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在也门和尼泊尔与结核病诊断相关的患者直接费用

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国际结核病与肺部疾病杂志 2010年第2期5卷 84-89页

作者： a.ramsay N.AI-Agbhari J.Scherchand N.AI-Sonboli A.Almotawa M.Gammo P.Gauchan M.A.Yassin L.E.Cuevas 阮云洲王雪静 Liverpool School of Tropical Medicine LiverpoolUK United Nations Children's Fund/United Nations Development Programme/World Bank/World Health Organization Special Programme for Research and Training GenevaSwitzerland Tuberculosis Research Centre Sana'aYemen 4. Tribhuvan UniversityKathmanduNepal

背景:结核病的诊断需要多次就诊。减少诊断过程中的就诊次数,可使服务更具可及性,并大大节约患者的费用。目的:描述患者在肺结核诊断中心就诊时发生的直接费用。方法:在也门和尼泊尔,使用设计好的问卷,对咳嗽时间超过3周的成年人进行面... 详细信息

背景:结核病的诊断需要多次就诊。减少诊断过程中的就诊次数,可使服务更具可及性,并大大节约患者的费用。目的:描述患者在肺结核诊断中心就诊时发生的直接费用。方法:在也门和尼泊尔,使用设计好的问卷,对咳嗽时间超过3周的成年人进行面对面调查,并记录他们的费用。结果:共调查了456例成年人。大多数患者就诊时都有人陪同,其中20%是涂阳患者。在尼泊尔,患者男性比例、居住在城市地区比例和平均年龄均高于也门(尼泊尔:123/206[60%],152[74%],平均年龄41岁;也门:120/250[48%],114[36%],平均年龄35岁)。虽然农村地区的患者多数住在亲戚家,但他们的整体费用仍高于城市地区的患者。在2个国家,最高的费用支出均为诊疗费,而且农村患者支付的诊疗费高于城市患者。诊断的费用相当于1周的人均国民收入。结论:患者需要承担相当大的诊断费用,而在医疗机构的诊疗费是这些费用的主要部分。需要接受结核病检查的患者应该能够得到免费的诊断服务。

关键词：结核病诊断涂片镜检低收入国家城市人口农村人口

在肺结核诊断中应用系列痰涂片的结果:系统综述

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国际结核病与肺部疾病杂志 2007年第3期2卷 71-80页

作者： S.R.Mase a.ramsay V.Ng M.Henry P.C.Hopewell J.Cunningham R.Urbanczik M.D.Perkins M.A.Aziz M.Pai 张宗德张立兴 Division of Pulmonary and Critical Care Medicine San Francisco General HospitalUniversity of California Francis J Curry National Tuberculosis Center University of California United Nations Children's Fund/United Nations Development Programme/World Bank/World Health Organization(WHO)Special Programme for Research and Training in Tropical Diseases(TDR) WHO Albany Medical College County of Sacramento Department of Health and Human Services Sacramento WHO Tuberculosis Laboratory Consultants Group Foundation for Innovative New Diagnostics(FIND) GenevaStop TB DepartmentWHO Stop TB Department WHO Department of Epidemiology & Biostatistics McGill University

目前的国际结核病(TB)指南推荐在对肺结核可疑患者评价时应用3次痰涂片镜检以寻找结核菌。我们对符合3次痰标本结果标准的研究进行了系统的评价。通过对多个数据库和资源的检索,我们确定了共37个合格的研究。第3份标本中涂阳结果的增加... 详细信息

目前的国际结核病(TB)指南推荐在对肺结核可疑患者评价时应用3次痰涂片镜检以寻找结核菌。我们对符合3次痰标本结果标准的研究进行了系统的评价。通过对多个数据库和资源的检索,我们确定了共37个合格的研究。第3份标本中涂阳结果的增加(所有培阳病例作为分母的研究)和敏感性的增高(所有培阳病例作为分母的研究)是我们关注的主要结果。虽然各研究的方法和结果不同对数据综合构成了挑战,但亚组的分析提示对第3份标本的检查使结果和/或敏感性平均增加了2%～ 5%。把推荐的标本检查数量从3份减至2份(特别是在同一天收集的2份标本)对结核控制项目有利。有很多理由可潜在增加病例检出;许多实施性研究问题需要强调。如果按照国际间协调和标准化的方法,在痰标本镜检时应用现行技术检验哪种方法最有效,这样的研究会是最有用的,既可以增加本国的数据,又可进行研究之间的对比。

