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protocol for the development and validation of a clinical measurement tool for fear of disease progression and recurrence in cardiac patients

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Chronic Diseases and Translational medicine 2024年第3期10卷 195-204页

作者： Sarah T.clarke michael Le Grande Barbara m.murphy Robert Hester Alun C.Jackson melbourne School of psychological Sciences University of MelbourneParkvilleVictoriaAustralia Australian Centre for Heart Health MelbourneVictoriaAustralia Centre on Behavioral Health University of Hong KongPokfulamHong KongChina

Introduction: One in two cardiac patients fear having another heart event or their heart condition getting worse. Research in other chronic illnesses demonstrates that screening for fear of progression and recurrence is vital for adequately addressing such concerns in clinical care. The current project aims to develop and validate a measure for fear of progression and recurrence in cardiac ***: The Fear of Cardiac Recurrence and progression Scale (FCRp) will be developed through a multistep process. An initial item.p.ol will be generated through a review of the literature and existing measures and consultation with and feedback from key informants. The item.p.ol will be tested in a sample of over 250 adults who have ever had an acute coronary event, undergone cardiac surgery, or a chronic cardiac condition. Exploratory factor analysis will be used to identify the underlying factors, and Rasch analysis will be used to reduce the number of items. A short form version of the FCRp will be developed for use as a brief screening tool, informed by clinical relevance and Rasch psychometric ***: While many cardiac patients experience fears related to the progression or recurrence of their illness, there remains the need for a validated tool with which these concerns can be identified and measured. It is expected that the design and validation of the FCRp will aid identification of cardiac patients suffering from clinically significant levels of fear of progression and recurrence and facilitate the design of tailored psychological interventions to target these fears.

关键词： anxiety cardiac anxiety cardiac recovery cardiac rehabilitation depression fear of progression fear of recurrence psychological measurement psychosocial screening

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Geometric morphometric analysis of the early pleistocene hominin teeth from Jianshi,Hubei province,China

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Science China Earth Sciences 2010年第8期53卷 1141-1152页

作者： Ronald clarke University of the Witwatersrand JohannesburgSouth Africa

Although the early pleistocene hominin fossils found in East Asia continent are widely recognized as the earliest hominins migrated from Africa, debates remain on the morphology and taxonomy of these fossils. In this study, dental crown shape of the three early pleistocene hominin teeth (p3, m1, and m1) found in Jianshi, Hubei province of China was analyzed by means of geometric morphometrics. The comparative samples of fossil hominins from Africa, Asia, and Europe as well as those of modern humans (N=257) were used. The results indicate that the contour, asymmetry, and cusp patterns of these three types of teeth differ obviously between the fossil hominins and modern humans. The crown shape of p3 in most fossil hominins including Australopithecus, African early Homo, and Asian pleistocene hominins are asymmetric with their crown occlusal contours long and curving elliptic-shaped. The occlusal contour of the fossil hominin m1 is symmetric and rectangle-shaped with no marked cusp protrusion. The crown shape of fossil m1 is characterized by asymmetric contour with slightly projected metaconid and hypoconid. On the contrary, in modern Chinese and some European late pleistocene hominins, the crowns of p3s show symmetric contours with buccal side wider than lingual side; the crown shape of m1 is asymmetric with lingual cusp distalplaced, especially for hypoconid; the m1 has symmetric and round crown contour. Our study reveals that Australopithecus has wide variations in its crown shape, whereas these dental morphospaces of Asian hominins are closely placed. The crown contour, symmetry, and cusp patterns of these three teeth of Jianshi hominin resemble those of Asian early and middle pleistocene hominins. No marked difference in dental crown shape is shown between the Jianshi hominin and other Chinese Homo erectus, and there is also no evidence in support of the Jianshi hominin's closeness to Australopithecus and African early Homo members.

