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Pancreatic enzyme replacement therapy for pancreatic exocrine insufficiency in the 21^(st) century

World Journal of Gastroenterology 2014年第33期20卷 11467-11485页

作者： Tony Trang Johanna Chan David Y graham Department of Medicine Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine Houston TX 77030 United States

Restitution of normal fat absorption in exocrine pancreatic insufficiency remains an elusive goal. Although many patients achieve satisfactory clinical results with enzyme therapy, few experience normalization of fat absorption, and many, if not most, will require individualized therapy. Increasing the quantity of lipase administered rarely eliminates steatorrhea but increases the cost of therapy. Enteric coated enzyme microbead formulations tend to separate from nutrients in the stomach precluding coordinated emptying of enzymes and nutrients. Unprotected enzymes mix well and empty with nutrients but are inactivated at pH 4 or below. We describe approaches for improving the results of enzyme therapy including changing to, or adding, a different product, adding non-enteric coated enzymes,(e.g., giving unprotected enzymes at the start of the mealand acid-protected formulations later), use of antisecretory drugs and/or antacids, and changing the timing of enzyme administration. Because considerable lipid is emptied in the first postprandial hour, it is prudent to start therapy with enteric coated microbead prior to the meal so that some enzymes are available during that first hour. Patients with hyperacidity may benefit from adjuvant antisecretory therapy to reduce the duodenal acid load and possibly also sodium bicarbonate to prevent duodenal acidity. Comparative studies of clinical effectiveness of different formulations as well as the characteristics of dispersion, emptying, and dissolution of enteric-coated microspheres of different diameter and density are needed; many such studies have been completed but not yet made public. We discuss the history of pancreatic enzyme therapy and describe current use of modern preparations, approaches to overcoming unsatisfactory clinical responses, as well as studies needed to be able to provide reliably effective therapy.

关键词： Pancreatic insufficiency Pancreatic enzyme replacement therapy Lipase Clinical trials Steator-rhea Fat malabsorption Chronic pancreatitis

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High-resolution two-photon polymerization:the most versatile technique for the fabrication of microneedle arrays

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Microsystems & Nanoengineering 2021年第5期7卷 1-17页

作者： Zahra Faraji Rad Philip D.Prewett graham J.Davies School of Mechanical and Elearical Engineering University of Southern QueenslandSpringfield CentralQLD 4300Australia Department of Mechanical Engineering University of BirminghamBirmingham B152TTUK Oxacus Ltd Dorchester-on-Thames 0X107HNUK Faculty of Engineering UNSW AustraliaKensingtonNSW 2052Australia College of Engineering and Physical Sciences School of EngineeringUniversity of BirminghamBirmingham B152TTUK

Microneedle patches have received much interest in the last two decades as drug/vaccine delivery or fluid sampling systems for diagnostic and monitoring *** are manufactured using a variety of additive and subtractive micromanufacturing *** the last decade,much attention has been paid to using additive manufacturing techniques in both research and industry,such as 3D printing,fused deposition modeling,inkjet printing,and two-photon polymerization(2PP),with 2PP being the most flexible method for the fabrication of microneedle arrays.2PP is one of the most versatile and precise additive manufacturing processes,which enables the fabrication of arbitrary three-dimensional(3D)prototypes directly from computer-aided-design(CAD)models with a resolution down to 100 *** to its unprecedented flexibility and high spatial resolution,the use of this technology has been widespread for the fabrication of bio-microdevices and bio-nanodevices such as microneedles and microfluidic *** is a pioneering transformative technology that facilitates the fabrication of complex miniaturized structures that cannot be fabricated with established multistep manufacturing methods such as injection molding,photolithography,and ***,microstructures are designed according to structural and fluid dynamics considerations rather than the manufacturing constraints imposed by methods such as machining or etching *** article presents the fundamentals of 2PP and the recent development of microneedle array fabrication through 2PP as a precise and unique method for the manufacture of microstructures,which may overcome the shortcomings of conventional manufacturing processes.

