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中华医学杂志(英文版) 2024年第16期137卷 2024 Jul 19页

作者： Cui Jingyu kwapong william robert Yan Yuying Cao Le Ye Chen Wang Hang Jiang Shuai Wu Bo Department of Neurology West China Hospital Sichuan University Chengdu Sichuan China

Analysis of Historic Pavement and Bridge Conditions and Alternative Funding Levels for the Michigan Department of Transportation

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Journal of Traffic and Transportation Engineering 2024年第3期12卷 107-118页

作者： william robert Spy Pond Partners LLCArlingtonMA 02474USA

In 1997 the Michigan Department of Transportation (MDOT) established an ambitious set of condition targets for its pavements and bridges, and the Department received increased revenue from a 4-cent-per-gallon increase in the state motor fuels tax to help meet its targets. However, over time, actual revenue was less than both what was initially estimated as needed to meet the targets and what was projected from the tax increase. Consequently, actual conditions were projected to fall short of the target levels, so the department issued bonds to address the shortfall through 2012. To support deliberations on future funding, in 2013 MDOT performed an analysis of historic conditions to determine what additional fuel tax revenues would have been required beginning in 1997 to: replace bond revenues used to fund pavement and bridge projects from 1997 to 2012;and enable MDOT to meet its condition targets. The analysis was performed using data on actual pavement and bridge funding and conditions;as well as predicted funding and conditions for different hypothetical increases in fuel taxes. The analysis concluded that, in addition to the actual increase of 4 cents per gallon, a fuel tax increase of another 10 cents per gallon would have been required in 1997 to replace bond revenue used for pavement and bridges and allow MDOT to meet its condition targets. The analysis results were used to help inform the discussion of Michigan’s target asset conditions and funding, and demonstrate application of MDOT’s pavement and bridge management systems for performing historic analyses.

关键词： Transportation asset management transportation finance performance measures pavement management bridge management

Nitrate reduction capacity of the oral microbiota is impaired in periodontitis:potential implications for systemic nitric oxide availability

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International Journal of Oral Science 2024年第1期16卷 52-61页

作者： Bob T.Rosier william Johnston Miguel Carda-Diéguez Annabel Simpson Elena Cabello-Yeves Krystyna Piela robert Reilly Alejandro Artacho Chris Easton Mia Burleigh Shauna Culshaw Alex Mira Department of Genomics and Health FISABIO FoundationCenter for Advanced Research in Public HealthValenciaSpain Department of Biological and Biomedical Sciences Glasgow Caledonian UniversityGlasgowUK Oral Sciences University of Glasgow Dental SchoolSchool of MedicineDentistry and NursingCollege of MedicalVeterinary and Life SciencesUniversity of GlasgowGlasgowUK Sport and Physical Activity Research Institute University of the West of ScotlandBlantyreScotland Instituto de Biomedicina de Valencia Consejo Superior de Investigaciones Científicas(IBV-CSIC)ValenciaSpain CIBER Center for Epidemiology and Public Health MadridSpain

The reduction of nitrate to nitrite by the oral microbiota has been proposed to be important for oral health and results in nitric oxide formation that can improve cardiometabolic conditions. Studies of bacterial composition in subgingival plaque suggest that nitrate-reducing bacteria are associated with periodontal health, but the impact of periodontitis on nitrate-reducing capacity(NRC)and, therefore, nitric oxide availability has not been evaluated. The current study aimed to evaluate how periodontitis affects the NRC of the oral microbiota. First, 16S rRNA sequencing data from five different countries were analyzed, revealing that nitratereducing bacteria were significantly lower in subgingival plaque of periodontitis patients compared with healthy individuals(P < 0.05 in all five datasets with n = 20–82 samples per dataset). Secondly, subgingival plaque, saliva, and plasma samples were obtained from 42 periodontitis patients before and after periodontal treatment. The oral NRC was determined in vitro by incubating saliva with 8 mmol/L nitrate(a concentration found in saliva after nitrate-rich vegetable intake) and compared with the NRC of 15healthy individuals. Salivary NRC was found to be diminished in periodontal patients before treatment(P < 0.05) but recovered to healthy levels 90 days post-treatment. Additionally, the subgingival levels of nitrate-reducing bacteria increased after treatment and correlated negatively with periodontitis-associated bacteria(P < 0.01). No significant effect of periodontal treatment on the baseline saliva and plasma nitrate and nitrite levels was found, indicating that differences in the NRC may only be revealed after nitrate intake. Our results suggest that an impaired NRC in periodontitis could limit dietary nitrate-derived nitric oxide levels, and the effect on systemic health should be explored in future studies.

