检索结果-南通市图书馆

The Effect of Exercise Therapy on Physical Function, Biochemistry and Dialysis Adequacy in Haemodialysis Patients: A Systematic Review and Meta-Analysis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Open Journal of Nephrology 2013年第1期3卷 25-36页

作者： neil smart james McFarlane Veronique Cornelissen Department of Exercise Science University of New England Armidale Australia. Department of Rehabilitation Sciences University of Leuven Leuven Belgium.

Background:Patients undergoing dialysis have high mortality rates and a unique risk factor profile. Some improvements elicited by exercise training have been shown in dialysis populations, here we aimed to further explore the bene-fits of exercise. As well as changes in physical fitness we quantified cardiac function, depression, serum biochemistry, dialysis adequacy and energy intake following exercise training in people with chronic kidney disease (CKD) undertaking dialysis. Methods:A systematic literature search was completed in December 2012 identifying randomized, controlled trials of exercise training studies in haemodialysis (HD) patients. A subsequent meta-analysis was ***: Twenty four studies were included, totalling 879 patients. Exercise training produced significant improvements in physical fitness: peak VO2 5.03 mlO2·kg-1·min-1 (95% CI 3.73, 6.33, p 0.0001), Knee extensor strength 2.99 kg (95% CI 0.46, 5.52, p = 0.02) and 6 minute walk distance 60.7 metres (95% CI 18.9, 103, p = 0.004). Significant increases in energy intake MD 238 Kcal·day-1 (95% CI 94, 383, p = 0.001), serum Interleukin-6 MD-0.58 pg·ml-1 (95% CI-1.01, -0.15, p = 0.008) and Creactive protein MD 0.92 mg/L-1 (95% CI 0.29, 1.56, p = 0.004), but not Albumin or BMI, were reported. Improved Beck Depression scores were reported MD-6.9 (95% CI-9.7,-4.1, p 0.00001). Dialysis adequacy was reduced MD-0.23 (95% CI -0.29, -0.17, p 0.00001), while serum potassium was higher MD 0.14 mmol·L-1 (95% CI 0.01, 0.27, p = 0.04). Moreover exercise training appeared safe, with no direct exercise-associated deaths in over 30,000 patient-hours. Conclusions: Our pooled analyses confirmed improvements in physical fitness following exercise training and suggested additional improvements in dialysis efficiency (kt/v), serum potassium, inflammation and depression in HD patients.

关键词： Exercise Training Haemodialysis Meta-Analysis Systematic Review

Degenerative meniscus: Pathogenesis, diagnosis, and treatment options

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Orthopedics 2014年第5期5卷 597-602页

作者： Richard Howell neil S Kumar Nimit Patel james Tom Department of Orthopedic Surgery Drexel University College of Medicine Hahnemann University Hospital

The symptomatic degenerative meniscus continues to be a source of discomfort for a significant number of patients. With vascular penetration of less than onethird of the adult meniscus, healing potential in the setting of chronic degeneration remains low. Continued hoop and shear stresses upon the degenerative meniscus results in gross failure, often in the form of complex tears in the posterior horn and midbody. Patient history and physical examination are critical to determine the true source of pain, particularly with the significant incidence of simultaneous articular pathology. Joint line tenderness, a positive Mc Murray test, and mechanical catching or locking can be highly suggestive of a meniscal source of knee pain and dysfunction. Radiographs and magnetic resonance imaging are frequently utilized to examine for osteoarthritis and to verify the presence of meniscal tears, in addition to ruling out other sources of pain. Non-operative therapy focused on nonsteroidal anti-inflammatory drugs and physical therapy may be able to provide pain relief as well as improve mechanical function of the knee joint. For patients re-fractory to conservative therapy, arthroscopic partial meniscectomy can provide short-term gains regarding pain relief, especially when combined with an effective, regular physiotherapy program. Patients with clear mechanical symptoms and meniscal pathology may benefit from arthroscopic partial meniscectomy, but surgery is not a guaranteed success, especially with concomitant articular pathology. Ultimately, the long-term outcomes of either treatment arm provide similar results for most patients. Further study is needed regarding the short and long-term outcomes regarding conservative and surgical therapy, with a particular focus on the economic impact of treatment as well.

