonti Tania Rebeiz Elisabeth Toumier-Lasserve Darrel Waggoner Kevin Whitehead 鄂同舟 雷宇 倪伟 顾宇翔 | 2017 | 国际脑血管病杂志2017，25，7： | 4 |
| 10 | A hierarchical indexing strategy for optimizing Apache Spark with HDFS to efficiently query big geospatial raster data显示文摘Earth observations and model simulations are generating big multidimensional array-based raster data.However,it is difficult to efficiently query these big raster data due to the inconsistency among the geospatial raster data model,distributed physical data storage model,and the data pipeline in distributed computing frameworks.To efficiently process big geospatial data,this paper proposes a three-layer hierarchical indexing strategy to optimize Apache Spark with Hadoop Distributed File System(HDFS)from the following aspects:(1)improve I/O efficiency by adopting the chunking data structure;(2)keep the workload balance and high data locality by building the global index(k-d tree);(3)enable Spark and HDFS to natively support geospatial raster data formats(e.g.,HDF4,NetCDF4,GeoTiff)by building the local index(hash table);(4)index the in-memory data to further improve geospatial data queries;(5)develop a data repartition strategy to tune the query parallelism while keeping high data locality.The above strategies are implemented by developing the customized RDDs,and evaluated by comparing the performance with that of Spark SQL and SciSpark.The proposed indexing strategy can be applied to other distributed frameworks or cloud-based computing systems to natively support big geospatial data query with high efficiency. | Fei Hu Chaowei Yang Yongyao Jiang Yun Li Weiwei Song Daniel Q.Duffy John L.Schnase Tsengdar Lee | 2020 | International Journal of Digital Earth2020，13，3： | 4 |
| 11 | Campylobacter concisus and inflammatory bowel disease显示文摘Investigation of the possible role of Campylobacter concisus(C. concisus) in inflammatory bowel disease(IBD) is an emerging research area. Despite the association found between C. concisus and IBD, it has been difficult to explain how C. concisus, a bacterium that is commonly present in the human oral cavity, may contribute to the development of enteric diseases. The evidence presented in this review shows that some C. concisus strains in the oral cavity acquired zonula occludens toxin(zot) gene from a virus(prophage) and that C. concisus Zot shares conserved motifs with both Vibrio cholerae Zot receptor binding domain and human zonulin receptor binding domain. Both Vibrio cholerae Zot and human zonulin are known to increase intestinal permeability by affecting the tight junctions. Increased intestinal permeability is a feature of IBD. Based on these data, we propose that a primary barrier function defect caused by C. concisus Zot is a mechanism by which zot-positive C. concisus strains may trigger the onset and relapse of IBD. | Li Zhang Hoyul Lee Michael C Grimm Stephen M Riordan Andrew S Day Daniel A Lemberg | 2014 | World Journal of Gastroenterology2014，20，5： | 4 |
| 12 | Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure显示文摘 | Aram V. Chobanian George L. Bakris Henry R. Black William C. Cushman Lee A. Green Joseph L. Izzo Daniel W. Jones Barry J. Materson Suzanne Oparil Jackson T. Wright Edward J. Roccella | 2003 | Hypertension: Journal of The American Heart Association2003，，6： | 4 |
