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  • 文章类型: Case Reports
    背景:心脏封堵器脱离的病例很少,并且在脱离后不进行开胸手术的情况下使用介入方法完全移除封堵器是罕见的。该病例创新性地采用超声引导结合数字减影血管造影(DSA)完全去除封堵器,积累一些经验。
    方法:患者因房颤在我院行左心耳封堵术。手术后,封堵器脱落并在左心室中自由,这是非常危险的。我们创新地使用了超声引导,结合DSA,和介入手术,使用捕集器成功捕获自由的封堵器,完全删除它,然后重新植入新的左心耳封堵器.手术后,病人恢复得很好。
    结论:封堵器的尺寸选择略显保守,左心耳开口的形状不规则。
    BACKGROUND: There are very few cases of cardiac occluder detachment, and it is rare to completely remove the occluder using interventional methods without undergoing thoracotomy surgery after detachment. This case innovatively used ultrasound guidance combined with digital subtraction angiography (DSA) to completely remove the occluder, accumulating some experience.
    METHODS: The patient underwent left atrial appendage occlusion surgery in our hospital due to atrial fibrillation. After the surgery, the occluder fell off and became free in the left ventricle, which is very dangerous. We innovatively used ultrasound guidance, combined with DSA, and interventional surgery to successfully capture the free occluder using a catcher, completely remove it, and then re implant a new left atrial appendage occluder. After the surgery, the patient recovered very well.
    CONCLUSIONS: The size selection of the occluder is slightly conservative, and the shape of the left atrial appendage opening is irregular.
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  • 文章类型: Journal Article
    尽管感觉不舒服,但工作-presenteism-是一种普遍的行为现象。先前的研究表明,出勤受各种与工作相关的因素和个人因素的影响。这是一种导致一系列负面但也有正面后果的疾病行为。由于2019年冠状病毒病(COVID-19)大流行,远程工作已成为许多员工的“新常态”。但到目前为止,对远程工作中的出勤主义知之甚少。本研究旨在通过观察远程出勤的程度来调查远程工作中的出勤,与现场工作中的presenteism的差异,和相关因素。
    在德国进行了一项全国性的横断面在线调查,其中N=233名参与者。数据采用描述性统计分析,t检验,和相关分析。
    结果显示,在远程工作中,出勤率普遍,x﹤=4.13天(Md=3;D=2;s=4.95)。较低的脱离工作能力(r=-.17;p=.005)和较低的主管支持(r=-.14;p=.02)与更多的远程出勤日有关。远程工作条件似乎促进了presenteism。
    这项研究为一个具有重大社会相关性的主题领域提供了经验见解。结果表明,应提高对远程工作中的出勤意识。它应该被视为一种可以是功能性的或功能失调的行为,取决于个人情况。应该培养主管的支持和脱离,以帮助减少功能失调的出勤。提高健康素养可能有助于远程工作者决定以健康为导向的疾病行为。进一步的研究对于分析远程工作中的出勤在多大程度上以及在何种情况下(dys)起作用并得出明确的建议至关重要。
    UNASSIGNED: Working despite feeling ill - presenteeism - is a widespread behavioral phenomenon. Previous research has shown that presenteeism is influenced by various work-related and personal factors. It\'s an illness behavior leading to a range of negative but also positive consequences. Due to coronavirus disease 2019 (COVID-19) pandemic, remote work has become the \"new normal\" for many employees. But so far, little is known about presenteeism in remote work. This study aims to investigate presenteeism in remote work by looking at the extent of remote presenteeism, differences to presenteeism in on-site work, and associated factors.
    UNASSIGNED: A nationwide cross-sectional online survey was conducted in Germany with N = 233 participants. Data were analyzed using descriptive statistics, t-tests, and correlation analysis.
    UNASSIGNED: The results reveal that presenteeism is prevalent in remote work x̅ = 4.13 days (Md = 3; D = 2; s = 4.95). A low ability to detach from work (r = -.17; p = .005) and low supervisor support (r = -.14; p = .02) is associated with more remote presenteeism days. Remote working conditions seem to facilitate presenteeism.
    UNASSIGNED: This study provides empirical insights into a subject area of great societal relevance. The results show that awareness should be raised for presenteeism in remote work. It should be regarded as a behavior that can be functional or dysfunctional, depending on the individual situation. Supervisor support and detachment should be fostered to help reduce dysfunctional presenteeism. Promotion of health literacy might help remote workers to decide on a health-oriented illness behavior. Further research is vital to analyze to what extent and under which circumstances presenteeism in remote work is (dys)functional and to derive clear recommendations.
