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Cost-effectiveness of Crohn's disease post-operative care

World Journal of Gastroenterology 2016年第14期22卷 3860-3868页

作者： emily k wright Michael A kamm Peter Dr Cruz Amy L Hamilton kathryn J Ritchie Sally J Bell Steven J Brown William R Connell Paul V Desmond Danny Liew Department of Gastroenterology St Vincent's Hospital University of Melbourne Fitzroy VIC 3065 Melbourne Australia Imperial College London SW7 2AZ United Kingdom Melbourne EpiCentre University of Melbourne and Melbourne Health Parkville VIC 3010 Melbourne Australia

AIM: To define the cost-effectiveness of strategies, including endoscopy and immunosuppression, to prevent endoscopic recurrence of Crohn’s disease following intestinal ***: In the “POCER” study patients undergoing intestinal resection were treated with post-operative drug therapy. Two thirds were randomized to active care (6 mo colonoscopy and drug intensification for endoscopic recurrence) and one third to drug therapy without early endoscopy. Colonoscopy at 18 mo and faecal calprotectin (FC) measurement were used to assess disease recurrence. Administrative data, chart review and patient questionnaires were collected prospectively over 18 ***: Sixty patients (active care n = 43, standard care n = 17) were included from one health service. Median total health care cost was $6440 per patient. Active care cost $4824 more than standard care over 18 mo. Medication accounted for 78% of total cost, of which 90% was for adalimumab. Median health care cost was higher for those with endoscopic recurrence compared to those in remission [$26347 (IQR 25045-27485) vs $2729 (IQR 1182-5215), P < 0.001]. FC to select patients for colonoscopy could reduce cost by $1010 per patient over 18 mo. Active care was associated with 18% decreased endoscopic recurrence, costing $861 for each recurrence ***: Post-operative management strategies are associated with high cost, primarily medication related. Calprotectin use reduces costs. The long term cost-benefit of these strategies remains to be evaluated.

关键词： Crohn’ s disease Post-operative Health economics Health care cost Biologics

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Prevalence and outcomes of pediatric surgical conditions at Connaught Hospital in Freetown:a retrospective study

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World Journal of Pediatric Surgery 2023年第1期6卷 1-7页

作者： Henang kwasau Juliana kamanda Aiah Lebbie Cesia Cotache-Condor Pamela Espinoza Andie Grimm Naomi wright emily Smith Department of Community Health College of Medicine and Allied Health SciencesUniversity of Sierra LeoneFreetownSierra Leone Department of Surgery Duke School of MedicineDuke UniversityDurhamNorth CarolinaUSA Duke Global Health Institute Duke UniversityDurhamNorth CarolinaUSA Duke Center for Global Surgery and Health Equity Duke UniversityDurhamNorth CarolinaUSA Department of Public Health Baylor UniversityWacoTexasUSA king’s Centre for Global Health and Health Partnerships King's College LondonLondonUK Department of Emergency Medicine Duke School of MedicineDuke UniversityDurhamNorth CarolinaUSA

Background Sub-Saharan Africa experiences a disproportionate amount of pediatric surgical disease,with 80%of children lacking access to timely,affordable,and safe surgical *** study aims to characterize the burden of disease and outcomes of pediatric surgical conditions at Connaught Hospital,the main pediatric referral hospital in Sierra *** This retrospective and hospital-based study included children up to 15 years old who were operated on between 2015 and June 2016 at Connaught Hospital in Freetown,Sierra *** and inferential statistics were used to characterize the distribution of disease and compare all variables against age category and *** A total of 215 patients were included in this study of which 72.5%(n=132)were male and 27.5%(n=50)were *** of the patients were diagnosed with congenital anomalies(60.9%;n=131).However,infection was the leading diagnosis(60.5%;n=23)among patients aged 5–10 years(n=38).Inguinal hernia was the leading condition(65.0%;n=85)among patients presenting with a congenital *** condition with the highest mortality was infections(17.0%;n=8),followed by other conditions(9.1%;n=2)and congenital anomalies(3.1%;n=4).Based on the results of this study,over 7000 children with inguinal hernias remain untreated annually in Freetown,Sierra *** This study quantifies the burden of surgical disease among children,a foundational step toward the prioritization of pediatric surgical care in national health agendas,the development of evidence-based interventions,and the strategic allocation of resources in Sierra Leone.