| 13 | To stay or to leave: Stem cells and progenitor cells navigating the S1P gradient显示文摘Most hematopoietic stem progenitor cells (HSPCs) reside in bone marrow (BM), but a small amount of HSPCs have been found to circulate between BM and tissues through blood and lymph. Several lines of evidence suggest that sphingosine-1-phosphate (S1P) gradient triggers HSPC egression to blood circulation after mobilization from BM stem cell niches. Stem cells also visit certain tissues. After a temporary 36 h short stay in local tissues, HSPCs go to lymph in response to S1P gradient between lymph and tissue and eventually enter the blood circulation. S1P also has a role in the guidance of the primitive HSPCs homing to BM in vivo, as S1P analogue FTY720 treatment can improve HSPC BM homing and engraftment. In stress conditions, various stem cells or progenitor cells can be attracted to local injured tissues and participate in local tissue cell differentiation and tissue rebuilding through modulation the expression level of S1P1, S1P2 or S1P3 receptors. Hence, S1P is important for stem cells circulation in blood system to accomplish its role in body surveillance and injury recovery. | Andrew Hsu Jen-Fu Lee Daniel E Cramer Menq-Jer Lee | 2011 | World Journal of Biological Chemistry2011，2，1： | 3 |
| 14 | 哮喘治疗的新进展显示文摘没有强有力的循证医学证据表明饮食方法或Buteyko技术对哮喘的临床管理有很大益处需要进一步研究确定当哮喘控制欠佳时患者应该怎么做小剂量吸入皮质激素可以和长效β2激动剂联合应用,以提供安全有效的哮喘控制静脉镁制剂和白三烯受体拮抗剂对急性哮喘可能具有一些作用,但仍需进一步评价将来哮喘治疗是否能得到炎症生物标志或患者基因型认识的帮助。 | Graeme P Currie Graham S Devereux Daniel K C Lee Jon G Ayres 刘艳(译) 代华平(校) | 2005 | 英国医学杂志中文版2005，8，4： | 3 |
| 15 | The Cost-Effectiveness of Neoadjuvant Chemoradiation is Superior to a Surgery-First Approach in the Treatment of Pancreatic Head Adenocarcinoma显示文摘 | Daniel E. Abbott Ching-Wei David Tzeng Ryan P. Merkow Scott B. Cantor George J. Chang Matthew Harold Katz David J. Bentrem Karl Y. Bilimoria Christopher H. Crane Gauri R. Varadhachary James L. Abbruzzese Robert A. Wolff Jeffrey E. Lee Douglas B. Evans Jas | 2013 | Annals of Surgical Oncology2013，，3： | 3 |
| 16 | RANKL/RANK control Brca1 mutation-driven mammary tumors显示文摘 | Verena Sig Kwadwo Owusu-Boaitey Puma A Joshi Anoop Kavirayani Gerald Wimsberger Maria Novatchkova Ivona Kozieradzki Daniel Schramek Nnamdi Edokobi Jerome Hersl Aishia Sampson Ashley Odai-Afotey Conxi Lazaro Eva Gonzalez-Suarez Miguel A Pujaaa for CIMBA Holger Heyn Enrique Vidal Jennifer Cru. ickshank Hal Berman Renu Sarao Melita Tieevic Iris Uribesalgo Luigi Tortola Shuan Rao Yen Tan Georg Pfeiler Eva YHP Lee Zsuzsanna Bago-Horvath Lukas Kenner Helmuth Popper Christian Singer Rama Khokha LaundeRe P Jones Josef M Penninger | 2016 | Cell Research2016，26，7： | 3 |
| 17 | The Treatment-Naive Microbiome in New-Onset Crohn’s Disease显示文摘 | Dirk Gevers Subra Kugathasan Lee A. Denson Yoshiki Vázquez-Baeza Will Van Treuren Boyu Ren Emma Schwager Dan Knights Se Jin Song Moran Yassour Xochitl C. Morgan Aleksandar D. Kostic Chengwei Luo Antonio González Daniel McDonald Yael Haberman Thomas Walter | 2014 | Cell Host & Microbe2014，，： | 3 |
