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Impact of a Pharmacist Implemented Protocol on Overall Use of Alvimopan （Entereg） and Length of Stay in Laparoscopic Colorectal Surgeries

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journal of Pharmacy and Pharmacology 2016年第10期4卷 521-525页

作者： Halle M. Orlinski Rachana R. Patel bradley j. Champagne joseph A. Trunzo Karen L. Kier University Hospitals St. john Medical Center Westlake Ohio 44145 USA

The primary objective of this study is to assess the impact of a pharmacist-implemented protocol on number of post-operative alvimopan doses. The secondary objective of this study is to assess LOS （length of stay）, in days, before and after protocol implementation. A retrospective chart review was conducted from October 2015 through March 2016 for all laparoscopic colorectal surgeries. Number of post-operative alvimopan doses received and LOS was recorded for each patient that received at least one dose of alvimopan. Comparative data, before protocol implementation, from November 2014 through june 2015 were analyzed against the study data. Number of post-operative alvimopan doses and LOS were recorded. The mean number of doses was 6.41 in the comparator group and 4.25 in the study group （probability size P 〈 0.001）, which did meet statistical significance. Although the secondary objective was not statistically significant, LOS slightly decreased as the mean LOS was 5.01 days in the comparator group versus 4.49 days in the study group （P = 0.256）. At the current price of $120 per capsule, close to $30,000 was saved during the study period, projecting an annual cost savings of approximately $68,000. Results from this study show that pharmacists can play a vital role in cost savings and ensuring appropriate use of certain high-risk medications, like alvimopan, without increasing overall length of stay.

关键词： Alvimopan pharmacist-implemented colorectal cost savings.

A novel non-invasive method for predicting bone mineral density and fracture risk using demographic and anthropometric measures

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Sports Medicine and Health Science 2023年第4期5卷 308-313页

作者： justin Aflatooni Steven Martin Adib Edilbi Pranav Gadangi William Singer Robert Loving Shreya Domakonda Nandini Solanki Patrick C.McCulloch bradley Lambert Orthopedic Biomechanics Research Laboratory Department of Orthopedics and Sports MedicineHouston Methodist HospitalHoustonTXUSA Sydney&j.L.Huffines Institute for Sports Medicine&Human Performance Department of Health and KinesiologyTexas A&M UniversityCollege StationTXUSA

Fractures are costly to treat and can significantly increase *** dual-energy x-ray absorptiometry(DEXA)is used to screen at risk people with low bone mineral density(BMD),not all areas have access to *** sought to create a readily accessible,inexpensive,high-throughput prediction tool for BMD that may identify people at risk of fracture for further *** and demographic data were collected from 492 volunteers(♂275,♀217;[44-20]years;Body Mass Index(BMI)=[27.6-6.0]kg/m^(2))in addition to total body bone mineral content(BMC,kg)and BMD measurements of the spine,pelvis,arms,legs and total ***-linear-regression with step-wise removal was used to develop a two-step prediction model for BMC followed by *** selection was determined by the highest adjusted R2,lowest error of estimate,and lowest level of variance inflation(α=0.05).Height(HTcm),age(years),sex^(m=1,f=0),%body fat(%fat),fat free mass(FFMkg),fat mass(FMkg),leg length(LLcm),shoulder width(SHWDTHcm),trunk length(TRNKLcm),and pelvis width(PWDTHcm)were observed to be significant predictors in the following two-step model(p<0.05).Step1:BMC(kg)=(0.0063×HT)+(-0.0024×AGE)+(0.1712×SEX^(m=1,f=0))+(0.0314×FFM)+(0.001×FM)+(0.0089×SHWDTH)+(-0.0145×TRNKL)+(-0.0278×PWDTH)-0.5073;R^(2)=0.819,***2:Total body BMD(g/cm^(2))=(-0.0028×HT)+(-0.0437×SEX^(m=1,f=0))+(0.0008×%FAT)+(0.2970×BMC)+(-0.0023×LL)+(0.0023×SHWDTH)+(-0.0025×TRNKL)+(-0.0113×PWDTH)+1.379;R^(2)=0.89,*** models were also developed to predict leg,arm,spine,and pelvis BMD(R^(2)=0.796-0.864,p<0.05).The equations developed here represent promising tools for identifying individuals with low BMD at risk of fracture who would benefit from further evaluation,especially in the resource or time restricted setting.

关键词： Bone Bone density Fracture Fracture risk Assessment Osteoporosis

The health and economic benefits of the global programme to eliminate lymphatic filariasis (2000–2014)

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Infectious Diseases of Poverty 2016年第1期5卷 453-471页

作者： Hugo C.Turner Alison A.Bettis Brian K.Chu Deborah A.McFarland Pamela j.Hooper Eric A.Ottesen Mark H.bradley London Centre for Neglected Tropical Disease Research LondonUK Department of Infectious Disease Epidemiology School of Public HealthFaculty of MedicineSt Marys CampusImperial College LondonNorfolk PlaceLondon W21PGUK Neglected Tropical Diseases Support Center Task Force for Global HealthDecaturGAUSA Rollins School of Public Health Emory UniversityAtlantaGAUSA. Global Health Programs GlaxoSmithKlineLondonUK