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  • 文章类型: Journal Article
    研究了正十二烷(C12H26)分子在具有可变表面化学(Q2,Q3,Q4环境)的二氧化硅表面上的吸附和分离过程,使用分子动力学模拟。硅烷醇基团的面积密度在9.4至0/nm2之间变化。油-水-固接触线的收缩是油分离的关键步骤,由于三相接触线上的水扩散。模拟结果表明,在具有(=Si(OH))型硅烷醇基团的完美Q3二氧化硅表面上,油分离更容易且更快,由于水和硅烷醇基团之间的H键形成。当表面含有更多的Q2结晶类型,具有(=Si(OH)2)型硅烷醇基,更少的油分离,由于硅烷醇基团之间形成H键。在Si-OH0表面上没有硅烷醇基团。水不能在水-油-二氧化硅接触线上扩散,油不能从Q4表面脱离。油从二氧化硅表面的分离效率不仅取决于面积密度,还有硅烷醇基团的类型。硅烷醇基团的密度和类型取决于晶体解理面,颗粒大小,粗糙度,和湿度。
    The adsorption and detachment processes of n-dodecane (C12H26) molecules were studied on silica surfaces with variable surface chemistry (Q2, Q3, Q4 environments), using molecular dynamics simulations. The area density of the silanol groups varied from 9.4 to 0 per nm2. The shrinking of the oil-water-solid contact line was a key step for the oil detachment, due to water diffusion on the three-phase contact line. The simulation results showed that oil detachment was easier and faster on a perfect Q3 silica surface which had (≡Si(OH))-type silanol groups, due to the H-bond formation between the water and silanol groups. When the surfaces contained more Q2 crystalline type which had (≡Si(OH)2)-type silanol groups, less oil detached, due to the formations of H-bonds among the silanol groups. There were no silanol groups on the Si-OH 0 surface. Water cannot diffuse on the water-oil-silica contact line, and oil cannot detach from the Q4 surface. The detachment efficiency of oil from the silica surface not only depended on the area density, but also on the types of silanol groups. The density and type of silanol groups depend on the crystal cleavage plane, particle size, roughness, and humidity.
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  • 文章类型: Journal Article
    本研究旨在检查基于三个恢复增强过程的纵向恢复曲线,即,心理脱离工作,体育锻炼,和睡眠。此外,我们研究了与工作相关的需求和资源是否可以预测个人资料成员资格,以及个人资料成员资格是否可以预测幸福感结果.参与者是芬兰雇员(N=664),他们连续三年填写了电子问卷。潜在轮廓分析(LPA)揭示了五个随时间变化的恢复增强过程的稳定轮廓:(1)物理不活动,高度分离(15%),(2)恢复过程受损(19%),(3)强化回收工艺(25%),(4)身体活跃,分离和睡眠不佳(19%),和(5)身体活跃(29%)。此外,与工作相关的前因和幸福感结局在确定的5个概况之间显示出独特的差异.总之,我们的研究使恢复研究向前迈出了一步,有助于了解恢复增强过程如何同时发挥长期作用,并表明,从幸福的角度来看,脱离工作和良好的睡眠是比身体活动更重要的恢复过程。
    The present study aimed to examine longitudinal recovery profiles based on three recovery-enhancing processes, i.e., psychological detachment from work, physical exercise, and sleep. In addition, we examined whether job-related demands and resources predict profile membership and whether profile membership predicts well-being outcomes. The participants were Finnish employees (N = 664) who filled in an electronic questionnaire in three successive years. Latent profile analysis (LPA) revealed five stable profiles of recovery-enhancing processes across time: (1) physically inactive, highly detaching (15%), (2) impaired recovery processes (19%), (3) enhanced recovery processes (25%), (4) physically active, poorly detaching and sleeping (19%), and (5) physically active (29%). In addition, job-related antecedents and well-being outcomes showed unique differences between the five profiles identified. Altogether, our study takes recovery research a step forward in helping to understand how recovery-enhancing processes function simultaneously over the long-term and suggests that, from the perspective of well-being, detachment from work and good sleep are more crucial recovery processes than physical activity.