| 18 | 国际卒中遗传学联盟的推荐意见(第1部分):标准化表型数据收集显示文摘与几乎所有复杂疾病一样,卒中的患病风险和临床转归也是多基因作用的[1]。探索相关基因突变有望为新型个体化治疗方法奠定基础,从而显著减少卒中对全球健康造成的毁灭性影响。为了达到足够的统计学效能以确认多个风险性等位基因,需要很大的样本量。尽管卒中是全世界范围内第二大致死病因和成年人致残的主要原因[2],但没有任何一家研究机构能独立收集到足够的样本。在认识到这一挑战之后,来自世界各地的卒中研究者们于2007年成立了国际卒中遗传学联盟( International Stroke Genetics Consortium, ISGC; http://www. strokegenetics.org),其使命是通过研究在全球多个研究机构入组的患者来识别影响卒中患病风险、临床预后和治疗效果的遗传学因素。尽管先前已取得了一些成功[3-5],仍有大量工作有待进行,这不仅是为了发现风险性等位基因从而达到卒中个体化医疗的最终目标,更是为了开发综合性卒中风险评估手段以及得到足以改变临床实践的结果[6]。根据糖尿病和冠状动脉疾病等其他复杂疾病的研究进展,为了识别与卒中相关的所有基因突变,需要100000~200000个样本。为了达到这个样本量,需要进行更为广泛的协作。 | Jennifer J. Majersik John W.Cole Jonathan Golledge Natalia S. Rost Yu-Feng Yvonne Chan M. Edip Gurol Ame G. Lindgren Daniel Woo Israel Fernandez-Cadenas Donna T. Chen Vincent Thijs Bradford B. Worrall Ayeesha Kamal Paul Bentley Joanna M. Wardlaw Ynte M. Ruigrok Thomas W.K Battey Reinhold Schmidt Joan Montaner Anne-Katrin Giese Jaume Roquer Jordi Jimenez-Conde Chaeyoung Lee Hakan Ay Juan Jose Martin 李海峰 岳耀先 徐军 | 2015 | 国际脑血管病杂志2015，23，9： | 3 |
| 19 | 船用低速二冲程柴油机燃烧与排放数值模拟研究显示文摘使用CFD软件对一台船用低速二冲程柴油机额定工况点缸内喷雾、燃料着火和燃烧过程、排放物NOx浓度分布及生成总量进行了数值模拟研究。模拟所得压缩压力和最高燃烧压力与实测值基本一致。在额定工况点运行时,柴油机预混合燃烧比例很小,基本呈现单峰状的扩散燃烧特征;燃烧放热初始时刻在上止点附近,整个燃烧持续期约为45℃A。同时,计算所得的NOx生成总量与实测值存在19.15%的偏差。 | 张俊军 吴朝晖 胡朝霞 周涌明 李大保 杨志村 Yun Kang Daniel Lee | 2012 | 柴油机2012，34，2： | 3 |
| 20 | Emergency department rectal temperatures in over 10 years:A retrospective observational study显示文摘BACKGROUND:Fever in patients can provide an important clue to the etiology of a patient's symptoms.Non-invasive temperature sites(oral,axillary,temporal) may be insensitive due to a variety of factors.This has not been well studied in adult emergency department patients.To determine whether emergency department triage temperatures detected fever adequately when compared to a rectal temperature.METHODS:A retrospective chart review was made of 27 130 adult patients in a high volume,urban emergency department over an eight-year period who received first a non-rectal triage temperature and then a subsequent rectal temperature.RESULTS:The mean difference in temperatures between the initial temperature and the rectal temperature was 1.3 °F(P<0.001),with 25.9%of the patients having higher rectal temperatures >2°F,and 5.0%having higher rectal temperatures >4 °F.The mean difference among the patients who received oral,axillary,and temporal temperatures was 1.2 °F(PO.001),1.8 °F(PO.001),and 1.2 °F(P<0.001) respectively.About 18.1%of the patients were initially afebrile and found to be febrile by rectal temperature,with an average difference of 2.5 °F(P<0.001).These patients had a higher rate of admission(61.4%,P<0.005),and were more likely to be admitted to the hospital for a higher level of care,such as an intensive care unit,when compared with the full cohort(12.5%vs.5.8%,P<0.005).CONCLUSIONS:There are significant differences between rectal temperatures and noninvasive triage temperatures in this emergency department cohort.In almost one in five patients,fever was missed by triage temperature. | Graham A.Walker Daniel Runde Daniel M.Rolston Dan Wiener Jarone Lee | 2013 | World Journal of Emergency Medicine2013，4，2： | 2 |
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