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Management of chronic heart failure in the older population

Journal of Geriatric Cardiology 2014年第4期11卷 329-337页

作者： Nahid Azad Genevieve lemay Ottawa Hospital Civic Campus Geriatric Assessment Unit 1053 Carling Avenue Box 678 Ottawa ON K1Y 4E9 Canada

Chronic heart failure （CHF） is the leading cause of hospitalization for those over the age of 65 and represents a significant clinical and economic burden. About half of hospital re-admissions are related to co-morbidities, polypharmacy and disabilities associated with CHF. Moreover, CHF also has an enormous cost in terms of poor prognosis with an average one year mortality of 33%–35%. While more than half of patients with CHF are over 75 years, most clinical trials have included younger patients with a mean age of 61 years. Inadequate data makes treatment decisions challenging for the providers. Older CHF patients are more often female, have less cardiovascular diseases and associated risk factors, but higher rates of non-cardiovascular conditions and diastolic dysfunction. The prevalence of CHF with reduced ejection fraction, ischemic heart disease, and its risk factors declines with age, whereas the prevalence of non-cardiac co-morbidities, such as chronic renal failure, dementia, anemia and malignancy increases with age. Diabetes and hypertension are among the strongest risk factors as predictors of CHF particularly among women with coronary heart disease. This review paper will focus on the specific consideration for CHF assessment in the older population. Management strategies will be reviewed, including non-pharmacologic, pharmacologic, quality care indicators, quality improvement in care transition and lastly, end-of-life issues. Palliative care should be an integral part of an interdiscipli-nary team approach for a comprehensive care plan over the whole disease trajectory. In addition, frailty contributes valuable prognostic in-sight incremental to existing risk models and assists clinicians in defining optimal care pathways for their patients.

关键词： Heart failure Elderly patient Management Hypertension Coronary artery disease diabetes

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Basic Study Impact of stimulant medication on behaviour and executive functions in children with attention-deficit/hyperactivity disorder

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World Journal of Clinical Pediatrics 2022年第1期11卷 48-60页

作者： Tasmia Hai Hanna A Duffy Julie Anne lemay Jean François lemay Werklund School of Education University of CalgaryCalgaryAB T2N 1N4Canada Department of Paediatrics Alberta Children's Hospital/Cumming School of MedicineUniversity of CalgaryCalgaryAB T3B 6A8Canada

BACKGROUND Children with attention-deficit/hyperactivity disorder(ADHD)often exhibit behaviour challenges and deficits in executive functions(EF).Psychostimulant medications[e.g.,methylphenidate(MPH)]are commonly prescribed for children with ADHD and are considered effective in 70%of the ***,only a handful of studies have investigated the long-term impact of MPH medication on EF and *** To evaluate behaviour and EF challenges in children with ADHD who were involved in an MPH treatment trial across three-time *** Thirty-seven children with ADHD completed a stimulant medication trial to study the short-and long-term impact of *** with ADHD completed three neuropsychological assessments[Continuous Performance Test(CPT)-II,Digit Span Backwards and Spatial Span Backwards].Parents of children with ADHD completed behaviour rating scales[Behaviour Rating Inventory of Executive Functioning(BRIEF)and Behaviour Assessment System for Children-Second Edition(BASC-2)].Participants were evaluated at:(1)Baseline(no medication);and(2)Best-dose(BD;following four-week MPH treatment).Additionally,18 participants returned for a long-term naturalistic follow up(FU;up to two years following BD).RESULTS Repeated measure analyses of variance found significant effects of time on two subscales of BRIEF and four subscales of *** assessments showed some improvement,but not on all tasks following the medication *** improvements did not sustain at FU,with increases in EF and behaviour challenges,and a decline in performance on the CPT-II task being *** Parents of children with ADHD reported improvements in EF and behaviours during the MPH trial but were not sustained at *** screening tools and neuropsychological assessments may be useful for monitoring medication responses.

关键词： Attention-deficit/hyperactive disorder Behaviour Executive functions Stimulant medications

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CONCRETE’S CONTRIBUTION TO SUSTAINABLE DEVELOPMENT

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Journal of Green Building 2008年第4期3卷 37-49页

作者： Erin Ashley Lionel lemay Sustainable Construction National Ready Mixed Concrete Association

INTRODUCTION Concrete is the most widely used building material on *** has a 2,000 year track record of helping build the Roman Empire to building today’s modern *** a result of its versatility,beauty,strength,and durability,concrete is used in most types of construction,including homes,buildings,roads,bridges,airports,subways,and water resource *** with today’s heightened awareness and demand for sustainable construction,concrete performs well when compared to other building materials.