关键词： impaired intake nitrate

Grow-light smart monitoring system leveraging lightweight deep learning for plant disease classification

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Artificial Intelligence in Agriculture 2024年第2期12卷 44-56页

作者： william Macdonald Yuksel Asli Sari Majid Pahlevani Department of Electrical&Computer Engineering Queen's UniversityKingstonON K7L 3N6Canada The robert M.Buchan Department of Mining Queen's UniversityKingstonON K7L 3N6Canada

This work focuses on a novel lightweight machine learning approach to the task of plant disease classification,posing as a core component of a larger grow-light smart monitoring *** the extent of our knowledge,this work is the first to implement lightweight convolutional neural network architectures leveraging down-scaled versions of inception blocks,residual connections,and dense residual connections applied without pre-training to the PlantVillage *** novel contributions of this work include the proposal of a smart monitor-ing framework outline;responsible for detection and classification of ailments via the devised lightweight net-works as well as interfacing with LED grow-light fixtures to optimize environmental parameters and lighting control for the growth of plants in a greenhouse *** adaptation of dense residual connections achieved the best balance of minimizing model parameters and maximizing performance metrics with accuracy,precision,recall,and F1-scores of 96.75%,97.62%,97.59%,and 97.58%respectively,while consisting of only 228,479 model *** results are further compared against various full-scale state-of-the-art model architectures trained on the PlantVillage dataset,of which the proposed down-scaled lightweight models were capable of performing equally to,if not better than many large-scale counterparts with drastically less com-putational requirements.

关键词： Plant disease classification Smart monitoring Deep learning Residual connections Inception Dense residual connections

Storylines of family medicine Ⅻ:family medicine and the healthcare system

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Family Medicine and Community Health 2024年第S3期12卷 109-118页

作者： william B Ventres Leslie A Stone Jeannette E South-Paul Kendall M Campbell Aerial R Petty Hima Ekanadham Kurt C Stange Rebecca S Etz william L Miller robert L Ferrer Marianna Kong Thomas Bodenheimer Roger Strasser Sharon C M Reece Joshua Freeman John M Westfall Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Meharry Medical College NashvilleTennesseeUSA Family Medicine University of Texas Medical Branch at Galveston School of MedicineGalvestonTexasUSA Family Medicine Residency Program New York-Presbyterian Columbia University Medical CenterNew YorkNew YorkUSA Center for Family and Community Medicine Columbia University Vagelos College of Physicians and SurgeonsNew YorkNew YorkUSA Center for Community Health Integration Case Western Reserve University School of MedicineClevelandOhioUSA Family Medicine and Population Health Virginia Commonwealth University School of MedicineRichmondVirginiaUSA Family Medicine Lehigh Valley Health NetworkAllentownPennsylvaniaUSA University of South Florida Morsani College of Medicine TampaFloridaUSA Family and Community Medicine UT Health San Antonio Long School of MedicineSan AntonioTexasUSA Family and Community Medicine University of California San Francisco School of MedicineSan FranciscoCaliforniaUSA Northern Ontario School of Medicine University SudburyOntarioCanada Family Medicine Baylor Scott and White HealthTempleTexasUSA Family Medicine University of Kansas School of MedicineKansas CityKansasUSA DARTNet Insitute AuroraColoradoUSA

Storylines of Family Medicine is a 12-part series of thematically linked mini-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 ***‘Ⅻ:Family medicine and the future of the healthcare system’,authors address the following themes:‘Leadership in family medicine’,‘Becoming an academic family physician’,‘Advocare—our call to act’,‘The paradox of primary care and three simple rules’,‘The quadruple aim—melding the patient and the health system’,‘Fit-for-purpose medical workforce’,‘Universal healthcare—coverage for all’,‘The futures of family medicine’and‘The 100th essay.’May readers of these essays feel empowered to be part of family medicine’s exciting future.

关键词： system illustration family

Storylines of family medicine Ⅹ:standing up for diversity,equity and inclusion

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Family Medicine and Community Health 2024年第S3期12卷 89-98页

作者： william B Ventres Leslie A Stone Wayne W Bryant Jr Mario F Pacheco Edgar Figueroa Francis N Chu Shailendra Prasad David N Blane Na'amah Razon Ranit Mishori robert L Ferrer Garrett S Kneese Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Family and Community Medicine University of New Mexico School of MedicineAlbuquerqueNew MexicoUSA Medicine Weill Cornell Medical CollegeNew YorkNew YorkUSA San Jose Family Medicine Residency Kaiser PermanenteSan JoseCaliforniaUSA Family Medicine and Community Health University of Minnesota Medical School—Twin Cities CampusMinneapolisMinnesotaUSA School of Health and Wellbeing University of GlasgowGlasgowUK Family and Community Medicine University of CaliforniaDavisSacramentoCaliforniaUSA Family Medicine Georgetown University School of MedicineWashingtonDistrict of ColumbiaUSA Family and Community Medicine UT Health San Antonio Long School of MedicineSan AntonioTexasUSA UC San Diego Family Medicine Residency Program San DiegoCaliforniaUSA

Storylines of Family Medicine is a 12-part series of thematically linked mini-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 ***‘Ⅹ:standing up for diversity,equity and inclusion’,authors address the following themes:‘The power of diversity—why inclusivity is essential to equity in healthcare’,‘Medical education for whom?’,‘Growing a diverse and inclusive workforce’,‘Therapeutic judo—an inclusive approach to patient care’,‘Global family medicine—seeing the world“upside down”’,‘The inverse care law‘,‘Social determinants of health as a lens for care’,‘Why family physicians should care about human rights’and‘Toward health equity—the opportunome’.May the essays that follow inspire readers to promote change.

