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Temporal trends and practice variation of paediatric diagnostic tests in primary care:retrospective analysis of 14 million tests

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Family Medicine and Community Health 2024年第4期12卷 1-8页

作者： Elizabeth T Thomas Diana R Withrow Cynthia Wright Drakesmith Peter j.gill Rafael Perera-Salazar Carl Heneghan Centre for Evidence-Based Medicine Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK Nuffield Department of Primary Care Health Sciences University of OxfordOxfordUK Department of Pediatrics University of TorontoTorontoOntarioCanada Hospital for Sick Children TorontoOntarioCanada

Objective The primary objective was to investigate temporal trends and between-practice variability of paediatric test use in primary *** and analysis This was a descriptive study of population-based data from Clinical Practice Research Datalink Aurum primary care consultation records from 1 january 2007 to 31 December *** aged 0–15 who were registered to one of the eligible 1464 general practices and had a diagnostic test code in their clinical record were *** primary outcome measures were(1)temporal changes in test rates measured by the average annual percent change,stratified by test type,gender,age group and deprivation level and(2)practice variability in test use,measured by the coefficient of *** 14299598 diagnostic tests were requested over 27.8 million child-years of observation for 2542101 *** test use increased by 3.6%/year(95%CI 3.4 to 3.8%)from 399/1000 child-years to 608/1000 child-years,driven by increases in blood tests(8.0%/year,95%CI 7.7 to 8.4),females aged 11–15(4.0%/year,95%CI 3.7 to 4.3),and children from the most socioeconomically deprived group(4.4%/year,95%CI 4.1 to 4.8).Tests subject to the greatest temporal increases were faecal calprotectin,fractional exhaled nitric oxide and vitamin *** classified as high-use and high-practice variability were iron studies,coeliac testing,vitamin B12,folate,and vitamin *** In this first nationwide study of paediatric test use in primary care,we observed significant temporal increases and practice variability in *** reflects inconsistency in practice and diagnosis rates and a scarcity of evidence-based *** test use generates more clinical activity with significant resource implications but conversely may improve clinical *** research should evaluate whether increased test use and variability are warranted by exploring test indications and test results and directly examine how increased test use impacts

关键词： vitamin nationwide stratified

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Local excision of early rectal cancer: A multi-centre experience of transanal endoscopic microsurgery from the United Kingdom

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World journal of Gastrointestinal Surgery 2024年第10期16卷 3114-3122页

作者： Ahmed Farid Matthew Tutton Prem Thambi TS gill jim Khan Department of General Surgery Oncology Center Mansoura UniversityCairo 11432Egypt Department of Colorectal Surgery East Suffolk and North Essex NHS TrustColchester CO11AAEssexUnited Kingdom Department of Colorectal Surgery Portsmouth Hospitals University NHS TrustPortsmouth PO63LYHampshireUnited Kingdom Department of Surgery University Hospital of North TeesStockton on Tees TS18-TS21DarlingtonUnited Kingdom Department of General Surgery Portsmouth Hospitals NHS TrustQueen Alexandra HospitalPortsmouth PO63LYHampshireUnited Kingdom

BACKGROUND Total mesorectal excision remains the gold standard for the management of rectal cancer however local excision of early rectal cancer is gaining popularity due to lower morbidity and higher acceptance by the elderly and frail *** To investigate the results of local excision of rectal cancer by transanal endoscopic microsurgery(TEMS)approach carried out at three large cancer centers in the United *** TEMS database was retrospectively reviewed to assess demographics,operative findings and post operative clinical and oncological *** is a retro-spective review of the prospective databases,which included all patients operated with TEMS approach,for early rectal cancer(Node-negative T1-T2),selected T3 in unfit/frail *** Two hundred and twenty-two patients underwent TEMS *** included 144 males(64.9%)and 78 females(35.1%),Median age was 71 *** median distance of the tumours from the anal verge 4.5 *** tumour size was 2.6 *** most frequent operative position of the patient was lithotomy(32.3%),Full-thickness rectal wall excision was done in 204 *** operating time was 90 *** blood loss was *** were two 90-day *** excision of the tumour with free microscopic margins by>1mm were accomplished in 171 patients(76.7%).Salvage total mesorectal excision was performed in 42 patients(19.8%).Median disease-free survival was 65 months(range:3-146 months)(82.8%),and median overall survival was 59 months(0-146 months).CONCLUSION TEMS provides a promising option for early rectal cancers(Large adenomas-cT1/cT2N0),and selected therapy-responding ***-thickness complete excision of the tumour is mandatory to avoid jeopardising the oncological outcomes.

