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2010年类风湿关节炎分类标准——美国风湿病学会和欧洲抗风湿病联盟的联合倡议

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2010年类风湿关节炎分类标准——美国风湿病学会和欧洲抗风湿病联...

Cardiovascular Care for Older Adults Aortic valve disease in the older adult

贵州省医学会风湿病学分会第四届学术年会

作者： Daniel Aletaha Tuhina Neogi Alan J silman Julia Funovits David T Felson Clifton O Bingham Ⅲ neal s birnbaum Gerd R Burmester Vivian P Bykerk Marc D Cohen Bernard Combe Karen H Costenbader Maxime Dougados Paul Emery Gianfranco Ferraccioli Johanna MW Hazes Kathryn Hobbs Tom WJ Huizinga Arthur Kavanaugh Jonathan Kay Tore K Kvien Timothy Laing Philip Mease Henri A Menard Larry W Moreland Raymond L Naden Theodore Pincus Josef s smolen Ewa stanislawska-Biernat Deborah symmons Paul P Tak Katherine s Upchurch Jiri Vencovsky Frederick Wolfe Gillian Hawker 季兰岚邓雪蓉赵明田真张卓莉 Medical University of Vienna ViennaAustria Boston University school of Medicine BostonMassachusettsUSA

目的 :在早期类风湿关节炎(rheumatoid arthritis,RA)的诊断中,1987年美国风湿病学会(AmericanCollege of Rheumatology,ACR;旧称AmericanRheumatism Association,ARA)的诊断标准因为缺乏敏感度而受到质疑。本研究的目的是建立新的RA分类标准。方法 :由ACR和欧洲抗风湿病联盟(EuropeanLeague Against Rheumatism,EULAR)共同组成的工作小组,分三个阶段建立RA新的分类标准。研究的目标人群是初发的未分化关节炎患者,主要研究目的是寻找能够预测这些病人发展为RA的危险因素,并将RA疾病特点定义为持续性和/或侵蚀性关节炎。结果 :在新的分类标准中,确诊RA至少需要一个关节有明确的滑膜炎表现,除外其他可能导致滑膜炎症的疾病,同时以下四项评分的总分≥6分(最高10分):受累关节的数量和部位(0-5分)、血清学自身抗体异常(0-3分)、急性期反应物升高(0-1分)和症状持续时间(共分两级;0-1分)。结论 :既往诊断RA比较依赖骨破坏这一RA晚期表现,而新的分类标准着重于疾病早期表现而不是晚期特点,将疾病特点重新定义为持续性和/或侵蚀性滑膜炎。这一新标准的推出将再次强调了RA早期诊断的必要性以及早期有效治疗对于预防或减少不良后遗症的发生具有重要意义。

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Journal of Geriatric Cardiology 2016年第12期13卷 941-944页

作者： neal Bhatia sukhdeep s Basra Adam H skolnick Nanette K Wenger Emory University school of Medicine Atlanta GA USA The Heart Hospital Baylor Piano Dallas TX USA Leon H Charney Division of Cardiology New York University Langone Medical Center NY USA

As the population continues to age, aortic stenosis re- mains as the most prevalent valvular disease in Western countries. The number of elderly patients with aortic ste- nosis continues to pose both a diagnostic and therapeutic challenge. Despite new advances such as transcatheter aortic valvular replacement （TAVR）, there is still much pa- tient-provider decision making that needs to take place giv- en the comorbidities and complex goals of care in an elderly patient population.

关键词： Aortic stenosis The elderly Valve disease

Leadless pacemakers： a contemporary review

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Journal of Geriatric Cardiology 2018年第4期15卷 249-253页

作者： neal Bhatia Mikhael El-Chami Department of Medicine Division of Cardiology Section of Electrophysiology Emory University School of Medicine Atlanta USA

1 Introduction Over one million cardiac pacemakers are implanted every year worldwide,[11 of which approximately 200,000 are implanted in the United states alone.121 Combined with an aging population and increasing pacing indications, these numbers are expected to grow. since the first pacemaker implantation in 1950s, cardiac pacemaker technology has rapidly advanced. Reduction in generator size, increased battery longevity, quality of pacemaker leads, algorithmic and rate responsive programming-all have revolutionized and transformed the implantation and management of transvenous cardiac pacemaker （TV-PPM）.

关键词： Leadless pacemakers Micra Nanostim Perforation

Reflections on studying Huang Di Nei Jing in the West

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Chinese Medicine and Culture 2024年第1期7卷 72-76页

作者： Edward neal Apricot Grove Educational services Portland 97213the United States of America Xinglin Institute for Early East Asian Medicine Portland 97213the United States of America

Huang Di Nei Jing(《黄帝内经》The Yellow Emperor’s Inner Classic) has been the source text of Chinese medicine knowledge and innovation for over two thousand years. Despite this key relevance, many of its ideas and practices have proven difficult to understand and implement fully into clinical practice. Cultural and language differences can be compounded with these challenges but may also present new opportunities for advancement and insight when studied by researchers outside of the originating culture. This article introduces the method of Classical-Text Archaeology and delves into the author’s two-decade journey of researching this text, with a discussion on cultural differences and issues of medical scholarship.

