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Impact of relative contraindications on the use, benefits, and risks of anticoagulant prophylaxis in atrial fibrillation: analysis of a claims database

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Open Journal of Internal medicine 2011年第3期1卷 60-67页

作者： maneesha mehra Julia DiBello alan C. Fisher Roger m. mills 不详

Background: many individuals with atrial fibrillation (AF) do not receive recommended anticoagulant prophylaxis for stroke prevention. The study investigators attempted to assess whether the presence of relative contraindications (RCIs) to anticoagulation with warfarin might contribute to this, and to assess the risks and benefits of prophylaxis in patients with RCIs. methods: Study investigators identified patients with established non-valvular AF and flutter in a claims database. Operationally defined RCIs included, in order of clinical severity: (1) prior intracranial hemorrhage;(2) gastrointestinal bleeding or esophageal varices;(3) neurological disorder;and (4) dizziness. Nonfatal events were attributed to warfarin if patients had an appropriate claim in the previous month. Results: A total of 67,082 AF patients were eligible for analysis, including 50,485 (75.3%) in the prevalent cohort. Warfarin exposure during the study period was 68% in the prevalent cohort. At baseline, 50.5% of prevalent cohort patients had one or more RCIs. Patients with RCI had higher prevalence of stroke risk factors (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, and prior stroke or transient ischemic attack) compared to those without RCI. Patients with RCIs often received warfarin and had lower rates of ischemic stroke than those who did not. Conclusions: These results suggest that RCIs do not account for underutilization of anticoagulant prophylaxis in AF patients. Further, the benefit/risk aspects of anticoagulation for stroke prophylaxis may be favorable for many patients with RCIs.

关键词： RCI Anticoagulant Atrial Fibrillation Prophylaxis Stroke Claims Database

Continuous wound infusion of local anaesthetic agents following colorectal surgery:Systematic review and meta-analysis

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World Journal of Gastroenterology 2008年第34期14卷 5301-5305页

作者： alan Karthikesalingam Stewart R Walsh Sheraz R markar Umar Sadat Tjun Y Tang Charles m malata Department of General Surgery Addenbrooke’s HospitalCambridge University Hospitals NHS Foundation Trust Department of Plastic and Reconstructive Surgery Addenbrooke’s HospitalCambridge University Hospitals Foundation Trust

AIm:To provide a specifi c review and meta-analysis of the available evidence for continuous wound infusion of local anaesthetic agents following midline laparoto-my for major colorectal surgery. mETHODS: medline, Embase, trial registries, conference proceedings and article reference lists were searched to identify randomised, controlled trials of continuous wound infusion of local anaesthetic agents following colorectal surgery. The primary outcomes were opioid consumption, pain visual analogue scores (VASs), return to bowel function and length of hospital stay. Weighted mean difference were calculated for continuous outcomes. RESULTS: Five trials containing 542 laparotomy wounds were eligible for inclusion. There was a sig- nificant decrease in post-operative pain VAS at rest on day 3 (weighted mean difference: -0.43; 95% CI: -0.81 to -0.04; P = 0.03) but not on post-operative day 1 and 2. Local anaesthetic infusion was associated with a signifi cant reduction in pain VAS on movement on all three post-operative days (day 1 weighted mean difference: -1.14; 95% CI: -2.24 to -0.041; P = 0.04, day 2 weighted mean difference: -0.97, 95% CI: -1.91to -0.029; P = 0.04, day 3 weighted mean difference: -0.61; 95% CI: 1.01 to -0.20; P = 0.0038). Local an- aesthetic wound infusion was associated with a signifi - cant decrease in total opioid consumption (weighted mean difference: -40.13; 95% CI: -76.74 to -3.53; P = 0.03). There was no signifi cant decrease in length of stay (weighted mean difference: -20.87; 95% CI: -46.96 to 5.21; P = 0.12) or return of bowel function (weighted mean difference: -9.40; 95% CI: -33.98 to 15.17; P = 0.45). CONCLUSION: The results of this systematic re- view and meta-analysis suggest that local anaesthetic wound infusion following laparotomy for major color- ectal surgery is a promising technique but do not pro- vide conclusive evidence of benefi t. Further research is required including cost-effectiveness analysis.