关键词： human evolution tooth shape geometric morphometric Jianshi Hubei China

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National trends in resection of the distal pancreas

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World Journal of Gastroenterology 2012年第32期18卷 4342-4349页

作者： Armando Rosales-Velderrain Steven p Bowers Ross F Goldberg Tatyan m clarke mauricia A Buchanan John A Stauffer Horacio J Asbun Department of General Surgery Mayo Clinic FloridaJacksonvilleFL 32225United States

AIm:To investigate national trends in distal pancreatectomy(Dp) through query of three national patient care ***:From the Nationwide Inpatient Sample(NIS,2003-2009),the National Surgical Quality Improvement project(NSQIp,2005-2010),and the Surveillance Epidemiology and End Results(SEER,2003-2009) databases using appropriate diagnostic and procedural codes we identified all patients with a diagnosis of a benign or malignant lesion of the body and/or tail of the pancreas that had undergone a partial or distal *** of laparoscopy was defined in NIS by the International Classification of Diseases,Ninth Revision correspondent procedure code;and in NSQIp by the exploratory laparoscopy or unlisted procedure current procedural terminology *** SEER,patients were identified by the International Classification of Diseases for Oncology,Third Edition diagnosis codes and the SEER program Code manual,third edition procedure *** analyzed the databases with respect to trends of inpatient outcome metrics,oncologic outcomes,and hospital volumes in patients with lesions of the neck and body of the pancreas that underwent operative ***:NIS,NSQIp and SEER identified 4242,2681 and 11 082 Dp resections,***,laparoscopy was utilized in 15%(NIS) and 27%(NSQIp).No significant increase was seen over the course of the *** was performed for malignancy in 59%(NIS) and 66%(NSQIp).Neither patient Body mass index nor comorbidities were associated with operative approach(p = 0.95 and p = 0.96,respectively).mortality(3% vs 2%,p = 0.05) and reoperation(4% vs 4%,p = 1.0) was not different between laparoscopy and open *** complications(10% vs 15%,p pital costs [44 741 dollars,interquartile range(IQR) 28 347-74 114 dollars vs 49 792 dollars,IQR 13 299-73 463,p = 0.02] and hospital length of stay(7 d,IQR 4-11 d vs 7 d,IQR 6-10,p paroscopy was *** and two year sur

关键词： Laparoscopic distal pancreatectomy Trends Nationwide Inpatient Sample National Surgical Quality Improvement project Surveillance epidemiology and end results

Interpreting uninterpretable predictors:kernel methods,Shtarkov solutions,and random forests

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Statistical Theory and Related Fields 2022年第1期6卷 10-28页

作者： T.m.Le Bertrand clarke Department of mathematics scienceand informaticsmercer universityatlantagausa department of statistics university of nebraska-lincolnlincolnneusa

many of the best predictors for complex problems are typically regarded as hard to interpret *** include kernel methods,Shtarkov solutions,and random *** show that,despite the inability to interpret these three predictors to infinite precision,they can be asymptotically approximated and admit conceptual interpretations in terms of their mathe-matical/statistical *** resulting expressions can be in terms of polynomials,basis elements,or other functions that an analyst may regard as interpretable.

关键词： Bayes boosting kernel methods random forest Shtarkov predictor stacking

Experimental models of endocrine responsive breast cancer: strengths, limitations, and use

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Cancer Drug Resistance 2021年第4期4卷 762-783页

作者： Robert clarke Brandon C.Jones Catherine m.Sevigny Leena A.Hilakivi-clarke Surojeet Sengupta The Hormel Institute and Department of Biochemistry Molecular Biology and BiophysicsUniversity of MinnesotaAustinMN 55912USA Department of Oncology Georgetown University Medical CenterWashingtonDC 20057USA The Jackson Laboratory 600 Main StreetBar HarborME 04609USA

Breast cancers characterized by expression of estrogen receptor-alpha(ER;ESR1)represent approximately 70%of all new cases and comprise the largest molecular subtype of this *** this high prevalence,the number of adequate experimental models of ER+breast cancer is relatively ***,these models have proved very useful in advancing understanding of how cells respond to and resist endocrine therapies,and how the ER acts as a transcription factor to regulate cell fate *** discuss the primary experimental models of ER+breast cancer including 2D and 3D cultures of established cell lines,cell line-and patient-derived xenografts,and chemically induced rodent models,with a consideration of their respective general strengths and *** can and cannot be learned easily from these models is also discussed,and some observations on how these models may be used more effectively are ***,despite their limitations,the panel of models currently available has enabled major advances in the field,and these models remain central to the ability to study mechanisms of therapy action and resistance and for hypothesis testing that would otherwise be intractable or unethical in human subjects.

