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Perceived Barriers to Asthma Therapy in Ethno-Cultural Communities: The Role of Culture, Beliefs and Social Support

Health 2017年第7期9卷 1029-1046页

作者： Michele Shum Iraj.Poureslami j.ng Liu j. mark fitzgerald University of j.hn Hopkins School of Public Health Baltimore MD USA University of British Columbia (UBC) Faculty of Medicine Research Scientist at the Centre for Clinical Epidemiology and Evaluation UBC British Columbia Canada British Columbia Cancer Agency Smoking Cessation Project Vancouver Canada Institute for Heart and Lung Health The Lung Centre 7th Floor Gordon and Leslie Diamond Health Care Centre UBC British Columbia Canada

Background : Adherence to therapy is integral to successfully managing asthma, which requires comprehension of what, when, and how to use medication and diligence in following management plan. Asthma patients from ethnic minority groups have more morbidity and reported filling their prescriptions less often. Limited information is available in Canadian literature on ethnic differences in their perceptions of asthma management. We aimed to document patient perceived adherence to asthma therapy among targeted ethno-cultural groups. Methods : We evaluated perceived barriers to therapy adherence, including: cultural beliefs and practices, patient/care-provider communication, self-management knowledge, and medication costs. We conducted a cross sectional study and interviewed 85 Chinese or Punj.bispeaking adult asthma patients. Results : Lack of sufficient instructions from physicians, language/communication barriers, lack of skills on how to use inhalers, and high medication costs and medication side effects were most reported barriers to proper self-management practices. Most participants lived with others in the same household and reported high social support from home caregivers. The influence of family on self-management practices was obvious. Conclusion: Better understanding of patient needs, provision of culturally and linguistically appropriate education, and inclusion of home caregivers into the management practices are necessary to improve asthma outcomes in Chinese and Punj.bi communities.

关键词： Asthma Medication Family Involvement Caregiver Language Culture Educational Materials Knowledge Communication Cost Beliefs

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Analysis of the inflection points of height-diameter models

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Forest Ecosystems 2024年第4期11卷 414-422页

作者： Tzeng Yih Lam mark j.Ducey Department of Forest Resources Management Faculty of ForestryThe University of British Columbia2045-2424 Main MallVancouverBCV6T 1Z4 Canada Department of Natural Resources and the Environment University of New Hampshire114 James HallDurhamNH 03824USA

The inflection point is an important feature of sigmoidal height-diameter(H-D)*** is often cited as one of the properties favoring sigmoidal model ***,there are very few studies analyzing the inflection points of H-D *** goals of this study were to theoretically and empirically examine the behaviors of inflection points of six common H-D models with a regional *** six models were the Wykoff(WYK),Schumacher(SCH),Curtis(CUR),HossfeldⅣ(HOS),von Bertalanffy-Richards(VBR),and Gompertz(GPZ)*** models were first fitted in their base forms with tree species as random effects and were then expanded to include functional traits and spatial *** distributions of the estimated inflection points were similar between the two-parameter models WYK,SCH,and CUR,but were different between the threeparameter models HOS,VBR,and *** produced some of the largest inflection *** and VBR produced concave H-D curves without inflection points for 12.7%and 39.7%of the tree *** species or decreasing shade tolerance resulted in larger inflection *** trends in the estimated inflection points of HOS and VBR were entirely opposite across the ***,HOS could produce concave H-D curves for portions of the *** on the studied behaviors,the choice between two-parameter models may not *** recommend comparing seve ral three-parameter model forms for consistency in estimated inflection points before deciding on *** sigmoidal models to have inflection points does not necessarily mean that they will produce fitted curves with *** study highlights the need to integrate analysis of inflection points into modeling H-D relationships.

关键词： Concavity Forest inventory and analysis Generalized height-diameter models Growth functions Height-diameter functions Mixed-effects modeling Points of inflection Species-specific models

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A Simulation of the Dependence of Tidal Interaction on Galaxy Type in Compact Groups

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International j.urnal of Astronomy and Astrophysics 2024年第2期14卷 85-100页

作者： mark j. Henriksen Mateo Mej.a Department of Physics University of Maryland Baltimore USA