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  • 文章类型: Journal Article
    根据坚持不懈的认知假设,例如,长时间的激活,通过与工作相关的沉思会损害恢复,从而对员工健康构成风险。性别在多大程度上,年龄,职业或纵向压力暴露可能会改变与工作相关的沉思是一个正在进行的辩论。与工作相关的沉思的分组或纵向比较是否有效,然而,从未测试过。在这份多研究报告中,因此,我们调查了广泛使用的跨性别的工作相关沉思问卷(WRRQ)的测量不变性,年龄,职业,和纵向测量,通过对与工作相关的沉思的现有数据进行二次分析。我们研究了两种语言的WRRQ测量的心理测量特性,并扩展了有关情感反思的法理网络的知识,与员工个人特征相关的解决问题的思考和超然(例如,个性,工作参与,承诺),工作压力源(例如,工作强度,决策纬度,与同事和主管的社会关系)和员工健康结果(例如,幸福,刺激,躯体症状)。多组验证性因素分析显示,英语和德语WRRQ测量的部分标量不变性以及跨性别的完全标量不变性,年龄,职业和1周期间(研究1,n=2,207)。相关分析支持的标准,WRRQ测量的收敛效度和判别效度(研究2,n=4,002)。这些发现代表了跨群体比较与工作相关的认知以及进一步理解不同类型与工作相关的认知的前因和结果的先决条件。
    According to the perseverative cognition hypothesis, prolonged activation for example, via work-related rumination impairs recovery and thereby poses a risk to employee health. The extent to which gender, age, occupation or longitudinal stress exposure may alter work-related rumination is an ongoing debate. Whether group or longitudinal comparisons of work-related rumination are valid, however, has never been tested. In this multistudy report, we therefore investigated measurement invariance of the widely used Work-Related Rumination Questionnaire (WRRQ) across gender, age, occupation, and longitudinal measurements by performing secondary analyses of preexisting data on work-related rumination. We examined the psychometric properties of WRRQ measurements in two languages and expand knowledge about the nomological network of affective rumination, problem-solving pondering and detachment in relation to individual employee characteristics (e.g., personality, work engagement, commitment), job stressors (e.g., work intensity, decision latitude, social relations with colleagues and supervisors) and employee health outcomes (e.g., wellbeing, irritation, somatic symptoms). Multigroup confirmatory factor analyses showed partial scalar invariance of English and German WRRQ measurements and full scalar invariance across gender, age, occupation and over the period of 1 week (Study 1, n = 2,207). Correlation analyses supported criterion, convergent and discriminant validity of WRRQ measurements (Study 2, n = 4,002). These findings represent a prerequisite for comparisons of work-related cognition across groups and further the understanding of the antecedents and outcomes of different types of work-related cognition.
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  • 文章类型: Case Reports
    作者介绍了一例成功经皮取出已迁移到无法手术的胰腺癌和肝转移患者的右心腔的分离的导管端口设备的情况。由于在另一家医院取出导管时意外脱离,该患者被紧急送往血管诊所。导管已从右锁骨下静脉的初始放置部位迁移到上腔静脉和右心腔。在局部麻醉下,使用Seldinger技术进入右股静脉,使用三重圈套器取出异物取出导管。取出手术后的胸部X光检查未显示右心室或上腔静脉有异物。患者第二天出院回家。
    The authors present a case of a successful percutaneous retrieval of a detached port-a-catheter device that had migrated to the right cardiac chambers in a patient with inoperable pancreatic cancer and hepatic metastases. The patient was admitted to the vascular clinic department on an urgent basis due to an accidental detachment of the catheter during removal at another hospital. The catheter had migrated from the initial placement site in the right subclavian vein to the superior vena cava and right heart chambers. Under local anesthesia, the right femoral vein was accessed using the Seldinger technique, and the migrated catheter was retrieved using a triple-snare-loop device for foreign body removal. Chest radiography after the retrieval procedure did not show any foreign bodies in the right heart chambers or superior vena cava. The patient was discharged home the following day.
