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Closing the Gap in Primary Care: A Systematic Review and Interpretation

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International Journal of Clinical Medicine 2022年第6期13卷 213-220页

作者： Katon harwood Joe Frye Harrison Albo School of Osteopathic Medicine Campbell University Lillington USA Department of Public Health Clemson University Clemson USA

Objective: The United States faces a health care provider shortage yearly in many areas of the country, but most of all the rural areas are most impacted. The aim of this paper is 2-fold: To understand the factors that drive a medical student’s specialty choice through a systematic review article and how government initiatives consider what is important to students, to understand how other clinicians can help close the gap in primary care in the United States and what policies or barriers prevent them from doing so. Methods: This paper looks at nationally collected data, as well as meta-analysis reviews on the topic to help the reader better understand the issue of health care provider shortages. Conclusion: We must change the way we look at primary care and rural medicine. Rather than investing money in avenues that yield little return on investment, we as a nation should strategically fund and advance the scope of practice for rural medicine to make it attractive and competitive for clinicians to pursue. Being in a large deficit of clinical providers in general in our country, we must try to find new pathways to grow coverage in rural areas before our health care system is no longer equitable.

关键词： Rural Medicine Healthcare Shortage Primary Care

Clinical Decision Making in Open vs Arthroscopic Rotator Cuff Repair: Evidence for Preoperative Decision Making

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Open Journal of Orthopedics 2022年第7期12卷 297-302页

作者： Katon harwood Zachary Hubler James Cappola III School of Osteopathic Medicine Campbell University Lillington USA

Objective: To further understand what factors should be considered when deciding to do mini-open versus arthroscopic rotator cuff repair. Methods: A systematic literature search on the computer was done with the help of the PubMed database. Of the articles searched through, three have been chosen to specifically address topics of interest concerning the factors affecting arthroscopic vs mini-open RCR surgical approaches. Discussion: As we continue to progress down the line of factors impacting a clinician’s decision making, we begin to see how postoperative management is unchanged. Tear severity lacks sufficient evidence to base a decision on, but financial, educational, and logistical factors are proven to play a significant role in this decision. Conclusion: As of right now it seems that mini-open RCR is the most cost and time efficient method, especially amongst non-fellowship trained surgeons or ones with lower volume of shoulder scopes. However, further studies should be done to examine cost and efficiency in Sport Medicine fellowship trained orthopedic surgeons to validate these findings.

关键词： Rotator Cuff Repair Shoulder Arthroscopy Mini-Open Rotator Cuff Repair Arthroscopic Rotator Cuff Repair

董氏中华盗龙(兽脚类:异特龙超科)脑颅新知:筛区、颅腔解剖和具气腔(英文)

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古脊椎动物学报 2012年第2期50卷 85-101页

作者： ariana PAULINA CARABAJAL Philip J．CURRIE 阿根廷国家科学技术研究委员会-卡门·富内斯博物馆内乌肯普拉萨温库尔8318 加拿大阿尔伯塔大学埃德蒙顿T6G2E9

董氏中华盗龙(Sinraptor dongi) 是产自中国西北部新疆侏罗纪石树沟组上部的一种大型兽脚类。其正型标本包括了保存完好的脑颅,这是在最近的化石修理中额外发现的。脑颅中骨化筛骨的横切面为 U 形。在脑颅的解剖方位,蝶筛骨和眶蝶骨之... 详细信息

董氏中华盗龙(Sinraptor dongi) 是产自中国西北部新疆侏罗纪石树沟组上部的一种大型兽脚类。其正型标本包括了保存完好的脑颅,这是在最近的化石修理中额外发现的。脑颅中骨化筛骨的横切面为 U 形。在脑颅的解剖方位,蝶筛骨和眶蝶骨之间有一未骨化空间,表明该恐龙存活时具有软骨质的中隔蝶骨。利用乳胶颅腔模型和 CT 扫描技术对颅腔和含气隐窝的形态进行了研究,发现了一些此前未描述过的特点。其中尤为引人注目的是,发育良好的尾鼓室隐窝[一般认为是虚骨龙类(coelurosaurs) 的典型特征]以及基蝶骨隐窝和相关气腔的内部形态。侧鼓室隐窝和基蝶骨隐窝有纵向通道连接,很可能同时具有气腔和血管功能。模型也表明,颅腔没有髓质隆起,小脑绒球隐窝的开孔为沙漏状。若不包含嗅束和嗅球,颅腔容积为 95 ml,脑容商在其他基干坚尾龙类( tetanurans) 的范围内。虽然这些类群的第Ⅱ-Ⅳ对脑神经相对位置各有差异,但前脑、中脑和后脑之间的角度与鲨齿龙类( carcharodontosaurids) [鲨齿龙(Carcharodontosaurus) 及南方巨兽龙(Giganotosaurus) ]相似。第Ⅸ,Ⅹ和Ⅺ对脑神经穿过一个半月形的孔。在异特龙超科( Allosauroidea) 中,中华盗龙(Sinraptor) 在颅腔形态上与鲨齿龙、南方巨兽龙和异特龙( Allosaurus) 的相似程度比它与高棘龙(Acrocanthosaurus) 的相似程度更高。