关键词： Colorectal surgery Laparotomy Local anaesthesia Infusion Wound healing

Crystal-oriented wrinkles with origami-type junctions in few-layer hexagonal boron nitride

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Nano Research 2015年第5期8卷 1680-1688页

作者： Camilla K. Oliveira Egleidson F. A. Gomes mariana C. Prado Thonimar V. Alencar Regiane Nascimento Leandro m. malard Ronaldo J. C. Batista alan B. de Oliveira Helio Chacham Ana m. de Paula Bernardo R, A. Neves Departamento de Fisica ICEx Universidade Federal de Minas Gerais - UFMG C.P. 702 30123-970 - Belo Horizonte Brazil Departamento de Fisica ICEB Universidade Federal de Ouro Preto - UFOP 35400-000 - Ouro Preto Brazil

Understanding layer interplay is the key to utilizing layered heterostructures formed by the stacking of different two-dimensional materials for device applications. Boron nitride has been demonstrated to be an ideal substrate on which to build graphene devices with improved mobilities. Here we present studies on the morphology and optical response of annealed few-layer hexagonal boron nitride flakes deposited on a silicon substrate that reveal the formation of linear wrinkles along well-defined crystallographic directions. The wrinkles formed a network of primarily threefold and occasionally fourfold origami-type junctions throughout the sample, and all threefold junctions and wrinkles formed along the armchair crystallographic direction. Furthermore, molecular dynamics simulations yielded, through spontaneous symmetry breaking, wrinkle junction morphologies that are consistent with both the experimental results and the proposed origami-folding model. Our findings indicate that this morphology may be a general feature of several two-dimensional materials under proper stress-strain conditions, resulting in direct consequences in device strain engineering.

关键词： hexagonal boron nitride 2D materials wrinkles origami folding annealing

Suicide ideation, depression and HIV among pregnant women in rural South Africa

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Health 2013年第3期5卷 650-661页

作者： Tamsen J. Rochat Ruth m. Bland mark Tomlinson alan Stein Africa Centre for Health and Population Studies University of KwaZulu-Natal Mtubatuba South Africa Department of Psychology Stellenbosch University Stellenbosch South Africa School of medicine University of Glasgow Glasgow UK Section of Child and Adolescent Psychiatry Department of Psychiatry University of Oxford Oxford UK

Background: Despite public perception to the contrary, pregnancy does not offer a protective effect for suicide ideation. In low and middle income countries (LmIC) multiple concurrent risk factors including unplanned pregnancies, testing for HIV, intimate partner violence and depression may increase suicide risk among pregnant women. We examine suicide ideation among women attending routine antenatal care in rural South Africa. method: A consecutive series of 109 women in the second half of pregnancy were enrolled in a cross-sectional study at a large primary health care facility in a rural area of KwaZulu-Natal with high HIV prevalence. Using a mixed-methods approach, women were assessed using the major Depression Section of the Structured Clinical Interview for Depression (SCID) for DSm-IV diagnosis;qualitative interview data were collected on women’s experiences of suicide ideation and plans. Women were assessed two weeks after routine HIV testing as part of Prevention of mother-to-Child Transmission (PmTCT) screening. Results: Both HIV-positive (49/109) and HIV-negative (60/109) women were assessed. Depression was high (51/109, 46.7%) and equally common amongst HIV-positive and negative women. Suicide ideation was high (30/109, 27.5%) with thoughts of self harm closely linked to suicide plans. Age, previous history of depression and current depression were significantly associated with suicide ideation. Close to equal numbers of HIV-positive and negative women were suicidal. Suicide methods were frequently violent and most women cited family and partnership conflict related to an unplanned pregnancy or their newly HIV-positive status as triggers to their suicide ideation. Conclusions: Rates of suicide ideation among pregnant women testing for HIV are high. Testing HIV-positive causes considerable distress, and among HIV-negative women unplanned and unwanted pregnancies are important risk factors for suicide ideation. Pregnancy brings women into increased contact

关键词： uicide Ideation Pregnancy Depression HIV Rural South Africa

Climate System Response to the Toba mega Eruption

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Climate System Response to the Toba Mega Eruption

CYP1B1-derived epoxides modulate the TRPA1channel in chronic pain

International Conference on Continental Volcanism

作者： Caspar m. Ammann alan Robock Samuel Levis Climate and Global Dynamics Division National Center for Atmospheric Research1850 Table Mesa DriveBoulderCO 80307-3000USA Center for Environmental Prediction Department of Environmental SciencesRutgers University14 College Farm RoadNew BrunswickNJ 08901-8551USA Climate and Global Dynamics Division National Center for Atmospheric Research1850 Table Mesa DriveBoulderCO 80307-3000USA

＜正＞Large explosive volcanic eruptions have repeatedly imposed significant radiative forcing onto the Earth’s climate system during historical times. The optical effects following eruptions such as Tambora （1815） or Krakatau （1883）, and, most recently, the eruption of Pinatubo （1991）, have generated attention around the world. The volcanic aerosol also left a clearly detectable climate signal through a general large scale cooling and changes in atmospheric circulation. The global hydrologic cycle has been temporarily slowed down