关键词：结核痰显微镜检查结果增加抗酸菌系列痰标本

Current practice of anticoagulant in the treatment of splanchnic vein thrombosis secondary to acute pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2020年第2期19卷 116-121页

作者： William Norton Gabija Lazaraviciute George ramsay Irene Kreis Irfan Ahmed Mohamed Bekheit Department of General Surgery Aberdeen Royal InfirmaryAberdeen AB252ZNUK Rowett Institute of Nutrition and Health University of AberdeenForesterhillAberdeen AB252ZDUK Clinical Effectiveness Unit Royal College of Surgeons of England35-43 Lincoln’s Inn FieldsHolbornLondon WC2A 3PEUK Department of Surgery El Kabbary HospitalEl KabbaryAlexandriaEgypt

Background:Severe acute pancreatitis is a common diagnosis in emergency general surgery and can be a cause of significant morbidity and mortality.A consequence of severe acute pancreatitis is thrombus in the splanchnic *** thrombi can potentially lead to bowel ischemia or hepatic ***,another complication of severe acute pancreatitis is retroperitoneal *** this time,it is unclear if treating patients for splanchnic vein thrombosis in the context of severe acute pancreatitis is associated with any outcome benefit.A systematic review might clarify this *** sources:A two-fold search strategy(one broad and one precise)looked at all published *** review was registered on PROSPERO(ID:CRD42018102705).MEDLINE,EMBASE,PubMed,Cochrane and Web of Science databases were searched and potentially relevant papers were reviewed indepen-dently by two *** disagreement was reviewed by a third independent *** outcome was reestablishment of flow in the thrombosed vein versus bleeding ***:Of 1462 papers assessed,a total of 16 papers were eligible for *** were no ran-domized controlled trials,2 were case series,5 retrospective single-center studies and 9 case *** were a total of 198 patients in these studies of whom 92(46.5%)received anticoagulation *** rates of recanalization of veins in the treated and non-treated groups was 14%and 11%and bleeding complications were 16%and 5%,***,the included studies were too heterogeneous to undertake a ***:The systematic review highlights the lack evidence addressing this clinical ***-fore a randomized controlled trial would be appropriate to undertake.

关键词： Severe acute pancreatitis Splanchnic vein thrombosis Anticoagulant therapy

The effects of tannins-containing ground pine bark diet upon nutrient digestion,nitrogen balance,and mineral retention in meat goats

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Journal of Animal Science and Biotechnology 2015年第3期6卷 347-354页

作者： Byeng Ryel Min Sandra Solaiman Thomas Terrill Aina.ramsay Irene Mueller-Harvey Department of Agricultural and Environmental Sciences Tuskegee University Agricultural Research Station Fort-Valley State University School of Agriculture Policy and DevelopmentUniversity of Reading