关键词： illustration education family

Storylines of family medicine Ⅱ:foundational building blocks—context,community and health

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Family Medicine and Community Health 2024年第S3期12卷 12-22页

作者： william B Ventres Leslie A Stone Rupal Shah Tamala Carter Geoffrey M Gusoff Winston Liaw Bich-May Nguyen Joanna V Rachelson Mary Alice Scott Teresa L Schiff-Elfalan Seiji Yamada robert C Like Kathleen Zoppi A Peter Catinella Richard M Frankel Shailendra Prasad Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Bridge Lane Group Practice LondonUK Penn Center for Community Health Workers University of PennsylvaniaPhiladelphiaPennsylvaniaUSA National Clinician Scholars Program UCLA David Geffen School of MedicineLos AngelesCaliforniaUSA Health Systems and Population Health Sciences University of Houston Tilman J Fertitta Family College of MedicineHoustonTexasUSA Southern New Mexico Family Medicine Residency Program Las CrucesNew MexicoUSA New Mexico Primary Care Training Program Silver CityNew MexicoUSA Anthropology New Mexico State UniversityLas CrucesNew MexicoUSA Family Medicine and Community Health University of Hawai'i at Manoa John A Burns School of MedicineHonoluluHawaiiUSA Family Medicine and Community Health Rutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA Family Medicine Indiana University School of MedicineIndianapolisIndianaUSA Family Medicine–Transmountain Texas Tech University Health Sciences CenterEl PasoTexasUSA Medicine Indiana University School of MedicineIndianapolisIndianaUSA Family Medicine and Community Health University of Minnesota Medical School-Twin Cities CampusMinneapolisMinnesotaUSA

Storylines of Family Medicine is a 12-part series of thematically linked mini-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 ***‘Ⅱ:foundational building blocks—context,community and health’,authors address the following themes:‘Context—grounding family medicine in time,place and being’,‘Recentring community’,‘Community-oriented primary care’,‘Embeddedness in practice’,‘The meaning of health’,‘Disease,illness and sickness—core concepts’,‘The biopsychosocial model’,‘The biopsychosocial approach’and‘Family medicine as social medicine.’May readers grasp new implications for medical education and practice in these essays.

关键词： thematic illustration dimensions

Storylines of family medicine Ⅳ:perspectives on practice—lenses of appreciation

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Family Medicine and Community Health 2024年第S3期12卷 33-42页

作者： william B Ventres Leslie A Stone Radeeb Akhtar Jeffrey M Ring Lucy M Candib Erick Messias Ronald M Epstein Marc Tunzi Amy L Lee Christopher P Morley Carina M Brown David Slawson Jill Konkin David G Campbell Ian Couper Susan williams robert Brooks Lucie Walters Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Family Medicine and Community Health Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA Independent Health Psychologist Los AngelesCaliforniaUSA Family Medicine and Community Health UMass Chan Medical SchoolWorcesterMassachusettsUSA Psychiatry and Behavioral Neurosciences Saint Louis University School of MedicineSaint LouisMissouriUSA Family Medicine University of Rochester Medical CenterRochesterNew YorkUSA Family Medicine Residency Program Natividad Medical CenterSalinasCaliforniaUSA Family Medicine Tufts University School of MedicineBostonMassachusettsUSA Public Health and Preventive Medicine SUNY Upstate Medical UniversitySyracuseNew YorkUSA Cone Health Family Medicine Residency The University of North Carolina School of MedicineGreensboroNorth CarolinaUSA Family Medicine Atrium HealthCharlotteNorth CarolinaUSA Family Medicine University of Alberta Faculty of Medicine&DentistryEdmontonAlbertaCanada Cunninghame Arm Medical Centre Australian College of Rural and Remote MedicineLakes EntranceQueenslandAustralia Ukwanda Centre for Rural Health Stellenbosch University Faculty of Medicine and Health SciencesCape TownWestern CapeSouth Africa Adelaide Rural Clinical School The University of AdelaideAdelaideSouth AustraliaAustralia Department of Rural Health Broken Hill UniversityBroken HillNew South WalesAustralia Adelaide Rural Clinical School The University of Adelaide Faculty of Health and Medical SciencesMount GambierSouth AustraliaAustralia

Storylines of Family Medicine is a 12-part series of thematically linked mini-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 ***‘Ⅳ:perspectives on practice—lenses of appreciation’,authors address the following themes:‘Relational connections in the doctor–patient partnership’,‘Feminism and family medicine’,‘Positive family medicine’,‘Mindful practice’,‘The new,old ethics of family medicine’,‘Public health,prevention and populations’,‘Information mastery in family medicine’and‘Clinical courage.’May readers nurture their curiosity through these essays.

