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Storylines of family medicine Ⅴ:ways of thinking—honing the therapeutic self

Family medicine and Community Health 2024年第S3期12卷 43-51页

作者： William B Ventres Leslie A Stone Johanna F Shapiro Cynthia Haq Jéssica R B Leao Donald E Nease Jr Liz Grant Stewart W mercer John C m Gillies Pablo González Blasco maria Auxiliadora C De Benedetto Graziela moreto marcelo R Levites Jennifer E DeVoe William R Phillips jane m uygur Thomas R Egnew Colette S Stanley Family and Preventive medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Family medicine University of California Irvine School of MedicineIrvineCaliforniaUSA Faculty of medicine University of Sao PauloSao PauloBrazil Family medicine University of Colorado Anschutz Medical Campus School of MedicineAuroraColoradoUSA Usher Institute Edinburgh Medical SchoolUniversity of EdinburghEdinburghUK SOBRAmFA-medical Education and Humanism Sao PauloBrazil Family medicine Oregon Health&Science University School of MedicinePortlandOregonUSA Family medicine University of Washington School of MedicineSeattleWashingtonUSA General Practice Royal College of Surgeons in IrelandDublinIreland General Internal medicine Geriatrics&Palliative MedicineTulane University School of MedicineNew OrleansLouisianaUSA

Storylines of Family medicine is a 12-part series of thematically linked essays with accompanying illustrations that explore the many dimensions of family medicine,as interpreted by individual family physicians and medical educators in the USA and elsewhere around the ***‘Ⅴ:ways of thinking—honing the therapeutic self’,authors present the following sections:‘Reflective practice in action’,‘The doctor as drug—Balint groups’,‘Cultivating compassion’,‘Towards a humanistic approach to doctoring’,‘Intimacy in family medicine’,‘The many faces of suffering’,‘Transcending suffering’and‘The power of listening to stories.’may readers feel a deeper sense of their own therapeutic agency by reflecting on these essays.

关键词： illustration dimensions suffering

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Gradient‑Layered mXene/Hollow Lignin Nanospheres Architecture Design for Flexible and Stretchable Supercapacitors

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Nano-micro Letters 2025年第2期17卷 447-462页

作者： Haonan Zhang Cheng Hao Tongtong Fu Dian Yu jane Howe Kaiwen Chen Ning Yan Hao Ren Huamin Zhai Jiangsu Provincial Key Lab of Sustainable Pulp and Paper Technology and Biomass materials NanJing Forestry UniversityNanjing 210037People’s Republic of China Department of Chemical Engineering and Applied Chemistry University of Toronto200 College StreetTorontoON M5S 3E5Canada Department of materials Science and Engineering University of Toronto184 College StreetTorontoON M5S 3E4Canada College of materials Science and Engineering Nanjing Forestry UniversityNanjing 210037People’s Republic of China

With the rapid development of flexible wearable electronics,the demand for stretchable energy storage devices has *** this work,a novel gradient-layered architecture was design based on single-pore hollow lignin nanospheres(HLNPs)-intercalated two-dimensional transition metal carbide(Ti_(3)C_(2)T_(x) mXene)for fabricating highly stretchable and durable *** depositing and inserting HLNPs in the mXene layers with a bottom-up decreasing gradient,a multilayered porous mXene structure with smooth ion channels was constructed by reducing the overstacking of mXene ***,the micro-chamber architecture of thin-walled lignin nanospheres effectively extended the contact area between lignin and mXene to improve ion and electron accessibility,thus better utilizing the pseudocapacitive property of *** these strategies effectively enhanced the capacitive performance of the *** addition,HLNPs,which acted as a protective phase for mXene layer,enhanced mechanical properties of the wrinkled stretchable electrodes by releasing stress through slip and deformation during the stretch-release cycling and greatly improved the structural integrity and capacitive stability of the *** electrodes and symmetric flexible all-solid-state supercapacitors capable of enduring 600%uniaxial tensile strain were developed with high specific capacitances of 1273 mF cm^(−2)(241 F g^(−1))and 514 mF cm^(−2)(95 F g^(−1)),***,their capacitances were well preserved after 1000 times of 600%stretch-release *** study showcased new possibilities of incorporating biobased lignin nanospheres in energy storage devices to fabricate stretchable devices leveraging synergies among various two-dimensional nanomaterials.