Background： Pine bark is a rich source of phytochemical compounds including tannins, phenolic acids, anthocyanins, and fatty acids. These phytochemicals have potential to significantly impact on animal health and animal production. The goal of this work is to measure the effects of tannins in ground pine bark as a partial feed replacement on feed intake, dietary apparent digestibility, nitrogen balance, and mineral retention in meat goats. Results： Eighteen Kiko cross goats （initial BW = 31.8 ± 1.49 kg） were randomly assigned to three treatment groups （n = 6）. Dietary treatments were tested： control （0 % pine bark powder （PB） and 30 % wheat straw （WS））; ] 5 % PB and 15 % WS, and 30 % PB and 0 % WS. Although dry matter （DM） intake and digestibility were not affected （P〉 0.10） by feeding PB, neutral detergent fiber （linear; P= 0.01）, acid detergent fiber （linear; P= 0.001） and lignin digestibility （linear; P= 0.01） decreased, and crude protein （CP） digestibility tended to decrease （P=0.09） as PB increased in the diet, apparent retention of Ca （P= 0.09）, P （P=0.03）, Mg （P= 0.01）, Mn （P= 0.01）, Zn （P= 0.01） and Fe （P= 0.09） also increased linearly. Nitrogen intake and fecal N excretion were not affected （P〉 0.05） by addition of PB in the diet, but N balance in the body was quadratically increased （P〈 0.01） in the 15 % PB diet compared to other diets. This may be due to more rumen escape protein and less excreted N in the urine with the 15 % PB diet. The study showed that a moderate level of tannin-containing pine bark supplementation could improve gastrointestinal nitrogen balance with the aim of improving animal performance. Conclusion： These results suggest that tannin-containing PB has negative impact on fiber, lignin, and protein digestibility, but positively impacted on N-balance.

关键词： Digestibility Goats Phytochemicals Tannins

Predicting long-term outcomes in acute intracerebral haemorrhage using delayed prognostication scores

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Stroke & Vascular Neurology 2021年第4期6卷 536-541,I0013-I0025页

作者： Ronda Lun Vignan Yogendrakumar Tim ramsay Michel Shamy Robert Fahed Magdy H Selim Dar Dowlatshahi Department of Medicine Division of NeurologyStroke ProgramOttawa HospitalOttawaOntarioCanada Clinical Epidemiology Program School of EpidemiologyPublic Health and Preventative MedicineOttawa Hospital Research InstituteOttawa UniversityOttawaOntarioCanada Ottawa Hospital Research Institute OttawaOntarioCanada Interventional Neuroradiology Rothschild FoundationParisÎle-de FranceFrance Department of Neurology Beth Israel Deaconess Medical CenterBostonMassachusettsUSA

Objective The concept of the‘self-fulfilling prophecy’is well established in intracerebral haemorrhage(ICH).The ability to improve prognostication and prediction of long-term outcomes during the first days of hospitalisation is important in guiding conversations around goals of *** previously demonstrated that incorporating delayed imaging into various prognostication scores for ICH improves the predictive accuracy of 90-day ***,delayed prognostication scores have not been used to predict long-term functional outcomes beyond 90 ***,setting and participants We analysed data from the ICH Deferoxamine trial to see if delaying the use of prognostication scores to 96 hours after ICH onset will improve performance to predict outcomes at 180 days.276 patients were *** and measurements We calculated the original ICH score(oICH),modified-ICH score(MICH),max-ICH score and the FUNC score on presentation(baseline),and on day 4(delayed).Outcomes assessed were mortality and poor functional outcome in survivors(defined as modified Rankin Scale of 4-5)at 180 *** generated receiver operating characteristic curves,and measured the area under the curve values(AUC)for mortality and functional *** compared baseline and delayed AUCs with non-parametric *** At 180 days,21 of 276(7.6%)*** of the survivors,54 of 255 had poor functional outcome(21.2%).The oICH,MICH and max-ICH performed significantly better at predicting 180-day mortality when calculated 4 days later compared with their baseline equivalents((0.74 vs 0.83,p=0.005),(0.73 vs 0.80,p=0.036),(0.74 vs 0.83,p=0.008),respectively).The delayed calculation of these scores did not significantly improve our accuracy for predicting poor functional *** Delaying the calculation of prognostication scores in acute ICH until day 4 improved prediction of 6-month mortality but not functional *** registration number *** Registry(NCT0

关键词： acute delayed score

Metabolomic analysis of longissimus from underperforming piglets relative to piglets with normal preweaning growth

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Journal of Animal Science and Biotechnology 2018年第3期9卷 630-638页

作者： Timothy G.ramsay Margo J.Stoll Amy E.Shannon Le Ann Blomberg Animal Biosciences and Biotechnology Laboratory U.S.Department of Agriculture Agricultural Research Service