关键词： Huang Di Nei Jing Chinese medicine Nei Jing nature-based medicine Classical text research Global health Medical anthropology Classical-Text Archaeology

Aquatic community structure and stream habitat in a karst agricultural landscape

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Ecological Processes 2022年第1期11卷 155-170页

作者： neal D.Mundahl Erik D.Mundahl Department of Biology and southeastern Minnesota Water Resources Center Winona State UniversityWinonaMN 55987USA Mundahl Nordic services Glennallen/McCarthyP.O.Box MXYAlaska 99588USA

Background:Watersheds dominated by agriculture often have significant,negative impacts on local stream habitats and *** study examined stream biota and habitats within an entire stream in a karst agricultural landscape to determine if several decades of watershed conservation and management had reversed the severe degradation caused by poor land use and catastrophic soil erosion during the 1920s and ***:Fish communities and stream habitats were degraded at over half of the 22 stream sites examined,and benthic macroinvertebrate communities were mostly poor throughout the entire *** fish communities were associated with missing or narrow riparian buffers,high percent fine sediments,high embeddedness of coarse sub-strates,and homogeneous run *** communities were dominated by filter-feeding taxa and those adapted to life on or within fine *** sites with wide buffers and influenced by groundwater springs had higher fish community integrity and good to excellent instream ***:Our results suggest that wide riparian buffers and karstic springs may have allowed recovery of some stream reaches,but more extensive buffers and additional soil conservation practices in upland areas likely are necessary to protect most stream segments and their biota from on-going agricultural *** state stream buffer laws instituted after this study resulted in establishment of vegetated buffers at all study sites,which may lead to improved stream habitat and biotic communities in future *** invertebrate community improvement also may require translocation of sensitive taxa from nearby watersheds due to limited dispersal abilities of many species currently absent from the study *** frequency and intensity of storm events and flooding may hinder future recovery of stream habitats and biota.

关键词： Agricultural stream Fish Macroinvertebrates stream habitats Karst

soil carbon sequestration,carbon markets,and conservation agriculture practices:A hypothetical examination in Mozambique

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International soil and Water Conservation Research 2017年第3期5卷 167-179页

作者： Timoteo E.simone Dayton M.Lambert Ivan Cuvaca neal s.Eash Department of Agricultural&Resource Economics 321 Morgan Hall2621 Morgan CircleKnoxvilleTN 37996-4518USA Department Biosystems Engineering&soil science 2506 EJ Chapman DriveKnoxvilleTN 37996-4531USA

Payments for Environmental services(PEs)are relatively novel mechanisms whereby the adoption of sustainable management practices by a stakeholder is rewarded by incentives linked to external *** of PEs for conservation agricultural practices(CAPs)by smallholder farmers may provide opportunities to increase household income or cover the technology costs of adoption if the carbon sequestration benefits of CAPs are quantifiable,adoption rates are accelerated and maintained,a mechanism exists whereby carbon sequestration services can be compensated,and carbon offset exchange markets are *** research suggests a methodology to examine a PEs market for carbon offsets generated by the adoption of CAPs by farmers in *** a cumulative adoption of 60%over a 20-year period,revenue from PEs market participation to CA adopters was two times higher than revenue earned when disadoption occurred midway through the *** adoption targets are associated with higher per household returns when fertilizer rates typical to the region are *** and maintaining a sustainable PEs system in the study region would require significant investment in time and *** lack of on-the-ground institutions or local support for such a program would also challenge successful ***,the programs where participant success depends on external markets,such as the hypothetical one suggested here,are subject to the ebb and flow of foreign demand for carbon *** these three broad constraints to a PEs/CAPs program in the region would require grass-roots driven policy initiatives with buy-in at multiple social,economic,and political levels.

关键词： Payment for environmental services Conservation agriculture adoption Carbon sequestration

T1 colorectal cancer management in the era of minimally invasive endoscopic resection

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2284-2294页

作者： shirley Xue Jiang Aein Zarrin neal shahidi Department of Medicine University of British ColumbiaVancouver V6Z2K5British ColumbiaCanada Division of Gastroenterology St.Paul’s HospitalVancouver V6Z2K5British ColumbiaCanada

T1 colorectal cancer(CRC),defined by tumor invasion confined to the submucosa,has historically been managed by *** understanding of recurrence and lymph node metastases risk,coupled with advances in endoscopic resection techniques,have led to an increasing capacity for organ-sparing local *** invasive management of T1 CRC begins with optical evaluation of the lesion to diagnose invasive disease and quantify depth of invasion,which informs therapeutic decision *** selection between various available endoscopic resection techniques depends upon lesion characteristics,technique risk-benefit profiles,and location-specific *** endoscopic resection,established histopathology features determine the risk of recurrence and subsequent management including surveillance or adjuvant surgical *** management of non-operative candidates deviates from conventional recommendations with emerging treatment strategies in select populations.