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  • 文章类型: Journal Article
    这项调查研究了三种相关人格风格之间的联系,如通过关系概况测试破坏性过度依赖评估的那样,功能失调的脱离,在100名平均年龄为38.62岁(SD=12.99)的初级保健患者的混合性别(74%为女性)样本中,健康依赖性和健康相关行为指数。14名初级保健医生也参加了会议。正如假设的那样,破坏性过度依赖和功能失调的脱离得分与与急诊科接触人数呈正相关;健康依赖得分与急诊科接触人数和过夜住院人数呈负相关.健康依赖评分与一系列积极的健康行为相关;破坏性过度依赖评分与积极的健康行为负相关。此外,健康依赖评分与医师对困难医患关系的评分呈负相关.这些结果表明,破坏性的过度依赖,功能失调的脱离和健康的依赖评分以预期的方式与健康和健康相关行为的指数相关联,并帮助阐明导致健康相对较差的潜在因素,以及过度依赖和分离的医疗患者在医疗服务使用方面的差异。
    This investigation examined links between three related personality styles as assessed with the Relationship Profile Test-destructive overdependence, dysfunctional detachment, and healthy dependency-and indices of health and health-related behavior in a mixed-sex (74% female) sample of 100 primary care patients with a mean age of 38.62 (SD = 12.99). Fourteen primary care physicians also participated. As hypothesized, destructive overdependence and dysfunctional detachment scores were positively correlated with number of contacts with the emergency department; healthy dependency scores were inversely related to emergency department contacts and number of overnight hospitalizations. Healthy dependency scores were associated with an array of positive health behaviors; destructive overdependence scores were negatively associated with positive health behaviors. In addition, healthy dependency scores were inversely related to physician ratings of a difficult doctor-patient relationship. These results demonstrate that destructive overdependence, dysfunctional detachment and healthy dependency scores are associated in expected ways with indices of health and health-related behavior, and help illuminate the underlying factors that contribute to comparatively poor health and variations in health service use among overdependent and detached medical patients.
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  • 文章类型: Case Reports
    肺大疱通常生长缓慢,壁薄。然而,我们观察到2例肺叶切除术后和手术中突然形成大疱。可以称为内脏胸膜脱离的病理发现非常独特:这些大疱有一个与肺相连的宽基部,他们的墙很厚,包括内脏胸膜和周围肺泡组织的全部范围,这表明内脏胸膜与远端肺泡分离。经胸膜高压可能是该类型大疱发病的关键因素,与以前已知的大疱性肺病不同。
    Pulmonary bullae usually grow slowly and have thin walls. However, we have observed 2 cases of abrupt bulla formation immediately after lobectomy and during surgery. The pathologic findings of what can be called visceral pleural detachment are quite distinctive: these bullae had a broad base connected to the lung, and their walls were thick, including the full extent of visceral pleural and peripheral alveolar tissues, which suggests that the visceral pleura were detached from the distal alveoli. High transpleural pressure might be the key factor in the pathogenesis of this type of bulla, unlike previously known types of bullous lung disease.
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  • 文章类型: Journal Article
    UNASSIGNED:该研究旨在调查外侧入路对插入性跟腱炎(IAT)伴Haglund畸形的功能结局。
    UNASSIGNED:从2016年1月至2019年9月,14例IAT伴Haglund畸形的患者在我科接受了手术治疗。使用外侧入路清除骨和软组织,并重新连接跟腱的插入。视觉模拟刻度(VAS),美国骨科足踝评分(AOFAS),和维多利亚运动肌腱研究所研究组跟腱病变评分(VISA-A)用于评估临床结局。
    未经证实:手术时患者平均年龄为39.57岁。平均随访时间为14.74个月。平均VAS评分从术前4.86±0.86降至术后1.21±1.58(P<0.001)。AOFAS评分从术前66.64±6.23显著提高至术后90.21±11.50(P<0.001)。术前和最后一次随访的VISA-A平均为66分(范围56.75-69.25)和86分(范围75.75-97.00),分别为(P<0.05)。
    UNASSIGNED:对于IAT伴Haglund畸形,外侧入路有效且安全。此外,中期功能结局是有希望的.
    未经批准:IV.
    UNASSIGNED: The study aims to investigate the functional outcome of the lateral approach for insertional Achilles tendinitis (IAT) with Haglund deformity.
    UNASSIGNED: From January 2016 to September 2019, 14 cases of IAT with Haglund deformity that resisted conservative treatment received surgery in our department. A lateral approach was used to debride the bony and soft tissue and reattach the insertion of the Achilles tendon. The Visual Analog Scale (VAS), American Orthopedic Foot and Ankle Score (AOFAS), and Victorian Institute of Sport Tendon Study Group-Achilles Tendinopathy score (VISA-A) were used to evaluate clinical outcomes.
    UNASSIGNED: The mean patient age was 39.57 years at the time of surgery. The mean follow-up was 14.74 months. The mean VAS score significantly decreased from 4.86 ± 0.86 preoperatively to 1.21 ± 1.58 postoperatively (P < 0.001). The mean AOFAS score significantly improved from 66.64 ± 6.23 preoperatively to 90.21 ± 11.50 postoperatively (P < 0.001). The mean preoperative and the last follow-up VISA-A were 66 (range 56.75-69.25) and 86 (range 75.75-97.00) points, respectively (P < 0.05).