We have investigated the role that different galaxy types have in galaxy-galaxy interactions in compact groups. N-body simulations of 6 galaxies consisting of a differing mixture of galaxy types were run to compare the relative importance of galaxy population demographic on evolution. Three different groups with differing galaxy content were tested: all spiral, a single elliptical and 50% elliptical. Tidal interaction strength and duration were recorded to assess the importance of an interaction. A group with an equal number of spiral and elliptical galaxies has some of the longest and strongest interactions with elliptical-elliptical interactions being most significant. These elliptical-elliptical interactions are not dominated by a single large event but consist of multiple interactions. Elliptical galaxies tidally interacting with spiral galaxies, have the next strongest interaction events. For the case when a group only has a single elliptical, the largest magnitude tidal interaction is an elliptical on a spiral. Spirals interact with each other through many small interactions. For a spiral only group, the interactions are the weakest compared to the other group types. These spiral interactions are not dominated by any singular event that might be expected to lead to a merger but are more of an ongoing harassment. These results suggest that within a compact group, early type galaxies will not form via merger out of an assemblage of spiral galaxies but rather that compact groups, in effect form around an early type galaxy.

关键词： Galaxy Groups Galaxy Clusters Galaxy Evolution N-Body Simulations

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Why Don’t We Adequately Identify and Manage Adverse Drug Reactions despite Having the Needed Information?

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Health 2024年第2期16卷 148-159页

作者： mark j. Kupersmith Karl Kieburtz Department of Neurology Ophthalmology and Neurosurgery Icahn School of Medicine at Mount Sinai New York NY USA SafeTherapeutics LLC New York NY USA Clintrex Research Corporation Sarasota FL USA

Importance/Obj.ctive: Adverse Drug Reactions (ADRs) are unavoidable, but recognizing and addressing ADRs early can improve wellness and prevent permanent inj.ry. We suggest that available medical information and digital/electronic methods could be used to manage this maj.r healthcare problem for individual patients in real time. Methods: We searched the available digital applications and three literature databases using the medical subj.ct heading terms, adverse drug reaction reporting systems or management, filtered by clinical trial or systemic reviews, to detect publications with data about ADR identification and management approaches. We reviewed the reports that had abstract or summary data or proposed or implemented methods or systems with potential to identify or manage ADRs in clinical settings. Results: The vast maj.rity of the 481 reports used retrospectively collected data for groups of patients or were limited to surveying one population group or class of medication. The reports showed potential and definite associations of ADRs for specific drugs and problems, mostly, but not exclusively, for patients in hospitals and nursing homes. No reports described complete methods to collect comprehensive data on ADRs for individual patients in a healthcare system. The digital applications have ADR information, but all are too cumbersome or incomplete for use in active clinical settings. Several studies suggested that providing information about potential ADRs to clinicians can reduce these problems. Conclusion and Relevance: Although investigators and government agencies agree with the need, there is no comprehensive ADR management program in current use. Informing the patient’s healthcare practitioners of potential ADRs at the point of service has the potential for reduction of these complications, which should improve healthcare and reduce unneeded costs.

关键词： Adverse Drug Reaction Medication Side Effect Identification Medication Complication Medication Safety

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What diameter?What height?Influence of measures of average tree size on area-based allometric volume relationships

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Forest Ecosystems 2024年第1期11卷 100-109页

作者： Yilin Wang j.hn A.Kershaw mark j.Ducey Yuan Sun j.mes B.McCarter Integrated Forest Mensuration and Systems Analysis Laboratory Faculty of Forestry and Environmental ManagementUniversity of New BrunswickFrederictonNBCanada Department of Natural Resources and the Environment University of New HampshireDurhamNHUSA College of Forestry Nanjing Forestry UniversityNanjing210037China Scientific Programmer RayonierYuleeFLUSA

Volume is an important attribute used in many forest management *** from 83 fixed-area plots located in central New Brunswick,Canada,are used to examine how different measures of stand-level diameter and height influence volume prediction using a stand-level variant of Honer's(1967)volume *** density was included in the models(Volume=f(Diameter,Height,Density))choice of diameter measure was more important than choice of height *** density was not included(Volume=f(Diameter,Height)),the opposite was *** models with density included,moment-based estimators of stand diameter and height performed better than all other *** models without density,largest tree estimators of stand diameter and height performed better than other *** overall best equation used quadratic mean diameter,Lorey's height,and density(root mean square error=5.26 m^3·ha^(-1);1.9%relative error).The best equation without density used mean diameter of the largest trees needed to calculate a stand density index of 400 and the mean height of the tallest 400 trees per ha(root mean square error=32.08 m^(3)·ha^(-1);11.8%relative error).The results of this study have some important implications for height subsampling and LiDAR-derived forest inventory analyses.

