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An open-access endoscopy screen correctly and safely identifies patients for conscious sedation

Gastroenterology Report 2016年第4期4卷 281-286,I0001页

作者： darshan Kothari joseph d.Feuerstein Laureen Moss Julie d’Souza Kerri Montanaro daniel A.Leffler Sunil G.Sheth department of Medicine and division of Gastroenterology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA department of Nursing Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA

Background and aims:Open-access scheduling is highly utilized for facilitating generally low-risk *** screening addresses sedation requirements;however,procedural safety may be compromised if screening is *** sought to determine the reliability of our open-access scheduling system for appropriate use of conscious ***:We prospectively and consecutively enrolled outpatient procedures booked at an academic center by open-access using screening after in-office gastroenterology(GI)*** collected the cases inappropriately booked for conscious sedation and compared the characteristics for significant ***:A total of 8063 outpatients were scheduled for procedures with conscious sedation,and 5959 were booked with *** 78 patients(0.97%,78/8063)were identified as subsequently needing anesthesiologist-assisted sedation;44(56.4%,44/78)were booked through open-access,of which chronic opioid(47.7%,21/44)or benzodiazepine use(34.1%,15/44)were the most common reasons for needing anesthesiologist-assisted *** on chronic benzodiazepines required more midazolam than those not on chronic benzodiazepines(P=0.03)of those patients who underwent conscious ***,patients with chronic opioid use required more fentanyl than those without chronic opioid use(P=0.04).Advanced liver disease and alcohol use were common reasons for patients being booked after in-office consultation and were significantly higher than those booked with open-access(both Pd that the majority of patients can be triaged for conscious sedation using a multi-tiered screening ***,few patients(d for conscious *** most common reasons for considering anesthesiologist-assisted sedation were chronic opioid,benzodiazepine and/or alcohol use and advanced liver *** suggests that these entities could be included in screening proces

关键词： open-access endoscopy sedation screen

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Identification of a novel HIV-1 intra-circulating recombinant form 01_AE in China: a descendant of the previously identified CRF01_AE transmission clusters 1 and 6

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Science China(Life Sciences) 2015年第7期58卷 724-726页

作者： NING ChuanYi LI XingGuang TANG WeiMing ZHOU Bo CAI WeiPing TUCKER joseph d. Guangzhou Eighth People's Hospital & University of North Carolina and China Project Research Center for Regenerative Medicine Guangxi Medical University HIV Molecular Epidemiology and Virology Research Group State Key Laboratory of Virology Wuhan Institute of Virology Chinese Academy of Sciences

dear Editors,Here, we report a novel HIV-1 intra-circulating recombinant form 01_AE （intra-CRF01_AE： CRF01-1AE/CRF01-6AE） composed of CRF01_AE transmission clusters 1 and 6, which was identified in a heterosexual male from Fujian, with one breakpoint observed in the vif gene. The CRF01_AE region I （HXB2： 868-5184） of the recombinant clustered with CRF01_AE transmission cluster 1, which is mainly circulating among injection drug users （IdUs） and heterosexuals in southern and southwestern China, with the support of a 100% bootstrap value. The CRF01_AE region II （HXB2： 5185-9605） of the recombinant clustered with CRF01_AE transmission cluster 6, which mainly prevails among heterosexuals in southern China, with the support of a 100% bootstrap value. To our knowledge, this is the first detection of a novel HIV-1 intra-CRF01_AE recombinant form （CRF01-1_AE/CRF01-6_ AE） in Fujian, China, which indicates ongoing active HIV-1 transmission among heter- osexuals in this region.

关键词： HIV-1 传输集群识别重组后代 AE

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TCR-pMHC: may the force be of you?

