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Reducing strain on primary healthcare systems through innovative models of care:the impact of direct access physiotherapy for musculoskeletal conditions—an interrupted time series analysis

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Family Medicine and Community health 2024年第3期12卷 1-12页

作者： james henry Zouch Bjørnar Berg Are hugo Pripp Kjersti Storheim Claire E Ashton-james Manuela l Ferreira Margreth Grotle Paulo h Ferreira Sydney Musculoskeletal health Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia Centre for Intelligent Musculoskeletal health Oslo Metropolitan University Faculty of Health SciencesOsloNorway Oslo Metropolitan University Faculty of health Sciences OsloNorway Oslo Centre of Biostatistics and Epidemiology Oslo University HospitalOsloNorway Department of Rehabilitation Science and health Technology Oslo Metropolitan University Faculty of Health SciencesOsloNorway Department of Research and Innovation Oslo University Hospital Division of Clinical NeuroscienceOsloNorway Sydney Medical School Kolling InstituteThe University of Sydney Faculty of Medicine and HealthSydneyNew South WalesAustralia The George Institute for Global health SydneyNew South WalesAustralia Department of Research and Innovation Oslo University HospitalOsloNorway Department of Rehabilitation and Technology Oslo Metropolitan University Faculty of Health SciencesOsloNorway Charles Perkins Centre Sydney Musculoskeletal HealthThe University of Sydney Faculty of Medicine and HealthSydneyNew South WalesAustralia

Objectives To evaluate the longitudinal impact of introducing a national,direct access physiotherapy model of care on the rates of primary and secondary care consultations for musculoskeletal(MSK)*** Interrupted time series analysis using segmented linear *** Norway primary care Participants A cohort of 82072 participants was derived from 3 population-based health surveys conducted across separate geographical regions in *** participants surveyed were eligible for inclusion as a national representative sample of the Norwegian *** MSK consultations were linked to the Norwegian Control and Payment of health Reimbursement database and the Norwegian Patient Register using the International Classification of Primary Care diagnostic medical codes l-chapter for MSK conditions and spine related International Classification of Diseases,10th Revision,*** Direct access to physiotherapy model of care introduced nationally in Norway in *** model allowed Norwegians to consult directly with qualified physiotherapists for MSK conditions(eg,back pain,knee osteoarthritis)without the need for a medical referral in order to claim a social security *** outcomes measured Rates of primary care consultations per 10000 population(general practitioner(GP)and physiotherapist consultations)and secondary care(specialist consultations and surgical procedures)measured from 2014 to *** The introduction of the direct access physiotherapy model was associated with an immediate stepped reduction of 391 general practice consultations per 10000 population,(95%CI:−564 to−216),without an associated change in physiotherapy *** analyses suggested there was an associated reduction in physiotherapy consultations for those in the lowest education group of 150 consultations per quarter(95%CI:−203 to−97),70 consultations per quarter in the intermediate education group(95%CI:−115 to−27)and a step

关键词： impact analysis strain

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Protective effects of cyclosporine and its analog NIM-811 in a murine model of hepatic ischemia-reperfusion injury

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liver Research 2024年第1期8卷 46-53页

作者： Joshua hefler Rena Pawlick Braulio A.Marfil-Garza Aducio Thiesen Nerea Cuesta-Gomez Sanaz hatami Darren h.Freed Constantine Karvellas David l.Bigam A.M.james Shapiro Department of Surgery Faculty of Medicine&DentistryUniversity of AlbertaEdmontonABCanada Department of Medicine Faculty of Medicine&DentistryUniversity of AlbertaEdmontonABCanada ChRISTUS-latAm hub Excellence&Innovation Center MonterreyMexico Alberta Diabetes Institute University of AlbertaEdmontonABCanada Clinical Islet Transplant Program University of AlbertaEdmontonABCanada Department of laboratory Medicine&Pathology Faculty of Medicine&DentistryUniversity of AlbertaEdmontonABCanada

