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| 1 | Multimorbidity patterns and association with mortality in 0.5 million Chinese adults显示文摘Background:Few studies have assessed the relationship between multimorbidity patterns and mortality risk in the Chinese population.We aimed to identify multimorbidity patterns and examined the associations of multimorbidity patterns and the number of chronic diseases with the risk of mortality among Chinese middle-aged and older adults.Methods:We used data from the China Kadoorie Biobank and included 512,723 participants aged 30 to 79 years.Multimorbidity was defined as the presence of two or more of the 15 chronic diseases collected by self-report or physical examination at baseline.Multimorbidity patterns were identified using hierarchical cluster analysis.Cox regression was used to estimate the associations of multimorbidity patterns and the number of chronic diseases with all-cause and cause-specific mortality.Results:Overall,15.8%of participants had multimorbidity.The prevalence of multimorbidity increased with age and was higher in urban than rural participants.Four multimorbidity patterns were identified,including cardiometabolic multimorbidity(diabetes,coronary heart disease,stroke,and hypertension),respiratory multimorbidity(tuberculosis,asthma,and chronic obstructive pulmonary disease),gastrointestinal and hepatorenal multimorbidity(gallstone disease,chronic kidney disease,cirrhosis,peptic ulcer,and cancer),and mental and arthritis multimorbidity(neurasthenia,psychiatric disorder,and rheumatoid arthritis).During a median of 10.8 years of follow-up,49,371 deaths occurred.Compared with participants without multimorbidity,cardiometabolic multimorbidity(hazard ratios[HR]=2.20,95%confidence intervals[CI]:2.14-2.26)and respiratory multimorbidity(HR=2.13,95%CI:1.97-2.31)demonstrated relatively higher risks of mortality,followed by gastrointestinal and hepatorenal multimorbidity(HR=1.33,95%CI:1.22-1.46).The mortality risk increased by 36%(HR=1.36,95%CI:1.35-1.37)with every additional disease.Conclusion:Cardiometabolic multimorbidity and respiratory multimorbidity posed the highest threat on mortality risk and deserved particular attention in Chinese adults. | Junning Fan Zhijia Sun Canqing Yu Yu Guo Pei Pei Ling Yang Yiping Chen Huaidong Du Dianjianyi Sun Yuanjie Pang Jun Zhang Simon Gilbert Daniel Avery Junshi Chen Zhengming Chen Jun Lyu Liming Li On Behalf of the China Kadoorie Biobank Collaborative Group | 2022 | Chinese Medical Journal2022，，6： | 17 |
| 2 | Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit显示文摘 | Juliana Barr Gilles L. Fraser Kathleen Puntillo E. Wesley Ely Céline Gélinas Joseph F. Dasta Judy E. Davidson John W. Devlin John P. Kress Aaron M. Joffe Douglas B. Coursin Daniel L. Herr Avery Tung Bryce R. H. Robinson Dorrie K. Fontaine Michael A. Ramsa | 2013 | Critical Care Medicine2013，，1： | 6 |
| 3 | Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit显示文摘 | Juliana Barr Gilles L. Fraser Kathleen Puntillo E. Wesley Ely Céline Gélinas Joseph F. Dasta Judy E. Davidson John W. Devlin John P. Kress Aaron M. Joffe Douglas B. Coursin Daniel L. Herr Avery Tung Bryce R. H. Robinson Dorrie K. Fontaine Michael A. Ramsa | 2013 | Critical Care Medicine2013，，1： | 2 |
