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C Tribouilloy V Ruiz R Roudaut JC Eicher B Denis JR Lusson JL Rey JL Schmit JP Lesbre 《Canadian Metallurgical Quarterly》1996,25(28):1276-1280
OBJECTIVES: Identify factors predicting favorable outcome after medical management of valve ring abscesses in order to propose a surveillance schedule for conservative treatment. METHODS: A multicentric study conducted from July 1989 to February 1996 included 28 patients (mean age 64 +/- 16 years, range 26-83) hospitalized for active endocarditis and valve ring abscesses diagnosed at transthoracic or transesophageal echography. Conservative medical therapy was given because of a decision of the medico-surgical team (n = 9), high surgical risk (n = 12), or patient refusal of surgery (n = 7). Outcome was favourable in 18 patients (Group I) and unfavorable in 10 (Group II) due to death (n = 9) or subsequent surgery (n = 1). Univariate and multivariate analysis were used to determine differences between the groups in terms of clinical and laboratory data. RESULTS: Mean follow-up in Group I was 33 +/- 18 months and 15 +/- 10 months in Group II. Univariate analysis showed significant differences between Group I and II respectively for age (59 +/- 18 yr vs 72 +/- 10, p = 0.04), delay to apyrexia after antibiotics (4.3 +/- 2.8 vs 8.3 +/- 2.4 days, p < 0.0008), heart failure (5% vs 70%, p = 0.003), grade III or IV valvular regurgitation (5% vs 60%, p < 0.04), and mean surface area of the abscess (1.5 +/- 1.2 vs 5.4 +/- 6.4 cm2, p < 0.03). Independent factors at multivariate analysis were by decreasing order: lack of heart failure at admission, delay to apyrexia, abscess surface area, and age. Outcome was favorable (mean follow-up 33 +/- 10 months) in all patients with an abscess surface area < 1.5 cm2, no signs of heart failure, no grade III or IV valvular regurgitation, apyrexia after less than 8 days on antibiotics and no staphylococcus positive blood culture. CONCLUSION: Medical management of valve ring abscesses may be indicated in selected patients in care units with rigorous surveillance facilities. Further studies are needed to precisely identify surveillance and treatment criteria. 相似文献
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A review of robust design methods for multiple responses 总被引:1,自引:0,他引:1
Terrence E. Murphy Kwok-Leung Tsui Janet K. Allen 《Research in Engineering Design》2005,16(3):118-132
Problems in engineering design often involve determining design variable settings to optimize individual product performance
for multiple criteria, which are often in conflict. We review mathematically rigorous techniques from the statistical literature
for finding a vector x of design variable settings, which produces an optimal compromise solution among a group of prioritized response variables.
The best compromise solution is typically gained by optimizing an objective function, which incorporates the prioritized demands
of multiple responses. Since most multi-response objective functions are constructed by combining the functions used to optimize
univariate responses, a review of the prominent univariate approaches is presented first. A multivariate approach from the
engineering literature called the compromise Decision Support Problem is also reviewed. Finally a table comparing the relative
merits of the different multivariate approaches summarizes the article in a concise and user-friendly fashion. 相似文献
25.
Lists of core competencies or critical capabilities are popular and plentiful. This article makes the case that a single core competency or critical capability accounts for professional success: the exercise of judgment. Judgment is the critical determinant of the quality of professional decisions, actions, and evaluations. Practical models of judgment are presented. The elements and dynamics of judgment are detailed. Individual, group, and organization implications are explored. Coaching and consulting interventions are explained. (PsycINFO Database Record (c) 2010 APA, all rights reserved) 相似文献
26.
Robert H. Doremus Denis Murphy Narottam P. Bansal William A. Lanford Chandra Burman 《Journal of Materials Science》1985,20(12):4445-4453
When liquid water contacts a zirconium-barium-lanthanum fluoride glass, at least three different processes occur. Barium and zirconium fluoride dissolve into the water, water penetrates into the glass, and zirconium fluoride crystals grow on the glass surface, in static solution. The rate of dissolution, as measured by solution analysis, is possibly controlled by diffusion in the solid surface; surface blockage and surface reactions are other possible kinetic steps involved. Diffusion in solution is not the controlling mechanism. Hydrogen profiles in the glass surface suggest that the penetration rate of water into the glass is controlled by diffusion and a surface reaction. 相似文献
27.
Collage grammars are context-free devices which generate picture languages consisting of collages—sets of parts, where a part is a set of points in a given space. In order to show that certain collage languages cannot be generated, the well-known pumping technique turns out to be rather useless. To circumvent this difficulty, other necessary criteria for context-freeness are established in this paper. Roughly speaking, these criteria reveal that (1) the collages in a context-free collage language can be deflated stepwise in such a manner that the difference between subsequent collages in the resulting chain is small and (2) the volume of parts can grow or shrink only exponentially. 相似文献
28.
O'Farrell Timothy J.; Fals-Stewart William; Murphy Marie; Murphy Christopher M. 《Canadian Metallurgical Quarterly》2003,71(1):92
This study examined partner violence in the year before and the year after individually based, outpatient alcoholism treatment for 301 married or cohabiting male alcoholic patients and used a demographically matched nonalcoholic comparison sample. In the year before treatment, 56% of the alcoholic patients had been violent toward their female partner, 4 times the rate of 14% in the comparison sample. In the year after treatment, violence decreased significantly to 25% of the alcoholic sample but remained higher than in the comparison group. Among remitted alcoholics after treatment, violence prevalence of 15% was nearly identical to the comparison sample and half the rate among relapsed patients (32%). Thus, partner violence decreased after alcoholism treatment, and clinically significant violence reductions occurred for patients whose alcoholism was remitted after treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved) 相似文献
29.
Bandura Albert; O'Leary Ann; Taylor C. Barr; Gauthier Janel; Gossard Denis 《Canadian Metallurgical Quarterly》1987,53(3):563
In this experiment, we tested for opioid and nonopioid mechanisms of pain control through cognitive means and the relation of opioid involvement to perceived coping efficacy. Subjects were taught cognitive methods of pain control, were administered a placebo, or received no intervention. Their pain tolerance was then measured at periodic intervals after they were administered either a saline solution or naloxone, an opiate antagonist that blocks the effects of endogenous opiates. Training in cognitive control strengthened perceived self-efficacy both to withstand and to reduce pain; placebo medication enhanced perceived efficacy to withstand pain but not reductive efficacy; and neither form of perceived self-efficacy changed without any intervention. Regardless of condition, the stronger the perceived self-efficacy to withstand pain, the longer subjects endured mounting pain stimulation. The findings provide evidence that attenuation of the impact of pain stimulation through cognitive control is mediated by both opioid and nonopioid mechanisms. (PsycINFO Database Record (c) 2010 APA, all rights reserved) 相似文献
30.
Myers Mark G.; MacPherson Laura; McCarthy Denis M.; Brown Sandra A. 《Canadian Metallurgical Quarterly》2003,15(2):163
The goal of the present studies was to construct and validate a short form of the 50-item Smoking Consequences Questionnaire (SCQ; T. H. Brandon & T. B. Baker, 1991), a measure of smoking outcome expectancies. In Study 1, a 21-item short form (S-SCQ) was derived from a sample of 107 young adults previously treated for substance abuse. In Study 2, the measure was cross-validated on 125 adolescents in treatment for substance abuse. Confirmatory factor analyses revealed good model fit and factorial invariance for the 4 S-SCQ subscales across both samples. Validation analyses on each sample found that subscale scores generally correlated significantly with smoking-related variables. The present studies provide initial evidence for the utility of the S-SCQ when used with young adults and adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved) 相似文献