Background and aim:The liver is susceptible to ischemia-reperfusion injury(IRI)during hepatic surgery,when the vessels are compressed to control bleeding,or liver transplantation,when there is an obligate period of *** hallmark of IRI comprises mitochondrial dysfunction,which generates reactive oxygen species,and cell death through necrosis or ***(CsA),which is a well-known immunosuppressive agent that inhibits calcineurin,has the additional effect of inhibiting the mito-chondrial permeability transition pore(mPTP),thereby,preventing mitochondrial swelling and ***-811,which is the nonimmunosuppressive analog of CsA,has a similar effect on the *** this study,we tested the effect of both agents on mitigating warm hepatic IRI in a murine *** and methods:Before ischemic insult,the mice were administered with intraperitoneal normal saline(control);CsA at 2.5,10,or 25 mg/kg;or NIM-811 at 10 mg/***,the mice were subjected to partial warm hepatic ischemia by selective pedicle clamping for 60 min,followed by 6 h of recovery after *** alanine transaminase(AlT)was measured,and the liver tissue was examined histologically for the presence of apoptosis and the levels of inflammatory ***:Compared with the control mice,the mice treated with 10 and 25 mg/kg of CsA and NIM-811 had significantly lower AlT levels(Ply).Moreover,the liver tissue showed reduced histological injury scores after treatment with CsA at 2.5,10,and 25 mg/kg and NIM-811(P=0.041,ly)and significant decrease in apoptosis after treatment with CsA at all doses(P=0.012,0.007,andly).levels of the pro-inflammatory cyto-kines,particularly interleukin(Il)-1β,Il-2,Il-4,Il-10,and keratinocyte chemoattractant/human growth-regulated oncogene significantly decreased in the mice treated with the highest dose of CsA(25 mg/kg)than those in the control ***

关键词： Cyclosporine(CsA) Cyclosporine analogue liver surgery Ischemia-reperfusion injury(IRI) Animal model NIM-811

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Nickel sulfate solution fluoride separation with hydrous zirconium oxide

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Tungsten 2024年第2期6卷 367-381页

作者： Elbert M.Nigri Ummul K.Sultana André l.A.Santos james W.Vaughan Sonia D.F.Rocha Department of Mining Engineering Federal University of Minas GeraisBelo Horizonte 31270-901Brazil School of Chemical Engineering University of QueenslandSt Lucia 4072Australia

Fluoride is an impurity in nickel sulfate production,which is required for electric vehicle *** zirconium oxide(hZO)was evaluated for removing fl uoride from nickel sulfate *** fluoride removal occurred at ph value 4 and optimal ph value is 4–5,considering Zr *** availability decreases with ph due to hydrogen fluoride and zirconium fluoride aqueous *** removal is initially rapid,with 50 wt.%removal in 7 min,followed by slow removal up to 68 wt.%after 72 h and follows second order rate *** removal was dominated by an ion exchange mechanism and resulting Zr–F bonds were observed using Fourier-transform infrared *** presence of nickel sulfate decreased loading capacity compared to a salt-free *** maintained adsorption capacity through five cycles of loading and regeneration.

关键词： hydrous zirconium oxide Nickel sulfate Fluoride Adsorption Anion exchange

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Silk-based nerve guidance conduits with macroscopic holes modulate the vascularization of regenerating rat sciatic nerve

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Neural Regeneration Research 2025年第6期20卷 1789-1800页

作者： Carina hromada Patrick heimel Markus Kerbl lászlóGál Sylvia Nürnberger Barbara Schaedl james Ferguson Nicole Swiadek Xavier Monforte Johannes C.heinzel Antal Nógrádi Andreas h.Teuschl-Woller David hercher Department life Science Engineering University of Applied Sciences Technikum WienViennaAustria Austrian Cluster for Tissue Regeneration ViennaAustria ludwig Boltzmann Institute for Traumatology The Research Center in Cooperation with AUVAViennaAustria University Clinic of Dentistry Medical University of ViennaViennaAustria Department of Plastic Reconstructive and Aesthetic SurgeryLandesklinikum Wiener Neustadt2700 Wiener NeustadtAustria Department of Anatomy Histology and EmbryologyAlbert Szent-Györgyi Medical SchoolUniversity of SzegedSzegedHungary Medical University of Vienna Department of Orthopedics and Trauma SurgeryDevision of Trauma SurgeryViennaAustria Department of hand- PlasticReconstructive and Burn SurgeryBG Unfallklinik TuebingenUniversity of TuebingenTuebingenGermany