关键词：中国侏罗系异特龙类脑颅古神经学

Early Weight Bearing Post Subchondral Microfracture Knee Arthroscopy: A Case Report

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Open Journal of Orthopedics 2022年第5期12卷 253-257页

作者： Katon harwood Kelsey Fraser John Spellman School of Osteopathic Medicine Campbell University Lillington NC USA Department of Orthopedic Surgery Carteret Health Care Morehead City NC USA

Traditionally physicians have advised patients to be non-weight bearing post arthroscopic knee microfracture surgery for at least 2 to 8 weeks. The microfracture procedure is a simple, low-risk method to induce self-cartilage regeneration to focal lesions. The procedure has shown that small fractures to the subchondral bone can recruit mesenchymal stem cells and growth factors to regenerate the fibrocartilage without compromising the subchondral plate. With the simplicity of this procedure and the positive effect it can have on patients, it is natural to want to push the bounds of rehabilitation to see what is necessary. The patient in this case report exhibits the potential for positive outcomes with early weight-bearing status in patients receiving microfractures via subchondral drilling. This positive outcome, along with others, should encourage clinicians to consider reestablishing evidence-guided rehabilitation post microfracture with new studies. Shortened rehabilitation time would decrease a barrier to surgery for many patients and would only enhance our treatment with this surgical modality.

关键词： Microfracture Patellofemoral Chondrosis Patellar Maltracking

Cambridge IGCSE chemistry coursebook 4

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Exercise interventions for older adults: A systematic review of meta-analyses

2014年

作者： Richard harwood Ian Lodge

ISBN: (纸本)9781107615038

This edition of our successful series to support the Cambridge IGCSE Chemistry syllabus (0620) is fully updated for the revised syllabus from first examination from 2016. Written by a team with teaching and examining experience, Cambridge IGCSE Chemistry Coursebook with CD-ROM gives comprehensive and accessible coverage of the syllabus. Suggestions for practical activities are included, designed to help develop the required experimental skills, with full guidance included on the CD-ROM. Study tips throughout the text, exam-style questions at the end of each chapter and a host of revision and practice material on the CD-ROM are designed to help students prepare for their examinations. Answers to the exam-style questions in the Coursebook are provided on the CD-ROM.

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Journal of Sport and Health Science 2021年第1期10卷 29-47,I0001页

作者： Claudio Di Lorito Annabelle Long Adrian Byrne Rowan H.harwood John R.F.Gladman Stefan Schneider Pip Logan Alessandro Bosco Veronika van der Wardt Division of Rehabilitation Ageingand WellbeingSchool of MedicineUniversity of NottinghamNottingham NG72UHUK Division of Health Sciences School of MedicineUniversity of NottinghamNottingham NG72UHUK Institute of Movement and Neurosciences German Sport UniversityCologne 50933Germany Division of Psychiatry and Applied Psychology School of MedicineUniversity of NottinghamNottingham NG72UHUK Center for Methodology and Health Research Department of General MedicinePreventive and Rehabilitative MedicinePhilipps-Universität MarburgMarburg 35032Germany

Background:The evidence concerning which physical exercise characteristics are most effective for older adults is *** aimed to characterize the extent of this diversity and inconsistency and identify future directions for research by undertaking a systematic review of metaanalyses of exercise interventions in older ***:We searched the Cochrane Database of Systematic Reviews,PsycInfo,MEDLINE,Embase,CINAHL,AMED,SPORTDiscus,and Web of Science for articles that met the following criteria:(1)meta-analyses that synthesized measures of improvement(e.g.,effect sizes)on any outcome identified in studies of exercise interventions;(2)participants in the studies meta-analyzed were adults aged 65+or had a mean age of 70+;(3)meta-analyses that included studies of any type of exercise,including its duration,frequency,intensity,and mode of delivery;(4)interventions that included multiple components(e.g.,exercise and cognitive stimulation),with effect sizes that were computed separately for the exercise component;and(5)meta-analyses that were published in any year or *** characteristics of the reviews,of the interventions,and of the parameters improved through exercise were reported through narrative *** of the interventions linked to the largest improvements was carried out by identifying the highest values for improvement recorded across the *** study included 56 meta-analyses that were heterogeneous in relation to population,sample size,settings,outcomes,and intervention ***:The largest effect sizes for improvement were found for resistance training,meditative movement interventions,and exercise-based active ***:The review identified important gaps in research,including a lack of studies investigating the benefits of group interventions,the characteristics of professionals delivering the interventions associated with better outcomes,and the impact of motivational strategies and of sig