Background:Lymphatic filariasis(LF),also known as elephantiasis,is a neglected tropical disease(NTD)targeted for elimination through a Global Programme to Eliminate LF(GPELF).Between 2000 and 2014,the GPELF has delivered 5.6 billion treatments to over 763 million *** the estimated health and economic benefits of this significant achievement is important in justifying the resources and investment needed for eliminating ***:We combined previously established models to estimate the number of clinical manifestations and disability-adjusted life years(DALYs)averted from three benefit cohorts(those protected from acquiring infection,those with subclinical morbidity prevented from progressing and those with clinical disease alleviated).The economic savings associated with this disease prevention was then analysed in the context of prevented medical expenses incurred by LF clinical patients,potential income loss through lost-labour,and prevented costs to the health system to care for affected *** indirect cost estimates were calculated using the human capital approach.A combination of four wage sources was used to estimate the fair market value of time for an agricultural worker with LF infection(to ensure a conservative estimate,the lowest wage value was used).Results:We projected that due to the first 15 years of the GPELF 36 million clinical cases and 175(116–250)million DALYs will potentially be *** was estimated that due to this notable health impact,US$100.5 billion will potentially be saved over the lifetimes of the benefit *** total amount results from summing the medical expenses incurred by LF patients(US$3 billion),potential income loss(US$94 billion),and costs to the health system(US$3.5 billion)that were projected to be *** results were subjected to sensitivity analysis and were most sensitive to the assumed percentage of work hours lost for those suffering from chronic disease(changing the total economic

关键词： Lymphatic filariasis DALYs averted Health impact Economic impact GPELF Programme evaluation

美国南卡罗莱纳州无纤维橡胶改性OGFC温拌混合料及试验路研究

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中外公路 2017年第1期37卷 258-264页

作者：郑鑫张科边开磊张春杰张智禹 bradley j.Putman Kimberly R.Lyons 中国石油天然气管道工程有限公司河北廊坊065000

该文对美国南卡罗莱纳州两条(开级配沥青混合料)OGFC试验路进行了针对性研究与总结,以确定不掺加纤维是否会对OGFC混合料的性能产生影响。其中一条试验路包含3种OGFC混合料:掺加木质素纤维的热拌沥青混合料(HMA)、未掺纤维而采用废轮胎... 详细信息

该文对美国南卡罗莱纳州两条(开级配沥青混合料)OGFC试验路进行了针对性研究与总结,以确定不掺加纤维是否会对OGFC混合料的性能产生影响。其中一条试验路包含3种OGFC混合料:掺加木质素纤维的热拌沥青混合料(HMA)、未掺纤维而采用废轮胎橡胶粉改性的沥青混合料(GTR),未掺纤维的温拌沥青混合料(WMA);另一条试验路包含两种:HMA、WMA。试验结果表明:(1)不掺加纤维对混合料的析漏损失、渗水率、抗磨耗性、间接拉伸强度和抗疲劳强度并未产生不利影响;(2)虽然没有掺加木质素纤维,采用温拌技术生产的温拌沥青混合料的抗疲劳强度仍然高于HMA混合料;(3)温拌沥青混合料可能会减少摊铺初始阶段(可流动的沥青混合料首先通过冷的材料传送装置,然后到达冷的摊铺装置)的热量损失,而较低的热量损失能够改善摊铺初始位置横向冷接缝附近OGFC面层的密度稳定性,从而可能改善路面性能。

关键词： OGFC路面 HMA GTR WMA 纤维性能

减少全球NO_x排放:开发先进的能量和运输技术

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AMBIO－人类环境杂志 2002年第2期31卷 141-149页

作者： Michael j.bradley Brian M.jones 肖玉美国洁净空气法案顾问委员会 M.j.bradley & Associates公司

从全球范围来讲,未来能量需求将会持续增长。由于发展中国家要提高其生活水平,因此,在可预见的将来,全球NO_x排放会呈现出不断增加的趋势。美国采取了一些改善措施来减少固定和流动污染源的NO_x排放,以减少对臭氧层的损坏。同时需要采... 详细信息

从全球范围来讲,未来能量需求将会持续增长。由于发展中国家要提高其生活水平,因此,在可预见的将来,全球NO_x排放会呈现出不断增加的趋势。美国采取了一些改善措施来减少固定和流动污染源的NO_x排放,以减少对臭氧层的损坏。同时需要采取进一步的改进措施以降低与NO_x排放有关的对身体健康和生态系统的影响。由于对电力和运输需求的增长,在世界上其他地区(尤其是发展中国家)NO_x排放一直在稳定增长。如果实施适当的政策措施,能源和运输技术的改善会有助于减少NO_x排放。这篇论文评价了商用电力生产和运输技术,相对于传统技术而言,它们排放较少的NO_x,同时还评价了近10年内商用方面的先进技术。文章还评估了可以在地区、国家和全球水平上实施的不同政策措施,以此来促进这些先进技术的开发并最终减少NO_排放。论文提出了技术飞跃的概念,很可能有助于发展中国家缩减那些导致NO_x排放增大的项目。