Background: Recent increases in intra-litter variability in weaning weight have raised swine production costs. A contributor to this variability is the normal birth weight pig that grows at a slower rate than littermates of similar birth weight. The goal of this study was to interrogate biochemical profiles manifested in skeletal muscle originating from slow growing(SG) and faster growing littermates(control), with the aim of identifying differences in metabolic pathway utilization between skeletal muscle of the SG pig relative to its littermates. Samples of longissimus muscle from littermate pairs of pigs were collected at 21 d of age for metabolomic ***: Birth weights did not differ between littermate pairs of SG and Control pigs(P > 0.05). Weaning weights differed by 1.51 ± 0.19 kg(P < 0.001). Random forest(RF) analysis was effective at segregating the metabolome of muscle samples by growth rate, resulting in a predictive accuracy of 81% versus random segregation(50%).Decreases in sugars in the pentose phosphate pathway(PPP) in the longissimus of SG pigs were detected(P < 0.05). Decreases were also apparent in glycolytic intermediates(glycerol-3-phosphate and lactate) and key glycolysis-derived intermediates(glucose-6-phosphate and fructose-6-phosphate; P < 0.05). SG pigs had increased levels of phospholipids, lysolipids, diacylglycerols, and sphingolipids(P < 0.05). Pathway analysis identified a cluster of molecules associated with muscle and collagen/extracellular matrix breakdown that are increased in the SG pig(glutamate, 3-methylhistidine and hydroxylated proline moieties; P < 0.05). Nicotinate metabolism was altered in SG pigs, resulting in a 78% decrease in the nicotinamide adenine dinucleotide pool(P < 0.05).Conclusions: These metabolomic data provide the first evidence for biochemical mechanisms that should be investigated to determine if they have a potential role in the slow growth in some normal birth weight piglets that contribute to inc

关键词： Growth rate Longissimus Metabolome Neonate Swine

Regulation of cytokine gene expression by orosomucoid in neonatal swine adipose tissue

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Journal of Animal Science and Biotechnology 2016年第3期7卷 403-411页

作者： Timothy G.ramsay Margo J.Stoll Le Ann Blomberg Thomas J.Caperna Animal Biosciences and Biotechnology Laboratory USDA/ARSBeltsville Agricultural Research CenterUSDABeltsvilieMD 20705USA

Background： Porcine adipose tissue expresses orosomucoid（ORM1） mRNA, a protein with anti-inflammatory and immunomodulatory properties. Previous research has demonstrated that porcine ORM1 can reduce insulin stimulated glucose metabolism in porcine adipose tissue in vitro. The present study was designed to examine the preweaning ontogeny of ORM1 m RNA abundance in porcine subcutaneous adipose and to determine if ORM1 can regulate m RNA abundance of inflammatory cytokines that contribute to insulin resistance in primary cultures derived from neonatal porcine subcutaneous adipose tissue. Cultures were differentiated in vitro and subsequently the adipocyte containing cultures were incubated for 24 h with 0–5000 ng porcine ORM1/m L medium. Cultures were then harvested, total RNA extracted for use in reverse transcription and the m RNA abundance of cytokine m RNA quantified by real-time ***： ORM1 m RNA abundance within neonatal adipose tissue does not change from d 1 to d 21 of age and is a very small fraction relative to liver m RNA abundance. The ORM1 m RNA level in porcine adipocytes and stromalvascular cells are similar（P 〉 0.05）. Treatment with ORM1 did not affect TNFα（tumor necrosis factor α） m RNA level（P 〉 0.05）, while interleukin 6（IL6） m RNA abundance was reduced 32 % at 1,000 ng ORM1/m L（P 〈 0.01）. However,TNFα protein content in the cell culture media was reduced by ORM1 treatment（5,000 ng/m L, P 〈 0.05）, whereas ORM1 had no detectable effect on the media content of IL6（P 〉 0.05）. The reduction of macrophage migration inhibitory factor（MIF） m RNA abundance by ORM1 was dose dependent（P 〈 0.01）. Monocyte chemotactic protein（MCP） m RNA level was reduced 27 % by 1,000 ng ORM1/m L（P 〈 0.05）.Conclusions： The data suggest that ORM1 has limited effects TNFα, IL6, MIF or MCP expression at the concentrations tested. Secondly, these cytokines do not appear to contribute to the reported insulin resistance induced by ORM1 in porcine adipose tissue in vitro as an in