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Acta Pharmaceutica Sinica B 2023年第1期13卷 68-81页

作者： Lili Sun Jie Zhang Changshan Niu Cassandra E.Deering-Rice Ronald W.Hughen John G.Lamb Katherine Rose Kevin m.Chase marysol Almestica-Roberts markel Walter Eric W.Schmidt alan R.Light Baldomero m.Olivera Christopher A.Reilly Department of Pharmacology and Toxicology Center for Human ToxicologyUniversity of UtahSalt Lake CityUT84112USA Department of Anesthesiology School of MedicineUniversity of UtahSalt Lake CityUT 84112USA Department of medicinal Chemistry University of UtahSalt Lake CityUT 84112USA School of Biological Sciences University of UtahSalt Lake CityUT 84112USA

Pain is often debilitating,and current treatments are neither universally efficacious nor without *** receptor potential(TRP)ion channels offer alternative targets for pain relief,but little is known about the regulation or identities of endogenous TRP ligands that affect inflammation and ***,transcriptomic and targeted lipidomic analysis of damaged tissue from the mouse spinal nerve ligation(SNL)-induced chronic pain model revealed a time-dependent increase in Cyp1b1 mRNA and a concurrent accumulation of 8,9-epoxyeicosatrienoic acid(EET)and 19,20-EpDPA post *** of 8,9-EET and 19,20-EpDPA by human/mouse CYP1B1 was confirmed in vitro,and 8,9-EET and 19,20-EpDPA selectively and dose-dependently sensitized and activated TRPA1 in overexpressing HEK-293 cells and Trpa1-expressing/AITC-responsive cultured mouse peptidergic dorsal root ganglia(DRG)***1 activation by 8,9-EET and 19,20-EpDPA was attenuated by the antagonist A967079,and mouse TRPA1 was more responsive to 8,9-EET and 19,20-EpDPA than human *** latter effect mapped to residues Y933,G939,and S921 of ***-plantar injection of 19,20-EpDPA induced acute mechanical,but not thermal hypersensitivity in mice,which was also blocked by ***,Cyp1b1-knockout mice displayed a reduced chronic pain phenotype following SNL *** data suggest that manipulation of the CYP1B1-oxylipin-TRPA1 axis might have therapeutic benefit.

关键词： CYPIB1 Spinal nerve ligation Epoxides TRPA1 Calcium imaging Hyperalgesia Chronic pain Inflammation

New considerations on the phylogeny of Sessilida(Protista:Ciliophora:Peritrichia)based on multiple-gene information,with emphasis on colonial taxa

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marine Life Science & Technology 2022年第4期4卷 569-583页

作者： Zhe Wang Xiaoting Feng Lifang Li Khaled A.S.Al-Rasheid alan Warren Chundi Wang Zemao Gu marine College Shandong UniversityWeihai264209China College of Fisheries/Shuangshui ShuanglüInstitute Huazhong Agricultural UniversityWuhan430070China Hubei Engineering Technology Research Center for Aquatic Animal Diseases Control and Prevention Wuhan430070China Department of Zoology College of ScienceKing Saud UniversityRiyadh11451Saudi Arabia Department of Life Sciences Natural History MuseumLondonSW75BDUK

The subclass Peritrichia,containing two orders Sessilida and mobilida,is a major group of ciliates with worldwide distribution and high species *** studies have investigated the phylogeny of peritrichs;however,the evolutionary relationships and classification of some families and genera within the Sessilida remain *** the present study,we isolated and identified 22 peritrich populations representing four families and six genera and obtained 64 rDNA sequences to perform phylogenetic analyses and assess their systematic *** character reconstruction was also carried out to infer evolutionary routes within the *** results indicate:(1)family Vaginicolidae is monophyletic and acquisition of the typical peritrich lorica represents a single evolutionary divergence;(2)core epistylidids evolved from a Zoothamnium-like ancestor and experienced spasmoneme loss during evolution;(3)Campanella clusters with species in the basal clade and shows stable morphological differences with other epistylidids,supporting its assignment to a separate family;(4)the structure of the peristomial lip may be a genus-level character rather than a diagnostic character for discriminating Epistylididae and Operculariidae,thus a redefinition of Operculariidae should be carried out when more species have been investigated;(5)some characters,such as lifestyle(solitary or colonial),spasmoneme and living habit(sessile or free-swimming),evolved repeatedly among sessilids indicating that species with non-contractile stalks or that are free-swimming have multiple evolutionary routes and might derive from any sessilid lineage without a *** close phylogenetic relationships of some morphologically distinct sessilids imply that the diagnoses of some genera and families should be improved.