关键词： NOx排放能量运输全球范围空气污染先进技术

Pancreatic exocrine insufficiency after pancreaticoduodenectomy: Current evidence and management

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World journal of Gastrointestinal Pathophysiology 2020年第2期11卷 20-31页

作者： Adithya M Pathanki joseph A Attard Elizabeth bradley Sarah Powell-Brett Bobby V M Dasari john R Isaac Keith j Roberts Nikolaos A Chatzizacharias Department of HPB and Liver Transplantation Queen Elizabeth HospitalUniversity Hospitals BirminghamBirmingham B152THUnited Kingdom Department of Nutrition and Dietetics Queen Elizabeth HospitalUniversity Hospitals BirminghamBirmingham B152THUnited Kingdom

Pancreaticoduodenectomy(PD)is the commonest procedure performed for pancreatic *** exocrine insufficiency(PEI)may be caused or exacerbated by surgery and remains underdiagnosed and *** aim of this review was to ascertain the incidence of PEI,its consequences and management in the setting of PD for indications other than chronic pancreatitis.A literature search of databases(MEDLINE,EMBASE,Cochrane and Scopus)was carried out with the MeSH terms“pancreatic exocrine insufficiency”and“Pancreaticoduodenectomy”.Studies that analysed PEI and its complications in the setting of PD for malignant and benign disease were *** reporting PEI in the setting of PD for chronic pancreatitis,conference abstracts and reviews were *** incidence of PEI approached 100%following PD in some *** pre-operative incidence varied depending on the characteristics of the patient cohort and it was higher(46%-93%)in series where pancreatic cancer was the predominant indication for *** was also recorded with regards to the method used for the diagnosis and evaluation of pancreatic function and *** enzyme replacement therapy is the mainstay of the *** is common and remains undertreated after *** studies are required for the identification of a welltolerated,reliable and reproducible diagnostic test in this setting.

关键词： Pancreatic exocrine insufficiency Pancreaticoduodenectomy Pancreatic enzyme replacement therapy Pancreatic cancer Malabsorption Steatorrhoea

Use of Three Dimensional Conformal Radiation Therapy for Node Positive Breast Cancer Does Not Result in Excess Lung and Heart Irradiation

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International journal of Medical Physics, Clinical Engineering and Radiation Oncology 2017年第1期6卷 1-9页

作者： Phillip Prior Irina Sparks j. Frank Wilson joseph Bovi Adam Currey julie bradley Tracy Kelly X. Allen Li julia R White Department of Radiation Oncology Medical College of Wisconsin Milwaukee WI USA Department of Radiation Oncology Ohio State University Columbus OH USA

Purpose: This work evaluates the use of target and organs at risk (OAR) dose-volume goals in 3D conformal radiotherapy (3DCRT) planning for node positive breast cancer (NPBC) patients undergoing regional nodal irradiation after lumpectomy/mastectomy. Methods: Dosimetric data for 262 NPBC patients receiving regional nodal and whole breast/chest wall (WB/CW) irradiation from 2000-2009 were analyzed. In all cases, target & OAR volumes were delineated on treatment CT scans for field generation and dose-volume histograms (DVHs) were generated. Cases were analyzed to identify how frequently they met treatment planning institutional dose-volume goals (“institutional guidelines” & standardized in 2005) and how this would affect OAR doses. Results: The incidence of cases from 2000-2009 meeting current institutional guidelines improved over the study period. Target coverage improved from 2005-2009, when guidelines were followed as a part of the plan approval. Those cases from 2000-2004 meeting acceptable target goals were found to be significantly different from those cases from 2005-2009 (p < 0.01). However, no significant difference between cases meeting OAR goals for plans from 2000-2004 versus 2005-2009 was found. Conclusions: The use of institutional guidelines in 3DCRT for WB/CW and regional nodal irradiation for NPBC patients improved target coverage without a statistically significant increase in heart and lung doses.

关键词： Node Positive Breast Cancer Dose-Volume Goals Target Coverage CT Based Planning

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静脉畸形（英文）

影像诊断与介入放射学 2014年第6期23卷 535-536页

作者： William G bradley William j Zwiebel Anne Roberts 关键中山大学附属第一医院医学影像科广州510080

Key Facts(1)Venous angioma(VA)consists of angiogenically mature elements,represent anatomic variants of normal venous drainage(also called"developmental venous anomalies").(2)Most VAs are asymptomatic.(3)VAs may be hi... 详细信息

关键词：静脉畸形临床治疗影像诊断

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脑表面铁沉积

影像诊断与介入放射学 2015年第2期24卷 174-175页

作者： William G bradley William j Zwiebel Anne Roberts 关键中山大学附属第一医院医学影像科广州510080

Key facts Synonym:***:Hemosiderin staining of leptomenginges following repeated subarachnoid hemorrhage(SAH).Classic imaging appearance:surface of brain appears to be outlined in black on *** causes deafness and *** finding General features:Best imaging clue is black outline of brain on *** findings:(1)Cerebral atrophy;(2)Slightly hyperdense rim over brain surface.

关键词：铁沉积软脑膜共济失调耳聋