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Cellular & Molecular Immunology 2021年第7期18卷 1622-1623页

作者： joseph S.Murray Xenolaüs Genetics LLC Los AngelesCA90024USA

Theα/βcomponent of the T-cell antigen receptor(TCR)is a transmembrane heterodimer containing genetically variable(V)domains and constant domains within each polypeptide chain.1 The Vαand Vβdomains bind with a clonally unique(clonotypic)interface angle,2 and the complementary determining regions(CdR1,CdR2,and CdR3)manifest as‘loops’between anti-parallelβ-strands of the overall sandwich ofβ-sheets with a central disulfide *** with immunoglobulins,the CdR1 and CdR2 loops are encoded in the germline via the particular V-region dNA segment involved in the RAG1/RAG2 recombination mechanism responsible for somatic construction,together with the d-and/or J-segment,of the third loop,CdR3.1,3 As shown by multiple solved X-ray crystallography structures,the CdRs contain the closest amino acid(a.a.)contacts with the peptide(p)plus the major histocompatibility complex(MHC)protein(together abbrev.,pMHC)composite *** rigorous selection in the thymus for only those TCRs that should function properly in the particular individual after birth(MHC restriction),4 T cells function clonally as well,i.e.,different T-cell clones display differential responses to not only different pMHC ligands but also perhaps more importantly,to the same pMHC ligands.5,6 A long-standing question is how(not whether)TCR V-domain binding to pMHC is ultimately responsible for such vast biological outcomes as protection *** to infectious diseases,atopy,the onset of autoimmune diseases,and the success of various types of transplantation.

关键词： properly sandwich rigorous

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Large-diameter trees, snags, and deadwood in southern Utah, USA

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Ecological Processes 2021年第1期10卷 130-141页

作者： James A.Lutz Soren Struckman Tucker J.Furniss joseph d.Birch Larissa *** darren J.McAvoy department of Wildland Resources S.J.and Jessie E.Quinney College of Natural ResourcesUtah State University5230 Old Main HillLoganUT 84322-5230USA. department of Renewable Resources University of AlbertaEdmontonAlbertaCanada.

Background:The epidemic dendroctonus rufipennis(spruce beetle)outbreak in the subalpine forests of the Colorado Plateau in the 1990s killed most larger Picea engelmannii(Engelmann spruce)*** quarter century later,the larger snags are beginning to fall,transitioning to deadwood(down woody debris)where they may influence fire behavior,regeneration,and habitat ***:We tracked all fallen trees≥1 cm in diameter at breast height(1.37-m high)and mapped all pieces of deadwood≥10-cm diameter and≥1 m in length within 13.64 ha of a high-elevation mixed-species forest in the Picea–Abies zone annually for 5 years from 2015 through *** examined the relative contribution of Picea engelmannii to snag and deadwood pools relative to other species and the relative contributions of large-diameter trees(≥33.2 cm at this subalpine site).We compared spatially explicit mapping of deadwood to traditional measures of surface fuels and introduce a new method for approximating vertical distribution of ***:In this mixed-species forest,there was relatively high density and basal area of live Picea engelmannii 20 years after the beetle outbreak(36 trees ha^(−1) and 1.94 m^(2) ha^(−1)≥10-cm diameter)contrasting with the near total mortality of mature Picea in forests *** from tree boles≥10-cm diameter on the ground had biomass of 42 Mg ha^(−1),7 Mg ha^(−1) of Picea engelmannii,and 35 Mg ha^(−1) of other *** live aboveground biomass was 119 Mg ha^(−1),while snag biomass was 36 Mg ha^(−1).Mean total fuel loading measured with planar transects was 63 Mg ha^(−1) but varied more than three orders of magnitude(0.1 to 257 Mg ha^(−1)).Planar transects recorded 32 Mg ha^(−1) of wood≥7.62-cm diameter compared to the 42 Mg ha^(−1) of wood≥10-cm diameter recorded by explicit *** pieces of deadwood were often stacked,forming a vertical structure likely to contribute to active fire ***:Bark beetle mortality in the 1990s has made