关键词： Allometric relationships Stand structure Volume estimation Stand-level attributes

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Management of monogenic diabetes in pregnancy:A narrative review

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World j.urnal of Diabetes 2024年第1期15卷 15-23页

作者： Mohammad Sadiq j.eyavudeen Sarah R Murray mark W j.Strachan Metabolic Unit Western General HospitalEdinburgh EH42XUUnited Kingdom MRC Centre for Reproductive Health University of Edinburgh Queen’s Medical Research InstituteEdinburgh EH164TJUnited Kingdom

Pregnancy in women with monogenic diabetes is potentially complex,with significant implications for both maternal and fetal *** these,maturity-onset diabetes of the young(MODY)stands out as a prevalent monogenic diabetes subtype frequently encountered in clinical *** subtype of MODY requires a distinct approach tailored to the pregnancy,diverging from management strategies in non-pregnant *** MODY(GCK-MODY)typically does not require treatment outside of pregnancy,but special considerations arise when a woman with GCK-MODY becomes *** glycemic targets in GCK-MODY pregnancies are not exclusively dictated by the maternal/paternal MODY genotype but are also influenced by the genotype of the developing *** pregnancy,the choice between sulfonylurea or insulin for treating hepatocyte nuclear factor 1-alpha(HNF1A)-MODY and HNF4A-MODY depends on the mother’s specific circumstances and the available *** of other rarer MODY subtypes is individu-alized,with decisions made on a case-by-case ***,a collaborative approach involving expert diabetes and obstetric teams is crucial for the compre-hensive management of MODY pregnancies.

关键词： Diabetes Pregnancy Maturity-onset diabetes of the young Insulin Sulphonylurea Glucokinase Hepatocyte nuclear factor 1-alpha,hepatocyte nuclear factor 1-beta,and hepatocyte nuclear factor 4-alpha

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Olympic Games and 24-hour movement behaviors:A match worth making

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j.urnal of Sport and Health Science 2024年第6期13卷 728-731页

作者： mark S.Tremblay Nicholas Kuzik markus j.Duncan Diego Augusto Santos Silva CHEO Research Institute OttawaON K1H 8L1Canada Department of Pediatrics University of OttawaOttawaON K1H 8L1Canada Federal University of Santa Catarina FlorianopolisSanta Catarina 88040-900Brazil

*** The Olympic motto,"Faster,Higher,Stronger-Together",represents the pursuit of athletic excellence,united as a global community."Excellence,respect and friendship"are the Olympic *** the motto and values are multifaceted and holistic in nature,and all-encompassing in their reach while recognizing no single entity rises above the ***,these foundational statements anchor the Olympic movement in its quest to build a better world through sport.

关键词： movement Together pursuit

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Towards precision 24-hour movement behavior recommendations—The next new paradigm?

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j.urnal of Sport and Health Science 2024年第6期13卷 743-748页

作者： mark S.Tremblay markus j.Duncan Nicholas Kuzik Diego Augusto Santos Silva Valerie Carson CHEO Research Institute OttawaON K1H 8L1Canada Department of Pediatrics University of OttawaOttawaON K1H 8L1Canada Federal University of Santa Catarina Santa Catarina 88040900Brazil Faculty of Kinesiology Sportand RecreationUniversity of AlbertaEdmontonAB T6G 2H9Canada

*** The importance of physical activity(PA)for health is unequivocal.^(1)Accordingly,population-based recommendations for exercise,and more recently public health guidelines for PA,have been developed and released by authoritative groups for many decades.^(2)Such guidelines emerged with leadership from the exercise physiology discipline and were rooted in,and loyal to,the importance of moderate-to-vigorous intensity PA(MVPA)or exercise.

关键词： movement behavior exercise

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Anneal-free ultra-low loss silicon nitride integrated photonics

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Light(Science & Applications) 2024年第8期13卷 1565-1577页

作者： Debapam Bose mark W.Harrington Andrei Isichenko Kaikai Liu j.awei Wang Nitesh Chauhan Zachary L.Newman Daniel j.Blumenthal Department of Electrical and Computer Engineering University of California Santa BarbaraSanta BarbaraCA 93106USA Octave Photonics LouisvilleCO 80027USA