关键词： Meniscus Degenerative joint disease Meniscal tear Osteoarthritis Arthroscopy

Portal hypertension in polycystic liver disease patients does not affect wait-list or immediate post-liver transplantation outcomes

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2016年第45期22卷 9966-9973页

作者： neil Rajoriya Dhiraj Tripathi Joanna A Leithead Bridget K Gunson Sophie Lord james W Ferguson Gideon M Hirschfield Liver Unit Queen Elizabeth Hospital Centre for Liver Research NIHR Birmingham Liver Biomedical Research Unit University of Birmingham

AIM To establish the impact of portal hypertension(PH) on wait-list/post-transplant outcomes in patients with polycystic liver disease(PCLD) listed for liver transplantation. METHODS A retrospective single-centre case controlled study of consecutive patients listed for liver transplantation over 12 years was performed from our centre. PH in the PCLD cohort was defined by the one or more of following parameters:(1) presence of radiological or endoscopic documented varices from our own centre or the referral centre;(2) splenomegaly(> 11 cm) on radiology inabsence of splenic cysts accounting for increased imaging size;(3) thrombocytopenia(platelets < 150 × 109/L); or(4) ascites without radiological evidence of hepatic venous outflow obstruction from a single cyst. RESULTS Forty-seven PCLD patients(F: M = 42: 5) were listed for liver transplantation(LT)(single organ, n = 35; combined liver-kidney transplantation, n = 12) with 19 patients(40.4%) having PH. When comparing the PH group with non-PH group, the mean listing age(PH group, 50.6(6.4); non-PH group, 47.1(7.4) years; P = 0.101), median listing MELD(PH group, 12; non-PH group, 11; P = 0.422) median listing UKELD score(PH group, 48; non-PH group, 46; P = 0.344) and need for renal replacement therapy(P = 0.317) were similar. In the patients who underwent LT alone, there was no difference in the duration of ICU stay(PH, 3 d; non-PH, 2 d; P = 0.188), hospital stay length(PH, 9 d; non-PH, 10 d; P = 0.973), or frequency of renal replacement therapy(PH, 2/8; non-PH, 1/14; P = 0.121) in the immediate post-transplantation period. CONCLUSION Clinically apparent portal hypertension in patients with PCLD listed for liver transplantation does not appear to have a major impact on wait-list or peri-transplant morbidity.

关键词： Polycystic liver disease Portal hypertension Liver transplantation

快速转诊的大量增加改善了英国肠癌患者的预后吗?

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

英国医学杂志中文版 2021年第4期24卷 193-196页

作者： Michael Thompson Daniel’Leary Iona Heath Lynn Faulds Wood Brian Ellis Karen Flashman neil smart John Nicholls neil Mortensen Paul Finan Asha Senapati Robert Steele Peter Dawson james Hill Brendan Moran 白静雯(译) 张国君(校) Queen Alexandra Hospital PortsmouthUK London UK University of Exeter Medical School ExeterUK Imperial College LondonUK John Radcliffe Hospital OxfordUK St james′s University Hospital LeedsUK University of Dundee DundeeUK Manchester University ManchesterUK North Hampshire Hospital BasingstokeUK 厦门大学附属翔安医院肿瘤诊治中心

Michael Thompson及其同事认为,需要更精确的风险分层以确保及时诊断肠癌,同时避免不必要的检查。英国卫生部为了提高肠癌患者的生存率,制定了全科医生转诊指南和公众宣传活动的政策,这些政策增加了紧急转诊到医院的人数,还导致了并无... 详细信息

Michael Thompson及其同事认为,需要更精确的风险分层以确保及时诊断肠癌,同时避免不必要的检查。英国卫生部为了提高肠癌患者的生存率,制定了全科医生转诊指南和公众宣传活动的政策,这些政策增加了紧急转诊到医院的人数,还导致了并无明显临床获益的不必要肠镜检查和CT结肠造影。

关键词：肠癌患者全科医生肠镜检查公众宣传转诊风险分层及时诊断临床获益

Role of endoscopy in the management of primary sclerosing cholangitis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Endoscopy 2019年第2期11卷 84-94页