关键词： Adipose Cytokines Neonate Orosomucoid Swine

Sperm fine-needle aspiration (FNA)mapping after failed microdissection testicular sperm extraction (TESE):location and patterns of found sperm

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Asian Journal of Andrology 2019年第1期21卷 50-55页

作者： Sheba Jarvis Heather K Yee Natalia Thomas Imok Cha Kedar Che Prasad Jonathan W a.ramsay Paul J Turek Imperial College London Hammersmlth HospitalLondon W12 ONNUK The Turek Clinic San FranciscoCA 94133USA Marin Medical Laboratories Greenbrae CA 94904USA.

We sought to evaluate the ability of fine-needle aspiration (FNA)mapping to find sperm and to guide sperm retrieval after failed microdissection testicular sperm extraction (micro-TESE)in nonobstructive azoospermic *** this study of consecutive male infertility cases,interventions included testicular FNA mapping and subsequent sperm *** included the frequency and location of found sperm on FNA maps after failed micro-TESE and the salvage sperm retrieval *** 548 patients undergoing FNA mapping from 2010 to 2016,82 men with previous micro-TESE procedures were *** mean time between micro-TESE and FNA mapping was 2.2 years.A total of 2825 (1424 on right and 1401 on left)sites were *** least one site revealed mature sperm in 24 (29.3%)of 82 men with prior failed micro-TESE *** was an equal likelihood of detecting sperm in either testis (6.1%right;5.7%left;P=0.58).Digital "heat maps"revealed differences in sperm findings within the testis with mature sperm more likely found in the testis periphery rather than *** (62.5%)patients subsequently underwent sperm retrieval procedures guided by FNA *** sperm were retrieved in all cases,and in 10 (66.7%)of 15 cases,extra sperm were frozen for future *** a significant proportion of failed micro-TESE procedures representing the largest study to date,sperm were detected by FNA mapping and could be reliably retrieved through FNA map-guided surgical sperm *** present,sperm were more likely to be found in the testis periphery rather than centrally with FNA mapping.

关键词： azoospermia hypogonadism IVF-ICSI microdissection TESE sperm FNA mapping sperm retrieval

Verification of an Explicitly Coupled Thermal-Phase Field-Mechanical Electromagnetic (TPME) Framework by the Method of Manufactured Solutions

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Open Journal of Modelling and Simulation 2021年第1期9卷 1-25页

作者： Travis S. ramsay Department of Mechanical Engineering Iowa State University Ames IA USA

An explicitly coupled two-dimensional (2D) multiphysics finite element method (FEM) framework comprised of thermal, phase field, mechanical and electromagnetic (TPME) equations was developed to simulate the conversion of solid kerogen in oil shale to liquid oil through in-situ pyrolysis by radio frequency heating. Radio frequency heating as a method of in-situ pyrolysis represents a tenable enhanced oil recovery method, whereby an applied electrical potential difference across a target oil shale formation is converted to thermal energy, heating the oil shale and causing it to liquify to become liquid oil. A number of in-situ pyrolysis methods are reviewed but the focus of this work is on the verification of the TPME numerical framework to model radio frequency heating as a potential dielectric heating process for enhanced oil recovery. Very few studies exist which describe production from oil shale;furthermore, there are none that specifically address the verification of numerical models describing radio frequency heating. As a result, the Method of Manufactured Solutions (MMS) was used as an analytical verification method of the developed numerical code. Results show that the multiphysics finite element framework was adequately modeled enabling the simulation of kerogen conversion to oil as a part of the analysis of a TPME numerical model.

关键词： Radio Frequency Heating In-Situ Pyrolysis Oil Shale Multiphysics Explicit Coupling Finite Element Method Method of Manufactured Solutions