关键词： Ancestral state reconstruction Ciliates morphology Peritrichs Phylogenetic analyses

Interaction between pollution and climate change augments ecological risk to a coastal ecosystem

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Ecosystem Health and Sustainability 2018年第7期4卷 2-9页

作者： Yonglong Lu Ruoshi Wang Yajuan Shi Chao Su Jingjing Yuan Andrew C.Johnson alan Jenkins Robert C.Ferrier Deliang Chen Hanqin Tian Jerry melillo Shuai Song Aaron m.Ellison State Key Laboratory of Urban and Regional Ecology Research Center for Eco-Environmental SciencesChinese Academy of SciencesBeijingChina University of Chinese Academy of Sciences BeijingChina cRenmin University of China BeijingChina Centre for Ecology and Hydrology OxonUK James Hutton Institute AberdeenScotlandUK Department of Earth Sciences University of GothenburgGothenburgSweden International Center for Climate and Global Change Research and School of Forestry and Wildlife SciencesAuburn UniversityAuburnALUSA The Ecosystem Center Marine Biological LaboratoryWoods HoleMAUSA Harvard Forest Harvard UniversityWoods HoleMAUSA

Pollution and climate change are among the most challenging issues for countries with developing economies,but we know little about the ecological risks that result when these pressures occur *** explored direct effects of,and interactions between,environmental pollution and climate change on ecosystem health in the Bohai Sea region of Northern *** developed an integrated approach to assess ecological risks to this region under four scenarios of climate *** ecological risks to the system from pollution alone have been declining,interactions between pollution and climate change have enhanced ecological risks to this coastal/marine *** results suggest that current policies focused strictly on pollution control alone should be changed to take into account the interactive effects of climate change so as to better forecast and manage potential ecological risks.

关键词： Climate change environmental pollution environmental risk stressors integrated ecological risk coastal ecosystem

Treatment for mild Chronic Hypertension during Pregnancy

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四川生理科学杂志 2022年第2期44卷 328-328页

作者： alan T Tita From the Department of Obstetrics and Gynecology (A.T.T. W.W.A.) the Center for Women’s Reproductive Health (A.T.T. J.M.S. N.A. S.O. G.R.C. W.W.A.) the Department of Biostatistics (J.M.S. G.R.C.) the Division of Neonatology Department of Pediatrics (N.A.) and the Division of Cardiovascular Disease Department of Medicine (S.O.) University of Alabama Birmingham the Department of Obstetrics and Gynecology University of North Carolina at Chapel Hill (K.B.) and the Department of Obstetrics and Gynecology Duke University Durham (B.L.H.) — both in North Carolina the Department of Obstetrics and Gynecology University of Pennsylvania (L.D.) and the Department of Obstetrics and Gynecology Drexel University College of Medicine (L.P.) Philadelphia St. Luke’s University Health Network Fountain Hill (J.B.) and the Department of Obstetrics and Gynecology Magee Women’s Hospital University of Pittsburgh Pittsburgh (H.N.S.) — all in Pennsylvania the Department of Obstetrics and Gynecology University of Texas (B.S.) and the Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children’s Hospital Houston (K.A.) the Department of Obstetrics and Gynecology University of Texas Southwestern Medical Center Dallas (B.C.) the Department of Obstetrics and Gynecology University of Texas Medical Branch Galveston (G.R.S.) and the Department of Women’s Health University of Texas Austin (L.H.) the Department of Obstetrics and Gynecology Columbia University (K.L.) Weill Cornell University (P.A.) and the Department of Obstetrics and Gynecology New York Presbyterian Queens Hospital (D.S.) New York and the Department of Obstetrics and Gynecology Winthrop University Hospital Mineola (W.K.) — all in New York the Department of Obstetrics and Gynecology University of Oklahoma Health Sciences Oklahoma City (R.K.E.) metroHealth System Cleveland (K.G.) the Department of Obstetrics and Gynecology Indiana University Indianapolis (D.M.H.) the Department of Obstetrics and Gynecology

Background:The benefits and safety of the treatment of mild chronic hypertension(blood pressure,<160/100 mm Hg)during pregnancy are *** are needed on whether a strategy of targeting a blood pressure of less than 140/9... 详细信息

Background:The benefits and safety of the treatment of mild chronic hypertension(blood pressure,mm Hg)during pregnancy are *** are needed on whether a strategy of targeting a blood pressure of less than 140/90 mm Hg reduces the incidence of adverse pregnancy outcomes without compromising fetal growth.

关键词： pregnancy fetal hypertension