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11.
STUDY OBJECTIVES: To determine the rates of alcohol-related morbidity and mortality in a cohort of intoxicated ED patients 5 years after presentation and to compare them with those of non-intoxicated ED patients. METHODS: The study group comprised 150 consecutive ED patients who presented with intoxication (blood alcohol level higher than 100 mg/dL) in June 1986 and 50 control patients matched for age, sex, ED arrival time, and date. The setting was an urban university hospital ED. Morbidity and mortality over a 5-year follow-up period were measured using hospital ED and admission records from all state Level I trauma centers and computerized statewide databases. RESULTS: The 5-year mortality rate among alcohol-intoxicated patients was 2.4 times that of the comparison group (95% confidence interval, .3 to 18.9). The 5-year death rate among intoxicated patients aged 40 to 69 years was especially high (19%). Thirty-seven percent of the intoxicated patients made at least one alcohol-related ED revisit during the follow-up period, compared with 6% of the comparison group (P < .001). Intoxicated patients were more likely to revisit EDs because of suicidal behavior or domestic violence (P = .001). Admission to an alcohol detoxification unit during the follow-up period occurred in 24% of the intoxicated patients, compared with 10% of the sober controls (P = .03). At least one arrest for drunk driving occurred in 47% of the intoxicated group; the rate was lower, but still substantial, in the comparison group (20%, P < .001). CONCLUSION: A single alcohol-related ED visit is an important predictor of continued problem drinking, alcohol-impaired driving and, possibly, premature death.  相似文献   
12.
This paper proposes an efficient method to develop requirement specifications for Plant Control Software (PCSW) using software-component-based prototypes. Prior to this proposal, domain analyses were conducted on existing PCSWs, and their functions were classified into “similar functions” and “individual functions”. Then PCSW Software Components (PSC: PCSW Software Component, PSCs: PCSW Software Components) were developed to correspond to these functions. PSCs as parameter-style components were developed in order to satisfy the clients’ (we define clients as owners, managers and operators of plants) requirements. A support environment for developing requirement specifications was developed. The environment consists of the Prototype Development Tool (PDT), the Behavior Check Simulator (BCS) and the Requirement Specification Development Tool (RSDT). The method consists of four steps. In the first step, PDT is used to define the parameters to customize PSCs and to compose a PCSW prototype by setting these parameters to PSCs. In the second step, BCS is used to execute the composed PCSW prototype and check its behavior and relevancy against the clients’ expectations. In the third step, steps 1 and 2 are repeated until the behavior of the PCSW prototype satisfies the clients’ requirements. Finally, a requirement specification is developed from the PCSW prototype which fully reflects the clients’ requirements. In order to evaluate the proposed method, it has been applied in five development cases. A Requirement Coverage of 91%, a Requirement Revision Rate of 6%, a PSC Reuse Rate of 92% and a LOC Reuse Rate of 83% have been achieved. In addition, a reduction of 55% in the amount of time required to develop requirement specifications has been achieved. These results indicate that the proposed method has sufficient capability to develop an exhaustive and an adequate PCSW requirement specification. And the developed PSCs have sufficient functions and capability to compose PCSW prototypes, and the support environment is capable of shortening the time taken to develop requirement specifications.  相似文献   
13.
In a fetal autopsy series, we have explored the occurrence of renal tubular dysgenesis in twins. Renal tubular dysgenesis was found exclusively among those monozygotic twins with evidence of twin transfusion syndrome, particularly in those donor twins with oligohydramnios and growth restriction. We infer that hypotension in the donor twin of the twin transfusion syndrome pair is responsible for the failure of proximal convoluted tubule differentiation, and the disturbance of renal function is manifested as oligohydramnios prenatally, and either oliguria or tubular dysfunction postnatally.  相似文献   
14.
BACKGROUND/PURPOSE: To develop practical and less invasive techniques for fetal endoscopic surgery, new methods of lifting the uterine wall to allow fetal surgery without maternal laparotomy were developed and assessed. METHODS: Fetal endoscopic surgical procedures, including tracheostomy and umbilical vascular cannulation, were performed using one of the three methods to enter the uterus without maternal laparotomy in pregnant goats (n = 6; 105 to 115 days' gestation): (1) direct uterine lifting with an air-cushion device; (2) indirect uterine lifting, in which the uterine wall was fixed to the maternal abdominal wall using balloon tip ports inserted percutaneously by Seldinger's method, then the maternal abdomen was lifted mechanically; and (3) combined method, in which low pressure CO2 (5 mm Hg for initial inflation and 2 mm Hg for maintenance) was insufflated into the uterus in addition to the indirect uterine lifting cited above. RESULTS: The direct uterine lifting caused massive injury of myometrium and uterine membranes. The creation of intrauterine space and the protection of the membranes were not accomplished effectively by the indirect uterine lifting only. The combined method provided the adequate intrauterine space and excellent endoscopic visibility for completion of the endoscopic procedures with minimal uterine injury. CONCLUSION: The fetal endoscopic surgery may be accomplished simply and safely by the combined method, a novel technique of uterine lifting to allow fetal surgery without maternal laparotomy.  相似文献   
15.