作者： neil Bharat Marya james H Tabibian Vatche and Tamar Manoukian Division of Digestive Diseases UCLA Gastroenterology Fellowship Training Program Division of Gastroenterology Department of Medicine Olive View-UCLA Medical Center

Primary sclerosing cholangitis(PSC) is a rare but prominent fibroinflammatory cholangiopathy which can affect individuals of essentially any age. It carries a median survival of 15-20 years, regardless of age at diagnosis, and is a foremost risk factor for cholangiocarcinoma. Given the chronic and progressive nature of PSC, its inherent risk for biliary tract and other complications, and the paucity of effective pharmacotherapies, endoscopy plays a major role in the care of many patients with this disorder. In this review, we discuss the endoscopic management of PSC, including established and evolving approaches to the diagnosis and treatment of its benign as well as malignant sequelae. Owing to the rarity of PSC and dearth of high-quality evidence, we propose pragmatic approaches based on both currently available data and expert opinion.

关键词： Bile duct diseases Cholangiocarcinoma Inflammatory bowel disease Endoscopic retrograde cholangiopancreatography Biopsy Primary sclerosing cholangitis

Exploring Barriers and Opportunities in Adopting Crowdsourcing Based New Product Development in Manufacturing SMEs

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Chinese Journal of Mechanical Engineering 2016年第6期29卷 1052-1066页

作者： QIN Shengfeng David VAN der VELDE Emmanouil CHATZAKIS Terry McSTEA neil SMITH School of Design Northumbria University Newcastle upon Tyne NE1 3PH UK Consult and Design International Sunderland SR1 1PB UK School of Arts & Media Teesside University Middlesbrough TS1 3BX UK RTCNorth Northern Design Centre Gateshead Tyne and Wear NE8 3DE UK

Crowdsourcing is an innovative business practice of obtaining needed services, ideas, or content or even funds by soliciting contributions from a large group of people （the ＇Crowd＇）. The potential benefits of utilizing crowdsourcing in product design are well-documented, but little research exists on what are the barriers and opportunities in adopting crowdsourcing in new product development （NPD） of manufacturing SMEs. In order to answer the above questions, a Proof of Market study is carried out on crowdsourcing-based product design under an Innovate UK funded smart project, which aims at identifying the needs, challenges and future development opportunities associated with adopting crowdsourcing strategies for NPD. The research findings from this study are reported here and can be used to guide future development of crowdsourcing-based collaborative design methods and tools and provide some practical references for industry to adopt this new and emerging collaborative design method in their business.

关键词： new product development open design innovation collaborative design crowdsourcing manufacturing SMEs

A Case Study of Ocean-Atmosphere Interactions during the Passage of an Extra-Tropical Cyclone in the Vicinity of Cape Hatteras, North Carolina

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

International Journal of Geosciences 2023年第9期14卷 855-876页

作者： neil Jacobs james Churchill Leonard Pietrafesa Shaowu Bao Paul Gayes University Corporation for Atmospheric Research Boulder USA Department of Physical Oceanographym Woods Hole Oceanographic Institution Woods Hole USA School of Coastal & Marine Systems Science Burroughs & Chapin Center for Marine & Wetland Studies Coastal Carolina University Conway USA Department of Marine Earth Atmospheric Sciences North Carolina State University Raleigh USA

The authors document the interaction of the atmosphere and ocean during the formation and passage of an Extra-Tropical Cyclone, which is a Nor-Easter, winter storm that formed in the southern apex of the Middle Atlantic Bight near Cape Hatteras North Carolina, between February 15 and 18, 1996. While Nor-Easters per se, which have formed along the Atlantic Eastern Seaboard of the United States have been studied for decades, the actual atmospheric-oceanic mechanics and thermodynamics in the formation of a Nor-Easter has never been documented. We report on having done so with in-situ observations and data-based calculations and a numerical model. The in-situ observations were made via a Control Volume consisting of an array of Eulerian Oceanic-Atmospheric Moorings with current meters, temperature and salinity sensors and meteorological towers. We find that Gulf Stream waters were located surrounding the mooring array, and that with the invasion of cold dry atmospheric air, there was a rapid loss of heat from the ocean to the atmosphere via latent and sensible surface heat flux during the cyclogenesis onset of the storm. A unique feature of this storm was that neither satellite nor buoy data showed significant sea surface cooling in the control volume. The findings indicate that storm winds drove warm saline waters from the Gulf Stream across the continental shelf into the control volume, accounting for a 51 cm rise in water level along the coast. This lateral heat advection provided heat to the control volume of 3.4e+18 Joules. On average, the heat loss at the surface of the control volume, via sensible and latent heat fluxes and radiation, was 0.7e+18 Joules, corresponding to a surface heat flux of -600 Watts per Meter2 (W/m2). However, the heat lost by the control volume as latent and sensible heat fluxes was less than the heat it received via lateral heat advection, resulting in the lack of an often-observed sea surface cooling during other winter storms.