关键词： resolution needle additive

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From thermal conductive to thermal insulating:Effect of carbon vacancy content on lattice thermal conductivity of ZrC_(x)

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Journal of Materials Science & Technology 2021年第23期82卷 105-113页

作者： Yue Zhou William G.Fahrenholtz Joseph graham Gregory E.Hilmas Department of Materials Science and Engineering Missouri University of Science and TechnologyRollaMO 65409USA

Lattice thermal conductivities of zirconium carbide(ZrC_(x),x=1,0.75 and 0.5)ceramics with different carbon vacancy concentrations were calculated using a combination of first-principles calculations and the Debye-Callaway *** Gruneisen parameters,Debye temperatures,and phonon group velocities were deduced from phonon dispersions of ZrC_(x) determined using first-principles *** addition,the effects of average atomic mass,grain size,average atomic volume and Zr isotopes on the lattice thermal conductivities of ZrC_(x) were analyzed using phonon scattering *** lattice thermal conductivity decreased as temperature increased for ZrC,ZrC_(0.75) and ZrC_(0.5)(Zr2 C),and decreased as carbon vacancy concentration ***,ZrC_(x) can be tailored from a thermal conducting material for ZrC with high lattice thermal conductivity to a thermal insulating material for ZrC_(0.5) with low lattice thermal ***,it opens a window to tune the thermal properties of ZrC_(x) by controlling the carbon vacancy content.

关键词： Zirconium carbide Lattice thermal conductivity Theoretical study First-principle calculations

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The Intelligent Industrial Facility in the New Economy

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食品科学 2001年第11期22卷 108-109页

作者： Earle Droppo graham Beattie Wood Banani Associates Ltd.Automation Specialists Majisoft Multimedia Inc.Network Architect

To quote from an article that appeared in the August 9th, 2000edition of the Toronto Globe and Mail, Report on Business:'Productivity soared in the United States at the strongest pace since theearly 1980' s, propelledbythecomputerizationoftheworkingworld and massive investment by business in ever faster high-tech *** billions of dollars being spent on new computer equipment and new electronic commerce systems continued to pay off in the second quarter, allowing the economic output per worker to surpass the already high expectations of financial *** U. S. Department of Labour reported yesterday that productivity in the United States rose at an annualized rate of 5.3 percent in the second quarter from the first quarter... its strongest 12 month increase since the third quarter of 1983 Much ofthe productivity gains in the computerization and on-line presence is in turn, expected to enable Canadian businesses to keep improving the productivity of their workers and match the gains of the United States. 'In order to achieve gains of this magnitude, we must move beyond automation at the plant floor level. New opportunities are emerging from the networked e-business environment of the internet, intranets and extranets. Fast and efficient access to these technologies is becomingessential for survival in today' s new economy. E-business lets you create and manage a network of employees, suppliers and partners working toward a common goal. The result is a seamless, integrated system that can sense and respond to customers, competitors and global markets in real time. By enabling collaboration, integration and empowerment, these new technologies increase productivity, reduce cycle times, lower costs, create new business opportunities and achievegreater return on *** summarize, we need to take a systems integration approach to automation.

关键词： The Intelligent Industrial Facility in the New Economy

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Relative fitness of susceptible and Cry1A.105/Cry2Ab2-single-/dual-protein-resistant Helicoverpa zea (Boddie) (Lepidoptera: Noctuidae) on non-Bt diet and a diet containing a low concentration of two proteins

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Insect Science 2023年第2期30卷 398-410页

作者： Shucong Lin graham Head Paula Price Ying Niu Fangneng Huang Department of Entomology Louisiana State University Agricultural CenterBaton RougeLouisianaUSA Bayer Crop Science ChesterfieldMissouriUSA