关键词： Hollow lignin nanospheres mXene Gradient-layered architecture Wrinkled electrodes Stretchable supercapacitors

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Satisfaction with patient-doctor relationships in inflammatory bowel diseases:Examining patient-initiated change of specialist

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World Journal of Gastroenterology 2012年第18期18卷 2212-2218页

作者： Daniel R van Langenberg jane m Andrews Department of Gastroenterology and Hepatology Royal Adelaide HospitalSchool of MedicineUniversity of AdelaideSouth Australia 5000Australia Department of Gastroenterology and Hepatology Eastern Health Clinical SchoolMonash UniversityVictoria 3128Australia

AIm:To assess the reasons for,and factors associated with,patient-initiated changes in treating specialist in inflammatory bowel diseases(IBD).mETHODS:Prospectively identified IBD patients(n = 256) with ≥ 1 encounter at a metropolitan hospital were surveyed,including whether they had changed treating specialist and *** reasons included loss of confidence,disagreement,and/or personality clash with the ***:Of 162 respondents,70(43%) had ever changed specialists;30/70(43%) for negative reasons,52/70(74%) in the preceding *** with negative reasons for changing(n = 30) were younger(median,35.2 years vs 45.3 years),had higher IBD knowledge(median,5.0 years vs 4.0 years),yet had lower medication adherence and satisfaction scores(median,19.0 years vs 22.0 years,14.0 years vs 16.0 years respectively,mann-Whitney tests,all P mpared to all other responders(n = 132).Patients with a recent change(for any reason) were more likely to have Crohn's disease,currently active disease,previous bowel resection and recent hospitalization [OR 2.6,95% CI(1.3-5.4),2.2(1.0-4.7),5.56(1.92-16.67),2.0(1.3-3.0),eachP mporaneous disease-related factors(recent relapse) which,where modifiable,may enhance patient-doctor relationships and therefore quality of care.

关键词： Inflammatory bowel disease Patient-doctor relationship Quality of care Disease outcomes Quality of life

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Defining Soil and Water Assessment Tool(SWAT)hydrologic responseunits(HRUs)by field boundaries

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International Journal of Agricultural and Biological Engineering 2015年第3期8卷 69-80页

作者： margaret m.Kalcic Indrajeet Chaubey jane Frankenberger Graham Sustainability Institute University of MichiganAnn ArborMI 48104USA Department of Earth Atmosphericand Planetary SciencesPurdue UniversityWest LafayetteIN 47907USA Department of Agricultural and Biological Engineeri ng Purdue UniversityWest LafayetteIN 47907USA

The Soil and Water Assessment Tool(SWAT)is widely used to relate farm management practices to their impacts on surface waters at the watershed scale,yet its smallest spatial unit is not generally defined by physically meaningful *** hydrologic response unit(HRU)is the smallest spatial unit of the model,and the standard HRU definition approach lumps all similar land uses,soils,and slopes within a subbasin based upon user-defined *** standard method provides an efficient way to discretize large watersheds where simulation at the field scale may not be computationally *** relatively smaller watersheds,however,defining HRUs to specific spatial locations bounded by property lines or field borders would often be advantageous,yet this is not currently possible within the ArcSWAT *** this study,a simple approach is demonstrated that defines HRUs by field boundaries through addition of uniquely named soils to the SWAT user soil database and creation of a field boundary layer with majority land use and soil *** of nitrogen,phosphorus,and sediment losses were compared in a case study watershed where SWAT was set up using both the standard HRU definition and field boundary ***-scale results were reasonable and similar for both methods,but aggregating fields by majority soil type masked extremely high soil erosion predicted for a few *** from field-based HRU delineation may be quite different from the standard approach due to choosing a majority soil type in each farm *** approach is flexible such that any land use and soil data prepared for SWAT can be used and any shapefile boundary can divide HRUs.