关键词： Breast cancer experimental models pDX xenografts study design

“Digging in the Dirt”faecal microRNAs as dietary biomarkers of host-microbe interactions

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Hepatobiliary Surgery and Nutrition 2022年第2期11卷 292-294页

作者： Gerard m.moloney John F.Cryan Gerard clarke Department of Anatomy&Neuroscience University College CorkCorkIreland ApC microbiome Ireland University College CorkCorkIreland Department of psychiatry and Neurobehavioural Science University College CorkCorkIreland

The role of diet and nutrition in maintaining a healthy lifestyle has become a central part of chronic disease prevention(1).Chronic conditions such as cancer,Inflammatory bowel disease(IBD)and obesity are more prevalent in people with poor diets(2).Food consumption is controlled by physiological systems such as the gut-microbiome and distinct neuroendocrine pathways that overlap to promote host nutritional gain resulting in people living longer healthier lives(3).A recent analysis of the global burden of disease by the World Health Organization(WHO),noted that factors associated with poor diet,including obesity and malnutrition,critically undermine health and *** note that undernutrition,deficiencies in key nutrients and obesity have high social and economic *** disease,cancer,diabetes,and respiratory diseases account for 77%of all diseases and are responsible for 86%of all premature deaths(4).There is an appreciation that diets that reduce or eliminate red meats and animal fats results in the reduction of many of the indicators of poor diet,such as body mass index(BmI)and levels of cholesterol in the blood.

关键词： prevention eliminate overlap

中国非动脉硬化性心血管疾病人群脂蛋白(a)水平分布特征及影响因素

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中华流行病学杂志 2024年第6期45卷 779-786页

作者：柯雅蕾潘烺吕筠孙点剑一裴培陈怡平杨玲杜怀东 clarke Robert 陈君石陈铮鸣章晓陈婷李润琴齐丽彤李立明余灿清中国慢性病前瞻性研究项目协作组北京大学公共卫生学院流行病与卫生统计学系北京100191 北京大学公众健康与重大疫情防控战略研究中心北京100191 重大疾病流行病学教育部重点实验室(北京大学) 北京100191 牛津大学临床与流行病学研究中心纳菲尔德人群健康系牛津OX37LF 国家食品安全风险评估中心北京100022 北京诺华制药有限公司北京102200 北京大学第一医院心内科北京100034 不详

目的描述中国非动脉硬化性心血管疾病(ASCVD)人群脂蛋白(a)[Lp(a)]的分布并分析其影响因素。方法基于中国慢性病前瞻性研究项目的一项巢式病例对照研究,选取其中进行了血液生化指标检测的对照人群进行分析,使用参比实验室检定的多克隆... 详细信息

目的描述中国非动脉硬化性心血管疾病(ASCVD)人群脂蛋白(a)[Lp(a)]的分布并分析其影响因素。方法基于中国慢性病前瞻性研究项目的一项巢式病例对照研究,选取其中进行了血液生化指标检测的对照人群进行分析,使用参比实验室检定的多克隆抗体比浊法测定Lp(a)水平,≥75.0 nmol/L定义为高Lp(a)。采用多因素logistic回归模型分析Lp(a)水平的影响因素。结果在纳入研究的5870名非ASCVD人群中,Lp(a)水平呈正偏态分布,m(Q_(1),Q_(3))为17.5(8.8,43.5)nmol/L。多因素logistic回归分析结果显示,女性与高Lp(a)相关(OR=1.23,95%CI:1.05~1.43),中心性肥胖者的高Lp(a)风险降低(OR=0.68,95%CI:0.52~0.89)。随TC、LDL-C、载脂蛋白A1(Apo A1)和载脂蛋白B(Apo B)水平升高,高Lp(a)风险增加,各升高组的OR值(95%CI)分别为2.40(1.76~3.24)、2.68(1.36~4.93)、1.29(1.03~1.61)和1.65(1.27~2.13);HDL-C降低组高Lp(a)风险降低,OR值(95%CI)为0.76(0.61~0.94);而TG、Apo A1与Apo B的比值(Apo A1/B)与高Lp(a)风险呈负相关,TG升高组的OR值(95%CI)为0.73(0.60~0.89),Apo A1/B升高组的OR值(95%CI)为0.60(0.50~0.72);Lp(a)水平与血脂指标(除Apo A1外)的相关性均存在线性趋势(线性趋势检验p≤0.001)。未发现行为生活方式因素如饮食、吸烟、体力活动水平与Lp(a)水平存在统计学关联。结论Lp(a)水平与性别及中心性肥胖有关,但受行为生活方式因素影响较小。