Peripheral nerve injuries induce a severe motor and sensory deficit. Since the availability of autologous nerve transplants for nerve repair is very limited, alternative treatment strategies are sought, including the use of tubular nerve guidance conduits(tNGCs). however, the use of tNGCs results in poor functional recovery and central necrosis of the regenerating tissue, which limits their application to short nerve lesion defects(typically shorter than 3 cm). Given the importance of vascularization in nerve regeneration, we hypothesized that enabling the growth of blood vessels from the surrounding tissue into the regenerating nerve within the tNGC would help eliminate necrotic processes and lead to improved regeneration. In this study, we reported the application of macroscopic holes into the tubular walls of silk-based tNGCs and compared the various features of these improved silk^(+) tNGCs with the tubes without holes(silk^(–) tNGCs) and autologous nerve transplants in an 8-mm sciatic nerve defect in rats. Using a combination of micro-computed tomography and histological analyses, we were able to prove that the use of silk^(+) tNGCs induced the growth of blood vessels from the adjacent tissue to the intraluminal neovascular formation. A significantly higher number of blood vessels in the silk^(+) group was found compared with autologous nerve transplants and silk^(–), accompanied by improved axon regeneration at the distal coaptation point compared with the silk^(–) tNGCs at 7 weeks postoperatively. In the 15-mm(critical size) sciatic nerve defect model, we again observed a distinct ingrowth of blood vessels through the tubular walls of silk^(+) tNGCs, but without improved functional recovery at 12 weeks postoperatively. Our data proves that macroporous tNGCs increase the vascular supply of regenerating nerves and facilitate improved axonal regeneration in a short-defect model but not in a critical-size defect model. This study suggests that further optimizatio

关键词： axon regeneration blood vessel functional recovery macroporous nerve lesion peripheral nerve repair sciatic nerve silk-based nerve guidance conduit vascularization

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Evaluating reservoir suitability for large-scale hydrogen storage:A preliminary assessment considering reservoir properties

Energy Geoscience

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Energy Geoscience 2024年第4期5卷 198-211页

作者： Chinedu J.Okere james J.Sheng Chinedu Ejike Bob l.herd Department of Petroleum Engineering Texas Tech UniversityLubbockTX79409United States Mewbourne School of Petroleum and Geological Engineering University of OklahomaOK73019United States

With rising demand for clean energy,global focus turns to finding ideal sites for large-scale underground hydrogen storage(UhS)in depleted petroleum reservoirs.A thorough preliminary reservoir evaluation before hydrogen(h_(2))injection is crucial for UhS success and *** criteria for UhS often emphasize economics and chemistry,neglecting key reservoir *** study introduces a comprehensive framework for the reservoir-scale preliminary assessment,specifically tailored for long-term h_(2) storage within depleted gas *** evaluation criteria encompass critical components,including reservoir geometry,petrophysical properties,tectonics,and formation *** illustrate the practical application of this approach,we assess the Barnett shale play reservoir *** assessment unfolds through three key stages:(1)A systematic evaluation of the reservoir's properties against our comprehensive screening criteria determines its suitability for h_(2) storage.(2)Using both homogeneous and multilayered gas reservoir models,we explore the feasibility and efficiency of h_(2) *** phase involves an in-depth examination of reservoir behavior during the injection stage.(3)To enhance understanding of UhS performance,sensitivity analyses investigate the impact of varying reservoir dimensions and injection/production *** findings reveal the following:(a)Despite potential challenges associated with reservoir compaction and aquifer support,the reservoir exhibits substantial promise as an h_(2) storage site.(b)Notably,a pronounced increase in reservoir pressure manifests during the injection stage,particularly in homogeneous reservoirs.(c)Furthermore,optimizing injection-extraction cycle efficiency can be achieved by augmenting reservoir dimensions while maintaining a consistent *** ensure a smooth transition to implementation,further comprehensive investigations are advised,including experimental and numerical studies to address

关键词： Site selection Underground hydrogen storage Preliminary evaluation Depleted petroleum reservoirs Reservoir assessment

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Methionine sources and genotype affect embryonic intestinal development,antioxidants,tight junctions,and growth-related gene expression in chickens

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Animal Nutrition 2024年第1期16卷 218-230页