关键词： Cancer Colonoscopy Endoscopy Polyp surgery

Combined U-Pb sHRIMP and Hf isotope study of the Late Paleozoic Yaminue Complex,Rio Negro Province,Argentina:Implications for the origin and evolution of the Patagonia composite terrane

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Geoscience Frontiers 2013年第1期4卷 37-56页

作者： Carlos J.Chernicoff Eduardo O.Zappettini Joao O.s.santos neal J.McNaughton Elena Belousova National scientific and Technical Research Council(CONICET) Argentina Argentine Geological-Mining survey(sEGEMAR) Argentina Argentine Geological-Mining Survey(SEGEMAR).Argentina University of Western Australia PerthWA 6009Australia Redstone Resources.Perth.WA 6849.Australia John de Laeter Centre Curtin UniversityPerthWA 6102Australia ARC National Key Centre for Geochemical Evolution and Metallogeny of Continents(GEMOC) Macquarie UniversitySydneyNSW 2109Australia

We have carried out zircon U-Pb sHRIMP dating and Hf isotope determinations on a biotite paraschist and on a tonalitic orthogneiss of the Yaminué Complex, and re-evaluate this complex in the broader context of the tectonic evolution of the Patagonia composite terrane. In the metasedimentary unit （msuYC）, the youngest detrital zircon dated at 318 ± 5 Ma （Mississippian/Pennsylvanian boundary） indicates a Pennsylvanian （or younger） depositional age. The three main age populations peak at 474, 454 and 374 Ma. Preliminary Hf isotope data for two detrital zircons （447 and 655 Ma） yielded ε（Hf） values of -0.32 and 0.48, indicating that their primary sources contained small amounts of recycled crustal components （of Calymmian age; TDM 1.56 Ga）. Zircons from the orthogneiss （miuYC; intrusive into msuYC） show a crystallization age of 261.3 - 2.7 Ma （Capitanian; late middle Permian） which is broadly coeval with deformation, and Neoarchean-Paleoproterozoic inheritance. Meaningful core-rim relationship between Neoarchean zircon cores and late Permian rims is well defined, indicating the occurrence of Archean crust in this sector of Patagonia. Hf TDM of Permian zircons is mainly Meso-Paleoarchean （2.97-3.35 Ga）, with highly negative e（Hf） values （ca, -33）. Hf TDM of inherited Neoarchean zircon cores is also Meso-Paleoarchean （3.14-3.45 Ga） but more juvenile （ε（Hf） = -0.3）. Hf isotopes reinforce the presence of unexposed ancient crust in this area. Combining geological and isotope data, as well as geophysical models, we identify the Yaminué Complex within the La Esperanza-Yaminué crustal block flanked by two other, distinct crustal blocks： the Eastern block which forms part of the Patagonia terrane sensu stricto, located in the eastern Patagonian region, and the Western block forming part of the southern Patagonia terrane. Their origins and timing of amalgamation to form the Patagonia composite terrane are also discussed.

关键词： Yaminue Complex U-Pb sHRIMP geochronology Hf isotopes Tectonics North Patagonian Massif Argentina

Epitaxially aligned single-crystal gold nanoplates formed in large-area arrays at high yield

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Nano Research 2022年第1期15卷 296-303页

作者： Trevor B.Demille Robert D.neal Arin s.Preston Zijuan Liang Allen G.Oliver Robert A.Hughes svetlana Neretina College of Engineering University of Notre DameNotre DameIndiana 46556USA Department of Chemistry and Biochemistry University of Notre DameNotre DameIndiana 46556USA

Well-tailored nanomaterials with a single-crystal character provide ideal building blocks for on-chip plasmonic *** colloidal methods have demonstrated mastery over the synthesis of such structures,it has proven quite difficult to deploy these same nanomaterials on substrate surfaces in a highly deterministic manner where precise control over position and orientation is ***,we demonstrate a room-temperature two-reagent liquid-phase seed-mediated synthesis of gold nanoplates directly on substrate surfaces in arrays over a square-centimeter *** synthesis is reliant on benchtop lithographic and directed-assembly processes that give rise to single-crystal seeds of gold that express both an epitaxial relationship with the underlying substrate and the internal defect structure required to promote a two-dimensional growth *** resulting structures are highly faceted and,because seed-substrate epitaxy is imposed upon the growing nanoplates,are identically aligned on the substrate *** yields are increased to values as high as 95%using a post-processing sonication procedure that selectively removes a small population of irregularly shaped nanostructures from the substrate surface,and in doing so,gives rise to an uncompromised plasmonic *** work,therefore,advances the techniques needed to integrate single-crystal nanomaterials with wafer-based technologies and provides leading-edge capabilities in terms of defining large-area arrays of plasmonic structures with the nanoplate geometry.

关键词： nanoplates epitaxial array plasmon Brij-700 block copolymer substrate