关键词：脂蛋白(a) 非动脉硬化性心血管疾病人群分布影响因素

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Transitions of care across hospital settings in patients with inflammatory bowel disease

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World Journal of Gastroenterology 2019年第17期25卷 2122-2132页

作者： Leigh R Warren Jonathan m clarke Sonal Arora mauricio Barahona Naila Arebi Ara Darzi patient Safety Translational Research Centre Imperial College London Department of Surgery and Cancer Imperial College London Centre for Health policy Imperial College London Centre for Mathematics of Precision HealthcareImperial College London Department of Biostatistics Harvard University Department of mathematics Imperial College London Department of Gastroenterology St.Marks Academic Institute

BACKGROUND Inflammatory bowel disease(IBD) is a chronic, inflammatory disorder characterised by both intestinal and extra-intestinal pathology. patients may receive both emergency and elective care from several providers, often in different hospital settings. poorly managed transitions of care between providers can lead to inefficiencies in care and patient safety issues. To ensure that the sharing of patient information between providers is appropriate, timely, accurate and secure, effective data-sharing infrastructure needs to be developed. To optimise inter-hospital data-sharing for IBD patients, we need to better understand patterns of hospital encounters in this *** To determine the type and location of hospital services accessed by IBD patients in *** was a retrospective observational study using Hospital Episode Statistics, a large administrative patient data set from the National Health Service in *** patients with a diagnosis of IBD following admission to hospital were followed over a 2-year period to determine the proportion of care accessed at the same hospital providing their outpatient IBD care, defined as their ‘home provider'. Secondary outcome measures included the geographic distribution of patient-sharing, regional and age-related differences in accessing services, and type and frequency of outpatient ***95055 patients accessed hospital services on 1760156 occasions over a 2-year follow-up period. The proportion of these encounters with their identified IBD‘home provider' was 73.3%, 87.8% and 83.1% for accident and emergency,inpatient and outpatient encounters respectively. patients living in metropolitan centres and younger patients were less likely to attend their ‘home provider' for hospital services. The most commonly attended specialty services were gastroenterology, general surgery and *** Transitions of care between secondary care settings are common for patients with IBD. E

关键词： Inflammatory bowel disease Crohn's disease Ulcerative colitis Transitions of care Continuity of care Fragmentation multi-morbidity

Synthetic biology in the UK-An outline of plans and progress

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Synthetic and Systems Biotechnology 2016年第4期1卷 243-257页

作者： L.J.clarke R.I.Kitney UK Synthetic Biology Leadership Council UK Department of BioEngineering Imperial CollegeUK Faculty of Life Sciences University of ManchesterUK BionerG UK EpSRC National Centre for Synthetic Biology and Innovation UK Institute of Systems and Synthetic Biology UK Biomedical Systems Engineering Imperial CollegeUK BioMedical Systems EngineeringImperial CollegeUK

Synthetic biology is capable of delivering new solutions to key challenges spanning the bioeconomy,both nationally and *** this significant potential and the associated need to facilitate its translation and commercialisation the UK government commissioned the production of a national Synthetic Biology Roadm.p.in 2011,and subsequently provided crucial support to assist its *** infrastructural investments have been made,and important strides made towards the development of an effectively connected community of practitioners and interest groups.A number of Synthetic Biology Research Centres,DNA Synthesis Foundries,a Centre for Doctoral Training,and an Innovation Knowledge Centre have been established,creating a nationally distributed and integrated network of complementary facilities and *** UK Synthetic Biology Leadership Council published a UK Synthetic Biology Strategic plan in 2016,increasing focus on the processes of translation and *** 50 start-ups,SmEs and larger companies are actively engaged in synthetic biology in the UK,and inward investments are starting to *** these initiatives provide an important foundation for stimulating innovation,actively contributing to international research and development partnerships,and helping deliver useful benefits from synthetic biology in response to local and global needs and challenges.

关键词： Synthetic biology Engineering biology Biodesign Roadmap Responsible Research and Innovation(RRI) Innovation and Knowledge Centre(IKC) Synthetic Biology Leadership Council(SBLC) Bioeconomy