关键词： Local excision Transanal endoscopic microsurgery Early rectal cancer Rectum preservation Rectum saving

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Genomic prediction of Fusarium head blight resistance in early stages using advanced breeding lines in hard winter wheat

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The Crop journal 2022年第6期10卷 1695-1704页

作者： jinfeng Zhang Harsimardeep S.gill Navreet K.Brar jyotirmoy Halder Shaukat Ali Xiaotian Liu Amy Bernardo Paul St.Amand Guihua Bai Upinder S.gill Brent Turnipseed Sunish K.Sehgal Department of Agronomy Horticulture&Plant ScienceSouth Dakota State UniversityBrookingsSD 57007USA School of Computing Queen’s UniversityKingstonON K7L 3N6Canada USDA-ARS Hard Winter Wheat Genetics Research UnitManhattanKS 66506USA Department of Plant Pathology North Dakota State UniversityFargoND 58108USA

Fusarium head blight(FHB),also known as scab,is a devastating fungal disease of wheat that causes significant losses in grain yield and *** inheritance and cumbersome phenotyping make FHB resistance a challenging trait for direct selection in wheat *** selection to predict FHB resistance traits has shown promise in several ***,we used univariate and multivariate genomic prediction models to evaluate the prediction accuracy(PA)for different FHB traits using 476elite and advanced breeding lines developed by South Dakota State University hard winter wheat breeding *** breeding lines were assessed for FHB disease index(DIS),and percentage of Fusarium damaged kernels(FDK)in three FHB nurseries in 2018,2019,and 2020(TP18,TP19,and TP20)and were evaluated as training populations(TP)for genomic prediction(GP)of FHB *** observed a moderate PA using univariate models for DIS(0.39 and 0.35)and FDK(0.35 and 0.37)using TP19 and TP20,respectively,while slightly higher PA was observed(0.41 for DIS and 0.38 for FDK)when TP19 and TP20(TP19+20)were combined to leverage the advantage of a large training *** GP with multivariate approach including plant height and days to heading as covariates did not significantly improve PA for DIS and FDK over univariate models,PA for DON increased by 20%using DIS,FDK,DTH as covariates using multi-trait model in ***,we used TP19,TP20,and TP19+20 in forward prediction to calculate genomic-estimated breeding values(GEBVs)for DIS and FDK in preliminary breeding lines at an early stage of the breeding *** observed moderate PA of up to 0.59 for DIS and 0.54for FDK,demonstrating the promise in genomic prediction for FHB resistance in earlier stages using advanced *** results suggest GP for expensive FHB traits like DON and FDK can facilitate the rejection of highly susceptible materials at an early stage in a breeding program.

关键词： FHB GBS Genomic selection Multi-trait models Winter wheat Wheat scab

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学习指导

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丛书名：外研社丽声拼读故事会

2011年

作者： (英) Clare Kirtley gill Howell

本书是故事: 奇怪的宠物、老师! 老师! 、这和那、鱼和薯条、爱唱歌的爸爸、鸭子医生的学习大纲, 包括介绍拼读规则、拼读指导和拓展训练。

ISBN: (纸本)9787513509268;7513509263;9787894788085

本书是故事: 奇怪的宠物、老师! 老师! 、这和那、鱼和薯条、爱唱歌的爸爸、鸭子医生的学习大纲, 包括介绍拼读规则、拼读指导和拓展训练。

关键词：英语

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T. S. Eliot＇s Spiritual journey in Designing The Cocktail Party as a Drama of Conversion