关键词： surgical pediatric mortality

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Relationship of Aboriginal family wellbeing to social and cultural determinants,Central Australia:‘Waltja tjutangku nyakunytjaku’

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Family Medicine and Community Health 2022年第4期10卷 4-15页

作者： Alyson wright Vanessa Napaltjarri Davis Makayla-May Brinckley Raymond Lovett Joanne Thandrayen Mandy Yap William Sanders emily Banks National Centre for Epidemiology and Population Health Research School of Population HealthAustralian National UniversityCanberraAustralian Capital TerritoryAustralia Tangentyere Research Hub Tangentyere CouncilAlice SpringsNorthern TerritoryAustralia Centre for Aboriginal Economic and Policy Research Australian National UniversityCanberraAustralian Capital TerritoryAustralia

Objective The objective of this study was to apply a strength-based approach to examine the relation of cultural and social determinants to high family functioning for Aboriginal people in Central *** Cross-sectional study involving a quantitative analysis of survey *** rate ratios(PRs)and 95%CIs were calculated from binomial regressions,adjusted for gender and *** data from workshops with Aboriginal leaders in Central Australia supported the interpretation of the research *** The study involved 639 Aboriginal people in Central Australia who participated in the Mayi kuwayu *** Overall,57.9%(370/639)of participants reported high/very high family functioning,16.9%(108/639)reported moderate and 13.3%(85/639)reported *** adjusted prevalence of family functioning was similar across gender,age groups and household *** functioning was associated with lower family financial status(aPR=0.74,95%CI=0.60 to 0.91)and receiving welfare(0.88,0.77 to 1.00).Family functioning was greater with high community cohesion(2.72,1.68 to 4.39),high individual agency in community(2.15,1.63 to 2.85);having an Aboriginal language as a first language(1.20,1.04 to 1.37);speaking your Aboriginal language a lot(1.37,1.12 to 1.68);high exposure to cultural practice and knowledge(1.45,1.28 to 1.65);and multigenerational or extended family households(1.19,1.02 to 1.38).Conclusion High family functioning is a strength in Central Australia and is intrinsically connected with *** providers and programmes that build on the foundations of culture and family are an important approach to improving wellbeing.

关键词： cohesion Australia apply

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Low melting point MCP-69, MCP-96, MCP-137, and MCP-200 alloys for radiation protection in radiological and therapeutic processes

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Radiation Medicine and Protection 2022年第4期3卷 175-182页

作者： Michael W.Perrigin kendall A.Williams Brandon k.wright Malaika Maqbool emily Caffrey Remo George Ghafar Ali Muhammad Maqbool Health Physics Program Department of Clinical&Diagnostic SciencesThe University of Alabama at BirminghamBirminghamAL 35294USA Nuclear Medicine and Molecular Imaging Sciences Program Department of Clinical&Diagnostic SciencesThe University of Alabama at BirminghamBirminghamAL 35294USA iomedical Sciences Program Department of Clinical&Diagnostic SciencesThe University of Alabama at BirminghamBirminghamAL 35294USA Nanomaterials Research Group Physics DivisionPINSTECHIslamabadPakistan

Objective To evaluate the low melting-point MCP-69,MCP-96,MCP-137,and MCP-200 alloys,and characterize them for their potential to protect from the harms associated with radiation and eliminate radiation hazards during radiological procedures and treatment of *** The klein-Nishina formula was used to calculate the electronic and atomic cross-sections of these alloys using photon beams with energies 4,6,9,12,and 18*** transfer coefficients,Compton mass attenuation coefficient,mass-energy transfer coefficient,and recoil energy of electrons in the specific photon energies of 4–18MeV were *** alloys'effective charge number and the photon energy were key factors in determining the properties found by utilizing the klein-Nishina formula and Compton *** The cross sections and energy transfer coefficients increased with the increasing effective charge number Z of the alloys and decreased as the photon energy *** Compton recoil of the ejected electrons was observed to have a direct relationship with photon energy,but mass-energy transfer decreased with increasing photon *** alloys can replace the toxic lead for environmentally cleaned radiation *** These calculations and characteristics of the MCP alloys can help further determine their viability as materials for radiation shielding,their use in safe cancer diagnosis,treatment,and environmental hazards protection.