关键词： Intervention Meta-analyses Old Physical exercise Systematic review

Aging and uremia:Is there cellular and molecular crossover?

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World Journal of Nephrology 2015年第1期4卷 19-30页

作者： William E White Muhammad M Yaqoob Steven M harwood Queen Mary University of London Translational Medicine and TherapeuticsWilliam Harvey Research InstituteJohn Vane Science CentreEC1M 6BQ LondonUnited Kingdom Department of Nephrology Barts Health NHS TrustThe Royal London HospitalWhitechapelE1 1BB LondonUnited Kingdom

Many observers have noted that the morphological changes that occur in chronic kidney disease(CKD) patients resemble those seen in the geriatric population, with strikingly similar morbidity and mortality profiles and rates of frailty in the two groups, and shared characteristics at a pathophysiological level especially in respect to the changes seen in their vascular andimmune systems. However, whilst much has been documented about the shared physical characteristics of aging and uremia, the molecular and cellular similarities between the two have received less attention. In order to bridge this perceived gap we have reviewed published research concerning the common molecular processes seen in aging subjects and CKD patients, with specific attention to altered proteostasis, mitochondrial dysfunction, post-translational protein modification, and senescence and telomere attrition. We have also sought to illustrate how the cell death and survival pathways apoptosis, necroptosis and autophagy are closely interrelated, and how an understanding of these overlapping pathways is helpful in order to appreciate the shared molecular basis behind the pathophysiology of aging and uremia. This analysis revealed many common molecular characteristics and showed similar patterns of cellular dysfunction. We conclude that the accelerated aging seen in patients with CKD is underpinned at the molecular level, and that a greater understanding of these molecular processes might eventually lead to new much needed therapeutic strategies of benefit to patients with renal disease.

关键词： Aging Uremia Apoptosis Autophagy Senescence Telomeres Mitochondria Post-transla-tional protein modification Klotho

Presence of the deep-bodied pipefish, <i>Leptonotus blainvilleanus </i>(Eydoux &Gervais, 1837) [Syngnathiformes: Syngnathidae], in San Jorge Gulf, Patagonia, Argentina

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Open Journal of Ecology 2012年第2期2卷 58-59页

作者： Guillermo M. Caille ariana Apezteguia Daniel Vaquero Pablo Cochia Ciencias Naturales Universidad Nacional de la Patagonia Trelew Argentina Fundación Patagonia Natural Puerto Madryn Argentina

This short report communicates the finding of a Deep-bodied pipefish, Leptonotus blainvilleanus, (Eydoux & Gervais, 1837) [Syngnathiformes, Syngnathidae] in shallow waters of the San Jorge Gulf, Patagonia Argentina, in August 2010. It’s a new record for its known distribution range in the coast of South America. Photos and videos are available.

关键词： Syngnathidae Leptonotus balainvilleanus San Jorge Gulf Coastal Cold-Temperate Waters Patagonia Argentina

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未来农场的想象图景

党员文摘 2023年第17期 24-25页

作者： ariana 不详

请想象这样一个场景:你站在超市货架前方,这里的灯光都被控制在最佳色温范围内,好让谷饲牛肉、有机蔬菜、应季水果显现出恰到好处的光泽。营销话术告诉我们,这些琳琅满目的商品本就该是如此诱人:牛、羊来自山清水秀的地方,享受过你我都... 详细信息

请想象这样一个场景:你站在超市货架前方,这里的灯光都被控制在最佳色温范围内,好让谷饲牛肉、有机蔬菜、应季水果显现出恰到好处的光泽。营销话术告诉我们,这些琳琅满目的商品本就该是如此诱人:牛、羊来自山清水秀的地方,享受过你我都不曾拥有的田园牧歌式生活。

关键词：田园牧歌式有机蔬菜想象恰到好处