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journal of Philosophy Study 2016年第6期6卷 367-376页

作者： gill Kurtulus Bilkem University

In his quest for spiritual fulfillment, Thomas Stearns Eliot conducts a meticulous religious study which teaches him distinctive interpretations of human existence and their various functions that they are supposed to assume in the world. Eliot＇s personal attachment to religious knowledge and his reflections of religious studies inevitably manifest themselves in his literary works; be it his dramas or poems, mostly in the forms of philosophical and psychoanalytical analysis of his characters and the detected problems observed in their relationships. The Cocktail Party, a play starting off as a drawing-room comedy soon converts to a serious analysis of human psychology and the nature of human interactions. While engaging with these particular points, the play offers possibilities to discuss several religious allusions, though dealt with subtly. Integrated with religion, characters＇ attitudes towards a given situation and their final decision position them in their quest either in ＂hypothetical＂ enlightenment or in a ＂supposed＂ repetition of a vicious circle. The enforcing power behind the play is interestingly a psychiatrist, who adds dynamism and mystery to the plot and has a special task in making the play a drama of conversion. The inner conflicts of the characters which ultimately lead to a series of problems in their relationships are the main concern which causes the characters search for different solutions. Accordingly, they make their own choices to cease their inner struggles. This paper aims to explore the concept of conversion in Eliot＇s The Cocktail Party with references to the playwright＇s religious journey in his literary career.

关键词： T. S. Eliot drama of conversion verse drama modem poetic drama Buddhism

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Targeting inflammation in pancreatic cancer: Clinical translation

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World journal of Gastrointestinal Oncology 2016年第4期8卷 380-388页

作者： Colin William Steele Nina Angharad Kaur gill Nigel Balfour jamieson chris.opher Ross Carter Department of Pancreaticobiliary Surgery Glasgow Royal Infirmary Department of General Surgery South Glasgow University Hospital

Preclinical modelling studies are beginning to aid development of therapies targeted against key regulators of pancreatic cancer progression. Pancreatic cancer is an aggressive, stromally-rich tumor, from which few people survive. Within the tumor microenvironment cellular and extracellular components exist, shielding tumor cells from immune cell clearance, and chemotherapy, enhancing progression of the disease. The cellular component of this microenvironment consists mainly of stellate cells and inflammatory cells. New findings suggest that manipulation of the cellular component of the tumor microenvironment is possible to promote immune cell killing of tumor cells. Here we explore possible immunogenic therapeutic strategies. Additionally extracellular stromal elements play a key role in protecting tumor cells from chemotherapies targeted at the pancreas. We describe the experimental findings and the pitfalls associated with translation of stromally targeted therapies to clinical trial. Finally, we discuss the key inflammatory signal transducers activated subsequent to driver mutations in oncogenic Kras in pancreatic cancer. We present the preclinical findings that have led to successful early trials of STAT3 inhibitors in pancreatic adenocarcinoma.

关键词： Pancreatic cancer Inflammation Stroma Microenvironment

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Virtual reality for immersive multi-user firefighter-training scenarios

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Virtual Reality & Intelligent Hardware 2022年第5期4卷 406-417页

作者： Philipp BRAUN Michaela GRAFELMANN Felix gill Hauke STOLZ johannes HINCKELDEYN Ann-Kathrin LANGE Hamburg University of Technology Hamburg 21073Germany

Background Virtual reality(VR)applications can be used to provide comprehensive training scenarios that are difficult or impossible to represent in physical *** includes team training for emergency services such as *** a high level of immersion is essential for achieving effective virtual *** this respect,motion-capture systems offer the possibility of creating highly immersive multi-user training experiences,including full-body *** This study presents a preliminary prototype that helps extin-guish a virtual fire on a container ship as a VR training *** prototype provides a full-body and multi-user VR experience based on the synthesis of position data provided by the motion-capture system and orientation data from the VR ***,the prototype facilitates an initial evaluation of the *** The results confirm the value of using VR for training procedures that are difficult to implement in the real ***,the results show that motion-capture-based VR technologies are particularly useful for firefighting training,in which participants can collaborate in difficult-to-access ***,this study also indicates that increasing the immersion in such training remains a *** This study presents a prototypical VR application that enables the multi-user training of maritime *** research should evaluate the initial results,provide more extensive training scenarios,and measure the training progress.