关键词： MCP alloys klein-Nishina formula Cross-sections Radiation shielding Safe cancer diagnosis and treatment

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写给艾米莉的信

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2004年

作者：（美）卡麦隆·莱特（Camron wright）黄哲译

本长篇小说充满了智慧、温暖人心和震撼心灵的情节和思想。故事中有失意，有眼泪，更充满了神奇色彩。

ISBN: (纸本)7801950739

本长篇小说充满了智慧、温暖人心和震撼心灵的情节和思想。故事中有失意，有眼泪，更充满了神奇色彩。

关键词：长篇小说美国现代

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Design and Characterization of an Aerosol Test Chamber for Emergency Response Patient Contamination Control Simulation and Research

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Occupational Diseases and Environmental Medicine 2023年第1期11卷 78-96页

作者： Megan L. Steele emily M. Spatz George P. Lemmer Jacob M. Denney Jeremy M. Slagley Casey W. Cooper Robert M. Eninger Fenic Ltd. Dayton USA Department of Systems Engineering and Management Air Force Institute of Technology Wright-Patterson Air Force Base Montgomery County USA Air Force Materiel Command Office of the Command Surgeon Wright-Patterson Air Force Base Montgomery County USA

Contaminated or infected patients present a risk of cross-contamination for emergency responders, attending medical personnel and medical facilities as they enter a treatment facility. The controlled conditions of an aerosol test chamber are required to examine factors of contamination, decontamination, and cross-contamination. This study presents the design, construction, and a method for characterizing an aerosol test chamber for a full-sized manikin on a standard North Atlantic Treaty Organization litter. The methodology combined air velocity measurements, aerosol particle counts and size distributions, and computational fluid dynamics modeling to describe the chamber’s performance in three dimensions. This detailed characterization facilitates future experimental design by predicting chamber performance for a variety of patient-focused research.

关键词： Test Chamber Characterization Aerosol Generation Exposure Chamber Design Air Velocity Mapping Spatial Variability CFD Modeling Patient Decontamination

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肠道真菌对造血干细胞移植临床结果的影响

肠道真菌对造血干细胞移植临床结果的影响

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中国菌物学会2023年学术年会

作者：翟冰 Thierry Rolling Mihaela Ola Mergim Gjonbalaj Nicholas L.Tosini keiko Yasuma Luigi A.Amoretti emily Fontana Roberta J.wright Jonathan U.Peled Geraldine Butler Ying Taur Tobias M.Hohl 中国科学院深圳先进技术研究院合成生物学研究所斯隆凯特琳癌症研究中心都柏林大学生物分子与生物医学学院

人的肠道微生物群落由细菌、真菌、病毒等微生物共同组成,影响人体多种生理或病理过程。相较于细菌组分,目前对于人体肠道菌群中的真菌组分认识严重不足。我们通过将高精度分析算法引入真菌ITS序列分析,结合培养组学和比较基因组学分析... 详细信息

人的肠道微生物群落由细菌、真菌、病毒等微生物共同组成,影响人体多种生理或病理过程。相较于细菌组分,目前对于人体肠道菌群中的真菌组分认识严重不足。我们通过将高精度分析算法引入真菌ITS序列分析,结合培养组学和比较基因组学分析,建立了一套可靠的真菌菌群分析平台,并以此为基础对造血干细胞移植初期的患者肠道真菌动态变化进行时序性分析。结合临床数据,我们发现移植前后肠道真菌DNA的载量和多样性并无显著区别,但其组分发生了巨大变化,其中有近20%的患者在移植后免疫抑制期出现明显的近平滑念珠菌定植扩增,同时具有特殊的细菌菌群组分变化。尤为重要的是,具有近平滑念珠菌肠道定植的患者比其他患者具有显著恶化的总存活率,以及更高的真菌菌血症发生风险。通过比较念珠菌菌血症患者血液分离株和肠道分离株的全基因组序列,我们发现血液感染发生前一周左右,造成感染的菌株就已经在肠道中发生定植。综上所述,本项研究系统分析了造血干细胞移植过程中人体肠道真菌的动态变化,预示着精准干预肠道病原真菌的定植扩增可以有效预防血液感染,并提高患者总存活率。

关键词：真菌菌群造血干细胞移植真菌菌血症培养组学比较基因组学真菌细菌互作

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