PURPOSE: To determine possible cognitive and behavioral effects of antiepileptic drug (AED) therapy by assessing children with newly diagnosed epilepsy before and after initiation of treatment. A comparison group of children with diabetes mellitus (DM) was included to control for the effects of practice, maturation, and chronic illness. METHODS: Baseline neuropsychological assessments were completed for children with epilepsy (n = 37) and children with DM (n = 26) recruited through outpatient clinics at a regional children's hospital. Children were reevaluated 6 months from baseline testing. At follow-up, children with epilepsy had therapeutic AED levels and controlled seizures. Statistical analysis included a between-group repeated measures ANCOVA with pretest scores serving as the covariate. RESULTS: Significant differences between groups were not found for any cognitive or behavioral factors, including attention (p < 0.24), immediate memory (p < 0.24), delayed memory (p < 0.10), complex motor speed (p < 0.19), or behavior problems (p < 0.89). CONCLUSIONS: Changes in performance on cognitive and behavioral measures were not different for children treated with AEDs and controls. Although adverse effects may be associated with prolonged treatment, results would not suggest adverse effects from AED monotherapy during the first 6 months of therapy.  相似文献   
16.
17.
SiC was infiltrated into a porous carbon or an SiC particulate preform from a gaseous system of 6% CH3SiCl3-H2 using a pulse chemical vapour infiltration apparatus and r.f. heating at 1273 to 1423 K. At 1273 K, the SiC matrix infiltrated the porous carbon initially to half the thickness of the substrate and finally over the full thickness. After 10000 pulses, three-point flexural strength saturated at about 120MPa. SiC particulate preform made from an average particle size of 4m was infiltrated by SiC. After 30000 pulses at 1273 K, the flexural strength of the composite increased to 200 to 220 M Pa.  相似文献   
18.

The efficiency of power dissipation (η) in a dynamic material model has been conventionally used for qualitative predictions to estimate the hot working conditions at which dynamic recrystallization (DRX) is dominant. However, predicting the quantitative value of the DRX fraction (XDRX) from η remains a challenge. In this paper, a constitutive equation is proposed to quantitatively predict XDRX using η. The proposed equation for describing XDRX is derived from the reaction rate equation using the assumption that the DRX rate depends on η. The proposed equation is verified via hot compression tests of equiaxed Ti–6Al–4V ELI alloys (Ti-64) in the (α + β) region. The predicted and experimental XDRX values are found to be generally consistent with one another, exhibiting an average absolute error of 0.05. Furthermore, the proposed equation provides the same level of prediction accuracy as the conventional Johnson–Mehl–Avrami–Kolmogorov (JMAK) equation. Therefore, the proposed equation can be used to quantitatively predict XDRX following hot compression tests of equiaxed Ti-64. Moreover, compared with the JMAK equation, the proposed equation is expressed in fewer parameters and constant terms. It is, thus, expected to facilitate the quantitative prediction of XDRX.

  相似文献   
19.
The hydrothermal stability of MCM-48 was conveniently and effectively improved by increasing the crystallization temperature and directly adding NaF to the synthesis gel. The crystallization temperature varied from 373 K to 403 K. The influences of NaF addition, crystallization temperature and crystallization time on the formation process and hydrothermal stability of MCM-48 were systematically studied here to solve the problem of poor reproducibility. Results from XRD patterns indicated that the crystallization temperature and crystallization time were very critical factors for the improvement of the hydrothermal stability besides NaF addition. The formation process of MCM-48 was significantly accelerated and the pore structure ordering was also greatly improved by increasing the crystallization temperature and F/Si ratio. A high hydrothermally stable MCM-48 mesoporous molecular sieve was obtained after being crystallized at 393 K for 36 h in the presence of NaF, which endured the hydrothermal treatment in boiling water at least for 4 days. However, only an amorphous product was obtained when the crystallization temperature was further increased to 403 K. Results from Si MAS NMR, N2 adsorption isotherms, TEM, Raman spectra and XRD patterns manifested that the improved stability of MCM-48 was attributed to the high silicates condensation degree and the excellent pore structure ordering. The possible reason for the successful formation of hydrothermally stable MCM-48 sample by controlling the crystallization temperature, time and F/Si ratio was explained here.  相似文献   
20.
Summary The synthesis of poly(-thiophenediyl)benzylidene (PTB) with high molecular weight is described. Number-average degrees of polymerization reached about 74. The characterizations of the polymer was investigated by 1H-NMR, 13C-NMR, IR, and UV-VIS spectra. The polymer with well-defined structure and high molecular weight was obtained by polymerization at low temperature and in polar solvent. This polymer was thermally stable and a thermal decomposition took place at 391°C under nitrogen and at 370°C under air. The glass transformation temperature was 117°C and this PTB was nonfusible.  相似文献   
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