| 4 | Sonicating bees demonstrate flexible pollen extraction without instrumental learning显示文摘Pollen collection is necessary for bee survival and important for flowering plant reproduction, yet if and how pollen extraction motor routines are modified with experience is largely unknown. Here, we used an automated reward and monitoring system to evaluate modification in a common pollen-extraction routine, floral sonication. Through a series of laboratory experiments with the bumblebee, Bombus impatiens, we examined whether variation in sonication frequency and acceleration is due to instrumental learning based on rewards, a fixed behavioral response to rewards, and/or a mechanical constraint. We first investigated whether bees could learn to adjust their sonication frequency in response to pollen rewards given only for specified frequency ranges and found no evidenee of instrumental learning. However, we found that absenee versus receipt of a pollen reward did lead to a predictable behavioral resp on se, which depe nded on bee size. Fin ally, we found some evide nee of mechanical con straints, in that flower mass affected sonication acceleration (but not frequency) through an interaction with bee size. In generalz larger bees showed more flexibility in sonication frequency and acceleration, potentially reflecting a size-based constraint on the range over which smaller bees can modify frequency and accelerati on. Overall our results show that although bees did not display instrumental learning of sonication frequency, their sonication motor routine is nevertheless flexible. | Callin M. Switzer Avery L. Russell Daniel R. Papaj Stacey A. Combes Robin Hopkins | 2019 | Current Zoology2019，65，4： | 1 |
| 5 | Robot-assisted extravesical ureteral reimplantation: Outcomes and conclusions from 78 ureters显示文摘 | Ardavan Akhavan Daniel Avery Thomas S. Lendvay | 2014 | Journal of Pediatric Urology2014，，： | 1 |
| 6 | 美国1例严重毁容患者的近全颜面移植显示文摘背景对于包括皮肤、软组织、骨骼及功能性亚单位(如鼻、嘴唇、眼睑)的复杂颜面畸形,常采用多次重建手术。然而,结果往往不尽如人意。行单次异体颜面移植手术的创新方法是一种可行的治疗选择,并可改善结局。方法2008年12月9日,1例曾有颜面中部严重创伤史的45岁女性接受了近全颜面移植——以根据其情况获取的复合组织瓣取代了其80%的颜面。作者重点关注免疫抑制治疗、心理学与伦理学结局、患者重新融入社会等问题。结果术后,患者身体和心理恢复良好,耐受免疫抑制治疗,且未发生严重的并发症。移植术后第47天,常规活栓显示移植组织瓣黏膜发生排异反应;但经皮质激素一次注射后,排异反应缓解。在移植后的最初3周之内.患者就接受了她的新面孔;术后6个月,其功能恢复良好。与移植前的状态相比,移植后患者可通过鼻子呼吸,可以嗅气味、尝味道、流利谈话,并能食用固体食物和使用杯子饮水。结论本病例的治疗显示了对严重毁容患者予一次手术,利用异体复合颜面移植进行重建是可行的。因此,应该考虑将这种治疗方案作为严重毁容患者的早期治疗选择。基金 无。 | Maria Siemionow Frank Papay Daniel Alarn Steven Bernard Risal Djohan Chad Gordon Mark Hendrickson Robert Lohrnan Bijan Eghtesad Kathy Coffman Eric Kodish Carmen Paradis Robin Avery John Fung 王睿(译) | 2009 | 世界临床医学2009，，12： | 0 |
| 7 | The weekend effect:does time of admission impact management and outcomes of small bowel obstruction?显示文摘Aims:To determine whether day and time of admission influences the practice patterns of the admitting general surgeon and subsequent outcomes for patients diagnosed with small bowel obstruction.Methods:A retrospective database review was carried out,covering patients admitted with the presumed diagnosis of partial small bowel obstruction from 2004–2011.Results:A total of 404 patients met the inclusion criteria.One hundred and thirty-nine were admitted during the day,93 at night and 172 on the weekend.Overall 30.2%of the patients were managed operatively with no significant difference between the groups(P=0.89);however,of patients taken to the operating room,patients admitted during the day received operative intervention over 24 hours earlier than those admitted at a weekend,0.79 days vs 1.90 days,respectively(P=0.05).Overall mortality was low at 1.7%,with no difference noted between the groups(P=0.35).Likewise there was no difference in morbidity rates between the three groups(P=0.90).Conclusions:Despite a faster time to operative intervention in those patients admitted during the day,our study revealed that time of admission does not appear to correlate to patient outcome or mortality. | Derek P.McVay Avery S.Walker Daniel W.Nelson Christopher R.Porta Marlin W.Causey Tommy A.Brown | 2014 | Gastroenterology Report2014，2，3： | 0 |
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