关键词： Cedar Breaks National Monument dendroctonus rufipennis Utah Forest dynamics Plot Vertical fuel structure

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Building the Capacity of Health Professionals in Monitoring and Evaluation in a Public Health Institution: Experience of the National Institute of Public Health (NIPH) of Côte d’Ivoire

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Health 2024年第8期16卷 731-749页

作者： Esme Marie Laure Essis N’guetta Mathilde Manouan Anna-Corine Estell Liema Bissouma Ethmonia Kouamé Ekissi Orsot Tetchi Sagou Olivier Yayo Stephane Claon Yao Eugene Konan William Yavo Agbaya Stephane Oga Tenenan Jean Marie Yeo joseph Aka National Institute of Public Health Abidjan Cte dIvoire Cellule de Recherche en Sant de la Reproduction de Cte dIvoire (CRESAR-CI) Abidjan Cte dIvoire department of Public Health and Biostatistics UFR of Medical Sciences Felix Houphout Boigny University Abidjan Cte dIvoire department of Public Health UFR of Pharmaceutical and Biological Sciences Felix Houphout Boigny University Abidjan Cte dIvoire

Background: In the context of the fight against HIV, a lack of skills in monitoring and evaluating the personnel in charge of activities has been identified at the national level. It was the subject of a priority axis of the national plan for monitoring and evaluating the fight against HIV (2006-2010) that was aimed at strengthening the capacities of actors in this area. To increase the critical mass of competent human resources in the short term, the National Institute of Public Health (NIPH) of Côte d’Ivoire organized monitoring and evaluation training sessions for healthcare professionals from 2011 to 2016. Methods: A single case study with multiple levels of analysis was carried out, combining a qualitative survey and a literature review. An evaluation was carried out six months after each training session. In addition, the results of the pre- and post-tests and of the daily and final evaluations that accompanied the various training sessions were used to provide further information. The qualitative data collected were analyzed using INVIVO 15 software. Results: Some 89 health professionals (69% men and 31% women) working at the national level (51% at the central level, including 58% in health programs) and in development partner agencies (37%) participated in this capacity building program. Most participants were senior health managers (56%), data managers (23%), and statisticians and computer scientists (10%). Almost all the trainings were financed by 16 technical and financial partners (85%), mainly the MEASURE Evaluation project (27%). Conclusion: M&E training, despite all its imperfections, has made it possible to identify M&E training needs at the national level and to increase the critical mass of national skills and to have some culture in M&E.

关键词： Short-Term Training Capacity Building Monitoring and Evaluation Health Professional Africa Côte d’Ivoire

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Associations of lifestyle and diet with the risk of nasopharyngeal carcinoma in Singapore:a case–control study

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Chinese Journal of Cancer 2017年第2期36卷 63-70页

作者： Sook Kwin Yong Tam Cam Ha Ming Chert Richard Yeo Valerie Gaborieau James d.McKay joseph Wee division of Clinical Trials and Epidemiological Sciences National Cancer Centre Singapore11 Hospital DriveSingapore 169610Singapore Medical Education Research&Evaluation Department(MERE)Duke-NUS Medical School8 College RoadSingapore 169857Singapore division of Radiation Oncology National Cancer Centre Singapore11 Hospital DriveSinga-pore 169610Singapore Genetic Cancer Susceptibility Group International Agency for Research on CancerWorld Health Organization150 Cours Albert Thomas69372 Lyon Cedex 08France