作者： james K.lugata Sawadi F.Ndunguru Gebrehaweria K.Reda Xénia E.Ozsváth Eszter Angyal levente Czeglédi Gabriella Gulyás Renáta Knop János Oláh Zoltán Mészár Rita Varga Brigitta Csernus Csaba Szabó Department of Animal Nutrition and Physiology Faculty of Agriculture and Food Sciences and Environmental ManagementUniversity of DebrecenDebrecenHungary Department of Animal husbandry Faculty of Agriculture and Food Sciences and Environmental ManagementUniversity of DebrecenDebrecenHungary Faculty of Agriculture and Food Sciences and Environmental Management Doctoral School of Animal ScienceUniversity of DebrecenDebrecenHungary Institutes for Agricultural Research and Educational Farm University of DebrecenDebrecenHungary Department of Anatomy Histology and EmbryologyFaculty of MedicineUniversity of DebrecenDebrecenHungary Department of Evolutionary Zoology and human Biology Faculty of Science and TechnologyUniversity of DebrecenDebrecenHungary

Methionine(Met)is an essential and first limiting amino acid in the poultry diet that plays a significant role in chicken embryonic development and *** present study examined the effect of in ovo injection of Dl-Met and l-Met sources and genotypes on chicken embryonic-intestinal development and *** eggs of the two genotypes,TETRA-Sl layer hybrid(TSl)—commercial layer hybrid and hungarian Partridge colored hen breed(hPC)—a native genotype,were randomly distributed into four treatments for each *** treatment groups include the following:1)control non-injected eggs(NoIn);2)saline-injected(SaIn);3)Dl-Met injected(DlM);and 4)l-Met injected(lM).The in ovo injection was carried out on 17.5 d of embryonic development;after hatching,eight chicks per group were sacrificed,and the jejunum was extracted for *** results showed that both DlM and lM groups had enhanced intestinal development as evidenced by increased villus width,villus height,and villus area(Phe *** DlM group had significantly reduced crypt depth,glutathione(GSh)content,glutathione S-transferase 3 alpha(GST3),occludin(OClN)gene expression and increased villus height to crypt depth ratio in the TSl genotype than the lM group(Phe hPC genotype has overexpressed insulin-like growth factor 1(IGF1)gene,tricellulin(MD2),occludin(OClN),superoxide dismutase 1(SOD1),and GST3 genes than the TSl genotype(Plusion,these findings showed that in ovo injection of Met enhanced intestinal development,and function,with genotypes responding differently under normal *** also influenced the expression of intestinal antioxidants,tight junction,and growth-related genes.

关键词： Dl-Methionine l-Methionine In ovo injection Intestinal development Poultry

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Fine-scale hydrologic modeling for regional landscape applications:the California Basin Characterization Model development and performance

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Ecological Processes 2013年第1期2卷 254-274页

作者： lorraine E Flint Alan l Flint james h Thorne Ryan Boynton Water Resources Discipline U.S.Geological SurveyPlacer Hall6000 J StreetSacramentoCA 95819-6129USA Information Center for the Environment University of CaliforniaDavisCA95616USA

Introduction:Resource managers need spatially explicit models of hydrologic response to changes in key climatic drivers across variable landscape *** demonstrate the utility of a Basin Characterization Model for California(CA-BCM)to integrate high-resolution data on physical watershed characteristics with historical or projected climate data to predict watershed-specific hydrologic ***:The CA-BCM applies a monthly regional water-balance model to simulate hydrologic responses to climate at the spatial resolution of a 270-m *** model has been calibrated using a total of 159 relatively unimpaired watersheds for the California ***:As a result of calibration,predicted basin discharge closely matches measured data for validation *** CA-BCM recharge and runoff estimates,combined with estimates of snowpack and timing of snowmelt,provide a basis for assessing variations in water *** important output variable,climatic water deficit,integrates the combined effects of temperature and rainfall on site-specific soil moisture,a factor that plants may respond to more directly than air temperature and precipitation *** outputs are calculated for each grid cell,allowing results to be summarized for a variety of planning units including hillslopes,watersheds,ecoregions,or political ***:The ability to confidently calculate hydrologic outputs at fine spatial scales provides a new suite of hydrologic predictor variables that can be used for a variety of purposes,such as projections of changes in water availability,environmental demand,or distribution of plants and *** we present the framework of the CA-BCM model for the California hydrologic region,a test of model performance on 159 watersheds,summary results for the region for the 1981–2010 time period,and changes since the 1951–1980 time period.