关键词： Virtual reality Multi-user Motion capture Training Firefighting

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DMP(1,1,1-Triacetoxy-1,1-dihydro-1,2-benziodoxol-3(1H)-one):A novel catalyst for synthesis of 2-substituted benzimidazoles derivatives

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Chinese Chemical Letters 2009年第8期20卷 893-897页

作者： Sanjay K.Dabhade Rajesh O.Bora Mazahar Farooqui Charansingh H.gill Department of Chemistry Dr.Babasaheb Ambedkar Marathwada UniversityAurangabadMaharashtra 431 004 India Maulana Azad Post Graduate Research Centre AurangabadMaharashtra 431 001 India

Various 2-arylbenzimidazoles were synthesized from o-phenylenediamine and aldehydes via one-step process using DMP （Dess-Martin-periodinane） reagent as an oxidant. The method was proved to be simple, convenient and the products were isolated with good yields （80-90%）. ？2009 Charansingh H. gill. Published by Elsevier B.V. on behalf of Chinese Chemical Society. All rights reserved.

关键词： Dess-Martin-periodinane Benzimidazole Aryl aldehydes Benzimidazole Oxidation

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丛书名：外研社丽声拼读故事会

2011年

作者： (英) Clare Kirrley gill Howell

本书主要包括: 足球大赛、购物单、奶奶生气了、象鼻和臭鼬、破烂火箭、噼里啪啦, 吧唧吧唧几部分的学习大纲, 介绍拼读规则 ; 拼读指导 ; 拓展训练。

ISBN: (纸本)9787513509251;7513509255;9787894788092

关键词：英语

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Effects of cosmetics containing purified honeybee(Apis mellifera L.) venom on acne vulgaris

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journal of Integrative Medicine 2013年第5期11卷 320-326页

作者： Sang Mi Han Kwang gill Lee Sok Cheon Pak Department of Agricultural Biology National Academy of Agricultural Science School of Biomedical Sciences Charles Sturt University

Acne vulgaris is a chronic dermatologic problem with multiple factors involved in its pathogenesis. Alternative solutions to acne treatment were instigated by antibiotic resistance despite of its extensive use. Purified bee venom （PBV） has been proposed as a promising candidate for that purpose. The present study was designed to confirm the antibacterial effect of PBV and access the efficacy of cosmetics containing PBV in subjects with acne vulgaris. METHODS： The skin bacterium Propionibacterium acnes was incubated with PBV at various concentrations and bacterial growth was evaluated using the colony forming unit （CFU） assay. The mechanism of PBV employed in killing P. acnes was examined by scanning electron microscopy （SEM） and transmission electron microscopy （TEM）. In addition, a total of 12 subjects were randomized in a double-blind, controlled trial to receive either cosmetics containing PBV or cosmetics without PBV for two weeks. Evaluations included lesion counts and skin microorganism. RESULTS： PBV exhibited antimicrobial activity in a concentration-dependent manner, reducing the number of P. acnes CFU by approximately 6 logs at a concentration of 0.5 mg. When PBV concentration was higher than 1.0 mg, no P. acnes colonies were spotted on an agar. TEM and SEM of untreated P. acnes illustrated the normal pleomorphic structure, whereas the PBV- treated bacterium lost the integrity of surface architecture. Significant difference （P=0.027） in the grading levels based on numbers of lesion counts for inflammatory and noninflammatory was observed in favour of the PBV group compared with the control group. In terms of average decrement of skin microorganism, subjects receiving cosmetics containing PBV experienced a significant 57.5% decrease of adenosine triphosphate levels, whereas participants receiving cosmetics without PBV experienced a nonsignificant decrease of 4.7%. CONCLUSION： These results show that the in vitro actions of antimicrobial activity of PBV were

关键词： bee venoms acne vulgaris Propionibacterium acnes skin cosmetics

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