关键词： concrete durability bridges

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Model-based estimation of above-ground biomass in the miombo ecoregion of Zambia

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Forest Ecosystems 2016年第4期3卷 258-274页

作者： James Halperin Valerie lemay Emmanuel Chidumayo Louis Verchot Peter Marshall Department of Forest Resources Management The University of British Columbia 2424 Main Mall Vancouver BC V6T 1Z4 Canada Makeni Savanna Research Project P.O. Box 50323 Ridgeway Lusaka Zambia International Center for Tropical Agriculture Km 17 Recta Cali-Palmira Apartado Aereo 6713 Cali 763537. Colombia

Background：Information on above-ground biomass（AGB） is important for managing forest resource use at local levels,land management planning at regional levels,and carbon emissions reporting at national and international *** many tropical developing countries,this information may be unreliable or at a scale too coarse for use at local *** is a vital need to provide estimates of AGB with quantifiable uncertainty that can facilitate land use management and policy development ***-based methods provide an efficient framework to estimate ***：Using National Forest Inventory（NFI） data for a^1,000,000 ha study area in the miombo ecoregion,Zambia,we estimated AGB using predicted canopy cover,environmental data,disturbance data,and Landsat 8 OLI satellite *** assessed different combinations of these datasets using three models,a semiparametric generalized additive model（GAM） and two nonlinear models（sigmoidal and exponential）,employing a genetic algorithm for variable selection that minimized root mean square prediction error（RMSPE）,calculated through *** compared model fit statistics to a null model as a baseline estimation *** bootstrap resampling methods,we calculated 95% confidence intervals for each model and compared results to a simple estimate of mean AGB from the NFI ground plot ***：Canopy cover,soil moisture,and vegetation indices were consistently selected as predictor *** sigmoidal model and the GAM performed similarly;for both models the RMSPE was -36.8 tonnes per hectare（i.e.,57% of the mean）.However,the sigmoidal model was approximately 30% more efficient than the GAM,assessed using bootstrapped variance estimates relative to a null *** selecting the sigmoidal model,we estimated total AGB for the study area at 64,526,209 tonnes（＋/- 477,730）,with a confidence interval 20 times more precise than a simple designbased ***：Our findings demonstrate that NFI

关键词： National Forest Inventory Above-ground biomass Miombo REDD+ Generalized additive model Nonlinear model Landsat 8 OLI

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Population isolation shapes plant genetics, phenotype and germination in naturally patchy ecosystems

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Journal of Plant Ecology 2017年第4期10卷 649-659页

作者： Laurent De Vriendt Marc-Andrélemay Martine Jean Sébastien Renaut Stéphanie Pellerin Simon Joly François Belzile Monique Poulin Département de Phytologie Facultédes Sciences de l’Agriculture et de l’AlimentationUniversitéLaval2425 rue de l’agriculture QuébecQuébec G1V 0A6Canada Québec Center for Biodiversity Science Department of BiologyMcGill UniversityStewart Biology Building1205 Dr.Penfield AvenueMontréal H3A 1B1Canada Institut de Biologie Intégrative et des Systèmes(IBIS) UniversitéLaval1030 avenue de la MédecineQuébec G1V 0A6Canada Institut de recherche en biologie végétale Département des Sciences biologiquesUniversitéde Montréal4101 Sherbrooke EstMontréal H1X 2B2Canada Jardin botanique de Montréal 4101 Sherbrooke EstMontréal H1X 2B2Canada

Aims Habitat connectivity is important in conservation since isolation can diminish the potential of a population for adaptation and increase its risk of ***,conservation of naturally patchy ecosystems such as peatlands has mainly focused on preserving specific sites with exceptional characteristics,neglecting the poten-tial interconnectivity between *** order to better under-stand plant dynamics within a peatland network,we assessed the effect of population isolation on genetic distinctiveness,phenotypic variations and germination rates using the peatland-obligate white-fringed orchid(Platanthera blephariglottis).Methods Fifteen phenotypic traits were measured for 24 individuals per pop-ulation(20 distinct populations,Quebec,Canada)and germination rates of nearly 20000 seeds were *** distinctiveness was quantified for 26 populations using single nucleotide polymor-phism markers obtained via a pooled genotyping-by-sequencing *** isolation was measured as the distance to the nearest population and as the number of populations occurring in concentric buffer zones(within a radius of 2,5 and 10 km)around the studied *** Findings All phenotypic traits showed significant differences among *** results also indicated a pattern of isolation-by-distance,which suggests that seed and/or pollen exchange is restricted ***,all phenotypic traits,as well as a reduced germination rate,were correlated with either geographic isolation or genetic *** conclude that geographic iso-lation likely restricts gene flow,which in turn may affect ***,it is imperative that conservation programs take into account the patchy nature of such ecosystems,rather than targeting a few specific sites with exceptional character for preservation.