Background: Nasopharyngeal carcinoma(NPC) is a commonly diagnosed cancer in Southeast Asia. Many studies have examined the risk factors for NPC, yet the roles of some risk factors remain inconclusive. The purpose of this study was to examine associations between modifiable lifestyle factors and the risk of NPC in the Singaporean ***: We conducted a case–control study in Singapore with 300 patients and 310 controls who were recruited between 2008 and 2012. Each control was selected and individually matched to each patient based on sex, ethnicity, and age(±5 years). A total of 290 pairs of cases and controls were matched successfully. We examined lifestyle factors such as tobacco smoking, alcohol drinking, various salted and preserved food consumption, and weaning ***: After adjusting for covariates, multivariate analysis showed that those participants who were current smokers and had ever smoked tobacco had a higher risk of NPC than participants who had never smoked, with odds ratios(ORs) of 4.50(95% confidence interval [CI] 2.58–7.86; P d 2.52(95% CI 1.54–4.12; P d salted vegetables at least once a week also showed a significantly increased risk of NPC than those who never or rarely consumed salted vegetables, with an OR of 4.18(95% CI 1.69–10.38; P = 0.002).Conclusion: Smoking(currently and ever-smoked) and consuming salted vegetables once a week or more were lifestyle risk factors for NPC, and changes of these factors for the better may reduce the risk of NPC.

关键词： Nasopharyngeal carcinoma diet Smoking Alcohol drinking Case–control study Preserved food

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dissemination of Resistance Integrons and Genes Coding for Blse and Cabapenemases in the Urban drainage Network in Cote d’Ivoire

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Advances in Microbiology 2024年第5期14卷 268-286页

作者： Coulibaly Kalpy Julien diaby Aboubakar Sidik Vakou N’dri Sabine M’bengue Gbonon Valérie Carole Claon Jean Stephane Yao Kouamé Eric Gnali Gbohounou Fabrice Yéo Yéfougnini Bagré Issa djaman Allico joseph dosso Mireille Pasteur Institute of Ivory Coast Abidjan C&#244te d&#8217Ivoire Fé lix Houphou&#235t-Boigny University Abidjan C&#244te d&#8217Ivoire

Antibiotic resistance has become a major threat to human health worldwide. Environment, particularly the water environment, has long been overlooked as a player in the antibiotic resistance cycle, although its role remains unclear. These can provide an ideal setting for the acquisition and dissemination of antibiotic resistance, as they are frequently affected by anthropogenic activities. The objective of this study was to establish a diffusion map of resistance integrons used as genetic markers of resistance associated with antibiotic resistance conferring genes (ARGs). Total dNA extracts from non-cultivable bacterial communities were used for the analyses. These communities were obtained from wastewater samples from 14 sites upstream and downstream of drainage channels or effluents in the cities of Abidjan, Bouaké, and Yamoussoukro. The results obtained correspond to the number of positives among the treated samples (n = 39). Among the genetic markers of dissemination, class 1 integrons were the most evident in 94.8% of samples in Abidjan (93.3%), Bouaké (100%) and Yamoussoukro (91.6%). Class 2 integrons and class 3 integrons were found respectively in 41% and 51% of all samples. Genes coding for β-lactamases and blaTEM was identified in almost all samples at a rate of 97.4%. A co-presence of the three genes blaTEM, blaSHV and blaCTX-M is also remarkable in the sites of the city of Yamoussoukro. Among the genes coding for carbapenemases, only blaKPC 17.94%, blaNdM 30.76% and blaOXA48 38.46% were detected in the samples.

关键词： Antibiotic Resistance Wastewater Resistance Integrons (RIs) Resistance Genes

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Evaluation of three-dimensional biofilms on antibacterial bonding agents containing novel quaternary ammonium methacrylates

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International Journal of Oral Science 2014年第2期6卷 77-86页

作者： Han Zhou Michael d Weir joseph M Antonucci Gary E Schumacher Xue-dong Zhou Hockin H K Xu department of Endodontics Prosthodontics and Operative Dentistry University of Maryland Dental School Baltimore USA State Key Laboratory of Oral diseases West China Hospital of Stomatology Sichuan University Biomaterials Group Biosystems and Biomaterials Division National Institute of Standards and TechnologyGaithersburg USA dr. Anthony Volpe Research Center American Dental Association Foundation Gaithersburg USA Center for Stem Cell Biology & Regenerative Medicine University of Maryland School of Medicine Baltimore USA department of Mechanical Engineering University of Maryland Baltimore County USA