关键词： watershed modeling Soil and Water Assessment Tool(SWAT) hydrologic response units field boundaries common land units landuse management

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Sedimentary diatom and pigment-inferred recent anthropogenic accelerated eutrophication of a mediterranean lake(Lake Dojran,Republic of North macedonia/Greece)

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Journal of Oceanology and Limnology 2020年第6期38卷 1787-1798页

作者： ZHANG Xiaosen XU Xinyu jane mREED Institute of Loess Plateau Shanxi UniversityTaiyuan 030006China Department of Geography Geology and EnvironmentUniversity of HullHull HU67RXUK

Lake eutrophication is recognised as a serious global challenge,and many regional legislative programmes are being made to attempt to relieve nutrient pollution and restore deteriorated lake ecological ***,it is of primary importance to understand the degradation processes and reference *** palaeolimnological approach allows us to use ecological evidences preserved in lake sediments to track the changes of lake trophic status under human ***,a proxy for ecological and limnological change,and pigments,a proxy for algal production and composition,were analysed on a short sediment sequence from Lake Dojran(Republic of North macedonia and Greece),and their preservation qualities were evaluated before environmental *** diatom preservation is inferred mainly from the consistent co-occurrence of robust,highly-silicified taxa and small taxa throughout the *** evaluation of the comparison between wet sediment samples in dark and cold storage and their corresponding dry sediment samples lyophilized immediately after the recovery reveals that sediment restoration conditions are critical for the accuracy of *** show that the increased chlorophyll and xanthophyll pigment concentrations,particularly the siliceous-algae pigment fucoxanthin and diatoxanthin,together with the distinct increase in diatom concentration,indicate accelerated lake eutrophication and a major ecological shift linked to intensified water abstraction practice and agricultural expansion in the late 18th to early 19th *** of diatom assemblage composition is muted probably by the dominance of widely-tolerant small fragilaroid species in diatom composition and the better competitive ability of cyanobacteria and chlorophytes than diatoms for low light under eutrophic and turbid *** study improves our understanding of recent human-induced environmental change and current ecological restoration target in this lake.

关键词： diatom,pigment Lake Dojran mediterranean lake eutrophication palaeolimnology

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Breeding system and pollination ecology of a potentially invasive alien Clematis vitalba *** Ireland

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Journal of Plant Ecology 2018年第1期11卷 56-63页

作者： Conor m.Redmond jane C.Stout Faculty of Science University of South BohemiaCeske BudejoviceBranisovska 176037005 Ceske BudejoviceCzech Republic Biology Centre Institute of EntomologyThe Czech Academy of SciencesBranisovska 3137005 Ceske BudejoviceCzech Republic School of Natural Sciences and Trinity Centre for Biodiversity Research Trinity College DublinDublin 2Ireland

Aims Invasive alien plants can greatly affect native communities and eco-system processes but only a small fraction of alien plant species become *** to establishment and invasion include reproductive *** vitalba *** been a popular hor-ticultural species for the past century and is widely distributed and can be highly *** Ireland,it is considered naturalized and potentially *** this,little is known about its reproduc-tive *** We carried out manipulative field experiments in Ireland and com-pared fruit and seed set from a number of pollination treatments,namely cross-pollination,geitonogamy,autogamy and natural *** also recorded floral visitation to *** through a series of timed *** Findings We found that *** is capable of uniparental reproduction via geitonogamy and autonomous selfing,albeit at a reduced rate com-pared with outcrossing *** vitalba was visited by at least 10 native pollinator taxa,with hoverflies dominating *** fruit set nor seed set in our study population was pollen *** the lack of reproductive constraint,*** may easily spread in suitable *** is of concern in Ireland,given its prevalence in some of the country’s most floristically diverse regions.

关键词： Clematis vitalba plant invasion invasive traits mutualism

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Evaluating the Performance of a EuroDivisia Index Using Artificial Intelligence Techniques

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International Journal of Automation and computing 2008年第1期5卷 58-62页

作者： jane m.Binner Alicia m.Gazely Graham Kendall Economics and Strategy Group Aston Business SchoolAston UniversityAston TriangleBirmingham B4 7ETUK Nottingham Business School Nottingham Trent UniversityBurton StreetNottingham NG1 4BUUK School of Computer Science & IT University of NottinghamJubilee CampusWonaton RoadNottingham NG8 1BBUK

This paper compares two methods to predict inflation rates in Europe. One method uses a standard back propagation neural network and the other uses an evolutionary approach, where the network weights and the network architecture are evolved. Results indicate that back propagation produces superior results. However, the evolving network still produces reasonable results with the advantage that the experimental set-up is minimal. Also of interest is the fact that the Divisia measure of money is superior as a predictive tool over simple sum.