Heterogeneous and monolithic integration of the versatile low-loss silicon nitride platform with low-temperature materials such as silicon electronics and photonics,III–V compound semiconductors,lithium niobate,organics,and glasses has been inhibited by the need for high-temperature annealing as well as the need for different process flows for thin and thick *** techniques are needed to maintain the state-of-the-art losses,nonlinear properties,and CMOS-compatible processes while enabling this next generation of 3D silicon nitride *** report a significant advance in silicon nitride integrated photonics,demonstrating the lowest losses to date for an anneal-free process at a maximum temperature 250℃,with the same deuterated silane based fabrication flow,for nitride and oxide,for an order of magnitude range in nitride thickness without requiring stress mitigation or *** report record low anneal-free losses for both nitride core and oxide cladding,enabling 1.77 dBm-1 loss and 14.9 million Q for 80 nm nitride core waveguides,more than half an order magnitude lower loss than previously reported sub 300℃ *** 800 nm-thick nitride,we achieve as good as 8.66 dBm-1 loss and 4.03 million Q,the highest reported Q for a low temperature processed resonator with equivalent device area,with a median of loss and Q of 13.9 dBm-1 and 2.59 million each *** demonstrate laser stabilization with over 4 orders of magnitude frequency noise reduction using a thin nitride reference cavity,and using a thick nitride micro-resonator we demonstrate OPO,over two octave supercontinuum generation,and four-wave mixing and parametric gain with the lowest reported optical parametric oscillation threshold per unit resonator *** results represent a significant step towards a uniform ultra-low loss silicon nitride homogeneous and heterogeneous platform for both thin and thick waveguides capable of linear and nonlinear photonic circuits and integrat

关键词： resonator thick free

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该呼吸困难急救患者是否存在充血性心力衰竭？

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美国医学会杂志（中文版） 2006年第5期25卷 290-301页

作者： Charlie S. Wang j. mark fitzgerald Michael SchulzerD Edwin Mak Naj.b T. Ayas 徐亚妹（译）黄冰清（译）彭娟（译）褚骏仁（校） Department of Medicine and Division of Respiratory Medicine Vancouver Hospitar and Hearth Science Centre University of British Columbia Centre for Clinical Epidemiology and Evaluation Vancouver Coastal Health Research Institute and Pacific Parkinson Research Centre University of British Columbia Vancouver British Columbia. 不详

背景：呼吸困难是急诊患者常见的主诉，急诊医生必须快速、准确地做出诊断。目的：评估急诊患者病史、症状、体征及常规的诊断性检查（胸部X线片、心电图、B型利尿肽[B—type natriuretic peptide，BNP]）在鉴别诊断心力衰竭及其他引起... 详细信息

背景：呼吸困难是急诊患者常见的主诉，急诊医生必须快速、准确地做出诊断。目的：评估急诊患者病史、症状、体征及常规的诊断性检查（胸部X线片、心电图、B型利尿肽[B—type natriuretic peptide，BNP]）在鉴别诊断心力衰竭及其他引起呼吸困难的原因中的作用。资料来源：检索MEDLINE数据库（1966年至2905年7月）及相关文章的参考文献、既往发表的综述以及有关体格检查的教科书。研究选取：最终获得22项研究，这些研究对因呼吸困难而到急诊室就诊的成年患者进行了观察，了解其心力衰竭的诊断情况，研究结果各异。数据提取：由本文的两名作者分别提取数据（敏感性、特异性及似然比[1ikelihood ratio，LRs]）并对研究的方法学质量进行评估。数据汇总：许多临床特点可增加心力衰竭的可能性，其中最突出的特点是：（1）具有心力衰竭既往史（阳性LR=5．8；95％可信期间[confidence interval，CI]，4．1．8．0）；（2）夜间出现阵发性呼吸困难（阳性LR=2．6；95％CI，1．5-4．5）；（3）听诊闻及第三心音（S3）奔马率（阳性LR=11；95％CI，4．9-25．0）；（4）胸部X线片示肺静脉淤血（阳性LR=12．0；95％CI，6．8-21．0）；（5）心电图示心房纤颤（阳性LR=3．8；95％CI，1．7—8．8）。也有一些临床特点可大大降低心力衰竭的可能性，包括：（1）无心力衰竭既往史（阴性LR=0．45；95％CI，0．38-0．53）；（2）活动时不出现呼吸困难症状（阴性LR=0．48；95％CI，0．35-0．67）；（3）肺部未闻及哕音（阴性LR=0．51；95％CI，0．37—0．70）；（4）胸部X线片未见心脏扩大（阴性LR=0．33；95％CI，0．23-0．48）；（5）心电图未见任何异常表现（阴性LR=0．64；95％CI，0．47-0．88）。经证实，血清BNP水平低下是最有价值的检查结果（血清BNP〈100pg／mL；阴性LR=0．11；95％CI，0．07-0．16）。结论：在收治呼吸困难的急诊患者时应直接询问其病史，进行体格检查，嘱做胸部X线片及心电图检查。如果对心力衰竭存有疑义，可化验血清BNP水平，这对排除心力衰竭极有帮助。

关键词：充血性心力衰竭阵发性呼吸困难胸部X线片诊断性检查 peptide MEDLINE 急救急诊患者

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