Helicoverpa zea(Boddie)is a destructive agricultural pest species that is targeted by both Bacillus thuringiensis(Bt)maize and cotton in the United ***1A.105 and Cry2Ab2 are two Bt proteins expressed in a widely planted maize event MON *** this study,two tests(Test-Ⅰ and Test-Ⅱ)were conducted to evaluate the relative fitness of Bt-susceptible and-resistant *** on non-Bt diet(Test-Ⅰ and Test-Ⅱ)and a diet containing a mix of Cry1A.105 and Cry2Ab2 at a low concentration(Test-Ⅱ only).Insect populations evaluated in Test-Ⅰ were two Bt-susceptible strains and three Bt-resistant strains(a single-protein Cry1A.105-,a single-protein Cry2Ab2-,and a dual-protein Cry1A.105/Cry2Ab2-resistant strains).Test-Ⅱ analyzed the same two susceptible strains,three backcrossed-and-reselected Cry1A.105/Cry2Ab2-single-/dual-protein-resistant strains,and three F1 heterozygous *** of life table parameters showed that neither the single-nor dual-protein Cry1A.105/Cry2Ab2 resistance in *** was associated with fitness costs under the test *** single Cry protein resistances at a concentration of a mix of Cry1A.105 and Cry2Ab2 that resulted in a zero net reproductive rate for the two susceptible strains were functionally incomplete recessive or codominant,and the dual-protein resistance was completely *** lack of fitness costs could be a factor contributing to the rapid revolution of resistance to the Cry proteins in this *** generated from this study should aid our understanding of Cry protein resistance evolution and help in refining IRM programs for ***.

关键词： resistance management Cry1A.105 Cry2Ab2 fitness costs Helicoverpa zea low dose effect

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Access to insulin delivery devices and glycated haemoglobin in lower-income countries

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World Journal of Diabetes 2020年第8期11卷 358-369页

作者： Emma Louise Klatman graham David Ogle Life for a Child Program GlebeNSW 2037Australia

BACKGROUNDYoung people with type 1 diabetes in low-and-middle income countries facemany challenges in accessing care, with various essential supplies needed forsurvival and long-term *** study insulin delivery devices and glycated haemoglobin (HbA1c) *** survey was conducted in 2019 of leading diabetes centres in 41 countriessupported by the Life for a Child Program. The survey covered numerous aspectsconcerning availability and costs at all levels of the health system, local usagepatterns and attitudes, obstacles, and other ***-seven countries returned the survey (90.2% response rate). Key findingsincluded: Syringe use was most common (83.1%), followed by insulin pens(16.7%) and pumps (0.2%). 48.6% of public health systems did not providesyringes, even with a co-payment. Use of suboptimal syringe/needlecombinations was common. Needles were generally reused in almost all countries(94.3%, n = 35). Aside from donated supplies, there was variable access to HbA1ctesting within public health facilities, and, when available, patients often had tocover the cost. Provision was further compromised by numerous problemsincluding stock-outs, and challenges with understanding the test, equipmentmaintenance, and *** gaps exist for adequate access to appropriate insulin delivery devices andHbA1c testing. Public health systems in low-and-middle income countries shouldincrease affordable provision. There are also needs for specific health professional training and diabetes education;elimination of customs duties and taxes;development of inexpensive, robust HbA1c testing methods that do not requirerefrigeration of testing supplies;differential pricing schemes;and other solutions.

关键词： Type 1 diabetes Diagnostics Glycated haemoglobin Syringes Insulin Access

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Mental health service users'progression from illicit drug use to schizophrenia in New Zealand

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General Psychiatry 2019年第5期32卷 257-260页

作者： graham Mellsop Rees Tapsell Pragya Holmes Research Contractor AucklandNew Zealand University of Auckland Waikato Clinical School HamiltonNew Zealand

Background Recently,publications have hypothesised that the demonstrated increase in the incidence of schizophrenia in New Zealand is a side effect of the increased strength of available cannabis derivatives over the last 25+years and the much more recent increase in the population's use of *** To compare the rates of later schizophrenia between age-matched mental health service users with initial diagnoses as alcohol abusers or illicit drug *** From the PRIMHD comprehensive national database,all users of the mental health services over a 5-year period who received an ICD-10 presenting diagnosis of alcohol or substance use/abuse were *** each person identified,the database was examined for the following 3 years to determine the numbers later diagnosed with *** For the initial alcohol problem people in their twenties,1.7%were diagnosed as suffering from schizophrenia in the subsequent 3 *** the initial drug problem people,the rate was 10.9%.Within that drug-using population,the indigenous Maori developed schizophrenia at a higher rate than did the remainder of the *** These findings in New Zealand require further research into their generalisability,context and explanation.