关键词： Water balance Basin models Watershed hydrology Climate change Downscaling Basin characterization model

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Primary sclerosing cholangitis:A review and update

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liver Research 2017年第4期1卷 221-230页

作者： james h.Tabibian Christopher l.Bowlus Division of Gastroenterology and hepatology University of California DavisSacramentoCAUSA Division of Gastroenterology Olive View-UCLA Medical CenterSylmarCAUSA

Primary sclerosing cholangitis(PSC)is a rare,chronic,cholestatic liver disease of uncertain etiology characterized biochemically by cholestasis and histologically and cholangiographically by fibroobliterative inflammation of the bile *** a clinically significant proportion of patients,PSC progresses to cirrhosis,end-stage liver disease,and/or hepatobiliary cancer,though the disease course can be highly *** clinical trials of numerous pharmacotherapies over several decades,safe and effective medical therapy remains to be *** transplantation is an option for select patients with severe complications of PSC,and its outcomes are generally *** surveillance testing for pre-as well as post-transplant patients is a cornerstone of preventive care and health *** we provide an overview of PSC,including its epidemiology,etiopathogenesis,clinical features,associated disorders,surveillance,and emerging potential therapies.

关键词： Bile duct diseases Primary sclerosing cholangitis(PSC) Cholestasis Cholangiocarcinoma Magnetic resonance imaging Cholangiography Natural history

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Emergency logistics Management for hazardous Materials with Demand Uncertainty and link Unavailability

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Journal of Systems Science and Systems Engineering 2023年第2期32卷 175-205页

作者： Ginger Y.Ke james h.Bookbinder Faculty of Business Administration Memorial University of NewfoundlandSt.John’sNewfoundland and LabradorA1B 3X5Canada Department of Management Sciences University of WaterlooWaterlooOntarioN2L 3G1Canada

Due to its harmful nature,any incident associated with hazardous material(hazmat)may cause tremendous impacts on the surrounding people and the *** on the incident involving this specific type of good,we develop a reliable and robust emergency logistics network that considers both demand uncertainty and possible unavailability of particular links.A time-based risk measure is carefully designed upon the traditional risk assessment to reflect the stakeholder’s sensitivity to risk over response *** disruption and uncertainty are modeled as two sets of scenarios which are integrated into a bi-objective robust model to evaluate the trade-offs between risk and *** effectiveness of the emergency response can be assured by expenditures that add extra capacities to certain links or establish additional facilities that aid recovery from *** apply our model and approach to a real-world network in Guangdong *** results reveal the necessity of embedding consideration of uncertainty and unreliability into emergency network design problems;outline the importance of hedging against unpredictability by system redundancies;and indicate the impact of stakeholder’s orientation towards cost and risk on the location,allocation,and routing decisions in hazmat emergency response.

关键词： Emergency response hazardous materials robust optimization link disruption emergency demand uncertainty

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Beyond the stomach: An updated view of helicobacter pylori pathogenesis, diagnosis, and treatment

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World Journal of Gastroenterology 2014年第36期20卷 12781-12808页

作者： Traci l Testerman james Morris Department of Microbiology and Immunology Uniformed Services University of the Health SciencesBethesda MD 20814 United States Department of Gastroenterology Louisiana State University Health Sciences Center-Shreveport Shreveport LA 71130 United States

helicobacter pylori (h. pylori) is an extremely common, yet underappreciated, pathogen that is able to alter host physiology and subvert the host immune response, allowing it to persist for the life of the host. h. pylori is the primary cause of peptic ulcers and gastric cancer. In the United States, the annual cost associated with peptic ulcer disease is estimated to be $6 billion and gastric cancer kills over 700000 people per year globally. The prevalence of h. pylori infection remains high (> 50%) in much of the world, although the infection rates are dropping in some developed nations. The drop in h. pylori prevalence could be a double-edged sword, reducing the incidence of gastric diseases while increasing the risk of allergies and esophageal diseases. The list of diseases potentially caused by h. pylori continues to grow; however, mechanistic explanations of how h. pylori could contribute to extragastric diseases lag far behind clinical studies. A number of host factors and h. pylori virulence factors act in concert to determine which individuals are at the highest risk of disease. These include bacterial cytotoxins and polymorphisms in host genes responsible for directing the immune response. This review discusses the latest advances in h. pylori pathogenesis, diagnosis, and treatment. Up-to-date information on correlations between h. pylori and extragastric diseases is also provided.

关键词： Enterohepatic Pathogenesis Diagnosis Treatment Extragastric CagA Cancer Autoimmune Inflammation Virulence factor

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