关键词： EuroDivisia Divisia money inflation evolutionary strategies neural networks

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In-host modeling

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Infectious Disease modelling 2017年第2期2卷 188-202页

作者： Stanca m.Ciupe jane m.Heffernan Department of mathematics Virginia TechBlacksburgVAUSA Centre for Disease modelling Department of Mathematics&StatisticsYork UniversityTorontoONCanada

Understanding the mechanisms governing host-pathogen kinetics is important and can guide human ***-host mathematical models,together with biological data,have been used in this *** this review,we present basic models used to describe acute and chronic pathogenic *** highlight the power of model predictions,the role of drug therapy,and advantage of considering the dynamics of immune *** also present the limitations of these models due in part to the trade-off between the complexity of the model and their predictive power,and the challenges a modeler faces in determining the appropriate formulation for a given problem.

关键词： problem. app formulation

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Hypothesized summative anal physiology score correlates but poorly predicts incontinence severity

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World Journal of Gastroenterology 2017年第31期23卷 5732-5738页

作者： Christopher J Young Assad Zahid Cherry E Koh jane m Young Department of Colorectal Surgery University of Sydney RPAH medical Centre Discipline of Surgery University of Sydney Surgical Outcome Research Centre(SOu RCe) Royal Prince Alfred HospitalUniversity of Sydney School of Public health University of Sydney

To explore the relationship between such a construct and an existing continence score. mETHODSA retrospective study of incontinent patients who underwent anal physiology (AP) was performed. AP results and Cleveland Clinic Continence Scores (CCCS) were extracted. An anal physiology score (APS) was developed using maximum resting pressures (mRP), anal canal length (ACL), internal and external sphincter defects and pudendal terminal motor latency. Univariate associations between each variable, APS and CCCS were assessed. multiple regression analyses were performed. RESULTSOf 508 (419 women) patients, 311 had both APS and CCCS measured. Average mRP was 51 mmHg (SD 23.2 mmHg) for men and 39 mmHg (19.2 mmHg) for women. Functional ACL was 1.7 cm for men and 0.7 cm for women. Univariate analyses demonstrated significant associations between CCCS and mRP (P = 0.0002), ACL (P = 0.0006) and pudendal neuropathy (P multiple regression showed that the variables most useful in predicting CCCS were external sphincter defect, pudendal neuropathy and previous pelvic surgery, but only improving the scores predictive ability to 12.5%. CONCLUSIONThis study shows that the ability of AP tests to predict continence scores improves when considered collectively, but that a constructed summation model before and after multiple regression is poor at predicting the variability in continence scores.

关键词： Incontinence Anal physiology Anal canal Anal ultrasound manometry Electromyography

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Doctor communication quality and Friends' attitudes influence complementary medicine use in inflammatory bowel disease

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World Journal of Gastroenterology 2015年第12期21卷 3663-3670页

作者： Réme mountifield jane m Andrews Antonina mikocka-Walus Peter Bampton Department of Gastro-enterology and Hepatology Flinders Medical Centre Flinders University of South Australia IBD Service Department of Gastroenterology and Hepatology and School of Medicine University of Adelaide at Royal Adelaide Hospital School of Nursing and midwifery University of South Australia

AIm: To examine the frequency of regular complementary and alternative therapy(CAm) use in three Australian cohorts of contrasting care setting and geography, and identify independent attitudinal and psychological predictors of CAm use across all cohorts. mETHODS: A cross sectional questionnaire was administered to inflammatory bowel disease(IBD) patients in 3 separate cohorts which differed by geographical region and care setting. Demographics and frequency of regular CAm use were assessed, along with attitudes towards IBD medication and psychological parameters such as anxiety, depression, personality traits and quality of life(QOL), and compared across cohorts. Independent attitudinal and psychological predictors of CAm use were determined using binary logistic regression analysis. RESULTS: In 473 respondents(mean age 50.3 years, 60.2% female) regular CAm use was reported by45.4%, and did not vary between cohorts. Only 54.1%of users disclosed CAm use to their doctor. Independent predictors of CAm use which confirm those reported previously were: covert conventional medication dose reduction(P ment(P medication(P = 0.043), and higher QOL(P m use by family or friends(P mmunication(P m use, these data show that physician attention to communication and the patient-doctor relationship is important as these factors influence CAm use. Patient reluctance to discuss CAm with physicians may promote greater reliance on social contacts to influence CAm decisions.

关键词： Complementary medicine Alternative therapy Therapy

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