关键词： Mid-Latitude Cyclone Extra-Tropical Cyclone Cyclogenesis Nor’easter Winter Storms Latent and Sensible Heat Fluxes Salt Flux

Street floods in Metro Manila and possible solutions

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Environmental Sciences 2017年第9期29卷 39-47页

作者： Alfredo Mahar Lagmay Jerico Mendoza Fatima Cipriano Patricia Anne Delmendo Micah Nieves Lacsamana Marc Anthony Moises Nicanor Pellejera III Kenneth Nino Punay Glenn Sabio Laurize Santos Jonathan Serrano Herbert james Taniza neil Eneri Tingin National Institute of Geological Sciences University of the PhilippinesQuezon City 1101Philippines Nationwide Operational Assessment of Hazards PhiI-LiDAR 1Flood Modelling Component UP NIGSQuezon City 1101Philippines

Urban floods from thunderstorms cause severe problems in Metro Manila due to road traffic. Using Light Detection and Ranging（Li DAR）-derived topography, flood simulations and anecdotal reports, the root of surface flood problems in Metro Manila is *** of flood-prone areas are along the intersection of creeks and streets located in topographic lows. When creeks overflow or when rapidly accumulated street flood does not drain fast enough to the nearest stream channel, the intersecting road also gets *** solutions include the elevation of roads or construction of well-designed drainage structures leading to the creeks. Proposed solutions to the flood problem of Metro Manila may avoid paralyzing traffic problems due to short-lived rain events, which according to Japan International Cooperation Agency（JICA） cost the Philippine economy 2.4 billion pesos/day.

关键词： Flood modeling LiDAR Urban flooding

MANUFACTURING AND SERVICES:FROM MASS PRODUCTION TO MASS CUSTOMIZATION

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Journal of Systems Science and Systems Engineering 2011年第2期20卷 129-154页

作者： james M.TIEN College of Engineering University of MiamiCoral Gables

Manufacturing and services constitute two of the five sectors of every country＇s economy;depending on the maturity of the economy,they are-in terms of employment-typically the two largest *** outputs or products of an economy can also be divided into goods products（due to manufacturing,construction,agriculture and mining） and services *** date,the goods and services products have,for the most part,been mass produced;it is the premise of this paper that recent technological advances-including flexible manufacturing,cloud computing,nanotechnology and smart sensing-can better enable the transformation from mass production to mass *** regard mass customization as the simultaneous and real time management of supply and demand chains,based on a taxonomy that can be defined in terms of its underpinning component and management *** a components perspective,we first consider the value chain of supplier,manufacturer,assembler,retailer,and customer,and then develop a consistent set of definitions for supply and demand chains based on the location of the customer order penetration *** a management perspective,we classify the methods that are employed in the management of these chains,based on whether supply and/or demand are flexible or ***,our management taxonomy highlights a very critical research area at which both supply and demand are flexible,thus *** management of supply and demand chains sets the stage for mass customization which is concerned with meeting the needs of an individualized customer *** and real time management of supply and demand chains set the stage for real time mass customization（e.g.,wherein a tailor first laser scans an individual＇s upper torso and then delivers a uniquely fitted jacket within a reasonable period,while the individual is waiting）.The benefits of real time mass customization cannot be over-stated as goods and services become indistinguishable

关键词： Value chain supply chain demand chain taxonomy real time management mass production mass customization manufacturing goods services