Antibacterial adhesives are promising to inhibit biofilms and secondary caries. The objectives of this study were to synthesize and incorporate quaternary ammonium methacrylates into adhesives, and investigate the alkyl chain length effects on three-dimensional biofilms adherent on adhesives for the first time. Six quaternary ammonium methacrylates with chain lengths of 3, 6, 9, 12, 16 and 18 were synthesized and incorporated into Scotchbond Multi-Purpose. Streptococcus mutans bacteria were cultured on resin to form biofilms. Confocal laser scanning microscopy was used to measure biofilm thickness, live/dead volumes and live-bacteria percentage vs. distance from resin surface. Biofilm thickness was the greatest for Scotchbond control; it decreased with increasing chain length, reaching a minimum at chain length 16. Live-biofilm volume had a similar trend. dead-biofilm volume increased with increasing chain length. The adhesive with chain length 9 had 37% live bacteria near resin surface, but close to 100% live bacteria in the biofilm top section. For chain length 16, there were nearly 0% live bacteria throughout the three-dimensional biofilm. In conclusion, strong antibacterial activity was achieved by adding quaternary ammonium into adhesive, with biofilm thickness and live-biofilm volume decreasing as chain length was increased from 3 to 16. Antibacterial adhesives typically only inhibited bacteria close to its surface; however, adhesive with chain length 16 had mostly dead bacteria in the entire three-dimensional biofilm. Antibacterial adhesive with chain length 16 is promising to inhibit biofilms at the margins and combat secondary caries.

关键词： alkyl chain length antibacterial bondingagent dental caries quaternaryammonium methacrylate Streptococcusmutans three-dimensional biofilm

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The current status of galaxy formation

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Research in Astronomy and Astrophysics 2012年第8期12卷 917-946页

作者： joseph Silk Gary A.Mamon Institut d'Astrophysique de Paris (UMR 7095:CNRS&UPMC) 98 bis Boulevard AragoParis 75014France department of Physics and Astronomy 3701 San Martin DriveThe Johns Hopkins UniversityBaltimore MD 21218USA Beecroft Institute of Particle Astrophysics and Cosmology 1 Keble RoadUniversity of OxfordOxford OX1 3RHUK

Understanding galaxy formation is one of the most pressing issues in cos- mology. We review the current status of galaxy formation from both an observational and a theoretical perspective, and summarize the prospects ... 详细信息

关键词： galaxy: formation -- galaxies: evolution -- galaxies: star formation --galaxies: active

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Simulating the dynamics of fluid-cylinder interactions

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Journal of Zhejiang University-Science A(Applied Physics & Engineering) 2005年第2期6卷 97-109页

作者： PAN Tsorng-Whay GLOWINSKI Roland joseph daniel d. department of Mathematics University of Houston Houston Texas 77204-3008 USADepartment of Mathematics University of Houston Houston Texas 77204-3008 USADepartment of Aerospace Engineering and Mechanics University of Minnesota Minnesota MN 55455 USA

We present the simulation of the dynamics of fluid-cylinder interactions in a narrow three-dimensional channel filled with a Newtonian fluid, using a Lagrange multiplier based fictitious domain methodology combined with a finite element method and an operator splitting technique. As expected, a settling truncated cylinder turns its broadside perpendicular to the main stream direction and the center of mass moves to the central axis of the channel. In the case of two truncated cylinders, they first move around each other for a while and then stay together in a "T" shape. After the "T" shape has been formed for a long enough time, we found no vortex shedding behind the cylinders. When simulating the fluidization of 60 truncated cylinders, we captured the features of interactions among fluidized cylinders as observed in experiments.

关键词： Particulate flow Finite element methods Operator-splitting methods Fictitious domain methods

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