关键词： schizophrenia alcohol service

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Extreme points, support points and the Loewner variation in several complex variables

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Science China Mathematics 2012年第7期55卷 1353-1366页

作者： graham Ian HAMADA Hidetaka KOHR Gabriela KOHR Mirela Department of Mathematics University of Toronto Toronto Ontario M5S 2E4 Canada Faculty of Engineering Kyushu Sangyo University 3-1 Matsukadai 2-Chome Higashi-ku Fukuoka 8138503 Japan Faculty of Mathematics and Computer Science Babe s-Bolyai University 1 M. Koga lniceanu Str. Cluj-Napoca 400084 Romania Faculty of Mathematics and Computer Science Babes-Bolyai University 1 M. Kogǎlniceanu Str. Cluj-Napoca 400084 Romania

In this paper we consider extreme points and support points for compact subclasses of normalized biholomorphic mappings of the Euclidean unit ball Bn in Cn. We consider the class So（Bn） of biholomorphic mappings on Bn which have parametric representation, i.e., they are the initial elements f（-, O） of a Loewner chain f（x,t） = etz ＋ ... such that {e-tf（.,t）}t≥o is a normal family on Bn. We show that if f（.,O） is an extreme point （respectively a support point） of So（Bn）, then e-t f（., t） is an extreme point of So（Bn） for t≥0 （respectively a support point of So（Bn） for t C [O, t0] and some to〉 0）. This is a generalization to the n-dimensional case of work due to Pell. Also, we prove analogous results for mappings which belong to So（Bn） and which are bounded in the norm by a fixed constant. We relate the study of this class to reachable sets in control theory generalizing work of Roth. Finally we consider extreme points and support points for biholomorphic mappings of Bn generated by using extension operators that preserve Loewner chains.

关键词： biholomorphic mapping Loewner chain parametric representation reachable set starlike map-ping

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Response to: Caution needed when interpreting muscle activity patterns during extremely low pedaling cadence

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Journal of Sport and Health Science 2021年第1期10卷 109-110页

作者： Sangsoo Park graham E.Caldwell Department of Kinesiology University of Massachusetts AmherstAmherstMA 01003USA

Dear editor,We would like to thank Drs Sun and Li for their interests and observations for our recently published article entitled“Muscular activity patterns in 1-legged vs.2-legged pedaling”.We have carefully read their letter and agree with their underlying premise that our low cadence is not indicative of competitive,recreational,or(in some cases)clinical 2-legged pedaling ***,our results were not meant to be extrapolated to higher cadences,as clearly stated in the Limitations Section of the Discussion:“The results of this study do not necessarily extend to muscular control in one-legged pedaling tasks with different mechanical demands,as our participants were asked to perform pedaling tasks with relatively low crank torque and velocity.”1 Further,we stand by the initial statement of the Abstract that“One-legged pedaling is of interest to elite cyclists and clinicians.”In the Introduction we cite 2 studies2,3 that refer to 1-legged cycling:“As such,1-legged pedaling has been suggested as a training tool to improve pedaling performance and is used in clinical settings for rehabilitation.”1 Our opening Abstract statement(which would presumably be read before the Results and Discussion)was not meant to imply that our study results would be directly applicable to elite cyclists and all clinical populations/treatments,as Drs Sun and Li seem to infer.

关键词： statement elite interpreting

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Quasi-Z-Source Based Bidirectional DC-DC Converter and Its Control Strategy

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Chinese Journal of Electrical Engineering 2019年第1期5卷 1-9页

作者： Yuba Raj Kafle Saad Ul Hasan graham E.Town School of Engineering Macquarie UniversityNSW 2109Australia

This paper presents a quasi-Z-source based isolated bidirectional DC-DC converter(qZIBDC)for renewable energy *** converter utilizes a dual active bridge circuit with a quasi-Z-source network on both sides,so the converter works as buck/boost converter from either *** has a wider input/output voltage operating range,soft-switching capabilities without additional devices,and higher boost capability than a traditional dual active bridge *** from that,shoot-through states are incorporated in its operating cycle to boost the input voltage resulting in high reliability of the proposed *** to the symmetrical structure of the circuit,there is no defined high voltage or low voltage side as in traditional isolated bidirectional DC-DC *** operating principle and control strategy of the proposed converter are *** and experimental results are provided to verify the effectiveness of the proposed converter topology and its control strategy.

关键词： Bidirectional DC-DC converter dual active bridge impedance source quasi-Z-source DC-DC converter

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