关键词： trait variation population genetics peatland orchid Platanthera blepharigottis genotyping by sequencing GBS

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Epidemiology of Cardiovascular Diseases in Children at the Teaching Hospital of Brazzaville, Congo

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World Journal of Cardiovascular Diseases 2016年第11期6卷 410-424页

作者： Anne Berthe M’pemba Loufoua-lemay Alphonse Massamba Department of Pediatrics University of Brazzaville Hospital Brazzaville Congo Laboratory of Health Exercise Physiology and Biomechanics Superior Institute of Physical Education University Marien Ngouabi Braz-zaville Congo

Context: Several studies were conducted throughout the world on heart diseases in children;no data is available in Congolese child. Objective: To evaluate epidemiological profile of Congolese children and teenager carrying cardiovascular diseases. Methods: A descriptive and prospective study was carried out during 4 years in the pediatric department of teaching hospital of Brazzaville, near the children received in consultation of pediatric cardiology. Results: On 41,472 patients admitted in pediatric service, 526 patients were received in consultation for suspicion of heart diseases. Among them, 444 had cardiopathy (incidence of 10.7‰). It was about a congenital heart disease to 316 (60%) incidence of 7.6‰;Acquired heart disease to 128 (24.4%) incidence of 3.1‰. Among congenital heart defects observed frequency of patients with ASD was 20.3%, isolated in 10.1% of cases, and associated with ECD (11.8%). The VSD was observed in 30.1% of cases, and the Tetralogy of Fallot in 10.1% of cases. Among the acquired heart diseases, severe hypo kinetic dilated cardiomyopathy (DCM) was noted in 24.4% of cases. The rheumatic heart diseases accounted for 41.4% of cases. It was mitral regurgitation (33.6%), a mitral stenosis (1.6%). Pericarditis was objectified at 10.1% of the patients. The evolution was favorable for 43.3% of patients. An aggravation of symptoms was observed to 2.7% of patients. Mortality was 11.9% and 71.9% of deaths were observed to not operate carriers of congenital heart disease. 69.9% of dead patients were carrying a cyanogen heart disease. Left to right shunt represented 21.7% of the deaths. Conclusion: Heart diseases are real problem of public health for Congolese children.

关键词： Congenital Heart Diseases Acquired Heart Diseases Children Brazzaville Sub-Saharan Africa

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21天学通Java 2 专业参考版三

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2004年

作者：（美）Rogers Cadenhead （美）Laura lemay 陈武袁国忠译

本书主要面对初学Java编程技术的读者，全面讲述使用Java开发应用程序、小程序和servlet三种程序的知识和技能。

ISBN: (数字)7115121869

ISBN: (纸本)7115121869

本书主要面对初学Java编程技术的读者，全面讲述使用Java开发应用程序、小程序和servlet三种程序的知识和技能。

关键词： JAVA语言程序设计

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Java 2编程21天自学通专业参考版 2版

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2002年

作者：（美）Laura lemay （美）Rogers Cadenhead 束闻等译

据美国培生教育出版集团2001年版译出，该集团授权出版:全书共分为两大部分。前一部分为3周共21天，主要讲解Java的基本概念、图形化编程的思想和方法、线程和动画、因特网通信以及数据库编程等高级主题；最后一周为附加的深入篇，主要... 详细信息

ISBN: (纸本)7900641718

据美国培生教育出版集团2001年版译出，该集团授权出版:全书共分为两大部分。前一部分为3周共21天，主要讲解Java的基本概念、图形化编程的思想和方法、线程和动画、因特网通信以及数据库编程等高级主题；最后一周为附加的深入篇，主要是扩展前3周所学的知识。

关键词： JAVA语言程序设计

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贴合实际的内容与全新的认证项目 THX-HAA培训属于偏向实战的课程

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家庭影院技术 2016年第5期 96-97页

作者： Gerry lemay HAA家庭声学联盟

优秀的房间声学与音视频系统设计以及合理的系统调校,对于家庭影院、微影院这类小空间多声道大画面音视频系统的构建是相当重要的。而当中涉及到专业的小房间声学、光学以及系统调校方面的专业知识,必须进行有针对性的系统学习,同时随... 详细信息

优秀的房间声学与音视频系统设计以及合理的系统调校,对于家庭影院、微影院这类小空间多声道大画面音视频系统的构建是相当重要的。而当中涉及到专业的小房间声学、光学以及系统调校方面的专业知识,必须进行有针对性的系统学习,同时随着家庭影院技术的发展与更新,包括沉浸式三维音效、4K超高清与HDR等众多新技术的面世,

关键词：家庭影院认证项目 THX-HAA 视频系统声学设计沉浸式系统学习多声道专业知识认证考试

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Espace 67——蒙特利尔世界博览会

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景观设计 2020年第3期 110-115页

作者： lemay(文/图) 潘婷(翻译) 不详

设计团队将1967年蒙特利尔世界博览会的核心区域进行了全面改造,修复并重塑了le-Sainte-Helene岛上的景观,使其重新焕发了生机。改造后的多功能广场与亚历山大·考尔德的Trois disques纪念雕塑相连,包括一处设有65000个座位的圆形剧场... 详细信息

设计团队将1967年蒙特利尔世界博览会的核心区域进行了全面改造,修复并重塑了le-Sainte-Helene岛上的景观,使其重新焕发了生机。改造后的多功能广场与亚历山大·考尔德的Trois disques纪念雕塑相连,包括一处设有65000个座位的圆形剧场和一条滨河步道,可供人们全年使用。

关键词：世界博览会滨河步道考尔德蒙特利尔设计团队核心区域多功能亚历山大

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