    UNASSIGNED: The lateral approach was effective and safe for IAT with Haglund deformity. Moreover, the mid-term functional outcome was promising.
    UNASSIGNED: IV.
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  • 文章类型: Journal Article
    UNASSIGNED:通过术中不使用填塞剂封闭泪液修复孔源性视网膜脱离应能更快地恢复视力和恢复正常活动。它避免了在硅油内填塞的情况下需要进一步的手术。这项研究评估了视网膜热融合(RTF)视网膜固定术方法,该方法在光凝前进行视网膜下间隙脱水,以在临床前模型中创建瞬时术中视网膜再附着。
    未经评估:临床前研究。
    未经批准:二十条荷兰腰带,实验性视网膜脱离后接受RTF修复的色素兔。
    UNASSIGNED:该离体模型量化了使用死后猪或人视网膜(6×12mm)处理1个视网膜边缘后视网膜与下面的视网膜色素上皮和脉络膜之间的粘附力。我们比较了(1)对照,(2)单独激光光凝,(3)单独脱水,和(4)脱水后进行光凝(RTF)。然后将优化的RTF参数应用于视网膜脱离的体内兔模型。动物随访14天。
    未经证实:对于这个离体模型,我们测量了粘合力,并将其与组织温度相关联。对于体内研究,我们使用眼底镜检查和组织学分析评估视网膜附着.
    UNASSIGNED:离体模型显示,RTF修复产生的粘附力明显高于单独的光凝术,而与脱水方法无关:温暖(60°C)高气流(50-70毫升/分钟)或使用激光波长靶向吸水峰(1470或1940纳米)和同轴低气流(10-20毫升/分钟)。后一种方法产生了较小的脱水足迹。RTF(1940-nm激光与同轴气流)在兔眼体内视网膜脱离模型中的应用导致视网膜立即粘连,实现类似于离体实验的力。视网膜热融合修复在2周的随访期内导致视网膜稳定的重新附着。
    UNASSIGNED:我们表明,在传统激光光凝术之前,对视网膜撕裂边缘进行短暂的初步脱水激光治疗可立即产生术中防水视网膜粘连,而与填塞和伤口愈合反应无关。这种方法可能会允许快速术后恢复,无论撕裂位置和改善视力。
    UNASSIGNED: Rhegmatogenous retinal detachment repair by intraoperative sealing of the tear without a tamponade agent should enable faster restoration of vision and resumption of normal activities. It avoids the need for further surgery in the case of silicone oil endotamponade. This study evaluated the retinal thermofusion (RTF) retinopexy method of subretinal space dehydration before photocoagulation to create an instantaneous intraoperative retina reattachment in a preclinical model.
    UNASSIGNED: Preclinical study.
    UNASSIGNED: Twenty Dutch Belt, pigmented rabbits that underwent RTF repair after experimental retinal detachment.
    UNASSIGNED: This ex vivo model quantified adhesion force between the retina and underlying retinal pigment epithelium and choroid after treatment of 1 retinal edge using postmortem porcine or human retina (6 × 12 mm). We compared (1) control, (2) laser photocoagulation alone, (3) dehydration alone, and (4) dehydration followed by photocoagulation (RTF). Optimized parameters for RTF were then applied in the in vivo rabbit model of retinal detachment. Animals were followed up for 14 days.
    UNASSIGNED: For this ex vivo model, we measured adhesion force and related this to tissue temperature. For the in vivo study, we assessed retinal attachment using funduscopy and histologic analysis.
    UNASSIGNED: The ex vivo model showed that RTF repair produced significantly higher adhesion force than photocoagulation alone independent of dehydration method: warm (60° C) high airflow (50-70 ml/minute) or using laser wavelengths targeting water absorption peaks (1470 or 1940 nm) with coaxial low airflow (10-20 ml/minute). The latter approach produced a smaller footprint of dehydration. Application of RTF (1940-nm laser with coaxial airflow) in an in vivo retinal detachment model in rabbit eyes resulted in immediate retinal adhesion, achieving forces similar to those in the ex vivo experiments. Retinal thermofusion repair resulted in stable reattachment of the retina over the 2-week follow-up period.
    UNASSIGNED: We showed that a short preliminary dehydrating laser treatment of a retinal tear margin before traditional laser photocoagulation creates an immediate intraoperative waterproof retinopexy adhesion independent of tamponade and a wound-healing response. This approach potentially will allow rapid postoperative recovery regardless of the tear location and improved vision.
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