关键词： thematic illustration doctor

Storylines of family medicine Ⅵ:ways of being—in the office with patients

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Family Medicine and Community Health 2024年第S3期12卷 52-60页

作者： william B Ventres Leslie A Stone Lisa A LaVallee David Loxterkamp Jonisha R Brown Dael M Waxman Peter S Dorward Jeanne Cawse-Lucas Larry B Mauksch Autumn M Kieber-Emmons Benjamin F Crabtree william L Miller Veronica M Brohm Timothy P Daaleman Kelly Bossenbroek Fedoriw Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA MAHEC Family Medicine Residency Mountain Area Health Education CenterAshevilleNorth CarolinaUSA Bucksport Regional Health Center BucksportMaineUSA Family Medicine Atrium HealthCharlotteNorth CarolinaUSA Southfield Medical Practice EdinburghUK Family Medicine University of Washington School of MedicineSeattleWashingtonUSA Family Medicine Lehigh Valley Health NetworkAllentownPennsylvaniaUSA Morsani College of Medicine University of South FloridaTampaFloridaUSA Family Medicine and Community Health Rutgers Robert Wood Johnson Medical SchoolPiscatawayNew JerseyUSA Cancer Institute of New Jersey New BrunswickNew JerseyUSA Family Medicine UNC School of MedicineChapel HillNorth CarolinaUSA

Storylines of Family Medicine is a 12-part series of thematically linked mini-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 ***‘Ⅵ:ways of being—in the office with patients’,authors address the following themes:‘Patient-centred care—cultivating deep listening skills’,‘Doctor as witness’,‘Words matter’,‘Understanding others—metaphor and its use in medicine’,‘Communicating with patients—making good use of time’,‘The patient-centred medical home—aspirations for the future’,‘Routine,ceremony or drama?’and‘The life course’.May readers better appreciate the nuances of patient care through these essays.

关键词： centre illustration dimensions

fRAP 2.0:a community engagement method applied to cervical cancer disparities among Hispanic women

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Family Medicine and Community Health 2024年第S2期12卷 44-57页

作者： Autumn M Kieber-Emmons Susan E Hansen Michael Topmiller Jaskaran Grewal Carlos roberto Jaen Benjamin F Crabtree william L Miller Department of Family Medicine Lehigh Valley Health NetworkAllentownPennsylvaniaUSA College of Medicine USFTampaFloridaUSA Lehigh Valley Health Network AllentownPennsylvaniaUSA American Academy of Family Physicians-Health Landscape CincinattiOHUSA Lafayette College EastonPennsylvaniaUSA UT Health San Antonio San AntonioTexasUSA Rutgers robert Wood Johnson Medical School PiscatawayNew JerseyUSA Cancer Institute of New Jersey New BrunswickNew JerseyUSA

focused Rapid Assessment Process(fRAP)2.0 is a community engagement approach combining geospatial mapping with rapid qualitative assessment in cyclical fashion within communities to capture multifactorial and multilevel features impacting primary care *** 2.0 offers primary care researchers a methodology framework for exploring complex community features that impact primary healthcare delivery and *** fRAP 2.0 study design expands the fRAP from a sequential design to a cyclical process of geospatial mapping and rapid qualitative assessment in search of modifiable contextual *** participants are stakeholders from various socioecological levels whose perspectives inform study outcomes that they may use to then become the agents of change for the very problems they helped ***,we present a proof-of-concept study for fRAP 2.0 examining disparities in cervical cancer mortality rates among Hispanic women in *** primary outcomes of interest are features at the community level,medical health system level and regional government policy levels that offer opportunities for collaborative interventions to improve cervical cancer *** this study,geospatial mapping of county and ZIP code-level variables impacting postdiagnosis cervical cancer care at community,medical and policy levels were created using publicly available data and then overlaid with maps created with Texas Cancer Registry data for cervical cancer cases in three of the largest population *** disparate areas were then qualitatively explored using participant observation and ethnographic field work,alongside 39 key informant *** discussion groups and stakeholder engagement existed at every phase of the *** the fRAP 2.0 method,we created an action-oriented roadmap of next steps to improve cervical cancer care disparities in the three Texas counties with emphasis on the high disparity *** identified local change

关键词： cervical qualitative policy